Loading...
HomeMy WebLinkAbout002-1047-30-000 T 1 ST. CROIX COUNTY WISCONSIN C, -Al ZONING OFFICE ■ N ST. CROIX COUNTY GOVERNMENT CENTER 1101 Carmichael Road - ® Hudson, WI 54016-7710 (715) 386-4680 March 4, 1994 Dale Hudson MP#6629 820 Main St. Baldwin, WI 54002 Dear Dale: The intent of this letter is to recap our conversation of last Monday afternoon. While completing my paper work on the Terry Nelson mound installation I discovered several design and possible installation mistakes associated with this system. I followed this finding with an inspection of the system, for which you were present. During this inspection I found several problems or possible problems with the installation. They are as follows: 1.) The mound has not been properly seeded and mulched. 2.) The septic tank manhole cover which is in the asphalt driveway is still in place. Has this tank been properly abandoned as required by code? If not, please see that it is. 3.) The septic tank and pump chamber were backfilled prior to inspection. Please provide me with the septic tank inlet, outlet, and cover elevations as well as the pump chamber inlet elevation. 4.) The pump chamber cross section contains several errors, including the minimum pump discharge rate, the tank elevation, the amount of lift required, and the tank capacities associated with the float settings. 5.) The system was installed requiring a pump which would be able to discharge a minimum dosing rate of 29.25 gal./min. at a TDH of 22.76'. The installed Goulds WE03111 pump will discharge approximately 22gpm at the installed TDH according to the pump curve you provided. Because of this, the system is not properly pressurized and may result in the mound failing prematurely. I verified this finding by measuring the amount of effluent which was pumped out of the tank over a known period of time. This calculation revealed a dosing rate of approximately 22.5 gpm - again not sufficient to pressurize t I the system. You are hereby ordered to replace the existing pump with one which will properly pressurize the system. 6.) The pressure distribution network was not installed in accordance with your design and state approved plans. Because of this, you must submit revised plans to the state. In an effort to minimize confusion and delays, I suggest that you include the changes to the pressure distribution network, recalculate the pump chamber capacities and float settings, show the proper minimum discharge rate required to pressurize the system, the correct TDH, and specify the pump which will replace the one installed. After you have received the state approvals on these revisions you must submit a copy of the plans and a new permit application to our office. There will not be any county fees associated with the revision as a new permit is not required. If you have any questions which I can clarify for you, please contact me at this office between the hours of 8:00am-5:00pm, Mon ay - Friday. Sincer ly, J mes Thompson ' 'Assistant Zoning Administrator cc: Terry Nelson LeRoy Jansky file 10-711 ZAJ d- " f~SO'aier~G~ 4 f STC - 104 AS BUILT SANITARY SYSTEM REPORT OWNER ADDRESS g'D5 z.ZC~> SUBDIVISION / CSM# LOT # SECTION ,fib T Z? N-R~W, Town of ~cy . '~R CM ST. CROIX COUNTY, WISCONSIN PLAN VIEW SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM Reid G P. GT Grr'~ fYl INDICATE NORTH ARROW Provide setback and elevation information on reverse of this form. Provide 2 dimensions to center of septic tank manhole cover. J , BENCHMARK: ALTERNATE BM: SEPTIC TANK / PUMP CHAMBER / HOLDING TANK INFORMATION Manufacturer: GJeeo~ Liquid Capacity: 1600 a l Setback from: Well House Other 100 le) p: Vouby Model#LJF03///ylSize /Z #6p Pump: Manufacturer r Float seperation Gallons/cycle: /y9-5 Alarm Location z4larm ~'S i SA661 SOIL ABSORPTION SYSTEM / Width:- 2S Length Number of trenches / Distance & Direction to nearest prop. line: S-, Setback from: well: House 150 Other Po l A~- ELEVATIONS Building Sewer ST Inlet ST outlet PC inlet 9,2,.9? PC bottom $8.'741 / Pump Off ~9• `7~' Header/Manifold Bottom of system Existing Grade/oz/.4/7- Final grade/09.,-/7_ DATE OF INSTALLATION: PLUMBER ON JOB: -)D47/e, ,C c 54Y. LICENSE NUMBER: 141P c Z? INSPECTOR: V Old>'O~ 3/93:jt Al, X, BOLDT'S PLUMBING & HEATING, INC. 820 MAIN STREET BALDWIN, WISCONSIN 54002 (7151) 684-3328- (715) 684-3144 119 Al qy, is loo a~ LJgI~ r~ Poo Sheol 63~ /,/ou S G D Ipo c Ajo. ~ ~ iartr lr r ry20.29.16. QWA frSEWA2GE SVS~@EET County: Labor and Human Relations INSPECTION~RtEPORT ' Safety and Buildings Division ST. CROIX (ATTACH TO PERMIT) Sanitary Permit No.: GENERAL INFORMATION 193450 Permit Holder's Name: ❑ City ❑ Village [Town of: State Plan ID No.: BARBARA BALDWIN A ~ CST BM Elev.: Insp. BM Elev.: BM Description: Parcel Tax No.: - "J /GJ. / r -Q 002-1047-30-000 TANK INFORMATION ELEVATION DATA A9300109 TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic 01-e Se C,ne l) Bench rk , 7-- le / 11 Dosing -%'J-~ / Aeration- Bldg. Sewer Holding St/ Ift Inlet TANK SETBACK INFORMATION St Outlet TANK TO P/ L WELL BLDG. Ventto ROAD Dt Inlet Air Intake Septic NA Dt Bottom s,..70r i Dosing <-751 NA Header / Man. , /I>7 Aeration'" NA Dist. Pipe /D Holding Bot. System PUMP / INFORMATION Final Grade Manufacturer Demand 89,77 Model Number GPM TDH Lift ,?;,4 Lrictioro, 74' System TDH a, t ►~o ; K . , tL°- + 675, mead orcemain Length X85' Dia. Dist. To Well > 3 SOIL ABSORPTION SYSTEM AWRW TRENCH Width Length~7 i No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth DIMENSIONS / DIMEN I N anufacturer: ( SYSTEM TO P / L BLDG WELL LAKE/STREAM LEACHING SETBACK INFORMATION Type O CHAMBER Model N er: v~ , 5/Ce`~~ ~ OR UNIT System: OCR DISTRIBUTION SYSTEM ZSlires Jt //7 ~.rr ><I,, F / M nifoId Distribution Pipe(s) , x Hole Size x Hole Spacing Vent To Air Intake / .i ~lGZ3 ~"l . Length ' , Dia length -f= Dia. Spacing ~ 7~ SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over p . Depth Over xx Depth Of xx Seeded LSeddee} xx Mulched §OV Trench Center /U awd4Trench Edges /j Topsoil ❑ Yes 0-1110- ❑ Yes ®.P1ef~ COMMENTS: (Include code discrepancies, persons present, etc.)/" ~-A~~ .11 1,17 2 LOCATION: BALDW~N 20.29.16.298C,SW,SW,220TH STREET ~dr ~Plan revision required? end? ❑ Yes [B'I~lo Use other side for additional information. G/ 7 SBD-671Q(R 0 /91) Date inspector'sSignatu Cert No. ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: r r SANITARY PERMIT APPLICATION 7-01L HR In accord with ILHR 83.05, Wis. Adm. Code COUNTY / STATE SANITARY PERMIT # -Attach complete plans (to the county copy only) for the system, on paper not less than /ep R 8% x 11 inches in size. 1:1 c1{eck if revisi to previous application -See reverse side for, Instructions for completing this application. STATE PLAN I.D. NUMBER 1. APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION. 9.31 PROPERTY 0 NER PROPERTY LOCATION fir, ~z % ~iz> Y., S 20 TG ~ , N, R ~ If (or) W PROPERTY OWN S MAILING ADDRESS LOT # BLOCK # S 0'0 S` cj /,X/ I /t /X CITY, STATE ZIP CODE PHONE NUMBER SUBDIVISION NAME OR CSM NUMBER al/c< r'c~ f iJ : 5`~a~c 715' III. TYPE OF BUILDING: (Check one) El State Owned O VILLAGE : NEAREST ROAD C~~1~7 r T~ .G ❑ Public Z 1 or 2 Fam. Dwelling-#of bedrooms a PARCEL TAX NUMBER(S) III. BUILDING USE: (If building type is public, check all that apply) ao Z / 0-517 36) ooh 1 ❑ Apt/Condo 2 ❑ Assembly Hall 6 ❑ Medical Facility/Nursing Home 10 ❑ Outdoor Recreational Facility 3 ❑ Campground 7 ❑ Merchandise: Sales/Repairs 11 ❑ Restaurant/Bar/Dining 40 Church/School 8 ❑ Mobile Home Park 12 ❑ Service Station/Car Wash 5 ❑ Hotel/Motel 9 ❑ Office/Factory 13 ❑ Other: Specify IV. TYPE OF PERMIT: (Check only one in line A. Check line B if applicable) A) 1.E1 New 2. ln( Replacement 3. ❑ Replacement of 4. ❑ Reconnection of 5.0 Repair of an System System Tank Only Existing System Existing System B) ❑ A Sanitary Permit was previously issued. Permit - Date Issued V. TYPE OF SYSTEM: (Check only one) Non-Pressurized Distribution Pressurized Distribution Experimental Other 11 ❑ Seepage Bed 21 A Mound 30 El SpecifyType 41 El Holding Tank 12 ❑ Seepage Trench 22 In-Ground 42 ❑ Pit Privy 13 ❑ Seepage Pit Pressure 43 ❑ Vault Privy 14 ❑ System-In-Fill VI. ABSORPTION SYSTEM INFORMATION: 1. GALLONS PER DAY 2. ABSORP. AREA 3. ABSORP. AREA 4. LOADING RATE 5. PERC. RATE 6. SYSTEM ELEV. 7. FINAL GRADE REQUIRED (sq. ft.) PROPOSED (sq. ft.) (Gals/day/sq. ft.) (Min./inch) ELEVATION ~~o :575 3 l- l©O Feet ~>>5 Feet VIL TANK CAPACITY Site in gallons Total # of Prefab. Fiber- Exper. INFORMATION New Existing Gallons Tanks Manufacturer's Name Concrete Con- Steel glass Plastic App Tanks Tanks strutted Septic Tank or Holdin Tank doG7 - -1 F-I I [I [I Lift Pump Tank/Si hon Chamber Zoo - D Vlll. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plumber's Name (Print): Plumber's Signature: (No Stamps) MP/MPRSW No.: Business Phone Number: Plumber's Address (Street, City, State, Zip Co/d : IX. COUNTY/DEPARTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (includes Groundwater a e issued Issuing Agent Signature (No Stamps) Approved El Owner Given Initial Surcharge Fee) Adverse Determination G~ X. CONDITIONS OF APPROVAL/REASONS FOR DISAPPROVAL: SBD-6398 (formerly Plb-67) (R. 11/88) DISTRIBUTION: Original to County, One Copy To: Safety & Buildings Division, Owner, Plumber 0 INSTRUCTIONS 1. A sanitary permit is valid for two (2) years. 2. Your sanitary, permit may be renewed before the expiration date, and at the time of renewal any new criteria in the Wisconsin Administrative Code will be applicable. 3. All revisions to this permit must be approved by the permit issuing authority. 4. Changes in ownership or plumber requires a Sanitary Permit Transfer/Renewal Form (SBD 6399) to be submitted to the county prior to installation. 5. Onsite sewage systems must be properly maintained. The septic tank(s) must be pumped by a licensed pumper whenever necessary, usually every 2 to 3 years. 6. If you have questions concerning your onsite sewage system, contact your local code administrator or the State of Wisconsin, Safety & Buildings Division, 608-266-3815. To be complete and accurate this sanitary permit application must include: 1. Property owner's name and mailing address. Provide the legal description and parcel tax number(s) of where the system is to be installed. II. Type of building being served. Check only one and complete # of bedrooms if 1 or 2 Family Dwelling. III. Building use. If building type is Public, check all appropriate boxes that apply. IV. Type of permit. Check only one in line A. Complete line B if permit is for tank replacement, reconnection, or repair. V. Type of system. Check appropriate box depending on system type. VI. Absorption system information. Provide all informalion requested in ##1-7. VII. Tank information. Fill in the capacity of every new and/or existing tank, list the total gallons, number of tanks and manufacturer's name. Indicate prefab or site constructed and tank material. Complete for all septic, pump/siphon and holding tanks for this system. Check experimental approval only if tanks received experimental product approval from DILHR. VIII. Responsibility statement. Installing plumber is to fill in name, license number with appropriate prefix (e.g. MP, etc.), address and phone number. Plumber must sign application form. IX. County/Department Use Only. X. County/Department Use Only. Complete plans and specifications not smaller than 8'f x 11 inches must be submitted to the county. The plans must include the following: A) plot plan, drawn to scale or with complete dimensions, iocation of holding tank(s), septic tank(s) or other treatment tanks; building sewers; wells; water mains/water service; streams and lakes; pump or siphon tanks; distribution boxes; soil absorption systems; replacement system areas; and the location of the building served; B) horizontal and vertical elevation reference points; C) complete specifications for pumps and controls; dose volume; elevation differences; friction loss; pump performance curve; pump model and pump manufacturer; D) cross section of the soil absorption system if required by the county; E) soil test data on a 115 form; and F) all sizing information. - - - - - - - - - - - - - GROUNDWATER SURCHARGE 1983 Wisconsin Act 410 included the creation of surcharges (fees) for a number of regulated practices which can effect groundwater. The monies collected through these surcharges are used for monitoring groundwater, ground- water contamination investigations and establishment of standards. SBD-6398 (R.11/88) ~ ~ Ne /fO11 gos zZ:o~ sf d4 2g~. 9~~ ~z -,/05,AiCEIVED J _ 119 10Y, 7Z MAY 14 1993 SAFETY 3 WIN- ON' The area 25 ft. below the downstope edge of a fi Soil Absorption System must remain undisturb d. Sc a I e _ 'j~0 U' I ro Cr4y LihG V ATE ~ pGE SY8'~ I_ Ily it10 UAII co 800 P. C, 1 too as Po o L • of 1l1d MT is B 6U4 w olv~ D~ I /UOc> go~S.T ~ . ~ I ~ ~~Q9e 7~ SeP~I~~ \✓t 0. r 1,98 a l ~ ~BANbCak '~.`il: EXt~ii ttiC- I I .$L-FT &C SVS-IXM MS eCFL Sys~e, ic.wm3: Zzo ~ sf /VG1dh, Cross Section Of A Mound Using A Trench For The Absorption Area `tedium Sand Fill ° F 6" TopsoAtCEIVED -Jl D 3 E PRIVA MAY 1 4 1993 Trench Of !2" 21" A r ate, Plowed Layer 6" Belo 'bpvdW j h D F3 Ft. SAFETY & BLDQS. DIV. Straw, Marsh Ha c Fabric I E2,07 Ft. G /,O Ft. ~ DW. OF INDUSTRY, LABOR & HUMAN RELATIONS F - 75 Ft. H 1-5 Ft. DIVISION OF SAFETY BUILDWGS iEE CO NDENCE Plan View Of ;found Using A Trench For The Absorption Area Force Main Distribution Pipe I Permanent Markers Observation Pipe W A Lp B K I Trench Of - 22" Aggregate L A 7 `t. IIzI Ft. K /Z -5 Ft. W g Ft. B Ft. J /0 -Ft. L //9 Ft. Signed: J / License 1~ Number: Date: e rr /ve~So ~ Z o Distribution Pipe Detail For Two Lateral Network RECEIVED MAY 1 4 1993 Holes Located On Bottom SAFETY & BLDGS. W. Are Equally Spaced PVC Force Main End Cap Y X X PVC Distribution Pipe P P X * Last Hole Should Be Next To End Cap 1 P Ft. Hole Diameter AV Inch X Inches Lateral Diameter z Inch(es) Y 411g Inches Force Main Diameter Z- Inches # Of Holes/Pipe /Z, Invert Elevation Of Laterals 109:57 Ft. Signed: License Number: r1%~~~1 - Date: pRjxjATE SEwp~GE SYSTEM condi"i 31r tp,ROR~ ,aN: gE~TIONS Of IIAOUSTftY, SI A,,,: Gs.. DIVISION OF ~FECY ~~%SEE CORK ' PAGE OF-Y-_ ' PUMP CHAMBER CROSS SECTION AND SPECIFICATIONS ' VENT CAP Hr C.I. VENT PIPE WEATHER PROOF APPROVED LOCRINGEIVED JUNCTION BOX MAWHOLE COVER 2S' FROM DOOR, IrMlu. WINDOW OR FRESH MAY 14 1993 I AIR INTAKE GRADE I UY & BLDG. DIY. I `I MIN. Ilk, 19'MIAI. CONDUIT TElA cEy~A ~ s • PROVIDE I I INLETd,. AIRTIGHT SEAL o I III °ci `ly I III v APPROVED JOIAfT A !L I I I APPROVED JOINTS W/C.7:. PIPE I III W/C.I. PIPE EXTENDING 3' r ' - I I) ALARM EXTENDING 3' !18 I aura sOLlo solL ONTO 3OL10 $011. I ~ ~ jt0 I 8~~ HU'~~ I I gOR S USTB , AND DU ~ ON OP 1ND pFEn I S PUMP OFF; . 00 on CONCRETE BLOCK ' 3" APPRoV6D RISER EXIT PERMITTED ONLY IF TANK MANUFACTURER HAS SUCH APPROVAL ..~~.LLL~~~LLL SEPTIC F SPECIFICATIOKIS . DOSE r TANK MAIJUFACTURCR: 6f2e,' S L° NUMBER OF DOSES: ~ PER DAy TANK 51ZE: Z049 C9 GALLONS DOSE VOLUME ALARM MA14U FACT U R. F R: Is J Alec-fro INCLUDING OACKFLOW: 11✓ GALLONS MODEL NUMBER: -Q CAPACITIES. A= 2 2'5-71NCHE5 OR 51-:5 GALLONSu SWITCH TYPE: a C, urn 8= 2 INCHES OR /t/7 4LLON5~ PUMP MANUFACTURER: V ON~ a~I/~ C = G' 7 INCHE5 OR / ' 0 GALLOUSOr MODEL NUMBER: 3gg ? &,~r0 3 D- ZZ INCHES OR z79 GALLON53'y'7 SWITCH TYPE: 14e v- r, -a MOTE: PUMP AND ALARM ARE TO DE q~ MINIMUM DISCHARGE RA E S G ° INSTALLED ON SEPARATE CIRCUITS 1~3~" VERTICAL DIFFERENCE DETWEEN PUMP OFF AND.015TRIBUTION PIPE.. _15 FEET -71 + MINIMUM NETWORK SUPPLY PRESSURE . , . , . . , , . 2.5 FEET + L ~ FEET OF FORCE MAIN X 1/04 FYo fTFKICTIOIJ FACTOR..'2170 FEET -15 = TOTAL DtIWAMIC HEAD = ~917 FEET INTERNAL DIMENSIOLIi OF TANK: LENGTH ;WIDTH o ;LIQUID DEPTH -9. 1JUMBER: 1111-6629 DATE: ~Z-~ SIGNED: SUbmersible Effluent Performance curves Pumps age -1"14- METERS FEET 90 MODEL 3885 25 SIZE 3/4' Solids WE15H 70 = 20- 60 t WE10H CEIVED 0 WE07H 50 1 , 15 4 1993 wEOSH 40 f a sLM. oiV. 10 30 wEOSM 5 10 +Pt- 0 0 0 10 20~ 40 50 60 70 80 90 100 110 120 GPM i~ L -L 0 10 20 30 ma/h CAPACITY [qGOULDS PUMPS. INC. SElea FALLS WW YM 13148 METERS FEET 120 MODEL 3885 35 SIZE 3/4" Solids 110 WE15HH 100 30 90 25 Q 70 w = 20 J la- 60 0 f- - 50 WE05HH 15 40 10 30 21) 5 10 0 0 0 10 20 30 40 50 60 70 80 90 100 110 120 GPM 1 1 1 i 0 10 20 30 m'/h CAPACITY 01985 Goulds Pumps, Inc. Effective July, 1985 C3885 -~-'^f ovrr_ HrvU 511 t_ CYALUAI IUN titVOti 1 DI l.. ! 11 1 in accord with ILHR 83.05, Wis. Adm. Code COUNTY Attach complete site plan on paper not less than 8 112 x 11 inches in size. Plan must include, but r o X not limited to vertical and horizontal reference point PARCEL I.D. M (BM). a or direction and of sloPa scat dimensioned, north arrow, and location and distance to nearest road. APPLICANT INFO RMATION-PLEASE PRINT ALL INFORMATION REVIEWED BY DATE PROPERTY OWNER: PROPERTY LOCATION ~I rt 11118 s GOVT. LOTS Gtr 1/4 .5G A/4,S ujT Z9 ,N.R 16 1f(a) W PROPERTY CWNEFt' MAILING ADDRESS LOT BLOCK A SUBO. NAME OR CSM t g0~ ZZO $f /jj// /V CITY, STAT ZIP CODE PHONE NUMBER ❑CITY ❑VILLA E MOWN NEAREST ROAD Z3Al GJ s ~aZ~ (7/sl - 306'7 ~Sa /0/Z.tw, n ZZO $ (J New Construction Use Residential / Number of bedrooms J}(( Replacement ( J Public or commercial describe IVO Code derived daily flow 5'0 gpd Recommended design loading rate - Z bed, gpolft2 -3 6WD Absorption area required 375 bed, 112 375 trench ft2 Maximum i d design loading rate bed 9Pdl'ft2 3 , Recommended infiltration surface elevation(s) - It as referred to site an benchmark~ ( PI ) Additional design / site considerations A VMS, 014W Parent material Flood plain elevation, if applicable ' S = Suitable for system ooNVENrIOruL MOUND INGROUNDPRESSURE AT-GRADE SYSTI M W FlLL HOLDING TANK U = Unsuitable forsystem ❑ S ❑ U ❑ S ❑ U ❑ S ❑ U ❑ S ❑ U ❑ S ❑ U ❑ S ❑ U SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure ~nce Baxidary Roots GPD/ft in. Munsell tau. Sz. Conl Color Gr. Sz. Sh. Bed Trerd o-g A 9 /vA s6 r a.5 Z -oz •o3 /t .03 Ground ~y / 7 lU y 5 , j 1222 ol_ r Z lei skk xyl e- C Z -,9 Z- -03 elev. ia3 n y 17-Z`f 5YR y y /'v) Z 0/ &d Z mss / Grr3 Z- -oz ,03 Depth to Zy S''`f y /YJ Z G3' B s m s~]` r C i •D y •05 limiting factor Remarks. Boring # 0-7 /O YR Z AIA BI v tr . as 2 -6Z 1,03 ~e - y Z Z -Zo /;SbIt~ s /r1I/ r G r Z O Z Ground 3 ZO U 5 X 13v\ 5/ 1 Z S ~r C t c> Z .o, elev. Z7-5'0 S 2- C Depth to - limiting factor 2 Remarks: CST Name:-Please Print Q / ~ ~ ~SOn Phone: 33 Address: ZZO 7 - Signature: Dale: CST Number: Boring # Horizo Depth Dominant Color Molttes Structure YDMt ` in. Munsell tDu., Cant Color Texture Gr. Sz. Sh. Consistence Boundary Roots o- Bed,tTrerd s 0--3 Qs Z .oz ,o S.3 Bn si /~lI C i Z •OL' •03 Ground S '%~6 Y~S~ rYJ S C~.J Z •Dy .,9 elev. AZ 2- Y S J / '1nl -oy ,off Depth to limiting factor Z Remark's: Boring # Sr in Ground elev. Depth to limiting factor L I Remarks: Boring # K .v v.= f: jr J.i•'xGround elev. Depth to limiting factor Remarks: Boring # Ground elev. (L Depth to limiting j factor Remarks: -^u•~ SOIL AND SITE EVALUATION REPORT D I L H R in accord with ILHR 83.05, Wis. Adm. Code COUNTY ' Attach complete site plan on paper not less than 8 112 x 11 inches in size. Plan must include, but S- C r'61 ~ not limited to vertical and horizontal reference point (8M), direction and % of slope, scale or PARCEL I.D.Ir dimensioned, north arrow, and location and distance to nearest road. APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION REVIEWED BY DATE PROPERTY OWNER PROPERTY LOCATION Q GOVT. LOT SO 1/4 SO1/4,Szo T X9 N.R 16 ti (or) W PROPERTY C WNER MAILING ADDRESS LEA BLOC~I SUED. NAME OR CSM 1 600-5 220 CITY, STATE , ZIP CODE PHONE NUMBER []CITY []VILLAGE,WOWN NEAREST ROAD oo Z. (71-41- S - 306 7 ( Ea -5v- I New Construction Use ( Residential ! Number of bedrooms 3 ,4 Replacement ( ( Public or commercial describe Code derived daily lbw s gpd Recommended design loading rate `Z bed, gpd4? • .3 trench, gpd/ft2 Absorption area required 376 bed, ft2 3 75 trench, ft2 Maximum design loading rate • 2 bed, gpd/tt2 3 trench, gpd/ft2 Recommended Infiltration surface elevation(s) It (as referred to site plan benchmark) Additional design / site considerations Parent material Flood plain elevation, if applicable /f~A It S - Suitable for system MW-ENTIONAL MOWD IN-GROUNOPRESSURE AT-GRADE SYSTEM IN FILL HOLDING TANK U= Unsuitable forsystem ❑ S AU_ ® SO U ❑ S 19U ❑ S U ❑ S Pff U ❑ S PI U SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Structure Consistence Bwidary GPD/ft 9 in. Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. Roots Bed Trend A 2 9-/1 /o YR 5/3 Ground 3 /1-17 /U XR:S' 3 /Vm 0/ rc8n 2 C / /03i' n. 7-Z 5/V9 4A Depth to Inm 0/ limiting tack I Remarks: ' Boring # o:• Z Z 7-2o lo YR 5/3 13 Ground 3 zo-Z'7 s vie q y eel By, 2 rn s6~ ~~'r G elev. `f 27-41-0 ioS~tt• roof an ,)'-{r c-, Depth to - - - - limiting for - 27 Remarks: CST Name:-Please Print ; -1a/e Phone: g _ •LJ -3.3 7 Address: Signature: Dale: CST Number: i~~ r/z 93 Boring # Horizon Depth Dominant Color Mottles Structure GPD/ft Texture Consistence in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh.Bw-ida Y Roots Bed :Trend 3 . / O- 1o YR Z Awl B sl / r a :a....: Z 7- o Y)e 511 n si' /y1 V r C - Ground 3 //-Z5~ 5 y~e `f 6 s s6 r G elev. 7 dt iV 2-'1-24 SYP 6 /l Ol yiP s ~h'I r Depth to y 6-A SY~ 6 mm~ limiting factor Remarks: Boring # £pr.f k: Ground elev. tL Depth to limiting factor Remarks: Boring # n Ground elev. tL Depth to limiting factor Remarks: Boring # Ground elev. fL Depth to limiting 1 (actor -_T Remarks: SAFETY & BUILDINGS DIVISION State of Wisconsin Department of Industry, Labor and Human Relations PRIVATE SEWAGE PLAN APPROVAL Western Regional Office 2226 Rose Street LaCrosse, Wisconsin 54603 BOLDTS PLBG & HTG 820 MAIN ST BALDWIN WI 54002 RE: Plan Number: S93-40240 Date Approved: May 20, 1993 Gallons Per Day: 450 Date Received: May 20, 1993 Project Name: NELSON, TERRY Location: SW,SW,20,29,16W Town of BALDWIN County: ST CROIX The plumbing plans and specifications for this project have been reviewed for compliance with applicable code requirements. This approval is based on Chapter 145, Wisconsin Statutes and the Wisconsin Administrative Code. The plans are stamped 'conditionally approved'. This approval is contingent upon compliance with any stipulations shown on the plans. All items that are noted must be corrected. All permits required by the city, village, township or county shall be obtained prior to construction. The licensed plumber responsible for this installation shall keep one set of plans with the department's approval stamp at the construction site. The installer shall notify the appropriate inspector when inspections can be made. This approval will expire two years from the date approved or if a sanitary permit is obtained, it will expire the day the initial sanitary permit expires. The Section of Private Sewage has reviewed these plans for private sewage system code requirements only. These plans have not been reviewed for the code requirements set forth in Section ILHR 82 for general plumbing or in Chapters 50-64 of the Wisconsin Administrative code. This approval is for the following components only: - REPLACEMENT MOUND Inquiries concerning this approval may be made by calling (608) 785-9348. Sincerely, P C4ERAR*DM. SWIM Section of Private Sewage Division of Safety and Buildings PPP039/0009n/43 cc: Private Sewage Consultant SUD-6423 (R. 0"1) ST. CROIX COUNTY WISCONSIN ZONING OFFICE ST. CROIX COUNTY COURTHOUSE 911 FOURTH STREET • HUDSON, WI 54016 (715) 386-4680 April 14, 1993 Division of Safety and Building Bureau of Plumbing P.O. Box 7969 Madison, WI 53707 To whom it may concern: An onsite soil investigation of the Terry Nelson property, located in the SW1/4 of the SW1/4, Sec.20, T29N, R16W, Town of Baldwin, St. Croix County, WI., has been conducted with the assistance of Dale Hudson, CST# 3413. This onsite revealed suitable soil for onsite sewage disposal to a depth of 14" while meeting the requirements of the A + 4" rule. This site should be suitable for new construction utilizing a mound septic system having 22" of sand fill. Should you have any questions, please feel free to contact me at this office. Sincere y, 51", J es hom so~ Assistant Zoning Administrator cc: file Wisconsin Department of Industry, SOIL AND SITE EVALUATION REPORT Page _ of Labor and Human Relations Division of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code COUNTY Attach complete site plan on paper not less than 8 1/2 x 11 inches.' e. Plan must include, but not limited to vertical and horizontal reference point (BM), directiorof slope, scale or PARCEL I.D. # dimensioned, north arrow, and location and distance to nearest road. APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION REVIEWED BY DATE 4/0- PROPERTY~JNNER: PROPERTY LOCATION GOVT. LOT 5W 1/450 1/4,S,-0 T vZf N,R f )W PROPERTY OWNER' MAILING ADDRESS LOT # BLOCK # SUBD. NAME OR CSM # CITY, STATE ZIP CODE PHONE NUMBER ❑CITY E ILLAGE E;OWN NEA%F T ROAD r un-rte SJ- 2, 2 20 -25t [ J Ne onstruction Use [Residential / Number of bedrooms [ J Addition to existing building eplacement [ ] Public or commercial describe Code derived daily flow gpd Recommended design loading rate bed, gpd/ft2 trench, gpd/ft2 Absorption area required bed, ft2 trench, ft2 Maximum design loading rate bed, gpd/ft2 trench, gpd/ft2 Recommended infiltration surface elevation(s) ft (as r4ferred to site plan benchmark) Additional design / site considerations Parent material Flood plain elevation, if applicable ft S = Suitable for system CONVENTION MOUN IN-GROUND P RE AT-GRADE SYSTEM ❑ S 9M-] IN FILL HOLDING ❑ S TANK U =Unsuitable fors stem El S El U El S ❑ i SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Bouirclary Roots GPD/ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench 75 13 lvxe A, C c- Ne, Ground l S l S' r r ;ei ;v K ft. Depth to ~ e Cs rh limiting fat d t I etr sb g -moo mass.✓~ Remarks: Boring # rv,l / ~l1 Ground 5 elev. rf ft. Depth to limiting r~ factor r` GJ er) Remarks: CST Name:-Please Print Phone: Address: Signature: Date: CST Number: PROPERTY OWNER SOIL DESCRIPTION REPORT Page _of PARCEL I.D. # Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench t'+kvv~v\\ Ground elev. ft. Depth to limiting factor Remarks: Boring # rye::: Ground elev. ft. Depth to limiting factor Remarks: Boring # t~g Ground elev. ft. Depth to limiting factor Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: SBD-8330(8.05/92) QILHR OUIt_ H" 511 t L VALUATION REPORT in accord with ILHR 83.05. Wis. Adm. Code W COUNTY Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or PARCEL I.D. ar dimensioned, north arrow, and location and distance to nearest road. APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION REVIEWED BY DATE PROPERTY OWNER PROPERTY LOCATION GOVT. LOT S (,J 1/4 SCj14,SCj T AR E (or) W PR PERTY NER' MAILING ADDRESS LOT N BLOCK M JSSOS 220 CITY, STATE ZIP CODE (NON' NUMBER []CITY []VILLAG N NEAREST ROAD New Construction Use ( residential / Number of bedrooms j,Keplacement ( ) Public or commercial describe Code derived daily flow gpd Recommended design loading rate bed, gpd/ft2 trench, gpd/ft2 Absorption area required bed, ft2 trench, 1t2 Maximum design loading rate bed, gpd$ trench, gpd/R2 Recommended infiltration surface elevation(s) if (as referred to site plan benchmark) Additional design I site considerations Parent material Flood plain elevation, if applicable ft S = Suitable for system O~NVENTIONA MOUND INGROUNDPREWRE AT-G S 4 DE SYSTEM IN FlL ~ TANK U = Unsuitable fors stem S S UW S ~j' ❑ SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Structure GPD/ft in. Munsell Qu. Sz. Corn- Color Texture Gr. Sz. Sh. Consistence Bminday Roots Bed Trend- (y, vyl Ground 6 -c J- V C'2 C; F. 6+ rq C elev. -Z M4,-; Depth to t limiting factor Remark's:_Y.~;.~ j./, - /1_ zl - "10 -60 , ~ I Boring # k~:i4 k?Q.]I 1 I v p}ti I Ground - elev. ft. - - Depth to - - - - limiting factor _ Remarks: CST Name:-please Print Phone: Address: Signature: - Date: CST Number: 1D"Ol /C rry /VC/SOll g S Csr 3 y/3 -d 13 98 i az 2c . s *7 ~Z lo5, 33 J3 _/oy,7Z ,c /00" nz 0 a ~ - ~ p l O fer~y 41, hc 0 goo So~. P.C, IJt Poo L Sbed 0 S .00 i ~ ~ ~~Q9e I ~J Sa i fr ti S I f em s S y i ,ZZO 7Y Si, I APPLICATION FOR SANITARY PERMIT S T C - 100 This application form is to be completed in full and signed by the owner(s) of the property being developed. Any inadequacies will only result in delays of the permit issuance. Should this development be intended for resale by owner/contractor,(spec house), then a second form should be retained and completed when the property is sold and submitted to this office with the appropriate deed recording. Owner of property e 14 4- Location of property .51t) 1/4 1/4, Section s , T N-R W Township Mailing address SCI ZC~ 'Address of site , /"n Subdivision name /V 1/ Lot number Previous owner of property ~d O /'~ETp~✓k Total size of parcel / 30 x / yo ` Date parcel was created Are all corners and lot lines identifiable? IA-1 es No Is this property being developed for resale (spec house)? Yes No Volume /0 /f and Page Number ,~9 as recorded with the Register of Deeds. INCLUDE WITH THIS APPLICATION THE FOLLOWING: A WARRANTY DEED which includes a DOCUMENT NUMBER, VOLUME AND PAGE NUMBER, and the SEAL OF THE REGISTER OF DEEDS. In addition, a certified survey, if available, would be helpful so as to avoid delays of the reviewing process. If the deed description references to a Certified Survey Map, the Certified Survey Map shall also be required. PROPERTY OWNER CERTIFICATION I(We) certify that., all statements on this form are true to the best of my (our) knowledge; that I (we) am (are) the owner(s) of the property described in this information form, by virtue of a warranty de d recorded in the Office of the County Register of Deeds as Document No., J~ ; and that I (We) presently own the proposed site for the sewage disposal system (or I (we) have obtained an easement, to run with the above described property, for the construction of said system, and the same has been duly recorded in the Office of the County Register of Deeds, as Document No. Signatu4 of Owner Signature of Co-Owner (If Applicable) i -e2 7 Y.3 `Date of Signature Date of Signature H a S T C- 105 r a SEPTIC TANK MAINTENANCE AGREEMENT o St. Croix County z a OWNER/BUYER -'/(--r-r- rri ROUTE/BOX NUMBER Fire Number P5 CITY/STATE ~G/lam( !v; yt t / ZIP e90,7- PROPERTY LOCATION: Section T hr? N, R W, Town of St. Croix County, Subdivision /I/ Lot number. Improper use and maintenance-of your septic system could result in its premature failure to handle wastes. Proper maintenance con- sists of pumping out the septic tank every three years or sooner, if needed, by a licensed septic tank pumper. What you put into the system can affect the function of the septic tank as a treat- ment stage in the waste disposal system. St. Croix.County residents may be eligible to receive a grant for a ,maximum of 60% of the cost of replacement of a failing system, which was in operation prior to July 1, 1978. St. Croix County accepted this program in August of 1980, with the requirement that owners of all new systems agree to keep their systems properly maintained. The property owner agrees to submit to St. Croix County Zoning a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper veri- fying that (1) the on-site wastewater disposal system is in proper operating condition and'(2) after inspection and pumping (if nec- essary), the septic'tank is less than 1/3 full of sludge and scum. Certification form will be sent approximately 30 days prior to three year expiration. H 0 I/WE; the undersigned, have read the above requirements and agree to main_tain,.the.private sewage disposal system in accordance with x the standards set forth, herein, as set by the Wisconsin Depart- b ment of Natural Resources. Certification form must be completed and returned to the St. Croix County Zoning Office within 30 days of the three year expiration date. SIGNED DATE_ Sal-9.3 St. Croix County Zoning Office P.O: Box. 98• Hammond, WI 54015 715-796-2239 or 715-425-8363 Sign,-date and return to above address. r DOCUMENT NO. I WARRANTY DEED THIS SPACE RESERVED FOR RECORDING DATA STATE BAR OF WISCONSIN FORM 2 -1982 1 R'S OFFICE 499685 oL 1011mi 403 [7Re;c IX CO., WI Jon M. Mentink and Jean A. Mentink, dforRecord h usband and wife, each in -his or hir MAY 2 6 1993 •---n•--- r - ow fi_ 1it 10.50 fM . . ° . . . and warrants . to -Terry--A. _ _ conveys . Nel-SO . n..dnd _Barbara --L at V t _M Nei-son,-..hu-sband_.-anal wfz-,-._h.ol.~_i_ng~..~_s_..s.ury-i.vo - q&ta of Delft ; shi-p marital--- Prope.rty P RETURN TO F _ II n• the following described real estate in St rrQA X_____________________County, L` State of Wisconsin: Tax Parcel No: i The South 140 feet of Outlot 1 of Certified Survey Map filed May 27, 1987, in Volume n7", page 1821, office of the Register of Deeds for St. Croix County, Wisconsin, being part of the Southwest Quarter of the Southwest Quarter (SW1 of SWI) of Section Twenty (20), Township s Twenty-nine (29) North, Range Sixteen (15) West. Mal y 00 j This _S..A-Ot----------- homestead property. (yar. (is not) Exception to warranties: Easements and restrictions of record. i 2 '1 Dated this 9 3 day of . 19......... f I ' - --(SEAL) . . .........................(SEAL) n M. Me n i i n k (SEAL) - ~•Fif (SEAL) ' .ean..A....Men.tin.k...._......._........._ AUTHENTICATION ACKNOWLEDGMENT I t Signature(s) STATE OF WISCONSIN ss r St. Croix as. - - County. authenticated this day of--------- 19------ Personally came before me this ................day of 19.93--- the above named ----Jon---W,.Aent.i.nk- a_nd.._dein---A---------------- Men-tin-k........................................................... TITLE: MEMBER STATE BAR OF WISCONSIN (If not, . - authorized by 706.06, Wis. State)L m k wn to be the person 5.......... who executed the `el r 4+ t nowled the same. THIS INSTRUMENT WAS DRAFTED BY Thomas A. McCormack - - s Baldwin, W1 54002 -z ZP ' - f > I~o ry'PUbfic -___--..-_--5 _-C-? _f~f'---- County, Wis. anot Signatures may be authenticated or acknowledged. Bott,+~;' .A[Y ComrrljSsion is permanent.(If not, state expiration necessary.) Now PU41k..Sfate4VY n.........., 19......-_.) My CortlrnisSlon Expires Mel E. 1994 *Names of persons sfanins in any capacity should be typed or printed below their signatures. II WARRANT? DEED STATE BAR OF WtSCONSiN Wisconsin Legal Blank Co.. Inc. _ FORM Na. 2- 1982 Milwaukee, Wisconsin a ! ".l t,`.'1^e Vi- ~ . "-,doh ..tip it - v:,>il. t, ,r . ti... .s, e-•..• s r-. _ It. ~F• v° c . ST. CROIX COUNTY WISCONSIN ZONING OFFICE x ST. CROIX COUNTY COURTHOUSE - 911 FOURTH STREET • HUDSON, WI 54016 (715) 386-4680 rw April 22, 1993 Division of Safety and Building Bureau of Plumbing P.O. Box 7969 Madison, WI 53707 To whom it may concern: An onsite soil investigation of the Terry Nelson property, located in the SW1/4 of the SW1/4, Sec.20, T29N, R16W, Town of Baldwin, St. Croix County, WI., has been conducted with the assistance of Dale Hudson, CST# 3413. This onsite revealed suitable soil for onsite sewage disposal to a depth of 14" while meeting the requirements of the A + 4" rule. This site should be suitable for new construction utilizing a mound septic system having 22" of sand fill. Should you have any questions, please feel free to contact me at this office. Sincerely, James K. Thompson Assistant Zoning Administrator cc: file ST. CROIX COUNTY WISCONSIN ZONING OFFICE M C N N ST. CROIX COUNTY GOVERNMENT CENTER 1101 Carmichael Road w Hudson WI 54016-7710 715 386-4680 March 24, 1994 Dale Hudson MP#6629 820 Main St. Baldwin, WI 54002 Dear Dale: The intent of this letter is to recap our conversation of last Monday afternoon. While completing my paper work on the Terry Nelson mound installation I discovered several design and possible installation mistakes associated with this system. I followed this finding with an inspection of the system, for which you were present. During this inspection I found several problems or possible problems with the installation. They are as follows: 1.) The mound has not been properly seeded and mulched. 2.) The septic tank manhole cover which is in the asphalt driveway is still in place. Has this tank been properly abandoned as required by code? If not, please see that it is. 3.) The septic tank and pump chamber were backfilled prior to inspection. Please provide me with the septic tank inlet, outlet, and manhole cover elevations as well as the pump chamber inlet elevation. 4.) The pump chamber cross section contains several errors, including the minimum pump discharge rate, the tank elevation, the amount of lift required, and the tank capacities associated with the float settings. 5.) The system was installed requiring a pump which would be able to discharge a minimum dosing rate of 29.25 gal./min. at a TDH of 22.761. The installed Goulds WE03111 pump will discharge approximately 22gpm at the installed TDH according to the pump curve you provided. Because of this, the system is not properly pressurized and may result in the mound failing prematurely. I verified this finding by measuring the amount of effluent which was pumped out of the tank over a known period of time. This calculation revealed a dosing rate of approximately 22.5 gpm - again not sufficient to pressurize the system. You are hereby ordered to replace the existing pump with one which will properly pressurize the system. 6.) The pressure distribution network was not installed in accordance with your design and state approved plans. Because of this, you must submit revised plans to the state. In an effort to minimize confusion and delays, I suggest that you include the changes to the pressure distribution network, recalculate the pump chamber capacities and float settings, show the proper minimum discharge rate required to pressurize the system, the correct TDH, and specify the pump which will replace the one installed. i After you have received the state approvals on these revisions you must submit a copy of the plans and a revised permit application to our office. This can be handled as a revision and will not require a new permit. Accordingly, there will be no additional county fees. If you have any questions which I can clarify for you, please contact me at this office between the hours of 8:00am-5:00pm, Monday - Friday. SJ Thompson 'Assistant zoning Administrator cc: file