HomeMy WebLinkAbout038-1237-01-000
Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix
Safety and Building Division
INSPECTION REPORT Sanitary Permit No:
552387 0
GENERAL INFORMATION (ATTACH TO PERMIT) Stat Ian ID N
Personal information you provide maybe used for secondary purposes [Privacy Law, s.15.04 (1)(m)].
Permit Holder's Name: City Village X Township Parcel Tax No: (IV VL4AZtV0CZj
Marek, Todd R. Star Prairie, Town of 038-1237-0 - 00
CST BM Elev: Insp. BM Elew BM Descri pri ./0,0. rA Section/Town/Range/Map No:
v 16.31.18.1252
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION B HI FS ELEV.
Z. M o:
Septic 14J Iu JA, 12o62 Benchmark
. y oy. /oa o
Dosing Alt. Bhj,_
DD /.4 a( Z G Gov 2
Aeration k q 7
D to uC 5 Bldg Seyigr~ 54-H YD
Holding t Inlet
a~ Z o.
TANK SETBACK INFORMATION
TANK TO P/L WELL BLDG. Ven to Air Intake St/Ht Outlet
ROAD Dt Inlet
Septic t Q t Bottom
8 0
Dosing Head r/Man.
Aeration Dist. Pipe( 177
YJZ
Holding Bot. ttemm
lrl~n V1 Final Grade
l PUMP/SIPHON INFORMATION rv-e1/ S X02, S
Manufacturer Demand St Cover
GPM lG~ S 3 10- s
Model Number
WL4 - t Y"- 31-~~
F~orcemain' Friction LSy tem H d -1a . a gt Dia, Distto Well S PTION SYSTEM
BED/TRENCH Width T ength No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth
DIMENSIONS
SETBACK SYSTEM TO l0 P/ BLD WELL LA REAM C Na Manufacturer:
INFORMATION CHA R OR
Type O System: /
t I °7 NI Model Number:
VV_
Gf7 11 0 w/ b~,eS
DISTRIB _ N SYSTEM Iv
Header/ anifol Esterisution 1 ole Size x Hole Spacing ` Vent Intake
11-ength(10 IODJL~ Length S ~Dia D Spacing e' f2- ro(1
_~l T PT._0_~
SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems On
Depth Over Depth Over xx Dept4~2"4
eded/Sodde ulched
Bed/Trench Center Bed/Trench Edges Topsoil Yes
®No Yes ffNo
COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / / Inspection #2:
Location: 2196 108th St et N hmond, 154017 (NE 1/4 NE 1/4 16 T31N R1 8W) Maple Ha en Lo 1 u Parcel No: 16.31.18.125Q
A ~11
IDA
1.) Alt BM Description D/- 4 (!t?1.~"Ll/
2.) Bldg sewer length = ~2 IUl/~-~rOS J ~J®, /
amount of cover
3.) Contour -8'lQ Wad
Plan revision Required? ❑ Yes /No rr /
Use other side for additional information. ( t (,{,cwtn E(o 0 ~ S
Date Insepctor's ign ture Cert. No.
SBD-6710 (R.3/97)
108th Street
Todd Marek
New Richmond, WI
NE1/4,NE1/4,S16,T31 N,R18W
Star Prairie Township
St. Croix County
Scale 1"=40' IE- 40' 0"
BM 1= 100.00' top of 3/4" pipe
BM2= 99.50' top of 3/4" pipe
C / North
CD
~ c
° Well o
o
o cn
Garage House
o
_
z A%, qO rot
~r
o ° f Out
o We" r 1200/800 tank
0
0
rV
of 2" force main
99.50' B2 B1 BM2
99.30' BM1
98.50' B3
CO
97.80' CL
N
West lot line <a9
Page 8of8
1
'l
comme, Safety and Buildings Divis' County C o (x
201 W. Washington Ave., P.O. B 16
G Of F k Madison, WI 53707-7162 Sanitary Permit Number (to be filled in by Co.)
,DepartmVlY~Zf3 ~tbs -
55 Z39 7
Sanitary Permit Application State. Transaction Number
In accordance with s. Comm. 83.21(2), Wis. Adm. Code, submission of this form to the appropriate governmental
unit is required prior to obtaining a sanitary permit. Note: Application forms for state-owned POWTS are Project Address (if different than mailing address)
submitted to the Department of Commerce. Personal information you provide may be used for secondary
purposes in accordance with the Privacy Law, s. 15.04 I m , Stats. # Z1 (7(p
L Application Information - Please Print All Inf a ' VDT
Property OwnerI&P / Parcel #
G c 438-, 1"L37- OI -ooD
Property Owner's Mailing Address Property Location
25 00 Z- ~ Govt. Lot Z)
City, State Zip Code Phone Number M & y., IJC- y., section _'LL
/u9 i j ~ IGY41AW W ( 7 7(1151 37 / b Z ~ev T ~ N; R (circle one)
C mil/ / / E orr
II. Type of Building (check all that apply) Lot #
l or2 FamilyDwelling•-- Number of Bedrooms _._.._u12d_i.Yi$iQrt Nye
Block# /V`Pt F
❑ Public/Commercial- Describe Use d7C dd
11 City of
dam'
-CM Number ❑ Village of
11 State Owned -Describe Use/A~
J 0~1L !)2
~v A J 0-Townof
III. Type of Permit: (Check only one box on line A. Complete line B if applicable)
A. New System ❑ y Only Replacement System ❑ Treatment/Holding Tank Replacement Onl ❑ Other Modification to Existing System (explain)
B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of Plumber ❑ Permit Transfer to New List Previous Permit Number and Date Issued
Before Expiration Owner
IV. Type of POWTS System/Component/Device: Check all that apply) i
❑ Non-Pressurized In-Ground ❑ Pressurized In-Ground ❑ At-Grade X Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil
❑ Holding Tank ❑ Other Dispersal Component (explain) ❑ Pretreatment Device (explain)
V. Dis ersal/Treat ent Area Information: INSAW
Design Flow .(gpd) Design Soil Application Rate(g sO Dispersal Arequir ~(AfJ DispetsaAre
pos 'System Elevation /3
D/I b-7 7.- 11h
VI. Tank Info Capacity in Total # of Manufacturer
Gallons Gallons Units
New Tanks Existing Tanks 'A./ ~
p cC Cg in w C7 a
Septic or Holding Tank j -Z
Dosing Chamber II
VII. Responsibility Statement- I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans.
Plu 's Name (Print) Plumber's Signature MPHVF -Number Business Phone Number
LC-J_,40A ZZ fo 7/S Z7
Plumber' Address (Street, City, S/gate, Zip Code) ` ) 7K Z7 _ Q AJAf&
VIII. ,Count epartment Use Only
Issuing ent Signatur
Approved Permit Fee Date 4suedi
$
.r ~,3 /Z
iven Reason for enial
IX. C0nllitl9>Fy0
OW""teasons for Disapproval y
I I oefl mu ri all be se ~ J r t ~ p ~ ~
dis Pers rvtces l maii
as per management plan provided by plumber.
2. Aq rslback t uireltiteMs mt .be maifttairttlid ~ ~,:rorbb it 5 rwaQ
Attach to complete plans for the system and sub to the County only o less than ,n 11 Inches In 4zi
SBD-6398 (R. 01/07) Valid thru 01/09
5 a~rsTU(h~d' Jam' ~GQ~MJ_r
9~pART,y Safety and Buildings
3824 N CREEKSIDE LA
HOLMEN WI 54636
0 Contact Through Relay
K
3 S P S www.dsps.wi.gov/sb/
7 ~w www.wisconsin.gov
°ssloNAy' Scott Walker, Governor
Dave Ross, Secretary
June 28, 2012
CUST ID No. 226497 A= POWTS Inspector
ROGER D NELSON ZONING OFFICE
NELSON PLUMBING ST CROIX COUNTY SPIA
122 E SUMMIT AVE 1101 CARMICHAEL RD
ELLSWORTH WI 54011 HUDSON WI 54016
CONDITIONAL APPROVAL
PLAN APPROVAL EXPIRES: 06/28/2014
Identification Numbers
SITE: Transaction ID No. 2104760
Todd Marek Site ID No. 781132
108TH Avenue Please refer to both identification numbers,
Town of Star Prairie above, in all correspondence with the agency.
St Croix County
NE 1/4, NE 1/4, S16, T3 IN, RI 8W
FOR:
Description: Four Bedroom Mound System / 3% slope
Object Type: POWTS Component Manual Regulated Object ID No.: 1379613
Maintenance required; 600 GPD Flow rate; 26 in Soil minimum depth to limiting factor from original grade; System(s):
Mound Component Manual - Version 2.0, SBD-10691-P (N.01/01), Pressure Distribution Component Manual - Version
2.0, SBD-10706-P (N.01/01); Effluent Filter
The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes
and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. This system is to be constructed
and located in accordance with the enclosed approved plans and with any component manual(s) referenced above.
The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code P O.W.T.
requirements. . .
Condition
06
No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145APPROI
stats. The following conditions shall be met during construction or installation and prior to occupancy or use:
D1V1610N OF SAFETY AN
Reminders
• A sanitary permit must be obtained from the county where this project is located in accordance with the- EE CORRESPO
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 of Sec. 145.20(2)(d), Wis. Stats.
• A state approved effluent filter is required. Maintenance information must be given to the owner of the tank
explaining that periodic cleaning of the filter is required. Access to the filter for cleaning must be provided
per SPS 384 product approval conditions.
• All POWTS component piping material shall be SPS 384, Wis. Adm. Code compliant.
• The area within 15' downslope of the dispersal cell shall remain undisturbed. Vehicular traffic, excavation or
soil compaction is prohibited in this area.
• 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.
1
ROGER D NELSON Page 2 6/28/2012
Owner Responsibilities
• The current owner, and each subsequent owner, shall receive a copy of this letter including instructions relating
to proper use and maintenance of the system. Owners shall receive a copy of the appropriate operation and
maintenance manual and/or owner's manual for the POWTS described in this approval.
• 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. SPS 383.54(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 acceptable 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 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 and the POWTS management plan to the owner and any
others who are responsible for the installation, operation or maintenance of the POWTS.
Sincerely, Fee Required $ 250.00
Fee Received $ 250.00
Balance Due $ 0.00
Gerard M Swim
POWTS Plan Reviewer, Integrated Services
(608)789-7892, Mon - Fri, 7:15 am - 4:00 pm WiSMART code: 7633
jerry.swim@wisconsin.gov
Note: Effective January 1, 2012, all codes under the jurisdiction of the Division of Safety & Buildings will be
modified. Code references with prefixes starting with "Comm" will be replaced with "SPS" to recognize the
relocation of the Division of Safety & Buildings from the former Dept. of Commerce to the Dept. of Safety &
Professional Services. Additionally, all S&B codes will be renumbered and addressed in a "300" series. For future
reference, the Wisconsin Commercial Building Code will be addressed by SPS Chapters 360-366.
MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN
Residential Application
INDEX AND TITLE PAGE F?~~CC/VeC
Project Name: Todd Marek `SUN 21 20
Owner's Name: Todd Marek W1 Pt: FY
& ~~~~~IPJr_'
Owner's Address: PO Box 228
New Richmond, WI 54017
Legal Description: NE 1/4, NE 1/4, S 16, T 31 N, R 18 W
Township: Star Prairie
County: St. Croix
Subdivision Name: Maple Haugen
Lot Number: 1 Block Number:
Parcel I.D. Number. 038-1237-01-00
Plan Transaction No.:
Page 1 index and title
Page 2 Data entry
Page 3 Mound drawings S
Page 4 Lateral and dose tank •
Page 5 System maintenance specifications ' ally
Page 6 Management and contingency plan ~ED
Page 7 Pump curve and specifications
Page 8 Plot Plan
o swwlNCa
,NDENCE
Designer. Roger Nelson License Number: MP 226497
Date: 06/18/12 Phone Number: 715-2734444
Signature: 10L
Designed Pursuant to the
Mound Component Manual for POWTS Version 2.0 SD&10691-P (N. 01101), and both
SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST-SAS (01181) and
Pressure Distribution Component Manual Ver. 2.0 SOD-107MP (N. 01101)
Version 5.1 (R. 06!06) Page 1 of 8
Mound and Pressure Distribution Component Design
Design Worksheet
Site information
(R or C) R Residential or Commercial Design ire: sand fiu (o) caiculOom assume a
400.00 Estimated Wastewater Flow (gpd) Table e3-44-3 u soa bmbnwd for =1
1.50 Peaking Factor (e.g. 1.5 = 150%) cx ftm of « 36 h2m.
600.00 Design Flow (gpd)
3.00 Site Slope
59.30 Contour Line Elevation (ft)
26.00 Depth to Limiting Factor (in)
0.60 In-situ Soil Application Rate (gpW)
Distribution Coil Information 3 10.00 Width (ft)
50.00 Dispersal Cell Length Along Contour (ft) Cell
1.00 Dispersal Cell Design Loading Rate (gpolfe)
1 Influent Wastewater Quality (1 or 2) Are the laterals the highest point
in the distribution Y
Pressure Dhtrlbution Information network? Enter Y or N
(C or E) E Center or End Manifold
3.33 Lateral Spacing (ft) If N above, enter the elevation ft
3 Number of Laterals of the highest point
0.128 orifice Diameter (in)
3.80 Estimated Orifice Spacing (ft) = 11.78 felorifice
2.00 Forcemain Diameter (in)
90.00 Forcemain Length (ft) Does the forcemain drain back?
82.00 Pump Tank Elevation (ft) Enter Y or N
6.50 System Head (ft) x 1.3 14.68 Forcemain Drainbac k (gal)
17.80 Vertical Lift (ft) 35.82 5x Void Volume (gal)
0.90 Friction Loss (ft) 50.50 Minimum Dose Volume (gal)
0.00 Incline Filter toss (ft) 21.01 System Demand (gpm)
25.20 Total Dynamic Head (ft)
Lateral Diameter Selection Maniifold Diameter Selection
in. dia. options choice in. dia. options choice
0.75 1.25 x x
1.00 x x 1.50 x
1.25 x 2.00
1.60 x 3.00
2.00 x
3.00 x
Gailorm/lnch Calculator (optional)
Treatment Tank Information Total Tank Capacity (gal)
1200 Septic Tank Capacity (gal) Total Working Liquid Depth (in)
Wieser Manufacturer gain (enter result in oeff 849)
Dose Tank Intorrnedon Effluent FIRar IMonnation
800.00 Dose Tank Capacity (gal) Poly Loc Filter Manufacturer
22.24 Dose Tank Volume (gal/in) 525 Filter Model Number
Wieser Manufacturer
Project: Told Marek Page 2 of 8
i
Mound Plan and Cross Section Views
1/108 obsenratioti Pyre 3' J
K..~ T
w -
. . .
.
.
. . . . . .
L
Mound Component Dimensions
ft
A 10.00 ft E 13.60 in H Eilft ft K Efift
B 60.00 ft F 9.00 in Z ft L ft
D 10.00 in G 0.50 ft J w 600.00 (fe) Dispersal Celt Area 1071.43 (fe) Basal Area Available
P10.04 (gpd/ft) Linear Loading Rate 6.00 (ft) 1/10 B Obs. Pipe Placement
Mound Cross Section View
Aggregate Dispersal Area
Finished Grade 101,88 (ft) -y---
* H
F Dispersant CN 100.63 (ft) Lateral
100.13 (ft)-10Invert
Dispersal Cell 4
Elevation E'
{
S J # # J # # 3 i { 3 # J 3 R # } 4 # 3 } # 1 J~D J J { { A # J # } 3 # # } ~i 4 # # 3
1„k x ~ x { x`sR+ r t t~}. s 3 i ♦ ,i a J # } { a .'i # S~z '1 a l x, d .t a .t 3
?
99.30 (ft) Contour Elevation
3.0 % Site Slope
Geotextile Fabric Cover
Shading Key w Dispersal Cell See lateral details on
[1] - Topsoil Cap a 1.5 ft Rage 4 far number, size,
Subsoil Cap and spacing of laterals.
ASTM C33 Sand F Laterals are equally
0.5 ft ryp~ai i absrai spaced tram the
Tilled Layer C
® ...1: Aggregate distribution cell's
centerline in the
distribution cell (AxB).
Project Todd Marek Page 3 of 8
End Connection Lateral Layout Diagram
C4nter tho laterals c wr Ow A & B dirnonsio n Turn-up wtbsll wet" or aloancutplug
P
AN laterals are idertticai (F x-a l t4 ars drged cn trio bottom of the tm4waa s
equaty =paced
Laterals Or foroe morn of PVC soh 4o s
(per CS1KW Table 84.30-5)
Foroe maln oonnoodo n via we or cross to manifold at any point.
Number of Laterals 3 Orifice Diameter 0.125 in
Lateral Diameter 1.00 in Orifice Spacing (X) 3.66 ft
Lateral Length (P) 58.56 ft Offices per Lateral 17
Lateral Spacing (S) 3.33 ft Orifice Density 11.76 ft2/orifice
Lateral Flow Rate 7.00 gpm Manifold Length 6.67 ft
System Flow Rabe 21.01 gpm Manifold Diameter 1.25 in
Total Dynamic Head 25.20 ft Forcemain Velocity 2.15 ft/sec
Dose Tank Information t.o>idng cover rAM waming
I" arid locking device arfd
sealed watertight
Ebdricsl as per NEC 300 and
Comm 18.28 WAC 4 m Diawnned Tank CWM)Onerat is properly vented E- Alternate ou dd
kmmtion
Foroerraain diameW
Wieser Manufacturer 2 in.
Ca ci 800.00 Gallons
Volume 22.24 galrnch T A
_ Weep We or anfi-
Dimension Inches Gallons B siphon device
A 21.70 482.62
B 2.00 44.48 C Pu p of elevation
C 2.27 50.50 82.83
D 10.00 222.40 0
Total 35.97 8A.00 Dose elevation (R)
3" Bedding uncTer tank 82.00
Alarm Manuafacturer S. J. Electra Systems
Alarm Model Number ICA L
Pump Manufacturer Goulds _
Pump Model Number PE 51
Pump Must Deliver 21.01 gpm at 25.20 ft TDH
Project: Todd Marek Page 4 of 8
Mound System Maintenance and Operation Soecificalons
Service Provider's Name I Nelson Plump ngg Phone 715-273-x4444
POWTS Regulator's Name St. Croix Zoning Phone 715-386-4680
Svstom Flour and Lo-od PenwWom
Design Flow - Peak 600 gpd Maximum Influent Particle Size 1/8 in
Estimated Flow - Average 400 gpd Maximum BOD5 220 mg/L
Septic Tank Capacity 1200 gal Maximum TSS 150 mg/L
Soil Absorption Component Size 600 fe Maximum FOG 30 mg/L
Type of Wastewater Domestic Maximum Fecal Co kwm >10E4 dull 00 mL
Service Freauencv
Septic and Pump Tank Inspect and/or service once every 3 Years
Effluent Filter Should inspect and dean at least once eve 3 years
Pump and Controls Test once every 3 ears
Alarm Should test month
Pressure System Laterals should be flushed and pressure tested every 1.5 years
Mound I for p2qding and see once ev 3 ears
Other
Miscellaneous GgngLW;ft and Il ste tats Standards
1. Observation pipes are slotted and materials conform to Table Comm 84.30-1, have a watertight cap,
and are secured in as shown in the mound component manual.
2. Dispersal cell aggregate conforms to Comm 84.30 (6)(1}, Wis. Adm. Code.
3. AN 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 Detall
Finish!
Grade
64r Diameter Lawn Threaded Cleanout
Sprinkler Valve Box Plug or Ball Valve
Distribution
Lateral
Lang Sweep 90 or Two
45 Degree Bends Same
Diameter as Lateral
Project: Todd Marek Page 5 of 8
Mound System Management Plan
Pursuant to Comm 83.54, Vide. Adm. Code
then fi
This system shall be operated in accordance with Conmh 82-U We. Adm. Code, and shall maintained in accordance with its
component manuals ISOD-10691-P (N.01I01), SSWMP Publication 9.6 (01/81), and Pressure Distribution Component Manual Ver. 2.0 SBD
10706-P (N. 01/01)) and local or state raise 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 tarn abandonment shall be in accordance with Comm 83.33, VVis. Adm. Code when the tanks are no urger used as
POWTS components.
Septic or pump tank nmrJwW dears, access risers and covers should be inspected for water tightness and soundness. Access
openings used for service and assessment shall be seated watertight upon the completion of service. Any opening deemed unsound,
defective, or subject to failure must be replaced. Exposed access openings greater than 84ndes in diameter shall be secured by an
efclive khddng device to prevent scdden" or unauthorized entry Into a tank or component.
$eaft Tank
The septic tank shall be na UmW by an individual certified to service septic tanks under a. 281.46, Stats. The contents of the septic
tank shall be disposed of in accordance with hR 113, Wis. Adm. Code. The operating condition of the septic tarts and outlet filter stall be
assessed at least once every 3 years by Inspection.
The outlet filter shall be cleaned as necessary to ensure proper operation. The filter cartridge should not be removed unless provisions
are made to retain solids in the tank that may slough off the filter when removed from its enclosure. If the filter a equipped with an alarm,
the filter shall be serviced if the alarm is activated corewousiy. Intermittent filter alarm may indicate surge flows or an impending
continuous alarm.
The septic tank shall have ks tents removed when the volume of sludge and scum in the tank exceeds 1/3 the klquid volume of the
tank. H the contents of the tarok are not removed at the time of a triennial assessment, maintenance personnel shall advise the owner of
when the next service needs to be pubmed to maw less than maximum scup and sludge accumulation in the isms.
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 Departrnern of Commerce.
Puma Tank
The pump (dosing) tank shall be inspected at West once every 3 years AN switches, alarms, and pumps shall be tested to verily proper
operation. N an effluent filer is Mshdied wWm the tank 4 shall be inspected and serviced as necessary.
No trees or shrubs should be planted on the mound. Plantings may be made around the mourd'a perimeter, and the mound shad be
seeded and rmuldied as necessary to prevent erosion and to provide some protection from frost penetration. Traffic (other than for
vagetatkre numAsnanoe) on the mound is not rocommeruded 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
mood be heavily mulched as protection from freezing.
tn&mt quality into the mound system may not exceed 220 mg& SOD4,150 ng& TSS, and 30 nglt FOG for septic tank eflkwnt or 30
m9& 8014, 30 mgri. TSS,10 rmglL. FOG, and W du/100 mil for highly treated of ark Influent flow may not emceed maximum design
flow speclltsd In the permit for tilts installation.
The pressure distribution system is provided with a tkrshing point at the aid of each lateral, and it a recommended that each lateral be
flushed of accumulated solids at least once every 18 months. When a pressure testa performed it should be compared to the initial test
when the system was installed to deter n * if ouffioe dogging has occurred and tf orifice cleaning is required to maintain equal distribution
within the dispersal cell.
Observation pipes within the dispersal CON shall be deiced for eflkuent pondirkg. Pondag levels shill be reported to the owner. and any
Web above 6 inches considered at an impeding hydraulic bdkre requiring additional. more frequent nhor*wft.
Contingency Plan
If the septic tank or any of its components become detective the tank or component shall be repaired or replaced to keep the system in
proper operafiog conditim.
If the dosing tank, pump, pump controls, alarm or related wiring becomes defective the defective component(s) shah the immediately
repaired or replaced with a component of the same or equal performance.
If the mound component falls to accept wastewater or begins to discharge w adewreter to the ground surface, it will be repaired or
replaced in its' present location by inaesi ft basal area if toe hiskage occurs or by rarrroving bmiogicaNy dogged absorption and dispovd
medta, and related piping, and mpiadrg said components as deemed necessary to bring the sy4 t m into proper operelirhg condition.
See Page 5 of this plan for the name and telephone number of your local POWTS regulator and service provider.
Pletrestment
The Wdarrmation snd schedule of mananagernent and maintenance for pretreatment devices such as aerobic Vestrnent urft or
disinfection units are attached as separate documents and are considered pert of the overall ranagerrhent plan for this system.
Project: Page 6 of 8
GOULDS PUMPS •
Submersible
Effluent Pump
PE
MOTOR
Paarrrp _ CVaaral: . Corrasiort,estxtt
• Dis~ Ile w • Single owe construction.
• TerflpvMwe:104°f (4M • 80 ftu a Cast iron body.
rnaxlrntso. C:oMtlnrrous whN' • 115 wits . Tmwapbsdc anpeller and
• Suit-irt ttremaal a mind pro Comer.
My "Oru.
• Solkb he : 'hw teC m with WAMINk reset. ■ Upper sleeve and ioww
mwdnn spurs. • Class-B amdadaa, tie" duty bal beemg
APly tC~►TlONS • Aatomadc models indnde a • Oil f" design. won.
that switch. • NO stmt Carbon suet ■ Motor is wmmwdy
Y • Manual models affable. shaft. lubricated for extended
SpW designed for the
• Pw,qx rra: so sonrioe iPe,
towshvUsm AAotffo system perfarrna w ad or am ~ 3 HP, 300b RPM t Powerod br aw"WiNs
• tgFluen Vosirq Systems •
• tow Pressure No System Mlardnturn tapadty: SQ GPM • goded pole design AN ta~lrlg~ are widtin the
• Baserrtertt Draining • Ma imm heart; 25' TDH PE41 Motor: woddrg limits of the rnow.
Ow Sint PE41 Pww • .40 HP, 3400 RPM a caQW& d, 20' or adard ieng!!t,
Mardrrarrn head: 29' TDH • PSC design amps heavy duty 1813 SITW with
NWA 5-1 SP, thine prorg,
PESt Pura PES1 Motor: 11S volt gnmidi tg phrg.
• Maximum capacity: 70 GPM • .50 1410, 3400 RPM ■ Ca"ke unk Is he" duty,
• Modrim head: 37' TDH • IS Maxmum amps
• PSC design • Med seal is cawkwk
MUM FE
Ir wa-Mr. 9" and stress
40
46 ; MOOELS Mi. Mi, ice! St!!l.
r ..t-.
• Stathriess steel fasteners.
44-
GPM AGD♦rY
30
I FT
i..' 1
CO
20
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4 4
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0 °0 10 7 30 0 r 50 60 70 com so Q5~e f
0 r s?/ 10 Is ft" Goulds Ptsnps
CfiPM►CITif /Q~,,
Norm r ~ f I
/n t/ lRt~i1St.''teS
vesr~e
w
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r
108th Street
Todd Marek
New Richmond, WI
NE1/4,NE1/4,S16,T31 N,R18W
Star Prairie Township
St. Croix County
Scale 1 "=40' I - 49 0"---A
i
BM1= 100.00' top of 3/4" pipe
BM2= 99.50' top of 3/4" pipe
North
a~
~ c
c ° Well o
o
o to
Garage House
o.
z S Oo
o Weiser 1200/800 tank
90' of 2" force main
99.50' B2 131 BM2
99.30' BM1
98.50' B
0
M
97.80' a
U)
West lot line
Page 8 of 8
C-4 L
0 N 0 rD 0
z ~jr~ w LOT 2
{ It r 0 =
I '~1-~ CSM, VOL. 16,
f RECORDED AS 337.27' i,- - - - - - - - -
.48 39nE 337.37 -66=- P 434
G, _ 2
S89
LOT I Z s86'50'20"F
F_ 65, 778 SO. FT. : co ~ ` i }
1.51 A ORES : 4
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)le Wetlands) =
ri -
n
N82'S3'24 E to 339.50'
890.0 tiN U
~ t) co 4
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1.60 ACRES - 3 o n
8000019
T :4000p 7
State Bar of Wisconsin Form 6-2003 6 175Y9
SPECIAL WARRANTY DEED BETH PABST
REGISTER OF
Document Number Document Name DEEDS
ST. CROIX CO., WI
THIS DEED, made between The RiverBank,("Grantor," whether one or more), and RECEIVED FOR RECORD
Todd Marek Construction, Inc.,("Grantee; ' whether one or more). 06/15/2010 1:22 PM
Grantor, for a valuable consideration, conveys and warrants to Grantee, the following SPECIAL WARRANTY DEED
described real estate, together with the rents, profits, fixtures and other appurtenant EXEMPT
interests, in St Croix County, State of Wisconsin ("Property") (if more space is REC FEE' 11.00
needed, please attach addendum):
TRANS FEE: 255.00
PAGES: 1
Lots 1, 2, 3, 6, 7 and 8 of MAPLEHAUGEN;
Being part of Lot 4 of Certified Survey Map in Vol. 16, Page 4342, as Document No.
684958;
Located in that part of the NE'/. of the NE'/, of Section 16, Township 31 North,
Range 18 West, TOWN OF STAR PRAIRIE, St. Croix County, Wisconsin.
Recording Area
Name and Return Address
Todd Marek Construction
PO Box 228
Grantor warrants that the title to the Property is good, indefeasible, in fee simple and New Richmond, WI 54017
free and clear of encumbrances arising by, through, or under Grantor except: All 038-1237-01-000
easements and restrictions of record. 038-1237-02-000
038-1237-03-000
038-1237-06-000
038-1237-07-000
038-1237-08-000
Parcel Identification Number (PIN)
This Is Not homestead property.
Dated: The RiverBek
(SEAL) (SEAL)
* * by Jeanine Sandberg, Chief Fin cis Officer
(SEAL) (SEAL)
* *
AUTHENTICATION ACKNOWLEDGMENT
Signature(s) STATEOF WI )
) ss.
authenticated on Polk COUNTY )
Personally came before me on 'ZO/d
* the above-named Jeanine Sandber
TITLE: MEMBER STATE BAR OF WISCONSIN
(If not, to me known to be the person(s) who executed the foregoing
authorized by Wis. Stat. § 706.06) instrument and acknowledged the same.
THIS INSTRUMENT DRAFTED BY: ,`r~: 64
Louis J. Andrew. Jr. r - ota y Pub tc, State of WI
Andrew Law Offices, SC Q t y commission (is permanent) (expires:) S- /1- /3
(Signs ay brhutAen ated o tiwledged. Both are not necessary.)
NOTE: THIS IS A STANDARD Ai~Y I FICA l 1'TO THIS FORM SHOULD BE CLEARLY IDENTIFIED.
SPECIAL WARRANTY DEED C®2003 $T trAR OF WISCONSIN FORM NO. 6-2003
'Type name below signatures. lt~~ INFO-PRO Legal Forms • (900)655-2021 • infopra(orms.Wm
1 of 1
ST. CROIX COUNTY
SEPTIC TANK MAINTENANCE AGREEMENT
AND
OWNERSHIP CERTIFICATION FORM
Owner/Buyer P AA Pc &C
Mailing Address Z 2 g ~U~ ~-J l G¢(.~toN~ r c) / S~vi~
Property Address
(Verification required from Planning & Zoning Department for new construction.)
City/State Parcel Identification Number 3 8 i Z L d O
LEGAL DESCRIPTION
Property Location '/a , lU '/a , Sec. T (_N R(W, Town of 54A& r(2414-16
Subdivision C 7 A-1 Lot #
Certified Survey Map # , Volume , Page #
Warranty Deed # Volume , Page #
Spec hour yes no Lot lines identifiable es no
SYSTEM MAINTENANCE AND OWNER CERTIFICATION
Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper
maintenance consists of pumping out the septic tank every three years or sooner, if needed, by a licensed pumper. What, you put into
the system can affect the function of the septic tank as a treatment stage in the waste disposal system. Owner maintenance
responsibilities are specified in §Comm. 83.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance.
The property owner agrees to submit to St. Croix County Planning & Zoning Department a certification form, signed by the
owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (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.
I/we, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the
standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin.
Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Planning
Zoning Department within 30 days of the three year expiration date.
Uwe certify that all statements on this form are true to the best of my/our knowledge. Uwe am/are the owner(s) of the
property described above, by virtue of :71anty deed recorded in Register of Deeds Office.
Number of bedrooms
SIGNATURE OF APPLICANT(S) DATE
***Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Department.
Include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if
reference is made in the warranty deed. - "
(REV. 08/05)
isconsin SOIL EVALUATION REPORT #1697
Page 1 of 3
Department of Commerce in accordance with Comm 85, Wis. Adm. Code
Division of Safety and Buildings Steel's Soil Service, Inc.
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
percent slo le Q im si s north arrow, and location and distance to nearest road. Parcel I.D. Q _ - p1
p 'tall information. Reviewed By Date
Fr. (Priva Law, s. 15.04 (1) (m)). 1.7 /05
Personal information you used
Property Owner Property Location
Gronquist, Nels Govt. Lot na NE114, NE1 4, S16, T31N, R18W
Property Owners Mailing Address Lot # Block # Subd. Name or CSM# u C
416 8Th Ave. NE 1 na MapleHaugen l 2
City Sta Zip ',?I"447 ber ~ City ❑ Village M Town Nearest Road
Minneapolis Mt 1 55413 1 78 Star Prairie 220Th Ave
® New Construction Use: ® Residential / Number of bedrooms 4 Code derived design flow rate 600 GPD
❑ Replacement ❑ Public or commercial - Describe: na
Parent material Ground and end moraines, pitted glaical drift Flood plain elevation, if applicable na ft.
General comments Mound design, system elevation 100.30ft based on contour line elevation 99.30ft.
and recommendations:
❑ Boring #
Ground surface elev. 99.50 ft. Depth to limiting factor 26 ""'in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
1 0-4 10yr3/1 none I 2msbk mfr a lc .6 .8
2 4-18 10yr4/4 none sl 2msbk mfr cs if .6 1.0
3 18-26 5yr4/4 none scl 2msbk mfr cs if .4 .6
4 26-96 5yr4/4 f1f 7.5yr5/6 sl om mf na na .2 .6
❑ Boring #
Ground surface elev. 99.50 ft. Depth to limiting factor 42 ✓ in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ftz
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
1 0-5 10yr3/1 none I 2msbk mfr is 2c .6 .8
2 5-19 10yr4/4 none sl 2msbk mfr cs 1c .6 1.0
3 19-42 5yr4/4 none sl/scl 2msbk mfr gw 1c .4 .6
4 42-96 5yr4/4 f1f 7.5yr5/6 sl om mfr gw na .2 .6
5 96-110 7.5yr4/4 none cos osg ml na na .7 1.6
* Effluent #1 = BOD? 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BODS < 30 mg/L and TSS s-30 mg/L
CST CST Number
CST Name (Please Print) nature-
David J. Steel 248956
Address Steel's Soil Service, Inc. Date Evaluation Conducted Telephone Number
994 200th St. Baldwin, WI 54002 6/16/2005 715-760-0347
SBD-8330 (R.07/00)
Property Owner Gronquist, Nels Parcel ID # Pending Page 2 of 3
a Boring # Ground surface elev. 98..50 ft. Depth to limiting factor 39 ✓in.
® Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
1 0-6 10yr3/1 none I 2msbk mfr cs 1c .6 .8
2 6-13 10yr4/4 none sl 2msbk mfr gw if .6 .8
3 13-39 5yr4/4 none Sid 2msbk mfr gw if .4 .6
4 39-58 5yr4/4 c2d 7.5yr5/6 sil/sicl om mfr gw na .0 .0
5 58-72 5yr4/4 c2d 7.5yr5/6 sl om ml na na .2 .6
I
❑ Boring # ❑ Ground surface elev. ft. Depth to limiting factor in,
~ Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
❑ Boring # L1 Ground surface elev. ft. Depth to limiting factor in,
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fe
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
* Effluent #1 = BOD5> 30 < 220 mg/L and TSS >30 <150 mg/L * Effluent #2 = BODS < 30 mg/L and TSS <30 mg/L
The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or
need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777.
SBD-8330 (R07/00) Steel's Sal Service. Inc.
STEEL'S SOIL SERVICE INC. 3 of 3
David J. Steel Nels Gronguist 994200 th St.
CST-POWTSM NE1/4,NE1/4,S16,T31N,R17W Baldwin, WI 54002
Lic. #248956 Town of Star Prairie, St. Croix Co. Direct 715-760-0347
Maplellaugen Sub. Lot,1 Fax 715-684-3449
This soil evaluation was conducted to satisfy a zoning requirement, it may or may not be suitable for your use.
The location of this test may or may not be as shown, as permanent lot lines were not established at the
time the soil test was conducted.
Legend N
1"=40'
♦ = Benchmark Ele. 100.00 ft
Top of 3/4" pvc pipe
• = Alt Benchmark Ele. 99.50 ft
Top of 3/4" pvc pipe
= Borings
Boring Elevations
B1 = 99.50 ft
B2 = 99.50 ft
B3 = 98.50 ft
B4 = 0.00 ft
coii~ Cq
/IOu- f
/1164(1'
fie q
77
-3 1, 50
E 337 _37 \ l o I ptG,~~32i 31
T
, t 1 L
\ \ \ Yn 0 1 / z 4
r vT 1 J l j
1 / S86'5020
E re 337.06' / }
N
958//
f
!340 f" l „ ` j
-77 a!
I %
cbF 404,
C) C4
o" cst.
C3 1
Now
,mow
# 1~ 373, O.H. W.M.
AL
I y i _ N
.
ALL
{
1\ V
1 1 . f `I I I j ~ ; !typical] /r I i L. B. 0. = 93 0' A,
0
52.0 l Drainage
' Easement
/
HWL--930. 0 ~Cj
f / Drainage
Easement-
f
IHIX=95 0"
ro7t7l i
0'
r +
Parcel 038-1237-01-000 04/03/2008 03:36 PM
PAGE 1 OF 1
Alt. Parcel 16.31.18.1252 038 - TOWN OF STAR PRAIRIE
Current X ST. CROIX COUNTY, WISCONSIN
Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type
08/19/2005 00 0
Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner
O - GRONQUIST, NELS A
NELS A GRONQUIST
416 8TH AVE NE
MINNEAPOLIS MN 55413
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description * 2196 108TH ST
SC 3962 NEW RICHMOND
SP 1700 WITC
Legal Description: Acres: 1.510 Plat: 10-072-MAPLEHAUGEN LOTS 1/10 038-05
SEC 16 T31 N R1 8W PT NE NE LOT 4 CSM Block/Condo Bldg: LOT 001
16/4342 NKA MAPLEHAUGEN ('05) LOT 1
(1.510AC) Tract(s): (Sec-Twn-Rng 401/4 1601/4)
16-31N-18W NE NE
Notes: Parcel History:
Date Doc # Vol/Page Type
01/19/2007 842879 QC
10/07/2005 808793 2905/059 2905
08/19/2005 803988 10/072 PLAT
2008 SUMMARY Bill M Fair Market Value: Assessed with:
0
Valuations: Last Changed: 06/27/2006
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 1.510 28,600 0 28,600 NO
Totals for 2008:
General Property 1.510 28,600 0 28,600
Woodland 0.000 0 0
Totals for 2007:
General Property 1.510 28,600 0 28,600
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
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Ryan Yarrington
From: Ryan Yarrington
Sent: Tuesday, July 03, 2012 10:10 AM
To: todd-marek@hotmail.com
Subject: Lot 1 Maple Haugen
Todd,
I just issued the Sanitary Permit (#552387) for Lot 1 in Maple Haugen. Keep in mind that this property falls within the
Shoreland Zoning District. Since you will be greater than 300 ft. but less than 1000 ft. from the Navigable Pond then you
only need a permit if you plan to fill and grade more than 10,000 square ft. This would be a Special Exception Permit
($1100) and takes approximately 3 months. Based on the driveway, house, and septic it appears that you can stay
beneath the 10,000 square foot limit.
Thanks
Ryan Yarrington
St. Croix County Zoning Technician
715-386-4680
1