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Home My WebLink About012-2007-07-000~/Viscons~~ Repartment of Commerce Safety and Building Division PRIVATE SEWAGE SYSTEM INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. permit Holder's Name: City Village X Township Mer en, Dean & Bett Erin Prairie, Town of SST BM Elev: Insp. BM Elev: BM Description: laZS ~ -~ ~ GSA TANK INFORMATION n TYPE MANUFACTURER ~ ~,~ CAPACITY Septic -r~ ~IrQ'~i~'`~ ~~ •.'~ ~/~ ' ~dW Dosing /O~a QiJ 'r7f~5 C.. ~ ~ps~ ratio ~ / ~ ~ 7 Holding r TANK SETBACK INFORMATION TANK TO //~~,~ P/LII ff 'VO~iM- WELL BLDG. Vent to Air Intake ROAD Septic ZL / , 1/I /Vf7~ ~~ ~ -~ Dosing / Zz tip- ~ !$ / 8' Aeration Holding PUMP/SIPHON INFORMATION Manufacturer ~ ~ - JIt Demand u V `\ GP~~ ,~'' Model Number ~~ ~ / TDH Lif~'~` Frictio~ os~ ~ System Hea TD , ry~Ft Forcema~`ijjn Lengt~ / Dia. ~/ Dist. to well ~ 4 Cn11 ARSnRPTION SYSTF_M ELEVATION UAIA county: St. Croix Sanitary Permit No: 514959 0 State Plan ID No: Parcel Tax No: 012-2007-07-000 Section/Town/Range/Map No: 06.30.17.607 STATION BS HI FS ELEV. Benchmark 3F ct /~, 9 ~~,y~ A~~~ Go~•--- 5 •~3 ~ Si ~i8 Bldg. Sewer ~a, 38 63.57 SUHt Inlet /6.4T ~ R , /5 SUHt Outlet ~ Dt Inlet ~, ~ Dt Bottom ~,/• ` ~ Q • ~ / / Header/Man. a ~ a ~t • I r_ Dist. Pipe Q, Z ~ • 7 Bot. System 9. Z. ~f '~ ~ ~~ Final Grade ~•~ ~~ •~ st cov~• r ~~ ~J 5,,3 q~S .~ width Length ~ / No. Of Trenches NS PIT DIM=N No. f Pits Ins' ia. Liquid D\ DIMENSIONS 3 $b~-7b z- er~.c \ SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING CHAMBER OR Manufacturer:.. ~ (~~0.~ ..~IV~}-/ INFORMATION Type/~f System: ~ J / 25 3~ 1*S- ~ 51 E UNIT Mo N b Off. C-ON.V C . nICTRIRI ITInN SYSTEM 1 laral. 7 del um er: ~ V~ Z~Sev~N~, i 7 D~~-~.~, -- HeaderJManifold /~ i Length ~ Dia ~ .-- . Distribution __ Pipe(s) ~ Length `~ Dia Spacing x Hole Size ~ x Hole Spacing ----~..~ Vert to Air Intake JTJ enu ('nVGR o. c. ~•,. n.. i. .... Mn„nfl (lr A4_r:rnrlc Ructamc rlnly ~~ a Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center ~~ ~ Z Bed/Trench Edges Topsoil ` Yes ~ No Yes ~ No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: Q! / ~~/ ~~ [~ Inspection #2: / /, Location: 1713 156th Street E erald, WI 54013 (SW 1/4 SW 1/4 6 T30N R17W) Pofolk Ridge (fka Willow River Ridge) Parcel No: 06.30.17.607 1.) Alt BM Description = ~ ... / ,( 2.) Bldg sewer length = 3(,0 ~~'~"~, ~ OJ F' ~-~., ~ / ~"-~ ~a w~ •Q~ ~0•~ -amount of cover = ~/ n o .n ~o, ~5 -'T ~,..~ --- Plan revision Required? ~ Yes ~ No ~ Q 5 ~~ ~ ~~~ Use other side for additional information. ~__~~- __~ ~ _ __ _ _ _ - _- _ ~_' ~~~ i Date pcto S ure ert. o. SBD-6710 (R.3/97) commerce.wi.gov Safety and Buildings Division County ~ S~ 201 W. Washing ve., .O. 7162 f j2.O[dC . i s e o n s i n Madison, 537 71 be filled in by Co.) Sanitary Permit Number Department of Commerce ~ 5 9955 Sanitary Pel-mit Application State Transactioni~lumber N~/~-" In accordance with s. Comm. 83.21(2), Wis. Adnt. Code, submission of this Corm to the appropriate governmental unit is required prior to obtaining a sanitary permit. Note: Application forms for state-owned POWTS are Project Address (if different thanrnailing address) submitted to the Department of Commerce. Personal information you provide or econdary ~ ~ ~~ ~ /L~ J / ~"( u ores in accordance with the Privacy Law, s. 15.04(1 (m). Stat "~7 ^ 1. A lication Information - Plcasc Print A ormati n Property Owners Name ~G ~~ ~~. ~i~/ ~ g 2008 Parcel a 0 ~ Z - Z~7 • a 7 - ~1ob Property Own er'sMa iling Address TY Property Location ~~ ` // ~ Zia ~F /V r, ~ ~G(.~ 1~tfG ST . CROIX COUN ~ Govt. Lot City, State Zip Code cµ/ ~ ~ ~ , 4 y / SW /, Section j "" ~~ ~~ ~~~~~~ ,,~~ 1~'~1rC.e+r/~vJC/ ~ W ~ ~-7 S~QrI ( (circle one T ~ N; R ~Z W II. Type of Building (check all that apply) Q Lot # ~I or 2 Family Dwelling - Number of Bedrooms - ~ ~~ ~ ~ ~ Subdivision Name ^ Public/Commercial -Describe Use ^ city of OJ ^ State Owned -Describe Use CSM Number ^ Village of ~~rr ~ 2-A-1~ R ~ITOwnof G -/ 1 tnJ Zb~"~ vr~ . [Il. Type of Permit: (Check only a box on line A. Complete line B if applicable) A' ,~L New S stem y ^ Replacement System ^ Treatment/Holding Tank Replacement Only ^ Other Modification to Existing System (explain) B• ^ Permit Renewal Before Ex iration ^ Pemtit Revision ^ Change of Plumber ~ ^ Permit Transfer to New List Previous Petmit Number and Date issued ~~ , p Owner I a.. I IV. Tv e of POWTS S stem/Com oncitUDet ice: Check all that a 1 Non-Pressurized In-Ground ^ Pressurized In-Ground ^ At-Grade ^ Mound >_ 24 in. ofsuitable sail ^ Mound < 24 in. of suitable soil ~ ~ { ~ ^ Holding Tank ^ Other Dispersal Component (explain) ^ Pretreatment Device (explain) V- Dis ersal/I'reatmentAeea Information: Design Flow (gpd) Design Soil Application Rate pdsQ Dispersal Area Required (st) Dispersal Area Proposed (s System Elevation SU ~ ~ ?Sp.S~ 4,5 G.So' VI. Tank Into Capacity in Total # of Manufacturer Gallons Gallons Units ~ ~ U u ti ~• New Tanks Esistitt ~ Tanks 6 - ~Do / k S '~`~- c u f H '+~ ~ "~ u V i~ ri a c>. U n ~ . . Septic or Holding Tank ~~~, ~_ / ~b ~N G/~- Dosing Chamber ~ Sv VII. Responsibilit-y Statement- 1, the undersign ,assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) P er's Si ure MP/MPRS Number Business Phone Number Plumbers Address (Street, City, State. Zip Code) ss'y-O77$' 29 aft ~trF ~'c.~~~ (~~ ~' w SY6 i3 VIII. unt ~/De artment Use Only Approved Permit Fee yea ~ Date I ued g~iy o~ issuing nt Signature yen Reason for De . [X. Condiq' easons for Disapproval 3` V~ L~~ t~_ L L~ 5 ti k fflu t f n d 1 S t ep c , e en i er an . an dispersal cetl must all be servtces! maintairKd ~ -~+~ ha~~ `OC.C.~ro~ /~J M as per management plan provided by phariitier. .i- ~ All tb n t t t 2 k m d ' requrer se ac en s mus x . i t ~~ ~j ~,p (G~ 4 ~ ~d /~ 0. ac i Yo complete plans or the system and submit to the County only on paper not less than S IR s I I inches in size '~,~tn 5~~~ ~~ ' SBD-6398 (R. 01/07) Valid tltty 01/09 i'T'; ~e v; f~. ., .per 0 0 ,C ~~ 1. ~ P N M (,`-- ~~ ~~4 c, d f~ W ~ ~~ n.,. J n :~ M 0 ~ ~ ~ ~ a`tn~'QO o ~ o cr ~` ~° :1 b ~- Q~ ~ ~ t `` `` `, ~, ~J {1 ~ M y- tin ~ ~ oa (+~ l~ (~ Q ~~ r cac M r ~ ~ ~ 2 u ~:( ~ ~ 2 A p( ` r ~1 ~~JJ ~, ~ (L a Z ~ ~ ~ ly ~' ~~ ~ ~ ~ ~ ~ /•~' r __ - ~ ~, ~~. as ~~ ~~° 2 m J f A ~y M 4, 0 r_ ~ ~ . . ~ o o~ ~1T ls. c 9 b a~~ ~ ~ ` t U ~~ ll ~ t ~ M ~ ~' 0 ,t ( ^~ v J r ~ ~ ," ~° ~~ ~ 2 ~ A + __ r ~ ~ ~ 1 ( C / N+ ~' n ~ ~ ~ ~ (L J AS 100 YEAR FLOOD ELEVATION ON CSM FILED IN VOL 21 PAGE 5189 DOC 822349 IN THE ST CROIX COUNTY REGISTER OF DEEDS 04/07/2006 T-~En ~.r~C'`~ ii~«LA ~ _ ___ ~ - I ;~N; S~5.5p'S~"w 61.49' ,, o S15 ~O - ~ ~ ~\. ~Y BM=995.5 TOP OF 1 " IRON PIPE N87'28'S6"E -~~`~' FI ? ~~ ~? ~U J 61 ~Z N N O La C. 6 C. 6 ' / 213.01' I Oft S .~O SS• ~ \ .~, O), ~~ 92 ~A'~ ~ ~~~~ I 1 C~L~ ~T~ ~ ~?/ ; .O ~\ tl Z ~ , '7 z 43, 525 s. f. !~, 10 ~~~ ~ ~ ~' 1.00 acres cV o /~~ ~ A '~ ~' ~ cr i~ ~ 40, 081 s. f.. `~ ~' a'- .- ^ 0.92 acres ~ ~ ~. ~-= 41 N AGE 43, 375 s. f. o. ~_ "' `~ ~ ~ Z G~ ~ CEMENT s 1.00 acres P ~~ ~. ~\ •J •W I11~ sue. ~ 12' Utility Qw~ ,~'~°c ~ ~ Easem, en t o`L \ 54i~~~ 13 (typica/) ,~~ ~~` 9 ~ 0' a 42, 871 s. f. ~~ ~`~- •••••• 40,148 s. f. ~ ~s 0.98 acres 0.92 acres ~ °- ~ L. B. 0. =1005.4' ono t~6 95 C 12 C \ 7 ~ ~ s ~ ~• 9 / / C13 ~ ~,, \ ~ •. N81.5T00.00"E a ~ • rn I 251/ 96 ~ ~ ~~~ o 9.42' rn 66. ~ ~~ 25 8 ~ ~ o ~ / / •~ 2 ~ 6p. rn WU' i" ~0 66' ~~` ~~ ~ I i'~ ~ ~ C17 ~ ~ 26, 353 s. f. ~ o 56• S ~r,~e C4 Cg ~,~ 0.60 acres ~ ~ ~ o 1 566 4, ~ 6. 55'19/7 ` ` ~ 298 g 2g „~ / 00 0 / D~ 10 ~ / ~ 6,3 Q. •,• - ~. N65 j 9/ ~ i 5 / ........ Zw,' l Z~J tJ ~.1 c.r~ 1 c,? N Q ~,? %" S ~, ~ 2 cry •~, c5` ~O. 7 ~ o ~ C. B. c. e. >0-11- C. B.. ~' ~ N~ 5 `'' ~ ~p S ~ o ~ ? ~ 42, 344 s. f. APPF ` . ~'- c'- ~ ~~ ~ 0.97 acres S H OF • 25, 089 s. f. ~ ; 15, 376 s. f. : ~ , Z ON I I 0.58 acres ~ 0.35 acres B OU ~ !~ O~•~ S ~, S~, 1~ ~~~ 4 N 6 ~ N66•a ~6 0 s ss. 6 ~`~ 1~~' 43, 503 s. f. i9" 6 0 0 0 ~~., 1.00 acres 33, 654 s. f. •~~, ~ o Ori ve way F ~ 0.77 acres ° N o ~typical~ v, °o c ~ ~ 2 ~~ ~ `r S R= N015839"W ' " ~~ ' 821 s. f. S ` • `~ 40 W N02'01 ' ~ 234.11' 04 79 48.71 '8 acres ~• ~ \ 50.61 ' _ N87'S8'18"E 361.86' ~ R= N88 ~0 59 E - I ~ /~ S87'S8'18"W 77.93'... -- I 933.69' 1 gg~ - ' 92' ` ~ - N87 58'18 "E 2598 19 • ' . R= S88 00 59 "W 2599.06' 504.15 POB ' I Il`,IDI nTTCfI i nnlnc . ~! ~r~~ Department of Commerce Division of Safety and Buildings ~ .~..~~ SOIL EVALUATION REPORT in accordance with Comm 85, Wis. Adm. Code ~,,~,,._ -_~age 1 of 3 Steel's Soil Service Attach complete site plan on paper not less than 8Y2 x 11 inches in size. Plan must include but not limited to: vertical and hori ontal f i t BM di ti d County St. Croix , z re erence po n ( ), rec on an percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel LD. ^?J„2 - i) -~ "7,,~~,%~\. -- Please print all information. Review By j Date Personal information you provide may be r(Privacy aw, s. 15.04 (1) (m)). VV - __ ^ ~~ ray ~~ --- Property Owner Property Location Ha In /~'}~?,~ ' ~~ Govt. Lot na S 1/4 SW1/4, S6, T30N, R17W Property Owner's Mailing Ad ss Lot # Block # Subd. Name or CSM# 404 South Green Ave. 5- 7 na ~r Ridge ~. ~ ` City State ip C um er i Villa e ^ tY ^ 9 ^ Town Nearest Road New Richmond WI - - 1 Erin Prairie Cty Rd GG ^ New Construction Use: ^ Residential /Number of bedrooms 4 Code derived design flow rate 600 GPD ^^ Replacement ^ Public or commercial -Describe: na Parent material outwash Flood plain elevation, if applicable 985.50 ~ General comments Conventional system, system elevation 97.37ft. Trenches spsaced and depth to code 3.58ft below grad/ and recommendations: ~--~-~--~ ~ ____ S U l`) ~' L `'~` ,` 1 ~ ~~ ~ ~ ~ ~. ~ , l Alai ~ ~~ ~~ t,~--e / 1 Boring # ^ Boring ^ Pit Ground surface elev. 100.95 ft. Depth to limiting factor 120 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistenc Boundary Roots GPD/ftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-8 10yr3/2 none sl 2msbk mfr cs ivf .6 1.0 2 8-20 7.5yr4/4 none scl 2msbk mfr cs na .4 .6 3 20-34 7.5yr4/4 none sl 2msbk mfr gw na .6 1.0 4 34-120 7.5yr4/6 none grcos osg ml na na .7 1.6 ,l ,i Z ~~~' 2 Boring # ~ Boring ^ Pit Ground surface elev. 100.95 ft. Depth to limiting factor 120 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consisten Boundary Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-6 10yr3/2 none sl 2msbk mfr cs 1vf .6 .8 2 6-16 7.5yr4/4 none cos osg ml cs na .7 1.6 3 16-120 7.5yr4/6 none cos osg ml na na .7 1.6 f ,3~ f~ ~'- -/ ~ '- I * Effluent #1 = BODS> 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BODS < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) Signature: CST Number ~ --' , David J. Steel .-- ~ ,~,~ 248956 Address Steel's Soil Service Date Evaluation Conducted Telephone Number 994 200th St. Baldwin, WI 54002 10/25/2006 715-760-0347 SBD-8330 (R.07/00) #2017 ~Z~'Yu/! Property Owner Haffner, Robin Parcel ID # Pend Page 2 of 3 Boring# ~ Boring ~.5s ~~ Pit Ground surface elev. 99.50 ft. Depth to limiting factor 120 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ftZ in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-8 10yr3/2 none sil 2msbk mfr cs 1vf .6 1.0 2 8-19 10yr4/4 none scl 2msbk mfr cs na .4 .6 3 19-30 7.5yr4/4 none scl/sl 2msbk mfr gw na .4 .6 4 30-120 7.5yr4/6 none cos osg ml na na .7 1.6 ~/ ,r g . ~ , h ti .~ ^Boring # ~ Boring Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ftZ 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 GPD/ftZ in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Ef!#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) Steel's Soil Service STEEL'S SOIL SERVICE David J. Steel Robin Haffner 994 200th St. CST-POWTSM SW1/4,SW1/4,S6,T30N,R17W Baldwin, WI 54002 Lic. #248956 Town of Erin Prarire, St Croix Co. Direct 715-760-0347 Willow River Ridge, Lots 5-6-7 Fax 715-684-3449 This soil evaluation was conducted to satisfy a zoning requirement, it may or may not be suitable for your use. The location of this test may or may not be as shown, as permanent lot lines were not established at the time the soil test was conducted. Z ~~~ ~ . ~~ ntr~~ ~;~- ~~ ~ ;~ 0~ %'~ ~ ~~ i ~~ 7',-=, ~% ~ ..~ ~~ Legend 1"=40' • =Benchmark Ele. 100.00 ft Top of 3/4" pvc pipe ~ =Alt Benchmark Ele. 99.60 ft Top of 3/4" pvc pipe ^ =Borings Boring Elevations B 1 = ] 00.95 ft B2 = 100.95 ft B3 = 99.50 ft B4 = 0.00 ft ~ y~c ~~ -l ~3 3of3 N (~~v~ S i ~ S' ~ rJ Sl-~C~~G~ ~~~1 I° ~~ .i ~/ 1`% 7~ ~~ , Ste: 7~~r vl ~'`~ .~ ~~~~~~n Department of Commerce Division of Safety and Buildings SOIL EVALUATION REPORT in accerdance with Comm 85, Wis. Adm. Code #54 Page 1 of 2 Northland Plumbing, Inc. County Attach complete site plan on paper not less than 8% x 11 inches in size. Plan must St. Croix include, but not limited to: vertical and horizontal reference point (BM), direction and percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D. Please print all information. Revie By Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). $ / 9 6 Property Owner . Property Location Haffner-Mergen Govt. Lot SW1/4, SW /4, Sti, T30N, R17W Properly Owner's Mailing Address Lot # Block # Subd. Name or C M# 404 S. Green 5$7 Pofolk Ridge City State Zip Code Phone Number ~ City ^ Village ®Town Nearest Road New Richmond WI 54017 Erin Prairie CTY Rd GG ®New Construction Use: ®Residential /Number of bedrooms 3 Code derived design flow rate GPD ^ Replacement ^ Public orcommercial -Describe: Parent material outWash Flood plain elevation, if applicable ft. General comments Conventional system. This is an addition to soil test done by David Steel, add these 2 pits to his first 3. and recommendations: 4 ^ Boring Boring # Pit Ground surtace elev. 99.45 fl. De th to limitin factor 140 in. ® P 9 Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consisten Boundary Roots GP D/ft~ in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Etf#2 1 0-9 10YR 3/2 sl 2msbk mfr a 1f .6 1.0 2 9-23 7.5YR 4/4 scl 2msbk mfr cs .4 .6 3 23-57 7.5YR 4/4 sl 2msbk mfr gw .6 1.0 4 57-140 7.5YR 4/6 5 Osg ml .7 1.6 °~ I l 5 a Boring # ~ Boring ® Pit Ground surface elev. 98.82 fl. Depth to limiting factor 145 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consisten Boundary Roots GP D/fls in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 •Efr#2 1 0-12 lOYR 3/2 sl 2msvk mfr a 1f .6 1.0 2 12-23 10YR 4/3 sl 2msbk mfr cs .6 1.0 3 31-65 7.5YR 4/4 s Osg ml gw .7 1.6 4 65-145 7.5YR 4/6 , tl s Osg ml .7 1.6 * Effluent #1 = BODS> 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BODS < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) Signature: CST Number Michael J. Myers 267985 Address Northland Plumbing, Inc. Date Evaluation Conducted Telephone Number 2943 130th Ave Glenwood City, WI 54013 8/4/08 715-265-4115 SSD-8330lR_07/001 Page 1 of 4 • ~ SYSTEMS I NC Environmental Onsite Wastewater Solutions`" Leaching Chamber Design Spreadsheet Project Name: Mergen-Conventional Owner's Name Dean Mergen Owners Address 236 N Arch Ave New Richmond, WI 54017 Legal Description ~- ~ %., ~ ~ %. Secr 6 ~ T 30 N, R 17 W ~ Township Erin Prairie County Saint Croix ~ Subdivision Pofolk Ridge Lot# 5/6/07 Parcel I D# Table of Contents Pg• 1 Cover page 2 Calculations and Drawings 3 Management and Contingency Plan 4 Plot Map total # of pages: 4 Designer Name: Michael J. Myers License #: 267985 Date: 8/5/08 Ph. #: 7 5-265-411 Signature: Design Methods Used "IN-GROUND SOIL ABSORPTION COMPONENT MANUAL FOR PRNATE ONSITE WASTEWATER TREATMENT SYSTEMS" (Version 1.0) SBD-10705-P (R.6/J9) svsrenns •IC Infiltrator and the Infiltrator logo are trademarks of Infiltrator Systems, Inc. ""'"""""°`"`"'~°"~'"~"' Spreadsheet provided under license to Infiltator Systems, Inc by: 3taAdvisement N12486 22l)th St, Boyceville, WI 54725 f srsrEnns ,' ~ Calculations and Drawings Page 2 of 0 Site Conditions Infiltration Elevations Site Type: ~~~ %Slope 2.4 # of Bedrooms 3 Depth to limiting factor 120 Soil Application Rate: 0.6 Effluent Quality Eff #1 Design Flow: 450 gaUday Max BOD 220 mg/I Max TSS 150 mg/I Trench #1 Trench #2 Trench #3 Contour Elev: 99.50 99.50 Ft Infiltration Elev: 96.50 96.50 Ft Limiting Factor Elev: 89.50 89.50 N/A Treatment and Dispersal Zone: 7.00 7.00 N/A Cover Material Required: 0 0 N/A In Finished Grade Over Cell: 99.50 99.50 N/A Distribution Cell Choose chamber type: Septic Tank Infiltrator Quidc 4 Standard ~ Manufacturer: Wieser Concrete # of trenches: 2 ~ Volume Chosen: 1000/650 Chamber Length: 4.00 Ft Effluent Filter Selected: Polylock Chamber EISA: 19.1 Ft2 Note: Access opening of sufficient size to be provided to allow removal of fitter. Endcap EISA: 5.8 Ft2 opening to terminate at or a R ' ed I f It t' A 750 0 Ft2 M ~ G vsr~•thS t Cross Secti . ~ 112" Min r- equlr n I ra the rea. Actual Infiltrative Area: 756.5 Ft2 ~ r ~ ~~ Total # of Chambers: 39 G ;~ Tank ` C L~~ Total # of Endcaps: 4 V Combined Length of Cells: 160.0 Ft Cross Section of Cell 18" Min Cover Material Observation Pipe (if required}~ - - _ _ - Final Grade - ~ II joi rrts to watertight D3034 or Ground ~ ~ Effluent Sch40 Contour Finer Pipe Leaching System Chamber ~~,,..,,.:,.., 3" Bedding Under Tank L 6 ~rfM 3034 Obserrlat,ton a Sr41 q0 ~ ~ ~ I~~e pVC ppe Length ~~ 1'~~ ~ ~O Observation Widlh (~~e Infiltrator and the Infiltrator logo are trademarks of Infiltrator Systems, Inc. Spreadsheet provided under license to Infittator Systems, Inc by: 3bAdvisement N124t2B 220th St, t3oyceville, WI 54725 1 Page 3 of 4 In-Ground System Management Plan pursuant to comm 83.54 W. A. C. 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 8 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 1/3 sludge volume. Septic tank should be routinely inspected to be watertight and of good repair. Absorbtion Cell The absorbtion 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 problemsffaiture. 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, vehicles, etc...) could compress the component and reduce it's absorbtion capabilities and/or possibly cause it to freeze in winter conditions. 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 or other components therein (including floats, alarms, etc) become defective, the defective tank or component must be replaced immediately to ensure that the system can operate as designed. If the absorbtion component cannot accept wastewater or ponds wastewater to the surface, the component must be repaired or replaced in it's current location by removing the clogged bacterial mat, aggregate/leaching chamber cell, and distribution piping within the cell and replaclng failing cemponents in order to return. system to proper working order as required. If repair is not feasible, a new system is to be constructed in a designated replacement area ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT .AND OWNERSHIP CERTIFICATION FORM OwnerBuyer ~EA~ 4 ~~~ y ~ ~~- F~~ Mailing Address 2 3 ~ /~/ A 2 c ff /•1 y6~ ~ ~-~ ~ eC ~'d //'r o-N~ • Gv / `sy~/ ? Property Address ~ 7 ~ 3 ~'~ ~ ~} ~~ (Verification required from Planning Department for new City/State ~~ ~ttl'~Nt1ic/b~ ~ ~ Parcel Identification Number V /2- !° ~~" (o _ 2So LEGAL DESCRIPTION Property Location Sc~/ '/,, S w `/,, Sec. ~a , T 3 dN-R~~W, Town of ~~! /~2,N-~/t/C~- Subdivision ~a~"~ ~ ~ b 6 ~' .Lot # ,S-~' 7 Certified Survey Map # ,Volume ~ ~ ,Page # S Warranty Deed # ~ l030 / y ,Volume ,Page # Spec house ^ yes ~ no Lot lines identifiable f ~ yes ^ no SYSTEM MAINTENANCE , Improper use and maintenanceofyoursep~ic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a master plumber, journeymanplumber, restricted plumber or a licensedpumper verifying that (1) the on-site wastewaterdisposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. Uwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification ling that your , eptic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 da f the thr ar expiration date. ~ g/8'/c4~ SIGNATURE OF APPLIC DATE OWNER CERTIFICATION I (we) rtify that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owner(s) of roperty des d above, by virtue of a warranty deed recorded in Register of Deeds Office. / ~ ~ ~/&/o SIGNATURE OF APPLICANT DATE ss«*«« «ss«s« Any information that is mis-represented may result in the sanitary permit being revoked by the Zoning Department. «s Include with thls application: a stamped warranty dead from the Register of Deeds office a copy of the certified survey map if reference is made in the warranty deed State Bar of Wisconsin Form 1-2003 WARRANTY DEED r)ncument Number ~ Document Name THIS DEED, made between Robin Jo Haffner and Colleen M. Haffner, husband and wife ("Grantor," whether one or more}, and Dean Mergen and Betty Mergen, husband and wife as survivorship marital property ("Grantee," whether one or more). Grantor, for a valuable consideration, conveys to Grantee the following described real estate, together with the rents, profits, fixtures and other appurtenant interests, in St. Croix County, State of Wisconsin ("Property") (if more space is needed, please attach addendum): SEE ATTACHED LEGAL DESCRIPTION Ililll !IIII IIIII 11111 Illll IIIII Ill! IIIIII IIIIfill *as3olo 2* ~fi3010 KATHLEEN H. WALSH REGISTER OF DEEDS ST. CROIX CO., WI RECEIVED FOR RECORD 10/25/2007 11;45AM WARRANTY DEED EXEi1Pi r REC FEE: 13.00 TRANS FEE: 183.90 PAGES: 2 Recording Area Name and Return Address WESTCONSIN CREDIT UNION PO BOX 264 NEW RICHMOND WI 54017 otz-tots-~a2so arce ent~ icatton um er P This is homestead property. (is) f~-netj Grantor warrants that the title to the Property is good, indefeasible in fee simple and free and clear of enctunbrances except: Easements, Restrictions, and Covenants of Record. Dated '~,~llUt (~ ~ , 2007. =--'-~ M. Haffner AUTHENTICATION ACKNOWLEDGEMENT Signature(s) STATE OF WISCONSIN ) _ ) ss. authenticated on St. Croix COUNTY ) TITLE: MEMBER STATE BAR OF WISCONSIN (If not, authorized by Wis. Stat. 706.06) THIS INSTRUMENT DRAFTED BY: Personally came before on July 2m 2007 Robin Jo Haffner and Colleen M. Haffner to me know to be the person(s) who executed the f,~'egoing instrument and acknowledged the same. Attorney John Schneider N O Tq : `y Balsam Lake, WI 54810 = -yt ' 9~•e ~ ~ .'• GeC f C .~r~ , 2~ i~~~~~ Lv1 S C O~y~```~ of Wisconsin t/ permanent) (expires: ~~ iZ? ~~~ ) (Signatures may be authenticated or acli(tHNklt~l!d. Both are not necessary.) NOTE: THIS IS A STANDARD FORM. ANY MODIFICATIONS TO THIS FORM SHOULD BE CLEARLY IDENTIFIED. WARRANTY DEED Copyr[ght 2003 STATE BAR OF WISCONSIN FORM NU. 1-2003 1 dl<e7n sotiware by: Automated Real Estate Services, inc. - 800.330.1295 rile: 7-1102W /,~ FILE: 7-1102 W Legal Description 2 of 2 Lots _5, G, and 7 of the Pofolk Ridge, Recorded in Volume 11 of .Plats at page 24 as Document No. 862145 and further located in that part of the Southeast Quarter of the Southeast. Quarter, and the Southwest Quarter of the Southeast Quarter (S1;'/- of the SEf/; and the S~~'%4 of the SE'/.,) of fractional Section 6, Township 34 Forth, Range 17 West, and part of the Northeast Quarter of the Northeast Quarter and the Northwest Quarter of the Northeast Quarter (NF,1/ of the NEI/ and the NVV% of the NEI/) of the fractional Section 7, 'Township 30 North, Range l7 'Vest, Town of Erin Prairie, being a part of Lot 2 of a Certified Survey ;Lap recorded in Volume Zi, page 5189, 5t. Croix County, Wisconsin Form SofMare b} Automated Rcd Estate Services, Ine. 1-800-J30.1295 Parcel #: 012-2007-07-000 02/12/2008 03:55 PM PAGE 1 OF 1 Alt. Parcel #: 06.30.17.607 012 -TOWN OF ERIN PRAIRIE Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 10/10/2007 00 0 Tax Address: Owner(s): O =Current Owner, C =Current Co-Owner O -MERGEN, DEAN & BETTY DEAN & BETTY MERGEN 236 N ARCH NEW RICHMOND WI 54017 Districts: SC =School SP =Special Property Address(es): ' =Primary Type Dist # Description * 1713 156TH ST SC 3962 NEW RICHMOND SP 8020 UPPER WILLOW REHAB DIST SP 1700 WITC Legal Description: Acres: 0.970 Plat: 11-024-POFOLK RIDGE 012-07 SEC 06 T30N R17W PT SE SE BEING LOT 7 Block/Condo Bldg: LOT 07 POFOLK RIDGE DEED RESTRICTION DOCUMENT #862097 Tract(s): (Sec-Twn-Rng 401/4 1601/4) 06-30N-17W SE SE Notes: Parcel History: Date Doc # Vol/Page Type 10/25/2007 863010 WD 10/10/2007 862105 11/24 PLAT 10/10/2007 862097 COV 05/04/2006 824360 WD more... 2008 SUMMARY Bill #: Fair Market Value: Assessed with: 0 Valuations: Description Class Acres Totals for 2008: General Property 0.000 Woodland 0.000 Last Changed: 10/18/2007 Land Improve Total State Reason 0 0 0 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch #: Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 . • Parcel #: 012-2007-06-000 o2i12i2oos 12:18 PM PAGE 1 OF 1 Alt. Parcel #: 06.30.17.606 012 -TOWN OF ERIN PRAIRIE Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 10/10/2007 00 0 Tax Address: Owner(s): O =Current Owner, C =Current Co-Owner O -MERGEN, DEAN & BETTY DEAN & BETTY MERGEN 236 N ARCH NEW RICHMOND WI 54017 Districts: SC =School SP =Special Property Address(es): ' =Primary Type Dist # Description " 1711 156TH ST SC 3962 NEW RICHMOND SP 8020 UPPER WILLOW REHAB DIST SP 1700 WITC Legal Description: Acres: 0.770 Plat: 11-024-POFOLK RIDGE 012-07 SEC 06 T30N R17W PT SE SE BEING LOT 6 Block/Condo Bldg: LOT 06 POFOLK RIDGE (DEED RESTRICTION DOCUMENT #862097) Tract(s): (Sec-Twn-Rng 401/4 1601/4) 06-30N-17W SE SE Notes: Parcel History: Date Doc # Vol/Page Type 10/25/2007 863010 WD 10/10/2007 862105 11/24 PLAT 10/10/2007 862097 COV 05/04/2006 824360 WD more... 7MS2 CI IMMARV Bill #: Fair Market Value: Assessed with: 0 Valuations: Description Class Totals for 2008: General Property Woodland Acres 0.000 0.000 Land Improve 0 0 0 Last Changed: 10/18/2007 Total State Reason 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch #: Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 ~60ULD5 PUMPS Submersible Effluent Pump .. PE SPECIRCATiONS APPLICATIONS Speaaliy designed for the following uses: • Mound Systems • Effluent/Dosing Systems • LDW Pressure Pipe Systems • Basement Drainir~ • Heavy Duty Sump) Dewraterir~ METERS FEET ao 35 10 30~ a = 25 a z 20 0 15 ~..' 10 5 0 00 10 20 30 40 50 60 70 GPMI >30 0 5 10 15 tn3/h CAPACrilf o aoo2 ~bs Pumps «....:.~..1~......,.M ,.~„ Pump - Gerreral: • Discharge:l'k" NPT • Temperature:104°F (40°C) maximum, o~ntinuous when fuAy submerged. • Solids handGng:'k" maximum sphere. • Automatic models indude a float switch. • Manual models available. • Pumping range: see perfom~arste chart or curve. VE31 Pump: • Maximum capaaty: 50 GPM • Maximum tread: 25' TDH PE41 Pump: • Maximum capadty: 60 GPM • Maximum tread: 29` TDH PE51 Pomp: • Maximum opaaty: 70 GPM • Maximum head: 37' TDH ~~ • Single phase • 60 Hertz • 115 votes • Butt-ur iilerrnal cnrerload pmr tectiar wih automatic reset. • Class 8 inwlation. • Oil-tilled design. • High strength carbon steel shaft PE31 Motor: • 33 HP, 3000 RPM • 12.0 Maximum amps • Shaded pole design PE41 Motor: • .40 HP, 3400 RPM • 7.5 Maxinnum amps • PSC design PEST Motor. • .50 HP, 3400 RPM • 9.5 Maximum amps • PSC design --r~-. ---~- . {-- - . --~---=-:---- -- - - ---+--- :-- * • PE31 PE41 PEST snoods. ! i _..__.-- - . ~ .4~ .rJ~ -. • • - ._ • • . • :-_~ _.:.. . ... .... • 1 2 i . .I f- - ~ .. . . . . --r- .. .... _y_ _ . _. . • __ _ ~_ -. . _ _ _ . _ + . - ,-+ - ~-- - - _ -_ - _ i_+.. ._ -S__ ~..._ _ _ --+ -- --... ' - - - - - °t-- - - ---~- + FEATtl~S . Canosion resist~t aDnstructiom. ^ Cast iron body. ^ Thermoplastic impeller and uov~. ^ Upper sleeve and borer heavy duty baU bearing conshuctiom. ^ Motor is perr~arrendy lubricated for extemded service rrbe. ^ Powered ~ mrltinuous opmation. ^ Ap ratings are within the worl6ng limits of the motor. ^ Quick disconnect power cord, 20' standard , heavy duty 16/3 SIf W with NEMA 5-15P, flues prong, 115 volt grounding ping. ^ Coir~lete unit is heavy duty. portable and eornpact. ^ (1Aecharrical seal is carbon, ceramic, BUNA and stainless steel. ^ Stamiess Steel fasteners. _ s~® c us /~Te~sted ~~~iNppcT/8 amend ~..71M~1W By C81u~R S~y~~~~~M~A990f~o9 !-YL7•T7 GosidsrauapsislSO900/ m~soestd. Goulds Pumps f~ ITT Industries .y