HomeMy WebLinkAbout032-1095-70-015Wisconsin 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-
CADE & CANDACE LEFEBER
City Village Township
TOWN OF SOMERSET
CST BM Elev-
Insp. BM Elev-
BM Description -
TANK INFORMATION
TYPE
MANUFACTURER
CAPACITY
Septic
Dosing
-75-D
Aer
(( II
Holdi
j I I I
91 I M+e A \i ✓t2
TANK SETBACK INFORMATION
TANK TO
P/L
WELL
BLDG.
Vent to Air Intake
ROAD
Septic
Dosing
U
Aeratio _
Hold'
PUMP/SIPHON INFORMATION
Manufacturer
La, 20 C L
Deman
l'�R_
GPM
`,�
13
Model Number
2 7
TDH
Lift r
Friction Loss
System Head
TDH Ft
)4.0
1 1. -+O
1 3. 2!�- 1
/19 f"75
Forcemain
Length
Dia.
Dist. to Well
r�
SOIL ABSORPTION SYSTEM
ELEVATION DATA
County- St. Croix
Sanitary Permit No-
648477
State Plan ID No -
Parcel Tax No-
032-1095-70-015
Section/Town/Range/Map No:
2 7.31.19.444A-15
STATION
BS
HI
FS
ELEV.
Benchmark
�
Alt. BM
SE coRwitf T e P� F^,IOPA O �4t� gaA�C
Bldg. Sewer
r
?0.00
St/Ht Inlet
j
tr
nlet -
Dt Bottom
13 �
g � j
Header/Man.
lqd
?3.3r'
Dist. Pipe
1� D
Bot. System
OO s�
2.20
gd�
Tina Grade
w-% << be Q.-F 12 `+
cotylr
310.
St Cover
1.5
%-�5
f-, e 10/11 1-2o2-.3 iEC
Z
r
`��� Da
BED/TRENCH
Width
Length
No. Of T+efrehes
PIT DIMENSIONS
No. Of Pits
Inside Dia.
Liquid Depth
DIMENSIONS
/
1, .5,0
2, ` S
SETBACK
SYSTEM TO
P/L
BLDG
WELL LAKE/STREAM
I
LEACHING
Manufacturer -
INFORMATION
I
CHAMBER OR
UNIT
C� a r' i
Type Of System:
I yovjv��
�
} lb
~ �'E"'�''�-
"31I� kI
N
L)
Model Number:
DISTRIBUTION SYSTEM
Header/Manifold [
Distribution t tc
Pipe(s) 3. 2�
x Hole Size
''
x Hole Spacing
Vent to Air Intake
.25 2
Di Length a
1
Length Dia Spacing
�
2 �p
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
MN 5NT4: onclucle code discrepencies, persons present, etc.)
Location: 192D C1Y 2P T-
1.) Alt BM Description =
2.) Bldg sewer length = 551
- amount of cover =
Plan revision Required? ❑ Yes No
Use other side for additional information.
SBD-6710 (R.3/97)
Inspection #1: 16 I«(Zoz) svf" Inspection #2: 10/012p23
U��., / P(,.L-r/ w,\k_ VW'A U4
lb oZ�)tU4�_ L
Z,
Date Insepctor's Signature Cert. No.
Z rl
CHUCK BOX AS APPLICABLE
S-01L EVALUATION
SITE MAP
PROJECT NAME:
LEFEBER
PROJECT ADDRESS.
C-TH I
Scab;, 1" 40'
40 60 80
2-
(10 ft grid) Cry
CHECK CIOX AS) APPLICARE,
SYSTEM PAGE 2 OF
PLAT PLAN
flow: _L12L GPD
Attach des,!gn How ccalcul,36oms, for commercial plans,
Pipe,Mate3dni / ASTM Standard (Tables 384.30-3 & 384.30-,lj)
Bm syllibui, -Iiw
Hivi Elevation-100
1- or AA I i
BM Dc!;criplion:
MED. PINE W/NAIL
ce a I c
Slope Gradient
of Testnd Area.
IMPORTANT
Show ground elevation conlour.,-,- at suitable, intervals
on the rippropritc iim.
COPY
IN
"b
US,
COPY
V
Wisconsin Department ol'Safety and Professional Senices
Division of Industry Smice-s.
4822 Madison Yards Way
PO Box 73021
Madison, W1 53707
May 10, 2023
CUST ID NO.: 824825
BOB J HARDINA
477 170TH AVE
TURTLE LAKE,, WI 54889
CONDITIONAL APPROVAL
PLAN APPROVAL EXPIRES: 05/10/2025
MUNICIPALITY:
TOWN OF SOMERSET
ST. CROIX COUNTY
SITE:
LEFEBER
CTIJ I
SOMERSET, WI 540225
NWINE134,3 I N-R 19
FOR:
Design Wastewater Flow Value: 600
Bedrooms: 4
Limiting Factor(s): 2.241
Maintenance Required: Effluent Filter
S P
Phone: 608-266-21112.
Web: hm-i.
Email: d,r�,_l
Tony Evers, Governor
Dan Hereth, Secretary
Identification Numbers
Plan Review No.: PWTS-05.2300733-C
Application No.: DIS-0423 ) 19912
Site ID No.: SIT-1 1533 )3
Please refer to all identification numbers in each
correspondence with the Department.
Conditionally
APPROVED
DEPT, OF SAFETY AND PROFESSIONAL
SERVICES
DIVISION OF INDUSTRY SERVICES
11 SA
SEE CORRESPONDENCE
Geomat Mound Component Manual - 51118/12
Pressure Distribution Component Manual - Version 2.1 (May 2022-2027)
SITE REQUIREMENTS
0 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 net 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 Arc,(,I.
• Divert surface water from all POWTS Areas.
• Prior to construction of the dispersal area, check the moisture content of the soil to a depth of 8 inches. Smearing and
compacting of wet soil will result in reducing the infiltration capacity of the soil. Proper soil moisture content can be determined
by rolling a soil sample between the hands. If it rolls into a 1/4- inch wire, the site is too wet to prepare. If it crumbles, site
preparation can proceed. If the site is too wet to prepare, do not proceed until it dries.
* All piping shall conform to SPS Table 384.30-3 and SPS Table 384.30-5
* Insulate building sewer beyond 30 feet per SPS 382.30 (1 1)(c)
• Well setbacks to meet chs. NR 811 & 812
• Tank Installation to follow all manufacture's recommendations.
• Verify property line(s) prior to installation.
• Pump Floats to be set and verified per approved plan. Any changes may result in pump resizing to meet TDH and GPM
Specifications.
Areas that are occupied NI 11 mck 1i-LulT ent4. tree roots, stunips ',1116 b0U WC-1'; rct,u-CC IlIC �1111,lt1nt Ot' So)il �IVMIablc 101, 111-011� r
tr � t tr1��•r1t. 11' r1�} c�tl1�•r it�� i� �i� ttilabl�3, tr �'�' inthel��r ai �rr�•a ()1' 111C r11o1.rrld 111USt be Cent 01�1�r_t �r-()U11Ll ICN- •l. A �Gir��r 1`111 az-C�i is
IICCCSS;11X xxi1cr1 ally ot, the ,(1b(.)\,C coli(11'6 11S M-C C11cOr_rr CN(l, to I)YO ILIC SUff-IC IC11t 111 h1tr,.rtiv Orr e"t.
Owner Responsibilities
The current owner, and each subsequent owner, shall receive a copy of this letter including instructions relating to proper use and
maintenance of the system. Owners shall receive a copy of the appropriate operation and maintenance manual and/or owner's
manual for the POWTS described in this approval SPS 383.54(l ).
In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard, the property
owner must follow the contingency plan as described in the approved plans.
OWNER RESPONSIBILITIES
• The current owner, and each subsequent owner, shall receive a copy of this letter including instructions relating to proper use
and maintenance of the system. Owners shall receive a copy of the appropriate operation and maintenance manual and/or
owner's manual for the POWTS described in this approval and Wis. Admin. Code §, SPS 383:
• In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard, the property
owner must follow the contingency plan as described in the approved plans.
The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin
Statutes. The submittal has been CONDITIONALLY APPROVED. This system is to be constructed and located in accordance with
the enclosed approved plans and with any component manual(s) referenced above. The owner, as defined in chapter 101.01(10),
Wisconsin Statutes, is responsible for compliance with all code requirements.
No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, stats.
All permits required by the state or the local municipality shall be obtained prior to commencement of
construction/installation/operation.
In granting this approval, the Division of Industry Services reserves the right to require changes or additions, should conditions arise
making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the
responsibility for designing a safe building, structure, or component. The Division does not take responsibility for the design or
construction of the reviewed items.
Inquiries concerning this correspondence may be made to me at the contact information listed below, or at the address on this
letterhead.
Sincerely, Fee Required: $250.00
Fee Received: $250.00
,# �»j�a� �,C'!'J f Balance Due: $0.00
'
Tim Vander Leest Refund Expected: $0.00
POWTS Plan Reviewer
Division of Industry Services
Phone: 608-516-6134
Email: tim.vanderleestC.bwisconsin.gov
S J'r T 1 C M P N ft- NT rN
np t I o I
conditionally
APPROVED
DEPT. OF SAFETY AND PROFESSIONAL
SERVICES
1� DIVISION OF INDUSTRY SERVICES
j-A'b L C C
L L
SEE CORPESPONDENCE
P o p fc I?. r,
P i-c) I- Add I
owl I
Collil,
S Narne-
Milnit-.,V
Phi)
No.
c-- x I a
C�1 10 titk:
q e
A
0
IS,
I corltif 4:--id I I ef I C N I n
I W\T-)IMA
Ic,)1 I'V.,
VvIl"'J'01
'm lj;.Iji i(i tilt,
,01 Acro") (4!ot'4j, K/lolind will NiL11,111ill (1-AI'lon I
I 0\1 I
t -.4) i0i I
C. Jeomzlt mcmlld 1'. (. 110(:111 1 1 1'
Mound and Pressure Distribution Component Design
Site Information
R Residential or Commercial Design N ISD Required?
400.00 Estimated Wastewater Flow (gpd)
1.50 Peaking Factor (e.g. 1.5 = 150%)
Egg C0 Design Flow (gpd)
2,50 Site Slope (%)
96.00 Installation Contour Line Elevation (ft)
22.00 Depth to Limiting Factor (in)
0.40 In -situ Soil Application Rate (gpd/ft)
100.00 COMOLIF Length Available (ft)
Distribution Cell Information
I 1111�� I ��'j
6.50 Cell Width (ft) 60.00 Designer Input Cell Length (ft)
2.00 Dispersal Cell Design Loading Rate (gpd/W) 1 60 001 Dispersal Cell Length Required (ft)
2 InflUent Wastewater Quality (I or 2)
Pressure Distribution Information
_E
Center or End Manifold
2
Number of Laterals
3.25
Lateral Spacing (ft)
8.97
Forcemain Drainback (gal)
0.50
Forcemain Filter Loss (ft)
2.00
Forcemain Diameter (in)
55-00
Forcemain Length (ft)
89.00
Inside Purnp Tank Elevation (ft)
0.188
Orifice Diameter (1n) (e.g. 0.25)
2.50
Orifice Spacinc (ft)
3.55
System Head (ft) x 1.3
7.91
Vertical Lift (ft)
0
1,16
12,83
Friction Loss (ft)
Total Dynamic Head (ft)
52.76
5x Void Volume (gal)
61.73
Minimum Dose Volume (gal)
31.461
System Demand (gpm)
Diameter Selection
Lateral Diameter Selection
in. dia. options choice
0.75
1.00
1.25
1.50 x x
200 x
3.00 x
Are the laterals the highest point
in the distribution Y
network?
If N above, enter the elevation (ft)
of the highest point.
Does the forcemain drain back? Y
-_]i f t 210 rifice
-Selection --
Manifold Diameter
in. d'ia- options choice
1.25 x
1-50 x x
2.00
3.00
Manufacturer Information
Treatment Tank Information Effluent Filter Information
1200.0,0 Septic Tank Capacity (gal) Lifetime Filter LLG Filter Manufacturer
SKAVV Manufacturer LT 1/8 Filter Model Number
Dose Tank Information Gallons/Inch Calculator ,
754.35 Dose Tank Capacity (gal) 754-35 Total Tank Capacity (gal)
16.05 Dose Tank Volume (gal/in) 47.00 Total Working Liquid Depth (in)
Skaw Precast Manufacturer 1 16 051 gal/in (enter result in cell DoseTankVolurrie)
Project- CADE LEFEBER Page 2 of '12
Mound Plan View
A
L low
Mound Component Dimensions
A 6.50 ft E 3.95 in
B 60,00 ft F 14.50 in
PE— 2.001in G 0.50 ft
390.00 (ft2 ) Dispersal Cell Area
10-00 (gpd/ft) Linear Loading Rate
H 1.00 ft K 7.37 ft
1 18.50 ft L 74.74 ft
1 5.23 ft W 30.23 1 ft
1500.00 (ft2 ) Basal Area Available
6.00 (ft) 1/10 B Obs. Pipe Placement
Mound Gross Section View GeoMat Dispersal Area �AA ��J �
4�r
Observation Pipe
12" ASTM C 33 sand as GeoMat
required for Geo Mat ............................... ......Distribution Cell
component rGeoMat + 12" -1 ASTM C-33 sand
I
98.38 Finish Grade Covet, Material
97.25 Lateral invert Elevation
96-17 Dispersal Cell Slope 2,5
Elevation
Contour Elevation 96.00
Tilled Area
Forcemain
in situ soil
In situ Soil
Shading Key
Topsoil Cap
Subsoil Cap
3 1 ASTM C 33 sand (F)
4 ASTM C 33 sand (D)
5 Tilled Layer
() Geo Mat
See details on page 4 for number, size, and spacing of laterals.
Project- LADE LEFEBER Page 3 of 12
End Connection Lateral Layout Diagram
0 = Turn -up w1ball v.-al-ve or clea nout plug
1st orifice located at z
All orifices point down
p
Laterals & force main of PVC Sch 40 per SPS Table 384.30-51
Number of Laterals 2 Orifice Diameter 0.188 in
Lateral Diameter 1 .50, in Orifice Spacing (X) 2.50, ft
Lateral Length (P) 58.75 ft Orifices per Lateral 24
2
Lateral End (Z) 1.25 ft Orifice Density 8. ft/orifice
13 orifice
Lateral Spacing (S) 3.25 ft Manifold Length 3.25 ft
Lateral Flow Rate 15.73 g prn Manifold Diameter 1.50 in
System Flow Rate 31.4 61 g p In Forcemain Velocity 3.21 Ift/sec
Dose Tank Information
I Ick n wal k IN,
w, p.-1- N1 ( . .011 )
msd SPIN Ito Is11 .fit
1.i I It k.
)IIIi'm 11 wilit.? FoirceniaM dianietei-
2 1 n,
X
M
Sim J Tech Filter
STF 100 1/16 ii
Pump off elevation (ft)
89.33
3lt 17i-dd 11 w In 1(lcr, uln,] W
Dimension
Inches
Gallons
A
37,15
59632
B
2.00
32.10
C
D
Total
3.85
4.00
47.00F
61-73
64.20
754.35
Filter Manufacturer Sim / Tech Filter
Filter Model Number STF100 1/16
Alarm Manufacturer SJE Rhombus
Alarm Model Number AB
Skaw Precast
Capacity
754.35
Volume
E 16.05
Pump Manufacturer Zoeller Company
Pump Model Number BN 152
Pump Must Deliver 31.4619 p rn at 12.83 ft TDH
Dose tank elevation (It)
89.00
gal/inch
Project: CADE LEFEBER Page 4 of *12
W�MAa�D�`�w�'obon�rU�e�b��
Cell xmm/,(vU | ' �`_ bmown//mL',,/(.�
DistrUuUonCell Cnss+smtion&nonnc`nnn�
mum/w/m.p/pevvm`p~s`mc/',icm/ /_./ m./"".sd'�u
nmamnis'"w.*"/with on."vAn,oevkw.pn^Jim Hui onv/",uu,"n~"^`/
DistributiomCoUPlanVicvjiayoux-TypuaX
�oovvum'AUU \ ,^!no_\Cell Lem oo 1300
sn ro"u"lfx/Luu'll Lw" xcwo°"'
^s�m 07 z!
.^'` ^. ..,.^. ,',,�.".' ... M. win Im,.^`
LA MI. u^�rLL.rcocR Kit 'It r
Mound System Maintenance and Operation Specifications
Service Provider's Name Robert Hardina Phone 715-491-5039
POW TS Regulator's Name St Croix County SPIA - Zoning Office Phone (715) 386-4680
System Flow and Load Parameters
Design Flow - Peak 600 gpd
Estimated Flow - Average 400 gpd
Septic Tank Capacity 1200 gal
Soil Absorption Component Size 390 ft
Type of Wastewater. Domestic
Septic and Pump Tank
Effluent Filter
PUMp and Controls
Alarm
Pressure System
Mound
Maximum Influent Particle Size 1/8 in
Service Frequency
Maximum TSS 30 n
Maximum FOG 10 rT
Maximum Fecal Coliform 10E C
Maximum BOD5
30
n-g/L
inspect and/or service once eve 3 years
Inspect and clean as necessary at least once every 3 years
t_
-Test once eve �y 3 ears
S
--Should test periodically
Laterals should be flushed and pressure tested every 3 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 Synergy Systems GeoMat Mound Component Manual Version 1, 2017.
2. Dispersal cell media conforms to GeoMat products approved for use with the Synergy Systems GeoMat Mound Component
Manual Version 1, 2017. Media is covered with an approved geotextile fabric.
3. All gravity and pressure piping materials conform to the requirements in SPS 384. \Nis. Adm. Code.
4, Tillage of the basal area is accomplished with a mold board or chisel plow.
5. The mound structure and other disturbed areas will be seeded and mulched to prevent soil erosion and help reduce frost
penetration.
Lateral Turn -up Detail
.. .... Threaded CleanOUt
6_9" Diameter Finished
lawn Sprinkler Grade Plug or Ball Valve
Box
Oteral Ends 4A Lust 0jr4jjC(! Where
,� __
Long Sweep 90 or Two
45 Degree Bends Same
Diameter C-Is Lateral
V
Distribution Lateral Lateral Cleanout
3 Feet
Project- CADE LEFEBER Page 6 of 12
Mound System Management Plan
Pursuant to SPS 383.54, Wis. Adm. Code
General
This system shall be operated in accordance with SPS 382-84 Wis. Adm. Code, and shall maintained in accordance with its' component
manuals (Synergy Systems L.L.C., Geomat Mound Component Manual version 1, 2017, Pressure Distribution Component Manual Ver. 2.0
SBD-10706-P (N. 01101) and SSWMP Publication 9.6 (01/81)) and local or state rules pertaining to system maintenance and maintenance
reporting.
Septic and pump tank abandonment shall be in accordance with SPS 383.33, Wis. Adm. Code when the tanks are no longer
used as POWTS components.
Septic or pump tank manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings
used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or
subject to failure must be replaced. Exposed access openings greater than 8-inches in diameter shall be secured by an effective locking
device to prevent accidental or unauthorized entry into a tank or component.
Septic Tank
The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, 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 1/3 the liquid volume of the
tank. If the contents of the tank are not removed at the time of a triennial assessment, maintenance personnel shall advise the owner as to
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 Wisconsin Department of Commerce.
Pumo_Tank
The dosing (pump) tank shall be inspected at least once every 3 years. All switches, alarms, and pumps shall be tested to verify proper
operation. If an effluent filter is installed within the tank it shall be inspected and serviced as necessary. If the force main has a weep hole, it
should be noted if it is functional during pump operation, and if not, it should be cleaned.
*****No one should ever enter a septic or dose tank since dangerous gases may be present that could cause death.****
Mound and Pressure Distribution System
No trees or shrubs should be planted on the mound. Plantings may be made around the mound's perimeter, and the mound shall be
seeded and mulched as necessary to prevent erosion and to provide some protection from frost penetration. Traffic (other than for
vegetative maintenance) on the mound is not recommended since soil compaction may hinder aeration of the infiltrative surface within the
mound and snow compaction in the winter will promote frost penetration. Cold weather installations (October -February) dictate that the
mound be heavily mulched as protection from freezing.
Influent quality into the mound system may not exceed 220 mg/L BOD,, 150 mg/L TSS, and 30 mg/L FOG for septic tank effluent or 30
mg/L BOD., 30 mg/L TSS, 10 mg/L FOG, and 104 cfu/100 mL for highly treated effluent. Influent flow may not exceed maximum design flow
specified in the permit for this installation.
The pressure distribution system is provided with a flushing point at the end of each lateral, and it is recommended that each lateral be
flushed of accumulated solids at least once every 3 years. When a pressure test is performed it should be compared to the initial test when
the system was installed to determine if orifice clogging has occurred and if orifice cleaning is required to maintain equal distribution within
the dispersal cell.
Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the owner, and any
levels above 4 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring.
Contingency Plan
If the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep the system in
proper operating condition.
If the dosing tank, pump, pump controls, alarm or related wiring becomes defective the defective component(s) shall be immediately
repaired or replaced with a component of the same or equal performance.
If the mound component fails to accept wastewater or begins to discharge wastewater to the ground surface, it will be repaired or
replaced in its' present location by increasing basal area if toe leakage occurs or by removing biologically clogged absorption and dispersal
media, and related piping, and replacing said components as deemed necessary to bring the system into proper operating condition.
See Page 6 of this plan for the name and telephone number of your local POvvTS regulator and service provider.
Project: CADE LEPEBER Page 7 of 12
PUMP PERPORMANCE CURVE
MODEL 151115,2/15� t
IONS
MI fed q �
WARNING DEATH MAY OCCUR IF TANK IS ENTERED
WITHOUT PROPER EQUIPMENT
NOTE; SEE INNER WALL PHOTO GN THE "EXCLUSIVELY AT SKAW S" PAGE.
3.00
4.00
�27.00� I--27.00� —27.00�� `-
24.00 I 24.00 24.40
5.00�� I �--
1---?6.00- t.pp J
- INLET
r2.D0 2.00
r:
9.00 ` OUTLET
2.00 J 16.00 � 4 lIJGH
4 CH PRESS PRESS
SEAL
SFAL GASKET
GASKET1NSINSTALLED
WHEN POURED FILTER /
8R �FLE
47.00
3.00 J SECTION VIEW OF TANK AND COVER
Model Number: 1200 / 750
Approved for: SEPTIC/SEPTlC,SEPTlC/PUMP,SEPTIC/SIPHON OR HOLDING
Wetght Inlet Dim. Qutlet Dim. -.--I
Liq. Depth Gal. / In. Nom. Cap.
16, 100 lbs. 54 " %50" 47" 16.05 1 754.35 gal.
OUTLETENDVIEW OF TANK
SKAW PREmCAST Phone: (715) 967-2277
26255 1 O5#h Street, New Auburn Toll Free: 1-800-924-8625
Wisconsin 54757 Fax: (715) 967-2707
m, ml.skawpriecast.com
Z rl
CHUCK BOX AS APPLICABLE
S-01L EVALUATION
SITE MAP
PROJECT NAME:
LEFEBER
PROJECT ADDRESS.
C-TH I
Scab;, 1" 40'
40 60 80
2-
(10 ft grid) Cry
CHECK CIOX AS) APPLICARE,
SYSTEM PAGE 2 OF
PLAT PLAN
flow: _L12L GPD
Attach des,!gn How ccalcul,36oms, for commercial plans,
Pipe,Mate3dni / ASTM Standard (Tables 384.30-3 & 384.30-,lj)
Bm syllibui, -Iiw
Hivi Elevation-100
1- or AA I i
BM Dc!;criplion:
MED. PINE W/NAIL
ce a I c
Slope Gradient
of Testnd Area.
IMPORTANT
Show ground elevation conlour.,-,- at suitable, intervals
on the rippropritc iim.
"b
v
IN
FILTER
n.11. I )rivc, I ',ov Ile( 'I I
INSTALLATION:
Toll Friv
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INSTALLATION & SERVICE INSTRUCTIONS
When installing an STF-1001 screw filter into d1schaf9e port of any pump that has a 2" National Pipe Thread.
PUMPS with a smaller discharge port may be adapted to fit. When installing an STF-10OA2 a tailpiece and male
adapter will need to be added to the inlet end of the filter to the desired height and a 2" union will need to bE.
added to the outlet end of the filter. Always install the filters in a position where they can be easily serviced.
*-"Always use caution when starting threads to avoid cross threading". Plumb force main into the 2" sch 80
PVC union. "We recommend that the union remain together during gluing to insure that glue or cleaner does
not ruin 0-ring or sealing SLirface'
SERVICE!
Service of filter screen is dependent on Usage as every systern IS unique. For most residential systems we
recommend inspecting the filter within the first year to determine the necessary service intervals for the filter. In
high volume systems we recommend inspection within the first 6 months to determine necessary service
intervals for the filter. Once the service interval is determined it should be consistent Unless something changes
in the system. Always inspect the filter screen for any damage or corrosion and replace if necessary. If our
STF-1 01 service alarm switch has been installed and adjusted properly it will alarm when the filter requires
service. It should be serviced no less than when periodic pumping of the septic tank and pump chamber is
performed. Servicing will be more frequent if using any one Of our optional filter socks (600 micron, 150-190
micron, and 100 micron). Check your local health department for septic system servicing recornmenclations.
If the screen becomes clogged before the periodic pumping requirements, a high level alarm or light will
indicate the need for set -vice. If system is equipped with a "pump on light" that stays on longer than normal, this
also may indicate a need to service filter.
To service filter screen, unscrew the 4 11 cap. Pull filter screen from canister and wash out thoroughly in
appropriate location with proper protection. In some cases an additional filter screen allows quicker service
allowing the dirty filter to be wasli(--:d later at the shop. Note that in cold conditions the filter cap may be difficult
to remove. Keep the filter in a warin area or pour warm water over the cap before removing. Once the filter is
installed in the tat* it maintains a stable temperahire and removing the cap will not be a problem.
If the system is equipped with our Service Alarm Switch, the filter screen does not need service Until the
Service Alarm Switch activates ra light or audio alarm. We still recommend that the filter be inspected once a
year for damage or corrosion.
NOTE- The total dynarnic head loss of the system must be increased by 0.5 feet of head to overcome friction
loss through the filter.
SERVICE ALARM SWITCH
The alarm switch is available in three pressure ranges, low head, medial-11 head, and high head. Installation
is simple, on SIM/TECH FILTER systerns, remove 1/`4" plug from base of filter chaniber and connect tube fitting.
Next, run the tube up into the tank riser and connect to service alarm switch. The alarm switch is fastened to
the side of the riser via the nylon strap provided. Run alarm wire to alarm box. The service alarri switch can be
wired with its own alarm or with the high water alarm.
Pressure adjustment is made by removing the end plug, and inserting the 7/32 allen. Clockwise increases
pressure. One turn cqLIOIS approximately 3 PSI. The low bead alarm switch comos factory preset at 8 PSI and
is completely field adjustable within it's range (3 to 24 PSI). We recommend the use of a ball valve when using
an alarm switch. Once you have installed the filter and alai -in switch, the ball valve can be closed off to simulate
a plugged filter so that you can make sere the alarm switch is working correctly.
*"**TRY OUR LID/SCREEN REMOVAL WRENCH. Our wrench holds filter lid firmly and hooks
screen for easy removal and installation. Made, of PVC plastic.
111stall"tholl scl-vicc Instructiolls.doc
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InsTalfation and Maintenance Instructions
4
Installation
'Step I Div fit the filter case onto the outlet pipe god to the drain fietd. Ensure it Is c4fitered directly on the
access opaning. (if outlat rApe is already In a fined position, additional pipe may need to be We 6)
Stop 2 If UU11Y.Ing the additional single We support asid the ttojo bottom sopports: WMIt"'A' the Cq3e
N sitill dry fit to the outlez pipe,, measure and cut V'scheoUle 40 pvc pipe to the Ic-nTjth neodod to extend froni the
hubs that are pile-moided 111to the case to tie b1de wall and the Inside flooF of tank. salt' ntvxjd I)Ipe unto tile
hubs that are pre -molded onto the case.
stop 3 solvent vield tlie case to the otiven p(pe. Inscrt the filter cartridge into vic case pressft down an t1to
oirWdge vintlfl IC loclks Into 13(am at the bottom 0( cuse-,.
SCC-p 4 If U1101agr a verft-al read S,AIM W (nsvt switch Into the hole pro-trialdud Iwo the top of the fitter, Pecz
Strlb,laht down until It locks Into plixe
1) Remove the ncce% lid of the tank. Note: To ensure undesirable solids do not mk the tank and Into the
dFaM fieldo the tank should be pursiped ont until the level of effluent is below the outlet level of 11W =110
2) To remove the fliter cartridge from the WtuT �Dse, ptall up flnWV on the bandle of the cartridor dislodphio
it from ti,iecase, '(If uttlizing a vertical read 5wltch, removal of svMr-h is optional)
3) using an oldittary aarden hose, rMse the fliter cartrldge ensuring till vMble septage. material Is rematted.
4) Place Me biker c4rtrldga back Into the filter case pressing down on [lbe cartridge unill It locl(s Into 1)face,
5� Plate the access lid bold onto tile tank ensuring It Is seculT, M-, jV
FE B CA "0 14
Mfoliffie filter 11C %A101'rasts till! nucry.111 ba trot of wlwwractutliio alld %M1m1Rw,;WP dtfotm durinu 1101mai Vism., (6t thelleTtO11 of
fte the ofwnal 1UY614ser Crt,1115 VIC Product. LIfetiMe fiftewt W111 MVIdO tl f0j)tacrment filtar hi rim imint thit tha oricinaf f6ur vias
ul 1401-Malf0d during the 1113011auan 01 to thh produtt aus2d hyaceftlani, i'Mr3wroo not
be CMred tmdar thIl vlarrafllVo IMPMPM CM Or malfunctions resuMne from Product aet being hmtaflK cparated or nialinlaIRW
properiv will void tift wmmnly. LifeUM0 f4ter mume-o" tIG respnelbifty for labor c-linges, ramoval Ousts, 4astaRfAlon or other
Irld[Injitt of C0113nqUfflthl C05M
Ohm; 002-M-22%
Cantu',
ST. C ROt,.:. -0u;vTY SANITARY SYSTEM File #:
Office Use Only
�� ��" OWNERSHIP/ADDRESS FORM Created 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
do so by using the Property Files Scanned weblink.
OWNER/BUYER INFORMATION
Owner/Buyer CADE LEFEBER
Mailing Address 208 WILLOW ST
City/State/Zip SOMERSET WI 5025
2- L-)i,".
Phone Number (equired) Aq
C
Email Address (required) L "I LC-EE ft,�g ec 0
Parcel Identification Number 032-1 o95r7o--&t5% c9 it)
(found on the property tax bill)
Property Location NW 'A 1
Subdivision Plat-
NEW SYSTEM: LEGAL DESCRIPTION
NE 1/4 ,Sec. 34 -1 T 31 —N R 19 W, Town of SOMERSET
Certified Survey Map #3.0-6699-0324H9 -Poc r. 11q15'j-
Warranty Deed #
Number of bedrooms 4
New Property Address
(Staff Initials)
, Lot #
volume 2 Page44-64�
(before 2006)Volume Page#
Spec house 13 yes N no Lot lines identifiable N yes 0 no
OFFICE USE ONLY
o C T Y 0 Z5,--
(Verification of new address required from Community Development Department for new construction.)
2 12 o 2-,?
(Date)
This form must be submitted with all Private Onsite Water Treatment System (POWTS) applications.
New System: Include with this form a recorded warranty deed from the Register of Deeds Office and a copy of the certified
survey map if reference is made in the warranty deed.
Community Development Department — Land Use Division
715-386-4680 St. Croix County Government Center
1101 Carmichael Road, Hudson, Wl 54016
715-245-4250 Fax
Www.SCCW1.a0V
State Bar Of Wi , sconsin Form - -2003
Document Nunniber WARRANTYKED
Document NgIlle
THIS DEED' made between John
MOntPeti:t and .1<ej M.
-MontPetit Trust
and Cade Lefeber and End ('Grantor," whether one or More),
Aber
("Grantee," Miethej- olle car more).
Grantor, for a valtiabic cansidoration, conv(�ys to Grantee the folJowing
t
described real estate, togethpr wi' h,the rents, profits, fixtures and other
appurtenant interests, in Croix
County, State of
Wisconsin ("Property") (if More, Space,is'.Tleeded, please attach uddcnduni):
.;Lot I Of Certified curve
Cart�fied.Su . rve y Map recorded in V01, 32 of
Y MaPP, J?aqQ 7172, as Doc. No. 1158157
located in.the sWI/4
S81/4 and in the sEl/4. SWI/4- 'of
Sec. 27-T31HAMR19W,
bein'g par.t of zot I Of Cer-tif;Led
Survey Map in Vol.
30, Page 6699 as Doc Na,1088850
St. Croix County, Wisconsin. ,
1161334
BETH PABST
REGISTER OF DEEDS
ST. CROIX CO., WI
RECEIVED FOR RECORD
11/18/2022 11:59 AM
EXEMPT#:
REC FEE 30.00
TRANS FEE 402.00
PAGES: 1
"The above recording information
verifies that this document has
been electronically recorded
& returned to the submitter
Recording Area
Namo wid Return Address
Attorney Kriatipa 0gland
Estree'n & Ogland
304 Locust Street
Hudson, W1 54016
Part of 032-1095-70-015
Parcel Idm6rica.tion-Nurnber (PIN'
This is not hoMestcad property.
(Is) (is not)
Grantor Nvarimilts'thAt the title to the Propelly is good, Indefeasible in. fee simple .nd
i' easlamelits, restriction, free and c1car of encunibrances except.,
and rights -of -way of reco%Cd, if any,
Dat
eo'lin L, -Montp-etit, tru tee
(SEAL)
.AUTHENTICATION
S.ig'iikure(s) John L. Montpet.jt
Kell Y-14 t -
—7
Suffictific'Mcd on �
0 land
-2' ai
TITLE: MEMB3—VR STAT BAR OF WISCONSIN
-BA1
authorized by Wis, S
tat, § 706-06)
`ITIISINS7'RUMENT DRAP'tjBD By.
(SEAL)
�n licit �i �T ru `T
ACKNOWLEDGM NT
STATL44OF WISCONSIN
(SEAL) .
)
COUNI*Y)
Personally came before'ine oil
theabove-narned
to me known to be the pe][san(s) who executed the
foregoing instrument and. acknowledged the same,
Krigstina 0gland, E treen & Caland
Hudson.. WT 54o16 Notary Public, State Of Wisconsin
1 n
MYC0'Mnlissio' (is pen-nanent) (expires:
(Sl9n8tures may be-authenticutedOr 4eknowledged.Doffi,tire 1101 accenary.)
NOTE: THIS IS A STANDARD FORM. ANY NIODIril
WARRANTY DEED CATIONS TO Till$ FORM SHOULD W11; CLEARLY IDENTIFIED,
STATE BAR OF WISCOMSIN
'Type namo below sigaall1rej. FORM No, 1-2003
L-strem 31J4 Loctw St Hudson, W1 54016-1667
KjislirA 0&1jnd
Produced W11h Z1P1=afrr0 tvy zjpL0qjX Pharr: 7)S-386.1850 Fax: 715.3B6.6560 MoMpett
18070 PiRcOn hilfo Road, FT810r. Michigan 48026' )MAj-,ij2LQgLx ,g=
St. Croix, County 1161334 Page 1 of 1
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CONTNUOUsIr SHEATHED BRACED WALLS � !
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13' . 0' 40' . 6. 20' - ff 24 - 0'
44 - 0'
a7 -e•
2404 SQ. FT.
MAIN LEVEL
L1�. \ N LEVEL
30 DESIGN LLC
ArthitecturaL Semites
(715)248-3010
NQTICEI
BUILDER TO VERIFY ALL DIMENSIONS,
SIZES, AND LOCATIONS AND REPORT
ANY ERRORS PRIOR TO PROCEEDING.
ALL CONTRACTORSMUSTFAMARM
THfmSELVES WITH ALL FEDERAL =TATE AHD
LOCAL SUILOWO CODES WWGK IN ANY MAMA.
AFFECT MMTERLAl.B OR EQUIPMENT UBRO ON
THIS PRO.fECT. IF NOT SPECIFICALL} STATED ON
PLANS aP w SPECIFICATIONS. THE
APPROPRLRTE CODE SHALL QDYERN SLLE,
QUALITY, AND OUA"TIES AND SLIP Dig ALL
WORK,
Cade & Candyce
Le#eber
Single Story W/ Walkout
MAIN LEVEL
Fir pw rwmw R-240a-3R-44
Do* 1-13-23
Drawn sr BIN
Cn.ek.d ey RYW
A3
Scra lraa = r-0'
',ONTIkLWju5 RW,uf VriJ
12' 1 N1 113 i Y IiIELL 'k US SSE S
ow
TYP OVF,�Hkqk� NAAAFION
MINE V I �,V
YEN t. KNQI 1
Cf r
i F, ' I C, 0 R F.-
F P V k I F
lk, _'F)s il, Srt;- Sl4CF7 ROCK
FZ20 FJBERC-LAS
i Ill (ISF W-7ii EA KW,
-ILWA� T r;WWR POLY VAPOR BARRIER
112�' Sf4jFrT ROCK
QLAIL-1 PEA'[-
WGIV
twWLATiON
2.4 EW RrY WALL.
R 1 1 INSULATION
'qJ' SHEET ROCK
+
j SLAB
I Dt Y VAPOR bARRW R
WIN wf'-i f 2' RKAD INW-A TIO N
I k A.r I, Vi P r4f, L'f
DRAIN IIL
FULL SECTION AT LOCK OUT
F!10` =JAPOR BARRIER
F' rsf4r CODE SHEET HOCK
JI-
FIRE CODE 5HEE T i;OCK
ON ALL 9YAt LE COMMON
W174 i. MNIG ARLA
6AR.46E LIVING
SPACE rI
g* VAPOR EAFWIF.,:
v�" SHEET RCICT.
4- "h la- FLOOR TRUSSES
4W PFA LAW DE CKI?40
R
:PRAY FOAM RW
J07
lq'GREEKTREATE.: PLYWOCILI
FLASHING A-, HFCCMf 0
iCr- &WATER BARRIER
ROCK
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4.
jo.
CCWINUQ�S S�,w�Pi I I f �4,
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GARAGE PARTY WALL DETAIL
i-*f h � ID Ski PLATE
PC Y JAPO R BAJ7 RjER
D4;1IN TILE
MOOF�
Wk" i He DeEw-nplion
Rawoh','V n'h Ro:jq" HeK7}11 Cou"I
NOTE -
A ELGLbLAi
157 - 0"
GLIDER
14' - {r LOW E
4' - 0 Yd- WINE'T.'V 11FOULF DOES NOT INCLUDE
5 -_)14, MARVIN ELEVATE I
"b ELDH426C,
ELGI-6042
7 - 0'
151-01 DBL HUNG LOW E
'_+CoWr__
ANYPATYJCNJORS
T - 'j 114 15' 0 '11p, �MARVIN ELEVATE !2
A, LViLNPOW 7 P�Y 2,ID EXCEPT AS N011E0
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-0
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_0 DRL HUNG '.LOW F
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4 -
4 -1
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18'FLO014 TRUSSES
14' T&U DECKING
7 R (111 NA
F
7RFATEV SR_' F:_A'L
+R',�T WALLS P41 -A
4 F C ':2ED CONC
CON11141JOUS CONCRETE FOOfING
tI' X 1'.d"MIN WITH " RFBAR
STEPPEIDASPFC.' DER GRADE
. 2,� AALX 9V r DLTA I
1i2' = 1 -0,
313 DESIGN LLG
A c -i i ' , e , ' u i � i 5 F" ! . I �
(715)248-3010
NOTICE!
PUil DFR TO VERIFY AlLt DIMF."IONS
517FS AND I OCATIONS AND RFPQRT
ANY ERRORS PRIOR 710 PROCEEC)1.4&
A Li (_�j N -PACTI)=5 VUS' F VIF-IL:1
T- F)AS F' W11-It APFC)F:4A, 4 -4 ANi+
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AFFECI k',.
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AppRr "•vr
D-�
4
-4
--Date
7 -7-i)
Cade & Candyce
Lefeber
Single Story W/ Walkout
SECTIONS
R-2404-3fi-A4
Big
A4
VWV1 S
n fessional Services Page of
Divi Fin fii ustry Services I !W:!
MA SOIL EVALUATION REPORT - C 5 71_2V 1
31
In accordance with SPS 385, Wis. Adm. Code County
Attach tmplet;e3�ite"090"bq 006inot less than 8 1/2 x 11 inches in size. Plan must include, ST CROIX
b u t not I m itigo M iiye rfic�i I Wd; 1i rence point (13M), direction and percent slope, Parcel I.D.
M Ju_s.
scale or ns, nort arrow, and location and distance to nearest road. _7AO CJS7
Please print all information. Reviewed by Dat
7z/� ))6) 2192�
Personal information you provide may be used for secondary OUrooses (Privacv Law s. 15. 4( V1 rn.
Property Owner
CADE LEFEBER
Property Owner's Mailing Address
tt) I C L c
P
City State
f L
Zip Code Phone Number
Property Location ❑
Govt. Lot SE 1/4 SW 1/4 S 27 T 31 N R 19 E (or) VV
Lot # Block # Subd. Name or CSM#
1 VOL 2 PF 461
0 city ❑ Village [] Town Nearest Road
OMERSET CTH I
New Construction Use: ❑ Residential/ Number of bedrooms 4 Code derived design flow rate 600 GPD
El Replacement ❑ Public or commercial — Describe:
Parent material ' OUTWASH v Lo aAm, Q4--c r- c,, Flood Plan elevation if applicable N/A ft,
General comments and recommendations: RECOMMENDED SYS MOUND
Boring # ❑ Boring
Pit Ground surface elev. 95.0 ft. Depth to limiting factor 24 in.
Soil Application Rate
Horizon
Depth
In.
Dominant Color
Munsell
Redox Description
QU Az- Cont. Color
Texture
SIL
Structure
Gr. Sz. Sh.
2MSBK
Consistence
MFR
Boundary
GW
Roots
GPD/Ft2
E ff#2
*Eff#1
1
0-9
1 OYR3/4
-0-
2M
.6
.8
2
3
9-20
20-24
1 OYR5/3
5YR4/6
*04r
-0-
SL
SCL
2MSBK
2MSBK
MFR
MFR
CW
N/A
1 M
N/A
.6
.4
1.0
.6
4
24-48
5YR4/6
C2D 1 OYR6/2
SCL
2MSBK
MFR
N/A
N/A
.4
.6
2 Boring # ❑ Boring
Pit Ground surface elev. 96.0 ft. Depth to limiting factor 23 in.
Boundary Roots
GVV 2M
Soil Application Rate
Horizon
Depth
In.
0-7
7-20
Dominant Color
Munsell
1 OYR3/4
Redox Description
Qu. Az- Cont. Color
*0*
Texture
SIL
Structure
Gr. Sz. Sh.
2MSBK
Consistence
MFR
GPD/Ft"'
*Eff#1 E"2
'6
.6 &__1*1
1
2
1 OYR5/3
*0*
SL
2MSBK
MFR
CVV
1 M
3
20-23
5YR4/6
-0-
SCL
2MSBK
MFR
N/A
N/A
.4
.6
4
23-46
5YR4/6
C2D1 OYR6/2
SCL
2MSBK
MFR
N/A
N/A
.4
.6
Pffh innt fit Q(-)r) '10 < ')?n mnli nnri T(ZCZ 'kf) < I r-.0 rnn/1 pffi, iant:ff?
= Rnn >,in < 99r1 mn/i :;nri TRS > in!!g 150 mn/[
CST Name (Please Print) slqpaare CST Number
ROBERTHARDINA
Address Date Evaluation Conducted Telephone Number
477 170"{ AVE TURTLE LAKE VVI 4/10/23 715-491-5039
SBD-8330 (R04/15)
3 1 Boring # ❑ Boring
El Pit Ground surface elev. 95.5 fL Depth to limiting fa or 22 in.
Cnil bnrnh#---% inn D-3tn
Horizon
Depth
In.
Dominant Color
Munsell
Redox Description
Qu. Az, Cont, Color
Texture
Structure
Gr. Sz. Sh.
Consistence
Boundary
Roots
GPD/Ft2
*Ef##1
*Eff#2
1
0-9
1OYR3/4
-0-
SlL
2MSBK
MFR
GIN
2M
.6
.8
2
9-18
1 OYR5/3
-0-
SL
2MSBK
MFR
CW
1 M
.6
3
4
18-22
5YR4/6
-0-
SCL
2MSBK
MFR
N/A
NIA
.4
.6
22-45
5YR4/6
C2D1OYR6/2
SCL
2MSBK
MFR
N.
NIA
.4
.6
4 Boring # ❑ Boring
Z Pit Ground surface elev. 96.0 ft. Depth to limiting factor 23 in.
Soil Application Rate
GPD/Ft2
Horizon
Depth
In.
Dominant Color
Munsell
Redox Description
Qu. Az. Cont. Color
Texture
Structure
Gr. Sz. Sh.
Consistence
Boundary
Roots
*Eff#1
*Eff#2
1
0-10
1OYR314
-0-
SlL
2MSBK
MFR
GIN
2M
.6
.8
2
10-19
10YR5f3
-0-
SL
SCL
SCL
2MSBK
MFR
Cw
1 F
.6
1.0
.6
3
19-23
5YR4I6
-0-
C2D1OYR6/2
2MSBK
MFR
NIA
NN/A
.4
4
23-46
5YR4/6
2MSBK
MFR
N/A
NIA
.4
.6
ElBoring #
0 Boring
[l Pit Ground surface elev. ft. Depth to limiting factor in.
Soil Application Rate
Horizon
Depth
In.
Dominant Color
Munsell
Redox Description
Qu. Az, Cont. Color
Texture
Structure
Gr, Sz. Sh.
Consistence
Boundary
Roots
GPD/Ft2
*Eff#1
*Eff#2
* Effluent #1 = BOD, > 30 s 220 mg/L and TSS > 30 s 150 mglL ' Effluent #2 = BOD, > 30 s 220 mg/L and TSS > 30 5 150 mg/L
i-� P v.
(,HL("K I'l(A)V, A11111AN.L. k*H[-(,K PDX A', APPIXAOI-L,
SOIL EVALUATION scrilo: 111 4 0' SYSTEM PAGE 2 OF
SITE MAP 40 Go 80
PLOT PLAN
PROJECT NAME: 10 I)F--.'-31(,7N I I 0Y1 GPI)
LEFEBER 202 Attach design flow u"alculations for commercial plims.
Pipe Matonal 'A. -')TM lc_-;t:lrlc4'lrd (Tnhlos 384 30-3 3H'30-5)
CTHI
Bk1l Hov;)fiorl -.-.loo �j N
Force Main
MED. PINE W/NAIL
Irldic;l10 north by IN PORTANIT
C) orilour.s Eit stjitriblc, intervals.
of T#,�Aod Arf,-, i. Sll(-)w ground elovi-ition c
on t1w;IpProprite h—
L
Li
.,.,;„,, , Private Onsite
APPLICATION FOR REVIEW
-i S -Complete all pages- Wastewater Treatment
P
S NOTE, Personal information you provide may be used for secondary purposes
[Privacy Law s. 15.04(1)(m), Stats] Systems
Division of Industry Services
❑ Plans to be E-filed. Provide SharePoint User name below-. For plan status, check our website at
Email technical code questions to
Several counties have been delegated certain authority to review plans in lieu of Division of Industry services. For a current list of those,
counties and their desig t na ion check our website at
1. Project Information - Fill in all known information. Confirmation of assignment to a reviewer.
Project/Site Name-.
Location, Number & Slreel of prqecl td unknown, irdicated nearest road)
Transaction ID:
Previous Related Trans. ID:
Estimated Completion Date:
I Assigned Reviewer:
Legal Description.,
County Assigned Office:
El City 0 Village ❑ Town of
Mail to your office of choice below:
2. After plans are reviewed, please: (check all that apply) LaCrosse, Green Bay
❑ Call customer 1, 2 (circle number)* NOTE: We reserve the right to re -distribute plans to another office if
F1 Requesting party will pick up needed to reasonably balance turnaround times. Check
Mail plans to customer 1, 2 (circle number)* for next available review date
*Refers to customer number from below.
3. Complete the following des ignorlowne r/ req tiesting information. Utilize the check boxes when designer, owner or requesting party is the sarne to
avoid repeating information.
Designer Information (Customer 1)
First Name Last Name
ROBERT HARDINA_
Company Name
HARDINA SEPTIC SYS.
Address
477 1701"
City
TURTLE LAKE
Phone Number
(area code)
DSPS
Customer Number
824825
State Z1p+4 (9 digits)
WI 54889
E-mail address Cell phone
Other Please Specify Below (Customer 2)
DSPS
First Name Last Name
Customer Number
Company Name
Add ress
City State
Zlp+4 (9 digits)
Phone Number E-mail address
Cell phone
(area code)
HARDINASEPTIC2GMAIL.COM 715-491-5039
Check if applicable Check if applicable or specify relationship
❑ Owner 0 Owner El 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 username 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 component manual
app POWTS p ��ring on the _rqg.rarn paqe under Publications
Holmen/Onalaska Area DSPS
Green Bay DSPS
2850 Midwest Dr Ste 104
j 2331 San Luis Place
Onalaska, Wl 54650
Green Bay, WI 54304
608-785-9334
920-492-5601
Fax.- 608-785-9330
Fax 920-492-5604
Email- i
E - w 1, a I . 1�
Make Checks Payable to: Division of Industry Services OR
❑ Check box to invoice designer and sign below
Designer Signature
SBD-1057-7 (R 3119)
TOTAL AMOUNT DUE
Review Code 7633
5. PpWTS SUBMITTAL (check all that apply - incomplete forms may result in processing delays)
0 NEW ❑ Aerobic Treatment Unit(s) ❑ Chlorinator ❑ Tank Replacement Only
❑ REPLACEMENT ❑ Commercial System ❑ UV Disinfection Unit '
❑ Add Effluent Filter
SYSTEM TYPE(S) NOTE: Submit separate sheets for each system if submitting multiple systems on the same site Enter Fee
❑ Revision to previously approved plan $85.00
❑ Miscellaneous Review (i.e. replacement of a septic tank, addition of an effluent filter or pretreatment device to an existing system, etc.) $801hr
❑ Component Manual
All treatment components are previously approved
ElAt-Grade Component Manual - Ver. 2. 0, SBD-10854 (N.03/07, R. 1112)
Design
Wastewater Flow in
under s. SPS 384.10 (2) or (3):
❑ In -ground Component Manual - Ver. 2.0. SBD-10705-P (N.01/01, R 10/12)
0 Mound Component Manual - Ver. 2.0. SBD-10691-P (N.01 /01. R 10/12)
Gallons Per day
1
Design wastewater flow of the proposed system:
❑ Pressure Distribution Component Manual - Ver. 2.0, SBD-10706-P (N.01101, R 10/12)
600
1,000 gpd or less $ 250 00
25D
® Other - Please specify GEO MAT
GPD
1,001 - 2,000 gpd $ 325.00
2,001 - 5,000 gpd $400.00
[] Soil Based Individual Site Design*
One or more treatment components are not
i
previously approved under s. SPS 384.10 (2) or (3):
❑ At Grade
(Individual site design/deviation from component
❑ Non -Pressurized In -ground
Design
manuals and use of components without product
❑ Pressurized In -ground
Wastewater Flow in
approval):
[] Mound
❑ Drip -line
� Gallons Per day
#
Design wastewater flow of the proposed system:
El Constructed Wetlands
GPD
1,000 gpd or less S450.00
* Documentation must be provided to support treatment and dispersal claims. In a separate
1.001 - 2.000 gpd 5600.00
statement, provide rationale for the project and attach supporting documents (code sections, test
2,001 -- 5,000 gpd 5750.00
reports, technical papers, research articles, etc.)
greater than 5,000 gpd $900.00
plus $0.08 for each gallon over 5000 gpd
State-owned facilities:
Design
Holding tanks previously approved under s. SPS
❑ Holding Tank Component Manual, Ver. 2.0, SBD-10855-P (N.03107, R1/12)*
i Wastewater Flow in
384 10 (2)(3)_ Design wastewater flow of the
proposed system:
Gallons Per day
" Non -state owned Commercial and Residential Holding tanks that completely utilize this manual
5,000 gpd or less $ 90.00
and have an estimated daily flow of less than 3000 gallons per day must be submitted to the
GPD
5,001 - 10,.000 gpd $150.00
appropriate governmental unit for review instead of the Department. (see SPS 383.32(3)(a)]
greater than 10,000 gpd $225.00
❑ Holding Tank Individual Site Design", (i.e. site constructed, <5 day holding capacity, Co-
,
Holding tanks including site constructed tanks NOT
mingled wastewater, etc.)
Design
Wastewater Flow in
previously approved under s. SPS 384.10 (2) or (3).
Please specify:
Gallons Per day
Design wastewater flow of the proposed system:
9 p p y
Documentation must be provided to support the rationale for the project. In a separate statement,
less le$18 or 0.00
5,001 - 5,000 gpd or le gpd $18S300.00
please include all code sections, test reports, technical papers, research articles, etc.)
GPD
greater than 10,000 gpd $450.00
�
❑ Soil Saturation Determination Report (using observation pipes) ❑ Interpretive Determination 5240.00
❑ Experimental System (One time additional fee). Submit fee for individual system as per appropriate above system type) Experiment Number 5400.00
Priority Review (enter same amount as normal review fee listed above)
Enter Total Grounded to the nearest dollar) $ 250
SBD-10577 (R 3119)
01
CERTIFIED SURVEY MAP
LOCATED IN PART OF THE SOUTHEAST QUARTER OF THE SOUTHWEST
QUARTER AND PART OF THE SOUTHWEST QUARTER OF THE SOUTHEAST
QUARTER OF SECTION 27., TOWNSHIP 31 NORTH, RANGE 19 WEST.,
TOWN OF SOMERSET, ST. CROIX COUNTY., WISCONSIN;
BEING PART OF LOT 1, CERTIFIED SURVEY MAP, VOLUME 30, PAGE 6699.,
DOCUMENT NUMBER 1088850.
PREPARED FOR:
JOHN & KELLY MONTPETIT
PO BOX 12
SOMERSETo W1 54025
SURVEYOR:
DOUGLAS J. ZAHLER
AUTH CONSULTING & ASSOC.
2920 ENLOE STREET SUITE 101
HUDSON, W1 54016
FIELD WORK COMPLETED:
06/02/2022
SCALE- I INCH = 250 FEET
1!!!5N
250
ENNOW
125 0 250
LEGEND
FOUND COUNTY SECTION CORNER
MONUMENT, AS NOTED
(D
FOUND 1-1/4 INCH OUTSIDE
DIAMETER IRON PIPE
N
FOUND 3/4 INCH DIAMETER IRON BAR
O
SET I INCH OUTSIDE DIAMETER BY IS
INCH LONG IRON PIPE WEIGHING 1.13
LBS. PER LINEAR FOOT
OHWM
ORDINARY HIGH WATER MARK
C. T. H.
L 0 T I C. S. M.
VO L. 2
PG. 461
::3-
L/i r-,J UJ
(i
N 16 '59 J,36"E
98.80 .4
i0I
>I 0—
01
LOT I
3.694 ACRES
N
1158157
BETH PABST
REGISTER OF DEEDS
ST. CROIX CO., WI
RECEIVED FOR RECORD
08/31/2022 10:54 AM
CERTIFIED SURVEY MAP
VOLUME: 32
PAGE: 7172
REC FEE: 30.00
PAGES: 2
06 / 0 11 / "2 12
r-%
0
LAJ V)
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LLJ
= N NORTH i-- as<Ln
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DETAIL A
NOT TO SCALE
UJ UJ
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A R E A --L-O-T 3 L�ArNrVrFZVV^
EASEMENT
140,492 SQ. FT. 0) 66.001 c)
3.225 ACRES
N 8,9'94 9 *5 9 ►OPE CA,
UJ
00,00
b(O
S' LOT 2 LOT01P
tp.\
-V!
Q.) 180,130 PRO OSED oo-
:;Z 4.135 ACRES
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7*H LINE SW 114 000
2289.45358.6 7 395.,30*
M- -
N89*30#05`vw;� IPOND
N891,30"05'W 2648.12* l*47`17"W".1
o P M89"30"13"W 2648.35'p
6
2 C S
Each Parcel shown on this map Is subject to G
- Al
-Z
Cr. State County and Township laws, rules and
regulations (I.e., wetlands, mInfm um lot size, C3 Q.
access to parcel, etc.) Before purchasing or
developing any parcel contact the St. Crolk The properfy dopicted by this n7ap contains areas
County Community Development Department that are subject to the Shoreland Overlay District.
and the Town of Somerset for advice. Addiflonal restrIctlons apply. Contact Community
Development for further information.
7H/S INSTRUMENT WAS DRAFTEO BY.- JLV JOB NO, 7096-009 DAM- DULY 20, 2022, REWSED: AUGUST 1 2022 SHEET 1 OF 2
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SBD-06499 (RI 1/20)
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.
. .. . .. ......... . . ...... : : .%:.: - . ... .. .............
.... .......
........ . . ...