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SAN-2023-156 026-1149-16-000
Wisconsin Department of Commerce Safety and Building Division PRIVATE SEWAGE SYSTEM INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: KENNY & TARA SHOQUIST City Village Township TOWN OF RICHMOND CST BM Elev: Insp. BM Elev: BM Description: TANK INFORMATION TYPE MANUFACTURER CAPACITY Septic Dosing Aeration Holding TANK SETBACK INFORMATION =�Mm - - - WJAM1111m, 1"W1 , �11�mm MMM= = wmmm PUMP/SIPHON INFORMATION Manufacturer D nd GP Model Nu er TDH ift Friction oss Sys m Hea jTqH�Ft Fo cemain t!y Dia. Lr t. to Well SOIL ABSORPTION SYSTEM ELEVATION DATA County: St. Croix Sanitary Permit No: SAN-2023-156 State Plan ID No: Parcel Tax No: 026-1149-16-000 Section/Town/Range/Map No: 36.30.18.1116A STATION BS HI FS ELEV. BenchmarkMU Alt. BM Bldg. Sewer SUHt Inlet St/Ht Outlet Dt Inlet Dt Bottom Header/Man. Dist. Pipe g •� 93 u Bot. System TI T2 TJ ��; `C52 S� 92.w 92 Final Grade St Cover �.2.1 BED/TRENCH DIMENSIONS Width � 1X3� Length C,O1 No. Of Trenches )I each 3 l� PIT DIM S No. Of Pits Inside ia. iquid Depth SETBACK SYSTEM` TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer: INFORMATION Type Of System: Co"I„c4}So„ig1 • 1 n W ei CHAMBER OR UNIT Model Number: �S DISTRIBUTION SYSTEM Header/Manifold Distribution x Hole Size x Hole Spacing Vent to Air Intake Pipe(s) Length Length Dia cing SOIL COVER x Pressure Svstems Only xx Mound Or At -Grade Svstems Only 01 Depth Over Depth Over xx D ded/Sodded��L]No xx Iched Bed/Trench Center Bed/Trenc ges opsoil ❑Y Yes ❑ No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: Inspection #2: Location: 1259 142ND ST 1.) Alt BM Description = 2.) Bldg sewer length = {xisfil - amount of cover = Plan revision Required? ❑ Yes X No Use other side for additional information. U Date Insepctor's Signa ure Cert. No. RECEIVED Indus" Services QIViSfOn County SAN-2023-156 St. Croix 0 07/ 17/2023 1400 E Washington Ave Sanitary Permit Number (to be filled in by Co.) p 5 Paid via Ascent P.O. Box 7162 Madison, Wl 53707--7152 12 J / Sanitary Permit Application State Transaction Number In accordance with SPS 383.21(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 submitted to ProJect Address (if different than marling address) the Department of Safety and Professional Services. Personal information you provide may be used for secondary 1259 142od Street purposes in accordance with the Privacy Law. s. 15. 1 (m), Stats. I. Applienflon Information — Please Print All Information Property Owner's Name Parcel 9 Kenny & Tara Shoquist 026-1149-16-000 Property Owner's Mauling Address Property Location 1259 142'u Street Gov- Lot SW 1!4, NW %a, Section 36 City, state "Lip Code Phone Number New Richmond, WI 54017 j cle one) T30N R18Ear 11. Type of Building (check all that apply) Lot H ® 1 or 2 Family Dwelling - Number of Bedrooms 16 Subdivision Name Torey Pines 11 # ❑ Public/Commercial - Describe Use Block ❑ City of ❑ State Owned- Describe Use El of CSM >6 Number �^ Z 'l own of Richmond Ill. "1ype of Permit: Check only one box on line A. Complete line B if a licabie A• ❑ New System Replacement System ❑ TreatmenUliolding Tank Replacement Only ❑ Other Modification to Existing System (explain) ❑ Permit Renewal ❑ Permit Revision ❑ Change of ❑' Permit Transfer to New List Previous Permit Number and Date Issued B. Before Expiration Plumber Owner IV. Type of POWTS System/Component/Device: Check all that 1 Nan -Pressurized In -Ground ❑ Pressurized In -Ground ❑ At -Grade ❑ Mound ? 24 in, of suitable soil ❑ Mound ¢ 24 in. of suitable soil Ll Holding -Tank Other Dispersal Component (explain) Pretreatment Device (explain} V. Dis ersal/TreatmentAres Information: a) 3 Y-90E,SF(-«r4-rede-6 Design Flow (gpd) Design Soil Application Dispersal Area Required (sf) Dispersal Area Proposed (s) Svstem Elevation 600 Rate(gpdst) 857 900 93.0' 03 Vi. Tank Info Capacity in �y4 AWyb �l� LL Gallons Total 1l of Manufacturer w c v ;, New Tanks Existing Tanks Gallons Units et u in- Septic or Holding Tank 1250 1250 1 Huffcutt 0 ❑ ❑ ❑ ❑ Dosing Chamber El ❑ ❑ ❑ ❑ VII. Responsibility Statement- i, the undersigned. assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print} 1,,1W6V oignaiure M.PIMPRS dumber Business Phone Number John Schmitt 223760 715-7604)486 Plumber's Address (Street- City, State, Zip Code) 586 Valley View Trail, Somerset, WI 54025 VIII. County/Department Use Only {g Approved i Permit Fee Date Issued Issuing gent Signature $ � ��lz02,3 ALAS Owner Gv n for _ -6 IX. Conditions A ro l9isapp. oval 3) to �S6,.�AQ'a��2z- ne�^A�.�4,A �A.w��e E'm�+°*%�r """`°�� d` .4- Pue1't u^�`^*-+ri2.u14-U SYSTEM OWNER- re-Xt I. Septic lank, affluent filter and dispe v'al cd '[ \ J _ ��y� �.px� -�p,�A -La a L, � i -D IX ,x jay` 4 46 must be serviced! maintained as per 7) Jdue�-n l L� 1 management by &6e.-Pj j4Ar, plan prrnnded piumber- PL 2AN setback. repuiremenls must be malnaloed as per applicable code[ ordinances. Attach to complete plans for the system and submit to the County only on paper not less than S in x 11 inches in size SBD-6398 (R03;14) SYSTEM PLOT PLAN Shoquist 4 Bedroom Septic System Project Address: 1259 142nd Ave BM1 Symbol: d& BM Elevation: 98.80' BM Description: Top of 5ter cover on septic tank BM2 Symbol: � BM Elevation: 94.60' BM Description: Septic tank outlet pipe Slope Gradient of Tested Area: (4%) Well Symbol (if applicable) Notes: See Plat Map for Complete Lot and location of the drainage easement P IqC N r Existing Well or Existing 4 Bedroom House Driveway B2 r r� 4% slope _ 1 I � I � fo�rB3 r / T3 ff2 99' T1 97' T1- 3'x89' Biodiffuser trench El.= 911' T2- 3'x89' 9iodiffuser trench El.= 92.9' T3- 3'x90' EZ Flow trench El.= 93.0' T4- 3'x9o` EZ Flow trench El.= 93.0' Design Flow: 60o GPD Attach design flow calculations for commercial plans: Pipe Materials I ASTM Standard Tables 384.30-3 & 384.30-5 4" SCH 40 PVC pipe ASTM- D2565 4" SCH 3034 PVC pi ASTM-D3034 Property Line Ive Pool Existing Hu tt 1250 gallon Sept' tank w/ Zabel A - AO Effluent filter N Scale: t" = 50' 0 50 75 100 ZA 12.5' CONVENTIONAL COMPONENT DESIGN INDEX AND TITLE PAGE Project Name: Shoquist 4 Bedroom Replacement Septic System Owners Name: Kenny & Tara Shoquist Owner's Address 1259 142nd Street New Richmond, W1 S4017 Legal Description: SW1/4, NW1/4, S36, T30N, R18W Township Richmond County: St. Croix Subdivision Name: Torey Panes 11 Lot Number: 16 Block Number Parcel I.D. Number 026-1149-16-000 Plan Transaction No. Page 1 Index and title Page 2 Plot Plan Page 3 Existing Tank Certification Page 4 Septic Tank Specifications Page 5 Effluent Filter Information Page 6 Valve Diagram Page 7 System Sizing & Cross Section Page 8 EZ Flaw Information Page 9 Management and contingency plan Page 10 Sanitary System Ownership/Address Form Page 11 Warranty Deed Page 12 CSM or Plat Attachment 1 Soil Evaluation Report Designer: John Schmitt Licnese Number: MPRS 223760 Date: 7/17/2023 Phone Number: 715-760-0486 Signature: ?7 In -Ground Soil Absorption Component Manual Version 2.1 May 2022 Page 1 SYSTEM PLOT PLAN Shoguist 4 Bedroom Septic System Project Address: 1259 142nd Ave BM1 Symbol AL BM Elevation: 98.80' BM Description: Top of rite cover on septic tank BM2 Symbol: Q BM Elevation: 94.60' BM Description: Septic tank outlet pipe Slope Gradient of Tested Area: (4%) Well Symbol (if applicable) Notes: See Plat Map for Complete Lot and location of the drainage easement P IqC N r Driveway Existing Well 0 r 82 r r� 4% slope I �t 1 1 I r I � f B311 for / T3 ff2 99' T1 97' T1- 3'x89' Biodtffuser trench El.= 911' T2- 3'x89' 8Iodlffuser trench EI.= 92.9' T3- 3'x90' EZ Flow trench El.= 93.0' T4- 3'x90' EZ Flow trench EI.= 93.0' Design Flow: 60o GPD Attach design flow calculations for commercial plans: Pipe Materials I ASTM Standard Tables 384.30-3 & 384.30-5 4" SCH 40 PVC pipe ASTM- D2565 4" SCH 3034 PVC pipe ASTM-D3034 Property Line Existing 4, Bedroom House 40 �o Q Pool Existing Hu It 1250 gallon Sept' tank w/ Zabel A- 0 Effluent filter Valve N Scale: V = 50' 0 50 75 100 2.5 ST. CROIX COUNTY ZONING OFFICE CERTIFICATION STATEMENT FOR UTILIZATION OF EXISTING SEPTIC TANK(S) This is to certify that I have inspected the existing septic and/or dose tank presently serving the following residence: (Street address)1259 142nd street located at: SW 1/4, NW '/4, Section 36 , Town 30 N, Range 18 W, Town of Richmond , St. Croix County Wisconsin. Upon inspection, I certify that I have found the tank(s), to the best of my knowledge, will conform to the requirements of SPS. 384.2.5, and it (they) appear(s) to be functioning properly. Most recent date of inspection or service Did flow back occur from absorption system? (if no, skip next line.) Approximate volume or length of time: Tank Capacity: 1250 Construction: Prefab Concrete x Steel Manufacturer (if known): wutfcutt Age of Tank. (if known): 7f 11 /2005 Perini number (if kilo ) 463460 John Schmitt (Li sed Plumber Signature) (Print Name) MPRS (Title) (Date) 223760 Yes Nox gallons Other minutes (License Number) MP/MPRS Form to be completed by licensed plumber (Dept of Safety and Professional Services Chapter 305 and s. 145.06, Wisconsin Statutes) or licensed disposer (NR 113 Wisconsin Administrative Code) Rev. 2/2012 Page 3 9 w W !^h 3> r3 n C z� r n� ---I rrI r 9Fri 0 PROJECT,HUFFCUTT 4154 1�3rd STREET a iV.P.C.A. CERTIFIED PLANT q 1,250 GAL. L13W PROFILE CHIPPEYA FALLS, VI 54729 X ..ls 11It PUMP, SEPTIC, HOLDING, (715) 723-7446 ■ (800) 924-1516 i j MEMBER OF: GREASE INTERCEPTOR C O (IC R E T E. I n C FAX (715) 723-7111 s www,huffcutt..con A g NATIONAL & 119SCONSM PRECAST CONCRETE ASSDLIAT10NS ➢IA. 1.5' 2G' ➢IA. 1.5' LIFTING Hf!-ik n.I N 24' DIA. n 4.5' IL7 5.25' iu 4' DIA, INLET na 'v BAFFLE e WARNING LABEL EMBEDDED INTO CONCRETE COVER READS AS FOLLOWS, CAUTIONa DO NOT ENTER WITHOUT PROPER VENTILATION. COULD CAUSE DEATH.,, DANGEROUS GAS. NOTE1 ADDITIONAL LABEL FOR GREASE INTERCEPTOR INFORMATIONAL LABEL READS AS FOLLOWS, GREASE INTERCEPTOR 29' DIAMETER CONCRETE COVER (TYPICAL) SEE 'ACCESSORIES' FOR OTHER COVER OPTIONS 112' GAL, PER INCH = 31.06 LIQUID CAP. = 1,305 GAL. MAX. LIQUID CAP. = 1,367 GAL.. (BELOW INLET) SECTION (TANK BASE, TOP, & COVER) 10( 5' 106.5' NOTE, THIS DRAWING REPRESENTS A SEPTIC TANK. SEE ACCESSORY tti' FOR OPENINGS LOCATED IN THE TOP OF o, 14OL➢ING TANK. u� e 4' 5' DIA. i OUTLET DIA. Rai NOTE, ADDITIONAL BAFFLE FOR GREASE INTERCEPTOR DIMENSION EQUALS 1/3 LIQUID LEVEL. (ONLY FOR GREASE INTERCEPTOR) DRAW SHM[ W BE fMID pR'iMTn ID ONR5111HOUl 11 owl 01 f1f,tIDPNA'. c .a u H- Li � u � °� 3 i4 7 m T� i� Ma w^ cu E en S A W cn nJ Loa: n n n _ n �- `� x u LAM dz U6 v =c Z Ci iy.j Li la ~ QQa (L oU u u W oua J F — �Ld0 iL W R' � f � ( d PAGE 2 of 2 The interval for servicing septic tanks is set by state and Total code. Throughout the United States, there is a wide difference of opinion on what this interval should be, but most regulatory agencies suggest two to five years. The Zabel filter, which does not increase the frequency of servicing for the tank; should be cleaned when the septic tank is normally inspected and pumped. However, our filter is virtually self-cleaning. The continued action of the anaerobic organisms on the Zabel filter causes lodged particles to disintegrate and fall to the bottom of the tank. If your filter contains a SmartFilter® alarm, you will be notified by an alarm when the filter needs servicing. P Step 1: Locate the outlet of the septic tank and remove the tank cover. Step 4: While holding the cartridge over the access opening, rinse off the cartridge with fresh water, being careful to rinse all septage material back into the tank. Step 2: Remove the tank cover and pump the tank if necessary to prevent any solids from escaping to the the drain field when the filter is removed. wIV Fl Step 5: Insert the filter cartridge back in the case, making sure the filter cartridge is properly aligned and completely inserted in the case. Replace the septic tank cover. S�? Step Z: Firmly pull the filter handle and slide the cartridge out of the case. Residential Applications Certified to ANSIMSF Standard 46 Copyright 2014, Polylok, Inc. All rights reserved Product(s) covered by one or more U.S. andlor Intemationaf patents. Other U.S. and International patents may be pending. 1-877-765-9565 / www.polylok.com Pages -Mac Home About I Site Map F Order Info Videos & Literature Cont-It Drip Systems Treatment Controls Products Downloads Design Guidance llle=!!Ii RISER GAP ADAPTER RI SER TUBE The Bull Run VaIVe"" is designed to split flows to septic fields or systems. In addition to the advantages of longer life and easier installation it is the most public health safe 4" OUT PORT alternating device available for wastewater disposal. applications. The use has absolutely no contact with wastewater due to the valve's leak -proof and external operating characteristics. The change over from one drainage field to another can be accomplished in less than a minute by simply turning the valve without digging or WATER -TIGHT 1, ACCESS OAP VALVE DIRECTION KA ND LE - 4" OUT PORT 4" IN PORT contact with wastewater. The Bull Run Valve is available in 4" sch 40 pvc Field No. 1 Valve Po sit' one on No. I during. Odd Fears FT*a Field No. 2 Field j--y � Field No. 1 rj No, 2 Valve Positioned on No. 2 during. Septic Even Years Tank ITEM DESCRIPTION BRV4 BULL RUN VALVE 4" BRVBULK BULL RUN VALVE & KEY ONLY BRVCIRISER BULL RUN VALVE RISER w/ CAST COVER BRVKEY28 BULL RUN VALVE KEY 28" BRVKFY36 BULL RUN VALVE KEY 36" BRVKEY48 BULL RUN VALVE KEY 48" and is suitable wherever septic disposal systems are used - in commercial, industrial, and residential applications, OPERATING THE VALVE The direction control handle should be rotated periodically to direct effluent to one or the other of two septic fields. After removing the screw cap at the top of the riser tube, the valve handle can be turned with the valve key furnished. BULL RUN VALVE Complete Vale Kit Contains 1. Bull Run Valve body 2. 28" Valve Key 3. Riser Cap Adapter 4. Watertight Access Cap BRVCIRISER - 4° ADJUSTABLE TO 28" HIGH Page 6 IN -GROUND GRAVITY DISPERSAL AREA Uniform Elevation Trenches with EZ1203HP Bundles 3-ft Trench (down -sizing credit) I Geotextile Cover SOIL COVER �r min. trench depth L (typical) — — '- System Elevation - 93.0ft. (typical) min. 12' (typical) Septic Tank(s) Manufacturer. Huffcutt Septic Tank(s) Volurne(s): 1250 gal gal gal gal Effluent Filter Manufacturer: Zabel Effluent Filter Model #: A-100 TYPICAL TRENCH CROSS SECTION VIEW (No Scale) Provide minimum 3 ft separation between trenches TYPICAL TRENCH (Show location of inlet 1 outlet pipe connection on plan view.) PLAN VIEW 4" 0 Observation pipe shall be ynstailc-d iV 1A o Scale) KJ atjuncton between two units. J Perforated Lateral Observation Pipe , (typical) (typical) —--_.__;� -w------- 7ji i9 -__-T_---��----------- B = 90 ft (typical) INSTALL PER TRENCH; 9 1 a-ft bundles @ 50 ff E1SAfunit = 450 ft` V + 0 5-ft bundles @ 25 ff EISA/unit = 0 T = Proposed EISA per trench = 450 ft` OBSERVATION PIPE DETAIL INo Scale] Screw -Type or Slip Cap (loose) 4"0 PVC Pipe Top of pipe to terminate _ at or above fin,shed grade (4) 1f4"-t: " Sits a 9 apae rt + Ancborinrg Device 1 10 ft (typical) A = 3.0 ft (typical) EZ1203H Bundle (typical) (mfd by infiltrator Systems, Inc.) Install pursuant to manufacturers Instructions. Required Infiltration Area = 857 W x 2 trenches = Proposed Total EISA = 900 ft2 ". • I'mished Grade (mulched & seeded) T opsod Cover ;min. 1 foot) Surface Distribution Method: branched manifold RESET Installation Instructions for o*EZ �WTM EZflaa)) Systems in Wisconsin by INFILtRATGR Wisconsin Department of Commerce, Safety and Buildings 5. The Absorption area (SF) necessary for a given site shalt Division, has reviewed the specifications and/or plans for this be sized based on maximum daily sewage flow (GPD) and product and determined it to be in compliance with chapters the Permeability for the site. If certain criteria is met, the Comm 82 through 84, Wisconsin Admin. Code, and Chapters EISA sizing can be used in Wisconsin, resulting in a 40% 145 and 160, Wisconsin Statutes. All sites must meet the Site smaller drainfield. & Soil Condition & Locati ns & Isolation distances as noted in local regulations. 6. Place EZflow bundle(s) in the EZflow configuration ap- proved by system design permit specified for the particu- The approved products are 1203H (3-12" bundles with pipe in lar site. The top or center -most bundles containing pipe center bundle in 5' or 10' lengths) and 1203HP (3-12" bundles are joined end to end with an internal pipe coupler. Any with pipe in each bundle in 5' or 10' lengths. additional aggregate only bundles that may be required, should be butted against the other aggregate -only bun - A single pipe bundle contains a four inch perforated pipe sur- dles and do not require any type of connection. rounded by EPS aggregate and is held together with poly- ehtyiene netting. A single aggregate bundle contains aggregate 7. The top of each GEO cylinder contains a filter fabric pre - only and is held together with polyethylene netting. manufactured in between the netting and aggregate. The • fabric is inserted to prevent soil intrusion. The installer Materials and Equipment Needed shall make sure the the CEO is positioned upward and is • EZflow Bundles in contact with the fabric contained in the adjacent cylin- • EZflow Geotextile Fabric der before backfilling. • EZflow Internal Pipe Couplers • Pipe for Header and Inlet 8. The EZflow Drainfield Systems should be installed in a • Backhoe/Excavator level trench in all directions (both across and along the trench bottom) and sl iuuld follow the contour of the ground Installation Instructions surface elevation (unitorm depth), with all continuous The instructions for installation of EZflow products are given adjoining 10-foot cylindrical bundles placed end to end, below. This product must be installed in accordance with state with central bundle distribution pipe interconnected, rules defined in chapters Comm 82 through 84, Wisconsin Ad- ; without any dams, stepdowns or other water stops.. minisirative Code, and Chapters 145 and 160, Wis,:;ui)sin Stat- utes, as well as the local health department's current design 9. The trench top shall be graded such that water will not manual. pond. Backfll should be seeded or sodded immediately after completion to reduce erosion. 1. After the local health department has determined sizing, configuration, and layout for the EZflow systems, stake 10. EZflow EPS bundles are flexible and can fit in curved or mark with paint the location of trenches and lines. Be trenches as may be necessary to avoid trees, boulders, or careful to set correct tank, invert pipe, header line or dis- • other obstacles. tribution box and trench bottom elevations before instal- lation of pipe bundles. 11. EPS aggregate is lighter than water, therefore, it might be expected that natural buoyancy forces would tend to 2. Remove plastic EZflow shipping bags prior to placing cause EZflow assemblies to float out of ground when bundles in the trench(es). Remove any plastic bags in the ponding occurs. Field experience has shown, however, trench before system is covered. that this is not a problem when systems have a minimum • of 6" of soil cover as recommended by manufacturer. 3. This product must have geotextile fabric that meets re- quirements of s. Comm 84.30 (6) (g), Wis. Adm. Code, installed directly on top of the product and extending 1203H-GEO down along the sides of the product to a point at least six inches from the bottom of product. ; __ Geotext is Ems- �'°;; o,• Barrier Material 4. When installed in a trench, the trench should be dug to a width of 36 inches. This not only saves labor in excava- 12 - tion, but also provides better load -bearing capacity after backfilling is complete. ...................................................................... .. .............. Page 8 In -ground Gravity Management Plan IMPORTANT: The owner of this in -ground gravity system shall be responsible for its perpetual operation and maintenance pursuant to requirements of SPS 382-384, Wisc. Admin, Code. Pursuant to SPS 383.52 (2), Wisc. Admin. Code, this system shall be considered a human health hazard if not maintained in accordance with this approved management plan. Furthermore, all inspection and maintenance activities shall be performed by a registered POWTS Maintalner in accordance with SPS 383,52 (3), Wisc. Admin. Code. Maximum Dispersal Area Operating Limits: Design Flow = 600 gpd; 130135 5 220 mgU'; TSS 5150 mgU ; FOG 5 30 mgL`' Inspection Checklist INSPECT EVERY 3 YEARS a type of use w age of system a nuisance factors (i.e. odors, user complaints, etc.) o mechanical malfunction (i.e., pumps, valves, switches, floats, etc.) o material fatigue (i.e., leaks, breaks, corrosion, etc.) o solids volume in anaerobic treatment tank(s) and any distribution appurtenance(s) (i.e., distribution i drop boxes) o neglect or improper use (i.e., exceeding design capacities, prohibited activities, etc.) o extent of ponding in distribution cell prior to dosing o dosing irregularities - if applicable (i.e., pump re -cycling, float switch settings, etc.) o electrical components - if applicable (i.e., wiring, connections, switches, controls, timers, alarms, etc.) o distribution lateral or lateral orifice plugging (measure lateral distal pressure — compare to design specification) © surface discharge of effluent or sewage back-up into structure served Maintenance Checklist MAINTAIN EVERY 3 YEARS (or when necessary) Septic and dose tank(s) shall be pumped by a certified septage servicing operator licensed under s. 281.48 Wis. Stats. when the volume of solids in the tank(s) exceeds one-third (1i3) the liquid volume of the tank(s) or as required by local ordinance. Disposal of contents shall be pursuant to NR 113, Wisc. Admin. Code. o Effluent filter(s) shall be inspected every 3 years and shall be cleaned when necessary to remove any accumulated solids according to manufacturer's specifications. A servicing period will always be greater than 12 months. System maintenance reports shall be submitted to the proper local government unit in accordance with SPS 383.55 Wisc. Admin. Code. Report any component failure or malfunction to: Name of individual or company: Local government unit: Schmitt & Sans Excavating, Inc. Phone: 715-760-0486 St_ Croix County Community Developement Phone: 715-386-4680 Local government unit address: 1101 Carmichael Road, Hudson Zip: 54016 Any defective part of this system shall be repaired, replaced, or removed pursuant to SPS 383.51 (1), Wisc. Admin. Code. Repair or replacement of failed or malfunctioning components shall comply with SPS 383, Wisc. Admin. Code. No product for chemical or physical restoration of the POWTS may be used unless approved by the department in accordance with SPS 384, Wisc. Admin. Code. Contingency Plan In the event that any failed treatment component of this POWTS cannot be repaired, it shall be replaced pursuant to a plan submitted to the appropriate agency for review and approval. A failed in -ground dispersal component may be abandoned and replaced by a code -complying dispersal component in a pre -determined area of suitable soils. System Abandonment If use of this POWTS is discontinued, it shall be abandoned In accordance with SPS 383,33, Wisc. Admin. Code, Page 9 l : C iti (� � a L 1 N File #:"i'Y SANITARY SYSTEM Ogee Use Only OWNERSHIP/ADDRESS FORM Created212021 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 permit online, you can do so by using the weblink. OWNER/BUYER INFORMATION Owner/Buyer Kenny 8t Tara Shoquist Mailing Address 1259 142nd Street City/State/Zip New Richmond, WI 54017 Phone Number (reauired) 715-523-0960 Email Address(req,ired)kennyjshoquist@gmail.com Parcel Identification Number 026-1149-16-000 (found on the property tax bill) NEW SYSTEM: LEGAL DESCRIPTION Property Location SW ,� , NW 1/4 , Sec. 36 , T 30 N R 18 W, Town of Richmond Subdivision Plat: Torey Pines II Certified Survey Map #Plat Warranty Deed # 969812 Number of bedrooms 4 — New Property Address (Staff Initials) Volume Page # (before 2006)Volume Page # , Lot # 16 Spec house L] yes ■ no Lot lines identifiable N yes E1 no OFFICE USE ONLY r /v lA (Verification of new address required from Community Development Department for new construction.) (Date) This form must be submitted with all Private Onsite Water Treatment System (POWTS) applications. New System: Include with this form a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey mop if reference is made in the warranty deed. Community Development Department — Land Use Division 715-386-4680 5t_ Croix County Government Center 1101 Carmichael Road, Hudson, WI 54016 715-245-4250 Fax Rage 10 Document Number Return to: Kenny Shoquist Tara Shoquist 941 Paperjack Drive New Richmond, WI 54017 Drafted by, Robert M. Piette 026-1149-16-000 Parcel Identification Number 8116569 Tx:4093116 SPECIAL 969812 WARRANTY DEED BETH PABST REGISTER OF DEEDS ST. CROIX CO., WI 12/19/2012 4:37 PM EXEMPT#: 2 REC FEE: 30.00 PAGES: 2 2 Fannie Mae alkla Federal National Mortgage Association, hereinafter GRANTOR and Kenny Shoquist and Tara Shoquist. hereinafter GRANTEES: WITNESSETH, that GRANTOR for a valuable consideration conveys to Grantees and to their successors and assigns, but without recourse, representation or warranty, except as expressed herein, all of its right, title and interest in and to that certain tract or parcel of land described as follows, to wit: Lot 16, Plat ofTorey Pines II in the Town of Richmond, St. Croix County, Wisconsin. EXEMPT FROM TRANSFER FEE AND FORM 77.25(2). RE: 1259 142nd Street, New Richmond, W1 TOGETHER with all and singular the hercditaments and appurtenances thereunto belonging, or in anywise appertaining; and the reversion or reversions, remainder or remainders, rents, issues and profits thereof, and all the estate, right, title, interest, claim or demands whatsoever, of the said GRANTOR, either in law or equity, or, in and to the above -bargained premises, with the said hereditaments and appurtenances: TO HAVE AND TO HOLD the premises as before described, with the appurtenances, unto the said Grantees, their successors and assigns. 1 of 2 Rage 11 • N 8905711 0' E 436.00Y • .. 1 oo. EtFVATIo. `. • .'.' cb . . ....... r.} •; LOT 16 2.613 ACRES �.. Zo '` 1 • . / (113,802 SQ. FT.) l' 4r . NA........ f' / MIN FIFE— 1009.00�r--,.z - .0 �— ;�.;�;�� ?, �ti ��, •. �,. ;t. / i LOT 17 ' !'...... P 3.473 ACRES (151,296 SCE. FT.) r rd' ' Q �� MIN FIFE = 1009.00 l ..�. ........ 14. S 8905146' W 527.55co— Page 12 RECEIVED Paid via Ascent �•r°°r 07/17/2023 Dgialtiwt Ot s ��. �a� Se►vices SOIL EVALUATION JREORT in accordance with Comm e5. Wis. Adm. Cede CST-2023-204 #2.269 Page 1 of 5 Schmitt Sort Testing. In: '*�•.w*`F County Attach complete site plan on paper not less than 8% x 11 inches in size. Plan must St. Croix include, teat not limited to: vertical and horizontal reference point (BM). direction and slope. scale or dlrreensi ons. north arrow, and kxMilon and distance to naarest road. Parcel I.D. percent 020- 1148.164= Please print eft in ftrmadon. Reviewed By Rate Personal hformaWn you pmvWa may be used b r s000ndwy Pins (Privacy Law, A. 16.04 (1 ) (m)f• Property Owner Property Location Shoquist. penny & Tare Govt flat SW 1/4, WW 1 /4, S36, T3DN, R 18W Property Owner's Matting Address Lot 0 Block if 1 Subd. Name or CSW 1 1259 142nd Street 16 Torey Pines Il City Stale Zip Code Phone Number � City [-1 Millep �j Town Nearest Road New Richmond Wl W17 715-523-MM Richmond I 142Nd Sfet New Construction Use: Residential I Number of bedrooms 4 Coda derived design flaw Date Soo GPD [] Replacement ❑ Public or commercial - Describe: Parent material C kAwash hardt-Settre 5ertes J� Flood plain elevation, if applicable NA . General comments Replacement area Is suitable for a conventional system with a 0.7 gp&KM rate. Possible system "ati m for I m Moacernent area and recommendations: I$ 9&(y. Boring # lr Prof Ground surface elev. 97.31 f . Depth to limiting factor 96+ in. Soil Application Rate Horn Depth In. Dominant Color Munsafl Redoar Descodon Qu. Sz. Cont. Color Teodure Gtructuna Gr. Sz. Sh. C*nsigence Boundary Roots GPDVR` -EW I `0W 1 0-13 14yr3/2 FILL sil 2mgr mvfr as 2vf .6 .8 2 13-29 10y14/3 none so 2fsbk mfr 9w lvf 0.6 0.8 3 29-38 10yr4/4 none hid 2msbk mfr gw 1vf 0.4 0.6 4 38-47 10yr5/6 none grls 0s9 ml cs 0.7 1.6 5 47-96 10yr6/4 none grs 059 ml -- .7 1.6 a Bon'% #❑ ebn% j Pit Ground surface elev. 99.16 R. Depth to Limiting factor 115+ in. Soil Application Rate Horizon Depth In. Dominant Coke WNW Radox Description Give. Sz Cont. Color Texture Structure Gr. S=. Slh. tonstallenos Boundary Roots GPDM' •� 'ElM�1 1 D-12 10yr3/2 FILL sl1 2mgr rnvfr as 2vf .6 .8 2 12-19 10yr3/3 none s11 2fsbk mfr 9w 1vf 0.6 0.8 3 19-29 10yr4/4 none hid 2m5bk mfr 9w lvf 0.4 0.6 4 29-64 1Dyr5/6 none ges 059 ml cs 0.7 1.6 5 64-115 IDyr6/4 none s 0sg ml -- 0.7 1.6 �3.9z a 2 Effluent #1 = BOD? 30 c 220 mg& and TSS'x30 < 150 mgA- ` Effluent 62 is 5005 g30 malt. and TS8 1.30 mgA- CST Name (Plisese PrbM Signature: CST Number Thomas J. Schmitt 227429 Address SdhrFrNt Golf TWing, Inc. Cate Evaluation Conduwwd Teiphom Number 15% 72nd St. Now Richmond, WI U017 7/11/2023 716-76D-1076 Property Owner Shoguisk Kertrty & Tare Parcel iD # 026-1149-16-M Page 2 of 5 EilBoring # 0 Boring Pit Ground surface elev. 99.56 ft•h limiting factor 120+ in. Soli Application Rate Horizon Depth In. Dominant Color Munsell Redox Description Qu. SL Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD 3 •EM •Elm 1 0-12 10yr3/4 node sl 2mgr mvfr as 2C,2f 0.6 1.0 2 12-16 10yr4/4 nine grsl 2mshlc mfr gw ivf 0.6 1.0 3 16-25 1Oyr5/6 none grs Osg ml Cs 1vf 0.7 1.6 4 25-49 1Dyyr5/6 none grMs 0s9 ml Cs -- --- 0.7 1.6 5 49-120 10yr6/4 none grs 0sg ml 0.7 1.6 ❑ Boring # LJ Boring Pit Ground surfaoe elev, ft. Depth to limiting factor in. Soil Application Rate Horizon Depth In. Dominant Color Munsell Redox Description Ou. SL Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots OItt' •Entri •£ U Boring Boring # ❑ P t Ground surface elev. ft. Depth to IimWng factor In. Soil Application Rate Horizon Depth in. Dominant Color Munsell Redox Description Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh, Consistence Boundary Roofs GPDW •EffBi •gam " Effluent #1 - BODs� 30 c 220 mA and TSS �30. 150 moll.. • Effluent #2 . BODs a 30 mg& and TSS -00 mglL The Department ofComnme is an equal oppoiiunity service provider and employer. If you need assistance to access services or need material in an alternate format„ please contact the department at 608-266-3131 or TTY 609-264-8777. Lot Corner El 1020.89' St Croix County. WI Conducted for: 336.0' 0Legend `13) Kenny & Tara Shcquist EEY s 1259 142nd Stree a_ New Richmond, VVI 54017 LOT 16 Torey Pines 11 SEE PAGE 4 OF 5 Pfa: 026-1149-16-000 FOR FULLVIEW IEW SW1 f4 NVV114 Safi T30N R'18VV OF PARCEL Town of Richmond USH�`::5 s t,1EL- LOT 16 0!, L,wal Roads i?,st. Rua€is R M HOUSE 643.86' _ r . l•ca„ -.. * us E <Isiing Hu Icul _ [][] gal sepSic Ialik �- 6M2 SEE FAGE 5 O1= 5 FOR DRAINAGE EASEMENT LOCATION (HWL 1007,0') 1'" Y 50' �• Exislus� i2) T x 89' . «� 1134.11 f3+Qrlif€fuser ti , Tier )cf.es I 2U 0 60fl 8PA 1 9t3.8(l' Top of Filter cover on septic Tank Conducted bN: P.,r P r r BM 2 94.60' Septic tank Outlet pine Existing drainfield infiltrative surface el. 93.0' Thcmas J. Schmitt (verified high trench) CS 227419 7-1 1 -2023 _ ., 4.1 m Page 5 of 5 LOT 14 CR LOT 26 ...�.,._. ' i It 2 It XY /r 1 Ff r� LOT 25 1 _ram-- LOT'1 �1 OD ` 2.3 ACRES • ` rl / 2.0-A-61F. �� (2.3 ACRES) AW - r f ter_ y � 1 LOT 24 ACRES�)N;E 1 418 .. T. 23++ I r Ir ref /` / �� �% rr = 1099.00 f 0 AC"EB J ' t' �f'rrj`1d [ fr 2 D ACR )RE,11� (2.8, RES) � 1 317" '•�_� /rr','T ...... r! 11.63 496' I f r` •. '' ( r . � cn r � 1 ss r�� / • • �r 'rr rf rt � ! � ` i r rr � 1 I � � "' r.i 007-4 /2 p i r- .� 1 G00.9a �1 r 1 r2. ACRE j I l .- _ . - ,'r f (1 ES� �' r 1 .. .. � .��-•.+ �" [ifYACRES) 4 .�.. ........�_ � ' , TORM WATER 1 �` nit F f 1 q T1pN AR i l 1 1 ► / �y F I 1i H w a . tinn7 n+ i ti= 1"00 1 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Safety and Building Dividlo , INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: City Village X Township Fox, Jon I Richmond, Town of CST BM Elev: Insp. BM Elev: BM Description: (inn ( - % TANK INFORMATION TYPE MANUFACTURER CAPACITY Septic Aeration Holding TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Septic Q s fV"1z 1z , Dosing Aeration Holding PUMP/SIPHON INFORMATION Manufacturer Demand GPM Model Num TDH Lift Friction Loss stem Head H Ft Forcemain Length Dia. Dist. to Well RnII AR.gf)RPTION SYSTEM ELEVATION DATA County: St. Croix Sanitary Permit No: 463460 0 State Plan ID No: Parcel Tax No: 026-1149-16-000 Section/Town/Range/Map No: 36.30.18.1116A STATION BS HI FS ELEV. Benchmark A0 Alt. BM F,1 C0 1 I ` 3,7 .$ Bldg. Sewer 4/ -5 St/Ht Inlet C f� ��• SUHt Outlet Dtlnlet Dt Bottom Header/Man. L0 I Dist. Pipe 173. 9 Bot. System ) n a cAJ Final Grade ��C( Cr , G St Cover to Tg pJ 1\ 75 17Z -i 1 ZL S • �j i/ . BED/TRENCH Width 1 Length No. Of Trenches PIT DIMENSIONS No. f Pits Inside Dia. Liquid Depth DIMENSIONS '2 111 •7 —M _ e \ SETBACK SYSTEM TO P/L BLDG IWELL LAKE/STREAM LEACHING Manufacturer INFORMATION CHAMBER OR te '`_L U Type Of System: r O#.NP�" 7 / 1 � w ILL /✓ Model Number. Q—c` DISTRIRt1TI0N SYSTEM 1.IaN.-/I20 -.4N Header/Manifold /� � Distribu ion v Pip Dia \Spacing x Hole Size x Hole Spacing Vent to Ai%r�nta Len th Dia 9� Len th g SOIL COVER Y Praccima Rvctamc nnly YY Mnund Or At -Grade Svsterns Only G—'VOcc> - Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched % Bed/Trench Center % V �j Bed/Trench Edges Topsoil Yes L`:] No Yes ' . 1 No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / / Location: 1259 142nd Street New Richrpond, WI 54017 (SW 1/4 NW 1 4 36 T30N R18W) Torey Pines II Lot 16 4• 1.) Alt BM Description = t , C TJQCA . � Ina VAS Q ✓\. 2.) Bldg sewer length = - amount of cover = I 114- ZO ?4Z N 7 /I Plan revision Required? i• ,I Yes XNo —7 I I,-65 Use other side for additional information. Date SBD-6710 (R.3/97) Inspection #2: Parcel No: 36.30.18.1116A ' Soil Test and System PLOT PLAN PROJECT John Fox YDRSS 261 155th St. Amery Wi 54001 'SW 1 /4 N W 1 /4S 36 /T 30 N/Rw TOWNRichmond COUNTY ST. CROIX MPRS Shaun Bird 226900 CONVENTIONAL XXX IN -GROUND DATE7/6/05 BEDROOM 4 CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1255 LIFT TANK SIZE DOSE TANK SI HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 872 # of chambe s 28 BENCHMARK V.R.P. Top of Lookout foundation ASSUME ELEVATION 100' Filter Zabel A-100 ❑ BOREHOLE O WELL * H. R. P. Same as Benchmark Plans Designed Using SYSTEM ELEVATION 93.0/92.0 5' below qrade Conventional Powts Property Line Manual Version 2.0 Do - Town Road Drainage easement elevation is 2. below basement floor. Well is to meet all This elevation was verified by the setbacks required by WDNR Pro 4 local building inspector! Bedroom House 0 140' 0' 25' ST B- 20' qi 10% Slope 51 , 150' ! , _ 5 0' ? 30' B-2 #UU4_ iae- 1007. 0' Ventsqi b Drainage iInj f lU�' Vent easement,bas�d on elevations taken! ALong Standard Biodiffuser 3. S Leaching Chamber with 3 1. 1 ft2 of Area Grade at System Elevation Town Road ------ WIk COUNT NO. �5')Z3� 251 TOP T, / r r 1 k-' 1AL /q2"`� OWNER t,6NNt' ��hRR Stko4�S� PLUMBER_:��Dtt �LIC.# TOWN OF AND/OR , BLOCK • SUBDIVISION AUTHORIZED ISSUING OFFICER err 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. — HATE �/2�- zaa THIS PERMIT EXPIRES 17207-10-55�- UNLESS VED BEFORE THAT DATE SBD-06499 (R11/20)