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HomeMy WebLinkAbout008-2007-02-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 479486 0 ATTACH TO PERMIT) GENERAL INFORMATION ( state Plan ID No: 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 Parcel Tax No: Willett, Joseph Eau Galle, Town of 008- 2007 -02 -000 CST BM Elev: Insp. BM Elev: BM Descri tion: Section/Town /Range /Map No: 6 L �� 1?,vu 19.28.16.561 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic 12's � Benchmark 4 /Oq / Dosing Alt. BM �l Aeration ` Bldg. Sewer 30 /3, 3 . Z<T W Holding St/Ht Inlet' St/Ht Outlet TANK SETBACK INFORMATION �" ^ TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic. y 201 1 ,4 ) 1 Z(' tST o � Dt Bottom q. - 7 4- . Dosing N Head /Ma 3 Aeration Dist. Pipe Z J fog • p Holding Bot. System Final Grade PUMP /SIPHON INFORMATION p ?i. p . 3 Manufacturer GPM over `�- , Q1. / GPM — J Model Number it / J -e 3 , $ Q0' 9 TDH Lif � +� Fricti Los Syste eqd T Z ,Ft c�0 Forcemain Length Dia , Dist. to Well `i � hs tm SOIL ABSORPTION SYSTEM BEDITRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS SETBACK SYSTEM TO P/L BLDG WELL LAKE /STREAM EAC Manufacturer. INFORMATION �� CH ER OR Type ystem: /54/ >10d U Model Number. DIST N SYSTEM 040" / — Head /Mani f Distribution x Hole Size x Hole Spaci Vent to Air I ke- 14, - � „ / N Pipe(s) 7 Z [ 7 / Lf 2 'fo / ' 42'e Lengt Dia Length Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only Depth Over y Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center 97 Bed/Trench Edges Topsoil J Yes ( No Yes _I No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / I / 0 nspection #2: Location: 213 215th Street Woodville, WI 54028 (SW 1/4 SE 1/4 19 T28N R16W) Star View Acres Lot 2 Vlpa ' Pa I No: 19.28.16.561 1.) Alt BM Description CrAW( 3 / - I, K 2.) Bldg sewer length = C / !/ - amount of cover = t / L� o ►!7t �7Nr.�L a �1(M- G�,•F1J / ( I � r� T '� l -- — b 'r 1tlr"J � n �0 r Plan revision Required? - j Yes No /_0 Use other side for additional information. Date Insepctor's S ure Cart. No. SBD -6710 (R.3/97) ' safety and Buildings Divl C r t 201 W W a On Ave., P.O. Box itary P rt Number (to be filled in by CO r WI 53707 - adiso -7 M � C r r Sin (608) 26 51 •= C' ; T con sin Department of Commerce State � Plan L # 0� _ "[-l?�S •/ .�l Sanitary Permit Application s � In 32 / In accord with Comm 83.21, Wis. Adm. Code, personal information you P vide tiG if different than mailing address) may be used for secondary Purposes Privacy Law, s15.04(l)(m) G� l I. Application Information - Please Print All Information � pa 7- - 0 2 - rcel# Property Owner's Name a Qd 0 U -3 S `�lJ property Location l Property Owner's Mailmg Address �� Section / Zip CodePhone Number le one) City, State T N: R /-4- 1 r W S AA \ CSM Number Subdivision Name II. ype of Building (check all that app1Y) IuAs Family Dwelling - Number of Bedrooms ❑Vill -- ' of ❑ publiclCommercial - Describe Use ❑City Qom,, ❑ State Owned- Describe Use III. Type o ermit: (Check only one box on line A. Complete line B if applicable) ❑ Replacement System C3 Treatmenthioldmg Tank Replacement Only ❑ Other Modificntion to Existing System A. New System List Previous permit Number and Date issued ❑ Change of E01 Permit Tran sfer to New B. ❑ Permit Renewal ❑Permit Revision Owner i / rr Plumber � S G Before Expiration S � _ /.30 At Grade ❑ Single Pass Sand Filter C3 IV. T e of pOW TS S stem: Check atl that a 1 d < 24 in. of sui t a ble soil ❑ ❑ ❑ Non- Pressurized In Ground ❑Mound? 24 in. of suitable soil r Holding Tank [I Peat Filter ❑Ai Treatment Unit ❑Recirculating Sand Fr t erobc Constructed Wetland [3 pressurized In- Ground [3 g ❑ Gravel -less Pipe ❑Other (explain) Leaching Chamber ❑ Drip Line _ Recirculating Synthet proposed (sf) ic Media C) /0/j c7 � Area Dispersal Area Required (sf) D l V. Dis ersa r VTeatmen�t Area I ppb�'on Rate.(gpdsf) Design Flow (gpd) 6 0-0 Site Steel Fiber Plastic ` v l� Manufacturer Prefab Glass Total Number Concrete Constructed Vl. Tank Info Capacity in Gallons of Units Gallons New FmstinB Tanks Tanks septic or Holding Tank Z S Aerobic - rreatinent Unit Dosing Clamber , responsibility for installation of the poWTS shown on the attached ss Phone N� / VII. Responsibility Statement- I, the enders' assume MppRS Number r✓ � t� / (�� / / Pl l s Name (Print) PE a Signature 6 {J� e � S _ Plumber's Address (Street, City, State Z ) (� v /( ' ) o Stamps) ent Use O n Date Issued Issuing Agent Si VIII. Coun /JJe artm � Sanitary permit Fee Ogclua� GTOUndwater pproved Disap Surcharge Fee) A ❑ cL.��= _� (� Z ❑ Given Reason for Die fal .,..c fn.• I►:e�nrtrrLlla] IX Conditions Prov SYSTEM OWNER: 1 Septic tank, effluent filter and dispersal cell must all be serviced /llumberd as per management plan provided by p 2. All setback requirements ode /or es must bmaintained as per applicable poach wmPlete plans to the County only) for the system on paper not teas than 812 x 11 inches, m StZe SBD -6398 (R. 01/03) PLOT PLAN seoh Willett ADDRESS 520 Deerwood Ct. Hammond Wi 54015 4 SE 1 /4S 19 /T 28 N/R 16 W TOWN Eau Galle COUNTY ST. CROIX SYSTEM ELEVATION 101.8' 1.3' sand lift! BEDROOM 4 CONVENTIONAL AT -GRADE CONVENTIONAL LIFT HOLDING TANK MOUND X)OC SEPTIC TANK SIZE 1255 galllons LIFT TANK SIZE DOSE TANK SIZE 765 HOLDING TANK SIZE LOAD RATE 1.0 ABSORPTION AREA 600 # of chambers none IL BENCHMARK V.R.P. Top of 3/4" I e 4 P�P ASSUME ELEVATION 100 Filter Zabel A -100 ❑ BOREHOLE O WELL *H.R.P Same as Benchmark 253' 215th st. Scale = 1 /4" = 10' 699 Property Line to meet all Area 15' below is to setbacks d in Comm. remain undisturbed 83 .ir,�,,, 11 %Slope B.M.* B -1 N� Huffcutt Combo Tank 98 Pro 4 Grading is to be done to 100.5' Bedroom divert run -off away from 101' House system Please note: Tank is to be properly bedded Nctual lot <St and provided with lockdown 215t covers with approved warning labels 27 CO 1 Safety and Buildings 4003 N KINNEY COULEE RD commerce .Wl.gov LA CROSSE WI 54601 -1831 TDD #: (608) 264 -8777 i sco n s i n www.wisconsin.go isco n sin.go iscosin.gov Department of Commerce Jim Doyle, Governor Mary P. Burke, Secretary September 13, 2005 CUST ID No. 226900 WT I ATTN.� PO S P SHAUN R BIRD ZONING OFFICE BIRD PLUMBING, INC ST CROIX COUNTY SPIA 1008 192 ND AVE . 1101 CARMICHAEL RD NEW RICHMOND WI 54017 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 09/13/2007 Identification Numbers Transaction ID No. 1193202 SITE: Site ID No. 704357 Joseph Willett Please refer to both identification numbers, 215 Street above, in all correspondence with the agency. Town of Eau Galle St Croix County SWIA, SETA, S19, T28N, R16W Lot: 2, Subdivision: Star View Acres FOR: Description: Proposed Four Bedroom Mound System Object Type: POWTS Component Manual Regulated Object ID No.: 1039035 Maintenance required; 600 GPD Flow rate; 21 in Soil minimum depth to limiting factor from original grade System(s): Mound Component Manual - Version 2.0, SBD- 10691 -P (N.01 101), Pressure Distribution Component Manual - Version 2.0, SBD - 10706 -P (N.01 101); 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: • This system is to be constructed and located in accordance with the approved plans, and the "Mound Component Manual for Private Onsite Wastewater Systems Version 2.0" SBD- 1069 1 -P(N.0 1 /0 1). • The pressure network is to be constructed in accordance with publications SBD- 10706- P(NO1 /O1) "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems - Version 2.0" and/or the sizing methods of publication "SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST -SAS (01/81)" • 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. Stats. • The area within 15 feet horizontally below the system shall remain undisturbed. Vehicular traffic or soil compaction in this area is prohibited. • 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 Comm 84 product approval conditions. • Comm 83.22(7) - A copy of the a roved plans, specifications and this letter shall be on -si . S, construction and open to inspection by authorized representatives of the Department, which tJ inspectors. 01� l •/ Ap paq YE CE ME SHAUN R BIRD Page 2 9/13/2005 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. • Comm 83.52(1)(a) - 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. 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 to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 Gerard M. Swim POWTS Plan Reviewer - Integrated Services (608)- 789 -7892, Mon. - Fri. 7:30 am to 4:15 pm WiSM.4RT coder 7633! jswim@commerce.state.wi.us cc: Leroy G Jansky, Wastewater Specialist, (715) 726 -2544 RF S SFP O 6 ?oo Cove AF S Page �e�,Zo I NKS Shaun Bird Bird Plumbing Inc. 1008 192nd Ave New Richmond Wi 54017 715- 246 -4516 Date: 8/31/05 Owner:Joseph Willett Location:SW1 /4 SE1 /4 S19 T28 N,R16 W Lot 2 Star View Acres Eau Galle System type: Mound System 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 6. Pump Curve 7 -8. Maintance and Contigency plan 9 -11. Soil test Shaun Bird Signature License num 226900 k,l, A . .. p D IVISION S hU1�w•.. -- 0 � '!Y AN OF AF E SEE COR RESP DENCE ' PLOT PLAN PROJECT Joseph Willett ADDRESS 520 Deerwood Ct. Hammond Wi 54015 SW 1/4 SE 1/4S 19 /T 28 N/R 16 W TOWN Eau Galle COUNTY ST. CROIX SYSTEM ELEVATION 1 01.8' 1.3' sand lift! 4 BEDROOM CONVENTIONAL AT -GRADE CONVENTIONAL LIFT HOLDING TANK MOUND XXX SEPTIC TANK SIZE 1255 galllons LIFT TANK SIZE DOSE TANK SIZE 765 HOLDING TANK SIZE LOAD RATE 1.0 ABSORPTION AREA 600 # of chambers none IL BENCHMARK V.R.P. Top of 3/4 "pipe ASSUME ELEVATION 100' Filter Zabel A -100 ❑ BOREHOLE O WELL H. R. P. Same as Benchmark 253' 215th st. Scale = 1/4" = 10' 699' Property Line Well is to meet all Area 15' below is to setbacks found in Comm. remain undisturbed 83 AL Sl 11 % Slo -3 B. M. B -1 �r Huffcutt Combo Tank 98' Pro 4 Grading is to be done to 100.5' Bedroom divert run -off away from 101' House system B-2 Please note: Tank is to be properly bedded actual lot shape and provided with lockdown 215th St covers with approved warning 699' labels 279' 537' r Designer No > Date Non -Woven Filter Fabric k" Observation Pipe Perforated ,Distribution Pipe Below Filter Fabric ASn4 C -33 Sand -� - / n ` � � F G !o Topsoil �i - - a_ % Slope `flowed Bed Of ;j�- 2 %2 Force Main Drain Rock From Pump Layer ID /'3 CrCSS Section Of A NSound S stem Us F A Bed For The Absorption Area C A O Ft . h -- -- O g 1 I r— g Ft. 0 �O Ft. K Ft_. L �, �o Ft. W � r r Ft. 0 T L 4'Observotion Pipe -� K ;n 0 Force Mo 0. From Pump Distribution Bed Of /2 Drain RocK Pipt ; 1 4Observation Pipe = a)V-z Permanent M , Marker �-' pe or Rods Pion View Of Mound Uilnq A Bed For The Ab sorption Areo PAG E,_,__OF Peffera±ed Pip* 0e100 � _ End Vie++ J �- f� Pvc P:pe tigfet: Lat4 On $attOm. Are EgU60y SROeeo f� P t ¢ r � f pvC Fact tlf � t Ft"T 440LL IfLXY TO Cd1f1tC�'Of N/ 1 PVC Manifold P ;pe 01-e, Dislr�DUl�IItf \ Pipe t?;str P;pt l.apovt F +/ Ft. .�.. �- 00 J R R. X v2 Inches y -741 7 inches Hole Diameter 5 /3a2inch Signed: Lateral �_ Inch{ e$ ) License Humber Manifold ` 2 F Date: Force Main Inches of holes /pipe , 3 2 l o. Z, 3 Invert FlevAtion of Laterals t Ft. FTIC TANK � Pt3"!F C�;AMS£R CROSS SECTi ANs� SFELtr jCATIOnS SE itEATHERPROF APPROVED MIN- �,BQYE GRADE � jUMCTION BOX VENT PIPE I •• 6�IAiDO €lit C� NDUIT MAAiPAPL CKf, G % DOOR, WITH W/ PADI.DCK y D PROFS r} WARNING tAHE: IR INTAi4E f® L FRESH AI �f % � 4" HZfI - �RADE IB" i i INLET GAS- ' pPRQ1EEo —�-- TIGHT t joti�tTs PITH i:ATER TIGHT 5 S�,L # AL M APPROVED PIPE SM ` IC SOIL APPx)VEO C pIpE 3smio SEMI P UMP OFF ELEV - 3s2 PpRO� � BEi VENG 'JI -MER - EA NR CONCRETE PAD p, l� j 5 TZ tJI� L4.1 �TY� SPrG ;FICA � � - KgER DOSES ? DAY: E ING SEPTIC f FACTIRER: �c� Cat £ VOLUME: Ir�cur� R: l__�. ----, GAL - TA NK MADRJ GAL . I3U5 ° S'� L ; c"s = �`�� AL- SIZES: SEPTIC� ab DOSE 6 GAPACITI£S : A = ._.. -=2- 2 tj GAL - AI.A !'FAM7FAC1t3R 8 = MODEL3'ISER = / INCHES = 1a_..: s ' GAL. C ' SWITCH TYPE: A C�r R£R z n = INCHES - /____--- C. Pump z x LHx 16.23 WAC m0DEL AS P SWITCH Gom purip R FEET DISCPiI+RGE RATE . p� I ' ice- �,.,5. FEET R .QulftED puTiP fls F AND gIS - EgI - - _ - `7" ` FE£T VERTICAL DIFFERENCE ' PRESSURE - � FRICTIQi� FACTQR � FEET �; 3 FT /101D IT- � NE1'�QRK S{3PPI.7C DYN��C MEAi� M ;NII'N T FORCEISgN X —.-- -- TOTAL + �_ PEE J - DIAMETER LENGTH INTERNAL DIMENSIONS QF FUMP TP.BIK � I.IQj ZD �'�--�- -`�- -- DA F- - -� LICENSE SIGNED: R • TOTAL DYNAMIC HEAD /CAPACITY HEAD CAPACITY CURVE PER MINUTE EFFLUENT AND DEWATERING MODEL 152/153 fy- W w MODEL 152 153 50 Feet Meters Gal. Liters Gol. Liters 153 5 1.5 69 261 77 291 12 40 10 3.1 61 231 70 265 152 0 15 4.6 53 201 61 231 a _ 20 6.1 44 167 52 197 30 25 • 7.6 34 129 42 159 z $ 30 I 9-1 23 i 87 33 1; %5 0 20- 35 10.7 -- -- 22 5 0 40 12.2 -- -- 11 4 4 Lock Valve 38.0 Ft. (11.6m) 44.0 Ft. (13.4m) 10 _. 0145M 0 20 60 80 100 GALLONS LITERS 6 1/4 0 80 160 240 320 3 27/32-- 4 5/8 FLOW PER MINUTE CONSULT FACTORY FOR SPECIAL APPLICATIONS 3 27/32 r _I I • Timed dosing panels available. ® 3 27/32 • Electrical alternators, for duplex systems, are available and supplied with an alarm. • Variable level control switches are available for controlling single phase systems. • Double piggyback variable level float switches are available for variable level long and short cycle controls. • Sealed Qwik -Box available for .outdoor installations. See FM1420. • Over 130 °F. (54 °C.) special quotation required. I 1521153 Series' 12 1/8 r 1521153 MODELS Control Selection Model V S -Ph Mode 1 Simplex Duplex 5 r/g LL I N152 115 1 Non 8.5 1 2or3 BN152 115 1 Auto 8.5 Included 2 or 3 1 ,L sic20e4 E152 230 1 Non 4.3 1 2 or 3 BE152 230 1 Auto 4.3 Included 2 or 3 N153 115 1 Non 10.5 1 2 or 3 BNt53 tt5 t Auto 10.5 Included 2or3 SELECTION GUIDE E153 230 1 Non 5.3 1 2 o 1. Single piggyback variable level float switch or double piggyback variable level float BE1531 230 1 Auto 5.3 Included 2 or 3 switch. Refer to FM0477. o cau N 2. See FM0712 for correct model of Electrical Altemator E -Pak All installation of controls, protection devices and wiring should be done by : a qualified 3. Variable level control switch 10 -0225 used as a control activator, specify duplex (3) licensed electrician. All electrical and safety codes should be followed including the most or (4) float system. 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. MAIL To: P.O. BOX 16347 ` Louisville, KY 40256 -0347 Manufacturersof.. _ O SHIP T0: 3649 Cane Run Road ® Louisville, KY 40211.1961 Ql1QL/T/'/"UMPS �7iNCE �,9�,9 (502) 778 - 2731.1(800) 928 -PUMP hftpJ/w. wwzoeller com PU/1�1P !O. FAX (502) 774 -3624 © Copyright 2000 Zoeller Co. All rights reserved. PLAN Page of • ER'S MANUAL & MANAGENFir TtONS 90VVTS Q N SYSTEM SPE oZ S" at Q NA ' 1 Septic Tank Cap Wirer Lc. 0 HA NE seplic Tank Man ❑ NA ow r Effluent Miter to wOft cWrel" b� p NA Petmit#. �� NA Effluent Flter Model L! 76,5-- o NA )1:StU>K P� pump -Tank CSPadW r ,c /G O NA fl�ber of BedM011I Units pump Tank Manufa�re hl Numb' of Comm `f LTD allda � P� ❑ NA' % Man -Pump iJ Es' flo ( an d x 1 -5) �J aUda tiLa Pump M10,110 peagn flow ) / Pretreatnent Unit O Peat FilteC Son tiPP�asOC1 Raw Monthly average' p ndlG�� p We Inftue �� Quardy <1 mgn- p Mechanl= n p Other. Fatsr 00 S GrtBase (FOG) �g220 mg/L 0 Disinfection Demand (600s) 5'l 50 rn IL Manufacturer BiocNeT Stiss�� Bonds (TSS) average" Dispersal Cell(s avltY) CI in-ground (Pressurized) _ p NA Monthly p in- ground (9 and Pretrea{ied went QuaGtY gOOs? 530 mgn- 13 At -3mde p Other. B pnticel Oxygen Demand ( 53e mg/L p Dd one r , ,rassr OW tied Solids (TS .S) 51 (3< c fal ooml d tnfln- Feel Tota (geometric mean) vatuestYaic� for Y, inch diameter s� sgnfc efifuesst u. Maximum Efflu partide Site .. values tyP Tor ° Semite FreQuencY CE SCHEDULE arts) (Maximum 3 yrs -) `7 ❑ months clams NTENAf i ta v (4(Al of to service At qt feast once every one-third (�) Ser vVhen combined sludge and scum equals ear(s) ( M�tmum 3 yrs.) co ndition of tank(S) � p months inspect contents of taks) once every me n t least on fltis r(s) Pump Out Co A / p mon inspect disPefaa cell(s) At }east once every ! months s) p NA C3 mo p NA Clean effluent filter At least once every C3 MO ntfis s) inspect Pl PUMP controls & alarm At least once every Q m onths 0 y ear(s) O NA Flush lab an pure test At least once every p months g ye,.I ❑ NA other At least once every ova= or of the fallowing ricenses or SePtOV iK EUCTIONS ils Shglt be made by an individ ", t s��Dr POWTS "n 9 b n � ca" of Wks and dispersal � Plumber RestrRestricted Sever • on of the tan too idenflfy nY for any backIs . Master Piambeplumber. Ma com bine d sludge ands to check the effluent lei Oe r, r. Tank inspecdc must include me of u the volume �uatiy o f effluent on t as af! be riding me sh leaks. - t(s The Po � tea ce () h � �f any cracks of - D,e dispersal round surface auft►oritY or Pon rMg of ofiuent on the grounds any finding of effluent on the 9 notifxa5on of the local r�egulatarY and to check requi the immediate of the tank volum e. ft,e in the observation pi faiTir►9 condition and nag ls one (K) more rcfance, NR cti. ground sum may ind icate a m in any tank eq sect o in taco mcllation of sludge and sw rotor grid dlspo k shall be re moved by a SePtage Servicing ape When itte comb , n gdm � t coR►Ponents�, and anY entire contents e. one P e rfo rm ed a ed POWCS Maintainer 113, Wiisconsiirr,strat;ve Cod anical or pressuri PO zed 1ltS comp of Completion of any se "I event The seVidng of effluent filters. 9 at rl of 12 months or less shat[ 1 Q d ays oMermaint+enanC9 ormtan'rtarin9 to the local regulatory authoritY in t 1 d A Se1YlQe rel shall be provided � of P tiltg Products or other riesenca e P if high concentrations are of the POWYS check �eatrilent tank {s) cell(s). START UP AND OPTl� t0 use riot to use s a nd/or damage the disp� For t1eW iO a the treatment Proms a septage servicing oPeraW P Chef tat �Y imo of the WKS) removed by - deteCted have the contents e surface. 1-,conditions are frozen at me infiltra wh P is resfnred the excess Y Smd up salt not occur tanks ma y IM above normal hK3l�water le,rels. d result in the s ,rrray IQ s pump tail cen(s) in one large dose, overloading the oe s p an tank removed by a poring r to ttl disPe�l Malrmainer to Vras yy �} be disdla�g � t - }'o avow Phis situation have me cones p umber or pQVYTS discharge pow to the effluent pump t Or p OPI P� ldrE -` ta store normal Levels within the pump � . manual operating the pump Pa lk over, or otherwise disturb or compact. assistin � over tanks and d cells_ Do not drive or pa p not drive or park slope of any mound O r a, grade soil absorption area � � and Pt 9 the fife the area wwdn 15 fee tdown Pe Im ve the � lion of the #oilorwing (Torn the wastewater stream may Pro degt _ dental floss' draPelx Reduction or e[irrttrta rte buds; condoms; tton b Crit s, . of t hetbiudes, meat • dg,M grater, it A and vegetable Pe 9 • 9� � Vie. the POWTS: antibiotics: -baby �P� . { fbun fi diallt (SEImF PAP} •des; sanitary' napkins: tampons: ttvater drsinfecmnn�y CC;, 0airtting produaW. P� �' steps shall Ike taken to Insure that the ABANDONMENT is Peim � r �y.taken out of service the following Aris in Adriiinis a Code When the POWTS fails andfor Rance with ch- Comm 83 .33, tc and �h, abandoned in carne logs sealed_ m� is properly �, shall be disconnected and the abandoned Pipe o pen b a Septage Servicing Operator. Alt piping to tanks and Pits removed and property disposed The contents of an Lanky and P and the void space hall b Alter P�P}"g, alt tanks and p �nert solid e xc av ated �� and removed or tfieir covers rem filled with soli, gravel or another i CONTINGENCY PLAN paired t h e fallowing measures have been, or must be. taken, to Provide a code fail if the POWTS - s and cannot be re . compliant replacement system evaluated and may be utilized for the Location of a replacement ant should not t has been p A suitable P�oerrren ent area should be protected from disturba lot Imes arx! �veelt�s. Failure to option tern_ The nepiacem tics from existing and proposed structure, be infringed upon by reQuin:d seffia test the replacement will res ult in the need for �� thelru{es effect at that tim a suitabl pro an R cement systems must comply advances in POWTS replacement area p A suitable replacement area is not available due to setback and1lace th failed POWfS- Barrin technology a holding tank may be i'�Iled as 3 Iasi resort i° rep lace a a suitable replacement are area is available a a Upon failure of the POt1vTS a sod.and e site has not been a suitable replace evaluated to identify t site evaluation must be perfom�'d to locate replacement area- }f no teplac�eri m be Ins as a fast resort to rep tac� the farted PO1I S- remote of the biomat at oldng tank ay n systems may be reconstructed in place foif a nd at -grade so o►nring that time the tn il i�o�° ns of such systems must t�mplY with the cafes in effect fihrative surface, ReconstnicdO Tl11[ENT TANKS llitAY TM CONTAIN LETHAL G Cl"S ANDIOR INSUFIDEATH AAYGENL <<WARNING>> PUMP AND OTHER TRF.A CiRCUMSTANGES. DEATH MAY DO NOT ENTER A SEPTIC, PUMP ON OTHER = REgENT TANK UNDER SEPTIC, ANY RES[tLT_ ,RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENT'' POWI'S MAfAITAiNER POWTS INSTALLER Name Dame ill ✓' Phone J1��d� Phone 71 1" —J� ppERATOR PUMPER LOCAL REGULATORY AUTHORITY SEPTAGE SFf;ViCING Agency Name e? z- 2 D Phone �.J { 7>,f"„" Phone 7 1 �✓ 5c 6 J� 7 This d=WA mess }he staff's of the Gift Marqu and Waushara Cot my Zoning and Sarti C d rlgenr3es not This dooxnent was diafl+ad by n Lake, Iilt3rq fi tfse of this document dues the minimwn,eQ�irerclents of di Comm 83-_(6HiHdja{t1 _W 83__5q,). (2) &. (3), W�soonsia CtitW C11I1 guarantee the performance of the POWTS. I scansin Isconsin SOIL EVALUATION REPORT #1790 Department of Commerce in accordance with Co 85, Wis. Adm. Code Page 1 of 3 Division of Safety and Buildings Q Steel's Soil Service, Inc. County Attach complete site plan on paper not less than 8%2 x 11 inches in size. P n St. Croix include, but not limited to: vertical and horizontal reference point (BM), dire n d /� percent slope, scale or dimensions, north arrow, and location and distance to a ;d?O . Parce11.D. Please print a info I V pending E D Rev' D Personal information you provide may be used secondary purposes (Privacy Law, . 15.04 (1) G b� Property Owner 5 i Es t 4y, , i) 0 Property Location Willett, Joseph & Jennifer Go na SW1 /4, SE1 /4, S19, T28N, R16W Property Owners Mailing Address Lo Block # Subd. Name or CSM# ST. CROIX COUNTY 520 Deerwood Ct ZONING 1 2 na Star View Acres City State zip C one N lintier City ❑ Village ® Town Nearest Road Hammond I WI 1 54015 1 715 - 497 - 4307 Eau Galle I 215Th ST ® New Construction Use: ® Residential/ Number of bedrooms 4 Code derived design flow rate 600 GPD ❑ Replacement ❑ Public or commercial - Describe na Parent material Glacial till Flood plain elevation, if applicable na ft. General comments Mound Design, system elevation 101.75ft based on contour line elevation 100.50ft. C s ` Samna( and recommendations: ` F-11 Boring # Z Ground surface elev. 101.00 ft. Depth to limiting factor 24 in. ® P 9 Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Ef= 1 0 -10 10yr3 /2 none sil 2msbk mfr rs if .6 .8 2 10 -24 10yr4 /4 none sicl 2msbk mfr 9W lvf .4 .6 3 24 -60 10yr4/4 c2d 7.5yr5/6 sicl 2csbk mfr na na .4 .6 F ] Boring # ❑ Ground surface elev. 101.00 ft. Depth to limiting factor 29 in. Soil P 9 Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consisten Boundary Roots GPD/ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0 -9 10yr3 /2 none Sil 2msbk mfr a ivf .6 .8 2 9 -29 10yr4 /4 none sicl 2msbk mfr cs na .4 .6 3 29 -60 10yr4 /4 c2d 7.5yr5/6 sicl/scl 2msbk mfr na na .4 .6 * Effluent #1 = BOD 5 > 30 < 220 mg /L and TSS >30 < 150 mg /L * Effluent #2 = BOD s30 mg/L and TSS <_30 mg/L CST Name (Please Print) Signature: CST Number David J. Steel 248956 Address Steel's Soil Service, Inc. Date Evaluation Conducted Telephone Number 994 200th St. Baldwin, WI 54002 9/1/2005 715- 760-0347 Property owner Willett, Joseph & Jennifer Parcel ID # pending Page 2 of 3 Til Boring # ❑ Ground surface elev. 97.70 ft. Depth to limiting factor 21 in. ❑ Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDtfF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff# 'Eff#2 1 0 -11 10yr3/2 none A 2msbk mfr a 1Vf .6 .8 2 11 -21 10yr4 /4 none sici 2msbk mfr a ivf .4 .6 3 1-28 10yr4 /4 c1d 7.5yr5/6 scl 2csbk mfr cs na .4 .6 4 28 -50 10yr4 /4 c2d 7.5yr5/6 cl 2csbk =Mfr na na .4 .6 F—I Boring # ❑ Ground surface elev. ft. Depth to limiting factor in. El Ground Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft' in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 F—I Boring # El Ground surface elev. ft. Depth to limiting factor in. ❑ Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft= in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 *Eff#2 * Effluent #1 = BOD 30 < 220 mg/- and TSS >30 <150 mg /L ' Effluent #2 = BOD < 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 (8.07/001 Steeps Sol Service. Inc. f - • 3of3 STEEL'S SOIL SERVICE INC. David J. Steel Joseph & Jennifer Willett 994 200' St. V�,' CST - POWTSM SW1 /4,SE1/4,S19,T28N,R16W Baldwin, Wl 54002 Lic. #248956 Town of Eau Galle, St Croix Co. Direct 715- 760 -0347 Star View Acres Lot, 2 Fax 715- 684 -3449 Legend N 1 = 40' ♦ = Benchmark Ele. 100.00 ft Top of 3/4" pvc pipe • = Alt Benchmark Ele. 100.55 ft Top of 3/4" pvc pipe C1 = Borings Boring Elevations B1 = 101.00 ft B2 = 101.00 ft ) �,�� B3 = 97.70 ft B4 = 0.00 ft X IoP 0 �►� ��' s • °; ► W " •- m I w ww t T 1 �$ a n .. .. M J C7 sO � to N i N J IMP 1 Lit N SWI Wisconsin Department of Commerce ' Division of Safety and Buildings Page I of ° in accordance with Comm 85, Wis. Adm. Code Attach complete site plan on pass than 8 1/2 x 1 County, per not le include, but not limited to: vertical and horizontal referen �, o E G�-U Waa . D S� C � � 1 X percent slope, scale or dimensions, north arrow, and Iota on and dis an�cetoarest road. Parcel I.D. Please print all informat� n. 1 Reviewed by , Date Personal information you provide may be used for seconds APR 8 2 0 Q 2 ry pu oses (Pri 1 vacy Law, s. 15.04 (m)). Property Owner ST. CROI L. LIT _ btbylt)6catio S! ZONIN OFFICE 114 SE 1/4 S T �$ N R E E (or W Property Owner Address 's Mailing Add „ Lot # Block Subd. Name or C City State Zip Code Phone Number ❑city ❑Village ®Town Nearest Road R.lumL [` fp wl 5q0 ZZ ( 1151 uZ6 - 1 - 1 - 1 GPrLI� 1 ZO Tjf-p J �, EL New Construction Use: fQ Residential /Number of bedrooms 4_ E] Replacement ❑ Public or commercial - Describe: Code derived design flow rate GPD Parent material G L (A L —n* L Flood Plain elevation if applicable General comments and recommendations: ►�-� pU�� Iti.l ! g 'x 6 7 ' � lS �C1Z(. 3(,►`i7 O >v �� , r"1 i ti L" U) 1 ' C) rF ZMt ,b }—i LL . �' Clrv�tjUiZ eZjE�j . cL S Boring # ❑ Boring ® pit Ground surface elev. ft. Depth to limiting factor ty in, Horizon Depth Dominant Color Redox Description Texture Structure Consistence Bounds Roots Soil Application Rate in. Munsell �' GPD /ft Qu. Sz. Cont. Color Gr. Sz. Sh. t O _a �b`tbz 3 L _ 'Eff#1 'Eff#2 s)1 3 2 -q0 •S`1R y Clc R.SI`s s 1 c I e� �j YYl `FN - • Z . 3 Boring # ❑ Boring © Pit Ground surface elev. ft. Depth to limiting factor Z y in, Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots Soil Application Rate in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. I 'Eff #1 I 'Eff#2 1 o_g log �3tz - sit Z'�'sbk �`�• a,g _ , s si ( Z-F' V� 1 3 ti - lad rL316 s! CI 3`FS i - S`1Ry c��l �.SK2 see L�sbk rn _ _Z - - s P w l ST�2UC _ u u— l3 Z Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 mg/L • Effluent #2 = BOD < 30 m CST Name (Please Print) — s _ 9/L and TSS < 30 mg/L , �Signture CST Number Arthur L. Wegerer d. �� -Z$ -Z 2STNum Address W e g e r e r Soil Testing & Design S e r v 1 C e Date Evaluation Conducted Tele phone Number 421 1 1. Main St. River Falls, WI 54022 3 -6 -U2 715 -425 -0165 44 Property Owner �' V S \ L }'C �l G Parcel 1D # Page Z of 3 Boring # ❑Boring pit Ground surface elev. q �J • S' ft. Depth to limiting factor " In. r -Ef Applic ation Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. f #1 •Eff #2 S . � )OLrZ 316 S)1 Z sbk ha'Fh Cf v — • S - 3 - 7.Sc1rZ Vl6 Cla S`1Cz518 gic F -1 Boring # ❑ Boring ❑ pit Ground surface elev. ft. Depth to limiliny factor / In. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft= In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sir. Eff #1 •Eff #2 ❑ Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft= In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Eff#1 •Eff#2 Effluent #1 = 8OD > 30 < 220 mA and TSS >30 150 mg/L • Effluent #2 = BOD < 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 die department at 608 -266 -3151 or TTY 608 -264 -8777. sou- 8330(R.6/00) PLOT PLAN Page 3 of 3 Scale 1'= q0' �v i L3 deLL cci 3 3 r � a r m , �,�"� a0 U pT eOwlPt�tT r do X13 p` p q7 r is 'I # 1 L,Ur Z- N- 715- 425 -0165 220254 CST Signature Date Telephone No. CST No. Job NO. SEP -14 -2005 14:46 SHAW /STEWART LUMBER 6514884791 P.02i02 Uw /A%iva emu 14:10 me ST CROLX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CLR'TIFICATION FORM Owttet'/Buyer Mailing Address 5 2 b beee Property Address w� (Verification requirod from Planing Department for new coosttuctioa) Ci /State t t� VV Parcel Idcatification Number t ErAL D SCRin sr r '+ r/� J �P�Y Location J 1,, . _ , Sec. � T o�N -R �_ W, Town of Subdivision c 4r ut a S Certified Survey Map # — 1 1 0 ! _ Volume _��... • Page # _ Wgrntnty Deed # ' 14 Volume �_ page Spec house 0 Yes % no Lot lines identifiable D Yes O no T�1K MAINTENANCE imroper use and mamtenanceof your mptic system could reatdt in its Prmatffe failure to bamdh wastes. Proper maiateaance p eaasists of pumping out the septic talc every &roe yeas or sooner. if needed by a licensed Pumper. V� 3at YOU Pre into can affect the &notion of the septic tank as a treatment stage in the waste disposal system' jU property owner agrees to submit to SL Croix Zoning DePuumt a =Uflesa n fornk "ad by the owEw and by a masterplwnbar. j ourneyman plumber, nst&tcdplumber or a Ucenwdpuwjw vaifYrag dbat (1) dw on-at : wastewater disposal ysum is in prop*r operating condition sndlat (2) after inspection and pumping (if accessary), the septic MA is I= than 18 full of sludge. Lfwe, 1h Undersigned bavc read th above rogaite=ts and agree 10 maintain the private sewage die al system with the standards eat of Natural Resources, Start of Wisconsin. Certification set fonts. herein, as set by the Depattment of Commerce and the Depa�a tasting that your septic system bas been maintained must be completed sad resumed m the St. Croix Coq my Zoning Office witbin 30 days gtf the throe year expiration �--, A DAIM ffl Mw;7 AP I.1C;ANi' OVA= CERTMQUION I (we) certify that all statements on ties form are true to tbo best of MY (our) knowledge. I ! we) am (are) the owner(s) of the p described above, �irtve of a warranty deed recorded in Resister of Aeeds Office. NA OP APPLICANT DATL Any information that is ads- represcatod may result in the s&nituy permit being revoked by th -,Zoning Doputmmt- ' +••• 9• K actvde with this application: a stamped waasaty decd firm the Register of Deeds office a oo" of eta certified survey snap if refcrw= is mad* in the war. aaty decd TOTAL P.02 09/14/05 WED 13:39 FAX Q002 f _ r • �•r Ly i s 1 f ..�,. -- - ..... - IINt ►:' 11 c. I�III 111 � -n . _ CD 'lot cn LU M1 � p aaTm I M O .. cn i N p x Ul i - LAJ M Q6 I c n - { y i , r • s - - • , , £ 1 F i , 3 - . C].: 5 LLI ?i s. , , j w, - - r= F' - D �x. Y, f , .. g J _ r 1. .- - Z - ,��; 0•.,.}. a L r bug wo K sr LL , 7 7 1 f+ 1 4 j U. Z 6 3 6 P 3 5 1 KATHLEEN H. WALSH REGISTER OF DEEDS ST. CROIX CO., MI RECEIVED FOR RECORD STATE BAR OF WISCONSIN FORM 2- 2000 88/11/2004 82:25PI1 Document Number WARRANTY DEED WARRANTY DEED EXEWT # HIS DEED, made between F &K Trucking and Excavating, Inc., Grantor, and Joseph TRANS Willett and Jennifer E. Willet husband and wife, as FEE: 13.08 Survivorship Marital Property, Grantee. TRA FEE: 131.78 COPY FEE: cantor, for a valuable consideration, conveys and warrants to Grantee CC FEE: the llowing described real estate in St. Croix County, State of Wisconsin: PAGES: 2 SEE ATTACHED EXHIBIT A Recording Area Name and Return Address: Edina Realty Title, Inc. 400 S. 2 St. — Suite 115 Exceptions to warranties: Hudson, WI 54016 Easements, restrictions and rights -of -way of record, if any. 441486 /1D SO -ODo Oaf — 7 -ao- oacb Parcel Identification Number (PIN) This is not homestead property. Dated this 9th day of August, 2004. F&1<1 Trucking and Excavating, Inc. _ BX . 00 B * Chris Kusilek, President, F & K Trucking and Excavating, * Dianna Kusilek, Vice President, F & K Trucking and Inc. Excavating, Inc. * * AUTHENTICATION ACKNOWLEDGMENT Signs re(s) STATE OF WISCONSIN ) COUNTY.dF ST. C2o t V ) ss.� authenticated this 9th day of August, 2004 Personally came before me this = day of A , s o o 4 the above named Chris * Kusil k, President of F & K Trucking and Excavating, Inc. and Dianna Kusilek, Vice President of F & K Trucking and TITL : MEMBER STATE BAR OF WISCONSIN Excavating, Inc. to me known to be the person(s) who executed ( f not, 4thef g oing instrument and acknowledged the same. a thorized by § 706.06, Wis. Stats.) I _ THIS INSTRUMENT WAS DRAFTED BY C.t W t Peterson, Fram & Bergman — Steven H. Bruns Notary Public, State of Wisconsin 50 East Fifth Street, St. Paul, MN 55101 My commission is permanent. (If not, state expiration date: (Signal ires may be authenticated or acknowledged. Both are not necessary.) �a ) *Names of persons signing in any capacity must be typed or printed below their signature Pamela A. Willman Notary Public State of Wisconsi WARRANTY DEED STATE BAR OF WISCONSIN RM No .2 -2000 U 2636P 352 EXHIBIT A Lot 2, Plat of Star View Acres, Town of Eau Galle, St. Croix County, Wisconsin. File No.: 441486 Q o �¢ Z w�P Z isl 11 � z �00"= -' wC7�aowzW¢�O�= 0 0 QcJnaO0 0 1 _ Y o U 0 m� cr U m W 2 g W o Z� z W - CL ? 0W pw� z l a li LL Z)0 OWpu'w Za�C=_'3a�p IA acnmXLLW n aOz0 z�z axaf- Ail a�laGu� too) � ,vE'eoz w c°� io N Eb'E8Z W9.6 Lo LOS �I M w Iz co A M QT O�Q� O 1p j d �a N¢ ci • . • Q T 0 06 1'E C6 co r \ v (3.8M5 LON) \ AIZ 3w &SP.B &o &ON co rl • 90'bEE I \ 1 \ Q� .• O <� W A \� I N r Q3 LC v M Ld