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HomeMy WebLinkAbout026-1290-15-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 538775 0 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: City Village X Township Parcel Tax No: Marek, Todd R. Richmond, Town of 026- 1290 -15 -000 CST BM Elev: Insp. BM Elev: BM Description: Section /Town /Range /Map No / LST 22.30.18.1468 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic (�� p L Z ' /Z56 Benchmark $ f bq. /a b Dosing Alt. BM Bldg. Sewer Holding St /Ht Inlet S. Z 9S• s TANK SETBACK INFORMATION St/Ht Outlet � TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic 216 / AA '5'4 _ _ Dt Bottom 1Z. 1 � / ` Dosing 8'4 S 11 / Header /Man. - , Aeration Dist. Pipe Holding Bot. System PUMP /SIPHON INFORMATION Final Grade 2. 1 1 Manufacturer Demand St Cov� 3.3 ) - Q �Iq GPM t". G O Model Number 15�/ Z 6 6V`(' ! 7. 3 16Af f> 5• `� �• TDH Lig Friction Loss Syste n H ead TDH / t Forcemain Length 1 Dia. ist. to Well - -- 3t� Z AA SOIL ABSORPTION SYSTEM BED /TRENCH Width Length / Ns PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS 1 Z / ,c6 r(L or� SETBACK SYSTEM TO C �.� P/L /rl B T LD_G WELL LAKE /STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR Type f ystem: f / / jJ _ /^ 1 b2 UNIT Model Number _ DISTRIBUTION SYSTEM �IrSQ� �•, Header /Manifold Distribution ( x Hole Lengt Size x Hole Spacing Ve Air In ke ) _/Q Z ` S - - - ,2- 1 Length Dia Length ___L (J 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 COMMENTS (Include code discrepencies, persons present, etc.) Inspection #1: b / 3 / / Inspection #2 / /__ _ Location: 1415 129th Street Ne York, NY 10007 (SE 1/4 SE 1/4 22 T30 R1 8W) Lundy's North Lot 15 4 Parcel No: 22.30.18.1468 1.) Alt BM Description = ! �` CA, 61. P%J 1 2.) Bldg sewer length = Q •7 �- �G��j P/ - amount of cover � ✓� ilk v� a� 3 1�1J - - - - - -- Plan revision Required? Yes No -T II Use other side for additional information. - SBD -6710 (R.3/97) Date Insepctor' Signal Cert No Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 538775 0 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: Personal information you provide may be used for secondary purposes (Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: City Village X Township Parcel Tax No: Marek, Todd R. I Richmond, Town of 026- 1290 -15 -000 CST BM Elev: Insp. BM Elev: BM Description: Section /Town /Range /Map No: 22.30.18.1468 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark Dosing Alt. BM Aeration Bldg. Sewer Holding St/Ht Inlet St/Ht Outlet TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic Dt Bottom Dosing Header /Man, Aeration Dist. Pipe Holding Bot. System Final Grade PUMP /SIPHON INFORMATION Manufacturer Demand St Cover GPM Model Number TDH Lift Friction Loss System Head TDH Ft Forcemain Length Dia. Dist. to Well SOIL ABSORPTION SYSTEM BEDITRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS SETBACK SYSTEM TO P/L BLDG WELL LAKE /STREAM LEACHING Manufacturer: INFORMATION Type Of System: CHA uBER OR Model Number. DISTRIBUTION SYSTEM Header /Manifold Distribution x Hole Size x Hole Spacing Vent to Air Intake Pipe(s) 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 COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / / Inspection #2: / /__ Location: 1415 129th Street New York, NY 10007 (SE 1/4 SE 114 22 T30N R1 8W) Lundy's North Lot 15 Parcel No: 22.30.18.1468 1.) Alt BM Description = 2.) Bldg sewer length = - amount of cover = l - - Plan revision Required? Yes R No Use other side for additional information. Date Insepctor's Signature Cert No SBD -6710 (R.3/97) -^ ccwnrm oe.Wl,g0V ty a uildings Division county — n - - C -- ington Ave., P.O. Box 7162 scr litliallinsirtm entn h Bison, WI 53707 -7162 Sanitary Permit Number (to be filled in by Co.) of Conanairce RECEI ED Sanitary Permit Applie 'on ta Transaction Number In accordance with s. Comm. 83.21(2), Wis. Adm. Code, submission of this to n to the p print ntal /14 ,5S 2- 1 _ unit i:i required prior to obtaining a sanitary permit. Note: Application f Ins for -0 are roject Address (if different th in mailing address) subnyitted to the Department of Commerce. Personal information you pr tide may be used for sec. ry u n +es in accordance with the Privacy Law, s. 15.04(1)(m), Stets. OM COUN /1,� js / ` l � I. A it lication Information - Please Print All I m ItJG & ZO / Property Owner's Naihc 3 Parcel Al 7 - m — dad - O �� t Property Owner's Mailing Address Property Location 2 2 Govt. Lot -8 City, State `` oo Zip Code Phone Number / / � . �,y, V4, Seel ion ' 2 2— I �� 77 (a>i � ��' (OZ7'O O( 1 rcl o L T �_ N ; R - - f / -E�-- i : II. 'Type of Building (cheek all that apply) r W .x 2 Family Dwelling Number of 8edmoR►s _ --- ---- — — Subdivision Name 4 U 1 -- Describe Use -44 i1 �1",�X J�� ❑ City of --- - -- - - -- - U .dale Owned -- Describe Use Number -- - -- ❑ Village of ___ — - - <own of At 111.11 1. ype of Permit: (Check only one box on line A. Complete line B if applicable) A ' ew System ❑ Replacement System U Tteatment/8olding Tank Replacement Only ❑ Other Modification to Exist ng System (explain) B. ❑ Permit Renewal El Permit Revision U Change of Plumber U Permit 'transfer to New List Previous Permit Number a td Date Issued Before Expiration Owner ._ IV„ Type of POWTS (Check A that apply} _ AIT- 7 U Plon- Pressurized In- Ground U Pressurized In- Ground At -Grade U Mound > 24 in. of suitable soil U Mound < 24 in. of suitable soil U holding Tank U Other Dispersal Component (explain)_ _ ❑ Pretreatment Device V. Dispersal/Tr ent Ar ea I nformation: _ _ _ Design Flow (gpd) Design Soil Application R (gpdet) Dispersal Area Required (so persal Area P used (sf) System Elev ition /4� /_�> Vll. Tank Info Capacity in Total # of Manufacturer Gallons Gallons Units g U New Tanks Existing Tanks a o re U in Septic or holding Tank - Dosing Chamber V1 1. Responsibility Statemen I, the undersigned, assuns onsibility for hastallation of the POWTS shown on the attached plans. Piumber's Name (Print) Plumber' ature MP /MFRS Number Business Phone Number Plumber's Address (Street, tty, State, Zip Cod 1 111. Count /De partment Use Only -- -- - -__ -- __ - -- _ -- —__ -- S proved tsa Per / mit Fc Date i ued Issuing nt Signatuner Given Reaso nisi S 6Z ✓ �1 /( _ H, Condi k + #Weawns for Disapproval Ae, -J,,,, - \ Q r L Septic tank, effluent- INter and 3 J fJJ A � � % AP l dispersal cell must all be services / maintained w �-�,,� y yW�,: 'rCMa%CSL as per management plan provided by phanfW, 2. All Setback requiremt>Ms must be maittairted ' 'T Ortl t ti _ Attach to complete plans for the system and sub It to the County on yo paper Kra a B IIE I�che4 yt aiz� r Cj "d3D -6398 (R. 01 /07) Valid thru 01/09 / PLOT PLAN PROJECT Todd Marek ADDRESS P•O. Box 228 New Richmond Wi 54017 SE 1/4 SE 1 /4S 22 /T 30 N/R 18 . W TOWN Richmond COUNTY ST. CROIX SYSTEM ELEVATION 101.0' BEDROOM 4 CONVENTIONAL AT -GRADE XXX CONVENTIONAL LIFT HOLDING TANK 1255 gallons LIFT TANK SIZE DOSE TANK SIZE MOUND SEPTIC TANK SIZE HOLDING TANK SIZE LOAD RATE .6 ABSORPTION AREA 1000 # of chambers none IL BENCHMARK V.R.P. top of survey iron ASSUME ELEVATION loo° Filter BEST GF10 -8 ❑ BOREHOLE O WELL *H. R. P. Same as Benchmark AL 177' Property Line B.M.* Area 15' below system 150' is to remain 99.5' undisturbed 100.5' 3% Slope 1.7 acre lot 101' 6 -3 Scale = 1/4" = 10' 101.5' House is to be a 3 bedroom, but may have a future 30' B -2 B -1 bedroom added in the future Tank is to be properly bedded and provided with Grading is to be done to lockdown covers divert run -off away with approved from system warning labels Hufcutt Combo Tank Well is to meet all setbacks found in Comm. 83 Pro 4 Bedroom 461' Property Line house Ci 129th St. Safety and Buildings commerce.wi. OV 141 NW BARSTOW ST FL 4TH g WAUKESHA WI 53188 -3789 Contact Through Relay 'sc O n s' n www.commer isco sin.go / department of Commerce www.wisconsin.gov Scott Walker, Governor Paul F. Jadin, Secretary May 24, 2011 CUST ID No. 226900 A77'N: POWTS Inspector SHAUN R BIRD ZONING OFFICE BIRD PLUMBING INC ST CROIX COUNTY SPIA 1008 192ND AVE 1101 CARMICHAEL RD NEW RICHMOND WI 54017 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 05/24/2013 Identification Numbers Transaction ID No. 1945521 SITE• Site ID No. 767622 Todd Marek Please refer to both identification numbers, 1415 129TH St above, in all correspondence with the Town of Richmond a en St Croix County SE1 /4, SE1 /4, S22, T30N, R18W Lot: 15, Subdivision: Lundys North FOR: Description: At- grade, 4 bedroom Object Type: POWTS Component Manual Regulated Object ID No.: 1316727 Maintenance required; 600 GPD Flow rate; 40 in Soil minimum depth to limiting factor from original grade; System(s): At -grade Component Manual, Version 2.0, SBD -10854 (N.03/07), Pressure Distribution Component Manual - Version 2.0, SBD - 10706 -P (N.01 /01); Effluent Filter The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. This system is to be constructed and located in accordance with the enclosed approved plans and with any component manual(s) referenced above. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s. 145.06, stats. The following conditions shall be met during construction or installation and prior to occupancy or use: This system is to be constructed and located in accordance with the enclosed approved plans and with the At -grade Component Manual, Version 2.0, SBD -10854 (N.03/07), and the Pressure Distribution Component Manual - Version 2.0, SBD - 10706 -P (N.01 /01) ,,pp The float switch shall be a type that does not contain mercury. 2009 Wisconsin Act 4 pl s(De installation of float switches or relays that contain mercury. Please specify an alte rWr to applying for a sanitary permit. �i� of� ��• • /S�� q The building sewer and distribution network piping shall be of material liste TablhA� , 4 , nd 84.30- 5, Wis. Adm. Code. �� C In the event this soil absorption system or any of its component parts malfunctions so as to a health hazard, the property owner must follow the contingency plan as described in the approved plans. In a dition, the owner must comply with the operation, maintenance and monitoring duties as described in section VIII of the at -grade component manual. A copy of this information must be given to the owner upon completion of the project. SHAUN R BIRD Page 2 5/24/2011 Maintenance information must be given to the owner of the tank explaining that periodic cleaning of the filter is required. Access to the filter for cleaning must be provided per Comm 84 product approval conditions. A Sanitary Permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.135 and 145.19, Wis. Stats. Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stats. Owner Responsibilities: • Comm 83.52 Responsibilities. The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s. Comm 83.54(1). • Comm 83.52(2) A POWTS that is not maintained in accordance with the approved management plan or as required under s. Comm 83.54(4) shall be considered a human health hazard. • Comm 83.55 The owner is responsible for submitting a maintenance verification report acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. A 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. 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 Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter and the POWTS management plan to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Fee Required $ 250.00 Fee Received $ 250.00 Balance Due $ 0.00 Julia Lewis- Osborne POWTS Reviewer 2 , Integrated Services WiS1 TART Code; 7 3 (262) 397 -6005, Fax: (608) 283 -7481 julia.lewis@wisconsin. gov Cover Page Shaun Bird RECEIVED Bird Plumbing Inc. t ' MAY 19 2011 1008 192nd Ave SAFETY & BUILDINGS New Richmond Wi 54017 715- 246 -4516 Date: 5/15/11 Owner: Todd Marek Location:SW1 /4 SW1 /4 S25 T30 N,R18W 1415 129th St. Richmond System type: At -Grade Manuals Used: At -Grade Component Manual version 2.0 SBD 10854 (N. 03/07) Pressure Distribution Manual version 2.0 SBD 10706 -P(N. 01 /01) Page# 1. Cover Page 2. At -Grade Plot Plan 3. At -Grade Cross Section 4. Pipe Cross Section /Pipe Layout 5. Pump Chamber Cross Section 6. Pump Curve 7 -8. Maintance and C nti cy plan 9 -11. Soil test Shaun Bird �. Signaturelg l lL License numb 900 F PLOT PLAN PROJECT Todd Marek ADDRESS P.O. Box 228 New Richmond Wi 54017 SE 1/4 SE 1 /4S 22 /T 30 N/R 18'. W TOWN Richmond COUNTY ST. CROIX SYSTEM ELEVATION 101.0' 4 BEDROOM CONVENTIONAL AT -GRADE XXX CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1255 gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .6 ABSORPTION AREA 1000 # of chambers none IL BENCHMARK V.R.P. top of survey iron ASSUME ELEVATION 100' Filter BEST GF10 -8 ❑ BOREHOLE O WELL *H. R. P. Same as Benchmark B.M. * 177' Property Line 150' Area 15' below system 99.51 is to remain undisturbed 100.5' 3% Slope 1.7' acre lot 101' B-3 101.5' Scale = 1/4" = 10' House is to be a 3 bedroom, 30' but may have a future B-2 bedroom added in the future B -1 Tank is to be properly bedded and Grading is to be done to provided with divert run -off away lockdown covers from system with approved warning labels Hufcutt Combo Tank Well is to meet all setbacks found in Comm. 83 Pro 4 Bedroom 461' Property Line house 129th St. At-grade System Sloping Site Cross Section and Plan V.ew �. i D imens Feet •L ■L■L ■} L•L �,■ L L■L ■L ■L. R o ll ■ • • ■ L ■L ■L■S L•ti,■ ■ • ■' J .r.r �' r r J },l • .J r■ r�" `rL L r }r}� L r L 1 ' ' L J.,Z' LS i� • }1' �.r•r•r r ■r. L L (l {• {�L,L L {•�.. L �L■L L■{•L'• ■L'�L•L {'t { +L.'1, L•� L.�..,ZrL +LTLC�L O N" ;. J•j Jr .f' r rr �' ,�• r•r •.� r r r J• r J• .�' r• .J �• r r• r• . 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Ft Contour � L }, :'' 1 i ■ • i �i��i a}NS '/ O � {i1iSf r'J'J' r' { {g,,� I Iy51 ,ii E 1� D ----- Plowed Surface, Slope Direction GENERAL INSTALLATION: The at -grade area is staked out along the design' contouj . Exist.ing vegetation is mowed and raked off the site. The basal area (L x W) is staked out and plowed with a moldboard or chisel plow. Plowing may not proceed if the soil is wet enough at the plow' depth to form a %4 inch soil wire when a sample is rolled between the palms of the hands. The A x B area. is covered by clean aggregate deposited overhead by a backhoe. Special care must be used when placing the aggregate to minimize compaction of the plowed surface. After the topsoil caf- is placed, the ent :re at -grade is seeded and mulched to promote vegetative groWth, limit erosion and protect from fr -lezing. The observation pipes are perforated in the lower 6 inches and secured in place. 03/051;] Page of Pressure Lateral Layout One Lateral - End Manifold "Threaded j Opt ;;leanm.tt Force Main Lateral Turn -up --► Plug X L Long Sweep 90 Bend Pressure System Construction Distribution Network Specifications Lateral Diameter 2 In. Laterals are constructed of Schedule 4( PVC Orifice Diameter 513 X In. pipe. Orifices are drilled perpendict tar to X Orifice Spacing) In. the pipe with a sharp drill bit and face sown. L Lateral Leng Ft. Lateral turn - ups terminate with a thi ended Force Main Diameter Z In. cleanout plug and are enclosed in a 6 - 1 inch Force Main Length '(� Ft. diameter lawn sprinkler valve box acct ssible from finished grade. ••• '� 0 000••• 0000• Grade 0000 p 6 -8 Inch Lawn Sprinkler Valve Box 03/05 lgj Page _ of Septic-'Dose Wank Cross Section And Pump Performance Specifications 'rank ivl anufacturer Pump Manufacturer _ Tank ] Dumber s Pump Mod Number - . - - - - -- Total Tank C_ apac y , s-, j- 6 �` Alarm Manufacturer t. G tN wQ - - -- Max.: D epth % Alarm Model Number � r..� ✓ Switch Type Filter Manuf acturer T �/ ___ . Total Dynamic Head (TDH)� Feet -- del Num ber (� ' Elevation Head F ilter Mo G Distal. Pressure 3 - s Network Loss Loss y __ M i n imum P ump'erformana e Re quired F orce Main Loss GPMi / S Ft TD To tal Outlet Manhole Min. 4" Above Grade With Manhole Min. 4" Above Grade Locking Device. Inlet Manhole With Locking Device < 6" Below Grade Sealed Watertight Securely Mounted Weather -proof 1 Junction Box, �- Figished Grade mom r -r __0_ r ♦-~ `r asr• nr _ w. Vent Minn. 12" Disconnect Above Grade Means With Vent Cap ,',., . •' >'.. r ! . a ... r a r r . > . > , . r Y Y'ti Y a'Y'!'r r'i r r'r'r'r' s r X . a r;r r.r r putlet Filter Inlet Irilet Baffle .y - - - -- :�: ...--- . -----~ ';,,` - 7 A A X. switch Songs and Reserve Capacity ,,.; , ,• Tank Volume = GPI W eep — Hole < Dimension. , Inches Volum Gal. B I reserve) A! 0 2 4 IS0. — ' : O Elevation C �` .1 ? ;> Ft Bottom (dose) C , > (dead) D _ /5 D Elevation Total Ft '.'�', - r .-r ��rr ��- s'��rTc�rr rs ; s-r-cs-rr� -rY-r- .•; : . 1 . < > 1 •• < > a ' , ` i ♦:•.> `.'1 a ,:`a'<'Ii.:Y r ! , > !� f� r,a,l,,,, ! ai i 1 1 Y,Y Y <', J < ''Y ' i t't l , > s r l { FEE'f 1', >,•' /`t GENEW& INSULLATION: The septicfdose tank is bedded and back filled in aceorditnce with the manufacturer's product approval specifications. Maximum depth of bury as specified by the manufa -,tuner may not be exceedirci without prior approval. Manhole covers exposed to grade have an effective locking device (padlock) installed. Piping at the inlet and outlet is of approved material, connected to the tank with watertight fittings, and laid on stable soil to prevent settling or sagging. The force main is sleeved with 4" Sch. 40 PVC to bridge the tank emavatior and the sleeve is sealed watertight. Electrical service complies with NEC 300 and Comm 16.28. 021/05 Li Page of Sent 8y: HP Lasemlet 3100; 1 715 MG tilf'L! � ;way -a -vo �.:svrwi, ' � "•• 9 F. H1 S ERIES SuMP /EFFLUENT PUMP 11.95 a Bottom, taR oa NOW 9� A681L 1 � t� � IIBi i�I88i M� �� NOW 1lIL � � Node WALk) Oman v a w a OL !IL 13.0 low 76 64 56 41 32 13 8 w 4!x 9 t1 x 1t e� [w a 31M ma Ore 1>s � 55 41 32 Sae 2a . 2a 8.11 x 11M LLM 984!!4 g 9li9 LQXM 4M 280 88 1000 70 fie S?7 811 r itbt tL2$ gm.*# SIM Wm 400 71ti 9k tbA 1000 76 BC 56 41 8P 136 � m AMI—'L lr�9i' OrAPS��������efd1111� ►t�P�lMM01�10' nMW LITERUMMM Ceet4rd Cast Iran 0 1000 2000 3000 M HO .. _Impeller Maid Poly Cerbonare liar Closed Vbm —. _. . to ADS P Cozd SiTW A 73 Nitrite with t A&M end ig Meclwnitatl;iiholl Sea! fec ... Suittletts SS1ee1 - s Fsstt t p 3ltstt Bell Heenngs 0 p p 80 40 60 s0 /�� FLOW- GAI.40N2/xwTE *� �,..�. � WL P JMP pER�p(tMpt4 CE CURVE e � 307 us ban lam!" jW pll 4Off4�41.$u OFm 4a„2s.F B.iaa/e ONE J. - mmv]:L 01601"tpL1MP -CAM 4E� Fam 406RSa- - 07lOs . T PLAN PO'YV"t" OWNER'S MANUAL & MANAGEM� DNS - BPEi�P�� - ..�...� FiLJE YNF TAN 8epdc k. "ran C '� S ma t D NA 00w v 8"00 a ,'� rank DNA. permit #. Iiluetd ' Niarftl w L� S © NA UOwn 0 NSA C1 KA of Pcrresp Tardt 5 . �e DNA mxnbor NA O comawmW vim t rtttnic G a NA . iumv v low (�1rt�Ord Pump Mom D NA to APPS' ° - Prr'b+serbt - p Peat tFOb w M tly aw�raoe © Sari FO 01 -430 � M n ec�at *W D Vlhdle�nd icrdusr� of 13 Obw- /L a1oNd Mom* overmoew II � I (Pir "fl - 11t 8d) p� o wd .<w YnwL 13 in -Ornund (Otis p iWound �Atrg!�ZO TOM* try e.1W dtt1100M1 [ i "WOW FwiGbflibnn Kinchdiaim&W t vatww Berra stna�aaw+r�wwle ti11n �� ! �b8 .« �4�rr tt1A� ibY'0 9aruto� Feeq _.. r e"t 2 13 n wnths s) (M�dtn , .urti s i ris.) awwon of"am S ) At iea6toru�e Y Yns ua�sone- tt*d (Kl oftanli vctum �:� la aYt aon� d tank(*) When corrYbtnsd sludge snd sc e4 Mmctn • Burn 3 Y � *.) Pump d rrionthC ris) a) At least On00 �Y r( tnapeCt d r] n _ _.. At test once even+' Ys) ❑ NA cbern uftw t ftthrr At test onCO Ovary' 3 d rrt °rte Ynsp of puwnp pwap °°r'ti"°1's Q rnon� s) ` At feast oncoe► awry' *) t1 NA Rust+ bNermb. wad W'' 00" fast p nwj'W* 13 Y"K 060r. At � vnas awry Q morYfhs �)rrlada) E3 N^ At bast: =us ewrY YuYArKrBwwcw wS=v=0w ,�� is . m dde by an i ndHi&W ati'f]tliV � of the itoens� C r Y� eYtil t P�urwdm Rem Saar, POW T9 ir1 ' P 1nu* tnCude CM bllGiarru wr+�.111t1t14or Plwttbsr' s VbUai 1nsA�l� ut'tltis tsnfc{e) � idewyAl�' auy �� d scum atfYd m+dfa A far 1Y iwdc. uP � WW ��• Ana ttii uniitrf�u of sh ed k 'a d miC Ufa _ The di:pe Rail e�aiifs) sifatil t rrisu .� ota w m on iher or pifYAWN ., Ulu two any po O( eflitWd of Vw gmund attl Faa of the kai !' a wullw*N,. gn the e1Y� g and teq:yilW tho imm odbtss rX0 Or Ot11111s oak VO ttr"l10.1f Vow on 001 a SW �6 ddi� of is , with cis,. NK etftitrt �`71ff *W be mnxwm W ftp Mp _ . 113, Womifo AO*dWndm Coda- pbiwritU p mt erm, and 101 "f The s o m0°rs'':"t or p urbCed pOW f8 #d tw�`tf� r. or � St � of-'12 MOM � tilt be � � a iD 9wvw 4 "mt bcUt A sett SW be dW to to � aulfi�t5+' 10 drays & camp ha START UP AND OPERATION 1! of ' or othi.r �rors&tra�a�f• paw m i�p nn!!($ �°ne are ctre +if " w O iimPade lanW) moved by a 580" Wr Adng oP Pd� to uv"' C�t3f�1 ft+d >dfe vntsnOs SystE:rrt Stara, up shall riot ocwrvvheri sotjj'cx;Fnditlons are frozen at the infiltrative surtatce. DuE6r ci pow,t r 0ABOgs P=P off" [ICY W above normal higtmater levets_ when power is to stiXed the ax ]ess vrasirtararrse , FA be dtxhafged too thee dbperasl c�elt(s) in one Large dose, overioadng t he c eels} and m8�t re cult in tha baCibAp ar=erfaos disege +3f To lvrly 8d this stluaticart have cite contents of the pcanls truck temorn sd t) a S6ege Sae triairltQ Opars011r p kjWr2 t w the ettluexrt pump or contact a Plumber or POWTS firer to ep i a wu [R foal op�rlQ the ptL�mp amUpb to castors normal Wets within the purnp• tank Do ll(A: ddn orParkVd idea QW Wft mW dslfWsal tags_ Doi not drive or pack over, or aftrwhe digRttttl OrCM11acL the Route web 15 feet dowrl sbpe Of OW MOUIld tar st-grade sod( 8bs6rpflon are& Reslutction o( - e"naW" of gm ftilvr kV Born the wasfaewaber sbwm may impMe the perRI(InanO and P )+9 that a of fbfa POWI'S- �; bobip 'd9 the butts, condoms; coWn swabs; degmsenr. dWW &W, f Gapers; dlslndieclanls fbt fotltad d1*b 2UMP PAP) Watw - flit and vegetable peelfitgsk gasoane; 91NOW bob Omer, meat scat rcr. modlmsow bt pti d tg plwluds; pes iddea. sanitary napkins. tampons. wstwWfgfe W brine. A8ANI[N3N$K [SIT When the PO WTS ft ft eandfor is pomm nnntly.taken out of service the fnitawing steps sMO he taken to Insui a thief the systern is proftertg OW $Sfalyabandonrrd In coMprrance with eh_ Comm 133.33, Wisconsin Admtnls11e119W Cate` AN ply Ing fn tanks and pits small be disconnected and the abandoned pipe openings saated_ The o mteento of an tanks end pRs shag be removed and property disposed of by a Se~ -Seri dng Operate After l,umplag, all ranks iond puts shall be ex avated and removed or their coverts r+eernc red -and tha v+jid spab!! Tilled v tQh to gravel or another Inert solid material C01M I PLAN If the i'r:)Vir S Fails and canrwt be n9paftW the following measures have been, or must be talerxe, to pnWWO a code compb,3 n m IOef wnt systen - O A sully ble rephwement�aree has been evaluated and may be utilized for the location of a neptsoemen t soil alasorption system. The repleAmment area should be protected from disturbance and c:ontpeactivn ane I should not be infrin upon W required setbacks from existing and proposed sflrtrt�rre, tot lines and VMRS at Ire to pnotsa ftte rep area vriil result in the need for a new soil and site vewa luation to emblish a su table replaoe ment area_ Replacement systems must comply with the rules in ell ect at that time. a w suitai Ne naplacement area is not available due to setback andf soil limitations. Stirring advances }n POM S tec knot )gy a molding tank may be bnstaiued as a last resort to replace the failed POWTS_ e site has not been +ewrarugmd to identify a suitable replacement area. Upon failure of the POW1 S : r sor7•and / site ewa usti nn must be peerf need to locate a suitable replacement anew tf no reptaceesrent area is available a . ioiding ink may be WSWed VS a last resort to rePiaoe the failed POWTS- ound :Ind at -gfade atilt abs�n ems may be reconstructed in place ft*owfng anovai of the 0 omat at the infrltt a& a surf ca., Re©onstrudlOns of such systems trust com ply with the roles in effect at that tir w- <<WARti'JNG > SEPTIC ., PUMP . WD OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES ANDIOR INSUFPICI ENT OXYGEN. 00 Hal' ENTER ASEPTIC, PUMP OR O77iER TRF.ATME-NT TANK UNOI =R ANY CIRCUMSTANCES. DFJ ►TN MA'f RESUL•Ir_ RESC UE OF A PERSOIN FROM THE I frMOR OF A TANK MAY ErE ]DIFFICULT OR 1MPOSSIE LE ADUmONAL COltll FMrs P O WTS INSTAL�LE R POWTS MAINTAINER Name - -� �. / Phone SEPTAGE;a OPERATOR pu m p-- 1.00Al_ REGULATORYAUTHOWY A9eny r �` nos d ocueaen,r , dmd W by the eta of 0a Gwen Lslre. Naaluede and Mushara County ZankV and San$ati err sperlCiBB This dodlrtt. eM meet4 me, mrnknenr,: negnr�rnarl is ar ch. rarrrtr as- zt1�@)l'iX�stl7 �a 83.sst'7f. (2l � (31. wrscnnsin ,A_omulrustr�+,a carte. tree of tick Qo�� `� not guaantee thn perfaman x of the POVVTS_ rM1r {?/ell eeUo � 5). GRU/ z0 X '- 0 0Nr Wisconsin Department of Commerce N'NG 0FF /CESOIL 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 include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D, percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Please print all information. R 'ewes Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Property Owner Property Location Q ,� ` Govt. Lot 1/*��1/4 S ��Tt.� N R I V E Property Owner's Mailing Addr ss.✓ Lot # Block # Name CSM# J ,r d city State Zip Code Phone Number ❑ City ❑ Villa a 1"Towrf Nearest Road ILK New Construction Us�9 idential / Number of bedrooms Code derived design flow rate as GPD ❑ Replacement ❑ Public or commea � r- Describe: _ Parent material - -' CW"7 UZ Flood Plain elevation if applicable -- - - -- - R General comments/0 and recommendations: S� �� i �& Ong # Boring � / F—/1 D i Pit Ground surface elev. t ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDM in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •Eff#2 3 yb� b CZ l3 FS l h114 r S /'0 Boring # a Boring .� X Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 `Eff#2 U'l 3/ I r b , o 2 3-yI r�l c t s l ---) ' (o C 2 U i b t. r c, v° ea- ,5- / .0 Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 ` Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) a CST Number Bird Plumbing, Inc. Shaun Bird 226900 Address Date Evaluation Conduc ed Telephone Number 1008 192nd Ave, New Richmond, WI 54017 ,' r-� 715 - 246 -4516 Properly Owner _ Parcel ID # Page of Pit Ground surface elev. ft. Depth to limiting factor in, orizon Soil it:ation Rate H Depth Dominant Color Redox Description Texture Stnrcture Consistence Boundary Roots GP in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 'Eft#2 (a^ rn �r •� .p F -1 Boi„ g # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. SaI Appli cation Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •Eff#2 Boring # ° Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate . Horizon Depth Dominant Color Redox Description. Texture Structure Consistence. Boundary Roots GPD/fF In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff #1 'Eff#2 ' Effluent #1 = BOD- > 30 < 220 mg/L and TSS >30 < 150 mg1L • Effluent #2 = BOD 130 mglL. and TSS < 30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608- 266 -3151 or TTY 608 -264 -8777. SOD -1330 (8.6=) r Soil Test Plot Plan Project Name Environmental Holdings LLP Sha ird Address 706 19th St. Hudson Wi 54016 STM #226900 Lot 1 5 Subdivision Lundy's North Date 12/1/04 S 1/2 SE 1/4S 22 T 30 N /R W Township Richmond Boring Q Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 100 ft. Top of Survey Iron System Elevation 101.0 *HRPSameasBenchmark Alternate Benchmark Top of Steel Fence Post C? 10 3.5' A1t.B.M. * B.M. 177' Property Line AC ale is 1" = 40' unless otherwise 99.5' noted 150' 100.5 B_3 40' 0 3°Io Slope 101.5' 30' 30' 90' B -2 0, B -1 Please note: soil test 61' may not be suitable for owners desired Line erty building location, Soil test was done to satisfy zoning requirements, please verify system location before excavating. 111111 Iilll VIII 11111 Illii IIIiI IIII Illlli llli 1111 914945 STATE BAR OF WISCONSIN FORM I - 2000 I REGISTER OF S DEEDS Document Number WARRANTY DEED 11 ST . CROIX CO., WI RECEIVED FOR RECORD THIS DEED, made between The Riverbank, Grantor, and Todd Marek 04/21/2010 02:30PM Construction, Inc., a Wisconsin corporation, Grantee. WARRANTY DEED Grantor, for a valuable consideration, conveys to Grantee the following EXEMPT A described real estate in St. Croix County, State of Wisconsin (the REC FEE: 11.00 "Property"): TRANS FEE: 102.00 PAGES: 1 Lots 15 and 17, Lundy's North Addition to the Town of Richmond, St. Croix County, Wisconsin. Recording Area Name and Return Address: St. Croix County Abstract and Title Co., Inc. 219 S. Knowles Ave. New Richmond, WI 54017 SST7249 Together with all appurtenant rights, title and interests. Parcel Identification Number (PIN) 026 - 1290 - 15-000 (lot 15) 026 - 1290 -17 -000 (lotl7) This is not homestead property. Grantor warrants that the title to the Property is good, indefeasible in fee simple and free and clear of encumbrances except easements, covenants, and conditions of record. Dated this ,16 of April, 2010 ;The erb S * By: Dqxklas S. Wynveepi±E2sident * * AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF WISCONSIN ) COUNTY • ) ss. Authenticated this Personally came before me this.,)4d'�ay of April, 2010 the above named The Riverbank by Douglas S. Wynveen, * President to me known to be the person(s) who executed the TITLE: MEMBER STATE BAR OF WISCONSIN foregoing instrument and acknowledged the same. (If not authorized by § 706.06, Wis. Stats.) * hlti,to, THIS INSTRUMENT WAS DRAFTED BY Nota bl , State of nsin My commission is ermanent. (If not, state expiration date: Robert L. Lober �� _I � _ ) Loberg Law Office (Signatures may be authenticated or acknowledged. Both are not necessary.) a "'�.,,��� *Names of persons signing in any capacity 13AAN pacity must be typed or printed below their signature �, y. •., WARRANTY DEED STATE BAR OF WISCONSIN Nqej-2�0 1 of 1 LUNDY'S MEADOWS NORTH LI OF THE LOS` 30 � LOT 31 t LOT 32 f /2 OF THE SEi/4 t / BENCH MARK: TOP (S8 9'47'03 "W) r OF 1• IRON PIPE, N89 °47'01 1496.60' ELEVATION 9880 1 -- ---- -- BLOCK DIST .! 199.09 15.22' �' b g' 176.58 - DRA/NAGE 28245 119.4 EASEMENT T 1 96- Q 4�. - - S89 47'01 "W 429.86' ' ACRES 1,y� 6 �� SQ. JlO 8 , LOT 14 65.70'.'i ( C"( 1 90,057 2.07 ACRES 96 8. 5 4p L.Q.O. LOT 1 S LOT 1 6i �; # s = 955 ►� 1.82 ACRES 2.16 ACRES 3 29.85 < CH MARK: �- BEN =� 0 E it (79 206 So. FT.) ;� (93.977 SO. FT.) S44 46 50 _ TOP OF 1 L.B.b. 955.5 1 •� q IRON PIPE, LOT 1 1RR/NAW ry 964.0 ELEVA TION y� 1.98 ACRES Ascmi'NT �� (86.420 SO. FT.) w y E y i4.5 .30'1 N88'15'11'E 409.83' -- ----- -129TH STREET ---- -- - -- ----- �9 ,38.92' S88'15`11 "Mt 409.83' �Z loe A N OV / 4 � \ lof rl• �' i k �. \ •. ST. CROIX COUNTY SI3.MC TANK MAINTENANCE At�RUEhII�T AND OWNERSHIP c iRTIFTCATION FORM Ownar,Buyear o Maftg Adds ass Property .Add.ss (V sequinod from Plaaming & Zoning Dgwbnent lbr now ca 0m) City► /Statie,� Parcel. fication Numba 0�6 �` 9 0 - � ✓ Prop m. ty Loci ttion , �� �/• ,Sec. Z2- , T �N R /1 W, Tome Zaijas'-Z Subdinsiwu_ �� K- " Lot # CerHed Survey Map # Volume ` , Page # ti+ C / Warrenty D t:ed. # , Volume • page # Spec have no Lot hnw ideti$ able ® no §XSjrEM r MMe M AND O R ,RIMUCAnoN Iaga per use sod wshonennce of your septic system could result in its prmnsture wove to bm to wastes. Paopar maintamance a aoists of p=4fto cut &t septic m>enk every three Years or sooner, ifneeded, by a lioensed pvnVer. wilt YOU pot intD drat sytdemt can affect the ftcdm of the septic tank as a ftRUBM stage in Ito waste &&001 syaaemt. Owner s+espoxasibilitia we specified in §Con m 83.52(1) and in Maptar 12 - 3t Croix Cowa ry Sanitary Ordintmce. Ths p mperty ovmw mess to submit to St Coo= Cauaty Pla n g & 7-ming Department a ce ttflcaitm form, signed by the owwer and by j n n ns w pk=*w t, journeyman phamber, restricted phumber or a litcensed p=* , r dmt (1) the on wastewater die posal sysbem is inn p War Operating condition and/or (2) after won and; , Il g (if aeaessary), the septic tank is less dwm 113 d LU of shndge: Vwe, the mlersigaed 1 aw vie road the above req and. agree'to maianfaia the Istiv a smvvage with the st n&-ds set f Deana, Iearata as sat by she Department of Cor nun and dw Depatrung Of Natural ROfOaoes, State Of VrwonshL CerWicatm s rating eat your septic system his been mamtaioed most be comp coed and rete®od lo the St Crow Carroty Plsffiiag & Zm&g Depw meant within 30 days of dw three year Cott date. Lae xstify that all stateaeeots.om this fo= are true to the best of may /car krmwledg& Vwe awfore dw owner(s) Of the property dew ibed above, by virtue of a waaramy deed recorded m Resister of Deeds Office. Number of bedrooms za �i� a, �itlz I'- S ��1 -IGNATCJRE CP APPLICANTS) DATE ' = *AAy i nft ?wiom drat is miarelursetmed may result in the samdary pmt 1f8 revoked by the P3ataming & Zoning Department- « *" Include witth t his app&gd m a recvrrted aanraaty deed ffom die Regidw of Deeds Offica and a copy of the certified survey map if refwwoe is m ado in du warrartalp deed. M"r. 02"