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Home My WebLink About002-1009-10-000n t_ ~ !-l~sa.t ~~ ~2~ ~. Wisconsi~~ Department of Commerce ibafery ,mod wilding Division PRIVATE SEWAGE SYSTEM INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Personal information you provide maybe used for secondary purposes [Privacy Law, s.15.04 (1)(m)J. Permit Holder's Name: City Village X Township Cronk, Richard & Brenda Baldwin Townshi SST BM Elev: Insp. BM Elev: BM Description: v /i _ ('> ( Ir TANK INFORMATION ELEVATI N DATA TYPE MANUFACTURER CAPACITY Septic (r~(J j ~(~ o C~ Dosing ~~ .d p v Aeration Holding TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Septic 7 Zt~ ~ / ~ Sb ~~ ~~ Dosing ~ 7~IJ0 / ~~ r ", r'" ~ ~ Aeration Holdin PUMP/SIPHON INFORMATION Manufacturer n (~ _ Demand ~ 6e-t.~j GPM Model Number (~ ~o S` C~ 2°~' TDH Lift Friction Loss System Head TDH Ft \\ ~~ -~ . ~ 2 2.SU rcemain Le~ h t t Dia. 2 r~ Dist. to Well ~ SOIL ABSORPTION SYSTEM County: St. CroiX Sanitary Permit No: 399495 0 State Plan ID No: - ~ 6 9 ~ roars . / J. Parcel Tax No: 002-1009-10-000 5: ~~g.- STATION BS HI FS ELEV. Benchmark 3.~~ 103- Dv Alt. BM Bldg. Sewer q•L ~~. (l Ht Inlet t Outlet Iz.~~ . v3 Dt Inlet 13_~ o.y Dt Bottom 1 . o fit:. ,~ Header/Man. ~ l ~ t `~.$~ Dist. Pipe .~ t Bot. System /n~ ~~""// _~ p • 2 . Z'Z Final~~G'rade: L( I'je 12~i-- ~ - ~ St Cover ~'~D2 (O~~J ~iTp~O 6-~ `~~-~ r ~~ r~. ~~ -cam BEDRRENCH ! Widt Length t No. Of PIT IONS No. Of Pits nside Dia. Liquid Depth DIMENSIONS ~ ~ SETBACK SYSTEM TO PIL BLDG WELL LAKE/STREAM LEACHIN turer: INFORMATION CHA OR Type Of System: ~ ~/ ~'~ ~ ~ ~ ~ 1 } ~~ UNIT Model Number: DISTRIBUTION SYSTEM (~i ~ _~__D~ (O . f`~`~~--~o(~l Header/Manifol Distribution r ( tt I pp c x Hole Size u t x Hole Spacing r ^ Vent to Air Intake t~ Di L th ~'20 i ~ ~ So ~ 2 S L i '9 Z Z - ~ J eng a pac eng s ng SOIL COVER x~Pressure Systems Onlv xx Mound Or At-Grade Systems Onlv Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center BedlTrench Edges Topsoil Yes No ~ Yes ~ No COMMENTS: (Include code discrepencies, persons present, etc.) ~ InspSi;FonS#1:~1 ~ f /~ Inspection #2: ~ ~ /~/ ~ ~ Location: 1186 230th Street Baldwi/n~, WI 54002 (NE 1/4 NE 1/4 5 T29N R1I6W~NA Lot Parce/l~ No: 05.29.16.65A 1.) Alt BM Description =~4'fT„` of Stern',..' y'~ ~fiS /(ueiYC !~ ~'c~r~ ,~c~,f f ~a~~ /o raw.5 ar-~ Lj¢riy f'cv iSGGf TD ,`_ ~ '~ 5 Sl~~'Ls~- 1 a,_. --:7 ~~oP rsutG 112-~~i 2.) Bldg sewer length = /2~' ~°`~`f Y ocq~• - amount of cover = s~ ~ ~rz/2'~ ~cyor.~ 30 ~ r '.~ c~e~ow1" .{o ~~ r`~n/ s' f~.l~d 3.) Contour= `~}.rrZ l.s~ o.~- ~ •`t o~t'~ ~ lo~-oL, (.•~I(/zD~i~ P~~v S{~t ~tfw,'t ~iC tkit~c~ p~ru.~.,../ C~,t~rsr,c.~i~,.~. li/r ! c ~ . Plan revision Required? ~ Yes ~ No Use other side for additional information. L -~ SBD-6710 (R.3/97) D t ~~ ~~ Insepctors Signature Cert. No. O~r~t~ 7 Safety and Buildings Division County r ~ ~ 201 W. Washington Ave., P.O. Box 7162 ~ p // ~ ~ ` ns`~ ~SCO Madison, WI 53707 - 7162 Site Address ~,(, ~ ~~ / ~" Commerce Dep ~ ~~ ' ~ "' Sanitary Permit Application Sanitary Permit Number 3 9 9 y 9s' in accord with Comm 83.21, Wis. Adm. Code, personal information you provide ,~,/ L+7 Check if Revision ma be used for seco ses Privac Law, s15. 1 m I. Application Information -Please Print All Information State I.D. N~ r~ ~ ~ , /~ `~ Property Owner's Name ~ ~ ~ Parcel Number 000 - .a>^ ~^©r~ r c o o Z /~09- /d - Property Owner's Mailing Address ~ ~~ Property Lo ~c))ation S'. L'1,~~, (ys/~} ~30 ~ ~ ~ ~ N~'k; S S T Z.9 N, R ~ City. State Zip Code Phone Number Lot Number,[ r~ Block Number s~~ ` ~.~~~~1~, ~ yea ~~~ f3~ ~ Q Subdi A ~ n Name CSM ~ber /~',~,,; ,~ , II ./Type of Building (check all that aPP1Y) ~ ~ C ~'~'~ ~' ~ 0 ~ ^City ~ ~~ 4 --~^ (Kl or 2 Family Dwelling -Number of Bedrootns ^V• ~ e ~ g ^ Public/Commer ' n se L~1To~vtlship ~ ~ ~ ~i ~~~ ^ State ' ~ C,~ ~ ~ ,. _~ Nearest Road III. Type of Pe eck only one box on line A (n be' ' sch QyA"dfe~nal use). Complete line B if applicable) A ~~ ~ :-For Coumy use 1 New 2 ^ Replacement p ce '~ 'oE ' 6 ^ Addition to m Tank Onl ~'~. ;Exis ' S stem , B. ~ Check if Sanitary Permit Previously Issued Permit Num ~ .' ~ .. - d~/~~~ Date Issued ~'~-ZO~I )(ntunbering scheme is for internal use) ly IV. Type of Permit: (Check all that app ~ / 44 ^ Non -Pressurized In-Ground 211 Mound ~~ k 9a') 47 ^ Sand Filter 50 ^ Const[ucted Wetland 22 ^ Pressurized In-Ground 41 ^ Holding Tank 48 ^ Single Pass 51 ^ Drip Line 45 ^ At-G[ade ~ 46 ^ Aerobic Treatment Unit 49 ^ Recirculating 30 ^ Other V. D' ersal/ZYeatment Area Informati on: ~ _ " S 3 Design Flow (gpd) Dispersal Area Dispersal Area Soil Application Percolation Rate System Elevation Final Grade Required ~/~ posedf~~f~ Rate(Ga1s./Days/Sq.Ft.) (Mitt./Inch Elevation ~~~~ ~ 9 99 ,.a VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber plastic Gallons Gallons of Tanks Concrete Constmcted Glass New Existing Tanks Tanks Septic or Holding Tank 1~`~ ~., jd0~ l v° ~ r~ r-s' Dosing Chamber ~O ~_, •~1~. Q < i dersigned, assume responsibility for installation of the POWTS shown on the attached plans. VII. Respoasibt'1tty Statement- I, the un Plumber's Name (Print) ~ ~ Pl 's Signature ~ G ~ MP/MPRS Number 2~a~~'3 Business Phone Number - 3~7~ 7l~-~~~ - r~-ti ~c l~ ~ . . Plumber's Address (Street, City, State, Zip Code) //~~ _ Q ~ J S' 700 h ' (/ ~ ~ ~ ..t_ .~ . - / ~~ d Gtt.;....- ` UQ l~ VIII. Count /De artment Use Onl (~ Approved ^ Disapproved Sanitary Permit Fee (includes Groundwater Date Issued Issuing Agent Signature (No Stamps) Surcharge Fee) ^ Owner Given Initial Adverse ,}~ ~~ O~ l t7 Determination 1T ~ Ldt/ IX. Conditions of Approval/Reasons for Disapproval 1. Effluent filter to be installed and maintained per manufacturer's recommendations. 2. This revision was submitted to reflect a change in system location. The original mound area was altered and determined unsuitable. 3. This revision/transfer was also submitted to reflect a change in plumber back to Dale Hudson. The permit has gone from Hudson to Sinz and back t Attach Complete plans tm me l:omuy oWy) [or me sys[em ou paper na iena w+ua oi,~. ,. as auwea m a¢c SBD-6398 (R. OS/O1) ~ ~ scons~n Department of Commerce Safety and Buildings 4003 N KINNEY COULEE RD LA CROSSE WI 54601-1831 TDD #: (608) 264-8777 www.commerce.state.wi. us/sb www.wisconsin.gov Scott Mccallum, Governor Philip Edw. Albert, Acting Secretary October 17, 2001 CUST ID No.220853 DALE E HUDSON 820 MAIN ST BALDWIN WI 54002 ATTN.' Powts Inspector ZONING OFFICE ST CROIX COUNTY SPIA 1101 CARMICHAEL RD HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 10/17/2003 SITE: Richard Cronk 1186 230TH St Town of Baldwin St Croix County NE1/4, NEl/4, S5, T29N, RI6W FOR: Description: Three Bedroom Mound System Object Type: Powt System Regulated Object [D No.: 782977 Identification Numbers Transaction ID No. 679944 Site ID No. 5365 Please refer to both identification numbers, above, in all comes ndence with the a enc . The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. The following conditions shall be met during construction or installation and prior to occupancy or use: • This system is to be constructed and located in accordance with the enclosed approved plans and with the "Mound Component Manual for Private Onsite Wastewater Systems VERSION 2.0" SBD-(0691-P (N.01/Ol) and the SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST_SAS (01/81) In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approved plans. In addition, the owner must insure that the operation, maintenance and monitoring duties as described in section V[II of the Mound manual, and the pressure distribution component manual are complied with. A copy of this letter including instructions and information relating to proper use and maintenance of the system must be given to the owner and each subsequent owner upon completion of the project. • Access to the filter for cleaning must be provided per Comm 84 product approval conditions. Maintenance information must be given to the owner of the tank explaining that periodic cleaning of the Clter is required. • Limited activities are allowed in the area I S feet down slope of the component area. Soil compaction, excavation, vehicular traffic and other similar activities that impact the treatment and dispersal are prohibited. • Comm 83.52 Responsibilities. The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s. Comm 83.54(1). In addition, the owner is responsible for submitting a maintenance verification report acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. DALE E HUDSON Page 2 10/17/01 • Comm 83.52(2) A POWTS that is not maintained in accordance with the approved management plan or as required under s. Comm 83.54(4) shall be considered a human health hazard. , • Comm 83.52(3) The activities relating to evaluation and monitoring mechanical POWTS components after the initial installation of the POWTS in accordance with an approved management plan shall be conducted by a person who holds a registration issued by the department as a registered POWTS maintainer. • A Sanitary Permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.135 and 145.19, Wis. Stats. • Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stats. • The changes made to this plan on 10/17/01 by this reviewer were acknowledged and approved by the system designer. A copy of the approved plans, specifications and this letter shall be on-site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of construction/instal lation/operation. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stars 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. Sincerely, C~J~ Charles L Bratz Powts Reviewer [[ ,Integrated Services (608)789-7893 , 7:45 am - 4:30 pm Monday -Friday cbratz@commerce. state.wi. us Fee Required $ 60.00 Fee Received $ 60.00 Balance Due $ 0.00 WiSMART code: 7633 cc: Richard Cronk ~EGEIVED MOUND AtdD PRESSURE DISTRIBUTION COMPONEf~IT DESIGP~CT ' 3 ZOO1 Residential Application INDEX AND TITLE PAGE SAFETY & BLDGS D11~. Project Name: Richard & Brenda Cronk 3 bedroom reskiential mound Owners Name: Richard & Brenda Cronk Owner's Address: 986 HwY 63 Baldwin, WI 54002 Site Address: 1186 230th Street Legal Description: NE1/4NE1/4, Sec. 5, T.29N., R.16W. Tcwnship: Baldwin County: St. Croix Subdivi.~ion Name: NA Lot Number. NA Block Number. NA - Parcel I.D. Number. 002-1009-10-00, ID#5.29.16.65A Plan Transaction No.: ~/~~ ~~ Ctm~tlonarlly APPRnVED DOMRIMEN~ OF COMi ,% , ~~ ~~, ~iRrfiESPONt~Ni~E4 Page 1 Index and title Page 2 Data entry Page 3 Mound drawings Page 4 Lateral and dose tank Page 5 System maintenance specifications Page 6 Management and contingency plan Page 7 Pump curve and spec cations Page 8 Site Plan Page 9 Soil Evaluation report Designer: Dale Hudson License Number: Date: 09/04!01_ ~ ~ Pho/ne Number: Signature: ~,,.~~ ~' Ihe~=x'~'`,-~ 220853 715-684-3378 Designed Pursuant to the Mound Component Manual for POWTS Version 2.0 SDB-10891-P (N. 01/01), and SSWtAP Publication 9.6 Design of Pressure Distribution Networks for ST-SAS (01/81) Version 3.0 (03/01/01) Page 1 of 9 Mound and Pressure Distribution Component Design Design Worksheet Site In_fo_rmatian (r ar c) G _ ~ R~ Residential or Commercial Design ~ _3.00.001 Estimated Wastewater Flow (gpd) ~~ 1.50 Peaking Factor (e.g. 1.5 = 150%) 450.00 Design Flow (gpd) __ 10.00 Site Slope (°Jo) ~ 97 70 Contour Line Elevation (ft) i _ _ ._ __ _ .•.__. { _30.OOi Depth to Limiting Factor (in) .. ' 0.50j In-situ Soil Application Rate (gpd/ft2) .._ _ _~_- Note: Sand fill (D) calculations assume a Table 83-44-3 in-situ sdl treatment for fecal colifonn of <= 3g inches. Distribution Cell Information [ ~ 90.00{ Dispersal Cell Length Along Contour (ft) = 5.00 Cell Width (ft) 1.OOi Dispersal Ceil Design Loading Rate (gpd/ft2) ~ _ _ __ __1 ~ Influent Wastewater Quality (1 or 2) Are the laterals the highestpoint ___ in the distribution C __Y__ _ Y] P_ res_ sure Disribution Information network? Enter Y or N (c or e) ~ c~ Center or End Manifold 2.50 Lateral Spacing (ft) If N above, enter the elevati_o_n_ (ft) I _ 4' Number of Laterals of the highest point. [~_ ______. 0.125 Orifice Diameter (in) (e.g. 0.25} 2.50 Estimated Orifice Spacing (ft) = 6.25 ft2/orifice 2.00 Forcemain Diameter (in) _ _ C _225 00 Forcemain Length (ft) Does the forcemain drain back? [^_ Y I 81 35~ Pump Tank Elevation (ft) Enter Y or N _._ . 6.50 System Head (ft) x 1.3 36.70 Forcemain Drainback (gal) 16.35 Vertical Lift (ft) 81.25 5x Void Volume (gal) ~" 4.27 Friction Loss (ft) 117.95 Minimum Dose Volume (gal) 27.12 Total Dynamic Head (ft) 29.66 System Demand (gpm) 27."7r' Lateral Diameter Selection in. dia. o tions choice _ 0.75 - - --.. _ _ 1.00 x _ . 1.25 x ~ 1.50 x x 2.00 x _ 3.00 x _ .. - Manifold Diameter Selection in. dia. o tions __ choice _ 1.25 x _ _ 1.50 x __ _x_ _~ 2.00 _ _ _- _ --~ 3.00 I Gallonsllnch Calculator (optional) Treatment Tank Information ~ 750.36 Total Tank Capacity (gal) - - _ _._._ ~ 1000.OOJ~Septic Tank Capacity (gal) ~ _37^00 Total Working Liquid Depth (in) ;Wieser Concrete Manufacturer 20.28 gal/in (enter result in cell B49) Oose Tank Information Effluent Filter Information 750 OOl Dose Tank Capacity (gal) SIM/TECH Filter Manufacturer 20 28 Dose Tank Volume (gal/in) STF - 100 Filter Model Number Wieser Concrete Manufacturer Project: Richard & Brenda Cronk 3 bedroom residential mound -Revision Page 2 of 9 Mound Plan View 1 • 1/10 B • • Observation Pipe • • • ~~' . .:~' K •• ,~5; ::~:~ .. O• .:.:.•.I. .:. .:.:.; ~ .. ..8~. .:.:..• .::. f:.•;:. ~~ ......................................... .~ Q •.. •.•.. ..•.. ~ ~. -T- ~ - L Mound Component Dimensions A 5.00 ft E 12.00 i n B 90.00 ft F 9.50 in D 6.00 l G 0.50 ft 450.00 (ft2) Dispersal Cell Area 5.00 (gpd/ft) Linear Loading Rate H 1.00 ft I 9.82 ft J 4.13 ft -t -f -t _i K 7.63 ft L 105.25 ft W 18.96 ft 1333.93 (ft2) Basal Area Available 9.00 (ft) 1/10 B Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area Finished Grade 99.99 (ft) --- „ , ..~~ f,,,. G • H 1 .firfifiii 2 iiiifiii., j Disper atera I F . ~ : ~ ~ ' •.••.••sai Cell 98.70 (ft) L I ?8.20 (ft)-- ~ : ~ Invert Dispersal Cell .~ ~ ~ ~' ~ ~ t Elevation E. ~ D ' ~ ~: r . 1 ~ 1. •,{. J. ~; i.. i 5 1 ~ !. ~ i i ~ i i ~ ~ i, i, a ~~ ~ ! 1.}., ) 7,, ~, ~ ~'~~ ~~ ~)~ ;;~ 1. Q { { !, { _i ~ i ~ 5 4 ~ 5 5 ! ~ i - i, ~ !.Ki ).Y! 1i ~`-i ~~ ~ {i. ]~ ~ ~ 1 ,t .. {`^{ { ~ ~ ~ ],_!. y., ~ .{ .{ !. ~. ~, .~ ~ .: ..r. 1,: 1. J. i. ~ ~ i. ~ l -~ ~ ~ ~~ ` " - ~ ~ 97.70 (ft) Contour Elevation 10.0 % Site Slope Geotextile Fabric Cover Shading Key ~ a ~ Dispersal Cell See lateral details on [] -y~~ Topsoil Cap c a 1.5 ft • •~.• .;;. ;; Page 4 for number, c ~] '%„"~ Subsoil Cap y o ~ .~•~e ~ ~~ °~ ~'~ :•~~ ~ ~ ~ ~ ~•• size, and spacing of © [~] ASTM C33 Sand 1° • ~~~- ~'° ~ ~ ~'• ~'•~•..•.~ F laterals. Laterals are Tilled Layer ~ ~ 0.5 ft ~' Typical Lateral ::•::• equally spaced from [] [ Aggregate ~ o ~ • ~' ~'•~~ ~ the distribution cell's ~--- A * centerline in the distribution cell (AxB). Project: Richard & Brenda Cronk 3 bedroom residential mound -Revision Page 3 of 9 Center Connection Lateral Layout Daigram Force main connection via tee or cross to manifold at any point. Laterals are identical jf P •=Turn-upwlball valve or IE-X--~IE-x12 I x12~I Laterals&forcemain of PVCSch40 cl ea n outplug per COMM Table 84.30-5 Holes drilled on the bottom of the lateral. Number of Laterals 4 Orifice Diameter 0.125 in Lateral Diameter 1.50 in Orifice Spacing (X) 2.53 ft Lateral Length (P) 44.28 ft Orifices per Lateral 18 Lateral Spacing (S) 2.50 ft Orifice Density 6.25 ftz/orifice Lateral Flow Rate 7.41 gpm Manifold Length 2.50 ft System Flow Rate 29.66 gpm Manifold Diameter 1.50 in Total Dynamic Head 27.12 ft Forr„emain Velocity 3.03 ft/sec Dose Tank Information Locking cover wdh warning label and locking device and sealed watertight Electrical as per NEC 300 and --~ Comm 16.28 WAC ~ 4 in. min. Dis~ect Tank component is properly vented Wieser Concrete Ca aci 750.00 Volume 20.28 Manufacturer Gallons gal/inch ~- A B C D Dimension Inches Gallons A J '~ 18.18 ''y 5" 368.74 B 2.00 40.56 C D Total ~0 ~zr.~~ 97.34 ~ 12.00 243.36 36.98 750.00 3" Bedding under tank. _ _ . _ _ Alarm Manuafacturer LevelA_ rm_ .__. _, _ Alarm Model Number DLV i _ .._ Pump Manufacturer Goulds Pump Model Number 3885 WE05H E- Alternate outlet location Forcemain diameter 2 in. Weep hole or anti- siphon device Pump off elevation (ft) ~ 82.35 ~ Dase tank elevation (ft) ~- 81.35 Pump Must Deliver 29.66 gpm at 2:12 ft TDH .~ ~ ~z Project: Richard & Brenda Cronk 3 bedroom residential mound -Revision Page 4 of 9 Mound System Maintenance and Operation Specifications _~ Service Provider's Name Boldt's Plumbing -Dale Hudson Phone 715-684-3378 _.. __. POWTS Regulator's Name St. Croix County Zoning Phone 715-386-4680 System Flow and Load Parameters Design Flow -Peak 450 gpd Maximum Influent Particle Size 1/8 in Estimated Flow -Average 300 gpd Maximum BOD5 220 mg/L Septic Tank Capacity 1000 gal Maximum TSS 150 mg/L Soil Absorption Component Size 450 ft2 Maximum FOG 30 mg/L Type of Wastewater Domestic Maximum Fecal Coliform >10E4 cfu/100 m Service Frequency Septic and Pump Tank Effluent Filter Pump and Controls Alarm Pressure System Mound Ins ct and/or service once eve 3 ears Should ins ct and clean at least once eve 3 ears Test once eve 3 ears Should test month) Laterals should be flushed and ressure tested eve 1.5 ears Inspect for ponding and seepage once every 3 years Miscellaneous Construction and Materials Standards 1. Observation pines are slotted and materials conform to Table Comm 84.30-1, have a'watertight cap.. and are secured in as shown in the mound component manual. 2. Dispersal cell aggregate conforms to Comm 84.30 (6)(i), Wis. Adm. Code. 3. All gravity and pressure piping materials conform to the requirements in Comm 84, Wis. Adm. Code. 4. Tillage of the basal area is accomplished with a mold board or chisel plow. 5. The mound structure and other disturbed areas will be seeded and mulched to prevent soil erosion and help reduce frost penetration. Lateral Turn-up Detail Finished • .............. .__~ ................ Grade \ ' .~ ~~~. .~.~.•. .•. 6-8" Diameter Lawn .~~ ~ Threaded Cleanout Sprinkler Valve Box _ ~ ' ~ " ~ .' ' ~' ~' ~ Plug or Ball Valve Distribution Lateral Long Sweep 90 or Two 45 Degree Bends Same Diameter as Lateral Project: Richard & Brenda Cronk 3 bedroom residential mound -Revision Page 5 of 9 Mound System Management Plan Pursuant to Comm 83.54, Wis. Adm. Code General This system shall be operated in accordance with Comm 82-84 Wls. Adm. Code, and shall maintained in accordance with its' component manuals [SBD-10691-P (N.01I01) and SSWMP Publication 9.6 (01!81)] and kx~l or state rules pertaining to system maintenance and maintenance reporting. No one should ever enter a septic or pump tank since dangerous gases may be present that could cause death. Septic and pump tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the tanks are no longer used as POWTS components. Septic or pump tank manhole risers, access risers and covers should be inspected for water tightness and soundr~s. Access openings used for service and assessmerrt shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or sut~ject to failure must be replaced. F_xposed 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 cert~ed to service septic tanks under s. 281.48, Slats. The contents of the septic tank shalt 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 rain solids in the tank that may slough off the filter when removed from its enclosure. If the filter is equipped with an alarm, the filter shall be serviced if the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an impending continuous alarm. The septic tank shall have its contents removed when the volume of sludge and scum in the tank exceeds 1/3 the liquid volume of the tank. If the corrtents of the tank are not removed ~ 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 ma~6mum 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 or>ce 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 inspeded and serviced as necessary. Mound and Pressure Distribution System No trees or shrubs should be planted on the mound.TPlantings may be made around the mound's perimeter, and the mound shall lie 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 sir>ce soil compaction may hinder aeration of the infiRrative surface Within the mound and snow compaction in the winter will promote frost penetration. Colo 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 mglL BODS, 150 mg/L TSS, and 30 mg/L FOG for septic tank effluent or 30 mglL BODS, 30 mg/L TSS, 10 mglL FOG, and 104cfu/100 mL for highly treated effluent. Influent flow may not exceed ma~amum design flaw specified in the permit for this installation. The pressure distribution system is provided with a flushing point at the end of each lateral, anf! 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 dogging has occurred and if orifice cloning 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 4evels 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. it 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 lie repaired or replaced in its' present location by increasing basal area if tce leakage occurs or by removing bidogically 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 ~ of this plan for the name and telephone number of your local POWTS regulator and service provider. i" Project: Richard & Brenda Cronk 3 bedroom residential mound -Revision Page 6 of 9 performance Curves METERS FEET 90 25 80 -i- a WE15H Q 70 W 2 20 WE10H H 60 I ~ -1h'E07H- ~- 50 15 WEOSIH 40 10 30 WE03M .~ .~.N. 20 WE03L 5 -" Ol Z 2 '~ ~, H-• "~ , 1 V` ~ / • 5 t ~/~ ~ '~~j ~.~ R u MODEL 3885 SIZE ~/4" Soiids i - - 0 0 _ 0 10 20 40 50 60 70 80 90 100 1110 120 G P M 0 10 20 -^_-- --- 3' rn~/h CAPACITY z9•!a(o .M, w~;hirr+um SK ! !`2{e /'e u,'/2cl . ~GOULDS PUMPS, INC. METERS FEET 12 35 ~- 11 ' 10 30 ~- 25 ~ 8 70 = 20 F ~ O r 15 50 40 10 30 20 5 10 0 0 ° MODEL 3885 0 WE15HH ~ i SIZE 3/4" Solids ~ i ~_ _~ 0 ~ _ _ -t- --t- - ~ 90 _ I I --._- i WE05HH - -,- -~ i -~ --- -I -I ---~--t-, ~~ ~~ ~ vv ou ou ,u tsU yU 100 itU 120 GPP~1 l-__- i ~ - 0 10 -- 20 ---- --~ ,~ /h P 7o~,Q CAPACITY 9 / ~~9b5 Gourds Pumps, Inc. E 1~ n+e . ~ ;, ;;_ IJ2n T/~ of%2"re.6ar-. Assumed ete,~: = 16d ,'. `~ ~ ~ ~ ~ 1 1 ~ ~~ ~ 1 1 1 ~ ~~ ~ / ~ ~ I ~ ~ ~ b`( ~ I I ; ~ ~ ~ ~ ~ i I ~~ ~ / ~ I ~~ ~ ~ ~ ~ /C i n ~~ ~ , ~ ~~` ~ ~~3 ..a , ~ . $~ . ~ ~ ~ ~ ~ ~,o , ~ i ~ ~ ,_.- ~~8 moo. ~~o- _, ,~~` •~1 ~o__.~I, ~~ o. ~:. ., ,~o ~. ~ ~ ~ ~0 i' i ~ ~ ~ i ~~ i' ~'o rcc rrta I iJ . 0 0..o- ~~~~~ o~ ~~ k; hi a ~ '~P`' I aPP''°.X ~a (Y~ ~o~ ~ ~oca~,%tm~+y ~~ ~ ~~ ~o~~'kec~ I of~~iCi~V ~o~ ~~'~ i shed ~>~ ~ ,~ `~--750 8~. PkmF chamber y",4•s. in.3o3~/Pd,~. Slav-c~~•.s~d.e bot~u,+,+ c~!!'/ue~ /.:,e _ o of f~.e. = 8/. 60; P7on ~aSEsa.re ~ Sor'~ ¢ Ja~ua~; an A~~ -~- CXiS~i~-~ ~ncc~%+f ICoE'~, ~- ~~ne ~ j 5 cri /e / ~- 5~0~ //86 z30=e ~tr~e,t, /IE~'!</IEJy, mac. S T . o~F' I, CfOo (000 G~o..>?, L' o rn 6 ,ti,cv~: v~ S.T~P C' . ~ be used as ~ep~'a (~.,~. babel /~-/!,~ ~u; I d;nq Se..v~r Geti.n owE ~lea~td E~, ~ ~cide • ~# --~------ °k.-~e 1~ 3 b c..d ~cb~•-~ ('e5ic~tn~ ~(~~~ ~f '",4sTm 303 p d,C. bur /d ~„ se~~-r' bo be ~r5n/a~eal as ~a~c~l ~'G/' Carr~.n.82.30(~~~4~. O NaS~ re driveway - 900'"` ~ ,, Wisconsin Department of Commerce Division of Safety and 8uitdings 30tL EVALUATION REPORT io-9-o~ 1459 page 1 of 3 AC.E. Soi18 Site Evaluations __- Cain plat plat on paper not less than 8h x 11 inches in sae. Plan must Attadt Coln a site St. Crobc indttde, but not limited to: vertic~ and hor¢ontal reference poirit (BM), direction and Parcel I D perc~rtt slope, scale or dimensions, north arrow, and locatior- and distance to nearest road. . . 002-1009-10-000, tD#5.29.16.65A Please print all /rrtormatyon. D~ Personal information y~ provide may be used for secondary twrposes (Privacy law, s. 15.04 (1) (m)). .~' Z wti Property Owner Property Location Richard ~ Brenda Cronk Govt. Lot NE 1A4 NE 1/4 S S T 29 N R 16 W Properly Ovmer's tJlailing Address Lot # Bkxdc # Subd. Name or CSM# 986 Hwy. B3 City State Zip Code Phone Number City Village / Town Baldwin ~ W! 54002 715-684-3684 Baldwin ~Z 3 Tfi b`tr~et -- / New Construction Use: / Residential / Nturtber ct bedrooms 3 Code derived 50 ~ ~ , ~ GPD Replacement Public or corrxnercisil -Describe: l Ptsrent rnaterial Glacial drift Fkxxl plain `~ , ~~ ~~~~ ne . General comments + ~a ~T O~X and recornmendatians: Mound system elev. = 98.20' at 6" above 97.70' contour. ~~~.,.-- ` r1~tM1"/~~ 2(70 ~, ~' ` , ,: ,~~ Pit Ground Surface elev. 95.95 R. to • 32" '-Irr.-=-~~ Depth hmidrg factor Soil ~ Rai Horizon Depth Dominatt Cdor Redox Description Texture Sbudure Consistence Boundayy Roots •Et~ 1 0-9 10yr3/3 none ail 2fsbk ds as 2f,1m 0.5 0.8 / 2 9-20 10yr4/4 none Ifs 2msbk ds aw 2f,1m 0.5 ;, 0.9 / 3 20-32 7.5yr4/6 none sl 2msbk mfi gw 1f&vf 0.5 / 0.9 / 4 32-68 7.5yr4/6 f2f 7.5yr5/8 Ls/sl 2msbk mfi - 1 f&vf 0.5 / 0.9 a Zmsbk sl. rake co~oe< horizon. / Pit Ground Surface elev. 96.16 ft p,apth to limiting factor 33" in. ~ Apphcsion Rate a# Horizon Death Dominant Color Redoz Description Texture Structure Cot>sistenc~ Boundary RooG~ GP DHN ~~ 1 0-9 10yr3/3 none sii 2fsbk ds as 2f,1m 0.5 / 0.8 ~ 2 9-18 10yr4/4 none sil 2msbk ds aw 2f,1m 0.5 ~ 0.8 ~ 3 18-33 7.5yr4/6 none s! 2msbk mfi gw 1f&vF 0.5 / 0.9 ~ 4 ~ 33-69 7.5yr4/6 f2f7.5yr5/8 slls/sl 2msbk mfi - 1f&vf 0.5 / 0.9 / s a, 40% 1mef~k~- sl. moettt.e~di~ktn, vl~n htximn. ' Effluent #1= BOD ~ 30 < 220 mgll. and TSS ~30 < 150 mglL ~ _ ~~ BODS < 30 ~ artd TSS <.,30 mg/t. James K. Thompson \ 3602 Address A.C.E. Soil 8< Site Evaluations ^ Dot Evaluation Conducted T®lephone Number 340 Paulson Lake Lane, Osceola. !M 0 8/29/01 715-248-7767 PrropertyOwner Rkhard 8~ Brenda Cnonk -_____-_. Paroel ID# 002-1009-10-000. ID#5.29.16.65A Pie 2 of 3 / Pit Ground Surface elev. 95.52 ft. Depth to limiting factor - 30" in. Soil Appkce6on Rate a ~~# ~~ Horizon Depth Domin~t Color Redox Description Texture Structure Consistence Boundary Roots "EtT#1 •Effilf2 1 0-9 10yr3/3 none sil 2fsbk ds as 2f,1 m 0.5 0.8 / 2 9-18 10yr4/4 none sil 2msbk ds aw 2f,1m 0.5 0.8 / 3 18-30 7.5yr4l8 none si 2msbk mfi gw 1 f&vf 0.5 0.9 / 4 - 30-72 7.5yr4/6 f2f7.5yr5/8 ~/sUscl 2msbk mfi - 1f&vf 0.4 ~ 0.6 / Npi4 cxxui~s alf tl tatsorNd rRiorliae of appmearrrsileiy 209b tmsbk Is, t309b 2msbk si 810% 2msbk sd. n~,~~iMttl~~ao4t` +anoowNetnd wltl~ hartaorr. / P~ Ground Surface elev. 100.48 ft. Depth to limiting factor ~ 39° in. ~{ qpp Rate ~9 # ~~ - Horizon De th Dominant Cola Redox Description Texture SWcture Consistence Boundary Roots p •Eff#9 •EtT#2 1 0-9 10yr3/3 none Ifs 2fsbk ds as 2f,1m 0.5 / 0.9 / 2 - 9-20 10yr4/4 none Ifs 2msbk ds aw 2f,1m 0.5 . 0.9 / 3 20-39 7.5yr4/6 none sl 2msbk mfi gw 1f8vf 0.5 0.9/ 4 39-77 7.5yr4l8 f2f 7.5yr518 sl 2msbk mfi - 1 f8vf 0.5 ~ 0.9 / Pit Ground Surface elev. ft. Depth to limiting factor in. ~ gppl~On Rate ~~ # ~~ Horizon Depth Dominant Cda Redox Description Texture Stnnriure Carsistence Boundary Rocrs •Eff#1 •Eft#'1 • Effluent #1= BUD 5> 30 < 220 mglL and TSS >30 < 130 mglL • Effluent #2 = BODE x,30 mglt. and TSS <~0 mgll. 't:}te.~nt of Com~me i5 an equal opQr~unitY seavice provider and eanp![r}+er. If you Hoed assistance to access services or nced met an a fcxmat r oflntact the drrcnt: at 60#-2.6.6-3151. arTi'Y 608-264-~8~?7. I-'a5~re _~ ~ pr-oyxo.~r~ r /; n¢~~ r ~~ ~, ~ .. 1 ~~ 1~ ®~;BZ'„ non ~as~wre 1 1 ~, 1 -~ 1 1 ~ 1 I , -~ ~ 1 ~ I/O aJ ' ~~ I i -z3i,~~' ~ , B`~ ~ , ,~ ~ I ; ; ^ ~ ~ r~ I ~ ~ , ~~ ~ ~ ~ ~ ~ ~, ~ ~ i ~ ~ ,~ ~ ~ ; F ~ ~e ~• ~ /ySy ^ Soil ¢~a~ua~;on A~~ {~ I S ca/e : / = S/0~ ~a. ~ -%. ~ ~~ ~.' '~r ~ ~ ~ ~: ~~~ 2;card Cron K Proper Top of%Z re,6ar. ~~, ~ .~ ,~~>;~~~9 ,~~ ,~~ ii86.230'~~ti'eet, A ~ ~~ /IE~'rn~; dec. S T o~ s ~ , - ~,~ i ~ . -~~ ~~ ~ i - . ..o, ~. ,~ ~~ ~. ~ ' -- ~~~ ~. ~ .' ~ ,~ ~e ~~'v , s °- ~~ , ~ yk'°~`~ ~~~ky\d 1 h~ ~a ~,P`' I ctpp~cX 6 ~a (Y~ (ol ~ ~OCa~SGn ~© ~~ ~\Lke~. i 6~2~I~^9 ~0\ ~' ~~ i S~[d V/ ~h ~h k I 0``~ b ~'~ ~ .. ~I~J' ~v `~ "``-7so Be.Q PkMP cha.n6`r Ela v; ~ ~~ s,'dc bo'C~vir, 0 of ~.e. = 8l. 60; w 1, 600 /GO0 ~c-fl. Co rn b ti,a~;o-, S.T~P C . to 6e u sz-d a s 5e~ 6'c- ba.,,~ . ;~a bP l ~-~GD bu: I d;r~~c Se,w~r' Clean ou..~ ~lendl.d ~o ~rad¢- r eF~'lccan~ ~" r'E.c.~ a~ow-~li~. J-=---- ~~Q ~ 3 b c.drao~, re5~d~n~e r~~~ 'f ",QSTm 3o3~P.d.C. bui Jd ~ n Se.~.aer fo be ,nSa/abed a5 \ ~ara~l PL 1' Ca.n.n. $2.30(I~~~.~. O d /' i /e .,Jay _ 9~, t ~,~ ,zyb'~` st . (~~ . 3 of 3 ,~,, < ~' ' ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND O WNER~S:HIP CERTIFICATION FORM Owner/I3uyer ~i"C ~ ~ r• ~ C r~,~ Mailing Address 9~ C /-,/w y ~ 3 3n ~~u,, ',ti -, , ' j ~DOZ Properly Address /~ ~~ 2S ~~ ~f ~' Q ~ t d~ i ~, (Vcrificatioa required from Planning Department for new construction) City/State ~ c~ ~~cyi'r- , l~ : ~3 ~-.3 °~S) ~ s. a8' 0.~KS~ Parcel Identification Ntunber ~; ~ a - - C 0 9 - ! ' U _ r ~; ~ -.r _ ~C o s. 29. ~ b . (oSA D.S . 29 . I to . to 6 i4~ LEGAL DESCRIPTION Properly Location N~ r/,, ~ y,, Sec. ~ . T Z 9 N-R /~ W, Town of L~~ ~~~.~ i rt Subdivision N~ Lot # Cer[il"ied Sarvey Map # N ~ Volume N ~ .Page # ~~ Warranty Deed # _ ~ 7ti ~ ~ g Volume _ ~~ ~br .Page # ~--- Sow . Spec house (] yes ,~ no Lot lines identifiable ~ yes ^ no SYSTEM-Ii'LAINTENANCE Improper use ~ maratenanceof Yom septic system could rosalt m its prematune~fa$are to handle wastes. Proper maim6eaance consists of pamping oat the septic tank every throe years or soonc~ if needed by a Licensed pamper. What you put into the system can affcd the function of ffie septic tank u a h+~rcmt stage is gre waste disposalsystem. The property owner agrees to sabmit to St. (~oix Zoning Dcpartrneat a amficatron foan, signed by the owner: and by a ~~Pl]~YmanpI~ restrictodplcrarberor a licensedpcunpcr verifying gnat (1) the on-site wastewaterdispoSal system is in proper operating condition andloc (2) after inspection rind pumping.(if necessary). the scptictank is less than 1/3 -full of sludge. Uwe. gre undersigned haver read the above noquinemeats and agnx to maintain the private sewage disposal system with the standards ~ f°~ ~~• ~ ~ by ~ Department of Commence and the Department of Natural Resources; State of Wisconsin,. t,,ert'ification stating that your scpfic systcan has beta maintained must be compldcd and returned to the St. Croix .County Zoning Office within 30 days of the tlrrce year expiration date. ~' ~-a2 ~ , I , q 8 SIGNATURE OF APPLICANT DATE .OWNER CERTIFICATION I ('°`r°) oertifY that all statements on this form erne true to the best of my (our) larowledga I (wc) am (are) the owaer{s) of the PmPuty descxfbed above, by virtue of a warranty decd recorded in .Register of Deeds Office. 4 rn ~f »-~~ (p i~ i g g SIGNATURE OF APPLICANT DATE «««««« Any information that is mis-reprtsentod may result in the sanitary permit bring revoked by the Zoning Department. «««««« «« Include with this application: a stamped warranty deed from the Register of Deeds office a copy of the certified survey map if reference is made in the warranty deed ,dam.. .'t .: !4 . ~Q'"` i 1,a.v~• k`... ,,.w' ~, 3 ~:': `F~:t•,.,y. '~i:~$~ ~~' ~i STATE BAR OF W15CON~~N FORM 2 - 1982 S `O~J•3~ WARRA'VTY DEED DOCU~AENT NO. E» awe ne_Yes,nendall..,__a,/_k1~~'"'~-~- F ~eenQ-+dal~ and Se~ridZ3.~Le""-"''At ~ } a/k1~_Sandra E eenendat t , h+:~*+~„~ and wife conveys and warrants to R chard 8. Croak and ~dri_ L. Croak, husban° ""' °'~ `° ''^~ `~{ nQ as survivorship mare---D;~B-~}y the following described real estate in St C r O i X County, Stan of Wisconsin: See Exhibit A attached hereto and made apart hereof. rtEGIST • R'S 4FFiCE 5T. v R~~iXRCO ~ 'NI JAN ~ 2 199 8:50 A M THIS SPAt.'c RESERVED fOR RECORD+NG DATA NAME AND RETURN ADDRESS ERT a r~-3~Y _0_0_2- ~ 009-10~ -20_ PARCEL IDENTIFICATION NUMBER ~ T s NSFER ~~'"" This _~g nn} .homestead property. 7~ {i~ trot) Exception towamenties: Easements and restrictions of record. Dated this.- 30th day of December _, A.D., 19~_. -- ~ U~Ghts~.~r~'"/ (SEAL) ,~' ."~^ yap 1?~S~aL: ~fl'~ '~ EXHIB~T A I- parcel of la~sd located isS part of the North Bs1t of the 1:ortAeast ~`~ Quarter Oi Section 5, To~cnahip 29 North, Range 16 treat, Torn of ~'' 8sid~in, St. Croix County, ><i6eonain; described ae foiieres: r, Ca:QnBACing at the NortA Quarter corner of acid Section 5; ttience South 02 degr$ea t3 minutes 47 Etcoads $aet a distance of 83.06 feet eieag the vest Tine of aaid Northta~t Quarter= thence North 89 degrees 44 a'.inutes 47 eecoacle Baet a distance of 811.48 feet along the south line o! that parcel of land dtsoribeQ on a deed recorded in Volume ia8, Page 463 in the office of tfie 6t. Croi~c County Register of Deeds to the point of Degi~aaing; thence North 89 dcgree8 44 minutes 47 secondQ Bast a diatauoe of 1384.22 feet along last said line; thence South o2 degrees ~5 minutes ii seconQ6 Baet~a'dietance of 349.93 feet along the meat line of that parcel of load described on a deed recorded in Volume 35s, page 182 in paid office; thence North 89 degreaa 44 minutes 47 seconds Bast a distance of !33.00 leer along the south line of last aaid ~Qsrcel;~ the~~c+e South o4 degrees 35 tciautes ii eecond8 Basta __. _ _ di6tanCe of x56.27 feet 41oag the east line of said 1~ortheaat Quarter; thence North 89 de~zae6 SS minutes S9 aeCOnda >zEat a distance of iel4.a6 le~et along the ~rwth liar of BaiQ North Fa! L of the Zlorthea6t {j~,;erter; thence xorcb 02 degrees 43 tninuteE 47 seconds t~•est a distance of 1196.17 feet to the point o= begina3ng. Containing 46.549 acres. 6ubjEct to right-oi-ray for the torn roaQ along the east line tDeraoi and subject to all ot2uer eaeecr~ents, reatrictiorls ar~8 cev+ezuo7ta of record. I y ~, Y SCDH-282&3 L{VING ROOM 1r-o" 1 '- L=14.90 V=6.52 VAULTED SCOH-3624-2 DINING ROOM 13'-1' X 13'-3' L=20.26 V=8.86 VAULTED ~- , ,~' ~~ `; SCCA-1836-2 ~• t 19 ~, W12, ~~ ~ ~ ~IV3;i ---- 3 WC243C 8i5 i ~„ 0\ 91 ~ DW _ -- BLS36`. ~ VENTHOOD '~ KITCHEN ~~`' _EE3-~4 1 r-1 r x s'-1o" ~ I (~f ' 3 r ~ L=5.21 V=2.28 I y BiSR I ` VAULTED C242aa ~ B21L - - , SK24 L- ~ 624E ~,*, ~ \ ~ ~ - - - - - ~ 0 SHIP LOOSE ~ ~ OAK CAP ~ ~ > j POST 0 W r w I 3 3 ~ r Z -~ ~ ~ j I r - - - - - - - - - - - - ~ ¢a ¢a > > m I I r a w u- U W U o I I Y ~ Y c U =C' =0 ~ I a I I a 2'X2' OC7 VAULTED i ~ I O ~ 'W W u. I ~'0 A ~~~ ~ OZ ~ 2 m I ~ m. ~~ ,oo m Q I >, I LAUNDRY BATH 2 ~ - - - - , 2/6 POCKET i OCTAGON ~~ _ - _ - J> cs~o a "' W BATH 1 B24R ~ z ~ ~ ~Zw x J M 3!0 sY6D 2!8 F1 ~,{,{~(~ h'l a. z_ -- S' G 4 SEASON PORCH 12'-2 X13' " L=11.97 V=5.24 SCHD-6!0X6/8 ~ SCHD-6/0X6/8 MASTER BEDROOM 12'-3" X 13'-3" L=13.08 V=5.72 / V r ti -•F-••-••- ~~~ .. ~ 3, C i ~1ti ~ ~ ~ . , i1 ~~- ate..- .. ~'`~ ~ rf ~ •, .. .: ~ ~ ; ~ 4 Q •f ~ ; ,_, ~ _i..s:. ......................................... .............................. t- r~ ~ ~ ~ ~ ~~ ~ ~ ~ ~ ~~ ~ ~ ~ ~ ~ ~~~ ~ ~~ ~ w~. ~ g~~ ~. ~ ~ ~ ~~ ~ w ~~ ~~ ~ ~ r t.. Department of Commerce INSPECTION. REPORT SAFETY AND BUILDINGS DNISION Field Operations Bureau 13 East Spruce Street Chippewa Falls, WI 54729 www.commerce.state.wi.us Scott McCallum, Governor Brenda J. Blanchard, Secretary Date of Inspection: August 22, 2001 Project Name: Cronk Use:. New Residential Legal Description: NE-NE-5-29-16W Site Number: 5365 Subdivision: Municipality: Town of Baldwin County: St. Croix Plan Transaction Number: 660737 Sanitary Permit Number: Wastewater Flow: 450 gpd Persons Present: No one home Plumber Name and Address: Todd L. Sinz, MP 139462 E5609 708th Ave Menomonie WI 54751-5520 Certified Soil Tester Name and Address: Dale Hudson, CST 220853 _.__. 820 Main St .~°'_~ Baldwin WI 54002 F''f. Owner Name and Adc Richard Cronk 1186 230th St Baldwin WI 5 ,: ; -. ~: _. -. n ~. 9~ `: \ti ~'~ ~. _-~ An onsite inspection and determination was requested by the CST (and former plumber~bf.`rec' ~ Qale Hudson regarding the suitability of a proposed mound system area. The area was originally~+est~d_by-~ Hudson in 1997 and found to be suitable for a mound. However, site modification (i.e. home and pole shed construction) has partially obstructed the mound site, and the county inspector has concerns about surface water drainage from the site. I too have concerns about surface water drainage from the proposed mound area. It appears that drainage is toward the mound area from three directions. Runoff from the roof of the shed, driveways to the shed and to the house will contribute water to this area after rainfall events and snow melt, there is a shallow bowl shaped depression that may concentrate treated wastewater to one part of the mound's basal area. Basically, the proposed mound area is more of a water collecting than shedding area. The mound component manual requires surface waters to be diverted around the mound and may be impossible without extensive filling or grading. In addition, parts of the basal area have across-slope of 2-3 % whereas the maximum cross-slope is supposed to be less than or equal to 1 %. It is my opinion that the area originally proposed for the mound should no longer be considered suitable. The factors previously discussed not only violate component manual requirements but are such that mound treatment and dispersal performance would be jeopardized. I recommend the reevaluation of a different area for the mound. Area wise, there may be a suitable area north of the current site and this should be considered a prime location to site a mound system. A certified soil tester should evaluate this area for a mound or at-grade system. If there are any questions regarding this report, please contact me. er G. Ja ky astewater Specialist Ljansky@commerce.state.wi.us E-mail 715/726-2549 Fax 715/726-2544 Voice cc: ~ounty Plumber CST ~ Owner ^ Other ~T BOLDTS PLBG`& HTG' Fax :715-584-3144 Aug 15 '01 07:37 P01 ~t ~ o ,S ~~~~~ i~ V LL 1 PLOMe1N0 8 NEATINO INC. ''Serving You For 40 Yeers" 820 Meln Strout Bsldwln, WI 540p2 (715) 684-3378 Fax (715) 684-3144 ~sx Transmissiol~ Date: ~-~5- O/ Company: -~ Cfp r Cp w~ Zorn , n, Y, V Phone: ~~~- ~~~ ~' ~~~~ ,r V From: .~ A ~~ fi~l ~ ~Sor~ Parr 7~5-.3~~-~~~ Including this page, there are ~ pages in this transfer MESSAC3E: _~ 1 ~~a ~-..- e ~~ c cn. I o u,r ~ fe va T ' g ~ o r- /o OCCnY~ R f -/ v ~ C 1'~'latlr~,~p~ ~i G 1 ~! i a- l ~ ~ ~. ~~- A ~~ ~~ ~~ ~ .~ }. 8~a ~/ 01 l~~ax Jam, ~- ~{ _~,o~a t~'-- _~a~~~ _ ~- ,~ ~ GLr~.t _ ~C ~l~ ~K~b~~RYL^9- I ~Q O ~-a~1ut. ~Qo P-toy~a ,. ~R ~- ~ Stf~R.~Q,I- ~~it5~ ~ BOLDTS PLBG &'HTG ' ~• -~ ~ ~~ ~, ~ ~w /~r~CsT ~zo8~3 B~~Y~Q~ Fax ~ 715-684-3144 Aug 15 ' 01 07 37 P02 ~.~ntr~ ~-'c /ta r~ o~ C ~, o ,~~ No . ~ ,~~ o~ sr, ~y_ `/O ~ Sca fe ,~ 9~- ~ 30 ~ P`~'6 "" r ~ rF ~, ~ ~~o~ Es: ~ ~a ,-,- '° ~° ~ ,b S1~eo~ 5~ fo e~ -ti •} Qio~ ~ L 3q G r¢~e ~ 7 I ~ 5he d i ~, give. a' ;Area ~,ktsTZNG ,~~~ coupe ~ ~;Yc ~ . +o~,gy ' s ~ ~ a ~ ~. s G 1459 Wisconsin Department of Commerce SOIL EVALUATION REPORT p~ t_ ~ _ 3 Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code AC.E. Sal & Site Evaluations County Attach complete site plan on paper not less than 8'/: x 11 inches in size. Plan must _ St._Croix___ ____ _ _ __ __ include, but not limited to: vertical and horizontal reference point (BM), direction and parcel I.D. percent slope, scale a dimemsions, north arrow, and location and distance to nearest road. 002-1009-10-000, ID#5.29.16.65A Please prfnt'all information. Revierued By -- Date -----_ Personal informatbn you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). i Property Owner Properly Location Richard & Brenda Cronk Govt. Lot __N_E 1/4 NE 1/4 S_ 5 T 29 N R 16 W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# 986 Hwy. 63 __- ~- ---~-- ------------------------- --------- ----- - ------- - City State Zip Code Phone Number ~ City _~ Village / Tarn Nearest Road Baldwin ~ W I 54002 715-684-3684 Baldwin 1186 230Th Street New Construction Use: ya Residential / Number of bedrooms 3 _ Code derived design flow rate 450 GPD Replacement _ ~ Public or cornrnercial -Describe: _ _ _- -- -~--_--- .-_-- - _- Parent material Glacial drift ____ _ _ _______ `___ __ Flood plain elevation, 'rf applic~le -__ _ na _____ General comments and recorrxnendations: Mound system elev. = 98.20' at 6" above 97.70' contour. ^ 'Burin g ~ Boring # 32° i Ground Surface elev. 95.95 __ ft. /i Pit Depth to - n. limiting factor _~ Soil Application Rate Horizon i Depth Dominant Color ' Redox Description Texture Structure Consistence Boundary Roots E~GP DIft'E~ ._ 1 0-9 ~ 10yr3/3 ~, none sil I 2fsbk ds as - 2f,1m , - 0.5 0.8 - ----- --t- -- - - --- 7 - -- --- --- - , 2 ' 9-20 10yr4/4 none Ifs j 2msbk ds aw 2f,1m ~ 0.5 0.9 _ - -~- - ~ 3 j 20-32 i - -- - - 7.5yr4/6 ~ none _ -t sl -- ---- 2msbk --- - mfi -~ r--- ! gw ------ j 1f&vf ----- -- i 0.5 _ _ --- 0.9 4 328 7.5yr4/6 f2f 7.5yr5/8 is/sl 2msbk mfi - 1 f8wf ~ 0.5 0.9 -- -~ - -- --- - - ; -r-- -- -- - - ---- _ ~ --r ------ -- ---- --- --~- __ i _ _ _ ~ - -- _ H#4 consists of a unsorted mixtu~apprmdmately 40 0 lmsbk Is & 60% 2msbk sl. Loading rate retests most restrictive coridifion encountered within horizon. ~~ # __-1 Boring - /'! Pft Ground Surface elev. 96.16 ___ ft. Depth to limiting factor _- 33° in. Soil Application Rs Horizon i Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots '~,___ _ _GPDIft' __ 'Eft#1 'Eftdl 1 ~ 0-9 10yr313 ~' none sil 2fsbk ds as 2f,1m ~ 0.5 0.8 --~ - - 2 9-18 10yr4/4 none sil 2msbk ds aw 2f,1m ' 0.5 0.8 - ---- -T--- --- -- -- - --- ---- --- ---- -- - - - - - ---- 3 i 18-33 7.5yr4/6 ', none sl 2msbk mfi gw 1f8wf 0.5 0.9 --r--- ---r-- 4 ! 33-69 7.5yr4/6 f2f7.5yr5/8 s/Is/sl 2msbk mfi - 1f8vf 0.5 0.9 --- _--- - -------------- - ----- --, -- ----- - -- ---- I -- _. _ __ .- -- --- --~-- -- -- 1 ---f- consists of-a unsorted mixture of approximat s, 40%1 msbk Is & 30%2msbk sl. Loading rate reflects most restnctiwe corid'ition I-i#4 en Mered within horizon. ' Effluent #1 = BOD ~ 30 <_ 220 mg/L and TSS 30 < 150 mg/L uent = BOD < 30 mg/L and TSS <~0 mg/L CST Name (Please Print) S nature: CST Number James K. Thompson 3602 Address AC.E. Sal 8 Site Evaluations Dat Evaluation Conducted Telephone Number 340 Paulson Lake Lane. Osceaa, WI 54 0 8/29/01 715-248-7767 prey p~ Richard .& .Brenda_ Cronk __ _ _ ___ __ p~ lp # 002-1009-10-000, ID#5.29.16.65A Page __2 of 3 J ~~ Bonng # /J Pit Ground Surface elev. 95.52 ___ ft. Depth to limiting factor 30" in. Sal Application Rate - Horizon Depth Dominant Color ~ Redox Description Texture Structure Consistence Boundary Roots _ GPDIft: __ ` •Eff#1 'Eff#2 1 00=9 L 10yr3/3 none s~ 2fsbk -------- ds - ------ as ----- 2f,1m ---- 0.5 I 0.8 ------ _--- - - --- 2 I 9-18 - --- 10yr4/4 --- -- ~ none _---- - sil - 2msbk ds aw 2f,1m 1 0.5 j 0.8 ---~ --- 3 ; 18-30 j 7.5yr4/8 ~ none sl 2msbk mfi gw 1f&vf 0.5 I 0.9 ~ 4 ~ 30-72 7.5yr4/6 ! f2f 7.5yr5/8 Is/sUscl 2msbk mfi - 1f&vf 0.6 0.4 ___ - i--- ~ - -- --- - --- --- --J ------ _ _ ~ _..~---- I ~ ~ ~ i l _ _ _ _ ~ ---- - -- - F##4 consists of a unsorted mixture of approximately 20% 1 msbk Is, 609'0 2msbk sl & 10% 2msbk scl. Loading rate reflects most restrictive condition encountered within horizon. ~~ # __J Boring Depth to limiting factor 39" in 48 ft 100 . . . Sal Application Rate hPit Ground Surface elev. _ -- Horizon Depth Dominant Caor Redox Description Texture Structure Consistence Boundary Roots GPDItt?-____ I ~ 'Eff#1 'Eff#2 1 0-9 10yr3/3 none Ifs 2fsbk ds as _-- 2f,1 m 0.5 0.9 2 ~ 9-20 10yr4/4 none Ifs 2msbk aw ds ~ 2f,1m 0.5 0.9 ------~----- ~ ~~ - -- --- -----r-- --- r-- 3 ~ 20-39 I'~ 7.5yr4/8 - --- ~ ---- none sl 2msbk mfi ~ gw _.,__ - _- 1f&vf --- ---_ 0.5 ~, 0.9 --- - r- ------ 7.5 r4/6 4 39-77 Y f2f 7.5 r5/8 y sl 2msbk . mfi .. a 1f&vf J 0.9 0.5 ~ ----- _- ----------- ------ -- ---- - _ I ~ rt----{- j ------f-- ----.~ __---- - i T i Boring # _.{ Boring Depth to limiting factor in ft . . Sal Application Rate J Pit Ground Surface elev. --- - Hor¢on Depth Dominant Color Redox Description Texture Structure Consistence ; Boundary Roots SPDIfi= -_ 'Eff#1 •Eff#2 I --- -- i ~- - --- -- '; i ~ ~ --- 1 ~ ~ ',~ i ~ ~ ' -- --+ ------- I -- - ---- ---- - -- --- --- -- --'------- ---- -- --- -- r- -__- - I ' ; ~ ---- ---- I~ ------1 ! - --- - - --- --- - ~ ' Effluent #1 = BOD 5> 30 < 220 mglL and TSS >30 < 150 rnglL ' Effluent #2 =BODE <30 mglL and TSS <~30 mg/L The I~psutnuerrt of Commence is an equal opportunity service provider and employer. If you need a~istance to access services or need material in an alternate format, t>lease contact the deprutrrrueatat:608-266-3}S} orTFY 608-264-8777. h'a5~ re ., >L Z.~ 1 ~ ;8 ~ - 1 ~ 1 1 ,~ i ~~~ ~ t ~ ~ fp I - i ~ V/ I I t / ~ / • / j /. ~ / / ~ ~ I ' '03 i , ~~ ~ , ..~ , i ..o , - - ~ , -~' ,' ,' ;~ - a . ~. ; ~ ~. ~ ~ , , Assumed ele,/: = /~D.60 ._ - ~~ ,. ,. ,~ s , ~ ~ ~_.. i i ~ ~ , ~, ~~~ i~ ~ ~ r ~~~ i ~ o ~ S ~ I _ ~' ~ _ , V Quo- I`~~cS~ o< <`~ k; ti~`~~ ~~~~\d Pa ~6 ~o( o ~a b\L ~~` ~'~`~o~` k9' Vic'` ,r c ~ ~~ha~~h °~ • ~ ;~" ~ ~' ~ ~_ Pion ~aSE~-re Ke ~. ~ iys9 ^ 5oil e ~a~ua4; on ~i~ • E"le /a,~ oY, S G0. ~e ~ ~ ,= ~~ 2;~~ c-~~, K p~o~-~Y //86 ~,30~ ~tree~, /IE~'tnE7y Sec, S T o¢' Qala/c.~~ ~, S£.G~o~k~y c.~/. ~a~~ ~ eF a,Cis~+ sl,~ ~ I i 7st~ S o.R . ' p k,„ P cha.n 6 cr E/aV~ a~ inSi~e bo'C~Hrr of P.e. = 8/. 60; I, C>ao /goo ~. Co ~, b ~,~: ~, S; r.~P ~ • _ ~ 6e li5~-~(as Sep~+'c. ~a,,,~. ~a-bel r4 ~GD bu; Id~n4 Se,~tr Clean ou~ ~ /eQ/td ~ ~ r'c>rde. J------ °~,,~~ ll 3 b c..d rw ~-, ~e5~dan~e ~'` ~f '".4sTm 3o3V p, d.C. ~ n Sn/a>tcol a S \ gaia~t PL r' Co.».n.82.30(~~~0~. O ~(~; ~ec,.>ay - 900 ~-` ~ .~~,~_st. ~~• 303 Safety and Buildings Division County ~ ~ 201 W. Washington Ave., P.O. Box 7162 ~>~ ~D 1 ~ (SCO~S,n Madison, WI 53707 - 7162 Site Ad dr ess Department of Commerce g~ -- otP Z30 , Sanitary Permit Application Sanitary PermitGNu beta ~ o ~~ ` In accord with Comm 83.21, Wis. Adm. Code, personal information you provide Ch k if R i i ma be used for second ses Privac Law, s15.04 1)(m ec ev s on I. Agplication Information -Please Print A31 Information State Plan I.D. Number yy,r.,g t 0 O Prope Owner's Name Parcel Number i~ o l~ Ooh /~9-~0 -Gba Property Owner's Mailing Ad ess Property Location pp ~ ` ~~ 0~ ~D •~3[ 'e I ~ ~'kI~I~',4; S J'f T v~g N, R City, State Zip Code Phone Number Lo umber Block Number Subdivision Name CSM Number GtJ~ r ~ft~2- f.~ (v8 -3~~' II. Type of Building (check all that apply) ' ^Ciry ,,~ ^ ,% ~1 or 2 Family Dwelling -Number of Bedrooms f~~VV' ^Villa e ^ Public/Commercial -Describe Use g ~ / 1 ownship {t )/V ^ State Owne n ~M/ ~ ~'S t ' 1 ~ ~ ~ Barest Road 22RR (' ~ p x ~~~~~ `~-~ o c.dJ III. Type of ermit: (Check only one box on e A (mum ring scheme~~for internal use). Complete line B if applicable) `~'' 1~New 2 ^ Replacement System 3 ^ Replacement 6 ~°Addition to For County ase S stem Tank Onl EXistin S stem B• Check if Sanitary Permit Previously Issued Permit Number ~ Date Issued ~ S~F 19 ~ ~-3 -o,~ IV. Type of Permit: (Check all that apply)(numbering scheme is f` internal use) ~1---(CA 44 ^ Non -Pressurized In-Ground 2y~Mound y y~''r 47 and Filter 50 ^ Constructed Wetland ~ 22 ^ Pressurized In-Ground 41 ^ Holding Tank~t' 48 ^ le Pass 51 ^ Drip Line 45 ^ At-Grade 46 ^ Aerobic Treatment Unit 49 ^ Rec lacing 30 ^ Other V. Dis ersal/Treatment Area Informati on: Design Flow (gpd) Dispersal Area Dispersal;>Area Soil Application Percolation Rate System Elevation Final Grade Required Proposed Rate(Gals./Days/Sq. (Min./Inch) Eeevation ~,~v ~~s~ ;mss ~ ~ - /" ~~ Z ~a/ 70 VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic Gallons aCiallons of Tanks Concrete Constructed Glass New Existing ~' Tanks Tanks Septic ~ Q~ ~_~rr° ~D / .rte ~/ Dosing Chamber .~ VII. Responsibility Statement- ,the untie fined, r ibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) Pl is a MP/MPRS Number Business Phone Number QED ~~ ~/v 9 ~ ~ 7/S"- ~~5= ~G Plumber's Address (Street, City rate, C e) VIII. Coun /De artment se Onl Approved ^ Disappro d Sanitary Permit Fee (includes Groundwater Date Issued Issuing Agent Sigma a (No Stamps) Surcharge Fee ^ Owner Given Initial Adverse . ~ ~~r - Determination wtr IX. Conditions of Approval/Reasons for Disapproval (~Z"2o' i~S3Q ~ (~ ~/" ~ ~Ql ,ta '~° ~ '~1 Qd ~~e ~ S ~ . p, x M - c t .~ , ~ ~ ~`'°~` 1dtx~ NI IV ~ - - ~n Attach complete plans (to the County only) for the system on per not less than S 2 x 11 Inches In size SBD-6398 (R. OS/Ol) ~~~~ ~~/ ,' ~. ~l ~ ~ ~scons~n Department of Commerce Safety and Buildings 4003 N KINNEY COULEE RD LA CROSSE WI 54601-1831 TDD #: (608) 264-8777 www.commerce.state.wi.us/sb www.wisconsin.gov Scott McCallum, Governor Brenda J. Blanchard, Secretary July 13, 2001 CUST ID bio.139462 TODD L SINZ E5609 708TH A MENOMONIE WI 751-5520 CONDITIONAL APPR~AL PLAN APPROVAL EXP S: 07/13/2003 SITE: Richard Cronk - 1186 230`" eet St. Croix County, Town of Bal NEl/4, NE1/4, S5, T29N, R16W FOR: Description: Three Bedroom Mound stem Object Type: POWT System Regulat Object ID N ATTN.• POWT'S ZONING OFFICE ` ST CROIX CO Y SPIA 1101 CARMIC EL RD HUDSON WI 4016 ransaction ID No. 660737 Site ID No. 5365 Please refer to both identification numbers, above, in all correspondence with the agency. 1594 The submittal described above has been review for and Wisconsin Statutes. The submittal has been t be met during construction or installation and prior • This system is to be constructed and located "Mound Component Manual for Private On: and the "Pressure Distribution Component ly 2.0" SBD-10706-P (N.O1/O1). e with applicable Wisconsin Administrative Codes ,LY APPROVED. The following conditions shall or use: with the enclosed approved plans and with the er Systems VERSION 2.0" SBD-10691-P (N.O1/O1) vate Onsite Wastewater Treatment Systems VERSION In the event this soil absorption syste r any of its compon t parts malfunctions so as to create a health hazard, the property owner must foll the contingency plan a described in the approved plans. The owner must insure that the operation, ma' enance and monitoring duti as described in section VIII of the mound manual, and section VI of the pre ure distribution component ma al are complied with. A copy of this letter including instructions and inf oration regarding proper use an aintenance of the system must be given to the owner and eac ubsequent owner upon completion o he project. • A state approved effluent ter is required. Maintenance information must a given to the owner of the tank explaining that periodic aping of the filter is required. Access to the filte or cleaning must be provided per Comm 84 product pproval conditions. • A Sanitary Permit m t be obtained from the county where this project is located accordance with the requirements of Se 145.135 and 145.19, Wis. Stats. • Inspection of th~rivate sewage system installation is required. Arrangements for insp tion shall be made with the designated c unty official in accordance with the provisions of Sec. 145.20(2)(d), . Stats. • Comm 83.52(2) A POWTS that is not maintained in accordance with the approved manag ent plan or as required under s. Comm 83.54(4) shall be considered a human health hazard. • Comm 83.52(3) The activities relating to evaluation and monitoring mechanical POWTS components after the initial installation of the POWTS in accordance with an approved management plan shall be conducted by a person who holds a registration issued by the department as a registered POWTS maintainer. / S~it~ `rte t, TODD L SINZ Page 2 7/13/01 • The owner is responsible for submitting a maintenance verification report acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. A copy of the approved plans, specifications and this letter shall be on-site during construction an pen to inspection by authorized representatives of the Department, which may include local inspector All permits required by the state or the local municipality shall be obtained prior to commencement of construction/installation/operation. , In granting this ap oval the Division of Safety & Buildings reserves the right to requ' changes or additions should conditions arise them necessary for code compliance. As per state stats 101 (2), nothing in this review shall relieve the design of the responsibility for designing a safe building, strut e, or component. Inquiries concerning this rrespondence may be made to me at the telephone umber listed below, or at the address on this letterhead. Sincerely, - . Gerard M. Swim POWTS Plan Reviewer -Integrated Servi~ 608-789-7892 Mon -Fri 7:15 AM to 4:30 j swim@commerce.state.wi.us FEE REQUIRED $ 175.00 FEE RECEIVED $ 175.00 BALANCE DUE $ 0.00 WSMART code: 7633 cc: Richard Cronk / .:._ y~ ~i ~ J ~ Richard & Brenda Cronk -Mound Transaction # Construction Materials and Techniq All materials must comply with Comm 84 and be installed in ;ation~Construction methods must comply with the follcyl! rdance with manufacturer's Component Manuals: Mound, SBD-10691-P 1 /O l ) Pressure Distribution, SBD-10 6-P (Ol/O1) Location: E 1/4, NE 1/4, Sec. 5, 29 N, R 16 W T :Baldwin Co : St. Croix Date: Owner: Address: Plumber: Signature: License # Attachments: July 5, 2 1 Richard & Br da Cronk 986 HW Baldwi I 5400 To inz P 139462 6748-Plan Approval Application SBD-8330 page l: cover 2: design cri ria & calculations 3: plot pl 4: system ross section 5: plan vi ,lateral detail 6: pump anlc exit detail 7: pump curve 8: system management v ~~ G ~ ~~ G ~°o ~~ O~~ • P.O.W.T.S. Conditionally APPROVED DEPARTMENT Of COMMERCE ~~VISIOI~~fnr~A~/ 0 WILDING: SEE page 1 of 8 ~~ r r FROM :CERTIFIED SOIL TESTING FAX N0. 715 233 0398 Jul. 13 2001 05:36AM P2 •, G~o~~ ~~ Design Criteria ~`~ Residential Wastewater Contaminant Load; 30 m~I, < BOD, < 220 mg/L Anticipated septic tank effluent 30 mg/L < TSS < 1 SOmg/L Fecal Coliform > 10,000 cfi~/100 mL. Fats, oils, grease ~ 30 mg/)r. 3 Bedrooms x I00 gal/bedroom/day x I.5 ~~ gallons/day hydraulic load In situ designed loading race Depth to estimated high ground water Depth to bedrock Cross Slope at SySte Force main length Manifvld/header length Drain-back Lateral length ~- @ Lateral elevation Lateral hole size ~~S ~- in. @ 3'S holesllateral Lateral volume Total lateral discharge rate network pressure compensation losses >=levation difference friction loss "i"ota! dynamic head Pump/sip~on Z`S gpm @ `` Manufacturer ~ ° "` DoCs~e volume,,,~I~ c (\~ L.t1U$t~ion tank ~~ wr'!Cw 1 Septic tank Effluent filter ~ Measurement pump and off Height alarm from ank bottom Reserve capacity sa-s.calcs.res Design Calculations ~' ~ ~ Z gallons/sq. ft. per day '~ ~ ~ in. ~ $ ~' in. lit ~. t ft- of ~ j t, in. ~ ~ ft. of in. ~; b gallon t o 9.1~ f[. 0 ~ in. `~ `~-~ ft bottom of later ~ g holes total ~ ~-$ ~ gallons 2a L allons/minute .~ i S•~ z. i 2 o.ca ~b ~~ uaro - V .c, Co ~~ ,, L : M,. sew. `.s w~L.: w1C x T' a ~~~~~~ al Spacing g 3' y~ ~_ head ft. ft. ft. @ ? ~ gallons/minute ft. ft. of head Model # ~ S Z gallons ~ gallons ~ • ~ in. z ~ ' ~ in. ~Z'~'t gallons Page Z of ~ FROM ~ CERTIFIED SOIL TESTING FAX N0. 715 233 0398 Jul. 13 2001 05:36AM P3 ., ~, . t~K 0.~~ ~G~a 0. Oy e T .~ Cr.4`,}~ ~ 63 s ~~ c~c ' ;4 ~ ~i~~Sw~Y~i~ ~a Q~ `C~ .. ~ ~e µ M I r s~ - -~ ~'Y Mme' A~~.. w ~i~T P•.pr~ 3bd~M- rc s: ae~o Ca ~.~~ ~r aZ r So,'I QisrrYa~+'~ P.~ ~dl,;T~•~ !'c~ct/~~u. -- . - ~..Q ~co.~, 4 ~• z ,.,~,~or. a, ~;~.ri~ "a~.c . . .~~Q/• s ~/.8y r e { ~ ``~Z,J" VC So.G. Q" ... ._ ~Yt~ (M~P1M f~ ~b~l .l ~ ~L,y hM ~. wc.\ r ~aS~ur~. ,ap~~posjrd wdt 7"'°'` dn-ut a J~ww~ 3 a~ ~ 3 FROM CERTIFIED SOIL TESTING FAX N0. 715 233 0398 .; J "S ~s. ~M C. ~ v s 1 ~ e. ¢. }- ~ oh nn Q4.'~ ~a Y a..,, . ~~ 44.x.. Jul. 13 2001 05:37AM P4 ~v O r. +~ ----'-~ . .. lp o `` w, ~y~~y s. w, ~vt ~.~ R (s'' ~t~ O ~ ~~o O vC ~co:l ~~ ° ~.~ a..~~ w~ q 8 ~ Lr 0~4'. , ~r o~~ ~4~ FROh~,: CERTIFIED SOIL TESTING FAX N0. 715 233 0398 r 1 `.~ r. V ; ~ w. f~' 1$ ` ----~1 Jul. 13 2001 05:37AM P5 C w ~ ,~ 1~ ~•3 - ~ --- K •~ ' 1~z ~' ~~~.a, 3~1 d~-~• \.F ab• .S~i ~~.,w~.: -..~s t ~l . 0.., 0.9•~ p • ~..~ ,.. .~. ` ,; .. . •~! ~~, ~.l f-'C Ow 1 ,v~ cwK ea.r.~Qw• ~o~~o~... t: aJ~ ? ~•~ N 0. N»~ (Z.Qb) ~~ ~ - ~ ~ ~ o~ ~ .~ FROM,,: CERTIFIED SOIL TESTING .~.,_ .. ~" CY OM 1~- Cr r..~ la.,.• ~~ ,,~ 4° PIPE s` n p uD+STuABED SD~L, z4u s.~. r~a~uc>~ - •-- ~ - FAX N0. 715 233 0398 l: X ~ ~ ,J Q.TA~ 4 _LOtK++JG~COVER ~'~ ©v1cK o+~~a-~tcT---~ ,~,- ~pWKwtO SIC~7 3Z}>K'f J t. ~tP'G .*W CC.'fl P7~ CL~v. ~ b• ~- LFV_ Q a c D ~FL~ Jul. 13 2001 05:38AM P6 ,~ tt~ I, ~e2~r M^IN W~1-T-1ERfROJK ~.jUN(,T1vN 8aot ~~ .. ZZ • o A~4w"r,lS ~ °" ~~ ~ ~•, o~ Q ~t.~" r ~'w~:p Nl~L ~L° ~ON(,RET'~ (yLO ~I~ i ~' n,,~~ +.1+ ~ a" 4~ V~NT'~ -~ ~$.s ` 4" P~ ti~~ 4p 3' o•+•ro tr•~c~:.tw.a (3RJVN4 5EPr1C f _ SPECIFI~CAY1b1JS GoSC - TA1,1..5 MA~IU>'ACTURCR: ~~ ~w~ I3lJMBER r poscS: ~' ~ PCK DAs TA-1K S1ZC: ~ ~~ ~ ~ `GA>r4.0U5 - .OC)SC VO ME AL~IRM ~'tA7.lUi,4C7'URCR: S L'~4t.YYV. ii~1CL1J011JG bAGKFLDW: ~~ G~t.t.ONS rlO~cL 1JUJh~rK: CAPACITIES: A wCHCS oK C,r-~~0+:5 ~w1TGH TJP£: ~. ...~~ 8 = Z 1>~iGHCS OA Z-G(.~ GA:40ti5 Pl1Mp MAUUFACTUPtca: ~p ~ ~ Q~ (' r `"' ~ ~ 11.1 C M [ S 01l ~~, G~ ~. l O e.• 5 ,)y- MOO£L iv1UMD `r Z"' D~ ~ tO 1n1~nE5 GR ~~Z"g ~AIIG-J~ SW17GN 7 C; ~~""`Y " IJOTE: PUMD AUD Aar+ ARC TO 9C M11.11MUM OSSCMAItGC RATC ~' 1 G+'M INSrALLf:O SE PAaATC C1KC:.1''~ VCfLTtCAC 01-FERC11Cf CCTWCCU PULP Oft A~70 OISYRt~UTIOLJ PIPE.. 13~o FELT ~-- ra1~11M1UM +~ETWOR-C SUPPLY PREtSL3K''rr,C//~ ~ ~ ~ ~ 3<~ _ FE.r7 ~ oZ + [9ti fCE7 OF iORCC !'Mi1J X 4~1 f/i00-£FRIGTIO+J fALTOII. Z ~ Fr~T ~ ~'t w ~,,,~ - ~,~ o~ ~ ~ •- TOTAL DyUA<MIC. MiEAb ~ ~._ FC.£T „ '` 2 `I 1+,17TRUAL OIMCU6101sC oI 7Ati.,tK: LE-1GTH ~ ~~ ;WiDTFI ~ ~ ~ L1QUtD pCpT 1-i a_. K _ 5~ FROM: CERTIFIED SOIL TESTING `; HkA{) C/1PRClTY CURVE r ~,outt ~ 5z/~ fi~ ~~ ~ +~ CC 157 1~ <a ly? ~ 30 -._. 8 ' ~ 10~ t 1 C3 „ c FAX N0. 715 233 0398 20 ao eo eo la U,~ r yt~s u:tr< Q 9D t 60 2AU 320 FLOW pER IA1N1fTC CONSULT FACTORY FOR SPECIAL APPLICATIONS • Tm+ed doelny panels aval~able, • Eleetlilxl altimalcrs, Ior duplex rysLsms, ere aveirable turd supptited wrT~t en alarm, • variable I~vel control switches are aYaNeble for Controlling angle phase syslertts: • Double Og9ybadc Yarisbly lsve- Host swltehes arp avatlab-a Ivr vadatyle level bn~ and shoR cycle pontrola. Sealed Qwlk 8px available /or txrldovrinstaNa6ons. See FM14Z0. • Over 130"F• {ys•C.) aPet'sa,l quoGlrfOn required. 1511157 5ertal ~..--•--._ RS 1 -Med+t ~ Yold-!4, 6aiad~ ~.r _ DrrpMs - j i ~t sis s tom- e.s 1 _ 7nrA SN152 it; „ ~ ~ 0.5 IneJuded ZvtS , Erb 230 t N4rt d.3 ~ ?m7 _ BEi53 Zia t _ AuW ~, - rid Z a 3 •. k,?3 1'Ib a ~ 67pn 1 2 a 3 ' eenS7 +u + Aso s0.5 1x4rdod Y or zto ~ E+53 nwr 5.3 t 7 _ ( 9Eti3 230 1 FWtO 5. Inrludtd ~ 3 . a cav o IUI mct3liatWn Or taNMrOls. At04WOP Ave End Dole 31e tf04e Oy a t;uWM~ frt:entad elOCltiCliti. AI[ ttet:Klal and yard'/ ta>rlp be t000hid ItKludirtptbe ptD~t nt;r>: NYtioMt t]aeY1c CaM {MCC) rind tfn Ocou iaNdY and MgNG ACL (tliHA)r Jul. 13 2001 05:38AM P7 I(I =.t ~'"1:~.M~C: Hf4,;`C1~G'A;:II'f ,~•, rarnr.;TE rr .lrrlr arvi; :;:v;~,lthl~l. .... t, rYl `+` I 1~.1 CqC) lrlrlax is+,r• literc 5:41 l~la• :+~ G.1 •r4 - iii' 13i rJ ' ~)c M vAlvt`; 5~.~ - (~ t.brn) ~".V I t !t.i ~:rl e,.aa J ~-n';~ s 's; /J3 }; :. 1 ~~•1 ._, ,s ~ _ (_,~ i i 1- Siggfe p'~gyybeck "a'vt'tu Yril 111 awilth. Rekr to FtJa4T1. 2- sti6 FM0T12 ter caner! ntOdd Or FJt 3, Vtiridl>le level control twWltch 10.4725 4< {a) Host system. .._ ~ ~ ~: t!is ~~ GUIDE Or doude D1D911DatJt wryWe level ibst rl Akerrrator E-pak. to ~ rpntrol acGraior, spoc~y d:rde>< 13? RE5ERVE PpWERED DESIGN Fvr unysual conditions a retit6rvs eatery fader ie v+~gineered Into the design of every ZaeUer pu - - .. ~IG61L T~ P.V. dCOf tistl Levuvda. KY 402SIf•036T lranrAadWCts Or. - ~ ° • ~,~ ~ sr w~a~so~ s~o2;Rf.~!'l~r ,..~ /939+ (6021 n&77"Jr • 1 f~rU D7JMPUl1P ~rr /~llMr~ .! ~~ t>~ ~1,/I`J'P ~CL7'. vox camel TrsJ6~a ~.. .. -~~... ~~ O CGAyri8h2 2:000 Zgeller Co. NI tushts reserved. ~ ~ Ch l.'` v ~ ~ 4 i •~ ~, ~ . System Management Management of this system is critical. As a condition of approval of these plans this system management section must be reviewed with the owner, and the owner must be provided with a complete set of plans including this management section. If problems develop with the adsorption system or any other system components, the installing plumber, T.L. Sinz Plumbing, 715-235-2644, or the St. Croix County Zoning Office, 715-386-4680, should be contacted for assistance. General Proper functioning of an on-site disposal system, "septic system," is significantly dependent on the volume of water which flows into the system and the level of contaminants in that volume. The lower the volume of water and the lower the level of contaminants, the better and longer the system will nction. Typical system components include a septic tank or compartment to settle out solids and contain greases and oils, a filter the outlet of the septic tank to retain small particles of the same de ity as water, a pump tank or compartment to allow a dose to b ccumulated, a pump and controls, and finally some type of soil ad rption cell to recycle the water in a manner to protect ground Ovate quality and public health. 1 . If the septic tank is installed prior ~ sheet-rock and/or painting, pump the septic tank before formal use begins to ensure adherence to contaminant load design criteria. 2 install water-saving appliances when ver and wherever possible. 3. Repair even small water leaks as soon s possible. 4. Never pour grease or oil down any drai or stool. 5. Garbage disposals are not recommended; you must have one, use it sparingly. 6. No paper products other than tissue should o into the system. 7. No chemicals should go into the system. / 8. Avoid surge flows of water; try to spread laun throughout the week. Maintenan I . The septic tank must be inspected every three years a properly li nsed person. 2. If necessary, the septic tank must be pumped to remove lids ands m; pumping is required if the combined scum and solids volume equals one third of the tank volume. 3. When the septic tank is pumped, any solids in the bottom th ump tank must be pumped, and the filter must be back-washed into the septic tank to remove accumulated material. 4. Periodic observation pipe inspections should be made by t omeowner to examine the state of the in-situ soil adsorption cell. Quarterly inspections are recommended; a licensed plu er ould be notified if effluent is consistently ponded in the adsorption cell. 5. If this system contains specific treatment components ther than ose mentioned here, maintenance requirements will accompany their specifications. 6. The pumping components for this system include alarm which m t be installed and remain on a separate circuit from the pump. If the alarm is activated, minimize water use and otify a licensed plu er for service as soon as possible. The system allows reserve capacity to accumulate some necessary flow u it normal service can restored; this volume is minimal, and no more than one or two days should pass before any necessary r airs can be made. 7. Avoid compaction such as vehicle traffic w' in 15' down-slope of the ads tion system. 8. Avoid disturbing the system itself such t might encourage erosion or dis b the required seeding of the system. 9. Particularly avoid winter traffic such as iding or snowmobiling which migh ompact snow and lead to increased frost depth. 10. Surface drainage must be diverted aro d the system; avoid landscape changes hick might send surface run-off into the system area. 1 I . Warning: Do not enter septic, pump r other treatment tanks; death may result cause they may contain lethal gases or insufficient oxygen. Contingency Plan Wastewater monitoring o volume and quality is not a normal requirement for to effluent strength systems; such monitoring may become necessary if problems develop. Any necessary monitoring shall be done in ac rd with the requirements of Comm 83.54 (2). Pumping and hauling of wastewater may be necessary while analysis and repairs are im emented. Additional testing, designing, and/or installation of additional treatment components or conversion to a holding tank may be necessary. Page 8 of 8 t , + r, 4 HEAD CAPACITY CURVE MODEL 152/153 ~~ ~~ 53 12 x U z 8 r 0 0 ~- 4 10 0 20 40 60 80 100 GALLONS LITERS 0 80 160 240 320 FLOW PER MINUTE CONSULT FACTORY FOR SPECIAL A (CATIONS • Timed dosing panels available. • Electrical alternators, for duplex systems, are available and supplied w an alarm. • Variable level control switches are available for controlling single phase systems. • Double piggyback variable level float switches are available for variable level long and short cycle controls. • Sealed Owik-Box available for outdoor installations. See FM1420. • Over 130°F. (54°C.) special quotation required. 1521153 Series 1521153 MODELS Control Selection Model Volts-Ph Mode Am Sim lex Du N152 115 1 Non 8.5 1 2or BN152 115 1 Auto 8.5 Included 3 E152 230 1 Non 4.3 1 or3 BE152 230 1 Auto 4.3 Included 2or 3 N153 115 1 Non 10.5 1 2or3 BN153 115 1 Auto 10.5 Includ 2or3 E153 230 1 Non 5.3 1 2or3 BE153 230 1 Auto 5.3 Inc ed 2or 3 a cau N All installation of controls, protection devices and wiring ahould be done by a qualified licensed electrician. All electrical and safety codes should be followed Including the most recent National Electric Code (NEC) and the Occupational Safety and Health Act (OSHA). TOTAL DYNAMIC HEAD/CAPACITY PER MINUTE EFFLUENT AND DEWATERING MODEL 152 153 Feet Meters Gal. Liters Gal. Liters 5 1.5 69 261 77 291 10 3.1 61 231 70 265 15 4.6 53 201 61 231 20 6.1 44 167 52 197 25 7.6 34 129 42 159 30 9.1 23 87 33 125 35 10.7 -- -- 22 85 40 12.2 -- -- 11 42 lock Valve: 38. t. (11.6m) 44.0 Ft. (13.4m) 3 27 i tz ~/s 5 1/ 1. Single piggyback switch. Refer tc FM 2. See FM0712 for con 3. Variable level control or (4) float system. 32 32 8 sKZOea SELECTION GUIDE level float switch or double piggyback variable level float yodel of Electrical Alternator E-Pak. h 10-0225 used as a control activator, specify duplex (3) RESERVE POWERED DESIGN For unusual conditions a reserve safety factor is engineered into the design of every eller pump. _ MAIL TO: P.O. BOX 16347 L, - ~ Louisville, KY 40256-0347 Ma acturersof.. ~~~~~!' 1 SHIP T0: 3649 Cane Run Road a ® Louisville, KY 40211-1961 Qvat/TY PUMPS ,/iNCE ~~~~ ~~ (502) 778-2731.1(800) 928-PUMP httpJ/www.zoellercom `~/ PUMP ~0 FAX(502)774-3624 ©Copyright 2000 Zoeller Co. All rights reserved. ~' r ~~ ` ~ l 23D Sanitary Permit Application Safety & Buildings Division 201 W. Washington Ave. y~ ?~ In accord with Comm 83.21, Wis. Adm. Code PO Box 7302 "" ' f See reverse side for instructions for completing this application Madison, WI 53707-7302 T ~ •~~+~1~*~,' ~ Oepertment of Cormnerce Personal information you provide tnay be used for secondary purposes S (Submit completed form to carnty if not state owned. Attach com f ete laps to onl for n than 8 -1/2 x I 1 inches in siu. ~,aty Sf Croi State P rt Number ^ 'sioyto previous ~ '~ 9~ ~°~ s 6 % q D~5~5 ~ ~S I ~ I. A ifcation Information - PI a Print atl Information <~' ~'~--' tion: Property Location Property Owner Name /~ +~ ~ ~/'O Y~+ 4 : ru.~~ ~ ~~' f ~~~ 1~- C r '/ Q ~L 1/4 N~I/4, S ~ T~ 7N. R~6 or W / 1 ! , Y Ptnpaiy Ownets Matlurg r""t . ~j ~ N~ Ati t,, ~ ~ ~U~ I.ot Number Block Number u~ :. . oFFI ~ 6 3 N~ . ~ City, State Zip Code P~t1,1, ~ : ~-~.^: T Subdivision Name or CSM Number IL~ype of Buildrng: heck one) ( S (4~ 1 or 2 Family Dwel g - No. of Bedrooms : ~ ~ ~ ~ p C j~ ~}y~' ®"i'ow ~ i l ~ N a t W ^ pablie/Commercial ( erihe use):_ ^ State-O ed t Road 2~3~ Gj, d~ s I v ~~ ~ A w , . M (~ ~ ~ « ^ ~ 4 /~ L r, yy ~ ~( ~ Iv Parcel Tax Number(s).a to Z -. / O~ 9 -/G- f a licable i ne B one box on line A. Check box on Ii k onl hec III. T e of P rmit: 5 D .2 • /b. IaS~A 6. ^ Addition to . A) 1, ew ^ Replacement 3. ^ Replacement of 4. Existin S em S stem S stem Tank Onl B) Permit Ntrmber Lf A Sani Pernti eviousl issued ~ t ~ ~ DatGe Iss 5 M `~ IV. Type of POWT Syste : (Check all that apply) e~`/°"~ d ^ Sand Filter b ^ Constructed Wetland oun ^ Non-pressurized In-ground ^ p~ ~_groun ^ Holding Tank ^ Single Pass ^ Drip Line ^ Other: ^ At de -60~ ~ /~ ^ Aerobic Treatm nit ^ Recirculatin V. Dis ersaUTreatment Areal rmation: Design Flow (gpd) 2. Dispersal 3. Dispersal Area 4. Application 5. Percolation Rate I 6. System Elevation 7. Final Grade Elevation . Required Proposed (GalsJday/sq. ft.) (Minhnch) ~~~ ~s® ~'o a~ N~ 9-~ ~~a,~ VII. Tank Capacity in Total of Manufacturer Prefab Con- Site Steel Fiber- Plastic Con- glass Information Crallons ons anks Crete structed New Existing Tanks Tanks ^ ^ ^ ^ S ~ 1' ~ o ~ DD C.c~~ i~G ~' _ ^ ^ ^ ^ ~~' ~t~"t'a ~5 D ~"' '750 i ~ ~ VIII. Responsibility .Statement I, the undersi ed, assume rli for installation of the PO own on the attached lots. Business Phone Number Plumber's Name (print)1~ Plumbet+s Signature (no stamps): tvfP/MPRS No. 3 Z 2 4~~ C ~ 7ls -~ ~1-~33 7$ . ~r/ s oQ... ale, ~ • 1 ~ u O~ Pltunber's Address (Street, City, ,Zip Code) ~DOZ = i ~ . ... ~ ~2 a cr, a t.v IX. County/Depar t Use Only ^ approved Sanitary Pemut Fee (Includes Groundwater ate Issued Issuing Agent Signature (No stamps) ~ Approved ^ vmer Given Initial Adverse Surc e ~ )Zs. ~ 3 ~ ~ j ennination X. Conditions Approval /Reasons for Disapproval: LL }~, n oQ e ~.S ~ ' '` da^" ~ ~ ~~- ~~~~~ . ~ . ' 4 +M 5 vw.~s. ,~ p~,( S~'~°r'~ ~ ~. ~n~wove.wte,w s_~ n ~ ~~ c,,,,,~;~ ~"""° 15 .~° fi°'1 JL+^ mil! i S ~'~ .-n w .~uw lNtP1A A / (.' ~(lnn2-~/ 1M.Q,t~~sn~~ ~ ~ ~~~tytJc,,,,,vr,~, , .._.., - ..-- .~,~', ' ,~ ~ r ~scons~n Department of Commerce Safety and Buildings 4003 N KINNEY COULEE RD LA CROSSE WI 5460 1-1 831 TDD #: (608) 264-8777 www.commerce.state.wi. us/SB Scott McCallum, Governor Brenda J. Blanchard, Secretary March 1 CUST DALE E HUDSON ~ 1416 220TH ST EMERALD WI 54012 ATTN: POWX'S Inspector ST CR COUNTY SPIA 1101 ICHAEL RD HUD N WI 54016 RE: CONDITIONAL APPR~AL PLAN APPROVAL EXPIRES: /1~ SITE: SITE ID: 5365, RICHARD CRONK ST CROIX COUNTY, TOWN OF BA NE1/4, NEI/4, S5, T29N, R16W FOR: DESCRIPTION: THREE BEDROOM OBJECT TYPE: POWT SYSTEM R Identification Numbers Transaction ID No. 619645 Site ID No. 5365 Please refer to both identification riumbers, .above, in all cones ndence with the a enc . 1186 23~I'H ST, BALDWIN 54002 JECT ID NO.: 782977 The submittal described above has been reviewed f con rmance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been C NDITI ALLY APPROVED. The following conditions shall be met during construction or installation and pri to occupa y or use: • This system is to be constructed and loca in accordance w the enclosed approved plans and with the "Mound Component Manual for Septic nk Effluent for Priva Onsite Wastewater Systems" SBD-10572-P (8.6/99). and the "Pressure Distributio Component Manual for 'vate Onsite Wastewater Treatment Systems" SBD-10573-P (8.6/99). • In the event this soil absorption sy em or any of its component parts m functions so as to create a health hazard, the property owner must llow the contingency plan as describ 'n the approved plans. In addition, the owner must insure that the oper ion, maintenance and monitoring duties escribed in section VIII of the at- grade, mound, conventional, sure distribution -section VI of the holding nk component manual are complied with. A copy of th' information must be given to the owner upon co letion of the project. • A Sanitary Permit must b btained from the county where this project is located i accordance with the requirements of Sec. 14 35 and 145.19, Wis. Stats. • Inspection of the priv a sewage system installation is required. Arrangements for insp ion shall be made with the designated count official in accordance with the provisions of Sec. 145.20(2)(d), Wi Stats. A copy of the approved plans, specifications and this letter shall be on-site during construction a open to inspection by authorized representatives of the Department, which may include local inspectors. permits required by the state or the local municipality shall be obtained prior to commencement of construction/installation/operation. In granting this approval the Division of Safety & Buildings reserves the right to require changes or addit~pns 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. t ~ ~ /~ ~~/ .~. ~-' DALE E HUDSON Page 2 3/1MOt Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. Sincerely, P ~ , ~~~ `F,. CHARLES L BRATZ POWTS REVIEWER 7:45 - 4:30 MONDAY CBRATZ@COMME] iF ~ 1 i ~ 1 t MOUND SYSTEM DESIGN Residential Application INDEX AND TITLE SHEET ~~~ ~,~ ~F~. 8 ~ooj ~`O Asa Project Richard 8~ Brenda Cronk 3 bedroom residential mound ~~ a Owner Richard & Brenda Cronk Address 986 Hwy. ~3 Legal Description NE1/4N 1/ Township Baldwin Subdivision Name Parcel ID Number 002-1009-1 Plan Transaction Number Designer Dale Hudson Signature ~~ Date 11 /01 /00 Sec. 5, T.29N., R.16W. County St. Croix ~ Lot No. Index and title sheet Mound calculations Mound drawings Pres. dist. talcs. and teral TDH and pump to drawing Pump specificati s Site Ian Tum-up det ' Attachm t: Soil evaluation re~ortl License N ~~ PI ~PROV~o DEAARTM~IT O~,F~ /~,~~ ~t~LS/G SEE CORRESPG3N~ENCE Page 1 Page 2 Page 3 Page 4 Page 5 Page 6 _ Page 7 Page 8 Page 9 Page 10 :r 220853 No. 715-6843378 Page 1 of 10 ~~•S~b T Complete Residential or ~(r or c) MOUND PLAN VIEW Slope 4 Design flow rate 450 Depth to limiting factor 0 In situ soil infiltration rate Contour line elevation 98. Use standard fill depths? Place X in box to use standard depths (24 Center or end manifold Lateral spacing Number of laterals Forcemain length 750 gpd maximum design flow. in 9Pd/ft` ft OR Design depth? ©in ~ +4 inclusive) OR specify design fill depth. Orifice density 5.92 Orifi per ft` e ~~ or Orifice diameter 0.125 in .12s, o.1s6, o.1aa, o.z19, o.2s, 0.281, or 0.313 inch only. 3.00 ft Use lateral spacing for trenches. stimated orifice space 1.95 ft Not a final cak;ulation. 2 mp tank elevation 8 ft Outside bottom of tank. 75.0 ft Fo main diameter .0 in ~ .5, 2, 3 or 4 inch only. 2.067 in Actual I.D. SYSTEM SOLUTIONS Design flow rate Absorption cell Application rate & area Linear loading rate (LLR) Design width (A) Cell length (B) Depth of cell (F) Sand filter Upslope fill depth (D) Downslope fill depth (E) Basal area required (gpd/ir Supporting c Topsoil depth Subsoil depth at ce er Subsoil depth at cell wall End slope toe length (K) Up slope toe length (J) Down slope toe length (I) Total mound length (L) Total mound width (V1n MOUND SYSTEM DESIGN observation PIPS (h~Pi~) w, . ~, ., 1.0 9P~ il'fration rate) ponents 450 0 ft` .00 gpd/ft 9.5 lin 6.0 in 8.9 in 2250.0 ft2 3.0 in 9.0 in 3.0 in 7.24 ft 5.50 ft 24.00 ft 89.48 ft 35.50 ft DIAMETER CONVERSIONS 1/8 = 0.125 1/4 = 0.250 5/32 = 0.156 9/32 = 0.281 -- 3J16 = 0.188 5/16 = 0.313 7/32 = 0.219 Basal adjustment made. PRESSURE DISTRIBUTION CALCULATIONS Dispersal cell Width (A) 6 ft Length (B) 75.0 ft Lateral specifications Number laterals 2 Orifice/lateral 38 holes Lateral length (P) 74.00 ft Orifice diameter 0.125 in Lat. dis. rate 15.65 gpm Sys. dis. rate 31.30 gpm Orifice spacing (X) 24 in al diameter Pipe diameter Design options Design choice Designer must '~C" one choice tom the options Manifold d4~rr crab ~ '?C" one from the provided. 1 in 1 1/4 in 1 1/2 in 7C 2 in x 3 in x Pipe diameter /Design options Design choice 1 in 1 1/4 i x 1 1 /2 x x x in x 4 in x approved manhole cover with warning label and locking device grade levels attemate F- outlet location 18" min. ~i~- approved ~ outlet joint Distribution syste tains: 2 Lateral(s) LATERAL DIAG - ND CONNECTION Place correct lateral diagram by clicking in one the drawin at right and dragging the diagram into this area. Laterals centeredoVertheA dimension ~ =Turn-up~m'bsll valve oralesnoutplug P All laterals are identical IE X-~I Holes 'led on the bottom of the lateral S equally s eed i Force main tonne n via tee or cross to maniFold at any point. Laterals & force main or PuC Sch 40 (per COMM Table 84.30-~ Lateral) gth (P) 74.00 ft Lateral acing (S) 3.00 ft Orific pacing (X) 24 in Mani Id length 3.00 ft Orif' diameter 0.125 in L rat diameter 1.50 in F cemain diameter 2.00 in Project: Richard & Brenda Cronk 3 bedroom residential mound Transaction Number: Page 4 of 10 TDH and Pump Tank Drawing Total Dynamic Head Operational head 6.50 ft Vertical lift 12.90 ft Are laterals the highest pant in the Friction loss 1.26 ft system? Yes "X" here. C~ Total dynamic head 20.66 ft If no, what is the highest elevation Dose Volume da~nmstream at pump? ~~ Dose is > 7.5 times lateral volume Forcemain drain Lateral void volume 15.6 gal back to tank? ("X' on Minimum dose 117.0 gal x Y Drain back 13.1 gal o Dose volume 1 .1 gal Typic ump Chamber Layout In I;,ombinati with state approved treatment weather proof grade levels junction tx~x ~L., I _ I I disconnect 4" vent pipe ~ I electric as per NEC 300 and ~I Comm 16.28 WAC wall of pump chamber or combination tank ;/ alarm on _ pump on pump 86.8 off elev. Tank manufacturer Pump tank capacity Pump tank volume A D 3 " of Jlbddinq under tank Pump manufacturer Goulds Pump model number 3885 WE05H o A c B Alarm manufactur r Levelarm ~~~~ ~ C Alarm model number DLV p D Project: Richard & Brenda Cronk 3 bedroom residential mound Transaction Number: Provide 1/4" weep hde or anti- siphon device as necessary Grade levels - pump tank manhole = 4" minimum above finished grade vent - 12" minimum -- finished grade Inches Place X in red box of chosen diameter. Place X in red box of chosen diameter Pump tank elevation at bottom of tank 25.9 3 5 2 23. 11.0 130.1 12 141.8 Page 5 of 10 ,r r .~ ;~ Performance Curves METERS FEET Submersila@e effluent Pumps 0 10 20 ~ 30 40 50 60 70 80 90 100 110 120 GPM t ~ ~ 0 10 20 01985 Goulds Pumps, Inc. CAPACITY GPM m'/h PS, INC. ~~ ~e 30 m'/h (~ o ~' f O EflecUve Juiy, 1985 . ', - Q ~^ .__ ~ ~ ~ ~ ~, • • ~ 1 ~, ` ~ ~ ~, .~ ' o ti , a ~ d I .~ ~ J ~ N ! r `~ r ~ Q `^ l ~, ~wy, l1. D fey ,~'e ~ ~~ !v TS `Q bso~ Oflri'G ~~r/ /~ ^ Sd; / 4bse~-va~o~-~ / P. ~ e.Xi:S~'~g ~'cnce~n¢ ~ Sca/c: / = ~' ~t 35.5',t~ 89. yB ~~ ~~.?,3ioaG,•nq , ~...~,~ Y8 ~, Qf,2y ~~j~1GlGil~q. ".sUt . ~o P. ~ e . ^ ~ ~orcenta%n•% E/e - io~.8y, Pao posed yuoo/ ~e.P. Combi~E~~ ~.T~l~e, ~„~/~'abe/s~-/~ ~-F'Icct,r~ ~•I~u'a{ 5.7:oc~~ltt• -•.(' scat . ~{o P C. build%r~ Se er• J)~Sfk~e p~opos~ ~bdrm• res;denc 0 4-P ~o~oase.d we-(( ~ara9e I p~opt7Sa.d driut ~~/ P~ . ~ aF'/o ~. ' . . , Lateral turn-up detail vtanifold Pg. 8 of 10 _~ Rib Mound System Management Plan Pursuant to Comm 83.54, Wis. Adm. Code General The mound septic system shall be operated in accordance with Comm 82-84 Wis. Adm. Code, and shall be maintained in accordance with component manual SBD-10572-P (R.6/99). All local and/or state rules pertaining to system maintenance and maintenance reporting shall be complied with. No individual should ever enter a septic tank or pump tank as dangerous gases may be present that could cause death. Septic and pump tank abandonment shall be in accordance with Comm83.33, Wis. Adm. Code when the tanks are no longer used as POWTS components. Septic or pump tank manholes 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 failwe must be replaced. Exposed access openings greater than 8 inches in diameter shall be secured by an effective locking device to prevent accidental oc unauthorized entry into a tank or component. , Septic Tank The operating conditi of the septic tank and outlet filter shall be assessed at least once e ry two years by inspection. The septic tank contents shal removed when the sludge and scum in the tank exceed 1/3 a liquid volume of the tank. The contents of the septic tanks ll be disposed of in accordance with NR 113, Wis. A ode, by an individual certified to service septic tanks under s. 2 .48, Stats. If the contents of the tank are not remov at the time of a biannual assessment, maintenance personnel shall ad the owner of when service will be needed to intain less than 1/3 scum and sludge accumulation in the tank. The outl titer shall be cleaned as necessary to ens proper operation. The filter cartridge should not be removed. unless provist s are made to retain solids in the tank at may slough off the filter when removed from its enclosure. If the filter is equip d with an alarm, the filter shall erviced if the alarm is activated. The addition of biological or chemical additives to enhan septic tank performance is g rally not required. If such products are used they shall be approved for septic tank use by the epartment of Commerce, afety and Buildings Division. Pump Tank The pump (dosing) tank shall be inspected at I verify proper operation. If an effluent filter is Mound and Pressure Distribution Svstem Trees or shrubs should not be planted directly on the m mound shall be seeded and mulched as necessary to pr (other than for vegetative maintenance) on the mound infiltrative surface within the mound and will prom installations (October-February) dictate that them n every tw ears. All switches, alarms, and pumps shall be tested to within tank it shall be inspected and serviced as necessary. o .Plantings may be made around the mound's perimeter. The e nt osion and provide some degree of frost protection. Traffic not r mmended. Soil compaction may hinder aeration of the frost pen ation dwing cold weather months. Cold weather d be heavil ulched for frost protection. Influent quality into the mound system may n~xceed 220mg/L BO , 150 MG/L TSS, and 30 mg/L FOG. Influent flow may not exceed maximum design flow sped din the permit for the Nation` The pressure distribution system is provi d with a flushing point at the en of each lateral. Each lateral should be flushed of accumulated solids at least once every 1 months. A pressure test should be erformed with the results compared to the initial test taken at the time of system ' stallation to determine if orifice clean' is required to maintain equal distribution within the dispersal cell. Observation pipes within the disp al cell shall be checked for effluent ponding. P ding levels shall be reported to the owner. Levels above 4 inches in cate an impending hydraulic failwe requiring addit nal, more frequent monitoring. Contin~ency Plan If the septic tank or any of its components become defective the tank or component shall be r aired or replaced to keep the system in proper operating condition. If the dosing tank, pump, pump controls, alarm or relat wiring become defective the defective component shall be immediately repaired or replaced with a component of the same or ual performance. If the mound component fails to accept wastewater or begins to discharge wastewater to the ground sw e, it will be repaired or replaced in its' present location. Toe leakage will be eliminated by increasing the basal area of the ystem. Excessive ponding within the dispersal cell will be eliminated by removing biologically clogged adsorption and dispersa! media and replacing said components as deemed necessary to bring the system into proper operating condition. Questions on the operation or maintenance of the system should be directed to your county zoning or health inspector. Pg. 9 Of 10 w~is ~•~~§-nfi~partmentofcommerce SOIL AND SITE EVALUATION Dl~isio,~t of'iaafety and Buildings Page of _ bureau of Integrated Services .. °cif7~`C nCe with s. ILHR 83.09, Wis. Adm. Code Attach complete site plan on paper no s 8 1/2 11 inch i s e. Plan must County include, but not limited to: vertical 4~0 ontal int ( ~ 'rection and ~f -. r ' percent slope, scale or dimensions~1 arrow, nd di to nearest road. parcel I.D. # APPLICANT INFORMATION --lease nt all rm Reviewed by Date ~f cROlx Personal information you provide may be ysed~or seconds (Privac ~ .15.04 (1) (m)). R. ~ ` .' ~ ~ Property Owner Property Location ~~~~~,~ ~~ ~~~ ~/~.~._..,~--~ ~ Govt. Lot 1~ L 1/4N~" 1/4,S ~ T zC~ ,N,R 1~ ~ (or~ Property Ownet's Mailing Address ``"~~..~, _'_ r•, ~,,~.,.~-~ Lot # Block# Subd. Name or CSM# 2 ~ 5 ;' G t~ 7~D/, ~ ~ ~ iV~ City // Statel Zip Code Phone Number ~n ^ City ^ Village ~ Town Nearest Road ~L.~q ~G'L.c.~ /, ~ Gvi', S'yLaC~~ ~ ?/~ )!v ~S ~ .~ r ~ ~ c7 ~G~~-c~ % rte- Z ~U~ ~- New Construction Use: ,Residential /Number of bedrooms~'^ 7\.-o:a t--Addition to existing building ^ Replacement ^ Public or commercial -Describe: Code derived daily flow gpd Recommended design loading rate ' Z bed, gpd/ft2 -,3_trench, gpd/fl2 Absorption area required bed, ft2 trench, ft2 Maximum design loading rate • S bed, gpd/fl2 ~ b trench, gpd/ft2 Recommended infiltration surface elevation(s) ft (as referred to site plan benchmark) Additional design/site considerations Parent material S i ,,~, ~~ /~r ~'~Of.',~'J~° ~~ ~ / /~ Flood plain elevation, if applicable N~'7 ft , S = Suitable for system Conventional Mound In-Ground Pressure AT-Grade System in Fill Holding Tank U Unsuitable for system ^ S ,~ U ~S ^ U ^ S .~'U ^ S ~ U ^ S ~ U ^ S ~ U Boring # _1. Ground elev. lCY~'~t. Depth to limiting fact 3 in. Boring # ;~ Ground ~lev. ~~ft. Depth to limiting factor min. SOIL DESCRIPTION REPORT Horizon Depth Dominant Color Mottles T t Structure Consi ten e nda Bo Roots GPD/fl2 in. Munsell Qu. Sz. Cont. Color ex ure Gr. Sz. Sh. s c ry u Bed ,Trench ~ 0 7.5~/ 1'Z /l~o ~ e. ~i'J /ms~ /37 Qtv .2 rn ' Z ' ,3 2 ;3 !o YR 6 Y si .Z.~ s b~ ry?-~r Q w 2 ' S'' b Remarks: 3 y.5-57 7~ 5 Y1C I6 s 2 r»s b~ r~ /~,r G ~ '-' ' $ ~-6 7-5y~'S Gzo/ 7s ~~ sc mss mom- "' ~--- ,L ~,3 Remarks: :ST Name (Please Print) j S~ignatu//re ~ / /_ Telephone No.~> -7 ~j ~q r' ~ ~- ~ :.~ ~50w- /L/Gt.C~- ~~ / V G-t~!~"i 7/~ - ~ji~`Y ~.~.~ / !J address Date CST Number ~' ~ ~' r' Gy~'t--.. ,' .S l~Dc'~ l0 2~ ~ 2ZD ~3 PROPERTY OWNER ~ ~Q// SOIL DESCRIPTION REPORT PARCEL I.D.# Boring # 3 Ground elev. 9~•37ft. limiting factor 3Z in. Boring # Ground elev. 9~ -~17ft. Depth to limiting factor ~~~in. Boring # Ground elev. ft. Depth to limiting factor in. Boring # Ground elev. ft. Depth to limiting factor Page ._~ of~~~ Horizon Depth Dominant Color Mottles Texture Structure ~~~~ Bounda Roots 2 in. Munsell Qu. Sz . Cont. Color Gr. Sz. Sh. ry Bed ,Trench e~ 3 ~Z 7•sy ~~ s sd ,~~~r cw ;,6 s z5 -5'Yf~s/b c2~~~- / s sb mv~ri ~, -- .~'; ~6 Remarks: ~ e D-/I . y 7'J~ f~ o~v Si t ~ h~ I'~'~ r QtJ ZM •Z '.3 2- ~-/9 /oy.~, 6 s; 2ms m~.- Qua 2~ •~ ~ •~ 3 ~Z~ - 551 /s .r,.s d v •~ ~,.~ • 5 ~ ~ ~ // ~ / ~ Remarks: Horizon Depth Dominant Cobr Mottles Texture Structure Consistence Bounda Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. ry Bed ,Trench Remarks: ~n' Remarks: SBD-8330 (R. 07/96) ~-' Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM • , Safety and Buildings Division INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Personal information you provice may be used for secondary purposes [Privacy l.aw, s.15.04 (11(mll. Permit Holder's Name: RONK, RICHARD & BRENDA age Town of: ~~~yD~~~ CST BM Elev.: Insp. BM Elev.: BM Description: TANK INFORMATION TYPE MANUFACTURER Septic Dosing Aeration Holding TANK SETBACK INFORMATION CAPAC I' TANK TO P/L WELL BLDG. vent to rlntake ~ Septic N, Dosing N, Aeration N, Holding PUMP / SIPH~1111111~R~ATION Manufacturer Dula Model Number TDH Lift Lriction System Fi T Forcemain Length la. T en SOIL ABSORPTION SY51~ Count~,I, ~ CROIX Sanitar~r~q~r~i~f~o.: State Plan ID No.: Parcel~~la1009-10-000 BED /TRENCH Width L th N f Trenches PIT No. Of Pits Inside Dia. Liquid Depth DI N 1 N DIMEN I N SYSTEM TO P/ L BLDG WELL LAKE/STREAM LEACHING Manu acturer: SETBACK INFORMATION TypeO CHAMBER Mo a Number: System: OR UNIT DISTRIBUTION SYSTEM Header/ Mani old Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake Length Dia. Length Dia. Spacing SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over xx Depth Of xx Seeded /Sodded xx Mulched Bed /Trench Center Bed /Trench Edges Topsoil ^ Yes ^ No ^ Yes ^ No COMMENTS: (Include code discrepancies, persons present, etc.) LOCATION: BALDWIN 05.29.16.65A,NE,NE 1186 230TH STREET Plan revision required? ^ Yes ^ No Use other side for additional information. SBD-6710 (R.3/97) Date Inspector's Signature Cert. No. ELEVATION DATA A9800214 ' v~?l~~r'Z SANITARY PERMIT APPLICATION safety andeuildinggsDivisi y Bureau of Buildin Water S stems 201 E. Washington Ave. In accord with ILHR 83:05, Wis. Adm. Code P.O. Box 7969 Madison, WI 53707-7969 • Attach complete plans (to the county copy only) for the system, on paper not less county ~,, ' than 8 12 x 11 inches in size. ~! ~ C t! off • See reverse side for instructions for. completing this application state san2ita/ry Permpit~IVu 7! S O ~~ th Th i f ti id ed b t lb c n orma on you prov e may e us y o er governmen agency programs e ation ^ Check if revision to previous appli (Privacy Law, s. 15.04 (1) (m)]. State Plan LD. Number I. APPLI ATION INFORMATION -PLEASE PRINT ALL INFORMATION 7~s~'G~ Z Property Owner Name ^~''~ C ' Property Location N R / 1E (o W E1/4 ~~1/4 S 5 T ~9 rOIti 7 IJ1~ -'~ Q AY , , , Property Owner's Mailing Address ~~ 8 ~GIJ , Lot Numbe~,~ /II Block Number ~~ City, State J ' l 13 l % Zip Code ''ooL ~~ Phone Number (7r~ > ~~y ~8 Subdivision Name or CSM N m r . > , ~, ~, ow i II. YPE F B ILDING: (check one) ^ State Owned 3 o it p Village ~ ~ ~1 ri Nearest Road ~ 3O ~ Public 1 or 2 Famil Dweltin - No. of bedrooms - Ld Q f r Town OF , 111. BUILDING USE: (If building type is public, check all that apply) Parcel Tax Number(s) Oa Z-~~'09-~d Ia~Z-~~9'~Z~ 1 ^ Apartment/Condo 2 ^ Assembly Hall 6 ^ Medical Facility/ Nursing Home 10 ^ Outdoor Recreational Facility 3 ^ Campground 7 ^ Merchandise:Sales/Repairs 11 ^ Restaurant/Bar/Dining 4 ^ Church /School 8 ^ Mobile Home Park 12 ^ Service Station /Car Wash 5 ^ Hotel /Motel 9 ^ Office /Factory 13 ^ Other: specify IV. TYPE OF PERMIT: (Check only one box on line A. Check box on line B, if applicable) A) 1. ~lew 2. ^ Replacement 3_ ^ Replacement of 4_ ^ Reconnection of 5_ ~ Repair of an ______System ________ System _____________ Tank Only______________ Existing System _________Exlsttng System B) ^ A Sanitary Permit was previously issued. Permit Number Date Issued V. TYPE OF SYSTEM: (Check only one) Non-Pressurized Distribution Pressurized Distribution Experimental Other 11 ^ Seepage Bed 21 pfMound 30 ^ Specify Type 41 ^ Holding Tank 12 ^ Seepage Trench 22 ^ In-Ground Pressure ' 42 ^ Pit Privy 13 ^ Seepage Pit 43 ^ Vault Privy 14 ^ System-In-Fill VI. ABSORPTION SYSTEM INFORMATION: 1. Gallons Per Day 2. Absorp. Area 3. Absorp. Area 4. Loading Rate 5. Pert. Rate 6. System Elev. 7. Final Grade Required (sq. ft.) Proposed (sq. ft.) (Gals/day/sq. ft.) (Min./inch) Elevation ~ ~5 /oG•~0 Feet /oJ, 70Feet Q .$ 3 7~ ~ VII. TANK INFORMATION Capaut in allo s g Total # of T Manufacturer s Name Prefab. ~ Site Con- l St Fiber- Plastic Exper. N E is i Gallons anks Concrete ee glass App ew x t n strutted Tanks Tanks Septic Tank or Holding Tank ~+ZSQ -'"~ l~s~ ~r ! ! t~O>~00 A ^ ^ ^ ^ ^ Lift Pump Tank/Siphon Chamber ~5Q -~ s~ C!'$G' /~~ ~ ^ ^ ^ ^ ^ VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name1Print) ~ Plu er's Signature: (No Stamps) MP/MPRSW No.: 'S Business Phone Number: 3 ' ' ~e ~ ~ sor-- ~ ~ Z ~ ~ ~ 78 -. 7.~,; 6 ~ ~ Plumber's Address (Street, City, State, Zip Code): ,/ / , - 1 IX. COUNTY /DEPARTMENT USE ONLY Approved ^ Disapproved ^ Owner Given Initial Sanitary Permit Fee (i^~IudesGroundwater ~j surcharge Fee> ` ~ ~ ate ssue ~ ~~ Is mg~ Si nature (No Stamps) ~ Adverse Determination 6 O ~~ ~ X. CONDITIONS OF APPROVAL /REASONS FOR DISAPPROVAL: SBD-6398 (R. 05/94) DISTRIBUTION: Qriginal to County, One copy To: Safety & RuilJings Division, Owner, Plumber INSTRUCTIONS 1. A sanitary permit is valid for two (2) years. 2. Your sanitary permit maybe renewed before the expiration date, and at a time of renewal any new criteria in the Wisconsin Administrative Code will beapplicable. 3. All revisions to this permit must be approved by the permit issuing authority_ 4. Changes in ownership or plumber requires a Sanitary Permit Transfer/ Renewal Form (SBD-6399) to be submitted to the county prior to installation 5. Onsite sewage systems must be properly maintained. The septic tank(s) must be pumped by a licensed pumper whenever necessary, usually every 2 to 3 years. 6. If you have questions concerning your onsite sewage system, contact your local code administrator or the State of Wisconsin, Safety and Buildings Division, 608-266-3815. To be complete and accurate this sanitary permit application must include: I. Property owner's name and mailing address. Provide the legal description and parcel tax number(s) of where the system is to be installed. II. Type of building being served. Check only one and complete # of bedrooms if 1 or 2 Family Dwelling. III. Building use. If building type is public, check all appropriate boxes that apply. IV. Type of permit. Check only one on line A. Complete line B if permit is for tank replacement, reconnection, or repair. V. Type of system. Check appropriate box depending on system type. VI. Absorption system information. Provide all information requested for numbers 1 through 7. VII. Tank information. Fill in the capacity of every new/or existing tank, list the total gallons, number of tanks and manufacturer's name, indicate prefab or site constructed and tank material. Complete for all septic, pump/siphon and holding tanks for this system. Check experimental approval only if tanks received experimental product approval from DILHR. VIII. Responsibility statement. Installing plumber is to fill in name, license number with appropriate prefix (e.g. MP, etc.), address and phone number. Plumber must sign application form. IX. County /Department Use Only. X. County /Department Use Only. Complete plans and specifications not smal ler than 8 1/2 x 1 1 inches must be submitted to the county. The plans must include the following: A) plot plan, drawn to scale or with complete dimensions, location of holding tank(s), septic tank(s) or other treatment tanks; building sewers; wells; water mains/water service; streams and lakes; pump or siphon tanks; distribution boxes; soil absorption systems; replacement system areas; and the location of the building served; B) horizontal and vertical elevation reference points; C) complete specifications for pumps and controls; dose volume; elevation differences; friction loss; pump performance curve; pump model and pump manufacturer; D) cross section of the soil absorption system if required by the county; E) soil test data on a 115 form; and F) all sizing information. GROUNDWATER SURCHARGE 1983 Wisconsin Act 410 included the creation of surcharges (fees) for a number of regulated practices which can effect groundwater. The monies collected through these surcharges are used for monitoring groundwater contamination investigations and establishment of standards. ~ ~ ~scons~n Department of Commerce Safety and Buildings 2226 ROSE ST LA CROSSE WI 54603-1905 Tommy G. Thompson, Governor William J. McCoshen, Secretary Apri120, 1998 CUST ID No.6306 ATTN: POII'TS INSPECTOR BOLDTS PLUMBING AND HEATING INC 820 MAIN ST PO BOX 87 BALDWIN WI 54002 RE: CONDITIONAL APPROVAL APPROVAL EXPIRES: 04/20/2000 Transaction ID No. 74662 SITE: Site ID: 5365 ST CROIX County, Town of BALDWIN NE1/4, NEI/4, S5, T29N, R16W RICHARD CRONK, BALDWIN FOR: Description: MOUND Object Type: POWT System Regulated Object ID No.: 15757 The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes listed in the regarding line above. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. The following conditions shall be met during construction or installation and prior to occupancy or use: • A Sanitary Permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.135 and 145.19, Wis. Adm. Code. • Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(d), Wis. Stats. A copy of the approved plans, specifications and this letter shall be on-site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of construction/installation operation. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. When making an inquiry or submitting additional information, please refer to Transaction ID No. in the regarding line. Sincerely, ~~ ~ GERARD M SWIM , POWTS PLAN REVIEWER Integrated Services (608)785-9348 , MON - FRI, 7:15 AM - 4:00 PM JS WIM@COMMERCE. STATE. WLUS DATE RECEIVED 04/17/1998 FEE REQUIRED $ 180.00 FEE RECEIVED $ 180.00 BALANCE DUE $ 0.00 t' • . BOLDT's J,7VLL 1 r~ ~V L1./ 1 ~.. ; , t 4 V~ . PLUMBING d~ HEATING INC. "Serving You For 40 Years" 820 Main Street Baldwin, WI 54002 (715) 684-3378 Fax (715) 684-3144 Date: ~ - /~ - 98 Mound System For A -3 Bedroom Residence Located in the N~ '/4 of the ~'/4 of Section ~, T z9 N, RAW; Town of C3oldGV~',-.- Sf ~ C~aix County, Wisconsin. ®~ M~gGE ~~OF QOM ~~,p1N ~~p(iSME FE~r AN Page 1 of 8 Page 2 of 8 Page 3 of 8 Page 4 of 8 Page6of8 Page 6 of 8 Page 7 of 8 Page8of8 Index Title Sheet Soil Evaluation Plan View-Cross Section Distribution Pipe Layout Pump Chamber Pump Performance Curve Plot Plan System Plan Prepared For: ,cn v 1>r O 4$G Nw~. 63 T3 a /alw~'~ , GJ,' ~ 5yoa Z Prepared Bv: ~~~~r s qpR ~ ~~~ gFFTY~ B 71~~~ l pGs 0~~ Dale Hudson Certified Soil Tester /Master Plumber #220863 ' ~~^r~a~.'"Daparar'entof~°'""'er~ SOIL AND SITE EVALUATION ~~ ,Z a~ ' otvtston ~ saffrly,~,nd swings • .. Bureeru of integrated senrtces in accordance with s. ILHR 83.09, Wis. Adm. Cade . ,Attach oorrtpleteslte plan on papecnot Jess than$ . x ! 1 anclres in size. _ Plan must County . "utclude.~twt rtot~gmlted fa:'treruca3u arb lwrizot,~l retoe point (BM), directlon;and Sf• :Percent slope iicaltli ~ ~rrfertsions, rtortl~ ariYOW, elh~ IoCallon and distance b nearest n~ad. Parcel LD. ~ . _. APPLICANT INFORMATION -Please print all information. Reviewed by Date Personal IMonrrsrlon You provide maybe used for secondary P~P~ (P~'Y Law. s. 15.04 (1) (m)). 1 Property Owner Property location GU B C (/~ ~i'I Q~/ Govt ~ ~~ 1/4N~"1/4,S 5 T Z(7 ,N,R I6 ~ (or W Properly s Matling Address lAt M Blodc# Subd. Name or CSMff 2Z 59 Gt ~'o/ ~~ NA yo A r Gty State Zip Code Phone Nurnber ^ ~ ^ vilage ~ Town Nearest Road Lea I G~~vi'r~- (,c~i'~ .5~/~oZ c 7r~ )G~y .39'7 ~ A /o/w: ,~- z ~o~ vi`± New Construction Use: ,Residential /Number of~:bedrooms• - . ~ = - Addition to existing building N~ ^ Replacement r] Public or domrneraal -Describe: _ Code derived daily flow gpd Recommended design loading rate • Z bed, gpdM~ '~_trench, 9Pd/(t~ Absorption area required 3 7s bed, ft2 3 7.~ trerx~, ft 2 Maximum design loading rate • S bed, gpd/flz , 6 trend, gpolFt~ Recommended iMiltration surface elevation(s) 99.7' ft (as referred to site plan bendwnark) Additional desigr>/Site considerations Parent materiel S i / f~ ~COI,~,~~~ Flood plain elevation, (f appNcable ~r7 ft _ . ". _ S = Sult~bie for system Conve~tianai.. ~ ~ .-Mound In-Ground Pressure AT-Grade System ~ Fill Holding Tank u = unsfJhaae for system ^ s ,~ u. " `" j~'s O u ^ s .0'u O s ~ u ^ s ,~ u ^ s ~ u Boring # 1, Ground elev. /Gb_~' ft Depth >b smiting faa Sin. Boring # Ground 9~ft. facmr ~M. SOIL DESCRIPTION REPORT Horizon Depth DominantCobr Mottles T .Structure i e C t d B Roots GPD/lt2 in. Munsell Qu. Sz. Cont Color exture Sh. Gr. Sz. ons s enc oun ary Bed . Trer>ch J ... b: 7.5y rZ" , /Vo ~ e. SiI - . // /ry1 S6 /rl .'QGt) 2 n^ ' Z- ' ~3 =3 ~o YR 6 `I Si ~..~ s ~ ~r .,Ci,~ ~ 2 ' ~ ' ~ 1, 3 3- 7~5Y~~~~ '_ _ 7•SY/Z~ sc s ~ /~~r :", '; •L ;.3 Remarks: 3 y.5- 7~ 5 YIC ~6 S R r»s b'~ M/~,r _~G i~J ' ~ ' ~ ~ 7-6 7-$ y~ c z .s ,e ~ sc s~ mom- ,: ~ ~ ' ~ 3 ~- Remarks: :ST Name (Please frri~ Signature Telephone No. 4ddress Date CST Number ~~~ otiv~~ Q~/ SOIL DESCRIPTION REPORT P~ac~. l.os Boring # 3 Ground 9~?ft m rrmiting tailor 3Z. in. Boring # Ground elev. 9~tt. Depth to tlmiting factor ~~,[Zin. Boring # Ground elev. tt Depth to limiting factor in. Boring # Ground elev. ft. i ~ ~ Horizon Depth DaNnaM Color Mottles T Stnx:ture ~ B ~ da R of in. MunseM (]u. Sz. Cont. Cobr Gr. Sz. Sh. or r ry o s 8ed , Trends ~~++ 3 -z 7.5y ~~ s s~ ~~~'.- cw : ~ b Z5= .~ 5 s~ .2ms mv~'r rrJ .~~ rb S Z-5 •.~y b C2ol'7--j ~ S 5~ /!')VTR" ~ ~.~; ~ t, Remarks: ~ /-/$ /oY•L' 6 s: ZmS I~?*,• Qua Z-~ •5 ~ '~ -( 7i Jr YR - ~ ~ Y~3S~ ~ ~-r'r G t~e~ • ~~ • d Remarks: Horizon Depth Dominant Cobr Mottles Texture Structure Consist n Bo r ~d R t GPD/ft2 in. Munsell tlu. Sz. Cont. Color Gr. Sz. Sh. e ce y ttt a oo s Bed .Trench I rniUng~ factor 'n' Remarks: Remarks: ssas33o iR. o~~ss~ Page .3 Of S Cross Section Of A Mound Using A Trench For The Absorption Area ~ STt~I c 33 Medium Sand Fill E Trench Of 2" - 2~" Aggregate, 6" Below Pipe. Covered With Straw, Marsh Nay Or Synthetic Fabric ~H ioo. zo' F 6" Topsoil 9.'70' w ~ Plowed Dyer D /~O Ft. ~ ./~ Ft. r, /moo Ft. F~ Ft. N .,j Ft. Plan View Of ;Mound Using A Trench For The Absorption Area Force Main ~ Distribution Pipe ~ Permanent Markers Observation Pipe A a ---------------- - -----------------. B '~ K Trench Of ~" - 2 Z" Aggregate I L A ~ :=t. I //•5 Ft. K ~_ Ft. W ~^ Ft. B 9y Ft. J '7•~ Ft. L //y Ft. Si ned:.~1/~ ~ l'~~.i License y- ~~~~~ g Number: ,220$ 53 Date: y ~f ~ Distribution Pipe Detail For Two Lateral Network Noles located On Bottom Are Equally Spaced •-pyC Force '4ain End Cap ~ -- */ 'Y ~ X X .PVC Distribution Pipe P P X '~ Last .Hole Should Be Next To End Cap ~ P ~ Ft. X ~_ Inches Y ~-g_ Inches Hole Diameter ~~ Inch /~i Inch(es) Z-- Inches Lateral Diameter Force Main Diameter # ~Jf Holes/Pipe i2 Invert Elevation Of Laterals /on•~p Ft. Signed: ~~- ~j Lc.~l~ License Number: .,ZZo~ S3 Date: 4-~6 - 98 Page ~ Of COMBINATION SEPTIC TANK/PUMP CHAMBER 4" CI Vent Pipe with (No Scale) Approved Cap, +25' ,Approved Locking Manhole Cover From Buildings With Warning Label Attached ~ Weatherproof Approved _ Warning Label Junction Box Yent Cap 12 Minimum ~- ~ . ~. Final Grade-~ 6" Minimum ~ 4" Minimum " 6" Maximum 4" C.I. ~ Quick 18 Minimum ~ Insp. Pipe ~ Disconnect ~- -- I i 1/4" Weep ~ ~ Hole Baffles D 1J ~ ~r ~ Approved Joint ~ A w/C.I. Pipe ~ Extending 3' Alarm ~ B Approved Joint Onto Solid Soil On 6; w/C.I. Pipe ~ C Extending 3' -C G. Onto Solid Soi~ Off 6' D Conc. Block 3" of Bedding Under Tank Note: Pump and Alarm Are On Separate Circuits Tank Manufacturer: GcJe," eY' Tank Size-Septic/Pump : /'Z So ~5o Ga 1 ons Alarm Manufacturer: 5'~1 t= F cf~-o Model Number : ~ - Q Switch Type: ~r uY- Pump Manufacturer: Uul Model Number: 3Q$~ C~~ 0 3 /I _.~_, Minimum Discharge Rate: Z8• ~8 Number of Doses: ~/ Per Day Gallons Per Day/ of Doses:/~Z•SnGallons Volume of Backfl ow:.......+ s'c~-6/ Gallons Total Dose Volume:........=i~f3e/! Gallons Capacities: A,~ :nches or ~p ~/O Gallons + B Z, inches or z9,aZGallons + C ,3 inches or /Gallons + D~~nches or/76_SL Gallons Total....._ ~_~nches or ~p.c~~ Gallons Vertical Difference Between Pump Off and Distribution Pipe:~_Feet 13.5~;~ Minimum Required Supply Pressure:....... .......... .......+ Z.°'Feet X35' Feet of Force Main x/.~5~ Friction Factor/100~Feet: + greet Z Inch Diameter Force Main ~ Total Dynamic Head:...= et (~:~~ Internal Tank Dimensions: Length Width; Liquid Depth 5~~~ Signature ~~~~ ~Lt~o~L~ License NumberZZo853 Date ~-/d'98 .~ i~erformance Curves METERS FEET C a = 20 U_ Q Z ~- J Fa- O ~ 10 ~ p f g Submersible Effluent - - Pumps ~OU.S. GPM m'/h METERS FEET i 35 1 ,,,, 1 0 w 25 x U a 20 Z O a 15 F- O F- 10 0~ ~GOULDS PUMPS.INC. WATER TECHNOLOGIES GROUP Sg.E~A FAILS, NEW 1OfiY DI48 U.S. GPM 0 10 20 30 m'!h CAPACITY Effective July, 1993 ®1993 Goulds Pumps, Inc ~~ DD ~ /,^~ SPECIFlCATI7ONS ARE SUBJzECT TO CHANGE WITH/O'UT N/O(~TICGE. PRINTED IN U.S.A. W, S, ~%~J ""'^~ ~ < `~ ~~C~G ~~"7'~i Z C, ~ ~ ~J y~~C'~1 ` 6 038853450 0 10 20 30 FLOW RATE II , ~'--•lM ' -- -- - Z 3 p~ S~'. -'~ ~ ' -t ~ ~ o ~-- ~ h y ~-, h ~ O A ~ ~ -. J ) y `T ~J N ~ ~ tea. ~ ~, ~1 -~ _0 ~ N ~ ~ `~' ~ o ~ ~ v ` ~ ~ n vl A A d V -_ 3 ~r ~ 2 ~ ~T z ~ ~ Z ~~ ~~ J .~ ~~ J p ~~ ~ o n M o o ~ ~ ~ ~i a b ~_ P Z '1. q S a ~ Q ~ ~ ~ ~ ~ ~ ~ °~ ~~ v ` _1 ~ ~ ., t ~ a ~ 3 ~ ~ ~ 3 N ~ a (~ 0 L. `I~ V'1 I ~ \ o z r r ~- o O ~ ~ 0 ~ 0 tl ~ ~ a M ~ g T o- q , ~ a ~ ~ ~~7`J~l, .. ;•7 ~ _ a~ y +I 23t~~ Sf, ' ~ fi ~ o ~ b ~ -- Q Q A -~ ` v ~ o ~ 1 T V ~ ,,^ N -1.. ,O ~ Q ~" o ~, ~ f~ o ~ ~ I~ V o~ Q A ~T v d .` ~-- 0 -~ h p ~! loo ~.~ C.~ M aq 3 ~r ~ 2 ~ ~~ a Z ~~,7 .~ b ~! ~~ J ~~ ~~ J ~ ~~ ~ o d ~ M O ~ t ~•~f I c~ v ~> `'. V J ~~ 4V ~o L<" Ztl ~~ ~~ ~~ ~` ~~ M N w~ Ate, 0 ~" H d .~ N ~~ ~- Q Z S ~ A ~ Q A ~ ~s ~ ~ . ~ ~ ~ o` +~ V ~ ~ 's ~ .~ ~ ~ v 3 h N K Q (~ ~ ~ ~ 0 o o 0 ., ~ ~ ~- ~ ~~ \ ~~ ado ~ ~ ~~ b ~ Q" ~~ M~ c M ~ ~~ C1 r T ~ t~ ? ~ # M ~~ v V `` oho ,~ N p ~ N ~ 1 ~ Q ~ ~ ~ °° O -~ ~ a~ wisoorisln Department of Commerce SOIL AND SITE EVALUATION , .Division of Safety and Buildings Bureau of Integrated Services . -Tin~'c nce with s. ILHR 83.09, Wis. Adm. Code Page of `i l 9 Attach complete site plan on paper 8 1/2 11 inch include, but not limited to: vertical ~o ontai nt ( ~ e. Plan must County recdon and ~7 . r. ' percent sbpe, scale or dimensions,j io, arrow, di to nearest road. Parcel I.D. # I ~; ~ ~,t(~V f ,A APPLICANT INFORMATION lease ~nt all rm Reviewed by Date ~. Personal informatan you provide may be ysed)or CROIX (Privy •15.04 (1) (m)). R• ' ~ r (,~ ~ ~ Property Ow`ner / / > \`~` "`, ,~ •~ , Property Location Govt. Lot ~~ 1/4N~ 1/4,S ~ T Z9 ,W,R l~ ~ (or W ~ `y ~ ~ !/~ Property s Mailing Address __~, Lot # Bbck# Subd. Name or CSM# ZZSq Gt ~o% ~-D NA City State Zip Code Phone Number ' ' ^ qty ^ village ~ Town Nearest Road ff fit= , ~ynnZ (7is)G~~ ~~ .13c~ic~u~i ,~- GJ~ ~AIc~/w;r--- Z ?o New Construction Use: ,Residential /Number of bedroomsu„ ,~o:a--'Addition to existing building ^ Replacement ^ Public or commercial -Describe: Code derived daily flow gpd Recommended design loading rate ' Z bed, gpd/ft2 '-trench, gpd/(t~ Absorption area required bed, ft2 trench, ft 2 Maximum design loading rate • S bed, gpolfl2 ~ 6 trench, 9P~ Recommended infiltration surface elevation(s) ft (as referred to site plan benchmark) Additbnal design/site consideratio njs /~ Parent material ~ 5 ~ n ~. ~~ //~~ ~'eO1,',~8~~ .Flood plain elevation,'rf applicable ~r'7 ft S = Suitable for system Conventional Mound In-Ground Pressure ' AT-Grade System in Fill Holding Tank ^ S ~ U U Unsuitable for system ^ S .,~ U ~S ^ U U ^ S ,® ^ S ~ U ^ S ~ U Boring # Ground elev. /CY,~'~. Depth to limiting 3 in. Boring # Ground _ elev. ~~'~~ft. Depth to limiting factor 5'7 ~~ SAII 1']FSCRIPTI[~N REPORT Horizon Depth Dominant Color Mottles Structure i B d R t GPD/ft2 in. Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. stence Cons oun ary oo s Bed ,Trench J a 7.Sy 1'2. /Voce. s~J /--~s~ /~? Qt,J 2m •Z~ .3 Z 3 /d ye 6 ~/ Si iZr~ 5 ~ ~~r Q w 2 ' ~ ~ ' ~s .3 33- 7~~Y~ ~~ 7.5y,~~ sc s ~( rn ~r `' .Z :.3 Remarks: l" o-1Z '7~5 yiZ y~Z e, / s~ r~-~,r 2 • Z ' • 3 3 `/.5-57 7~ 5 Y1C l6 s 2 r»s b~ r7/~,r G ~;J -" ~ S ~ ~ ~ ~-6 7•~YP 5 Gz~ -S R/b' SG ~s6 rn~r 'r 'L ; ~3 Ramarkc~ CST Name (Please Print) Signature Telephone No. ~a ! e ~. ~ ~ c'tsov~.- cr,2., ~'. Uu~~ 7/~ ~ ~ ~ .33 7 Address Date CST Number r' ~I~v~',... ~,~ .s" ooZ, /018 I- 2zo ~3 PROPERTY OWNER ~ ~ ~l~ SOIL DESCRIPTION REPORT PARCEL I.D. Boring # 3 Ground elev. 9~-37ft 3Z in. Boring # Ground elev. 9n m Nmitlng factor ~~Q_in. Boling # Ground elev. R Oepth tD limiting factor in. Boring # Ground elev. ft. :, Page of ~ . Horizon Depth Dominant Cobr Mottles Texture Structure Consisterxre Roots 2 in. MunseN Qu. Sz . Cont. Color Gr. Sz. Sh. Y i3ed ,Trench ~ ° - ~ `~ ~ ~ None.. 5'i~ S ~+ /n -t' r A u7 ,Z, ~ 2 ' . 3 1_ &/~ !D y,~ 6 y si/ Z-rYJ ~'t T A t.J ~~' • 5 ; • ~o 3 -Z 7.5Y ~~ s s~ rn ~~',- c w : , 6 Z5- ~~y 5~ S~ .ZmS mv~r W -- ,~: ~b S Z-5 ~~y>~ s~b C2o/'7.5' ~ s S~i /YJ/T~" ~,,~ T-• .,S'; , 6 Remarks: - J o-// 7~~y~Z y /Voy...ci s: / 6~ ~ r Qr~7 ZM •Z •3 j Z ii8 /aye, 6 s; Zms m-1~.- out 2-F •~ ; -~ Remarks: Horizon Depth OominaM Color Mottles Texture Structure Consistence Bounda Roots GPO in. MunseH Du. Sz. Cont. Cobr Gr. Sz. Sh. ry Bed ,Trench Remarks: Depth to lirrdting factor 'n' Remarks: SBD-8330 (R. 07/96) ,~ G 0 ~~ ~ ~ ~ y ~ l v N ~ b o ~• (~o W ~t. p - 3 H 0~ , P d ~ ~" O, w ri'~ ~~ ~ N ~ ~ . ~1 WI ' v ` W A ~. ~v^1 ~, M~ 1 q od ~ ,/ - 3 ~j .t w ~ o ~J iii J J oo ~ ~ ~ Q • ~ ~ ~ .C 0 ~ ~ ~ ` ~ N 0 E ~ 1 ~ L ~` ~ 1 .. 0 0 -~ . T ~ z ~ ~o ~ - ~ ~ ~ . ~ ~ D ~ O d r 3 ~ ~ D '~- a ~ °` ~ 3 ~„ w 3 °~ ~~ V~ ~~ ~~ c U~ ~~ a d~~ y~ .~ z .c~ ~v ~ ~ ,tom ,~, L ~ ~ be W -.l ~_ N c~ n ~ ~ {- b £ b ~-- ~ N ~ e ~ ~ ~' ~ ~' ~ ~ ~ ~ D' A ' N n ~- ~ o ~. ~ t~ ,~.. ~,QSZ T d d ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM OwnerBuyer ~i'C n ~ -^ p~ (., r Mailing Address ~ ~ w ~ ,3 ~a W ,',,` Property Address _ ~~~~ 2~~~ ~'~ ,~ ~~ J a w~ r (Verification required from Plaaniag Department for new construction ' . S'~DOZ /.vi' City/State 13 a ~Gt w~'r- CJ. ~ Parcel identification Number U U a - i ~0 5 - l~ y ~ -/c1o g- Zp LEGAL DESCRIPTION Property Location N~ y,, ~~ /, Ste, .5' . T .Z 9 N R /~ W, Town of L~ ~ fl Gy i~ ii1 Subdivision it/~y Lot # ~• Certified Sarvey Map # N~ Volume N ~ ,Page # ~~ Warranty Deed # 7ti ~ g Volume ~a~~ .Page # ~--~ So7 . Spec house ^ yes ,~ no Lot lines identifiable ~ yes ^ no SYSTEM 11~IAINT'IENANCE Improperuse andmaintenanceofY~septic conldresaltia itsprcmatucefar~ureto haadlewastes. Propermaiabeaaa~ce consists of pumping out the septic tank every three Years or if nodded by a licensed pumper. What you put into the system can affect-the function of the septic tank as a ireatmeat stage is the waste disposal ys~m, - Tlue property owner agrees to submit to St Croix Zoning Dcparbmart a oeatification foam, signed by the owner. and by a PIo~Y~nPI~ restrictedphimber or a licensedpumperverifying that (1) the oa-site wastowaterdisposal system is is prnpec operating condition and/or(2) after inspection and ptmrping.(if necessary), the septic tank is less than 1/3 full of sludge. t/we. the tmdersignod have read the above noqui sadagree to maintain the private sewage disposal system with the standards ~ f~, ha+ein, as set by the Department of Commerce and the Department of Natural Resources; State of Wisconsin.. Certification stating that Your septic system has been maintained must be ~aipleted sad returned to the St. Croix -County Zoning Office within 30 days of the three year expiration date. SIGNATURE OF APPLICANT DATE .OWNER CERTITICATION I (we) certify that all statements oa this form are true to the best of my (our) laiowledge. I (we) am (are) the owner(s) of the property descn'bcd above, by virtue of a warranty decd t+xorded in Register. of Deeds Office. m ~f J~ ~ ~ / 1 / 9 8 SIGNATURE OF APPLICANT DATE «««««« Any information that is mis-represented slay result in the sanitary peraut being revoked by the Zoning Department. ««s««« «« Include frith this applicaNoa: a stamped warranty decd from the Register of Deeds office a copy of the certified survey map if reference is made in the warranty decd ~~.1 ~ x~~~..~ .. r ~ },~' .4_ r r'. ~ _. e x ;.}. ~ . .T.'Ab. ^,~: :z1.,~ a -a• w• _. CF... /~~ ~ ~i ~ STATE BAR OF WI5CON~~N FORM 2 - 1982 5 •QfJ•-7~ WARRA'.VTY DEED DOCU•AENT NO. Eugene Ye-e_nensiall.._a.11~+L~--~ " ~~ - E - ~e@n nda~ 1 and Gandy.d...-~CSpnF+nda11,T_____-__- a~k1~i andlsa_F Veenend311L.~t1Q~'anA and wife and R_ Cronk .~1ricL $~da- convcys and warrants to Rich-- }[ n ~ A i nQ L CrOnK nusoand 'and wife as survivorship marital _groP_p~'tY the following described real estate in St • Croix _ County, State of Wisconsin: See Exhibit A attached hereto and made a part hereof. ttEGISTE~R'S OFFICE ST. SCR ~XRC4.~ `N1 JAN ~ 2 199 ~, a:s~~~ TH13 SPA(,E RESERVED FOR RECORDING DATA NAME AND RETURN ADDRESS ERT a r~3~y 002-1009-10. -20_ PARCEL IDENTIFICATION NUMBER TRANSFER ~' S p0 This__~ not hotnesreadproperty. 7fiD[ (is trot) Exception towarranues: Easements and restrictions of record. Dated this _ ~Oth day of December _., A.D., 19 9Z_. (SEAL) • (SEAL) AUTHENTiCAT10N Signature(s) authenticated this _._ day o[ __ . 19- TITLE: MEMBER STATE BAR OF WISCONSIN (If not, 3rentia Poulin authoriz_d by §706.06, Wis. Stars.) Notary Public Stitt t~f Wiscon L-~s~.~ ~ V~~~I.Ka~~tia%'`~ (SEAL) • ene •. Veenendali SEAL) • Sandra A Veenendali __ ACKNOWLEDGMENT State o! Vv:sconsin, ss. Gt Crni x County. Personally came before me this 30th day of fleeter , 1991._. the above named FugEL11° veo»a~nAa 1 1 a/ /a Eugene F Qnonandatt and Gandr;~ Vpenendal ] _a/1c~a Gandr~~_ to me kno to be the person _S.~ who executed the foregoing ~tstru a and acknowledge the me. THIS INSTRUMENT WAS GRAFTED BY - Thomas A McCormack. l l°~ WI 54002 _ - Not ry P lic, unty, Wis. Ratdwin, (Signatures may be authenticated or acknowledged. &xh are not ht commission is permanent. (If nut, statt •~~ tin necessaryJ -----~-~ • Names of pca~ns signing in am~ ca}~aeity should by typed er panted below ih?v signatures. wiu~yn L•yal [hark Co. a+a STATE aAR JF wt5COti51!V A,y,~~g, ws. WAR'R~1rTY DEEn Form No. 2 - 1982 got 1?~ i~a~: ~f}3 EXHIBIT A ~ parcel of land located in part of the i~'orth Self of the 2~ortAeart Quarter of Section 5, Torcaabip 19 i:ortt~, Range 16 Meet, Tot-n of 8aldrin, St. Croix County, 1cf6eonsan; Described ae toiloxs: Co;unsncing at tha North Quazker eozbez of acid &ection 5; ttience south DZ degrees 43 mi.nutta t7 seconds Baet a distance of 83.08 feet along the vent line of said Nartheaet Quartez; thence North 89 degrees 4t t!,inutee 47 secvade East a distance of 811.48 feet along the ~oouth lint Oi that pa.rCtl of land de6Cribe~! on a deed recorded in volume 1a9. page 463 in t a oliice of the St. Croix County itegister of Deeds to the point of begixmingj thtace North 89 degzeee 44 minutes 47 secondQ ftast a dittanoe of 138t.s~ feet along iaet said tine; thence South o2 degrees 35 mtautes 11 seconds Naet~a'dietaace a! 349.83 Last along the meat line of that parcel of land de8cribed oa a dead recorded in volua+e 353 gage i62 in acid office; thtace NortD e9 degreaa 44 minutes 47 eecvnds Bast a distance O! 433.00 feet aior-g LAE south line of last said .par~cal ~- t~Ae.nce Svutb OT degrees 35 raia~ztes ii seconds Bast. a _ _ distance o! eSb.?7 lest along the east line of said l~ort2uaat Quarter; thtace Korth 89 degrae8 SS minutes 59 aeeondr xEat a dietaries of 18i4.Q6 feet along the south linE of said North Fa!i of the Kortheast Q~.:trter; thence North OT degrees t3 misuses 47 second6 t~tst a distance of ii96.i? feet to the point O! beginning. Containing 46.349 t-crea. gubjECt to right-of-gray for the torn, road along the east line thereof i-rid subject to all other laeecr.ent6, reatzictions and ceaenants of record.