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HomeMy WebLinkAbout645445 026-1130-43-000c Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Safety and Building Division INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Personal information you provide may be used for secondary purposes [Privacy Law, s,15.04 (1)(m)]. Permit Holder's Name: City 7--Village Township Jeff Iverson TOWN OF RICHMOND CST BM Elev: Insp. BM Elev: r IBM Description: / 9 -7o ` C� 5f,41-f. 6 M u",O- — q g -7o 1 ANr% INrUKMA I IUN TYPE MANUFACTUR CAPACITY Septic VU b <LVI i A: Dosing Aeration TANK SETBACK INFORMATION PUMP/SIPHON INFORMATION Manufacturer Demand 0 tALb GPM I _ Model Number n� , r� aq, A. TDH Lift Friction Loss `' System Hea� TDH t 2 q5- j9.5 Forcemain Length Dia. I Dist. to Well 5-q t 7 ELEVATION DATA County: -- � St. Croix Sanitary Permit No: 645445 State Plan ID No: 102202440-c Parcel Tax No: 026-1130-43-000 Section/Town/Range/Map No: 25.30.18.903 STATION BS HI FS ELEV. Benchngk � ��S 22� p / O-� �t � I W Bldg. Sewer r Is, gD St/Ht Inlet D.SD St/Ht Outlet f Dt Inlet Dt Bottom �. 22 Header/Man. ag rb� y r oo.9d Dist. Pipe ,,r Bot. System / [D o •20 Final Grade /t W,u �f c2f bQr C er �z f 8b Q L4,1--W 2 SOIL ABSORPTION SYSTEM ED R6N6N ENSIGNS Width / I Length No. Of T� 3� e f PIT DIMENSIONS No. Of Pits Inside Dia. Depth 1:! SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Ma facturer: INFORMATION Type Of System: CHAMBER OR UNIT Mod u DISTRIBUTION SYSTEM I— °" —CA .Prtnafe-V&n. Header/Manifold f t 11 1 2 Distribu n Pipe(s) �$$6 / I/ I/ ` b2 3 .33 x Hole Size 5- N /�z x Hole Spacing G/ Vent to Air Intake l0 Length Dia Length Dia Spacing 3 -% SOIL COVER x Pressure Svstems Only xx Mnund nr Ot_Grado Svstams Only Depth Over Depth Over xx Depth of Seeded/Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil IM Yes 'E] No]— i_7 Yes No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: fxAt5 3110125 YZ Inspectio #2: S12Y1zo23 — K6a Location: 1425 136TH AVE 1.) Alt BM Description 2.) Bldg sewer length = �$ j:. - amount of cover =.W- ) Plan revision Required? Yes (No Use other side for additional information. SBD-6710 (R.3/97) Date Insepctor's Signature Cert. No. a�� st_za(1f) Industry Services Division Cou`j� P a 2022 1400 E Washington Ave P.O. Box 7162 Sanitary Permit Number (to be filled in by Co.) C T Mattison, 53 7-7 / L f 4 L1 LIE ` E C ` Application Stag Transaction Number accordance with ), R'fi Adm. Code, submission of this form to flat � La-pv eniai tm[t is required prior to obWnin-- a sanitary permit. Note_ Application forms for state-onned POWTS ate submitted to n �^ • /`" �t.( 1 � --- � /� 7 �� ) / y c� 16). L C Project Address (if drff than mailing address) t/ -E, 2,36 � =` }4 U" the Department of Safety and Professional Services- Peron! information )nu provide may be used for secondan. purposes in accordance with the Privacy Lau, s- I5.03(I)(m), Stars- I. Application InforniationzfleascYrit All Information Property Owner's Name Parcel -v 3 -va Property Owner's Mailing Addrm, P"Y: � o Govt- Lot St Ll %, /Wi• %, Section City, State ( Zip Code Phone Number (> I �` j _ t_ T i\ R �ai le t � H. Type Building of (check all that apply) (l or 2 Family D,,Ui Number Lot € Subdivision Name L-- of Bedrooms l V3 ❑ Public/Commercial - Describe Use Bruck € ❑ State Chtined -Describe Use ❑ City of �f/(Q ❑ Village of Town -of CShl\umber III. Type of Permit: (Check only one box on line A. Complete line B if applicable) A. New System ❑ Replacement System Treatment/Holdin� ❑ .-: Tani: Replacement Only ❑ Other Modification to Existing System (explain) B. ❑ Permit Rmewal Before Expiration ❑ Permit Recision ❑ Change of t ❑ Permit Transfer m lxetir List Previous Permit Number and Date Issued Plumber Owner IV. Type of POWTS S COrn onent/Device: (Check all that ap ❑ Non -Pressurized ht-Ground ❑ Pressurized In -Ground ❑ At -Grade ❑ Holding Taal: ❑ Other Di � found > 2-1 in- o�,,Witbl, ❑ 1tlound <2d in. of suitable soil spersal Component (explain) ❑ Pre ent Device (ca yUrf= V.Dis rsai/TreatmentAreainforrnation: n � Design Flow (gpd) Destgn Soil Application sf) Dispersal Area Propos (sf) S) Elevation Rate(gpdst) I 1, o /1!r VI. Tank Info Capacity in Gallons_Tlanufacturer - o U NewTan}:s Exis<ingTanla c o C o = v Septic or Holding Tank f � -- C ❑ ❑ ❑ C Dosing Chamber > — Q�v L� 7� ❑ ❑ ❑ C V1I. Responsibility Statement- 1, the undersigned, assume responst'Iiility for installatioa of the PON TS show n on the attached plans. Plumber's ' - 7 ) ! , /- �f � PI *s S z � � 1IPRS Number Btbidess Phone Number ( Plumber's Address (Street_ City, State, Zip Code) Counts/De artment Use Onh AA7pproved, ❑ Disapproved Permit FYn De f �V Z issuing Agent e Owner Given Reason forfktti:tl 5 /7• oe� /U �,�j1{❑l U' 'feF�<ia' i�C"�'ft RNr"ns for Disapproval ?j (� I ,L 6 ` !/-• 5 ' /� dispersal be s@rvi rell mrat eitmaintaMed as per management plan provided by plumber. !`e/ ➢`-f' GC V'{ / VJ � G� 2. All setback requirements must be maintained )�( rr per anpliCrble cocie/ordinances• Y 1 Vy� =+(� !/l•� V S� .inn to —Flew plans oqe s�sga( axe submit to the Cemtr oats myapormtkss 6= S w z II vdees m size i h �r` rt-r li �` 6 C) K-c� 7&,) 1 `15 ._ L 94 Wisconsin Department of Safety and Professional Services Division of Industry Services 4822 Madison Yards Way PO Box 7302 Madison, WI 53707 October 4, 2022 CUST ID NO.: 224832 MARY JO HUPPERT 25720 FIREFLY LANE WEBSTER, WI 54893 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 10/04/2024 MUNICIPALITY: TOWN OF RICHMOND ST. CROIX COUNTY SITE: IVERSON CARPENTRY 8t: CONSTRUCTION 1425 136TH AVENUE NEW RICHMOND, WI 54017 SW 1/4 OF THE NW 1/4, SEC. 25, T30N, R18W FOR: Design Wastewater Flow Value: 600 Bedrooms: 4 Limiting Factor(s): 38" Maintenance Required: Effluent Filter 64 544608-266-2112 Web: http: dsps.wi.eov Email: dspscu%wisconsin.gov Tony Evers, Governor Dan Hereth, Secretary Identification Numbers Plan Re-iew No.: PWTS- I 02202440-C Application No.: DIS-092247218 Site ID No.: SIT-107464 Please refer to all identification numbers in each correspondence with the Department. Conditionally APPROVED DEPT. OF SAFETY AND PROFESSIONAL SERVICES DIVIS40N OF INDUSTRY SERVICES SEE CORRESPONDENCE Mound Component Manual - Version 2.1 (May 2022-2027) Pressure Distribution Component Manual - Version 2.1 (May 2022-2027) SITE REQUIREMENTS • A full size copy of the approved plans, specifications, and this letter shall be on -site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. A Department electronic stamp and signature shall be on the plans which are used at the job site for construction. The following conditions shall be met during construction or installation and prior to occupancy or use: • Preserve dispersal area prior and during construction to avoid disturbance, compaction and use of the site. • With new construction; it is recommended not to activate the pump in the dose tank until the tanks are pumped prior to homeowner occupancy. • Wastewater generated from contractors cleaning of equipment and tools and/or left over construction products shall not be discharged into the drains discharging to the private onsite wastewater treatment system (POWTS). Waste generated shall be properly disposed of on -site or off site. • Any tall grasses, leaves and shrubs shall be cut short and removed prior to tilling the surface for installation to prevent matting under the dispersal area. All loose organic material to be removed from POWTS Dispersal Area. • Divert surface water from all POWTS Areas. • Prior to construction of the dispersal area, check the moisture content of the soil to a depth of 8 inches. Smearing and compacting of wet soil will result in reducing the infiltration capacity of the soil. Proper soil moisture content can be determined by rolling a soil sample between the hands. If it rolls into a 1/4- inch wire, the site is too wet to prepare. If it crumbles, site preparation can proceed. If the site is too wet to prepare, do not proceed until it dries. • All piping shall conform to SPS Table 384.30-3 and SPS Table 384.30-5 • Insulate building sewer beyond 30 feet per SPS 382.30 (11)(c) • Well setbacks to meet chs. NR 811 & 812 • Tank Installation to follow all manufacture's recommendations. • Verify property line(s) prior to installation. 645445 • Pump Floats to be set and verified per approved plan. Any changes may result in pump resizing to meet TDH and GPM Specifications. • Areas that are occupied with rock fragments, tree roots, stumps and boulders reduce the amount of soil available for proper treatment. If no other site is available, trees in the basal area of the mound must be cut off at ground level. A larger fill area is necessary when any of the above conditions are encountered, to provide sufficient infiltrative area. Owner Responsibilities • The current owner, and each subsequent owner, shall receive a copy of this letter including instructions relating to proper use and maintenance of the system. Owners shall receive a copy of the appropriate operation and maintenance manual and/or owner's manual for the POWTS described in this approval SPS 383.54(1). • In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approved plans. OWNER RESPONSIBILITIES • The current owner, and each subsequent owner, shall receive a copy of this letter including instructions relating to proper use and maintenance of the system. Owners shall receive a copy of the appropriate operation and maintenance manual and/or owner's manual for the POWTS described in this approval and Wis. Admin. Code § SPS 383.540). • In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approved plans. The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. This system is to be constructed and located in accordance with the enclosed approved plans and with any component manual(s) referenced above. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, stets. All permits required by the state or the local municipality shall be obtained prior to commencement of construction/installation/operation. In granting this approval, the Division of Industry Services reserves the right to require changes or additions, should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. The Division does not take responsibility for the design or construction of the reviewed items. Inquiries concerning this correspondence may be made to me at the contact information listed below, or at the address on this letterhead. Sincerely, tzw g"/t 4 nC Plrtf Tim Vander Leest POWTS Plan Reviewer Division of Industry Services Phone: 608-516-6134 Email: tim.vanderleestgawisconsin.gov Fee Required: $250.00 Fee Received: $250.00 Balance Due: $0.00 Refund Expected: $0.00 645445 MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN INDEX AND TITLE PAGE CondiWnally APPROVED Proud Name: IVERSON CARPENTRY 6 CONSTRUCTION DEPT. OF SAFETY AND PROFESSIONAL SERVICES DIVISION OF INDUSTRY SERVICES Owners Name: (Same) Owners Address: 1109 PINEWOOD TRAIL NEW RICHMOND, WI 54017 Legal Description: SW 1 /4 OF THE MIY 114, SEC. 25. T30N, RI SW Township: RICHMOND County. St. Croix Subdivision Name: RED PINE CORNER Lot Number: 43 Block Number. NA Parcel I.D. Number. 026 -1130 - 43 - 000 Plan Transaction No.: SEE CORRESPONDENCE Page 1 Index and tide !!,pucueru"•-,, Page 2 Data entry Page 3 Mound drawings �•� `' Page 4 Lateral and dose tank ` Page 5 System maintenance specfications Page 6 Management and contingency plan Page 7 Pump curve and specifications is Page 8 Plot RiPMn Page 9 Soil test =' Page 10 .-•••�, �+� Page 11 ���11► '� �r ..: Page 12 �ea� Page ► 3 swa � Designer. Mary Jo Huppert License Number 1859 - 007 Date: 09/20/22 Phone Nkm,.:, 715 -426 -1775 Signature . P" 1 of 13 nAigned Parsuarit to the Mound Component Manuel for POWTS Ve-- SM 1O801 P (m QV OV. omdbstS (NVIII ZoZz) 5&lrw PuwKwon 5.o 0er-," in -for :;L 5A5 ; 4KK 11 and preka.•en:••.X..� _ Co+^ya•u.�wneaa�VCe.2:lS6o- 7p4�Pt/ldif/i) (/v�M ZA21-2tud (AAOVAlq 05A7rz2) 645445 Mound and Pressure Distribution Component Design Design Worksheet (R or C) Site Infonmation Residential or Commercial Design Estimated Wastewater Flow (gpd) Peaking Factor (e.g. 1.5 = 150%) Design Flow (gpd) Site Slope (%) Contour Line Elevation (ft) Depth to Limiting Factor (in) In -situ Soil Application Rate (gpd/ft2 R 400.00 1.50 600.00 1.00 99.80 38.00 0.40 Distribution Cell Information 60.001 Dispersal Cell Length Along Contour (ft) _ 1.00 Dispersal Cell Design Loading Rate (gpd/ft2) 1 Influent Wastewater Quality (1 or 2) (C or E) Pressure Disribution Information Center or End Manifold Lateral Spacing (ft) Number of Laterals Orifice Diameter (in) Estimated Orifice Spacing (ft) _ Forcemain Diameter (in) Forcemain Length (ft) Pump Tank Elevation (ft) a 3.33 3 0.156 3.50 2.00 103.00 86.00 4.55 System Head (ft) x 1.3 13.89 Vertical Lift (ft) 1.70 Friction Loss (ft) 0.00 In -line Filter Loss (ft) 20.14 Total Dynamic Head (ft) Lateral Diameter Selection in. dia. options choice 0.75 1.00 1.25 x 1.50 x x 2.00 x 3.00 x Treatment Tank Information 1200.00 Septic Tank Capacity (gal) Wieser IManufacturer Note: Sand fill (D) calculations assume a Table 383-44-3 in -situ soil treatment for fecal coliform of - 36 inches. 0 10.0 Cell Width (ft) Are the laterals the highest point in the distribution Y network? Enter Y or N If N above, enter the elevation ft of the highest point. 11.76 ft2/orifice Does the forcemain drain back? I Y Enter Y or N 16.80 Forcemain Drainback (gal) 80.60 5x Void Volume (gal) 97.40 Minimum Dose Volume (gal) 27.46 System Demand (gpm) Manifold Diameter Selection in. dia. options choice 1.25 x 1.50 x x 2.00 3.00 Gallons/Inch Calculator (optional) Total Tank Capacity (gal) Total Working Liquid Depth (in) gain (enter result in cell B49) Dose Tank Information Effluent Filter Information 800.001 Dose Tank Capacity (gal) I Pol Lok Filter Manufacturer 22.241 Dose Tank Volume (gal/in) 1 525 Filter Model Number Weiser IManufacturer Project: IVERSON CARPENTRY & CONSTRUCTION Page 2 of 13 645445 Mound Plan and Cross Section Views L Mound Component Dimensions Down slop e toe extension made. A 10.00 ft E 7.20 in H 1.00 ft K aft ft B 60.00 ft F 9.50 in z 15.00 ft L ft D 6.00 in G 0.50 ft J 5.22 ft W 600.00 (ft`) Dispersal Cell Area 1 1500.00 (ft) Basal Area Available 10.00 (gpd/ft) Linear Loading Rate 1 6.00 (ft) 1/10 B Obs, Pipe Placement Finished Grade 100.30 (ft) IF — Dispersal Cell Elevation Mound Cross Section View Aggregate Dispersal Area - - - - - - - - - - - - - - - - - - H 100.80 (ft) Lateral Invert .80 (ft) Contour Elevation 1.0 %Site Slope Geotextile Fabric Cover Shading Key IV a — Dispersal Cell See lateral details on ] Topsoil Cap o a 1.5 ft T Page 4 for number, size, n o and spacing of laterals. 2� Subsoil Cap � %''�'Q ASTM C33 Sand to > '0 Laterals are equally Tilled Layer m 0.5 ft Typical Lateral F spaced from the y distribution cell's © Aggregate v o © centerline in the — A r distribution cell (AxB). Project: IVERSON CARPENTRY & CONSTRUCTION Page 3 of 13 645445 Project: End Connection Lateral Layout Diagram Center the laterals over the A & B dimension •- Turn -up wfball valve or oleanoutplug e P All laterals are identical IE- X —� I Holes driNed on the bottom of the lateral S equally spaced Laterals Morcemain Sch 40 PVC per SPS Table 384.30-6 S Force main connection via tee or cross to manifold at any point. Number of Laterals Lateral Diameter Lateral Length (P) Lateral Spacing (S) Lateral Flow Rate System Flow Rate Total Dynamic Head 3 1.50 in 58.56 ft 3.33 ft 9.15 gpm 27.46 gpm 20.14 ft Orifice Diameter Orifice Spacing (X) Orifices per Lateral Orifice Density Manifold Length Manifold Diameter Forcemain Velocity Dose Tank Information Electrical as per NEC 300 and 10 SPS 316.300 WAC Disconnect Tank component is properly vented Weiser Capacityl 800.00 Volume 1 22.24 Manufacturer Gallons gal/inch Dimension Inches Gallons A 18.69 415.71 B 2.00 44.48 C 4.38 97.40 D 10.90 242.42 Total 35.97 800.00 3" Bedd A B C —f er tank. Alarm Manuafacturer ISJE Rhombus —� Alarm Model Number ITank Alert AB �— Pump Manufacturer IGOULD Pump Model Number I PE 41 Pump Must Deliver 27.46 gpm at 20.14 ft TDH IVERSON CARPENTRY & CONSTRUCTION 0.1561in t�s1.1lui 17 11.76 ft2/orifice 6.67 ft 2.801ft/sec Locking cover with waming label and locking device and sealed watertight 4 in. min_ E- Alternate outlet location Forcemain diameter --1 2 in. Weep hole or anti - siphon device Pump off elevation (ft) 86.91 Dos tank elevation (ft) 86.00 Note: Switches containing mercury may not be used in this system. Page 4 of 13 645445 Mound System Maintenance and Operation Specifications Service Provider's Name POWERS Phone 715-246-5738 POWTS Regulator's Name St. Croix County Zoning Phone 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 ft'` Maximum FOG 30 mg/L Type of Wastewater Domestic Maximum Fecal Coliform >10E4 cfu/100 mL Septic and Pump Tank Effluent Filter Pump and Controls Alarm Pressure System Mound Other Service Frequency Inspect and/or service once every 3 years Should inspect and clean at least once every 3 years Test once every 3 ears Should test monthly Laterals should be flushed and pressure tested every 1.5 years Inspect for ponding and see a e once every 3 years Miscellaneous Construction and Materials Standards 1. Observation pipes are slotted and materials conform to Table SPS 384.30-1, have a watertight cap, and are secured in as shown in the mound component manual. 2. Dispersal cell aggregate conforms to SPS 384.30 (6)(i), Wis. Adm. Code. 3. All gravity and pressure piping materials conform to the requirements in SPS 384, 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 Turn -up Detail Finished •........... -- ............... .............. Grade 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: IVERSON CARPENTRY & CONSTRUCTION Page 5 of 13 Mound System Management Plan 645445 Pursuant to SPS 383.54, Wis. Adm. Code General This system shall be operated in accordance with SPS 382-84 Wis. Adm. Code, and shall maintained in accordance with its' component manuals [SBD-10691-P (N.01101), SSWMP Publication 9.6 (01 /81), and Pressure Distribution Component Manual Ver. 2.0 SBD-10706-P (N. 01 /01)j 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 SPS 383.33, Wis. Adm. Code when the tanks are no longer used as POWTS components. Septic or pump tank manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 8-inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into a tank or component. Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Slats. 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 fitter shall be serviced if the alarm is activated continuously. Intermittent fitter 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 filter 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 BODS, 150 mg/L TSS, and 30 mg/L FOG for septic tank effluent or 30 mg/L BOD5, 30 mg/L TSS, 10 mg/L FOG, and 104cfu/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. Contingency Plan If the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep the system in proper operating condition. If the dosing tank, pump, pump controls, alarm or related wiring becomes defective the defective component(s) shall be immediately repaired or replaced with a component of the same or equal performance. If the mound component fails to accept wastewater or begins to discharge wastewater to the ground surface, it will be repaired or replaced in its' present location by increasing basal area if toe leakage occurs or by removing biologically clogged absorption and dispersal media, and related piping, and replacing said components as deemed necessary to bring the system into proper operating condition. See Page 5 of this plan for the name and telephone number of your local POWTS regulator and service provider. Pretreatment Units The information and schedule of mananagement and maintenance for pretreatment devices such as aerobic treatment units or disinfection units are attached as separate documents and are considered part of the overall management plan for this system. Project: Page 6 of 13 Wastewater NAETERS FEET ___--__ MODELS: PE31, PE41, PE51, i PE51 + HP- .33..40..50 35 _ _- 10 2 GPM 30 _ PE4i 1 FT 2 0 PERFORMANCE RAMGS PEVI 10 20 30 40 50 60 70 GPM 80 5 1 10 15 m3/h Raw H d of w tell Gm S 52 10 Q /s 29 20 16 25 0 CAPAUIY Taw Nod Point d "to GAM 8 61 10 57 15 46 20 33 25 16 (%* of "to l GPM 10 67 is 99 20 50 25 39 30 26 35 a xvFrsor✓ 645445 Plot Plan Page r of 13 PROPER7YOWNER: 40 FT. r (except +here noW) teal Description: LOT `M KW PNE eoM fig, 5W /4of 1lW D WKkhoe pit SEC. ag. -np j- Rtu T -rm Aih. of Rc,*AwP D, 5r CRV, Camay, 1Aii�c'nl�SiN . 02io - wdo- 4 3- ODO f 14 Z5 131, +" AVE/V U6 a \ Y Site location: SvJ Gc Ns 98. 10 645445 m1e1da ,.1Oe SOIL EVALUATION REPORT pop' a Ohrsion d8iM/arWB�q� In soo do "a Cairn a. VAL Adm. Cods Colxdlr st- nix Alsdr aorplele of om an pepw nd Isas dwn a 112 x 111rldlss in sits. Mw must buk d% bur nor irisd be vs,Md wd holimlllsl rsrwwras aoYi" drec on nxed. Pamd I.D. pwc+wd dope, sds ordUrl.rwimw, naMr avow, cad Dart phow pine a ko6rr� �. ` a�.a�r�rd.nre.leuoi•r+e..irr...ew.iw�+rr u..�,1s.�+la•u- PIOM%10~ ART, IR, ?�..%._i Propwglodfon C,aA Ld. SW im 101 1M S T N R (a) w Pam!► Qd �isirrp / - Brock / Su6d Nsnr ar CSW 11 W � wO+Mpi ❑ VMW KITown Nedred Road zao r , Spring RLak Pa k,NN. '` 7a0-4 Richmond �NswCmwWMAM Um CB Reddwrrd/Nleibw __. tt cod. dw+ad ds4r row nr 600 _ GM O RwbM wr ❑ Pubro or oommwdr - Deuadw. IL Palarrtnrslwlr lariat drift Fk=dP%b rnKappk-sw Gawgl axlwwlb � rM•�•-+ cad rw�omnlwdMwr: . nand a el. 100.60' be an oontour line of el. 99.60' l ❑ rim' M 1 Boe+o r pp Ckound srrbw dev. • 80 p q binwrg laclor 4�_ ML Sol Rsle Fl-X 0" Mr in. Oondllwlt Mune/ Redo,t DssWOM CAL Sz- Cart Cdw 1 2 3 0-11 11-2 25-4 10 r 3 10 r 4/4 7 5 r4/ none none none 4 -7 7.5yr4/ c2d7.5yr 5/6 V4 Team Srudue Corrsblerros BbwldwY Rod 'EMI 'E11a2 �'— Qr. Sz Sh L 2msbk of cs 2f 5 •8 •� sicl 2mabk mfr g. if .4 •`f sl 2msb]c mfr 9W na • 5 r sl 2msbk mfi na na .5 jj r p GMwd eurlsos dev. • 80 IL DwM to fi�r� 0 6o1or �� it gd Rate Nmimn Deer+ Dan* wa il. Mlawd Rsdal Dssatprar Qu. Sz. COIR dolor Tsdue Slrucaae CmltlsMroe ela,nd.n Gr. Sr-SI►. Rood I '! 1 I 'E: . 8 . 2 8-17 7.5 r4/ none sicl sl 2msbk 2msbk estone mfr mvfr esidu 1f na na .4 .5 np -6 .9 np •�( .� 3 17-3 7.5 >F4/ AOAe 4 38-5 10yr6/1 c2p7.5yr5 6 ___----- 1 L • Elnrt rH a BODEE 30 <?20 m01L cad TW >30 _< 150 mall CST Nsme (Picas p*4 " Gary L. Steel Address 1554 200th. Ave., New Richmand, WI. 54017 • 1:0.t 22 - B+OD. 25 30 "V& wrd TSS _ 3030 11 715-246-6200 645445 p+ape1bn w Qnlrwnnd TanA Developmenbwwo• finding papa 2 d 3 aems ❑ goev © pR aamad mdroa dwr. 99. 20 1L DspTh 10 rninp 6tmr 4—r` llelaon Dapdk k DaaMW Mund Ra i= Dno4� Cllt Sz Cod cdw Term" Sfrdw or. Sz SIL Cmwk m Oow do w Fum '�1 •Cs� 1 -8 0 r3/3 none L 2msbk mfr cs 2f .5 8 2 -20 .5yr4/ none sicl 2msbk mfr gw if .4 3 - r4/ none sl 12msbk mvfr aw I na .5 .9 4 -5 5yr4/4 2d7.5 r5 6 sl 2msbk ■fi 9w na .5 5 58-7 10 6 1 Lip2stone Res Yi na •EMmdn=WD,�30<MmgLandTW>30<1somgL .EMmt92-SCIC�S3owQ&andTW13owiplL The Deparaseae of Comm me is as c"M opporaway service provider amd employer. if you and assistance to woo services a oosd aamesial in as almasse >amat, pkm coarser at depatrotat at NO-M&3131 ow TIT Mg-260-SM. 645445 GaryL Stet! OSTM2298 MPRSW-32`4 STEEL'S SOIL SERVICE LaSwjWj rT30N-RD�e�+elol�Pent town of RiciWand la /43-Aed Pine Oaecrw N -1M-40' dgQmtm of SC Lot stake a el. 1 o bop of sm lot stake 1_ 15M 2001h Ave - New Richmond. 7 (715 r ` 75. f E - � 2' 4 0% A Z• W 645445 .• �„ . ` ti� �/ � 645446 LOT 33 5.952 SO FT. - • L51 ACRIES ' . a-0• i 'Aw ••. (d ` • 6ti' •�`L ` Z 6e ,�01 . ors ems. - I ,y'1h ♦ i I *10 OF 1p f.5f ACRES %Alb L :�'• • ' LOT 4+2 Z 67,6?? SO. iT. 1.55 ACRES w � W � I 326. 76' . S2' EAST/MEST WARZ& LAC S M 1ST I :T._ UVCT 1 /A 1 o%9^o%Pfow — — — — — PWu.ru 645445 _ Ft JNTY Office Use onhST. CR� OWNERSHIP/ADDRESS FORM C--W2/202r Community Development Department will utilize this information to provide the property owner with information regarding operation and maintenance of your new or replacement sanitary system! This information will be provided as part of our ongoing efforts to protect public health, your well, groundwater, surface water, property values, and county resources. Once approved, this completed form and educational information will be sent to you by email. If you would like to view your issued sanitary petntrt online Vou cdn do so by us+ny the Property Files Scanned web -link. OWNER/BUYER INFORMATION Owner/Buyer JEFFREY IVERSON Mailing Address City/State/Zip Phone Number Email Address 1109 PINEWOOD TRAIL NEW RICHMOND, WI 54017 Parcel Identification Number 026 - 1130 - 43 - 000 ;found an the property tan ball NEW SYSTEM: LEGAL DESCRIPTION Property Location SW '/. , NW '/,., Sec. 25 , T 30 N R 18 W. Town of RICHMOND Subdivision Plat RED PINE CORNER Lot e> 43 Certified Survey Map aw NA Warranty Deed • Number of bedrooms 4 Volume NA Page a NA (before 2006)Volume , Page Spec house O yes O no Lot lines identifiable ■ yes G no OFFKI USE Dray New Property Address---_.—_- N'eriicat:on o1 new address reqused from Comrnr. nrt, Jr.taprnert Uep.rr-ic�t for Weis c3rYstrir6ort1 & P, / 41 (Staff Ind ms] 03w This form must be submitted with all Private Onsite Water Treatment System (POWTS) applications. New Systen►: Include with ttus form a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if reference is made in the warranty deed. Community Development Department - Land Use Division 715-386-4680 St. Croix County Government Center 715-245-4250 Fax cddasccwi.00v 1101 Carmichael Road. Hudson, WI 54016 IrOtOR3�iQQlt C1YY0. N1IjMnN.pu ocruwllrrl--- `- -- IW1[0 � lua.rolrar«po un+uu wk�aw no N1 oouapnaonYoale.Mr I ir•nf,.l.0 w NIwQUANMI.[tp Vr4lYUNln - ® PMCro7 CpHiWUDUCLYM<111KtlLo@t nYC,IYY. fporIIM1Y ttOppplNpfUMl pMllt CpNlYllpllCCr VlfUllCp IpI1G/llf ip llU4plpMNprt IIIA .I.4MCI n.IN. _ ® IMY Iea IppINpIC 1 p(M)pOr1WC14N4 rYY1L.p11cflli lbxllYax6tY N61INIp lunMl.ut pxlM W'tllnip 111-01u1n Ipi! .9 WMIINICMp Mxr1A rr11C11 Wat Cf plrrWWlhC 14 C. 4MA 645445 Wisconsin Department of Commerce SOIL EVALUATION REPORT Page -L— of —3— Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code County Attach complete site plan on paper not less than 8 112 x 11 inches in size. Plan must S t Croix include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Please print all information. nevi ed by, Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 %(1) (m)). Property Owner Property! Location _ Govt. Lot SW 1/4 NW 114 S Tin N R (or) W Property Owner's Mailing Address L Lot # Block # Subd. Name or CSM# " i�01 X -'N na RPd Pinp Corner City State Zip Code Phone Numbek 1.NG OFFiCE M-4996 �Ci ❑ Village ® Town Nearest Road Spring Lak Pa k,MN. (6� ,j Richmond I 1 a New Construction Use: [3 Residential / Number o rob_mis 4 � Code derived design flow rate 600 GPD ❑ Replacement ❑ Public or commercial - Describe: Parent material gl aci al drift Flood Plain eleT on if applicable ft. General comments and recommendations: ^^ mound @ el. 100.60' based on contour line of el. 99.60' Boring Boring Fil g # � pit Ground surface elev. 99.80 ft. Depth to limiting factor 4_—�— in. �► �, � tea. � Soil Application Rate' Horizon Depth in. Dominant Color Munsell Redox Description Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPDlfft •Eff#1 •Eff#2 1 0-11 10 r 3/3 none L 2msbk mfr CS 2f .5 .8 2 11-2 10yr 4/4 none sicl 2msbk mfr gw if .4 .6 3 25-4 7.5 r4/4 none sl 2msbk mfr gw na .5 .9 4 46-7 7.5yr4/6c2d7.5yr 5/6 S11 2msbk mfi na na .5 9 Boring # 1-1Boring99.80 38 2 air Ground surface elev. ft. Depth to limiting factor in.I c u A—li ii— Qaro Horizon Depth in. Dominant Color Munsell Redox Description Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPDIft'- 'Eff#1 •Eff#2 .8 2 8-17 7.5yr4/4 none sicl 2msbk mfr gw if .4 .6 3 17-3d7.5yr4/4 none sl 2msbk mvfr gw na .5 .9 4 38-5 10yr6/1 c2p7.5yr5/6 1/7 estone Residuum na np np Effluent #1 = BOO > 30 < 220 mg/L and TSS >30 < 150 mgfL tnluem st = tsw - Ou rnyrL dJ1U 100 - ov I IIV' CST Name (Please Print) Signature CST Number Gar L. Steel -- 02298 Address Date Evaluation onducted Telephone Number 1554 200th. Ave., New Richmond, WI. 54017 11-3-2000 715-246-6200 Property Owner Oakwood T,a nd nevelopmenParcel lD # pending Bori ❑ Boring F3 � # ©pit Ground surface elev. 99.20 ft.Depth to limiting factor 43 _ in. 645445 Page 2 —of 3 Gnil Annlir-afinn Rafa Horizon Depth in. Dominant Color Munsell Redox Description Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/ff 'Eff#1 'Eff#2 1 0-8 10yr3/3 none L 2msbk mfr cs 2f .5 .8 2 8-20 7.5yr4/4 none sicl 2msbk mfr gw if .4 .6 3 20-431 .5yr4/6 none sl 2msbk mvfr qw na .5 .9 4 41,,-5 5yr4/4 ic2d7.5yr5/6 sl 2msbk mfi gw na .5 5 58-7 10 r6 1 Limestone Residuum na na I njD n ❑ Boring # ❑ Boring ❑ pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth in. Dominant Color Munsell Redox Description Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/ff 'Eff#1 `Eff#2 F-1 ❑ Boring Boring # Ground surface elev. ft. Depth to limiting factor in. pit Soil Application Rate Horizon Depth in. Dominant Color Munsell Redox Description Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/ff 'Eff#1 `Eff#2 Effluent #1 = BODS > 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BODS < 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. SBD-8330 (R.6/00) 645445 ' PropertyOvmer Oakwnnd Land evelopmenfarcel ID#_nPnr1j n7 Boring # ❑ Boring 3 © pit Ground surface elev. 99' 20 ft. Depth to limiting factor 4— in. Page 2 of 3 Soil Annliratinn Rate Horizon Depth in. Dominant Color Munsell Redox Description Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/ff 'Eff#1 I 'Eff#2 1 0-8 10yr3/3 none L 2msbk mfr Cs 2f .5 .8 2 "8=20 7.5yr4/4 none sicl 2msbk mfr gw if .4 .6 3 -437 5_r4/ none sl 2mpbli, mvfr qw na .5 .9 4 4 -5 5yr4/4 c2d7.5yr5/6 sl,� 2msbk) mfi gw na .5 5 58-7 10 r6/1 Limestone Residuum /r21 1 na na nD n F-1 Boring # ❑ Boring ❑ pit Ground surface elev. ft. Depth to limiting factor in. Soil Anolication Rate Horizon Depth in. Dominant Color Munsell Redox Description Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/ff 'Eff#1 'Eff#2 1-1Boring # ❑ Boring — ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil ADnlication Rate Horizon Depth in. Dominant Color Munsell Redox Description Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/ff 'Eff#1 `Eff#2 Effluent #1 = BOD, > 30 < 220 mg/L and TSS >30 < 150 mg/L . Effluent #2 = BODS < 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. SBD-9330 (R6/00) STEEL'S SOIL SERVICE o Gary L. Steel Oakwood Land Development M P SW 3254 SW -.NW' S25-T30N-R18W town of Richmond lot #43-Red Pine Corner �N �-� 40op of SE lot stake @ el. 100.092 �fE= top of SW lot stake el. 98.70' \ I Gary L. Steel 11-3-2000 645445 1554 200th Ave. New Richmond, WL--94LL17 (715) 246-6200 -71 L- 9 'bbk LOB' 33 `ter 952 J O FT . 7.51 A CRES / \ 45445 / A. LOT 43 z �`� . • • 1. 51 ACRES L 81, � O '� ._� •,•• sue, � 3 v' LOT 42 , Z 67,622 50. i7. N 1.55 ACRES 326.76' 3.52' EA S T10fS T R TER /NE, SEC. 25. Z' Y .._ 1A1f:' C T A 11 A I f" . r- • r P% I o-% lqo!5 1364 X-Vt 645445 %-L"s couNry NO. 645445 STATE SNITARY PERMITEll '.-/ OWNER 14—kk— PLUMBER TOWN OF SEC 25 AND/.OR LOT �,3 BLOCK THIS PERMIT EXPIRES SUBDIVISION CHAPTER 145.135 (2) WISCONSIN STATUTES (a) The purpose of the sanitary permit is to allow installation of the private sewage system described in the permit. (b) The approval of the sanitary permit is based on regulations in force on the date of approval. (c) The sanitary permit is valid and may be renewed for a specified period. (d) Changed regulations will not impair the validity of a sanitary permit. (e) Renewal of the sanitary permit will be based on regulations in force at the time renewal is sought, and that changed regulations may impede renewal. (f) The sanitary permit is transferable. History: 1977 c.168; 1979 c. 34,221; 1981 c. 314 Note: If you wish to renew the permit, or transfer ownership of the permit, please contact the county authority. D ISSUING OFFICER - DATE UNLESS RENEWED B O THAT DATE POST IN PLAIN VIEW VISIBLE FROM THE ROAD FRONTING THE LOT DURING CONSTRUCTION SBD-06499 (R11/20) State Bar of Wisconsin Form 1-2003 WARRANTY DEED Document Number 11 Document Name THIS DEED, made between John Martin and Jill Martin, married to each other ("Grantor," whether one ,or more), and Jeffrey Iverson, a /nwri,,d ("Grantee," whether one or more). Grantor, for a valuable consideration, conveys to Grantee the following described real estate, together with the rents, profits, fixtures and other appurtenant interests, in St. Croix County, State of Wisconsin ("Property") (if more space is needed, please attach addendum): See attached Exhibit A 11593694J445 BETH PABST REGISTER OF DEEDS ST. CROIX CO., WI RECEIVED FOR RECORD 09/30/2022 11:44 AM EXEMPT#: REC FEE 30.00 TRANS FEE 135.00 PAGES: 2 **The above recording information verifies that this document has been electronically recorded & returned to the submitter Recording Area Name and Return Address Land'ritle, Inc. 2200 West County Road C, Suite 2205 Roseville, MN 55113 LT File No. 665592 026-1130-43-000 Parcel Identification Numher (PIN) This IS NOT homestead property. (is) (is not) Grantor warrants that the title to the Property is good, indefeasible in fee simple and free and clear of encumbrances except: Easements, Restrictions and Covenants of record, if any. Dated. * * Signature(s) _ authenticated on AUTHENTICATION TITLE: MEMBER STATE BAR OF WISCONSIN (If not, authorized by Wis. Stat. § 706.06) THIS INSTRUMENT DRAFTED BY: Larry S. Mountain, Attorney at Law Grantors (SEAL)-ft— �s�`{- t� -��, (SEAL) ohn Martin fl (SEAL) 71�� (SEAL) * Ji artin ACKNOWLEDGMENT STATE OF Texas ) ss. COUNTY ) Personally came before me on I 1 Oct. the above -named John Martin and Jill Martin, married to each other to me known to be the person(s) who executed the foregoing insty>: ment,and acknowledpA, the same. 1) * typed name: � )L25,\(y: L Notary Public, State of Texas My Commission (is permanent) (ex (St1?n8tures Inay be authenticated or acknowledged. Ruth are not necessary.) NODE: THIS IS A STANDARD FORM. ANY MODIFICATION'S TO THIS FORUM SliOI.ILD 13E CLEARLY WARRANTY DICED O 2003 STATE BAR 01, WISCONSIN r 'Type name below signatures. St. Croix County 1159395 Page 1 of 2 HN R H ••® o� MYCI p cv 9 rn ' r AED. � ftt�1 ddO.TE2O� ,4i e c, 2 .••. •'••<G a•••" 641 * eeuaa0e 645445 LT File No. 665592 L�3;Ilj111111"TA Lot 43, Red Pine Corner, Town of Richmond, St. Croix County, Wisconsin. St. Croix County 1159395 Page 2 of 2