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HomeMy WebLinkAbout004-1027-95-300Page 1 of 1 Pam Quinn From: Julie Koehler [4js@bloomer.net] Sent: Wednesday, January 28, 2009 8:11 PM To: Pam Quinn Subject: sanitary info please Hi Pam Could you please fax me the sanitary system as-built at the Justin Putirskis property located at 3223 45th avenue Knapp NW SW 12-28-15 # 852072 822335 817596 Home moved on site in fall of 2008. thanks you very much Jim fax # 568-2044 1/29/2009 ~ , Wisconsin Department of Commerce Safety and Building Division PRIVATE SEWAGE SYSTEM INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERM[T} Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: City Village X Township Putirski, Justin Cad ,Town of CST BM Elev: Insp. BM Elev: BM Descrip'on: 2 TANK INFORMATION TYPE MANUFACTURER CAPACITY Septic /O 0 ~ Dosing DD Aeration Holding TANK SETBACK INFORMATION TANK TO P/L WELL i~ BLDG. Vent to irlntake ROAD Septic (~ ! D //~^ ~ ~ ~ / Dosing y?i ~ q _ 1 1 Aeration Holding PUMP/SIPHON INFORMATION ~~,(~ Manufacturer ~~ Demand G`P~M ^ Model Number / d `' 'ep/!O TDH Lift Friction L s /System Head TDH Ft ~•~~ . ~ ~~Y 22~L1~ Forcemain L ~ng~ y Dia. 2 ~~ Dist. to Wely~ SOIL ABSORPTION SYSTEM ~1 `1 ELEVATION DATA County: $t. CrOiX Sanitary Permit No: 514936 0 State Plan ID No: Parcel Tax No: 004-1027-95-300 Section/Town/Range/Map No: 12.28.15.188A3 STATION BS HI FS ELEV. Benchmark / / l0. ` Alt_~~ Bldg. Sewer SUHt Inlet ~/ ~" /~ ~ ~! !!o~ I SUHt Outlet ~- ~- Dt Inlet ~ ,~ Dt Bottom / ~Sr/~rh ~- /Z- S /,~S 9S. / Hea r/Ma~~~ /% ~,,, 9 p /I v y-~ Dist. Pipe 5 - y~ !' 0 , ~ Z Bot. Syste - Final Grade T ~ /J >/ ~ S St Cover ~ U~ ~ ~3 ~~, Z S D 7 , (P ~ ~- i ~ ia~-7P' ~ ~ - ~ off. 3 . %~~ BED/TRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS ~ / ~ / (? SETBACK SYSTEM TO P/L BLD WELL LAKE/STREAM LEACHING Manufacturer: ATION CHAMBER OR INFORM Type f ysteG' w/`-~' ~ \l ~b ~ Iwo ~ ~ D~ I Model Number: ^ISTRIgUTION SYSTEM _ (/.i_ i~.1/U~ _/ n n,r _ i~,('LI,._ 11-~~ re..~- G.ri -~m~/!_ ~ 1/1/~ ~~ ~-i ~n ~ Header/ anifold 9 ~ ~, `J Len th Dia Distribution PiP9s) ~/i i Len th Dia ~ Spacing x Ho a Size x Hole Spacing Vent to Air Intake SOIL COVER x Pressure Systems ~nlv ~ xx Mound dr At-Grade Systems Only Depth Over Depth Over xx Depth of ~ ~ xx Seeded/Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil Yes 0 No ~ Yes No ~oK COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1:~/~/~~ Inspection #2: / / Location: 322345th Ave Knapp//~~, WI 54749 (NW~1/Q4~SW 1/4 12 T28N R15W) NA /Jt~3~~ /~~ ~ Parcel No: 12.28.15.188A3 1.) Alt BM Description = TJV "()~ 3 t'yl~"'"`~ ~J~~~ ""°~ ~ ~ 2J Bldg sewer length = ,~( ~- S~ L~0 ~ ~ - (ise~~~ -amount of cover = ~ ~ y ~~~ / /~,,,,~, ~~ ~-}p~~~ ~ ~ ~' - --- ~ 7 ~~°w` ___`_ `_ I I Plan revision Required? Yes [i~No i ~ I~ JJ _ -_ -- - J L_ / ~J ~ ~ Q (1! Use other side for additional information. ~ SBD-6710 (R.3/97) ate Insepctor's Signa re Cert. No. r ~ 1_M °° ~ and Division ~ r..~...... . t~wty N 201 W. W~ ~ P~ ~ ?I6~ ~. ^ 0 S~ie~rr P~xn~it N~n6er (b be ~ledw by Cb.) . 5159 3 Sanitary Permit Application ~'"eT'''~ la aceaiusaee wdm s. caaaa. a3ZK~l, ws. waa~ ~, au6ais:ioa arms ~.la me T~ ~ rs~6 b ~7 aa~ o ~equ6ed prior to obuiwia~ a ~' pertain. lreee: Appiieation Wlrats tior sfalsowoad ae sr6wioed to ute Deptratreal of CaramereR Piewouel iwfanaidoa you protride aapr be need ihr ~ aecorataoe ~m m Fioje~twddre+fs(irtdma~Wta~sddRa~I . e i,aar : is ~ S1aa.. ~- Pl ~1 3 2 Z 3 ~~~` /L. ,e f'J [/ - ase Prat M ~tita~ Plntperty oa~aere 1 Mr. ju~in Putirski ~ 008 . P ©~ - ~oz7 -9 s- Gb ~o~r ,,-~,-~ _ t - 1870 30th Ave. ST. CROIX COUNTY , ~OVNOa ~ (. ~~~~-~ 3) L +b.Sale C Baldwin WI ~ ot PiVY ~ ~y ~ Seetioa 12 . 2 n-1y'Pa a~f B (ehcek a@ fiat appilr) 4k a.b .r ~ ~ R IS tcireie aisw R tar~r~-r.~re~at tl~e - ~. sab~iviiie. ii.ma ^ Sate oaatad - ikaer~e tax CSM P1mtUer ~ vaiye ~2Z33 ~ S' ' ~ _ xT aft . . ,, ui.T~arr~ cc~o,b..ai~vi~~ ~Bir~ - ~ x Htaw sear ^ ~ D 7 Tank ~oemaat Oalr O outer Afo~iaBoa b t Syatm texpirin) s. ^ i iiatarai ^ i'orarit itovieioa ^ ~ orriearrter O i?ierarit ~m Plan i.~R - i~ntabtr ad i7ete 6wad ~°" o,eter t~ r I d `7 IV. afPOW1s ar tlatt ^ ~ o P+exarmed is•Garad o ~crats o ~ _> Z4 in. ofsaiabs x irlovoei «4 ~ o{y~riawe aaa O Maw saeit O attar i)a eteei C p oaQoeeni telcp4ia) O ~ ~ v. ~, cksi,r, Flow • ~s~aieao ~~. ten i~eeasi Area s~ 450 0.6 + 450 bed ' Z ~ Ogg BEp ~ , , 10&67 Yi. Tastic info C~ia Tod far Qodoas llais tiro Tads $dpies'1Yets $ ~ , r ~ ~ ~ a~ Sytiearflali~Tst , 000 loo0 1 WlF~R CREtE Ce+is t7Ae+bec soo z 600 1 COMBO X ~i' ~~t` is lM! ata1~ J~raa N aea t~VY'i"8 et~rr~ M tfe agaatiett Mtaa6er's Nleae (hin!) Plateb~tr'fi ~~ ALTD MP231075 715/495-8886 'sAddeeae/Gsr fw.. ^_ _ r nom. W682 CYy. H, MaJ>davi, WI $4755 ~ , wppr°u°a ~ ~ l ""_" ~~ ~ s f. S4ptic tank, eitlulnt lifter and dispersal cell must all be services /maintained as-per management plan provided by plumper, 2 AN must be maintained AwaN M taaaioe eiue ar tlr ~r ~ ~ 7 ~j ~~ 3) Lehi ~-io.y5 ;,~. ~Jl~i,1{, e~.~ w/ ~ ~Qer~ w /~~~ •• ~ ., Jei~c~. g,f~ ~ ~. t4 s SBD-639f (R. OiN07) Vsiid tluu OI/09 .• s NW,SW,12,28,15W Cady township St. Croix county S~~E PLAN ~5~' A~ \ ~s~~,~~ ~1f/),/1(11//III ~ b ~ ~~~' I V Oaf \ ~~ ~ ~ GJ~aA o.~-~'- i lO 1''n"~ .ems ~~\C 0 0 Ll]GEND - 0 1 n 10 nail w/ribbon on side of 12" cherry tree bm107 nail w/ribbon on ~~~ side of 12" elm tree _cv~ ~`" ~co ~ ~±...SZ ~x ~aa..... ~oP~ ~ pits ~ u;~a~~: ~.ns~_. e grade elev. -,-- --contour c/o clean-out / scale 1" - 40' except where indicated NO Conn 83 setback ~ ~ ~ ~~ problems Syst m elev ~ 108.67' ~ !~ on contour 107.0' o 1' ~ l ~ 1 --~71 ~ ~~ ~ 1 ~ 1 j ~ ~ y~ ~ ~ ~l~ b ~ ~ '~ 1 ~ E---~-y ~, . ,~ .~ 4 0 ~ ,~ ~ ~ M ~. ~ i~ ` t ~ ~ ~ ~ ~' ~ ~ t 1 ~ ~ ~ .~ p ~ ~~ ~ 1 ~~~ • ~- project: PUTIRSKIS 7 r ~~~ (F'l.C. . Page 8 of 8 1 ~ SDT~E PLAN ~5 ~ A~ o ~ ~~~- NW,SW,12,28,15W ~ Cady township ~ ~t~ St. Croix county 6bc ~~,~~_ a.~.yL io~'~"°k `~`~ o yA~~ `o L~ 1,~Q10 ,' nail w/ribbon on side of 12" cherry tree • 2bm107 nail w/ribbon on side of 12" elm tree ~ i~~: s grade elev. ~^-- -~-contour c/o clean-out scale 1" - 40' except where indicated ~~~- z" NO Com¢n 83 setback `~ ~ ~ti problems System elev ~ 108.67' ~ ~"~'"" ~`~` on contour 107.0' ~ ~ I l ~ ~ , ~ ~~ 1 ~~ ~ ~ 1 ~ ~ r ( ~ ~no,~, ~` 1 ~i l~~y I ~ E ` ^ ~1 ~ l ~ ~ ~. ~~ O ~ ~~ ® _ ~ ~ ~~ ~ ~ ,~' ~ ~ ~ ~ ~ ~ ~ J `~ L ~ ~ l ~ ~ o ,~ ~ ~ e ~_~ ~ ~ ~ -~ L ~ P ~ ~e„Le ~,,,~ . L _ project : gp'I'IRSKIS Page 8 of 8 > > commerce.wi.gov iscansin Department of Commerce V" Safety and Buildings 3824 N CREEKSIDE LA HOLMEN WI 54636 TDD #: (608) 264-8777 www. commerce.wi. gov/sb/ www.wisconsin.gov Jim Doyle, Governor Jack L. Fischer, A.I.A., Secretary July 11, 2008 CUST ID No. 224580 LORETTA LARRABEE L & L PERC TESTING N2089 CTY RD Y MENOMONIE WI 54751 ATTN.• POWTS Inspector ZONING OFFICE ST CROIX COUNTY SPIA 1101 CARMICHAEL RD HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 07/11/2010 Identif cation Numbers Transaction ID No. 1556677 SITE: Site ID No. 739723 Justin Putirski Please refer to both identification numbers, 45TH Ave above, in all corres ondence with the a ens Town of Cady St Croix County NWl/4, SW1/4,512, T28N, R15W FOR: Description: Three Bedroom Mound System /New construction / 11 % slope / concaved site Object Type: POWTS Component Manual Regulated Object ID No.: 1190530 Maintenance required; 450 GPD Flow rate; 16 in Soil minimum depth to limiting factor from original grade; System(s): Mound Component Manual- Version 2.0, SBD-10691-P (N.O1/O1), 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. 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 constructim or installation and prior to occupancy or use: • This system is to be constructed and located in accordance with the enclosed approved plans and with the component manual(s) referenced above. • A sanitary permit must be obtained from the county where this project is located in accordance with the requirements of Sec. -145.135 and 145.19, Wis. Stats. • Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions ofSec. 145.20(2)(d), Wis. Stats. • The area within 15 feet horizontally down slope of the dispersal cell shall remain undisturbed. Vehicular traffic or soil compaction in this area is prohibited. • Maintenance information must be given to the owner of the tank explaining that periods cleaning of the effluent filter is required. Access to the filter for cleaning must be provided per Comm 84 product approval conditions. • A copy of the approved plans specifications and this letter shall be on•site during construction and o ep n to mspechon by authorized representatives of the Department which may include local ins en ctors. P.O.W.T'.S. Conditionut'ly R~~ DEPARTMENT OF COMA+:ER DIVISION OF SAFETY AND BUILDINGS LORETTA LARRABEE Owner Responsibilities: Page 2 7/11/2008 • 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. • The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s.Comm 83.54(1). • In 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 owner is responsible for submitting a maintenance verification report acceptab)r to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions shodd 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, Gerard M Swim POWTS Plan Reviewer, Integrated Services (608)789-7892, Mon -Fri, 7:15 am - 4:00 pm j erry. sw im@w iscon sin. gov Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 WiSMART code:7633' cc: Leroy G Jansky, POWTS Wastewater Specialist, (715) 726-2544 ,Friday, 7:00 A.M. To 3:30 P.M. W k ~ «~ ~ o 0 ~ N ~ ~ Private On-Site Wastewater Treatment System (POWYS) Mound and Pressure Distribution Component Design New Residential application z 0 F"~ Q Index and Title Sheet Project Name: Putirskis Owner: Justin Putirski Owner's address: 1870 30`~ Ave., Baldwin, WI 54002 Location: 45`~ Ave. Legal Description: NW,SW,12,28,15W Lot: lot 3 Township/County: Cady to~rnship, St .Croix county Contents: Page 1: Page 2: Page 3: Page 4: Page 5: Page 6: Page 7: Page 8: index and title general information & lateral diagram mound drawings dose tank pump information management plan contingency plan site plan Attachment: soil test to state plan deflection sheet r . • ` ~ ~ ~ i ~ ~j~•. ~ ~j ••`•.. ••~•~ ~~ '~/ ~~'C~`_ ``` ~~~/1~1111~~~ Date: June 30, 2008 I the undersigned submitted these plans under my authority Mound component manual for POWYS Version 2.0 SBD-10691-P {N.Ol/Ol), and Pressure Distribution component manual -Version 2.0 SBD-10706-P (N.O1/01} page 1 of 8 Designer's name and license no.: Address: Phone: Cell: E-mail Loretta. Larrabee license# 1872-007 N2089 Cty Rd. Y ``~~~ui` ~ jI ,~~~i Menomonie, WI 54751 ~.~Ga ' !M • .,~'~, 715/664-8184 = ~~ 715/308-1668 = ~ ~' lamp erctesting~ w~vt. net Designer's Signature: SEE GOR ESPONDENCE GENERAL INFORMATION New Site Three bedroom home, 450ga1 DWF 11 % slope system area 0.6 soil application rate 16" limiting soil factor 10001600 Wieser tank with polylok 525 effluent quality # 1 end fed system w/2 laterals dispersal cell design loading rate 1.0 linear rate 5.88 orifice sq/ft. 9.00 LATERAL LAYOUT DIAGRAM (not to scale) End Fed System Number of laterals 2 orifice dia. 5/32in. (0.156) Lateral dia. 1 '/Z" orifice spacing (X) 36in. (3.0') Lateral length (P) 75.0 ft. orifice per lateral 26 Lateral spacing (S) 3.Oft. lateral discharge rate 14.04gpm Manifold dia. 1 t/2 in total system rate 28.08gpm Forcemain dia. 2.Oin ~~ turn-up end on lateral at manifold for access of lateral at both ends for servicing ,~_Valve box \ Pressure lug finish ade ~ . r-- P first orifice next to fitting X manif 1 1/ " 0. 5' ( ') ~ Orifices located on bottom of lateral I Last orifice next to fitting Force main 2" dia. project: PITTIRSKL~ page 2 of 8 PLAN VIEW OF MOUND (not to scale) 1= 7.0' D~ 1.67' (20") K= 11.5' required bed 450sq.ft A= b.0' E= 2.33' (28") B= 76.5' proposed bed 459sq.ft. I = 5' F= 0.83' (10") L= 99.5' required Basel area 750sq.ft. = 29.5' (3= 0.50' (6") proposed Basel area 1721sq.ft. H= 1.00' (12") observation pipe @ 15ft. W L Mound Cross Section View (not to scale) Finished grade elev. 120.50' Lateral invert elev. 109.17' fllil~ 2 ~lllJl Dispersal cell elev. 108.b7' l l l l l l ll }~-rrr-~ / l l l l/ l l l l/ l //////// //////////////////////// ----- 4 dispersal cell ~ 2" ------- ---- --- --- --- Ot-lateral -- --- --- 3 - --- ~----- ---- - Aggre ate bed 6" --- --- -- --- --- ---- ----- --- --- --- - E -- -- ----- ---- ---- ---- ---- '-~ tilled layer -- -- -- D --- ---- -- --- --- --- -- -- tilled layer contour 11% site slope elev.107.0' Numeral Key 1 topsoil cap 2 subsoil cap 1.5ft. 3 ASTM C33 sand 4in. dia. observation pipe 4 synthetic cover over cell with 1/4in slot 5 aggregate I o.sft. project: PUTIRSKI~ page 3 of 8 COMBINATION SEPTIC TANK /PUMP CHAMBER (No Sca I e) ~ ~'" Approved Go ,Approved Locking Manhole Cover ~~ With Warning Label Attached ~ Warnin Label Weatherproof Vent Cad 9 Junction Box p -~ • ~ low. ~~~ took 12" Mi nlimum Final Grade-~_ ~_ ~ ~ ' ~ 4 Minimum 1 18" Mini Quick Disconnect 1/4" Weep Nole Approved Joint w/~='_'s~9-~(a Frye Extending 3 Onto Solid Soi Baffle - r ~~ ~ A Alarm ~ B Approved Joint On 6; w/~~ Srf,t{Ue ~ C Extending 3` ' Onto Solid Soi Off 6' ~ .- Conc. Biock 3" of Bedding Under Tank --T Note: P~ and Alarm Are On Separate Circuits ab °Ia D ~'`! F _ 9~.D Q c~.o s ~!-~ ncc~ - ~y,_~ att~n ~ M 1,0.4 3Z, ie tiQn U Tank Manufacturer: ° ~ ~ o i, b~~ ~~ i z ~. 6 Gn4.d - Tank Size--Septic/Pump : o 00 0 0 Ga ions ~~_ Alarm Manufacturer: Spn}ror;,c~ Model Number: i^~3 _~ Capacities: A~_inches or~j Gallons Switch Type: me~,i.ax.;c~.i + B 2, inches orb .~a Gallons _ Pump Manufacturer: + C_~inches or II~•3a 6a71ons Model Number: ~ t> ~ + D 8 ~ nche~k nor i 34. os 6a1 i ons . Minimum Discharge Rate: 28.0 ~ Tota1....._~ 3~ inches or p~_Gallons Vertical Difference BetweenOff and Distribution Pipe:lq.b~l Feet ~h ib.76 Minimum Required Suppiy Pressure:....~~ *!:~... .......+ 5 Feet ~ 6b 2Q~ Feet of Force Main x ,~~Fri cti on Factor/100 ~ Feet: + 3,g g Feet -. ~ Inch Diameter Force Main ~ \ Total -Dynamic Head :.. - Z$, l o Feet 22, 2(~ project: PUTIlZSKIS page 4 of 8 LL PUMP PERFORMANCE CURVE MODEL 140/4140 so 45 40 140, 4140 35 ~ t0 = 30 U 6 c 25 070940 10 20 30 40 50 60 70 BO 90 TOTAL CIYNAMIC HEAD/FLOW PER MINUTE EFFLUENTAND DEWATERING MODEL 140/4140 Feet Meters Gal. Liters 5 1.5 86 326 10 3.0 80 303 15 4.6 73 276 20 6.1 66 250 25 7.6 59 223 30 9.1 49 185 35 10.7 38 144 40 12.2 28 106 45 13.7 17 64 ShW-ofl Head: 50 ft. 152m GALLONS I LITERS 0 80 160 240 320 FLOW PER MINUTE CONSULT FACTORY FOR SPECIAL APPLICATIONS • Electrical alternators, for duplex systems, are available and supplied with an alarm. • Mechanical alternators, for duplex systems, are available with or without alarms. • Control alarm systems are available for 1 phase pumps used in simplex system. See FM0732. • Variable level control switches are available for controlling single phase sys- tems. • Double piggyback variable level float switches are available for variable level long cycle controls. • Sealed Qwik-Sox available for outdoor installations. See FM1420. • Refer to FM0806 for applications above 130°F (54°C). 14 014140 MODELS Control Selection Model Model Volts-Ph Mode Amps Simplex Duple N140 N4140 115 1 Non 12.0 1 or 2 3 E140 E4140 230 1 Non 6.0 1 or 2 3 BN140 BN4140 115 1 Auto 12.0 -- BE140 BE4140 230 1 Auto 6.0 -- 'Single piggyback switch included. SELECTION GUIDE ~a r~r SK15248 1. For automatic use single piggyback variable level float switch or double piggyback variable level float switch. Refer to FM0477. 2. See FM1228 for correct model of simplex control panel. 3. See FM0712 for correct model of duplex control panel. O CAUTION All installation of controls, protection devices and wiring should be done by a qualified licensed electrician. All electrical and safety codes should be followed including the most recent National Electric Code (NEC) and the Occupational Safety and Health Act (OSHA). RESERVE POWERED DESIGN For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump. nfarL ro: Po. eox 16347 ~~ Louisville, KY 40256-0347 Manufacturers of.. ~O SHIP Tt7: 3649 Cana Run Road ® Louisville, KY 40211-1961 lJ!/4L?Y/-UMP9 J~NCE ~,Jil~/ r www.zoellercom PU/{/1P ~0 (~2)77~~~2~nM~3624&PUMP • ' ~ r • '. ©Copyright 2005 Zoeller Co. All rights reserved. Mound Svstem Maintenance and Operation Specifications Service Provider's Name: Chris Rud Plumbing, LLC POWTS Regulator's Name: St. Croix Zoning Phone: 715/495-8586 Phone: 7151386-4680 Svstem Flow and Load Parameters Design Flow -Peak 450gpd Estimated Flow -Average 300gpd Septic tank Capacity 1000ga1s Soil absorption component Size 459bed Type of Wastewater Domestic Maximum Influent Particles Size 1/bin Maximum BODS 220mg/L Maximum TSS 150mg/L Maximum FOG 30mg/L Maximum Fecal Conform >10E4 cfu/100mL 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 monthly Pressure System --------------Laterals should be flushed and pressure tested every 1.5 years Mound --------------------------Inspect for ponding and seepage once every 3 years Other----------------------------Initially filter should be checked yearly to determine service schedule Miscellaneous Construction and Materials Standards 1. Observation pipes are slotted and materials conform to Table Comm 84.30-1, have a watertight cap and are secured as shown in the mound component manual. 2. Dispersal cell aggregate conforms to Comm 84.30 (6)(n, 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 6. Lateral Turn-un to finish at grade or above, enclosed in a 6-8" diameter lawn sprinkler valve box or similar product. (lateral turn-up consists of a long sweep 90 or two 45degree bends same diameter as lateral) 7. Lateral Turn-up on end of distribution laterals after the last orifice. project: PIITIRSKIS page 6 of $ 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 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 manholes risers, access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 8" 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 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 slip off the filer when removed from its enclosure. If the filter is equipped with an alarm, the filter shall be serviced if the alarm is activated continuously. 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 personal shall advise the owner of when the next service needs to be done to maintain less than maximum scum and sludge accumulation in the tank. 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 maybe 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 surface within the mound and snow compaction in the winter will promote frost penetration. Cold weather installations dictate that the mound be heavily mulched as protection from freezing. 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 at least once every 18months. When a pressure test is performed is should be compared to the initial test when the system was installed to determine if orifice clogging has occurred, if clogging has occurred orifice cleaning is required to maintain equal distribution within the 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 6" considered impending failure requiring additional, more frequent monitoring. Contingency Plan If the septic tank or any of its components become defective the tank or components shall be repaired or replaced to keep the system in proper operating condition. If the dosing tank or its components become defective the defective components(s) shall be immediately repaired or replaced with a component of same or equal performance. If the mound fails to accept wastewater or discharges wastewater to the ground surface, it will be repaired or replaced. Increasing basal area if toe leakage or by removing biologically clogged absorption and dispersal media and related piping and replacing components as deemed necessary to bring the system into proper operating condition. See page 6 of this plan for the name and telephone number of your local POWTS regulator and service provider. project: PLTTIRSKTS page 7 of 8 p i *( ~ Mound Deflection Worksheet project: PUTIl2SKIS Formula 8 Oft. divided by 71ft. = 0.056338 0.056338 multiply 100 = 5.6338% deflection Formula 9 5.6338% times 0.00265 = 0.0149 plus 1 = 1.0149 1.0149 multiply 75ft. = 76.12ft Required 76.12ft cell length Proposing 76.Sft. cell length Deparhnent of Commerce rlnricinn of Safiafv anrt Ruikiin~e SOIL EVA ATION REPORT in accordance 85, Wis. Adm. Code ~1 #54 Page 1 of 3 Fredericks Pert Testing County C ~ Attach complete site plan on paper not less than 8~4 x 11 inches in py ~ a~ include. but not rrrr-ited to: vertical and homm~tai reference point (BM>, percent slope, scale or dimensions, north arrow. and location and diets nea Parcel I.D. FYi ^ ~ Q Z 7 _ ~'.~ 3(fD Please prln R g Date Personal i[dormation You provide may be tar . s. 15.04 (1} (m)). C ~ O Q property Owner Property Location KEMP, JEFF MAY 0 7 2008 Govt. lot N 14, SW1/4, S12, T28N, R15W Property Owners Mailing Address ST CRpIX COUNTY Lot # Bbdc # Subd. Name or CSM# 3 ?/ - ~~ L 219 - 75th ST . ot p City State ^ City [] village ^ Town Nearest Road Clear Lake WI 54005 715-263-3427 45TH Ave ® New Constnx3ion ~~~ ®Residential ! Number of bedrooms 3 Code derived design flaw rate 450 GPD ^ Replacement ^ Public or commerkaal - Descrbe: Parent material Glacial drift & loess Flood plain elevation, iF applcable ~ ft- General comments Recommend a mound, having a centerline located on or near the 107.0' contour. and retwrrrrnendations: ~~ 1 a ~~ # ~ Pit Ground surface elev. 104.7 ft Depth to limiting factor 19 min. Sod gppbgppn Rai Horizon Deptlt Dominant Cobr Redox Description Texture Structure Consists Bourxiary Roots ~' Dfft" ar. MunseN Qu. Sz Cont. Color Gr. Sz Sh. 'Effaitl *Etfla 1 0-6 7.5YR 3/2 ----- sii 2mgr mfr gw 2f .6 .8 2 6-14 7.SYR 5/4 ---- i bk ~ mfr dw if .6 .8 3 1419 7.SYR 4/4 ---- sl 2mabk mfr gw if .6 1.0 4 19-32 7.SYR 4/4 cid SYR 5/8 & c2d 7.SYR 5/4 ~ 2mdt~c mfr dw ---- .6 1.0 5 32-66 7.5YR 5/6 c2d~5Y5R 5/3 sd imabk mfr - --- .2 .3 Ilk Bonr~ # ^ Boring ® Pit Ground surface elev. 106.$ ft Depth to limiting factor 18 m. SoU Application Rate Horizon Depth Dominant Color Redox Description Texture Stnuxure Cord Boundary Roots GP D/fP in. MunseN tlu. Sz Cont Corr Gr. Sz Sh. •Ett#1 •lti#2 1 0-9 7,5YR 3/2 ---- sit 2mgr mfr gw 2f .6 .8 2 9-18 7.5YR 5/4 ----- f 2fabk mfr dw if .6 .8 3 1 -39 7.SYR 4/4 cid 7.SYR s/8 & c2d 7.SYR 5/4 ~ 2mabk mfr dw if .6 1.0 4 39-70 7.5YR 5/6 -~ si imabk mfr ---- - .4 .7 * Eft}uent #1 = 6~5> 30 < 220 mgA. and TSS >30 < 150 ~ * Effluent #2 = BODS <_30 mglL and TSS <_30 mglL CST Name (Please Print} Signature: CST Number Chris Fredericks 71618 Address Fredericks Pert Testing Dabs Evalu lion Coraiucted Telephone Number 20176# Street Cumberland, WI 54829 1212 your 715-419-0127 C/AG~ f-l6/. ~ ssu-s~3o ix.mrooi P~~ Owner KEMR; JEFF Parcel ID # Page 2 of 3 Big # ^ Boring ./ ®Pit Ground surface elev. 109.5 ft. Depth to Nmiting factor 16 in. Sofl APPI~n Rate Horizon Depth Dominant Color Redox Descxiption Texture Stnrcture Consistence Boundary Roots t in. Mansell t'lu. Sz Cont. Color Gr. Sz Sh. •Eti#t 'EtllX2 1 0-6 7.5YR 3/2 - sil 2mgr mfr gw 2f .6 .8 2 6-16 7.5YR 5/4 - 1 2fat~c mfr di 1f .6 .8 3 16-35 7.SYR 4/4 cid 7.SYR 5/8 & ~d T 5YR 5 4 s) 2mabk mfr dw if .6 1.0 4 35-67 7.5YR 5/6 cld SYR 5/8 & c2d 7.5YR 5/3 ~ imabk mfr ---- --- .4 .7 ' Effluent #1 = BODS> 30 < 220 mg/l and TSS >30 < ~ 50 mglt. * Effluent #2 = BODS < 30 mglL and TSS <_30 mglL 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 wntact the department at 608-266-3151 or TTY 608-264-8777. SHD-8330 (R.0'I100) ~ T,~ .. ~ . /.,...,._m~a_ .,~ ...r_. /~eRfr~ D Zo ko ~u=~D1 ~ ~itC~PT WARE SNoWPI - ~~ 1 1~ ®8, 's~ ~ WoaDEQ / o}~!~ rvt t X ° 1, r2 J' ~_ v ~ ~~~ KrrM~ PRfl~2~ ~r-o~SG~ Lo'~ 3 P~~- N ~, N~ -SW -~z- F C.prD`~ 'raWtdSHr~ ST. GRt»X Go Wei ?•~ csT- ?!~ ~~ 12-2~ °~~ '~' _ ~~ /v 4 M `~ o Y -Q~ ~`` ~ v 9 ~ f { 7 { ~ .~ k t=. `~a, E~.EV. ~tc~fa.a ~ i r Na, f~ T~ ~~ i n W es~ '~ 5~~~-~ IZ" G+aERRY try ~4~. z " o ~ gZ ~M "a .~ ''~ O 9 S~corJDl~t~~ ~. ~ ELY. s (0?~q' l~.u1 ~ rib~ri~ in rlotf{n .. .~ _ v ~. ,~~".~,_ _. _, .~_ , , _,r..~..,. _ CERTIFIED SURVEY MA VOLUME 27 PAGE 5788 . THE NORTH HALF OF THE NORTHWEST QUARTER OF THE SOUTHWEST QUARTER, SECTION 12, TOWNSHIP 28 NORTH, RANGE 15 WEST, TOWN OF CADY, ST.CROIX COUNTY,WISCONSIN ;.~ , - West 1/4 Section 12-28-15 Fd Aluminum Cop P.(]. E;. N89'4d _. f ~N89'S centerline t 1 i s rb -P Cr1 fV C>o ~a ;~ OWNER/PREPARED FOR: Jeffery Kemp 219 75th Street Clear Lake. WI 54005 I50', a~ ;c IZ , Y $ ;o N 89'40' 17"E Ot'- i •4 2 99' N89'S7'00"E 3 .82' . 39 1291.09' N Imp ~ sue. /1\\ ' 1 Im 1 O m / Y D u ~ O~ ~ O~ i '/1n~ ~ ~ fV • I / ~ I 0 Set 3/4" Iron rebor l33 00' 11' south o/ fence ~l I I7 south o! fence ~~ ~ I I Z. off, ~Im ? ~ N Ni Obi r+i ~ ~y ~ Southwest corner Section 12-28-15 Fd Aluminum Cap INI I Set 3/4" Iron rebor S89"48'19"W 342.00 375.00' 5335.18r 1324.17' 45th Av_e_ aN i• AUG ~ 3 2006 ST. CROIXCOUMyFast 7/4 SURVEYOR'S AECO ection 12-28-15 Fd Aluminum Cap NE corner centerline ~ NW/SW 39.44' build g setbock line ~ L OT 3 378,429 sq.tt. 8.69 acres incl. r-o-w ~, 353,844 sq. ft ~ 8.12 acres not incl. r-o-w Set 3/4" Iran rebor 13' south o/ fence UNPLATTED LANDS PREPARED BY: Joel A. Brandt JB SURVEYING LLC 966 Rustic Road 3 Glenwood City, WI 8 2 2 3 3 5 VOL 27 PAGE 578$ KA'fALEEA H. REGISTER OF DEEDS P ST. CROIx CO. MI RECEIVED FOR ~tECORD 04/®7/2N6 t08s15A11 CHRTIFIED SURVEY pAP REC FEE: 13. t~ COPY FEE : 3.00 PAGES : 2 DECEIVED LOT 1 247,958 sq.ft. 5.69 acres intl. r-o-w 214,525 sq. f t. 4.92 acres not incl. r-o-w -_4_01_1._01' ~ - " ' r~ N89"40 17 E t ~' ~ Set 3/4" Iron rebor t8' west o/ fence corner I VI ~~ ~ "' i z 11. ~ 'U I~ + i ~ I t~ ~ j ~ I C7 w I N I ~ I ~ t i~ Set 3/4" Iron rebor 14' south and 13' west of fence corner LOT 2 250,545 sq.ft. 5.75 acres incl. r-o-w 239,886 sq. f t. 5.51 acres not incl. r-o-w Note: Each parcel on this map is subject to State and County laws, rules and regulations (i.e. wetlands, minimurn lot size, access to parcel, etc.l. Before purchasing or developing any parcel, contact the St. Croix County Zoning Office and Town Board for advice. `W ~ North is referenced to the west line of the Southwest Quarter of Section 12-28-15, which Is bears N00°24'22"E ISt. Croix County Grid System) 1 of 2 13"' 2 LEGEND ~~~~N .........Government Corner las noted) .rloa~° o..........Set 3/4" x 18" Iron rebor weighing ~` ~ rt 1.502 lbs./lineal ft. o~eMwoooprv, ... soil tests ~„qA` . 3 SCALE: 1" = 250' ~ y 1~ v'~ It ~Z3~ 3 0' 250' 500' Page 1 of 2 Vol 27 Page 5788 UNPLATTED LANDS ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM OWner~i~~,~4 irlr Justin P ~ i r~ki G Mailing Address Property Address 3z z3 ~~T~ ~ (Verification required from Planning & Zoning Department for new construction.) LoT3 0~ CSr~ ~~ ~Dtota irJ City/State ~N~ / W-~- Parcel Identification Number UD ~ l2 0~ C r-7~T hlA~ p4 S"/8~ LEGAL DESCRIPTION Property Location nTw/4 , ~pj_'/4 ,Sec. ~_, T ~g_N R~5_W, Town of ~~~ Subdivision N . A . Lot # 3 Certified Survey Map # LaT3 ~p ~ $'2L 3-3~ ,Volume ~ 2 ,Page # ~ 8S Warranty Deed # ~, A ,Volume N . A . ,Page # N . A . Spec house X,~€~ no Lot lines identifiable yes X~I~X 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 (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 completed and returned to the St. Croix County Planning & Zoning Department within 34 days of the three year expiration date. Uwe certify that all statements on this form are true to the best of my/our lmowledge. Uwe am/are the owner(s) of the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. ~ ~, Number of dr om SIGNA OF APPLICANT(S) ~/g/4~ 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/OS) State Bar of Wisconsin Form 2-2003 WARRANTY DEED Document Number ~~ Document Name THIS DEED, made between Jeff KemQ a married person ("Grantor," whether one or more), and Justin A. Putirskis ("Grantee," whether one or more). Grantor, for a valuable consideration, conveys and warrants to Grantee the following described real estate, together with the rents, profits, fixtures and other appurtenant interests, in St. Croix County, State of Wisconsin ("Property") (if more space is needed, please attach addendum}: That part of Ni/2NW1/4SW1/4 Sec. 12-T28N-R15W described as follows: Lot 3 of Certified Survey Map recorded in V,Q], 21 of Certified Survey Maps, page 5188 as Doc. No. 822335. St. Croix County, Wisconsin. " I IIIII! illll I{III IIIII III{I IIlII IIII 111111 IIII lIII * 8 5 2 0 7 2 1 ~~~~~~ KATHLEEN H, WALSH REGISTER OF DEEDS ST, CRDIX CD., WI RECEIVED FOR RECORD 06/06/2007 01:35AM WARRANTY DEED EKEMPi ;F REC FEE: 11.00 TRANS FEE: 171.90 PAGES: 1 Recording Area Estreen ~ Ogtand 304 Locust Stree# Hudson, W15401 B 0_04-1027-95-300 Pazcel Identification Number (PIIV) This is not homestead property. (is) (is not) Exceptions to warranties: Easements, restrictions and rights-of-way of record, if any. Dated ~°'~/~ 1 U ~~ *Jeff (SEAL) (SEAL) * * AUTHENTICATION Signature(s) Jeff Kemn, a married person authenticatJJed on ~ ~ 0 '~"' l *Kristina O land TITLE: MEMBER STA BAR OF WISCONSIN (If not, authorized by Wis. Stat. § 706.06) THIS INSTRUMENT DRAFTED BY: ACKNOWLEDGMENT STATE OF ) ss. COUNTY ) Personally came before me on the above-named to me known to be the person(s) who executed the foregoing instrument and acknowledged the same. Attorney Kristine Oland Notary Public, State of Hudson. WI 54016 My Commission (is permanent) (expires: ) (Signatures may be authenticated or acknowledged. Both are net necessary.) NOTE; THLS IS A STANDARD FORM. ANY MODIFICATIONS TO THIS FORM SEIOl1LD BE CLEARLY IDENTIFIED. WARRANTY DEED ®2003 STATE BAR OF WISCONSIN FORbf N0.2-2003 • Type name below signatures. INFO-PRO"' legal Fomts 800-655-2021 www.infoprofortns.eom 1 of 1 Parcel #: 004-9027-95-300 07/22/2008 10:40 AM PAGE 1 OF 1 Alt. Parcel #: 12.28.15.188A-3 004 -TOWN OF CADY Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 05/03/2006 00 0 Tax Address: Owner(s): O =Current Owner, C =Current Co-Owner O -PUTIRSKIS, JUSTIN A JUSTIN A PUTIRSKIS 1870 30TH AVE BALDWIN WI 54002 Districts: SC =School SP =Special Property Address(es): * =Primary Type Dist # Description * 3223 45TH AVE SC 5586 SPRING VALLEY SP 0100 CHIP VALLEY VOTECH Legal Description: Acres: 8.690 Plat: 5188-CSM 21-5188 SEC 12 T28N R15W PT NW SW CSM 21-5188 BlocklCondo Bldg: LOT 03 LOT 3 Tract(s): (Sec-Twn-Rng 40 1 /4 160 1 /4) 12-28N-15W NW SW Notes: Parcel History: Date Doc # Vol/Page Type 06/06/2007 852072 WD 04/07/2006 822335 CSM 01 /31 /2006 817596 WD 01/16/1985 399158 704/146 JUDG 2008 SUMMARY Bill #: Fair Market Value: Assessed with: 0 Valuations: Last Changed: 04/06/2007 Description Class Acres Land Improve Total State Reason PRODUCTIVE FORST LANDS G6 8.690 26,100 0 26,100 NO Totals for 2008: General Property 8.690 26,100 0 26,100 Woodland 0.000 0 0 Totals for 2007: General Property 8.690 26,100 0 26,100 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch #: Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 ~~ N '~ a ;~ ;~ ~; n~no^ ^©~o^ a^ v^^~ D^^! ^©f ~ •a^r pA M r+ r~^t ^ ^~d ^ ~r as n ta, o 3yDraor u ~ L~[3vt]ot ^^^^^q^^^o^r D^OCt^CJQ^^D©^[ ^^d~Ci.p^Cl^^^:C1^t ^^~ DO^^~Ot7^[ ^^C~~j'C147^O•^^^t ^U1.~ ~t7t717^C.7^^t~~ +ycao^•o^u^t r?at~^oo^^o^^at CID^L~C3^^O~O^CtO[ C7V^L'1Q p[ d• ^ U ,~ ~. ~~ t Dt"]^^^ oo^n^a ~ ^o^~>aQ^.^_ ^claoooao ^^o^^Qo^ ^CIC~CICir"IV^ ^ a•ct p^o Q^ ^ ^^ a^ ^ ^ O^^I~C ^D'^^^ ' ^^^C"T ^G7Q^ [ n^^dr ^on.^ •t y~ ham, V ~~ j ~~ ~~ o~ 5'S'~~~N Si~'g w t t`~O ~~ am9~a ~~~~ ~~ w°~~ .•. 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