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002-1055-20-000
Wiscoitsa~0epartmentofCommerce PRIVATE SEWAGE SYSTEM , Safety and l;uilding Division INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. 'ermit Holder's Name: City Village X Township Bun e, Doris Baldwin, Town of ;ST BM Elev: /~ ~ Insp. BM Elev: BM Description: ~ m , cs- TANK INFORMATION TYPE MANUFACTURER CAPACITY Septic J ~ /~ ^~ J Dosing Aeration Holding TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Septic ~ / > zs ~ Q ~ -t Dosing ~ ~~ ~ ~ Aeration Holding PUMP/SIPHON INFORMATION /"~~ Manufacturer ~ f 1 !~~ ~ 0 ' Demand tT GPM Model Number /~`~ ~~ TDH Lift ' ~ Fric~ on Lo ss Systerxa,He~d ~~Ft T ~ • ~ ~ j, O Forcemain Length~~/ Dia. 7i ., Dist. to Well c SOIL' ABSORPTION~3'4'6TEM BED/TRENCH Width ' Length DIMENSIONS Q~! SETBACK SYSTEM TO (INFORMATION _ ~,,, __ DISTRI UTI SYSTEM No. BLDG (WELL t ~~10~ ~ 20+~ a-~ s uv,~, ELEVATION DATA County: $t. CroiX Sanitary Permit No: 514928 0 State Plan ID No: Parcel Tax No: 002-1055-20-000 Section/Town/Range/Map No: 23.29.16.337 STATION BS G •/ P HI O(a / FS ELEV. ao~ o Benchmark ~~ b.., /bf.~-~ ~Oa Alt. ~, 3.~1 ~ o-~~~ Bldg. Sewer ~,! /~/.~~ St/Ht Inlet ~, ~ /~ . SUHt Outlet ~_ Dt Inlet ,~--- Dt B ~G. o~ Hea r/Man. Z , ~, /a2.~Z~ Dis^t• Pipe ~s y p 39 ~~Z F Bot~ Syste ~-- o~•s~ ~7S /o/• Final G~ ~~ ` yQ >, / Ste- Z ~.1 /0 3. a~ c1 ~ 7 • {~~ ~[.CJ PI7 DIMENSIONS INo. Of Pits LAKE/STREAM LEACHING CHAMBER OR UNIT Heade /Manifol Distribution( ~1 / /y ~~ x Hole Size/" xHole Spacing Vent to Air Intake Length~_ Dia ~ r ` Length ~ 0~ •' b x Dia ~' ~ Spacing 3 ' ~ t to p ~~ '• ~~~•~~~ SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only ~d 1ti.° `d` Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil ~~ ~ ~/~~ Yes ~ No 0 Yes COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1:~/ Z.`/ O ~ spection #2: /~ Location: 2559 90th Avenue Woodville, WI 54028 (NW 1/4 NE 1/4 23 T29N R16W 40 acres ~ ~v~~%~~D ~'Z Parc I NJ~• 1.) Alt BM Description = ~ '~gc~~~~ ~ l~'1 c~ C ~ ~ 2.) Bldg sewer length = ! / L~j ~ Z ~,~, ~5 ~,d( /~ ~ P` - amount of cover = r ~ ~b,~ ~b d~ y ~ r~ ~• -~ - a~a i ___- ~ - _ Plan revision Re wired. Yes ~~ No ~ i -:_. ~i / I Use other side for additional information. L~ _ ~~ _,-- - -~ -- -- - -- (.~'~ SBD-6710 (R.3/97) Date Insepctor's Si ature G/L S/!~o ., 7~ Z~ ~o ,,u~0 v ~" ~. J p ~Yv`. s. G~`7 ~r~l e,~-J!• ~a ~. ~~ g~~ s~~~ l ~~ ~~ ~k~- ~~ d-~ zs~~ z~~ 9 /f~ s s~..l ~acc 5 ~ics~- %oc{-~. 6cr.~ ~~~ ~/o~~ ~; l dog Gc~ece~ ,~,«pt~w D"~. v~- ~ v~ 1 Z~ ~4~ ~~ S~>ti z3 ~,i~w,~ l Cam, Gw~ O ~.. ~~ ~~S-gz9- ~si7 r ~~~~ 3(3 !, 2Cr~ 2-. ~ v , a,,.,ti,.,~~. ~~ J~~ , / i /, St. C`~oix County ~'lanning and Zoning Detail Sanitary Information Friday, September 26, 2008 nt 9:17:04 AM Page 1 of 1 Computer #: 018-1040-70-000 Sub/Plat: NA Parcel #: 18.29.17.2826 Lot: Municipality: Hammond, Town of CSM: Owner: Knudtson, Keith 927 150th Street Roberts, WI 54023 State Permit: 514985 Issued: 09/15/2008 POWTS Dispersal: At-grade County Permit: 0 Installed: POWTS Detail: NA POWTS Pretreatment: NA Notes Issuer/Ins ector As Built Plumber Ryan Yarrington NA Fogerty, Dave Not determined ;>~~r3r;:~~~ari: No Section: 18 TN/RNG: T29N R17W 1/4 114: NW 114 SW 114 Permit: Replacement Bedrooms: 4 WI Fund: Other Requirements Additional Notes Money Owed $0.00 Jl D (~ COmmerte.Wl.gOV Safety and Buildings Division county ~ ~ 201 W. Washington Ave., P.O. Box 7162 ST CROIX i sco n s ~ n Madison, WI 53707-7162 Sanitary Permit Number (to be filled in by Co.) Departmer-t of Commerce ~ /'~ 9~ Sanitary Permit Applicat' StateTransCactionNumberG y r ~ In accordance with s. Comm. 83.21(2), Wis. Adm. Code, submission of this form priate govern~ ' tal J fS unit is required prior to obtaining a sanitary permit. Note: Application forms for state-ow~}E~ f d ~ are pro~ect Address (if differe t than mailing address) ~ or secon used submitted to the De artment of Commerce. Personal information ou rovide„,,,, u oses in accordan a with the Privac Law, s. 15.04 1 m , Stats. y p ~"°~ "' ~ rx 90 AVENUE ~%~ - I. A lication Informs ' Please Print All Information .~ Property Owner's Name Parcel # PSOZ - ~D $ ' ZO "' DORIS BUNGE Property Owner's Mailing Address 2546 90TH AV 1U! U L. Property Location ~ a J ~ ' Govt Lot NA ~ d~~ . City, Stat Zip Code Phon~ OFFICE Nw'/<,NE v<, Section 23 WOODVILLE, WI 54028 (circle one) R 16 W T 29 N IL Type of Building (check all that apply Lot # ; ~~~ ®1 or 2 Family Dwelling -Number of Bedr oms 3 ~ A Subdivision Name _ ~. ~1 ~ NA , C~ I ck # Bl ~ ^ b Q ` ~ ~ o -11-~ Public/Commercial -Describe Use~,,, ~ p~ ) ~ j~ -, " .. "_ ~ J~~" /" l(~ l~lT~(,~ i' ^ City of ^ State Owned -Describe Use umber ^ Village of ~ iX ~/ti m~~~ NA ®Town of BALDWIN III. Type of Permit: (Check only one box on line A. Complete line B if applicable) A' New System ^ Replacement Treatment/Holding Tank Replacement Only ^ Other Modification to Existing System (explain) --~.~„-, System S. ^ Permit ^ Permit Revision Change of ^ Permit Transfer to List Previous Permit Number and Date Issued Renewal Before Plumber New Owner Ex iration IV. T e of POWTS S stem/Com onent/Device: Check all that a 1 D Qv ^ Non-Pressurized In-Ground ^ Pressurized In-Ground At-Grade ^ Mound > 24 in. of suitable soil ®Mound < 24 in. of suitable soil ^ Holding Tank ^ Other Dispersal Component (explain) ^ Pretreatment Device (explain) // V. Dis ersaVTreatment Area Information: a. ~ Design Flow ~gpd) Design Soil Application Rate(gpdsf) Dispersal Area Required (sfj Dispersai Area Proposed (sf) System Elevation 4so // p, ZS 1 ~7/Z, /DI. 5 VI. Tank Info Capacity in Gallons Total Gallons # of Units Manufacturer /; * w ~ a U ~ ~ ~ ~ • `( < a y New Tanks Existing Tanks ((~~ ~ ~ c 7r. z0 fX WN. ~ ~ ~ a H a Septic or Holding Tank 1 ~~~ ~ 1000 I HUFFCUTT ^ Dosing Chamber 600 0 600 1 HUFFCUTT ® ^ VII. Responsibility Statement- I, the undersigned, assume r onsibility for installation of the POWTS shown on the attached pleas. Plumber's Name (Print) Plum gnature ~ _ MP/MPRS Number Business Phone Number KERRY KJELSTAD 224207 715-834-9052 Plumber's Address (Street, City, State, Zip Code) ~~ 3705 VOLD COURT -EAU CLAIRE, WI 54701 VI I. Coun /De artment Use On1 Approved _ Di ed Permit Fee Date sued Issuin gent Sign e _ r Give n for Denial $ ~~ , Op ~~15 V g IX. Condit~~'~iteasons for Disapproval ~ / ~ ~~ ;~ C.o,. t ~ 0.x.5 ~-~ `~ ~+, f. Septic tank, efflulnt filter and ~ (`~ t ,n E%~~ C"t:>~ ersal cell musd alt be servk;esY majntahled ~ dis -- ~-/ ~ ' ~^".' pP,~~M.~ ~- , p asper management plan provided by plumber. I 2 AN setback cequkemertts lntlet be tnaintaitted Attach to complete plans for the system and submit to the County only on paper not less h 8 1/Z x 11 in~es in ~z{ r v i ~ I ~ ~ ~fe~. ~ 5 w. ~ ~ 3tx~ ~ c~ee.~ SBD-6398 (R. 01/07) Valid thru 01/09 ' BUNGE POINTS' NW-NE-23-29-16W 90TH AVENUE BALDWIN TOWNSHIP ST CROIX COUNTY, WI (90TH AVE) PAACE RIBEDAS 40+ C. --------------------------- N ~~~~ ~ ~$ ~~~ v~ ~t'~ ~~~ ~'p ~~ W E (BUILDING SEWER MUSTCOMPLY~ I WITH COMM 82.30 WAC (11}(C) ~ S I LOCATION OF WELL MUST COMPLY I L WITH WDNR CHS_NR 8118 812 J SCALE __________ rt9 BENCHMARKELEVATION =100.D' ~ I -t-post stake on eNtter stake I I o LOCATION OF SOIL BORING(S) I 0 15 3O I ^ LOCA710N OF SOIL PIT(S) I (UNLESS SHOWN OTHERWISE) '* NO APPARENT COMM 83.43 SETBACKS I ®DESCRIBED LOCATION OF LOT LINE I WILLIAM J, BERGH I ~ LOCATION OF R1GHi-0FWAY I ® CENTERLINE OF DESCRIBED ROAD WISCONSIN CERTIFIED SOIL TESTER I- - - - - - - - - - - J DESIGNER OF ENGINEERING SYSTEMS CUSTOMER ID 227819 20' • 2" SCH 40-PVC FORCEMAIN (must drain back to pump tank) (100} (98) \ 1 ,~ ~~~~o~` `®~~~~~~ ("CU ~p~ v~<~ (102) J \ ~ 1 `1 -50' - 4" ASTM PVC )BUILDING SEINER LINE i ~~~ ^_ #1 LL t_.LLLLL LLLLLLLLL LLLLLLLLLLL LLL( I I I I I- _LL L L (PROPOSED 3-BR _ L L L L I suILDING srre _LLL L LLLLLLLLLLL LLLLLLLLLL LLLLLLLLL LLLLLLL LLLL~ iQi1 f , . L UU°°'' HUFFCUTT OD SEPT /DOSE S (wla roved outlet fitter) '~~ '^ PLACE UPSLOPE EDGE OF CELL r ~ ALONG FLAGGED 100.00' CONTOUR ~~ =----- 80.0' X 6.0' DISTRIBUTION CELL WITHIN A MOUND COMPONENT ~ICOPY ,, ' ` . BUNGE POWTS ~ NW-NE-23=29-16W 90TH AVENUE BALDWIN TOWNSHIP ST CROIX COUNTY, WI (90TH AVE) PARCE IBED AS 40+ C. l~`b ~° ~ ~, ~~~ =~ ate' ~ N ~ ~C,vI 1~1 gip- '-~ ' Y V ~ (-BUIIDING SEWER MUST COMPLY ~ WITH COMM 8230 WAC (11)(C) ~ L+ ~ LOCATION OF WELL MUST COMPLY ~ J L WITH WDNR CHS_NR 911 8812 J SCALE r~ BENCHMARK ELEVATION =100.0' ~ ~. ~ -t pos[stakeeae9herstake (n LOCATION OF SOIL BORING(S) 0 15 3O ^ LOCATION OF SOIL PTf(S) I ~k NO APPARENT COMM 83.43 SETBACKS ~ ~ ®OESCRIBED LOCATION OF LOT LINE ~ (UNLESS SHOWN OTHERWISE) ) ®LOCATION OF RIGHT-OF-WAY WILLIAM J. BERGH L® CENTERLINE OF DESCRIBED ROAD J WISCONSIN CERTIFIED SOIL TESTER DESIGNER OF ENGINEERING SYSTEMS CUSTOMER ID 227Bt9 20' • 2" SCH 40-PVC FORCEMAIN _ (must drain back to pump tank) (100) (96) r~ ~~v~ ~~ e ~~,`, `d~~~e~,,. ~,r'' (,~v~ (1oz) 1 1 -50' - 4" ASTM PVC BUILDING SEWER LINE #3 ~LL LLLL LtLLLLLL LLLLLLLLL LLLLLLLLLL L L L (PROPOSED 3-BR _ L L LLLI _LLLL LLLI BuILDINCSrrE _LLLLL LLLLLLLLLLLLL LLLLLLLLLLL LLLLLLLLL LLLLLLL LLLL L HUFFCUTT MODEL 1000160D ~\ #2 ~` ~- __ \ #1 SEPTIC/DOSE TANK (wlapproved outlet filter) ~~ __,~ \~ ~ --~~~ ~lPLACEUPSLOPEEDGEOFCELL ~ ALONG FLAGGED 1D0.00' CONTOUR ~ ^ \ ~I~~~ ~=~=--- 8D.0' X 6.0' DISTRIBUTION CELL WITHIN A MOUND COMPONENT PAGE30F10 commerce.wi.gov isconsin Department of Commerce Safety and Buildings PO BOX 7162 MADISON WI 53707-7162 TDD #: (608) 264-8777 www. commerce.wi.gov/sb/ www.wisconsin.gov Jim Doyle, Governor Jack L. Fischer, A.I.A., Secretary July 09, 2008 CUST ID No. 227819 WILLIAM J BERGH GEO TECH 2667 113TH ST CHIPPEWA FALLS WI 54729-6575 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 07/09/2010 SITE: Doris Bunge -Dwelling 90TH Avenue Town of Baldwin, 54002 St Croix County NW1/4, NE1/4, 523, T29N, R16W ATTN.• POWTS Inspector ZONING OFFICE ST CROIX COUNTY SPIA 1101 CARMICHAEL RD HUDSON WI 54016 Identification Numbers Transaction ID No. 1555389 Site ID No. 739429 Please refer to both identification numbers, above, in all corres ondence with the a enc . FOR: Description: Mound Object Type: POWTS Component Manual Regulated Object ID No.: 1189527 Maintenance required; 450 GPD Flow rate; 18 in Soil minimum depth to limiting factor from original grade; System(s): Ezflow Mound Component Manual, (N.6/03), Pressure Distribution Component Manual -Version 2.0, SBD-10706-P (N.O1/O1) 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 the 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. The following conditions shall be met during construction or installation and prior to occupancy or use: 1. As specified in the approved mound system component manual, the system plot plan must show the direction and percent of the slope in the system area. 2. On page 4, the dispersal cell shall be covered with approved geotextile fabric that conforms to s. Comm 84.30(6)(g)., Wis. Adm. Code. The fabric shall be laid over the EZFIow product and extend down along the sides to a point at least 6 inches from the system elevation. This is approval stipulation #1331 as found in the Wisconsin Plumbing Products Register. 3. On page 4, an observation pipe detail was not provided. Observation pipes shall have a minimum diameter of 4 inches, provided with a watertight cap, have the bottom six inches vertically slotted, and provided with a suitable means of anchoring. Refer to Figure 8 of the approved mound system component manual for complete details. P,Q.W Canditt 4. On page 5, a center feed force main to the distribution network shall have the following characteristics as specified in the approved EZFIow component manual: WILLIAM J BERGH Page 2 7/9/2008 a. Due to the size of the EZFIow product, a center feed mound will have a small separation in the center of the mound that is equal to the diameter of the force main. b. Insert the shoulders of the tee into the EZFIow 4" pipe as far as possible to minimize the size of the gap. This can be achieved by inserting the 4" plug into a corrugation that is far enough into the EZFIow pipe so as not to impede the shoulders of the force main tee from being fully inserted into the EZFIow 4"pipe. When finished, the gap will be only as wide as the diameter of the force main because the EZFIow bundles on each side will be butted against the force main. c. Backfill the center gap with mound sand. 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. 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 stats 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. The above left addressee shall provide a copy of this letter to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerel , eter E Pagel Private Sewage Plan viewer ,Integrated Services (608)266-2889 , M - F, 0630 - 1500 Hrs pete.pagel@wisconsin.gov Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 WiSMART code: 7633 cc: Leroy G Jansky, POWTS Wastewater Specialist, (71S) 726-2544 ,Friday, 7:00 A.M. To 3:30 P.M. Kerry Kjelstad, Kjelstad Plumbing Inc (Plans Mailed To) Youa Soa Taw ~ Sync D E~o~aera Proudly Serving the Chippewa Valley Since ?994 ~~ ~ ~~~i~~i~~ _ .. Client: DORIS BUNGE 254b 9~`~` Avenue -Woodville, WI 54028 MOUND COMPONENT -USING EZFLOW GRAVELLESS PIPE Reference Component Manuals: Pressure Distribution Component Manual SBD-10706-P (N.01/01) -version 2.0 Ring Industrial Group -EZflow Mound Component Manual Job Site Location: Legal Description: Designer's name and license #: Designer's signature: Designer's mailing address: Designer's contact information 90T" AVENUE NW'/a, NE Sec. 23 T 39 N, 16 W Town: BALDWIN County: ST. CROIX William J. Bergh (License No. 15 1 the under~gned state that these plans were d submitted under my authority. 4255 N Prairi View oad, Suite 2 Chippewa Fal W 4729 715-723-5555 voice 715-720-1101 fax 715-577-6838 cellular email: billy@wastewaterpros.com Contents Page 1 cover sheet tt~ ~.+P system calculations t ~ _ a e 3- site plan Y ~ . a e cross section of mound component :~' F== age 5 plan view of mound component & distribution lateral schematics ~~.,^~ age EZflow manufacturer specifications '~ °"~' Page 7 - Y~ pump chamber x-section schematic `~~~ ' ~' Pa e 8 c,..~ x ~. _ 9 um curve P P ~° Page 9 maintenance & contingency plan ~'" ~-~`' Page i 0 ~~~ maintenance & contingency plan ~~ (.,,_,~ f_z. f.':P 13ECEIVED JUN 2 6 2008 SAFETY & BUILDINGS ~~.••'' pNSllli j••~,•~ 'S '~ ~ r '~' ~''•.- 'StON~'..~' ~haly f'f'e~ N1EaF7 ~Z53 S. Prairie Yiew Road, Suite 4 • ~hippewa4~'alls, WI 54729 LOCAL: 1715) 723-5555 FAX: (715) 720-1101 w w w. w a s t e w o t e r p r o s. c o m Page 1 of 10 SYSTEM CALCULATIONS USING HUFFCUTT COMBINATION TANK residential dwelling with total of 3 bdrm calculated at LLR (linear loading rate} 5.6 gal/day/ft DL-R {designlsoil loading rate) 0~4 gal/sgft/day depth to limiting factor 18 inches system area cross slope i l th ~10% 20 percent t~` `feet using ' n forcema eng 3 manifold and/or header length 3.0 r- feet using f I 3 3 gallons 450 gpd design wastewater flow 480 actual distribution cell area 1125.0 minimum required..basal-area 2~ inch -SCH 40 PVC (~ inch -SCH 40 PVC orcemain vo ume length of each lateral 38.750 feet using 1 1I2 inch -SCH 40 PVC total number of laterals 4 invert elevation bottom of lateral). ~ orifice diameter o.1s75 = 3116 tenths/inches 101.50' system elevation is/. y~ distance between orifices 30 inches or 2.50 feet total orifices per lateral 16 total orifices all laterals 64 lateral volume (each lateral) 3.57 gallons 10.56 lateral discharge rate system discharge rate 42.2 gallons calculated at 3.25_ distal pressure x 1.3 ft. vertical lift 6.O 1/' feet_ friction loss in the forcemain ~ feet calculated at 42.2 gal/min discharge rate TDH (total dynamic head) 10_0 feet minimum pump discharge ^ 42.2 gpm at 10.0 TDH (total dynamic head) pump manufacturer L GIANT model number 9EH 5 x void vol. +forcemain vo{. 74.6 gallons 71.4 actual dose (total-forcemain) pump tank model 600 actual tank size 627 gallons sepfic tank model 1000 actual tank size 1029 gallons manufacturer of tank(s) Huffcutt pump float onloff measurement 5.0 inches alarm float from bottom of tank 19.0 inches gallonJhole/dose 1.12 orifice density 7.50 ;. Page 2 of 10 . ___ EZFLOW MOUND COMPONENT CF~OSS SECTION (typical) ~: ,,~~ 4" OBSERVATION PIPE ~~~=` C,r , ~~~~ >12 SO{L TO PROMOTE < <~, ~', f`~~'`~r; SUITABLE PLANT GROWTH 6r ~ A i I. ~ '"~ ~'! ~ln .. 1 1 ~"!, DISTRIBUTION CELL I SYNTHETIC MATERIAL DISTRIBUTION LATERAL(S) INVERT ELEVATION = 102.00' s° CAP 18" .2' 7.0' >12^ UNDISTURBED SOIL & VEGITATION 6.. i • 1 Z" ! 25.2" 'ATION = ~oo.oo' PLOWED/TILLED AREA 5,8' 6.0'- 28.4'- ~sll ASTM C-33 fill material 13.3' 15.4 2.1' EZ1203H (10' bottom area - 30 sq. ft per product) 16 EZ1203H (5' bottom area -15 sq. ft per product) NA CUBIC YARDS OF SAND (minimum) 140 SYSTEM AREA SLOPE ~10% SYSTEM AREA LONGITUDINAL (long axis) SLOPE NA ALL MATERIAL & PIPING SPECIFICATIONS AS PER THE EZflow MOUND & PRESSURE DISTRIBUTION COMPONENT MANUALS DRAWING NOT TO SCALE PAGE4QF1Q - ' ~ PLAN VIEW OF E~flow MOUND COMPONENT (typical} * All piping & mat r~' ~;i(;,cations per the EZflow Mound & Pressure Component Manuals 7.d' 10' "V~Cf[L"~~7o `L UNIT D15TRI8UTION CELLS 1.5L-~~ o000000o FORCEMAIN/MANIFOLD °o°o°o°o°o °°O°oo° °°°O°OO°°O° 3.0' _ : °oo°°°°°° DISTRIBUTION °ooooo0 6.0' _ LATERAL(S) _ O°O°O°O L ° °... 0 0 28.4' /~ 06SERVATION PIPE(S) per Table 3 -EZflow 15.4' Mound Manual 80.00' ~ -11.4' 11.4'---~ 102.80' Distribution laterals terminate at the end of-the distribution cell ~ Access box covering threaded plug at the end of each distiibution lateral ~ ° o ° ~ DISTRIBUTION CELL ~~ EFFECTIVE BASAL AREA 7 0 ° o°_ ` EZflow BUNDLE //~ ~'O DISTRIBUTION LATERAL (typical) * All discharge orifices are located per the EZflow Mound Component Manual <s., final grade <s" final grade 1 1l2" SCH 40 PVC threaded cap threaded cap DISTRIBUT40N LATERAL access box access box 2" SCH 40 PVC MANIFOLD 1st & last orifiice located. 15" from end of lateral(s) 38.75' 0 0°o°o.c o°o°o°o°o ' ~ I tI l~ °o°o°o°o°O o°C1 °o°°c°30~~ o°° o°0 30" 15"-+-X/2 X X c o _OO°c 77.50'. 80.00' EZFLOW BUNDLE Discharge. orifice diameter 3116" = 0.1875 X/2 spacing 15" Number of orifices per lateral 16 X spacing 30" Total number of orifices (all laterals) 64 ..ORIFICES MUST BE LOCATED IN A (4 UP -1 DOWN) SEQUENCE (DRAwINC Is Nor ro scALE) PAGE 5 OF 10 __ ___ __ ___ ___ _ __ ............................ _ __ EZ1203H _ __. o~oooovoo '° =-s~ _ -~~ .•ovovoov~o o ovoo o-00; = '_ ~~_= "ooo~o vo ov '1211 • o00 1 oov. _ V,i.""_- - "` ooo o~vo - .~- o00 vov, _ :o~oo- 24" e e.e. - ~. eve.. .. oo-o oov 4.625" ovo pee o PV. ev0 ~ ~~ vee. o.v.o, v o v v,ov.- v-o 0 o o.o oov 00 0ov ooooovo-v¢ vovoooovovo ~.v:ooovvo ooo-vv oov ooov'ovooovooovovvoo -evevvoo ovvvov:vooeooov~~voooovv oooo-ovvoooo~ovvoooovoov~ vooovvo 24" Bottom 36" 12-1/2" DIA. (typ.) Soil Interface Area Void Volume Vcid Coefficient in Aggregate given at 57.4%. Sidewall (2 Sidewalls) O.D. of 4" pipe = 4.625 inches (2.3125in ~ Bottom V oid volume par linear ft. = 3.14 * f 12in /ft) * ~ - 0.117 fr' \ Total Soil Interface Area 1/2 Circ. = 18.84" In. to Ft. Sg Ft 2* 18.84in - 3.14 12in lft 2.00 5.14 O.D. of center cylinder = 12.5 inches al 6.25in l2 2.3125in l J Void volume in aggregate of canter cylinder = 3.14 * ~ 12in /ft J - 3.14 * ~ 12in / R I * .574 = .422 i4' / Projected Trench Area O.D. of outside cylinders = 12 inches r is Sidewall Height = 12 in. *`2 = 2.00 Sq.Ft. Void volume in outside cylinders = 2 * 3. IM 12~ ~ ft I * .574= ,901 ft' 111 JJl Bottom = 36 in. = 3.00 Sq.Ft. s `( 24ia bin l ( / bin l Void volume at bottom between cylinders = I I * J-I 3.1M J = 0.215 ft' Projected Trench Area = 5.00 Sq.Ft. 12in/ft 12in/ft l 112in/ftJ Void volume at outside bottom comers (1/2 of void volume between cylinders) 0.215 / 2 = 0.108 ft' Total void volume = 0.117 + 0.422 + D.901 + 0.215 + 0.108 = 1.763 cubic fr / ft Gallons per ft = 1.763 X 7.48 = 13 2~allom oer linear ft. o~ ro _ _ ._ _ .. COMBINATION SEPTIC TANK/PUMP`CHAMBERX-SECTION (DRAWING NOT TO SCALE) FINAL GRADE (slope ground surface away from manhole(s) for proper drainage) MANHOLE RISER & COVER {per COMM 84.25 (7) & (8)} (wlapproved locking device) ELECTRICAL & ALARM SUPPLY (electric & alarm wiring must be _ installed on separate circuits) BUILDING SEWER (per COMM 82.30 (11)} APPROVED ELECTRICAL Jl1NCT10N BOX MANHOLE MANHOLE 18" INLET MANHOLE r :~ BOTTOM OF INLET (invert elevation) ~ 3„ •••• ••• •• (wastewater level)----- /v-,,,.., ............ ~,....i ///////////////~J// U///i J % / // / / / i ii~ /i%///////// i C " . - FILTERED B INLET PIPE 4 '' APPROVED EFFLUENT FILTER EFFLUENT (tee or baffle) REQUIRED ON OUTLET A =: MINIMUM OF " OF SUITABLE BEDDING BENEATH TANK EFFLUENT FILTER BEST ** '~ OR EQUIVALENT COMPONENT Tank Manufacturer HUFFCUTT DWF (daily wastewater flow) 450 GPD Septic/Pump tank model 10001600 Number of daily doses -6.3 (DWF I actual dose volume) Alarm manufacturer S.J. ELECTRO *~ Alarm model number NW 101 *~` Forcemain volume 3.3 Type of float switch MERCURY *'` Actual dose volume (gallons) 21.35 (total dose volume - volume of forcemain) Effluent pump manufacturer LITTLE G1AN Effluent pump model. number 9EH Minimum pump discharge rate (GPM) 42. Vertical lift (pump off to distribution lateral) system head (distal pressure X 1.3 feet) Friction loss in the forcemain Zd ~ Total dynamic head (TDH) properly sealed when not used ~~ i/./~i/i/iii ALARM FLOAT ON FLOAT OFF FLOAT elev = 96.00' PUMP PAD T PUMP TANK CAPACITIES Reserve above alarm 21 inches = 313.53 gallons Alarm float above on float 2 inches = 29.86 gallons (C) 2 OnlOff float measurement 5 inches = 74.65 gallons (B) Off above bottom of tank 14 inches = 209.02 gallons (A) 6.0' ~ ~ ~ 3.25 PUMP CHAMBER DIMENSIONS ~0.7 ~ a Length 49.0" Width 70.0" 10.0 Liquid depth 42.0" Gallons per inch 14.93 PAGE 7 OF 10 T _.a+-a- -. ~4, 9EH SERIES SUMP/EFFLUENT :PUMP CnArifirrltinnS MDDa CAL SDIIDS SQE BUNNIN6 PEYFORNANCE (6PN @ NEADI SHUTOFF PS L ren. eau. nnnm u~.~u+w~ llSTIYfi YP YDUS IDia lad AN6'SryIlA1T5 5' 1D' 15' 20' 1~1 let 1-msl (Y:LcM1I ND. 9EH-CDd ND. 509330 UUC6A 4110 115 . 3i4 13.9 1DDD 11 69 6D 49 32 13.8 2D' 27 9.11 x 11.64 x 8.94 9EH-GlM 50934D UUC6A 4I1D 230 3/4 6.5 1000 71 66 60 49 32 13:6 20' 27 9.11 x 11.64 z 6.94 9EH-CIA-RFS 509350 UUC6A 4/10 115 3/4 13.0 1000 71 66 60 49 32 13.6 20' 27 9.11 x 11.64 x 6.94 9EH-CIA-AR 509360 UUCSA 4/10 230 3/4 6.5 10DD 71 68 60 49 32 13.6 20' 27 9.11 x 11.64 x 8.94 /'mar. ..+.~ ~r.a-inn 30 w zo A W_ 10 0 to ~.5 W r W F s A 4 2 2.5 0 vv~ w~~u Motor Housing Epoxy Coated Cast Iron Impeller Material Poly Carbonate Im eller T e Closed Vane Volute ABS Power Cord SJTW-A Mechanical Shaft Seal Nitrite with carbon and ceramic faces Fasteners Stainless Steel Shaft Stainless Steel Bearings Upper Sleeve and Lower Ball Bearings FLaW- GALLCINS/MINUTE PUMP RERFdRMANCE CURVE ~ a,~""'" ~~ Little Cxiallt Pump Co. II5V 60H2 G J"'"' PO Box 12010 ~ Phone: 405.947.2511 g. ~ ` Okla. City, OK 73157 Fax: 405.951.5674 ISO 9001 CERTIFIED WWW'Ll~tle~laritPL1I21p.CUlri Form 995235- 01!00 o~ ~ FLAW- LITERS/HOUR 0 1000 2000 3000 POWTS OWNER'S MANUAL MANAGEMENT PLAN PERMIT f~UMBER: Owner: POWTS Maintainer; Local Regulatory Authority: POWTS Installer: Septage Servicing Operator DORIS BUNGE - 90T" AVENUUE Geo Tech Soil & Site Evaluation -Chippewa Falls, WI 715-723-5555 ST CROIX County Zoning Department- HUDSON, WI 715.286.4682 Kerry Kjelstad, Kjelstad Plumbing Inc. -Eau Claire, WI 715-834-9052 DESIGN PARAMETERS InfluentlEffluentquolity (values typical for domestic (non-commercial wastewater and septic tank effluent) Fats, Oil and greases (FOG) <30 mglL, Biochemical Oxygen Demand (BOD) <220-mgIL, Total-Suspended-Solids (TSS)-<150 mg/L. -Soil Loading Rate (SLR) = D_4 -BASAL AREA SYSTEM SPECIFICATIONS The components of this septic system are intended to serve athree-bedroom (450-GPD) single-family residence. The components include; a Huffcutt model 10001600 septicldose tank (with approved outlet filter}, a Little Giant 9EH effluent pump, alarm & controls and a 80.0' x 6.0' distribution cell within a mound POWTS component. Ali components must comply with WI Adm. Code COMM 84 and be installed per manufacturers specifications and approval fetters. DESIGN CRITERIA o SBD -10572-P (R.6199) "Mound Component Manual" o SBD-10691-P (N.01/01) "Mound Component Manual" Version 2.0 / EZFLOW MOUND COMPONENT MANUAL o SBD -10570-P (R.6/99) "At-Grade Component Manual Using Pressure Distribution" o SBD -10567-P (R.6199) "In Ground Absorption Component Manual" o SBD -10705-P (N.01 /01) "ln Ground soil Absorption Component Manual" Version 2.0 o SBD -10573-P (R.6199) "Pressure Distribution Component Manual" / SBD -10706-P (N.01/01) "Pressure Distribution Component Manual" Version 2.0 MAINTENANCE & MANAGEMENT Inspect the condition of the treatment tank(s) and dispersal cell(s) a minimum of every three years. The septic tank contents must be removed in accordance with Chapter NR 113, WI Adm. Code when the combined sludge and scum equals one-third (1/3) the tank volume. The effluent filter(s), effluent pump, controls & alarm and distribution lateral(s) should be inspected annually to ensure maximum performance. L~eral inspectionlmaintenance should include flushing of the laterals and pressure testing. STARTUP For new construction prior to use of the POWTS check treatment tank(s) for presence of painting products or other chemicals that may impede the treatment process andlor damage the dispersal cell(s). If high concentrations are detected have the contents of the tank(s) removed by a Septage-servicing operator prior to use. OPERATION The property owner is responsible for the operation and maintenance of the POWTS and submission of required reports. The quartity and quality of wastewater will affect the performance and longevity of your POWTS, The installation of water-saving appliances and fixtures along with prompt repair of leaks reduces the wastewater volume. Also, the brine or waste from water softeners, iron removal uhitS and other clear water treatment devices and foundation drains should be discharged to the ground surface whenever possible, Note: this does not include laundry waste, showers, dishwater, etc. The system is designed to handle domestic strength wastewater, however the disposal of food based greases and oils, vegetableffruit peels and seeds, bones, and food solids such as those produced be a garbage disposal should be minimized. Toilet tissue is the only paper that should be discharged into the system. Other non-biodegradable items such as baby wipes, tampons, sanitary napkins, condoms, cigarette butts, dental floss, and cotton swabs should not enter the system. Chemicals such as petroleum products, paint, disinfectants, pesticides, antibiotics (medications), solvents, etc., should not be flushed into the system as they can seriously damage your POWTS and contaminate your drinking water supply. Maintain regular steady flow by spreading the laundry washing throughout the week. Avoid vehicle traffic over all system components. Compaction of snow over the unit may cause it to freeze up. o Valves Valves should be operated in the following manner / Alarms Alarms should be tested on a regular basis by the homeowner, If an alarm sounds, contact an individual licensed to serve POWTS. There is normally a one day reserve capacity under regular operating conditions, however water should be conserved until anyproblems with the system are corrected to prevent back-up of sewage into the dwelling or surface discharge. ~CFI~ Paga"8~oF5"' y' .- INSPECTIONS Inspections shall be made by a person carrying one of the following licenses or certifications: Master Plumber, Master Plumbs Restricted Sewer, POWTS Maintainer or Septage Servicing Operator (per the attached Maintenance Schedule) / Septic Tank Component Tank inspections must include a visual inspection of the tank to identify any missing or broken hardware, identify any cracks of leaks, measure the volume of combined sludge and scum and to check for any backup or surface discharge of effluent. Access openings used for service of assessment shall be sealed and/or locked upon completion of service. Any defects shall be promptly corrected. Exposed openings greater than 8 inches in diameter shall be secured with an effective locking device to prevent accidental of unauthorized entry into the tank. The outlet(effluent) filter(s) shall be inspected and cleaned to remove any accumulated solids according to manufacturer's specifications. Provisions are to be made to retain solids in the tank during cleaning, Filter cleaning may be necessary at more frequent intervals than stated in the maintenance schedule to keep the system operating properly. / Pump Chamber/Treatment Tank(s) Component The inspection must include a test of all electrical equipment such as pumps, alarms and floats. A visual check must me made for leaks, backups, surfacing, missing or broken security devices and other hardware and the condition of the filter, Any service needs or repairs shall be promptly taken care of. / Mound, At-Grade, fn-Ground Pressure The inspection shall include recording the levels of ponding, if any in the observation tubes and a visual inspection for any evidence of surface seepage or discharge. Any discharge to the ground must be promptly reported to the regulatory authority. Ponding greater than 75% of the height of the component may indicate overloading or impending hydraulic failure necessitating more frequent monitoring. REPORTS Reports for maintenance, inspection, and monitoring shall be submitted in accordance with COMM 83.55 Wisconsin Administrative Code. ABANDONMENT When the POWTS fails and/or is permanently taken out of service the following steps shall be taken to ensure that the system is properly and safely abandoned incompliance with Ch. COMM 83.33, Wisconsin Administrative Code. - All piping to tanks and pits shall be disconnected and the abandoned pipe opening sealed. - The contents of all tanks and pits shall be removed and properly disposed of be 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 other inert solid material. CONTINGENCY PLAN Ifi the POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide a code compliant replacement system. o 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 and should not be infringed upon by required setbacks from existing and proposed structure(s), lot lines and wells. Failure to protect the replacement area will result in the need fora new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rules in effect at that time. o 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. o The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluation must be performed to locate a suitable replacement area. If no replacement area is available a holding tank may be installed as a last resort to replace the failed POWTS, / 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. WARNING SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASES ANDIOR INSUFFICIENT OXYGEN. DO NOT ENTER ASEPTIC, PUMP OF OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. Page.f}ef~' (O Q~ f~ t Wisconsin Department of Commerce SOIL EVALUATION REPORT Division of Safety and Buildings • in accordance with Comrn t3.5, Wis. Adm. Code Count Y ~ C~a ~ e Attach complete site plan on paper not less than 8 tI2 x 11 inches 'ze. n t Page t of~ include, but not limited to: vertical and horizontal reference point ( dir n a Parcel LD. ~2 _~ ~5 ~'°~~~~ r ~ ~ l percent slope, scale or dimensions, north arrow d loca(ian and is an R ewed Date Please pri ~/'-~{`, Personal inrormation you provide may be us for se~rt~aly~rucpolk~acy t.a , s. 15.04 (1) (rn)). Property Owner ; l~ ~" r Property Location ppr S ~r~n Q 1/JUN 1 Z 2008 Govt. Lot N~ 1/4 Nf 1/4 S~ 3T ~ I N R 1 ~ ~ W Property Owner's Mailing Addres Lot # Block # Subd. Narne a CSM# ~ ST. CROIX COUNTY / ~ (rl~~ }~~~ ~- ~ y'~ ~~ 1Qt,esti Crty State Zip Cod ^ City p ~ Village ~ Town Nearest Road GJ~~Zt~~ w= SYoz~ ('~~s~riS~b~-2sY~ 1~0.~c~- Q~~Au~¢.,.~.~.d~~d~ New Construction Use: -Residential / Number of bedrooms 3 Code derived design flow rate ~ So _ GPD ^ Replacement Public or commercial -Describe: `~~ Flood Plain elevation i1 applicable ft• Parent material ~ t) p ~ (} 11 1~ ]~ ~ I General comment ~GorYn -'~ng ~-. ~ ~ (` S ~~<<~ (/rno w ~J v . -I l Da..p)- V'O.~'Q '/ S 1 r`RX~ ~•~- \e~ and recommendations: J V U r rg r~'-'~ s r/u ~~ 5 ~o~ t h- S u,~ ~. vw 0.-r~_~ s~ ~.>„^,~, t~lu~-S-F S ~4a_r~ ~0~~'~.avr- / U Boring d Boring # Ground surface elev. ~ a'Z' tt. Oepth to limiting factor °~~ in. Pit Sob lication Rate Horizon Depth Dorninanl Color Redox pesaiption Texture Structure Consistence Boundary Roots ~Eff#1 P D ~~ in. Munsetl Du. Sz. Cont. Color Gr. Sz. Sh. Z (}~2c7 S`P~Z YI 5 ~s t~-„~,~F'w Z O ~ d ~? 3 o-z ~5`~i2%4 c z -s~' ~/ ~'~j s +~s6 `,...~ s z 4~~ O~~ `/ -4~d ~s`~2 y Sul ~s~lr IS ~~ 5 ~, a-~ ~~ ~a~ ~-~ Yrw ~ ~,c.~ ~ ~.t,.~- ~~ g iJ Boring V Boring # ~© Q; ,~ •~ pit Ground surface elev. tt. Uepth to limiting factor rn• Soil . li.:rtion pate Horizon ' ~ 3 Oeplh in. O- A/~~0 • (/rG l ~ Dominant Color Munsell l0~ ~z ln~~ /~ 7 /~~T~l y ~ Redox Description Du. Sz. Cont. Color No ~ ~ c Z~' 2 5`~ / ~ Texture S ~OCa w.. .J Structure Gr. Sz. Sh. ~~~~ Z~~'C ~ ~Y~ 5~ Consistence rw..~ -1'~r~_^~ / ^~~ Boundary ~ -S` C~ Roots 3~ Z ~C1 GPD/ft= 'Eff#t 'Eff#2 D•~ ~_~~n ~' t~ CY~~'//) Dr ~ ~ • / ~ s y~ . ~sY2 y.~ ~ 3 ~~~~ ~i~. ~ s ~~t - ~~ __ ' Efnuenl At = tr~u, ~ JV = LLU,myrl anu r vv --+~+ _ ~.+•• •••y,~ - -- ~ - - CST Name (Please Print) Sry ur ~ !~ aa~j ~e~ Z Address Data Ev~lualron CorWucted Telephone Number Soil Testing Service ~~~~ g3 z -d ozv W 3503 H -- - ,~..-...... ondovi, W154755 ~ r t o) ~r;3;~2-0020 s~ 7" Y ° =' .~ ° "+ .~, p~f~S ~~ , ~.~ ~~ ~~. Property Owner t'Vv-.~-- Parcel ID # Page 2 of Z_ 3 Boring "~" ~'"""'"'" ~/ Boring # pit Ground surface elev.! ~~`~ ft• Depth to limiting fador ~ in• Soit lication Rate T t Structure Consistence Boundary Roots GP D/fF Horizon ~ ,3 ~ Depth in. ~za 3S ~-y~ Dominant Color Munsell o~ 3 ~oYi~ x/3 ~ $`1,p `~l ~Y2 y ~ Redox Description Du. Sz. Cont. Color c:( ~-5`•r % c z 4S`tYY{ ,Ft 6(~ ~~ % ure ex s s g s Gr. Sz. Sh. ~s ~ Imo. s (c s~'~ ~ ~~~ ~,.r.~ (nnti'~+'- .~~~ ~J ~ z~ 2 1 ~- 'Etf#1 o-N a • ~' a • `~ 'Eff#2 a-'~ a -'7 ©-~ LJ Boring Boring # ^ Pit Ground surface elev. ft. Depth to limiting fador in. Soil licetion Rate Horizon Depth Dominant Color Redox Description Texture Slrudure Consistence Boundary Roots •E~GPD1fPEff#2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. [J Boring Boring # Ground surface elev. ft. Depth to limiting fador in. ^ Pit Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots P Ht' in. Munsell Du. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 • Effluent #1 = BOD, > 30 < 220 mg/L and TSS >30 _< 150 mgR. 'Effluent #2 = BOD, _< 30 mg/L and. TSS < 30 mg/L . r The. Department of Conunerce is an cyual 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. sao-u3o tROVOOI 3~ )/~) Property Owner I~ ~° t S ~ ~-hfv-2- ~ Parcel 1D # ' Page Z of -Z-- 3 Boring # Boring ~ ~w=+.rr Pit Ground surface elev. ~~~ ft. Depth to limiting fador ~~ in. Soil lication Rate Horizon Depth Dominant Color Redox Oescriptiori Texture Structure Consistence Boundary Roots GPD/fF• in. Munsell t]u. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 O"~ ~v'~c'12 `( No n~~ S '~'su~- tM.,,~..- ~ S 3s b y 8-~ ~-ZL7 ~`~ 3 S w+'..S ` wvt.'~r Zp ~- d~~ 3 /t7Yn ~/3 c.:l ~5`r /~ s I~.r.. s ~,,,,.~- ~ z 6 ~ ~ a •' 7 t, ~~' 7SN~ ~l G Z ~~`~ ~fi61~ °J / ~G 50~ Wn~r- c.~ ~ d~~ n d- ~ -y~ ~-Y~y ~ I-~ ~~ s ~ ~,.~~ ~-- Q Boring # ^ Boring ^ pit Ground surface elev. ft. Depth to limiting fador in. Soil lication Rate tdorizon Depth Dominant Color Redox Description Texture Strudure Consistence Boundary Roots GP D/fP in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Etf#1 'Eff#2 ^ Boring Boring # Ground surface elev. ft. Depth to limiting fador in. ^ Pit Soil lication Rate Horizon Depth Dominant Color Redox Destxiplion Texture Structure Consistence Boundary Roots P in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •EtT#1 •Eff#2 'Effluent #1 = GODS > 30 < 220 mg/L and TSS >30 < 150 mg/l 'Effluent #2 =GODS < 30 mg/l and TSS _< 30 mg/L . The:Ucparunent of Commerce is an cyual oppurtunily service pnw•idcr and amploycr. If you need assistance to access services or need material in an alternate format, please contact the department ut 608.266-315! or TTY 608-264-8777. sao-u~o cRO~root ' t~ 02 S ~~ ~ Q~~'k uQ.hu.~2 ~~o~~ <<~ ~~ s N ~ Z g ~~~s~ 6~~_a~~~~l Nw~a~ a3 ~q-l>f~ ~~~~~ ~~ 6.~ ~'op~`~.`Q.s tws \ .7 Z a; ,row... w+.owr- S ~' ~.J gf~a ~~D ~\ t~~"' ~~ ~ ~_ ~--; - 4 _ , (o° he ~ ~ 3~~~ ~ ~ i~~~~ ' ~` ,~ ;~ ~ ~ ~ ,o ., ~~ ~,. loo \ ~'r3 ~~ -~o ~ ~~ ~_~ ~~,~ a ~6.~ 1 1 1 o (o' ao 30 g.~~6~- ray r;$~a Wili Heidt Soifi Testing Service W 3503 Hemlock Rd. Mondovi, Wl 54755 (715j 832-0020 1 c~. no-a~7~~ Z d7nu 16,~oo~s ~~~~~- o~~ e~ • Parcel #: 002-1055-20-000 06/19/2008 04:39 PM • PAGE 1 OF 1 v' Alt. Parcel #: 23.29.16.337 002 -TOWN OF BALDWIN Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): O =Current Owner, C =Current Co-Owner O -GUNGE, DORIS A SURVIVORS TRUST DORIS A SURVIVORS TRUST GUNGE 2546 90TH AVE WOODVILLE WI 54028 Districts: SC =School SP =Special Property Address(es): * =Primary Type Dist # Description SC 0231 BALDWIN-WOODVILLE AREA SP 1700 WITC Legal Description: Acres: 40.000 Pla : N/A-NOT AVAILABLE SEC 23 T29N R16W NW NE ock/Condo Bldg: Tract(s): (Sec-Twn-Rng 40114 160114) 23-29N-16W Notes: Parcel History: Date Doc # Vol/Page Type 03(19/2007 846687 TD 10/01 /2003 741980 2424/391 QC 10/01 /2003 741979 2424/390 QC 2008 SUMMARY Bill #: Fair Market Value: Assessed with: Use Value Assessment Valuations: Description Class AGRICULTURAL G4 UNDEVELOPED G5 Totals for 2008: General Property Woodland Totals for 2007: General Property Woodland Last Changed: 04/11/2008 Acres Land Improve Total State Reason 39.000 5,300 0 5,300 NO 00 1.000 100 0 100 NO 40.000 0.000 40.000 0.000 5,400 0 5,000 0 0 0 Lottery Credit: Claim Count: 0 Certification Date: 04/17/2001 Batch #: PRGRM Specials: User Special Code Category 5,400 0 5, 000 0 Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer Mailing Address ~_~h~/~ ~D f ~'4' ~. ~, Property Address ~ G~p~d ~'~~~, ~ f , ,~" y~ ~, ~ a ~ C~ g ~~ (Verification regwred from Planning & Zoning Department for new construction.) %~} City/State ~ e Parcel Identification Number (.~~Z "' j~S 1/I,~zBc11 IP I ~~'-r---~l ~~ 5 Zp -- G~ LEGAL DESCRIPTION ~ 33~ Pro ert Location i p y ~ '/4 , ~ `/4 ,Sec. __~~_, T N R~W, Town of ~lX-~~ll ,~ Subdivision Plat: Lot # Certified Survey Map # ~~ l~l'e 5 ,Volume ,Page # Warranty Deed # ZS' ~ (o(p ~ ~ (before 2007)Volume ,Page #_ Spec house :yes 'no Lot lines identifiable yes no SYSTEM MAINTENANCE AND OWNER CERTIFICATION Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed, by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. Owner maintenance responsibilities are specified in §Comm. 83.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance. The property owner agrees to submit to St. Croix County Planning & Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (I) the on-site wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 113 full of sludge_ 1/we, the undersigned have read the above reQuirements and agree to maintain the private sewage disposal system with the standards set forth, herein, 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 completed and returned to the St. Croix County Planning & Zoning Department within 30 days of the three year expiration date. I/we certify that all statements on this form are true to the best of my/our knowledge. I/we am/are the owner(s) of the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. Number of bedrooms ____ SIGNATURE OF PLICANT(S) /~/O~ DATE ***Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Department. *** Include with this application 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. (REV. 08/05) State Bar of Wisconsin Form 7-2003 TRUSTEE'S DEED Document Number ~ ~ Document Name THIS DEED, made between Doris A. Bunge, in her individual right and ss surviving IQS Trustee of David F. and Doris A. Bunge Revocable Trust dated September 9, 2003 _ _ _ _ ("Grantor," whether one or more), and Doris A. Bunge Survivor's Trust dated March 5 , 2007, Doris A. Bunge, initial trustee with full power to convey; ("Grantee," whether one or more). Grantor conveys to Grantee, without warranty, the following described real estate, together with the rents, profits, fixtures and other appurtenant interests, in St. Croix County, State of Wisconsin ("Property") (if more space is needed, please attach addendum): I. The East Half of the Southwest Quarter (E'/: of SW'/,), in Section Fourteen (14), Township Twenty-nine (29) North, Range Sixteen (16) West 2. West Half of Northeast Quarter (W'/~ of NE'/.) of Section Twenty-three (23), Township Twenty-nine (29) North, Range Sixteen (16) West. 3. South 22 feet of Lot Four (4), Block Six (6); and Lot Five (5), Block Six (6), Original Plat of the Village of Woodville. 84.668? KATHLEEN H. WALSH REGISTER OF DEEDS ST. CROIR CO. , MI RECEIVED FOR RECORD 03/19/2007 11:00AM TRUSTEES DEED t:XEhiRT I i i REC FEE: 11.00 TRANS FEE: COPY FEE: CC FEE: PAGES: 1 Recording Arca Name and Return Address Thomas A. McCormack PO Box 2120 BaldK~n WI 5400 002-1029-40,002-1029-70,002-1055-20, 002-1055-30,192-1006-95 Parcel Identification Number (PIN) THIS DEED IS EXEMPT FROM TRANSFER FEE AND RETURN PURSUANT TO 77.25(] 1), WIS. STATS. *Bradley Bunge and Steven Bunge, successor trustees Dated ~~.~ ~T~j~7 s Signarirre(s) authenticated on AUTHENTICATION (SEAL) G _ ~ (SEAL) * Doris A. Bunge TITLE: MEMBER STATE BAR OF WISCONSIN (If not, ` authorized by Wis. 5tat. § 706.06 ) * ACKNOWLEDGMENT STATE OF WISCONSIN ) ss. ST. CROIX COUNTY ) Personally came before me on ~ r~ ..S . ~+~7 , the above-named Doris A, Bunge ~~ T- T to me known to be the persforf(s) who ex red >;~ie foregoing instrument and acknowledged'the same. -~ ,~ ''••. •'; `__ ~ U ~. THIS INSTRUMENT DRAFTED BY: ^ _ ~(.q ~ i'1,(yC.Cd Thomas A. McCormack __ _________ _ Notary Pub ic, State of WISCONSTl~„ ~, ~ Baldwin WI 54002 -___ -- _ -`-- M commission is rmanen • '~-''••: ` (Signatures may be authentipted or acknowledged. Both are not oteessary.) • ' ~.•~; ~ ~ }. ~~ NOTE: THIS IS A STANDARD FORM. ANY MODIFICATION TO THIS FORM SHOULD BE CLEARLY <DENTIFIED: TRUSTEE'S DEED STATE BAR OF WISCONSIN FORM N0.7-2003 •Type name below signatures. ®State Bar of Wiaconsin 2003 INFO-PRO"' Lepel Forms • (eools5szo2~ • irwoprdomis.oom s~ ~~ ...~-..~ ~.y~ ~a ~„_„ ~~ I ~:~~ ~CL1[+ITY BOISNDARY ~~ ~a~ IN`L~UUEU ~~.~_. ~ ~....~:~_ ,_,...~J 5 ~'~ ~E`~ti~,,r~ ~ ~-AREA tJOT l 0 ¢ lNCt.UDED ~ _ k >. ~ ~ i /~ ! r C Y f ~..__.~. J .~.~...__.. ~q { A ~~.A ' Y~' E i d ~ ~~ ~ ~ f a ~ 6 ~ ~ ~ ~ 5 1° ~~ ~~ E ~ ~ F J 24* 2~~ ' 9 ~ F {~~ 1 ? ~ E ~ ~ ~ ~ / i!i l 3 7 27~ _._____ ~~~, 29* 30~ 3~~ II AREA NOT ~ INCLUDED F Y~ _r ~ tS ~--AREA NOT INCi_UD[D- _~____~ -AREA NOT ING_UDED~ AREA iNCLU 33s 34 3~~ 3 ~ ~ ' ~i 3~ lNTERS7 ~-' _._._. A ~~ E 94 ~_ J c° " i ~_-~--~ ~ 39 4® ~ 41 42 43 ~ AREA NOT INCLUDED + e ®'COUNTY BOUNDARY~ ~ ~^ ~~ -- ZONE C)