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026-1298-06-000
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)] Permit Holder's Name: City Village Township Kyle D. &Sarah A. Kopczyk TOWN OF RICHMOND CST BM Elev: Insp. BM Elev: BM Description: Apr 54 PVL PIu"-,- TAAIV IPIFrIRMATInN P// Prulo G." ELEVATION DATA TYPE MANUFACTURER CAPACITY Septic , Dosing r� 6V1 SC C Aeration PL 5zs TANK SETBACK INFORMATION Jinni'LLh - )tiv0 PI IMP/SIPHnN INFORMATION Manufacturer Demand Zc7�LwR GPM 458em Model Number WI5a5r swrl,ea S�- TDH Lift Friction Loss System Head TDH Ft I�.25 0,�� N Iti'oI Forcemain Length Dia- Dist to well .Z.� 1� WSCI, eG'r.vc 6� •mj c�. 0 SOIL ABSORPTION SYST(=M BED/TRENCH Width No. Of Trenches DIMENSIONS dI O PLength Z 2.I DuE SETBACK TYSTEM TO P/L BLDG WELL INFORMATION Type Of System: DISTRIBUTION SYSTEM 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 HI FS ELEV. mark F �•0 �O,r.O0M `[ Bldg. Sewer II•�J 9 Z ,Z� St/Ht Inlet f�-12 �lo,sx u t_ l9t-rntt?t— V'_ (0ii r; lk►.r Dt Bottom IQ 5S gs t�� Dist. Pipe 5•°1D I O , Bot. System 3S COS Final Grade �f,>a �I�I,`-f StCover y• lc) •S q� I I -, g (PEE To 0� 5.3 9 8•� PIT DIMENSIONS No, Of Pits IInside Dia. LAKE/STREAM LEACHING Manufacturer: CRAM ER O 1 j^ U T Mod Nr m x Hole Size Ix Hole Spacing e rteaaenivr nnuiu t I Pips) ' d Lengt Length IZ� Dia O Spacing SOIL COVER x Pressure Systems Only xx Mound Or At -Grade S De th Over Depth Over xx Depth xx Bed/Trench Center �`I/ I iJ )Y� Bed/Trench Edges To oil /Yes ��o ves �+ivo Vl� Inspection #2 1 �_,'ba, F` `RA &I I.- a ll i, Al srkm el llm au,• y. d vs a_0 -11 -51 }e.(L,M - DA ro 0 Liquid Depth Vent to Air Intake COMMENTS: (Include code discrepencies, persons present. etc.) IL etc.) Inspection #1: -'I o� Ga✓ex Location: 1222 128TH AVE N�761� PlvMbu Uri I t II 1.) Alt BM Description = s R S� S y_;4(_P4 5[q. 2.) Bldg sewer length = (03 - amount of cover = t s On f I oily �MdkbvyL q[� Plan revision Required? � Yes l0 2 J Igo7%' Use other side for additional information. 44�lnsepctor's Sign ture Cert. No. D e SBD-6710 (RII.3/97) LLI I °�rR-srctT 7? — 70 l Services Division Counh s 1' P S FEBF�B 1 �� 1400 E Washington Ave .•Z� P.O. Box Sanitan• Permit Number (to be fled in b} Co.) _ � �5I(1tiA�•� ^ F B i l St. C_IO" Madison, WI 53707-71 U O `f>7 y State. Transaction Number -, lication In accordance with SPS 333.21(2�: Wts-, Adm. Code, s mttbissron of this form to the appropriate goveernmentaI unit is required prior to obtaining a sanitary" permit. Note: Application forms for state owned PONi-S are submitted to Project Address (if different than mailing address 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). Stats. nn I. Application Information - Please Print All Information Property Owner's Name Parcel r _ J Property Owner's klailing Address Property Location ,- C16-m Lot /v �� �!, Ntt_*, Section City, State // Zip Code Phone Number fc/oif 7L (circle one) T � 30 N R E or�l) T IL of Building (check all that apply Lot r 011 or 2 Family Dwelling - Number of 0 � Subdivision Name 00111 �s i Block # ❑ Publ is/Commercial - Describe Use %1, ❑ State Otitned - Describe Use f ^ ❑ City of ` �EV, ❑ Village of Ej Town of CSM Number / III. Ty e of Permit: (Cheek only one box on line A. Complete line B if applicable) A. New System ❑ Replacement System ❑ Treatment/Holding Tank Replacement Onh ❑ Other Modification to Existing System (explai B. ❑Permit Renewal Permit Revision El Change of I El Permit Transfer to Nea List Previous Permit Dumber and Date Issued Before Expiration Plumber I Oksner IV. Type of POWTS System/Component/Device: (Check all that apply) ❑ Non -Pressurized In -Ground ❑ Pressurized In -Ground ❑ At -Grade ❑ Mound 24 in. of suitable soil El Mound < 24 in. of suitable soil ? ❑ Holding Tank 0 Ot rsa Co, nt (explain) El Pretreatment Device (explain) V. Dispersal/Treatment Ar a on: 1 X 12 o tAl Design Flow (gpd) Design Soil Application Disperrrssal Area Requir (sf) Dispersal Area Propa (sf) Svskm Ellevatio 50 Rate(pdsAj6?-, / 3 7, 5 3 / , VI. Tank Info Capacity in Gallons / tfD Total Gallons = of Units �tanufactun>r, _ Nzti� Tans Existinc Tanks Septic or Holding Tank e ❑ ! ❑ ❑ Dosin, Chamber e S �� J✓c�& I ❑ I ❑ ❑ VII. Responsibility Statement- 1, the undersigned, assume responsibility for installation of the P011TS sho«n on the attached plans. Plumber's Name (Print) , l5 r) Y Plumber's ignatur r ^ MN-MPRS Number Business Phone Number 7(,s -7( Plumbers Address (Street City, State, Zip Code) _L01 1-113 VIII. CounrilDe artment Use Only Approved ❑ Disa prov d Permit Fee D;aIssed Issui a Aeent Signaur, Elivert a for Denial 3 Z Il. Conditions Ap ov �� �� so-, S n SYSTEM OWNER: �� 1 l�' o--I CQ (9�p 1. Septic tank, effluent filter and dispersal cell �% d p,�l-6s) w ; tt !� /^� „ ,Fe, � � must be serviced 1 maintained as per %A sicY. o �� 5 t-t r 4—i S r the systew a submit to tie_ .TP#e en��, A- wrS I C, :0 ) 9 14 plot Plan PROpEgT-y x I f"', I MI F ACEM-4 ?M. T"i � -R, 3u YA411 vif !Wpv-� Pimp 100,00 4 Te PVvg F9 qq� Site locaticYn: A is al Aw / 11 ?fv,?muu J— 40 FT. 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Residential or Commercial Design 5()0.8f0 Estimated Wastewater Flow (gpd) r 1.50 Peaking Factor (e g 1 5 = 150%) 750 00 Design Flow (gpd) 2.00. Site Slope (%) _97.80j Prop System Elevation (ft) A Depth to Limiting Factor (in) In -situ Soil Application Rate (gpdit2) Lowest Original Grade Ele In System Area (ft) Highest Original Grade Ele In System Area (ft) Limiting Factor Elevation (ft) Depth Below Grade DIMMI—Mon cell information 3.25 Cell Width (ft) 1 Number of Cells 2.00 Dispersal Cell Design Loading Rate (gpd/W) 2 Influent Wastewater Quality 0 or 2) [51167 t>rutlW Ponfeation FE.' Center or End Manifold, Dist. Box or Drop Box i .l _# l ,.�Ic System dosed _ r I 0 001 Pfullfu , — Ic..�.. ,... Lateral Spacing (ft) Does the forcemain dram back?E Y--� 791 Forcemain Drainback (gal) 0:50 Forcemain Filter Loss (ft) 2.00 $0.00 Forcemain Diameter (in) Forcemain Lengthift) 60 FT X 1 391100 FT � 83 FRICTION FACTOR �_ 00 Inside Pump Tank Elevation (ft) x 3 0 00 System Head (ft) x 1 3 s 901 Vertical Lift (it) •^ 0.83 17 23 Friction Loss (ft) Total Dynamic Head (ft) Des:gnea trust ante+ t,,Icbon loss and system demand (gpm) _JW:19 Minimum Dose Volume (gal) w 1&00 System 6irriWW (gfnn) Manufacturer Information - Treatment Tank Inf6W adon EfflumA Plftr III E1585 00 Septic Tank Capacity (gal) PolylrllC (n0:%Ubii Filter Manufacturer Wiesef Concrete Products __ Manufacturer 626 Filter Model Number Dose Tank Information Gallonslinch Calculator 950 00 Dose Tank City (gill) Total Tank Capacity (gal) 25.00 Dose Tank Wume (gal/in) Total Working Liquid Depth (In) Cam Ptroduat: the Manufacturer �� gal/in (enter result in cell DoseTankVolume) Pr"Id KYLE D. & SARAH A. KOPCZYK Page 2 of 16 el -2-3-Z3 Calculations 1 2.29 R o o ft F R f4 g 120 ft 1 ft W 7 ft 044 Arena Calculation___-_ Laaidin Rate �6® a 9"gq today Tptfai 932 5 W Nuhibei of Cell Length 120.00 ft Min Ca I Lan th i 15:4 ft Gatl Odin d ft B—ml Area R uired I 937:6 fe Baaal Area Pr tted 039 6 fr Lineal FeN of GeoAAat ulf'd 115:4 final Feat at pr rrd N07JE Min S om@nsi®n = f ` aVaUon f! Liml Og FWW ra tan -- ft V ANR Directions Play with cell length to get desired cell spacing. length and width Remember system SHOULD be longer than a is wide It must also Satisfy basal loading rate and GeoMat cell loading rate Project- KYLE M & IN~ A. KOPCZYK Paps 3 of 16 it-ac 't-cy U ,s a_ve V 1/g�"� 117' h@I@ @I A ! ®' Fi@fNR! A �` !" h@fR @RA #'W rt i) *ipr i f lo7a; 0f +?" n Jrrr @F4 q W �. atnr 3l R,y�iif'•9 f�l V!(ifE3f �VV IR �1 Distribution Cell Cross 5eC on l"III" t�M+ Ind l evd d" cow �►Pp rrit. (kN E� 1 Too of p0ml te be at —M MA wo g►wfmi f f I f NATIV@ =av"a s �oes isf Obsevbfion Pipes -- i M M" Bfa 1T lYifR _ bp" Max T rtHF, 14pr�� prom KYLA 0 i PMM A KMZ" PW4 of 1d 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 7%gPons 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. repaired in conformance with SPS383 Wis. Admin. Code, 3. Defects or malfunctions identified during maintenance described above shall be 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. 6. 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. p, float, electrical outage causes the dose tank to fill, the homeowner should see to it that This system may contain a dose chamber. If a pum 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 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 16 In Ground System Maintenance and Operation Specifications Service Provider's Name POWERS Phone 715-246-5738 POWTS Regulator's Name St Croix County SPIA - Zoning Office Phone 715 386-4680 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 Maximum Influent Particle Size 1/8 in Maximum BOD5 30 mg/L Maximum TSS 30 mg/L Maximum FOG 10 mg/L Maximum Fecal Coliform 10E4 cfu/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 years Should test periodicalyl Laterals should be flushed and pressure tested every 3 years Inspect for p_onding and see a e once eve 3 ears 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 Threaded Cleanout 6 8" Diameter Finished Lawn Sprinkler Grade Plug or Ball Valve Box o" ! Lateral Ends at Last O Distribution Lateral 97.8 Feet L++A Long Sweep 90 or Two *`45 Degree Bends Same Diameter as Lateral Page 6 of 16 Project: KYLE D. & SARAH A KOPCZYK t•Qckinp 4M'4R %it" "WIVIIg6 -- n Inckintt dtivico anal %plot tight Goal a„ Y4nlekl u�vr �" 1`IFF4fIkA) bnk - - ' as rPf *1'.t 3QU r�, �I�Gt�tltlo4t� : t f Wool M11 piles 1> vonlrl t)alt d of - � kpnlrul.luhl n( Wifvs I. "lip I Icelri> ��urEo \ tllluant �rin�th)+kd eu(lptiafial Py41d P►tkil4cr - - � ti ' �71AaG GtPt) !, ., ✓ 4" nr+kl3n�i pi1� 4��' h4a)C Il�/kk'Al�It1 ,n,4P Arikt Nalti! .L1 �,Ihlpr,u�nkl ® tight tl2"I fufnca Fefoomaln dfom*P.f 3 In. µ�vpl4*,::.., I�h a Atvr a►Ann � )Nlnp OilI�wl I)ulnp t)i'i i�k>at� � )un� , � ,�= Pur�tp �ff fflevetl®fl (Hl 1 1 84 (37 Dom thnk @100h®n A auF tan � # `�'� 64IOC) —`TT' Wieser Concrete 1jMouCW, tnc, CMM Volume 1 251, gavinch Filter Manufacturar INEW SEPTIC SOLUTIONS Filt@f Model Number 1324 Alarm Manufacturef WE Rhombus -� AkM Model Number JAB TANK ALERfi Pump Manufacturer 7-oetler Company Pump Moo Number if 1521 Pump mug, i' @over 24: ppm at 17.23 ft TDH Note Switches contalnima mprcury may not be used In this system project: KYLE D & SARAH A KOPCZYK page 7 of !i ,' loiY�+K ®Cali width IR) sidewarl to LOWGI ill ®lsi ibutlnn Call ems4aailon AffilliPments Q Owoparaffl id diglFl@Uw NO@ t hi@! rs €ovomd vwth aw0'w 0e_x400u00 IOWIC-"w 0* O%w ~ AMOVK, ®IatAbtitib" call Flan Vkw Lavow • Typical PAN VAM - A iK) 1 (hl ® �7 via ® — o-o ® ® i am—* t'Mii�1f� Ciro � I�l�RiJc i! -4 >�► tiFt _ 1trbm —CEO MAT 1 1 1 1 1 ,t f t l r l ��It�tieive a x kv d@GM§ on jib@ A (4I %ffw f. §10 ice@ 589Etfie Hr kil��g W@Wl KYLE ® a SARAH A KOPOZYK Pp@ 0 yt j+ ��_ 23- plot Plan pw q of &I PROPEFM OWNER: SASH A, korczIyKI (.mpt where noted) LOW peWpOon.LC la ► un N6, N L-AQ4W' 1A m,,' 44Nv� LQF TtiE Q. -m beckhoo pit N , fi 3W 'kilo, m AE F I nMr ,srF• Coo �SO ��,�� uJ�scor���la• lz� 14-4W Ozb=izqf-%- coo N®rth pie ti awl �► I,sTM lF AE 'iG/ �Y� plot fl . �� OPTIC 'TANK PV c I F9 Site locati NEW SEnc Address: N6643 Blue Lagoon Lane I U fi I A N t City, State, Zip: Casco, WI S42SO Telephone: 60 -1133=3610 C LEAR F LOW Email: Info@new&epticsystem$-Com Webslte: www.newsepticsoluti"A.Com FIL-TF-R INSTALLLATION AND SERVICE INSTRUCTIONS - -- , MODEL NO. NSSCFF324----------- -- , FILTRATION 1%16" 1.062' diameter holes) 0.50 FLOW RATE 11113,11151111101116 per MInute 0 10 TDN increase the total dynamic head loss by .05 feet of head to onrcome friction loss from the filter -- - - - ° INSTALLATUM The NWF324 Ci@arFlow Is made to fit on the discharge port of any pump with a 2-inch NPT discharge. The filter can be adapted to fit pump& with a smaller diameter discharge. Install the filter in a position where It will be easy to service. Place a 2=inch Schedule 40 PVC male adapter (MIPT x wk@t) on the end of filter. • M asure the amount of Schedule 40 PVC (tail section) needed between the filter and pump. Cut the pipe to the desired length and insert Into the pump A filter, The filter housing has a 2-Inch Camlock coupling connection to the fare@ main. NVellf 00 NOT R9MOV'9 PILTN IF WAIMN MAL 18 ASM OUTER OANIIIIMRJ The length of time required between service Intervals Is unique to every application. As such, we recommend the filter be checked within 12 Months of installation to det@rmin@ future service intervals, Systems with known or suspected high volume usage should W r4tited six months after installation, . - DO NOT U89 PLL1I1f101N0 WHILE FILTER IS REMOM CLEANING THE SCREEN 00 NOT ALLOW SOLIDS TO FALL III FILYEN GAIIIII • Unscrew the 44nch cap and remove the screen from the filter housing. • Taking proper` protection, Clean the screen lasing a hose with a spray connection. • After cleaning, inspect the screen for damage or Corrosion. (Replace if ri*055411r0 • Plac@ the screen back Into the filter housing and screw the cap back on, taking care not to crass the threads. QUALITY The filter housing, cap and coupling are made of h@avy4uty ABS injection molded plastic. Injection Molding insures the first part made and the ten thousandth part are virtually the saris@, insuring consistently high quality In every part, I KtM 90, I PART WJMKR -1 1 idler In* ? 6®m Ilk -- � I� c�ket - s �►+ ells The stainle4i steel screen is made of 316L ((L stands for Low - meaning low carbon) 316L stainl@tj itontains Molybdenum, an allay which increases strength A hardness and enhances resistance in areas high In saltale and chloride, giving it th@ ni€knamc+ `marine grade stainless steel. IICM NO. sW-fil@ Nnrrvitlle Nw"@l 1 Kween 2 - 3 Wee handle -_ 4 LsrpeRange if ��i$conSii� oeoarvrienl oN G c roon of NOW Auw:h oample!s site.- w�M � kw-kde,Wnot w"O porcell Si". scale 6f pow"d wall w rw+ t�iipetty s 1221 1 SAW Airs c+lv VMS gp 6 ��A'TION REPORT � WM Coon es. Wis Adm Cosa , O* OWN ow nwm wow. xri = f ,r g ISMmM�k TW NOW LA AMA. 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RH I-H141 t will N, n Wagsoo Homes New Richmond 675 Noon Knowles Ave KOPCZYK QR287FV BASSWOOD N9w Richmond, WI 54017 hj715.246.1)(104 1222 128TH AVE PRELIMINARY SET sr-j@waIj5Auhpmes--m- NEW RICHMONU, WI S4017 Wausau Homes New Richmond DR287FV BA55WOOD rcwsau575 North Knowles Ave KAPCZYK New Richmond, WI54017I [ PRELIMINARY SET 715.246-NO4 1222 128TH AVE gggglNungliw&rNlrrgfrpanencn 5mithj@wausauhomes.cnm — NEW RICHMONO, WI 54017 tan av w'• �.�w ekhmme. �nc'> e.✓d�rdoe co%dghs barer: and gyree nam dWa1aW alHdhum reyrna p A Wa_ usau Homes New Richmond omsau575 North Knowles Ave KOPCZYK DR287FV BASSWOOD New Richmond, WI 54017 71S.24&9004 1222 128TH Of PRELIMINARY SET RadahnngtleQuiWE,p�,wwe smi17 l K f Fc.. 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L 'u 4 P;opemya4K�N�dg?�*ybL�� w g 1p Vy.y+ CXv- j4Z��'4racliw ht �t{tom" Q+�tasce!altt?� itcE.af'et'o. /' N& v/ tifi- -Tw itf !{i '" C1n cte:� w tip T�s •. p1.mpg �{„ta b L —) 9 Arta lM6m4s"'4*VF NA Rp On C Nw C k� 1ct s .N*ltu t4 Pro L'ppl i t� bit• r., kaW±t� ,ti.{a - t, L;rso. i 4{' ac►sts NNtei [ E tAl 19Pr w'' .;tattrt107 it—a�_._._.____ sTGigA110Ai� Pills' SYSTEM OWNER: 1. Septic tank, effluent filter and dispersal cell mus be serviced I maintained as per mana ement plan provided by plumber. 2. All se as per a� l cabl code I ordinances. ni-VU00 - 0 1, ` v' s ' M M— �vlS Sys is K NMl6 �N . _- -- GeofMat IN GROUND AND DOSING pis 1 KIDW I N."""'. INDIM AND TITLV PAGE Owner Into KYLE A, KOPCZYK Project Name: Owners Name: Owner's Address; 644 HIOHVIEW DR= UNIT A NEW CHNAOND VYI 64017 Property Into Property Address: 12221`H AVENUE Legal Dowiphon NW NW S 34 T 30 N R 18 W TI�YVn.. Richmond County: $t. Crdx Subdivision Name RIDING MEADOWS NORTH Lot Number 4 BbCCk Number. NA CBfiAi1: NA Parcel I. D: Number. old-1298.Off - 000 Plan Transaction No (pages Page 1 Index and We Page 9 Page 10 Plot plan Filter specifications Page 2 Page 3 Data entry GeoMat disc cell dr@iwings & calculations Page I I Soil test Page A Lateral and cell cross section Page 12 Page 13 Soil test Soil test Page 5 Management & contingency Pam; Page 6 Maintenance & specifications • - + CUA2rve 3+ BDICe Page 7 Tank cross sections IL 14 A Page S Distribution media MARY JO HUPPERT License Number. 1r 50-007 718y4' 1i76 Date` 12J07/22 B/=Aa; Phone Number Signature. - Designer StgM : 4 Designed PUMUa M tO tt1@ S GeoMat In Ground component Manual Ver June 26. 2018 Vemionf hUW 044 pop 1 At 1G GeoMat IN GROUND AND DOSING DISTRIBUTION COMPONENT DESIGN INDEX AND TITLE PAGE Owner Info - m,. 1.mN-111VWqW Project Name KYLE D, 81SARAN & KOPCZYK Owner's Name �SAMQ _ Owner's Address $44 HIGHV1EW QR; UNIT A NEW Ii81CNMOND, WI 84017 Property Info Property Address 1222128TH AVENUE Legal Description Township Subdivision Name. Lot Number Parcel I D NumA Plan Transaction No. Index NW NW 8 34 T 30 N Richmond County, 8t, Crl 6 Black Numb 026 - 1298 - 06 - 000 Page 1 Index and title Page 2 Data entry Page 3 GeoMat drat cell drawing Page 4 Lateral and cell cross sectio Page 5 Management & contingency Page 6 Maintenance & specifications Page 7 Tank cross sections Page 8 Distribution media MARY JC HUPPERT Date 12/07/23 Signature' Designer Stam ; 18 W CBMN; NA FPage 9 PW Plan Page 10 Fi ter specifications Page II So., — Page 13 Sod test Page 13 Soil test Page 14 IIW MA*P 1� Pump Curve & Specs_ ii Number; 18138.007 Number 716-438.1778 Designed Pursuant to the GeoMat In Ground Component Manual Ver. June 26, 2018 Version f VkAY 4c4x Page 1 of 16 In Ground and Dosing Distribution Component Design Design Worksheet Site Information R Residential or Commercial Design L—ry� ISD Required? { 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) 95.80 Limiting Factor Elevation (ft) -0.20 Depth Below Grade Distribution Cell rn -rmation 3.25 1Cell Width (ft) 1 Number of Cells 2.00' Dispersal Cell Design Loading Rate (gpd/ftz) _ __ 2 InfluenkWastewater Quality (1 or 2) ution Center or Number of La' Is Lateral Spacing Forcemain Drainb k Forcemain Filter Lo Forcemain Diameter I Forcemain Length (ft) Inside Pump Tank EIS System Head (ft) x 1. Vertical Lift (ft) Friction Loss (ft) Total Dynamic H Minimum Dose lun , Dist. Box or Box System dosed I Y (gal) / Does the forcemain drain back? Y IN X 1.39/100 FT. = 0.78 FRICTION FACTOR (ft) \ Designer must enter friction loss and system demand (gpm) System Deman (gpm) (gal) Manufacturer Informatio Treatment Tank Information Effluent er Information 1200.001 Septic Tank Capacity (gal) Pol lok Inc./ bel Filter Manufacturer Wieser Concrete Products, Inc. ;Manufacturer 525 Filter Model Number Dose Tank Information Gallons/inch Calculator (optional) 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 Calculations I 2.17 ft A Basal Area Required 750 fe KV— 1 ft _ y00 Basal I Pro osed 759 ft� S 0.00 ft L 10 W 7. ft _ BasalA_reaCalculation _���..a....�..•-..•__.___.__ GPD _ LoadingRate_ GP© Lcir1 Hate 600 0.8 9 y ft/day i 00 2.00 9� Total 7_50 Total 325 ft' Pro osed 325 ft' Number of Cells GeoMat W —id th 3.25 ft Cell Length 1 .00 Lineal �Feet at Required 92.3 Min. Cell Length 92.3 ft Lineal GeoMatPro sed 100 r'pll Snacina 0.00 ft NOTE Min S dimension = 1' Elevation 97.8 ft Factor 95.8 ft krntinn 2 ft 2' Min ft/day 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 basal loading rate 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 a ana 8 O'clock Holes at 12" from end. Lateral Spacing F---TOft Pipe Diameter in Distribution Cell Cross S on OF 99.1 ft Finished Grad [}isor�utiati x■e►rr t+ LxVd 12"-4 =0.2 ft — Szod Cflva infiltrative 2 In —► PipeDia . IS Top of� o be at o L A —GED MAT II CoqcID� below original grade I �■ 1 1 - q I I 1 I Infiitraave Surface JZ Z - ;-NA VE.S01 = _ Filler 39 ft-- Observation Pipes 99.1 ft era 0"Ift 12" Min. 48" Max. iWei hmo- I I ,' a I I J-Rc41ur �III�IT111l1l I111111l 1l11111 111�11111�1�1l1�11 1'II11111I 'III' ��1111 1l 111 11�1l11 111lI j1� �''II� 1l11l1111lI 1111llll,i �i �I I11 11!1�1�111111111�1�1�1�1!I�l 97.8 ft 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 60Q3�Rons of wastewater per day. The quality of influent discharge into the POWTS treatmentdispersal component of 30 mg/L fall b equal to or less 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 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. see the effluentllevel inothe tanks brought downfgradually and nolt all dosed ectrical tto the system atage causes the on.e. One olarge hdose rcould causedamage.o it that may age. 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 Ground System Maintenance and Operation Specifications PhoneE1,5-246-5738 Service Provider's Name POWERS Phone5 386-4680 POWTS Regulator's Name St Croix Count SPIA - Zo 'If Office S Flow and Load Parameters Design Flow -Peak 0 pd Maximum Influent Particle Size 118 in Estimated Flow - Average 4 gpd Maximum TSS 30 mg/L Septic Tank Capacity 12 gal Maximum TSS 30 mglL Soil Absorption Component Size ftz Maximum FOG 10 mg/L Type of Wastewater estic Maximum Fecal Coliform 10E4 cfu1100 mL Septic and Pump Tank Effluent Filter Pump and Controls Alarm Pressure System In Ground Service Frequency inspect and/or servic nce every 3 years Inspect and clean as ne 'Nssary at least once every 3 years Test once every 3 years Should test periodically — Laterals should be flushed and pressure tested every 3 years Inspect for ponding and seepa e once every 3 ears 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 SIPS 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 �— Threaded Cleanout 6-8" Diameter Finished Plug or Ball Valve Lawn Sprinkler Grade Box Lateral Ends at Last Orifice Where ri a 0 0 000000000oc ' ' p_... 0=' " 0 0 (5, Long Sweep90 or Two 0 45 Degree Bends Same o a o n o 0 o U U 0 0 O OOGU '7UODU OOOUO�-. D 0 0 0 - O U o00Q0 �700 oODUU00W rj Diameter as Lateral i OOOUOUO�oO-OGr�O O U o 0 C, O O O O-Oc� 0.0p r 'e� nvOOr�(?r_'C'DgOOOU Distribution Lateral Lateral Cleanout 97.8 Feet Page 6 of 10 Project: KYLE D. & SARAH A. KOPCZYK Dose Tank Information looking cover , ilh -arnlhill IttMl. _-- lwkiing ddwiw %nd WfiW light s h,I �� vented t✓awwr li4 Blutdiiii NIT ilA _-- iNidCt 1" itigfl critt Hi( 0010nat Wi r va l .l to antral 4 of Wireq Frant Fleetrie ttt QMW# t brin da4otl Forc amain diameter fits 9ti� ° 4" A — ' 103 PIPQ to 2 In. flitd h`AIH l+ii fB�c�iti in onto 4Ni tfhtsket dgruund Funlr�ti Weep hate }x ant 4fphan d�tc� tli�ti Wtit@r ttlarnt, 'Entiff Ott FWt G C H41vip Off 1111041 Pump � �— Pump off elevation (ft) 84.33 Dose tank elevation (ft) Be+lt�i �t fln ♦- 84.00 Dimensioni Inches Ga�i s A 26.86 59 3 g 2.00 44. 3.11 69.13 i 4.00 88.96l 35.97 800.00 Filter Manufacturer Filter Model Number Alarm Manufacturer Alarm Model Number Pump Manufacturer Pump Model Number Concrete Products, Inc. a acit 800.00 plume 22.24 gal/inch Pump Must Deliver 5.00 gpm at 17.18 WNH Note: Switches containing rcury may not be used in this system. Project: KYLE D. & SARAH A. KOPCZYK Page 7 of 10 GeoMat Distribution Cell 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 geotexlLayoiagram eir product approval. Dis ution Cell Plan ypical Cell Widt A (ft) ell Length - B (ft) En onnection Latit .. p. �b" Y�r war I - _ J77 V Typical Dispersal Cell IFInished Grade 4y NYW 4.T C�iYr� 1248 . Fabric 4. - _GFA MAT Camcnew ' 1 r I I Infiltrative Surface See details on page 4 for number, size. and spacing of laterals. Project: KYLE D. & SARAH A. KOPCZYK Page 8 of 10 Pita Plan s �,�� �, Igo p�•�Vk_ RRoR RTY OWNER: K, � Legal Description: __ .1., wrY AFRQrJr 1 a?,,= i701-a1.- cC10 x pro�r Flr / Iw 3i'Of4'Pva s I qq, of Site locab ;LD (i .Tpph1 pap q of /(,a 10 am 40 Fr. (@wApt whore noted) M _= backhoe pit �SD Aom-b North I W41, " 'D ? P5 , `-A'TK� � fA / BRIM LAWN _ ZI�LL- 1 1 E C Addregs: NF"3 Blue Lagoon Lane NEW r B A t U 1 1 A N i City, State, Zip, Casco, Wi 54250 Telephone: 608-333=3610 CLEAR�LOW EiYtawil: info@ney�gepticsystems.com Website: www.newseolicsolutions.com FIL-TER INSTALLIATION AND SERVICE INSTIIUCTIO14S -�--� K40DEL NO. NSSCFF324 0.50 FILTRATION 1/16" (.062" diameter holes) FLOW RATE 83.8 gallons per minute @ 1psi. TDp Increase the total dynamic head loss by AS felt of head to overcome friction loss from the filter The NSSCFF324 Clearf low is made to fit on the discharge port of Any Pump with a 2=1rith NPT discharg@. The filter Can be adapted to fit pumps with a smaller diam@wt discharge. Install the filter in a position where it will b8 leey to 1119MI e' Place a 2-inch Schedule 40 WC Male adapter (mlp li tockAt) on the and of filter. Measure the amount of Schedule 40 pvC (tail section) needed between the filter and pump. Cut the pipe to the desired length and insert into the pump & fitter. • The filter housing has a 2-inch Camlock coupling connection to the forCe Malin. 'S l NNI�Ti � g 131LTRIt IF WATER LEVEL 19 ABOW FILM CII►NIGTIeR S1 RVIt The length of tint@ required botwoon service intervalf` is uniqu@ to !very application, As such, we recommend the filter be chocked within 12 Months of Installation to determine future servic# int@rliel[. Systems with known or suspected high volute usage should be checked silt m hs aftern y USE PLUIWRINi61 WHILE FILTER IS REAMOW® CLEANING ME satmap and r T ggOb Yid pa t L INTO FILTEMr CASE Unstr@w the 44ch reemove the screenfrom the filter housing. c Taking PMP@f protoction, clan the #Green using a hots With a spray connection. a After cleaning, inspect the screen for damage or corrosion. (Replace if necessary.) o Place the screen back into the file@r housing and screw the cap back on, taking care not to crost the thmads. QUAVa1TY Tho filter housing, cap and coupling are mid! of hlitryifiity ASS injection molded plastic, Injection molding insures the first part mad@ and the ten thousandth part ere virtually this same; insuring Consistently high quality in every part. Th@ stainl@ss §tied icr!!n is mad! of 316L ((L stands for Low - meaning low carbon) 316l stainll contain! Molybdenum, an alloy which increases strength & hardness' reas high in salt air and chloride, giving it the nickname M *4UM and enhances resrstanee m a marine grade' stainless steel: ItLM �'=&W44NWMJFA0 N®) 23ndle ['L , 0 of Ar 2, , 91713 L IIALLIAMN REPORT ►w� IL NVIsconsin ,w� "°"' coe. s,. f6 foie w", m o a D%atrwt of C TWMce v' C� 51 Cron.. Mac" oompwo 'ale P �' � � no�ifror�RN b���� �j_ how i A►tY�d., Dul nd fn+ted norat arroYi. 61Y� p«cra slops. scale or dknsrl1O Pro JV� 1 L0�5 Lei - �+Wrildr �W1S3�. T30i'i, f�1i� At i� 1 " grow propem p .fi AM Stallion N&CW%- ST CRQM Uh r I 8 Plg N.aie Rtit� 12211 Aai Vlil (7 91� ds�, »vv ra+. 01iD New Ri&-OndLim _-cob — — .. J 1 or Fboe Dl.p. �.t� '. if .00�� _ns parent maM.tst ` iuoi ester lenlss i -0611 based on C6 Sky®dpn 9 06" General conments ► DUW or At grade syslern and raaw 1 proud surtax. e1w ? t I i A - p - COW i2edar D.so 011"Wo Ou Sz cone COW 001 none c2d 710" ti �N1fi ii ➢ — 39 - in R00b No GIoU►tt'� - -- 001" 6tucaia Boundary -- �rtft Litt Ss. SR - �� .6 -may —cc 2msbk _ -T - — — w* 9w no A 0 .� -- t� reOdm" — na na .0 �-- v a --r ----7 A � 1 . : z +— -.,� i t ]qDf4v 0 �( U - tl? — ILA rt� and Tw 00 nryl sa:t.rzers.r� rw t:aA-- cow .4 A A 1A� .7 .0 ,0 J��! • �''�"' �laar tIH� bier l _ _ ,� 14 � �' � � ®�• of Appficaeort Ra! Stru�n+rei GPMt' �16 1N6iG� f31! Car SL SA 'E1tt �liil�li> 1 d owgs 301 M N*k ow Yes -* 1181 ffitt ' eftw9 02 a MI 961ot wd YU 400 " D M1NIdnf itf 6►1Mricroe is at l o�p�xtwl ly aar�ioe D�9v'dcr and employer. It you nca0 assiva= to aacss vtv°oo ur ,OW r WNW Ia an AlkMalc fwm,4 plcksc coniva the °kpanmcnl a 601-266J 1 S 1 at Tr Y 601-26"TT7 saw its ir°sar � 3 of 3 STEEL'S SOIL SERVI'NC' 994 Z(i(i`� St Stallion Development LLB David J. Steel 6:,ldvrirti � 54t}02 CST_Pt'1W'I'SM SE1t4,NW 1/4,S34,T)ON.RISW Direct 71546347 L.iC. �246956 Town of RichAaad. St.CroixCo. Fax � i ���`�� Riding Meadows Sub. Lot, 6 Tbis soil evatualft VOW � to SaMfY a zoniaIg requ nemeat, it may or may sot be mamble for your use. not established at the The Iot3tioo of tbis test may or may not be as sbow,* as P tot lines were time the sal test was conducted. N A MAD fit Top*( 3t4" pve pipe i w All Benchmark Ele-$ it Tap of 3/4" pvc piPe j ® - somp l� Boring Elevations I31 - 99-35 ft Ott d B? , 96.35 ft �� th B3 = ".65 ft 134 - 0.00 ft Fo fn, oI-Y%��%�e��/� Y .27. o f, -4a1; ; �{ ►b opw �y �I i� `4f two ft* wl um C€3NWLT FACI-VRY SPEC AL APPL"1100 • iawd do$* pma • Ebd cal alertia— tar drpwM NPANA M aw b' and sy�pied we an abm V imm ia.a1 wS s io waam i w aadiar "*v* 00- srsi M . Daieie p vwiade Iiyel tloil sw ar�te � ibrei tong 04 short qM ooireols. • Seabd 0-*S r Sw&*b tea wi DW iif Hit t'10: om i30rV {54'C,) wacW * 90" 001 Id 15ZM53 Salina Ili d ads o® or +sal sNa�1a ae ftm M a *mh&d kam ditreo.. is eiretiw art so" cods shmm bi 1dfw+.s recent Nwam1 Becric CaAe plFq ad awa000�+i Saieq �ii4iJiM Mtn IYI� iK�i 13a 1;�� feat iaer •Lim �, 1.4 � tfii 11 rl�l t0 } 1 41 231 M M5 4-6 20 !:1 /4 107 197 t,i 3q f IA 42 . 30 !.1 ? 21 33 ! 22� A i S*LECT'M own 1 Srge P Ama ow*"airy wim w &" t4w6ma .aide b-d aa.R s.iD. Arta r FUWY ? see iSlevt2 fai � grid d i� E� 3. vsiabb tavdmld aim 1"ns uard"i6aw wwow. spe* &vim (Jq or (4) seal siasm& Fx �tlsriiotl wn�iaria r i�ir0 � � id a`r�issai� i1� ii� M �� � ;- .�, — - — iisir►�➢ a�i i91f wai' — - r iii,-iii� i"iiiiiwi/ i�ifii►,. joAAkw ilWHO /�iii rr AMM /;ate iV 3 !!- ��.w•w.oti�+rw.��.i+...��.w.a.rrnr.M.w.e.aw� ...�....... I i. � I 4gF S II !4S F�.n�rvMMaMw��Y.a4a�4771�11�V��9FF��F � �V { ed �s �•us oW _ ., sue. � Y �� ' M�11f11 'I� ss `ss= • 3 - s di' x �•i x I - o i..' I i fi ,1 } II � • I Q I LL s . j' j4 14. H ji ;sy Bj11 g0g I y�E�Si -- �� ; ' n.w�o7.wc M..n� .v�w.ra...tw.voa�w..a�...os+so• �_ � � �r.+�7cwa•m rww '! V/ 1 S .S ar.+.'+a�s'a.Awa merw�r..vr/+.2ao.ws �r•�r•••w••im.. i F a yb 1 p `8 Sx "� _ •f � #rw� n..Nm+.r�-�rmw��.v .�rr�n.a�a.� I.-Q�V t�C�}1 __ 1 I I 0 a �a irisa �+ 1 FOL ;4 1 4 1 �j I I I i k I J, I I SANITARY SYSTEM File ST. C RO UNTY Office Use Only t r:'r_" OWNERSHIP/ADDRESS FORM Creaied2/2027 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. 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 /) PC 2 Mailing Address��y City/State/Zip /U� G� ( ���/►�� �'� LA-e Phone Number (required) Email Address (required) —� Parcel Identification Number C2 L, 1 2 2 E' — 4) 6 (found on the property tax bill) NEW SYSTEM: LEGAL DESCRIPTION Property Location '/a , '/a , Sec. T 3U N RW, Town of Subdivision Plat: AV MG��S Lot # Certified Survey Map # Volume Page # Warranty Deed # (before 2006)Volume Page # Number of bedrooms Spec house ❑ yes A_no Lot lines identifiable eyes ❑ no New Property Address (Sta Initials) USE ONLY (Verifica ion of new address required from Community Development Department for new construction.) (Date) This form must be submitted with all Private Onsite Water Treatment System (POWTS) applications. New System: Include with this form a recorded warranty deed from the Register of Deeds Office and a copy of the certified 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 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., 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: 2134022-01919 ». V�ti p. i�ovc Ly Ri rrn Ie 19E)i GOO e Rd. 026-1298-06-000 Hudson, WI 64016 Parcel Identification Nmnber Together with all and singular the hereditaments and This is not homestead appurtenances thereunto belonging; and the Grantor warrants that 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. Pa urst authenticated this day of (1 I ,2022. (Print Name) TITLE: MEMBER STATE BAR OF W ISCONSIN (If not, authorized by §706.06, Wis. Stats,) THIS INSTRUMENT WAS DRAFTED BY: Attorney Jordan C. Sundell Ruder Ware, L1,.S.C. Per Legal Description Provided �fiL-L�Cn�L_G L Randall A. Parkliur ACKNOWLEDGMENT STATE OF SGGN91N m�: 4i : SS. COUNTY OP Z DZGi S : Personally came before me this j_q _day of r—r 2022, the above -named S . Parkhurst and Randall A_ Parkhurst, to me known to be the persons who executed the foregoing instrument and acknowledged the same. O (Print Name) Notary Public, State of W ise my Co 2 My Commission R bee eCCa J Elko Notary Public Minnesota 312023 pry clm) ss ol+ ores IVM7 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 Richmond 4893-0704-1307, v. 1 St. Croix County 1151858 Page 2 of 2 rl UD c � I 4 i t e �m fl0`ZLZ "WZZ.00N 00 ' �t.L w V M,,9t,ZZ.QON lb M,,9-V,ZZ.00N z Ck C� co 0 i L V1 to JCS k 01 i ci E LO I 5 I- L- #1713 �'Wisco sin SOIL EVALUATION REPORT Page 1 of 3 Department of Commerce in accordance with Comm 85, Wis. Adm. Code Steels 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 D I.. Z percent slope, scale or dimensio north arrow, and location and distance to nearest road. Parcel �O Plea all i Revie Date d Personal information you provide for ses (Privacy s. 15.04 (1) (m)). 3 / Property Owner roperty Location Stallion Development LLC a JUL 1 5 2005 ovt. Lot na SE1/4, NW1/4, S34, T30N, R18W Property Owner's Mailing Address ST. CROIX COUNTY of # Blodc "Riding ubd. Name�A)61 1221 130th Ave 6 na Me'�� city n City ['1 Village �l Town Nearest Road New Richmond WI 54017 715-246-5440 Richmond 12060 St 4 Code derived design flow rate 600 GPD New Construction Use: ®Residential /Number of bedrooms - - -- - - - Replacement ❑ Public or commercial - Describe: na _ _ — - Parent material Ridges, foot slopes, and valley escarof sandstone Flood plain elevation, if applicable __ __na ft. pments General comments Mound or At grade system, system elevation 100.05ft based on contour line elevation 99.05ft and recommendations: Boring # ❑ Boring Ej Pit Ground surface elev. ant Color nsell Redox Description Qu. Sz. Cont. Color yr3/1 none W58-7210y�/2 yr3/3 none yr7/8 c2d 7.5yr5/6 yr8/2 c2d 7.5yr5/6 Fz I Boring # � Boring 17 pit 98.35 ft. Depth to limiting factor 39 in. Texture Structure Gr. Sz. Sh. Consisten Boundary Roots sil 2msbk mfr cs lvf sic[ 2msbk mfr cs na ;andston ;andstont residuum residuum mfr mfr gw na na na Ground surface elev. 98.35 ft. escri tion Texture Horizon Depth in. Dominant Color. Munsell Redox Description Qu. Sz. Cont. Color none 1 0-18 10yr3/1 2 18-38 10yr4/4 none 3 38-56 7.5yr4/4 none 4 56-76 10yr8/2 c2d 7.5yr5/6 Effluent #1 = BODS> 30 < 220 mg/L and TSS >30 < 150 mg/L CST Name (Please Print) Signature - David J. Steel Address Steel's Soil Service, Inc. 994 200th St. Baldwin, WI 54002 Depth to limiting factor Structure Consiste Gr. Sz. Sh. 2msbk mfr 2msbk mfr 2msbk mfr residuum na Soil Application Rate GPD/ft2 •Eff#1 *Eff#2 .6 .8 .4 .6 0 .0 .0 .0 56 in. (Soil Application Rate Boundary Roots GPD/ft2 'Eff#1 'Eff#2 cs if .6 •8 gw gw na na .4 .6 .6 1.0 I a na .0 .0 Effluent #2 = BOD5 < 30 mg/L and TSS < 30 mg/L CST Number 248956 Date Evaluation Conducted Telephone Number 6/27/2005 715-760-0347 SBD-8330 M07/0M Property Owner Stallion Development LLC Parcel ID # pending Page 2 of 3 3 L I Boring Boring # E 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 GPDtW *Eff#1 *Eff#2 1 0-23 10yr3/1 none SO 2msbk mfr cs 1f .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 a na .7 1.6 5 84-100 5yr4/4 none scl om mfr na na .0 .0 ❑ Boring Boring # [A Pit Ground surface elev. ft. Depth to limiting factor 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 F-1U Boring Boring # Pit Ground surface elev. ft. Depth to limiting factor in. CJ 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 'EflW * 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 M07100) STEEL'S SOIL SERVICE INC. 3 of 3 David J. Steel Stallion Development LLC 994 200"' St. CST-POWTSM SEl/4,NW1/4,S34,T30N,R18W Baldwin, W154002 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. W Legend 1"=40' ♦ = Benchmark Ele. 100.00 ft Top of 3/4" pvc pipe • = Alt Benchmark Ele. 99.95 ft Top of 3/4" pvc pipe Q = Borings Boring Elevations B 1 = 98.35 ft B2 = 98.35 ft B3 = 99.65 ft I B4 = 0.00 ft N � u 5r /q Ou Ct i N .979.2 .x 987.6 x 981.2 x x 982.8 ' x 241 ' , 41 976.7 -.1 — � 975 981.3 x .`i V 977.3 1.5 ac es2'7 �'. 1.50 acres �'I � 1.500 es Co x 981. LL 2 R8.8 241 ' ,a�► x w i ---------- ----------------- --------- 13 N 1.50 res acres I = 987.4 x �. x 250' 992.1 250' 991.6 x 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 X te Map # Sales OArea Application # Permit # Permit Type # of Units Creation Date Historical Da 01 /18/2006 00 Ts):O =Current Owner, C =Current Co -Owner Tax Address: KHURST, SUSAN K & RANDALL A SUSAN K & RANDALL A PARKHURST 3946 COLGATE AVE MINNETONKA MN 55345 Districts: SC = School Sp = Special 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) Notes: Property Address(es): = Primary 1222 128TH AVE 1.500 Plat: 10-097-RIDING MEADOWS NORTH 026-06 LOTS 1/2 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: Date Doc # 04/06/2006 822035 01/18/2006 816695 Bill #: Fair Market Value: 2011 SUMMARY 168703 17,400 Valuations: Class Acres Land Description 1.500 17,100 RESIDENTIAL G1 Totals for 2011: 1.500 17,100 General Property 0,000 0 Woodland Totals for 2010: General Property Woodland Lottery Credit: claim count: Specials: User Special Code 1.500 42,5000 0.000 0 Certification Date: Vol/Page Type WD 10/0097 PLAT Assessed with: Last Changed: 09/27/2011 Improve Total State Reason 0 17,100 NO 10 0 17,100 0 0 42,500 0 Category Batch #: Amount Special Charges Delinquent Charges 0 Special Assessments 00 Total 0.00.00 0 �a a W fj h +O+ d A 07 N d •a10 M Cd tea', 4,1 a'C W o y o w a'�;aaq�abiE��o'er U Hss F2 .a," TOw T=v Io l"p, a '*Z CA 6 O a a A 1 w w 0 d a a 4 H O a