HomeMy WebLinkAbout004-1025-90-000 St. Croix County Planning and Zoning Thursday, February 22, 2007 at 4:58:09 PM
Detail Sanitary Information Page t oft
Computer #: 004 - 1025 -90 -000 Sub /Plat: NA Section: 11
Parcel #: 11.28.15.177 L TN /RNG: T28N R15W
Municipality: Cady, Town of C Vol. Pg 20 1/4 1/4: SW 1/4 SE 1/4
Owner: Backus, Lane 405 215th Street Baldwin,
State Permit: 404942 Issued: 03/18/2002 POWTS Dispersal: Mound Permit: New
County Permit: 0 Installed: 07/19/2002 POWTS Detail: NA Bedrooms: 4 WI Fund:
POWTS Pretreatment: NA
N o N
Issuer /Inspector As Built Plumber Other Requirements Additional Notes Money Owed
Kevin Grabau >411/00 - Not Required McDonell, Mike Kevin forgot to enter data; finished calculations $0.00
Kevin Grabau Signed Off: Yes 12/30/02 and filed paperwork
Scheduled Pump Date Pumped 1st Notification 2nd Notification 3rd Notification
7/19/2005
Owner: , Shafe , Robe & Jeanine 405 215th Street Baldwin, WI 54002
State Per it: 289493 Issued: 08/12/1997 POWTS Dispersal: Mound Permit: New
County P rmit: 0 Installed: POWTS Detail: NA Bedrooms: 3 WI Fund:
OWTS J P�etreatment: NA
1 0 6 Issuer /Inspector As Built As Built Plumber Other Requirements ! Additional Notes Money Owed
Jim Thompson NA Timm, Roger apparently not installed before Shafer sold to $0.00
Not determined Sinned Off: No Backus - file with 2002 permit
Wisconsin Department of Commerce
PRIVATE SEWAGE SYSTEM County: St. Croix
Safety and Building Division
INSPECTION REPORT Sanitary Permit No: 404942 0
GENERAL INFORMATION (ATTACH TO PERMIT) S to an ID No:
Personal Information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. # - +1 owl
= Tro�sGla6+� �A•
Permit Holder's Name: City Village X Township Parcel Tax No:
Backus, Lane I Cady Township 004 - 1025 - 90-000
CST BM Elev: Insp. BM Elev: BM Description:
1 00.0 ' M . o t Yt- P = C e Ak i
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic Benchmar r TV Iro
Dosing � loo � ( Alt. BM
Aeration Bldg. Sewer
Holding St/Ht Inlet G' 1 - �D .1
r
St/Ht Outlet
TANK SETBACK INFORMATION
TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet
Septic ( ( r Dt Bottom r
tCD I UD (A --}- -, P -83 ?' . (,�
Dosing �� Lt Q � Header /Man. q q
t l �
Aeration Dist. Pipe D /
18. 00
Holding Bot. System
Final Grade 1
P MP /SIPHON INFORMATION (�? �,; (( b-e Iz r t
Manufacturer Demand St Cover r
GP VcV .38 96./z
Model Number
o
2� TDH Lift Friction Loss System Head TDH Ft
1 �� `�� .Z • `I I 6 5 2 • 3g
0 Forcemain Length- _ 1 Dia l I Dist. to Well r
> (c?0
SOIL ABSORPTION SYSTEM . C{ /_
D i4�Mi6M Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Liquid Depth
ENSIONS / ' Mo Z � `
SETBACK SYSTEM TO I P/L JBLDG IWELL LAKE /STREAM LE HI Manufacturer:
INFORMATION CHAM
Type Of System: _
r Zt�i NIT
DISTRIBUTION SYSTEM
Header /Manifold Distribution t � r x Hole Size Y x Hole Spacing Vent to Air Intake
Length Dia L Dia Spacing
SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only
Depth Over Depth Over xx Depth of xx Seeded /Sodded -- F mulched
Bed /Trench Center BedlTrench Edges Topsoil Yes No j Yes [ No
COMMENTS: (Include code discrepencies, persons present, etc.) Inspection / #4:.���� /Z� Inspection #2:
" "
Location: 405 215th St Baldwin, WI 54002 (SW 1/4 SE 1/4 11 T28N R15W) NA Lot ",� "'- 4l Parcel No: 11.28.75.177
1.) Alt BM Description = ^^ S c` 5�, C^^
2.) Bldg sewer length
- amount of cover
3.) Contour
P revision Required? Yes No - — -- —
Use other side for additional information. 12 3 0
's Signature Cart. No.
Insepctor
\ - -6710 (R.3/97) `�) C'
Sanitary Permit Application Safety & Buildings Division
In accord with Comm 83.21, Wis. Adm. Code 201 W. Washington Ave.
`41 �. See reverse side for instructions for completing this application PO Box 7302
sconsin Personal information you provide may be used for secondary purposes Madison, WI 53707 -7302
Department of Commerce [Privacy Law, s. L 15.04(l)(m)) (Submit completed form to county ifnot
' ` state owned.
Attach complete plans to a dounty copy only) for the system, on paper not less lian 8 -1/2 x I 1 in hes in size.
Cos State Sani P,eq it umber ❑ Check if revision to previous application State Plan 1 7D. Num r
h
CO `C t o A_ IT s In
1. Apolication Information - Please Print all Informatio Location:
Property Owner Name / Property Location '' pp
0 114 S �� T LCJ,N, � 1V
L p / erty Owner's M // ailing Address
P
IVIMIN
ro Lot Number Block Number
7 !K WQ-/ 1$/ S NTY 71 A
C , State Zip Code PLRDNMG FFICE Subdivision Name or CSA4 Number
Gt�a Lo I. 6 O Z 2 Z S -3X0 0 A
❑ City
II. Type of Building: eck one) `� N^^ duS ❑ Village
❑ 1 or 2 Family Dwelling -No. of Bedrooms :___' R<own of
❑ Public/Commercial (describe use):_
❑ State - Owned
^ � ,fib a Newest Road� 3/S
r tJip ` W Lo-a ) %%.fl Ic = Z3 r 0 -1 2- ') S4 Parcel Tax Numbers) _ 1o2 4 0
III. T e of P it: Check onl one box on line A. Check box on line B if applicable) G. ❑Addition to
A) 1. M 2. ❑ Replacement 3. ❑ Replacement of 4. 5•
system System Tank Only Existing, S stern
Permit Numbe r Date Issued
B)
❑ A Sanitary Permit was previously issued
IV. Type of POWT System: (Check all that apply) `I
• Non - pressurized In- ground 9<0und ❑ Sand Filter ❑ Constructed Wetland
• Pressurized In- ground ❑ Holding Tank ❑ Single Pass ❑ Drip Line
• At- de ❑ Aerobic Treatment Unit ❑ Recirculating ❑ Other:
V. Dispersal/Treatment Area Information:
I Design Flow (gpd) 2. Dispersal Area 3. Dispersal Area 4. Soil Application 5. Percolation Rate 6. System Elevation 7. Final Grade
Required Proposed Rate (GalsJday /sq. ft.) (Minlinch) Elevation
�OC�D o.�o t174 9 i�9.2"
VII. Tank Capa in Total # of Manufacturer Prefab Site Steel Fib ass Plastic
Information Gallons Gallons Tanks Con- Con- g
n New Existing crete structed
l C/>r17� j Tanks Tanks
❑ ❑ ❑ ❑
426D &); Se
❑ ❑ ❑ c
G 75a 7� '�» c+'
VIII. R sponsibility Statement
I, tl:e under gned, assume responsibility for installation of the POWTS shown on the attached plans. Business Pl;re ?dumber
Plumber's Name (print) PI u bed s Si ature (no stamps): MP/Iv0?RS No.
c ne 2-Z-56 (71 s
Plumber's Address (Street, City, State, Zip e) �
Id 7 fie C c.( /. S
K. County /Department Use Only
El Disapproved Sanitary Permit Fee ( des Groundwater Dat71ssued Issui A '=stamps) Approved ❑ Owner Given Initial Adverse Surc e Fee)
Determination 3 �' 2aDZ �} �
X Condit'ons of Approval / easons for Dis�pro
akV. SaS�to. S Mtrt►7i: v im °' °'� t cj C ems( a4"
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prap., Se.JSf, Sec. 11,
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buod;nj S%ta f (opo -54 C4 ),2Sd 7S0 a.P C'omEii%�a ti►r
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proposed ►v�
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' Safety and Buildings
4003 N KINNEY COULEE RD
LA CROSSE WI 54601 -1831
Visconsin
wwwTDD #: (608) 264 -8777 er
www.comm www.wisconsin.gov
.wisonsin.gov
Department of Commerce
Scott McCallum, Governor
Philip Edw. Albert, Secretary
March 06, 2002
CUST ID No.225036 ATTIC• POWTS Inspector
MICHAEL P MC DONELL ZONING OFFICE
ACE SOIL & SITE EVALUATIONS ST CROIX COUNTY SPIA
340 PAULSON LAKE LANE 1101 CARMICHAEL RD
OSCEOLA WI 54020 HUDSON WI 54016
CONDITIONAL APPROVAL
PLAN APPROVAL EXPIRES: 03/06/2004 Identifio. 710784
, be
Transaction ID o.
SITE: Site ID No. 6416
Lane & Julie Backus Please refer to both identification numbers,
405 315TH Ave above,, in all correspondence with the agenc
Town of Cady
St Croix County
SWi /4, SE1/4, S11, T28N, R15W
FOR:
Description: Four Bedroom Mound System
Object Type: POWT System Regulated Object ID No.: 831242
The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes
and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in
chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements.
The following conditions shall be met during construction or installation and prior to occupancy or use:
General Approval Requirements:
• This system is to be constructed and located in accordance with the enclosed approved plans and with the
"Mound Component Manual for Private Onsite Wastewater Systems VERSION 2.0" SBD- 10691 -P (N.01/01)
and the SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST SAS (01/81)
• Comm 83.52(2) A POWTS that is not maintained in accordance with the approved management plan or as
required under s. Comm 83.54(4) shall be considered a human health hazard.
• Per manual sited above, limited activities are allowed in the area 15 feet down slope of the component area.
Soil compaction, excavation, vehicular traffic and other similar activities that impact the treatment and dispersal
are prohibited. C
• The well must be a minimum of 25 feet from any POWTS tank, and a minimum of 50 feet from the absorption Apink()
area. chs. NR 811 & 812c pp 1
• A Sanitary Permit must be obtained from the county where this project is located in accordance with the , fi110F
requirements of Sec. 145.135 and 145.19, Wis. Stats. 8F C$I
• Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with the
designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stat
• Comm 83.22(7) A copy of he 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.
MICHAEL P MC DONELL Page 2 3/6102
Owner Responsiblities:
• Comm 83.52 Responsibilities. The owner of a POWTS shall be responsible for ensuring that the operation and
maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s.
Comm 83.54(1).
• Comm 83.55 The owner is responsible for submitting a maintenance verification report acceptable to the county
for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s)
utilized in the POWTS.
• The changes made to this plan on 3/06/02 by this reviewer were acknowledged and approved by the system
designer.
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.
Sincerely, Fee Required $ 175.00
<7 Fee Received $ 175.00
9 Balance Due $ 0.00
Charles L Bratz
POWTS Reviewer II, Integrated Services WiSMARTcode: 7.633
(608)789-7893, 7:45 am 4:30 pm Monday - Friday
cbratz@commerce.state.wi.us
MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN
Residential Application
INDEX AND TITLE PAGE
Project Name: Lane & Julie Backus 4 bedroom residential mound
Owner's Name: Lane & Julie Backus
Owner's Address: 4424 Weiker's
Port Washington WI 53074
Legal Description: SW1 /4SE1/4, Sec.11, T.28N., R.15W.�
Township: Cady ' ® �F
Z� 4
County: St. Croix �® e'
�O� Subdivision Name: s
Lot Number: Block Number:
Parcel I.D. Number: 004- 1025 -90-000
Plan Transaction No.:
Page 1 Index and title
Page 2 Data entry
Page 3 Mound drawings
Page 4 Lateral and dose tank
Page 5 System maintenance specifications
Page 6 Management and contingency plan
Page 7 Pump curve and specifications
Page 8 Site Plan
Page 9 Soil Evaluation Report
Designer: Mike McDonell License Number: 225036 !afy
Date: 02/28/02 Phone Number: 715 - 386 -8692 Iy OMD
Signature: / " ; OW ERCE
$tlN.01
Designed Pursuant to the
Mound Component Manual for POWTS Version 2.0 SDB- 10691 -P (N. 01/01), and '0
SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST -SAS (01/81)
Version 3.0 (03/01/01) Page 1 of 9
MAR -06 -2002 02:36 PM A.C.E. Soil & Site Eval. 715 248 7764 P.02
Mound and Pressure Distribution Component Design
Design worksheet
site Information
(r or c) Al Reddenuaal or cwnmerdd peWgn Note So fill (0) J" aea M a
400.00 Estimated wear Flow (gpd) TdA 83,448 � td keabn�rlt far fecal
A 1.50 Peaking Factor (9.9.1.5 a lw%) Cl Af l d -GE 88lrWhw
800.00 Design Flow (go)
7.00 Site Slope (%)
96.00 Contour Line Elevation (ft)
13.00 Depth to Limiting Factor (in)
0.50 In -situ Soil Application Rate (gpdNe)
Distribution Ceti lnfnnuUon
n 1-00 D9perset Cell Length Along Contour (ft) = 600 cell Width (ft)
Dispersal Cell Design Loading Rabe (gpdKe)
Influent Wastewater Quality (1 or 2) Are the laterals the highest point
Pressure Disribution Infom Lion in the distribution Y
(c or e) a Center or End Manifold network? Enter Y or N
3.00 Lateral Spacing (ft) If N above, enter the elevation ft
2 Number of Laterals of the highest point.
0.125 Orifice Diameter (in) (e.g. 0.25)
3.00 &jm at _ td Orifice Spadng (ft) = 9. feiorifice
2.00 Forcemain D(dmetw (in)
180.00 For cemain Length (ft) Does the forcemain drain back?E7 Y
85.50 Pump Tank Elevation (ft) Enter Y or N
8.50 System Head (ft) x 1.3 29.36 Fomemain Drainback (gal)
11.96 vertical Uft (ft) 90.43 5x void volume (gal)
2.91 Friction Lass (ft) 119.79 Minimum Dose Volume (gal)
2137 Total Dynamic Head (ft) 27.19 System Demand (gpm)
Lateral Diameter selection Manifold Diameter SeMcftn
in. dia. glions, choice in_ dia. ores choice
0.75 1.25 x
1.00 150 x x
1.25 2.00
1.50 x x 3.00
2.00 x
3.00 x
Treatment Tank Information
Gallonsfinch Calculator (optional)
757.64 Total Tank Capacity (gal)
1250.00 Se is Tank C (gat) 47.00 Total Working Liquid Depth (in)
Wier Concrete Manufacturer 16.12 9NAn (enter result in cell B49)
0020 Tank Information Effluent Filter Information
750.00 Dose Tank Capacity (gal) Zabel Filter Manufacturer
16.12 Dose Tank Volume (gain) A100 Filter Model Number
Wieser =Manufacturer
Protect: lane & Julie Backus 4 bedroom residential mound Page 2 of 9
MAR -06 -2002 02:37 PM A.C.E. Soil & Site Eval. 715 248 7764 P.03
Mound Plan View
11 /i0 B —`t
• ••Obelirvom PW ( •
, filLfi� ■•i�'Lf•lijS'fir•• .L••••.h • L• •L• • L• • • , •
••• . .....
�...�
L�,if. L.i { . r�} • �'j.r r {l.j�Ji•r. :j: .r L ••'
• ?y.L.ti�7s•1 j,� L •" .r7 i�iri �1. •L• ••�'•L ti•L■ Sr j ti�ti�'i '',
l. j.l; l; r r ? r.r.�j }r.a�+ }jL$•� ti ! •yL 1•y7 ti•• ;• •y. 1 .•.
• ..
.
••• • LEI. ,•
, ••
Mound Component Dimensions
A 6.00 ft E in H A15 ft K A27-73 ft
B 100.00 ft F fflin z ft L ft D 23.00 in G ft J ft' W ft
800.00 (ft Dispersal Cell Area L 1977.85 (ft) Basal Area Available
6 •� (9lt) Linlaar Loading Rate 10.00 (ft) 1/10 B Obs. Pipe Placement
Mound Cross Section View
Aggregate Dispersal Area
Fini shed Grade 99.71 (ft) --►
— H
97.92 (ft)♦ F ° CeN 98.42 (ft) Lateral
Dispersal Cell Invert
Elevation E • p
.il 4 4
.00 (n) Contour Elevation
7.0 96 Site Slope
Geotextile Fabric Cover
Shading Key � $ � Dispersal Cell
Topsoil Cap _ I ` 1.5 ft See lateral details an
(21 .��„ f•%••r- r.a.r.f g•;.�.f P 4 for number,
LLJ � Subsoil ( M O 5 j,'�,�,� j'4. 4 -L.ti.
y � ■r•r
ASTM C33 Sand 10 w "�" tir ; q i r_r -: f xtif fie, and Spacing of
_ .L•ti•R•L.L•y
EM Tilled layer w : 8.5 ft sf Typicet i aoera� , f; r F laterals- ��s are
y - L•z e : •r•!•a -' • -`'• •' • -�+ r equal spaced from
0
Va r"..lcaae a r•!• ti"....1�.�•L•'`.ti• 5
j- r• " the distribution cell's
^'-
A centerline in the
distribution Cell (
PrOiect: Lane & JUlie Backus 4 bedroom residential mound Page 3 of 9
MAR -06 -2002 02:37 PM A.C.E. Soil & Site Eval. 715 248 7764 P.04
End Connection Lateral Layout Diagram
a r o+rar •.Tum-up wfbrallwlworol4-noutpluo
AN la0rals we ldaKioal k. X --*l Hors 16 Nis d on the bottom OF tM larval
O"d! spaced S
Face main oonnMon ela we of Own to malifold at
M! pCinL i.at.ralslr i«o9 rmatn of Prrc Sob 40
(par C[1 W Tabb 94'll ff)
Number of Laterals 2 Orifice Diameter I M2.78
�. 98 In
Loitered Diameter 1.50 In Orifice Spacing ((X) ft
Lsteral Length (P) 56 ft Orifices per Lateral
Spwjng (S) 3.00 ft Orifice Density ft /orifloe
Lateral Flow Rate 13.56 9pm Manifold Length ft
System Flow hate 27.19 9Pm Manifold Diameter in
Total Dynamic Head 21.37 ft Forcemain Velocity ft/sec
Dose Tank Informat ion LAadra emw VAth WMlng
Wd and Wft dmtoe are
E*&iiCal n per NEC 300 8rtd 5O@w wAwdgIlt
Camel 18.28 WAC Dkeennea 4 in. min.
Tank component is properly wer ftd ANbtllels Nutlet
IOC81ion
FO censin diameter
Wieser Concrete Manttfacturt;r 2 in.
capacity 750.00 Gallons
Volume 16.12 galAnch A
DimenSio Inches Gallons B Weep hole e
A : ;2 6 2�� � � i � siphon detAce
9 2.00 32.24 C
p °tr eleuati°" —f 4 C ) . 7--ffl 125.87 1 86.48
� 91.50 185.38 D
Total
Y '7 750.00
11 Opee tart °Is"rfl°"
3" Bedding under tank. 85.50
Alarm Manuafacturer I LevglA
Alarm Model Number DLV
Pump Manufacturer 7.o et i er
Pump Model Number L140
Pump Must Deliver C 27 - 1 91 at F 21.371 ft TDH
Protect: Lane & Julie Backus 4 bedroom residential mound Page 4 of 9
Mound System Maintenance and Operation Specifications
Service Provider's Name ( _- J. Thompson, POWTS INSP.#4819 Phone 715 - 248 -3271
POWTS Regulator's Name St. Croix County Zoning Phone 715- 386 -4680
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 1250 gal Maximum TSS 150 mg /L
Soil Absorption Component Size 600 ft 2 Maximum FOG 30 mg /L
Type of Wastewaterl Domestic Maximum Fecal Coliform >10E4 cfu /100 mL
Service Frequency
Septic and Pump Tank Inspect and /or service once every 3 years
Effluent Filter Should inspect and clean at least once every 3 years
Pump and Controls Test once every 3 years
Alarm Should test month)
Pressure System Laterals should be flushed and pressure tested every 1.5 years
Mound Inspect for ponding and seepage once every 3 years
Other
Miscellaneous Construction and Materials Standards
1. Observation pipes are slotted and materials conform to Table Comm 84.30 -1, have 6 watertight cap,
and are secured in as shown in the mound component manual.
2. Dispersal cell aggregate conforms to Comm 84.30 (6)(i), Wis. Adm. Code.
3. All gravity and pressure piping materials conform to the requirements in Comm 84, Wis. Adm. Code.
4. Tillage of the basal area is accomplished with a mold board or chisel plow.
5. The mound structure and other disturbed areas will be seeded and mulched to prevent soil erosion
and help reduce frost penetration.
Lateral Turn -up Detail
Finished .........•••••..
Grade
6 -8" Diameter Lawn Threaded Cleanout
Sprinkler Valve Box Plug or Ball Valve
Distribution
Lateral
Long Sweep 90 or Two
45 Degree Bends Same
Diameter as Lateral
Project: Lane & Julie Backus 4 bedroom residential mound Page 5 of 9
Mound System Management Plan
Pursuant to Comm 83.54, Wis. Adm. Code
General
This system shall be operated in accordance with Comm 82 -84 Wis. Adm. Code, and shall maintained in accordance with its' component
manuals [SBD- 10691 -P (N.01/01) and SSWMP Publication 9.6 (01/81)) 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 Comm 83.33, Wis. Adm. Code when the tanks are no longer used as
POWTS components.
Septic or pump tank manhole risers, access risers and covers should be inspected for water tightness and 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 filter shall be assessed at
least once every 3 years by inspection.
The outlet fitter 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 finer is equipped with an alarm, the filter
shall be serviced if the alarm is activated continuously. Intermittent fitter alarms may indicate surge flaws 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.
Mound and Pressure Distribution System
No trees or shrubs should be planted on the mound. Plantings may be made around the mound's perimeter, and the mound 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 mound 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 mound be heavily mulched
as protection from freezing.
Influent quality into the mound system may not exceed 220 mg/L BOD 150 mg/L TSS, and 30 mg/L FOG for septic tank effluent or
30 mg/L BOD 30 mg/L TSS, 10 mg/L FOG, and 10 cfu/100 mL for highly treated effluent. Influent flow may not exceed mamdmum 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 pomding. Ponding levels shall be reported to the owner, and any levels
above 6 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring.
Contingency Plan
If the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep the system
in proper operating condition.
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 mound 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 removing biologically clogged absorption and dispersal media, and related
piping, and replacing said components as deemed necessary to bring the system into proper operating condition.
See Page of this plan for the name and telephone number of your local POWTS regulator and service provider.
i
Project: Lane & Julie Backus 4 bedroom residential mound Page 6 of 9
MAR -06 -2002 02:38 PM A.C.E. Soil & Site Eval. 715 248 7764 P.05
HEAD /CAPACITY CURVE
EFFLUENT and DEWATERING
WARNING: Model 185/4185 should not be subjected to less than 30 feet TDH,
tY TOTAL D YNAMIC HEADICAPACITY PER MINUTE
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Note: For IIcQ paclty on Mode) '(Z, IndusOriaf�ColwTln- explosion pr000f pump, see FMO219.
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1449
. Wisconsin Department of Commerce SOIL EVALUATION REPORT page - 1 of _3
Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code AC.E. Soil & Site Evaluations
Attach complete site plan on paper not less than 8' %x 11 inches in size. Plan must County St. Croix
include, but not limited to: vertical and horizontal reference point (BM), direction and p �� I D. $ - - - - -- - -
percent slope, scale or dimernsions, north arrow, and location and distance to nearest road. 004 - 1025- 9 -000, ID #11. 2_8.15.177
Please print all lnfonnatfon. Reviewed By Date
Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)).
Property Owner Property Location
S tephen Sonmor Jr Etal. _ Govt Lot SW 114 SE 1/4 S t I T_ 28 N R 15 - W
Property Owner's Mailing Address Block # Subd. s
P. Box 5871 Lot # Name or CSM#
_ _
City State Zip Code Phone Number City s �j Village j6 Town Nearest Road
81147 1 Cady 1 315Th Street
✓0 New Construction Use: J6 Residential / Number of bedrooms 4 Code derKred design flow rate 6 0_0___ GPD
,I Replacement Public or commercial - Describe:
Parent material Glacia Till __- -_ Flood plain elevation, if applicable na
General comments
and recommendations: Mound system elev. = 97.92' at 23" above 96.00' contour.
Boring # Boring -
v Pit Ground Surface elev. 96.78 - ft. Depth to limiting factor -_ - 21" in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft -__
'Eff#1 'Eff#2
1 % 0 -10 ! - 10yr4/2 none S O f 2 fsbk ds - as 2fm - 0.5 0.8
2 10 -17 1 - none sil 2msbk ds cw - 2fm - 0.5 0.8
3 17 -21 7.5yr4/6 j none sl 2msbk mfr cw 1 f 0.5 0.9
4 21 -32 j 7.5yr4/6 f2d 7.5yr5/8 sl 2msbk mfi cw 1fm 0.5 0.9
m3d7.5Yy /8 &
5 Y 32-49 7.5yr4/6 m2d I Oyr6/2 scl 1 csbk mfi - - 0.2 0.3 -
i
a Boring # ad Boring
e Pit Ground Surface elev. 95.18 fL Depth to limiting factor 18° in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDIft..___ --
`Eff#1 Eff#2
1 0 -12 10yr4 /2 none sil 2fsbk ds as 2fm 0.5 0.8
2 12 -18 10yr5 /4 none sil 2m sbk ds cw 2fm 0.5 0.8
3 18 -23 7.5yr4/6 f2d 7.5yr5 /8 sil 2msbk mfr cw 1 f 0.5 0.8
4 23 -30 7.5yr4/6 f2d 7.5yr5/8 sl 2msbk mfi cw 1 fm 1 0.5 0.9
30-42 7.5yr4l6 i m m2d l0 r6 // 2 scl 1 csbk mfi - - 0.2 0.3
Effluent #1 = BOD ? 30 < 220 mg/L and TSS > < 150 mg/L ' E = BOD < 30 mg/L and TSS <JO mg/L
CST Name (Please Print) Sign CST Number
Jame K. Thompson 3 602
Address A.C.E. Soil & Site Evaluations Dite Evaluation Conducted Telephone Number
340 Paulson Lake Lane, Osceola, WI 540 8/6/01 715- 248 -7767
Property owner Stephen So n_mor J r., Etal. -- Parcel ID # . 004 = 1025- 90 -p D #11_28 . Page _ -2 —,of _3
7 _
Boring # �wr. Boring - --
1d -- -- —
Pit Ground Surface elev. _ 9`1 .32 ft Depth to limiting factor 13" in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots SPQ1fL - -__
'Eff#1 'Eff#2
1 0 -7 10yr4/2 non si 2 ds as 2fm 0.5 0.8
2 7 -13 1Cyr5/4 none sil lmedpl ds cw 2fm 0.2 —' 0.3
3 13 -19
10yr5/4 f2d 7.5yr5/8 sil 2msbk mfr cw 1 fm 0.5 0.8
4 ; 19 7.5yr f2d 7.5yr5/8 sl 2msbk mfi cw 1 fm 0.5 0.9
m3d7.5yr5/8 &
5 28-45 7.5yr4/6 m 2d 10 /2 scl 1 cs bk mfi - - 0.2 0.3
- -- — 3 - - - -- -- -- — — - -- - - - - - -- -- - -- • - - - --
i
4 Boring #
J Boring
Pit Ground Surface elev. 92.30 ft. Depth to limiting factor 16 ° in. Soil Application Rate
Horizon i Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots SPQI�__—
'Eff#1 'Eff#2
1 0 -14 1 none sil 2 ds a s 2fm 0.5 0.8
2 14 -16 1Cyr5/4 none sil 1medpl ds cw 2fm 0.2 0.3
3 16 -25 1Cyr5/4 f2d 7.5yr5/8 — sil 2msbk mfr cw 1fm 0.5 T 0.8
4 25 -37 7. f2d 7.5yr5/8 sl 2msbk mfi 1 cw 1 f 0.5 0.9
Bonng i
i
F7 # ru Boring
ft. Depth to limiting factor in.
A Pit Ground Surface elev. � _ —_ Sal Application Rate
Horizon I Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots SP-Dl -
*Eff#1 'Eff#2
I
Effluent #1 = BOD ? 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BOD < rng/L and TSS <_30 mg/L
The Depament of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or
need material in an attemate format. please contact the department at 608- 266 -3151 or TTY 608- 264 -8777.
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1449
Wisconsin Department of Commerce SOIL EVALUATION REPORT page t of 3
Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code A.C.E. Sol & Site Evaivatlorra
Attach complete site plan on paper not less than ' in size. Plan must County
St. CroBc
include, but not limited to: vertical and tar' ( direction and
percent slope, scale or dimeansions, ce to nearest road. Parcel I.D.
004- 1025- 90 -000, 1D*11.28.15.177
Please p nfonnatl4R- . J BY Date
Psrson� information you provide m for Low 15.04 (1) (m)}.
Property Owner _ 1 ,�/ roperty Location
Stephen Sonmor Jr., Etat. - I 2 l Lot B SW 1/4 SE 114 S 11 T 28 N R 15 W V uf Property Owner's Mailing Address 1 ,`_)' t $T' AK !�
# kxk =Subd. m e or CSMf1
P.O. Box 5871
City ,` _ f City �j village iW1 Town Nearest Road
4 - . Cady 315Th Street
tM New Construction Use Residential / N of bedrooms 4 Code derived design flaw rate 600 GPD
I Replacement _I Public or commercial - Describe:
Parent material Glacial Till Flood plain elevation, if applicable na
General comments
and recommendations: Mound system elev. = 97.92' at 23" above 96.00' contour.
goring # � Boring
JIM Pit Ground Surface elev. 96.78 ft Depth to limiting factor ? 1 � th• Sol Application Rate
Horizon Depth Dominant Color Redoa Desaiptim Texture struck" Consistence Boundary Roots *E GPD/
1 0 - 10 10yr4/2 none so 2fsbk ds as 21m 0.5 0.8
2 10 -17 10yr5 /4 none sil 2msbk ds cw 2fm 0.5 0.8
3 17 -21 7.5yr4/6 none sl 2msbk mfr cw 1 fm 0.5 0.9
4 21 -32 7.5yr4/6 f2d 7.5yr5/8 sl 2msbk mfi Cw 1fm 0.5 0.9
5 32-49 7.5yr4/6 m3d7.5yr5 /_8 & � 1 csbk mfi - - 0.2 0.3
m2d 10yr6/2
a Boring #
Pit Ground Surface elev. 95.18 ft Depth to limiting factor P in. Sal Application Rate
Horizon boo Dominant Color Redox DwApfion Texture Structure Consistence Boundary Roots GPD1Pt'
"Eff#1
1 0 -12 10yr4/2 none sil 2fsb ds as 2fm 0.5 0.8
2 12 -18 10yr5/4 none sil 2msbk ds cw 2fm 0.5 0.8
3 1 - 3 7.5yr4/6 12d 7.5yr5/8 sil 2msbk mfr cw 1h 0.5 0.8
4 23 -30 7.5yr4/6 f2d 7.5yr5/8 sl 2msbk mfi Cw 1 fm 0.5 0.9
5 30-42 7.5yr4 /6 m3d7.5yr5/_8 & scI 1 csbk mfi - - 0.2 0.3
m2d 10yr6/2
*
Effluent #1= BOD ? 30 < 220 mg1L and TSS -4- 15o mg1L ' Wd6W = BOD <_30 mg/L and TSS <-o m9&
CST Name (Please Print) Signafikmr CST Number
James K. Thompson S 3602
Address AC.E. Sol & Site Evaluations Evaluation Conducted Telephone Number
340 Paulson Lake Lane, Osceola, WI 8/6/01 715 -248 -7767
Property Owner Stephen Sonmor Jr., Etal. Parcel ID # 0041025 -90 -000, ID# 11.28.15.177 Page 2 of 3 Boring F 31 # �j Boring
g Pit n
Ground Surface elev. 94.32 ft Depth to limiting factor 13 _ in. SoN Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDr
*Eff#1 *Efl#2
1 0 -7 10yr4/2 none so 2fsbk ds as 2f n 0.5 0.8
2 7 -13 10yr5/4 none sil 1 m d I ds cw 2fm 0.2 0.3
3 13 - 9 10yr5 /4 12d 7.5yr5/8 sil 2msbk mfr cw 1 fm 0.5 0.8
4 19 -28 7.5yr4/6 f2d 7.5yr5/8 si 2msbk mfi Cw 1 fm 0.5 0.9
5 28-45 7.5yr4/6 m3d7.5yr5/8 8c m2d 10yr6/2 scl 1CS mfi - - 0.2 0.3
Boring Al Borin a Am P8 Ground Surface elev. 92.30 ft. Depth to I ' 'ng factor 16 in. Sol Application Rye
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots
*Eff#1 *Eff#2
1 0 -14 10yr4/2 none sil 2fsbk ds as 2fm 0.5 0.8
2 14 -16 10yr5 /4 none sii 1 MeO l ds Cw 2h 0.2 0.3
3 16 -25 10yr5/4 f2d 7.5yr5/8 sii 2msbk mfr Cw 1fm 0.5 0.8
4 25 -37 7.5yr4/6 f2d 7.5yr5/8 sl 2msbk mfi cw 1fm 0.5 0.9
T -- ----------
F Boring # 1 Boring
Pit Ground Surface slay. ft. Depth to limiting factor in. Sol APPS Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Root GPDW
"Eff#1 *Eff#2
* Effluent #1= BOD 5> 30 < 220 nVL and TSS >30 < 150 nvk * Effluent #2 = BOD <_30 rr#L and TSS < rnglL
The Department of Commerce is an equal unity service provider and employer. ff you need amdar►ce to access services or
need material in an akernate format, vicam contact the dwmtment at 608- 266 -3151 or TTY 608 -264 -8777.
Pet "N'IF
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ST CROIX COUNTY
SEPTIC TANK MAINTENANCE AGREEMENT
AND
OWNERSHIP CERTIFICATION FORM
Owner/Buyer L �k, t_,-c
Mailing Address 'Al2 e ' /'S
Property Address 5/
(Verification required from Plann artmeJ f r new construction)
City /State W/ lson , (07 Parcel Identification Number yy,l /p,2S - -CAZ
LEGAL DESCRIPTION
Property Location 1 4, 5E ` /a, Sec. I �, T.2, N -R /rW, Town of v
Subdivision 11 __ . Lot # _ .
Certified Survey Map # 4-- . Volume , . Page # 4
Warranty Deed # & 5 2a , Volume / 7/ X , Page # 5 -Z
Spec house ❑ yes 2-no Lot lines identifiable ages ❑, no
SY STEM MAINTENANCE
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.
The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a
master plumber, journeyman plumber, restricted plumber or a licensedpumper verifying that (1) 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 1/3 full of sludge.
Uwe, 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 cornpleted and returned to the St. Croix County Zoning Office within 30
days of e three year expiration date.
/'1
SIGNATURE OF APPLICANT DATE
OWNER CERTIFICATION
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.
SI ATURE OF APPLICANT DATE
* * * * * * Any information that is mis- represented may result in the sanitary permit being revoked by the Zoning Department.
** Include with this application: a stamped warranty deed from the Register of Deeds office
a copy of the certified survey map if reference is made in the warranty deed
/UoeJ� !U
o� ioas - 1
VOL 1714 Gf 152 , 3
STATE BAR OF WISCONSIN FORM 1 -'2000
WARRANTY DEED 65594Es
Document Number M11HLEEN H. WALSH
REGISTER OF DEEDS
This Deed, made between Stephen Sonmor, Jr. ST. CROIX CN. , WI
a /k /a Stephen M. Sonmor, Jr, and Phoebe M. Koentopf, RECEIVED FOR RECORD
both married persons, as tenants in common
Grantor, 03 -05 -2001 8:00 API
and Lane F. Backus and Julie M. Backus, WARRANTY DEED
husband and wife as survivqrship marital property EXEMPT D
CERT COPY FEE:
G COPY FEE:
Grantee.
TRANSFER FEE: 567.00
Grantor, for a valuable consideration, conveys to Grantee the following RECORDING FEE: 13.00
described real estate in St. Croix County, State of PAGES: 2
Wisconsin (the "Property ") (if more space is needed, please attach addendum):
The South Half of the Southeast Quarter
(S1 /2 of SE1 /4) , SectionU, Township 28 North,
Range 15 West, Town of Cady, EXCEPT Lot 1 of Recording Area
Certified Survey Map recorded in Volume 2 on page ,
420.
RETURN TO:
TITLE ONE PREMIER GROUP, INC.
706 19TH STREET SOUTH
HUDSON, Wi 54016
004 - 1025 -90 -000
004 - 1025 -95 -000
Parcel Identification Number (PIN)
Together with all appurtenant rights, title and interests. This is not homestead property.
(is) (is not)
Grantor warrants that the title to the Property is good, indefeasible in fee simple and free and clear of encumbrances except
Roadways, Easements, and Restrictions of Record.
Dated this .31 day of August 2001
l
* *St hen Sonmor, Jr.
* *Phoebe 14. oento
AUTHENTICATION ACKNOWLEDGMENT
ST OF 11 St: yes-14 )
Signature(s) ) ss•
hu1X County. )
authenticated this day of Jrd Personally came before me this day of
�J August 2001 the above named
TITLE: MEMBER STATE BAR OF IN
(If not, tome no n to be the on who executed
authorized by §706.06, Wis. Stets.) Mw► in i strum nowledg the same.
THIS INSTRUMENT WAS DRAFTED BY * �.. '
Michael H. Forecki, Attorney Notary Publ State of W consin
Eau Claire Wisconsin My Commissi is atieat, (j t, stet expiration ate:
( Signatures may be authenticated or acknowledged. Both are not necess I I U
*Names of persons signing in any capacity must be typed or printed below their signature.
WARRANTY DEED STATE BAR OF WISCONSIN FORM No. 1 -2000
ttorney Michael H Forecki 1830 Brackett Ave, Eau Claire WI 547014627
\
'hone: (715) 835 -3029 Fax: (715) 8354112 Michael H. Forecki T5415304.ZFX
L.� Produced with ZipForrn ' by RE FamsNet, LLC 19025 Fifteen Mile Road, Clinton Township, Michigan 411035, (600) 383.9905
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