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HomeMy WebLinkAbout038-1150-20-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 538837 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: White, Clark J. Star Prairie, Town of 038 - 1150 -20 -000 CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range/Map No: /dC> 1 8 ✓Y\ ( 30.31.18.673 TANK INFORMATION 19 ELEVATION DATA TYPE MANUFACTURER f CAPACITY STATION B� HI FS ELEV. Jd 3 tx�) Septic Benchmark Un'I-`Y1.0 ' Z • Z.. /C2- Dosing y„ Alt. BM Z. 7`-r 1 Aeration L Bldg. Sewer L Holding St/Ht Inlet TANK SETBACK INFORMATION St/Ht Outlet TANK TO P`L WELL BLDG. Vent to Air Intake ROAD Dt Inlet 2 Septic 7 ZS 2,6 Dt Bottom A.Z_ 47 � Dosing 7 .26 / 5 ! 05 Z Header/man. /. Q � cl Aeration Dist. Pipe O Holding Bot. System PUMP /SIPHON INFORMATION Final Grade Manufacturer � � � GP ^and St Cove / J Z. Z 9S . 1 �� L O Model Number � � � o ✓ � �' 97 5 TDH Lif Friction Loses System Head TDH Ft Forcemain Length Dia. Dis . o Well Z SOIL ABSORPTION SYSTEM , �;• i BED/TRENCH Width Length No. Trenche PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS 6 (f C ` \ SETBACK SYSTEM TO !J P/L JBLDG WELL LAKE/STREAM LEACHING Manufacturer: INFORMATION T S stem: UNIT CHAMBER OR YP y .6 V � 57 r / Model Number. ` DISTRIBUTION SYSTEM J l�l� Header /Manifold i IDistribution ( 3 x Hole Size x Hole Spacin9e I VPo Air In ake Length Dia Pipes) 4 Length L Dia �' S Spacing L SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only G 4 Depth Over Depth Over xx Depth of xx Seeded /Sodded xx Mulched Bed/Trench Center / / S Bed/Trench Edges ` Topsoil ' 0 Yes 0 No Yes 0 No COMMENTS (Include code discrepancies, persons present, etc.) Inspection #1: 7 / /Z / I � Inspection #2: Location: 1943 Sicard L SOMERSET, WI 54025 (SW 1/4 SE 1/4/30�T�3�1,N R1 8W) Carrie's Apple River Add Lot 2 Parcel No: 30.31.18.673 1.) Alt BM Description = Ca,� `� "'-� IP /o � tJ e J 7 2.) Bldg sewer length = � U3 - amount of cover = �x� �' A �!_ J` 61 Plan revision Required? Yes o r 1 1„ Q Use other side for additional information. l l ((J u SBD -6710 (R.3/97) Date Insepc is Sign ure Cert. No. Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division Sanitary Permit No: INSPECTION REPORT 538837 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: White, Clark J. Star Prairie, Town of 038 - 1150 -20 -000 CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range /Map No: 30.31.18.673 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark Dosing Alt. BM Aeration Bldg. Sewer Holding St/Ht Inlet St/Ht Outlet TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic Dt Bottom Dosing Header /Man. Aeration Dist. Pipe Holding Bot. System Final Grade PUMP /SIPHON INFORMATION Manufacturer Demand St Cover GPM Model Number TDH Lift Friction Loss System Head T Ft Forcemain Length Dia. Dist. to Well SOIL ABSORPTION SYSTEM BEDITRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS SETBACK SYSTEM TO P/L BLD IWELL 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 I 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 Fp,,] Yes Rfl No ® Yes No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / / Inspection #2: / / Location: 1943 Sicard Lane SOMERSET, WI 54025 (SW 1/4 SE 1/4 30 T31 N R1 8W) Carrie's Apple River Add Lot 2 Parcel No: 30.31.18.673 1.) Alt BM Description = 2.) Bldg sewer length = - amount of cover = Plan revision Required? ❑ Yes E No Use other side for additional information. Date Insepctors Signature Cert. No. SBD -6710 (R.3/97) RECEIVED All eOq@PC�. I OV Safety and Buildings ie J l(JJ f r I 201 W. Washington Ave., P. x 7162 /p / SCMSd1111 Madison, WI 53707 -7162 � .aanilaty Permit Number (to be filled in by Co.) Sanitary ermit Application State Transaction N In accordance with s. Comm. 83.21(2), Wis. Adm. Code, submission of this form to the appropriate governmental / (� 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 p urposes in accordance with the Privacy Law, s. 15.04 1 (m), Slats. I. Application Information - Please Print All Information Property Owner's Name Parcel # ' e � Property Owner's Mailing Address Property Location (67 \ J Govt. Lot City, State Zip Code� Phone Number y, y,, Section lc one - T_/ N; R1 II. Type of Building (check all that apply) Lot # 1011 r 2 Family Dwelling -Number of Bedrooms Subdivision Name Block # ❑ Public /Commercial - Describe Use e", El city of --- - - - - -- _ —_- - ❑ State Owned - Describe Use 0 Village of 1,6 44 - 'own of..�l III. Type of Permit: (Check only one box on line A. Complete line B if applicable) A. — — — ❑ New System cement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System (explain) B. ❑ Permit Renewal ❑ Permit Revision ❑ El Transfer to New a of Plumber Chan g List Previous Permit Number and Date Issued / Before Expiration Owner _ IV. Type of POWTS System /Component /De vice: Chec all that a I — ❑ Non - Pressurized In- Ground ❑ Pressurized In- Ground ❑ At -Grade > 4 osi o ❑ Mound < 24 in. of suitable soil ❑ Holding Tank ❑ Other Dispersal Component (explain)___- _______ — ___ ❑ Pretreatment Device (explain)— V. Dispersal/Treq6nent Area Inform � Design Flow (gpd) Design Soil Applicatio te(gpdsf) Dispersal Area Requir Dispersal Area Pro pos st) System Efevan A L2 VI. Tank Info Capacity in Total # of Manufacturer Gallons _ Gallons Units re C U New Tanks Existing Tanks o y ^4�? f'i✓ :$ f mir e,. tr /! a U in v Septic or Holding Tank Dosing Chamber f�tLU> VII. Responsibility Statement I , the ugoersigned, assume r sibility for inst allation of the POWTS shown on the attached plans. Plumber's ame (Print) Plumber's Si rc MP /MPRS Number Business Phone Number 22 pD 17o -,z 6 8 V Plumber's Address (Street, City, State, Zip Code) 44w�, V1 . Countyl De artment Use Onl Approved Disappr Per /mi4�FceD at I sue / Issuin cnt Signatu ven Reaso enial V / � IX. ConditvaUBeasons Tor Disapproval t`�- +'t�+A {�» -4A 1. 5eptic tank iftMt filter and .t dispersal cell must all be services / mairttakted as per management plan provided by plumber. 2 AN's61bfckt+egt* tents Must be maintained 4 61 1 670 4... - - Aff a i ch o comp e e p arts o e system and submit to Site County only on paper not less titan 8 112 x 1l inches in size SBD -6398 (R. 01/07) Valid thru 01/09 PLOT PLAN PROJECT Clark White ADDRESS 1943 Sicard Lane Somerset Wi 54025 NE 1/4 SE 1 /4S 30 /T 31 N/R 18 W TOWN Star Prairie COUNTY ST. CROIX SYSTEM ELEVATION 98.8' BEDROOM 3 CONVENTIONAL AT -GRADE CONVENTIONAL LIFT HOLDING TANK MOUND XXX SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE 630 HOLDING TANK SIZE LOAD RATE 1.0 ABSORPTION AREA 450 # of chambers none IL BENCHMARK V.R.P. Bottom of siding ASSUME ELEVATION 100° Filter BEST GF10 -8 ❑ BOREHOLE O WELL *H.R.P. Same as Benchmark Scale = 1/4" 10' Sicard Lane R.O.W. Grading is to be done to divert run -off away from system Well Apple River Tank is to be Garage O Area 15' below properly bedded and system is to remain provided with undisturbed lockdown covers 3 with approved rDT Bedroorr warning labels DW house B -1 B -20 98'--E 97,8' Old drywell is to be pumped and buried 97' 2% Slope B-3 Property Line South neighbor's lot is vacant and has no structures ®rocr-, ST. CROIX COUNTY ZONING OFFICE CERTIFICATION STATEMENT FOR UTILIZATION OF AN EXISTING SEPTIC TANK `'hi.s is to certify that I have inspected the septic tank presently serving the _C.� 64_ 114 kl residence located at: ', , , Section p T�N, R W, Town of Upon inspection, I certify that I have found the tank and baffles to be in good condition, and it appears to be functioning properly. , Last time serviced: 1:?id flow back occur from absorption system? Yes No (If no, skip next line) Approximate volume or length of time: gallons minutes Capacity: �j Construction: Prefab Concrete Steel Other Manufacturer: (If known) : Age of Tank (If known).: {Sig re} (Name) Please print (`Pit e) 7 (License Number) D ate 1.orm to be completed by licensed plumber (s.145.06, Wisconsin Statutes) or Licensed Disposer (NR 113 Wisconsin Administrative Code) Plumber (applying for sanitary permit) Certification: In accepting the above statement regarding existing septic tank condition, I certify that the tank to the best of my knowledge will conform to the requirements of ILHR 83, Wis. Code (except for inspection opening ov r outlet baffle). Name /! � �/ Signature MP /MPRS 61 76 ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM 1 Owner/Buyer 1 �Ar K 1 i te- Mailing Address `i -'?, ..S, C az4 a Lei, -a- Sty a ,0 1 � k2 l S�Oo � Property Address 341-e— (Verification required from Planning & Zoning Department for new construction.) City /State Parcel Identification Number LEGAL DESCRIPTION Property Location 1 /4 , s , e 1 /4, Sec- , T 3 / N RAW, Town of ' 5 � Subdivision �� 1e' ,Lot # Certified Survey Map # , Volume , Page # Warranty Deed # , Volume , Page # Spec house yes no Lot lines identifiable ye SYSTEM MAINTENANCE AND OWNER CERTIFICATION 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 a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. Owner maintenance responsibilities are specified in §Comm. 83.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance. The property owner agrees to submit to St. Croix County Planning & Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on -site wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. I/we, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Planning & Zoning Department within 30 days of the three year expiration date. I/we certify that all statements on this form are true to the best of my /our knowledge. Uwe am/are the owner(s) of the Ek irtue of a warranty deed recorded in Register of Deeds Office. -5 OF APPLICANT(S) DATE ** *Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Department. * ** Include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if reference is made in the warranty deed. (REV. 08/05) �y @AR7Ag Safety and Buildings 141 NW BARSTOW ST FL 4TH WAUKESHA WI 53188 -3789 3 K Contact Through Relay www.commerce.W.gov/sb/ ° www.wisconsin.gov �1 O ss� °NP� Scott Walker, Governor Dave Ross, Secretary August 31, 2011 CUST ID No. 226900 A7 POWTS Inspector SHAUN R BIRD ZONING OFFICE BIRD PLUMBING INC ST CROIX COUNTY SPIA 1432 120TH ST 1101 CARMICHAEL RD NEW RICHMOND WI 54017 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 08/31/2013 Identification Numbers Transaction ID No. 1991667 SITE• Site ID No. 771192 Clark White Please refer to both identi%ation nuimbers> 1943 Sicard Ln above, m ail correspondence wtth the Town of Star Prairie, 54025 agCa St Croix County NE1 /4, SE1 /4, S30, T3 IN, R18W Lot: 2, Subdivision: Carrie's Apple River Addition FOR: Description: Mound, 3 bedroom Object Type: POWTS Component Manual Regulated Object ID No.: 1332668 Maintenance required; Replacement system; 450 GPD Flow rate; 24 in Soil minimum depth to limiting factor from original grade; System(s): Mound Component Manual, SBD- 10572 -P (8.6/99), Pressure Distribution Component Manual - Version 2.0, SBD - 10706 -P (N.01 /01); Effluent Filter The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. This system is to be constructed and located in accordance with the enclosed approved plans and with any component manual(s) referenced above. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s. 145.06, stats. The following conditions shall be met during construction or installation and prior to occupancy or use: This system is to be constructed and located in accordance with the enclosed approved plans and with the "Mound Component Manual for Private Onsite Wastewater Systems VERSION 2.0" SBD- 10691 -P (N.01 101) and the "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems VERSION 2.0" SBD - 10706 -P (N.01 101). 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. Please specify an alternative p qQ lugt prior to applying for a sanitary permit. �> d The building sewer and distribution network piping shall be of material lis d 1 4. / and 84.30- 5, Wis. Adm. Code. ° '1 �i 1 In the event this soil absorption system or any of its component parts malfunctions s U reate a health hazard, the property owner must follow the contingency plan as described in the approved plans�In addition, the owner must comply with the operation, maintenance and monitoring duties as described in section VIII of the mound component manual. A copy of this information must be given to the owner upon completion of the project. SHAUN R BIRD Page 2 8/31/2011 f All holding/treatment tanks are to comply with Comm. 84.25(7)(a). Maintenance information must be given to the owner of the tank explaining that periodic cleaning of the filter is required. Access to the filter for cleaning must be provided per Comm 84 product approval conditions. A Sanitary Permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.135 and 145.19, Wis. Stats. Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stats. Owner Responsibilities: • Comm 83.52 Responsibilities. The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s. Comm 83.54(1). • Comm 83.52(2) A POWTS that is not maintained in accordance with the approved management plan or as required under s. Comm 83.54(4) shall be considered a human health hazard. • Comm 83.55 The owner is responsible for submitting a maintenance verification report acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. A copy of the approved plans, specifications and this letter shall be on -site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of construction /instal lation/operation. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter and the POWTS management plan to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Fee Required $ 250.00 Fee Received $ 250.00 Balance Due $ 0.00 Julia Lewis- Osborne POWTS Reviewer 2, Integrated Services WSMAR'I cede6 (262) 397 -6005, Fax: (608) 283 -7481 julia.lewis@wisconsin. gov Cover Page Shaun Bird RECEIVED Bird Plumbing Inc. AUG 18 2011 1008 192nd Ave SAFETY & BUILDINGS New Richmond Wi 54017 715- 246 -4516 Date: 08/ 18/11 Owner:Clark White Location:NE1 /4 SE1 /4 S30 T31 N,R18 W 1943 Sicard Lane Star Prairie System type: Mound System Manuals Used: Mound Component Manual Version 2.0 (01/31) Pressure Distribution Manual Version 2.0 (01/31) Page# 1. Cover Page 2. Mound Plot Plan 3. Mound Cross Section 4. Pipe Cross Section /Pipe Layout 5. Pump Chamber Cross Section 6. Pump Curve 7 -8. Maintance and Contigency plan 9 -12. Soil test 13. Filter Specifications ross section Shaun Bird Signature License numbe 900 ET l Cc` #W F i PLOT PLAN PROJECT Clark White ADDRESS 1943 Sicard Lane Somerset Wi 54025 NE 1/4 SE 1/4S 30 /T 31 N/R 18 W TOWN Star Prairie COUNTY ST. CROIX SYSTEM ELEVATION 98.8' 3 BEDROOM CONVENTIONAL AT -GRADE CONVENTIONAL LIFT HOLDING TANK MOUND XXX SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE 630 HOLDING TANK SIZE LOAD RATE 1.0 ABSORPTION AREA 450 # of chambers none IL BENCHMARK V.R.P. Bottom of siding ASSUME ELEVATION 100' Filter BEST GF10 -8 ❑ BOREHOLE O WELL *H. R. P. Same as Benchmark Scale = 1/4" = 10' Sicard Lane R.O.W. Grading is to be done to divert run -off away from system Tank is to be Garage 0 Well Area 15' below Apple River properly bedded and system is to remain provided with undisturbed lockdown covers 3 with approved rDT Bedroo rr warning labels DW house B -1 B -20 98'_—E 97.8' Old drywell is to be pumped and buried 97 1 2% Slope B-3 Property Line South neighbor's lot is vacant and has no structures Mound System. Cross Section and Plan View ,.--- :-- ,- - - - - -- ,_._�___: - - -- – - - - - -� Dim Feet 77 A J - .......... B S 1 t D �f r l � t. T i 4 4M1• t r• r 3 { { ; { {7r r ifr'37�7 {:? { S:r 1 41 t t W i t 9 G t i H 0 t t -- L 1 — I I t t J S t K 8 .7 t ........... ' L - - -- I{ 1 B —T Z Slop L t" 1 = Topsoil = ASTM C ice, = Clean aggregate = 4 in. sch. 40 pvc _ 1 Cap Material sand fill U '/z to 2 % in. dia. observation pipe Geotextile G ! H Fabric F Ft D E Plowed Surface Ft Contour Slope Direction GENERAL INSTALLATION: The mound area is staked out along the design contour. Existing vegetation is mowed and raked off the site. The mound basal area (L x W) is plowed with a. moldboard or chisel plow. Plowing may not proceed if the soil is wet enough at the plow depth to form a' /a inch soil wire when a sample is rolled between the palms of the hands. ASTM C -33 quality sand is placed immediately after plowing. Sand is placed with a tracked machine keeping 12 or more inches of sand under the tracks or is placed overhead by a backhoe. Special care must be used when placing sand of less than one foot thickness to minimize compaction of the plowed surface. After the topsoil cap is placed, the entire mound is seeded and mulched to promote vegetative growth, limit erosion and protect from freezing. The observation pipes are slotted in the lower 6 inches and secured in place with rebar or a closet flange. 10 /07lgj Page of Perforates Pip$ 001011 End V, 1 Ptr OOr0�1tF `,/�. PVC P.pe Him$ LOaatsd On 11e11enT, JQ Are 9Ouatltr $00910 � JA P �a k t 4 PvC Face Main i' flit 1401.E Nax! Ir• GenAeC }it PVC Manifold Pips ��, S��'o pi s r riaut�an Pipe u- - Oistribotion Pipe i_ayoul P y Ft R Ft. X InChq% Y Inches Signed: Hole Diameter* Inch License Number: Lateral /� Inch Date: Manifold " - Inches Force Main " „' Inches # of holes /pipe Invert Elevation of Lateral s, 33 Ft. Dose Tank Cross Section And Pump Performance Specifications Tank Manufacturer t� - -- Minimum Pu Pe rforma nce R Tank Model Number (�(7 - -- _ GPM @ - _ Ft TDfT Total Tank Capacity -. - -- Max. Bury Depth - - -- -- -- -- - - - - -- Tota Dynami Head (171311) Feet Pump Manufacturer L _ Elevation h ead Pump Model Number — Distal Pressure Alarm Manufacturer c 5 kAA Network Pressure Loss_ _• �_- -�� - Alarm Model Number - 40 �0 For Main Pressure L oss -:7 F1— Switch Type Ire . ` Total (S Manhole Min. 4" Above Grade With Locking Device Vent Min. 12" Above Grade Weather -proof With Cap Junction Box � Finished Grade ✓ T +__ Depth of Cover —_ Ft ,Disconnect Means i 4 1 i i{ t i{ S i t t t i t i { i i ,< outlet Inlet r` Switch Setti and Reserve Capacity ' ` Tank Volume = + 15� GPI i '< Dimension Inches Volume Gal. A } i i .�' 1f4er ' (reserve) A S �_ _ t � >i (alarm) B 2 B Weep t Hole ' ( dose) C OtfElev. �< `(dead) D r 3 9 Ft L t Total p ' =-► i Bottom of Tank Elev. GENERAL INSTALLATION: The dose tank is bedded and back filled in accordance with the manufacturer's product approval specifications. Maximum depth of bury as specified by the manufacturer may not be exceeded without prior approval. Manhole covers exposed to grade have an effective locking device (padlock) installed. Piping at the inlet and outlet is of approved material, connected to the tank with watertight fittings, and laid on stable soil to prevent settling or sagging. The force main is sleeved with 4" Sch. 40 PVC to bridge the excavation and is sealed ' watertight. Electrical service complies with NEC 300 and Comm 16.28 Wis. Adm. Code. 03/05 igi Page - of AP LaserJet 3100; 1 /1b bbl tR11/ ; MelJl G.:7urwix ' vyv •., •+ C EH SERIES SUMP /EF'F'LUENT PUMP 8.95 0 3 Specifications lamrtn t>� tt�wonllln 3i/IIFf ,� 1 CIL WW trtemta ttq�lt is ILL fWat Ot,e t tq Ml 1N W= M► t Iln.wti 13iJt WH 9 14' R' 3f �) 50A�p tA1CS4 U10 115 314 130 1000 70 54 55 41 32 13$ W 24 9.11 01.641 &91 934 OF-am 509349 ow 230 31A 9.5 10119 70 K4 55 k1 32 138 Sip Wo {t +0 115 314 13.0 10M 70 04 55 41 32 13.8 20' 27 9.11 � t 1.64 t 8.84 230 3M F'.5 in 70 � 41 32 13 8 21! 27 9.11 x 11.64 r @ 9 co�nuaus Duty RMad — "LittM 6iaQNhalswatirPumna are triad w�nuoua dutyas bn0��ym tun witldn tlttpt�ttad►>�9nia twRNs FLAW LiTERUMOUR constmetion Epoxy Coated Cast Iron 0 1,000 2000 3000 Motor Housing Po( Carfilonatc _ Impeller Materiel y Im eller'I c Closed Vane t0 __'.........._ YP 30 V olute _ ABS - - -- - _. . LIP Power Cord -- — SJ "l'W -A 75 ch _._ . Shaft SW w i t h carbon and Mechanical Sh Li 20 ceramic feces s Q Fasteners Stainlers Steel 10 S hah Staint4 Steel e -s . I Upper Sleeve and Lower H4:arinbs i Ball Hearings 4 m, 0 20 40 60 EO rLOt1- GALLONS /MINUTE Little Giant Pump C o. P UMP PERFORMANCE CURVE It5v �tZ � pop Box I791U • 4)Idsbema E.'�S', OK 73157 \ pb 405347.3511 • Fps: W5 236 1490 t'r�+ai: caa�omana'"��tlashet.cota 4! Fern 945 235 — 0 710 3 wwW. 1ttfeG1&nt.PumP -00M Pav+rTS OWTr�tJ�.R'S MANUAL. 8� MANAGE1ViEi SYSTEM Sr t =fLJf: INFURiti4�t�c Septic Taralc C:sPY ❑ NA �ywrser Jo o r GtJ Sepgc Table Manufwwbxr o W rt/ M to Fettt�t - Effluent FMRr Htentut>tus nw S' fn TiE C- ❑ NA Pl y 3 Oued nw* Udder 5t' F- t 00 D NA JyurnTser of 8etooR� Pump -Tank � `` � 0 N Nanbet of Commsrcui Units 3 DZ pump Think Matnub MW r� © NA } �� 0 NA aemad Ow q_*t-O Piimp Matsu w rreetpn now (�paekf • t °� i 5) Pump #Model NA Rate U �10�r average' L3 .:jj vr� Fititet p Feat Ffiter Quay X30 mgt D Weiland tcrtic>ar� to dD � I= mg/L LJ D n Aec 0 Other_ :,d CtS4) 6150 rn /L NA Montt b a'✓erage Disporsm Cogs) E j rKn7und (pt+essuUed? probldW t QuarttY s;30 mglL Q in ground (gmv ) Mound Do 9iod o ed S (r-4--s) S30 mglL [3 At-grade CE Othet' rrretriic ) .e d`uT1DOtn3 Q [7ri ne Food Or> �( inch diameter varuas typed i cr rfacrrs� (non�o f �i0" •nd M�dmunt E"kWd PwIde Stns kM brvbCat ItW prom we AiNTENMCIE SCHEDULE gendee Frequency service Event C3 months r(s) (tlflaxhnum 3 yra.) At feast once every uais one.4drd (K) of tank volume inspecttcarj&dcn of banks) Vvhen Combined sludge and scum eq Pump VA contents of tanktsl 33 months r(s) tNtaxiMnurn 3 y rs -) cells) At least once eveb r(s) . Inspect cdspersat Al least once everY C3 months { Clean *Mont 11111W © months s} DNA f' oontr�o� s� Siarn+ ,art least once enrorY 3 s) o rw �, tits :ns�.�e w' P, pump teas At least once every Q rnon r7usb Wwals and t M qt iea6t canoe OYerY C3 rnonthd a year(s) D NA At least oncx every C) months 0 years) 0 NA O&Ar L_ ii+t3'IROC'YicINS Mons o f �Sep�rae i Oftle t and ° `+r be rrraci® by a indiy ldtnsi certYin A �. Metes' Maso tr visual � tech ldwr&W NEW a* ern► � uQ eirvic krti T � me" -the volume of combined afudgB S� jo chew* OM taotf+r+ m kler tt:ltty The dispersal MKS) shelf be V rid s Y T h e pondlg o f �+nt on the "r pOn" of aft" the 9�d MOWS- acre- din>I of effluent Ct3 ttte 9�nd SUC1`dc7e- in d>us obeer+/adt>at t and to Cnaft t{br any P� S t{trteS the lmrrrediete nogkaftn of the ideal MOUTA torY gtrt�'rOrtty . svrt� mw i�� a �$ wnd and m4 or M" of the tetiK Vo lume, the t Vbw iris aomt>tned of'stuciga Septa Ssr�k*V Opeml or and drsPo °f In � � �+ NR enter of the toy, shelf the ren;<oved t aompanetrts: and any 1't3, tyy�t gdmrnls[r-ativa t',Ctl�i�i or pi�essurl�ed PO'tiATTS CO ed bY�� P0 � The �9 k3kuvaw of.12 M017 � ,,M,er maJi � or m�ttrnorm9 08 a Im shall be of oO;"p*fion of any setvic� event ,k =�� aira be po v� to the local tnegul8bury au tarIty vviifiirt 1l1 t OP UP A ether For V ART ND F.RA'nollt r of Q 1a Fo eewti x"tuAw. Prior to use of tt� PDVSrTS check r d t di y fioriite J e if hIgh cotter "0 � Cnemink Viet mw r, - e the 137e8tJ7i'ient A�sS t3nd/ damage the dc�perael f )- detgCW tkvm th contents of the t removed try a sePtaf3e servicing operator 1� to UM i Paye of system s t ar t up strap not Occur whet: sc>sI conditions are frozen at the infiltrdWe sutfaoe Dumg power outages pump tanks tnay fill above nom - gat 19tiwater levels_ Wen h povvW is restored the excess �I.o be discharged t # cispersal cell in one large dose. overioadrrg the cr~B(s and MW raesuft in the disd1at13e of e ffktent To avoid this situation have the contents of the pump tank removed by vamp or surface Prior a e Butt Operator t&restoting power to the effluent pump or contact a Plumber or POWTS Adebtainer to mist in manually op�ng the pump ooatrpls to restore normal levels within the pump tank D)o not drive or park vdndw oYer'tanks and dlspmaf COS- Do net drive or pant aver, .or othemm d*Wb or =np, the attar whin 15 feet down slope of airy moufld or at -grade soil absorption area. Reduction or erurtrinadw of the f+olklwing from the wasLaw2 er stream may improve the performance and prolong rite Gfe of the Pt7VYTS: BrifJ �; bebyvlflAes'dgar�ette buds; condoms; cotton swabs; degn3asers; dental floss; drapew. dam" fat fourida gG n drain (sump PuMP) water, fruit and vegetable peelings. gasefti ; grease',• herblddes; meat scraps; Itledtcatiot>f% of painting products; pesitades� sanitary napkins: tampons'and wafer softener brine. ABANDONNUENT When the ppwVM falls andfor is permanently.taken out of service the following steps shall W taken tO Insure that the system is prvperly'2tnd Safely abandoned in compliance with ch_ comm 83.33, Wiswrisin Adrttfrsls1MW0 Code: • All plpfng to tanks and pits shall be disconnected and the abandoned pipe openings seated_ The contents of aR tanks and pits shall , r emnoved and property disposed of by a Septage Servicing Operator_ • After pumping. all tanks and pits shall be excavated and removed or their covers removed-and the void sparse fled w jjh soi{ gravel or another inert solid material CONTINGENCY PLAN it the POWTS fatis and cannot be repaired the following measures have been, or must be taken, to provide a code compliant nephwe rent system_ ❑ A suitable nepiacemenYarea has been evaluated and may be utilized for the location of a replacement soil absorption system_ The replacement area should be protected from disturbance and compaction and should not be infringed upon by required setbacks from existing and proposed structure, lot lines and wells_ Failure to protect the replacement area will result in the need for a new soil and site revaluation to establish a suitable replacement area- Replaoement systems must comply with the rules in effect at that time. 0 A suitable replacement area is not available due to setback and/or soil limitations_ Barring advances in POYYTS technology a holding tank may be installed as a last resort to replace the failed POWTS_ T site has not been evaluated to identify a suitable repfacsrnent area_ upon failure of the POINTS a soil.and rte evaluation must be perforated to locate a suitable replacement area_ if no replacement area is available a holing tank may be installed as a last resort to rep(acae the failed POWI S_ Mound and at- grade soil absorption systems may be reconstructed in place fallowing removal of the biemat at Itratnre surface. Reconstiructions of such systems must comply with the rules in effect at that time. «WARNING» SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES ANDIOR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT_ RESCUE OFA PERSON FROM THE INTERIOR. OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE ADDITIONAL COMMENTS POWVTS INSTA9 POWTS MAINTAINER yy�� /Name r1 GL �.. j N ame Phase '7 /J ' _«l' b _ /)�' Pfione L �J� 7 SEPTAGE SERVICING OPERATU PUMPER .LOCAL REGULATORY AUTHOWY Name Agency J /b I ©u Phone / J­%_ C:?� 6 q — - Phone /✓ = -� This aoaxrur[ was drat6ad by the srarl5r of the rz+aen L�ahe. Marquette and Waushara county Zaning and Sanifatiort agr�ndes_ rlt$ document meets the nwdmu.n requuenNnrs of cut Cohan and 8:3.54(•F). (2) � C31. W crosiri wmfnNua"C•edc. Use of this daannent not , guarantee the performance of the POWT-S. GMW (Ml) Wisconsin Depa n je 1 2O1 SOIL EVALUATION RvO 11 D Page � of 1 Division of Safet rda with Comm 85, Wis. Adm. Coe ST. c�oix co��i�`F° d county c Attach complete t�GiAN�itt�(6a(iei�fh�is� 1 x 11 inches in size. Plan must c J include, but not lit onzon re erence point (BM), direction and Parcel I.D. percent slope, scale or dimensions, north arrow, and location and distance to nearest road. (j 000 Please Please print all information. ewe y D Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). >' e- / Property Owner Property Location p, Govt. Lot 1/4 S,� 1/4 S 30 T f N R E (or W Property Owner's Mailing Address Lot # Block # ubd. Name or CSM# City State Zip Code Phone Number ❑ City ❑ Village Town Nearest Road 4 4-X--, L� L/CC/.-,- ❑ New Construction Use Residential / Number of bedrooms Code derived design flow rate Sy GPD Replaoement Public or commercial - Describe: __— Parent material FI Plain elevation if applicable General corrvner>ts �-/' 4.� �J ��..� � %r�-- � •� �S / and recomrtrendations: System Type /�%'L7U System Elevation 71 Boring # a Boris f{ it Ground surface elev. y 1 ft. Depth to limiting factor ___ in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDAf in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 I 'Eff#2 cs aBoring # Boring Q Pit Ground surface elev. ft. Depth to limiting factor 3 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. `Eff#1 I - Eff#2 Z ' �— r� c 7 Effluent #1 = BOD > 30 1220 mg1L and TSS >30 1 150 T . 9 YZ ' Effluent #2 = BOD 1 30 mg/L and TSS < 30 mg/L CST Name (Please Print) CST Number Bird Plumbing, Inc. Shaun Bird Si r 226900 Address Date Evaluation Conducted Telephone Number 1008 192nd Ave, New Richmond, WI 54017 r _ —� 715- 246 -4516 Property Owner µ Parcel ID # Page of Boring # ❑ Boring Pit Ground surface elev. t ft. Depth to limiting factor in. Soil ADDlication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDM in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 I 'Eff#2 r bk U -M -- - 0 10 F-1 Boring # Boring ❑ pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'EfW E-1 Boring # ❑ Boring El pit Ground surface elev. ft. Depth to limiting factor in. Soil ication Rate Horizon ')epth Dominant Color Redox Description. Texture Structure Consistence. Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BOD < 30 mg/l- and TSS < 30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608 - 266 -3151 or TTY 608 -264 -8777. SBD4330 (P-6=) Soil Test Plo)an Project Name Clark White ird Address 1943 Sicard Lane Somerset Wi 54025 226900 Lot 2 Subdivision Carrie's Apple River D NE 1/4 SE 1/4S 30 T 31 N /R18 W Town irie Boring Q Well PL Property Line County ST. CROIX IL BM or VRP Assume Elevation 100 ft. Bottom of house siding System Elevation 98.8' *HRpSame as Benchmark Sicard Lane R.O.W. Scale is 1" = 40' unless otherwise noted Garage Well Apple River 5 ' 5'A k 15' Existing 3 25' bedroom 10' house T 20 ' 100' 5 ' D 5 ' 65' 6' 5 , Filled area 98' B -1 2% Slope B -2 30' B -3 45' 5' 97' Property Line I 1 i I I I I I I I a I , L � 75 it ' I I i h F I I I I 1 I li , , V �i �I l' I . G A s I M/ 06596 Hoy: r9N B AY WRT H RD I Mytf. CITY, MI 4311� FAX 1,:21 � , g� -7 24 � � SINVTI - C I FII..TEI� ".��" r r 1x,11. PATE °i 568 ._....._ ...... -. �7F 1 q0 _....1»Cti— I GARY K[1rC'SKPI` W,Ntk � - _L `....�Q�`- _:!..j 59 /Z0 39Vd 93 c4wnd MJdd3i3dd $9$LpL$5TL 0 :0Z TTOZ /90/L0 r t Y ^ �, ` £ ` ••y _ 1 " T�l k$ `y7A!:i APJ4E.YtXBD C4T� fl6fOR0 Dir>`"q _ { 7 S� a %Urnr =iw€ �l�z _' VAt, 0A TY rx�E� a 2 { j y $ ' i s �i `SIT CllOtX C. Vif1�a 'I „ eta this 1 > f s 'd fxar !ii rd, Keaclxsa th �. , q► en en�t Jcrict . M . Ot�}'ens a c onveys- o15d'+vcrrants to ._CPk -y ' .. r s S•i - !i { ...' _.....: -: '•...r :. .. _ _ . �t FE rUN N. TO 4 .` -_. . -• -••- �: Fa rs.t F n� a . 1 5 & L .... 130 S. Bars tai! F .0 $oXi 776 . ........ ...... - - - -•- - �� rlaa r - ,e,��JI__ Vie following described real estate in' -..----- . -. c `yt•.c � . ........... .... 1 K 1 State of Nisconslr>::. 1 Tax Parcel No:. }� Lot 2, Carrie's Apple River Add3.tion to the Township of Star Prai ri e. - a t` 'e _l aid- = 11 FED 4 This _j:§ . .............. . .. homestead Property. (is) (is not) Exception to warranties: no except-ions Dated this O!._........ •....... day of rl((! "_/ ................ .............c---............., 19. x... !.........(SEAL) (SEAL) ....... ... - {J Kenneth E. O$?'........_... * .... ..Joann M Oren... . .(SEAL) .... - • ......... ........................ .................................... ............. .............. * _....... .......... ... ........_............._..._.......---- AUTIIENTICATIO117 ACKN0WLEDGR4ENT STATE OF VMQWUUMY Signature (s) ----------------------- Kansas ss. ..--- --- --••••---- - ---------- ------- --- Count authenticated this -------- day of_____________ 1-0 ...... Psonally came before me this _..- y._...day of _..&Z.7 -- -_-------------------_- 19�_the above named ........- --•- -. ----------------- -- •-- •-- •- --- '•- -•......•- - - ° ---- Kenneth_ F.._ Ogren. and_ Joann - M. Ogren - - -- -- ... .............................................................. TITLE: MEMBER STATE BAR OF WISCONSIN ..... ............. ..................... . (If. no!' . -- - ----- ----- ----- -- ---•- - -•- S p1lY_1D j._t14TE�E authorized by Q 746.46, Wis. Stats.) tc me known to be the per:;... wh�Qt c @'C foregoing instrwt:ent and ac o -'- .. -_::r i OF KANSAS MY A *' :. 1' r6 JANUARY is, 1989 THIS iNS rnUMENT WAS DRAFTED BY John. D Walsh - •-......-- ••-•--- -'-........._ - ......•..... --- -••......• - -••• Notary Public _! ''`s^ __ ntv, ansas (Signatures may be authenticated or acknowledged. Both My CO�nission is permanent . I' not, taxpirat are not necessary.) date: JM,U1) j{ I ----------- - •----...... 18.x. /...) *Names or persons signing in any capacity should be typed or printed bolo- Ch^.ir signatures. WARRANTY DEED STATE DAR OF WISCONSIN Vi'isconsin Lcgal Blaak C... lac. FORM NO. z —.1982 nli:- ukue, Wis. DOCUMENT NO. E STATE BAR Or WISCONSIN FORM 1 — 3.8S�i r>:c_ .PA__ s_=eRvEV FOR l4EE9Rt'i•.[o u.rw it WARRANTY DEED — - - -`��" �' .. ► v.>_ �J- i ,�., Ia, :x-33 -- — REG ISIMS OFFICE sr. C RQDX CG, WI This DE3ed, made between s? �i ^ is ... E i T6riivoord !4 AA.S:... _ ... - ... I ^ „ MAR 7 1995 n ...... ........ . ........ ... --•-- -- - -• ---.. .._ ... .................... ............. I ............... .. -- --•....-•••- °............ – - -• Grantor, i 2t 9:45 �T ...i�lhi e__ and.. Christina. _I,...tdtlite.,_______ __ r and Clark _______ 6 A. li his c._- as--_ sur�rivr�rshig ..mar_ital ............. .. �� jam ?s. -A- (,JcsteQ�, ro art .. - -- -- -. -- _P P y . ... . .... .. ..............._..._ .._.. --- � ----- --- - I Rogf �i'erctDROds ..... .... -----------... ......... ...................... ......_..._....... ..... ....... • Grantee, I� Witnesseth, That the said Grantor, for a valuable consideration_..._. ........ . ............................... ..... .................... ..... ............... I aerueN To �� + conveys to Grantee the following described real estate in --- St•-...- GzO'tX ---- County, State of Wisconsin: ji �9 Tax Parcel Nu: _0.3.8_•- :1.13.0_- 3_0 _____ -__ Lot 3 and Northerly 1/2 of Lot 4, Carries Apple River A Ltion to the Town of Star Prairie. I •� • ti If I� I, H This homestead property. Ii •• -- - (is) - (is • not) �� Together with all and singular the hereditaments and appurtenances thereunto belonging; And. Grantor •-•-__.._._-•--• ................................................... ....__.__............__........ ....... .....................--- warrants that the title is good, indefeasible in fee simple and free and clear of encumbrances except subject to easements, restrictions and covenants of record, if any, II and will warrant and defend the same. II Dated this -- - - -- - - -- _ j . .......... . ..... day of .... ... .... ... ............................... ifl_.9..... ......................... (SEAL) t .. • .._. ohn... Stop �f �' Ig ..._ k ................... ............................... (SEAL) Col lette R . po0 er �•� "��g �i AUTELENTICATION AOXNO W LEDG?MENT ture(a) _______________________°___ _____._.__..._.__..____________ STATE OF 39bbOMMM i t1_Ssolxt'' sa. authenticated this ______ ay of___ _________________ ___ 133_____. Personally came before me this ____��}_______day of �I a .'_bh+i: r•-----••- °__ 1 J t:��l the abo.o eta •., tl --- -- -•-- ------ - -- - - °--- ---- poorier__and__ e Coll - _ '- --- ---- -- ----- -- -- ---- -- - - - -•-- --•---......_ -•-- Spooner ................................. ,,•'� �` +._ TIT EMBER STATE BAR OF R'ISCO Z7 ____ ti N ' \� '' Q i(If not, -------------------------------------------------- -°----•- --- ------ •-- ...--° - _ � . authorized by § 706.06. Wis. Stats.) - ' ”' "' • •- _ -•-•---- -•-••--- - in me known to be the person ash :ore -in rumext and � the ' i o;a THIS INSTRiJ 7N ENT WAS DRAFTED 8Y �... ]•' �• of thissoud �\ REALTY WORLD - Pauley & Johnson ... -._ � I <-- r�_�_..... .r Sti- ilwater NIN 5508 2__ - _ - -- - Notary ub'13c ......._._.�.�_Q �. �� .......... .....County, WC 0. (Signatures may be luthencicated or acknowledged. Both My Con mission is permanent. (rf not, state expiration I are not necessary.) date: ...._.�....al.- a.._..- _ ... .............. , 13..R(o - 'Name. or peso.. e�Tninx in nny —r —ity ah.-Id he Printed h,l..m thrir nisna tnrc?. WARRANTY DEED $TATF. BAR OF w1SGONS1N i—i ninnic C - inc. F•]R.1t No. 1 11S2 Mi:-0— Wis. c rr 1 0 6 °36 I SO 4 f+ 15 " t10003M �# . .