HomeMy WebLinkAbout040-1318-00-050
Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix
Safety and Building Division
INSPECTION REPORT Sanitary Permit No:
556344 0
GENERAL INFORMATION (ATTACH TO PERMIT) 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:
Topaz LLC, C/o William E. Ryan, Pres. Troy, T n of 040-1318-00-050 911 CST BM Elev: Insp. BM Elev: BM Description: Section/Town/Range/Map No:
A u4 ~ 11.28.19.2125
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATI 7 r6 f III 21 IS ELEV.
12. l5 Q t r (v
Septic Benchmark
1M 12 C /i7J,3 0 , b
Dosing Alt. BM,,,
by wry z 4 5_
Aeration Bldg. Sewer 3S le 71,17
Holding St/Ht Inlet O ~ 7 1
TANK SETBACK INFORMATION St/Ht Outlet
TANK TO P/LWELJ.. BLDG. Vent to Air Intake -ROAD Dt Inlet
~ y'f'Ltyl .n
Septic r U s.2 c) / L Dt Bottom
>'7 G 33 o7b
Dosing c f Header/ an.
Aeration Dist. Pipe fi D 7 Z
Holding Bot. System
Final Gcaelie /
PUMP/SIPHON INFORMATION
Manufacturer ,1 Demand ver CIO
_
d LtJX GPM tIC j / ~i 7 r
Model Number
r,ol a 7
TDH Lift Friction Lo s System Head T Ft
'I1-7
Forcemain Le gth Dia. /r Dist. to Well
r
SOIL ABSORPTI SYSTEM
BEDITRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth
DIMENSIONS `(1 160
SETBACK SYSTEM TO P/L BLDG WELL LAKE REAM EACHING Manufacturer:
INFORMATION C BE
Type O System: ( Model Number:
DISTR ION SYSTEM et AAA- x-11\ ( 25f Gtr
Head /Manifol Distribution y / Hole ^Si e x Hole Spacing Vent to Air Intake
Length ia Length Dia Spacing '3 /5 1 I V"~~C
SOIL COVER x Pressure Systems Only xx Moun Or At-Grade Systems Only
Depth onch Center Bed/Trench Edge Topsoil ofo 6: x~Seeded(~Sj,0 4,.~~G 1 xx Mulched
Bed/Tre Gam., 1/ - 1 Yes No 0 Yes 0 No
COMMENT (Include code discrepencies, persons present, etc.) Inspection #1: 21 Inspection #2: /
Location: 717 Crest Cunr dson~Wl 4016 ( W 1/g NW 1/4 11 T28N R1 9W) Hills of Troy Lot 50 Parcel No: 11.28.19.2125 N
1.) Alt BM Description =
2.) Bldg sewer length 4-05rGW. 4e-'
- amountof cover = ~I
If
Plan revision Required. F0 Yes No I r7i,'_ y ~L ~0~
Use other side for additional information.
SBD-6710 (R.3/97) Date Insepctor's Signature Cert. No.
it _
Plot Plan j or Buts o, j 1 roy Page 8 of 6
Town of Troy, SL Croft County
Legal Description JAW-04 ac-- -stir. f4, Sg& It, T, 2 ft contoan
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Safety and Buildings D i n County
commerce.whgov
261 W. Washington Ave. ,P.O. o
• at Madison, WI 53707-71 Sanitary Permit Number (to be filled in by Co.)
111, f
lsGonsin 575(K 3
tvepartment of Cotstmeroq State.Trans n Number
Sanitary Permit Application rnmental OM4 ~l
In accordance with s. Comm. 83.21(2), Wis. Adm. Code, submission of this form to the appropriate go e
unit is required prior to obtaining a sanitary permit. Note: Application fortes for state-o ed POWTS are Project Address (if different than mailing address)
submitted to the Department of Commerce. Personal information you provide may be or secondary
purposes in accordance with the Privac Law, s. 15.04 I m Stats. I% l . 7
1. A lication Information - Please Print All Information Parcel #
Property Owner' Name
LL e-, co W1l4?(W l
~ Property Location
Property er's Mailing Address `UN/N~•, t~
c yam} A~ d_-U6 Govt. Lot
`1r'~ Zip Code ~ Phone Number C' ,r~ 71 (f Section
/k L / 5-~ / ~(1 915-2 ' G3 " DUU T 7 QN; R cle one)
II. Type of Building (check all that apply) Lot #
-1or2FamilyDwelling-NumberofBedrooms
O Block # C• v!-
❑ Public/Commer al -Describe Use_ ❑ City of
CSM Number ❑ Village of
11 State Owned -Describe Use {Town of 'T
III. T er t (Check only one box on line A. Complete line B if applicable)
A. New Syste ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System (explain)
List Previous it Ntunber and Date Issued
B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of Plumber ❑ Permit Transfer to New
Before Expiration Owner
IV. T e of POWTS S stem/Com onent/Device: Check all that
ound> 24 in. of suitable soil Mound < 24 in of suitable soil
❑ Non-Pressurized In-Ground ❑ Pressurized In-Ground ❑ At-Grad
n ° -ttgtrtieiif evic (explain)
❑ Holding Tank C1 Other Dispersal Component (explain) Z
V, Dis ersaVrreatment Area Information: a' Elevation
Design Flow (gpd) Design Soil Applicat' n Rate( pdst) Dispersal Area Requi (sf) Dispersal A ea Propos (sf) ystem
®a 010 .0 1( 6 0-0 /000 X e o 1 76,5-0
Total # of Manufacturer
VI. Tank Info ~apacity Gallonstn Gallons Units / 4_ ° tg ti
l N , o.
New Tanks Existing Tanks ~Q l~// o/L 2.5"
Septic or Holding Tank Z &-0 ~tll ~~Z
Dming G,amber
VII. Responsibility Statement- I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans.
P's Name (Print) Plumber's Signature MP/MPRS Number Business Phone Number
D l-0'J ~2~ 7 773
Plumber' Address (Street, City, State, Zip Code)
t Lis cUd 4 ( 7 ~D
V11I. ount /De artment Ilse 0nIv
Permit Fee Date sued ssuing Agent Sig
pproved ❑ Disapproved S 00
13 Owner Given Reason for Denial " 2
IX. Conditions of Approval/Reasons for Disapproval 3 /1 _ a~~~ S~ lt~f1 !nt
SYSTEM OWNER:
1 Septic tank, effluent filter and UA_A~ A
dispersal cell must all be serviced ! maintained
as per management plan provided by plumber.
a KNMd submit to the County only on paper not less than 8 112 x I I inches In size
as per applicable code ordinances.
SBD-6398 (R. 01/07) Valid thru 01/09
Safety and Buildings
.~o ARTt~~~T 10541N RANCH ROAD
HAYWARD WI 54843
(D Contact Through Relay
3 ! S www.dsps.wi.gov/sb/
P S www.wisconsin.gov
%
Scott Walker, Governor
AoNA~ Sw
Dave Ross, Secretary
September 07, 2012
CUST ID No. 224832 ATTN. pOWTS Inspector
MARY JO HUPPERT ZONING OFFICE
HOLLISTERS SOIL TESTING & DESIGN ST CROIX COUNTY SPIA
W9875 690TH AVE 1101 CARMICHAEL RD
RIVER FALLS WI 54022 HUDSON WI 54016
CONDITIONAL APPROVAL Identification Numbers
PLAN APPROVAL EXPIRES: 09/07/2014 Transaction ID No. 2145413
Site ID No. 783628
SITE: Please refer to both identification numbers,
Topaz LLC above, in all correspondence with the agency.
717 Crest Curve
Town of Troy
St Croix County
NWI/4, NW1/4, S11, T28N, RI 9W
FOR:
Description: Mound, 4 bedroom residence
Object Type: POWTS Component Manual Regulated Object ID No.: 1390365 itt
Maintenance required; 600 GPD Flow rate; 30 in Soil m' ' um depth to limiting factor from original grade; S} t~s
Mound Component Manual -Version 2.0, SBD-10691-P (N. 1/O1), Pressure Distribution ComponentVlanual
2.0, SBD-10706-P (N.01101), SSWMP Pub. 9.6; Effluent Fi er
The submittal described above has been reviewed for conformanc with applicable Wisconsin Administrative Codes
and Wisconsin Statutes. The submittal has been CONDITIONAL APPROVED. This system is to be constructed
and located in accordance with the enclosed approved plans and with any component manual(s) referenced above. S~EGOR
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:
Key Item(s)
• 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. In addition, the
owner must insure that the operation, maintenance and monitoring duties as described in section VIII of the
mound component manual are complied with. A copy of this information must be given to the owner upon
completion of the project.
• The float switch shall be a type that does not contain mercury. 2009 Wisconsin Act 44 prohibits the installation
of float switches or relays that contain mercury.
• The designer proposes to install a state approved effluent filter to achieve the requirement of wastewater particle
size. Pursuant to outlet filter product approval stipulations, maintenance information must be given to the owner
of the POWTS explaining that periodic cleaning of the effluent filter is required. The access opening used to
service the filter shall terminate at or above finished grade with a watertight cover.
Reminder
• The orientation of the mound system must be such that the longest dimension is oriented along the surface
contour per SPS 383.44(6)(a)2.
MARY JO HUPPERT Page 2 9/7/2012 •
• Limit activities in the area 15' beyond the down slope edge of the mound per Mound Component Manual.
• Surface water drainage shall be diverted away from the system area per Mound Component Manual.
• Materials shall conform to the requirements of SPS 384.10. No fixture, appliance, appurtenance, material,
device or product may be sold for use in a plumbing system or may be installed in a plumbing system, unless it
is of a type conforming to the standards or specifications of chs. SPS 382 and 383 and this chapter and ch. 145,
Stats.
• Maintain well and waterline set backs per SPS 383.43(8)(i). Consult the Department of Natural Resources for
well setbacks and other regulations and exceptions.
• Insulate building sewer per SPS 382.30(11)(c).
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. All permits
required by the state or the local municipality shall be obtained prior to commencement of
construction/installation/operation.
In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should
conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review
shall relieve the designer of the responsibility for designing a safe building, structure, or component.
Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address
on this letterhead.
The above left addressee shall provide a copy of this letter and the POWTS management plan to the owner and any
others who are responsible for the nstallation, operation or maintenance of the POWTS.
Sincerely, Fee Required $ 250.00
This Amount Will Be Invoiced.
When You Receive That Invoice,
Patricia L Shandorf Please Include a Copy With Your
POWTS Plan Reviewer , In grated ervices Payment Submittal.
(715) 634-7810, Fax: (715) 634- 50, M - F 8:00 a.m. - 4:45 p.m. WiSMART code: 1633
pat.shandorf@wisconsin.gov
cc: Charles L Bratz, POWTS Reviewer II, (608) 789-7893 , 7:45 am - 4:30 pm Monday - Friday
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
Project Name: TOPAZ LLC
Owner's Name: same
Owner's Address: 14750 Cedar Avenue South
Apple Valley, MN 55124
Legal Description: NW1/4 of the NW1/4, S 11, T28N, R1 9W
Township: Troy
County: St Croix
Subdivision Name: Hills of Troy
Lot Number 50 Block Number. NA
Parcel I.D. Number. 040 -1318 - 00 -050 S.
Plan Transaction No.: P
Page 1 Index and title
p,T1D b
Page 2 Data entry
Page 3 Mound drawings
Page 4 Lateral and dose tank DENC
• MARY Jt~ Page 5 System maintenance specifications tESPON
HUPPE~T Page 6 Management and contingency plan
!31859 Page 7 Pump curve and specifications
RIVER FALLSPage 8 Plot Plan r L 1 ~
,~www W1 lj -t
wws+~~ S~~~
Designer. Mary Jo Huppert License Number: 1859 - 007
Date: 08127/12 Phone Number. (715) 426 -1775
Signature:
Designed Pursuant to the
Mound Component Manual for POW17S Version 2.0 SDB-10691-P (N. 01/01), and both
SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST-SAS (01/81) and
Pressure Distribution Component Manual Ver. 2.0 SBD-10706-P (N. 01/01)
I
Version 7.0 (R. 03/2012) Page 1 of 8
i
Mound and Pressure Distribution Component Design
Design Worksheet
Site Information _
(R or C) R Residential or Commercial Design Note: Sand fill (D) calculations assume a
400.00 Estimated Wastewater Flow (gpd) Table 383-443 in-situ soil treatment for
1.50 Peaking Factor (e.g. 1.5 = 150°/x) fecal colrform of - 36 inches.
600.00 Design Flow (gpd)
11.00 Site Slope
1076.00 Contour Line Elevation (ft)
30.00 Depth to Limiting Factor (in)
0.60 In-situ Soil Application Rate (gpd/fe)
Distribution Cell Information
60.00 Dispersal Cell Length Along Contour (ft) = 10.00 Cell Width (ft)
1.00 Dispersal Cell Design Loading Rate (gpd/fe)
1 Influent Wastewater Quality (1 or 2) Are the laterals the highest point
in the distribution Y
Pressure Disribution Information network? Enter Y or N
(C or E) a Center or End Manifold
3.33 Lateral Spacing (ft) If N above, enter the elevation (ft)
3 Number of Laterals of the highest point.
0.156 Orifice Diameter (in)
3.50 Estimated Orifice Spacing (ft) = 11.76 fe/orifice
2.00 Forcemain Diameter (in)
24.00 Forcemain Length (ft) Does the forcemain drain back? Y
1070.00 Pump Tank Elevation (ft) Enter Y or N
4.55 System Head (ft) x 1.3 3.91 Forcemain Drainback (gal)
6.17 Vertical Lift (ft) 55.97 5x Void Volume (gal)
0.40 Friction Loss (ft) 59.88 Minimum Dose Volume (gal)
0.00 In-tine Filter Loss (ft) 27.46 System Demand (gpm)
11.11 Total Dynamic Head (ft)
Lateral Diameter Selection Manifold Diameter Selection
in. dia. options choice in. dia. options choice
0.75 1.25 x x
1.00 1.50 x
1.25 x x 2.00
1.50 x 3.00
2.00 x
3.00 x
Gallons/Inch Calculator (optional)
Treatment Tank Information Total Tank Capacity (gal)
1200.00 Septic Tank Capacity (gal) Total Working Liquid Depth (in)
Wieser Manufacturer gal/in (enter result in cell B49)
Dose Tank Information Effluent Filter Information
800.00 Dose Tank Capacity (gal) Pol Lok Filter Manufacturer
22.24 Dose Tank Volume (gaUn) 525 Filter Model Number
Weiser Manufacturer
Project: TOPAZ LLC Page 2 of 8
Mound Plan and Cross Section Views
-
B t
J
Observation .Pipe
K o p
W T-~ B I . .
L
Mound Component Dimensions
ft
A 10.00 ft E 19.20 in H Aft ft K EAft
B 60.00 ft F 9.25 in 1 ft L ft
D 6.00 in G 0.50 ft J W 600.00 (ft2) Dispersal Cell Area 1371.27 (ft2) Basal Area Available
10.00 (gpd/ft) Linear Loading Rate 6.00 (ft) 1/10 B Obs. Pipe Placement
Mound Cross Section View
Aggregate Dispersal Area
Finished Grade 1078.27 (ft)
ruin rriu H
I F Dispersal Cell r 1077.00 (ft) Lateral
1076.50 (ft)--0- Invert
Dispersal Cell
Elevation D
1076.00 (ft) Contour Elevation
11.0 % She Slope
Geotextile Fabric Cover
Shading Key ~ I - Dispersal Cell See lateral details on
Q Topsoil Cap C 1.5 ft Page 4 for number, size,
Q rrrr..r Subsoil Cap 0 ,t00 ® O T and spacing of laterals.
ASTM C33 Sand .a F Laterals are equally
Tilled Layer UZI Typical Lateral spaced from the
distribution cell's
Aggregate o ~ centerline in the
in the
} -A distribution cell (AxB).
Project: TOPAZ LLC Page 3 of 8
End Connection Lateral Layout Diagram
Coma I#-I yresala ovw the A 6 dirr-r-s~ 41- Turn-up wi!)an-.*h s c~
cl~:i erw.i~tuy
P
ilt Ia:,o-r:rls .+.^.e f.irs.x-l f.- x _-1 He+l:~ d..l'e.! .ten !fn.r bc~t.sm c* IF.r• l..vr:l
,e U. lly _{r- -d
Uiter~?~ -ioreerAz in Sch 40 PV Per SPS Ta44e- 334. tr-~
F'or_e rr.s,-..,er;r, r.:lien. w,+rr or c:o_ tG rn..anr'ald at arrp ycerK.
Number of Laterals 3 Orifice Diameter 01156 in
Lateral Diameter 1.25 in Orifice Spacing (X) 3.66 ft
Lateral Length (P) 58.56 ft Orifices per Lateral 17
Lateral Spatting (S) 3.33 ft Orifice Density 11.76 fe/orifice
Lateral Flow Rate 9.15 gpm Manifold Length 6.67 ft
System Flow Rate 27.46 gpm Manifold Diameter 1.25 in
Total Dynamic Head 11.11 ft Forcemain Velocity 2.80 ft/sec
Dose Tank Information t.oCkft cm'w raid, warning
Mel and loddog device and
sealed watertight
Elec~►ical as per NEC 300 and 0
SPS 316.300 WAC Disconnect 4 in.' min.
Tank conent is propery verded E- A~emate otdiet
location
Foreenmain diameter
Weiser Manufacturer 2 in.
Capacity! 800.00 Gallons _r
Volume 22.24 gallinch A
Weep hole or anti-
Dimension Inches Gallons B siphon device
A 21.28 473.24
B 2.00 44.48 C,, (R)
C 2.69 59.88 -t 1070.83
D 1000 222.40 D
Total 35.97 800.00
Dose tank elevation (R)
3" Bedding uncTer tank ♦ 1070.00
Alarm Manuafacturer Tank Alert e: Switches
Alarm Model Number HVN101 _ T.___, containing mercury
may not be used in
Pump Manufacturer Gould this system.
Pump Model Number PE31
Pump Must Deliver 27.46 gpM at 11.11 ft TDH
Project: TOPAZ LLC Page 4 of 8
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Mound System Maintenance and Operation Specifications
Service Provider's Name Ron's Sewer Service Phone 715 749-0153
POWTS Regulator's Name St. Croix County Zoning Phone 715 386-4680
System Flow and Load Parameters
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 ftz Maximum FOG 30 mg/L
Type of Wastewater Domestic Maximum Fecal Coliform >10E4 cfu/100 mL
~I
Service Frequency
Septic and Pump Tank Inspect and/or service once eve 3 ears
Effluent Filter Should inspect and clean at least once eve 3 ears
Pump and Controls Test once eve 3 ears
Alarm Should test monthly
Pressure System Laterals should be flushed and pressure tested eve 1.5 ears
Mound Inspect for ndin and seepage once eve 3 ears
Other
Miscellaneous Construction and Materials Standards
1. Observation pipes are slotted and materials conform to Table SPS 384.30-1, have a watertight cap,
and are secured in as shown in the mound component manual.
2. Dispersal cell aggregate conforms to SPS 384.30 (6)(i), Wis. Adm. Code.
3. All gravity and pressure piping materials conform to the requirements in SPS 384, 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 Detail
Finished
Grade
6-8" Diameter Lawn Threaded Cleanout
Sprinkler Valve Box Plug or Ball Valve
Distribution
Long Sweep 90 or Two
45 Degree Bends Same
Diameter as Lateral
Project: TOPAZ LLC Page 5 of 8
Mound System Management Plan
Pursuant to SPS 383.54, Wis. Adm. Code
This system shall be operated in accordance with SIPS 382-84 Wis. Adm. Code, and shag maintained in accordance with its' component
manuals [SBD-10691-P (N.01/01), SSWMP Publication 9.6 (01/81), and Pressure Distribution Component Manual Ver. 2.0 SBD-10706-P (N.
01101)] and local or state rules pertaining to system maintenance and maintenance reporting.
No one should ever enter a septic or pump tank since dangerous gases may be present that could cause death.
Septic and pump tank abandonment shag be in accordance with SIPS 383.33, Wis. Adm. Code when the tanks are no linger used as
POWTS components.
Septic or pump tank manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings
used for service and assessment shag be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or
subject to failure must be replaced. B posed access openings greater than 84nches in diameter shag be secured by an effecti,.* locking
device to prevent accidental or unauthorized entry into a tank or component.
Septic Tank
The septic tank :drag be maintained by an individual certified to service septic tanks under s. 281.48, Slats. The contents of the septic
tank shall be disposed of in accordance with NR 113, VUis. Ante. Code. The operating condition of the septic tank and outlet filter shag 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 Titer is equipped with an alarm, the
filter shag be serviced if the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an impendng continuous
alarm.
The septic tank shag have its contents removed when the volume of sludge and scum in the tank exceeds 1 /3 the liquid volume of the
tank. If the contents of the tank are not removed at the time of a triennial assessment, maintenance personnel shag advise the owner of
when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank.
The addition of biological or chemical additives to enhance septic tank performance is generally not required. However, if such products
are used they shag be approved for septic tank use by the Departrnent of Commerce.
Pump Tank
The pump (dosing) tank shag be inspected at least once awry 3 years. AN switches, alarms, and pumps shag be tested to verify proper
operation. If an effluent filter is installed within the tank it shall be Inspected and serviced as necessary.
(Mound and Pressure Distribution System
No trees or shrubs should be planted on the mound. Plantings may be made around the mound's perimeter, and the mound shall be
seeded and mulched as necessary to prevent erosion and to provide some protection from frost penetration. Traffic (other than for
vegetative maintenance) on the mound is not recommended since soil compaction may hinder aeration of the infilt alive surface within the
mound and snow compaction in the winter will promote frost penetration. Cold weather installations (October-February) dictate that the
mound be heavily muk:W as protection from freezing.
Influent quality into the mound system may net exceed 220 mg/L BODs, 150 mg/L TSS, and 30 mg/L FOG for septic tank affluent or 30
mg/L BOD5. 30 mg/L TSS,10 mg/L FOG, and 104 kxu/100 mL for highly treated effluent. Influent flow may not exceed mandmun design flow
specified in the permit for this installation.
The pressure diminution system is provided with a bushing point at the end of each lateral, and it is recommended that each lateral be
flushed of accumulated solids at least once every 18 months. When a pressure test is performed it should be compared to the initial test
when the system was installed to determine if orifice dogging has occurred and if orifice cleaning is required to maintain equal distribution
within the dispersal cell.
Observation pipes within the dispersal cell shag be Checked for effluent pondkg. Ponding levels shag be reported to the owner, and any
levels above 6 inches considered as an impending hydraulic failure requiring additional, more
frequent monitoring.
Continaerncv Plan
If the septic tank or any of its components become defective the tank or component shag be repaired or replaced to keep the system in
proper operating condition.
If the dosing tank, pump, pump controls, alarm or related wiring becomes defective the defective component(s) zhall be immediately
repaired or replaced with a component of the same or equal performance,
If the mound component fails to accept wastewater or begins to discharge wastewater to the ground surface, it will be repaired or
replaced in its' present location by increasing basal area if toe leakage occurs or by removing biologically dogged absorption and dispersal
media, and related piping, and replacing said components as deemed necessary to bring the system into proper operating condition.
See Page 5 of this plan for the narne and telephone number of your local POWT'S regulator and service provider.
Pretreabnerd Units
The information and schedule of mananagement and maintenance for pretreatnment devices such as aerobic treatment units or disinfection
units are attached as separate docsurnants and are considerW part of the overall management plan for this system.
I
i ~L~T; ?c3?Az LA-C-
l
L%UOULDS PUMPS Sub '
mersrbte
Effluent Pump
PE
MOM ~
FUmp-+: cam: „coon resistant
. :1%` NPT • Sin* phase
Tie: 1 off WO •60 HOU U Cag kon body.
ma ldrnurn, CNOMW when • 115 and 230 volts ■ Thenrroplasdt i npeeer and
• BUS-Ifi
tIWlna) OVelOad pro. NYef:
Solids har j: 'h' tecdon Withautn" reset ■ t1p%r sieewe and lower
rnaximlrrn sphere. • class B im"afion. heavy duty W bearing
• Automatic models inchrde a • 4+n-tied derigm fin,
float switch. • High strength cMm steel r Motor is penzanendy
SW* designed for the ' Manual avaN shalt
Mrlxicated far extended
folb*f" uses: ' Purnf range: see PE31 Motor: service Gfe,
• Mound Sy erns Peftm3nft chart or turns. • 3314P, 3000 RPM ■ Powered for ContnuoUs
• Ef luentMosing Sysmns ? PE31 Pump: • 115 Vohs • low Pressure Pipe Systems Ma*num capaW. 53 GPM • Shaded poie design ■ AOpeation.
N ratings are within the
• Basement Drainer • Affirm head. 25' TDH PE41 Motor
working Nrnu of the motor.
• Heavy Duty Sump/ M41 Puarp: • .4014P. 3400 RPM M Quick disconnect power
Dewateriog Ma>erntan may; 61 GPM • 115 and 230 voKs cad, 20' standard length,
• Mmimtan head: 29' TRH ` PSC design 1h15~ ► 16/3 SIIW with or 230 vok 99
PE51 Pump; PE51 Mawr.
pkig-
• Mahdmum capacity: 70 GPM • 50 HP, 3400 RPM ■ Coviete unit b heavy duly.
• Ma)drnwnn head. 37' TRH • 115 oral 230 voks and =npact
woETras FEET
j • PSC design ■ kcal sea[ is tarbwh,
40' _ Ceram BtJNA attd si riess
' Won& PE31
. W*I, PESTi steel.
35 'w':.~..ao so I 0 Stainless steel fasteners.
10 I '
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AGENCY LISTUM
p 30
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Plot Plan for guts of l Croy Page 8 of i
Town of Droy, Sk Croix County, Trownsin '
Lrjt I 40 ft
Legal Descr4ntwn Aw' f4 sa~ 11, Tzw 2 ft contour
a = BackhoePh
~k cam`
' v~ tee.
Ar-S
r r
c pD-,W-D 1
1 088.4 0-4 BE:3RooM I (SD----"
9
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t ®t%- 107'7 Z r 8 i
t q3' ~ `Lv t
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o ~ ~..1rS•7+~.t0f~ t
~r A 1
t
.102k r 1 1020
®F-1- t C'Tr : 50 ` r R-100A
T 1 1/4"
01 Z~ sou
o/"
BENCH
TOP OF 1 1/4"
RON PIPE
j ELEVATION = i n7. ~
09/24/12 13:27 FAX 9529536699 RYAN. REAL ESTATE 002
va;ta1cv14 vo.vi r A A rio 4fO V444 N~LJUN-rLUMblNd 001/001
ST. CROIX COUNTY
SEPTIC TANK MAINTENANCE AGREEMENT
AND
OWNERSHIP CERTIFICATION FORM
Owner/Buyer _ f A Mailing Addresses
Property Address -7 LUA~_ t l flit
(Verification required from Planning & Zoning Department for new construction.)
City/State W~Dl Parcel ldentification Number&Y6 /31/2 06 050
LEGAL DESCRIPTION
Property Location A W V., ~ %4 , Sec. LL, T Z-5?N R~W, Town of _ ze~
Subdivision T)/ r Lot #
Certified Survey Map # , Volume , Page #
Warranty Deed # Volume , Page #f
Spec house yes ( ' Lot lines identifiable ~ no
SYSTEM MMNTENANCE AND O]MER CERTIF TXON
Improper use and maintenance of your septic system could result in its premature failure to handle wastes, Proper
maintenance consists of pumping out the septic tank every three years or sooner, if needed, by a licensed pumper. What you put into
the system can affect the function of the septic tank as a treatment stage in the waste disposal system. Owner maintenance
responsibilities are specified in §Comm. 83,52(1) and in Chapter 12 - St Croix County Sanitary Ordinance.
The property owner agrees to submit to St. Croix County Planning & Zoning Department a certification form signed by the
owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site
wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is
less than 1/3 full of sludge.
Uwe, the undersigned have read the above requirements and agree to maintain the private sowage disposal system with the
standards set forth, herein, as sot by tho 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 CountyPlanning g
Zoning Department within 30 days of the three year expiration date.
I/we certify that all statements on this form are true to the best of my/our knowledge. Uwe arn/are the owner(s) of the
property described above, by vi f a warranty deed recorded in Register of Deeds Office.
Number of bedroo
L~ ~e4 ii 5.
do i. P
SI PLICAN'T(S) • DATE
'Any information that is 'are sented 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 Offioe and a copy of the certified survey map if
reference is made in the warranty deed.
(REV. 08/05)
Wisconsin Department of JAI
t- OIL~CWREPORT Page 1 of 3
Division of Safety and Buildings
- - ---ineocordance jh Comm 85, Wis. Adm. Code
County ST. CROIX
Attach complete site plan on paper not less than 8 1/2 x1 inches in size: Plan must:
include, but not limited to: vertical and horizontal referent>ee point (BM), direction and
Parcel I.D. percent slope, scale or dimensions, north arrow, and to . tion A cU, f ~ ~o,nearest road. _ S~
7(
J
~tl
Please print all informatio . " : Reuiewe Dat
Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.1)4 (T)"(m)). 1 / 7 (jC~
Property Owner Property Location
0
LEONARD & MARGARET DELAURIERS NW 11 28 ■
Govt. Lot 1/4 NW 1/4 S T N R 19 E (or) W
Property Owner's Mailing Address ;=Town me or CSM#
706 Coulee Trail Hills of Troy
City State Zip Code Phone Number Nearest Road
Hudson, WI 54016 ) C.T.H. U
New Construction UseE] Residential / Number of bedrooms 4 Code derived design flow rate 600 GPD
Replacement 0 Public or commercial - Describe:
Parent material loess over till Flood Plain elevation if applicable Nth ft.
General comments Mound System 0.50 ft. sand fill 0.6 loading rate
and recommendations:
(If pre-treatment system - below-ground drip irrigation 0.8 loading rate)
/0///02
G U~ s' d a~
F] Boring # oring
El pit Ground surface elev. 10° b ft. Depth to limiting factor 32 in.
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDfif
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
1 0-4 10YR3/2 - sil 3fgr&sbk mvfr cb 3vf-m 0.6 0.8
2 4-9 sil 3fa&sbk mvfr cb 2vf-m 0.6 0.8
3 9-16 10YR3/3 sil 3f-msbk mfr ci 2vf-m 0.6 0.8
4 16-32 10YR3/4 - sil 2f-mabk mfr as lvf-m 0.6 0.8
5 32-34 1OYR3/4 f2f 10YR4/6&10YR6/1 sicl If--mabk mfi 0.4 0.6
F B Boring # Q Boring 32
pit Ground surface elev. iG-77, 20 ft. Depth to limiting factor in.
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fP
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
1 0-5 10YR3/2 - sil 3fgr mvfr as 3vf-m 0.6 0.8
2 5-10 10YR3/2 sil 3fabk mvfr as 2vf-m 0.6 0.8
3 10-18 10YR3/3 sil 3fabk mfr ci 2vf-m 0.6 0.8
4 18-24 10YR3/4 sil 2fabk mfr cw lvf-m 0.6 0.8
5 24-32 10YR3/4 sl lfsbk mfr cs lvf-f 0.4c 0.6
6 32-36 .5YR4/4 f2f 7.5YR4/6 sl Om mfr 0.2 0.6
Horizon 5 has some gr.
* Effluent #1 = BOD > 30:5 220 mg/L and TSS >30 < 150 mg/L * E uent #2 = BOD < 30 mg/L and TSS < 30 mg/L
CST Name (Please Print) Signature CST Number
Ma Jo Hollister 224832
Address Date Evaluation Conducted Telephone Number
W9875 690th Avenue, River Falls, WI 54022 09 - 06 - 05 (715) 426 - 1775
Property Owner DELAURIERS (Lot N50) Parcel ID # (Pending) Page 2 of 3
a Bviiny # Boring
■ 30
Pit Ground surface elev. f 67 3 SC 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
1 0-9 10YR3/2 6~ ~t~/y 51 1 3f-ma sbk mvfr as 3vf-m 0.6 0.8
2 9-15 10YR3/3 Maw ho-- an 1 mfr as 2vf-m 0.6 0.8
3 15-22 10YR3/4 sl Om mfr as lvf-m 0.2 0.6
4 22-30 10YR2/1 pYi ZlI ~o Osg dl as lvf m 0.7 1.6
5 0-34 7.5YR4/4 f2f 7.5YR3/4 sl Om mfr 0.2 0.6
Some gr.
114 s / 0-4
El Boring # LJ Boring J u~
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
Q F-I Boring # Boring
Ground surface elev. ft. Depth to limiting factor in.
0 Pit 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
* Effluent #1 = BOD5 > 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BOD5 < 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-8330TB t (R.07/00)
Plot Plan for Hills of Troy Page 3 of 3
Town of Troy, ,S. Croix County, Wisconsin
Lot !o 1 4o ft.
Legal Description tiw,/Lj t, 1-fE Nw/4, sa,1,,-1 z,& 2 ft. contours
Backhoe pit
I
y / I
I
10884
X80---
i
9 I
I I
I
i
a
I
' -101B
~ I ® /G`7`T 2i2 ~ ~ I
-2 026~~ i
® 50
A 0
toyl EL i L'``7rfa IiTfl
~I I
r
I 1 102C
102A R-100A
BE CH~1ARK: I
0 ~F 1 1 /4"
/ELEVATION
~U,
BENCH MASK.
TOP OF 1 J/
1 IRON PIPE
~~l ELEVATION = ''00
J
I i
T
t
963866 r
BETH PABST
State Bar of Wisconsin Form 6-2003
SPECIAL WARRANTY DEED REGISTER OF DgEDS
ST. CROIX CO., WI
IbeumentNumber DtmnmentName RECEIVED FOR RECORD
09/21/2012 08:01;1 AM
TBTS DEED, made between BMO Harris Bank National Association, successor by EXEMPT # NA
me`serwith M&INfardiall&lWbyBantt REC FEE: 30.QD
("Grantor," whether one or more), and .
Topaz,Ltc TRANS FEE: 67:50
2
~Grantcc" whether one rantee,the following d scribed real PAGES:
Grantor for a valuable consideration, conveys to G
estate, together with the rents, profits, fixtures and other appurtenant interests, in
St. Croix County, State of Wisconsin ("Property") (if more space is **The above recording information
needed, please attach addendum): R00°~i"aAfei verifies that this docurnein has
Nam and Return Ad een electronically recorded
Lot 50, Plat of Hills of Troy, in the Town of Troy, St. Croix County, Topaz LLC & returned to the subrtitter
Wisconsin 14750 Cedar Avenue, Suitt #100
Apple Va cy, MN 55124
(
040-13184)0-050 i
Parcel identification Number (PIN)
i
711ia is not hanesend p upeny. I
(is) (is not)
Grantor warrants that the title to the Property is good, indefeasible, in fee simple and lieu and clear of encumbrances arising by, 11 rough, or under ,
Grantor, except municipal and zoning ordinances and agreements entered under them, recorded easements for the distribution of utility and
municipal services, recorded building and use restrictions and covenant
g n, general taxes levied in the year 2012, and Permitted Enetnnbrences i
described on the attached Exhibit A.
i
Dated September 2012 BMO HARRIS BANK NATIONAL ASSOCIATION
success r th Marshall & Ilsley Bank
(SEAL) (SEAL)
" ` B S. tLu4rjice President -
(SEAL) (SEAL)
y • By.
AUTHENTICApTAgy ACKNOWLEDGMENT
Signature(s) VP I& STATE OF WISCONSIN )
as.
authenticated on O O MILWAUKEE COUNTY ) j
~ s' Personally carte before me on September , 2012 ?
TITLE MEMBER STATE BAR the above-named GUYS. ICautzer, Vice President of BMO
Harris Bank N.A.
(If not, to me known to be the person(s) o ecuted the foregoing
authorized by Wis. Stat § 706.06) t It sa e
THIS INSTRUMBNT DRAFTED BY:
,
-zis
Lynn A. Ludke, Godfrey & Kahn, S.C. `Cam! Lee M
Notary Public, State of Wisconsin
My Commission (is-p et) (expires: April 6, 2014 )
8451318 1
(Signtares maybe authenticated w acknowledged. Both are not necessary)
NOTE: THIS IS A STANDARD FORM. ANY MODIWCATIONS TO THIS FORM SHOULD BE CLEARLY IDENTIFIED. f
SPECIAL WARRANTY DEED ® 2003 STATE BAR OF WISCONSIN FORM NO. (-2003
• Type name below signature. n
i
1 of 2
ss
s:
EXH[B1T A
PERBG= ENCUMBRANCES r
1. Any encroachment, encumbtancq violation, variation, or adverse circumstance affecting title to the Property that
would be disclosed by an accurate and complete land survey of the Property.
2. Easen=ts or claims of easements not shown by the public records.
3. There is an easement for utility purposes over that part of the property described as 12 feet along Crest Curve, as
shown on the recorded plat.
4. Subject to the easement and building setback lines as shown on the recorded plat of Hills of Troy.
5. Subject to rho terms and conditions as shown on the recorded plat of Hills of Troy.
r
6. Thee are restrictive and protective covenants which affect this property, which do not include any forfeiture or -
reversionary clause, and which were recorded as Document No. 816569. (NOTE: Any restrictions based upon race,
color, religion, sex, sexual orientation, familial status, marital satus,.disability, handicap, national origin, ancestry, t
or source of income, as set forth in applicable state or federal laws, are unenforceable.)
The above restrictive and protective covenants have been amended by Document No. 841464.
7. Subject to the terms and conditions of the Landscaping easement in favor ofHills of Troy Homeowners e!
Association, Inc. as shown as Document No. 816571.
8. Subject to the terms and conditions of that Conservation Easement recorded on July 1, 2005 in Vol. 2834, pages
155-173, as Document No. 799119.
:a
The above Conservation Easement was amended in Vol. 2937, page 68-77, by Document No. 813315.
r
' k
G
.1
'i
C
2of2
Parcel 040-1318-00-050 09/25/2012 01:43 PM
PAGE 1 OF 1
Alt. Parcel M 11.28.19.2125 040 - TOWN OF TROY
Current ❑X ST. CROIX COUNTY, WISCONSIN
Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type # of Units
01/17/2006 00 0
Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner
O - M&I MARSHALL & ILSLEY BANK
M&I MARSHALL & ILSLEY BANK
770 N WATER ST
MILWAUKEE WI 53202
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description " 717 CREST CURVE
SC 4893 SCH DIST RIVER FALLS
SP 0100 CHIP VALLEY VOTECH
Legal Description: Acres: 1.034 Plat: 10-095-HILLS OF TROY 040-06 LOTS 1/62
SEC 11 T28N R1 9W PT NW NW HILLS OF TROY Block/Condo Bldg: LOT 050
('06) LOT 50 (1.034AC)
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
11-28N-19W NW NW
Notes: Parcel History:
Date Doc # Vol/Page Type
01/10/2011 930266 WD
01/17/2006 816571 EZ
01/17/2006 816568 10/095 PLAT
12/01/2005 813315 2937/038 EZ-CONS
more...
2012 SUMMARY Bill Fair Market Value: Assessed with:
0
Valuations: Last Changed: 11/09/2009
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 1.034 52,000 0 52,000 NO
Totals for 2012:
General Property 1.034 52,000 0 52,000
Woodland 0.000 0 0
Totals for 2011:
General Property 1.034 52,000 0 52,000
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