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HomeMy WebLinkAboutSAN-2019-226 004-1004-30-00015 'A"." J 5,.,q Saf and Buildi Division County ` 201 , ashin ton Av P.O. Box 7162 VI? St. Croix Sanitary Permit Number (to be filled in by Co ) 02 Q19 adison WI 53707 — 7162 ` De artment of o ekc (608) 266-3151 , Sane U o A lieatiab State Plan I.D Number 310617 In accord with Comm 83.21, Wis. A etpe onal information you provi P Address (if different than mailing address) may be used for secondary purposes r cy Law, s15 04(1 )(m) 310A S� I. Application Information — Please Print All Information Property Owner' Name Parcel # Lot # Block # Gary Accola r TV I Qo y _ 1 0 0 y _ 3v - ()o 0 Property Owner's Mailing Address MIJ10 F Property Location o;). big, iS. 553 310th St. co ) � SW 4, NW '/., Section 2 City, State Zip Code Phone Number Wilson, WI 54027 715-308-2180 T 28 N, R 1 5(circle one) ✓ Il. Type of Building (check all that apply) Subdivision Name CSM Number ❑Q 1 or 2 Family Dwelling —Number of Bedroom 4Pefkck � r` � Public/Commercial — Describe Use r-t� r-7 ' t-t L Jv iry IJv illage 1 1t ow7iship of Cady ❑ State Owned —Describe Use � /(.�..1 T / _J III. Type of Permit: (Check a A. Complete line B if applicable) A. 13 New System Replacement System Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System B. ❑ Permit Renew Permit Revision ermit Transfer to New Li t Previous Permit Number and Date Issued Before Expiration I r Owner I'll I IN'. Type of POWTS System: Check all that a ❑ Non —Pressurized In -Ground ❑ Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil At -Grade ❑ Single Pass Sand Filter ❑ Constructed Wetland ❑ Pressurized In -Ground 0 Holding Tank erobic Treatment Unit ❑ Recirculating nd Filter ❑ Recirculating Synthetic Media Filter ❑ LeachingChamber ❑ Drip Line t p ❑Gravel -less Pipe ❑ Other (explain) a, r V. Dis ersal/Treatment Area Information: Design Flow (gpd)l Design Soil Application Rate(gpdsf) Dispersal Area Required (SO Dispersal Area o d (s0 System Elevation a t�} ! 5� Z /aZ V1. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Units Concrete Constructed Glass � 1 ar New Existing Tanks Tanks X Septic or Holding Tank X 1200 1 Wieser Aerobic Treatment Unit Dosing chamber X 800 1 We r X II. Responsibility Statement- 1, the and Red, assume res .silbik for installation of the POWTS shown on the attached plans. Plumbers Name (Print) MP/MPRS Number Business Phone Number Lewis Bjork 253976 715-231-7375 Plumber's Address (Street, City, State, Zip E7818 County Road E, Menomonie, WI, 54751 'III. C n /De artment Use Only pproved Sanitary Permit Fee (includes Groundwater D I lssu n ent r t Surcharge Fee) I Ot iven Reason for Denial �j�J IX. Conditions of Approval/Reasons for Disapproval 3` ' n ; e I 1_ ( r ) (�dr� yL •� � avt-�1 r ti �4K-- ft1 SYSTEM OWNER: t�rnit.a/ �.,, Llyper:•�„ crn ,tnt an >e Z_•`�,S_... 1. & per par 3gemeW.. pIFn r. u ,iae, by .,u,, nbE 2. AM W!Mr:k rect„iret-OM mu*t Le ..:,rt�,; E al s per AKk sWs co:5e / aill"v ice s. attach complete plans (to the County only) for the system on paper not less than 8 I 11 inches in size' d5) SBD-6398 (R. 01 /03) J IN October 02, 2018 CUST ID No. 253976 LEWIS C BJORK LEWIS BJORK LLC E7818 CTY RD E MENOMONIE WI DIVISION OF INDUSTRY SERVICES 10541 N RANCH RD HAYWARD WI 54843-6462 Contact Through Relay http://dsps.wi.gov/programs/industry-services www.wisconsin.gov A7TN: POWTS Inspector 49NING OFFICE ST CROIX COUNTY SPIA 1101 CARMICHAEL RD 54751-6637 HUDSON WI 54016-7708 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 10/02/2020 Scott Walker, Governor Laura Gutierrez, Secretary Identification Numbers Transaction ID No. 3163017 SITE: Site ID No. 854153 Gary Accola Please refer to both identification numbers, 553 310TH St above, in all correspondence with the agency. Town of Cady St Croix County SW1/4, NW1/4, S2, T28N, R15W FOR: Object Type: POWTS Component Manual Regulated Object ID No.: 1798569 Maintenance required; Replacement system; 600 GPD Flow rate; System(s): Mound Component Manual - Ver. 2.0, SBD-10691-P (N.01/01, R. 10/12), Pressure Distribution Component Manual - Ver. 2.0, SBD-10706-P (N.01/01, R. 10/12); 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. 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 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 CCi.' P'J shall relieve the designer of the responsibility for designing a safe building, structure, or component. DEPT OF SAFETY Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the addreDIVISION 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, Edwi A Tay or Wastewater Specialist, Division of Industry Services (715)634-3484 , Mon-fri, 8:00 a.m. - 4:30 p.m. edwin.taylor@wi.gov Fee Required $ 250.00 This Amount Will Be Invoiced. When You Receive That Invoice, Please Include a Copy With Your Payment Submittal. WiSMART code: 7633 AP AND OF It' 0 Mound Plan Index & Cover Sheet R(-�t"V `" PAGE 1 OF 6 SEP 2 0 ZZ1S n� 1C�Tv" rD\I1r'� Component Manual Design References: Version 2.0, SBD-10691-P (N.01/01, R. 10/12) & Version 2.0, SBD-10706-P (N.01/01, R. 10/12) Pg 1 of 6 Index & Cover Page Pg 2 of 6 Plot Plan Pg 3 of 6 Mound Cross -Section & Plan View Pg 4 of 6 Distribution Network Specifications Pg 5 of 6 Pump Tank Specifications Pg 6 of 6 Management Plan Attachments: Enclosures: _ Pump Curve POWTS Application for Review Tank Alert / Tuf-Tite Riser cut sheet Soil Evaluation Report & Site Map Tank approval / Biotube cut sheet Effluent Maintenance instructions Project Name / Description (80-2018) Gary Accola 0 Owner Name(s): Gary Accola Owner Address: 553 310th Street Project Address: same Govt. Lot: SW 1/4 of NW Township: Cady Project Parcel ID #: 004-1004-30-000 Designer Name: Lewis Bjork Wilson WI Phone: 715 _308 _2180 0-3 1/4, Section 2 T 28 N-R 15 E ❑ or W❑✓ County: St. Croix Designer Information Designer Address: E7818 County E , Menomonie WI E-mail: lewisbjork@yahoo.com License Number: 253976 Remarks: Phone: 715 - 231," 17375 Zip: 547,61 .,. AL SE�Vif S ,sir S5aU&, , " . Signature: Date Original signature required on each submitted copy. 9-10-2018 CHECK BOX AS APPLICABLE. CHECK BO AB ABLE. [� SOIL EVALUATION Scale or imension O I SYSTEM PAGE 2 OF SITE MAP--------------_����_�___ LOT PLAN PROJECT NAME: Treatment dispersal cell DESIGN FLOW: 600 GPD 8018) Gary Accola -- theme scale 1" = 30' Attach design flow calculations for commercial plans. PROJECT ADDRESS: 553 310th Street Wilson Pipe Material / ASTM Standard (Tables 384.303 8 384,30-5) N Sanitary sewer. 4" / sch 40PVC SM Symbol: BM Elevetbn: �� FT 2" wZ 40 PVC Force Main:/ SM D.,,pwn: Top concrete cover over effluent filter Slotted (96) Well mbol a applicable): k'd� north Rion c IMPORTANT of Tested Area: 8 ( O on Sho ground elevation contours at suitable intervals. Vi4EI U. � Stl} ��,, ts� ffrnr.+.r -5A y "1 3c&&2n.3 �- t? } w WAIT., ' K. L w � �E_�_ - 1 110 Ac-r-) � y r � Vti By') sit L —7 z i ` ook i, 5 690 6 I I S SAna o�1 Y � L.r s N 725b+ ►s'� ( S� . q5- 1 5y5t Fm 8 x �I, Lott R1t 7 firr,nr► f;'1 atd ` 41v 10icy.4i)��� ct 0.5" TO 2.5" WASHED AGGREGATE pacom (min. 6.0" beneath distribution pipe - min.2.0" over distribution pipe and covered with approved synthetic fabric) i ASTM C-33 SAND FILL min. 0.5 ft T Plowed Surface T Surface Contour Elevation = 100.5 ft SINGLE -CELL MOUND DISPERSAL AREA D = 1.5 ft MIN. 6.0" OF TOPSOIL COVER E = : ft { Q C% min. 1.0 ft System Elevation = 102 l ft (� Q Lateral Invert Elevation = 102.5 ft r�cr:rc�c�rr« (Show force main, manifold, and flush valve locations on plan view.) 8 % Slope CROSS S: _ PLAN VIEW (No Scale) 1.5 " 0 Schdl 40 f PVC Lateral J = 8.37 ft 10 ft (typical) (typical) Observation - — --- �- ------------------- — — — — — — -- —------- — -- Pipe-ttipic—al)-0 L— — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — J W = 25.67 ft I _ f B = 100 ft I = 12.91 ft K = Bend as necessary to follow contour DOWNSLOPE TOE L= 121.b ft Prohibit disturbance and vehicular traffic within 15 feet of downslope toe. Reset Page 10.6 ft (typical) D G) m Lo O n cr) DISTRIBUTION NETWORK SPECIFICATIONS (No Scale) FLUSH VALVE DETAIL (No Scale) Orifice in — Valve Box Lateral Spacing Center of Threaded Cap (insulation optional) S = 3 ft for Head Testing (optional) \ t Shield orifices for 2 "0 Schdl40 PVC Force Main (slope to pump tank (riser pipes for drain -back) } optional) 1 1.5 °O Schd140 First Orifice PVC Manifold (typical) t \ gravelless applications Ball Valve I \ \ / (tips Laterals to be level (optional) J \ Q �� gal) .� Q� Schdl 40 PVC Lateral 0 = 1.5 in (typical) i J Lateral Length (P) _ .9$"ft Number of Orifices per Lateral = 25 Orifices equally spaced: [check a) OR b) below] ` > > � Orifices equally spaced Orifice Discharge Rate = .54 gpm a) along bottom of lateral Flush Valve along bottom of lateral b) along top of lateral Assembly �\ Number of Laterals = 2 with every th hole (typical - see detail) \�� facing down Last Orifice Lateral Discharge Rate = 13.46 gpm (typical) Orifice Spacing (X) = 48 in LATERAL INVERT ELEVATION = 102.5 ft (typical) TOTAL DISCHARGE RATE = 26.93 GPM (typical) Orifice Diameter = .156 in (typical) First Orifice OBSERVATION PIPE DETAIL (No Scale) Screw -Type or Finished Grade Slip Cap (loose) `y (mulched & seeded) 4"0 PVC Pipe Topsoil Cover 1 foot) Top of pipe to terminate (rein. at or above finished grade (4) 114"-112" X 6" Slots @ 90 apart Anchoring Device Inftltration Surface (typical) END MANIFOLD (typical) ❑✓ CONNECTION Check applicable box. Manifold (riser pipe optional) D First Orifice (typical) rn m I-- X �}� Xi2 x/2 --I-- X --I .p (typical) (typical) 0 CENTER MANIFOLD -r1 Manifold CONNECTION 0)(riser pipe optional) PAGE 5OF6 SEPTIC / PUMP N 4"0 Vent Pipe >10 ft from Building 12" Min. or 2.0 ft above Established Flood Elevation (typical) \ Approved IMPORTANT: vent Cap Anchor tank(s) as necessary pursuant to SPS 383.43(8)(g) Finished Grade CAPACITIES @ 22.24 gain � I Depth (in) Volume (gal) A 18.73 416.52 B 2.0 44.48 [C] 4.24 94.36 D 11 244.64 *Pump Tank Liquid Level = 35.97 in Force Main Diameter = 2 in Force Main Length = 25 ft Force Main Void Volume = 4•08 gal JK SPECIFICATIONS Scale) �aI must comply with 316 and NEC 300 Weatherproof —Junction Bar * T Weep Hole A Y Alarm B �On is TIC i ump off D 3" Approved E [C] Total Dose Volume (TDV = 94.36 gal/dose 1(5x total lateral void volume < TDV < 0.2X design flow) + (force main drainback volume) MIN. PUMP DISCHARGE RATE = 26.93 gpm PUMP TANK: Volume = 800 gal Manufacturer: Weiser Pump Manufacturer: Zoehler Pump Model: 152 (See attached pump curve.) Controls/Alarm Manufacturer: SJERombus Controls/Alarm Model: AB Float switches containing_ mercury are prohibited. Extend manhole riser as necessary. Approved Locking Manhole with Warning Label Attached (typical) 4" Min. or 2.0 ft above Established Flood Elevation (typical) Quick Disconnect �. 18" Min. 6(typical) Approved Joints with Approved Pipe 3 ft onto Solid Ground (typal) PUMP -OFF ELEVATION = 93.42 ft I Material Beneath Tank INSIDE BOTTOM ELEVATION = 92.5 ft Vertical Head = 9.08 �ft + Min. Supply Head = 3.5 ft + FM Friction Loss = .40 ft + Fitting Loss* = 1.05 ft *(min. supply head x 0.3) = TOTAL DYNAMIC HEAD = 14.03 ft SEPTIC TANK(S): Total Volume = 1200 gal Manufacturer(s): weiser Install approved effluent filter at the septic tank outlet immediately upstream of the pump tank inlet. Filter Manufacturer: Orenco -Bio-tube Filter Model: FT-0822-14B PAGE 6 OF 6 Mound Management Plan IMPORTANT: The owner of this mound 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 Maintainer in accordance with SPS 383.52 (3), Wisc. Admin. Code. Maximum Dispersal Area Operating Limits: Design Flow = •1e gpd; BODE <_ 220 mgL"'; TSS <_ 150 mgL"'; FOGS 30 mgL" Inspection Checklist INSPECT EVERY 3 YEARS o type of use o age of system o 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 / 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 (i.e., pump re -cycling, float switch settings, etc.) o electrical components (i.e., wiring, connections, switches, controls, timers, alarms, etc.) o distribution lateral or lateral orifice plugging (measure lateral distal pressure — compare to design specification) o surface discharge of effluent or sewage back-up into structure served Maintenance Checklist MAINTAIN EVERY 3 YEARS (or when necessary) o 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 (113) the liquid volume of the tank(s) or as required by local ordinance. Disposal of contents shall be pursuant to NR 113, Wisc. Admin. Code. 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. o Distribution laterals shall be flushed once every 3 years or when necessary. 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: Lewis Bjork & Family Septic Service Phone: 715-231-7375 Local government unit: St. Croix County Zoning Phone: 715-386-4680 Local government unit address: 1101 Carmicheal Rd, Hudson , WI ZIP: 54016-7708 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 mound dispersal component may be re -constructed within the originally approved area after removal of all failed components. System Abandonment If use of this POWTS is discontinued, it shall be abandoned in accordance with SPS 383.33, Wisc. Admin. Code. Wisconsin Department of Commerce SOIL EVALUATION REPORT Page I of 3 Division of Safety and Buildings in accordance with Comm 65, Wis. Adm. Code Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must County St. Croix include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. 044-1004-30-000 percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Please print all Information. Reviewed by Date Personal information you provide may be used for secondary purposes (Privacy Law, a. 15.04 (1) (m)1. Property Owner Property Location Cary Aocola Govt, Lot SW 1/4 NW 1/4 S 2 T 28 N R 15 D0a Property Owner's Mailing Address Lot # Block # Subd. Name or CSW 553 31 Oth street - part of 36 acres parcel City Shite Zip ode Phone Num5ir ity Village ■ Town Nearest Road Wilson WI 1 54027 ( 7)5-308-2180 310th street New Construction Llsetn Residential / Number of bedrooms 4 , Code derived design flow rate 600 GPD Replacement Public or commercial - Describe: _ _ NA Parent material Loess cap over till r Flood Plain elevation if applicable N1A ft. General comments Install on the designcontour 100.5 6' x 100' cell with 1.5' sand u and recommendations:p -slope edge use basil loading / .8 after 12" sand , B 1 Boring # ® Boring a pit Ground surface elev. 100.5 ft. Depth to limiting factor 20 in. Snit Annliratirm Rates Horizon Depth in. Dominant Color Munsell Redox Description Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistenoe Boundary Roots GPDff 'Eff#1 'Eff#2 IAp 0-4 1Oyr3/3 sit 2fgr mvfr cs 2f .6 .8 2Ap 4-11 10 r3/4 sit 2fsbk mvfr as if .6 .8 3E I1-20 1Oyr5/3 sit 2msbk mvfr gs If .6 .8 4Bt 20-26 IOyr4/6 171f5yr5/3, IOyr6/2 sit - - - - - 5C 1 26-30 1Oyr4/6 c2p5yr, I Oyr6/2 sit- 6C 30+ 5yr High density bulk till scl II Boring# U Boring 100.5 18 Elpit Ground surface elev, ft. Depth to limiting factor in, q�,I Annl{reH .. Data 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 IAp 0-4 1Oyr3/3 sit 2f$r mvfr cs 2f .6 .8 2A 4-12 10 r3/4 sit 2fsbk mvfr as 2f/lm .6 .8 3E 12-18 1Oyr5/3 sit 2msbc mvfr gs if •6 .8 4Bt 18-24 1Oyr6/4 1`1f5yr5r3, 10yr612 sit- 5C 24-30 10yr6/4 c2p5yr, I Oyr6/2 sit - - - - - - ' Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < t ' EM04nt #2 = BOD < 30 mglL and TSS � 30 rrg/L CST Name (Please Print) Siena CST Number Lewis Bork 7--r- -.,.— - 253976 Address Nate EvaluatblillConducted Telephone Number E7818 County E Menomonie WI 54751 5-21-2018 715-231-7375 Property Owner �BoringGary AooWa ParallID0 044-1004-30-M B3 Bori * w'j + � 19 Pit around wrftw elev. 98.5 -ft. Depth to Iknitlnp factor 19 In Pape 2 of 3 Horizon Depth In. Dominant Color Munsell Redox Description Ou. Sz. Cent Color Texture Structure Or. Sz. Sh. Conaldence Boundary Roots OPDW "Eti81 V11112 lAp 0-5 10yr3/3 - sil 2fgr mvfr cs 2f .6 .8 2A 5-10 1 /4 sil 2fsbk mvfr as 2f .6 .8 3E 10-15 10yr5/3 - A 2msbk mvfr gs l f .6 .8 4Bt 15-19 10yr6/4 _ ail 2msbk mvfr gs if .6 .8 5C 19.24 10yr6/4 c2 5 ,1 r6/2 A 0 - - - - F-1"S H Pit Ground elev. -ft. Depth to Nrrdunp factor in. ceA a Q.h. MER • i�imw M:I'A FBoring 0 Boring � Pit Oroundaurfaceslev. tt, Depth to Iknitinp factor in. 9 Pit AM Anna%Mn Rah " Effluent 01 a BOD, > 30 1220 rnWL and TSS >30 1160 mWL • Efivant Art • BOO, 130 nVL and TSS 130 ffg& The Department of Commerce is an equal opportunity servipe 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. SSM833or u OLOM) J 1 s I ' Sk' Cro\. ( Z CHECK BOX AS APPLICABLE -,cHECKBO As Scale 4;;�noSOIL EVALUATION 1 SYSTEM PAGE 2 OF SITE MAP ------ ------------------- LOT PLAN PROJECT NAME: Treatment dispersal cell DESIGN FLOW: 600 GPD 8018) Gary Accola -- theme scale 1 H = 30' Attach design flow calculations for commercial plans. PROJECT ADDRESS: 553 310th Street Wilson Pipte Material / ASTM Standard (Tables 384.30-3 8 384.305) — N Sanitary Sewer. 4" _ jI Bch 40PVC 2 BM Symbd:F BM Elevaam: 100 FT Force Main: 2" / sch 40 PVC BM tlption: Top concrete cover over effluent fiker In0lcatr nxch by IMPORTANT: Slope Oradkxri (°K) 8 well Symbol (a appllude} arawlr,p a, snow Sho ground elevation contours at suitable Intervals. of Tested Area: an the swap(lq kw. Svc'-( IN Gt.", I tM V:es t�-j (,tyn 0or Y W Z13 6r21' 16 r'16 -1AArtF1tIAIL A_ tzz i a6 ' v) db Acre C y c3A 6A-j K + loll 900)( E.S� GPq CIS I % P?F r � r� � I t 5' Sn,�l n•a � a Qq ISw 1 Z40 � 1 S —106 i V �' 4 2�- 4z - A,'. SEP.151_j52_153.curvel ._jpg (JPEG Image, 2397 x 2758 pixels) - Sc... https://www.zoellerpumps.com/content/literature/Curves/SED.151_15... C L" `nO 0 40 80 120 160 200 240 280 320 360 FLOW PER MINUTE 1 of 1 2/9/2018, 12:20 PM Ylnll'iINIIVIIIVIIIIIII State Bar of Wisconsin Form 1-2003 WARRANTY DEED Document Number I Document Name THIS DEED, made between Ammon A. Miller and Edna C. Miller, husband ("Grantor," whether one or more), and Gary L. Accola and Amber D. Accola, husband and wife as survivorship marital property ("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" for Legal Description 1060940 BETH PABST REGISTER OF DEEDS ST. CROIX CO., WI 02/08/2018 02:42 PM EXEMPT#: REC FEE 30.00 TRANS FEE 975.00 PAGES: 2 Recording Area Name and Return Address WESTconsin Title Services P.O. Box 607 Hudson, WI 54016 004-1004-304) Rand 004-1003-70-200 (Part of) Parcel Identification Number (PIN) This is 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: Zoning ordinances, rights -of -way, all easements, covenants, conditions, reservations and restrictions, and general real estate taxes and assessments levied in the year of conveyance. Dated: February 1.2018 .iFig, .WMAA VA _ II 11 AUTHENTICATIONO`tt"I"Al" rr/1���� Signature(s) authenticated on •r 'y ' *n p(*��Cs -•c TITLE: MEMBER STATE BAR OF WISC ?q$0V '_ (If not, authorized by Wis.Stat § 706,06) THIS INSTRUMENT DRAFTED BY: Tony R. Schrader. Attorney (715) 235-3403 _ File No. OR-18-11027 n,t 1 • 4 &_./ (SEAL) *Edna C. Miller ACKNOWLEDGMENT STATE OF WISCONSIN ) ) ss. COUNTY OF ST. CROIX ) Personally came before me on February 1. 2018 the above -named Ammon A. Miller and Edna C. Miller to me known to be the person(s) who executed the foregoing instrument and acknowledged the same. *Allison Markall Notary Public, State of Wisconsin My Commission (is permanent) (expires: 2/26119) (Signatures may be authendeated or acknowledged. Both are not necessary.) NOTE: THIS IS A STANDARD FORM. ANY MODIFICATIONS TO THIS FORM SHOULD BE CLEARLY IDENTIFIED. WARRANTY DEED 02003 STATE BAR OF WISCONSIN FORM NO. 1-2003 *Type name below signatures. St. Croix County 1060940 Page 1 of 2 EDIT "A" LEGAL DESCRIPTION The Northwest Quarter (NW V.) of the Southwest Quarter (SW Y.) of Section Two (2), Township Twenty- eight (28) North, Range Mean (15) Wert, Town of Cady, SL Croix County, Wisconsin; Less and except those lauds token for highway purposes. AND The Southwest Quarter (SW Y•) of the Northwest Quarter (NW Va) of Section Two (2), Township Twenty- eight (28) North, Range Filieen (15) West, Town of Cady, St. Croix County, Wbconsio; EXCEPT Certified Survey Map recorded in Volume 2 Certified Survey Maps, Page 5414 as Document No. 853946. "b Na MIS-11427 St Croix County 1060940 Page 2 of 2 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 [Pnvacv Law. s 15,04 (1)(m)1 Permit Holder's Name. Ammon Miller City Village Township TOWN OF CADY CST BM Elev: Insp BM Elev BM Description. TANK INFORMATION TYPE MANUFACTURER CAPACITY Septic Dosing on T1'Q Hol ng TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Septic Dosing Aeration Holding PUMP/SIPHON INFORMATION Manufacturer Demand GPM Model Number TDH Lift Friction Loss System Head TDH Ft Forcemain Length Dia. Dist. to Well SOIL ABSORPTION SYSTEM ELEVATION DATA County St. Croix Sanitary Permit No 600314 State Plan ID No Parcel Tax No: 004-1004-30-000 Section/Town/Range/Map No 02.28.15.26A STATION BS HI FS ELEV. Benchmark Alt. BM Bldg. Sewer SUHt Inlet SUHt Outlet Dt Inlet Dt Bottom Header/Man. Dist. Pipe Bot System Final Grade St Cover BEDlTRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer. INFORMATION CHAMBER OR UNIT Type Of System. Model Number DISTRIBUTION SYSTEM Header/Manifold x Hole Size x Hole Spacing Vent to Air Intake IDistribution Pipe(s) Length Dia Length Dia Spacing SOIL COVER x Pressure Svstems Only xx Mound Or At -Grade Svstems Only Depth Over Depth Over xx Depth of xx Seeded/Sodded Mulched Bed/Trench Center Bed/Trench Edges Topsoil Yes No jxx Yes No COMMENTS: (Include code discrepencies, persons present, etc.) Location: 553 310TH ST 1.) Alt BM Description = 2.) Bldg sewer length = V; amount of cover = '�Lj Lr i�- Inspection #1: Inspection #2: I Plan revision Required? Yes No Use other side for additional Information. SBD-6710 (R 3/97) Date Insepctor's Signature Cert. No. <Ary 0 J9 - 0d� '' D ! Safety and Buildings Division County C , � Q 1 t r ���p 201 W. Washington Ave., P.O. Box 7162 O JAN 0 5 M9dison, WI 53707-7162 Samtarry Permit Numbe (to he tilled in bN Co) St. Croix County �R 4 �� y � corn It e erini L A 1, t�ppla- VAy� State Transaction umber In accordance with SPS 383 21(2), Wis. Adm. Code, submission of this form to trw 7 is required prior to obtaining a sanitary permit. Note: Application forms for state-owned r 9e� Project Address (if different than mailing address) . the Department of Safety and Professional w, s 15. Personal information you provide may be use purposes in accordance with the Privacy Law, s 15.04(I)(m), Slats, �� + �',,(J I. Application Information - Please Print All Information Property Owner's Name Parcel # w%,O n Property Owner's Mailing Address Property Location SS O�� Srcci-- of .S��D /., �- '/., Section City, State Zip Code Phone Number l lb p WL C;lQ � -7�r_ I �/ J� (circle one) T �_ N; R !� E or W 11. Type of Building (check all that apply) Lott# I or 2 Family Dwelling - Number of Bedroom XBlock# /1L l� Subdivision Name ❑ Public/Commercial - Describe Use �`— ❑ City of ❑ State Owned - Describe. Use CSM ❑ Village of Town of Number III. Type of Pe it: (Che only one box on •ne A. Complete line B if applicable) A ❑ New System ❑ Replacement System Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System (explain) B. El Permit Renewal El Permit Revision El Change of Plumber El Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Owner IV.Type of POWTS System/Component/Device: Check all that apply) ❑ Non -Pressurized In -Ground ❑ Pressurized In -Ground ❑ At -Grade ❑ Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil ❑ Holding Tank ❑ Other Dispersal Component (explain) __ ❑ Pretreatment Device (explain) _ V. Dispersal/Treatment Area Information: Design Flow (gpd) /f Design Soil Applicktion XJfr Rate(gpdsf) Dispersal Area Required (sf) Dispersal Area Proposed (sf) `� S_cstem Flesation(,no ` % Vl. Tank Info Capacity in Total # of Manufacturer o Gallons Gallons Units New Tanks Existing Tanks 'Z.: c u y Septic or Holding Tank Dosing Chamber V11. Responsibility Statement- 1, the undersigns a responsibility forinstallation of the PONI'TS shown on the attached plans. Plumber's Name (Print) Plumber Si na a MP/MPRS Number Business Phone Number '��: 2539-7/0 231- 7375— Plumber's Address (Sireet, City, State, Zip Code) C 76/ a d s VIIL County/De artment Use Only Pproved ❑ Permit Fee $ Date Issu IS Issuing ent Signature 2 55.00 00 / —777'�:� Own en n o Reasoenial �. Conditions ations o prioval/Ree-aso s for Disapproval / L ;�q w �. Tyr P "7 • J \ i $ PWL " JiL I o 11 Z 64 S ct,r• dr Al J cu- &64L JWJ JAttach to complete plans for of system gT submit tope Coyttty only on paper not less In S 1/2 x 11 inches in siz� wW 6:- �J 2-4 " D `}1- Gov eA ..., SB -6394(. 11/1 ) PI l:l�i �ax o HOLDING TANK SITE PLAN Project: Gary Accola i NLk� SL Legal Description: S S 2 T28N 15W Subdivision Name: Scale: 1 40 ft Parcel ID: Lot No.: �g 4 c ! ' v \ � I I 4 I� N v Transaction I.D.: � 002 Cam' J r Page 3 of 6 CONCRETE HOLDING TANK DESIGN Single Combo Tank Option INDEX AND TITLE SHEET Project Gary Accola Owner Gary Accola Address 553 310th street Wilson WI 54027 gary@stonebrookcarpentry.com 715-308-2180 Legal Description 94V-4 i S 2 T28N 15W Township County St. Croix Subdivision Name Lot No. Parcel ID Number Plan Transaction ID Number Index and title sheet Holding tank specifications Site plan Maintenance and contingency plan Tank drawing Service contract Designer ewis Bork \> Signature License Number 253976 Page 1 Page 2 Page 3 Page 4 Page 5 Page 6 Phone No. 715-231-7375 Date 01/05/18 Designed pursuant to: Holding Tank Component Manual For POWTS (Version 2.0) SBD-10855-P (N. 03/07) Version 7.0 (03/12) Page 1 of 6 HOLDING TANK SITE PLAN Project: Gary Accola N Nw L� Legal Description: SW= S 2 T28N 15W Subdivision Name: Scale: F," = 40 ft Parcel ID: Lot No.: J a.. N S-, 4 /r , V N ITransaction I.D.: U Page 3 of 6 k � HOLDING TANK SPECIFICATIONS 4 Number of bedrooms Non-residential estimated flow (gpd) 2000 0 Minimum holding tank volume required (gal) Side A Side B Total 1200.0 1 800.0 1 2000 0 JProposed tank capacity (gal) Wieser Tank manufacturer WLP 1200/800 Tank model number SJE Rhombus Alarm manufacturer NAA-T2008 JAlarm model number Tank Dimensions and Data X for round tank 36.0 Liquid depth below inlet invert (in) 8.0 Maximum depth of soil cover (ft) 53.0 Height (in) Outside 164.0 Length (in) Dimensions I 96.0 Width (in) Only Tank Anchor Calculations Ibs Weight of tank and cover Safety factor Ibs Weight of anchor required in Soil cover req. for anchor or yd' Concrete counter weight HOLDING TANK CROSS SECTION Electrical complies with NEC 300 and SPS 316 optional vent pipe manhole cover with location locking device and junction warning label box 31. 4" min. —�� <— 23 in. conduit —� blind plug to seal outlet thether weight service alarm on 90% Full 30.0 1 in Side A 1200.0 1 oal 3 in. bedding under tank. vent pipe finished grade n� 4" min. —I I Note: All tank joints, and joints between tank openings and piping are sealed watertight. All pipe and vent materials comply with SPS 384. Manholes with locking device are typical for each manhole opening . Side B 800.0 gal Tank is anchored as necessary to negate buoyancy. T 18" min. building sewer inlet Project: Gary Accola Transaction Number: Page 2 of 6 Zy a?.a Z3.1 (o , Z HOLDING TANK MANAGEMENT PLAN This Private Onsite Wastewater Treatment System (POWTS) has been designed, and is to be installed and maintained according to SIP 383, Wis. Admin. Code, the Holding Tank Component Manual (SBD-10855-P N. 03/07), and the St. Croix County Sanitary Ordinance. 1. This POWTS is designed to accommodate a wastewater flow of 80 to 400.0 gpd. 2. The owner of this POWTS is responsible for system operation and maintenance, including all provisions in the attached Holding Tank Servicing Contract and Maintenance Agreements. 3. Each time the wastewater in the tank reaches 90% of the tank(s) capacity or a level of 12" below the inlet (at which time the alarm will activate), the pumper listed in the current Servicing Contract must be called to empty the tank(s contents and dispose of them in accordance with NR 113, Wis. Adm. Code. 4. At each service event, the service provider should visually inspect the condition of the tank, risers and manhole cover(s) and verify that the alarm system functions and manhole locking devices are present. Discrepancies are reported to the owner in a timely manner for corrective action. All corrective actions shall comply with the county sanitary ordinance and SPS 383 and 384 Wis. Adm. Code. 5. All service events or inspections of this POWTS shall be reported to the county within 30 days. 6. The owner may not remove any of the wastes from the holding tank(s), or cause such wastes to be removed by any person not authorized to do so under Ch. 281, Wis. Statutes. The discharge of wastes tank to the ground surface, including intentional discharges and discharges caused by neglect, constitutes a failing POWTS and may result in issuance of correction orders or a citation by the county or state. 7. No one should enter a holding tank for any reason without being in full compliance with OSHA standards for entering a confined space. The atmosphere within these tanks may contain lethal gases, and rescue of a person from the interior of the tank may be difficult or impossible. 8. In the event that this POWTS fails and cannot be repaired, a code compliant replacement holding tank may be installed in the same location (a new sanitary permit is required for such a replacement). Con- nection to municipal services would also be considered at this time if they are deemed available to the property. 9. If this POWTS is replaced, or its use discontinued, components no longer in use it shall be abandoned in accordance with SPS 383.33 Wis. Adm. Code. 10. If there is a problem with, or question about this installation, the following persons may be contacted: a. Installer ......................... b. Service Provider .............. c. Co. Zoning or Health Dept. 11 Lewis bjork LLC Phone: 715-231-7375 Lewis bjork LLC Phone: 715-231-7375 St. Croix county Phone: 715-386-4680 Project: Gary Accola Transaction Number: Page 4 of 6 0 ui N u 164" Illl II 4" CAST -A -SEAL I III I I I �� ��IIII III 024 IIII °I I FILTER OR II BAFFLE IIII II SIDE VIEW TANKS ARE MANUFACTURED TO MEET OR EXCEED ASTM C-1227 REQUIREMENTS WLP1200/800-MR TANK SPECIFICATIONS DIMENSIONS: WALL: 3" BOTTOM: 3" COVER: 6" MANHOLE: 24" I.D. PRECAST CONCRETE RISER HEIGHT: 53" O.D. LENGTH: 164" O.D. WIDTH: 96" O.D. BELOW INLET: 41" O.D. 4" CAST -A -SEAL LIQUID LEVEL: 36" WEIGHT: BOTTOM 12,000 LBS. COVER 8,170 LBS. INLET AND OUTLET: 4" CAST -A -SEAL BOOT OR EQUAL GASKET, CAST -A -SEAL BOOT OR EQUAL INLET AND OUTLET BAFFLE AND FILTER: WISCONSIN, SEE DETAIL #10 (OTHER STATES SEE CHART) LIQUID CAPACITY: 33.46 GAL/IN (SEPTIC) 22.24 GAL/IN (PUMP) LOADING DESIGN: 8' 0" UNSATURATED SOIL 4" VENT TANK CAN BE USED AS: SEPTIC/SEPTIC, SEPTIC/PUMP OR SEPTIC/SIPHON COVER: MIX DESIGN #8 (NO FIBER) TANK: MIX DESIGN #9 (SMALL FIBER) CUSTOMIZED TANKS: FOR CUSTOM TANKS CONTACT WIESER CONCRETE DRAWINGS SUBMITTED FOR APPROVAL APPROVED BY: APPROVAL DATE: PRODUCTS NEEDED BY: WLo 0 In a W an Ne U (.0 CLn cr ,A- z o0 o a 7 N r� LM 00 W=00 r: SEPTIC or HOLDING TANK SERVICING CONTRACT tract uate ",j — zzi gj This contract is made between the Tank Owner(s) Name(s) and Pumper's Name -�� Gc We ackno ledge the installation o (a) se c/holding tank(s) on the following prop 1. The owner agrees to file a copy of this contract with the local governmental unit (St. Croix County Planning & Zoning Department) to document maintenance by a certified septage servicing operator as required in SPS 383.52(1)(c)2. Wis. Adm. Code and the approved Component Manual. 2. The owner agrees to have the septic/holding tank(s) serviced by the undersigned pumper and guarantees to permit the pumper to have access and to enter upon the property for the purpose of servicing the septic/holding tank(s). The owner agrees to maintain the access road or drive so that the pumper can service the septic/holding tank(s) with the pumping equipment. The owner further agrees to pay the pumper for all charges incurred in servicing the septic/holding tank(s) as mutually agreed upon by the owner and pumper. The pumper agrees to submit to the local governmental unit (St. Croix County) a report for the servicing of the septic/holding tank(s) on a monthly basis. The pumper further agrees to include the following in the monthly report: a. The name and address of the person responsible for servicing the septic/holding tank: b. The name of the owner of the septic/holding tank; c. The location of the property on which the septic/holding tank is installed; d. The sanitary permit number issued for the septic/holding tank (if known); e. The dates on which the septic/holding tank was serviced; f. The volume in gallons of the contents pumped from the septic/holding tank for each servicing; g. The disposal sites to which the contents from the septic/holding tank were delivered. 4. This agreement will remain in effect until the owner or pumper terminates this contract. In the event of a change in this contract, the owner agrees to file a copy of any changes to this service contract or a copy of a new service contract with the local governmental unit named above within ten (10) business days from the date of change to this service contract. Owner(s) Name(s) (Print) Owner's Signature(s) Subscribed and sworn to me on this date. Today's Date Pumper's Name (Print) Pumper's Signatu Notary Public Signature w -- Pumper's Registration Number Commission Expiration z -11 is State Bar of Wisconsin Fonn 1-2003 WARRANTY DEED Document Number I I Document Name THIS DEED, made between Lee Gordon Schutts alk/a Lee G. Schutts and Pauline L. Schutts a/k/a Pauline Schutts, husband and wife ("Grantor," whether one or more), and Ammon A. Miller and Edna C. Miller, husband and wife as survivorship marital property ("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): The Southeast Quarter of the Northwest Quarter (SE 114 of NW 1/4); the West Half of the Northwest Quarter (W % of NW 114) EXCEPT Certified Survey Map in Volume 16, page 4419 as document number 7o0977 AND EXCEPT Certified Survey Map in Volume 22, page 5414 as document number 853946; AND the Northwest Quarter of the Southwest Quarter (NW 114 of SW 114) less and except those lands taken for highway purposes; all in Section Two (2), Township Twenty Eight (28) North, Range Fifteen (15) West, Town of Cady. Subject to 310th Street, 315th Street and 53rd Avenue rights of way. St. Croix County, Wisconsin This deed is given in satisfaction of a Land Contract by and between the parties dated March 6, 2014, and recorded in the Office of the Register of Deeds for St. Croix County on March 7, 2014 as Document 0993267. I IIIIIIIIgIUIIMIIIIIIBII� 8 3 6 6 7 2 3 1028142 BETH PABST REGISTER OF DEEDS ST. CROIX CO., WI 04/29/2016 11:13 AM EXEMPT#': 17 REC FEE: 30.00 PAGES: 1 Area Name and Return Address Leo A. Beskar Attorney at Law 219 N. Main Street River Falls, WI 54022 004-1004-30-000 & 004-1003-70-200 Parcel Identification Number (PIN) This is 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 reservations, if any, of record. Dated Q (SEAL) AUTHENTICATION Signature(s) authenticated on TITLE: MEMBER STATE BAR OF WISCONSIN (If not, authorized by Wis. Stat. § 706.06 } THIS INSTRUMENT DRAFTED BY: Leo A. Beskar, Rodli, Beskar, Neuhaus, Murray & Pletcher, S.C., 2 19 N. Ma►n Street; River FWts7,—W .,.{` ACKNOWLEDGMENT STATE OF W4�iY/Vc�LL�I ) ss. COUNTY) Personally came before me on �e-Cr✓k& the above -named Lee Gordon Schutts a/k/a Lee G. Schutts and to me known to be the person(s) who extcti i tstr tent and 431INwkdfesame.,y/ Notary Public, State of My commission (is permanent) (Signatures may be authenticated or acknowledged. Both are not necessary.) e`''•I NOTE: THIS IS A STANDARD FORM. ANY MODIFICATION TO THIS FORM SHOULD BE CLEARLYIDI WARIU0TY DEED ©2003 STATE BAR OF WISCONSIN 'Tyne name below signatures. INFO -PRO- Legal Farms he-'.for i9 QTIFIED 1, ;1 SY,�'. p• ,t,F,ORNINQ:1-2003 St. Croix County 1028142 Page 1 of 1