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Safety and Buildings Division County / 1 ( '~~ 201 W. Washington Ave., P.O. Box 7162 - ` i ~ ~ Madison, WI 53707 - 7162 Sanitary Pemut Number (to be filled in by Co.) rS~~r~Sl>~ (608) 266-3151 4( ~ z Qepartment Of Commerce State PIanLD.Number Sanitary Permit Application ou n r ri l f ~ p y o orma m Tn accord with Comm 83.21, Wis. Adm. Code, persona may be used for secondary Purposes Privacy Law, s 1 ~.04(1)(m •~ (if different mailing address) O ~ / ~ ~ ~ S l ~ Y. Applicat"ron Information -Please Print All Tnfo do REC ENEt~ ~o o ~ -% n ~ ~ Property Own 's Name ~ ~ Lot k ~ t ~ NOV ~ ~ ~OOfi Property owner's Mailing Address ,~ /~ ,.~ , , ( J , ST. CROIX CfhlikRllT~ v~"~' operty Location ~~ ,/S ~f~S Section Zip Code Ci Statc (~ ~ _ ~ J b i ~l _ _ '~ i` u f 2 ~,f TJ/ N- R /~.rcleW ) ~ ~ . C~ t TI. ype of Building (check all that apply) ~ ak at,6 C M Number Subdivision Name 1 or .Family Dwelling - Number of Bedrooms ~ ~/~ ~ ~ ~~ ~ S3 ) / ^ PublicJCommercial -Describe Use ' '~- ^City ^Villa ip of ^ State Owned -Describe Use d X ITT. Type f Permit: (Check only one box on IIne A. Complete line B if applicable) stem ^ Treatment/fiolding Tank Replacement Only lacement S A ^ R ^ Other Modificarion to Existing System y ep • stem ~--- List Previous Permit Number and Date Issued B. ^ Permit Renewal ^ Permit Revision ^ Change of ^ Permit Transfer to New Before Expiration Plumber Owner TV. T of POWTS S stem: Check all that s ) of suitable soil ound < 24 in. of suitable soil d ^ Mound ? 24 in d J ^ Single Pass Ssad Filter ^ • ^ Non -Pressurized ln-Groun Constructed Wetland ^ Pressurized Tn-Ground ^ T-lolding Tank ^ Peat Filter ^ Aerobic Treatrnent Unit. ^ Recirc and Filter ^ Q~' ^ Other (explain) Recuculating Synthetic Media Filter ^ Leaching Chain ~ Drip Line ^ Gravel-less t '~. Dis ersal/Treatm t Area Information: ~ ispersal Area Required (sf) ispersal Ar Proposed ( yseem EI Design Fl (gPd) esign Soil Ap 12a ec// `~ + JJ ~ ` l~~V ! .'Tank Info Cap ity in To Numb Manufacturer Prefab Site Steel Fber Plastic Concrete Co Glass Gallons Gallons of Units ~ /+/~ ~" 1~~~( dstin C ~ E S ,, . r Ncw Tanis Tanks Septic or Holding Tank ~~~ Aerobic Treataoent Unit Dosing Cbarnber k- 6 VII.1Responsibility Statement- I, the trade , assume responsibility for installation of the POWTS shown on the attached plans. Business Phone Number Plumber's Name (Print) Pl Signature MPM1;:'RS NuLmber ~- n ~ZVj l ~/J ~~ mil Chi r . Plumber's Address (Street, City, State, e) ` ~~ ~ ~ G VIII. Coua /De attment TJse Onl Sanitary Permit Fee (includes Groundwater Date Issued Tssuin; t Si o Stem ,,~ aGl Approved Pero' Surcharge Fee) ~ ~~~ 0 v ~L//~ ven Reason for Denial TX. Conditions of ApprovaUReasons for Disapproval 3) Lon.Q; ~-;~ ~ ~. 5 eM~~ ai.~.t~ SYSTEM OWNER: nn 1. Septa tank, effluent filter and ~'~ G d"Y2 c d^ r, ' G/l ~-~.0 ~ 2C.~•...~ ~-^. dispersal cell must all be services /main in as per management plan provided by plumber. 2. Ali setback requirements must be rrlairdsirted p per appNcaWie coda 1 ordirlancaa. a_ . .not 1'ee then S12 Y I I inehaa fn Siu wmun compreie pma+ tw we w,....~ ,.,..J, ..» ..... o~...._ -- r-. SBD-6398 (lt. 01/03) ' ~ PLOT PLAN PROJECT Shaun Bird ADDRESS 1008 192nd Ave New Richmond Wi 54017 S E i /4 SW 1 /4S 33 /T 31 N/R 16 W TOWN Cylon COUNTY ST. CRQIX SYSTEM ELEVATION 102.0' 1.5' sand lift BEDROOM 3 CONVENTIONAL AT-GRADE CONVENTIONAL LIFT MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE HOLDING TANK SIZE LOAD RATE ABSORPTION AREA 450 BENCHMARK V.R.P. Top of Survey Iron # of chambers none ASSUME ELEVATION 100' Filter BEST GF10-8 ^ BOREHOLE n WELL x u u n Sams ac Rr~nrrhmark M. 0~ .M. cal = 1 " _ ~~' '~ '~Nel l is to meet all setbacks found i n Gomm. 83 224th Tank is to be properly bedd~cu ni~u provided with iockdown savers with approved warning labels Please note: a onsite was done on this site and found to have some mottles present @ 18", hence the 1.5' sand lift, also the system will be size to have a 3 bedroom house HOLDING TANK DOSE TANK SIZE 630 B-1 Property Line Huffcutt Combo Tank 182nd Ave Pro Well Location Alt Huffcutt Combo ~ PLOT PLAN PROJECT Shaun Bird ADDRESS 1008 192nd Ave New Richmond Wi 54017 SE 1/4 SW 1/4S 33 /T 31 N/R 16 W TOWN Cylon COUNTY ST.CRDIX SYSTEM ELEVATION 102.0' 1.5' sand lift BEDROOM 3 CONVENTIONAL AT-GRADE CONVENTIONAL LIFT MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE 630 HOLDING TANK SIZE LOAD RATE ABSORPTION AREA 450 # of chambers none BENCHMARK V.R.P. Top of Survey Iron ASSUME ELEVATION 100° Filter BEST GF10-8 ^ BOREHOLE ~ WELL * H. R. P. Same as Benchmark M.* 0~ HOLDING TANK M. ~Fel I is to meet al I se#backs found in Comm. 83 224th Tank is #a be properly bedded anv provided wi#h lackdar~n savers with approved warning labels B-1 Please note: a onsite was done on this site and found to have some mottles present @ 18", hence the 1.5' sand lift, also the system will be size to have a 3 bedroom house Prapert~ Line Huffcutt Camba Tank 182nd Ave Pro Well Location Alt Huffcutt Combo ~ Wisconsin Depa nt of Comm Division of Safety an s ~O~REPORT D f Page of -~„~ m accoroan wnn ~,omm ao, vv~s. ream. i,oa _ - ~n~ ~ t lan on paper not les s than 8 1/ x 11 ~~I s i i~ ~~ ust Attach com lete site ~ 'r i p ¢~ p ~ ~ diretditirt indude, but not limited to: vertical and horizontal refe ence point (BI nd Parcel I.D. percent slope, scale or dimensions, north arrow, and ocati and distance to nearest r d. ~T . CROiX COUNTY R ' d b t D Please print all info ation. e e y a e Personal i~fortnation you provide may be used for secondary purposes (Privacy )). ~ 3~ ~ (p Properly Owne ~ ll- -^~ 4 r Property Location Govt. Lot ~~ 1/~~/4 S T N R l 6 E (o W Property Owner's Mailing Address Lot # Block # Subd. Name or CS ' ~ 3 v ; l - C City State Zip Code Phone Number ^ City ^ V'Ilage own Barest Road~J ~ N } S ( ) C ~, So ncSl ~Al~w Construction Use;~tesidential /Number of bedrooms ~_ Code derived design flow rate `l'°~~ GPD ^ Replacement Public or commerdal -Describe: ,_______ _ _ ___ Parent material Flood Plain elevation if applicable ~~ ft. General oormrer~ts Q t1/~ ~ /~~~ C ~ ~~ Q ~.5 ~ ,~.~_ , L . 6 {A and recorrunendations: L / ~1 Q [J_/, ~ f, Q.~' System Type d~~u' ~ ~~ ~ / ~ l"' ~7 System Elevation__ ~ ~ ham! d ~~ U ~ c7 ~/ a ~~ # o ~~~ ~~D. ~ ~ Pit Ground surface elev. ft. Depth to limiting factor ~ _ in. Sal ication Rate Horizon Depth Dominant Cdor Redox Description Texture Structure Consistence Boundary Roots GP DJft' in. Munsell Qu. Sz. Cont. Caor Gr. Sz. Sh. 'Eff#1 •Eff#2 `- I o ~ ~ ~ ~ ~ S /~ , 3o-Y~ , s , ~ Ds c f i,¢ - ~ y~-~ . ~ ~ Z~ ~6 s~ l ~ - ''~l~ ~~~ . O - c7 Boring # p^~ Boring ~ ,~ Pit Ground surface elev. ~' ft. Depth to limiting factor / ~__ in. Soil lication Rate Horizon Depth Dominant Color Redox Desrxiption Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Qu. Sz. Cont. Caor Gr. Sz. Sh. •Eff#1 •Eff#2 o - U , 3- - ~ ~ ~ .~- ~., - 6 . 2 ~-- rot 3 ~ bk - ,3 I~-3Z ,-~ ~ ~ mSh ~ I ~ ~ 1 a- A,7 0~ l.. ~ s ~ --~ ~ .sc ti~~ ~ . v • Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 mglL 'Effluent #2 = BOD < 30 mg/L and TS5 < 30 mg/L CST I~larrte (Please Print) Si CST Number Bird Plumbing, Inc. Shaun Bird ,~'~ 226900 Address Date Evaluation Conducted Telephone Number 1008 192nd Ave, New Richmond, WI 54017 ~-~~ 715-246-4516 Property Owner Parcel ID # ~~,,:: . ..~~° Page of ® Q,Boring Boring # ~~'Pi t Ground surface elev. ft. Depth to limiting factor ~ ~ in. Soil liption Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP DIft' in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 ~ 3-Z -- sl~ a,~ ~ s 2. ' I~ ~1 ~ ~~ rrS ~ r Z~ ~ , ; , _--- ~- 6 ~ ~i - S ys-w , s ~ z I U se~ - ~- - ~~ ~~ ~ v a ring # ^ Boring ^ Pit Ground surface elev. ft. Depth to limiting factor in. Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP DIfF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 ^ Bonng Bonng # Ground surface elev. ft. Depth to limiting factor in. ^ Pit Soil ication Rate Horizon 'depth Dominant Color Redox Description. Texture Structure Consistence Boundary Roots GP O/fP in. Munsell Qu. Sz. Cont. Cdor Gr. Sz. Sh, 'Eff#1 'Eff#2 'Effluent #1 = BODS > 30 < 220 rrxyL and TSS >30 < 150 mglL 'Effluent #2 =GODS < 30 rrx,IlL 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 contact the department at 608-266-3151 or TTY 608-264-8777. sao-eaw (re.euo) ~1 Soil Test Plot Plan Project Name Shaun Bird Shaun i Address 1008 192nd Ave New Richmond Wi 54017 C #226900 Lot 7,8,9 Subdivision _~/illage of Cylon Date 1 /06 SE 1/q S W 1/4S 33 T 31 N/R16 W Township Cylon [~ Boring Q Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 100 ft. Top of Survey Iron System Elevation - ~~~, p *HRPSame as Benchmark Alternate Benchmark Tnn of Cnrvav Trnn n ~ nn <+ ~3 3 8395.9'9 CERTIFIED SURVEY MAP LOTS 4-9 OF BLOCK III OF THE VILLAGE OF CYLON. LOCATED IN THE SE 1/4 OF THE SW 1/4 OF SECTION 33, T31N, R16W, TOWN OF CYLON, ST. CROIX COUNTY, 1MSCONSIN. PREPARED FOR: SURVEYOR: SHAUN BIRD TY R. DODGE 1008 192ND AVENUE S de N LAND SURVEYING, INC. NEW RICHMOND, WI 54017 2920 ENLOE STREET HUDSON, VM 54016 - 1'r R~ OC}DGE = s-aria '-~,,,,~'4 Suav~~ u+e:hrmrizsn~ 113.00' VOL PAGE 5317 KA? H. M7IL~- REGISTER OF DEEDS ST. CROIX CO.. MI RfiCEI VED FL1R RECORD 11/29/200G 10:45AM CERTIFIED SURVEY MAP REC FEfi : ] 3.00 CUPY FfiE: 3.00 PAGES: 2 I I ----~--L=--- ------~ i R E" ~ ~'- ~ - ° 6 TRAVELED _18_2N_ _D_A_V_E_N_U_E_ a, r'cENTERU~ o: (PLATTED AS 3RD STREET) -S89'46'39`E 271.00'- µ I ~ ,)x•00' 142.00' i LOT 1 ~~11,240 SQ. .~~. - ~ -.~ O~ r~ ~~ ~~ e? y<~ ~~>? t Q `~~ \~ \ ~3 m' I ~ ~~ I I I I - i h Yo I ~ I I ' ~ ~ ~ I ~ OVOMEAD II~ S S ---- I I LOT 2 ' ~I I I-2.6•f I ~ eunnNa ~ 7,124 SQ. FT. (~ _ - 4.8'~ 1 . ME1.L1~---~--r-- S89'46'39`E 1 2.00' I t~ ~ I NOlE: CURREt~1T DRIVEWAY 25 ~, - L°~~2~AN~1~.5 10 F F oou+nr RoA~ a ^i ,o ~\ ~ O .~ z m p \QO° 1 L 4 8 SQ FT. ~ $ ~ n GVS - ---- ~ ` ! l - 12.5'-: - `} - ~ A~R~xXMA7E AREA OF FOltl~7t --- ~PTC SY57EL/ FROM d.D IINfDN1ARE sTOnE [ExAC'r LCCA71g1 uNwlovlN) 8 ~ ~~ ~ I I L_ I I ~~ olz 1 yl~ I ~i~ I z;~ I `~ I I I ~ ° 1 I O'J ~ ~ I N89'46"39-W 142.00' T z I 0'~9 I \o (~g I I I I I I \ I C~i+W m J ~~ ~ ~ 16' i ~ I ~ '~ - - - - - - - - - - I ~ G~~ r -~- r*i w ~ ~ I I SOUTH 1/4 -Na~ ~ ~~ SOUTH UNE OF THE SWI/4 I 3~31~-16 C110N SOUTHWEST ~ 2596.27' _ ( 42.18' S:n ~ CORNER SECT10N~r- - - - - - - - - A rn N g~~ Q~ ~ ~ ~N ~QQ~ bf C SCALE IN FEET 1" 50' 50 O 50 S7 56 E 2638.46 S89 EACH PARCEL SHOWN ON THIS MAP IS SUBJECT TO STATE, COUNTY AND TOWNSHIP LAWS, RULES AND REGULATIONS (I.E., O WETLANDS, MINIMUM LOT SIZE, ACCESS TO PARCEL. ETC.) BEFORE PURCHASING ~ OR DEVELOPING ANY PARCEL CONTACT THE ST. • CROIX COUNTY ZONING OFFICE AND THE TOWN OF US CYLON FOR ADVICE. ' THIS INSTRUMENT DRAFTED BY: WIWAM KANE Joe No. s4ss-o4 DATE: oa/o7/loos SHEET 1 OF 2 LEGEND FOUND ALUMINUM COUNTY SECTION CORNER MONUMENT FOUND 1-1/4` OUTSIDE DIAMETER IRON PIPE FOUND 1` OUTSIDE DIAMETER IRON PIPE FOUND 2-3/8` OUTSIDE DIAMETER IRRON PIPE SEPTIC HOU)ING TANKS POWER POLE ROADWAY SETBACK (50' OR PER AVERAGING METHODS FROM ZONING ORDINANCE) tof2 Vol 22 Page 5317 commerce.wi.gov isconsin Department of Commerce Safety and Buildings 4003 N KINNEY COULEE RD LA CROSSE WI 54601-1831 TDD #: (608) 264-8777 www. comme rce.wi.gov/sb/ www.wisconsin.gov Jim Doyle, Governor Mary P. Burke, Secretary December 06, 2006 CUST ID No. 226900 SHAUN R BIRD BIRD PLUMBING INC 1008 192 ND AVE NEW RICHMOND WI ATTN: POWTS Inspector ZONING OFFICE ST CROIX COUNTY SPIA 1101 CARMICHAEL RD 54017 HUDSON WI.54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 12/06/2008 SITE: Shaun Bird 182 Ave Town of Cylon, 54017 St Croix County ___ SI/2, SW1/4, S33, T31N, R16W Lot: 7-8-9, Block: 3, Subdivision Village of Cyclone Identification Numbers Transaction ID No. 1348011 Site ID No. 716677 Please refer to both identification numbers; :.above, in all corres ondence with the a enc FOR: Description: Mound /Three Bedroom /Level Site Object Type: POWTS Component Manual Regulated Object ID No.: 1091051 Revision; Mainteriance required;' 450 GPD Flow rate; 18 in Soil minimum depth to limiting factor from original grade; System: Mound Component Manual -Version 2.0, SBD-10691-P (N.01/O1), Pressure Distribution Component Manual -Version 2.0, SBD-10706-P (N.O1/O1); Biofilter 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 construction or installation and prior to occupancy or use: Reminders • This system is to be constructed and located in accordance with the enclosed approved plans and with the component manuals listed above. • Per manual cited 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. ('~;+l~It) • The well must be a minimum of 25 feet from any POWTS tank, and a minimum of 50 feet from the absorption_.~~ '' area. chs. NR 811 & 812c '~~ C1cFRRTAREWE ' A Sanitary Permit must be obtained from the county where this project is located in accordance with the ~%!~ 2 • < ~ requirements of Sec. 145.135-and 145.19, Wis. Stats. ""'- $EE CpRR4 • Inspection of the POWTS 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 SHAUN R BIRD Page 2 12/6/2006 • Comm 83.22(7) 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. Owner Responsibilities: • 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 83.52(2) A POWTS that is not maintained in accordance with the approved management plan or as required under s. Comm 83.54(4) shall be considered a human health hazard. • Comm 83.55 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. All pernuts required by the state or the local municipality shall be obtained prior to commencement of construction/insta llation/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 maybe 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, Charles L Bratz `~ POWTS Reviewer II ,Integrated Services (608)789-7893 , 7:45 am - 4:30 pm Monday -Friday charlie.bratz@wisconsin. gov Fee Required $ 75.00 Fee Received $ 75.00 Balance Due $ 0.00 WiSMART-code: 7633 cc: Leroy G Jansky, POWTS Wastewater Specialist, (715) 726-2544 a~~tvE~ ~~~ ~ zoos .~,~ ~°~~ ~ .;,~~~DINt'S, ~:,. Shaun Bird Bird Plumbing Inc. 1008 192nd Ave New Richmond Wi 54017 715-246-4516 Date: 12/ 2/06 Owner:Shaun Bird Cover Page Location:SE1/4 SW1/4 S33 T31 N,R16 W XXX 224th St. Cylon System type: Mound System Revision Plan #1308988 Manuals Used: Mound Component Manual Version 2.0 (01 /31) Pressure Distribution Manual Version 2.0 (01 /31) Page# 1. Cover Page 2. Mound Plot Plan 3. Mound Cross Section 4. Pipe Cross Section/Pipe Layout .,,~~~~~,,,,,~~ ,,,~ 5. Pump Chamber Cross Section a`,,.~~~®~d ,.~..,. ~Ji~~'~%,,, 6. Pump Curve ~`'~~~~ ~2 S' S~ ~= ,~ y 'O , 7-8. Maintance and Contigency plar~ ~~'~ ~ G ~; Z ~~ 9-11. Soil test ~ '' ?°o~ p::"~ _ '/~'O ~. Shaun Bird '~~,,, FSlO~~~ ,,,,,,. Signature License nu~x6er 1864-007 3~~~~~'y ~~~ ~F CUP~~!EF7CE ~' -d DINGS G~- .SPONDENC /~ .Page . rJf Synthetic Covering ~Sf~-C 33 Sand J.. _.., Topsoil ~'""~ ~ E 3 °!° Slope Bed Of 2y- 2 2 Aggregate _ Distribution , Pipe Force Main From Pump Cross Section Of A Mound System Using A Bed For The Absorption Area Signed: i_icense Number: Date L ~ t 1 Observation Pipe--~ ~ g K r _..~ _.._ ._._ _._. _ _.._ ._.. _ _ .._...:........_ A L---------------- ------ ~ ---= ==~_-_-- __----- I .-----~.-_,_____------~~_____________________ ~ Farce Main W ~... ~ ..._._ ._._ .._ ~. ~ _._. ~ _, ..._ ~ _.._ ~ . Distribution" ~ Bed Of Z~~- 2 2~ `~.._ ;, Ptpe Aggregate ~~~~ i i:,{,~5~' Observation Pipe Permanent Markers ~ /O Ft. B ~~ Ft. K~~ Ft . L ~_~ F t . d ~ Ft. ~~~ Ft. .bJ ~~s ~ Ft . Ptowed Layer i D ~~~'t. E /~ J Ft. F : S Ft . G ,~ Ft. H lU Ft. C e/ l Plan View Of Mound Using A .For The Absorption Area L'/eG ietetsd On ~OttOT, r Eayst+y Sposee tR$T 1101.E H1iXT YO tertntG}~a:1 Ft. Signed; ~icertse Number: Date: x a thc~es v °~ Inches koi a Diameter ._ ~/ ~ Inch Laterai •" /% • Inchtes) Manifflid " ~~ Inches Force Main ~- inches #`of hates/pipe ~~ ~_ Invert Eievdtior~ of Laterais/~ Ft... Pertoroteo Dipt Qeleit ~- ~; . _ _____ SPE~~~ FLR~IC~I~iS ' :: ~t~ . ABA. J~ ~ ~~F4LE C~ Eii y ~~` ~ gt~iT~}~f~~fl~y~, ~ ~ ~~TiABE~ / ~ ~ ,t. ~. ~ fNfii- i sa = s ~~ ~ i . ....:~ ~3~.~~.R - -'_'' ~ ~ . _ ~ . AFB ~~ ' . ~• c. ~ ~ ~It ~ i _ . .~ . • ~. s~~~~~~~c~r~s . #,1AY = !rte ~i'48~ ~,EZS~ ?E~ ~~ TftiiK SZZ£~? 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Y'a 280 3N &S 1000 74 fiQ 55 6t 3 ~{.~},qs - Cadnems DYtY~-'iriua Gis~tWp~PS~e~sOsargnuaiesOelY~bnC~~l'ffieranw2~ ttup~ahm~ MOtor 1-lOtzsing Itnpeiler I+~fatetiaE to ~_.r=... ~~ W Power l:oru C, Mechanic:el Shad Seal 4 ~ ~ Fasteners = Shaft ---- --- z.5 Bearings ---- 0 i~Uv- {,pE~,pntSlyrMtltE PUMP PERFORMANCE CURVE t15V baFf2 www LittleGiantPump.com COmCCtI C8S[ 1roII sed Vane S :: -- -• . Nitsile with carbon and ceramic faces _ - _ Sramless Suer . .. _ _ Stainless Stdet ! Uppcr Steevc and Lower ! E;all Bearings Lithe c,~t~t ca. tK) tix: t2B10.Oldattoma Ctcp+OK T31S1 P4ame: d1lS.if?.251! -Fat: ~06.2Z11.1566 F.taif: eastoQas ~t Form 99b235-O7A3 it_Qb!- LITE~HdIR UAL S~ MAI+iAGE1~tEt~~ P~.AN QOyYTS QVYNER'S ~-~ ~..~,,,~,~ SPEC[FtCATfONS ~giGN PI~R~'t~ ~ ~ ~ ~+4 i+i~~~~~s - ~ie[A Numbetof Comtrie~ UriRs ~ ~.~ atld Es6tna#ed t~ ~} d ~-. T J~ Oes~a ttA~ ~poat~. ~ x 1,51 ::: ,~ :~ ~'~PP' Rate MorrthiY aver~3$` Irttiuecttl~~ Q ~ 1~ Grease .(FOG) ts F ~ m9n- l .. a Gx~~ D~ttartd {BOA S L Q2fl rrtg S't 5Q m /L ? Total SuaP~~ $Osds {TS ~tlostthly average" ~ Pry Eft ~ p~~d tBOOs1 t O '~ S30 mglL A ~J 1 Biod'terr-ica Total Susp SoIIds ~ _ 53o mg s't D` cfut'i QOmi } FE~I ~~ Metric 3a inch~ameter ~orr-urrr ERtuert Particle Sme Serves Event _.-.--- n of tank(s) Inspect cond'sdo Pump out oonter~ of tank(s) inspect dispersal cents) Clean elciueriL fr7tec tnspe~ pump. controls 8: atarsn Flush laterals and pyre tssi Septirc T~ ~p~cTa~ctk Martur ~~ ~r M3ntt~C~tfet Effluettf Fier-Model Pumg-7'ank C.aPad~Y pump Tactic Mt~cttifs~~r Pump ~~~~ Pump Model .. _ y rr~~-.. ~~ FIIber B ~~ha[ticat Aeca~on LI t?IsatfectiQn . D lre~cJmund ~gravitY~ Q At-grade Drf ne .-- Page` ~ QvL/ ai ©PtA > ~'! t~tA ~~ Q I`IA ~l~'-- a NA ~ ~ ~ fl i~a ~ ~ ~-/~,.. ~ O NA~ © Peat F7tber D Welland p ether. Q tiZ-9rDUtid (Pt+essUttzEdl. eonesec tnan~oo~-ems w"st'"~ao'~.na t~ fa' Yahtes~ ~[ueei serer ~~ ~ „rs~er . Servirx Frequency ~~ ^ months }~ least once every uaFs ~~~ vvt,Pn combined sludge and scum` PA ~~- At least once ~~~` At least ante every Rt least once every At least once every }it least once every At isast Once every D months pm p mQntts~ CI rnon~5 ;1 (Maxiraurn 3 yrs-) tY,) of tank voiurtre ;1 tEBaxfmum 3 y~-) p NA a c~- Q m u II Yearf5l DNA Q months II year{s1 DNA Ngy~ANCE tN~UCTtt~NS one of the foibowtstg fioenseS or ~~ sr~att to made by art inQnriduat can~'fns ppWTS 1~m~1er SeP~ oftamt~s and d"rs~~ Rrsbri'c.'te~ Sstiver, POWTS Pew' ~g ~~ MBSdx Piumtter: Maser Pt ~ de a visual inspedfOil of the tanK($1 ~' iden~[ir any ~ t~ up Tsttk ir,sp~~ ;trust ' e and swm acid to fur any leva~ se[~S °i ur'e the voiurs~ of oornbined tsludg iia check the efAra~ iratd~. klen~ yny ~dts or ieaafcs, rsteais The disAersai ceil[51 shall be visualtl' ~~.~ ~ eiRu~ on tha or pondieg of ett[uent Ott the: gnpund surFave- d.~g of pfliuent Dri the ground ggr'l`doe_ $uthotitY in ~ o~ prP~ '~ ~ dledcnponand ~getires the ~immedrate notification of the t ~ nDg"~Qt~' Mme. tftB S~ maq- indreaUe s ~'~ sludge and scum in any #actk e4~ tarot acrd spy °f in ~~ ~ ~' NR ate' a Septage Servicing Cape _ ~ '~ ~ ~K shall be recr+oved ~ ~ nom; and any 113. WL9f~ctSlD RQmtA3St!'dlNe Code BctEnrS, prerr~eant ~~ a ppVVTS Maintain T~16 9 °f effluent tl'f~c5. lrt~lan{cat or pressurized POWTS comp of.12 months or less suit be i~ v ~ ple~ion of any semce event otherrrminzenanoe or m~il~bolm9 ~ ink ~ ~ min ~Q days A ~-~ ceded m ilia local re~iarory aclf#3ariiy of patt~g ploduds ar ath~ STAKT L!P ANO OPERATION PD{tu'f'S eJ't~c t~eatmert# tank{s~ for t~8 p~ af~e For crew oottsa. Qr#or to use of the tali s if h"rgh oontxntla~~ an a the treatment S antilar damage the dYS ~ rotor prior Lo use: dE hii~ ~ ~ of the tanks} removed ray a septage servicing Pe . ,-, ~ ., ~~ ~ System siart up shah not ocarr when srn~3 cortdifions one frozen at the infiltrative sur€ace_ ~~ t ~~ tip ~' ~r iii abov$ normal highwaier revels. Then i is t>~[ed [tie wit be died tp tfie dspers~ ~t(s} in one targe dose, overfoadutg the ceps} and may mutt in the F a srtr[aca ~ To avoid this sihration have the wnberzts of the pca~t tank removed by a Sege S ~P~' t~~ 4 t~~ to the effluent purt-p ar contact a Pi[ttr~ ar POYItTS der m amain tifatfir~l[yOperdfing ~e pump c~n~ to restore rlolmat fevers H~ittlin the pvmg task Do not dmr+e or patio ~ tats and dtspe~ t~:tfs. Do trot Eftive or patfc t~j ar oflnettivise dtst<iiia:?r comp tfte att=a +r t5 feet down sb~e of any rno~rid of at-grade sot'( absorption area - ftedsrctiott oreraztina~ott of the fol~g fii~rrt [tie vrastewafer str:;atn may impivve tha Feriotman0e and pto[otig $~ &~ of ti)e PUY+ftS= e~~Y~~tte btitts,',condoms, Minn s~rv2tbs; deg; de~a(tIGSS; d(apers d~;.fat: ~~ dta~tn {swnp p~p~ rYater, fruit arld vegetabte peers ~% 9 ~~ scraps ittetf O~ n9 P~u~ fides= sartr~ary napkins: tampons; •atxf water satt~et brjrte. AB~illidQAl~iy[ENT 1t~ften the POW;'S faits andlar is permanenffY.takere out of service the foitovring steps slant[ ~ taken Da insure that ttte s3rste[n is pmp~{yand safiely abandoned irm oorrtptiance rvtfh ch_ Comm 83.38, ~ Adrit~t2five Code: r Art piping to tanks and pits at~ait -be disoonrtected artd the abandoned pipe operttrtgs sealed- .. fie ccntenis of au tanks and f~ ~~ be removed and property disposed of by a Seps;3ge •Senticittg Opetator_ • After pumping, art tan[cs Sttd pits shad be ,excavated and removed or [trait covers reana+red•and the.rss~ space filed with sots 9~ ~ ar:oft;er inert sflGd rrlateriaL COH77NGENCY PLAM If the POWI'S Earls and c~not be repaired the foltowirtg measu; es have been, or must be fiaK,en, b~ provide a code compirartt rieni 53rstr=tit O A scrirabie r?ep[acement'area has been evatuated and may be u~ized for ttte location afa rep~enland shou[d.rm2 absorption system_ The replacement area sttocrld be protected from C"rsturbance and eorrtpactiott be infringed upon tsy required setbacks from eusttng and proposed stYUCture, tat [Ines and vretrs_ Far~ur+e bo proTect the reeplacement attea v~ r+esutt in the need for a ne+~sr soft and site=evaruaDia~rtt ~ estabfrslt a suitable replacement area. ReplaGettlQnt systems. must comply vstittt the rules in efl5eci at that: tin:e_ Q A suitable nepiaoement area is not available due to setback artdlor soiE Crmita5ons_ Barring advances In POWI'S piggy a hotd'rng tank. ina3r Ise QtstaEted as a fast resflrt La replace the Paled PUWi•S_ site has not been evarr~fied do identify a suitabte reptacemerst area. Upon farZurir of [fie Pt3VYTS $ Soa.and site evd{uatiOtt must t?e pes'fonn~ ~ kxa~ a suitable replacement area If no replacement area is a~raiFable a Idutg-tank maybe irtstatied as a last resort to regEace the failed POVYTS _• and at-grade sod absocPtiOn systems may tie r~econszructed to pfaoe feflavsrifsg rernosrat o€ the b~omat ai [tie irr5lh~ative sutfaae. Recxxislsu of such systems must comply vritft Etta rotes in ef[ect at 8tattirna <c1rEfAREYiNt(~~ SEPTIC, P[ilYrP AND OTHER TRFA?MEl~1T TANItS EI[AY C©~VTi4ft~r LETHAL G14,SSPS AN[71OR IiiiSUEFiCtlrNT OXY~EK 13D rtOT EnrTF.R sf SEPTlC, PUMP OR tTTHFR. TRE.4TitilEMF T'A1titK UNDER AlStY CiRCLrEUi.STANGES. t3F~Tff MA1r RESULT RESGtlE OF A PERSON FROM THE i1117'ER7oft a~ A TAtdK ifRAY BE D[FFICLILT OR Ii3liPOSSiBi F AODI7TOiYAL COMiiIiEiVTS -. POWfS INSTALLER Name ~' ~ 1 / Phone ~~J ~~, ~~ ~~.~!' PO~tYTS IiifAlAtFaINER tame ~ Q~~-.~, r`/ ~' Ptlorze ~l:J =z~~~' ~ ~~ S~PTA6E SFRYfCINt's QPERATOR PUMP LOGAL FZFGULATORY A€lIH - / .---- Name ~'~ / A9enc3' T r` l ~c~~ / p Phone ~lJ -- ~~fl "_ / ~ Ptton9 ,~iJJ-"_'`- ~d b a Qoa~ xas Qca~++ee bY. tha sniffs of ine Llreen carte, rNarquelfe and Wauslrara county Zcrttng and Saoif2itiort a. ~liis daaaTteRt m~ ttze tninirmm~ regvi~tma~ss af' di Casa t>visz(.t}(b}(t}td}a~fj artd 83_Sa(1}, (Zj is (3}, Wisosnsin Afftafttis'rt'a8ne Ccd~ [Jai: of this t does IIot gtrararttee the performance of ttte POvtitT$. OuW t7Jt1 t1 WiscoruinDepa ntof ~y~t~y`L-`.+~~EPORT Page of Division of Safety a s 1 in accoroan wrtn t:omm era, wis. Ham. over County ~ ~, ~ i ust 11 ' ! 1/ ! x ~~ s i Attach complete site plan on paper not less than 8 ire~nd t~(Biv~ l f h ri l I D , nce pom re zonta o include, but not limited to: vertical and parce . . percent slope, scale or dimensions, north arrow, and ocatio and distance to nearest r d. ~ T CRfliX COUNTY ' b R Date Please print all info ation. y e Personal infom~ation you provide may be used for secondary purposes (Pnvaq - ))• 7 3f ~~O P ~ ~ ~ ~ yam/ ~ ~~ Property Location Govt. Lot ~~ 1/~t~/4 S //~ T N R 1 ©E ( W Property Owner's Mailing Address ~ o~# Block # ~ . a' r State Zip Cade Phone Number ^ City ^ V' lage own earest Road Construction Use;,~2esidential ! Number of bedrooms Code derived design flow rate ~~ GPD ^ Replacement Public or cammeraai -Describe: _~_. - Parent material ..~~ JI Flood Plain elevation if applicable _ ~~^ ~ ft. reoomrnerrdatiorts: ~ ~~E1 ~~(~~~~ r System Type. ~~~~ ~ ~ ~'~"~ ~v! ~~ SYstem Elevation-' ~- /~ ~' U ~~ # ~ Bonng / ~5 / ,Pit Ground surface elev. ! y~• ft. Depth to limiting factor ~ ~ _ in. ~1 iglion Rate Horizon Depth Dominant Redox Descxiption Texhsre Structure Consistence Boundary Roots GPD/~ in. MunseN Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •E1f#2 Y . r "'~ ~ y, ~ ,+° v i /p~ ,,y~ ~~ ~~ ~ ~ Z~ tQ~ s~ l ''- 'tJ>~¢ /tiff V C7 a1 Boring 1/ / Bonrtg # ti7• pit Ground surface elev. ~' ~ ft. Depth to limiting facxor / ~__ in• Sal lication Rate ri n H De th Dominant Cdor Redox Description Texture Structure Consis~nce Boundary Roots GPDIfF o zo p in. Munselt Qu. Sz. ConL Color Gr. Sz. Sh. •Eff#1 •Eff#2 ~.J ~ 1 tI ,if D ! l ~ / d ~ ~ J 1 ~ 7 'S ~ ~f"' L' t t ~~ O~ i y /'r' ~ /~ / ~ C/ J `~'~ry ) I /- -3 1 ~ JJ'~J • Ellluetlt iF't = [SVU ~ 3U ~ LN ngrr- aria ~ a> >ov _ ~av nyr~ ~ c~nuo,,..r~ - _ ...yam .,.. _ - •••~- ~[ ~~ Situ CST Number Bird Plumbing; Inc. Shaun Bird ~,.~'" 226900 Address Date Evaluation Conducted ~ Telephone Number 1008.-1~~~2nd Ave, New Richmond, WI 54017 ~--~~~ -~~ ~ 715-246-4516 ~~ # ^ yBonn9 /~ ~.~p~rit Ground surface elev. /lC/ ' ft. Depth bo Limiting factor ,~ ~ ln• ~ ~~ ~ Horizon Depth Dominant Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Muruell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 i ~-z~ G , l ~ o~~ ~~ ~ ~ ~ sb ~' 5 s ~v ,; r~ z I D se,1 ~- - ~--~ .~r~ CU a ^ Pit Grauca surface elev. ft. Depth to limiting factor in. Sod Rate ~~# ° ~~ ri H th De Dominant Redox Oesaiption Texture Stnx;ture Consistence Boundary Roots GPD/ff zon o p in. Munsell Qu. Sz. Cont Cdor Gr. Sz. Sh. ~~ ~~ ^ Pit Ground surface elev. ft. Depih to limiting factor Kr. - Soi ication Rate Horizon Dominant Redox Description. Texture Stnx4ure Consistencee. Boundary Roofs GPDIff in. MunseU Qu. Sz. Cont Color Gr. Sz. Sh. 'Eff#1 'Eff#2 ' Efllvent #1 = BODs > 30 < 220 mglL and TSS >30 =150 mgll ` Efftuerrt #2 = BODS <_ 30 mglL and~'f SS < 9p mgll. The Department ot/;Commerce is an equal opporturuty service provider aad employer. If you need assistance W access services or need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. seesaw trteoo Soil Test Plot Plan Project Name Shaun Bird Shaun i ' Address 1008 192nd Ave New Richmond Wi 54017 C #226900 Lot 7,8,9 Subdivision village of Cylon Date 1 /06 SE 1/4 S W 1/4S 33 T 31 N/R16 W Township Cylon [~ Boring ~ Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 100 ft. Top of Survey Iron System Elevation ~~~~' ~~~, ~ *HRpSameasBenchmark Alternate Benchmark Top of survey iron @ 100.6' ^ At1.B.M. ~.M. 113' _ I \ 182nd Ave 30'~ 30' B-2 60' 0% Slope Scale is 1" = 40' unless otherwise noted r B-3 60' 224th St. 30' _ B-1 198.9'Property 229.5' Line U 2?52P 0?0 State Bar of Wisconsin Form 2-2003 WARRANTY DEED Document Number ll Document Name THIS DEED, made between Marty A. Wallin ("Grantor," whether one or more), and Shaun R. Bird ("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): Lots 4, 5, 6 and 9, Block 3, Original Plat of the Village of Cylon. St. Croix County, Wisconsin. Exceptions to warranties~,Eaasements, restrictions and rights-of--way of record, if any. Dated ~ 2~ ~ '~/ f7 ~ ~ ,~/ ~r -r ~8~~~~ KATHLEEN H. WALSH REGISTER OF DEEDS ST. GROIX CO.. WI RECEIVED FOR RECORD 02/18/2005 08:00AM WARRANTY DEED CyCl,'~~T # REC FEE: 11.00 TRANS FEE: 180.@0 COPY FEE: CC FEE: PAGES: 1 Recording Area Name and Retum Address n ooh-lu8g-ao-ooo:ooh-loss-so-ooo 006-1088-60-000:006-1088-90-000 Parcel Identification Number (PM) This is not homestead property. (is) (is not) (SEAL) * *Marty A. AUTHENTICATION Signature(s) Marty A. Wallin authenticated on Z ( V *Kristina 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 Kristina Ogland Hudson. WI 54016 Notary Public, State of My Commission (is permanent) (expires: L) L) (Signatures may be authenticated or acknowledged. Both are not necessary.) NOTE: THIS IS A STANDARD FORM. ANY MODIFICATIONS TO THIS FORM SHOULD BE CLEARLY IDENTIFIED. WARRANTY DEED ®2003 STATE BAR OF WISCONSIN FORM NO.2-2003 * Type name below signatures. INFO-PRO"" legal Forms B00-655-2021 www.infoproforms.com U 27y5 P 216 State Bar of Wisconsin Form 2-2003 WARRANTY DEED Document Number ~~ Document Name THIS DEED, made between Richard D. Jonas. ("Grantor," whether one or more), and Shaun Bird. ("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): Lots 7 and 8, Block 3, Village of Cylon. St. Croix County, Wisconsin. 786932 ~/ KATHLEEN H. MALSH REGISTER OF DEEDS ST. CROIX CO. , MI RECEIVED FOR RECORD 02/07/2005 01:08PM 1rARRANT'Y DEED EXEKyT # REC FEE: 11.00 TRAAS FEE: 2.90 COPY FEE: CC FEE: PAGES: 1 Recording Area Name and Return Add~ss~ ~,Q J ~( ~/ / `r'~(1 Ne~,~Jti~c~t.. ~ 1 ~ Yl?! J 006-1088-70-000 & 006-1088-80-000 Parcel Identification Number (PIN) This is not homestead property. (is) (is not) Exceptions to warranties: Easements, restrictions aodrights-of-way of record, if any. Dated ~ ' 7 ' l~ :~ * Signature(s) authenticated on * TITLE: MEMBER STATE BAR OF WISCONSIN (If not, authorized by Wis. Stat. § 706.06) THIS INSTRUMENT DRAFTED BY: Attorney Kristina Oland Hudson. WI 54016 ~ ~. *Richard D. Jonas (SEAL) ACKNOWLEDGMENT STATE OF ~.,,,, ~ . S ~'~^--S't ~ __ ) 1 ss. C(~'t ~ COUNTY ) Personally came before me on p~. - ~ ' 0'1 ~ 05 , the above-named Richard D. Jonas. to me known to instrument an ~ .• r TA * Notary Pu c~C;s My Comm ~~~~4~ (Signatures may be authenticated or acknowlr NOTE: THIS IS A STANDARD FORM. ANY MODIFICATIONS TO WARRANTY DEED ®2003 STATE BAR OF W; AUTHENTICATION who bxecuted the foregoing e. ~- .-.p EARLY IDENTIFIED. FORM NO.2-2003 ~ Type name below signatures. INFO-PROTM Legal Forms 80055-2021 www.infoprofonns.com ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND O~EgSHIP CERTIFICATION FORM ~c , ..~ OwnerBuyer ~-- `- Mailing Address property Address $ / ~~~~, ~~ ~ u l Z ~ r~ ~ ~ ~~ (Verification required from Planning Department for new construction) gab /~~8~76-~ G~ty~taze parcel Identification Number LEGAL D~CgIpTION ~ r/4 ~;..~ ~/., Sec. J~~, T`~N-R~-~=-w' Town of property Location ~ J ~ -~--_ ~ ~, ~ ~' .. ~~ .~ ~..w ~r gyn. ~ I.Ot Subdl,ViS10n U~ `~ r ~ ~ '"~ ~ ~ ,Volume -,.page # _ Certified Survey Map # ~ e '~ ?~-~' ~' page # Zl lO an Deed # ~ ~ ~ ~ ~' ~ Volum warn ty Spec hous%eS ^ no Lot lines identifiabi~^ no SYSTEM M~ENANCE remature failure to handle wastes. Proper maintenance Improper use and maintenanceof your septic system could result in its P a licensed pumper- What you put into the system consists of pumping out the septic tank every three years or sooner, if needed by can affect the function of the septic tank as a treatment stage in the waste disP°sal systom' b the owner and by a t a certification form, signed y m The property owner agrees to submit to St. Croix Zoning DePa~~ rifying that (1) the on site wastewater disposal syste inasterplumber, journeymaaplumber, restrictedplumber or a licensedpumper the tic tank is less than I/3 full of sludge. is is proper operating condition and/or (2) after inspection and pumping (~ necessary), ~P with the standards ements and agree to maintain the private sewage disposal system Certification Uwe, the undersigned have read the above requir artment of Natural Resources, State of WisconsO~~ within 30 set forth, he set by the Department of Commerce and the Dep tic system has been maintained must be completed and returned to the St. Croix County Zoning stahag that y / J ^ days of th y eacpiration date. ~ ~/ f~ DATE OF APPLICANT 3I pWNER TIFICATION the owner(s) of I e certify that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) escn'bed above, by virtue of a warranty deed recorded in Register of Deeds Office. the pro ~~ ~v 1 ~ CJ DATE TUBE OF APPLICANT De artment. «««««« Any information that is mis-represented may result in the sanitary Permit being revoked by the Zoning P «««««« lication: a stamped warranty deed from the Register of Deeds office «« Ynclude with this app ma if reference is made in the warranty deed a copy of the certified survey P 0 0 0 o (`v ~ ~~~~ A product of Wyk BuNdt~g Systems, Ma 2301 East FauM Street BtJiDd6~tg S~/SDB~f18, k1C. Rost Ollics Baoc 5~0 Marshtkld, Wtscons~n 54449 715.387-2561 A=1 HOrnes, fnc. www.wickrnaashflsid.com f655 Hwy SS South, F0 BOx 3~$ . Rics Lake, WI 54$58 f -8.535-814a or 715-234-927 SELECT SECTIONAL HOME MODELS R N ,o'er 1 W WIRDCDLNa 1 • S'J' • 1r-0' " 27~E' • IFS-421 1093SO. FT. (OIJ'i51DE FLOOR) OIR~4NLOlR8~6 GR~WTE61~.8eSC.FT. _ • «' 0. I•s commerce.wi.gov isconsin Department of Commerce Safety and Buildings 4003 N KINNEY COULEE RD LACROSSE WI 54601-1831 TDD #: (608) 264-8777 www. com m e rce.wi.gov/sb/ www.wisconsin.gov Jim Doyle, Governor Mary P. Burke, Secretary August 15, 2006 CUST ID No. 226900 SHAUN R BIRD BIRD PLUMBING INC 1008 192 ND AVE NEW RICHMOND WI 54017 ATTN: POWTS Inspector ZONING OFFICE ST CROIX COUNTY SPIA 1101 CARMICHAEL RD HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 08/15/2008 SITE: Shaun Bird 182 Ave Lots 7,8,9 Town of Cylon, 54017 Identification Numbers Transaction ID No. 1308988 Site ID No. 716677 Please refer to both identification numbers, above, in all correspondence with the a enc . St Croix County S1/2, SW1/4, S33, T31N, R16W Lot: 7-8-9, Block: 3 FOR: Description: At-Grade System /Two Bedroom /Level Site Object Type: POWTS Component Manual Regulated Object ID No.: 1091051 Maintenance required; 300 GPD Flow rate; 45 in Soil minimum depth to limiting factor from original grade; System: At-grade Component Manual, SBD-10570-P (R.6/99), Pressure Distribution Component Manual, SBD-10573-P (R.6/99); Biofilter 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 construction or installation and prior to occupancy or use: Reminders • This system is to be constructed and located in accordance with the enclosed approved plans and with the component manuals listed above. • The changes made to this plan on 8/15/06 by this reviewer were acknowledged and approved by the system designer. SHAiJN R BIRD Page 2 8/15/2006 • Per manual cited 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. • The well must be a minimum of 25 feet from any POWTS tank, and a minimum of 50 feet from the absorption area. chs. NR 811 & 812c • 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 POWTS 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 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. Owner Responsibilities: • 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 83.52(2) A POWTS that is not maintained in accordance with the approved management plan or as required under s. Comm 83.54(4) shall be considered a human health hazard. • Comm 83.55 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. 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. SHAUN R BIRD Sincerely, Charles L Bratz POWTS Reviewer II ,Integrated Services (608)789-7893 , 7:45 am - 4:30 pm Monday -Friday charlie.bratz@wisconsin. gov Page 3 8/15/2006 Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 WiSMART code: 7633 cc: Leroy G Jansky, Wastewater Specialist, (715) 726-2544 \ ~ r- :.z ,._ .mss •~, ? 6 o T ~_ .g S _ ~S m Z ~ v r r 1Z E x ®~: aTHiRO ~ ST. a ~ 7 6 ®6 ? t g ~ • c 8 ~-C F~ 3 ~" 3 ~O z ~ ~ 2 n -- 1 ~ 1 -72 . .S. S_ .1r3 e~ e~ b e~ w~'~ 2 _o ST. _ ~ Z + ~ ~ w . _ - L O Q ~ ~ r f $ .. •~c (n 3 ~ •~ • f •... ~ W . z ,~~ 3 ~ .1 is. w~ is Lf _ 3~ GO!a!aECT M _,~y.~ST ,fC~'- ST. ~/NC, r- ~ . ~ ~ ' ... rv: -1 L / / J T -d a ~: ~: a. ~_ .~ dSb=BO SO 60 qa~ Sc~/~ ~O/ee! Lo oiae~. iiac/i.