Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
651323 038-1223-06-000
Wisconsin Department of Commerce Safety and Building Division PRIVATE SEWAGE SYSTEM INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: City Village Township Ryan & Emily Keaveny TOWN OF STAR PRAIRIE CST BM Elev: Insp. BM Elev: BM Description: i Ito. D 180.0 / CST Bwk.I — -lap TANK INFORMATION r TYPE MA FACTURER CAPACITY Septic �1 Dosing I V 00 Aerati TANK SETBACK INFORMATION LbCyh 't,fin�,itws. TANK TO P�/L Pt WELL BLDG. Vent to Air Intake ROAD Septic ' t O I Q J Dosing 7 Lt , Aerati Holding PUMP/SIPHON INFORMATION Manufacturer © �� 7TDHFt Model Number TDH Lift Frict n Loss System Head �•d2 Forcemain Length i (r Dist. to Well F7; �L) I SOIL ABSORPTION SYSTEM ELEVATION DATA County: St. Croix Sanitary Permit No: 651323 State Plan ID No: / r,Y(S 22 3 02 Parcel Tax No: 038-1223-06-000 Section/Town/Range/Map No: 04.31.18.1243 STATION BS HI FS ELEV. Benchmark r Alt. BM Bldg. Sewer 011 SUHt Inlet SUHt Outlet Dt Inlet Dt Bottom `03 9l�a� Header/Man. Dist. Pipe ¢ 5 a�� 5 79, / ! Bot. Syst 2- � V100 final Grade LIL (x 12- �r fAe Cover /09,, -� /D©,9� d THE Width Length / No. Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS � 8© SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHIN Manufa er: INFORMATION CHAMBER O Type Of System: r f r � UNIT Number: 1 �5 I � � � � S�Q DISTRIBUTION SYSTEM Header/�*Dia__2�L Distribution I I x Hole Size x Hole Spacing Vent to Air Intake Pipe(s) 2 ' j q 3�- LengthLength Dia Spacing SOIL COVER x Pressure Svstems Only xx Mound Or At -Grade Svstems Only Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil ❑ Yes ❑ No ❑ Yes ❑ No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: Q111-12o23 Inspection #2: Ka.(�> ,-) Location: 1057 238TH AVE - ) ` ` ZL /2o24, 1.) Alt BM Description = �Xkklr 2.) Bldg sewer length = -76 - amount of cover =.p�'► i Plan revision Required? ❑Yes V No L 4 Z� Use other side for additional information. "j G`� Date �� Insepctor's Signature Cent. No. Uepartnient of Safety Comm 5 St Croix p =, & Professional Services, Sarut-in l'rcnlzt'`urnhci ,c 611ed by Co l I77 $''i r) ryllLa � •� L:1 Industry Services Division U m ,a; J�{ 4vs1 323CWvIsCID _ Sanitary Permit Application Stntc IransacnanNumber I :..':CurJunce'w-Ith SPS 393 21(2) Wis. Adnt lode, suhmissioii of this limns to the iplifopriaie Sovcmmental unit '' WTS — 122-3 02721 Plojcci Addicas Itfdiffercnt than maihne addressl icqutred prior to obtaining a sanitary permit Note Apphcauon fllrTnS lur Slate -united 1'UWTS are submitted to the l3cpiwillcnt of Safcty and Professional Scrvlcc8 Pcrskirial rnfnrinatlnn you Provide may he used for sccondar} purposes in accordance with the Privacy lase, s 13 04(1 )(m), Slats 1057 238TH AVE STAR PRAIRE -- 1. Application Information - Please Prism All Information Propem Owiiei -s Nitric Parcel H RYAN AND EMILY KEAVENY b3$—/22'3-06 -Coo Property 0"1icr"s Mauling Address S�1`� Property location 1713 W 88TH STREET Ciao+t Lot Cuy. Slate Zip Cade -i 'cumber BLOOMINGTON MN 55431 W y NE Section 4 T 3 N R 18 E or kk x 11. Cype of Btailding (Check all chat apply) n 0 1 or 2 Family Dwelling - Number of-Bednxims 4 6 Subdivision Name LOGANBERRY - I v t; a 0 PuhhcPComntcrcrall - Desc ribe Use ❑Cityof 11 State Chased - Describe Use ❑ Village of CSM Number 0 Town of STAR PRAIRE 111, Ty pe of PONNTS Pel•nlit: (('heck either "'tier+" or "ltepiact ineut" and other applicable on line :1. ( heel; one I)ox tin litre It, Oiniplete line C i nlslrlir:a. x i � Hera• System ❑Replacement System ❑ Other Msxlificatlun to Existing System (explain) ❑ Additional Pretreatment Unit Irsplain) R. C lTold ing Tank ❑ In-tiruund ®At -Grade ❑ Mound ❑ Individual Site Design ❑ (lthet T}pe (explain) { owxnttonall C [, licneNaal Before Revision J Chance n1 Plumber _. ❑ Transfer to New (timer ,ist Previous Permit Number and Date Issued 1-xlrnaliiril IV. Dispersal/Treatment Area and Tank Information: lo X [b0'A+-4i&Ag AU Design Flaw tgpd1 1)c,r2n Soil Application Raie(gpd/sf] Dispersal Area Requr d (sl) 1JrsperF••' a Proposed (sI) Ssst m E vation t 600 /0,71-J %t 740 q q . o Capactty in Total N of Manufacturer Tank Information Gallons Gallons Units L c U u New Tanks rvi,ting Tank, •' t �, r z o' .� Septic or Holding Tank x 1200 1 WIES+�E-R x r)nSrnm k('habcr x 800 _ WIESER I x N . Respou.ihilitF Statement- 1, the undersu ned• ammme responsibility For iostallatiun of The 1'()Y►7.4 shown un Ilre anArlied Plans. Plumber �. N,ii , (Print) plumber's Signature y11'%)vgl'RS Number Business Phonc . PAUL R KOEHLER �.�..�•��. ��'' - 225410 715 246 2660 Pluinbct's Address (Street. City. State, Zip Code) 321 WISCONSIN DR NEW RICHMOND 54017 %T ConntylDepartment Use Only IS:lpJ7 i PCmtlt FCC I)jtc ls,ucd Issuing Alent Signature .Apf�eoved $ g� r2�Z� nncr G cnial �23 ("nndititms of •lpprnrall 3 ) 9,evl S t o ti _v, � roxl�r ,. � h sin-:-t SYSTEM OWNER. CLAD-CL-. 1. SepIic Tank, efFlut nt filter and dispersal cd mus: be q) / -eBr6 L.A b F9 /44--Grr 2 °'� °' �� .^'• 2, maintained as per • In :mu'v ;' r ;: -guided by plumber. W;+tn itit� p2J•w A 2. All sczu,a0k rr ui-rr.r,rt; must be maintained as per applicable Code / .rdinarim, AI ach to coinplror plans for the Mtrm Anil sutnintt to tit County nnh on paper not less than A tr1 x 11 inches in sin SBD-6398 (R• 03/22) Pnc��.1 o,�g- 12z�-ob-avr 4��$ T3Gr l.ar�an autk I OD 0 All proposed wE shall remain >2 from treatment dose tank and l' from At -Grade System. 11�a /sae Casa [ � f t�-�ai1� C,.l l b � ( E i 1 � f Li.1 ► r y� COPY Wisconsin Department of Safety and Professional Services Division of Industry Services 4822 Madison Yards Way PO Box 7302 Madison, WI 53707 December 7, 2023 CUST ID NO.: 225410 PAUL R KOEHLER 321 WISCONSIN DR NEW RICHMOND, WI 54017 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: MUNICIPALITY: TOWN OF STAR PRAIRIE ST. CROIX COUNTY SITE: RYAN KAEVENY 1057 238TH STREET NEW RICHMOND, WI 54017 W 1/4 NE 1/4 SEC 4 T 3 R 18W FOR: Design Wastewater Flow Value: 600 Bedrooms: 4 Limiting Factor(s): >36" Maintenance Required: Effluent Filter Phone:608-266-2112 Web: http://dsps.wi.gov Email: dspsnwisconsin.gov Tony Evers, Governor Dan Hereth, Secretary Identification Numbers Plan Review No.: PWTS-122302721-C Application No.: DIS-I 12349797 Site ID No.: SIT-124301 Please refer to all identification numbers in each correspondence with the Department. Conditionally APPROVED DEPT. OF SAFETY AND PROFESSIONAL SERVICES DIVISION OF INDUSTRY SERVICES SEE CORRESPONDENCE At -Grade Component Manual - Version 3.0 (May 2022- 2027) Pressure Distribution Component Manual Ver. 2.1 (May 2022 — 2027) SITE REQUIREMENTS • A full size copy of the approved plans, specifications, and this letter shall be on -site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. A Department electronic stamp and signature shall be on the plans which are used at the job site for construction. The following conditions shall be met during construction or installation and prior to occupancy or use: • Preserve dispersal area prior and during construction to avoid disturbance, compaction and use of the site. • With new construction; it is recommended not to activate the pump in the dose tank until the tanks are pumped prior to homeowner occupancy. • Wastewater generated from contractors cleaning of equipment and tools and/or left over construction products shall not be discharged into the drains discharging to the private onsite wastewater treatment system (POWTS). Waste generated shall be properly disposed of on -site or off site. • Any tall grasses, leaves and shrubs shall be cut short and removed prior to tilling the surface for installation to prevent matting under the dispersal area. All loose organic material to be removed from POWTS Dispersal Area. • Divert surface water from all POWTS Areas. • Prior to construction of the dispersal area, check the moisture content of the soil to a depth of 8 inches. Smearing and compacting of wet soil will result in reducing the infiltration capacity of the soil. Proper soil moisture content can be determined by roiling a soil sample between the hands. if it rolls into a I/4- inch wire, the site is too wet to prepare. If it crumbles, site preparation can proceed. If the site is too wet to prepare, do not proceed until it dries. • All piping shall conform to SPS Table 384.30-3 and SPS Table 384.30-5 • Insulate building sewer beyond 30 feet per SPS 382.30 (I 1)(c) • Well setbacks to meet chs. NR 811 & 812 • Tank Installation to follow all manufacture's recommendations. • Verify property line(s) prior to installation. • Pump Floats to beset and verified per approved plan. Any changes may result in pump resizing to meet TDH and GPM Specifications. • Areas that are occupied with rock fragments, tree roots, stumps and boulders reduce the amount of soil available for proper treatment. If no other site is available, trees in the basal area of the mound must be cut off at ground level. A larger fill area is necessary when any of the above conditions are encountered, to provide sufficient infiltrative area. Owner Responsibilities The current owner, and each subsequent owner, shall receive a copy of this letter including instructions relating to proper use and maintenance of the system. Owners shall receive a copy of the appropriate operation and maintenance manual and/or owner's manual for the POWTS described in this approval SPS 383.54(I). In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approved plans. The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. This system is to be constructed and located in accordance with the enclosed approved plans and with any component manual(s) referenced above. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, stats. All permits required by the state or the local municipality shall be obtained prior to commencement of construction/instal lation/operation. In granting this approval, the Division of Industry Services reserves the right to require changes or additions, should conditions arise making them necessary for code compliance. As per state stats 101.I2(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. The Division does not take responsibility for the design or construction of the reviewed items. Inquiries concerning this correspondence may be made to me at the contact information listed below, or at the address on this letterhead. Sincerely, Fee Required: $250.00 Fee Received: $250.00 Balance Due: $0.00 Jeff Brewbaker Refund Expected: $0.00 Division of Industry Services Phone: 608-5 16-6428 Email: jeffbrewbaker@wisconsin.gov RESIDENTIAL AT -GRADE DESIGN Pressurized - Sloping Site INDEX AND TITLE SHEET Project RYAN AND EMILY KEAVENY Owner Address 1057 238 TH AVE STAR PRAIRE Legal Description W 1/4 NE 1/4 SEC 4 T 3 R 18 W Township STAR PRAIRE County ST CROIX Subdivision Name LOGAN BERRY Lot No. 6 Parcel ID Number 038-1223-06-000 Plan Transaction Number Conditionally APPROVED DEPT. OF SAFETY AND PROFESSIONAL SERVICES DIVISION OF INDUSTRY SERVICES SEE CORRESPONDENCE Index sheet Page 1 Calculations Page 2 At -grade drawings Page 3 Laterals and dose tank Page 4 Specifications Page 5 Management & contingency plan Page 6 Designer PAUL R KOEHLER Signature�f;,�''�--- Date 11 /21 /23 License Number 225410 Phone Number 715-246-2660 Designed pursuant to: At -grade Component Manual Ver. 3.0 for POWfS (May 2022-2027), and both SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST - SAS (01/81) and Pressure Distribution Component Manual Ver. 2.1 (May 2022-2027) Version 7.1 (07/22) Pagel of 6 PRESSURIZED AT -GRADE DESIGN At -grade Design Worksheet - Sloping Site Flows and Site Data Entry. (r or c) r Residential or commercial? 400.0 Estimated wastewater flow (gpd) 600.0 Design wastewater flow (gpd) 6 % Site slope Slope may not exceed 25% 99.00 Contour elev. below lateral (ft) 42.00 Depth to limiting factor (in) 0.60 In -situ soil application rate (gpd/f A2) Distribution Cell Information (1 or 2) 1 Influent wastewater quality 6.00 Linear loading rate gpd/ft 10.00 Effective absorption width (ft) 10.00 Max. effective width permitted (ft) 100.00 Aggregate length (ft) Pressure Distribution Data Entry (c or e) E Center or end lateral connection 1 Number of laterals 0.156 Orifice diameter (in) e.g. 0.25 Not a final calculation 2.00 Estimated orifices spacing ft P 9 ( ) 2.00 Forcemain diameter (in) 2.801 Forcemain flow velocity (ft/sec) 110.00 Forcemain length (ft) 93.00 Pump tank elevation (ft) 4.55 System head (ft) x 1.3 5.58' Vertical lift (ft) 1.80 Friction loss (ft) 0.00 In -line Filter Loss (ft) I 11.93' # ! Total dynamic head (ft) Designer must select one lateral diameter Lateral Diameter Selection Pipe diameter Design options Design choice 1 In 1.25 in 1.5 in 2 in X X 3 in X y or n y Does forcemain drain back? y or n y Are laterals at highest point? NA 17.9 Forcemain drainback (gal) 80.0 5x Lateral void volume (gal) 97.91 Minimum dose volume (gal) 27.4'System demand (gpm) Gallons/inch Calculator (optional) 867 Total Tank Capacity (gal) 39 Total Working Liquid Depth (in) 22.2 Gal/in (enter result in cell G46) Treatment Tank Information 1200 Septic tank capacity (gal) W[ESER lmanufacturer Effluent Filter Information Dose Tank Information POLY LOCK IFilter manufacturer __8_00501 Dose tank capacity (gal) 525 Filter model number 22.2 Dose tank volume (gal/in) WIESER IManufacturer Project: RYAN AND EMILY KEAVENY Transaction Number: Page 2 of 6 AT -GRADE PLAN VIEW D —t D r1/6 B Observation pipes (2 typical) g 11 , 0.00 ft 1/6B 16.67ft - C 12.00 ft W c D 5.00 ft E 2.00 ft d I L 110.00 ft B T W 22.00 ft A x B 1000.00 ft^2 T L <--- Cap = Total a re ate cell A x B Typical obs. pipe. gg g Slotted in the lower 6", and = Plowed area L x W anchored securely. Im s" Svnthetic fabric cover Lateral t-99.5 invert elev. f * F! ft 99.0 Surface contour # ! ft and system elevation AT -GRADE CROSS SECTION C •�.A = 12 in. topsoil and subsoil over aggregate and tapered to toes. = 6 in. aggregate below pipe(s), and 2 in. above pipe. Project: RYAN AND EMILY KEAVENY Transaction Number: #REF! Finished grade elevation �— Observation pipe at aggregate toe D -T 1 �►+— Plowed layer below L x W Page 3 of 6 PRESSURE DISTRIBUTION AND DOSE TANK Lateral Diagram - End Connection P Last hole ddWed next to end cap (F X--+l Laterals & force main of PVC Soh 40 Holes drAled on the bottom of the lateral per SPS Table 384.30.6 equally spaced ♦ =Turn-upvwfbsllvalvaoroloonoutplug Lateral SpecWications 0.156 Orifice diameter (in) X 1.96 Orifice spacing (ft) 51 Orificestiateral 27.4 Lat discharge rate (gpm) 27.4 Sys. discharge rate (gpm) 11.93 # Fl TDH (ft) Final grade Weather-proof junction box ' End Lateral connection point 1 Number laterals P 98.00 Lateral length (ft) 2.00 Lateral diameter (in) 2.00 Forcemain diameter (in) 110.00 Forcemain Length (ft) Typical Pump Chamber Layout Tank component is properly vented Electrical as per NEC 300 and SPS 316.300 WAC c o A C B E C S�. Totals Inches Gallons 18.6 413.5 2.0 44.4 4.4 97.9 11.0 244.2 36.0 800.0 Tank full JA Alarm on Pump on B 93.92 ft I C Pump off GOULDS � Pump manufacturer EP05 Pump model number Project: RYAN AND EMILY KEAVENY Transaction Number: K Approved manhole cover with warning label and belting device 4" disconnect - —,,, Alternate~ r_ outlet -^ location 18" min. I� Approved outlet joint Provide 1/4" weep hole or antisiphon device. 4 93.00 ft SJ ROMBUS� Alarm manufacturer PS PATROL Alarm model number Page 4 of 6 At -grade System Maintenance and Operation Specifications Service Provider's Name COUNTRYSIDE PLUMBING I Phone 715-246-2660 POWTS Regulator's Name COUNTRYSIDE PLUMBING Phone 715-246-2660 System Flow and Load Parameters Design Flow - Peak 600 gpd Maximum Influent Particle Size 1/8 in Estimated Flow - Average 400 gpd Maximum BOD5 220 mg/L Septic Tank Capacity 1200 gal Maximum TSS 150 mg/L Soil Absorption Component Size 1000.0 ft2 Maximum FOG 30 mg/L Type of Wastewater Domestic Maximum Fecal Coliform >10E4 cfu/100 mL Septic and Pump Tank Effluent Filter Pump and Controls Alarm Pressure System Mound Other Service Frequency Inspect and/or service once every 3 years Inspect and clean at least once every 3 years Test once every 3 years Should test month! Laterals should be flushed and pressure tested every 1.5 years Inspect for ponding and seepage once every 3 years Miscellaneous Construction and Materials Standards 1. Observation pipes are slotted and materials conform to Table SPS 384.30-1, have a watertight cap, and are secured in as shown in the at -grade component manual. 2. Dispersal cell aggregate conforms to SPS 384.30 (6)(i), Wis. Adm. Code. 3. All gravity and pressure piping materials conform to the requirements in SPS 384, Wis. Adm. Code. 4. Tillage of the basal area is accomplished with a mold board or chisel plow. 5. The at -grade structure and other disturbed areas will be seeded and mulched to prevent soil erosion and help reduce frost penetration. 6. Areas within 15 feet of the downslope toe will be protected from compaction. 7. All other construction details are as per the at -grade component manual SBD-10854-P (N. 03/07). Lateral Turn -up Detail Finished ,�._.:.,:. r...�. ............... Grade 64' Diameter Lawn Threaded Cleanout Sprinkler Valve Box Plug or Ball Valve Distribution Long Sweep 90 or Two #REF! ft 45 Degree Bends Same Diameter as Lateral Project: RYAN AND EMILY KEAVENY Transaction Number: Page 5 of 6 At -grade System Management Plan Pursuant to SPS 383.54, Wis. Adm. Code General This system shall be operated in accordance with SPS 382-384 Wis. Adm. Code, and shall maintained in accordance with its' component manuals (SBD-10854-P (N. 03/07, R, 01/12), SSWMP Pub. 9.6 (01181), and Pressure Distribution Component Manual Ver. 2.0 SBD-10706 (N. 01/01, R. 10/12)] and local or state rules pertaining. to system maintenance and maintenance reporting. No one should ever enter a septic or pump tank since dangerous gases may be present that could cause death. Septic and pump tank abandonment shall be In accordance with SPS 383.33, Wis. Adm. Code when the tanks are no longer used as POWTS components. Septic or pump tank manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 8-inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into a tank or component. Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Stats. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code. The operating condition of the septic tank and outlet fitter shall be assessed at least once every 3 years by inspection. The outlet filter shall be cleaned as necessary to ensure proper operation. The filter cartridge should not be removed unless provisions are made to retain solids in the tank that may slough off the filter when removed from its enclosure. If the fitter is equipped with an alarm, the filter shall be serviced if the alarm Is activated continuously. Intermittent fiker alarms may indicate surge flows or an impending continuous alarm. The septic tank shall have its contents removed when the volume of sludge and scum in the tank exceeds 1/3 the liquid volume of the tank. If the contents of the tank are not removed at the time of a triennial assessment, maintenance personnel shall advise the owner of when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank. The addition of biological or chemical additives to enhance septic tank performance is generally not required. However, if such products are used they shall be approved for septic tank use by the Department of Commerce. Pump Tank The pump (dosing) tank shall be inspected at least once every 3 years. All switches, alarms, and pumps shall be tested to verify proper operation. If an effluent filter is installed within the tank it shall be inspected and serviced as necessary. At -grade and Pressure Distribution System No trees or shrubs should be planted on the at -grade. Plantings may be made around the at -grade's parimeter, and the at -grade shall be seeded and mulched as necessary to prevent erosion and to provide some protection from frost penetration. Traffic (other than for vegetative maintenance) on the at -grade is not recommended since soil compaction may hinder aeration of the infiltrative surface within the mound and snow compaction in the winter will promote frost penetration. Cold weather installations (October -February) dictate that the at - grade be heavily mulched as protection from freezing. Influent quality into the at -grade system may not exceed 220 mg/L BOD5.150 mg/L TSS, and 30 mg/L FOG for septic tank effluent or 30 mg/L BOD5 30 mg/L TSS, 10 mg/L FOG, and 104 cfu/100 mL for highly treated effluent. Influent flow may not exceed maximum design flow specified in the permit for this installation. The pressure distribution system Is provided with a flushing point at the end of each lateral, and it is recommended that each lateral be flushed of accumulated solids at least once every 18 months. When a pressure test is performed it should be compared to the initial test when the system was installed to determine if orifice clogging has occurred and if orifice cleaning is required to maintain equal distribution within the dispersal cell. Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the owner, and any levels above 4 Inches considered as an impending hydraulic failure requiring additional, more frequent monitoring. Gonttnnencv Plan If the septic tank or any of its components become defective the tarn or component shall be repaired or replaced to keep the system in proper operating condition. If the dosing tank, pump, pump controls, alarm or related wiring becomes defective the defective component(s) shall be immediately repaired or replaced with a component of the same or equal performance. If the at -grade component fails to accept wastewater or begins to discharge wastewater to the ground surface, it will be repaired or replaced in Its' present location by Increasing basal area If toe leakage occurs or by renovating the biologically clogged absorption and dispersal media, installing new piping, and replacing other components as deemed necessary to bring the system into proper operating condition. See Page 5 of this plan for the name and telephone number of your local POWTS regulator and service provider. Project: RYAN AND EMILY KEAVENY Transaction Number: Page 6 of 6 Pnc��.1 o,�g- 12z�-ob-avr 4��$ T3Gr l.ar�an autk �Yrt i00 I OD 0 All proposed wE shall remain >2 from treatment dose tank and l' from At -Grade System. 11�a /sae Casa [ � f t�-�ai1� C,.l l b � ( E i Li.11 ► r J!i �+ 2 ►po �y �� � ' A � tip y� nT39! Inc. l• PL-525 Effluent Filter We of PoVok Inc. PL-525 Filter The PL-525 Filter is rated for 10,000 GPD (gallons per day) making it one of the largest filters in its class. It has 525 linear feet of 1/16" filtration slots. Like the Polylok PL-122, the Polylok PL-525 has an automatic shut-off ball installed with every filter. When the filter is removed for cleaning, the ball will float up and temporarily shut off the system so the effluent won't leave the tank. \ Features: • Rated for 10,000 GPD (gallons per day). • 525 linear feet of 1/16" filtration. • Accepts 4" and 6" SCHD 40 pipe. • Built in gas deflector. • Automatic shut-off ball when filter is removed. • Alarm accessibility. • Accepts PVC extension handle. PL-525 Installation: Ideal for residential and commercial waste flows up to 10,000 gallons per day (GPD). 1. Locate the outlet of the septic tank 2. Remove the tank cover and pump tank if necessary. 3. Glue the filter housing to the 4" or 6" outlet pipe. If the filter is not centered under the access opening use a Polylok Extend & Lok or piece of pipe to center filter. 4. Insert the PL-525 filter into its housing. S. Replace and secure the septic tank cover. PLr525 Maintenance: The PL-525 Effluent Filters will operate efficiently for several years under normal conditions before requiring cleaning. It is recommended that the filter be cleaned every time the tank is pumped, or at least every three years. If the installed filter contains an optional alarm, the owner will be notified by an alarm when the filter needs servicing. Servicing should be done by a certified septic tank pumper or installer. Locate the outlet of the septic tank. 2. Remove tank cover and pump tank if necessary. 3. Do not use plumbing when filter is removed. 4. Pull PL-525 cartridge out of the housing. 5. Hose off filter over the septic tank. Make sure all solids fall back into septic tank. 6. Insert the filter cartridge back into the housing making sure the filter is properly aligned and completely inserted. 7. Replace and secure septic tank cover. 1A6" Filtration Slots z Accepts 4" & 6" SCHD 40 pipe Alarm Switch (Optional) Accepts 1" PVC Extension Handle Rated for 10,000 GPD 525 Linear Ft. of 1/16" Filtration Slots Certified to NSF/ANSI Standard 46 Gas Deflector Automatic Shut -Off Ball ^a' Outdoor SmartFiltere Alarm Extend & LokTb Polylok, Zabel & Best filters accept Easily installs the SmartFilter® switch and alarm. into existing tanks. Polylok, Inc. 3 Fairfield Blvd. Wallingford, CT 06492 Toll Free: 877.765.9565 Fax: 203.284.8514 www.polylok.com Wastewater �1 METERS FEET 10 9 3 8 2 7 V 6 2( 5 4 H 0 3 10 2 5 1 0 0 MODEL INFORMATION Order i Number HP Vohs Amps EP0411 EP0411A 115 12 EP0411F 4 EP0411AC EP0412 230 6 EP0412F EP0511 F 115 13 EP0511AC .5 EP0512F 230 6.5 wummum Circuit Float Phase Switeh Cord Breaker StA* k*ngtl Plug / No Switch 10' Piggyback / 20 Wide -Angle 10' Plug / No Switch 20' W110 No Switch Plug / No Switch 20' 20 Piggyback ! 20' Id e Angle 10 _ Plug / No Switch 20' cz�-L� r�� s eCL/� scherge nn9dion Minimum On Level Manual Minimum Off Level Manual Minimum Basin Diameter 15" Maximum Solids Sim ' 4' Shippia Weigh, ibs.hg 20/9.1 21 / 9.5 12" Manual 12" 6- Manual 6" 20/9.1 21 / 9.5 Manual Manual Manual Manual Manual Manual 20/9.1 20/9.1 22 / 10 12" 6" 23 / 10.4 Manual Manual 22 / 10 PAGE 3 13 -R., --_,�-.-_--.-.tea 4" CAST -A-SEAL f i v LS7 !' Y I Yf r � i I•�� I I _ III FILTER OR -/ I BAFFLE WLP1200/800-MR TANS SPECIFICATIONS DIMENSIONS: WALL: 3" BOTTOM: 3" COVER: 6" Lj MANHOLE: 24" I.D_ PRECAST CONCRETE RISER o 4" CAST--A-SEAL HEIGHT: 53" LENGTH 13' 8" d � � 1-4" VENT OUTLET t------LJ-------- f t \-PUMP rAD [TANKS ARE MANUFACTURED TO MEET OR EXCEED ASTM C--1227 REQUIREMENTS W DTH: 8'-0" BELOW INLET: 41" LIQUID LEVEL: 36" o WEIGHT. BOTTOM 14.800 LBS. - a COVER 8,170 LBS. a Q C71 INLET AND OUTLET: n 4" CAST -A -SEAL BOOT OR EQUAL GASKET INLET AND OUTLET BAFFLE AND FILTER: a o WISCONSIN, SEE DETAIL #10 (OTHER STATES SEE CHART) LIQUID CAPACITY: 33.46 GAL%IN (SEPTIC) ET.. 22.24 GAL/IN (PUMP) v C Ln LOADING DESIGN: 8'-0" UNSATURATED SOIL L7 �L7 TANK CAN BE USED AS: SEPTIC / HOLDING / PUMP OR SIPHON COVER: MIX DESIGN #0 (NO FIBER) TANK: MIX DESIGN #9 (SMALL FIBER) N CUSTOMIZED TANKS: FOR CUSTOM TANKS CONTACT WESER CONCRETE REVIEWED BY REVIEW DATE DRAWINGS SUBMITTED FOR APPROVAL APPROVED BY: APPROVAL DATE: PRoDucT5 NEEDED BY: POWTS OWNER'S MANUAL & MANAGEMENT PLAN I Page I of 2 FILE INFORMATION Owner RYAN AND EMILY KEAVENY Permit # nFCIr.'N PARAMFTGRC Number of Bedrooms 4 ❑ NA Number of Public Facility Units NA Estimated flow (average) 400 gal/day Design flow (peak), (Estimated x 1.5) 600 al/de Soil Application Rate al/da /ft2 Standard Influent/Effluent Quality Monthly average• Fats, Oil & Grease (FOG) S30 mg/L Biochemical Oxygen Demand (BOD6) 5220 mg/L ❑ NA Total Suspended Solids (TSS) 5150 mg/L Pretreeted Effluent Quality Monthly average Biochemical Oxygen Demand (BODE) 530 mg/L Total Suspended Solids (TSS) 530 mg/L ❑ NA Focal Collform (geometric mean) 510` cfu/100ml Maximum Effluent Particle Size Y. in die. ❑ NA Other: ❑ NA `Values typical for domestic wastewater and septic tank effluent. MAINTENANCE SCHMUIF SYSTFM SPFCIFI(:ATIANC Septic Tank Capacity 120al ❑ NA Septic Tank Manufacturer WIESER ❑ NA Effluent Filter Manufacturer POL LOCK ❑ NA Effluent Filter Model 525 ❑ NA Pump Tank Capacity 800 al ❑ NA Pump Tank Manufacturer WIESER ❑ NA Pump Manufacturer GOULDS ❑ NA Pump Model EP05 ❑ NA Pretreatment Unit NA ❑ Send/Gravel Filter ❑ Peat Filter ❑ Mechanical Aeration ❑ Wetland ❑ Disinfection ❑ Other: Dispersal Cellls) ❑ NA ❑ In -Ground (gravity) ❑ In -Ground (pressurizedl 9 At -Grade ❑ Mound ❑ Drip -Line ❑ Other: Other ❑ NA Other: ❑ NA Other: ❑ NA Service Event Service Frequency Inspect condition of tank(s) At least once every: 3 month(s) (Maximum 3 years) sar(s) ❑ NA Pump out contents of tank(s) When combined sludge and scum equals one-third (Y) of tank volume ❑ NA Inspect dispersal cell(s) At least once every: 3 ❑ month(s) I$( year(g) (Maximum 3 years) ❑ NA Clean effluent filter At least once every: onth 1 (� ❑ meaerrls(s)) ❑ NA Inspect pump, pump controls & alarm At least once every: 3 ❑ months) CK earls) ❑ NA Flush laterals and pressure test At least once every: ❑ month(s) AS NEEDED ❑ year(s) ❑ NA Other: At least once every: ❑ month(s) ❑ year(s) A NA Other. JIQ NA MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications: Master Plumber; Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer; Septage Servicing Operator. Tank inspections must include a visual inspection of the tenk(s) to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of combined sludge and scum and to check for any back up or ponding of effluent on the ground surface. The dispersal call(s) shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a falling condition and requires the immediate notification of the local regulatory authority. When the combined accumulation of sludge and scum in any tank equals one-third (Y3) or more of the tank volume, the entire contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113, Wisconsin Administrative Code. All other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment units, and any servicing at intervals of S12 months, shall be performed by a certified POWTS Maintainer. A service report shall be provided to the local regulatory authority within 10 days of completion of any service event. Page C__ of _71- START UP AND OPERATION For new construction, prior to use of the POVV T S check treatment tankW for the presence of painting products or other chemicals that may impede the treatment process and/or damage the dispersal cell(s). If high concentrations are detected have the contents of the tankls) removed by a septage servicing operator prior to use. System start up shall not occur when soil conditions are frozen at the infiltrative surface. During power outages pump tanks may fill alove normal highwater levels. When power is restored the excess wastewater will be discharged to the dispersal cells) in one large dose, overloading the cell(s) and may result in the backup or surface discharge of effluent. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to restore normal levels within the pump tank. Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area within 15 feet down slope of any mound or at -grade soll dbsorpban area. Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat, foundation drain Isump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; mea; scraps; medications; oil; painting products; pesticides; sanitary napkins; tampons; and water softener brine. ABANDONMENT When the POWTS falls and/or is permanently taken out of service the following steps shall be taken to insure that the system is properly and safety abandoned in compliance with chapter Comm 63.33, Wisconsin Administrative Code: • Alt piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. 6 The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator. 0 After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil, gravel or another inert solid material. CONTINGENCY PLAN If the POWTS fails and cannot be repaired the following measures have been, or.must be taken, to provide a code compliant replacement system; 13 A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system. The replacement area should be protected from disturbance and compaction anc should not be infringed upon by required setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result in the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rules in effect at that time. ❑ A suitable replacement area is not available due to setback and/or soil limitations. Barring advances in POV%TS technology a holding tank may be installed as a last resort to replace the failed POWTS. Th a f alua ' =rrtt r o rng tank b M e of oo 77X=15. 'PfZD141t /TETZ, V�b ie— Ivr,� CraNS"r'72Otj El Mound and at -grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time. C C WARNING 7 SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND/OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLER POWTS MAINTAINER Name COUNTRYSIDE PLUMBING name PAUL R KOEHLER Phone 715 246 2660 Phone 715 246 2660 SEPTAGE SERVICING OPERATOR (PUMPEM LOCAL REGULATORY AUTHORITY Name POWERS SEPTIC Name ~[t t . t1 Y � k1 AA) Phone 715-410-8820 Phone This documam was dratted in compliance with chapter Gomm E3.t2,Z;(hli' iidl&!fi and 63.54[7), (2) & (3), Wisconsin Administrative Code. ST. C yo,UNTY SANITARY SYSTEM File#. use only : OWNERSHIP/ADDRESS FORM c-eted2/20 y Community Development Department will utilize this information to provide the property owner with information regarding operation and maintenance of your new or replacement sanitary system! This information will be provided as part of our ongoing efforts to protect public health, your well, groundwater, surface water, property values, and county resources. Once approved, this completed form and educational information will be sent to you by email. OWNER/BUYER INFORMATION Owner/Buyer Ryan and Emily Keaveny Mailing Address 1713 W. 88th St, City/State/Zip Bloomington, MN 55431 Phone Number (mquim.4 612-865-4878, 651-214.2981 Email Address (required) rWO20@yahoo.com , emilykeaveny@hotmaii.com Parcel Identification Number 038-1223-06-000 (found on the property tax bill) NEW SYSTEM: LEGAL DESCRIPTION Property Location -W'/4 , _46/4 , Sec. T 5N R t)Town of 5' -e- Subdivision Plat: —j4- ne Certified Survey Map # 7 ? ,Volume . Page # Warranty Deed # 1160683 (before 2006)Volume . Page # Number of bedrooms _ _f ___ Spec house D yes 13Cho Lot lines identifiable D yes O no OFRCE USE ONLY New Property Address (verification of new address required from community Development Department for new construction.) --/ 1 (Staff Initials) (Date) This form must be submitted with all Private Onsite Water Treatment System (POWTS) applications. New SYstem: Include with this form a recorded warranty deed from the Register of Deeds office and a copy of the certified survey map if reference is made in the warranty deed. Community Development Department - Land Use Division 715"365-46$0 St. Croix County Government Center 1101 Carmichael Road. Hudson. WI 54016 715-2454250 Fax „ ` m Wisconsin Department of Safety & Professional Services Page 1 of Division of Industry Services r 2 202 SOIL EVALUATION REPORT In accordance with SPS 385, Wis. Adm. Code County Alt ach complete site plan on paper not less than B 112 x 11 inches in size. Plan must include, __ St Croix but not limited to vertical and horizontal reference point (BM), direction and percent slope, Parcel I.D. scale or dimensons, north arrow, and location arm distance to nearest road. 036-1223-06-000 - Please print all Information. Rev'ewed by I Date 12/Zg�ZD2 Personal information you provide msy be used for secondary purpadar_r; (Prrvticy Law, s- 15-DA(t }(m}}- ` Property Owner Property Location Ryan and Emily Keaven _ , Govt. Lot W ,/4 NE % s 4 T 31 N R 18 E (or) W Property Owner's Mailing Address v Site Address or CSM and Lot #: 1713 w 88th street — �— 1057 238th aWe City, State, Tip Phone Number ❑ City ❑Village ® Town i Nearest Road bloomington mn I ( ► Star Praire POLK I ST Croix RD E] New Construction Use: 0 Residential l Numberof bedrooms 4 ❑ Replacement i] Public or commercial —Describe: — Parent material tills General comments and recommendations: ❑ Haring at grade system Boring # ❑Pit Ground surface elev. 100 ft. Code derived designflow rate 6Q0 GPD Flood Plan elevation if applicable ft. Depth to limiting factor 4 n, 96.7 ft. _ Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots In. Munsell Qu. Az. Cont. Color Gr. Sz. Sh. Soil Application Rate GPDIFt= 'Eft#1 -Eff#2 A 0-14 10 YR 3/3 ----- ------ SL 2 MGR ML GW 1 F -6 mil. B 14-33 7.5YR 513 -- GR-SCL 2 M BK MFR GW 1 F .4 .6 B1 3344 7.5YR 413 __-__-___SCL 2 M BK MFR GW 1 VF ,4 .6 C 4 -52 7.5YR4f4 C2D-7.5 YR 414 SCL 2 M BK M FR DI --- 4 .6 C1 52-76 5 YR 414 SCL 2 M BK MFf __-- .4 1 6 12 Boring ❑Boring ®Ptt Ground surface elev. 100 ft. Depth to limiting fad r 42 in. ! elev. 96.5 ft. Anit Arrnlir_atinn RaMP. Horizon Depth In. Dominant Color Mursell 10 YR 313 Redox Description Qu, Az. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/Ftr •Eff#1 'Eff#2 A 0-13 -------- --- --- ---- -- ---- -. SL SCL SCL SL _2 MBK 2 M BK 2 MBK 2 M BK ML MFR MFR ML GW GW GW CA 1 F 1 VF --- --- .6 A .4 .6 .6 6 -8 S 13-32 7.5 YR 5/3 C 32-42 5 YR 4/4 Cl 42-52 7.5 YR 414 C2 52-76 1” LAYERS GR S 0 SG 1 GR NIL/ MFR _ ___. .71.4 1..6/.6 CST Name (Please Print) Sd nature CST Number PAUL R KOEHLER �-�"J 225410 —.v Address Date Evaluation Conducted Telephone Number 321 WISCONSIN DRIVE NOV 7TH 2O23 715-246-2660 Effluent #1 = BOD > 30:5 220 rng/L and TSS n 30:5 150 mg1L ' Effluent #2 = BOD, 5 30 nrg/L and TSS 5 30 mglL SBD-8330 (R022) 3] Boring # Page 2 of 3 Boring ® Pit Ground surface elev. 97.5 ft. Depth to limiting factor � in. / eIev. g3-8 ft. c..a e.,.a:..o�:..., os•e Horizon Depth In. Dominant Color Munsell Redox Description Qu. Az. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/Ft2 `Etf#1 `Eff#2 A 0-14 10 YR 3/2 SL 2 M BK ML CW 2 VF .6 --ir a B 14-32 7.5 YR 4/4 SCL 2 M BK MER GW 1 VF .4 .6 C 32-44 7.5 YR 5/3 S 0 M SG ML I DI — 7 1.6 C/E 44-60 10 YR 5/4 M2Q 7.5YR 5/6 SC 3 M ABK MFI ------ .2 ,3 ❑ Boring # rl Boring rl Pitt Ground surface elev. ft. Depth to limiting factor in. / elev. ft. Q-;1 e..•.rs•:. , oe•e Dominant Color Munsell Redox Descriptionjo Qu. Az. Cont Colo 1-1 Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. / elev. ft. CAI e.,•,n. fle .•, o��e Rldox Description Effluent #1 - BOD > 30 s 220 mg/L and TSS > 30 s 150 mg/L • Effluent #2 = BOD, s 30 mg/L and TSS s 30 mg/L a" a.,.a T- M � 1 'Ke }vS7 Add sl,kf Pro""ram w k, N E l scc-4 T3 R g w L01an c l" P.ec. f p� 3:.i w�sc.en3niJft rnf, zzSy15 nTRANSFER/RENEWAL wrl SBD-06499 (R11/20) NOG CHAPTER 145.135 (2) WISCONSIN STATUTES (a) The purpose of the sanitary permit is to allow installation of the private sewage system described in the permit. (b) The approval of the sanitary permit is based on regulations in force on the date of approval. (c) The sanitary permit is valid and may be renewed for a specified period. (d) Changed regulations will not impair the validity of a sanitary permit. (e) Renewal of the sanitary permit will be based on regulations in force at the time renewal is sought, and that changed regulations may impede renewal. (f) The sanitary permit is transferable. History: 1977 c. 168; 1979 c. 34,221; 1981 c. 314 Note: If you wish to renew the permit, or transfer ownership of the permit, please contact the county authority. Department of Safety "dory r r ( 7i1L3 & Professional Services, 5t Croix a rtltary I'erI„ i i Nu:l:i?cr t(o be t;llcd In by co ) Industry Services Division �I 32 3 ' Sanitary Permit Application Slate [eaNumberr°sactlnn It, accordance with tiPti ;g,i 21(2), Wts Ar-m Cudc, submiss;orl of this form IV the apprcrpriatc govcrnmenial unit Q 2- is required prior to abtair Ind, a san,trn. permit Note Application fntms 16r state-owned POW IS life sui:mltted to Piolect Adcresl(rt dif'efenl thali mailing addi"q) the Department nl'S.ttrty ultd Professional Services Personal information yuu p w%ide may be used for sccondan' pu ses in accordance wuh the Prlvauv Law, s IS 04(1Xrn), SLtLi 1057 23$TH AVE STAR PRAIRIE I. Application Information-Pleasc Print All lnfrrrmation I'ropelty Owner's Name Paged if RYAN AND BMILY KEAVENY Property Chl,nrr'S !tta:Iirr; Address Property Lnca[i 1713 W 88TH STREET A / /V Govt I_ot city, State Zip C ndc Phoink Number BLOOMING N MN 55431 _ •. E �. Section_ _ N R 18 E or W x II. Type of Bin ildi Nchcck all that apply) / ® 1 or 2 Fnrnlly D,,I c!hn hwnhci ofUcdrooms •/ ubd,e lsro l Nantc LOGANBERRY Block # — EJ PUNIC.Corrnlucial— Drscrib sc f] City vl El ti;atc LhG^teC - f)e crihe Use ❑ Villar?e of Q;X4 Nu . ier _ IV' Town of STAR PR IRE Ill. Type of1'0WT5 Permit: (Check either `cw" or "Replacemen and other pplica n line A° Checlt aloe 1 i eB. Compkie line C if applicable.) _ — _ _. A _ ,, Ne k Sy'stent l F.epl...crrcnl syAcrn Orl rr KItx;1 alum to Exi g Sys n i aI11) ( Add, P t:raun Unit (explain) !t. �] Iloldmg'lank ,� tri-rtround K''t A lid - J nc rdual." lie n 0(ht Iypc(exp (rnnven,Irtnal) t • Ir^' EI Itcilmal Pleurae '-I Rcvibi ,:i [J C11ar C la lti 'P L 'lla:ltiter [ri N'nCr 1`"t Pr:`�' IS l'�:,n .'u I„3>Cf and I),ltc I>" .. r� �jti r aE IN1 IV, Dispersal/Treatment Area and Tank Information; r C- i)esigai ir6nu (lxpd) D[ persill C:t 1)C54tn SU11 Appllcalmn Ralc(gpC 5tj Sr sal ANn,,., Proposed (S,7 ySS ll'VJttrni ^^ / saa .5 12001200 6 a f . D0 Capacily In roMarlufacturrrlart to ll}rmailon (ia',Itlrls a�����UUNra• IanFg Ex�.; n,'1-anks`yVP(,9'� �L•" c 'x' 1 E-ER 'J Vl '7 'A i.7 L x mpr•c ur 11„ ho Tn11 nl, tra,r:,, rtu,r•rt"' x $'a0 _ 5ER x V. Responsibility Statement- 1, the undersig . sssunre respornibility for installation or the P 1VT5 Shawn on iht snitched plans. r'1u t o t tl,rr ; p'r.?,'t V �:: cr's 5lenanlre 1.fk',h91'}2S S u rlxr Business Phow ',ut,rher PAUL R KOEHLER J'r,. � �.- __- 225410 715 246 2660 t';ttA.ddres (Stretl, Lrh, Stale.. LrW 1',. I 321 ISCONSIN DR NEW RICHMOND 54017 V1. CounttJl)cpartnrenr [Ise Only/ v;p•1 tier: I)t ltgn:" rcrTlul Fee Date ISS,cd psscrna Ag,nr S; . attire ._: 0111111 t.is l'e .,, C. 6$s I�/2�/�%¢"� ii/ L'vG t'or',dkions of Ahp+rova a1 SYSTEM OWN 3) St� ��/ pp ►S2 S_- `^ate �s 1. Septic tank, effluent filter nd dispersal cell Ct ��Q 4 �e D� K� t must be serviced 1 m ' tained as per management plan pro ed by plumber. a (����,MCS 1 �d / � -C Cc� 2. All setback requirements must be maintained as per applicable code I ordinances. Ut.�— LL 1 rtach m r-nmpie I Irlans rirr der 4y tcm an �ulan"r lr. 1'1IV. t. art rs c.Ill. •m paprf Nt jf1. th'.A 1;7 01 r�. 5131)-6398 4 `Lb Qi��•�-�(�/'I /UAdCnC,(�11,• ka t^. e �Ce � L,9t-Y' l A-s KJQ i+. �a non T& , pe aa{ d►,r COPY Wisconsin Department of Safety and Professional Services Division of Indu," Services 022 Madison Yards Way' PO Box 7 302 Madison. Wt 53707 October 16, 2023 CUST ID NO.: 225410 PAUL R K(A I ILL:R 321 G%IISCONSIN DR NEW RICHMOND, WI 5401.7 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 10/16/2.025 MUNICIPALITY: TOWN OF STAR PRA1 E ST. CROIX COUNTY SITE: RYAN AND EMILY KEAVE 1057 238TH AVE STAR PRAIR Wl STAR PRAIRE, WI 54026 W 112NE 1/4SEC 4T3 R 18W FOR: Design Wastewater Flow Value: 600 Bedrooms. 4 Limiting Factor(s): 38" Maintenance Required: Effluent Filter Phone: 608''66-21 12 Web. Itt_ip •dTs M1e i coy Email dtips a m is uns.iij Tony Evers, Governor Dan Hereth, Secretary Identification Numbers Plan Review No.: PWTS- 10230232 1 -C Application No.: DIS-092342277 Site ID No.: SI-I-121938 Please refer to all identification numbers in each correspondence with the Department. Conditionally APPROVED DEPT. OF SAFETY AND PROFESSI AL SERVICES DIVISION OF INDUSTRY SE ICES SEE COIRKESPONDENCE Component Manual - Version 3.0 (May 2022- SITE REQUIREMENTS • A full sire copti (if the approved plans, specifi/tjob is letter shall be on -site during construction and open to inspection by authorized representatives of the Departmeay iude local inspectors. A Department electronic stamp and signature shall be on the plans which are usede for nstruction. The following conditions shall be met during consinstallation d prior to occupancy or use: • It is recommended to fence off dis aersal ;t i prior and (luring consiructi a to avoid disturbance, Conapaclion and Ilse of the site. • N%ith news constructirn. it is recomrnen ed not to activeate the pump in the dose ' nil. until the tanks are pumped prior to hurncc,wncr oceirp:ant•y. • Mi asteM1M1art^r �eneralcd frurn contra ors cleaning of eiluipruent :and foals anifior Icl't rr rnnsu uetieua prnelucts SIa:III nlrt be disch�u•-ed info the drains disc arging to the priwale onsile ":astewater treatment +M1 na I!'l)�1 l �y. \\rite generated shall hr lon,pt^rIw 1lislomcrl nl'eon rtc ur nff site. • Any tall grasses, leaves and sh bs shall be cut short and removed prior to tilling the surface for in lation to prevent matting under the dispersal area. • Prior to construction of th dispersal area, cheek the moisture content of the soil to a depth of 8 inches. Smrarirag and compacting of ' wwet snit veil exult in reclining the infiltration capacity of the soil. Proper soil moisture content can be determined by rolling a soil ti.ample b wween the Imilds. If it rolls into a 1 /4- inch wire:. the ."4c is too M1sct to preparc. If it crumbles, site preparation can proceed. f the site is too ww.+. i o prepare, do not proceed until it dries. • It is recommended to cut as short as possiNk: and remove L'i ^tind cover prior to tilling the ground surface for the dispersal area. • Electrical connections shall comply N01i 316.300 mid N 1 [ 300 • All piping shall conform to SPS Toble 384.30-3 mid �,Ps I able 3S4.30-5 • Insulate building sewers beyond 30 feet per SPS 382.30 (11)(c) OWNER RESPONSIBILITIES ■ The current ow ncr, and each subsequent owner, shall receive a copy of this letter including instructions relating to proper use and maintenance of the system. Owners shall receive a copy of the appropriate operation and maintenance manual and/or owner's manual for the POWTS described in this approval and Wis. Admin. Code § SPS 383.54( l ). • In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approved plans. The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. This system is to be constructed and located in accordance with the enclosed approved plans and with any component manual(s) referenced above. The owner, as defin in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. No person may engage in or work kplumbing in the state unless licensed to do so by the Dep ment per s.145.06, slats. All permits required by the state or t local municipality shall be obtained prior to com ncement of co n stru ct i o nl i nstal lat i on/operation . In granting this approval, the Division of 1 ustry Services reserves the r/touire changes or additions, should conditions arise making them necessary for code compliance. s per state slats 101.12(2in this review shall relieve the designer of the responsibility for designing a safe building, stru reor component. Thdoes not take responsibility for the design or construction of the reviewed items. Inquiries concerning this correspondence may be letterhead. Sincerely, Travis Wagner Division of Industry Services Phone:608-598-0715 Email: travis.wagner@wisconsin.gov me at the cgAlact information listed below, or at the address on this Fee Required: $250.00 Fee Received: $250.00 alance Due: $0.00 fund FxPected: $0.00 RESIDENTIAL AT -GRADE DESIGN Pressurized - Sloping Site INDEX AND TITLE SHEET Conditionally Project RYAN AND EMILY KEAVENY APPROVED DEPT. OF SAFETY AND PROFESSIONAL Owner SERVICES DIVISION OF INDUSTRY SERVICES Address 1057 238TH AVE STAR PRAIRIE L� Legal Description W114 NE V4 SEC 4 T 3 RIME CO wnship STAR PRAIRE County Sy ROIX Sub ision Name LOGAN BERRY Lot No. Parcel ID Plan Trans umber 038-1223-06-000 Number Designer PAUL R KOEHLE Signature Date 09/22/23 Vsheetgsse tank contingency plan PONDENCE Page 1 Page 2 Page 3 Page 4 Page 5 Page 6 Licel,,V Number 225410 J Phone Num 715-246-2660 Designed pursuant to: At -grade Component Manual Ver. 3.0 for POVVTS (May 2022-2027), and both SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST- SAS (01181) and Pressure Distribution Component Manual Ver. 2.1 (May 2022-2027) Version 7.1 (07/22) Pagel of 6 PRESSURIZED AT -GRADE DESIGN At -grade Design Worksheet - Sloping Site Flows and Site Data Entry. (r or c) r Residential or commercial? 400.0 Estimated wastewater flow (gpd) 600.0 Design wastewater flow (gpd) 13,00 % Site slope 101.00 Contour elev. below lateral (ft) 38 00'Depth to limiting factor (in) 0.50 1 In -situ soil application rate (gpd/ft"2) Distribution Celt Information (1 or 2) N-i"_0026, Influent wastewater quality Linear loading rate gpolft Effective absorption width (h) 8. Max. effective width permitted (ft) 150.0 Aggregate length (h) Pressure Distribution Dataa*ntry (c or e) Not a anal ralculatpn cl Ce r or end lateral connection Nu_r of laterals Orific diameter (in) e.g. 0.25 pacing (ft) Forcemainr (in) Forcemain ocity (ftl ec) Estimate X1. Forcemain )97.00 Pump tank System he1.3.50 Vertical lift Friction los0.00 In -line Filteft)11.82 Total dynad (ft) 2 0.156 2.00 2.00 4.17 110.00 4.55 3.77 Designer must select one lateral diameter Lateral ❑iameter Vtection Pipe diameter Design optiui Desrgn choice 1 in 1.25 in 1.5 in X 2 in 3 in x y or in y Does Forcemain drain back? y or n y Are laterals at highest point? NA 17.9 Forcemain drainback (gal) 6&0 5x Lateral void volume (gal) 85.9 Minimum dose volume (gal) \ 40.8 System demand (gpm) Effluent Filter nformation POLY LOCK Filter manufacturer 525 Filter model number tons/inch Calculator (optional) i7.4 Total Tank Capacity (gal) 9 Total Working Liquid Depth (in) '.2. aVin (enter result in cell G46) Treatment INk Information 1200 Septic t capacity (gal) WIESER ufacturer Dose Tank Information s00.0 Dose tank capacity (gal) 22.2 Dose tank volume (galrn) WIESER IManufactureir Project: RYAN AND EMILY KEAVENY Transaction Number: Page 2 of 6 AT -GRADE PLAN VIEW = Total aggregate cell A x = Plowed area L x W Svnthetic fabric cove Lateral invert elev Surface cant© and system elevation Typical obs. pipe. Slotted in the lower 6", and anchored securely. 13 % Slope f/ = 12 in. topsoil and subsoil Plowed layer over aggregate and tapered to toes. below L x W = 6 in. aggregate below pipe(s), and 2 in. above pipe. Project: RYAN AND EMILY KEAVENY Transaction Number Page 3 of 6 PRESSURE DISTRIBUTION AND DOSE TANK Lateral Diagram - Center Connection 1� p iE X I<.x1?1 x1231 Laterals & force main C Sch 40 Last hole drilled next to end cap per SPS Table 38 Holes drilled on the bottom of the lateral equally spaced 0 = Turn -up vdb vahreor olesnoutpluQ Lateral Specificatio 0.156 C]n diameter (in) X 1.97 Orifice acing (ft) 38 Orifices/la al 20.4 Lat. discharg to (gpm) 40.8 Sys. discharge rate m) 11.82 TDH (ft) Typic Weather-proof junction box Final grade `11, Tank compon t is properly ventjfd Electrical as per NEC 300 and SPS 316.300 WAC enter Lateral connection point 2 Number laterals P 73.88 Lateral length (ft) 1.50 Lateral diameter (in) 2.00 Forcemain diameter (in) 110.00 Forcemain Length (ft) Pump Chamber Layout Issr---- Approved manhole cover with All warning label and locking device di nnect 4" Alternate - outlet location 18" min NQApprove _ outlet Tank full tInches Gallon JA - Provide 1/4" A 18.2 40 .3 Alarm an weep hale or B 2.0 4.4 13 antisiphon 3 85 9 Pump on device. O D 12.0 2 6.4 98.00 ft C Totals 36.i 800.0 I 1E] Pump 3" Bedding under tank 97.00 ft GOULDS Pump manufacturer ISJ ROMBUS I Alarm manufacturer EPOS Pump model number I PS PATROL. I Alarm model number Project RYAN AND EMILY KEAVENY Transaction Number: Page 4 of 6 At -grade System Maintenance and Operation Specifications Service Providers Name C-oUNTRYSIDE PLUMBING Phone F7'1 15-246-2660 POWTS Regutator's Name PAUL R k0-EHLER Phone5-246-2.660 System Flew and Load Parameters Design Flow - Peak 600 gpd Maximum Influent Particle Size 1/8 in Estimated Flow - Average 400 gpd Maximum B005 220 mgtL Septic Tank Capacity 1200 gal Maximum TSS 150 mg/L Soil Absorption Component Size 1200.0 ft2 Maximum FUG 30 mg1L Type of Wastewater Domestic Maximum Fecal Coliform > 10E4 cfu/100 mL Septic and Pum Tank Effluent filter Pump and Cont Is Ala Pressure System Mound Other Service Frequent Inspect and/or service once every 3 years Inspect and clean at least once eve 3 years Test once every 3 years Should test month/ Laterals should be flushed and Pressure tested a 1.5 ears s ct far pondin and seeps a once eve ears Mlsceilanftus Co Standa Observation pipes are slotted and ma ials conform to Tab SPS 384.30-1, have a watertight cap, and are secured in as shown in the at-g a component nual. Dispersal cell aggregate conforms to SPS 4.30 (6){i] is. Adm. Code. All gravity and pressure piping materials con m to t requirements in SPS 384, Wis. Adm. Code. Tillage of the basal area is accomplished with a board or chisel plow. The at -grade structure and other disturbed areas I be seeded and mulched to prevent soil erosion and help reduce frost penetration. Areas within 15 feet of the downslope toe wil a prate from compaction. All other construction details are as per the t-grade com nent manual SBD-10854-P (N. 03107). /�teral Turn -up Detail Finished Grade 6-8" Diameter Lawn Sprinkler Valve Box Distribution 101.50 ft ...... • . Plug Cleanout ill Valve Sweep 90 or Two ree bends Same Diamezvter as Lateral Project: RYAN AND EMILY KEAVENY Transaction Number; page 5 of 6 At -grade System Management Plan Pursuant to SPS 383.54, Wis. Adm. Code General This system shall be operated in accordance with SPS 382-384 Wis, Adm. Code, and shall maintained in accordancee with its' component manuals [SBD-10854-P (N. 03107, R, 01/12), SSWMP Pub. 9.6 (01181), and Pressure Distribution Component Manual Ver. 2.0 SBI7-10706 (N. 01101, R. 10112)) and local or state rules pertaining to system maintenance and maintenance reporting, No one should ever enter a septic or pump tank since dangerous gases may be present that could cause death. Septic and pump tank abandonment shall be in accordance with SPS 383 33, Wis. Adm. Code when the tanks are no longer used as POWTS components. Septic or pump tank manhole risers, access risers and covers should be inspected for watertightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 8-inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into a tank or component. Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s 281.48, Slats The contents of the septic tank shall be disposed of in accordance with NR 113. Wis. Adm. Code. The operating condition of the septic tank and outlet filter shall be assessed at least once every 3 years by inspection. The outlet filter shall be cleaned as necessary to ensure proper operation The filter cartridge should not be removed unless provisions are made to retain solids in the tank that may slough off the 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 contents of the tank are not removed at the time of a triennial assessment, maintenance personnel shall advise the owner of when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank. The addition of biological or chemical additives to enhance septic tank performance is generally not required. However, if such products are used they shall be approved for septic tank use by the Department of Commerce. Pump Tank The pump (dosing) tank shall be inspected at least once every 3 years. AR switches, alarms, and pumps shall be tested to verify proper operation. If an effluent fitter is installed within the tank it shall be inspected and serviced as necessary. At -grade and Pressure Distribution Systern No trees or shrubs should be planted on the al -grade Plantings may be made around the at -grade's perimeter, and the at -grade shall be seeded and mulched as necessary to prevent erosion and to provide some protection from frost penetration. Traffic (other than for vegetative maintenance) on the at -grade is not recommended since soil compaction may hinder aeration of the infiltrative surface within the mound and snow compaction in the winter will promote frost penetration. Cold weather installations (October -February) dictate that the at - grade be heavily mulched as protection from freezing. Influent quality into the at -grade system may not exceed 220 mg/L 8005 150 nnWL TSS, and 30 mg1L FOG for septic tank effluent or 30 mglL t3OD5 30 mglL TSS, 10 mA FOG, and 104 cfull00 mL for highly treated effluent. Influent flow may not exceed maximum design flow specified in the permit for this installation The pressure distribution system is provided with a flushing point at the end of each lateral, and it is recommended that each lateral be flushed of accumulated solids at least once every 18 months. When a pressure test is performed it should be compared to the initial test when the system was installed to determine if orifice clogging has occurred and if orifice cleanurg is required to maintain equal distribution within the dispersal cell. Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the owner, and any levels above 4 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring. Contingenov P!Mn If the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep the system in proper operating condition. If the dosing tank, pump, pump controls, alarm or related wiring becomes defective the defective component(s) shall be immediately repaired or replaced with a component of the same or equal performance. If the at -grade component fails to accept wastewater or begins to discharge wastewater to the ground surface, it will be repaired or replaced in its' present location by increasing basal area it toe leakage occurs or by renovating the biologically clogged absorption and dispersal media, installing new piping, and replacing other components as deemed necessary to bring the system into proper operating condition. See Page 5 of this plan for the name and telephone number of your local POWTS regulator and service provider. Project: RYAN AND EMILY KEAVENY Transaction Number, Page 6 of 6 non T& , pe aa{ d►,r lnnavafions in Freest, Dra tape �yj Zabel* d Wasf•water PrpdtKCs CC�� A pividan M PoYA hc. PL-525 Effluent Filter PL-525 Filter The PL-525 Filter is rated for 10,000 GPD (gallons per day) making it one of the largest filters in its class. It has 525 linear feet of 1/1.6" filtration slots. Like the Polylok PL-222, the Polylok PL-525 has an automatic shut-off ball installed with every filter. When the filter is removed for cleaning, the ball will float up and temporarily shut off the system so the effluent won't leave the tank. Features: • Rated for 10,000 GPD (gallons per day). • 525 linear feet of 1/16" filtration. • Accepts 4" and 6" SCHD 40 pipe, • Built in gas deflector. • Automatic shut-off ball when filter is removed. • Alarm accessibility. • Accepts PVC extension handle. PL-525 Installation: Ideal for residential and commercial waste flows up to 10,000 gallons per day (GPD), 1. Locate the outlet of the septic tank. 2. Remove the tank cover and pump tank if necessary, 3. Glue the filter housing to the 4" or 6" outlet pipe. If the filter is not centered under the access opening use a Polylok Extend & Lok or piece of pipe to center filter. 4. Insert the PL-525 filter into its housing. 5. Replace and secure the septic tank cover. PL-525 Maintenance: The PI-525 Effluent Filters will operate efficiently for several years under normal conditions before requiring cleaning. It is recommended that the filter be cleaned every time the tank is pumped, or at least every three years. If the installed filter contains an optional alarm, the owner will be notified by an alarm when the filter needs servicing. Servicing should be done by a certified septic tank pumper or installer. 1. Locate the outlet of the septic tank. 2. Remove tank cover and pump tank if necessary. 3. Do not use plumbing when filter is removed. 4 Pull PL-525 cartridge out of the housing. 5. hose off filter over the septic tank. Make sure all solids fall back into septic tank. 6. Insert the filter cartridge back into the housing making sure the filter is properly a[if+nv(t , : ind ccitnpletely inserted. 7. Replace and secure septic tatlk L LIB sr. 1/6„ Filtrati( Accepts 4" & 6" SCHD 40 pipe -m Switch tional) -cepts 1' PVC tension Handle Rated for 10,bMO GPD 525 Linear Ft. of 1 / 16" Filtration Slots Certified to NSFIANSI Standard 46 0 t.. Gas Deflector Automatic Shut-off Ball OutdoorSmaflFiltir(e: Alarm Extend & Lokt^' Poll lc)1, Z-)1vt & Best filtcr� ,1L crt Easily installs the Stn,trti ilterr" sn•itc', a1,1 at,;rnr. into existing Conks. Polylok, Inc. 3 Fairfield Blvd, WL�Ihj 11,Id, CY 0M452 Toll Free: 877 70..95G5, 1= tx: 203.2h ., ,51.4 www polylok.coln Wastewater METERS FE 10 - GPM 25 2.5 FT � 7 S � 15 4 O �.- EPGS � 3 10 2 -—EP04_-- 5 D 0 0 10 20 30 40 5o GPM D 2 4 6 8 10 12 ITfs/h CAPACITY MODEL INFORMATION NumOrdeber Number NP Volts Am p Urwit PSwitch inimumt20' t Cord Discharge � Minimum Minimum Minimum Maximu Shipping 9 8reeltere Lang Connection C1n Level p{f Level ,Basin Diameter Solids eight EP0411 / Site f kg itch 1 Q Manual Manual 20 / 1 EP0411A ck/ 115 12 20 10, ngle 12" 6` 21 / 9.5 EP0411 F / .4 itch 20 Manual Manual 20 /9 1 EP0411 AC ck / -- ngle 20 f2 6` 2119,5 EP0412 1 Plug / - - 230 6 14 No Switch 10 f'r4' Manual Manual 15" yr 20 / 9.1 EP0412F Plug / No Switch 20 Manual Manual 2019.1 EP0511 F Plug / 22/ 10 115 13 20 No Switch 20' Manual Manual EPO511AC .5 Piggybackl 23 / 10A Wide Angle 20 12` 6' [EP05121' 230 6.5 f0 Plug 1 22 / 10 Nc $witch 20 Manual Manual PAGE 3 n w 13'-8" j 4" CAST -A-SEAL P'T it I FILTER OR t I BAFFLE 4" CAST -A -SEAL PUMP PAD (TANKS ARE MANUFACTURED TO MEET OR EXCEED ASTM C-1227 REQUIREMENTS WLP1200/800-MR TANK SPECIFICATIONS DIMENSIONS: WALL: 3" BOTTOM: 3" COVER: 6' MANHOLE. 24" I.D. PRECAST CONCRETE RISER HEIGHT: 53" LENGTH: 13'-8" WIDTH: 8'-0" BELOW INLET: 41" LIQUID LEVEL: 36" WEIGHT: BOTTOM 14,80D LBS. COVER 8,170 LBS. INLET AND OUTLET: 4" CAST -A -SEAL BOOT OR EQUAL GASKET INLET AND OUTLET BAFFLE AND FILTER: WISCONSIN, SEE DETAIL #10 (OTHER STATES SEE CHART) LIQUID CAPACITY: 3146 GAL/IN (SEPTIC) 22.24 GAL/IN (PUMP) LOADING DESIGN: 8'-D" UNSATURATED SOIL TANK CAN BE USED AS: SEPTIC / HOLDING / PUMP OR SIPHON COVER: MIX DESIGN #8 (NO FIBER) TANK: MIX DESIGN #9 (SMALL FIBER) CUSTOMIZED TANKS: FOR CUSTOM TANKS CONTACT WIESER CONCRETE REVIEWED BY REVIEW DATE DRAWINGS SUBMITTED FOR APPROVAL APPROVED BY: APPROVAL DATE: PRODUCTS NEEDED BY: K W � to V U-) 0 00 a � 0 �mO moo Lu 3 lz OF POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page I p, 'l. FILE INFORMATION Owner RYAN AND EMILY KEAVENY Permit d _ DESIGN PARAMlFTGRc Number of Bedrooms C !VA Number of Public Facility Units NA Estimated flow (average) 400 Rai/day Design flow (peak), (Estimated x 1.5) 600 Wd ay Soil Application Rate .5 al/daWW Standard Influent/Effluent Quality Monthly average Fats, Oil & Grease IFOG) !30 mg/L Biochemical Oxygen Demand (BODO) 5220 mg/L ❑ NA Total Suspended Solids (TSS) 5150 mg/L Monthly average Pretreated Effluent Quality Biochemical Oxygen Demand (BODs) <30 mg/L Total Suspended Solids ITSS) 530 mg/L ❑ NA Fecal Coliform (geometric mean) _,0 0' cfu/100mi Maximum Effluent Particle Size Ya in dia. ❑ NA other: 11 NA -Values typical tw domestic vVastewater and septic tank e`fiuent. MAINTENANCE SCHEDULE SYSTEM gPFmFlrnT:ine+c Septic Tank Capacity 1.200 gal 17 NA Septic Tank Manufacturer WIESER ❑ NA Effluent Filter Manufacturer PaL LDCK O NA Effluent Filter Model 525 ❑ NA Pump Tank Capacity 800 al p NA Pump Tank Manufacturer WIESER ❑ NA Pump Manufacturer GOULDS p NA Pump Model EP05 ❑ NA Pretreatment Unit R NA ❑ Sand/Gravel Filter M Peat Filter ❑ Mechanical Aeration ❑ Wetland 17 Disinfection ❑ Other: Dispersal Collis) ❑ NA ❑ In -Ground (gravity) ❑ In -Ground (pressurized) A At -Grade ❑ Mound ❑ Drip -Line ❑ Other: Other: ❑ NA Other: © NA Other: ❑ NA Service Event Service Frequency Inspect condition of tank(s) - At least once every: 3 �J yearW l (Maximum 3 years) 44YY yearlsy ❑ NA Pump out contents of tankls) When combined sludge _ and scum equals ono -third IY;1 of tank volume ❑ NA Inspect dispersal call(s) At least once eve every: ❑ Inonth(s) 3 years) (Maximum 3 years) ❑ NA Clean effluent filter At least once every: ❑ mcnthW CKyearfs) Q NA Inspect pump, pump controls & alarm At least once every: 17 rr'urtthlsl 3 iKYear (s+ 0 NA Flush laterals and pressure test At least once every: 0 month(s) AS NEEDED ❑ yoar(s) ❑ NA Other: At least once every. ❑ month(s) ❑ year(sl NA Other: 119 NA MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications: Master Plumber; Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer; Septage Servicing Operator. Tank inspections must include a visual inspection of the tank(s) to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of combined sludge and scum and to check for any back up or ponding of effluent on the ground surface. The dispersal cell1s) shall be visually inspected to check the effluent leveis in the observation pipes and to check for any ponding of effluent on the around surface. The ponding of effluent on the ground surface may indicate a failing condition and requires the immediate notification of the local regulatory authority. When the combined accumulation of sludge and scum in any tank equals one-third (y,i or more of the tank volume, the entire contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113, Wisconsin Administrative Code. Ail other services, including but not limited to the servicing of effluent filters, mochan}cal or pressurized components, pretreatment units, and any servicing at intervals of 512 months, shall be performed by a certified POWTS Maintainer. A service report shall be provided to the local regulatory authority within 10 days of completion of any service event. START UP AND OPERATION Page 7r of -7—.f - For new construction, prior to use of the POWTS check treatment tank(0 for the presence of painting products or other chemicals that may impede the treatment process andlor damage the dispersal cellls). If high concentrations are detected have the contents of the tank(s) removed by a sentage servicing operator prior to use. System start up shall not occur when soil conditions are frozen at the infiltrative surface. During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will be discharged to the dispersal cellist in one large dose, overloading the cell(s) and may result in the backup or surface discharge of effluent. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to restore normal levels within the pump tank. Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area within 15 feet down slope of any mound or at -grade soil absorption area. Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat; foundation drain Isump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting products; pesticides; sanitary napkins; tampons; and water softener brine. ABANDONMENT When the POWTS fails and/or is permanently taken out of service the following steps shall be taken to insure that the system is proper!), and safely abandoned in compliance with chapter Comm 83,33, Wisconsin Administrative Code: • All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed, 0 The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator. • After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil, gravel or another inert solid material. CONTINGENCY PLAN If the POWTS fails and cannot be repaired the following measures have been, or.must he taken, to provide a code compliant replacement system: ❑ A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system. The replacement area should he protected from disturbance and compaction and should not be infringed upon by required setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result in the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rules in effect at that time. ❑ A suitable replacement area is not available due to setback and/or soil limitations. Barring advances in POWTS technology a holding tank may be installed as a last resort to replace the failed POWTS. alubaet, name re U .- Menr are�_a_o7 ng��—a.l_ k a Al e ?P'Did18nerz, r-b%1J aIV5--R[iG�tprj ❑ Mound and at -grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time. C C WARNING ] SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND)OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLER Name COUNTRYSIDE PLUMBING Phone 715 246 2660 POWTS MAINTAINER Name PAUL R KOEHLER Phone 715 246 2660 — SEPTAGE SERVICING OPERATOR !PUMPER) LOCAL REGULATORY AUTHORITY Name POWERS SEPTIC Name �'r re 715410-8820 Phone This ao: ument was drottcd in compliance wftn chaotrrr Cnlnrn and 63.540). Q) S (3), Wisconsin Administrative. Code. ST. C R c ii x C)UNTY SANITARY SYSTEM File #: OffiOWNERSHIP/ADDRESS FORMe�r 2 Community Development Department will utilize this information to provide the property owner with information regarding operation and maintenance of your new or replacement sanitary system! This information will be provided as part of our ongoing efforts to protect public health, your well, groundwater, surface water, property values, and county resources. once approved, this completed form and educational information will be sent to you by email. OWNER/BUYER INFORMATION Owner/Buyer Ryan and Emily Keaveny Mailing Address 1713 W. 88th St, City/State/Zip Bloomington, MN 55431 Phone Number (required) 612 865-4878, 651-214-2981 Email Address (required) rpk202O@yahoo.com , emilykeaveny@hotrnail.com Parcel Identification Number 038-1223-08-000 (found an the property tax bill) NEW SYSTEM: LEGAL DESCRIPTION Property Location t/4 , �/, , Sec. � , T aN R f ,;Town of ++'<-_ i GV Subdivision Plat:M Lot #. Certified Survey Map # 7 7o -W Volume . Page # Warranty Deed # 1160683 {before 2006}Volume . Page # Number of bedrooms Spec house 13 yes 2Qho Lot lines identifiable 0 yes E3 no OFIK C ISE ONLY New Property Address IDS-7 23 � (Veriftcabon/of new address required from Community Developm tent Department for new construction-) iID��2S(�3 (StaA Initials) (pate) This form must be submitted with oil Private Onsite Water Treatment System (POWTS) applications. New system: Intrude with this farm a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if reference is made in the warranty deed. Community Development Department - Land Use Division 715.386-4680 St. Croix County Govemment Center 715-245-42$0 Fax 1101 Carmichael Road. Hudsnn. WI 54016 Fill ST. C Rom" IUNTY SANITARY SYSTEM office use only OWNERSHIP/ADDRESS FORM ovowz=1 Community Development Department will utilize this information to provide the property owner with information regarding operation and maintenance of your new or replacement sanitary system! This information will be provided as part of our ongoing efforts to protect public health, your well, groundwater, surface water, property values, and county resources. Once approved, this completed form and educational information will be sent to you by email. OWNER/BUYER INFORMATION Owner/Buyer Ryan and Emily Keaveny Mailing Address 1713 W. 88th St. City/State/Zip Bloomington, MN 55431 Phone Number (require4612-865-4878, 651-214-2981 Email Address (nKluired) rpk2O2O@yahoo.com , emilykeaveny@hotmail.com Parcel identification Number 038-1223-06-000 (found on the property tax bill) NEW SYSTEM: LEGAL. DESCRIPTION Property Location _Wt/4 , _,Lv/4 , Sec. , L , T _aN R,�Town of ��4ti- T "ad't '- Subdivision Plat: Lot # �o . Certified Survey Map # 71(?b2D . Volume . Page # Warranty Deed # 1160683 (before 2006)Volume . Page # Number of bedrooms _ Spec house 0 yes 6ho Lot lines identifiable 0 yes 13 no New Property Address (staff Initials) oFRCE USE ONLY (Verification of new address inquired from Community Development Department for new construction.) (Date) This form must be submitted with all Private Onsite Water Treatment System (POINTS) applications. New System: Include with this form a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if reference is made in the warranty deed 715-386-4680 Community Development Department - Land Use Division St. Croix County Government Center 1101 Carmichael Read. Hudson. WI 54016 715-245-4250 Fax State Bar of Wisconsin Form 1-2003 VL'ARJRA1tiTY DEED C]ocumenl Number II I7ocumcnt Namc BY THIS DEED, Julie McClelland-Komorouski, M.440IFD (hereinafter "kiprantor,- � hether one or more), convey and warrant to Ryan Keaveny and Emily Keaveny, husband and wife as survivorship marital property, (hereinafter "C irarttce," whether one or mare), the following described real estate in St. Croix County, State of Wisconsin: Lot L, Plat of Loganberry in the I"own of Star Prairie. St. Croix County, Wisconsin. Fxception to warranties: easements, restrictions and covenants of record; highway and street rights of way. and Municipal and zoning ordinances and agreements entered under them; and further cxccp+ real estate taxes accruing in the year of this conveyance. Dated Kj d vrnj86g— /, 2..UL2— __ (SFAI_) * .Julie tic{`lell:,nd-liomorl,uski AUTHE,N'rICA7'lON Signature(s) 1160683 BETH PAB5T REGISTER OF DEEDS ST. CROIX CO., WI RECEIVED FOR RECORD 11/01/2022 11:49 AM EXEMPT#: REC FEE 30.00 TRANS FEE 345.00 PAGES: 1 "The above retarding information verifies that this document has been electronically recorded & returned to the submitter Hrcnrding Arca N am, l( r Address St. Cro ,i::..4bstract lie Title Co- Inc. 575 \ NCXV Ricttr1101id, W 1 54017 038-1223-06-000 Parcel Iderinficazion Ntrmher (PEN) This IS NOT homestead pn7perty. ACKNOWI,FDGMENT S FA TE OF WISCONSIIN' ) authelllicalyd t r ) ss. St, Croix COUN'l-Y ) + Personally came before me on NOV 11 ZDl.2— J'ITLE: IvILIviBER STATC_ BAR OF WISCONSFN rho above -Warned .Julie 1VIct'lellanrl hnfnarousl.i, - -ro — (If not, __-- auithorired hY Wis_ Stal. § 706.06) to true known ttr hc• 111C %vho executed the foregoing instrument and dLkntrtvledgeu the same. .l'11IS INS l ltUllIl:itiT DRAT I HD BY: tit. ( roux At -tract &C Trtic Co. Inc. by Andrea S. Ctlrpetrt"r a: tllt direCtiutt u# t11e tir,intor. 22-S34849 Notary l',lhlic. `~rate of Wi con in My Ctnnmi lion (is permantiti (expires: z iSignatures mar he autt,cnficated nr ackwmledrd. Boils are nor nerra,:ert.l NOTE: I HIS IS A S rANDARD I ONN1. ANI N10011 1( A I If )NS 10 l lllti 1-0kR I StI0t LD HE (1, EARLY Il1ENTIFiEU. NN ARIZAN I) I0140 S 211113 SI 4 11. BAR t 11 NVIS( ONSIN FORM NO. 1-2003 " Type Namc WON% sigr,ature> St. Crotx County 1160683 Page 1 of 1 IMPORTANT NOTE: ::ei�..e o�.c•eeHe. evccRr.,e•.n U DINETTE �n —r- I i } .. .-... x we ; v - I',O J v� M6TR. BDRM. KITGNEN 4 BDRM, t v - . �. : .._.. ... . LIVING RM. '._ {_ _. -_ —.. — • __ a j ' r4HiR G Y .« ..:. _ _ .. _ I !.� I 4 _--• y I MDD RM. i j FOTEe OFFICE . ? L Q BDRM �3 �y ti— I J W GARAGE 7z • I p. Quit .•.�.,...� .... DEF __ -. ... e-..�..... r.. DIIl16l OdiE IISI IEMB[D 1 _ -- ,MAIN �EvEL PLAN oA6E f A3 ------------ f ---------- L- - - - - - - - - - - - - - - - ------------- ------------------- SA51EMENT LV---------------- t i I -- - - - - - - - - - - - - - - - - - - - - - - ---------- ------------ i --------- I------------- ------------------------- 11 3 ------------- ----------- -------- FI, ----------- ---------- -- --------------------- ---------- ------------ --____ --______ -- UNEXCAVATED -------------- ------------------- UNExCAVATED . . ........... ;FOUNDATIONTIFOUNDATIONI LOWER LEVEL PLAN 1.1- -- A.- 0 z O DEP kL Ulf: Itylito 09 07,23 (1 11 A2 IMPORTANT NOTE: ccx re..r_�..rc y_a a Ell, a .��. __----- FRONT ELEVATION xxc w• . ra W W A 0 �W m m �a W a x LEFT ELEVATION , RIGNT ELEVATION pCA{.F: Vp' r I'-0• /6' . 1'a' p 6sall: a 47- AS NOTED ou" 8YDEP asnm oerl: m a o 0 o 09.01-23 un �svnlo RIMID 09.0723 (1) PAGE i REAR ELEVATION xa.e.. vs • l o' Al IMPORTANT NOTE: cvounee •o �.ea.- u w enowe'� _ __- _______- ______- 5+ AS NOTED a ROOF PLAN f�.��- W U E •i �:_..._•..� ....DEP_..._.... . Y "^ MINI DAR 09.01.23 .....I. .............. .. IASI .AEYISED�. ......^....." 09.07.23 (1) i BUILDING SECTION PAS{' A4 TYPE: a— IMPORTANT NOTE: pry Fiv. JEI.EJ-A METHOD PF - PORTAL FRAME£ BRACE C 0%9TR£CTW*" .........._.._. ... =r -- T MEE II rf o..: « a ,a W roYw--1 NlD�T♦ /t 41 NOT USED raverrLEVATgN yfcnoN !�«r. twl u.w..wp.m..ear.r•.I nr r»Nw.wm. c J.n, A. We..r YMv dw-..caa. V•_�tlRlrr Npoulau�M.+..aOr�l.rx uY dbr.0 9�C TYPE: TYPE: \�31— AS NOTED EfRACED WALL PANEL / FRAME DETAILS TYPICAL AB PART OF A OONTtNt1 LT SNEP.T14p W/ L NOT TO -L. DEP AI11I1t OdiE: 09.01.23 ................... _. _........ Itil tEYifFU: 09.07.23 (1) PAGE # A5 Wisconsin Department of commerce Division of Safety and Buildings SOIL EVALUATION REPORT Page t of 3 In accorcance wrtn uomm tso, VYIS. Aom, L oQe County C Attach complete site plan on paper not less than 6 112 x 1.1 inches in size. Plan must f P �- 3 include, but not limited to: verticzal and horizontal reference point (BM), direction and percent slope, scale or dimensions, north arrow, and location and distance to nearest road. R ewad Date Please pant all information. Personal infarrnwton you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1 ) {m}] / t7 Property Owner 7 _ Property Location r� Gout. Lot 114 S T� N I E ( W Property Owner's MailingAddress Lot Block # Subd Name AA# City fate Zip Code Ph umber City El Village Town Ne rest Ro New Construction Use Residential 1 Number of bedrooms Code derived design flow rate GPD Replacement Public or commercial - Describe.f Parent malarial � Jl {=food Plain elevation if applicabe General axrartents and recommendations: �� �1 ' r � f f' // '- r L 3 22 Q 03C177 Ix N QBoring '9je. Y r 'rr r•■ ��•. a:.a it arc D r • Qu.Sz. Cont.ck)iorMM Ca r.� ���y/E���� �r u�►�■r�i■r■���_mom Baring Pit Ground surface elev&-'7Zft Horizon Depth Dominant Colcu Redox Description in. Munsell Qu. Sz. Cont. Color 0 - epth to limiting factor in. Tex r Structure Consistence Boundary Roots Gr. Sz. Sh- OU 7 hrl. CA -f- Effluent 91 = BOO > 30c 220 nVL and TSS >30 a 150 GST Name (Please Print) Sr e Bird Plumbing, Inc. Shaun Bird A-jdrr.>ss 1008 192nd Ave, New Richmond, WI 54017 � ' Effluent #2 = 60D,1 30 Date Evaluatio Cond:,r,led 1�7?" i Soil!1eplication Rate GPDifF 'Eff#1 "Eff#2 2;, and TSS < 30 mgrL CST Number 226900 'pICC nU"i C• %Yjr,%Ler 715-246-4516 ,I Property Gamer _�_ u- _� Parcel ID # Page �+ Bonng Boring # L6 a.ft. limiting factor in, Pit Ground surface elegy. Depth to Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots in. Munsell Qu Sz Cont- Color �-- Gr- Sz. Sh. )�" d -1- 3 l 41(1 .j _ r� M Soil Application Rate GPD ff 'Eff#1 'Eff#2, sr F-1 Boring # L] Boring ❑ pit Ground surf elegy. ft. Depth to limiting factor in- Soil Application Rate Horizon Depth Dominant Color R x Description Texture structure Corsi Boundary Roots GPDtff 'Eff#1 'Eff#2 in. Munsell Qu. A Cont. Color Gr. Sz. Sh. [J Boring F-1 Boring # Ground surface elegy. _ ft. De to limiting factor _ in. Pit Horizon Depth Dominant Color Redox Descriptio Texture Stru re Consistence Boundary Roots in. Munsell Gu. Sz Cont. C or Gr- Sz. Soil Application Rate GPDtfl: 'Eff#1 'Eff#2 Nil ' Effluent #1 = BOD. > 30 � 220 mgfL anti TSS >30 a 150 M41L ' Effluent #2 = BOD,! 30 mglL and TSS a 30 MgrL The Department of Commerce is an equal opportunity service provider and employer. if you need assistance to access services or need material in an alternate format, please contact the department at 608.266-3151 or TTY 608-264-8777. SBD•8310 (R.600) Soil Test Plot Pl, Project Name 6-G Corporation S Add ress 58 Dunbar Way Mahtnmarli Mn .r,-c;1 1 Lot 6 Subdivision W 112NE 1/4S4 T31 1Alnrnr 1nnrl W;11 N/R 1 is W ®Boring ()Well PL Property Line kk BM or VVRP Assume Elevation 100 ft System Elevation At- Grade Alt. BM 7n, nr 1 /)" n'". n oQ i Please Note: Testec[N may not be suitable foi desired building area. Check system location before excavating. Please note: survey was not completed at time of testing, setbacks from lot lines may change. Installer must verify all lot lines and setbacks before installation. CSTM #226900 Date 7/24/03 Township Star Prairie County ST. CROIX Top of 112" Pipe * H R PSame as Benchmark Wismnsfn f]epaMnentof Commerce SOIL EVALUATION REPORT Page i of 3 Dvision of Safety and Buildings in accordance with Comm 85, Wis. Adm, Code Y r Attach complete sits plan on paper not less than 8112 x 11 inches In size. Plan must County zC-3 include. but not fimded W7 vertical and horizontal reference point (BM), directidl and Parcel I.D. percent slope, scale or dimensions, nodh arrow, and location and distance to nearest road- �' 3 ` 6 io wb Please print all information. R Owed Date Pdrewsai I r}wmal on ya prbridC mrar be useC for �eco+tdery Purpo�er (Pr racy Law, s. 15 e4 (i) (ri)) / Property Done ' f/_ 7 _ Property Loca? on '• t.-;7 / ! �yy� Govt- Lot 114 5 T_�N E ( a W P+np 4 Chuner's Maik ddmss Eot Block !! Sibd Nww Max City rate CxJde Piwx 7- Cdy 0 vrlage Mn N rest Nei"' Constructor Use Residential / Number of b.:1r ns Code derived design ftow rat® GPp Replacement Pu"ic or commercial - Describe: _ f Parent material _ Hood PWn elevation if applicable ' ` I it Gmwral corrrtl" j� q and r000mmendabons: �¢C /1L ,i JUL J 1 2003 1 sr cr Ix N e Pit Ground su ce etev&r/, ft. Depth to limiUng factor Soil Annlir.Nim Ralrx r M OF NO MA M L!J�►LIl1J�r/ / ®�� r� �. 1 W!W�M� WON, W� �"�M `lid �® Pit Ground surface elev/�ft- ilmiung lactor ? Sal Anolicalion Rare -;W �!►��� 'Effluent #1 - BOD s 30 s 220 nVL and TSS 3,30 5150 mW 'Effluent Wr1 = UW < -vJ IT19L ano r a0 t .w mgrL CST Name (Please mit) CST Number Bird Plumbing, Inc. Shaun Bird 226900 Address ©ate Evaivar+a Conducted Telernonc rJumher 1008 192nd Arne, few Richmond, WI 54017 �%j J 715 246-4516 Property Owner Parcel 10 9—ire _ -- -- �fo S LL � �fl Pit Ground surface V. P ft. Depth to d nib da in. Page .---_—of 11�tvl Ar,"irAfir Rafe �WMIr. MI FIR WNFAr al � . fiRINd MMAM E �x ❑ Q Pit Ground Surface Blew. tt. Depth to Vrriuling factor In- /_ Sol Amliraltrm Rate # [] Boring ❑ Pit Ground surfaoe elev, ft. Depth to fim&V factor _ in Sat nmliration Rate Honzon Depth In. Dominant Color Murtsell Redou Description. Qu. Sz. Cont. Color Texture St ucture Car. Sz. Sh. Consistence Boundary Roots GPDMf 'Ef i 'EffN2 ' Effluent ff1 t SOD,.- 30 t 226 rrgl. arm TSS >30� f 50 nv& ' Efiluent #2 a BOO, 130 rrtg,t and TSS t 30 m9t The Department of Commerce is an equal opportunity service provider and employer. if you need assistance to access services or need material in an alternate tormat, please contact the department at 608-206-3151 or 7 TY 64$-264-6777. sacs-IaHrta.aaol Soil Test Plot Project Name 6-G Corporation Address 58 Dunbar Way Maht ame A. M 5 i n Itoo �TM #226900 Lot 6 Subdivision Woodland Hills Date 7/24/03 W 1 /2 NE 1/ S 4 T 31 N/R18 W Township Star Prairie [� Boring (� W PL Property Line County ST. CROI BM or VRP As me Elevation 100 ft. Top of 1 /2" Pipe System Elevation At Grade *HRpSame as Bernmark Alt. BM Top of 1/2" A Q 98.1' ff Please Note: Tested area may not be suitable for desired building area. Check system location/ before excavating. Please note: survey was not completed at time of testing, setbacks from lot lines may change. Installer must verify all lot lines and setbacks before installation. MU , Scale is 1" = 40' unless otherwise noted B-3"S, 60' a 0 0 00 M 12 bU' KF LWUJ 1 LMF'UKHK Y p CUL-DE-SAC EASEMENT,- (� TO BE REMOVED UPON D WESTERLY EXTENSION OF / ROADWAY. \ // b r 1 O / 14 �6s airs• t7 3 N 58`30'11' W �216� 24.84' d \ 13 11 \� o 109 N 6 9-,--�-S 89'32'35' W - -- M/°�q�5, 381.14' �/ \� \ Zrr�� 993.10' a22ti 2�Iq TOWN ROAD �— � � � 10 � �\ � y 6 . \ 'gyp/"2 Zo JN 89'32'35' E - - - G _ - \ \ �\ a3g041f -----DRAINAGE o - - 381,14' "a � \\ � EASEMEN' ry — — -- J- — -- S 58'30'11' E \ \O 1 Li 30.07' S 67°07'37' W N 1 86.54' 10 U1 N w 6 28F 060 S, , 6.59 Ac, LBO = 1000.30' cn 0 Ic z r D I� m U ID z Itj v DRAINAGE \O9 O 1 EASEMENT o 0 33 33 98 \ v' \ N 7 9.29' 517 ` \ N N 83`3 8• E 2' ` 01 N `s N D 1 � 1 I O 5 \\ \ INAGE \ SEMENT I O s 56• 42• w S 87.2 / PCj i 77. N 40'51'00' E J` 25.19' • 996. s� �� — 740 �m H\ N 46.52'S . -J 8 W S 86.28'19' E114.04 _ 114.04' y �sNiS` / \ S 41.54'46' W 67.50, . rp HW 984 80' a�e �21zgj�23 ST, r_Pbj)C -COUNTY STATE SANITARY PERMIT JDS-4- 23�'AV8 - F]TRANQ_v1:R/k_"NEWA1.—,� PREVIOUS O PLUMBERY&tAt ��LIC.# -22-q-q/0 I TOWN , �,. AND/OR , BLOCK Lo4mr', , br4X CHAPTER 145.135 (2) WISCONSIN STATUTES (a) The purpose of the sanitary permit is to allow installation of the private sewage system described in the permit. (b) The approval of the sanitary permit is based on regulations in force on the date of approval. (c) The sanitary permit is valid and may be renewed for a specified period. (d) Changed regulations will not impair the validity of a sanitary permit. (e) Renewal of the sanitary permit will be based on regulations in force at the time renewal is sought, and that changed regulations may impede renewal. (f) The sanitary permit is transferable. History: 1977 c. 168; 1979 c. 34,221; 1981 c. 314 Note: If you wish to renew the permit, or transfer ownership of the permit, please contact the county authority. ,rED ISSUING OFFICER — DATEr BEFORETHIS PERMIT EXPIRES UNLESS RENEWED SBD-06499 (R11/20)