HomeMy WebLinkAbout030-2095-10-000 (2)Wisconsin Department of Commerce
Safety and Building Division
PRIVATE SEWAGE SYSTEM
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
LAURA TOOMEY
TOWN OF SAINT JOSEPH
CST BM Elev:
Insp. BM Elev:
BM Description-
ob. OC)
J
TANK INFORMATION
TYPE
MANUFACTURER
CAPACITY
Septic
W
79b ., jo�
Bes+ng
ci s�S
Pbl ��Ic 52s
TANK SETBACK INFORMATION
TANK TO
P/L
WELL
BLDG.
Vent to Air Intake
ROAD
Septic
2�
3
I LD O
20,
Aefat+an
PUMP/SIPHON INFORMATION
M '-4' turer
Demand
GP
Mod Numbe
TD
Lift
Friction Loss
System Head ;
TDH Ft
Forcemain
Length '
Dia.
Dist. t Well
SOIL ABSORPTION SYSTEM
ELEVATION DATA
County: St. Croix
Sanitary Permit No:
651314
State Plan ID No:
Parcel Tax No:
030-2095-10-000
Section/Town/Range/Map No:
24.30.20.794
STATION
BS
HI
FS
ELEV.
Benchmark
DO
Alt. BM
-&4W, 1-1p Of Md'd 614-mi na 5I -P.
101.1
Bldg. Sewer
cc
St/Ht Inlet
St/Ht Outlet
00
9T D�
Di II li%,
DL Boi om
uo.,d„rrnn.,n
Dist st p4p
Bot. System
Final Grade
Cam. d
St Cover
Rie'r Covey
3
BED/TRENCH
DIMENSIONS
Width
Length
15
No. Of Trenches
1
PIT DIMENSIONS
No. Of Pits
Inside Dia.
Liquid Depth
SETBACK
SYSTEM TO
P/L
BLDG
WELL LAKE/STREAM
LEACHING
Manufacturer:
INFORMATION
I
CHAMBER OR
UNIT
Type Of System:
I CNIEWTOOL—
❑
2
3 ��
I �� N fl
Model Number:
FLAW
DISTRIBUTION SYSTEM
Header/Manifold
Distribution
x Hole Size
x Hole Spacing
Vent to Air Intake
Length Dia
Length Dia Spacing
SOIL COVER x Pressure Svstems Only xx Mound Or At -Grade Svstems Only
Depth Over
Bed/Trench Center
Depth Over
Bed/Trenc dge
xx Depth of
Topsoil
xx Se d/Sodded
xx Mulched
es ❑ o
COMMENTS: (Include code discrepencies, persons present, etc.)
Location: 1467 24TH ST
1.) Alt BM Description =
2.) Bldg sewer length = FRm *k I�' 4-b qs" g.s
- amount of cover = '
i❑
Inspection #1:
orE) : % Ins t,+ion ppe 0 'Cat oar 31s" .
2 3L" 4 Soil Aesr,l.bed be Io,j Ss�.
y
Inspection #2:
Plan revision Required? ❑ Yes ❑ No
Use other side for additional information. SBD-6710 (R.3/97) �--�-
Date Insepctor's Sign ure Cert. No.
RECEIVED Industry Services Division St, Croix SAN-2023-246
09/21/2023 1400 E Washington Ave Sanitary Permit Number (to tx fii1L:d In b� Co.)
Paid via Ascent P-0. Box 7162
Madison, W1 53707-7162
#31294
T1 i3)q
S an.1 t o ' State Tr sact ion N anumber
Permit Application I -
In accordance with SPS 483.21(2), is. Adana, Code, suhml,_L,�'H ITI I, Hhi�' , if IrT71 to the appropriate Sri i� emniciltal tintl
is required prior to obtaining a sanitary permit. Note: Application form, s tbr state-owned POS aj-c subp1mited lo i\dtice,ss (if ditterem thwi mall ink address)
the Department of Safety and Professional Services- Personal information you provide may he uwd t6rsccorldan'
pu!pose s in accordance with the Priv acy Law. s - 15," 1 Xm)l Stats.
1. Application Information —PlIgase-Priot.All Information
Property Owner's Name Parcel #
Koury & Laura 'l 'oonie) 030-2095-10-000
11ropeTty uwner's Mall ingm, Aarrus.T_� 11,roperty Location
e
14 6 .4 " S t ii-c ct
Govt. Lot
I Stage Zip CPhone Number s u., /,k, N W /4. section 24
I loul toll 1 54082 T 30 N R2GEor �ijrcie one)
10 R0
11. 'fvpe of Bu i Iding (check all that apply) Lot 0
Subdi'v1sion Nam
EX] [ or 2 Fainih, Dv�cifing - Nm4rer Lrf ftediUMM
ri-.!; C'cpuntr� 'side F'State's
VON R
F-1 Ni b I Wi0i i n m e rc I al - Describe U se Block #
L-5 - 0 cltN, of
L] State Ownknj - DesLmhe Use C.SM Number 0 of
1-own of St. Joseph
ill. Type of Permit-, jCheck only one box on line A. Complete line 8 if applicable)
A
0 Mocag Sys. I (ffNe%v_S'y%7(eTn) JE] Rcplacernent Svsrenn 0 TivatmentlYfol ding -I'ank Replacement Only (Xher cif tiDn to Existintem (explain)
0 Pennif Rene-wal L1 Permit Revision E] Changc of E] Permit Transfer to New List Previous PeTmit Number and Date Issued
13 e kiTc Expiration Plumber Owner
IV. Type �of POWTS System/Component-Device: (Check all that Kply)
ED Non -Pressurized in-Crround Pressurized In-Oround E] At-(Irade 7 Mound > 24 in, of sul itabi e 3 1 E] Nititind - 241 n (4,,u'rinble soil
El I lolding Tank Other Dispersal Component i L° x, P I a in i Pattreatnient Device (explain)
. x � _ �
V. Dispersal/Tre0ment Area l nform ation l 3 s-
152,v
fl
Design F)ov, f gpd) Desism Soil Application Dispersal Area Required (sf) Dispersal Area Proposed (0) Syntern Elevation
150 Rate(gpdst) 375 375 93 011T
0.4
VI. "I'a is k I Fi k) Capacitv In
1'olal o f U
Z a Lrj
Gallons 11nits
New Tanks Existing Taaks LZ 5
1 ;1. C/5
Septic oi- I lolding Tank 750 750 1 Concrctk2 I U Li
Dosing (,'ham[w'r I o I c- - La
V 11. Responsi bil ity Statem ent- 1, the tondersigned,,assume responsibility, for installation of the POWT'S_shown on the atuched plans.
I I I urnhcr',,Name (PrInt.) Plu MP1W-'1RS Number Busincss Phone Number
Jolin soil milt 223760 715-760-0486
PN111b,cr'q �ddre,;� tare (_'itv. State. 7,ip Code)
596 Valley Vitn� Trail. 1�nmk�r�n Wl 54025
V
.1 Y III. Coust y/Deparlitivitt L's e 0111-
ful Approved Isapp Permit Fee Date Issued Issult g Agent Signat ire
V3
for m
�35�� tb�r��Zo23 t
IX. Conditions of pprov Reasons-�i 1)isapprn
MTEM CWNER
1. Sepik dank, -efluent filtar and dispersa! cog!
mus.1 be sewced � maintained as per
r,onagen,Qw, plan prowled by plumber. CpcL V &
All se:beck raqw,eisustpmaimntalned.
ap6uiW code; WoRneas ce-
I I inches iT; stle
�kmch to cam lets plans for thesystem and -sull
iyo-e
ib
mr-- - dolt& QLA_
C �.
iB W4.3 9 8 C`Cek
tD A&A A0 me Sicuja
HA" 7;�VL
1� �f_frl
S/?023;_� _\cLo Pco� T Z-;q"Gk
SYSTEM PLOT PLAN
Toomey 150GPD Shed Septic System
Project Address- 1467 24th Street
BMI Symbol: A SM Elevation- 100 00'
BIVI Cie Seri ption. Top of 2" PVC Pipe
BV12 Symbol, A BM Elevation: 109.14'
SDI Description Top of ground at NE lot oomer
Slope Gradient of Tested Area, (2G%)
Well Symbol (if applicable)
Notes: See CSM for Complete Lot
COPY
ILI"
na
Design Flow, 150 GPD
Attach des'ion flow calculations for
commerclai plans'.
Pipe Matedals / ASTM Standard
Tables 384-30-3 & 384-30-5
4" SCH 40 PV� pipe ASTIV- D2W5
4" SCH 303.4 PVC pipe ASTM-D3034
RAN 24th ',;tree!
Diiveway
P ro pose d VVL P-7 50 - M R
Se-,'Lic tar,k w.'Polylok 525
Existing
Driveway
Game House
EAlSling SePtiC SYBLeM
N
Scale: 1 60
J 60 90 120
z 17
15"
BIV12
z� f
961
94'
P st7d TX75' EZ Flow tre nC4 Et-;-- 95,0'
CONVENTIONAL COMPONENT DESIGN
Residential Application
INDEX AND TITLE PAGE
Project;\�,an-s.,,,-,: Toomey 150 gpd Accessory Building Septic System
Owners Name: Koury & Laura Toomey
owner's Address 1467 24th Street
Houlton, W1 54082
Legal Description: SE1/4,, NWI/4, S24, T30N. R20W
Township St. Joseph
County. St. Croix
Subdivision Name: Country Side Estates
Lot Number: I Block Number
Parse-1 I.D. Number 030-2095-10-000
Plan Transaction Nc,
Page
I
Index and title
page
2
Not Plan
Page
3
Septic Tank Specifications
Page
4
Effluent Filter Information
Page
5
System Sizing & Cross Section
Page
6
EZ Flow Information
Page
7
Management and contingency plan
Page-
8
Sanitary System Ownership/Address Form
Page
9
Warranty Deed
Page
10
CSM or Plat
Attachment I Soil Evaluation Report
Designer'. John Schmitt
Date, 9/21/2023
Lien Number, MPRS 223760
Phone Number- 715-760-0486
Signature:
in -Ground Soil Absorption Componient Manual Version 2.1 may 2022
Page 1
SYSTEM PLOT PLAN
Toomey 150GPD Shed Septic System
Project Address- 1467 24th Street
BMI Symbol: A SM Elevation- 100 00'
BIVI Cie Seri ption. Top of 2" PVC Pipe
BV12 Symbol, A BM Elevation: 109.14'
SDI Description Top of ground at NE lot oomer
Slope Gradient of Tested Area, (2G%)
Well Symbol (if applicable)
Notes: See CSM for Complete Lot
ILI"
0
OL
Design Flow, 150 GPD
Attach des'ion flow calculations for
commerclai plans'.
Pipe Matedals / ASTM Standard
Tables 384-30-3 & 384-30-5
4" SCH 40 PV� pipe ASTIV- D2W5
4" SCH 303.4 PVC pipe ASTM-D3034
RAN 24th ',;tree!
Diiveway
P ro pose d VVL P-7 50 - M R
Se-,'Lic tar,k w.'Polylok 525
Existing
Driveway
Game House
EAlSling SePtiC SYBLeM
N
Scale: 1 60
J 60 90 120
z17
15"
BIV12
z� f
961
94'
P st7d TX75' EZ Flow tre nelt Et-;-- 95,0'
4" T-A-SEAL
4" CAST —A — SE -AL
cr-
.3
0
Lki
Lo
INLET T CUTLET
7LET
F" -7 T-V
CIL - CL
Nr D
21�,
_Z_:
\-PLJMP PAD
rn
allAvj1xlj
WLP =%50-MR I �I a
TANK SFLCIFICATIONS
DIMENSIONS:
L.L.1
ct�
u 0
0
WALL: 2 1/2'0
BOTTOM: 3"
COVER. 5 It
MANHOLE: 24 T1 I.D. PPECAST CONCRETE P!SER
HEIGHT- 54"
OUTSIDE DIAMETER,. 7'-0"
BELOW iNLET, 42'
LIQUID LEVELr 37
WEIGHT: 6,150 LRS.
INLET AND OUTLET:
4" CAST -A -SEAL BOOT OR EQUAL GASKET
LJ
cn
CL
INLET AND OUTLET BAFFLE AND FILTER-
�;
WSCONSIII, SEE OLTAIL #10
(OTHER STATES SEE CHART)
LIOUID, CAPACITY- D. GAL/IN
La ul)
Ln
HOLDING TANK:
OUTLET HOLE PLUGGED
ACTUAL CAPACITY: 790 GALLONS
00
LOADING DESIGN- 8"-0" UNSATURATED SOIL
w I
TANK CAN BE USED AS:
SEPTIC / HOLDING / PUMP OR SIPHON
COVER: MIX DESIGN #8 (NO FIBER)
co
TANK: MIX DESIGN #10 (STRUCTURAL FIBER)
cn
CUSTOMIZED TANKS:
FOR CUSTOM TANKS CONTACT WESER CONCRETE
REVIEWED BY
REVIEW DATE
SHEE"I ND,
I Z
OF
TANKS ARE MANUFACTURED TO MEET OR EXCEED ASTIM C-1227 REQUIREMENTS
Inc.
M oo vtWort5 in PrF c is 1, Drai"42ye Zabelff
& MISNL,7,111�r pu;,(Iucf?� A Dkiwvk_�i i A POMOk KC.
NOOMSIM
PL-525 Effluent Filter
The PL- 525 F i I to r r,-:i tee for 1 ON GPD (ga I I can per day) making it one of th e I ka rgest filters in i is c I a ss. It has
52-he Polylok IPL-122, the Polytok PL-525) has an automatic shut-off ball
lots. LI*I,,e L
"linear (eet of 1/16" f i1tration s
installecl with every filter. Wheii the filter is removed for cleaning, the ball will float up and temporarily shut off
the system tlie of fl uen t Nv on't leave the tank.
Features:
Rated for 10,000 GPD (a I I o ms per day).
525 linear feet of 1/16" filtrr-itiOn.
o Accepts 4" and 6f' SCHD 40 pipe.
* Built in CDc7as deflector.
v Automatic shut-off ball when filter is removed.
Alarm accessibility.
* Accepts PVC extension handle.
PL-5,25 Installation -
Ideal for residential and commercial waste flows up to
10,000 gallons per day (GPD).
1. Locate the outlet of the septic tank.
Remo�,,-u the tank coN:er and pump tank if necesc?ary.
-1. Glue thc,, filfcr housincr0 to the 4" or 6"" outlet pipe. If
-
the filter is not centered unde-r the access operdng use a
Polylok Extend & Lok or piece of pipe to center filter.
4. Insert the PL-525 filter into its housing,
5. R e p I �� ce 11-1 Ll S CC 0 re th e- F, epti c tank corer.
IT-325 Nlal,ptj
The PL-. Effluent Filtcn�-. �vffl opi�rate efficiently for
several ears under norni a I conditions before re q u in ng
cleaning. It is recommended thik-it the filter be cleaned
everr time the tai-ik, ib pumped, or at least every three
yea r.s. if the, i ris ta I I e J 6 1 ter con I a iris ire optional alarm,
t11 C OW11 LT 1,V 1.11 L)c i i u ti f 1c J by i ii i I arin v,,hu i i the filter
.0
needs servicing. Servicing should be done by a certified
I"
septic tank pumper or installer.
1, Locate ttle. outlet of the septic tank.
I R'Qn-iove tank co�ver and p. un-ip tank if neces,_-.ary.
3 - Dry not use phimbing xvhei-i filter is removed.
4. Pull PL-52.5 cartrldVie. out ot the housing.
Hose off filter over the septic tank. Make sure al.1
so ids fall }pack into septic (ank.
6. Lnsert the filter cartridge back into the housing making
SUTC the filter is properly ahgned and completely inserted.
7 ./. N e p I -ace aid sec ure septic tank co �-, er
I r
1/16 Filtration Copts
3:= Alan-n Switch
(Opti o n a 1)
LUIVVV
Accepts 4"'" 6"
.-C] I D 4
Outdoor SmairtfiltWr, ALI,arni
Polylok? ZaW & Best filters accept
the Sm zi rtFi 1 terV switch a n d alarm.
Accepbr; V" PVC
TIR.
iensioii Han le
Riated for
10,000 GPD
525 Linear Ft.
of 1/16 rr
Filtration Slots
Ce,rtified to
NSFIANSI Standard 46
Gas Doflector
Automatic
Shut-off all
I I
-Atend & Lok,
EaRfly installs
into existing tanks.
Pot ylok,Inc. 3Fairfield&vd. Wallingford,CT 06492 Toll Free: 877.765,9565 Fax: 203.284.8514 www.polylok,com
PaS* 4
IN -GROUND GRAVITY DISPERSAL AREA
Jniform Elevation Trenches with EZ1 203HP Bundieg
3-ft Trench (down -sizing credit)
G e 1) te x Z11.9 r� i n 12'
r, 0 J e r (ty P C�a
SOIL COVER
59 1211
min. trench
116
depth
(typical)
S
95ft. yste rn E- I evat -10 [1 .0
(typical)
Septic Tank(') Mantilacturer:
Wieser Concrete
Septic Tanks) Voltime(sy
750
gal! gal gal
Effluent Filter MantpfacturiF!r:
Pohlok
Effluent Filter McxJel-4- 525
TYPICAL TRENCH
CROSS SECTION VIEW
(No Scale)
Provide minimum 3 ft
separation between trenches
(Show loclat lot i o f Idel I outlet pi pe clon nectio n on plan view.)
TYPICAL TRENCH
PLAN VIEW
4 Pt 0 Ct bF, e rv-, tion pipe s Mal I t* insUlivd
(No Sca le) Perforated Lateral at j U r. clio n tmtweo n two un ft
Observation Pipe
(typical) (typical)
75
ft
(typicall)
INSTALL PER TRENCH
7 1 0-ft bundles @ 50 f� E I SA/unj t = 350 ft�
4n + 5-ft bond I es @ 4215 ff E I SA/Unit = 3 5 ft,
Scmw-llrype or A
F n 19 r! ed G ri�de
Slip Cap (loo-ga)
'he) & seeded) (r
4`0 PVC PIP0 T 1.3 psi o\ er
fmirl root)
f o-,) of ji P-e I o to rmjnato k" L
a or a brj,, e- f in i s ried g rade
(4) 1 /4 1
S IcAs
4b r'l Pn I
n I rat[on
A ch n ri i Dc:.v i
a
i' 2" X 61
SUrfeice
10 ft
(typical)
I
==—j (typical) EZ1203H Bundle
(typic.al')
(mffl by Infiltrator ysterns, Inc,)
Instal I pursuant to manuf acturnes linstri ictions
Proposed EISA :ier trench = 375 ft2
ft Req u i red I nfi I tration Area 375
x
hes = Proposed Total EISA 375 ft 2
try
OBSERVATION PIPE DETAIL
f N-0 S c. i ie -1
Installation Instructions for O*Wlru
E EZfiZfl,
b"'. ow Systems in Wisconsin by IN
o0owwo 0 is ft do be, Moog 6 006
Wisconsin Department of Cornmerce, Safety and Buildings 5. The Absorption a( - ea (SF) necessary for a given Oe Shall
Division, has reviewed the specifications and/or plans for this be sized based on, rraximulm daily sewage Flr)v, (GPD) arid
produt and determined it to be in compliance with chapters the Pei rn e s I f ce tlaj n cri t u [ i zi r
eability for the IL riet, the
Coftim 82 through 8-:1, Wjscon�Iri AU'rnin. Code, and Chap, [erti EISA sizing can be used in Wscon5iin, resultiny. ir i a 40%
'145 and 160, Wis0-on._:71n Statutes. All sites must meel the. Site smaller draintield.
& of Conditions& Locations & lsolaton distances as noted in
)n6. Place. EZflow bundle(s) in the EZflow configuration ap-
local requlatirr,,. proved by system design peunit specified for the particu-
The appi oved prod ucts are 1 203H (3- 12' bundles wi lir-i pi pI F1 lar 51 _ The top or center most cur idL?c: contairon g pipe
center bu ndle in 5' or 10' lengths) and I 203H P (3-12" Lru r id I are joined end to end with an Inteinal pipe coupler. Arly
with pipe in each bundle in 5' or 10' lengths. -additional aggregate only bundles that may Lie required,
■ should be ht.itted against the other aggregate -only bun-
■
j 1.-7 e q U! ton.
cur- r-
A 5inglu pipc bundle contains a four, InC."Ji perforatc;d pips �A d do -ijt r re any type of connect"
rounded by EPS ,he at and is held together witl�i pally-
eMylene netting. A single aggregate bundle conlatns aggregate 7� The top of ea(:n CEO cylindei con tai n s a filter tab' ic. pre-
9 . T11 e
aq.e . reqat
-;are m hot n the nettin .9 and
1)rl I y and is he Id topether with oolyethylene netting i,
• fabric is inserted to prevent soil intrusion, TI-ie installer
Materials and Equipment Needed shall make sure the the GEO is posifioned upward and is
EZL f j'uw B u i i J I ts in cutitact witk . the fabric contained in the adjacent cyl'lrl-
EZtIow Geotextile Fabric der bei,oie backfilling,
EZ1`10WInternal Pipe Couple!
Pipe for Header and Inlet 8. The EZfiovv Drainfield Systems should be instal led in a
Back.hoe/Excavator level Uench in all directions (both across and along the
trench bottom ) and should follow the contour of'the grouf id -
Installation Instructions st,jrface elevation. (uniform depth), with all c-ontMUOUS
The instructions for installation of EZflow products are given adioining 10-foot cylindrical bundles placed end to end,
in accordance ith stag aith central bundle distdbution pipe interconnected,
below. This product rnust be instailled, wi e
rules defined in chapters Con -irri E-2 thirc ugh 84, Wisconsin Ad - without any dam s, stepdown5 or other grater stops
ministrative Code, arid 0)ap'lers 145 af,id 160, Wiscon5in Stat-
utes, as 'well as the local ne,-:flfh depa!lment s current design 9. The trench top shall be graded such that water will not
manual. pond. Bach ill shuuld be seeded or o(:i b ed '11-1 M e d ja tely
after completion to. redijce erosion,
1. After the local health departmJ7.1nt has determined sizing,
configuration, and layout for the EZflow systerns, stake I ClEZflow Elm S uLojJl.�s as flexible and cart fit a c-urved
or mark with paint the location of trenches and lines. Be Irenc hes as may be neces:sary tL) dV()Id trees, boulders, Q F
careful to set cu,i-rect tank, inve-it pipe, header Ilne or dis- ,_ether o bs ta. c 1 e s.
tribution box and trench botfom elevations before instal ■
-
lation of pipe bundles. 1 I.EPS aggre9L., t e 'I s I ighter than water, therefore, it might
be ex.PeL'ke:,d that natural buoyancy foi-ces would tend to
2, Remove plasiic EZfllow shipping bags prior [o placinq cause E7-flow assemblies to float out of ground wrien
bundles in the, trenchies). Remove any plastic baq-,5 in the panding occurs. Field experience has shown, however.
trench before system is covered, that this is not a problem when systems have a minimum
of 6' of soil cover as recommended by manUfaCtffe r,
3. This product ri-,iusl have qeotextilt. fabric that meets re_
qLilrements or s. Uornin 84.30 �6) (g)t Wis. Aim. Code,
installed directty on too of the product and exfendina
V 1203H-GEO
down along the sides of the product to a point at least six
inches from the bottom of product. &,olextl
F171
Barr'er Mater'al
�671 .71
4. Wnen 'Installed in a trencri, the trericJ--; should be dug to
77, a vvidth of :x,
36 inches. This not only saves labor in excava-
V V 7 7 W V
tititan, htit also provides better ioad-bearing capar-Ity after, Y Y
hackfilling is complct�_
IF9991196 009*0004 F491PIR Mo" M P * # 0 0*4 0 0—P4400 06e 4 0 foe a V
Page 6
Na jk A 0 j
sww��Z�
.,n-ground Gravity Management Plar
IMPORTANT:
ble for its perpetual operation and maintenance pursuant to
The owner of this in -ground gravity system shall be responsible 0
requirements of SPS 382-384, Wisc. Admin. Code. Pursuant to SPS 38352 (2), Wisc. Admin. Code, this system shall
be considered a human health hazard if not maintained in accordance with this approved management plan.
I e
Furthermore, all inspection and maintenance activities shall be perfornne,d by a reg'stered POWTS Maintain r in
accordance with SIBS 383.52 (), Wisc. Admin. Code.
Maximum Dig real Area eratinq Limits;
Design Flow = 150 gpd; 130135:5 220 rngLl; TSS!5150 mgL"; FOG 15 30 mgL-1
Inspection Checklist INSPECT EVERY 3 YEARS
o type of use
o age of system
o nu[sance factors (i.e. odors, user complaints, etc.)
c mechanical malfunction (i.e., pumps, valves, svvitches, floats, etc.)
o material fatigue (Le., leaks. breaks, corrosion, etc,,)
o solids volume in anaerobic treatment tank(s) and any distribution appurtenance(s) (i.e., dist6bution drop boxes)
0 neglect or improper use (i.e., exceeding design capadities., prohibited activities, etc,)
0 extent of ponding in distribution cell prior to dosing
dosing irregularities - if applicable (i.e., pump re -cycling, float with settings, etc,)
electrIcal components if applicable (J,e., wiring, connections,. switches, controls, timers, alarms. etc.)
distribution lateral or lateral on-fice plugging (measure lateral distal pressure — compare to design specification)
surface discharge of effluent or sewage back-up into structure served
Maintenance Checklist MAINTAIN EVERY 3 YEARS (or when necessary)
Septic and dose tan shall be pumped by a certified septage servicing operator licensed under s. 281.48 VVIS.
Stat s, when the volume of solids in the tank(s) exceeds one-third (113) the liquid volume of the tank(s) or
as required by local ordinance. Disposal of contents shall be pursuant to NR 113. Wisc. Admin. Code.
Effluent f! it r shall be inspected evs
ery 3 years and lull be cleaned waccessary when necessato remove any
accumulated solids according to manufacturer's specifications. A servicing period will always be greater than 1'2
months,
System maintenance reports shall be submitted to the proper local government unit In accordance with
SPS 383.55 Wisc. Admin. Code. Report any component failure or malfunction to:
Name of individual or company.
Schmitt & Sons Excavating, Inc. Phone:
Local government unit: St- Croix County Community Developement PE,,,,: 715-386-4680
Local government unit address'. 1101 Carmichael Road, Hudson
ONE=*
Any del"ective part of this system shall be repaired, replaced. or removed pursuant to SPS 383-51 (1), Wisc. Admin.
Code, Repair or replacement of failed or malfunctioning components shall comply with SPS 383, Wisc. drain. Code.
No prod Lild for chemical or physical restoration of the POWTS may be used unless approved by the department in
accordance with SPS 384, Wisc. Admin. Code.
ContingLencv Plan
In the event that any failed treatment component of this POWTS cannot be repaired. it shall be replac,,,ed pursuant to
a plan submitted to the appropriate agency for review and approval. A failed in -ground dispersal component may be
abandoned and replaced by a code -complying dispersal component in a pre -determined area of suitable soils.
System Abandonment
If use of this POVVTS Is discontinued, It shall be abandoned In accordance with SPS 383-33, Wlsr.. AdmIn. Code.
Page 7
s17+ C RO le, [JN'l-Y SANITARY SYSTEM File #-.Office Use Only
OWNERSHIP/ADDRESS FORM Created 21202 7
Community Develo pr-nent Department will utilize this -information to provide the property owner with
information regarding operation and maintenance, of your new or replacement sanitary system! THIS
infoi-oration will be provided as pat-t of our ongoing efforts to protect public health, your welJ, groundwater,
surface water, property values, and county resources. Once approved, this completed form and educatAna l
information will be sent to you by email. If yoci would like to view your issued sanitary permit online, you can
do so by using the Property Files Scanned eblink
OWNER/BUYER INFORMATION
Owner/BuyerKoury &Laura Toomey
Mailing Address 1467 24th Street
City/State/Zip Moulton, W1 54082
Phone Number (required)651-278-3317
Email Address tr-equired)rschmidt7906@gmail.com
Parcel Identification Number 030-2095-10-000
(found on the property tax b- III)
NEW SYSTEM: LEGAL DESCRIPTION
Property Location SE /4 0 NW i 1A , Sec. 24 j T 30 NR20
Subdivision Plat: Country Side, Estates
W1, Town of St. Joseph
Certified Survey Map # Plat Volume. Page
Warranty Deed# gg061 9 _(before 2006)Volume Page#
Number of bedrooms, NA
New Property Address
(Staff Initials)
Jot # 1
Spec house 0 yes N no Lot lines identifiable N yes 13 no
OFFICE USE ONLY
N/Fl
(Ver-Ificast ion of new addre/ss required from C.orrmtinjty Develoornent Department for Fle��l COTIStruction
I " - _ /
(Date)
This form must be submitted with c1l Private Onsite Woter Treatment System (POWs S) opplications-
New System: Ire ctude with th�_s foriii a recorded wart -only deed from the Register of Deeds Office at)d o copy of the certified
SUrve mop if reference is niode in the worranty deed.
Y I
Cutiimunity Development Department:- Land Use Dlvis,"OP
Tl 5-386-4680 St. Croix County Government Center
cdd@sccw1.Q0V I 101 Carm'lchael Road, Hudson, W1 54016
SPECIAL WAIU�ANTN` DEED
41
R FIT U RN TOW
a u ra Too m ey
�AA-c) Y-)
',hiX ['3TL'el No-
0-3 )0-2 09 5-1 -00
I F-_Ci A 1. DESCR I PTIO-N-
Lot I , CO litt') -Sldc Eski tc,, it; (lie T(jimVp Of St. Joseph, St. Croix County, Wisconsin.
Ei—)r I nfom i atiwi ur R,).ics (-)nlv
1467 2.4th Street
% Lf
I 14"Ailton. Wl 5 'ON-1
E X L M P'l - Fs R N-1 TRA N S FE K FE E A N 1) F0 R N 1 13 F, It I 1 2.' 2)
tllt le [-':[I c- 120147
P;luc I
P-q
BETH PABST
REGISTER OF DEEDS
ST., CROIX CO., WI
V
.-tECEIVED FOR RECORM,
06/18/2013 08:00 AM
EXEMPT # NA
REC FEE: 30.00
PAGES: 2
"The above recarding infw-mation
v-crifree that this documect has
Ueen electronically rc,-,curded
& f'jr.tU[ rjjr�sj to the st iJ)n-Wtt-,r
of 2
Page 9
DFUl'.), 1.11'ade bel,,veen Federal National Mortgagi: As.�ociation (GP,,ArT(.)k"',), zim! ainmed.
RA I F. F"', whether One or wore). Grantor, for a valuable considerati on.
" c-onvevsto re�I �,u IC decri I Ick-I
11e "I�t'.1ChdL I�DI(_'RI PT1O. tother �� I I Ii [lit- rents,, IWures and otherIPIL)LI rIantI f.IC 1,estS in S'V
CROIX COUnty, St'lflfC. qJt'WiSCQJ1Si11.
Grantor warTants OhLii title it-1 the Properly is pod indefeas. L��e, in ate slriiplt Lind frec MIJ _]Car of encurnbrance.'s, airislitig
by, through or tinder Grant ur . c x°jn) I I n i i [Nd �) 11 d 70 11111 Ork] i n- nagreericitsenteed Linder the. I ed
j r: T a tit I tis e re -7thictiOris i-iridi and
casements for the distribution (A dtihl� illid MUT'Milp.�d Sel N ices. FCC4 0.' tl, ��
further except the 20 13 real estate taxes.
�
Dated this d � iy cl 2I ) f ' _I I -
Fedevid Nlatiomol Assuciation
Jif
For: Blommer Peterman., S.C. as Attornev-inJ �.wl f_r) r KN M:4.®
il'lil al'c �1 U III I
C 1111 LcLi
M Ili[ VE_ BAR OF A Min-ic
Jaines W. Rmseyer
SBN: 1003705
I
Debrwah A. Moinmer
Meril'fitle File, 120147
ire
L t ,ey
P:ige 2 of 2
�CKNONVLE DC1 NMEN'T"
) ssi
I "Y' nf� "X AUKESHA
'ItA
as attomey in fact for FNjvlA-
Notary PtiMic, State
t%eiv Commiss',o,-'i e�Tirc.�-'
K�
RECEIVED
0 9/21/2023 #2259
Dv~tot
;POR
SOIL EVALUATION JRF T
pop 1 of 4
9 aps -Mi SaNtyand in Somrdance wfth, Gomm' 85, Wis, Aft. Code Paid via Ascent
Pmftwonw SeMm #31294 8doNt Sail Tesow in:
S cou" SCroix CST-2023-307
Ali ompiwis afte plan on paper not less than 8% x I I hidm in $bW pla n Enu- I t.
In, but nC4 ftmftd W vwwM and hoftonts1l re%mnm � (B&4),, dkoction and
petm rot WIx. scale of 41knembu. no armw, wW kmWn and dkftfm to nearest road, Pur001 I.D. 030-2095-10-000
Pt"se print all InfomatIM Reviamd By 084
Perawal Inkmvbm yDu pmw4e may to used %w qN=wWy pwposas (PdvoW Law. s, 15,04 (1) �M))-
Pmperty Owner Pfxperty LoCaWn
TOOMOY, KouirY & Laura CoM. Lot SEI/40 NW114., S24, T30N, R20W
Pj;�e_rty Owmft Matflng Address Lot # Black 11 ubd. Name or CSW
1467 24th Street Country Side EsWes
Shft Zip CCKW Ptwm Number CK)t [L1 Village [71 Town 148arest Road
CAY
Houlton W1 1 54082 1 651-2784317 lJoseph 1._ E.2.4Th Street
NeW C4rfflbVW0rj LIse: Reshiergal IN u mbe r of bodnXM 1 Code deer W deton frm nde ISO GPD
Pubfic or owmefda I n- W
6 This W11 sme a pole building
Parent matefial Gladal Till (SanUS904WjP_ Silt LOOM Sefks) Flood plain ekwaffon, N apprcaw ft.
Geneml mmments Arga is WftWe fa a coevent cnal systm wfth a 0A 90mift rate. POSSible SY:StaM 816vatcn W the mW is 915M I . S" Cd the
and mwmmendeWns: a= IS 2D%, ;ZONE Y
Boring
Elort� 0
Pft
Ground sudace eWv.
Ha
cwgm
D=MM C4br
Re&x DeW
In.
murow
Qu. SL C00a crdIllor
I
D-17
10yr3/4
FILL
2
17-28
1*3/3
none
3
28-36
10yr4/4
rK"
4
36-84
1Dyr5/6
rKM
98.29 ft. Dapth to limfting factor
lmmwi;�
I
PTA
PT#.,k,Ft Moffff-W on":
Bmw a L I BOOM 96+
Pot Ground surface elev. 97.49 fL Depth to fteV fftW in. SoO AWk*Wn Rate
lill 010
Horkm
DOVM
In,
DorninsM Cokw
Munsell
Redox DesorOWn
Qu. SL C4mt Co4or
TeAure
sbuch"
0
Gr. Sat Sk
Conswence
Boundary
Roca
GF
210&
40 02
1
0-18
INT314
FILL
sl
lmsbk
n*
CS
—0.4
0.7
2
18-30
1OW3/3
none
S1
2ffkd*
Mfr
9W
2fr2vf
0.6
- - - - ------------
1.0
3
4
30-51
51-M
10�"/4
10yr5/6
none
_Sl_
2msbk
2
n*
mfr
9W
CS
2frlvf
0.6
0.4
1.0
0.8
5
60-96
7.5,Vr5/6
none
S
ft
M1
0.7
1.6
9!!;.- C)
a9
4C 30 mgA- and TSS S.30 ffKOL
Iff Efflumd 101 m BOD SA30 < 220 n*L end TSS ;o 30 w- 150 M91L Mont 02 = BOD5
No" 048" P" 91grottue: Number
Thomas J,. Schmitt 227429
AWM" SchmId Sod To", Inc. Dal* EvolusUw CwWucW Tolophofte Number
15" 72nd St Now nut W1 SM7 8=023 715-760-1978
Prop" der Toorney, KouLau ra Parw11 D # - ' 5-10-0 00
Sri n;�
3
rrn
Pft
� surface elev.
f .
factor
# # rr� t n a
#
�
Horizon
Depth
Domlwnt Coles
Icedox Description
Texture
Structure
!Consistence EWWWary
Roob
in.
Munsell
QU, Sz, coat 0010F
Gr. Sz. Sh.
10rvr3/3
FILL
S11
2mgr
MfF
as
2m,2f
9-17
IDYrS/3
none
A
2mshk
mfr
gw
2f,2vf
17- 7
IGVr4/4
none
S11
2msbk
Mfr
g
27-53
10yr4/4
none
S11
3msbk
rnfr
CS...
53-84
7.5yr5/6none
s
OS9Mfr
..
page 2 of
[j B odn
B c�& PR Ground surface elan. ft. Depth to limiting factor in.. Soil Application Rate
Horizon Depth Dom f n art Color Redox CWscotfcm Texture structure Consistence Boundary Roots WWII,
err. Munsell Qu. SL Cont. Color Gr. Sz, Sh.
F I An r nn
F I An r nn
boring # � Pd Groo nd surface elev. ft. Depth to limiting factor In,
Soil Application Rate
Ho ran
Depth
tn.
Dom lnant. Color
Munsell
Redox Des ptl o n
Qu. Sz. Cont. Color
Texture
structure
Dr. Sz. Sh.
ConsistenceBoundary
Roots
GPM"
*E l
*E
0
fiffluem 0 1 a 8006> 30 4 220 mglL and TSS >30 �c 150 mg/L " Effluent #2 cl SOD, 30 mg�L and TSS -,�_30 mgl
The Deparm=t of Comma Is an equal opportunIty wrvice provider d employer. If you nted aulsimce to ueml or
necd material in m &[tomato Ewan at, p lewe contact the depanment at 608*26&3 151 or TTY 609,@264-8777.
St Croix County, W1
CondUcted for:
Koury & Laura Toomey
1467 24th St.
Houlton, W1 54082
Lot 1 Country Side Estates
PID- 030-2095-10-000
SE 14 NW1/4 S24 T30N R20
Town of St.Joseph I
Conducted by:
Thomas J. SchniA'L
Aff
ell
CST 227429
8-22-2023
BM 1 1 MOO' Top of 2" PVC Pipe
BM 2 109.14' Top of ground at
lot corner
24TH STREET
SEPTIC
SERVINC; 0
HOUSE
BM 1
VL-24
Bi 9151 -
3C
PR01�10SED sLOPE
BUILDING
loot -2
Legend
LiAbs and Riv- rs
Rivers arc' s
I'llewa tes
VS H not, 9,- -,i? s
Slate Kghwa.,
County HigJ%v�•----ys
Local Roads
R,jstir Roads
Ramps
Rid Ri;h� ol-`day
L
RaAlroaos
Con veyaraw- D visjon
1, = 60'
N
0 2.0 40 160ti
D 1 c;(-'t Al I 11qE R T h:s map i:S nr I quaf-3 nlevm 1 10 tat
I Ln, rorre�rt_ Curierl. Or r-ompletio
d rawn are She re-spam, lift' �01
ustr.
4
wm
m
St Croix County.Wl
c
g
a Legend
f R15iem and Sr.r•t
€ yI
7
U5
e E�• d L�,A1.1 I �F��IfR�
3
r
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[ sr j soft
= g CAIGILi T i�, tc� `k,•,� U,1Ft�r'r 1+
y cCicralE!, �offectl curr qt. Cs co`TSpMo and
AACI rs�I xr ! r#r: i .�r i l °I- r � � ��C hty� i t
if 4
k
r
ulvvl)iLn
R20W, TOWN uF ST JOSEPH.,
VERNELL A.SIB OGLUND
STEPPE N L,SKOGLUND
149 ��ICH STREET
NEW RICHNIONDlwi.
5 4 () 17
U
r
PIPE LIES N4Z"C6'41'*
COU P U TEO FOS I T 0 ON .
Cho 1)( COUNTY
) q67
......... .. 1 ivl
OWNER Lo"I"l�u�R� 1, aontiEY
2
NO... 513 � u
INN
PREVIOUS NO. 3or+007o3
PLUMBER afiFj �-►}du.�-�'I" LIC.# 223e7W
TOWN OF 5yora aS6PH
sr-ju 9'1YNq Inx
B"D L %d J% C
AND/ LIU
r �♦
60%j'"'ftM'f 61tsf,
. . . ..... . ................................... ......... ... . .
AUTHORIZED ISSUING OFFICER
...... ..... I'll ............ 11, -& -..&*
•
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
# ca authority.
t e erm�t lease contact he uu h
permit, P ty
DATE ' If /2-oZ.3
..... ............ ...... ..
.. .. ...... %L