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HomeMy WebLinkAbout026-1108-95-000 County: St. Croix Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Sanitary Permit No: Safety and Building Division INSPECTION REPORT 556322 0 (ATTACH TO PERMIT) State Plan ID No: GENERAL INFORMATION Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Parcel Tax No: Permit Holder's Name: city Village X Township Wells Fargo Bank NA , 026-1108-95-000 foreclosure Richmond, Town of Section/Town/Range/Map No: CST BM Elev: Insp. BM Elev: BM Descripti n: 04.30.18.608 ELEVATION DATA TANK INFORMATION CAPACITY STATION BS HI FS ELEV. TYPE MANUFACTURER t Benchmark Septic ~~'S~': n ~ ©t~r.• u Al BM Z to ' S ® co ~Bldg. Se r .d" Aeration St/Ht Inlet Holding SUHt Outlet TANK SETBACK INFORMATION >Q .15 9d. TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet 1 I Dt Bottom t3.1 - T Z Septic 449 / ~ Dosing Header/Man. 7.0 `74 17 3 i] yr,gJ 1 d , ~ '33 ist. Pipe -7,0 d Aeration 3 I 9 Bot. System IS. 0 731 Holding S Final Grade PUMP/SIPHON INFORMATION and St Covp~ Manufacturer Demand Dem GPM Model Number ~V QW 53 3 d H' C~ Ft TDH Lit Friction Lo~S. System HeY TD Forcemain Length / Dia. i t Dist. to Well 6 r SOIL ABSORPTION SYSTEM PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth BED/ TRENCH Width Length No. Of Trenches DIMENSIONS 13 Z n~ch 1 t e,,, ` LAKE/STREAM LEACHING Manufacturer: CHAMBER OR ,1 ;ZA, II SETBACK SYSTEM TO P/L BLDG WELL _ INFORMATION Typ Of System: UNIT Model Number. r DISTRIBUTION SYSTEM Hole Spacing Ve to Air Intake HeaderlManifolc~ ~ I Distribution x Hole Size x 1 \ G~,. . Pipe(s) Spacing Length ~ Dia 1 Length SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Mul Depth Over xx Depth of xx Seeded/Sodded Depth Over Yes No 0`~ Bed/Trench Center r Bedffrench Edges Topsoil Yes No Inspection Inspection COMMENTS: (Include code discrepencies, persons present, etc.) Location: 1189 CARROL T New Richmond, WI 54017 (NE 1/4 SE 1/4 4 T30N R1 8W) Viebrocks River Valley Additio Parcel No: 04.30.18.608 1.) Alt BM Description = ✓I I I - 2.) Bldg sewer length V 6.~.~ - amount of cover Plan revision Required? ❑ Yes + No 19 Fi Z I Use other side for additional information. Insepct s Sign Cert. No. SBD-6710 (R.3197) Date commerce.wl.ftCO MD Safety and Buildipgs Division County 201 W. Washington Ash.t, P.O. 7 62 f , Madison, W1 5 )7-7 S+,nita+ry rte , /NG~r (i~ -n.7riu~n by co-.> ~scons'i~ 0~ Z Z _ Department of 2 8 2,917 State Transaction bet Sani~~ 'gj##,ppfication 4 In accordance with s. Comm. 83.21( Is m. Code, submission of this form to the appropriate goverr ' u _ unit is required prior to obtaining a sanitary permit. Note: Application forms for state-owned POWTS're roject Address (if different than mailing address) submitted to the Department of Commert,e. Personal information you provide may be used for secondary u ses in accordance with the Privacy Lahr s. 15.04(1)(m), Sta is. ~ 1. Application Information - Please Print All Information - cc, Parcel - Owner-'Oar e Property Owner's Mailing Address Property location ~i Z ~ (goo Z Govt. Lot city, state Zip Code Phone Number 'A, Section ' cle or 3-D N; It rW II. yPe of Building (check a 1 that appl Lot Subdivision Name or 2 Fancily Dwelling - Number of Beds oo Block i - ❑ City or,__-.____ ❑ Public/Commercial - Describe Use lace CSM Number l~ Village of Stale Owned -Describe Use - - 'Coven of Z 0;6U l (o ,f- G f III. Type of Permit: (Check my one box on line A. Complete line B if applicable) A. D New System mant System ❑ Treatment/Holding Tank Replacement Only D Other Modification to Existing System (explain) List Previous Penuit Number and Date Issued B. D Permit Renewal D Permit Revision D Change of Plumber Ll Permit Transfer to New Before Expiration Owner _ . IV. a of POWTS S stern/Com onent/Device (Check all that apply) _ Non-Pressurized h -Ground ❑ Pressu) ized In-Ground D At-Grade D Mound > 24 in. of suitable soil D Mound < 24 in. of suitable soil D D 1-loading'rank El Other Dispersal Component Pretreatment Device V. Dis ersZsl~n t Area Information: Dispersal Area Pr sed (s System lev ton Vl. sign Flow Soil .ion te(gpdsp Dispersal Area Required De ~T7o/tat # of f M ufact rer „ ~ - aacity in c _2 Tank Gallons Gallons Units Exisliug Talil:s Septic or HolD osing Chamb L~ _ - VII. Responsibility Statement- 1, the undersigned, ass responsibility for installation of the POWTs sPow o the attached plans. Pl Business Phone umber - / RS u s Name (Print} Plumb ignature --~n~ - Gam) Plumber's Address (Street, City, State, Zip,C o / J Z_ /Z VIII. ount /Department.use Only Permit Fee Date I -ued Issuing a Signature Approved DisaPP $ pa $ ZS~ D even Reason enial r IX. Condits[yA~OrMNi1W Reasons for Disapproval a, n L 1. peptic tank, effluent fifer and ~J ) (d 1~7 j dispersal cell must all . services l maintained 6,6 as per, management plan provided by plumber. 2 M saowk requ'Uements must. be maintained - as per appllo" code / ordinances: Attach to complete plans for the system and submit to the County only on paper not less than 8 in : 11 inches in size SBD-6398 (R. 02/09) PLOT PLAN PROJECT Shaun Bird ADDRESS 1432 120th St. New Richmond Wi 54017 SE 1/4 SE 1/4S 4 /T 30 N/R 18 W TOWN Richmond COUNTY ST. CROIX 8/27/12 BEDROOM 3 MPRS Shaun Bird 226900 DATE CONVENTIONAL IN-GROUND PRESSURE CONVENTIONAL LIFT XXX HOLDING TANK SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE630 DOSE TANK SIZE MOUND HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 651 # of chambers 32 BENCHMARK V.R.P. Bottom of garage siding ASSUME ELEVATION 100' Filter BE ~i ilter ❑ BOREHOLE SWELL * H . R. P . Same as Benchmark All piping shall be SDR 30/34, within 10' SYSTEM ELEVATION 92.6/92.5 4.5'below qrade of tank, piping shall be Schedule 40. Property Line Well 15' Property Line/road 4 >5 25' B-1 60' 20' 0% Slope Existing 3 Bedroom House 25' B.M.* Scale is 1" = 40' 1111 40' unless otherwise ;F- 30' Vents noted Il, T B-3 50' 5' 2-3' X 66'cells with >3' spacing 0' Pump Tank B-2 174th Ave 20' Carrol St. Quick4 Standard jnt Leaching Chamber with 20.0 ft2 of Area 10.Zft^2/pair of end caps 7~~ 34" Grade at System Elevation Cover Page Shaun Bird Bird Plumbing Inc. 1008 192nd Ave New Richmond Wi 54017 715-246-4516 Date: 2 Owner: Shaun Bird Location: SE1/4 SE1/4 S4 T30 N,R18W 1189 Carrol St. Richmond System type: In-ground absorbtion system(conventional) Manuals Used: In-ground absorbtion system (version 2.0) Pressure Distribution Manual (version 2.0) Page# 1. Cover Page 2. Plot Plan 3. Chamber Cross Section 4-6. Maintanance and Contingency Plan 7. Filter Specifications Sheet 8. Dose Tank Cross Section 9. Pump Curve 10.-12. Soil Test 13. Utilization of exi septic ank form. Signature License nu r #226900 PLOT PLAN 1432 120th St. New Richmond Wi 54017 PROJECT Shaun Bird ADDRESS SE 1/4 SE 1/4S 4 /T 30 N/R 18 W TOWN Richmond COUNTY ST. CROIX MPRS Shaun Bird 226900 DATE 8/27/12 BEDROOM 3 CONVENTIONAL IN-GROUND PRESSURE CONVENTIONAL LIFT XXX HOLDING TANK 1000 gallons LIFT TANK SIZE630 DOSE TANK SIZE MOUND SEPTIC TANK SIZE HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 651 # of chambers 32 BENCHMARK V.R.P. Bottom of garage siding ASSUME ELEVATION 100' Filter BE filter 10, ❑ BOREHOLE O WELL *H.R.P. Same as Benchmark All piping shall be SDR 30/34, within 10' SYSTEM ELEVATION 92.6/92.5 4.5'below grade of tank, piping shall be Schedule 40. Property Line Well ;15' Property Line/road 4 > 251 60' 20' -AL 0% Slope Existing 3 Bedroom House 25' B.M.* Scale is 1" = 40' 40' unless otherwise 1 30' Vents noted 0.0 1 T B-3 50' Pump Tank 2-3' X 66'cells with >3' spacing 10' B-2 174th Ave 20' Carrol St. Vent >6„ Quick4 Standard of Cover Leaching Chamber with 20.0 ft2 of Area 10.2ft^2/pair of end caps 4' Long 12" Grade at System Elevation 34" Cross Section of Infiltrator Quick 4 Leaching Chamber Typical cross section for 2 of 2 cells Quick 4 Standard Leaching Chamber with 20.0 ft2 of Area per Chamber To be >1' above grade 10.2ft 2 pair of end plates Finish grade elevation Typical Installation 97.0' Vent Grade Vent 11K4 3' Septic Tank 5 5' LonGrade at System Elevation 3 6Grade at System Elevation Spacing 5' 2-3' X 66' Cells Same on other end Observation tubeNent At end of cell A B 16 chambers per cell System elevations: A__92.6 B 92.5' ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND ~CERTIFICATION FORM Owner/Buyer a t-c 13) , -S21 Mailing Address 2- a 1 Property Address --fill- (~tf f y (Verification required from Planning & Zoning Department for new construction.) City/State Parcel Identification Number LEGAL DESCRIPTION Property Location, '/a Sec. ON R dW, Town of _ Subdivision Lot # Certified Survey Map # Volume , Page # _ ty e # I/V ~p Volume Page # Spec house es no Lot lines identifiable yes 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 if ensed 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 tc the St. Croix County Planning & Zoning Department within 30 days of the three year expiration date. I/we certify that all statements on th' form are true to the best of my/our knowledge. Uwe am/are the owner(s) of the property described above, by v' a anty deed recorded in Register of Deeds Office. Number of beds ATURE OF~/ / APPLICANT(S) DATE ***Any information that is misrepresented may result in the sanitarypermit being revoked by the PI knning & 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) POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page of FILE INFORMATION SYSTEM SPECIFICATIONS Owner~ iJ/ti Septic Tank Capacity gal El NA Permit # Septic Tank Manufactut er U /'a ❑ NA DESIGN PARAMETERS _ Effluent Filter Manufacturer <7 7 ❑ NA Number of Bedrooms ❑ NA Effluent Filter Model - _ 3 - / 417 ❑ NA Number of Public Facility Units A Pump Tank Capacity G ❑ NA s c7 al Estimated flow (average) al/da Pump Tank Manufacturer C ❑ NA Design flow (peak), (Estimated.: 1.5) 1~11 IVO gal/day Pump Manufacturer ❑ NA Soil Application Rate al/da /ft2 Pump Model ❑ NA Standard Influent/Effluent Qualit,/ Monthly average" Pretreatment Unit NA Fats, OH & Grease (FOG) 530 mg/L ❑ Sand/Gravel Filter ❑ Peat Filter Biochemical Oxygen Demar,d (BODs) x220 mg/L A ❑ Mechanical Aeration ❑ Wetland Total Suspended Solids (TSS) 5150 mg/L ~~~111 ❑ Disinfection ❑ Other: Pretreated Effluent Quality Monthly average Dispersal Cell(s) ❑ NA Biochemical Oxygen Demand (BODs) 530 mg/L -Ground (gravity) ❑ In-Ground (pressurized) Total Suspended Solids (TSS) <_30 mg/L ;~A ❑ At-Grade ❑ Mound Fecal Coliform (geometric mean) s104 cfu/100 ❑ Drip-Line ❑ Other: Maximum Effluent Particle Size X in dia. ❑ NA Other, Other: T ❑ NA R Other. _ _ ❑ NA *Values typical for domestic wastewater and septic tank effluent. Other: - ❑ NA MAINTENANCE SCHEDULE _ Service Event Service Frequency Inspect condition of tank(s) At least once every' ❑ onth(s) ar s (Maximum 3 years) 11 NR Pump out contents of tank(s) _ When combined sludge and scum equals one-third (X) of tank volume ❑ NA Inspect dispersal cell(s) At least once every: months) pear(s' (Maximum 3 years) ❑ NA Clean effluent filter At least once every: ❑ onthrs) - ❑ NA year(s; Inspect pump, pump controls & alarm At least once every: ❑ earlsls) ❑ NA Flush laterals and pressure test At least once every: ❑ monthly) - fN ❑ At least once every; p year(sj s) Other: MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications: Master Plumber; Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer; Septage Servii.:ing Operator. Tank inspections must include a visual inspection of the tank(s) to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of combined sludge and scum and to check for any back up or ponding of effluent on the ground surface. The dispersal cell(s) shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a failing condition and requires the immediate notification of the local regulatory authority. When the combined accumulation of sludge and scum in any tank equals one-third or more of the tank volume, the entire contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113, Wisconsin Administrative Code. All other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment units, and any servicing at intervals of 512 months, shall be performed by a certified POWTS Maintainer. A service report shall be provided to the local regulatory authority within 10 days of completion of an.v service event. Page _ of START UP AND OPERATION For new construction, prior to use of the POWTS' check treatment tank(s) for the presence of painting products or other chemicals that may impede the treatment procass and/or damage the dispersal cell(s). If high concentrations are detected have the contents of the tank(s) removed by a septage servicing operator prior to use. System start up shall not occur vivhen soil conditions are frozen at the infiltrative surface. During power outages pump to iks may fill above normal highwater levels. When power is restored the excess wastewater will be discharged to the dispersal cell(s) in one large dose, overloading the cell(s) and may result in the backup or surface discharge of effluent. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to restore normal levels within the pump tank. Do not drive or park vehicles ovor tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area within 15 feet down slope of any mouno or at-grade soil absorption area. Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the POWTS: antibiotics; baby wipes; cigarette; butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat; foundation drain (sump pump) water; fruit and ifegetable peelings; gasoline; grease; herbicides; meat scrap:; medications; oil; painting products; pesticides; sanitary napkins; tampons; and water softener brine. ABANDONMENT When the POWTS fails and/or is permanently taken out of service the following steps shall be taken to insure that the system is properly and safety abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code: • All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. • The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator. • After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil, gravel or another inert solid material. CONTINGENCY PLAN If the POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide a code compliant replacement system: ❑ A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system. The replacement area should be protected from disturbance and compaction and shortid not be infringed upon by required setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result in the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rules in effect at that time. A suitable replacement area is not available due to setback and/or soil limitations. Barring advances in POWTS technology a Iding tank may be installed as a last resort to replace the failed POWTS. ❑ The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluation must be performed to locate a suitable replacement area. If no replacement area is available a holding tank may be installed as a last resort to replace the failed POWTS. ❑ Mound and at-grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time. <<WARNING>> SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND/OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLER POWTS MAINTAINER Name Name Phone J , J 7~ --GJJ / I IF Phone I SEPTAGE SERVICING OPERATOR P PER LOCAL REGULATORY AU'T'HORITY Name Name ' - Phone ~J J(r Phone This document was drafted in compliance with chapter SPS 383.22(2)(b)(1)(d)&(f) and 383.54(1), (2) & (3), Wisconsin Administrative Code. t -.y.. A. F i tl (I _ ~I 1 It It ~I l((,'~~l r1 , ~ I I ~ j I t ~t II ~t I i .75 t t ~i I I L ! I'I II ~ ~ I { ti I I I I , } I I I! FLCI~ ~ ~ I I I Il I ~ i l l ~ Q i l A ~ t` 6 06596 HOt•`MN BAY NORTH RO BOYNE LITY, MI 4T12 4 1-888--999-290 VAX 1~~~~(w`'B~-~ w PPP4. ( 58854.:? SIM/TDI 4 { L~ _iT ..ER r I1 .j _^-r--- STF-110 HOWERY 90Iz0 MV8 o3 jwncj Q38a33388 89BLVLOSTL Lp:0Z T106/90/L0 Dose Tank Cross Section And Pump Performance Specifications Tank Manufacturer Minimum Pump Performance N:.equired Tank Model Number 606 GPM @ Ft TDH Total Tank Capacity Max. Bury Depth - Total Dynamic Head (TDH) Feet Pump Manufacturer 2 Elevation Head Pump Model Numbe S 3 Distal Pressure Alarm Manufacturer Network Pressure Loss 1- Alarm Model Numbcr L--`~ Force Main Pressure Loss Switch Type 1n e Total Manhole Min. 4" Above Grade With Locking Device Vent Min. 12" 4bove Grade Weather-proof With Cap Junction Box mums 0. " Finished Grade Depth of Cover Ft Disconnect Means outlet Switch Settings and Reserve Capacity i 4eett In 41 Tank: Volume= / GPI Dimension Inches Volume Gal. i A { >{a (reserve;b A a , s 3 7. 3- '/a" } K' (alarm) B 2 3 $ i < Weep 'i i~•{ Hole (dose) C C. s 97, r c (dead) D 2 Off Ele G C F c Ft rt K a Total ~ 6 ~ v -----1► aial ~Ft D ' Bottom of Tank Elev. i r a a a a r a r r r r r a>> r> a> a: r a r a r>> a s> a a r r r r a a t a r a t> , i t i i t i i •i t{{ t t{ S{ i i{ S{ i f K t i i c i i S K i i C i i i S S i{ i S i{; S S C;{ S; i{ S i S i i{ S S>ii GENERAL INSTALLATION: The dose tank is bedded and back filled in accordance with the manufacturer's produr,t approval specifications. Maximum depth of bury as specified by the manufacturer may not be exceeded without prior approval. Manhole covers exposed to grade have an effective locking device (padlock) installed. Piping at the inlet and outlet is of approved material, connected to the tank with watertight fittings, and laid on stable soil to prevent settling; or sagging. The force main is sleeved with 4" Sch. 40 PVC to bridge the excavation and is sealed watertight. Electrical ,.service complies with NEC 300 and Comm 16.28 Wis. Adm. Code. 03/05lgj Page of v~ L-J TOTAL DYNAMIC N :..ALI/,;.APACI IY w HEAD CITY CURVE PER MODELS~53/ 5/57/59 ~411!) EFFLUENT AND ~EW FWAiE:RiNG 25 Model 53~55/`>7/59 6 20 - - - - I - - - - - - 2 Ft Meters of - t, U 15 _ 5 43 63 - - - z 4 I C .a.1 SG- 29 ,5 4.6 c 7i o ;hut off Hecd_ 19.25 ft. (59m) 2 i. 5 - - - - - - S 1,-)/16~ 6 5/32-- o -1----- /2 --11 MFT 0 U.S. GALLONS 1 10 - 30 40 50 LITERS I r 16 f p 80 100 Z~/ % 1;`i/1F FLOW Pf R MINUTE ooesei - 4 Variable level float switches available. -r r - - Variable level long cycle systems available. Available with special cord lengths of 15', 25', 35' and 50'.-~ Alarm systems available. iCy-~ -1 i Duplex systems available. - - r - 3 3,/32 SK858 f. Sin Single Seal Control Selection Listings 9 Co Model Volts Phase Mode ` Ampa Simplex Duplex CSA UL 1. Integral float operated mechanical switch, no external control required. M53/55 & M57/59 115 1 Auto 9.7 1 Y Y 2, Single piggyback~variable level float switch or double piggyback variable level N53/55 & N57/59 115 - 1 Non 9.7 3 or 4 & 5 Y Y - f. BN53 115 1~ Auto 9.7 Y Y float switch, Refer to FM0477. -9.9.7 - 3. Mechanical alternator "M-Pak" 10-0072 or 10-0075. - I 1- Auto - I " BN57 115 -4- BE53/57 230 ! 1 Auto 4-6 Y y 4. See FM0712 for correct model of Electrical Alternator. D53/55 & D57/59 230 1 Auto 4.8 ^ 1 _ Y Y 5. Variable level control switch 10.0225 used as a control activator, with Electrical y E53155 & E57159 230 1 Non -4--8- 4.8 ~2 3 or _4 & 5 Y Y Alternator (3) or (4) float system. Single piggyback switch included. O CAUTION For information on additional Zoellerproducts refer to catalog on lggyback Variable Level Float Switches, FM0477; , Electrical Alternator, FM0486; Mechanical Alternator, FM0495; `iumpiSewage Basins, FM0487; and Single Phase Simplex Pump Control/Alarm Systems, FM0732. L i For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump. MAIL TO: P.O. BOX 1&147 Louisville, KY 402500, r SNIP TO. 3649 Cane Run Road Manufacturers of . . Louisville, KY 40211-1961 :aO,L,TTY PLW„s F1#LT j9,79 (502) 778-2731.1 (800) 928-PUMP http://Www.zoeller.com FAX (502) 774.3624 © Copyright 2002 Zoeller Co. All rights reserved. 2 8 2012 _ Wisconsin Department of Com " SOIL EVALUATION REP'OR.T' Page of Division of Safety and Buildings ICE . rNtithG`& r(D~ilrr~ce with Comm 85, wis. Adm. Code County Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must rol include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Please print all information. Re 'wed by Date Personal information you provide may be used for seco ry purposes (Privacy Law, s. 15.04 (1) (m)). a Z C~ P er Property Location Govt. Lot 1/4 A S T30 N R/ E( ) w Prope wner's Mailing Address Lot Block # Subd. Name or CSM# t 7:3 2- &'eLpc1ks- ktz;~ City tate Zip Code Phone Number City ❑ Vllage Ne rest Road " 7 ( > C?- r0 - ❑ ew Construction us idential / Number of bedrooms Code derived design flow rate ~Jy GPD e lacement ❑ Public mmerclal -Describe: Parent material -7Z,0'-- /C2 Flood Plain elevation if applicable jam,, ft. General comments S / "~L and recomrnendatiions: l ' Gt J System Type L 47 r)/ 0 System Elevation 9-7° Boring /Boring # '0~pit Ground surface elevt-7 Z ft. Depth to limiting factor &2-in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 -Eff#2 yz• ~ r 17 Boring # Boring Pit Ground surface ele . jO ft. Depth to limiting factor ~ in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 'Eff#2 ell ONP O ~S h? " 1 /4 Effluent #1 = BOD > 30 < 220 mg/L and TSS 30 < 150 mg/L ' Effluent #2 = BOD < 30 mg/- and TSS < 30 mg/L CST Name (Please Print) Signa CST Number Bird Plumbing, Inc. Shaun Bird 226900 Address Date Evaluation Conducted Telephone Number 1008 192nd Ave, New Richmond, WI 54017 9 -07 715-246-4516 Property Owner_ Parcel ID # Page of FT Boring # ❑ Boring ~L-- `A-Pit Ground surface elev.2,Z ~2 ft. Depth to limiting factor in. p*Eff#l Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots /ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#2 r ,E -Ail a B oring # ❑ 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 GPD/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 ❑ Boring Boring # Ground surface elev. ft. Depth to limiting factor in. F-1 ❑ Pit Soil Application Rate Horizon ')epth Dominant Color Redox Description. Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 Effluent #1 = BODS > 30 < 220 mg/L and TSS >30 < 150 mg/_ ' Effluent #2 = BODS < 30 mg/_ 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 (R.W00) Property Owner Parcel ID # Page of ❑ng # 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/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 D-a o , ~ /Z- 2- t4 vilm -7 i F-1 Boring # ❑ 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 GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 F-1 Boring # 13 E] Boring Pit Ground surface elev. ft. Depth to limiting factor in. " Soil Application Rate Horizon Iepth Dominant Color Redox Description. Texture Structure Consistence Boundary Roots GPDM in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 Effluent #1 = BOD6 > 30 < 220 mg/L and TSS >30 < 150 mgA- ' Effluent #2 = BODS < 30 ffxA 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. SOD-8330 (R.sroo) Soil Test Plot Pla Project Name Shaun Bird Sh Bird Address 1432 120th St. New Richmond Wi 54017 C M #226900 Lot 9 Subdivision Viebrocks Addition Date 8/27/12 SE 1/4 SE 1/4S 4 T 30 N/R18 W Township Richmond ❑ Boring Q Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 100 ft. Bottom of garage siding System Elevation 92.6/92.5 *HRpSame as Benchmark Property Line Scale is 1" = 40' Well 15' Property Line/roa unless otherwise 4 25' B-1 60' noted 20' Existing 3 Bedroom House 25' B.M.* 0% Slope 15 30' L-J T B-3 50' 10' B-2 174th Ave 20' Carrol St. ST. CROIX COUNTY ZONING OFFICE CERTIFICATION STATEMENT FOR UTILIZATION OF AN EXISTING SEPTIC TANK 'riiis is to certify that I ha7ve 'respected the septic tank. presently sorving the residence located at: of 1 , Section `1'.. ,.~~O _N R W, Town -711 /Z Upon inspection, I certify that I have found the tank and baffles to be in good condition, and it appears to be functioning properly. least time serviced: Oi.d flow back occur from absorption system? Yes ~ No (I f . no, skip next line) Approximate volume or length of time: _ gallons minutes t'apacity: ~ 9--0 Construction: Prefab Concrete Steel other_ Manufacturer: (If known) Acle of Tank (If known) : (Signature) (Name) Please print tie) (License Number) -(2~ 7-1 L) a t-. e t;'or.m to be completed by licensed plumber (s.145.06, Wisconsin Statutes) or Licensed Disposer (NR 113 Wisconsin Administrative Code) - - - - - - - - - - - - - Plumber (applying for sanitary permit) Certification: Iii accepting the above statement regardi g existing septic tank will condition, I certify that the tank to the t of my knowledge for conform to the requirements of ILHR 83, Ad . Code (except inspection open' over outlet baffle). Name Signatur MP/MPRS___ 260 9~ a .0 R a t 247-27 am raorst, 00 60-00' 87, 50' oo ST50' 9 4. (:D4 PS ..M1 J' ' ci r%... ANpk 0. OU • ~Y1r 7K p t tiA" i11A4MC,i,~O,gS11wN YY ITS t 8 P We st cl 7 m 105.00$ 32.5 w SHERIFF'S DEED ON FORECLOSURE 11 CV 57 947096 Document Number TITLE OF DOCUMENT BETH PABST REGISTER OF DEEDS ST. CROIX CO., WI WHEREAS, pursuant to a judgment of foreclosure and sale rendered in the RECEIVED FOR RECORD Circuit Court of St. Croix, Wisconsin, in an action between, Ocwen Loan 12/12/2011 10.33 AM Servicing, LLC as servicer for Wells Fargo Bank, National Association, as EXEMPT # 14 Trustee under Pooling and Servicing Agreement dated as of November 1, 2004 Asset-Backed Pass Through Certificates, Series 2004_WHQ2, plaintiff and Bryan REC FEE: 30.00 M. Belting, defendant(s), and after due advertisement, the mortgaged premises PAGES: 1 hereinafter described was sold on October 18, 2011 to the plaintiff,, WELLS FARGO BANK, N.A. Trustee POOLING AND SERVICING AGREEMENT -The above recording information Dated as of November 1, 2004 Asset-Backed Pass-Through Certificates Series verifies that this document has 2004-WHQ2, for the sum of 93,000.00. been electronically recorded & returned to the submitter AND WHEREAS, the said purchaser, plaintiff, WELLS FARGO BANK, Record this document with the Register of Deeds N.A. Trustee POOLING AND SERVICING AGREEMENT Dated as of November 1, 2004 Asset-Backed Pass-Through Certificates Series 2004-WHQ2, Name and Return Address is now entitled to a conveyance according to law, NOW THEREFORE, the Blommer Peterman S.C. undersigned conveys to R' ARGO BANK N.A. Trustee POOLING AND 165 Bishops Way SERVICING AGREEMENT Dated as-7-November 1, 2004 Asset-Backed Pass- Brookfield, WI 53005 Through Certificates Series 2004-WHQ2, the tract of land in St. Croix County, Wisconsin as described below. 026-1108-95-000 Pe John A Shllts Parcel Identification Number (PIN) Fiff eriff of St. Croix, County Date: 4e 4Z;W STATE OF WISCONSIN St. Croix COUNTY On MtP her 71'_ a0l/ before me came Sheriff John A Shilts known to be the individual and officer described in said document and who executed the above conveyance and acknowledged that he executed the same for such sheriff, for the uses and purposes therein set forth. r~ a'. m U L/ Print Name: - Notary Public, State of Wisconsin SIy .Martell My commission expires: Notary Public 7 State of Wisconsin This instrument was drafted by Scott D Nabke 165 Bishops Way Brookfield, W1 53005 LEGAL DESCRIPTION Lot 9, Viebrock's River Valley View Addition, Town of New Richmond, St. Croix County, Wisconsin IIIII IIII III IIII III IIII IIII III III 1 of 1