The URL can be used to link to this page

Home My WebLink About026-1167-10-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division Sanitary Permit No: INSPECTION REPORT 561031 0 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No Personal information you provide maybe used for secondary purposes [Privacy Law, s.15.04 (1)(m)J. Z24 3 3 Permit Holder's Name: City Village X Township Parcel Tax No: Marek Construction, c/o Todd Marek Richmond, Town of 026-1167-10-000 CST BM Elev: Insp. BM Elev: BM Description: Section/Town/Range/Map No: 27.30.18.1312 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic L& (Z40j (a,,,~v Benchmark J 25 lbb, 3 91 Dosing S~ Alt. BM / Aeration /1w^,ggj-(w `~r- Bldg. Sewer Z 9 S . Holding ( ctsy.e' St/Ht Inlet / TANK SETBACK INFORMATION St/Ht Outlet TANK TO P/L WELL BLDG. ent to Air Int a ROAD Dt Inlet Septic y TU Dt Bottom A A~. ~O I Dosing L4 Header/Man. 4. 8 6 3o' Aeration Dist. Pipe S 4b . 3a Holding Bot. System Fina Gradgg,, 1( PUMP/SIPHON INFORMATION to & os~ Manufacturer n /1 Demand St ver QS-. ~S s GP ~p gu xc~( C, 3 tk s at Model Number n~- 1 S~ / r ~ S.ZS / TDH OW Friction .15*kogs System`s 55 r TDHi Ft Co~G(~ r4 T T 1-375 9 ~ - Forcemain Lengt 5'/ ia.Dist. to Well 0/ SOIL ABSORPtFW SY TEM BEDITRENCH Width Length l No. Of T e ches PIT DIMENSIONS No. Of Pits Inside . epth DIMENSIONS 6a f SETBACK SYST M TO. P/L DG WELL LAKE/STREAM LEACHING nufacturer INFORMATION Type Of System: CHAMBER O P~~ ` pV I UNIT umber: DISTRIBUTION SYSTEM j Header7:ia_2L Distribution x Hole Size x Hole Spacing Vent to Air Intake Pipe(s) ( Length Length cing Lq o1~ '•-(n SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center Bedrrrench Edges Topsoil C Yes No Yes ❑ No OMM TS' In ude o e iscrepencies, persons present, etc.) Inspection #1: 9 / Z3/ Inspection #2: Z3 I RV4_ Gl Location: 1260 138th Ave Ne ichmond, WI 54017 (NE 1/4 N)E 1/4 27 T30N R18W) Lundy's Pre erve Lot 10 cd'JParcel No. 27.30.18.1 1 1.) Alt BM Description 54M,r- ~4 r 2.) Bldg sewer length = 7b -amount of cover = A54- 361 LIT" ILL Al z ~ ~ a re 5~-- J Plan revision Required? ®Yes No Use other side for additional information. Date Insepctor's Signature Cert. No. SBD-6710 (R.3/97) 196' \ slot Mme \ north Todd Marek P O Box 228 New Richmond, WI 54017 Lot 10 Lundy's Preserve Richmond Township St. Croix County, Wisconsin N 1/2, NE 1/4, S 27, T 30 N, R 18 W 1.528 acres Scale 1 " = 40' r-- ao o°- - BM1 = 100.00' top of steel fence post Driveway BM A4= - 96.00 top of survey iron w w 0 4" pvc o Wieser 1200/800 tank C9 80' of 2" pvc forcemain Gay 94.5' ,A 0 95.5' oB1 B3 CD 396, East / BM2 BM 1 of A/7e B2 Page 8 of 8 County 3i~ C R-0 0 X oararuq~ dr Safety and Buildings Division 82 201 W. Washington Ave., P.O. Box 7162 Sanitary Permit Number (to be Slled in y Co.) a $p K Madison, WI ~~7- 162 5 State Transaction Number KIN &i`tary Permit Application .z -33 uni Project Address (if different than mailing address) zlz In accordance with SPS 383.21(2), Wis. Adm. Code, submission forms form to the appropriate state-owned POWTS are ub!' rhttted tot is required prior to obtaining a sanitary permit. Note: Application the Department of Safety and Professional Servies. Personal information you provide may be used for secondary oses in accordance with the Privacy Law, s. 15.04(1 m , Stats. Z~oO purp 1. A lication Information - Please Print All Information _ Parcel # Property Owner's Name Lt ® -Z 114 -7 d - 6 e IAA d Property Location (131z) Pr eOwner's Mailing ddress v~ Z ~ 9 Govt. ~L-ot Zip Code Phone Number r~ 1f~~~'/•, Section Ci S~tat,~e J / circle one Lo t# ~N; R Eo V_~'~TI✓/I,QN(~ L l Q /5 ✓?~7 Ti / T H. Type of Building (check all that apply) ~ Subdivision Name 4V ~v J 1 or 2 Family Dwelling -Number of B / edroom it A f PY Block # it, / V l: ❑ Public/Commercial - Describe Use 6k.~ ❑ City of t'•~~ ❑ State Owned - Describe Use CSM Number ❑ Village of .Town of 1 ('.1 nn 0,J / f ' III. Type of Permit: (Check only one box on line A. Complete line B if applicable) A. ❑ Treatment/Holding Tank Replacement Only El Other Modification to Existing System (explain) New System ❑ Replacement System List Previous Permit Number and Date Issued / El Chan e of Plumber ❑ Permit Transfer to New B. 11 Permit Renewal _ ❑-Permit Revision g Before Expiration Owner IV. Type of POWTS S stem/Com onent/Device: Check all that apply) ❑ Non-Pressurized In-Ground ❑ Pressurized In-Ground At-Grade ❑ Mound ? 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil 0 Holding Tank El Other Dispersal Component (explain) ❑ Pretreatment Device (explain) V. Dis ersal/Treat nt Area Information: Dispersal Area Required (sf Dispersal Area Proposed (sf) System Elevation 14 Desi Flow (gpd) Design Soil Application Rate( fl 16 &6 Capacity in Total # of Manufacturer VI. Tank Info Gallons Gallons Units w = a, u New Tanks Existing Tanks " j Z a. U iii Z v) is, 5 IKI Septic or Holding Tank o~ ~ wr Dosing Chamber p L . , - ~ VII. Responsibility Statement- I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's 'gnature NIP/# sNumber Business Phone Number Plumb r' Name (Print) Plumber's dress (Street, City, State, Zip Code) VI oun /Department Use Only Permit Fee Date Issued Issuin gent Sign re Approved ~ 3 ='=iYenn Reaso Denial IX. Condi easons for Disapproval /l eptiC tank, effluent filter and i~ytc;,~.4~Y~c .~e-~ ~ tl~f :~••~``-~-o•cl~ . ;dispersal cellmust all be services / maintained as as.per management plan provided by plumber. t 2. All $60ack requirements must be maintained r X z a ` Attach to complete plans for the system and submit to the County only on paper not less than 8 a II inches in size SBD-6398 (R. 11/11) l • _ IAVARTME~~pn Safety and Buildings 3824 N CREEKSIDE LA d1 HOLMEN WI 54636 T U ~ ~ ~ Contact Through Relay F k www.dsps.wi.gov/sb/ q www.wisconsin.gov A~4'ssrorScott Walker, Governor Dave Ross, Secretary March 05, 2013 CUST ID No. 226497 ATTN: POWTS Inspector ROGER D NELSON ZONING OFFICE NELSON PLUMBING ST CROIX COUNTY SPIA 122 E SUMMIT AVE 1101 CARMICHAEL RD ELLSWORTH WI 54011 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 03/05/2015 SITE: Identification Numbers Marek # 10 Transaction ID No. 2214533 140TH Ave Site ID No. 788537 Town of Richmond Please refer to both identification numbers, St Croix County above, in all correspondence with the agency. N1/2, NEIA, S27, T30N, R18W Lot: 10, Subdivision: Lundy's Preserve FOR: Description: Four bedroom At-grade System / 4% slope Object Type: POWTS Component Manual Regulated Object ID No.: 1415560 Maintenance required; 600 GPD Flow rate; 38 in Soil minimum depth to limiting factor from original grade; System(s): At-grade Component Manual, Version 2.0, SBD-10854 (N.03/07), Pressure Distribution Component Manual - Version 2.0, SBD-10706-P (N.01/O1); Effluent Filter The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. This system is to be constructed and located in accordance with the enclosed approved plans and with any component manual(s) referenced above. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code P O.W T. requirements. Condltl0 No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.( stats. The following conditions shall be met during construction or installation and prior to occupancy or use: DIVISION Of SAFETY AN Reminders • A sanitary permit must be obtained from the county where this project is located in accordance with,the SEE CORRE ON 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 state approved effluent filter is required. Maintenance information must be given to the owner of the tank explaining that periodic cleaning of the filter is required. Access to the filter for cleaning must be provided per SPS 384 product approval conditions. • All POWTS component piping material shall be SPS 384, Wis. Adm. Code compliant. • The area within 15' downslope of the dispersal cell shall remain undisturbed. Vehicular traffic, excavation or soil compaction is prohibited in this area. • The proposed well shall be a min. 25' from treatment tank and a min. 50' from dispersal cell. • 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. ROGER D NELSON Page 2 3/5/2013 Owner Responsibilities • The current owner, and each subsequent owner, shall receive a copy of this letter including instructions relating to proper use and maintenance of the system. Owners shall receive a copy of the appropriate operation and maintenance manual and/or owner's manual for the POWTS described in this approval. • 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. SPS 383.54(1). • 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. • 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 and the POWTS management plan to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Fee Required $ 250.00 Fee Received $ 250.00 Balance Due $ 0.00 4 era rd M Swim POWTS Plan Reviewer, Integrated Services (608)789-7892, Mon - Fri, 7:15 am - 4:00 pm WiSMART code: 7633 jerry.swirn@wisconsin.gov Note: Effective January 1, 2012, all codes under the jurisdiction of the Division of Safety& Buildings will be modified. Code references with prefixes starting with "Comm" will be replaced with "SPS" to recognize the relocation of the Division of Safety & Buildings from the former Dept. of Commerce to the Dept. of Safety & Professional Services. Additionally, all S&B codes will be renumbered and addressed in a "300" series. For future reference, the Wisconsin Commercial Building Code will be addressed by SPS Chapters 360-366. /iV~~ST ~ySFR~ RESIDENTIAL AT-GRADE DESIGN FS Pressurized - Sloping Site lc INDEX AND TITLE SHEET Project Marek lot #10 Owner Todd Marek Address PO Box 228 New Richmond, WI 54017 Legal Description N 1/2, NE 1/4, S 27, T 30 N, R 18 W Township Richmond County St. Criox Subdivision Name Lundy's Preserve Lot No. 10 S. Parcel ID Number 026-1167-10-000 ally Plan Transaction Number f ED Index sheet Page 1 dU1L011YGS Calculations Page 2 At-grade drawings Page 3 FENCE Laterals and dose tank Page 4 Specifications Page 5 Management & contingency plan Page 6 Pump curve & s ecifications Page 7 Designer Roger Nelson License Number MP226497 Signature Phone Number 715-821-4444 61 L Date 02/22/13 Designed pursuant to: At-grade Component Manual for POWTS SBD-10570-P (R.6/99), and both SSWMP Publication 9.6 Design of lure Distribution Networks for ST - SAS (01/81) and Pressure Distribution Component Manual Ver. 2.0 SBD-10706-P (N. 01/01) Version 5.0 (10/05) Page 1 of $ PRESSURIZED AT-GRADE DESIGN At-grade Design Worksheet - Sloping Site Flows and Site Data Entry. (r or c) r Residential or commercial? 400.0 Estimated wastewater flow (gpd) 600.0 Design wastewater flow (gpd) 4.00 % Site slope 95.10 Contour elev. below lateral (ft) 38.00 Depth to limiting factor (in) 0.60 In-situ soil application rate (gpd/ft^2) f Distribution Cell Information (1 or 2) 1 Influent wastewater quality 10.00 Linear loading rate gpd/ft 10.00 Effective absorption width (ft) 10.00 Max. effective width permitted (ft) 100.00 Aggregate length (ft) Pressure Distribution Data Entry (c or e) a Center or end lateral connection 1 Number of laterals 0.156 Orifice diameter (in) e.g. 0.25 Not a final calculation 2.00 Estimated orifice spacing (ft) 2.00 Forcemain diameter (in) 2.80 Forcemain flow velocity (ft/sec) 80.00 Forcemain length (ft) y or n Does forcemain drain back? 85.00 Pump tank elevation (ft) y or n Are laterals at highest point? 4.55 System head (ft) x 1.3 NA 9.77 Vertical lift (ft) 13.0 Forcemain drainback (gal) 1.31 Friction loss (ft) 80.0 5x Lateral void volume (gal) 0.00 In-line Filter Loss (ft) 93.0 Minimum dose volume (gal) 15.63 Total dynamic head (ft) 27.4 System demand (gpm) Lateral Diameter Selection Gallonslinch Calculator (optional) Pipe diameter Design options Design choice Total Tank Capacity (gal) Designer 1 in Total Working Liquid Depth (in) must select 1.25 in GaVin (enter result in cell G46) one lateral 1.5 in diameter 2 in x x Treatment Tank Information 3 in x 1200 Septic tank capacity (gal) Wieser Manufacturer Effluent Filter Information Dose Tank Information Pol loc filter manufacturer 800.0 Dose tank capacity (gal) PL 525 Filter model number 22.2 Dose tank volume (gal/in) Wieser Manufacturer Project: Marek lot #10 Transaction Number: Page 2 of AT-GRADE PLAN VIEW D 1/6 B Observation pipes (2 typical) A 10.00 ft D Pss 7-A B 100.00 ft 1/6 B 16.67 ft Less 74 e7 C 12.00 ft W C D 5.00 ft E 2.00 ft L 110.00 ft L D B W 22.00 ft A x B 1000.00 ft^2 L T E~ Cap Typical obs. pipe. = Total aggregate cell A x B Slotted in the lower se and anchored = Plowed area L x W s I securely. -6. AT-GRADE CROSS SECTION Svnthetic fabric cover 93 ft Finished grade Lateral elevation invert elev. 95.60 ft Observation pipe at aggregate toe E 4 % Slope Surface contour 95,10 ft C A and system D elevation = 12 in. topsoil and subsoil Plowed layer ® over aggregate and tapered to toes. below L x W 0 = 6 in. aggregate below pipe(s), and 2 in. above pipe. Project: Marek lot #10 Transaction Number: Page 3 of PRESSURE DISTRIBUTION AND DOSE TANK Lateral Diagram - End Connection 1P Fr7L.t dlydled next to end cap IF XLaterals & force main of PVC Sch 40 ~d on the bottom of th e lateral (per CONIM Table 54.30-5) aced • =Turn-up wlball valve oroleanoutplug Lateral Specifications 0.156 Orifice diameter (in) End Lateral connection point x 1.96 Orifice spacing (ft) 1 Number laterals 51 Orifices/lateral P 98.00 Lateral length (ft) 27.4 Lat. discharge rate (gpm) 2.00 Lateral diameter (in) 2.00 Forcemain diameter (in) 27.4 Sys. discharge rate (gpm) 80.00 Forcemain Length (ft) 15.63 TDH (ft) Typical Pump Chamber Layout Approved manhole cover with Weather-proof warning label and locking device junction box 4" Final grade disconnect Tank component is Aftemate properly vented E. V, outlet location 18" min. Electrical as per NEC 300 and /c Approved outlet Comm 18.28 WAC joint Tank full C Inches Gallons JA Provide 1/4" C A 19.8 440.6 Alarm on weep hole or B 2.0 44.4 antisiphon C 4.2 g 0 Pump on B device. o D 10.0 222.0 85.83 C Totals 36.0 800.0 Pump off D 3" Bedding under tank 85.00 ft _ I Goulds Pump manufacturer S. J. Electra Alarm manufacturer PE 41Pump model number 101 hw Alarm model number Project: Marek lot #10 Transaction Number: Page 4 of 2 i At-grade System Maintenance and Operation Specifications Service Provider's Name Nelson Plumbing Phone 715-821-4444 POWTS Regulator's Name St. Croix County Zoning Phone 715-386-4680 System Flow and Load Parameters Design Flow - Peak 600 gpd Maximum Influent Particle Size 1/8 in Estimated Flow - Average 400 gpd Maximum BOD5 220 mg/L Septic Tank Capacity. 1200 gal Maximum TSS 150 mg/L Soil Absorption Component Size 1000.0 fe Maximum FOG 30 mg/L Type of Wastewater Domestic Maximum Fecal Coliform >10E4 cfu/100 mL Service Frequency Septic and Pump Tank Inspect and/or service once eve 3 ears Effluent Filter Inspect and clean at least once eve 3 ears Pump and Controls Test once eve 3 ears Alarm Should test month) Pressure System Laterals should be flushed and pressure tested eve 1.5 ears Mound Inspect for ndin and seepage once eve 3 ears Other Miscellaneous Construction and Materials Standards 1. Observation pipes are slotted and materials conform to Table Comm 84.30-1, have a watertight cap, and are secured in as shown in the at-grade component manual. 2. Dispersal cell aggregate conforms to Comm 84.30 (6)(i), Wis. Adm. Code. 3. All gravity and pressure piping materials conform to the requirements in Comm 84, Wis. Adm. Code. 4. Tillage of the basal area is accomplished with a mold board or chisel plow. 5. The at-grade structure and other disturbed areas will be seeded and mulched to prevent soil erosion and help reduce frost penetration. 6. Areas within 15 feet of the downslope toe will be protected from compaction. 7. All other construction details are as per the at-grade component manual SBD-10570-P (R. 6/99). Lateral Tum-up Detail Finished Grade 6-8" Diameter Lawn Threaded Cleanout Sprinkler Valve Box Plug or Ball Valve . Distribution Lateral - Long Sweep 90 or Two 95.60 ft ► 45 Degree Bends Same Diameter as Lateral Project: Marek lot #10 Transaction Number: Page 5 of i At-grade System Management Plan Pursuant to Comm 83.54, Wis. Adm. Code General This system shall be operated in accordance with Comm 82-84 Wis. Adm. Code, and shall maintained in accordance with its' component manuals [SBD-10570-P (R. 06199), SSWMP Pub. 9.6 (01/81), and Pressure Distribution Component Manual Ver. 2.0 SBD- 10706 (N. 01/01)] and local or state rules pertaining to system maintenance and maintenance reporting. No one should ever enter a septic or pump tank since dangerous gases may be present that could cause death. Septic and pump tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the tanks are no longer used as POWTS components. Septic or pump tank manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 8-inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into a tank or component. Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Slats. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code. The operating condition of the septic tank and outlet filter shall be assessed at least once every 3 years by inspection. The outlet filter shall be cleaned as necessary to ensure proper operation. The filter cartridge should not be removed unless provisions are made to retain solids in the tank that may slough off the filter when removed from its enclosure. If the filter is equipped with an alarm, the fitter shall be serviced if the alarm is activated continuously. Intermittent fitter alarms may indicate surge flows or an impending continuous alarm. The septic tank shall have its contents removed when the volume of sludge and scum in the tank exceeds 1/3 the liquid volume of the tank. If the contents of the tank are not removed at the time of a triennial assessment, maintenance personnel shall advise the owner of when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank. The addition of biological or chemical additives to enhance septic tank performance is generally not required. However, if such products are used they shall be approved for septic tank use by the Department of Commerce. Pump Tank The pump (dosing) tank shall be inspected at least once every 3 years. All switches, alarms, and pumps shall be tested to verify proper operation. If an effluent filter is installed within the tank it shall be inspected and serviced as necessary. At-grade and Pressure Distribution System No trees or shrubs should be planted on the at-grade. Plantings may be made around the at-grade's perimeter, and the at-grade shall be seeded and mulched as necessary to prevent erosion and to provide some protection from frost penetration. Traffic (other than for vegetative maintenance) on the at-grade is not recommended since soil compaction may hinder aeration of the infiltrative surface within the mound and snow compaction in the winter will promote frost penetration. Cold weather installations (October-February) dictate that the at- grade be heavily mulched as protection from freezing. Influent quality into the at-grade system may not exceed 220 mg/L BOD5. 150 mg/L TSS, and 30 mg/L FOG for septic tank effluent or 30 mg/L BODS 30 mg/L TSS, 10 mg/L FOG, and 10° du/100 mL for highly treated effluent. Influent flow may not exceed maximum design flow specified in the permit for this installation. The pressure distribution system is provided with a flushing point at the end of each lateral, and it is recommended that each lateral be flushed of accumulated solids at least once every 18 months. When a pressure test is performed it should be compared to the initial test when the system was installed to determine if orifice clogging has occurred and if orifice cleaning is required to maintain equal distribution within the dispersal cell. Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the owner, and any levels above 4 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring. Continuencv Plan If the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep the system in proper operating condition. If the dosing tank, pump, pump controls, alarm or related wiring becomes defective the defective component(s) shall be immediately repaired or replaced with a component of the same or equal performance. If the at-grade component fails to accept wastewater or begins to discharge wastewater to the ground surface, it will be repaired or replaced in its' present location by increasing basal area if toe leakage occurs or by renovating the biologically clogged absorption and dispersal media, installing new piping, and replacing other components as deemed necessary to bring the system into proper operating condition. See Page 5 of this plan for the name and telephone number of your local POWTS regulator and service provider. Project: Marek lot #10 Transaction Number: Page 6 of GOULDS PUMPS Submersible Effluent Pump PE pow Unm mom WARNS f,,~,►_Crmeiaf: General: ■ Corrosionresiswn ' Disc~ 1'e WT • Sinew Plum construction. • Tempera": I"IF (4t1PQ • W N" • Cast iron body. rnaxvmn, Cen"=" wher♦ • 115 volts a Tllesmolftdc impew and submerged. • Butt in d*w4 ovabed pro- cover. • Solids handling: V tecdon wldn avtonnec reset. • Upper sleeve and Tower mrarinnxn sphere. • Cla$ B iosuw n, tleevy duty bai bearing • Aulmnatic models Wade a • Willed design. conswtKtian. APKKATIOtitS float Switch. • High strwo caton steel ■ Motor is Permanendy SpeciWy designed for the • Manual models avar'labie. shaft. iubdcated for extended following uses; • Pumping mange: see PE31 Motor: service life. • Mound systems performennce d:ad or wrlwe. • .33 HP, 3000 RPM a Powwerod for corthxr0us • f9kw*' osing Sysa ' s PE31 Pump: • 12.0 Mw*nurn antes oPeraton• • Low Pressure Pipe sys"M • Madrnum ploedty: s0 GPM • Shaded pow design ■ AN ratings are within the • Baserrr" Dr~eh*V • MAawn um heed: 25' Tw K41 Mow, wodang Ih ft of the nrotor. ' Heavy Duty Sumer PE41 ft": • .40 HP, 3400 RPM m Quid disaw*wd Powr • Maximum capaci!y ti0 GPM • 7.5 Maximum amps cord, 20` standard length, • Maudr" lneat~ 29' TDtI • PSC design heavy duly 1513 S1TW with NfMA 5.15P, twee prong, PE51 Puma PEST Motor. 115 Vdt 9r wov plug. • Maximum capacity: 70 CAM • .50 HP, 3400 RPM i3 Complete unit is heavy duty, • Modrrarnt head: 37' TDH • 9.5 Math wm amps P0nableand aompw. METERS FEET • PSC design • Medsani W Seal is carbon, MODELS! PE31, K41. M! Am. -t..., . . a• `1Y. 3), .45.30 SIwSS Stee) . 35 i 10 24M i •Y..?.... i 2 AGEWUSWM 30 1 FT 25 - 4-T .1-1 1 a. ; -r....~ ....t. CE us io T40W to UL 778 ad - E- 15, T r : ' CSA 222108 Sondemh 7"~ l f s ,...,...,..Y - 4- -4 O L 00 10 20 30 40 so 60 70 so pa~c ?o 0 5 10 is nary Goulds Rsnps . CAPACITY i0a: ITT Industries 196 Nest 10~ ~~ne north Todd Marek P O Box 228 New Richmond, WI 54017 Lot 10 Lundy's Preserve Richmond Township St. Croix County, Wisconsin N 1/2, NE 1/4, S 27, T 30 N, R 18 W 1.528 acres Scale 1" = 40' i--490- BM1 = 100.00' top of steel fence post Driveway BM2 = 96.00' top of survey iron w w f4ty z 0 4" pvc o Wieser 1200/800 tank cv 80' of 2" pvc forcemain 94.5' oX 95.5' OBI 63 3961 East to BM2 BM 1 t /one B2 Page 8 of 8 LM3 A IFPP- rr. . LILCL y L' 11 r ~ LOT 1 aro R ~ r~ i• LOT I ~R f. AM *swoon 074M W es, ' WO-Opp, ce - ` . a ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer -4-O Pb Mailing Address 601. Z Z 8 A/ &k1 gM fl ti 1D LO t v ZJ/ Property Address (Z~ d U U (Verification required from Planning & Zoning Department for new construction.) City/State N E td Q ~CkX1o Nb 0( Parcel Identification Number ( Z ~--/0 OM LEGAL DESCRIPTION Property Location Af IU('/4 , Sec. -7 T N R~W, Town of (e. A Subdivision , Lot # / V Certified Survey Map # , Volume , Page # Warranty Deed # I !ZZ -7 lf~:z , Volume , Page # Spec house es no Lot lines identifiable es no SYSTEM MAINTENANCE AND OWNER CERTIFICATION Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed, by a licensed pumper. What. you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. Owner maintenance responsibilities are specified in §Comm. 83.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance. The property owner agrees to submit to St. Croix County Planning & Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. I/we, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Planning & Zoning Department within 30 days of the three year expiration date. Itwe certify that all statements /ons formaxe true to the best of my/our knowledge. I/we am/are the owner(s) of the property described above, by virtue of ty deed recorded in Register of Deeds Office. Number of bedrooms SIGNATURE OF APPLICANT(S) DATE ***Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Department. Include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if reference is made in the warranty deed, - ty (REV. 08/05) 8 0 5 0 6 1 8 Txi4037564 State Bar of Wisconsin Form 3-2003 961766 QUIT CLAIM DEED BETH PABST Document Number Document Name REGISTER OF DEEDS ST. CROIX CO., WI 03/02/2012 2:06 PM EXEMPT#: NA THIS DEED, made between Citizens State Bank REC FEE: 30.00 ("Grantor," whether one or more), TRANS FEE: 273.00 and Todd Marek Construction Inc. PAGES: 1 ("Grantee," whether one or more). Grantor quit claims AS-IS. AND WITHOUT REPRESENTATION OF ANY KIND to Grantee the following described real estate, together with the rents, profits, fixtures Recording Area and other appurtenant interests, in St: Croix County, State of Wisconsin ("Property") (if more space is needed, please attach addendum): Name and Return Address LAND KRISTINA OGi ESTREEN & OGLAND Lots I, 2 Veonsin. 14 and 15, Lundy's Preserve in the Town of Richmond, SL Croix 304 Locust - County, Hudson, W1 54016 026-1167-01-000;026-1167-02-000:026- 1167-03-000: 026-1167-10-000: 026-1167- 13-000;026-1167-14-000:026-1167-15- 000 Parcel Identification Number (PIN) Dated a"a o` CitiunsS by: I~ 1or (SEAL) v (SEAL) * *Thom s Van Pelt, President and CEO (SEAL) (SEAL) AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF WISCONSIN ) authenticated on C ~ q Ot ) ss. V v'- x COUNTY ) * Personally came before me on Thomas Van Pelt on IeJ- TITLE: MEMBER STATE BAR OF WISCONSIN the above-named (If not, to me known to be the person(s) who executed the for'~~~ggQQ~lTqJg authorized by Wis. Stat. § 706.06) instru ent and acknowledged the same. UIHNt B. WILLERT % Notary Public THIS INSTRUMENT DRAFTED BY: 1lt laStQts Of tviScOflSin * i` Kristina Deland Estreen & 021and Notary Public, State of 304 Locust Street Hudson W154.016 My Commission (ir~eRE) (expires:-'I S' ) (Signatures may be authenticated or acknowledged. Both are not necessary.) NOTE: THIS IS A STANDARD FORM. ANY MODIFICATIONS TO THIS FORM SHOULD BE CLEARLY IDENTIFIED. QUIT CLAIM DEED 0 2003 STATE BAR OF WISCONSIN FORM NO. 3-2003 ' Type name below signatures. INFO-PRO° Legal Fors 800.655.2021 www.intopmforTns.com 1 of 1 Wisconsin Department of Commerce SOIL EVALUATION REPORT Page of Division of Safety and Buildings s-,4dexr 6e~e-- in accordaje ~/~+F'` J~ County Attach complete site plan on paper not less than 8 es in s lerI an mttST~ include, but not limited to: vertical and horizontal ref(BM), direction and Parcel I.D. percent slope, scale or dimensions, north arrow, and gearrpad. P/eas e print all info i 4 e~ew Y Date y i ~7 Personal information you provide may be used for secondrDvbcya(eJ,la tS~G1~)!(m)). Property Owner 7 Govt. Lot 1/4) l A S~ T N R SE (o W Property Owner's Mailing Address Lott); Block # u . Name or CSM# City State Zip Code Phone Number City E] village wn Nearest Ro. /C; c New Construction Use: Residential / Number of bedrooms Code derived design flow rate tJ GPD ❑ Replacement Public or /6 t 7` pvL commercial - D~ scrbe: Flood Plain elevation if applicable /V1---- - - ft. Parent material General comments and recommendations: Boring # r~- riPit Ground surface elev. C 01q ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 ' ff#2 qt, se- / A Boring # ❑ jBoring Pit Ground surface elev. ft. Depth to limiting factor ~ in. Soil Application Rate A - Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 HCV- CS 2H i ► c~ s ~ C-1 ~ . 3 L I F t , y~3b r S I CS I 2 - d S I LI - 12 N t Effluent #1 = BOD > 30 < 220 mg/L and TSS >30:E 150 Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L Sig CST Number CST Name (Please Print) 226900 Bird Plumbing, Inc. Shaun Bird Address Telephone Number Date Evaluation Conducted 715-246-4516 1008 192nd Ave, New Richmond, WI 54017 a i 4 I ^J • rr V Property Owner Parcel ID # Page of Boring # Boring y Pit Ground surface elev.! ft. Depth to limiting factor ~in Soil Application Rate 13-1 ~ l Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff° in. Munseli Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 1z„ J r I!'r C 2 C1 `3 ❑ Boring # Boring pit Ground surface elev. ft. Depth to limiting factor in. Soil ~iplication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fP in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 Boring Boring # Ground surface elev. ft. Depth to limiting factor in- ❑ Pit - Soil Application Rate . Horizon Depth Dominant Color Redox Description. Texture Structure Consistence. Boundary Roots GPD/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 Effluent #1 = BODE > 30 720 mg/L and TSS >30 1150 mg/_ ' Effluent #2 = BODS < 30 mg/L and TSS 30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. sao68330 (RAM) Soil Test Plot Plan Project Name Environmental Holding L.L.P. Sha Vird Address 706 19th St. S. Hudson Wi 54016 M #226900 Lot 10 Subdivision Lundy's Preserve Date 5/24/04 N 1/2 NE 1/4S 27 T 30 N/R 18 W Township Richmond Boring 0 Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 100 ft. Top of Steel Fence Post System Elevation 95.1 *HRPSame as Benchmark Alternate Benchmark Top of Survey Iron @ 96.0' 30' 353' Property Line 20' 95.5' B-2 4% Slope B-3 60' 156' 30 BAY-B.M. B-1 196' Property Line 396' Please note: Soil test Property was done to satisfy Line county zoning requirement. Soil Scale is 1 = 40 test may not be unless otherwise suitable for owners desired building noted location. RECE'VEDD r O JUN 0 1 2004 Lundy's Preserve Comments: ST. CROIX COUNTY ZONING OFFICE The soils in this subdivision are quite variable and differ across the 80 acres. Some consist of a clean outwash sand, other consist of glacial tills. In certain areas, the medium sands have a very deep red color unlike I have seen in all of St. Croix county. The color does not indicate high ground water because the color is so consistent. If you go through the red sands then the sands turn off white/yellow but not those of a sand stone. In talking with Pam Quinn from zoning, she commented that there could be a different chemical reaction with a sands. I believe this is the case for the sands have a consistent size, and no mottles were found above or below the sands. Sometimes bands were present, but were very slight, and were mentioned to have the systems sized a little bigger in order to accommodate for any inconsistencies in the soil. Also it is worth mentioning that the intersections of lots 6,7,8, and 9 have a extremely poor soil present not suitable for a mound system. The surveyor and I discussed this condition, and the resulting tests were spaced as far away from this area as possible. All the soils tests were done to the best of my ability and I hold no liability for anomalies and other oddities that can be found on this site. Shaun Bird CSTM #226900 / 5/28/04