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008-1093-80-000
St. Croix County Zoning Wednesday, January 14, 2004 a:11:14:20AM Detail Sanitary Information Page 1 ojl Computer #: 008-1093-80-000 Sub/Plat: NA Section: 33 Parcel #: 33.28.16.4958 Lot: TNIRNG: T28N R16W Municipality: Eau Galle Township CSM: 1/4114: SW 114 NW 114 Owner: Palm, Rory 81 230th Street Baldwin, W l 54002 State Permit: 420554 Issued: 11115!2002 POWTS Dispersal: Mound less than 24" suitable s Permit: New County Permit: 0 Installed: 06/08/2003 POWTS Detail: Mound Bedrooms: 4 WI Fund: POWTS Pretreatment: Unknown Notes Insaector As Built Plumber Other Requirements Pam Quinn NA Myers, Lyle receipt to show septic tank maintenance by Signed Off: No a licensed pumper Additional Notes Money Owed Revised state plan -changed mound location. $0.00 Installing tank only on 3!19/03 with service contract until mound can be installed. Owner used without pumping, then had Ron Montieth illegally pump the tank when it backed up into the house after a big party!! Sent a code enforcement notification letter 6127!03 Maintenance Scheduled Puma Date Pumped 1st Notification 2nd Notification 3rd Notfcation 6!8/2006 June 27, 2003 Rory and Beth Palm 81 230`x` Street Baldwin, WI 54002 ~: _, 5T. CROIX COUNT WISCONSIN ZONING OFFICE ST. CROIX COUNTY GOVERNMENT CENTER 1101 Carmichael Road Hudson, WI 54016-7710 (715) 386-4680 FAX (715) 386-4686 RE: Notice of St. Croix County Ordinance Violation -Sanitary Ordinance Location: Residence at 81 230"' Street, Baldwin, Eau Galle Twp. Computer #: 008-1093-80-000 Parcel #: 33.28.16.495B Dear Mr. & Mrs. Palm: As required by the ST. CROIX COUNTY ZONING ORDINANCE, notice is hereby given that you are in violation of § 254.59(2) Wisconsin Statutes, COMM $3.32(1) Wisconsin Administrative Code, and Article 15.04 of the St. Croix County Zoning Ordinance. This system encountered temporary failure under the definition in § 145.245(4)(d) Wisconsin Statutes (Category II). This violation was first noted on June 18, 2003. The violation noted is septic effluent discharged to the surface of the ground. An on-site inspection on June 18th revealed that septic effluent had previously been pumped onto the surface of the ground on an adjacent landowner's property. Staff observed the presence of a pump and hose that was used to remove the contents of the septic/dose tank that was installed on March 19, 2003. The tank installation was allowed with the understanding that if the mound construction was delayed, a licensed septic hauler would pump the tank and dispose of the contents. It is the owner's responsibility to schedule maintenance of all components of a POWTS, per Wisconsin Admin. Code COMM 83.52. Due to the fact that the tank was full prior to installation of the mound component, the accumulated solids may have compromised the effluent filter's ability to clarify the wastewater prior to dosing the mound. The septic tank must be cleaned to reduce the possibility of premature failure of the mound. REQUIRED ACTION: • Immediately remove all hoses, pipes, pumps, etc that were used to discharge wastewater from the existing tank. • Schedule cleanine of the septic tank by a licensed septic hauler and provide the Zoning Department with a copy of the receipt to document that waste material was delivered to a licensed waste treatment facility. The POWTS inspection form will not be completed and signed until receipt of the documentation required above. Due to the completion of the POWTS as of June 18`}', recurrence of this illegal discharge is not anticipated. You will receive a maintenance reminder for tank cleaning from the Zoning Department prior to the 3-year maximum interval. If fines and or forfeitures become necessary due to another occurrence of this violation, they will be assessed in accordance with Chapter 145.12(4) Wisconsin Statutes. If you have any questions or concerns that I can address for you in this matter, please feel free to contact me. Sin rely, L~~~ Pam Quinn, POWTS Inspector #665054 Zoning Technician Cc: J hn Murtha -Deputy Zoning Administrator (Town of Eau Galle) ~le Wisconsin Department of Comi?I~:rce Safety and Building Division PRIVATE SEWAGE SYSTEM INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Personal information you provide may be used for secondary purposes fPrivacv Law, s.15.04 (1)(m)l. Permit Holder's Name: City Village X Township Palm, Ro Eau Galle Townshi CST BM Elev: Insp. BM Elev: BM Description: i OD• v ! ~O • ~ w ~Ct_ TANK INFORMATION TYPE MANUFACTURER CAPACITY Septic ~~ ~ Dosing ~ ~/ j~ -7 Aeration Holding TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Septic ,~O ~ ~ l 2~- ~ ~ Z , f Dosing r7 (ha Aeration _~-- Holding PUMP/SIPHON INFORMATION Manufacturer ~ -~/~ ~~~ r GPM nd Model Number r ~ I TDH Lif ,~ Friction loss 3 .o System Hea~, S TDH ,Et ~/, os Forcemalrl Le ~ S Dia. n ~, G Dist. to Weld , /,/ZO SOIL ABSORPTION SYSTEM BED/TRENCH Width Length DIMENSIONS ~ / /b O ~ SETBACK SYSTEM TO INFORMATION Type O~,System: / A /`/ DISTRIBUT ION Y STEM S Of Trenches I ~~ BLDG ~ S, >~j b' -r -f~ d~.~- X000 ELEV(ATIOI~ DATA county: St. Croix Sanitary Permit No: 420554 0 State Plan ID No: g(~ 2S L Parcel Tax No: 008-1093-80-000 STATION BS HI FS ELEV. Benchmark 5'' ACS- ~DS,1 lay a A . B~-f~{ar~t r ~_ '' a -7 t~Z. 2 Bldg. Sewer 1 , (~ 93.5 SUHt Inlet 2 . y ~a. SUHt Outlet Dt Inlet 1 _~ Dt Bo tom a ~ _ /7 ~. ~ 8~ 3 7 pleader/Man. '~~ ~p . a Bot.S,Ystem I •r~?~.~•jI z 7, Final Grade ~ ~\~` ~ ~ St Cover 3 3~ ~~ 3, /~ ~~~, ~ ~ ) 'Tl3lN~-/ ~•~ 7- / G ~~f '~• l~ ~ ~~(~• Z UZ' PIT DIMENSI S No. Of Pits Inside Dia. LAKE/STREAM L C Manufactui CHA OR / UNIT Model Nun ~ ., Oa_ ~~ HeadedManifoid Distribution ~ ~ ~ x Hole Si x Hole Spacing Vent to Air Intal~e Len th Dia Len th Dia S acin SOIL COVER x Pressure SYStems Only xx Mound Or At-Grade Systems Only ~~~~~ i Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil ~ Yes I-] No i ,, Yes ~ No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1. 3 / ~ ! / ~.3 Inspection #2: ~ / ~~ Location: 81 230th Street Baldwin, WPI_/5.4~10.02 (SW 1/4 NW 1/4 33 T28N R16W) NA Lot ~~~ ~ Parcel N : 3 .2 16. 956 1.) Alt BM Description =~~ °~~`~~ ~~'~'• ~ f~~a/ -"/~~~~'3 ~~ 2.) Bidg sewer length = ~j~0/~pr~-t (p~ ~1-/~~w~/~ U - ~ ~~~ -amount of cover =~? r 3.) Contour = ~ A, _ I Z I j r~~~~~~ r---~ -~ -- ~ ,..... - -- ---- ---- -- -- ---------I ~ ---I~ r I i Plan revision Required? ~,,., Yes t"ryO , ~ , i, 7 ~ ~ ~ i~~'` Use other side for additional information. ~--- ~~~ _! ~ __-- _--__-- ~-~~~//tt-JJJ--,,,- ~~,~~J _~ _~_-_._ Date Insepctor's Signature Cert. o. SBD-6710 (R.3/97) ~ ry ~~/ ~~6 3 ~w-~J ~~ ~ ~.~. ~~~ ~/~~ Ulac~d U~ c~~„~ cua~~ ~ ~~~~ ~~~-~ ~~ ~~ ~~ ~ ~~~~ ~~ U -,~%.ti r~2. /f~ 7 N~)rZT?J ~~rs S7-; ~r ~.! c<,z t`iQ~s~ <L r, :5 dYO,c Z ~L~ ~'~-~ ,c9~~,-L -------~ ~~ ~' Ir1~ S Q/~~~~~I ~~>c ~/Orc.~ Cr j- sr. C~o~x ~pa,t.~~ ~y ~ 6 ~o 4S ~ -ra ~ r ~'t .4y t~ ~ ~Sr ~ Pn~-~,Y ~ . rv~(6 ~ ~ ,(c.~~ ~{ +3,i2 - f~ j~vus ~ P~ ..__ ~ ~ ~ ~p Jt`1 dtl ~'~2Z~ (~ ~- r vf~.~~ .~(~r ~~ ~g ~ ~~ L Z' ~ ~RLL~ n1 Rr ~ /~ ~ ~`' N p ~ ~A/ G C r~ z~~~. ~a ~~~~ TV r~j~V'_ ~'~ee~ ~ '~ ~ ~ ~ ~7 ~ ~ ~~ Safety and Buildings Division 20 County ~ ~ s~~ ` ~ ~ '~ 1 W. Washington Ave., P.O. Box ?082 ~ ( x / ,sCO~s ',n Madison, WI 53707 - 7082 Sanitary Permit Number (to be fillod is by Co.) Oe artment of Commerce (608) 261-6546 ~ O ~- • • • • anrtary Permit Apphcahon State Plan I.D. Number ~ In accord with Comm 83.21, Wis. Adm. Code, ~` $,Z 3~Z maybe used for secadary purposes Privacy w, sl D Project Address (if different than mailing address) I. Application Information -Please Print All Informatio Owner's Name ~ ST ~ CROIX CO Parcel # Lot p Block p ~ . / UNTY ~ ~93~ ~ _ ~ 3J Owner': fling Address Property Location /n L~ r s Sep y~ ~ ~ section 3 3 City, State Zip Code Phone Number I _ d 2. Z y ~ ss~ ~~ [~q {~ J~ / S L~ T °~~ N R a _ I I .r Type of Building (check all that apply) / S~~ a,~ / ; E W • ~L ~ , ~ ~ ~ P~1 2 F il D lli "t Subdivision Name CSM Numb er ~ or am y we ng - Number of Bedrooms l ~ ^ Public/Canmercial -Describe Use / ~ ^ state owned - Describe Use d . Z6 r/ ~ , , ce.P~ ^City ^Vi»age of ~L~ IIL Type of Permit: (Check only one box on line A. Complete IIne B if applicable) - w. New System ^ Replacement System ^ Tteatment/Hokiing Taolc Replacement Only ^ Other Modificati~ to Existing System B • ^ Permit Renewal Petmit Revision ^ Change of ^ Permit Transfer to New List Previous Permit Number and Date Lssued ~ Before Expiration Plumber Owner J~ n / 2lJ S~T - ~r ~ s o ~i IV. of POW15 S teen: Check all that a 1 ^ Nat-Pressurized In-Ground ^ Mound > 24 is of suitable soil ~ Mound < 24 in. of suitable soil ^ At-Crtade ^ Single Pass Sand Filter ^ Construtted Wetland ^ Prrasutized In-Ground ^ Iiokiing Tank ^ Peat Filter ^ Aerobic Treatment Unit ^ Recirculating Sand Filter ^ Rairathtting Synthetic Media Filter ^ Leaching Chamber Drip Line ^ Gravel-less Pipe ^ Odter (explain) V. Dis rsai/Treatment Area Information: - O (~ Deli Flow (gpd) Design Soil Application Rate(gpdsfj Dispersal Area Required (sfj Dis Area Proposed (s em Ekvatwn ~~ ~a ~ ~ ~'m ~ i2~ ~ ~ v ~~ yo , ~'3 VI. Tank Info Capacity in Total Number Manufacturer fab Site Steel Fiber Plastic Gaiktns Gallons of Units Concrete Constructed Glass IJew Euistieg Tanks Tanks Septic ar Floklint Tank /~~ ~~ Aerobic Trcatmeat Unit ~tj~ Datn` Chstober ~J _._ VII. Res asibility Statement- I, the undersigned, aasutne reaponsibiUty for in tallatioo of the POWTS :howa on the attached plans. Plumber's Nsme (Print) PI 's Si P PRS Number Business Phone Number ~~ ~ ~.~, ~z ~ 7 r~~ ~ ~ ~ Plum 's Addtess (Street, ity, State, ip e ~ - s ~~ s ,~~ ~_ ~ ~ ~-t; ~ ~ r 2 s` VIII. Dun artment Use Onl pproved ^ Disapproved Sanitary Permit Fee (includes Groundwater Da a Issued ing A t Signature ) ^ Owner Given Reasat for Denial Surcharge Fce) prU ~ ~ • ~ ~ ~ j~3 UG Conditions of ApprovaUReasons for Disapproval - - _ 'r () J - liter- .~~a~ /'Z/j2/d 2. at/L[ vt. /~~~ (~{,~i~i `.~'° ./ti~G~G•~ " , ~-~ ~ ~: Corn ,~ ~ ~-,~ l ~ ~ ~ ~ h, ~ y. Ow .~ ~vit' ~~ ~3 /v~tJ i~tJ/ /!/t ~ ~~n G¢ - ~ D , " ~u ~~h ° z ~,~~ h- Qha~- ! ,~n,/ h~.e-u~n.d ~ ~`t ~~~n,. Ce>~t~~~.-~t.~- ~w ~ d1 -~~ r.~~n. yvi q>~C,~jt-~ ~ - waaea earptete plans (ta th C~y Daly) for the s jitem ea ps~fer rwt fas)Yaf4 SI12 :11 facYes is size ~T fZ SBD-6398 (R. 08/02) s isconsin Department of Commerce Safety and Buildings 401 PILOT CT STE C WAUKESHA WI 53188-2439 TDD #: (608) 264-8777 www.commerce.state.wt.ustsb www.wisconsin.gov Scott McCallum, Governor Philip Edw. Albert, Secretary December 12, 2002 CUST ID No.224617 LYLE J MYERS NORTHLAND PLUMBING INC E1556 ST RD 64 BOYCEVILLE WI 54725 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 12/12/2004 SITE: Rory Palm g) 230TH Street ' Town of Eau Galle, 54028 St Croix County SW1/4, NW1/4, S33, T28N, R16W FOR: A7TN: POWTS Inspector ZONING OFFICE ST CROIX COUNTY SPIA ~~~ 1101 CARMICHAEL RD HUDSON WI 54016 -~~~v s5~ 3~/3 'Identification Numbers Transaction ID No. 818252 Site ID No. 654165 Please refer to both identification numbers, above, in all correspondence with the agency. Description: Mound, 4 Bedroom / Object Type: POWT System Regulated Object ID No.: 884995 The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. The following conditions shall be met during construction or installation and prior to occupancy or use: This system is to be constructed and located in accordance with the enclosed approved plans and with the "Mound Component Manual for Private Onsite Wastewater Treatment Systems" SBD-10691-P (N.O1/O1) and the "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems" SBD-10706-P (N.O1/O1). 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 comply with the operation, maintenance and monitoring duties as described in section VIII of the mound component manual. A copy of this information must be given to the owner upon completion of the project. Maintenance information must be given to the owner of the tank explaining that periodic cleaning of theer is required. Access to the filter for cleaning must be provided per Comm 84 product approval condi ' O~ O ~ 4 A Sanitary Permit must be obtained from the county where this project is located in a ordan~~ requirements of Sec. 145.135 and 145.19, Wis. Stats. ~~LO~~~, 4` ]ns~ection of the private sewage system installation is required. Arrangements for inspectioli~~k be ~de with the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stats. O~Q~, 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. LYLE J MYERS Page 2 12/12/02 ~~ .. Owner Responsibilities: • Comm 83.52 Responsibilities. The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s. Comm 83.54(1). • Comm 83.52(2) A POWTS that is not maintained in accordance with the approved management plan or as required under s. Comm 83.54(4) shall be considered a human health hazard. • Comm 83.55 The owner is responsible for submitting a maintenance verification report acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Julia ALewis-Osborne POWTS Reviewer 2 ,Integrated Services (262) 548-8638, Fax: (262) 548-8614 jlewis@commerce.state.wi.us Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 WiSMART code: 7633 cc: Leroy G Jansky ,Wastewater Specialist, (715) 726-2544 Mound System Cover Page ~ ~ ~ 6 WIEgE~ ~oE~ Project Name: PALM - RDM Owner's Name Rory & Seth Palm Owners Address 109 North Lewis St. River Falls, WI 54022 legal Description ~ _~ %., Nw ~ %+ Sec 33 T 28 N, R 16 w ~ Township Eau Galle County saint Croix ~ Subdivision N/A Lot# N/A Parcel ID# Table of Contents P9~ 1 Cover page 2 Mound Sizing Calculations 3 Pressure Distribution Layout and Dynamics 4 Dose Tank 5 Management and Contingency Plan 6 Plot Map total # of pages: 6 DEC - ~ 2002 SRfETY ~ BLOG3. Designer Name: Lyle J. Myers MP/License #: 224617 ,.:G~ Date: 11 /27/02 j~? Ph. #: 715-643-2520 ' )~,~ ,~ Signature: Mound System Design Methods Used .,' .u~ per "Mound Component Manual For Private Onaite Wastewater Treatment Systems" (Version 2.0) SBD-10691-P (N.01/01) ~`~; , `. per "Pressure Distribution Com manual for Private OnsRe Wastewater Treatment S (N 01101) r.~~` ponent ystems" (Version 2.0) SBD-10706-P Spreadsheet provided by: 3bAdvisement N12486 220th St, Boyoeville, WI 54725 Ph: 715-643~G068 email: 3be~3badvisement.com r Mound System Mound Sizing Calculations Project Name: PALM - RDM Site Conditions Project Type: 1 or 2 Famly Dwelling °1° 51ope: # of Bedrooms: Depth to limiting factor: Absorbtion rate of fill material: Absorbtion rate of in-situ soil: Effluent quality Max BOD effluent value: Max TSS effluent value: o~ 20 in. 1 gal/ft2/day 0.5 gal/ft2/day Eff#tl ~ 220 mg/I 150 mgll Design of Entire Fill Cell depth at upslope edge (D): Cell depth at downslope edge (E): Distribution cell depth (F): Cover thickness over edge (G): Cover thickness over center (H): End slope width (K): Fill length (L): Upslope width (J): Downslope width (Toe) (1): Fill Width (W): eye 2 a e 16.0 in. 19.6 in. 9.5 in. 6 in. 12 in. 9.9 ft. 119.8 ft. 6.9 ft. 10.4 ft. 23.3 ft. Design of the Distribution Cell Basal Area System Design Flow: 600.0 gal/day Basal area required: 1200 ft2 Distribution cell width (A): 6.00 ft Basal area available: 1640 ft2 Distribution cell length (B): 100.0 ft Area of Distribution Cell: 600.0 {~ Observation Pipes Contour FI v_~of Mound ~982o1 ft Location from end of cell (Z): 16.67 ft System Elevation of Mound: 99.53 ft Final Grade of Mound: 101.33 ft Mound Plan View ' ... L Mound Cross Section Final Grade ObsenratG n Pipe Synthetic Fabric (~ ' Distribution Cell 4 ~ System Elevation a ,°' ;, ~ ~~~a. F °' 1 Cover Material ~~ Fill Material lfev~rt Tilted Area ~.,..---Slope €``~-Forcemain System Contour Notes: FiN material to consist of ASTM C33 Sand Distribution cell aggregate to compy with Comm 84.30(6)(1) Synthetic Fabric covering on cell per Comm 84.30(6)(8) Distribution Cell to have minimum 6" aggregate below lateral and 2" above. Mound System ~•a• s w s Pressure Distribution Calculations Project Name: PALM - RDM Lateral Layout Lateral/Manifold Design Lateral elevation: 100.0 ft Lateral diameter. 1'~ • In. Rows of Laterals: 2 • Lateral spacing (S): 3 ft Manifold type: Cerrber • Lateral to cell edge: 1.5 ft Orifice diameter. o.>.2s • In. Lateral discharge rate: ~p # of Laterals: 4 System discharge rate: 31.31 gpm Distal Pressure: 5 ft Manifold diameter. 2 • In. Lateral Length: 49.5 ft Manifold length: 3 Orifice Spacing/Distribution Forcemain Friction Loss Orifice spacing (X): 32.11 Inches Forcemain length: 100 ft Orifices per lateral: 19 Forcemain diameter. 2 • In. Avg. ft2/Or~ce: 7.89 ftz I --nn Friction loss in forcemain: 2,Og8 ft ~ ~L 4f1Y ~ W ~. 3 i Lateral Side View Manifald Lateral ~ Lateral x x x x x ~ x x x x x x 2 2 ateral engt Lateral Length Lateral Plan View Lateral Length ~ ~ Turn•up w1baN valve or cleanout plug a o -~ 0 0 Orifices on botkom of PVC laterals and Forcemain to comply with lateral equa~y spaced specifications per Comm 134.30[2][e] Forcemain connection via tee or cross to manifold at any point Clean Out Detail Observation Pipes Clean-out plug Fnal Grade or ball valve "~"'`--~tr- Water tight cap or plug Lawn Sprinkler Box lot Nate: Cbset CoAar 6" Minimum "'~' b°''~'" Long Sareep 90 Plaae ~ ~8" ~' or iwo 45's L 3/6" Bar Lateral Mound System Septic, Pump and Dose Tank Project: PALM - RDM Tank Information Pump tank manufacturer. Wieser Concrete Pump tank size/model: W1250/750-MR ~ Pump tank gaU"inch: 16.12 Actual Pump Tank Volume: 758 gal Tank bottom elevation (inside): r ~ft Septic tank size/model: wi250/~so-MR ~ Pump and Filter Pump Manufacturer. Little Giant Pump Model: 9EH Effluent Filter. Zabel A100 Note: Access opening of sufi5cient size to be provided to allow removal of filter. Opening to terminate at or above grade. Pump Tank Diagram WaAertight Locking Cover q Inch With Warning Label Minimum _ finish Grade Alternate j Outlet Locarion Eled. per Comm 16.28 and .. NEC 300 eep Hole p` Anti- phon B ?VICe C D Pump must be capable of: and head pressure of: 31.3 GPM 21.7 Feet Pape 4 d 6 Dosage Volume Forcemain drains back to tank? Q Yes O No Lateral void volume: 20.9 gal Dosage to absorbtion Cell: 104.6 gal Forcemain volume: 17.4 gal Total dosage: 122.1 gal Total Dynamic Head Are laterals highest point? y if not, enter highest elevation: 0 ft System head (distal x 1.3) 8,50 ft Vertical Lift ("D" to lateral) 13.03 ft Friction loss in forcemain: 2.10 ft Pressure loss from filter. I Olft Total dynamic head (TDH): Dose Tank Levels tn. Gal A Reserve 25.4 410.3 B Pump off to Alarm 2.0 32.2 C Total Dosage 7.6 122.1 D Effluent depth for pump 12.0 193.4 Total Capacity: 47.0 758.0 1•L(7V- L[TERSJFpItt W W W a to Vl ~.s ~ WF Z $ ~ 25 Little Giant FLOV- GALLONS/MINUTE 9EH PUMP PERFORMANCE CURVE I15V 6pHZ Mound System Management Plan pursuarrt to comm 83.54 W. A. C. page 5 of 6 Owner's Responsibility: The component owner is responsible for the operation and maintenance of the component. The county, department or POWTS service contractor may make periodic inspections of the components, checking for surface discharge, treated effluent levels, etc. The owner or owner's agent is required to submit necessary maintenance reports to the appropriate jurisdiction and/or the department. Septic Tank: Septic tank(s) are to be inspected routinely and maintained by department approved individuals when necessary in accordance with their approvals. The use of chemical/biological "treatments" is not required or recommended. If such additives are used, make sure they are approved by Department of Commerce, Safety and Buildings Div.. Effluent filters are to be removed & Leaned as necessary, with provisions to keep solids from passing the septic during removal. No more than 1/3 of the usable tank volume may be occupied by sludge/scum. 3 year inspection: If tank has greater than 1/3 volume sludge, tank contents must be emptied and disposed of in accordance with NR 113 Wisconsin Administrative Code by an approved individual. If the inspector does not recommend pumping of the septic tank, then the owner must be notified of when pumping should be done as to not exceed 113 sludge volume. Septic tank should be routinely inspected to be watertight and of good repair. PumplDose Tank If an effluent filter has been installed in the pump/dose tank, it must be removed & cleaned as necessary, with provisions to keep solids from passing to the mound component during removal. The pump, float switches and alarms must be inspected at least every three years for proper operation. Pump/dose tank should be routinely inspected to be watertight and of good repair. Mound and Lateral System The mound system component must remain free of ponded surface water prior to pump operation. If 4 inches or more water level is detected in the observation pipes, the owner must be notified of possible problems/failure. The designed daily flow capabilities of the component should never be exceeded. Trees and any other deep rooted vegetation should never be planted, or allowed to grow anywhere on the component. Activities OTHER than mowing/maintenance (i.e. excessive walking, pets, vehiGes, etc...) could compress the component and reduce it's absorbtion capabilities and/or possibly cause it to freeze in winter conditions. Lateral distribution pipes should be flushed ouUtested every 18 months using the cleanout points at each end of the component to remove scum that may clog orifices. Performance Monitoring: Performance monitoring must be done at least once every three years following the installation or at the time of a problem, complaint, or failure. Contingency Plan: If the septic tank, pump tank or any of their components therein (including floats, alarms, pumps, etc) become defective, the defective tank or component must be replaced immediately to ensure that the system can operate as designed. If the mound component cannot accept wastewater or ponds wastewater to the surface, the component must be repaired or replaced in it's current location by either: extending basal toe to provide added absorbtion area; or by removing the clogged bacterial mat,aggregate cell, and distribution piping within the mound and replacing said components in order to return system to proper working order as required. ~~~~~ /chi N.~~Z-ter ~~rs `.~~-; 6'L~ -~, ~`.,~ -------f__,_ ~=r53~ s7--i.~,~Y ~ ~ ~~~c~ v f c ~ LtJ ~ + ' Sys- ~~ r0~ ~~' ~ 3o~~t s ,~- ~ Ct 9~,.~ ~~ ~ ~ ~~ 1 ~ ~.~3'7. '75.• .tiM ~l c~J L C ~-~ - s 7- C ~d~x • > r Gwscons'~,7epartmentoft;,nmmerrs SOIL EVALUAT,(~)hf REPORT Page,~„o1 3 Division of 5ality and Buikfinys Wis. qdm Co ie in accordance with Comm B5, countys7"• ~,ea~ k Attach Optrtpiete alts plan nn paper not less than 81R x 11 irw~ee fn size. Plan rn .;st incitde, but root kmited to. vsrtlcai and hcrirantal reference point (BM), direoUcn a~ ~d Parcel l.D. Q _~-~ percent slope, acala or dir-wsnstona, north arrow, and location artd diatanai to neap ust I cad. ~~ l~3 '~ Date I~IAas@ pr1 811 1~9Jp R Iswed ~,: 3 ~ ~ 03 P4raonwl IMormst(an you pravltle rr+rry b~ tl ta. waorufary purQoYio (Priwoy , a. 1 S.oa (1) I any'), PropsrtyCiwnar AR 1 7 2003 Propar'yLix~ation ~/gs-13 Pa ~~ Ro-r ~ (3ovt...at sw 1i4 /l~ClhJa S 33 T o'L8 N R (o 'ozt°'~L° Lot ~~illock d Subd. Name or C ~ roperty Clwtur's MaNigp Addtesle ING OFFICE ~~ ~ 3~ /G GI ~llo-rr~t .C~~~ Via own Nearost Ro•d ,- tl s•~a a c / > _ ~ ^ City , ~l ~~ ~~~ s_ ~._.r__ 1~,~ ~. s w l a __. ~` ,_,_ c~cio arrived desdpr+ flow rata l~ o a Opa New Gonst<votbn tJse: (~Reeidentiai J Number of bedrooms Repiacsmani ^ PubNc ar cnmtnerChll • peecribe: - --- ,...,... Ficad i^latn efevatlon ii apppoabie fl• Panr>t mderiai , Genarai oamm.n<s / ~-{U.~ r 98• ~. and reoontmsndatbna; ~-j ~~`" 1~i . ~'/ /U0, a ' __ ~ -f d Est e -~' ,9re ~-~~-~- pa.s~ u~t ~- d /v-~ -~~-y ~ •~ ~ ,~ s ~ ~Ofidy e ~`y l ~ ``-' ^ eorfnp q ~ ~ ~~ ~ ~ Pit Drouru! surface eiev, (~ Deptt, to 1 mlt4n~ tsatnr ±n. 8oN _lfatlon Ra~ ® ~- Ptt ~ aurfac~ elev. ~~~, Depth is limltlnp hc~or gpN Rab i~irxizon Depth ar>:rrt Color Dom Retlox Dsscriptian Texturo :~n,~ciutt ~ s: 8h Coneisterxe 9oundary F~OOts G1PD «~ Ik ~ In. lV~naeR Qu, 8a. Cort;, Color ; r' - ,t. . .. 5 ~ v--1~ ores/ s a~bk m Y ~ . -aa IoYr~s% ~ ~~k --~ ~.S ~ ~~ 4 ' ~IVV Ie~~~~/ J~ S~~ ~ « 1 /~../J O~~ J 8 :3a . 1 oy ~ s~ m a- 0 `(r~s%3 b~.,~" .5 r'-- C,~.~ ~s ~ ~ ~- • ~{~~ ~ . BiJfl a 3Q ~ 22p t~1L ~rtd T;~4 s3p ~ 1 00 mgll. .~ ..'. ~ < a0 and Tss _ 30 myL Etik~ant ~2 60D .. ~ C8T Nun-bsr csri ~c~+,p~t} ~. ~S ,.-J ~ ~, ~' ' ~_lr~ .~..~,~ _ 1;~ Evehia~rm s/anduoted Flo Telaphot>~ Number nwn ~, h'ht+ nrw i a Prope-rty Qwner ' a `n` . ~r,yf ~7~ Paraal ID ~____ •„_„ Pays ,~ of ~,_,,, J J k~- p~ GrourW aurtaco elev. L~'• r ~_ tr. ~epm w S~mK~ng tac~or o- - m. _ Hor'aon Depth Dominant Color Redox Deeeription Textu» Structure Coreistenoe Boundary Roots Soq !laetlon Rato OND/!p in. Muneed t3.u. &z. CoM. CWar C3r..:~. 8h. `Etf~ •Efttl2 / a - ~ /oY~e-~/a- s l o2s 6 k rn. ~'r ~S ~3 n-. . 5 • 9~ /4 o R s s a sb l~ rn r- es ~ . S ~- s ~~ k r e -- . 4 ~o- s ~'~d s s ©~ ~ -- -- . ~ ._.... .,...... ~~ a >30~ ^ Pit around gurtaos sbv. ~,_„ft. Depth to gmatnp tex~or In• Sol1 Ilostlon Rate H > th De Domirernt t:aior Redox Deecriptian Textu» Stnatu» Caneietenoe 13ourtdsry Roots 4P YOn or p !n. AM.n~eelt Qu. Sz. Cont. Color Cr. taz. 8h. •EffilEl 'Eil52 ^ Pit Orowtd as<stfeoe elev. ~R. Depth to llmitiny factor __,_,,__„ in. Bor~+O ~ ^ SoU I lion Rate Horizon Depth Dominant Cobr Redox Deeoription Tutture 5truoturs ConslWnoe Boundary Roots ~. Mur>se>r Qu. 6x. Cant. Cobr Ctr. fat. Bh. 'EflM~1 'Ef}/Z • Effluent ~1 ~ BCD > ~ c 2Z4 mpA. and TSS >30 <_ 150 mqn. ' Et'Ausrtt ~2 ~ BODb ~ 30 rrrpR snd TS8 < 30 mplL The Departtnart of Commerce is an equal opportunity service pmvid~~• at~d employer. If you aced assisteaoe to access services or resod ruatesiat in au alternate format, please contact the depattaxard at 648-266-3251 ar TTY 608-264-8777. BHD•8330 pt.07100) 1 3 ~,, . t'a I fh , ~i o r y s a~~~ S w `~4 N! G> Yf S' 33 T ~ 8 n/ R t ~ 1n/ CouNT`1 : S'7. C.IZot1c "~"~wrvsi~l P 5 [-RV Gr~Le~' SeR t, ~ t " = 4~i' ~.M. a` I c MCC-E N FENGE ~eg7~ OvIT41 ~l.u.r, FC.~G oN C-~tsT ~IZOp~rtry e.e~(6 CG~u~o e.EVE~~ 2 3~~~` S+ ~o. 3 e~ 3 n~ 6 ~~:~5 ~ > ). 5 0O ~-0 l~oaa~ S~ s/ap~ q~,oo 98~`~'a ~dn~ y~ qd at 9R. ~~ Q,M• !oo"o ¢r 7j rc.v'Post~ t3 t~ D ~vc,v~ Ma~sE ~11M. ~I..~t.l ~S . Yl~~~er~ s cs~~ a~~985 ``~. ~ ~ ~3 d ~' Ste, Sanitary Permit Application Safety & Buildings Division In accord with Comm 83.21, Wis. Adm. Code 201 W. Washington Ave. `~ C See reverse side for instructions for completing this application PO Box 7302 S OfISin Personal information you provide may be used for secondary u oses p ~ Madison, WI 53707-7302 Department of Commerce ri acy Law, s. 15.04(1)(m)] (Submit completed form to county if not ' S~ ~ i j O L1 state owned.) Attach complete plans (to the county copy only) for the system, on paper not less than 8 -1/2 x 11 inches in size. County ~- CR-orX State Sanitary Permit Number ^ Check if revision to previous application ZOSS State Plan I. D. Numb r -~ ~bS off- !p. I. Application Information -Please Print all Information Location: Property Owner Name ~ ~ ~~~~rti~~~ Property Location r ~ ~ !4 4 S N, R or W S , ~3 .~c ) ( Property Owner's M ' ng Address ~~`~ ®~ zooz Lot Number Block Number s -~ City, State Zip Code hone $i~gtvlX COU~'~J"."i' Subdivision Name or CSM Number ~ ZONIiVG OFFICE ~~ , J~7c- ~~ 2~ II. Type of Building: (check one) cis S ~~ au+s, 1 or 2 Famil D ellin ~ ~ N f B d ^ City ~ ~ ~_ ^ Village r' y g - w o. o e rooms : Town of ^ Public/Commercial (describe use):_ ^ State-O ed ~~~ G ~~. c . ! p ~ r ~ Nearest Road ~~// Tq'~ X11 ~~ ~' l ~ k ~ ~ W1 tw~c.eQ:Q. D = ~ (. ~ /• 33 ~S~ ~%-~ . ParcelTaxN ber(s v ,- d .~ - FS - ~ d t~ III. Type of ermit: (Check only one box on line A. Check box on line B if applicable) A) 1. New 2. ^ Replacement 3. ^ Replacement of 4. 5. 6. Addition to System System Tank Only Existing System $) Permit Number Date Issued ^ A Sanitary Permit was previously issued IV. Type of POWT System: (Check all that apply) -~- -( aD . ^ Non-pressurized In-ground ~IVlound ^ Sand Filter ^ Constructed Wetland ^ Pressurized In-ground ((~~ Holding Tank ^ Single Pass ^ Drip Line ^ At-grade ^ Aerobic Treatment Unit ^ Recirculating ^ Other: V. DispersallTreatment Area Information: 1. Design Flow (gpd) 2. Dispersal Area 3. Dispersal Area 4. Soil Application 5. Percolation Rate 6. System Elevation 7. Final Grade ~~ Re uired ~ Proposed Rate (Gals./day/ . ft.) " (Min./inch) Elevation ~o ~ ~o (~ ~c~ , ~ ~ ~ ~3 o t ~ VII. Tank Capacity in Total # of M ufacturer Prefab Site Steel Fiber- Plastic Information Gallons Gallons Tanks Con- Con- glass New Existing Crete sttucted Tanks Tanks ' t c ' / L~ ^ ^ ^ ^ L.I ~ VIII. Responsibility Statement I, the undersigned, assume responsibility for installation of the POWTS show n the attached plans. .Plumber's Name (print) Plumber's Signature (nos ps): PRS No. Business Phone Number lum is Address (Street, C' ,State, Zip e) ~ / S ~~_ ~ cJ G.L tom= / IX. County/Department Use Only ^ Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued ss ' g Agent Signature (No stamps) Approved ^ Owner Given Initial Adverse Surchazge e) ~ ~"~ r l/1 S102 \ Determination j _ X. Conditions of A proval /Reasons for Disapproval: .- ~ , n + ~11 4 J ~ ' . 1 d nn - ~~~e.t~ - 0.~..~. ~ ill s.~ ~- (~e~ntie~t~lrHnr~ ~.~- c~.2~ ~w~~„~v~ ,c-~- ~`~ ~ P.c„ ,M~-~-~~5 SBD-6398 (R. 07/00) ~ ~L.6s~D ~ ~ ~ ~~ C) /1J~`Yl- --"~' Q~ v ~~rr.. ~,a-c.c r , uJ i , Sy~zZ ~ sue. , r- ta~P 6 ~ t3d~~ r «~~ c.Q~t ~~7z5'- ~~ 1!J 2~'4~~~'7 ~~~ Sc~'f~ ~c.~~ ~iP ~vc..e.:•~tr S ~ ~ -- ~ ~. _. s ; . I'H~~~~ ¢~ p,y G C~~` S ~3 T'.z ~ ~«~ ~G c~1 C 2a ~~c ~(~ ~ ~ ~°~~~ S+ qq.4 ~~ ~ ~ / ~.~0 ~~ ~2~ ~~ ~ ~r ~~ ~ ,~ , S~~ g.3 ~r,~ ~x rgv CG'Ll' z isconsin Department of Commerce Scott McCallum, Governor Philip Edw. Albert, Secretary October 30, 2002 CUST ID No.224617 LYLE J MYERS NORTHLAND PLUMBING INC E1556 ST RD 64 BOYCEVILLE WI 54725 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 10/30/2004 ;1 TTiV: PO11~'TS Inspc clor ZONING OFFICE ST CROII COUNTY SPIA 1101 CARwIICHAEL RD HUDSON WI 54016 SITE: Rory & Beth Palm 230TH Street Town of Eau Galle, 54028 St Croix County SE1/4, NW1/4, S33, T28N, R16W FOR: Safety and Buildings 401 PILOT CT STE C WAUKESHA WI 53188-2439 TDD #: (608) 264-8777 www. com merce. s to te. wi. us/s b www.wisconsin.gov Identification Numbers Transaction ID No. 805107 Site ID No. 652889 Please refer to both identification numbers, above, in all correspondence with the agency. Object Type: POWT System Regulated Object ID No.: 879386 Description: 600 gpd design wastewater flow mound system. The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. The following conditions shall be met during construction or installation and prior to occupancy or use: • This system is to be constructed and located in accordance with the enclosed approved plans and with the "Mound Component Manual for Septic Tank Effluent for Private Onsite Waste Treatment Systems" SBD- 10691-P (N O1/O1) and the "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems" SBD-10706-P (N O1/O1). • 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 mound component manual are complied with. A copy of this information must be given to the owner upon completion of the project. • Maintenance information must be given to the owner of the tank explaining that period' e]Ednin~f the filter is required. Access to the filter for cleaning must be provided per Comm 84 product ct~litl®s. 0~~ oFA ~~,•; ~j • A Sanitary Permit must be obtained from the county where this project is ated ~{~ the requirements of Sec. 145.135 and 145.19, Wis. Stats. ~~F ~ ~~~ ~ • Inspection of the private sewage system installation is required. Arrangements ecti~on shall be made with the designated county official in accordance with the provisions of Sec. 145.20(2) is. Stats. 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 LYLE J ~I1'ERS Pa ~~ 3 l U/1pr0~ 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 to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS, Sincerely, ~ Z~~ Thomas J Perkins POWTS Plan Reviewer ,Integrated Services (262)521-5064 , 7:30-4:00 tperkins@commerc e. state.wi.us Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 WiSMART code: 7633 cc: Leroy G Jansky ,Wastewater Specialist, (715) 726-2544 Mound System Cover Page ~ 1 ~ 6 RECEIVE[ ~~ "" ~ ~Q I' E~ CCT 2 1 2002 SAFETY & BLDGS. DIU. Project Name: RORY~,4AA MOUND Owner's Name RORY & BETH PL~rbl, ~i4~ ~~/~ Owners Address 109 North Lewis St. River Falls Wi. 54022 Legal Description s'v ~ ' ' m /4,_ 'S'~`_ ~ /< Sec 33 T 28 N, R 16 W ~ Township Eau Gape County Saint Croot ~ Subdivision N/A Lot# N/A ParcellD# PENDING Table of Contents P9• 1 Caver page 2 Mound Sizing Calculations 3 Pressure Distribution Layout and Dynamics 4 Dose Tank 5 Management and Contingency Plan 6 Plot Map total # of pages: 6 Designer Name: Lyle J. Myers MP/License #: I.D.# 224617 Date: 9/26/02 ,~ Ph. #: 7156432520 . .~~ri~~ Signature: °"' ,~ Mound System Design Methods Used .- \ ~~~ ~~~~z>' 'Mound Com ent Manual For Private Onsite Wastewater Treatment S ~ ~~` ~ per' pon ystems" (Version 2.0) SBD-10691-P (N.01/01) ~;',•,., +rN per" Pressure Distribution Component manual for Private Onsite Wastewater Treatment Systems" (Version 2.0) SBD-10706-P (N 01/01] ~;.~, C~ 3bAdvisement N12486 220th St, Boyceville, WI 54725 Ph: 715-643.6068 email: ., , Mound System Septic, Pump and Dose Tank Project: RORY PLAM MOUND Tank Information Pump tank manufacturer: Wieser Concrete Pump tank size/model: w12so/~so-MR Pump tank gaUinch: 16.12 Actual Pump Tank Volume: 758 gal Tank bottom elevation (inside): 86 ft Septic tank size/model: wizso/~so-MR Pump and Filter Pump Manufacturer: Little Giant Pump Model: 9EH Effluent Filter: Zabel A100 Note: Access opening of sufficient size to be provided to allow removal of filter. Opening to terminate at or above grade. Pegs 4 d 6 Dosage Volume Forcemain drains back to tank? ~ Yes ~ No Lateral void volume: 20.9 gal Dosage to absorbtion Cell: 104.6 gal Forcemain volume: 10.5 gal Total dosage: 115.1 gal Total Dynamic Head Are laterals highest point? y if not, enter highest elevation: p ft System head (distal x 1.3) 6.50 ft Vertical Lift ("D" to lateral) 13.27 ft Friction loss in forcemain: 1.26 ft Pressure loss from filter: L ~!ft Total dynamic head (TDH): 21.03 ft Pump Tank Diagram Dose Tank Levels Watertight Locking Gover In. Gal 4 Inch With blaming Label finished A Reserve 29.9 481.7 Minimum Grade g pump off to Alarm 2.0 32.2 Altemate''r C Total Dosage 7.1 115.1 Outlet Location Elect. per Comm D Effluent depth for pump 8.0 129.0 mai 1628 and NEC 300 Total Capacity: 47.0 758.0 Weep Hole A orAnti- Siphon 6 device FLOV- LITERS/FOUR 0 3 W ~2 a ~1 10 ~.s ~W Z 5 ~ ~_ z,s 0 Pump must be capable of: 31.3 GPM and head pressure of: 21.1 Feet 0 20 40 60 BD Little Giant FLAW- GALLONS/MINUTE 9EH PUMP PERFORMANCE CURVE 115V 60HZ r ~, ~ Mound System Management Plan pursuaMto Comm 83.54 W. A. C. page 5 of 6 Owner's Responsibility: The component owner is responsible for the operation and maintenance of the component. The county, department or POWTS service contractor may make periodic inspections of the components, checking for surtace discharge, treated effluent levels, etc. The owner or owners agent is required to submit necessary maintenance reports to the appropriate jurisdiction and/or the department. Septic Tank: Septic tank(s) are to be inspected routinely and maintained by department approved individuals when necessary in accordance with their approvals. The use of chemical/biological "treatments" is not required or recommended. If such additives are used, make sure they are approved by Department of Commerce, Safety and Buildings Div.. Effluent filters are to be removed & cleaned as necessary, with provisions to keep solids from passing the septic during removal. No more than 1!3 of the usable tank volume may be occupied by sludge/scum. 3 year inspection: If tank has greater than 1/3 volume sludge, tank contents must be emptied and disposed of in accordance with NR 113 Wisconsin Administrative Code by an approved individual. If the inspector does not recommend pumping of the septic tank, then the owner must be notified of when pumping should be done as to not exceed 1/3 sludge volume. Septic tank should be routinely inspected to be watertight and of good repair. Pump/Dose Tank If an effluent filter has been installed in the pump/dose tank, it must be removed & cleaned as necessary, with provisions to keep solids from passing to the mound component during removal. The pump, float switches and alarms must be inspected at least every three years for proper operation. Pump/dose tank should be routinely inspected to be watertight and of good repair. Mound and Lateral System The mound system component must remain free of ponded surface water prior to pump operation. If 4 inches or more water level is detected in the observation pipes, the owner must be notified of possible problems/failure. The designed daily flow capabilities of the component should never be exceeded. Trees and any other deep rooted vegetation should never be planted, or allowed to grow anywhere on the component. Activities OTHER than mowinglmaintenance (i.e. excessive walking, pets, vehiGes, etc...) could compress the component and reduce it's absorbtion capabilities and/or possibty cause it to freeze in winter conditions. Lateral distribution pipes should be flushed out/tested every 18 months using the cleanout points at each end of the component to remove scum that may clog orifices. Performance Monitoring: Performance monitoring must be done at least once every three years following the installation or at the time of a problem, complaint, or failure. Contingency Plan: If the septic tank, pump tank or any of their components therein (including floats, alarms, pumps, etc) become defective, the defective tank or component must be replaced immediately to ensure that the system can operate as designed. If the mound component cannot accept wastewater or ponds wastewater to the surface, the component must be repaired or replaced in it's current location by either: extending basal toe to provide added absorbtion area; or by removing the Dogged bacterial mat,aggregate cell, and distribution piping within the mound and replacing said components in order to return system to proper working order as required. ~ y ~- ~-ry~ ~~ ~ ~7 l D~ ~r~-ria ~L~J ~ s ~i'" rs~ sT"" r~ !o ~ -r3t!cp~~rc,G.~~ C..Q~t ~~f7z5'r c~,/J ~ ~` / L~'! ~ ~~~~'~~ kY ~~ ,2 ~g~~ ~.q ~Z~ Sc~'f},, ,v~~'l~ ~ ~~ ~~ s Sc..~-` r " ~ ~1~ S.3 ~ C' /tv roc ~! ~;; ' two ~ CG'L~' °T ~ ~ ~ . ~, ~ i Wisconsin Department of Commerce Division of Safety and Buildings SOIL EVALUATION REPORT ~a`-~ ~~ ~~ ~ in arrnrAanra with (:nmm R.ri Wisil~dm Y$dd~ ~`~ 1475 Page 1 of 3 Certified Soil Testing ~l ,~ ~~t.~--a.._,..._ i i Pl t '' ' Courit Y~ n s ze. an `~ ~ /z x 11 inches Attach complete site plan on paper not less than 8 ~> St. Croix include, but not limited to: vertical and horizontal reference point (BM), directi end, `~ north arrow, and location and distance t peayEst roa ~V L percent slope scale or dimemsions ~~CE parcel I.D.r' 1 , , t::; ; 33.28.16.495B Please print all information. ~- ,r ~~,._ e e y`: Date ~ ~i ' Personal information you provide may be used for secondary purposes (Privacy Law, s..15.04 (1) (~. R I ~ ~ _r„±`1 ! ~ (js /OL Property Owner ` •Property LoB~ti 00't1~ ~ • Palm, Rory & Beth NW 1/4 g 33 T 28 N R 16 W -Govt t.ot 1/a'` Property Owner's Mailing Address bot•~ ock # ~ Subd. flame or CSM# 109 North Lewis St. .: ~ i ` ~' --35 Acre Site City State Zip Code Phone Number ~f Town Nearest Road River Falls ~ WI 54022 715-425-6487 Eau Galle 230Th St. New Construction Use: '~ Residential / Number of bedrooms 4 Code derived design flow rate Replacement Public or commercial -Describe: Parent material loess over till Flood plain elevation, if applicable General comments and recommendations: install 5' x 124' rock unit mound on 98.9 contour as upslope edge of rock w/ 1.4' sand fill 600 GPD NA ^ Boring # Boring V_ Pit Ground Surface elev. 96.5 ft. Depth to limiting factor min. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/ft' in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 1 0-8 10YR 3/3 - sl 2 f sbk mvfr cs 1f/m .5 .9 2 8-20 10YR 4/4 - sl 2 m sbk mvfr cs 1 m .5 .9 3 20-24 10YR 4/4 f2f 10YR 6/2 sl 2 m sbk mvfr cs 1f .5 .9 4 24-40 5YR 4/4 cad 7.5YR 5/3 sl 0 m mvfr - - .3 .5 Boring # --j Boring Pit Ground Surface elev. 98.9 ft. Depth to limiting factor - 2T Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/ft' in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *EfF#1 'Eff#2 1 0-9 10YR 3/3 - sl 2 f sbk mvfr cs 1 f/m .5 .9 2 9-22 10YR 4/4 - sl 2 m sbk mvfr cs 1f .5 .9 3 22-25 10YR 4/4 f2d lOYR 6/2 7.5YR 5/8 sl 2 m sbk mvfr cs 1f .5 .9 4 25-45 5YR 4/4 --~ cad 7.5YR 5/3 sl 0 m mvfr - - .3 .5 "Effluent #1 = BODS> 30 < 220 mg/L and TS > 0 < 150 /L 'Effluent #2 = BODS < 30 mg/L and TSS < 30 mgr CST Name (Please Print) 'gn lure: CST Number Henry F. Grote 222774 Address Certified Soil Testing Date Evaluation Conducted Telephone Number E. 4366 353rd Ave., Menomonie, WI 54751 1/5/2002 715-233-0398 4 fit. ' Property Owner Pdlm, Rory & Beth Parcel ID # 33.28.16.4956 Page 2 of 3 ^ Boring # Boring . /` Pit Ground Surface elev. 98.9 ft. Depth to limiting factor 35 Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots Z in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-9 10YR 3/3 - sl 2 f sbk mvfr cs 1f/m .5 .9 2 9-24 10YR 4!4 - sl 2 m sbk mvfr cs 1 F .5 .9 3 24-35 7.5YR 5/6 - s 0 sg ml cs 1f .7 1.2 4 35-37 7.5YR 5/6 f2d 10YR 6/2 Is 0 sg ml cs - .7 1.2 5 37-47 5YR 4/4 f2f 7.5YR 5/3 sl 0 m mfr - - .3 .5 ^ Boring # Boring Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots = in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 ^ Boring # Boring Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots PD 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/L * Effluent #2 = BODS <_ 30 mg/Land 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.07/00) Certified SOiI Testing - •~ > 4 ~ ~ t ~ (~ YZ,,. ~a_~-~. 1 al~,_ n ~,w Sw -raw -~3 -z.g -taw ~~ 0.. S'1t `Vi'n--~: L'~a,~ G..ll~ ~ ~ ~ :~ ~ i M L'Lt} i~f ~1q., V.:.l ~ ~ ~~ ~ Vim' 1 Nrr11~1 / 1 I T~~R.N Y.4 V C. q/1 Q. I" _ ~, S ~ CAI S' ~ `.1~~'~~ ~ , f ~ti~ t7 2 0 ~i"o ~ . ~~~ o ~.,, „~4a.u L- 13 we ate, ~cn ~ ~ ok a ~~ v ~~ ~~~aa.Q ,~.5~ ~~ ;. ~S n ~~ `o.n o / \ C 41..a i~ ti~ ~ + ~, (wa4.t) 'k~ v (~ ~~ d1 ~ a-~~~ ,, e „e , s ~~q ` -Q S ~ ~ S~~ ~~~~ ~3ov'~ ~~• ~^ ~ 3s~~ a~ ti~ ~ ~ Se.,l ~ k~~ ~,,o1~t,s.~. 3 e~~ 1 3 NOU+~$-a,Q92„ 98:38 FROM:RF JOURN{R.U PRINT 715 425 5666 FR[p+1 NLRTHLRhID PLUh~ I NG ~ ! NC. FAi4 ht7, 71, 5-64,3-252 ~ `I f ~ SBI~'TiC: TAi~G. MhXN'~3NAt+~C~ 1-.Q~iE~BNI' ~; r ~~ ~ QWNSRS~' C8R'~iFICA"I't~~l~ P~}P~M Oww.adBuy~ C~~ (Yetipataaa xa~uiird ~vnt k1~-aeiug ~ aea+ ~- 3 a Picobl ~~l~~ 3+Itt~r o - ~0 4 3 - go - crw team .. -•-------,--- ~ . ~~~ ZaFd~illi:. ` s~S ~tf~ ~ ~.~ Pm~ttY Loc~d`ian ~.,..._ ~, ~....~ ~ Sao. ~ s3 ~ ~-~`~`R =~-W~ Town a~f ,.i ___._ _____ ~,at# 8~divi~ (~~y AA~ ~--..... ~~ • ~ ~ rIT~~~~~~T YMl{l{{~19 ~ r , k raid ~ ~_ ._. wxrr~ty $pea f>QUSe ^ yap li~'sa ~ ~de1i Ct~ Q ~o P:1 S'f S T, 1 ao~liW ~P~P~6 oat dro ~k ~- te~lE Y~ pt ~1°c~ iEneadadt~7- s 1~Per. q~at ym pork lade ae~- abet ~ba ~doa aE d+~- aepNe ~k u a #+ottr~ar ebb is de-+reote dUlaewwl 'tea pao~aq- ~ 10 a-~mlt to $t. Cta1s Zaol~ Iiapas4ae~'t ~ ~'~'~" ~ ~ aeAat tit! by a ~3~~loladpt~gpyCratHgpMedptt~~ ~~y ~ ~ tot b~c. it ir-t'°°~i°°t ~no~Yat(~! ~' ~ ~ ` ~ ~ ~ ~~iavead the abew-~ and ~ ~" taw~agt ~~ vytiam ~ 1ba s ~tetlbrtbr ~+.n~R1f~ dM ~aad Wa~o~Zi~atA+~baf ' ~katFen rbrdaf ~!"~ ~ ~ beea~mooee be ~ vd m too 8t. t~ C~ 30 dt~r o! dre +I~ae i o . ratiTB ~~ a~ ~~oNS'r ~ t~l ' ~ at! astaeapta ana Y 4~ raaoeAed ~ pewit a i (era) te- (ere) tbo a3 °f tba peapat~ ~. pA'R`8 calt~x .•••~• J-np a~lbemat~rt~mtle ~~msylt~llt iseba aedwtypelmitbe~Sreanalaedby dte Za~aiot ~" ~'~+«* rw ~~ ~ tab tMeM: i dat~pld d~od 1yDnt tbo ~ ~G ~ ' ~~ r ~{+T of !~a aged wt,+aY,~'A TO:81'156432529 l~Civ. 07 ?00.2 104 ~ ~4PM P1 '~ ..r u Y . s-~oo~a ypl ~ 828oAGE ~2~ ItEGI9TER OF DEEDS . S;. CFOTX CO., WI RECEIVED fOk kECORD WARRANTY DEED 42-44-?07P 9:J0 AM NAkkAKTY DEED Document Number Document Title E:~ Ei1PT 9 CERT COPY fEE: CDi''' rEE: TRANSfEk fEE: 241.54 This Deed, made between Don B. Gavic and Diane L. niiCGRDI^IG FEE: 11.44 PAGE5: t Gavic, husband and wife as survivorship marital property, Grantors, and Rory K. Palm and Beth A. Palm, husband and wife as survivorship marital property, Grantees, Witnesseth, That the said Grantor, for a valuable RETURN TO: _ consideration of one dollar and other good and valuable consideration REIURNTO: conveys to Grantees the following described real estate in St. Croix 71TL1: ONE PREMIER GROUP, tHC County, State of Wisconsin: 706 19TH STREET SOUTH P.I.N.: 008-1093-80-000 LEGAL DESCRIPTION: The Southwest Quarter (SW'/o) of the Northwest Quarter (NWtl4} Of Sec lori 33, Township 2ii North, Kange I b west, r,xe;~r ~_. Lot I o Certified Survey Map recorded in Volume 4 on page 919 as Document No. 362962, Town of Eau Galle, St. Croix County, Wisconsin. This is not homestead property. Together with all and singular the hereditaments and appurtenances thereunto belonging; And grantor warrants that the title is good, indefeasible in fee simple and free and clear of encumbrances except easements of record, if any and will warrant and defend the same. Date is 31st day of January, 2002 ~Q /r 'w~ Vt EAL) ~/a~ EAL) *Don B Gavic *Diane L. Gavic !SEAL} (SEAL) AUTHENTICATION Signatures of: authenticated this day of 2002 Diane L. Gavic Title: MEMBER STATE BAR OF WISCONSIN THIS INSTRUMENT DRAFTED BY: Diane L. Gavic Attorney P.O. Box 344 Spring Valley, WI. 54767 ,?,~~~q.y~, ACKNOWLEDGMENT STATE OF WISCONSIN ) ss. County of ~'''u- ) Personally came before me this January 3l'~ 2Q02 the above named Don B. Gavic \~\5 t4~' ~~' ~ Diane L. Gavic ~ 1 '~ y~ ~ Y ' ~ _ 1, [o me known to be the person(3?}~+'~~ ~ e foregoing i t and ackno e t e' •„ Bever! Bune Notary Public of Pierce County, Wis. NOTARY PUBLIC-Pierce Co. Wisconsin My Commission Expires Sept. 28, 2003 ... , ~ ~ ~scons~n Department of Commerce ~~ ~ ~ ~> ~~~ ~~ ~ 202 J i ~~~ ZUI ~ ~~~ ~,~;,~~; October 30, 2002 CUST ID No.224617 LYLE J MYERS NORTHLAND PLUMBING INC E1556 ST RD 64 BOYCEVILLE WI 54725 Safety and Buildings 401 PILOT CT STE C WAUKESHA WI 53188-2439 TDD #: (608) 264-8777 www.commerce.state.wi. us/sb www.wisconsin.gov Scott McCallum, Governor Philip Edw. Albert, Secretary ATTN: POWTS Inspector ZONING OFFICE ST CROIX COUNTY SPIA 1101 CARMICHAEL RD HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 10/30/2004 Identification Numbers Transaction ID No. 805107 SITE: Site ID No. 652889 Rory & Beth Palm Please refer to both identification 230TH Street numbers, above, in all Town of Eau Galle, 54028 correspondence with the agency. St Croix County SE1/4, NW1/4, S33, T28N, R16W FOR: Object Type: POWT System Regulated Object ID No.: 879386 Description: 600 gpd design wastewater flow mound system. The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. The following conditions shall be met during construction or installation and prior to occupancy or use: • This system is to be constructed and located in accordance with the enclosed approved plans and with the "Mound Component Manual for Septic Tank Effluent for Private Onsite Waste Treatment Systems" SBD-10691-P (N 01/01) and the "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems" SBD-10706-P (N 01/01). • 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 mound component manual are complied with. A copy of this information must be given to the owner upon completion of the project. • Maintenance information must be given to the owner of the tank explaining that LYLE J MYERS Page 2 10/30/02 periodic cleaning of the filter is required. Access to the filter for cleaning must be provided per Comm 84 product approval conditions. A Sanitary Permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.135 and 145.19, Wis. Stats. • Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stats. A 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 fisted below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Thomas J Perkins POWTS Plan Reviewer ,Integrated Services (262)521-5064 , 7:30-4:00 tperkins@commerce.state.wi.us Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 WiSMART code: 7633 cc: Leroy G Jansky ,Wastewater Specialist, (715) 726-2544