HomeMy WebLinkAbout018-1066-70-000 (2)Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM C... ty
Safety and Budding Dmsion St. Croix
INSPECTION REPORT Sanitary Permit No
GENERAL INFORMATION (�
ATTACH TO PERMIT 645429
Stile Plan ID No
Personal information you provde may lie used for secondary purposes (Pnvacy Law. a 15.0e (1)tm)j
Perron Hdders Name' Clty Village Township Parcel Tax No
HEINBUCH TRUST (JENNA MYER) TOWN OF HAMMOND 018-1066-70-000
CST SM Elee Insp. SM Elev: BM Iffi Dex ion. Secl-rT—n/Rangeaaap No.
VXk 30.29.17.454
TANK INFORMATION OLEVATION DATA
TYPE
MANUFAC URE .7
7
CAPACITY
Septic
Dosing
Aeration
TANK SETBACK INFORMATION I MI/)- . n. _ -
TANK TO
P/L
WELL
BLDG.
Venttb rmta-
AD
Septic
�f
.7
Dosing
/
Aeration
Holding
PLIMP/SIPI-inn INFORMATIm1J
Manufacturer
v
Demand
156
Model Number
i
TDH Lift
Friction Loss I System g8d TDW.
Ft
Forcemam Le 1• Dia. d Dist. to Wel I
► 1
is
I�
--
t�71�►'
BED/TRENCN
DIMENSIONS
With s
Langtn
jp01
Na nchas
p1T DIMENSIONS
No. Of Pits
Inside Dia.
Liquid Depth
SETBACK
INFORMATION
SY TEM TO
Ty OI yata
P/L
5
IBLLTG
IWELL
LAKE/STREAM
LEACHING
CHAMBER OR
UNIT
Manufacturer
MrMel Number
SOIL COVER K Pressure Sysl
Depth O Depm Over
Bed/Tr ch Center I I .n... - Bed/Trench Edges
COMMENTS: (Include eotle discrepancies. persons present, etc.)
Location: No Address Available
1.) All BM Description =
2.) Bldg sewer length
- amount of cover = Jyr
I 's—W
XX Mound Or Al -Grade
xx Depth of `
Topsoil (( r _ 1 � �Ves No
Inspection #2:
Inspection #1
.%I
Yes No
Plan revision Required? Yes No rLq
Use other side for additional information (/�_I1I —YA�7 1UIN
SBD-6710 Fl 3107) `�a s—sS,gna re--- -- I• —
.1J�SV�t ill v-�ro - l0a-4r< e-1-W loca+�001 0� W%f
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17A..1 , —, .-,As
s �a.7.s
'a' !. L
County ,I IV Lax,. /--t s—
Industry Services Division
ST CROIX
: anitary Permit Nu. a (to be filled in by Co.)
1400 E Washington Ave
\ P 1'
S
P.O. BqX 7162
�h, l coontY
WI
53707-7 Madison,
�ls�q
f
St. Gaoix evelo
I -
M riiiiee�
�Sanitary Permit Applicatio
State Transaction Number
In accordance with SPS 383.21(2), Wis. Adm. Code, submission of this f nm to the juipillopmWe governmental unit
_ 09ZZ 0 Z2?5'_4-
is required prior to obtaining a sanitary permit. Note: Application forms I% stteow'ned POW'I'S are submitted in
Protect Address (if different than mailing address)
the Department of Safety and Professional Services. Personal information you provide may b: used for secondary
157"' ST��-
purposes in accordance with the Privacy Law, s. 15.04 1 m . Stats.
1. Application Information - Please Print All Information
perry (honer' Name
Parcel a
IENNA MYER_ T,E.�
018.1066.70-0000
Property Owner's Mailing Address
Property Location
1624 CTY RD Z
Gow. Lot
SW%, NE'/., Section 30
City. State
Zip Code
one Number
HAMMOND, WI
54015
(circle one)
T 29N R17Eo,W
11. Type of Building (check all that apply) Lot
a
Subdivision Name inurt1
IL'.lA�s
® I or 2 Family Dwelling- Number of Bedr s
a
y ❑ Public/Commercial - Describe Use Block
3,0
❑City of
_
❑ State Owned - Describe Use
Cl Village of
Num=r
C
1ki�E t/
® Town of HAMMOND
i 111. T
e of Permit: Cheek only one'liox on line A. Complete line B if applicable)
P A.
New Sys(cm
I ❑ Replacement System
❑ TreatmenUHolding rank Replacement Only
❑ Other Modification to Existing System (explain)
❑ Permit Renewal
❑ Permit Revision
❑ Change of
❑ Permit Transfer to New
List Previous Permit Number and Date Issued
B.
Before Expiration
Plumber
Owner
X
IV. Type of POWTS S stem/Component/Device: Check all that apply)
❑ Non -Pressurized In4 iround ❑ Pressurized In-Gmund ® At-Grede ❑ Mound > 24 in. of suitable suil ❑ Mound < 24 in. ofsuitable wil
E❑ Holding Tank ❑ Other Dispersal Component (explaiLj Pretreatment Device (explain)
bV. Dis ereal/Treatment Area Information:
Design Flow (gpd)
Design Soil Application
Dispersal Area Required (sf)
DispersalArea Proposed (sp
System Elevation
600
Rate(gpdsn
1000
1000
91.4 CONTOUR a
.6
V1. Tank no
Capacity in
Gallons
y/,,'a.a
Lll�' ' MG
T
Total
Gallons
a of
Units
Manufacturer
L
Ci
New Tanks
Ezisang Tanks
6
U
Septic or Holding Tank
1250
1250
1
SKAW
Dosing Chamber
754
754
COMRO
V II. Responsibility Statement- 1, the undersigned assume mponsibilily for b atalladon ofthe POWTS shown on the attached phimi.
ift, Plumber's Name (Print) Plu
's 5-
MP/MPRS Number
Business Phone Number
ii ROBERT HARDINA
824825
715491.5039
dr I Plumber's Address (Street City. State. Zip Code)
c 477170TMAVE TURTLE LAKE WI54889
County/Department Use Only
tttV���Ittrll.
Approved
❑ DnVv
PermityFee�
ate Issued
Issui Age` Signal re
❑ Own isel
on for Denial
Z
IX. Conditiolpp,lt � 3) tDs. 2 �" Zmu_ ,
1. Septic tank,, TTeffluent filter and dispersal cell > �rj �nJQOSPS x -AA_
must be serviced / maintained as per1 management plan d
Aram t mplere plans Por Me systems b it m roe unry anly ao P+Peron Ins Man 8 to x 1 tare"
2. All setback requirements must be maintained P 1��5
as per pliable code /ordinances.
SBD-6p98 (�03/14)
L bN"
N
ft
lZOSEe1 4441A14 r116231C-5 `9:949S
CHECK BOX Aa APPDflHLE. CHECK BOX AS APPLICABLE.
SOIL EVALUATION Sc0-:1' = 4( N SYSTEM PAGE 2 OF
SITE MAP D 40 PLOT PLAN
PROJECT NAME: DESIGN FLOW. 600 GPD
HEINBUCHWER Dnra) tD' Attach design flow calcu)cbons for mmnwdel plans.
PROJECT ADDRESS. 157TH ST _ P43o M onel t ASTM Stendald (Tables 384.304 & 984.3M)
San So3q
BM Symbol: !4r BM ElevatIm '- 1D0 N F Sower y 1
aM Ooacnplbn TOP OFFENCE POVT N. PIL FOB" ` l scfl ya
Shoo&,xilnt(x) woo. papPueaue� aa«q a' IMPORTANT:
at Shaw uib
M TeMedanfe: O mYv WpaM�a ti ground Bbvadm oonbura a�blB Intervals.
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Ply
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Wisco, Depv l or Se&q end Proren wl Se _'
D,r,s norIedwiry Srry
4922 MM.— Y,& W ey
PO Box 7302
Madison. WI 53707
September 21, 2022
Mr,e,Lt4i
I ±
Phone 606-266-2112
Web. hno:::dsos.
F—L d—a— o
Tom' Even, Governor
No Herelh, Secrcl•ry
conamo�wy
APPROVED
pEPT. OF N1fETY •M PROFE!lxNML
CONDITIONAL APPROVAL A-4- A",
PLAN APPROVAL EXPIRES: 2024-9-20 we coane�
Plan Review: PWTS-092202275-C
Bob Hardina
477 170" Ave
Turtle Lake, WI
SITE:
Heinbuch
1062 75`h St
Hammond Township
St Croix County
SW Y NE X 530—T29N — R17W
FOR:
Description: At -Grade Component Manual—Ver. 3.0 (May
At -Grade 4 Bedroom— 600 GPD —46" to 2022-2027
limiting factor — Effluent Filter - Pressure Distribution Component Manual —Ver.
Maintenance required 2.1(May2022-2025)
"Manuals Have Been UPDATEDII••
The submittal described above has been reviewed for conformance with applicable Wisconsin
Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. This
system is to be constructed and located in accordance with the enclosed approved plans and with any
component manual(s) referenced above. The owner, as defined in chapter 101.01(10), Wisconsin
Statutes, is responsible for compliance with all code requirements.
No person may engage in or work at plumbing in the state unless licensed to do so by the
Department per s.145.06, stats.
The following conditions shall be met during construction or installation and prior to occupancy or use:
Reminders
The site shall be properly prepared prior to plowing. Any grasses longer than 6" shall be cut short
and removed. To avoid matting, any leaves or loose organic matter shall be raked up and
removed. Cut trees and shrubs flush to the ground and leave stumps. Avoid operating equipment
on the At -Grade site. If necessary, use only tracked equipment, during dry conditions, with
minimal passes, to avoid compaction.
Components and soil removed from an existing drainfield shall be properly disposed of so that
there is no risk to public or environmental health.
• A sanitary permit must be obtained from the county where this project is located in accordance
with the requirements of Sec. 145.19, Wis. Stats.
�.,.,
Dwm— n Depamnw, orsdery a,d Rofusional Servi«, .++ '4 Phone: (AS-z66-211 T
4822 Mad 1, Yu Services t i t� Web- Mm., da wi ao,
<Sxx Madison Ymds Way j' M1; Finad. Qyp}J, w' in em
PO Aos 7702 �
M,diwn. WI 57707 . m Tony Evers, Governor
Da• Hereth, Secretary
• Inspection of the private sewage system installation is required. Arrangements for inspection shall
be made with the designated county official in accordance with the provisions of Sec.
145.20(2)(d), Wis. Stats.
• A state approved effluent filter is required. Maintenance information must be given to the owner
of the tank explaining that periodic cleaning of the filter is required.
• A copy of the aporoved plans specifications and this letter shall be on -site during construction and
open to inspection by authorized representatives of the Department, which may include local
inspectors.
Owner Responsibilities
• The current owner, and each subsequent owner, shall receive a copy of this letter. Owners shall also
receive a copy of the appropriate operation and maintenance manual(s) and be responsible for
ensuring that POWTS is operated and maintained in accordance with this chapter and the approved
management plan unders. SPS383.54(1).
• In the event this soil absorption system or any of its component parts malfunctions so as to create a
health hazard, the property owner must follow the contingency plan as described in the approved
plans.
• The owner is responsible for submitting a maintenance verification report acceptable to the county
for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the
component(s) utilized in the POWTS.
In granting this approval the Division of Industry Services reserves the right to require changes or
additions should conditions arise making them necessary for code compliance. As per state stats
101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe
building, structure, or component.
Inquiries concerning this correspondence may be made to me at the telephone number listed below, or
at the address on this letterhead.
The above left addressee shall provide a copy of this letter and the POWTS management plan to the
owner and any others who are responsible for the installation, operation or maintenance of the POWTS.
Sincerely,
,TmhU49190Wy
Joshua Rowley
POWTS Plan Reviewer, Division of Industry Services
(715) 634-5124
Joshua. rowlevOwaconsin.gov
APPLICATION FOR REVIEW
- Complowall pa9es-
.t ti : NOTE: Personal information you provide may be used for secondary purposes
7...V^a [Privacy Law s. 15.04(1)(m), Slats.)
Private Onsite
Wastewater Treatment
Systems
Division of Industry Services
❑ Plane to be E-Tiled. Provide Sherelsood deter name below:
For plan status, t9beck our webs" at ..
Fmsi aecistol code questions to
Several couties have been delegated certain atdf ci ft to rtavkrw plane in Neu of DNleion of Industry servkas. For a cunera Id of thin
colxttles and their anon check our websile at
1. Pnolset kaarr isixi r - Fill In ad known Information.
ConfImuslon of aslprnNnt so a revewr.
Pro(scIrSM Name: MreT&c if,
Tranasction 10:
Location, Number a Street of protect IN unknown. indicated nearest road)
Pravlous Related Trans. 10:
Estimated Completion Dab:
Assigned Reviewer:
Legal Dgaoipboh. .SWT_34� ZY� A%' C 1 14J
County S%- C i
Assigned Omcs:
Mall to your offlco of choleo batow:
La Crosse, Green Bay
❑ City ❑ Vrape ® Town of .S
2. After plans are reviewed, plaaaa: (check all that apply)
❑ Call Customer 1, 2 (Circle number)'
NOTE: We reserve the right to edlstnbute plans to another office if
❑ Requesting party will pick up
needed to reasonably balance turnaround times. Check
® Mai plans to customer 1, 2 (cacle number)'
for next available mvlew date
'ftelers to customer number from below.
3. Complete the following dssignarkremo hpussllrrg Information. Ulalse
the Neck boxes when designer, owner or requesting party Is the same to
avee repeating Information.
Designer Information (Customer 1) DSPS
Other Please Specify Below (Customer 2) DSPS
First Name Last Name Customer Number
First Name Last Name Customer Number
ROBERT HARDINA 824825
Company No.
Conipsey Name
HARDINA SEPTIC SYS.
Address
477 170'
Address,
City Stela Z4p 4 (9 d'ets)
City State Zip.4 (9 digts)
TURTLE LAKE WI 54809
Phone Number E-mail sddmss Cog phone
Plane Number E-mat address Coo phone
(ore■ code)
(area coda)
HARDINASEPTICOGMAIL.COM 715491.5039
Check N appirabls
Chalk if applicable of specWy, relationship
❑ Owner
Owner Other —specify relationship
Information and Plan Submittal Checklists. To request electronic plan review complete the appropriate application form and e-mail it,
along with your registered SharePoint usemame to
If plans are being submitted via paper, they
will be assigned to a reviewer after receipt at a DSPS office. Submittal checklists can be found in each applicable comporrent manual
appearing on the POWTS program page udder Publications
HokneNOnaWka Area DSPS
Orson Bay DEPB
2850 Midwest of Ste 104
2331 San Luis Piece
Onalaska. Will 54650
Green Bay. VN 54304
006-7W9334
920-492-Mi
For: SM785-9330
Fax 220-492.5804
Ems4: ,
Ernest
NOW Checks Payable to: Division of Industry Services OR
❑ Check box to invoice designer and sign below TOTAL AMOUNT DUE f _
Review Cods 7633
lealgnar Signature
SBD-10577 (R 3119)
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RESIDENTIAL AT -GRADE DESIGN
INDEX AND TITLE SHEET
CondMlonally
Project
MYER
APPROVED
Owner
JENNA MYER
SERVICES
IIIVICIr1N f1F INn11CTRV CFRVI C
Address
1624 CTY RD Z
HAMMOND WI 54015
SEE CORRESPONDENCE
Legal Description SW,NE,30,29N-R17W
Township HAMMON,) County ST.CROIX
Subdivision Name Lot No.
ParcellD Number 018-1066-70-000
Plan Transaction Number
Index sheet
Page 1
Calculations
Page 2
At -grade drawings
Page 3
Laterals and dose tank
Page 4
Specifications
Page 5
Management 8 contingency plan
Page 6
Pump curve d specifications
Page 7
PLOT PLAN
Page 8
FILTER MAINT.
Page 9
SOIL TEST
Page 10
Designer ROBERT H/ARDINA License Number
824825
Signature s > . Phone Number
715-491-5039
tX
Date 08/15/22
Designed pursuant to.
At -grade Component Manual for POWTS SBO-10570-P (R.6/99), and
SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST - SAS (01181)
Version 4.0 (04I03) Page 1 of 10
PRESSURIZED AT -GRADE DESIGN
At 9-du Uesign Wurkshn.
l - Slupmtj Situ
Flows and Site Data Entry.
r Residential or commercial?
400.0 Estimated wastewater flow (gpd)
600.0 Design wastewater flow (gpd)
11.40 % Site slope
91.40 Contour elev. below lateral (ft)
46.00 Depth to limiting factor (in)
0.60 In -situ soil application rate (gpd/f A2)
Distribution Cell Information
1 Influent wastewater quality
10MI Linear loading rate gpd/ft
10.00Effective absorption width (ft)
10.00 Max. effective width permitted (it)
100.001 Aggregate length (ft)
Pressure Distribution Data Entry
E Center or end lateral connection
Number of laterals
0.156 Orifice diameter (in) e g 0 188
2.00 Estimated orifice spacing (ft)
2.00 Forcemain diameter (in)
2.80 Forcemain flow velocity (ft/sec)
_
60.00 Forcemain length (ft)
84.00 Pump tank elevation (ft)
y Does forcemain drain back?
y Are laterals at highest point?
455 System head (ft) x 1.3
6.90 Vertical lift (ft)
NA
Forcemain drainback (gal)
5x Lateral void volume (gal)
A21.
L1
0.98 Friction loss (ft)
Minimum dose volume (gal)
1
12.43 Total dynamic head (R)
System demand (gpm)
-,mot
Lateral Diameter Selection
Pipe dwrerer Design wbi— Decpndom
t in
tzs in6)
GallwreAnch Calculator
754 Total Tank Capacity (gal)
47 Total Waking Liquid Depth
16.0 GaYin (enter resu0 in cell G46)
1.5 N
2 in x x
Treatment Tank Information
a in x
1250 Septic tank capacity (gal)
skew Manufacturer
Effluent Filter Information
Dose Tank Information
._
LIFETIME Fitter manufacturer
754.0 Dose tank capacity (gal)
LT 118 Fifter model number
16.0 Dose tank volume (galfn)
skew Manufacturer
Project:
MYER
Transaction
Number:
Page 2 of 10
AT -GRADE PLAN VIEW
To , re e oesen lbn pees (z typical) B 100.060 R
1t---{ 1/6 B 16.67 ft
C 12.00 ft W
c D 5.00 ft
t E 2.00 ft
I L 110.00 ft
D B W 22.00 ft
—L A x B 1000.00 ftA2
L
f_ cap
Typical obs. pipe.
0 = Total aggregate cell A x B Slotted in the lower
Oa", and aixiiaad
= Plowed area L x W a.a,nN
lu
a
T
AT -GRADE CROSS SECTION
Svnthebc fabric cover
R Finished grade
Lateral /i '; " i elevation
invert elev.91.90 ft
Observation pipe
✓/ i��� at aggregate toe
E
Surface contour 11.4 % Slope
and system 91.40 ft 0 A -1
elevation D T
= 12 in. topsoil and subsoil pad layer
over aggregate and tapered to toes. below L x W
0 = 6 in. aggregate below
pipe(s), and 2 in. above pipe.
Project: MYER
Transaction Number Page 3 of 10
PRESSURE DISTRIBUTION AND DOSE TANK
Lateral Diagram - End Connection
L. rLOL•./1Ylod rr .�.rd• q. L. x—•I
1. yr .1: .. + rrt. rm ._a F4_ :.. 1. 4p
...1+'I,:a`I'
-pWq-P 1'+1
• - Imn-uV wl4.ru..�n.o •r afw�noul Wuq
r1 Lateral Specifications
Orifice diameter (in) End Lateral connection point
X Orifice spacing (ft)
[127.4
1
Number laterals
Orifices/lateral
— P
98.00
Lateral length (ft)
Lat discharge rate (gpm)
2.00
Lateral diameter (in)
2-7-41
Sys. discharge rate (gpm)
2.00
60.00
Forcemain diameter (in)
Forcemain Length (ft)
12.43
TDH (ft)
Typical
Pump Chamber Layout
Final grade
was"r-proof
junction box
Tarfk-Vol-4n
propa*y versed
Electrical m par NEC 300 and
Came 16.76 WAC
c Inches Gallons
o A 27.5 440.2
4r B 2.0 32.0
E C 5.6 89.8
o D 12.0 192.0
Totals 47 IT 754.0
Zoeller
bn 192
Approved le land coverwith
waMrfer rq label and loq[kq device
1'
daconrfed
AMmab
�� olfllet
otor' M.
�, Appmved ewe[ wka
Tank hi
:JA
Ali. on
P—vw B
85.00 ft C
Pf .p olr
D
leer tank
Pump manufacturer ale rhombus
Pump model number tank alert
Provide 1w
.sep hole or
antao—
device.
84.00 it
Alarm manufacturer
Alarm model number
Project MYER
Transaction Number: Page 4 of 10
Ayarade System Maintenance and Operation Specifications
Service ProvkWs Name Robert Hardin Phone 715491-5039
POWTS Regulator's Name St.croix Co wiI Phone 715386 4680
System Flow and Load Parameters
Design Flow - Peak 600 gpd
Estimated Flow -Average 400 gpd
Septic Tank Capacity 1250 gal
Sal Absorption Component Size 1000.0 R'
Type of Wastewaterl Domestic
Septic and Pump Tank
Effluent Fitter
Pump and Controls
Alarm
Pressure System
Mound
Maximum Influent Particle Size 1/8 in
Maximum BOD5 220 mg/L
Maximum TSS 150 mg/L
Maximum FOG 30 mg/L
Maximum Fecal Coliform >10E4 cfu/100 mL
Service Frequency
Inspect and/or service once every 3 years
Inspect and clean at least once every 3 years
Test once every 3 years
Should test monthly
Laterals should be flushed and pressure tested every 1.5 years
Inspect for ponding and seepage once every 3 years
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 at -grade component manual.
2. Dispersal cell aggregate conforms to Comm 84.30 (6)(i), Wis. Adm. Code.
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 at -grade structure and other disturbed areas will be seeded and mulched to prevent soil erosion
and help reduce frost penetration.
6. Areas within 15 feet of the downslope toe will be protected from corn . pact__
7. All other construction details are as per the at -grade component manuaconstructionD-10570-P (R. 6199).
Lateral Turn -up Detail
Finished ......
Grade v1
6-W Diameter Lawn
Sprinkler Valve Box
Distribution
91.90 It
Threaded Cleanout
Plug or Ball Valve
�Sweep 90 or Two
egree Bends Sarne
Diameter as Lateral
Project: MYER
Transaction Number. Page 5 of 10
At -grade System Management Plan
Pursuant to Comm 83.54, Wis. Adm. Code
General
This system shall be operated in adcerdanoe with Comm 82-84 Wis. Adm. Code, and shall maintained in accordance with es' component
manuals (SBD-10570-P (R. 06M) and SSWMP Pub. 9.6 (O1/81)1 end local or slate 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 lank abandonment shell 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 near, access risers and covers should be inspected fun 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 of unauthorized entry into a tank or component.
septic Tank
The septic tank shall be maintained by an individwl certified to service "'clan. under s. 281.48, State. The contents of the septic
tank shall be disposed of in accordance with NR 113, Wis. Adm. Code. The operating condition of the septic tank and outlet fitter shall be
assessed al least once every 3 year by inspection.
The outlet fitter shall be cleaned as necessary to ensure proper operation, The finer urbidge should not be removed unless provisions
are made to retain solids In the lank that may slough o9 the timer when removed from its enclosure. If the finer is equipped with an alarm. the
finer shall be serviced it the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an impending Continuous
alarm.
The septic lank shall have Its contents removed when the volume of shdge and scum In the tank exceeds t/3 the liquid volume of the
tank. If the contents of the tank are not removed at the time of a biennial assessment, maintenance personnel shall advise the owner of
when this need service needs to be performed to maintain feu than maximum seam and sludge accumulation in the tank.
The addition of biological or chemical additives to enhance septic tank performance is generally not required. However. a such products
are used they shell be approved for sal lank use by the Department of Commerce.
Pum, Tank
The pump (dosing) lank shall be inspected at least once every 3 years. An switches, sienna, and pumps shall be tested to verify proper
operator. If an effluent finer is installed within the tank a sham be inspected and serviced as necessary.
At -grade and Pressure Distribution Svetem
No bees or shrubs should he planted on the at -grade. Plantings maybe made around the al -grade's perimeter, and the at -grade shall be
seeded and mulched as necessary to prevent erosion and to provide some protection from host penetration. Traffic (other than for
vegetative maintenance) on the at -grade d not recommended sing soil compaction may hinder mention of the infiltrative surface within [he
mound and snow compaction in the winter wiH promote frost penetration. Cold weather instalWgns (October -February) dictate that the at -
grade be he" mulched as protection from freazing.
Influent quality into the at -grade system may not exceed 220 rg/L BOOS 150 rg/L TSS, and 30 rgX FOG for septic tank effluent or 30
rg/L SODS 30 wV& TSS, 10 mg/L FOG, and 104 ch.000 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 pole at the end of each lateral, and it is recommended that each lateral be
flushed of scou,nualed solids at loam once every 18 months. When a preswre test a performed it should be compared to the initial test
when the system was installed to determine if onfcs dogging has occurred and if orifice cleaning is required to maintain equal distribution
within the dispersal cell.
Observation pipes within the dispersal cel shall be checked for effluent pendinrg. Pending levels shall be reported to the owner, and any
levels above 4 inches considered as an impending hydraulic f nium requiring additional, more frequent monitoring
Contingency Plan
If the aspic tank or any of its Components become defective the tank or component shalt be repaired or replaced to keep the
system in proper operating condition.
If the dosing tank, pump, pump controls, alarm a related wiring becomes defective the defective components) shall be Immediately
repaired or replaced with a component of the same or equal performance.
If the at -grade component falls to accept wastewater or begins to discharge wastewater to the ground surface, it will be repaired or
replaced in ins' preaa a location by increasing basal area if toe lsakaga occurs or by renovating the biologically dogged absorption and
dispersal media, installing new piping. and repladng other components as deemed necessary to bring
the system into proper operating Condition.
See Page 5 of this plan for the name and telephone number of your local POWTS regu later and service provider.
Project: MYER Transaction Number. Page 6 of 10
PERFORMANCE
1�EC. PDX AS APPLIUAE.
❑ SOIL EVALUATION
SITE MAP
PROJECT NAME:
HEINBUCHIMYER
CNECX WX AS AVNICI&C.
Scala: 1" = 4C D SYSTEM PAGE 2 OF
0 40 m 80
PLOT PLAN
(io"ww) 10' DESIGN FEO& SW GFD
Attach deco Mo. calwisbons for ow-rwcial plane.
PROJECT AD[MEss
S7 _
P{at Material / ASTM Sw lord (Tables 384.30.3 Q 384.30.51
_--_----1577f'f
---
N
S-"S— 4 f 5-39J
BM&p bd. Itip
BM Ei-v 100 FT
Fan Mda
TOP OF FENCE POST N. P/L
awovwm.snlx)
M Taxed Area
was saw+raaet
SY^inol ( O
> � ma.
m ti pweas. ti
Slaw IMPORs—
gtournd ele`aean oontolsa a slilahla knlaveM.
PI L
B=1i5'o1-jSD�c,.3c a1SCAaI
1111- Ar 6 awS & AQ6 A
we-k�7l
qGS��
20140048A I
I
47 f
Will I r
Installation and Maintenance Instructions
ktshllatlon (j
Step" pry fit the f lter case onto theoutkt pipe going to the dt* held, Ensure It b txY{twM dkecdy � access openktg. ("'Outlet MlIu Is atready In a Heed tMsltton, addwana)
pipe may need to be added) I
Step 2 If uttllyng the additional singlo skit silpf wt akul the two bottom support; !! f s sttg &y fit to the outlet P{pe, w"ura.w cut !"sWhile the ease
Atrf,- Ap
dle1 f
Q to the k-M
hubs that are prcanolded Into the m:,e to Ute ski,- mall a,ul the AWE ( ,r tlt tded M eattend frwn the f
tubs that -CO Re -molded onto tfte case sulvvnl wed 1 ploy hry Ulu, i
Stop m SoMmt weld the uses to the octet pipe, hint the filter cartridge into the case pressing down on
cartrklgs until 1t loclu Into plaea M the bottom of case. the
step q 9 ulilldng a vertkal read swheb: Imrrt NA,4) into the hole pre-motdcdinto the top of (he i(R��r. press
:•lndl�q diva! mall It h+ri!s kde.>f:tty
MaIntenance .
1) Ra hove the access ad of the tank. Notes TO ensure undegrabte solids do drain not skit (he fink and Into rile
drainfield, the tank should be pumped out until the lend oh effluent Is below the outlet level of the tank.
y the cose. (it rm e the. iWrt
er ddge from the filter cose,
x from NPull up firmly on the handle of the c4rtvkga ldlsWeing
ulUltlrng a vertical read mud; removal o(W*dn b opilomdl
7) tJskng nn nrrllu�>ty�:uutn, ;ru:a�, nin:r th(I flhnr ca,u:d4:r a;j b%jvWNa seyxal;r: r;,al.; lvi is re.•pt4y,-ll.
e) Pico the filter mrttdoo back loft the Aler rase presslag diva at ltle cartridge until It
S) Place the access Rd back onto the tank w mring ft Is sm e kicks Into pAtte
fiEa B 18N !
taPtkaa raw kn, Hausa taapo I SAFETY
lYmLm: Iltgl4C ulvrJla9 ue low ere Ac etc of in-mdxw �•'t` "�
tfN MavrlaYwl wrtaaw oeae tilt aaatl• aC xel P. lee Pdnniic'M1 t•. 4thle"l tth theankapWMil
Mdrae[Idarinethe laRaWebnwMtenanra efiltartwlproadeerdrbmnxet RlrAe eaaawot thst the^MSsnAwtws
Aemwdaakrlak wxraair. InWroaerfa„ye weeylhharod.ctauxd yPeocru. eaaeesaww"wat
Pt4stlydvoN thA:rxrmry. uredeeelatesuw. r�ruvetIkenwaam%bftputyty4v-w4f«AilahW
4datieakmtomewnUd mats, esaeasatl�0.yfor hAariRl110yddnreq aaeiPaaM aMAr
��ltSt�l1 Moat Set�%27•a331
VNaeornin Department of Safety and Professwnal Services Page _ of
Onmon of Industry Services
SOIL EVALUATION REPORT
In acmManoe with SPS 365. Nee. Ado. Code CO-4
Attachcomplete sne elan on paper not lees then 6 12 x 11 leeches m size. Plan roust Ylcsede, ST CROIX
out not lumled tovertical and horizontal reference polne (SM), direction and percent slope, Parcel I.D.
scale of dirnensions, north arrow, and bnAlldn and distance to nearest read. 018-IOW70-00
Please print all Information. Ravxwed by DOW
Penonet irdmnetlon m be usM for law. s. 15.04MMA
Property Owner Property Laced" ❑
HEINSUCH TRUST/JENNA MYER Got. IN SW % NE % S 30 T 20 N R 17 E (ad W
Property O~s MaYbp Addition Late BIorA a Strad. Helm or CSMe
1524 CTY RD Z
City . SUM Zip Code Plane NtarbM ❑ CM - ❑ View - ® Town Nearest Road
] New Construction Use: ❑ Resitlenoal / Nun0erof bedroo ne 4 Code damad design now raw §0 GPD
]Replaaernent ❑ Pubec or cornrnarcial- OeeulW: _
'arent material OUTWASH Flood Pion elevation d applicable W9 it
;enerel comments and roconrrwbNbns: AT GRADE
s ❑ Boring
ElPt Ground surface ekv. 6QQ ri Dagh to Nmitinp factor ¢Q on,
Horizon
Depth
In.
Dwwwft Color
Mulaw
Redox Description
Ou. Az, Cont. Color
Texture
Structure
Gr. Sz. Sh.
Consistence
Boundary
Roots
GPD/FP
'EfM
'ES02
1
0.18
10YR3f3
-0-
SIL
211ISSK
MFR
TJW
2011
.6
.6
2
16.36
t0YR4/4
-0-
SIL
2MS8K
MFR
CW
1M
.6
1.0
3
3640
7.5YPAM
-0-
LS
OSG
ML
GW
WA
.7
1.6
4
00.75
IGYRSM
F2D5YR4/4
VFS
OSO
ML
CW
WA
.7
1.0
L ._ _J BorNg a
PP ®S Ground surface elev QU n Depth to Ymb factor g in.
Horizon
Oapth
Dominwit Color
Redox Dsealgion
Taxturo
Soudan
Consistence
Bourxlry,
Raub
CiPDIF1'
In.
Murim
Ou. At. Coral. Color
Gr. St. Sh.
'EIMt
'EfN2
1
0.15
t0YR3/4
.0.
SIL
2MSBK
MFR
GW
2e1
.6
A
2
16-34
10YR4/4
-0•
SIL
2MSSK
MFR
CW
1M
.6
1.0
3
344a
IOYR614
-0-
LS
0.SG
MIL
WA
WA
.7
1.6
4
48-00
f0YR614
F205YR4/4
VFS
OSG
NL
WA
NIA
.7
1.0
CST Noma (Plena Print)
Z
CST Nwriber
1
ROBERTf MINA
=x
624625
Address
090 E.MuTton Conducted
Tokohore Maribor
1
477 170' AVE TURTLE LAID: VA
7$22
715491-5039
wwa*r I-)
31 I eor.q s
❑ Bonng
® Pit Ground surface elev. 21A ft. Depth to emzing factor A§ in.
fc.�al ��rw. aw I
Horizon
Depth
In.
Oorltinent Color
Murrell
Redox DasaWtIon
Do. Az. Cord. Color
Texture
svwure
Gr. Sz. Sh.
Conslelence
Baurldery
Root
GpDlW
•EIMt
1
ate
1OYft3/4
-0.
SIL
2MSBK
MFR
GW
2M
.0
.6
2
1840
10YR414
-0.
SIL
2MSSK
MFR
CW
1M
.6
1.0
3
30-46
tOYR8f4
4)-
LS
OSG
ML
WA
WA
.7
1.6
a
4663
tOYR64
F2D5YR4//
VFS
OSO
ML
WA
WA
.7
1.6
❑ Boring s
❑ Boring
® pit Gmund surleae Nee. __ R Depth to limiting factor_ in. �
o Bonng 0 ❑Ocieg
❑ Pe Grouts suAaa OW. _ R Depth to IanCrlg lector _ in.
�- I
M
Etlluerll 91 • BOD. > 30 s 220 wq& and TSS > 30 s 150 ng • Effluent e2 + BOO. > 30 s 220 mg& and TSS > 30 s 150 rr1glL
noP>EQ ,
cNr cK naX tic �xlc�E.
SOIL EVALUATION
SITE MAP
PROJECT NAME:
HEINBUCH/MYER
(:MFCK PDX •5 AMI.IGeIE.
Scale: 1• = 4a SYSTEM PAGE 2 OF
n 4o co tto
PLOT PLAN
(to"wwj 10' DESIGN Ft( 600 GPI)
Attach design Row Calculations IQ cc—nm 1 plans.
PROJECTADDRESS 157THS7 ftI - Malachi%ASTM Slandmd(TaNas 384.304d 384 ,1051
eu sye� i. eu Ei— 100 FT Fuca w.I 1
eu D.-PIIm TOP OF FENCE POST N. P/L
IMPORT
G
swws sr.n 1xI �+r RTANT.
Te hen we0 �Y�� 1+:wk:.�1 p aa..y a,•, Show ground aW.IlDn lolra at sutahlo Inlavals.
on b,�ayr r.
fiI-v
IN
4.
File #:
-iT- CRO IU.NTY SANITARY SYSTEM File
Office Only
vwsi�� OWNERSHIP/ADDRESS FORM c�red2/2azl
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 —I a dh/ A !K ft f�
Mailing Address 1 &o W 4" rY da Z.
City/State/Zip eJ 1 5`iDIS
Phone Number (required) -1 1S7 - L4 I - I 14 91
Email Address (required)
Parcel Identification Number 401 -l6) t, 70-0000
(found on the property tax bill)
NEW SYSTEM: LEGAL DESCRIPTION' /
Property Locations u) t/. , t.1E V. , Sec., T _N RpJW, Town of HA/9r1 ay f�
Subdivision Plat: Lot #
Certift d Survey Ma # flwt9 Volume Page #
(before 2006)Volume Page #
Number of bedrooms Spec house O yes-) no Lot lines identifiable O yes O no
Q IIOFFICEU�SEONLY/ I , //
New Property Address 77CJ / 5 7 JA S 17. POb Y I S �7 Z 3
(Verification of new address required frooh Community Development Department for new construction.)
912712022
(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 Once 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
cddLmsccwi.aov 1101 Carmichael Road, Hudson, WI 54016 wwwsccwi.aov
01111,1
Eli
11lf,! Pfs � ..........................:'"
CERTIFIED SURVEY MAP
PART OF THE SOUTHWEST QUARTER OF THE
NORTHEAST QUARTER OF SECTION 30, TOWNSHIP
29 NORTH, RANGE 17 WEST, TOWN OF HAMMOND,
ST. CROIX COUNTY, WISCONSIN
PREPARED FOR.
Heintwch Trust
1624 County Road Z'
Hammond City, W154015
EMERALD ACRES
1ST ADD1T10N
LOT 73 � LOT 72 i l07 71
i
(NU-26'14-E) 1
N89-26'13-E i 442.30'
Northeast Comer
Section 30-29-17
Survey Mach Naill
o� f'
UII I O,IN
N
n l LO7 70 '? l
h o
S89.26'13'w I i
66' 1798.05
W 1732.05' --)I
r N
O ♦ i [n l
LOT >
TTLATTED s� a�"'o ,�'A80
133.000 sq.ft. rn ' 1 'n Z
8 �i 3.053 acres i 8 �A
/Z NLANDS
� East Comer
xQi Section
30-29-11
/ s. a6J Survey Mark Nail
/ S89'26'13'W 4.44.36' 66' wide access easement to
EE u_Nv_u_TT_ED serve Lot 1 and unplatted
LANos lards, recorded in
---- Documents
Each parcel on this map is subject to State and County laws,
rules and regulations(i.e. wetlands, minimum lot size, access to
parcels, density limitations, etc.). Before purchasing or
`2,00N�
3 .JIM� •
developing any parcel, contact the Community Development
It? rwoT
Department and Town Board for advice.
&.31110
•' r.�aaDmaRi
SCALE 1" = 150'
0" 150' 300'
^ Z2'
W.
d
DRAFTED BY:
LEGEND
)oelA.Brandt
0 Found Government Comer JB Surveying LLC
y (Government Comer verified)
North is referenced to the o._.. Set 3//4' x 18' Iron Rebar
weighing 1.502 Ibs./foot
Completion Dale
East Line of the Northeast
Quarter of Section 30-29-17, Found 3/4' Iron Rebar
July 2022
which bears N00'14'22W •.-. Found 2,38' o.d. Iron Pipe
(St. Croix County Grid System) (o'oa) Recorded Data
Sheet 1 of 2 Sheets
CERTIFIED SURVEY MAP
PART OF THE SOUTHWEST QUARTER OF THE
NORTHEAST QUARTER OF SECTION 30, TOWNSHIP
29 NORTH, RANGE 17 WEST, TOWN OF HAMMOND,
ST. CROIX COUNTY, WISCONSIN
DESCRIPTION
A parcel of land located in part of the Southwest quarter of the Northeast quarter of Section 30,
Township 29 North, Range 17 West, Town of Hammond, St. Croix County, Wisconsin; more
particularly described as follows:
Commencing at the East quarter comer of said Section 3Q thence N00'14'22 W, along the east line of
the Northeast quarter of said section, a distance of 1323.97 feet thence S89°26'13'W, a distance of
1798.05 feet to the point of beginning; thence S00°31'07'E, a distance of 300.00 feet thence
S89°26'13'W, a distance of 444.36 feet thence N0(.07'34 W, a distance of 300.01 feet to the south
line of the Plat of Emerald Acres 1st Addition; thence N89'2613'E, along said south line, a distance of
442.30 feet to the point of beginning. The described parcel contains 133,000 square feet, (3.053
'acres), and is subject to easements of record and as shown.
SURVEYOR'S CERTIFICATE
I, Joel A. Brandt. Professional Land Surveyor, hereby certify That I have Surveyed, Divided and
Mapped the above described parcel of land in full compliance with the provisions of Chapter 236.34
of the Wisconsin State Statutes, and Chapter A-E 7 of the Wisconsin Administrative Code 'Minimum
Standards for Property Surveys' in surveying, dividing and mapping the same. That such map is a
correct representation of the exterior boundaries of the land surveyed and the subdivision thereof
made, and was done by the direction of Scott Heinbuch.
�A� 8/22122 $cop
Joel A. Brandt, P.LS. S-2603'
JB SURVEYING LLC ataw *' XNLA #
silt
�.11r10m drti
t•
STATE OF WISCONSIN)+
COUNTY OF ST. CROIX) SS
I, the duly elected, qualified and acting treasurer of the county of St Croix,
do hereby certify that the records in my office show no unredeemed tax sales and no unpaid taxes or
special assessments as of affecting the lands of this Certified Survey Map.
Date Treasurer
Sheet 2 of 2 Sheets
Zrticion
(njD # " CSr a
Wisconsin Depo�lpr(al ervices Page of
Dwsionoflndu
p22SOIL ION REPORT
Ina rdanoe with SPS 385, Wis. Adm. Code County
ST COIX
Attach complete she sQ1111 i 8 x 11 inches in size. Plan mustui e,but not limited to: veBM), directiorl nQpyrGl�y „� Percel LD.scab or dimensions, ion and distance to near t aov%s— Ot&1088- 0-000
Please print all Information. 7by 17 - 1
Property Owner Property Location U ❑
HEINBUCH TRUST/JENNA MYER Govt. Lot SW % NE % S 30 T 24 N R 17 E (or) W
Property Owners Mailing Address Lot Ni Block 0 Subd. Name or CSM# ?e
1624 CTY RD Z
City State Zip Code Phone Number ❑ City ❑ Village ® Town Nearest Road
New Construction Use: ❑ Residential/ Numberofbedrooms 4 Code derived design flow rate M GPD
]Replacement r m`pte:
rarem material OUTWASH �ublic orcial— Describe
1��I1]i .ICYIeS 1 Flood Plan elevation it applicable NIA ft. Lf�
ieneral comments and recommendations: AT GRADE OY If- p
OV
IF Boring N ❑ Boring
® Pit Ground surface elev. AU ft. Depth to limiting factor 5Q in.
Horizon
Depth
In.
Dominant Color
Munsell
Redox Description
Ou. Az. Cont. Color
Texture
Structure
Gr. Sz. Sh.
Consistence
Boundary
Roots
GPD/FN
•Elfet
-Eftk2
1
OAS
10YR3/3
-0-
SIL
2MSBK
MFR
GW
2M
.6
.8
2
18-36
10YR4/4
-0-
SIL
2MSBK
MFR
CW
I
.6
1.0
3
36-60
7.5YR4/6
-0-
LS
OSG
ML
GW
WA
.7
1.6
4
6D-75
10YR8/4
F205YR4/4
VFS
OSG
ML
CW
WA
.7
1.6
Boring t ❑ Boring
® Pit Ground surface elev. 88.0 ft. Depth to limiting factor 4fl in.
Horizon
Depth
In.
Dominant Color
Munsell
Redox Description
Ou. Az. Cont. Color
Texture
Structure
Gr. Sz. Sh.
Consistence
Boundary
Roots
GPD/FF
•EtMr1
•EIfAe2
1
0.18
10YR314
•0•
SIL
2MSBK
MFR
GW
2M
.6
.8
2
18-34
10YR4/4
-0-
SIL
2MSBK
MFR
CW
1M
.6
1.0
3
34-0
10YR8/4
-0-
LS
OSG
ML
N/A
N/A
.7
1.6
4
48-60
10YR814
F2D5YR4/4
VFS
OSG
ML
N/A
WA
.7
1.6
CST No (Please Print)
®/r'l
CST Number
ROBERT HARDINA
824825
Address
Date Evalu lion Conducted
Telephone Number
477 170' AVE TURTLE LAKE WI
7-8-22
715-491-5039
Pi C'T
3❑ Boring *
❑ Boring
® Ph Ground surface elev. 1�.4 ft. Depth to limiting fa r 9¢ in.
Cnil nnn� lirblinn R.t.
Horizon
Dominant Color
Munsell
Redox Description
Ou. Az. Cont. Color
Texture
Structure
Gr. Sz. Sh.
Consistence
Boundary
Roots
GPD/Ftz
•Efl#1
'Efl#2
1
10YR314
-0-
SIL
2MSBK
MFR
GW
2M
.6
.8
2
d
t0YR4/4
-0-
SIL
2MSBK
MFR
CW
1M
.6
1.0
3
10YR814
-0•
LS
OSG
ML
WA
WA
.7
1.8
4
10YR8/4
F2D5YR4/4
VFS
OSG
MIL
WA
WA
.7
1.6
❑ Boring 0
❑ Boring
® Pa Ground surface elev. _ ft. Depth to limiting factor
Snil Aenl liration Rate I
Dominant Color
Munsell
❑ Boring #
❑ Boring
❑ Ph Ground surface elev. _ ft. Depth to limiting factor_ in.
Anil Annl Ir tinn Rnfw I
Effluent 01 = BOD, > 30 s 220 mg/L and TSS > 30 s 150 m91L ' Effluent #2 = BOD, > 30 s 220 mg/L and TSS > 30 s 150 mg/L
Wo6ee,
CHECK BOX AS APPLICABLE.
❑ SOIL EVALUATION
SITE MAP
PROJECT NAME:
HEINBUCH/MYER
CHECK BOX AS APPLICABLE.
Scale: V = 40' ❑ SYSTEM PAGE 2 OF
0 40 60 60
PLOT PLAN
(re n grLd) I ID' DESIGN FLOW- 600 GPD
Attach design flow calculations for commercial plans.
PROJECT ADDRESS
157TH ST
Pipe Material / ASTM Standard (Tables 384.30-36 384.30-5)
BM Symbol +}r
BM ElevalKm 100 FT
N
Sanitary S- l
BM Daecnplon
TOP OF FENCE POST N. P1L
Face Main /
Slope
Teems �a I%)
Well Symbol la appiluble): p
Indian- noon by
drew��g.-
o�m..Pwaam.��ro.
IMPORTANT.
Show ground elevation contours at suitable intervals.
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