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030-1076-50-100
Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 5..38806 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: Mitchell, Mark I St. Joseph, Town of 030 - 1076 -50 -100 CST BM Elev: Insp. BM Elev: BM Description: Section /Town /Range /Map No: /6/. I i / G 27.30.19.2708 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV Septic Benchmark Z. c.5 tbq.6 1o1 Dosing r r Alt. BMA `j3 ` _7 Aeration Bldg. Sew r r . vh. Holding � � � � St/Ht Inlet r a 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 3 , � g5 • '7 / he- ( Final Grade PUMP /SIPHON INFORMATION /b /• SF� /D /. �S Manufacturer Demand St Cover Z .(L " GPM Model Number (NO P 291 ��� r 95-/ TDH Lift Friction Loss System Head T 3(g.31 DH Ft Z� �7 t l? ( 66 oe Forcemain Length i Dia. n Dist. to Well SOIL ABSORPTION SYSTEM BEDITRENCH Width Length i No. Of Tren s PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth 1111 DIMENSIONS 9 2 L SETBACK SYSTEM TO P/L BLDG WELL LAKE /STREAM LEACHING Manufacturer INFORMATION CHAMBER OR _ Type Of S stem: ° f J UNIT �Z 0 > /00 ` /CO Model Number DISTRIBUTION SYSTEM 46i Header /Manifold 41 Distribution r3 ; x Hole Size x Hole Spacing d Venito Air Intake — l Pipe(s) ( / /J J Length ' /(p Dia 63- /' Length Dia 4 5 Spacing /$ v 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 r n e & % SYes , No Yes No COMMENTS: (Include code discrepencies persons present, etc.) Inspection #1: 7 / Z / / Inspection #2: -- _I /___._ Location: 616 Perch Lake r Road Hudson, WI 54016 (SW 1/4 NE 1/4 27 T N R19W) NA Lot 1G� arcel No: 27 30.19.27015 1.) Alt BM Description = U Je(, L 2.) Bldg sewer length = �� - amount of cover = Plan revision Required? 0 Yes No / 17-5 Use other side for additional information. L 7 I, Date In pctor's gnature Cen No SBD -6710 (R.3/97) 4 _��A Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM county: St. Croix Safety and Building Division Sanitary Permit No: INSPECTION REPORT 538806 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: Mitchell, Mark I St. Joseph, Town of 030 - 1076 -50 -100 CST BM Elev: Insp. BM Elev: BM Description: Section /Town /Range /Map No: 27.30.19.270B TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI =1EV 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 BED /TRENCH 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 CHAMBER OR Type Of System: UNIT 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 0 No Yes No COMMENTS (Include code discrepencies, persons present, etc.) Inspection #1: / / Inspection #2: / /__ Location: 616 Perch Lake Road Hudson, WI 54016 (SW 1/4 NE 1/4 27 T30N R1 9W) NA Lot 1 Parcel No: 27.30.19.27013 1.) Alt BM Description = 2.) Bldg sewer length = - amount of cover = F_ - - Plan revision Required? ❑ Yes Fa� No Cert. t Use other side for additional information. - - -- -- - - -- Date Insepctor's Signature . No. SBD -6710 (R.3/97) RECEIVED comm rce.wi.gov Safety and Buildings Division County 201 W. Washington Ave., P.O. Box 7162 ' � Madison, WI 53707— S CO 4 Sanitary Permit Number (to be filled in by Co.) - Department f CorreaefiNOIX COL NTY 8� S rm>! . A pplication Transaction Number In accordance with s. Comm. 83.21(2), Wis. Adm. Code, submission of this form to the appropriate governmental Z2,(,7 unit is required prior to obtaining a sanitary permit Note: Application forms for state -owned POWTS are Project Address (if different than mailing address) submitted to the Department of Commerce. Personal information you provide may be used for secondary oses in accordance with the Privacy Law, s. 15.04(1 )(m), Stats. I. Application Information — Please All Information Property Owner's Name Parcel # I'll plc M (TOLL 030 -)0742 - :50 - 100 Property Owner's Mailing Ad—dre ('A ^ Property Location City , St " - Govt. Lot 6t Z �0 State l!�� Zip Code J Phone Number SW Y ,S W �� Section L �upS V lii , `r �/�/ f V'(Q 1 0( circle on II. Type of Building (check all that apply) Lot # T �� N; R 1 E oziW 1 0 1 or 2 Family Dwelling — Number of Bedro s 1 Subdivision Name to # 1 El — Describe Use 11 City of ❑ State Owned — Describe Use C�SpM Number ! ❑ Village of , -�L �Townof ST Jb- III. Type of Permit: (Check only one box on line A. Complete line B if applicable) Id�J A. ❑ New System Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System (explain) B• ❑ Permit Renewal ❑ Permit Revision ❑ Change of Plumber ❑ Permit Transfer to New List Previous Permit Number and Date�issued Before Expiration Owner // IV. Type of POWTS S stem /Com onent/Device: (Check all that appl ❑ Non - Pressurized In- Ground ❑ Pressurized In- Ground ❑ At -Grade M > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil ❑ Holding Tank ❑ Other Dispersal Component (explain) ❑ Pretreatment Device (explai V. Dis ersal/Tre ent Area Information• Design Flow (gpd) Design Soil Applicati ate dsf) Dispersal Area Requir s Dispersal Area Propos sf) System Elevation VI. Tank Info Capacity in Total # of Manufactu er Gallons Gallons Units °J New Tanks Existing Tanks / ,," w o U Septic or Holding Tank Dosing Chamber VII. Responsibility Statement- I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) er's S ature MP mber Business Phone Number OFF t'ok / 2737 1 - 71 - 5- 75Y- (a Plumber's Address (Street, City, State, Zip Code) Po, VII Coun /De artment Use Onl pproved a Permit Fee Date Is ed Issuin ent Signature w en Reaso ecDenial $625 IX. Con dit$ pMF2easons for Disapproval 4, Septic tank, effluent frker and 3, `� �'�t`eAS �,'� +ter a ($,�( 4� dispersal cell must all be services / maintained as per management plan provided by plumber. 2. Al' k requirements /J must� 6 Attach to complete plans for the system and subm to the County at per not less than 81/2 x 11 inches in size Mk%z,1C NVT e HC Ll— o 2$ (OL PCRO-14 LAVIC i�AN) �9bfl UIARY flrCl f7ILEV IM k�C k �scfL FICAs& 0(,1JV6z TC 1 0 1, 4 4 - TO NRA - Kc - r -stNR- roK - 7 �2 ' Safety and Buildings commerce .Wl.gov 10541N RANCH ROAD HAYWARD WI 54843 Contact Through Relay I isconsin www.commerce.wi.gov /sb/ epartment of Commerce www.wisconsin.gov Scott Walker, Governor Paul F. Jadin, Secretary July 19, 2011 CUST ID No. 223242 ATTN: POWTSInspector JEFFERY V FOX ZONING OFFICE JEFF FOX CONTRACTING & SEPTIC INC ST CROIX COUNTY SPIA PO BOX 565 1101 CARMICHAEL RD DRESSER WI 54009 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 07/19/2013 rabove, entification Numbers ID No. 1962267 SITE: 69396 Mark Mitchell to both identification numbers, 616 Perch Lake Rd correspondence with the a enc Town of Sa int Joseph St Croix County SW1 /4, SW1 /4, S27, T30N, R19W FOR: Description: Mound, 4 bedroom residence Object Type: POWTS Component Manual Regulated Object ID No.: 1325068 Maintenance required; Replacement system; 600 GPD Flow rate; 60 in Soil minimum depth to limiting factor from W "� original grade; System(s): Mound Component Manual - Version 2.0, SBD- 10691 -P (N.01 /01), SS Effluent Filter WMP Pub. 9.6• pO L Cond t10 p ■ PR The submittal described above has been reviewed for conformance with applicable Wisconsin Administrativt,CodeA and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. This system is to be cotstriicted DEPART and located in accordance with the enclosed approved plans and with any component manual(s) referenced abowt,' . N The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. CORRE No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.14 stats. The following conditions shall be met during construction or installation and prior to occupancy or use: Key Item(s) • 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. In addition, the owner must insure that the operation, maintenance and monitoring duties as described in section VIII of the mound component manual are complied with. A copy of this information must be given to the owner upon completion of the project. • The float switch shall be a type that does not contain mercury. 2009 Wisconsin Act 44 prohibits the installation of float switches or relays that contain mercury. • The designer proposes to install a state approved effluent filter to achieve the requirement of wastewater particle size. Pursuant to outldt filter product approval stipulations, maintenance information must be given to the owner of the POWTS explaining that periodic cleaning of the effluent filter is required. The access opening used to service the filter shall terminate at or above finished grade with a watertight cover. Reminder • The orientation of the mound system must be such that the longest dimension is oriented along the surface contour per COMM 83.44(6)(a)2. JEFFERY V FOX Pale 2 7/19/2011 • Limit activities in the area 15' beyond the down slope edge of the mound per Mound Component Manual. • Surface water drainage shall be diverted away from the system area per Mound Component Manual. • Materials shall conform to the requirements of COMM 84. Comm 84.10. No fixture, appliance, appurtenance, material, device or product may be sold for use in a plumbing system or may be installed in a plumbing system, unless it is of a type conforming to the standards or specifications of chs. Comm 82 and 83 and this chapter and ch. 145, Stats. • The existing POWTS must be properly abandoned per s. Comm 83.33 Wis. Adm. Code. • Insulate building sewer per COMM 82.30(11)(c). 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 This Amount Will Be Invoiced. �fy t+ -- When You Receive That Invoice, ;. Patricia L Shan dorf t Please Include a Copy With Your POWTS Plan Reviewer. ;Integrated Services Payment Submittal. (715) 634 -7810, Fax: (715) 634-5150, M -fr 8:00 - 4:45 WiSMART. code: 7633 A pat.shandorf @wisconsin.gov cc: Leroy G Jansky, POWTS Wastewater Specialist, (715) 828-5902, Monday, 7:00 A.M. To 3:30 P.M. .. Notice: Starting July 1, 2009, no person or entity may engage or offer to engage in construction business in Wisconsin unless they hold a Building Contractor Registration, or equivalent, issued by the Safety and Buildings Division of the Wisconsin Department of Commerce. "Construction business" means a trade that installs, alters or repairs any building element, component, material or device that is regulated under the commercial building code, chs: Comm 60 to 66, the uniform dwelling code, chs. Comm 20 to 25, the electrical code, ch. Comm 16, the plumbing code, chs. Comm 81 to 87, or the public swimming pools and water attractions code, ch. Comm 90. The term does not include the delivery of building supplies or materials, or the manufacture of a building product not on the building site. For further information, go to our website: www. commerce. wi. eov/ SB/ SB- BuildinaContractorProQram.html MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Project Name: Mark Mitchell Owner's Name: same Owner's Address: 616 Perch Lake Road Hudson WI 54016 Legal Description: SW1 /4 SW1 /4 S27 T30 N /R19 W Township: St. Joseph County: St. Croix Subdivision Name: VOL 10 PG 2968 Lot Number: 1 Block Number: Parcel I.D. Number: 030 - 1076 -50 -100 S• Plan Transaction No.:v COMMER Page 1 Index and title A gU DINGS Page 2 Data entry Page 3 Mound drawings 1�EN�E Page 4 Lateral and dose tank P Page 5 System maintenance specifications Page 6 Management and contingency plan Page 7 Pump curve and specifications , 1 Page 8 Plot Plan Page 9 Soil Test A All Designer: Jeff Fox License Number: MPRS 223242 Date: 06/15/11 Phone Number: 715 755 2461 Signature. Designed Pursuant to the Mound Component Manual for POWTS Version 2.0 SDB- 10691 -P (N. 01/01), and SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST -SAS (01/81) Version 4.0 (R. 04/03) Page 1 of 9 Mound and Pressure Distribution Component Design Design Worksheet Site Information (r or c) R Residential or Commercial Design Note: Sand fill (D) calculations assume a 400.00 Estimated Wastewater Flow (gpd) Table 8344 -3 in -situ soil treatment for 1.50 Peaking Factor (e.g. 1.5 = 150 %) fecal coliform of <= 36 inches. 600.00 Design Flow (gpd) 13.70 Site Slope ( %) 99.00 Contour Line Elevation (ft) 36.00 Depth to Limiting Factor (in) 0.40 In -situ Soil Application Rate (gpd/ft Distribution Cell Information 65-001 Dispersal Cell Length Along Contour (ft) = 9.24 Cell Width (ft) 1.001 Dispersal Cell Design Loading Rate (gpd /fe) 111 Influent Wastewater Quality (1 or 2) Are the laterals the highest point in the distribution Y Pressure Disribution Information network? Enter Y or N (c or e) a Center or End Manifold 3.08 Lateral Spacing (ft) If N above, enter the elevation ft 3 Number of Laterals of the highest point. 0.125 Orifice Diameter (in) (e.g. 0.25) 2.75 Estimated Orifice Spacing (ft) = 8.34 ft /orifice 2.00 Forcemain Diameter (in) 230.00 Forcemain Length (ft) Does the forcemain drain back? Y 74.65 Pump Tank Elevation (ft) Enter Y or N 6.50 System Head (ft) x 1.3 37.52 Forcemain Drainback (gal) 24.52 Vertical Lift (ft) 87.37 5x Void Volume (gal) 4.36 Friction Loss (ft) 124.88 Minimum Dose Volume (gal) 35.38 Total Dynamic Head (ft) 29.66 System Demand (gpm) Lateral Diameter Selection Manifold Diameter Selection in. dia. options choice in. dia. options choice 0.75 1.25 x 1.00 1.50 x x 1.25 x 2.00 x 1.50 x x 3.00 2.00 x 3.00 x Gallons/inch Calculator (optional) Treatment Tank Information Total Tank Capacity (gal) 1200.001 Septic Tank Capacity (gal) Total Working Liquid Depth (in) Weeks Manufacturer gal /in (enter result in cell 1349) Dose Tank Information Effluent Filter Information 800.00 Dose Tank Capacity (gal) ISimtec Filter Manufacturer 22.00 Dose Tank Volume (gal/in) STF -100A2 ]Filter Model Number Weeks Manufacturer Project: Mark Mitchell Page 2 of 9 ' t , Mound Plan View T 1/108: : : : : : ::.... :: :: :: ::. ". ::::::. r JJ ..............Observation Pipe ... — 1 " A W :l. : — B: ...... ..... ............................. I L Mound Component Dimensions A 9.24ft E 21.19 in H 1.00ft K Efift ft B 65.00 ft F 9.50 in z 15.57 ft L ft D 6.00 in G 0.50 ft J 3.81 ft W 600.60 (ft Dispersal Cell Area 1 1612.86 (ft Area Available 9.23 (gpd/ft) Linear Loading Rate 1 6.50 (ft) 1/10 B Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area Finished Grade 101.29 (ft) ► G , . , I F 100.00 ( Dispersal Cell (ft) Lateral 99.50 (ft) --► — Invert Dispersal Cell Elevation D .< j 9 .00 (ft) Contour Elevation 13.7 %Site Slope Geotextile Fabric Cover Shading Key a Dispersal Cell See lateral details on 10 _ Topsoil Cap 0 °L 1.5 ft Page 4 for number, size, Subsoil Cap c and spacing of laterals. ASTM C33 Sand `-° Laterals are equally Z F spaced from the Tilled Layer m 0.5 ft Typical Lateral an distribution cell's Aggregate o� centerline in the * A - -t distribution cell (AxB). Project: Mark Mitchell Page 3 of 9 End Connection Lateral Layout Diagram Center Use laNrals purr rM A& B dimension •- Turn -up wfbellvilvoor eloanoutplug P .1 pFo.te.owl wical 1*. ?C —> Floles drifted do the bo[com Of the N[Nal equaogspaced Laterals 6 face main of PVC Sah 40 bl (per CO64M Tae 84.30 -5) mama eoinneot.on via tee or cross to Manifold At "pornt- Number of Laterals 3 Orifice Diameter 0.125 in Lateral Diameter 1.50 in Orifice Spacing (X) 2.76 ft Lateral Length (P) 63.48 ft Orifices per Lateral 24 Lateral Spacing (S) 3.08 ft Orifice Density 8.34 ft /orifice Lateral Flow Rate 9.89 gpm Manifold Length 6.16 ft System Flow Rate 29.66 gpm Manifold Diameter 1.50 in Total Dynamic Head 35.38 ft Forcemain Velocity 3.03 ft/sec Dose Tank Information locking cover with warning label and locking device and sealed watertight Electrical as per NEC 300 and —♦ 111���� Comm 16.28 WAC 4 in. min. � Disconnect _�_ � Tank component is properly vented F Alternate outlet location Forcemain diameter Weeks Manufacturer 2 in. Cap acityl 800.00 Gallons —T Volume 22.00 gal/inch A Weep hole or anti - Dimension Inches Gallons B siphon device A 18.69 411.12 C B 2.00 44.00 P� ump off elevation (ft) C 5.68 124.88 —f 1 75.48 D 10.00 220.00 D Total 36.361 800.00 k elevation (ft) 3" Bedding unde r tank. 74.65 Alarm Manuafacturer ISeptronics Alarm Model Number I MJJ 2501 Pump Manufacturer JZoeller Pump Model Number I BN 140 Pump Must Deliver 29.66 gpm at - 3 - 5 - 3 - 81 ft TDH Project: Mark Mitchell Page 4 of 9 Mound System Maintenance and Operation Specifica Service Provider's Name Jeff Fox Phone 715- 755 -2461 POWTS Regulator's Name �— St. Croix County Zoning Phone 1- 715 - 386 -4680 System Flow and Load Parameters Design Flow - Peak 600 gpd Maximum Influent Particle Size 1/8 in Estimated Flow - Average 400 gpd Maximum BOD5 220 mg /L Septic Tank Capacity 1200 gal Maximum TSS 150 mg/L Soil Absorption Component Size 600.6 if Maximum FOG 30 mg /L Type of Wastewaterl Domestic Maximum Fecal Coliform >10E4 cfu /100 mL Service Frequency Septic and Pump Tank Inspect and /or service once every 3 years Effluent Filter Should inspect and clean at least once every 3 years Pump and Controls Test once every 3 years Alarm Should test month) Pressure System Laterals should be flushed and p ssure tested every 1.5 years Mound Inspect for ponding and seepage once every 3 years Other Miscellaneous Construction and Materials Standards 1. Observation pipes are slotted and materials conform to Table Comm 84.30 -1, have a watertight cap, and are secured in as shown in the mound component manual. n 1"1:..ra......1 ....0 . ............a........c... -.o... a.. /'�.. w..o. OA 7n Jcv:. JA1;3 AA flo,J.. L. V,spe JQI c d ' ! aggragatO C o n " l o r m . 3 lV Co . v _?%J wl�l /, V V I J. /14111. VV4G. 3. All gravity and pressure piping materials conform to the requirements in Comm 84, Wis. Adm. Code. 4. Tillage of the basal area is accomplished with a mold board or chisel plow. 5. The mound structure and other disturbed areas will be seeded and mulched to prevent soil erosion and help reduce frost penetration. Lateral Tum -up Detail Finished .............. . Grade vl 6-8" Diameter Lawn - Threaded Cleanout Sprinkler Valve Box Plug or Ball Valve Distribution Long Sweep 90 or Two 45 Degree Bends Same Diameter as Lateral Project: Mark Mitchell Page 5 of 9 Mound System Management Plan Pursuant to Comm 83.54, Wis. Adm. Code General This system shall be operated in accordance with Comm 82-84 Wis. Adm. Code, and shall maintained in accordance with its' component manuals [SBD- 10691 -P (N.01/01) and SSWMP Publication 9.6 (01/81)] and local or state rules pertaining to system maintenance and maintenance reporting. No one should ever enter a septic or pump tank since dangerous gases may be present that could cause death. Septic and pump tank abandonment shall be in accordance with Comm 83.33, 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 fitter 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 of when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank. The addition of biological or chemical additives to enhance septic tank performance is generally not required. However, if such products are used they shall be approved for septic tank use by the Department of Commerce. Pump Tank The pump (dosing) 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 fitter is installed within the tank it shall be inspected and serviced as necessary. 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 10 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 18 months. 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 6 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring. Continuencv 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 5 of this plan for the name and telephone number of your local POWTS regulator and service provider. Project: Mark Mitchell Page 6 of 9 torAL arNwl>c lwlc+�aacnr a page $ of 9 W HEAD CAPACti Y EFFL MODEL 137 - 131140 -4140} ImaEts i 110667.9 137/139 140/4140 - - t xz' 14 a ; e S i n. ".t. CaL L1n. Cd. Ltra. , 0 35 12 � _i. » sW �• m •• set _ m se• s ea n " to i n >R • a 1/2 tiff 1 30 L%4 - - 33 301 s 137.139 +� - ' - n w •e tL» - - a tt• i 45 Un q i = 7t — N � St Z s tae► vaYe a 46 u E t5 Y • shwa 2 s A 1 B 1 C I D I E F 1377139 -4 314 7 318 1 8118 a 3k 12 314 a U.S. CM.LONS to m +o so eo m eo eo 10D t10 140 4 314 8 5M6 813A2 4 314 15 6114 LITERS W 2A o FLOW M aew7E 140 4 3l4 8 5r1s B 13f32 4 3u t8 25142 6114 160 240 ] CONSULT FACTORY FOR SPECIAL APPLICATIONS • Three phase pumps are available in 200 MV or 230V - 1371139 Models. - Variable level control wAd are available for calhrdin9 single and three • Electrical of motors, for duplex systems. are ava and supped with plisse systems. an alarm. • Dotes plggybadt variable level float smiches are available forvariable level • Mecharkat aitemators. jar duplex systems, are available wflh or wifltoul: long vyde corers. alarm v tches. - Long cords swil ie in of 15 -2&3&W 1eeL (emu n 25' length • Combination staffers are availaW for 3 phase pumps- for 14014140 models @ 11510 • Contrd alarm systems are avaitabte for 1 pflase pumps. • Over 130'F. (W.) special cation r gied. 137 Series - 47 its. 139 Series - 31 its. 140 Series - 53 >bs. 4140 Belies - 73 Ms. • Refer to FM0808 for 200' F. appBCabons. - Sloole Seal Coatrd Sekelion Model 1OW% Mob AMs 510111le Duplex CSA M' SELECTION GM N137t139 115 1 Arlo 10.7 1 et &8 — Y Y N1371139 115 1 Non 10 2or2 &7 3orS &6 Y Y 1. htWd lost opt2pdemedmrkalswk*noexlerruil . BN137 115 1 MAD 10.7 2 y Y 2. SkIC pigm0a& varldble bM bd sAch or double pkimba* variabl6 level 0137/139 230 1 Rub 58 7 or i 8 8 — Y Y flod w1clL Refer to FLOW E 737r139 230 1 Non 5.8 2"2&7 3or5 & e Y Y 3. tt1 edwkai sRarralor'M4W 10.0072 or 10-0075. • H1371139 200 -209 1 Aldo 53 1&8 — Y N 4. CoMbklathn 50W.Reler to fM0514. 1137/139 200 208 1 Non 55 2&7 3 a 5 & 6 Y N S. See j4l0712 for earrad model of FJedriCet ANethstor • E W. J137r139 200.2118 3 Non 2B 284 WOMB Y Y 6. V ieuelrw" wAld110 02�rsadasaaoehbtadtvalor. idupW 01371139 _ 23D3 Nat 26 2&4 WorS88 • 2137 480 3 Non 14 284 3&4orS58 N 7- N Few(4)hoieJ- Paid '.jrmeimbMkiorwswVtcorawmnor ll r • G139' 3 Nan 1.4 2 &4 3&4ar5&6 N M or2pwr4loperatior1 .• ta8ti148 - " MODELS Cor" SekcBolt 8. Two (2) hole - J W, for Wd rtigt* coweellm or spice . 10-0003. mom Model vak ph oupla CSA UL N140 N4140 115 1 Non 1 150 2or2&7 3erS&S E140 C-414o 230 iT Non 1 7.5 2a2 &7 3orS88 N N BE140 BE4140 230 1 Fbn 7-5i 2or2&7 3or5&6 N N SN140 ON4140 115 1 Non 150 2or2 &7 3or5 &8 N N CAt1TIM • ?bm*bdoilg ° sw*0WAa&sw* bdWW All onatconbuls, prot ecdon do inesandtr by -- n, = w aw , a" s ,acpda,d>� – swoes.sedFdWScawg*mabbbaaBM rNEM4x a „e,It #Cerwed eioctdcipl. AN and sdo � should be " P� Mowed ••"•n iq the most mw* Ill orrd leC6iC Code Offiq and the ftnp9vAstbeopara1edsn*Wp=&W ompr1lonat Safety and Health Act tf> Three phase tnfttequilaamr soMbopmabaooderae I magndcormclbilre6oltdaclec For infocrlleticrl an atitd5a W Za ft products mw b cst ft on Colab4tfan stow FM0514; PWyba dVali "LeretF4etSwkt*&FMd477:Eled dAUMdwFMOMMedwiealA6e s. 1w.>Ara11n FM,andsla,pSewaa. RESERVE POWERED DESIGN For unusual conditions a reserve safety facdw is engineered into the design of every Zoeller pump. M4L car P.O. Box 16347 L KY 4MMCX7 Aar3rlaCaleetad.. `./" S'fMP7R �rscarletau,r4aeo_ L KY4021r -1 f isuryf —90M- 1939 PUILIP E71, ` FAXt5C1j7743624 *j IA-1 PCROO [JAYIC P�L Wee lc-; D: TA Ry - ICO - ScIL - ReAs& (. a" Tc 101. '4 - TV )XIA'104-I r-) Lij 11:,6 _7� q g t�P ONI IG�AX 4 f PAGE 01/02 -Iso . 4k PA I D S�W�E" Wisconsin Departmen f Comm Q2 OI EVALUr4Tl , t R,EP - _ page of Division of Safety and Ildhu�s �U \� _ U yS� E — Comm 85, Wis. Adm. Code .Attach complete site pi on an 8 112 x 11 inches In size. Plan (must County ' C . ' 1. include, but not liirilted t V@ horizontal reference point (6M), ditualon and R ome) I percent slope, scale or di slons, north arrow, and location and distance to nearest road. Please print all information, eviewed b Date 2 Personll Information you provide may de used for soeondary purposes (Privacy Lt w, s. 15.04 (1) (m)). (f J { I Property Owner Property L,OCat10n K ar l< M . 4 Govt_ I_at 5 to 1/4 g 0 14 S T 3 O N K 1 9 a (o Properly Owner's Mailing Address Sub rEO t # Block # d, Name or CSW r o �. a City Code Fhone Number City Q Village ®.Town Nearest Road V [� New Construction use: 1A Residential / Number of bedrooms „ Code derived design flow rats / n h GPD Fjj .riepiace Terri J/, 11 &1WI-7 arc mm•rclal - 04g"ihe _ ---- -` Pare ntm aterial `�� " � Flood Plain elevation if appllcable $. General comments �L and rec mendations. 2 S VS 5 C 5 �7 A. , 7 J t ! k*_ I-A p) w% Q .2 . 4 -I%A Q7. y y bG 5a oir� > 30) 4 D Of- W/rtq 9gr4A&,L llil � 7 , L . 9 y • r -� Boring # FE Boring ,�i ib'71,5 . Pit Grouno surface elev. 8 V R. Depth to limlting f actor In $oil AppII086517 Rate Horizon Depth Dominant Color Redox Descriptlon Texture Structure Consistence boundary Roots PD/1? In. Munseil Qu. Sz. Cont. Color C;r. Sz. Sh. S V4AVr V 3 QY - -- LIA 0 1 •" 7 Y l - w { Boring # Q Boring I I El Pit Ground surface rlay. ft . Depth to !lm!t!ng f000f � in, -- - .. Soil A 11catlon Rai- Ftorlion Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD1lF _ In. Munsell Qu. Sz, Cont. Color Gr. Sz. Sh. "Efr#1 .E Y`• " Eiftuent i�'l Q BQD � 30 a 220 mg1L. and TSE >gp � 16P mg /L " Pfili iAnt #2 m BOC1 c CST Name (Please Print) _ 30 — gA, and TSS a 30 mg/L Signature CST Number dress # t + ' e Ga#a EWaluat!on Cvndualed Telephone Number s- 1- 16 -OP t'a` '/� � � w ;f '� 5 �� , • �'�i at ' 3 n�, �. ! �i w 0�1�1 its �, �`' fi e. _ r ". 3 too p _ - -- - di *4 L W «-� fo i 1 S ry 531742 AUG 15 195 St CROIX COUNTY : SURVEYOR'S RECORD CERT_ I F.I ED.. _SURVEY MAP Located in part of the SWj of the SWi, Section 27, T30N, R19W, Town of St. Joseph, St. Croix County, Wisconsin. _ _ OWNER UNPL i E D LANDS John Schottler 1374 C.T.H. "I" Somerset, WI 54025 N88 029127 11W 300.00' POND, o a of << s �---- FILED Cft N 01 JUL 2 6 1995 b 3 = fD (D d 0- o I c:: KATHLEEN H. WALSH o -, � z Register of Deeds CD M 0 I L o o I 6 SL Croix C o, WI S Iv O I to N o N to 4W 0 I r N N 1 � N N°' I' o LOT I C) 1y y t0 N O Nn Ct I Ill I —I 4 Cr mo c, ICS ( 3.99 Acres Inc. R/W I IC7 ,p- vi 173,965 Sq. Ft. Ir F F 3.77 Acres Exc. R/W m m l> 164,064 Sq. Ft. W Ir I � Ln - - I o I I Ln 1L' 0 o IC7 Co F t �a r S, w I o w � 5 88 ° 29'27 "E S88 0 29 1 27 "E W O : '"' S88 0 29 1 27 "E SW Corners 625.00 S88 °29'27 "E 300.00' w - Section 27A South L of the SW k F of Sect 27 =� 1709.27' Sk Corner i Section 27 L AKE F��/aC i LEGEND LQ I 1 UNPLA I I ED Lj� Alum Pn "94rlty tion qw 0 to O 0 cn O 3 v 0 � y1 c c 3 3 n 3 - H 3 m = K (c v a� • v (D a # c c � ��T Z O rn ZL m Z O N) K 'I N to o W ! o• 3 c 3 o 3 c " o C_ W i o eo m J• a. -I CD � 'I 0 o C N N J Q qp t. Z � (D CD S O rr, ro o m m p m co C A N A a N cn 3 m S N 9' 'S O O O C sPS Cn Ca 7r CD O 0 X O W L >y CO O N O C1 J CA :E O y l O y C O O O V fD C a. (D h� D o a Z En 0) o 00 =r D ( ° :r rn m r ` r N A N O `-•^• c O O F I CD N N (O CD �-,, CD CD 0 N C.0 O W CD -», CO � -b, A O fU (n CD m rn a o � O c = y r `+ 2 c Z CL a !I O O O 0 0 0? Z p p `2 p °_ 0 C7 N W y (7 c N N N D N � CJ T a G A 7 cr G A J CD M N M _O (D w N O O O W CD O N CD (P (p Z N 3 3 °' 3 3 °' N CD (D (P J 7 C Z 0 y a k D D c 0 o =r CL N • CD (D m c CD c CD CD c CL 3 z m (n m Z co o 4 � , 1p U ; Z O p, J C — n � ¢ N W G W J CL '+ G Z 00 3 0 3 A a 0 0 ",; Z N m Z y Z co 'O N 7 A "O 3 ° o -cr3 a 3C: a � (p va _ .•. c T J T CL as m c r Z c �= Z o m :3 a o o m y o N CO 7 Cn N 0 � C = C D -n O fl '� Q N 03 0 A x s� A 7c n O CD m cp cr CD � m — �j 3 •w o d 0(0 N Cn J O CD O O O O N ? 5 cn CL O =r (D (n N J ((D O' _ CD CD 'o j CD f> � a- O J O 0 0 b � b CD CD �0 w +4i 0 0 o O o CD CD 0 CL ST. CROIX COUNTY WISCONSIN ZONING OFFICE ST. CROIX COUNTY GOVERNMENT CENTER rrrrf '' • ' _ 1101 Carmichael Road r - _ Hudson, WI 54016 -7710 (715) 386 -4680 October 7, 1996 Attention: Becky Hartman Homes P.O. Box 326 Somerset, Wisconsin 54025 Re: Septic Inspection for Property Located at 616 Perch Lake Road, Hudson, Wisconsin Dear Becky: An inspection of the septic system installed to serve the above described residence was conducted on September 19, 1996. This property is located in the SWa of the SW, of Section 27, T30N -R19W, Town of St. Joseph, St. Croix County, Wisconsin. At the time of the installation, this septic system was found to be code compliant for a four (4) bedroom home. If you have any questions with regard to the above, please do not hesitate in contacting our office. Sincerely, Mary Jenkins Assistant Zoning Administrator pe Y STC - 104 AS BUILT SANITARY SYSTEM REPORT`; OWNER Y- �.x� �► ' ADDRESS SUBDIVISION / CSM # ��p`f�g LOT SECTION ,,,2_. T _3�^, N -R /Z W, Town of - ST. CROIX C UNTY, WISCONSIN P VIEW S OW EVERYTHING W THIN 100 FEET OF SYSTEM x° ©o N y le e l I DICATE NORTH ARROW Provide setback and elevation information on reverse of this form. Provide 2 dimensions to center of septic tank manhole cover- WisconsnDeparXnentof ,industry, PRIVATE SEWAGE SYSTEM County: Labor and Human Relations INSPECTION REPORT ST. CROIX Safety a id B1jildings D1vision (ATTACH TO PERMIT) Sanitary 68700 GENERAL INFORMATION Z Permit Holder's Name: City pp Villa Be Town of: State Plan ID No.: MITCHELL, MARK 1 1 �T JOSE)�H CST BM Elev.: Insp. BM Elev.: BM Description: Parcel Tax No.: xl !r TANK INFORMATION ELEVATION DATA A9600345 TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic) dUC� Benchmark Dosing y ' a Aeration Bldg. Sewer ?,L S Holding St/ Ht Inlet ' TANK SETBACK INFORMATION St /Ht Outlet TANKTO P/L WELL BLDG. VV,enttake ROAD Dt Inlet a i x,93' Septic >'A � 70 � y y r).� s NA Dt Bottom Dosing NA Header / Man. ,, 77 Aeration NA Dist. Pipe 5, Sy �/G 1a�1 Holding Bot. System �. z1y q5 7 PUMP/ SIPHON INFORMATION Final Grade of q . 7 Manufacturer (� ; ? s Demand Model Number _? � // k I GPM TDH Lift ;z 19, Friction o Syste TDHdLcif Ft Head I Forcemain Lengthy` Dia. ,Z " Dist. To Well SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth DIMENSIONS DIMENSION SYSTEM TO P / L BLDG WELL LAKE/STREAM LEACHING Manufacturer. SETBACK INFORMATION TypeO CHAMBER �Az,,r model Number: System: 'a S o r 'aSv ��� OR UNIT DISTRIBUTION SYSTEM Header/Manifold Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake 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 discrepancies, persons present, etc.) LOCATION: ST JOSEPH.27.30.19W, SW, SW, PERCH LAKE ROAD "-� .�b 0-'- V Plan revision required? ❑ Yes 6, No Use other side for additional information. SBD -6710 (R 05/91) Date nsp s Signature Cert. No SANITARY PERMIT APPLICATION S afety and Buildings Division Bureau of Building Water Systems In accord with ILHR 83.05, Wis. Adm. Code 201 E. Washington Ave. P.O. Box 7969 Madison, WI 53707 -7969 • Attach complete plans (to the county copy only) for the system, on paper not less County than 81/2 x 11 inches in size. • See reverse side for instructions for completing this application state sanitar y Number The information you provide may be used by other government agency programs 19Z � 7 [Privacy Law, s. 15.04 (1) (m)]. Check if revision to previous application State Plan I.D. Number I. APPLICATION INFORMATION - PLEASE PRINT ALL INFORMATION Pr ope wrier Name I I Property Location N, R(or� Pro rt Owner' ailing dress Lot Number Block Nurn beyl City ate Zip Coe Phone Number Subdi is on Name or CSM Number ( ) 11. YPE OF UILDING: (check one) [I State Owned ❑ Uty Near st Road Public 0 1 or 2 Family Dwelling � - No. of bedrooms c] VII age Town OF III BUILDING USE (If building type is public, check all that apply) Parcel Tax Number(s) 1 ❑ Apartment/ Condo ( Ze -le76 - s'Q —160 2 ❑ Assembly Hall 6 ❑ Medical Facility/ Nursing Home 10 ❑ Outdoor Recreational Facility 3 ❑ Campground 7 ❑ Merchandise: Sales/ Repairs 11 ❑ Restaurant /Bar /Dining 4 ❑ Church/School 8 ❑ Mobile Home Park 12 ❑ Service Station / Car Wash 5 ❑ Hotel /Motel 9 ❑ Office/ Factory 13 ❑ Other: specify IV. TYPE OF PERMIT: (Check only one box on line A. Check box on line B, if applicable) A) 1 • 5g System 2. E] Replacement 3_ E] Replacementof 4_ E] Reconnection of 5_ E] Repair of an - -_____ ____-------- _y= _ _________ -- Tank Only _- ____ -_ -- ---------- Existing System ___- ___ Existing System_ B) E] A Sanitary Permit was previously issued. Permit Number y6 Date Issued y g V. TYPE OF SYSTEM: (Check only one) Non - Pressurized Distribution Pressurized Distribution Experimental Other 11 R[Seepage Bed 21 ❑ Mound 30 ❑ Specify Type 41 ❑ Holding Tank 12 ❑ Seepage Trench 22 ❑ In- Ground Pressure 42 ❑ Pit Privy 13 ❑ Seepage Pit 43 ❑ Vault Privy 14 ❑ System -In -Fill VI. ABSORPTION SYSTEM INFORMATION: 1. Gallons Per Day 2. Absorp. Area 3. Absorp. Area 4. Loading Rate 5. Per . Rate 6. System Elev. 7. Final Grade Required (sq. ft.) Proposed (sq. ft.) (Gals/day /sq. ft.) (Min inch) Elevation VII. TANK Capacity Feet Feet INFORMATION in gallons Total # of Prefab. Site Manufacturer's N Fiber- Ex er. New —Existing Gallons Tanks urer's ame Concrete Con- Steel glass Plastic A p p Tanks Tanks strutted Septic Tank or Holding Tank — ! El El E] ❑ ❑ Lift Pump Tank /Siphon Chamber / I� El ❑ El ❑ VIII. RESPONSIBILITY STATEMENT 1L51 I, the. ndersigned, assume responsibility for i stallation the onsite sewage system shown on the attached plans. Plum er' Nam : (P tj Plum er' it N Sta ps MP /MPRSW No.: Business Phone Number: Plumber's Address (Street, ity, State p Code): S IX. COUNTY / DEPARTMENT USEONL ❑ Disapproved Sa dry Permit Fee (I ncludes Groundwater ate Issue Issuing Agent Signatu o Stamps) ❑ Approved ❑ Owner Given Initial / Surcharge Fee) w Adverse Determination �I X. CONDITIONS OF APPROVAL/ REASONS FOR DISAPPROVAL: SSD -6398 (R. 05/94) DISTRIBUTION: Original to county. One copy To: Safety & Buildings Div. ion, Owner, Plumber I f F Al ArAV Cie -r r , �- r 0 ka m a z a ` Q fD a LAI �rt n cn N N m rt Q 'p O O O M ro n � N f � rt M N =------- - - - --- w N — M a rt 0 '< C M r ��► 0 : 0� p 0 ` r rt d n N• rr a 0 K rt 0 rt �n r• a w n a a 0 PAGE OF PUMP CHAMBER CROSS SECTION AND SPECIFICATIONS VE NT CAP y" . VENT PIPE WEATHERPROOF APPROVED LOCKING JUIJCTIOM BOX MANHOLE COVGR WITH 25' FROM OOOR, WARNING LASEL WINDOW Olt FRESH 12�MIU. AIR INTAKE GRADE I 4•' MIAJ. I COIJDUIT -- — _- ________ Ie•nw.\ - - - - -- IIULET PROVIDE 1 - - - -- - 'T - AIRTIGHT SEAL I I 1 I I APPROVED JOIWT A I I APPROVED JOIIJTS W/ PIPE I II w/" ' PIPE EXTENDIMC9 3' I I ALARM EXTEIJDIIJG 3' OWTO SOLID SOIL B I I) ONTO SOLID SOIL I 1 I i O c I 1 ELEV. FT. PUMP j � b OFF 0 COUCKETE BLOCK RISER EXIT PERMITTED OIJLtl IF TANK MAUUFACTURER HAS SUCH APPROVAL Z" p}PPA0VE.a BE 9>bING vAV%d "r^04K SEPTIC E SPECIFICATIOAIS DOSE TACKS MANUFACTURER: ,1'fs (DUMBER OF DOSES: PER DAB TA WK SIZE: GALLOWS DOSE VOLUME ��yy ALARM MAUUFACTURER: S - INCLUDING BACKFLOW: 1 GALLONS MODEL )JUMBEK: � � CAPACITIES: A WCHES OR GALLOWS SWITCH TYPE: �/�✓° / B = INCHES OR _F- GALLONS PUMP MAUUFACTURCK: � .12c�d 1 C,- 1uCHE$ OR _ &< GALLONS MODEL AIUM8E It' < ���5 - lt/�(�� //L D INCHES OR -)". GALLONS SWITCH TYPE: - ����� iJOTE: PUMP AND ALARM ARE TO BE MIMIMUM DISCHARGE RATE �� GPM INSTALLED OW SEPARATE CIRCUITS VERTICAL DIFFEKE BETWEEN PUMP OFF ARID DISTRIBUTION PIPE.. ,)Z,O FEET + MIIJIMUM METWORK SUPPLY PRESSUR ✓ . . . . . . . . . 4s� FEET + 6 ^� FEET OF FORCE MAIN X F / oo r T.FRtCTIOU FACYOR.. _52 FEET TOTAL DyIJAMIC HEAD = FEET IMTERIJAL DIME SIOMf. OF T K LENGTH jWIDTH jLIQUID DEPTH 5 IGrJE D: LICE NUMBER: � �� DATE: r � ' ■■■■MINE■ ■ ■� ■ ■ ■ ■ ■ ■ ■■ :: MEN EEN�EEMINNE ■ ■NE of "� ■ ■ \'� EEMINMIMIMIN ■E■ ■■■MIEN■ :�� ■ orb 0 M IN ■E=iE\ ■ ■ ► \ ■�■ ■ ■ ■ ■N ■ ■ ■■ No ram■ ■ \ENN ENN ►� ■ ■ ■ ■ ■ ■ ■■ lK ■MINEEMI \MIN ►� ■■NMI \NNN■NN■ ■���!�NMIE ■ ■ \ \■MI:�NMI \� ►N ■S EMI■ M MOM NONE INK3 ME ■E■■■■■ ■E■■■ ■ ► ■ \ \�� \��V ■ ■ Own ME MODEL 3885 MEMO M SIZEA" Solids ■■ ■EMI ■ ■ ■ ■N ■ ■MI�MINEMIE ■EEENE■ 1►1 MORMON M M 0 IN ME IN ■E ■ ■ ■NE■■■ ■ MEN M ME ■ ENN■EMN■■■■■■■■■■■■■■■■■■ ■■■E■EE\VENN ■ ■ ■ ■NNE■■N■mo MENNEN • �mom EEEEEN ■ \ ■ ■MI■EMI ■ ■■ ■■mom 'MIEEEEEEEN►EENEEENEEE■ MEN ■ MENOMONEE UNIN no ME ■ ■ ■ ■ ■ ■ ■� ■ ■ ■ ■ ■ ■ ■ ■ ■■■■■ I MEMMMIOMMMMUMU MENUS ■ ■■ ■EN\■EE ■MIE\EN■NEEMINNNE ' ■■E■■EEE\\N ■N■ ON ■N■■ ■EE■ ■\■EE NONE EMIE ■■NNNW ' ■EEE ■E■ ■EE\EN■NE�NMI ■EEmom 'O:: ■ ■■E ■ ■NENN ■EN ► ■NNNN■■■ ■NE mmmmmmmm— mm m���� ONE Wiscons'in of Industry SOIL AND SITE EVALUATION Labor and Human Relations Page _'Z_ of Division of Safety and Buildings in accordance with s. ILHR 83.09, Wis. Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must County include, but not limited to: vertical and horizontal reference point (BM), direction and percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D. # APPLICANT INFORMATION - Please print all information Reviewed by Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Prope er Property Location Govt. Lot T N,R E�'(orK Pr perry Owner's Mailing Address Lot # Bloc Subd. Name or CSM# !L Sta�e Zip Code Phone Number Nearest Road ( ) El city ills a 10 own [Z New Construction Use: Residential / Number of bedrooms Addition to existing building ❑ Replacement ❑ Public or commercial - Describe: Code derived daily flow 4 �40 gpd Recommended design loading rate _�� bed, gpd/ft gpd/ft Absorption area required bed, ft j trench, ft � Maximum design loading rate Z bed, gpd/ft trench, gpd/ft Recommended infiltration surface elevation(s) 25 �s ft (as referred to site plan benchmark) Additional design /site considerations Parent material LT Flood plain elevation, if applicable ft S = Suitable for system Conventional Mound In- Ground Pressure AT-Grade System in Fill Holding Tank U = Unsuitable for system ® S ❑ U 0 S ❑ U 0 s ❑ u ® s ❑ U I ❑ s U EIS O U SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Structure GPD /ft2 in. Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. Consistence Boundary Roots Bed , Trench L1 j Q 7 Ground elev. _ s Depth to limiting factor Remarks: Boring # - ' Ground ft. Depth to limiting factor yin. Re arks: CST Nam (P ase P int) 1 Signature Telephone No. ✓/ 1 - J Address Da a CST Number ".fix' /�'t'� : �s°�.iy, s�'�� s�:�7 � - �3a,✓- x , sy y fi %looA j - ¢� 3� 9 :8 51742 AUG i 51995 ST. CROIX COUNTY g SURVEYOR'S RECORD CERTIFIED__SURVEY MAP Located in part of the SWi of the SWj, Section 27, T30N, R19W, Town of St. Joseph, St. Croix County, Wisconsin. OWNER U N LANDS John Schottler -- -- � I -- 1374 C.T.H. "I" 1 Somerset, WI 54025 N88 0 29 1 27 11 W 300.00' OD N o P0N ° CA c �� 3 FILED ' - 0! JUL 2 61995 ► 4 3 m KATHLEEN H. WALM c f° co Register of Deeds -*' I o I F SL CrOfic Co., WI S 0 -v 0 N I m to co I r N N V 000 M I o LOT I ,gyp (y —� N o Ct I fTl CS � A o I I I 3.99 Acres Inc. R/W I I C7 -P Ln 173,965 Sq. Ft. O 0 3.77 Acres Exc. R/W m m co y 164,064 Sq. Ft. Ir- I Ln I - ID I C7 00 I to I Z o 00 W W W W . C S 88 0 29' 27_! 'E 300.0 S88 029127 11E w S88 0 29 1 27 11 E SW Corner S88 0 29'27 "E 300.00' W Section 27� 625.00 South L in e of the SW of Sect 27 1 709.27 Sk, Corner Section 27 LEGEND y g, l� l i JNPLA ED LA N-- Mlum nu ` � � l tion L Wisconsin Department of industry, PRIVATE SEWAGE SYSTEM County: ST. CROIX 1 Labor and Human telations INSPECTION REPORT Safety and Buildings Division (ATTACH TO PERMIT) Sanitary Permit No GENERAL INFORMATION P n �� fm ❑City ❑Village Town of: State Plan No.: CST BM Elev.: Insp. BM Elev.: BM Description: Parcel Tax No.: TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark Dosing Aeration Bldg. Sewer Holding St / Ht Inlet TANK SETBACK INFORMATION St/ Ht Outlet TANK TO P/ L WELL BLDG. Air I to ROAD Dt Inlet irntake Septic NA Dt Bottom Dosing NA Header/Man. Aeration NA Dist. Pipe Holding Bot. System PUMP/ SIPHON INFORMATION Final Grade Manufacturer Demand Model Number GPM TDH Lift Friction System TDH Ft e Forcemain Length Did. Dist. To Well SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth DIMENSIONS DIMEN ION SETBACK SYSTEM TO P / L BLDG WELL LAKE/STREAM LEACHING Manufacturer: INFORMATION TypeO CHAMBER Model Number: System: OR UNIT DISTRIBUTION SYSTEM Header/Manifold Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake 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 discrepancies, persons present, etc.) LOCATION: ST JOSEPH.27.30.19W, SW, SW, PERCH LAKE RD Plan revision required? ❑ Yes ❑ No Use other side for additional information. SBD- 6710(R 05/91) Date Inspector's Signature Cert.No. Safety and Buildings Division �' ■��■■� SANITARY PERMIT APPLICATION Bureau of Buildin water s In accord with ILHR 83.05, Wis. Adm. Code 201 E. Washington Ave. P.O. Box 7969 • Attach complete plans (to the county copy only) for the system, on paper not less :County Madison, WI 53707 -7969 than 8112 x 11 inches in size. • See reverse side for instructions for completing this application state sanitary Permit Number The information you provide may be used by other government agency programs [Privacy Law, s. 15.04 (1) (m)]. ❑Check if revision to previous application I. APPLICATION INFORMATION -PLEASE PRINT ALL INFORMATION State Plan I.D. Number Proper, Owner Name Property Location tLotNum:ber /a 1/4, $ T , N, R(pr� Property Owner' ailing Ad ress Block Nur;i r Cit , ate Zip Code Phone Number Subdivisi n Name or CSM Number i t , Ir ( ) I. TYPE OF B ILDING: (check one) ❑ State Owned ❑ it a � Neare t Road Ej Public 1 or 2 Family Dwelling - No. of bedrooms ❑vige Town OF III. BUILDING USE (If building ° g ype is public, check all that apply) Parcel Tax Number(s) 1 ❑ Apartment/ Condo 0 3�5 - /D 2 ❑ Assembly Hall 6 ❑ Medical Facility/ Nursing Home 10 ❑ Outdoor Recreational Facility 3 ❑ Campground 7 ❑ Merchandise: Sales/ Repairs 11 ❑ Restaurant/ Bar/ Dining 4 ❑ Church/School 8 ❑ Mobile Home Park 12 ❑ Service Station/ Car Wash 5 ❑ Hotel/ Motel 9 ❑ Office/Factory 13 ❑ Other: specify IV. TYPE OF PERMIT: (Check only one box on line A. Check box on line B, if applicable) A) 1. V� New 2. ❑ Replacement 3. ❑ Replacement of 4 Reconnection of ------ System --- System Tank ❑ 5. p Repair of an ------- ----------------- ------- Y _ ------ _ - ____ Existing System -- - - - - -- Existing System B) ❑ A Sanitary Permit was previously issued. Permit Number Date Issued V. TYPE OF SYSTEM: (Check only one) Non- Pressurized Distribution Pressurized Distribution Experimental Other 11 ❑ Seepage Bed 21 Mound 12 ® 30 El Specify Type 41 ❑Holding Tank ❑ Seepage e p g Trench 22 ❑ In- Ground Pressure 13 42 E] Pit Privy E] Seepage Pit 14 ❑ System -In -Fill 43 ❑ Vault Privy VI. ABSORPTION SYSTEM INFORMATION: 1. Gallons Per Day 2. Absorp. Area 3. Absorp. Area 4. Loading Rate 5. Perc. Rate 6. System Elev. 7. Final Grade Required (sq. ft.) Proposed (sq. ft.) (Gals/day /sq. ft.) (Min inch) Elevation All VII TANK Capacity Feet Feet INFORMATION in gallons Total # of Prefab. Site G N Fiber- E x per- New Existin Gallons Tanks Manufacturer's Name concrete con- steel glass Plastic A p p Tanks Tanks structed Septic Tank or Holding Tank _ ❑ ❑ ❑ ❑ ❑ Lift Pump Tank /Siphon Chamber ® ❑ ❑ ❑ ❑ ❑ VIII. RESPONSIBILITY STATEMENT 1, the undersigned, assume responsibility for i stallation of the onsite sewage system shown on the attached plans. Plu b 's Na e: P in Plum er' i to . N t ps) MP /MPRSW No.: Business Phone Number: Plumber s Addr ss (Strget, Ci y, tate, Zip ode): — 5' IX. COUNTY / DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (includes Groundwater ate Issuing Ag nt Signature (N ps) Approved El Owner Given Initial Surcharge Fee) Adverse Determination �a %, sy X. CONDITIONS OFAPPROVAIJ REASONS FOR DISAPPROVAL: SBD -6398 (R.0"4) DISTRIBUTION: Original to County, one copy To: Safety & Buildings Dive ion, owner, Plumber SAFETY & BUILDINGS DIVISION State of Wisconsin Department of Industry, Labor and Human Relations March 7, 1996 2226 Rose Street La Crosse WI 54603 K 0 CONSTRUCTION KIM 0 CONNELL 308 MIDPINE CT STAR PRAIRIE WI 54026 RE: PLAN S96 -40055 FEE RECEIVED: 180.00 MITCHELL, MARK SW,SW,27,30,19W TOWN OF ST JOSEPH COUNTY OF ST CROIX MOUND SYSTEM The Department has reviewed the above - referenced submittal. Conditional approval is hereby granted for the system plan submittal. All noted items must be corrected. The review and approval of the system is based on chapter 145, Wisconsin Statutes, and chapters ILHR 83 and 84, Wisconsin Administrative Code, and is contingent upon compliance with any stipulations shown on the plans. This system has not been reviewed for the code requirements set forth in chapter ILHR 82 or in chapters ILHR 50 -64, Wisconsin Administrative Code. This plan submittal approval will expire two years from the approval date, or if a sanitary permit is obtained, plan approval will expire on the day the initial sanitary permit expires. The licensed plumber responsible for this installation shall keep one set of plans with the Department's stamp of approval at the construction site. The installer shall notify the appropriate inspector when inspections can be made. All permits required by the city, village, township or county shall be obtained prior to installation. Inquiries should be directed to me at the number listed below. Please refer to the plan number shown above. Sincerely, erard M. S Plan Reviewer Section of Private Sewage (608) 785 -9348 3974R/ 1 SHDA -7987 (R. 10/84) Wisconsin Department of Industry PRIVATE SEWAGE SYSTEM Safety and Buildings Division Laborl3pd Human Relations REVIEW APPLICATION Bureau of Building Water Systems ' Hayward Office La Crosse Office Madison Office Shawano Office Waukesha Office 209 W 1 st Street 2226 Rose Street 201 E Washington Ave. 1340 E. Green Bay Street 401 Pilot Court, Suite C Rt 8, Box 8072 LaCrosse, WI 54603 P.O. Box 7969 Suite 300 Waukesha, WI 53188 Hayward, WI 54843 Phon (608) 785 -934 _ Madison, WI 53707 Shawano, WI 54166 Phone (414) 548 -8606 Phone (715) 634 -4804 Fax (608) 785 -9330 Phone (608) 267 -5119 Phone (715) 524 -3626 Fax (414) 548 -8614 Fax (715) 634 -5150 Fax (608) 267 -0592 Fax (715) 524 -3633 INSTRUCTIONS: To save time, schedule your review with one of the offices listed above prior to submittal. Fill in all applicable data and submit this form together with fees and plans /information. Your submittal must be received at least one working day prior to h pg tment.Ot o�ce� I n of the fisted offices rf y ou need help fillet out the form or hav neivh�tn m ore Yd ' where your review was scheduled Please cal a Y P 9 submit. PLEASE PRINT VERY CLEARLY. A sample of a completed form is on the reverse side for your reference. 1. APPOINTMENT INFORMATION - you have scheduled an appointment, fill in the information requested below to save time: Appointment Date Revie r Name Plan Identification Number 2. PROJECT INFORMATION If this review is a revision or extension to your existing plan identification number, provide that number here: Project Name El City El Village ®Town Of: County n roject location .2 GOVT LOT 1/4 114,$ N,R C or . , .1 All 3. APPLICATION FOR 4. FEE COMPUTATIONS FEE SUBMITTED System Type (check one): System Type r (include new and existing tanks) Up To 1,500 gallon septic tank .................. $110.00 ........ /f� _ A At -Grade 1,501 -2,500 gallon septic tank .................. $120.00 H Holding Tank 2,501- 5,000 gallon septic tank .................. $160.00 ........ M Mound 5,001 - 9,000 gallon septic tank .................. $200.00 ........ N El Non - Pressurized In- Ground (Conventional) 9.001 - 15,000 gallon septic tank .................. $ 300.00 ........ P 1:1 Pressurized In- Ground Over 15,000 gallon septic tank .................. $ 500.00 ........ O E] Other: Up To 1,000 gallon dose chamber S 70.00 ........ zo 1,001 -2,000 gallon dose chamber S 80.00 ........ Building Type (check one): 2,001 - 4,000 gallon dose chamber $100.00 ........ 4,001 - 8,000 gallon dose chamber ............... $120.00 ........ D Dwelling, 1 or 2 Family 8,001 - 12,000gallon dose chamber ............... $140.00 ........ P Public Building Over 12,000 gallon dose chamber $160.00 ........ S State -Owned Building Up To 5,000 gallon holding tank ................ $ 60.00 5,001 - 10,000 gallon holding tank ................ $100.00 ........ Code Derived Daily Flow 1!::;n6 gpd Over 10,000 gallon holding tank $150.00 Check If Replacing Existing System Experimental System (additional onetime fee) $ 300.00 ........ Revisions To Approved Plan I $ 60.00 ....... . REeEIVED Petition For Variance: Setback ..... ..... .... $100.00 ........ Petition For Variance Site Evaluation MAR _. 6 1PP.00 ........ Plumbing 25.00 ....... . ............ Revision ............ ..... 7 ...... Groundwater Monitoring - Per Site SA............ $ - 60 ........ Groundwater Monitoring A0 (other than a proposed subdivision) Site Evaluation in Lieu of Groundwater Monitoring Site Evaluation in Lieu of Groundwater Monitoring $ 60.00 Subtotal: ......... Priority Review: Enter same amount as Subtotal: ........ MAKE ALL CHECKS PAYABLE TO: SAFETY AND BUILDINGS DIVISION Total Fee: ...... 5. SUBMITTING PARTY INFORMATION Telephone No (include area code & extension) Comp$aili Name Conta Pers v '] ( > / No Street Ad ress Or P.O ox City, Town r Village fate, lip Code 1 2 2 / t Aerobic or prepackaged treatment system fees are calculated based on equivalent size septic tanks and dose chambers z Revision fees are not applicable to temporary holding tanks or extensions to existing approvals. NOTE: Fees are pursuant to Wis Adm. Code, Chapter ILHR 2, and are subject to change annually The information you provide may be used by other government agency programs (Privacy Law, s. 15.04 (1) (ril SBDW -6748 (R. 09/94) OVER ��' / !' Nor i7;; // o Size -� � � S- . I ,? 7x'oles4o Q l K �7OctSG �tJkrJ/,"N .$tp i ,I 8 1 �-19 q i SA GE SYSTEM p�► TE 0 d itionallY UN &K UiAR4i F;s99i:viiS �F tFygtlSTR`f, F,N,B� ANA fiiUiLG���� plVl aF E �0 SF'�N��cF Pag - S 96 40 Straw, Marsh Hay, Or Synthetic Covering Distribution Pipe ASTM Medium Sand _ H G Topsoil -\ -- -- F 3 1 E D C) $ Slope Force Main Plowed Layer Bed of 3 2" -2 Aggregate Cross Section of a Mound System Using A Bed For The Absorption Area D /,Q Ft. E Ft. F '3 Ft. A Ft. G J, Q Ft. B Ft. i s H �, Ft. Signe Ft. • L z,S' Ft. License # : Ft. Date: W Ft. 3 - Face :4 I L I J Observation Pipe Imo-- K B —r ------- - - - - -- ------ - - - - -- i------ ---- -- ----- - - - - -- I 7k - A I T rc Main W IO - Distribution Pipe IBed of � " -2�" Aggregate Observation I .Pipe Permanent Marker Plan View of Mound Using a Bed For the Absorption Area Poe ZOiL Perforated Pipe Detail S96 n nd View )Petforolsd End Cop PVC Pipe a r ° Hobs Located On Bottom, �s Are Equally Spaced A d Q PVC Face Main W 14CXr Tr_ w .7 AI root• Po�'llon �f O�tlriD dion F ce Mp Pipe Lost Mole Should Be Neat To End Cop End Cap Distribution Pipe Layout P_ Ft. R X ._ Inches Y 1 d - Inches / Hole Diameter Inch Signed: Lateral " 'Z Inches) License Number: p '� Manifold " Inches Date: Force Main " . 2 Inches # of holes /pipe I �J Invert Elevation of Laterals//,) b • a � o rn 6 ro ft ff n N (D F1 n ft r • a 0 O r4 ro n cD N � N ro N 'a. I< ro -- - --- -- =------- - - - - -- N rt W O O. N - C1 - .� 1"r f'S _ \ O m' rt p d b• a X rt 0 rt r• a w n a a co PAGE -1 OF �L ' PUMP CHAMBER CK055 SECTION AND SPECIFICAT(ONS VEWT CAP 4 VENT PIPE WEATHERPROOF _NPPROVCO LOCKING JVW CTIOAJ BOX MANHOLE COVGR WITH ZS' FROM DOOR, IZ'MIU. WAANING L1►8EL WINDOW OR FRESH AIR INTAKE GRADE I y" MIAJ. � Ie'Mlu. CONDUIT 1\ __ PROVIDE I -- '-- IAILET r AIRTIGHT SEAL I I I v APPROVED JOIAIT A I I APPROVED JOIWTS W/ PIPE I I W/ " PIPE EXTENDIMG 3' I I ALARM EXTEM011J6 3' ON TO SOLID SOIL I 11 ONTO SOLID SOIL D I i I I O C I I E LEV. l 1 J FT. PUMP -�- - -� b OFF D CONCRETE DLOCK RISER EXIT PERMITTED OIJL`J IF TAWK MAWUFACTURER HAS SUCH APPROVAL 'Z" r}PPAcVEa 6EDDING Uncicr TIawK SEPTIC F SPECIFI'CATIOMS 005E ,� „ TAWKS MAWUFACTURER: (DUMBER OF DOSES: PER DAS TAWK SIZE: GAL OWS DOSE VOLUME ALARM MAUUFACTURER: ��L -�-1E S ��� �s INCLUDING OACKFLOW: / ! 7 / GALLONS MODEL IJUM6ER: CAPACITIES: A =, IIJCHCS OR GALLOWS SWITCH TYPE: B= IWCHES OR _ ' y/ _ GALLOWS PUMP MAMUFACTURCR: 1 C s ` I WCHES OR l y/ GALLOWS MODEL NUMDER: , L D= INCHES OR �_ GALLONS SWITCH T`JPE: MOTE: PUMP AMD ALARM ARE TO DE MILIIMUM DISCHARGE KATE GP Ac, ---vo INSTALLED OW SEPARATE CIRCUITS I VERTICAL DIFFE KEMCE 6ETWEELI PUMP OFF AUD ISTRIBUTIONI PIPE.. 11._= FEET + MINIMUM NETWORK SUPPLY PKESSSSUR . . . . . . . . . . 2 . 5 FILET X } FEET OF FORCE MAIN !1szs, :�...F/oo►r.FRICTIOU FACTOR. FEET TOTAL DSWAMIC, HEAD FEET IIJTERWAL DIM S WC TAWK: LENGTH iWIDTH jLIQUID DEPTH l � � SIGIJED. r LICENSE NU14 8F. R: �� QATM� "u ! 1:a+�t b ni � .� Performance Curves Pu III-we METERS FEET S9 6 - 4 0 0 55 MODEL 3885 25 80 SIZE 3 /4" Solids /y//� -Z;2.s i WE15H 70 I 20 WE10H 60 O -WE07H - 15 50 W E05H 40 10 WE03M 20 WE 03L 5 10 0 0 0 10 20 30 40 50 60 70 80 90 100 110 120 GPM L L 0 10 20 30 m'/h CAPACITY (� GOU LDS PUMPS, INC. S&ECA PALLS *w yc%w 3 . METERS FEET 120 ,1 1-1 MODEL 3885 35 SIZE 3 /4 " Solids 110 -WE15 30 100 90 25 80 70 20 60 O f- WEOSHH 15 40 10 30 20 5 10 0 0 0 10 20 30 40 50 60 70 80 90 100 110 120 GPM L L 0 10 20 30 m CAPACITY •1%5 Goulds Pumps, Inc. Ellsctive July, 1985 C38PI Labor any ..0 an Relations y Z ANU til It ' _ V> �LUA t 1 iri i_ : Vage _ o _ Division of Safety 8 Buildings in accord with ILHR 83.05. 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 St. Croix not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or PARCEL I.D. dimensioned, north arrow, and location and distance to nearest road. pending_ APPLICANT INFORMATION PLEASE PRINT ALL INFORMATION REVIEWED BY DATE PkUPERTY OWN ER: ROPERTY LOCATION Mark & Ann Mitchell '� GOVT. LOT SW 1/4 SW 1i4,S 27 T 30 N, 19 1£(or) y ti PROPERTY OWNERS MAIi.ING ADDRESS LOT r WK. NAME OR CSM � 1.382 Co. Rd. -# I na na _ csm pending CITY, STATE ZIP CODE PHONE NUMBER ❑CITY ❑VILLAGE (NEAREST ROAD Somerset, WI. 54025 (715)549 -6918 St. Joseph Perch Lake Rd. [xj New Construction Use [ Residential / Number of bedrooms 4 [ ] Addition to existing building Replacement [ J Public or commercial describe Code derived daily flow 600 gpd Recommended design loading rate • 5 bed, gpdm • trench, gpdm Anorption area required 375 bed h2 375 trench, ft Maximum design loading rate • 5 bed, gpdm • trench, gpdm Recommended infiltration surface elevation(s) 112.00 ft (as referred to site plan benchmark) Additional design / site considerations na Parent material glacial drift Flood plain elevation, if applicable na S = Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM IN FILL HOLDING TAN U= Unsuitable for system S @tU I 93 O U ❑ S KJ U I El S Q U I CS ® U I 0S ® U SOIL DESCRIPTION REPORT Boring # Horizon De Dominant Color Mottles Structure GPD /fv R Str r Texture I Consistence Boundary Roots in. Munsell Ou. Sz. Cont Color Gr. Sz. Sh. Bed Mira 1 1 0 -9 10yr3/3 none 1 2msbk mfr I gw 2f .5 .( 2 9 -17 10yr4 /4 none sil 2msbk mfr gw if .5 .c Ground 3 17 -29 7.5yr4/4 none scl 2msb mfr gw na .4 .� elev. 1 4 29 -39 7.5yr4/4 c2p 7.5yr5/8 scl 2msbk mfr gw na .4 .F Depth to 5 39 -50 10yr4 /4 c2p 7.5yr5/8 sicl M na na na np .2 limiting factor 291 I Remarks: Boring # 1 0 -11 10yr3 /3 none 1 2msbk mfr gw 2f .5 6 2 11 - 10yr4 /4 none sit. 2msbk mfr gw if .5 .� 3 24 -38 7.5yr4/4 none scl 2msbk mfr gw na .4 5 Ground l lQv ft 4 38 -50 10yr5 /4 c2p 7.5yr5/8 sil M na na na np .2 Depth to limiting f cttor Remarks: CST Name: Please Print Gary L. Steel Phone: 715- 246 -6200 Address: , 54 200th. Av . , New Richmond, WI. 54017 Sign ; Date: CST Number: /_ •% , r' '!' 7 -26 -95 cstm 02298 PROPERTY OWNER Mark & Ann Mitchel SOIL DESCRIPTION REPORT 2 3 . Page of • PARCEL I.D. u pending Boring Horizon Depth Dominant Color Mottles Structure GPD/ttl in. Munse 9.... I I I Texture I Consistence iBoundary I Roots Ou Sz Cont. Color Bed iTrer ll . . I Gr. Sz. Sh. r: 3 1 0 -11 ' 10yr3/3 none 1 2msbk mfr gw 2f .5 . E> 2 11 -28 10yr4 /4 none sil 2msbk mfr gw if .5 .6 i Ground 3 28 -35 7.5yr4/4 none scl 2msbk mfr gw na .4 elev. ' 1 11.0 ft. 4 35 -55 7.5 r4/4 2p 2/5yr4/6 sicl M na na na np !.2 Depth to limiting Remarks: Boring # Ground elev. ft. Depth to I T limiting factor Remarks: Boring # Ground elev. f t. Depth to limiting factor Remarks: Boring # Ground elev. ft. \ M Depth to limiting factor I j I � Remarks: S80- 8330(R.05r,�� STEEL'S SOIL SERVICE Gary L. Steel Mark & Ann Mitchell 1554 200th Ave. CSTM2298 SW4Sw4 S27- T30N -R19W New Richmond, WI 54017 MPRSW -3254 town of St. Joseph (715) 246 -6200 t N 111_401 BM. = top of mid line lurvey stake @ el. 100' f3A E SL M au 7 o -I o R(LC II- 0J 0 58' J_3 ZJ7 Z � lu b ` Pe V Cary L. Steel 7 -26 -95 llloee �. WORKSHEET - MOUND SYSTEM DESIGN PROBLEM: S 96 _„ 0 Q Design a mound system for a The site characteristics are. Depth to groundwater or bedrock in. Landslope Percolation rate JJ �' Distance from dose chamber to distribution system ,,90 � ft. Elevation difference between Dump and distribution system -.L ft. Step 1. WASTEWATER LOAD • 1�, �Sp�,�, Sal Step 2. SIZE THE ABSORPTION AREA A) Area required ,Z= sq. ft. B) Bed or trench length (B) = f ft. C) Bed or trench width (A) ■ ti x' -D) Trench spacing (C) x Wastewater load .24 gal/ 2 /day S = ft. �e i c e�i `- Step 3. MOUND HEIGHT A) Fill depth (D) _ ....cLC. ft. B) Fill depth (E) D + slope (AJ'��� .�� ft. C) Bed or trench depth (F) _ - 1,93 . ft. D) Cap and topsoil depth (G) _ ft. E) Cap an topsoil depth _ � - ft. win -� • Licanue Jat of Step 4. MOUND LENGTH A) End slope (K) = r0 E 1 + F + H x 3 = _ ft. B) Total mound len9 (�) B + 2(K)'' ft. Step 5. MOUND WIDTH Al) Upslope correction factor = 896 _Z19 A2) Upslope width (J) (D + F + G)(3)(factor) _ , ft. (/ + , 8-? t /)(3) (Ia) 8, "19 Bl) Downslope correction factor = . B2) Downslope width (I) _ (E + F + G (3)(factor) _ - eft. (I,o 4- ,93r l) (3j t /,c7 =X99 C1) Total mound width (W) for bed = J + A + I = � - ft. C2) Total mound width (W) for trenches + t + (no. trenches -1)(c) + A + I • ft. Step 6. BASAL AREA - A) Infiltrative capacity of natural soil = .�.:�. gal • /ft /d_ay B) Basal area required ■ wastewater flow = natural s9il infilttr tiv capacity = , C1) Basal area available for bed for sloping sites = Bx (A +I) • sq. ft. C2) Bas are avail W for trench for sloping sites = J + q ;!e � sq. ft. 3),Basal area available for trench or bed for level �es =BxW= . License Ru:.. Data: s P40 a.3 Of -Y . Step 7. DISTRIBUTION SYSTEM 1A) SIZE DISTRIBUTION SYSTEM 1) Hole size = in. 2) Hole spacing 1f.t.._ in, 3) Distribution pipe length iao. 4) Distribution pipe diameter = in, 5) Spacing between distribution pipes in. 6) Distance from sidewall to distribution pipe in. 78) DISTRIBUTION PIPE DISCHARGE RATE _ ft. 1) Number of holes per pipe ■ 2) Flow per pipe = , X" /I = i�CrS/ /� GPM 7C) SIZE MANIFOLD 1) Manifold is central / �( _ end 2) Manifold length • ft. 3) Number of distribution lines = 02 4) Manifold diameter = _�_ in. 7D) SIZE FORCE MAIN 1) Minimum dosing rate GPM 2) Force main diameter 2 in. X33 3) Friction loss =� = ft, I 7E) TOTA DYNAMIC HEAD 1) Vertical lift c ft. 2) Friction loss = ft. 3) System head 2.5 ft. = G ,�� ft. - �;A) T tal dynamic head /� ft. eve. of 7F) PUMP SELECTION 1) Pump selected will discharge �,5 GPM at ft. total dynamic head. 2) Pump model and manufacturer 7G) DOSE VOLUME 1) 10 times void volume qf distribution lines J10, gal. /cycle /O r40'r,e%;?) = l /O,Y 2) Daily wastetyater volume : 4 doses /24 hrs. z,,5 gal. /cycle /SD 3) Minimum dose volume = gal. /cycle 7H) DOSE CHAMBER 1) Minimum capacity required }SO� �_ gal. Sign. Licunse I:u: Date: Wisconsin Department Industry L.sbo� and, Human Relations SOIL AND SITE EVALUATION REPORT Page 1 of 3 lac -: of Safety &Buildings in accord with ILHR 83.05, Wis. Adm. Code COUNTY Attach complete site plan on paper not Ietsdhr 8 in size. Plan must include, but St. Croix not limited to vertical and horizontal reft3 "FP nod point (BM), di d % of slope, scale or PARCEL I.D. # dimensioned, north arrow, and locati nand' distar ce teparest a . pendin APPLICANT INFORMATION — P ,ASE PR4('r AL" OR ION REVIEWED BY DATE PROPERTY OWNER: _ PROPERTY LOCATION c Mark & Ann Mitchell .4 r � j GOVT. LOTSW 1/4 SW t /4,S 27 T Rd. 30 N,R 19 for) W PROPERTY OW MAILING ADDR �- LOT # BLOCK # SUBD. NAME OR CSM # 1382 Co. Rd. #I ', *� ° na na csm CITY, STATE ZIP C pending Somerset, WI. 54025 15 918 DCITY :]VILLAGE MOWN NEAREST ROAD St. Joseph Perch Lake Rd. k* New Construction Use 1* Residential I Number of bedrooms 4 ( J Addition to existing building J Replacement ( J Public or commercial describe Code derived daily flow 600 gpd Recommended design loading rate .5' bed, gpd/ft • E_ - trench, gpd/ t Absorption area required 500 bed, ft2 500 trench, ft2 Maximum design loading rate . 5 bed, gpd/ft .6 trench, gpd/11 Recommended infiltration surface elevation(s) 111.70 ft (as referred to site plan benchmark) Additional design / site considerations system el. based on contour line of el 110.70 Parent material glacial drift Flood plain elevation, if applicabll ft $ =Suitable for system CONVENTIONAL MOUND IN- GROUND PRESSURE AT -GRADE SYSTEM IN FILL HOLDING TANK U= Unsuitable fors stem [Is U ®S f_] U D S L U ❑ S ®U CTS ® U D S nu SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence GPD /ft in. Munsell Ou. Sz. Cont Color Gr. Sz. Sh. Ro ITmr& 0 -8 10yr3 /3 none L 2msbk mfr gw 2f .5 1.6 >Iv 2 8 -16 Z Oyr4 /4 none S i l 2msbk mfr gw if .5 .6 Ground 3 R26-48 E55yr4 none sl lmsbk mfr gw na .4 .5 111 ft. 4 c2p2.5yr4/8 sl lmsbk mfr na na .4 1.5 Depth to limiting factor 26" Remarks: Boring # 0 -17 10yr3 /3 none L 2msbk mfr gw 2f .5 ` .6 Iowa - 2 " 2 17 -32 10yr4 /3 none sil 2msbk mfr gw if .5 .6 3 32 -55 10yr4 /4 c2p 5yr5/8 sicl M na na na np 1.2 Ground 1 Depth to limiting factor 32" Remarks: CST Name:— Please Print Gary L. Steel Phone: 715- 246 -6200 Address: 1554 300th. ave., New Richmond, WI. 54017 Signature: /� Date: CST Number: , 7 -20 -95 cstm 02298 STEEL'S SOIL SERVICE Gary L. Steel Mark & Ann Mitchell 1554 200th Ave. CSTM2298 WI WI S27- T30N - R19W New Richmond, WI 54017 MPRSW 3254 town of St Joseph (715) 246 -6200 t N 1"=401 'P0 BM.= top of mid line survey stake C el. 100' r 1441. 015jp I 6P AA0\ , r 174 � 3 <03 ' 4 , x\ C- 0 /343 Gary L. Steel 7 -20 -95 Fa vor and Hu^ ` tm aeiaao► "` SOIL AND SITE EVALUATION REPORT Page 1 of 3 Division of safety Buildings in accord with ILHR 83.05, Wis. Adm. Code COUNTY ti Attach complete site plan on paper not less than k#Vx ` 1 ir%an must include, but St. Croix not limited to vertical and horizontal reference point (BM), dire slope, scale or PARCEL I.D. # dimensioned, north arrow, and location an distance to r,at pendiris APPLICANT INFORMATION -PLEA RINT ALA14, REVIEWED BY DATE E P PROPERTY OWNER: PROPERTY LOCATION Mark & Ann Mitchell I , X9 9 ] GOVT. LOT SW 1/4 SW 1/4,S 27 T 30 N,R 19 2 (or) W PROPERTY OWNERS MAILING ADDRESS �_ J�- y '� fi LOT # BLOCK # SUED. NAME OR CSM # 1382 Co. Rd. # I fir- - na na csm pending CITY, STATE ZIP CODE ' 0 NU 98 "CITY [:]VILLAGE MOWN NEAREST ROAD Somerset, WI. 54025 7r`° St. Joseph Perch Lake Rd. (x] New Construction Use ( Residential / Number of bedrooms 4 [ ] Addition to existing building I ] Replacement () Public or commercial describe Code derived daily flow 600 gpd Recommended design loading rate • 5 bed, gp(W .6 trench, gpd/ft Absorption area required, 375 bed, ft2 375 trench ft Maximum design loading rate • 5 bed gpd/ft2 .6 trench, gpd/ft Recommended infiltration surface elevation(s) 112.00 ft (as referred to site plan benchmark) Additional design / site considerations na Parent material glacial drift Flood plain elevation, if applicable na ft S = Suitable for system CONVENTIONAL MOUND IN- GROUND PRESSURE AT-GRADE SYSTEM IN FILL HOLDING TANK U= Unsuitable for stem 1❑ S MU gas ❑ U ❑ S :K1 U ❑ S �] U ❑ S ®U CIS O U SOIL DESCRIPTION REPORT Dep Dominant Color Mottles Structure GPD /ft Boring # Horizon Texture Consistence Boundary Roots in. Munsell Ou. Sz. Cons Color Gr. Sz. Sh. Bed lTmr& 1 0 -9 10yr3/3 none 1 2msbk mfr gw 2f .5 .6 .fi 1 2 9 -17 10yr4 /4 none sit 2msbk mfr gw if .5 .6 Ground 3 17 -29 7.5yr4/4 none scl 2msbk mfr gw na .4 .5 elev. 1 4 29 -39 7.5yr4/4 c2p 7.5yr5/8 scl 2msbk mfr gw na .4 .5 Depth to 5 39 -50 10yr4 /4 c2p 7.5yr5/8 sicl M na na na np .2 limiting factor 29" ner, arks: Boring # 1 0 -11 10yr3 /3 none 1 2msbk mfr gw 2f .5 .6 2 2 11 -24 10yr4 /4 none sil 2msbk mfr gw if .5 .6 GaJ 3 24 -38 7.5yr4/4 none scl 2msbk mfr gw na .4 .5 Ground 11 ft. 4 38 -50 10yr5 /4 c2p 7.5yr5/8 sil M na na na np .2 Depth to limiting f�ctor Remarks: CST Name: — Please Print Gary L. Steel Pho 715 - 246 -6200 Address: 54 200th. Ave., New Richmond, WI. 54017 Signature: 7 Date: CST Number: 7 -26 -95 cstm 02298 I STEEL'S SOIL SERVICE Gary L. Steel Mark & Ann Mitchell 1554 200th Ave. CSTM2298 WIWI S27- T30N -R19w New Richmond, WI 54017 MPRSW 3254 town of St. Joseph (715) 246 -6200 t N 1 =40' BM.= top of mid line lurvey stake @ el. 100' BM 1� X O f D ui oh °7o Pe yr t4 06. Gary L. Steel 7 -26 -95 STC -105 SEPTIC TANK MAINTENANCE AGREEMENT St. Croix County OWNER/BUYER - _L�2 e ' fit- /o A) YYN I T , MAILING ADDRESS _ 13,62— --, PROPERTY ADDRESS (location of septic system) Please obtain from the Planning Dept. CITY /STATE p p` 30 � PROPERTY LOCATION z.J iJ 1/4, 1/4, Section _a ] , T 3o N_R Iq W TOWN OF '� je Ep ST. CROIX COUNTY WI SU13DMSION LOT NUMBER CERTIFIED SURVEY MAP w� 6 VOLUME10 _ ,PAGE LOT NUMBER Improper• use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by licensed septic tank pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. St. Croix County residents may be eligible to receive a grant for a maximum of 60% of the cost of replacement of a failing system, which was in operation prior to July 1, 1978. St. Croix County accepted this program in August of 1980, with the requirement that owners of all new systems agree to keep their system properly maintained. The property owner agrees to submit to St. Croix Zoning a certification form, signed by the owner and by a mater plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on -site wastewater disposal system is in proper operating condition and (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge and scum. I/We, the undersigned have read the above requirements and agree to maintain the private sewage disposal system in accordance with the standards set forth, herein, as set by the Wisconsin DNR. Certification stating that your septic has been maintained must be completed and returned to the St. Croix County Zoning Officer within 30 days of the three year expiration date. - SIGNED: DATE: St. Croix County Zoning Office Government Center 1101 Carmichael Road Hudson, WI 54016 11/93 1 A. S T C " 100 This application form is to be completed in full'and signed by the owner(s) of the property being developed. Any inadequacies will only result in delays of the permit issuance. Should this development be intended for resale by owner/ contractor (spec house), then a second form should be retained and completed when the property is sold and submitted to this office with the appropriate deed recording. ------------------------ -------------------------- Owner of property _ [C l AAJJ 17�G,FE.c_4_— Location of property_,%�_1 SU) 1/4, Section Z7 N- RqW Township Mailing address Address of Subdivision name Lot no. Other homes on property? Yes ><-_ Previous owner of property — �v, 'zkd ��� Total size of property q Total size of parcel Date parcel was created � V / o p Are all corners and lot lines identifiable? Yes No Is this property being developed for (spec house) ? Yes 1 14- No Volume ._ and Page Number ON66 as recorded with the Register of Deeds. ------------------------------------------------ INCLUDE WITH THIS APPLICATION THE FOLLOWING: A WARRANTY DEED which includes a DOCUMENT NUMBER, VOLUME AND PAGE NUMBER AND THE SEAL OF THE REGISTER OF DEEDS. In addition, a certified survey, if available, would be helpful so as to avoid delays of the reviewing process. If the deed description references to a Certified Survey Map, the Certified Survey Map shall also be required. PROPERTY OWNER CERTIFICATION I (we) certify that all statements on this form are true to the best of my (our) knowledge that I (we) am (are) the owner(s) of the property described in this information form, by virtue of a warranty deed recorded in t office of the County Register of Deeds as Document No. 3� and that I (we) presently own the proposed site for the sewage disposal system. or I (we) obtained an easement, to run the above described property, for the construction of said system, and the same has been duly recorded in the office of the County Register of Deeds as Document No. Signature of Applicant to-Applicant A Z Date of Signature Date of Signature X31'742 CERTIFIED SURVEY _MAP__ j Located in part of the SWj of the SWi, Section 27, T30N, R19W, Town of St. Joseph, St. Croix County, Wisconsin. OWNER UNPLA I _ I Ev LANDS John Schottler — — — — — — — 1374 C.T.H. "I" Somerset, WI 54025 N88 °29'27 "W 300.00' N o o POND r1% ° FILED a J UL 2 6 1995 ► KATHLEEN H. W AM ° CD C. z W S W of Deeds o ct � ( o Co I 6 St Croix Co., M S c m m I —U o o I `£ � I �- N N N $e n l y tv Ir co e co a I —I o LOT 1 I 113 Ct N n rr I R� ( m t�J i —I ' Q IC 3.99 Acres Inc. R/W I IC7 173,965 Sq. Ft. ��- 3.77 Acres Exc. R/W m m y 164,064 Sq. Ft. kD w Ir' I Ln ID IC7 00 I ( Ln I Z 00 I0 o F I (� Cl w � w w ♦' — w .r � S 88 ° 29 1 27 "E 300.0 o S88 ° 29 1 27 "E u , _ I t S88 ° 29 1 27 "E o= E 300.00 S88 °29'27 "' w — W Corriere 625.00' w AN Section 27� South L in e of the SWk of Sect 27 1 709.27' Ski Corner REr L AKE ROAD Section 27 LEGEND i DOCUMENT NO. � WARRANTY DEED t' THIS SPACE RESERYCD FOR RECI'RnIRG DATA ESTATE BAR OF WISCONSIN FORbt 2 -1962 j .533183 -- - ----� -- ►, - c� _ _ 54 9 1 � -- -- - -- - JOHN T. SCHOTTLER and GEORGINE M. SCHOTTLER, ' Foedyuri'..,1;_ ........................................... ......................... . . . . .. �� husband and wife, A UG 9 t9�5 i i ....................................................... ......................... . .•• -• - •--- ..........-- •- • - - - -•- 12:20 P.' conveys and warrants to ..MA RK J. MITCHELL and ANN E. MITCHELL, husband. and - wife, ... h0].�i,itg..?s..surv�,yorshi p..marital . '> ` '..t`a�,. • 1. ,,�, ;'.' property .................• - -- I ........................._....� li ........................................................................ ........... .................... ..... •... ... ..... ......... ...... .... .... ... ••••••••••.•••- ••.•...• . .............. ....__- i RETURN T O Mr. . .. Mrs. Mark Mi tche ......... .. ... ... for•.$1..QQ -- an d..o t - d -cons i,derst�,on............... - -_ I 1382 County Road I . . ........................---............................. ......---- ........._........... . Somerset, WI 54025 the following described real estate in .................$ris..4'O1X - - County, State of Wisconsin: Tax Parcel No: 030- 1076 -50 -100 A parcel located in the SVA of SWk, Section 27, T30N, R19Td, Town of St. Joseph, St. Croix County, Wisconsin more fully described as follows: Lot 1 of Certified Survey Map filed July 26, 1995, in Vol. 10 of C&4s, Page 2968, Doc. No. 531742,. ii in the office of the St. Croix County Register of Deeds. i I A i i I i This .......... l.$ AQt ...... homestead property. (is) (is not) Exception to warranties Subj to town road right- of -vay oa�er the southerly side of Lot 1 as shown on said Certified Survey Map, and also subject to recorder: easements, reservations and restrictions, if any.. Dated this ...................... -&1 ................... day of ................. 1?l:[Pst............ .................. ........... ............................... .........................(SEAL) ?l. l ............(SEAL) • ................................... ............................... John T.._ Schottler ......... . G�//� /,/ ............. ............................... •---.....................(SEAL) ..... -GCs O .J�i f .. ........(SEAL) � ... rgule • H... Schottler• .. ............ II AUTHENTICATION ACKNOWLEDGMENT Signatures) -John T Schottler and_ : TE OF WISCONSIN I Geor ine. M. Schottler _ St St... rso came ........... ....._ .......County. (I a t ca i ......da �. . ........, 19.95- Pen before me this .._ ss day of ...... At, gust- - - - - -- --------- - - ---- 19.95.. he above named .. . ............................... William Gilbert .......... - - - ---- - .. .................. ............................ ' ....................... ...............•-•-•.. ..........-- •---- ••------ -• -... ----- �bha- T- _Srhn er -.an .---- •--- ....................... II TITLE: MEMBUR STATE BAR OF WISCONSIN .--- Geargi.ue_1L_ - Ech t r.---- • • .. ...................... (If hor not, ..... ------------------------------•--- autized by § 708.08. Wis. Stets.) - -- ........... .... ............................... to me known to be the son ..... ..... who executed the I�