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Home My WebLink About018-2007-18-000Wisconsin 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 Kha Vang TOWN OF HAMMOND CST BM Elev: Insp. BM Elev: BM Description: CX 4a ✓A �ae o C � • TANK INFORMATION TYPE MANUFACTURER CAPACITY I Septic koLescp- k 2-M /ft q4- Dosing L�-7 << Aeratio Holdi TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Septic r r Dosing t 3 �- �S Aeratio Holding PUMP/SIPHON INFORMATION Manufacturer Demand GPM Model Number TDH Lift Friction o�ss� System Head4-5-s� TDH Ft �'�� ;L S'-.2 Forcemain Length I Dia. N Dist. to Well (�D 1 2 1 nL SOIL ABSORPTION SYSTEM ELEVATION DATA County: St. Croix Sanitary Permit No: 651235 State Plan ID No: PWTS - 072301362-C Parcel Tax No: 018-2007-18-000 Section/Town/Range/Map No: 05.29.17.957 STATION BS H I FS ELEV. Benchmark Alt. BM Bldg. Sewer r St/Ht Inlet ,d ro C 3z' � St/Ht Outlet Dt Inlet Dt Bottom Header/Man. ,r R,r `T J c 16 Dist. Pipe 1?7-jq / Bot. System C Final Grade l r w`% Zri St Cover ` � � 2 • � �D% f 6rct �7-2D / odc, 5-- �AiSf teJ� (ef .a1�) 4? -°l $ Li3-oq= 4f) RD.o,6 BED/TRENCH DIMENSIONS Width I Length t No. Of PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth SETBACK INFORMATION SYSTEM TO P/ B L D G WELL LAKE/STREAM LEACHING CHAMBER OR UNIT Man cturer: Type Of System: A+_C:XM4& I A0 eIL r � � 1 � Model- umber: DISTRIBUTION SYSTEM Header/Ma o d Distribution x Hole Size x Hole Spacing Vent to Air Intake r� Pipe(s) I 1Z U Length Dia Length Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil ❑ Yes No ❑ Yes No OMM NT : , (includ code discrepencies, persons present, etc.) Inspection #1: 10 20�3 Inspection #2: `oXq�2� %�If4— Je i� (49vc-,6 NOUX-) UL Location: 1659 115TH AVE 1.) Alt BM Description = C � l� 2.B1 sewer= dg se eZ, D �r r - r 4*-6X - amount of cover = & bfl ��^^^ `f z n. Lwjx� • [o Ifeaek tw 5 Plan revision Required? V 23 I,Z Use other side for additiona mation. / ate f sepctor's Sig a90:;� ert.��Si SBD-6710 (R.3/97) (^ ^ ' [�U'oice i °� S 1iA D , -WE 10 County Depai-tinent of Safety JUL 11 2023 St. Croix & PI-Ofessional. Services ....... I 'ermit Nunibcr to k- filled 'it 1)), Co,) I sam(fary I I t I , I Industry Set -vices Division S. Croix County i�v npv�ninrr .1orr r)., ....__.1 23 State Transaction Nonil)er Sanitary Permit Application In accordance with SPS 383.21(2), Wis, Adni, Code, submission of this form to the appropriate governineMal unit Fuyrs- 0�23013(02—eo, is require(] prior to ObL31111lig a sanitary permit, Note: Application fornis for state-owticd POWTS aresubriii((ed to P ro.j c c t Address (if d I ffe runi. t h an mailing 11iddress)- the Departinent of Safety and Professional Services, Persollal jilt'(), 11)ation you provide may be used for secondaty ptirposes in accordance with t11.e'11dWWy1.L0Wt s, 15,04(l)(m), Stak; 1659 115th ave I. A )V1ticatJon Information — Please 1`,rh.it All Jiff(ln11111011 Prr�l)crty Owner"s Name Paul fl Kha C Van g 018-2007-18-000 Property 0«vfier's Mailing Address Property Location 23273 vintage st nw cjty� state Zip CC)& Phone Numlier. GovL Lot SW V, ne 14, Se0oll 0 St Francis Mn 55070 11. T pe of Building (�I*Jk all that a Ply) Lot # y pp 1 —E. or V-1, I or 2 I"ani i I y Dwe I I i ng - Number o f Be droonis 4 18 Nanie Public/Ctn oniercial -Describe Urm sc Block 4 F-a-V _ejW Ridoe El 0 City of Ell State Owned - Describe Use CSM Number 0 Village of -� _.._____ o,rown of hammond Ill. J')Ipe of POWTS Permit: (Check either' "New" or "Replacement" and other applicable on line A. Check one b'O:'x on Iiiii.e B. Cornplete line CJf A, New System F1 f�ephlcernent sys(cill U 0111cf-Modification to Existing systeill (explain) E Additional Pretreati-nent. Unit (explain❑ ) Holding Tank El In -Ground At -Grade ❑ Mound 0 Individual Site Desig n ❑El Other Typ-e (explain) (conventional) C. Ej Renewal Before FJJ Revision Change of 111uniber El Transfer to New ONY11.0- I .1st Provinus Pcrinit Number- mid Date Issued Expiration e I and lt&wniatiow Design Flow (g -1)' -4 1) Design Soil Applic, figii Rate(gpd/sf) Dispeissal Area Required (,Sf) DispeN, al Area Proposed (so Sys-lerr Capacity in Total 11 of Tank Information Ciallorts Gallons Units U New Tan U ,ks E'x I s t fi,, i T a i i ks 49 CO U SePI ic 01 HoldingTank X 1200 WIESER x Nnsif)g Chumbel T -J X X 800 17 V ....... JZeNponsibilityStaternent- 1, the undlersigued, assume responsibility for installation of the POW'TS show n on the attached plans., I'lunibur's Name (Print) Plumber" IN411IMPRS Number Flusincss P I . lone Null-l-bcr PAUL R KOEHLER 225410 7152462660 Plurnbcr's AddrCSS (Street, City, .State, Zip Code) 321 WISCONSIN DR NEW RICHMOND 54017 Approved 01 Duisa )roved Pernift Fee Date Issued Issiling A clit signature grove" $ 0 �on for Dunial �n for Dc Cr/� Z condiLions df Appr( Nt,- T:41 ) tlhmasum IM SYSTEM OWNER: 3) Alt LA, DSPS CAa- 11. Septic tank, effluent filter and dispersal cell[t\ must be serviced / maintained as per (,��i�2 management plan provided by plumber. 2. All setback requirements must be maintained as per applicable code / ordinances. Attach to coinjilete plans for the system and submi(to the ('ollilty only 011 papel. not less thall 9 112x I I inches in size ,MD-6398 (R. 03/22) Wastewater .. ME= APPLICATIONS Specifically designed for the following uses: • Homes, Farms, Trailer Courts, Motels, Schools, Hospitals, Industry, Effluent Systems SPECIFICATIONS Pump • Solids handling capabilities: W maximum. • Discharge size: 2" NPT. • Capacities: up to 140 GPM. ■ Tota I heads: up to 128 feet TDH. ■ Temperature: 1040F (40"C) continuous, 140°F (60°C) intermittent. • See order numbers on reverse side for specific HP, voltage, phase and RPM's available. MOTORS • Fully submerged in high-grade turbine oil for lubri- cation and efficient heat transfer. • Class B insulation on --11Ix HP models. • Class F insulation on 2 HP models. Single phase (60 Hz): Is Capacitor start motors for maximum starting torque. • Built-in overload with automatic reset. METERS FEET 40- ��- 35 � 0 25 U Q 20 Z } 15 R 10 5 0 PAGE 2 • S.JTOW or STOW severe duty oil and water resistant power cords. ■ '/3 -- 1 HP models have NEMA three prong grounding plugs. • 1 1/2 HP and larger units have bare lead cord ends, Three phase (60 Hz): • Class 10 overload protection must be provided in separately ordered starter unit. • STOW power cords all have bare lead cord ends. • Designed for Continuous operation: Pump ratings are within the motor manufacturer's recommended working limits, can be operated continuously with- out damage when fully submerged. • Bearings: Upper and lower heavy duty ball bearing construction. • Power Cable: Severe duty rated, oil and water resis- tant. Epoxy seal on motor end provides secondary moisture barrier in case of outer jacket damage and to prevent oil wicking. Standard cord is 20'. Option- al lengths are available. • o-ring: Assures positive sealing against contami- nants and oil leakage. AGENCY LISTINGS cTested to UL 778 and CSA 22.2 108 Standards By Canadian Standards Association File #LR38549 us ,0 GPM n3/h r Wisconsin Department of Safety and Professional Services Division of Industry Services 4822 Madison Yards Way PO Box 7302 Madison, W I 53707 July 11, 2023 OUST ID NO.: 225410 PAUL R KOEHLER 321 WI SCONSIN DR NEW RICHMOND, WI 54017 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 07/11/2025 MUNICIPALITY: TOWN OF HAMMOND ST. CROIX COUNTY SITE: DERRICK VANE 1659 115TH AVE HAMMOND WI, WI 54015 SW 1 /4 NE 1 /4 SEC 05 T 29 R 17W FOR: Design Wastewater Flow Value: 600 Bedrooms: 4 Limiting Factor(s): 40" Maintenance Required: Effluent Filter Phone: 608-266.2112 Web: http:lldsps; -vyioy Email: dspsLy�wisconsin.,,ov Tony Evers, Governor Dan Hereth, Secretary Identification Numbers Plan Review No.: PWTS-072301362-C Application No.: DIS-062329128 Site ID No.: SIT-117905 .Please refer. to all identif cation numbers in each correspondence with the Department. Conditionally APPROVED ❑EPT_ OF SAFETY AND PROFESSIONAL SERVICES DIVISION OF INDUSTRY SERVICES 211t4lt. 414t SEE CORRESPONDENCE At -Grade Component Manual - Version 3.0 (May 2022-2027) Pressure Distribution Component Manual - Version 2.1 (May 2022-2027) SITE R.E UIR.EMENTS • A full size copy of the approved plans, specifications, and this letter shall be on -site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. A Department electronic stamp and signature shall be on the plans which are used at the job site for construction. The following conditions shall be met during construction or installation and prior to occupancy or use: • Preserve dispersal area prior and during construction to avoid disturbance, compaction and use of the site. • With new construction; it is recommended not to activate the pump in the dose tank until the tanks are pumped prior to homeowner occupancy. • Wastewater generated from contractors cleaning of equipment and tools and/or left over construction products shall not be discharged into the drains discharging to the private onsite wastewater treatment system (POWTS). 'Waste generated shall be properly disposed of on -site or off site. • Any tall grasses, leaves and shrubs shall be cut short and removed prior to tilling the surface for installation to prevent matting under the dispersal area. All loose organic material to be removed from POWTS Dispersal Area. ■ Divert surface water from all POWTS Areas. ■ Prior to construction of the dispersal area, check the moisture content of the soil to a depth of 8 inches. Smearing and compacting of wet soil will result in reducing the infiltration capacity of the soil. Proper soil moisture content can be determined by rolling a soil sample between the hands. If it rolls into a 114- inch wire, the site is too wet to prepare. If it crumbles, site preparation can proceed. If the site is too wet to prepare, do not proceed until it dries. • All piping shall conform to SPS Table 384.30-3 and SPS Table 384.30-5 ■ Insulate building sewer beyond 30 feet per SPS 382.30 (11)(c) ■ Well setbacks to meet chs. NR 811 & 812 • Tanli Installation to follow all manufacture's recommendations. ■ Verify property line(s) prior to installation. • Pump Floats to be set and verified per approved plan. Any changes may result in pump resizing to meet TDH and GPM Specifications, 40 Areas that are occupied with rock fragriients, tree roots, stumps and moulders reduce the aniount of soil a-%,ailable for proper treatment. If no other site is available, trees in the basal area of the mound inust be cut off at ground level. A larger fell area is necessary when any of the above conditions are encountered, to provide sufficient infiltrative area. OWNER RESPONSIBILITIES • The current owner, and each subsequent owner, shall receive a copy of this letter including instructions relating to proper use and maintenance of the system. Owners shall receive a copy of the appropriate operation and maintenance manual and/or owner's manual for the POWTS described in this approval and Wis. Admin. Code SPS 383.54(1T}}. ■ In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approved plans. The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. This system is to be constructed and located in accordance with the enclosed approved plans and with any component rnanual(s) referenced above. Tile owner, as defined in chapter 1.01.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, stats. All permits required by the state or the local municipality shall be obtained prior to commencement of construction/installation/operation. In granting this approval, the Division of Industry Services reserves the right to require changes or additions, should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. The Division does not take responsibility for the design or construction of the reviewed items. Inquiries concerning this correspondence may be made to me at the contact information listed below, or at the address oil this letterhead. Sincerely, Fee Required: $250.00 Fee Received: $250.00 ,:{,�{►. Balance Due: $0.00 Tim Vander Leest Refund Expected: $0.00 POWTS Plan Reviewer Division of industry Services Phone: 608-5I6-6I34 Email: tim.vanderleest@wiscojisin.gov Conditionally APPROVED DEPT. OF SAFETY AND PROFESSIONAL. SERVICES DIVISION OF INDUSTRY SERVICES •srq f/ rr^4r sC s SEE CORRESPONDENCE RESIDENTIAL AT -GRADE DESIGN Pressurized -Sloping Site INDEX AND TITLE SHEET Project Derrick 1 Van Owner KhaVang Address 23273 vintage street nw St Francis MN 55070 Legal Description nw 1 14 se 1 14 sec 05 t29n r1 7w Township .Hammond County 5t Croix Subdivision Name Farm View Ride Lot No. 18 Parcel ID Number 018-2007-18-000 Plan Transaction Number Index sheet Calculations At -grade drawings Laterals and dose tank Specifications Management & contingency plan Designer PAUL R KOEHLER License Number Signature . ..._ .. e Phan Number Gate 06/23/23 Page 1 Page 2 Page 3 Page 4 Page 5 Page 6 NIP 225410 715--246-2660 Designed pursuant to: At -grade Component Manual Ver. 2.0 for POWTS SBD-10854-P (N. 03107, R. 01/12), and both SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST -- SAS (01 /81) and Pressure Distribution Component Manual Ver. 2.0 SBD-10700-P (N. 011011 R. 10112) Version TO (11!12) Page I of 6 PRESSURIZED AT -GRADE DESIGN At -grade Design Worksheet -Sloping Site Flows and Site Data Entry. (r or c) r Residential or commercial? 400.0 Estimated wastewater flow (g pd ) 600.0 Design wastewater flow (gpd) 12.00 % Site slope 96.00 Contour elev. below lateral (ft) 36.00 Depth to limiting factor (in) 0.60 In -situ soil application rate (gpolft"2) Distribution Cell Information (1 or 2) -1 Influent wastewater quality 4.50 Linear loading rate gpd/ft 7.50 Effective absorption width (ft) 7.50 Max. effective width permitted (ft) 134.00 Aggregate length (ft) Pressure Distribution Data Entry (c or e) c Center or end lateral connection 2 Number of laterals 0-156 - - - Orifice diameter (in) e.g. 0.25 Not a final calculation 2.00 Estimated orifice spacing (ft) 2.00 Forcemain diameter (in) 3.74 Forcemain flow velocity (ft/sec) 60.00 Forcemain length (ft) 85.00 Pump tank elevation (ft) 4.55 System head (ft) x 1.3 fl 10.58 Vertical lift (ft) Friction loss (ft) 1.68 0.50 In -line Filter Loss (ft) 17.31 Total dynamic head (ft) Designer must select one lateral diameter Lateral Diameter Selection Pipe diameter design options Design choice 1 in 1.25 in 1.5 in X X 2 in X 3 in x y or n Does forcemain drain back? y or n Are laterals at highest point? NA 9.8 Forcemain, drainback (gal) 60.5 5x Lateral void volume (gal) 70.3 Minimum dose volume (gal) 36.61 System demand (9pm) Gallons/inch Calculator (optional) 1000 Total Tank Capacity (gal) Total Working Liquid Depth (in) ............... Gal/in (enter result in cell G46) Treatment Tank Information 1200ISeetic tangy parity (gal) WIESER Manufacturer Effluent Filter Information Dose Tank Information POLY LOCK Filter manufacturer 800.0 Dose tank capacity (gal) FILTER Filter model number 22.2 dose tank volume (gal/in) . . . ...............-.- ..... WIESER Manufacturer Project: Derrick / Vang Transaction Number: Page 2 of 6 AT -GRADE PLAN VIE a� 1/6 B observation pipes ( typical) A 7. ft D B 'I34.QD ft I r, IL 1 l6 B 22.33 ft C K ti L.]if'JYi]♦ •C{ Y sip -}•` n`,.f'�- C ............. <r •+w ry; r.<. r ft { f •[${ 1 fr '< ; h {` S y i i i r t R.r s;}; rL T i! w i C• r P i rt} V•Y{ iix r< r+< +t6 k �kr isr t t 5ro►./ {/�} 0. ] �• • it n ] >- L i C r e F � = [ + 5 a. T r ; � r < ' ! [ L i• .' • i ; ] ,• y �... k r P r .. ....... .. - ft • 5 E 2.00 ft: . . ........... L 1 44.90 ft D g W 19.5D t A x B 1000.90 tt^2 L Gap Typical obs. pipe. 9'[•; < b ° }'' = Total aggregate cell A x B Slotted in the lower 6" and 4i> 1 Plowed area L x W anchored securely. lu 611 Svnthetic fabric cover Lateral invert elev. 96.50 ft Surface contour and system elevation AT -GRADE doss SECTION _91.19-1 ft Finished grade elevation .` < t . K , � f Y C � � i � ' < • 4 � ! < 6 < t [ [ r'a ��/yY f/,/J�. {�rY e lk �fa^a"a'tiAdL r'; `rY F'Sitk -��; 4 .fir �fJ �- 12 in. topsoil and subsoil over aggregate and tapered to toes. e in. aggregate below pipes), and 2 in, above pipe. •-- observation pipe at aggregate toe t r+ �e e ,r12 % Slope D Plowed layer below L x w Project: Derrick 1 Vang Transaction Dumber: Page 3 of 16 PRESSURE DISTRIBUTION AND DOSE TANK Lateral Diagram - Center Connection ......... ... ..... ........ . ....... ........... . ............. . . . . .. ... . ..... - -- Laterals 14 foroe main of PVC Soh 40 Last hole drilled next to end cap per SP `able 384.30 Holes drilled on t he bottom of the Iateral, equally.spaced 6 =Turn-upvdballvolveoraleanoutplug Lateral Specifications et 2 0.156 Orifice diameter (in) Center Lateral connection point X 1.97 Orifice spacing (ft) 2 Number laterals 34 Orifices/lateral P 66.00 Lateral length (ft) 18.31 Lat, discharge rate (gpm) 1.50 Lateral diameter (in) 2.00 Forcemain diameter (in) 36.6 Sys. discharge rate (gpm) ..._...... 60.00 Forcemain Length (ft) 17.31 TDH (ft) Typical Pump Chamber Layout Final grade Approved manhole cover with Weather-proof � warning label and locking device junction box Tank component is properly vented Electrical as per NEC 300 and SPS 316.300 WAC C xarr � B E C 0 p Totals Inches Gallons 19.9 441.1 2.0 44.4 3.2 70.3 11.0 244.2 36.11300.D Tank full A Alarm on Pump on 85, 92 C Pump off D 3" Reddirtg under tarok 1W GOCLDS Pump manufacturer EPOS Pump model number Project: Derrick 1 Vang Transaction Number: 4" disconnect Alternate outlet location 18" min, Approved .. L . J outlet joint Provide 1 f4" weep hole or antisiphon device. 4 55.00 ft SJ ROMBUS Alarm manufacturer PS PATROL Alarm model number Page 4 of 6 At rode �_vstem Maintenance and Operat.ion,Specifications Service Provider's Name Phone POWTS Regulator's Name COUNTRY SIDE PLUMBING Phone 715-246-2660 S stern Flow and Load Parameters Design Flow - Peak 600 gpd Maximum Influent Particle Size 1/8 in Estimated Flow - Average 400 gpd Maximum BOD5 220 mg/L Septic Tank Capacity 1200 gal Maximum TSS 150 mg/L Soil Absorption Component Size 1000.0 ft2 Maximum FOG 30 mg/L Type of Wastewater Domestic Maximum Fecal Colifo rm > I 0 E4 cful1 00 m L Septic and Pump Tanl� Effluent Filtet Pump and Control Alarrr Pressure Systerr Mounc Other Service Fre�L_uen�� i Inspect and/or service once eve 3 years Inspect and clean at least once every 3 years Test once eve 3 years Should test month) Laterals should be flushed and_pressure tested every1.5 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 SPS 384.30-1, have a watertight cap, and are secured in as shown in the at -grade component manual. 2. Dispersal cell aggregate conforms to SPS 384.30 (6)(i), Wis. Adm. Code. 3. All gravity and pressure piping materials conform to the requirements in SPS 384, Wis. Adm. Code. 4. Tillage of the basal area is accomplished with a mold board or chisel plow. 5. The 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 compaction. 7. All other construction details are as per the at -grade component manual SBD-10854-P (N. 03/07). Lateral Turn -tip Detail Finished ••�++++e...+++�` s z ++e+++,++s�+++, Grade P i 4,} S } .• L i •�> L - L > i r i> i�- i a Threaded Cleanout 6- 8" Diameter Lawn Sprinkler Valve Box } L . , . e A ' •Y Y �' °. Plug or Ball Valve Y S' • 5 �- i q -- 1' L, .. 4 e� ` e e�♦ 1 a i 1• t } e >> e > F a L T" a 1 + Y> rr h 1 4 •k L' a s > Distribution s • + � a s a } Lion Sweep 00 or Two 4 15e ree Bends Sate 96.50 ft Diameler as Lateral Project: Derrick 1 Vang Transaction Number: Page 5 of 6 At -grade System Management Plan Pursuant to SPS 333,54, leis. Adm, Code General This system shall be operated in accordance with SPS 382-384 Mils. Adm, Code, and shall maintained in accordance with its' component manuals SBD- 10854-P (N. 03107, R. 01112), SSWIVIP Pub. 9.6 (01/81), and Pressure Distribution Component Manual Ver. 2.0 SBD-10706 (N. 01101, R. 10/12)] and local or state rules pertaining to system maintenance and maintenance reporting. No one should ever enter a septic or pump tank since dangerous gases may be present that could cause death. Septic and pump tank abandonment shall be in accordance with SPS 383.331 Wis. Adm. Code when the tanks are no longer used as POvVTS components, Septic or pump tank manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 8-inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into a tank or component. septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Stats. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code, The operating condition of the septic tank and outlet filter shall be assessed at least once every 3 years by inspection. The outlet filter shall be cleaned as necessary to ensure proper operation. The filter cartridge should not be removed unless provisions are made to retain solids in the tank that may slough off the filter when removed from its enclosure. If the filter is equipped with an alarm, the filter shall be serviced if the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an impending continuous alarm. The septic tank shall have its contents removed when the volume of sludge and scum in the tank exceeds 113 the liquid volume of the tank. If the contents of the tank are not removed at the time of a triennial assessment, maintenance personnel shall advise the owner of when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank. The addition of biological or chemical additives to enhance septic tank performance is generally not required. However, if such products are used they shall be approved for septic tank use by the Department of Commerce. Pure The pump (dosing) tank shall be inspected at least once every 3 years. Ali switches, alarms, and pumps shall be tested to verify proper operation. If an effluent filter is installed within the tank it shall be inspected and serviced as necessary. At- rade and.l ressure stelbutlari S stern No trees or shrubs should be planted on the at -grade. Plantings may be made around the at -grade's perimeter, and the at -grade shall be seeded and mulched as necessary to prevent erosion and to provide some protection from frost penetration, Traffic (other than for vegetative maintenance) on the at -grade is not recommended since soil compaction may hinder aeration of the infiltrative surface within the mound and snow compaction in the winter will promote frost penetration. Cold weather installations (October -February) dictate that the at - grade be heavily mulched as protection from freezing. Influent quality into the at -grade system may not exceed 220 mg/L BOD5, 150 mg/L TSS, and 30 mg1L FOG for septic tank effluent or 30 mg�L BOD5, 30 mg/L TSS, 10 mgfL FOG, and 104 cfuf100 mL for highly treated effluent. Influent flow may not exceed maximum design flow spec'fi in the permit for this installation. The pressure distribution system is provided with a flushing point at the end of each lateral, and it is recommended that each lateral be flushed of accumulated solids at least once every 18 months. When a pressure'tdst is perfort -ed it should be com- red to the initial test when the system was installed to determine if orifice clogging has occurred and if orifice cleaning is required to maintain equal distribution within the dispersal cell. Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the owner, and any levels above 4 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring. ContingeLioy Plat If the septic tank or any of its components become defective the tank er component shall be repaired or replaced to keep the system In proper operating condition. if t d+ shag tank, pump; pump controls, alarm or related firing becomes defective the defective component(s) shall be immediately repaired or replaced with a component of the same or equal perfdrni rice, If the 'a4rade:compon n fAIIs to accept wastewater or begins to. discharge wastewater to the ground surface, it will be repaired or replaced in its' present location by increasing basal area if toe leakage occurs or by renovating the biologically clogged absorption and dispersal media, installing new piping, and replacing 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 regulator and service provider. Project: Derrick 1 Vang Transaction Number: Page 6 of 6 YM, i�ati�rs Zabel' & r'Z'Sfe-ViatEf 't i Es' fS `t. A Devi ion of PoVOK he. PL--525 Filter PL-525 Effluent Filter '1"he PLw-525 Filter is rated for 10,000 GPD (gallons per day) making it one of the largest filters in its class. It has 525 linear feet of 1116" filtration slots. Like the Polylok PL-122, the Poly lok PL-525 has an automatic shut-off ball histalled. with every f.iIter. When the filter is reinoved for cleani1-rg, the ball will float up acid temporarily shut- off the system so the effluent won't leave the tank. i. Features: • Rated for 1.0,000 GPD (gallons per day). * 525 linear feet of 1/16" filtration. • Accepts 4" and. 6" SCHD 40 pipe. . built in uas deflector. * Automatic shut-off ball when filter. is .removed.. a Alarm accessibility. * Accepts PVC extension handle. PL--525 Installation.: Ideal for residential and commercial waste flows pup to 10,000 gallons per day (GPD). . Locate the outlet of the septic tank. 2. Remove the tank cover and pump tank if necessaiAr. 3. Glue the filter housing to the 4" or 6" outlet pipe, If the filter is not centered under the access opening use a Polylok Extend & L-ok or piece of pipe to center filter. 4. Insert the PL-525 filter into its housing,. 5. Replace and secure the septic tank cover, PL--525 Maintenance: The PL--525 Effluent Filters will operate efficiently for several years under normal conditions before requiring cleaning. It is recommended that the filter be cleaned every time the tank is pumped, or at least every three years. If the installed filter contains an optional alarm, the owner will be notified by an alarn-i when the falter needs servicing. Servicing should be done by a certified septic tank pumper or installer. 1. Locate the outlet of the septic tank. 2. Remove tank cover and pump tank if necessary. 3. Do not use plumbbig when filter is removed, 4. Pull PL-525 cartridge out: of the housing, ..5. Hose off filter ove14 the septic tank. Make sure all solids fall. back into septic tank. 6. Insert the filter cartridge back into the housing inaking sure the fil ter is properly aligned kind completely inserted. 7. Replace and secure septic tank cover. /16",' FiltratiC L.I06,0(00 G •n-i Switch lionall -1cepts 1." PVC tension Handy Rated foi- 1 525 Linear Ft. of 1. / 16" Filtration Slots Polylok, Inc. 3 Fairfield Blvd. Wallingford, CT 0649? Toll Free: 877.765.9565 Fax: 203.284.8514 xvw�v.polylok.coili Wastewater ("') METERS FFPr I S 8 7 Z u 6 4 5 q 4 H O � 3 z 1 0. 9 rn3/h CAPACITY MODIEL INFORMATION Order Number Minimum: HP Volts Amps Circuit Float Phase Switch Card Discharge i',Ilinimurn Minimum Minimum �asinMaximum Shipping Breaker Style Length Connection On Level Off i eel Basin Diameter Solids Weight _ Sipe fbs.k 9 EP0411 Plug 1 No Switch 106 Manual Manual 2019.1 EP0411 A Piggyback 1 . 115 12 20 Wide -Angle 10, 1 f1 660 21 19.5 EP0411 F Plug 1 .4 No Switch 20' Manual Manual 20191 EP041 IAC Piggyback / Wide -Angle 201 12" 6" 21 19.5 EP0412 230, 10 .l Plug 1 No Switch 10' 1 f�" Manual Manual 15" 3/�" 20/9.1 EP0412F Plug / No Switch 20, Manual Manual 20 / 9.1 EP0511 F Plug 1 201 115 13 20 No Switch Manual Manual 22110 [E :PO11A .5 Piggyback ! Wide -Angle 20, 12" '� 23 / 10.4 EP0512F 230 6.5 10 Plug 1 No Switch 20, Manual Manual 22110 PAGE 3 13'- 8 - - -- ----------- fs� ( I -,-4" CAST- CAST -A -SEAL 11� v4 6 I oi 1- FILTER OR BAFFLE .. .. .. ...... 4"" VENT - - -------------------- - -------- ou Q 0- n -j. -PUMP PAD IME YIEW WLP1200 800- M R TANK SPECIFICATIONS 0 a_ CL DIMENSIONS: uj WALL.- S), cl- 0- BOTTOM- 3" COVER. 6 uj .MANHOLE.24!' I.D. PRECAST CONCRETE RISER < H E I G H T: 53 LENG7 H: 1.3:-o WDTH-R 8 f. off BELOW INLET-- 41 E LIQUID LEVEL. 3,6" WE) GH -R, BOTTOM 14,800 LBS. co COVER 8,170 LBS. it 0 INLET AND OUTLET: 4" CAST A -SEAL BOOT OR EQUAL GASKET INLET AND OUTLET BAFFLE AND FILTER: o cn x 0 n WSCONSIN, SEE DETAIL #10 0 (OTHER STATES SEE CHART) r- NI, LIQUID CAPACITY: 33.46 GAL/IN (SEPTIC) 22.24 GAL/IN (PUMP) LOADING DESIGN: 8*-0" UNSATURATED SOIL co I U) TANK CAN BE USED AS: SEPTIC / HOLDING / PUMP OR SIPHON COVER: MIX DESIGN #8 (NO FIBER) Cc) co TANK: MIX DESIGN #9 (SMALL FIBER) CUSTOMIZED TANKS: FOR CUSTOM TANKS CONTACT WESER CONCRETE REVIEWED BY REVIEW DATE ............................ SHEET NO, OF TANKS ARE MANUFACTURED TO MEET OR EXCEED ASTM C-1227 REQUIREMENTS R OWTS OWNER'S MANUAL & MANAGEMENT FLAN Page of I � FILE INFORMATION Owner Kha Vang Permit # DESIGN PARAMETERS Number of Bedrooms 4 ❑ NA Number of Public Facility Units Xl NA Estimated flow (average) 450 gallda Design flow (peak), (Estimated x 1.5) 600 gal/day Soli Application Rate ¢0 gavdaylftl Standard Influent/Effluent Quality Monthly average* Fats, Oil & Grease (FOG) Sao mg/L Biochemical Oxygen Demand (BODE) S220 mg/L ❑ NA Total Suspended Solids (TSS) S150 mg/L Pretreated Effluent Quality Monthly average Biochemical Oxygen Demand (BODr) S30 mg/L Total Suspended Solids (TSS) Sao mg1L ❑ NA Fecal Coliform (geometric mean) Sl0'4 cfu/100ml Maximum Effluent Particle Size Ya in dia, ❑ NA Other; ❑ NA *Values typical for domestic wastewater and septic tank effluent. MAINTENANCE SCHEDULE SYSTEM SPECIFICATIONS Septic Tank Capacity 1200 gal ❑ NA Septic Tank Manufacturer WIESER ❑ NA Effluent Filter Manufacturer POLY LOCK ❑ NA Effluent Filter Model 525 ❑ NA Pump Tank Capacity 800 gal ❑ NA Pump Tank Manufacturer WI ESER ❑ NA Pump Manufacturer GOULDS ❑ NA Pump Model epo 5 ❑ NA Pretreatment Unit NA ❑ Sand/Gravel Filter ❑ Peat Filter ❑ Mechanical Aeration ❑ Wetland ❑ Disinfection ❑ Other. - Dispersal Cell(s) ❑ NA ❑ In -Ground (gravity) ❑ in -Ground (pressurized) [R At -Grade ❑. Mound ❑ Drip -Line ❑ Other: Other: k ❑ NA Othen ❑ NA Other ❑ NA Service Event Service Frequency Inspect condition of tank(s) At least once every; 3 ❑ month(s) (Maximum 3 years) � year(s) ❑ NA Pump out contents of tank(s) When combined sludge and scum equals one-third (Y) of tank volume 0 NA Inspect dispersal cell(s) R P -- At least once every: 3 ❑ month(s) ((Maximum 3 years) lZ year(g) ❑ NA Clean effluent filter . At least once ewe�..y, . .� ❑ month(s) ..... ......... . year(s) ❑ NA Inspect pump, pump controls &alarm At least once every: 3 Cl month(s) R year(s) 0 NA Flush laterals and pressure test At least once every: .......... i ❑ month(s) AS NEEDED ❑ year(s) ❑ NA Other` At least once every: ❑ month(s) ❑ year(s) Qk NA Other-, IR NA MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications; Master Plumber; Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer; Septage Servicing Operator. Tank inspections must include a visual inspection of the tanks) to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of combined sludge and scum and to check for any back up or ponding of effluent on the ground surface. The dispersal cell(s) shall be visually inspected to 'check the effluent levels in the observation pipes and to check for any ponding of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a failing condition and requires the immediate notification of the local regulatory authority. When the combined accumulation of sludge and scum in any tank equals one-third (Y.) or more of the tank volume, the entire contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113, Wisconsin Administrative Code, All other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment units, and any servicing at intervals of : 'l 2 months, shall be performed by a certified POWTS Maintainer. A service report shall be provided to the local regulatory authority within 10 days of completion of any service event. Pane 7�1_ of START UP AND OPERATION For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or other ,chemicals that may impede the treatment process and/or damage the dispersal cell(s). If high concentrations are detected have the contents of the tank(s) removed by a septage servicing operator prior to use. System start up shall not occur when soil conditions are frozen at the infiltrative surface. During pourer outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will be discharged to the dispersal cell(s) in one large dose, overloading the cell(s) and may result in the backup or surface discharge of effluent, To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to restore normal levels within the pump tank. Do not drive or park vehicles over tanks and dispersal cells. Do not drive or part: over, or otherwise disturb or compact, the area within 15 feet down slope of any mound or at -grade soil absorption area. Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat; foundation drain (sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting products; pesticides, sanitary napkins; tampons; and water softener brine. ABANDONMENT When the POWTS fails and/or is permanently taken out of service the following steps shall be taken to insure that the system is properly and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code: 0 All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator. • After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil, gravel or another inert solid material. CONTINGENCY PLAN If the POWTS fails and cannot be repaired the following measures have been, or,must be taken, to provide a code compliant replacement system: • A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system. The replacement area should be protected from disturbance and compaction and should not be infringed upon by required setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area gill result in the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rules its effect at that time. • A suitable replacement area is not available due to setback and/or soil limitations. Barring advances in POWTS technology a holding tank may be installed as a last resort to replace the failed POWTS. d � . aluat' a: d hg ank El Mound and at -grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time. < < WARNING > > SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND/OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT CAR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLER Name' COUNTRYSIDE PLUMBING Phone 246 2560 -POWTS MAINTAINER Name PAU L R KOEHLER Phone 715 246 2660 SEPTACE SERVIGINC OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name POWERS SEPTIC Phone 715 246 5600 Name G�CpUtil Phone his— 3gCo—Y(P 4YE) This document was drafted in comp3iance with chapter Comm 83.22(2){b}{1 )[d)&ffi and 83.540 ), (2) & (3), Wisconsin Administrative Code. f } Page�.�. of wCs�n , nt of (;. " rce SOIL EVALUATION REPORT 3 i cfGafoty and Build Ns �'iliAdmCode � In acccxdance with COMM 85, s. . '# . ttitnr nit lsnl as int.� [hxe= t flat i Att. �t t4ErcCi Pare 1.D, N lnce.. I t l n t 1 v6h€ (izo.A C retr r1 �t , '- f# t d_ ��ht SW; 6c.�� ot arr�erisir�s' � 6r�: ac�c� t��i��r �n� d��r��$ � r�� t Please print all Informatlop. f s�rCQilcfYrY pt3"at (RnVOgr. p6MrNj ird0"& �n y*u provk1a may ba u� for ropeny silo►) :0*ner s^ r!^'6 w:-7c'*.�sa r...J r4.'t. �. iM � W rp Qf 7 O�- N R C Of W.. 114 S J rED) "� or CSNW Block P p ii.Aftess ,�it�0 x , -'Nearest R Vili4 .� CAY derived designAi _ . p[] Code eri� aw rite Us public or commercial - Desait>e. if a •cabie Parent mate" Flood Plain eievaoon pp l ONUTWO (e=n4*r09CW&11 e, Wing +� Boft # Qv► nd surface etev. Depth to 11MM" faCtGr � Pit Roots Hodizon Depth DotWnant � Redox Texhn Structure �:0 l n rY •Bff#1 `L�.f#2 In. hion a Chit. SL Cont. Flo'Jv// ._ ........ ng gartng # Oath to limtfirrg facW Ground uriace via. . GPDO consistence �R Rex est'ioTexture *� #� o# Homan�► Dominant x irr< t>c#unseu u. Sz. Coont: Or, S� �t�. �- COW Is and TSS � � �� t #1 1300. y 30 � . VO WPO- 30,. SQ �MG& a CST Wnber Nam ( pmt) 22599 Bird Plurtlhin!�, ine, Shaun Bird 715-246-451-6 Te1a hone Number Date Evaluation CvnOucted 08 192nd Ave, NowRichmond, W1 54017 .. Page of Ply OwnerBang SOAV # elev.� Deptf� �irniting fatiar' -- W . Ground isurface -- x{r n Depth .Pitt D minant � Redm Resaription Texwm Struc# Ga i�t� 0091 `EffN2 a Mui Nag ou'. Ss. coat. Wo ...... .. - .. 46 +vj . r a } Veq !!!;7 v APO, C] M�dng gin. Pit Ground auftc* eiov. fL Depth to rimitirg factor d2 . Horgan carit Re; GxL� + Toxue S,ruc.0 e isn&P40% Ot~ Ru�fi� �� Pit Ground surface e#ev. fL &Xing # [I Depth to iinftV tares in. t � #1 SOE _ � 30 E 220 � and TSS >30=150 rfi ' Ef�uent #2 = � 30 T �- r � { ��t o#' ��.�rce is �� 1 t�pp�r�i�Iservice provi��r' ��d tmployef� i�° you nacd $.�i st�cc tb et�ss services or The Dep 1 '"n an AINMato f0�ati pIt-m cc�n�t the department. at 608_256-3151 or ` TY �� -�7� . need rated . sew Soil Test Project Marne P-C, Collova Mrs. Inc. Shaun. Address P.O. Box 489 Air Somerset W1' 54025 �Il #226900 Lot 18 Subdivision Farmy'ew Ridge Cate e/04 1/4 SE 1 /4S 5 T 29 N/R17 W Hammond ... ..� Township E] Boring Q Well PL Property Line, County ST. C Ra I X k�BMorVRp Assume Elevation 100 ft. Tap of Survey iron System Elevation 96..O' * H R pSame as Benchmark Alternate Benchmark To of 112" pipe C& 140.2 i ST. CROI-A'a&OUNTY SANITARY ��OWNERSHIPADDRESS FORMCreated 212021 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 dosob«using the Property Files Scanned vveb|ink. OWNER/BUYER INFORMATION Owner/Buyer e Rok 04 PJ Cai Mailing Address 2.7V3 V'P1.0r4Gt AST- MWO000 City/State/Zip !6r. F-1?**AJcx14S j VU °0 1;7 g o 7 Q Phone Number (required Email Address (required) Parcel Identification Number 619 000 2PD ? 9-- 19 0-&" NEW SYSTEM: LEGAL DESCRIPTION 0 �^ �� PropedvLocation hf ��4;*��\�,Sec��_-TAu��' lq'W, Town of 14 A Subdivision Plat:Ow60Lot #____. Certified Survey Map # Pege# Warranty Deed# before |urne Page Number of bedrooms q Spec house 13 yes 0 no Lot lines identifiable 0 yes 0 no New Property Address OFFICE USE ONLY �cl *~�1� � � /= y/. v�/�~. &e, (Verification ornew address required from Community Development Department for new constmcmon.) This form must besubmitted with all Private OnsiteN/oterTreatment System (PDN/7I) applications. New System: Include with this formorecorded warranty deed from the Register of Deeds Office and ocopy of the certified survey map if reference is made in the warranty deed. Community Development Depadment—LandUse Division 715-386-4680 St. Croix County Government Center 715'24S4250Rm State Bar of Wisconsin Farm 1 -2003 WARRANTY DEED Document Number ii Document Name BY THIS DEED, Matthew John Hamilton, a single person, (hereinafter "Grantor," whether one or more), convey and warrant to Kha C. Vang, , (hereinafter "Grantee," whether one or more), the following described real estate in St. Croix. County, State of Wisconsin; Lot 18, Plat of Farm View Ridge in the Town of Hammond, St, Croix County, Wisconsin. Exception to warranties: easements, restrictions and covenants of record; highway and street rights of way; and Municipal and zoning ordinances and agreements entered under there; and further except real estate taxes accruing in the year of this conveyance. Dateda� yz, //Y SEAL) �tthe ,John �IaMilton AUTHENTICA.TION Signature(s) authenticated on TITLE: MEMBER STATE BAR OF WISCONSIN (If not, authorized by Wis. Stat. § 706.06) THIS INSTRUMENT DRAFTED BY: St. Croix County Abstract & Title Co,, Inc. by Samantha Olson at the direction of the Grantor. 22-S33871 1156703 B ETH PAB ST REGISTER OF DEEDS ST. C ROIX CO., WI RECEIVED FOR RECORD 07/29/2022 02:22 PM EXEMPT#x REC FEE 30.00 TRANS FEE 129.00 PAG ES: 1 **The above recording information verifies that this document has been electronically recorded & returned to the submitter Recording Area Name and Return Address St. Croix County Abstract & Title Co., Inc. 575 N. Knowles Ave., Suite f#B New Richmond, WI 54017 018-2007-18-000 Parcel Identification Number (PIN) This IS NOT homestead property. (SEAL) I \\O�jj I I I I fjjjjjj�/ ACKNOWLEDGMENT � � ,,r `� �� y _j t Or \�(j ' F: STATE OF WIS CONS IN_ +; r .� • . C St, Croix COUNTY �, •.._.:.-��. Personally came before me on the above --named Matthew John Ramilton a sin le Rellsoll to me known to be the person(s) who executed the foregoing inst . in t and acknow edged the same. .f Notary Public, State of Wisconsin My Commission (is permanent) (expires: (Signatures may be authenticated or ackno�Nledged. .Both are not necessary.) NOTE: THIS IS A STANDARD FORM. ANY MODIFICATIONS TO THIS FORM SHOULD BE CLEARLY IDENTIFIED. WARRANTY DEED (D 2003 STATE BAR. OF WISCONSIN FORM NO. 1-2003 * Type naine below signatures. St. Croix County 1156703 Page 1 of 1 ` � of �(�\L \[)N REPORT Pauo_»�_ vwmmomun of commerce EVALUATIONDivis,,"Ijn of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code ECo:untyj 1) rived design flow rate --7-a New Construction Us �5Residential / Number of bedrooms Code de El Public or commercial - Describe: 0 Replacement Flood Plain elevabon if applicable Parent material General ommnents and recommendations: ,.54el' e, Boring Bonng # Pit Ground surface elev. M ;R - Depth to limiting factor —J-6— in. _____Gpo Page of Parcel ID # Property owner [� Baring Boring # - ft. Depth to limiting factor in. Pit Ground surface elev. ❑ Boring Boring # Depth to limiting factor in. ❑ Pit Ground surface elev. - ft�f—SoiLAlication Rate #�edox prescription Texture Structure Consistence Boundary Routs GPDfft� F�onzon Depth Dominant Color *Eff#'i *Eff#2 Qu. 5z. Cont. Color Gr. Sz. Sh. in. Munsell Boring # Boring ❑ Pit Ground surface elev. ft• f Depth to limiting factor in. Effluent #2 = BQD < 30 mg/L and TSS � 30 mglL ' Effluent #1 = BQD. > 30220 mgn. and TSS �30 50 mglL -- • opportunity service provider and employer. if you need assistance to access services or The Department of Commerce �s an equal oppo tY p need material in an alternate format, please contact the department at 648W256-3151 or TTY 608-264-8777. MD-8330 (RAM) Soil TesPlot Plan Project Name P.C. collova Bldrs. Inc. • Sh4a d Address P.O. Box 489 � Somerset wi 54025 C` M #226900 Lot 2 Subdivision Farm View Ridge Date 5I'I/04 NE 114 S E 114 S 5 T 29 NIR 17 W Township Hammond [� Boring 0 well PL Property Line County ST. CROIX BM or VRP Assume Elevation 1 oo ft. Top of Survey Iron System Elevation 99.2$ * H R pSame as Benchmark Alternate Benchmark Top of 112" Pipe @ 100.2' Pro Town Road EASEMENT )TE: W z t 0 00 F ch W o � <[ o Q 0 { I ~ 0 ■ \ / Va to `�v rY Lf l 11VJJ��. A' � 25 C) 1 66514 S.F. �VIICC) 1 S f .53 Ac. ►� 1 f 41 t 3 , C) R C1 24 72161 S.F. co 1 N ' 1.66 Ac. Cl)cw , c� Cli � CO 18 - R 72 S.F. ��1], 1 4r 1.66 Ac. `'� _ 1 28 664 1.5. :>31 .� 17 68999 S.F. � .# 1.58 Ac. <,-, / C/Q) 3/4 p 4" _ A� 35 9VATION S3 2S7 + � 1 .�� 1'�, % / 66591 S.F. 81 '- S.F. '��° 1.53 Ac. - 1.73 Ac. tia� ,a ,`� N 88 3 5 4 E 49 2. tK 1 �` 36. i5399 S.F. / 111321 S.F. 1.50 Ac. / � 2.56 Ac. N 828f s3W 636.09 . : I 1 184.70' 107 nCZ' Wisconsin Department of commerce SOIL EVALUATION REPORT page of Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code County Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must t limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. include, but no and location and distance to nearest road. percent slope, scale or dimensions, north arrow, a Reviewed b Date Please print all Information. 11LPersonal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Property Location Property Owner Govt. Lot 1/4 1/4 S T N R 12 E (or(W P Of Lot Block # Subd. ame or CSM# Property S 2I (2 Mailing Address c3tyState Zip Code Phone Number city E] Village Town Nearest RoYd0 New construction Use. Residential / Number of bedrooms L��Z_ Code derived design flow rate GPD El Replacement Public or commercial - Describe: ft. Flood Plain elevation if applicable Parent material General comments and recommendations: < 01 Boring Boring # pi, Boring # Boring Pit Ground surface elev. Ground surface elev. * Effluent #1 = BOD, > 30 5 ZZU MgIL anU 100 '-Ov Z I -;v 11 FW ` Depth to limiting factor L/I — in. Depth to limiting factor in. cffi, nont ff9 = FkOr) < 30 mcYL and TSS < 30 mg/L oanA C�) Of Property Owner Parcel ID # Ej Boring Y--", Baring # ft, ZL Pit Ground surface elev. De th tQ limiting factor ;n• PEso!L,-aTplication Rate Dominant Color Depth Dvm Redox Description Texture Structure Consistence Boundary I Roots GPDff *Eff#� *Eff#2 ' �Honzon in. Munsell C.�u. Sz. Cant. Color Gr. Sz. Sh........ . . .. . 0-13 U *,\ i - I/ "1 I r !..... qL ..i`� $ 1� Cam- Boring # [� Boring ❑ Pit Ground surface elev. _ - ft. Depth to limiting factor in. Soil qefication Rate Horizon De th Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDff� P *Eff#1 *Eff#2 in. I Munsell Q.U. Sz. Cont., Color Gr. Sz. Sh. [:] Boring Boring # Ground surface elev. ft. Depth to limiting factor in. Sail ..... D Pit on Rate . r x Description Texture Structure Consistence Boundary Roots GPDlfF Horizon Depth Dominant Color Redo P *Eff#1 *Eff#2 in, Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Effluent� 3g r� #1 = BOD- < 220 L and TSS >31 ,� 150 m9A- * Effluent #2 = BQD,5 :S 30 mgk and TSS < 30 mg1L �. ` equal opportunity service provider and employer. 1f you need assistance to access sery The Department of Commerce �s an ices or q pp need material in an alternate format, please contact the department at 608-266-31 S 1 or TTY 608-264-8777. SBD-8330 ('R.610 ) Soil TesPlot Plan Project Name P.C. Collova Bldrs. Inc. Shaun g ,r Address P. 0. Box 489 ff Somerset W1 54025 C ir 0 #226900 'i Lot 18 Subdivision Farm View Ridge Date I8104 Nw 114 SE 1145 5 T 29 NIR17 w Township Hammond E:] Boring 0 Well PL Property Line county ST. C Ro I X IL BM or VRP Assume Elevation 1 oo ft. Top of Survey Iron System Elevation 95.0' * H R pSame as Benchmark Alternate Benchmark Top of 112" Pipe @ 100.2' 1/12 ROOF ROOF VENTS AS REQ'D. VINYL SIDING RIGHT ELEVATION ,/8'•,'-0' II II II II I I dl ocFj pFp I II II II II II II II II II II II II II II II II II � II AS a D.RDOr TS w II II II II I Ij f-----------�I �I II II II II �j Qr II I II II II II I �I II II II II II II II II II n I II II Loo---------JI II I I � II II II II LL �__-- ____= JJ I l N 51RD6 EYE ROOD i�LAN 1/S'•1'-0' 12 7 EDE VINYL SIDING 0 4 4i �L WINDOW WELL (FIELD VERIFY) REAR ELEVATION MAIN LEVEL PLATE HG1 ,` WINDOUI HDR HGT. _ u i 0 f `TOP of MAIN LEVEL SL, 2x10 DECK LEDGER WINDOW WELL WINDOW WELL (FIELD VERIFY) (FIELD VERIFY) LEFT ELEVATION I/S'•1'-0' 9 v bxb CEDAR BRACKET DETAIL ALUMINUM SOFFITS AND FASCIA VINYL SIDING STANARD VINYL CORNER TRIM STONE VENEER w/ STONE CAP 1610x810 O.H. DR. w/ WINDOW LITES NOTEM EXTERIOR DOORS a GARAGE FRONT ELEVATION v4'•1'-0' DOORS ARE REPRESENTATION ONLY. VERIFY EXACT STYLE OF 12% Wr-T. MAIN LEVEL DOORS w/ BUILDER OCOPYRIGHT 2022-2023 NOTICE, ALL RIGHTS RESERVED CROIX DESIGN and DRAFTING, INC. • 3 m DRAM RV.S. CMCMD XX. DAZE. 04/24/2023 &ME, AS NOTED CARD FILE - 23065 SHEET O of 3 REVISIONS XX/><X/XX 000m BY:XX XX/)(X/XX 000w IBY:XX 22'-10' 14'-2' It -0. NOTEM CONIC. PATIO Riau (VERIFY)�, 12'-10' 24'-2' VERIFY ALL MECHANICAL S.-O. EQUIPMENT LOCATIONS, LOCATIONS ON PLAN ARE REPRESENTATION ONLY WINDOW WEL L (FIELD VERI:Y) — — — — — — — — — — L 8, I F .0 2' 6.14. �L -- — — — — — — — — — — — — — — — — - i LkO)AVSLIVER Ej 60 PATIO DOOR 1 '02' S.H. (EGRESS) — — — 11 1 ROOF 66W \ I i I I ROOF -ir 1 11 1 TRUSSES liN, 71 1' I I I IS'FLOOR TRUSSES IS'FLOOR 24' OZ. TRUSSES TRUSSES 'HIM I r uj + 2M. -RINUU LIJ A, .0 1LIVING RM. 2 6 8 10'2xS'4 10UNERS SUE 06 VAULT 5 xMim VAULT 13'roxl4'4 12'-10' 5-3. 3.-9. FUT. FAM1LY:R::M::j 22'SxI(v'II L — — — — —mn rp'-11 ---------- --------- IL j 3: a --- [--- i & - C= "—'�n C4 IN ( 'Oxb'a BYPASS 5 0 I— kw FKT.DP- -------------------- 2X& STUC>s --------- F -- — — — — — — — — — — — — — — — — - - HALF WALL Z4 KITCHEN I P STILIDS TUFNED 304TH Lo A, 13 1I'2xI4'(p m + LF LLR VAULT j ^A 4^A A u ---------- -- 1 2. RANGE per, W/HOOD V-S. I --- N GI 9 ' / I ( R-1.15ATH a LQ im /f if /I F: WASH� DRY Ti ---- 2l' i � I:EN MT1 IR- ------------ 1MECH 10'Ox5'O in IS' FLOOR AUN. 5ATH I A I 0 U VU 4M!�Eos 2--ro IFb F�e Iz' I ----- i4 ---- - L ----- — — — — — — — — — — — — — — — — — — — — — — -- — — ___________ REVISIONS XXnanoc 000m BY:Xx XX/XX/XX 000mm BY:Xx ROOF TRUSSES p oaf KF�J� 24' O.C. p 12 oz=a pw�wp> �� aro}pJ�a u a R4S BLOWN INSULATION w F o d mw oaf T 7w�K 13 Z?a�W W wi 5/8' GYP. BD. lOR EQUAL) wa az q 12 w/ VAPOR BARRIER o CLG. NL=8 ozpa�� L) wiz aQ 24' 24' uN�uoz aON�wN CD� t0� BATH STAIR INFORMATION: o�doo (4)2xl2 STRINGERS(OR EQUAL) 10' TREADS+1' NOSING ~ W p NO RISERS $: a ° a 3/4' TAG 3/4' TAG o 4N. UxN�I,21 18' FLOOR'TRUSSES + 192' O.C. N z ~ 18' FLOOR TRUSSES �uoo�pa zp� 5/8' GYP. BD. (OR EQUAL) ® IS2' O.G. w/ VAPOrq BARRIER ® CLG. ;p = 7L r 0(III IIIIII nrmiw� a III= 9 nazi con x U n O U x0 333 3 1/2' CONC. SLAB 3 0 6 MIL POLY OVER o ti DRAIN 4' THICK LAYER of DRAIN u = 2m' TILE 16' CLEAN AGGREGATE TILE Z F 0 m a CROSS SECTION "A" 1/4'=r-O' z UW O VU ROOF CONSTRUCTION: • PREMANUFACTURED ROOF TRUSSES - I/12 ROOF ENGINEERED BY SUPPLIER - SLOPES VARY - SEE PLAN • R49 BLOWN FIBERGLASS INSULATION • IA50 ROOF VENT AT SOFFITS, 1/150 VENT AT RIDGE 2' ROOF TRUSd =6 ROOF TRU S 2. • AIR CHUTE AT EACH TRUSS SPACE 24' C. ®24' C. • 15/32' ROOF SHEATHING • ISO ROOFING FELT • ICE A WATER MEMBRANE APPLIED 24' PAST EXTERIOR WALL • ASPHALT SHINGLES 2' SOFFIT / FASCIA: R4S SLOW •2x6 SUB -FASCIA IN ATI • ALUMINUM FASCIA COVER • ALUMINUM VENTED SOFFIT 5/8' GYP. BD. (OR EQUAL) WALL CONSTRUCTION: f� w/ VAPOR BARRIER m CLG. • HOUSE WRAP fE • 1/16' OSB SHEATHING Q • WINDOWS PER SPECS. •-2F.G. IBATT INSULATION 1/ M0 POLYRETARDER s GARAGE LAUN. HALL OUJNERS SUITE � � • 1/2' GYPSUMPSUM BOARD _@ RIM AREA CONSTRUCTION: • CLOSED CELL SPRAYED FOAM INSUL. R20 (MINIMUM) * RIM AREA AND R30 3/4' TAG (MINIMUM) • CANTS. J I U iA SILL CONSTRUCTION: 4' CONC. SLAB IS' FLOOR TRUSSES 5/8' GYP. BD. OR EQUAL) • 2x8 SILL PLATE A SEALER IS2' O.G. w/ VAPOR BA IER ®CLG. • 1/2, ANCHOR BOLTS * 48' O.G. FILL AS REQ'D. — — _ STAIR INFORMATION: FOUNDATION CONSTRUCTION: r (4)2x12 STRINGERS(OR EQUAL) III • POURED CONCRETE WALL FOUNDATION s o I0' TREADS+1' NOSING C —III= 0 (WALL THICKNESS VARIES, SEE FOUNDATION RISERS PLAN FOR SIZESJ r ,n III FOUNDATION INSULATION: -FOUNDATION EXTERIOR- 2' R-10 RIGID FOAM BOARD INSULATION 3 1/2' CONC. SLAB -FOUNDATION INTERIOR- 1' R-5 o b MIL POLY OVER o RIGID FOAM BOARD INSULATION DRAIN 4' THICK LAYER of DRAIN r0 "20-TILE CLEAN AGGREGATE TILE 16' SLAB CONSTRUCTION: • 3 1/2' POURED CONCRETE FLOOR • b MIL POLY VAPOR RETARDER UNDER SLAB • UNIFORM LAYER OF 3/4' CLEAN AGGRIGATE 4' THICK (MINIMUM) SHEET CROSS SECT ION 11531/4'•I'-0' • SAND FILL AS REQUIRED O OF3 CARD FILE' 23065 ir Ara *P-A y. UO I X C 0 U N TY Noe..�3� RON . ........... ... .. ... . ... ML /to " T L=j -AL'k� 11'j V V -,t-V-IL- i 0 wl"'N" r E R �� V N) �, / 1! 1 A48. f� 7 D►�/ [�117.Y►[a PLUMBER r',4,ut_. �DE�tLE2 LIC.# TOWN "O"k F 1-F ,4v�nw�.o ti.0 „�Q- AUTn P RIZED ISSUING OFFICER TiVIS PERMIT EXPIRES SBD-06499 (RI 1/20) ONE x CHAPTER 145.135 (2) WISCONSIN STATUTES (a) The purpose of the sanitary permit is to allow installation of the private sewage system described in the permit. (b) The approval of the sanitary permit is based on regulations in force on the date of approval. (c) The sanitary permit is valid and may be renewed for a specified period. (d) Changed regulations will not impair the validity of a sanitary permit. (e) Renewal of the sanitary permit will be based on regulations in force at the time renewal is sought, and that changed regulations may impede renewal. (f) The sanitary permit is transferable. History: 1977 c. 168; 1979 c. 34,221; 1981 c. 314 Note: 1f you wish to renew the permit, or transfer ownership of the permit, please contact the county authority. D.1?j5?,3 . .. . .. ......... . . ...... : : .%:.: - . ... .. ............. .... ....... . ..... ..... .. . .. ..