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.;onsin~7epartment of Commerce PRIVATE SEWAGE SYSTEM oaf^ty and Building Division x INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m 'ermit Holder's Name City Village X Township Murtha, Mike & bie Erin Prairie, Town of ;ST BM Elev: Insp. BM Elev: BM Description: 99,E ~~Z GSA TANK INFORMATION TYPE MANUFACTURER : ~s CAPACITY Septic ~ .5 ~• .~.. ~OQD Dosing /D~ ( Aeration e ~~~ J ~O~ Holding TANK SETBACK INFORMATION TANK TO r P/ ( WELL BLDG. Vent to Air Intake ROAD Septic ~ ~ 1 /~ r / ~ / Dosing b G / / ,t /~- /" / ~ / / ~ / _~ Aeration Holding 4 PUMP/SIPHON INFORMATION rn ~, Manufacturer n Demand ~ja~ Ldl GPM Model Number EPa ~ 3 j, 4'~.Q TDH Lift /Z.57 FrictionFriction Loss a . 45 System Head 3. ZS TDH Ft / ~ 7 Forcemain Lengtf[ ~ Dia. r t Dist. to well ~ / ~ ~ ICJ"' 5 TT Z C(lll ~RCARPTIC~N SYSTEM / ELEVATION UA I A County: St. CroiX Sanitary Permit No: 488182 0 State Plan ID No: Parcel Tax No: 012-1062-20-200 Sectionlrown/Range/Map No: 28.30.17.431 B20 ,,,../ ~~ STATION "~~f BS 7• ~5 ~~t~~HyyI.~~,.. e~reaa~ FS ELEV. ~. `3g Benchmark 3.38 IoZ•ug 99-t AI~BM J ~ L) ~i /f,~j 99'• ~9 Bldg. S wer // 3Z 3.5 SUHt Inlet ~z.~-5 X2.3 ~ St/Ht Outlet ~ ~ Dt Inlet ~, Dt Bottom ~S.sS 4s4t. ~ Header/Man. 3.3$ /ol. ~S Dist. Pipe 3. ~ /D/r 3y Bot. System ~~ dg ~~ . Final Grade ,1 L St Cover ,/ y ~9 , 0 3.5o y$ .S~ P~a~art~. a'~ 6~r~ Z,c,~ yq.9~6 BED/TRENCH Width / Length i No. Of Tyt~ches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS ~ ~ 7 ~~'J[ ~ ~ SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING O Manufacturer: ~ INFORMATION Type f tem: I / - /~ CHA UN T R Model Number: r11CTDIR11Tlt'l1U CVCTFM Header/Manifold ~ / Distribution / [ 1/ ~ Fipe(s) 3 Z 'f d ~ ~ x Hole Size ~i r t r ° ~ x Hole Spacing r Ve~ to Air Intake / Z Length 3 • b Dia Spacing Dia Length ~ • ~ • z d Go U ~~ Cull CP1\/GR ., o....~~..... c.,~~e...e n..~.. .... Mn~mrl nr Af.r:rada Svs+ams Only Depth Over / -' Bed/Trench Center Depth Over BedlTrench Edges ` xx Depth of Topsoil t ~ xx Seeded/Sodded s ~ No Y xx Mulched Yes 0 No ' ~ ~ , e t . T. GK COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: /O / 38 / ~P (~ Inspection #2: / / Location: 1762 130th Avenue Hammond, WI 54015 (SW 1/4 SE 1/4 28 T30N R17W) NA Lot 2 ~.l;' l5 $k„ Parcel No: 28.30.17.431820 /~' l' p~Cu.td 1 J Alt BM Description = ~ ~ ~ C~J ~- G~c~; ~ 5 Ga,,~~( 54wr ~0~3/~O[P 4~ o..J d,~ 2.) Bldg sewer length = 3~ d„- LU f - amount of cover = / c,I,eS o,n. 7 ~~ ,I - T i-- -- r Plan revision Required? ~ Yes No Use other side for additional information. I~._I 1 ~~ ~ ~ ~~i l_____ __ L ~~~~ Date Cert. No. SBD-6710 (R.3/97) ' ~ RECEIVED MAY 0 0 2006 ` Safety and uildi Co ~ , 201 W. Washin on Avc. P.O. Box 7 ~' ~S~jOns',n Madison, Wf 53707 - 7082 a Sanitary Permit Number (to be filled in by Co.) Oe artment of Commerce (~8)261~544 ~G /GZ Sanitary Permit Application Sate Plan I.D. Number In accord wiW Comm 8J.ZI, Wis. Adm. Code, personal information you provide ~ a ~ (O.J~ may be used for socondary Purposes Privacy Law, s 13.04(1 xm) I Project Address (ifditTerent than mailing address) I. Appllcatloa Information -Please Print All Information Property Owne's Name ~ ~ ~ ~ !~O ~ / / v ~ ~ Pucel N ~ Block M S¢~/ \ Property Owoer's Mailing Addreu ~ IGC.s.~ \ i / ~~ ~~ Property Location City, State ~' ' T ~ Zip Code Phone Number -~f~ ~~~ ~'A, Section ~_ (~ II. T of Bulldia /~ ?fS - 791D -' S~~ circle o ) ~~ ~,3~ "3 I Zt~ YPe Q (check aU that apP1Y) T • ~v N; R~E o~ ~1 or 2 Family Dwelling - Numbu of Bedrooms ~~ a~ Su~ovN "~} ~Ca~- Subdivision Name CSM umber ^ PublicJCommercial - Describe Use / 5 ~d D 9 ~~..ti. ^ Sete owntd - Describe use ~/ OtJ 1. ^cit~ v~` ~ ~;p ~• lIL Type of Permit: (Check only one boz on line A. Complete line B If applicable) ~ ~ ~Ncw S tan ~ /z ' ~~ ~ Ys ^ Replacement System ^ Trcatrnent/Holding Tank Replacement Onl Y ^ Othu Modification to Existing System B• ^ Permit Renewal ^ Permit Revision List Previous Pumii Numbu and Date Lssucd Before Expiration ^ C~Be of ^ Permit Transfer to New Plumber Owner ~ IV. T e of POWTS S stem: Check all that a I I 'rte du r ^ Non -Pressurized !n-Ground ^ Mound > 24 in. of suitable soil f y_~ Mound < 24 in, of suitable soil ^ At-Grade n ~~~~ `yid r~ ^ Single Pau Sand Filter ^ Preuurized la-Ground ^ Nolding Tank ^ Pcat Filter ' ^ Aerobic Treatment Unit ^ Recirculating Sand Filter ~ i Rsxirwlatin S thctic Medu Filter ^ Leaching Chamber ^ Dri Line ~ /f ~ V. Dis ersa!!I'reatmentAreer Information: ^ Gravel-lus Pipe ^ Ocher (explain)/, l07 p.~- o ~ ; Design Flow (gpd) Deign Soil Application Rat i / ~D ~ a s Dispersal Area Required (s Dispersal Area Proposed (s System Elevation VI. Tank Info Capacity in Toul Number Gallons Manufacture Prefab Site Stccl Fibu Gallons of Units Concrctc Plastic Nc~.• Exutine C~onswcted Glass Tanks Tanks !nJ Ze ~ /W ~ue ~L. t-, kpv< ~ I~w;n~ ranlt ob0 -- /ooc>~ K--cC Mobic Trcarrrsca Uwt / ~`~-~ Dodo` C3arnbcr ~ o VII. Responsibility Statement- 1, the undersigned, assume responsibility for'In allatton of the POWTS shown on the attached plans. Plumber's Name (Print) Plumber' ignatu f ~~ PRS Numbu B7usines~s+Phone Number¢ Qp Plumber's Address (Stmt, Ciry, Stat ,Zip Code ~~~~~ ~ " /`~ - ~(~ U' 6T/S /~~ ~ U. ,~ ~ ~ S`-y6o VIII. Coen /De artment Use Onl ~DDrovcd ^ isapproved Su ~cthar c «tt Fu (include Groundwater Datc issue Issuin cnt Signatur (Tv Su .ps i ^ iven Reason 8 ) `ri S 5 ~ ~b CJ ' ~ O 1 _ en is 1 ~~""fff `!i [}C- Conditions of ApprovaUReasons (or Disapproval SYSTEM OWNER: 3~ C°''~ ' ~' ° ~.s ' ~- ~°~-- ~ fd fie, 1. Septic tank, effluent finer and ~ (~ n ~ / ~ ~ • 1 dispersal cell must all tie senrites / rnair-tah,~d ~~~ ' "- ~t'~ w s ~erw. r V' , 2. AN sNllacknagement plan provided by plumber. i nquirernents rrwst be rrtaintaned se per aPPfic~bM catty / adir~rtces. y ~ ~ j/~\ I Y j v M ~ ~ ~ ~ ~ ~ ~ ~ , {- ~ -~ o ~ ~ ,°~ o o p ~~ ,~ ~ ~ ~~ ~~~~~ ~ ~ ~ ~ ~ ~ ~ M ~-- as i ~ ~ ~ °° ~~ ~ ~ ~ ~ ~a`. ~ V ~~~ _~ p.2 c~- •• r - 5 + ~ ~ ~ '~ ~ ` ~ i. -~ o ~ ~ ,°s o o O °~ ~ ~ ~ ~ ,~ ~ \ ~'''' _ M i y ,' .. ~\ ~. N1 ~7 ~ j OD k4 ~ ~ ~ ~ ~ ~ ~ v ~1 M Cj- ...~ - ~ ~~ ~-~ _ < < ~~ ~ p.2 F y ~ commerce.wi.gov isconsin Department of Commerce May O5, 2006 CUST ID No. 220357 ATTN.• POWTS Inspector Safety and Buildings 10541 N RANCH ROAD HAYWARD WI 54843 TDD #: (608) 264-8777 www.commerce.wi.gov/sb/ www.wisconsin.gov Jim Doyle, Governor Mary P. Burke, Secretary BRADY J UTGARD ZONING OFFICE UTGARD PLUMBING & HEATING ST CROIX COUNTY SPIA 110 ICELLER AVE N APT 112 1101 CARMICHAEL RD AMERY WI 54001-1034 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 05/05/2008 Identification Numbers Transaction ID No.1266369 SITE: Site ID No. 712130 Mike Murtha Please refer to both identification numbers, 130TH Ave above in all comes ondence with the a enc . Town of Erin Prairie St Croix County p.O w~ SW1/4, SE1/4, S28; T30N, R17W ~~.~ FOR: Description: New mound, 3 bedroom residence (;O Object Type: POWTS Component Manual Regulated Object ID No.: 1072979 ~ P R Maintenance required; 450 GPD Flow rate; 16 in Soil minimum depth to limiting factor from on ~ i System(s): Mound Component Manual -Version 2.0, SBD-10691-P (N.O1/O1) ginal grade; ~ The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Code and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. This system is to be c,EE COR constructed and located in accordance with the enclosed approved plans and with the component rnanual(s) referenced above. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, stats. The following conditions shall be met during construction or installation and prior to occupancy or use: Key Item(s) • In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approved plans. In addition, the owner must insure that the operation, maintenance and monitoring duties as described in section VIII of the mound component manual are complied with. A copy of this information must be given to the owner upon completion of the project. • The designer proposes to install a state approved effluent filter to achieve the requirement of wastewater particle size. Pursuant to outlet filter product approval stipulations, maintenance information must be given to the owner of the POWTS explaining that periodic cleaning of the effluent filter is required. The access opening used to service the filter shall terminate at or above finished grade with a watertight cover. Reminder • This mound is designed to be installed on a level site. • Limit activities in the area 15' beyond the edges of the mound per Mound Component Manual. • Surface water drainage shall be diverted away from the system area per Mound Component Manual. • Materials shall conform to the requirements of COMM 84. • Maintain well and waterline set backs per COMM 83.43(8)(1). Consult the Department of Natural Resources for well setbacks and other regulations and exceptions. . . The above left addressee installation, operation or Page 2 5/5/2006 i 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 maybe made to me at the telephone number listed below, or at the address on this letterhead. Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 Patricia L Shando~ POWTS Plan Reviewer , to (715) 634-7810, Fax: (715) pat. shandorf@wisconsin. gov BRADYJUTGARD a copy of this letter to the owner and any others who are responsible for the of the POWTS. (Services 50 , M-f 7:45 am - 4:30 pm cc: Leroy G Jansky, Wastewater Specialist, (715) 726-2544 WiSMART code: 7633 Wisconsin Building Safety Week is May 7-13, 2006. Codes, Design, Plan Review, Permits, Construction, Installation, Inspections -All part of protecting the health and safety of people in Wisconsin -All part of supporting the quality of communities and the value of properties - http://commerce.wi.gov/SB/SB-DivBuildingSafetyWeek2006.htm1 MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Project Name: MIKE MURTHA Owner's Name: MIKE MURTHA Owner's Address: 1754 130th AVE. HAMMOND, WI. 54015 Legal Description: SW SE S 28, T 30 N , R 17 W Township: ERIN PRAIRE County: ST. CROIX Subdivision Name: CSM # 663141 VOL. 1 PG .104 anptt~ Lot Number: 2 Btock Number: ~~ Parcel I.D. Number: Plan Transaction No.: CE pN0 Page 1 Index and title Page 2 Data entry C ~~~ ~~ Page 3 Mound drawings ~ (~~ ~~' j , Page 4 Lateral and dose tank Page 5 System maintenance specifications Page 6 Management and contingency plan Page 7 Pump curve and specifications Page 8 PLOT PLAN Page 9 SOIL EVALUATION Designer: BRADY UTGARD icense Number: 220357 Date: 1 04 Phone Number: 715-268-6995 Signature: Designed Pursuant to the Mound Component Manual for POWTS Version 2.0 SDB-10691-P (N 01/01 r . ), and SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST-SAS (01/81) Version 3.11 (R. 06/01) Page 1 of 9 • Mound and Pressure Distribution. Component Design Design Worksheet Site Information (r or c) - R R Residential or Commercial Design Note: sand ru (v) c~lcuiations assume a 300.00 Estimated Wastewater Flow (gpd) Tab~e 83-44-3 in-situ son treaanent for fecal .1.50 Peaking FaCtgr (e.g. 1.5 = 150%) ~~~ ~ a ~ Inches. 450.00 Design Flow (gpd) 0.00 Site Slope (%) 99.10 Contour Line Elevation (ft) • 16.00 Depth to Limiting Factor (in) 0.40 iri-situ Soil Application Rate (gpd/ft2) Distribution Cell Information 75.00 Dispersal Cell Length Along Contour (ft) = 6.00 Cell Width (ft) 1.00 Dispersal Cell Design Loading Rate (gpd/ftz) 1 Influent Wastewater Quality (1 or 2) Are the laterals the highest oint in the distribution Y Pressure Disribution Information network? Enter Y or N (core)... c Center or End Manifold 3.00 Lateral Spacing (ft) If N above, enter the elevation ft 4 Number of Laterals of the highest point. 0.188 Orifice Diameter (in) (e.g. 0.25) 3.00 Estimated Orifice Spacing (ft) = 9.38 ft2/orifice 2.00 Forcemain Diameter (in) 100.00 Forcemain Length (ft) Does the forcemain drain back? ~~ 87.00 Pump Tank Elevation (ft) Enter Y or N 3.25 System Head (ft) x 1.3 16.31 Forcemain Drainback (gal) x 13.77 Vertical Lift (ft) 46.90 5x Void Volume (galj~ ~ Z • ~ 2 / 2.12 Friction Loss (ft) 63.21 Minimum. Dose Volume (gal) ~~ 19.13 1'otai Dynamic Head (ft) 31.46 .System Demand (gpm) Lateral Diameter Selection in. dia o ions choice 0.75. 1.00 , 1.25 x ~ . x 1.50 x 2.00 x 3.00 x , ~~ Manifold Diameter Selection in. dia. o tions choice 1.25 x 1.50 x X 2.00. 3.00 Gallons/inch Calculator (optional) Treatment Tank information 600.00 Total Tank Capacity (gal) 1000.00 Se is Tank Capacity (gal) 51.00 Total Working Liquid Depth (in) Weiser Manufacturer 11.76 gaUn (enter result in cell B49) ~ Dose Tank Information ' Effluent Filter Information 600.00 Dose Tank Capacity (gal) Zabel Filter Manufacturer 11.76 Dose Tank Volume .(gaUn) A100 Filter Model Number Weiser ~ Manufacturer . Project; MIKE MURTHA Page 2 of 9 _, . ~: ;,. i ~' s .- Mound Plan View I 1, 1 /10 B ~ ~ ~ - ..pbservation Pipe ' 3Q ' r':~r•: '': t l•: •: •: •:.~ ~:.:.:. 5i•ti :t•ti ~~.•. S L S ti'L• ti•ti. • : •f •r••~ r•' •r'r'~ •r•••:: •1 ~+~~ J~ r~ f:. f•: •:.,r.f•; .,•.r.f ~ j.•r,r, : •1.•,. ti.•,. •,.S,. ti..,,ti, Y-r~ 1•ti:ti••.••.•ti.ti.ti. .•:~:~:~r~:~:~:~:~r~:~:~ j•r•~:~: f.r•:•f•r•r•:•...•:tirti~tirti.•r:;ti~~~: .~' B •F, L~ f . L I -T -~+ -I -~ Mound Component Dimensions Down slo a toe extension made. A 6.00 ft E 20.00 in H 1.00 ft K 10.31 ft B 75.00 ft F 9.25 in z 8.81 ft L 95.63 ft D 20.00 in G 0.50 ft J 8.81 ft W 23.63 ft 450.00 (ft2) Dispersal Cell Area 1771.88 (ftZ) Basal Area Available 6.00 (gpd/ft) Linear Loading Rate 7.50 (ft) 1/10 B Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area Finished Grade 102.54 (ft} .,~.... F 100.77 (ft)--- - Dispersal Cell Elevation -I H . . . . . . . . . . . . . . . . . . . . . . . Dispersal Cell 101.27 (ft) Lateral :.: • Invert 'p ~ ~ ....... ~l~ ~~. _ _ _ _ _ _ _ _ _ _ _ .,~.~. 99.10 (ft) Contour Elevation 0.0 % Site Slope Geotextile Fabric Cover Shading Key Q _ Topsoil Ca '~ ~, ~ a ~- Dispersal Cell 1 See lateral details on p riiii Subsoil Cap jp C ~ .5 ft 5 ;:,f'r:•~ tij•r~r•~ tir~.~ti ti ti:.: . ~ ` .~ '~ Page 4 for number, size, and spacing of laterals. ASTM C33 Sand R t6 ~ Z ;:•;~:~i~ ,1~ti•ti::l~: ' f'j ' • r; . : ' F Laterals are equally ~. Tilled La er Y m c ~ Typical Lateral r:; e;' 0.5 ft r; ,.-.._,._,._ ,_ spaced from the 5 }:r:f: A regate ^ ~~ 99 v c , , .... r;; ,;~}- ~ ; ~.•,r; :ti tifrti.: ;.:;~: ~ distribution cell's . ~_ A•~ '_* J centerline in the distribution cell (Ax6). Project: MIKE MURTHA Page 3 of 9 Center Connection Lateral Layout Daigram Force main connection via tee or cross to manifold at any point. E P •=Turn-upv.>tball valve or IEX--~IExl2~It-xt2~l oleanoutplup I'I Holes drilled on the bottom of the lateral. S .~k Number of Laterals 4 Lateral Diameter 1.25 in Lateral Length (P) 36.80 ft Lateral Spacing (S) 3.00 ft Lateral Flow Rate 7.86 gpm System Flow Rate 31.46 gpm Total Dynamic Head 19.13 ft Dose Tank Information Electrical as per NEC 300 and -- Comm 16.28 WAC Laterals & Force main of PVC Sch 40 per COMM Table 84.30.5 Orifice Diameter Orifice Spacing (X) Orifices per Lateral Orifice Density Manifold Length Manifold Diameter Forcemain Velocity Disconnect laterals are identic al Tank component is properly Nertted Weiser Ca aci 600.00 Volume 11.76 Manufacturer Gallons gal/inch A Ba C D Dimension Inches Gallons A 37.65 442.71 B 2.00 23.52 C 5.37 63.21 D 6.00 70.56 Total 51.02 600.00 3" tank. Alarm Manuafacturer LEVEL Alarm Model Number DLV Pump Manufacturer GOURDS Pump Model Number EP05 Pump Must Deliver 31.46 gpm at 19.13 ft TDH 0.188 in 3.20 ft 12 9.38 ft2/orifice 3.00 ft 1.50 in 3.21 ft/sec Locking cover with warning label and locking device and sealed watertight i 4 in. min. -~~ E-- Alternate outlet location Forcemain diameter ~( 2 in. Weep hole or anti- siphon device P~um~off elevation (ft) 87.50 Dose tank elevation (ft) 87.00 Project: MIKE MURTHA Page 4 of 9 Mound Svstem Maintenance and Oaeration Saecifications Service Provider's Name _ UTGARD -~ Phone 715-268995 POWTS Regulator's Name ~ POLK Phone 715-485-9279 Svstem Flow and Load Parameters Design Ffow -Peak 450 gpd Maximum Influent Particle Size 1/8 in Estimated Flow -Average 300 gpd Maximum GODS 220 mg/L Septic Tank Capacity 1000 gal Maximum TSS 150 mg/L Soil Absorption Component Size 450 ftz Maximum FOG 30 mg/L Type of Wastewater Domestic Maximum Fecal Coliform >10E4 cfu/100 mL Service Freauencv Septic and Pump TanM ` Effluent Filter Pump and Control; Alarm Pressure System Mound Other Ins and/or service once eve 3 ears Should ins , and clean at least once eve 3 ears Test once eve 3 ears Should test month) Laterals should be flushed and ressure tested eve 1.5 ears Ins for ndin and see a once eve 3 ears INSPECT FILTER ONCE A YEAR 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 mound 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 mound structure and other disturbed areas will be seeded and mulched to prevent soil erosion and help reduce frost penetration. Lateral Turn-up Detail Finished .~~ ~ ................ Grade 6-8" Diameter Lawn ,• Threaded Cleanout Sprinkler Valve Box Plug or Ball Valve Distribution Lateral Long Sweep 90 or Two 45 Degree Bends Same y Diameter as Lateral Project: ~ MIKE MURTHA Page 5 of 9 Mound System Management Plan Pursuant to Comm 83.54, Wis. Adm. Code General This system shall tie operated in accordance with Comm 82-84 Wis. Adm. Code, and shall maintained in accordance with its' component, manuals [SBD-10691-P (N.01l01) and SSWMP Publication 9.6 (01!81)] 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 manhde 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 canpletion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. F~osed 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, Stats. 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 fitter shall be cleaned as necessary to ensure proper operation. The fitter 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 ff the alarm is activ~ed continuously. Intermittent filter alarms may indicate surge flows or an impending continuous alarm. The septic tank shall have its contents removed when the vdume of sludge and scum in the tank exceeds 1/3 the liquid volume of the tank. If the contents of the tank an: not removed at the time of a triennial assessment, maintenance personnel shall advise the owner of when the next service needs to be perfomred to maintain less than ma>amum scum and sludge accumulation in the tank. The addition of bidogical or chemical additives to enhance septic tank performance is generally not required. However, 'rf 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 tt shall be inspected and serviced as necessary. Mound and Pressure Distribution Svstem No trees or shrubs should be planted on the mound. Plantings may be made around the mound's perimeter, and the mound shall be seeded and mulched as necessary to prevent erosion and to provide some protection from frost penetration. Traffic (other than for vegetative maintenance) on the mound is not recommended since soil compaction may hinder aeration of the infiltrative surface within the mound and snow compaction in the winter wilt promote frost penetration. Cold weather installations (October-February) dictate that the mound be heavily mulched as protection from freezing. Influent quality into the mound system may not exceed 220 mg/L BODS, 150 mg/L TSS, and 30 mg/L FOG for septic tank effluent or 30 my/l. GODS, 30 mg/L TSS, 10 rrg/L FOG, and 10" cfuh 00 mL for highly treated effluent. Influent flow may not exceed maramum design flaw specified in the permtt for this installation. The pressure distribution system is provided with a flushing point at the end of each lateral, and tt is recommended that each lateral be flushed of accumulated solids at least once every 18 months. When a pressure test is perfomred it should be compared to the initial test when the system was installed to determine if orifice clogging has occurred and ff 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 8 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring. Conttnstencv Plan If the septic tank or any of its components become defective the tank or com onent shall be operating condition. p repaired or replaced to keep the system in proper 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 mound component fails to accept wastewater or begins to discharge wastewater to the ground surface, tt will be repaired or replaced in its' present location by increasing basal area ff toe leakage occurs or by removing biologically clogged absorption and dispersal media, and related piping, and replacing said components ~ 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: MIKE MURTHA Page 6 of 9 APPLICATIONS Specifically designed for the following uses: • Effluent systems • Homes - •Farms • Heavy duty sump • Water transfer • Dewatering SPECIFICATIONS Pump: EP04 . • Solids handling capability: 3/4" maximum. • Capacities: up to 55 GPM. • Total heads: up to 24 feet. -" • Discharge size: 1'/z" NPT. • Mechanical seal: carbon- rotary/ce ramic-stationary, BUNA-N elastomers. • Temperature:. 104°F (40°C) continuous 140°F (60°C) intermittent. • Fasteners: 300 series stainless steel. • Capable of running dry without damage to components. Pump: EP05 • Solids handling capability: 3~4" maximum. • Capacities: up to 60 GPM. • Total heads: up to 31 feet. • Discharge size: 1'/z" NPT. • Mechanical seal: carbon- rotary/ceram ic-stationary, BUNA-N elastomers. • Temperature: 104°F (40°C) continuous 140°F (60°C) intermittent. • Fasteners: 300 series stainless steel. • Capable of running dry without damage to components. Motor: • EP04 Single phase: 0.4 HP, 115 or 230 V, 60 Hz, 1550 RPM, built in overload with automatic reset. • EP05 Single phase: 0.5 HP, 115 V, 60 Hz, 1550 RPM, built in overload with automatic reset. • Power cord: l0 foot standard length,16/3 SJTO with three prong grounding plug. Optional 20 foot length,16/3 SJTW with three prong grounding plug (standard on EP05). METERS FEET 10 9 30 e 25 o ~ W x U 6 20 y 5 c, 15 a -4. 0 ~" 3 10 2 5 1 0 4 • Fully submerged in high grade turbine oil for lubrication-and efficient heat transfer. Available for`automatic and manual operation. Automatic models include Mechanical Float Switch assembled and preset at the factory. FEATURES ^ EP04 Impeller: Thermo- plastic Semi-open design with pump out vanes for mechanical seal protection. ^ EP05 Impeller: Thermo- plasticenclosed design for improved performance. ^ Casing and Base: Rugged thermoplastic design provides superior strength and corrosion resistance. ^ Motor Housing: Cast iron for efficient heat transfer, strength, and durability. ^ Motor Cover: Thermoplas- ticcover with integral handle and float switch attachment points. ^ Power Cable: Severe duty rated oil and water resistant. ^ Bearings: Upper and lower heavy duty ball bearing construction. AGENCY LISTING SP• Canadian Standards Association (CSA listed model numbers end in "F" or "AC".) -- ------ r_..-- -- --- --- ~ --- -- ~ ----- I--- -- -- -- ----- - 't----- i I ~ i .~ ~ i i ---- - --- ~ _~ --- _- _._ i - I -; -----, -- ---I I 1 00 0 ~v N JV 2 4 6 8 4u 5v GPM 10 12 m~/h -~ _ _ ' wsconsfrt Departrnentof'Comme~e SOIL EVA!,.~JATIO,N REPORT Page / of Div~sicxtoiSafety and Bu'Idings _. _ _ - in accordance with Comm 85, Wis. Adm. Code r.,,w- . ~_ _ county S• ~ _ _ ,. _ - Attach comp[etesite~taererspaperrtottessttran8l ~11j~adiesui.~rz~~.?lanmust _ irniude, but not limited to: vertipt and horizontal point (BM), dlrand Paroet ~ t.D. " percent slope, scale or dimensions, north a , a~`lo$atic~ and distance ffrpe~est road, _ - - - ` ' JAR`"' ' ~ Date Please print a t drm ~1~.~ ~- Re - //_ Personal information you provide may Ne used f ~turdary ~ (Priva s. 1 ~,d4'.:( (m))• ~. ~~ ~ l~ .~ P e er ry ~ ProperT ovation . ~ ~ t 1, A . .[/R. +~~ ' \ ` ~ ~.~-1 ovt,_C_ 1/4 1/4 S T 3C~ N R I ~ E (or1~ Property Owner's MailingAddre~ ~~ ~`NG Lot ; ,~ Block # Subd. Name pr J ' 'O 3 ~ tl~~ y ,,, i ` r C' State Zip Code Pho •-`.--- `^-, ~ City ^ Vllage Town ~ Neare t Roams ~ New Construction Use: ^ Residential / Number of bedrooms Code derived design flow rate '~7~~ GPI . m nt ) ~ R l r Pubb ~ ommerdal -Describe: , ep ace e ~ n e g: ~ J~ ParBnt material ~ ! ~ ( ~ ~c~~ l Rccd :°!cin elava~r. if appli~b!e~ - ~ General ~mments qr ~ ~-~ Lc~' S` sti /(?~. 7 7 and recommendations: ~ 19, ~ i // J ~~ ) U~~ 1 ~ Boring p Boring # / 9. ~ ft. Depth to limitin factor in. nl Pit Ground surface elev. g -~- Soi ication Rate i tion D R d Texture Structure Consistence Boundary Roots GP D/fP Horizon Depth in. Dominant Color Munsell escr p ox e Qu. Sz Cont. Color Gr. Sz Sh. ` Z - ~ ~'~ a' ~' -~ c c, ~b'k' mgr ~~ w ~~ ' -~ l° ~asy, y( rcw o S (~ o____ „ ^ Boring .~_ ~ ~ ~ __ ~ ~ Pit Ground surface elev. 77~ / ft. Depth to limiting factor / 1 in. Sell A lication Rate i H D th D i t C l don dox Desai R Texture Structure Consistence Boundary Roots GPD/fg zon or ep in. om nan o or Munsell p e Qu. Sz. Cont. Color Gr. Sz. Sh. ~E - l S/` -- C~ = C~ fry ~-icv U~ 3 ~~ s y .~~~ z ~ .s s~ c L Q ' v ~- ~ _- ~~ 'Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 mglL ' tmuent a:~ = nuu < su mgiu ana ~ ~~ = ~~ ~~~~ CST Name (Please Print) i ature CST Number ~~/Ir1iS ~, // ZL/ Y7/ Address Date Evaluation Conducted Telephone Number 37 Z I yo ~ S~7 ~rn.~,+~ w..2- .s vvc~ 5-~~- ~ / .s"~ 6Y- 667 L• e ParcetlD # •r • i J Panes ~. of 3 Boring # ^ Boring // ~ pit Ground surface elev. ~ ft. Depth to limiting factor ~fp in _ . Soil liption Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/ff in. Mu nsell Qu. Sz. Cont. Color Gr. Sz. Sh. •E ©~ A~ , SYA-ZJ CL IJ~SC1'~ /97Gt ~ ~tCt~ ,~(/ 9~ ,sY s/3 ~-' ~L n, ,~' v ~P ~ w v~ ^ Boring # ^ Boring ^ Pit Ground surface elev. ft. Depth to limiting factor ~n• Soil Application Rate Horizon Depth Dominant Colo r Redox Description Texture Structure Consistence Boundary Roots GPD/ff? in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 'Eff#2 a Boring # ^ Boring ^ Pit Ground surface elev. ft. Depth to limiting factor in. Soil ligtion Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP DJfF 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/L and TSS < 30 mg(L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. SBD-8730 (R.6/00) F ~ j ~, ~ Property Owner ~ _ - ~ ._ Paroel ID # ^ Boring - _ page Z of ~ Boring # 3 ®pit Ground surtace elev. ~s ~ ft, De th t li i i ~ _ p o m t n g factor (D in. Horizon Depth in. Dominant Color Redox Description Texture Mansell Qu. Sz Cont Color Stnx~ure Consistence Boundary ~ ~~ Rate Roots GPD/ft° . Gr. Sz Sh. 'E 9~ sY s/ 3 ~ _ . . CL 3 6.30 ~.~'yRsy3 K ' v :P a c~ v~ ` cc ~A~R ~v~ P - .~ ~ _ a Boring # ^ Boring ^ Pit Ground surface elev. ft. Depth to limiting factor in. Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots ~ GPO' ~ Rate in. Mansell Qu. Sz Cont. Color Gr. Sz Sh. 'E(f#1 ~ 'Eff#2 ^ Boring # ^ Boring ^ pit Ground surface elev. ft. Depth to limiting factor in. Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots Sorl GPD/fF ~ in. Mansell Qu. Sz Cont. Color Gr. Sz. Sh. 'Eff#1 I 'Eff#2 'Effluent #1 =GODS > 30 < 220 mg/L and TSS >30 < 150 mg/L '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. SBD-1330 (R.6AD0) f .. , ~ ~ t ` 2Z~y7r ~ ~ ~ 7" 30 ~r~w S ~/~ /od->7 ` 1~. ~~-- T `~ ~~ 7~ ..ra ` 9q ~ -T~, ~~ moo, .~. ~~ a~ a ry° ~ $S. ~ ~~ qq. L s~ ~ ~ S~bp~ _~ ~, l~ `~~' ~ ~. i ~~ ~I I" ~ . . ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIl' CERTIFICATION FORM OwnerBuyer ~ ~ ~C,~. .I ~.P b roe !" ~ In ry~-- Mailing Address ~ ~ S `I ) 3 0~ ~4-re ~~ r~~d , I a ~ ~ ~ -'S Property Address 3 (Verification required from Planning Department for new construction) City/State ~.I'n 1~-~~ i ~n~ I Parcel Identification Number ~ ~ 3 - 1 D 6 ~ - ~O _~y LEGAL DESCRIPTION Property Location S~ '/,, S ~ %,, Sec. ~-g , T 3 ~ N-R ~ ~ W, Town of ~'~ ~ ~~~t ~ Subdivision in,y-~o-,-~ , 1,~1 I Lot # ~. Certified Survey Map # ~ ~ 3 ~y ~ Volume ~ S ,Page # ~9 Warranty Deed # 3 ~b 3 $ S Volume ~~ ~ .Page # ~ 3 1 Spec house ^ yes ~( no Lot lines identifiable ~ yes ^ no SYSTEM MAINTENANCE 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. The properly owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a mastCrphrmber, joumeymanplumbcr, 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 nGCessary), 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 stating that your septic system has been maintained must be completed and returned to the St. Cmix County Zoning Office within 30 days of the thrice year expiration date. SIGNATURE OF APPLICANT DATE OWNER CERTIFICATION I (we) certify that all statements on this form are true to the best of my (our) knowledge. I (wc) am (are) the owner(s) of the property describedabove, by virtue of a warranty deed recorded in Register of Deeds Office. SIGNATURE OF APPLICANT DATE ss««ss Any information that is mis-rcpresentcdmay result in the sanitary pemut being revoked by the Zoning Department. *«**" «« Include with this application: a stamped warranty deed from the Register of Deeds office a copy of the certified survey map if reference is made in the warranty deed ' Parcel #: X12-062-2U-20U 05/16/2006 04:48 PM Alt. Parcel #: 28.30.17.431 B-20 PAGE 1 OF 1 Current j_X 012 -TOWN OF ERIN PRAIRIE Creation Date Historical Date Map # Sales Area ST. CROIX COUNTY, WISCONSIN Application # Permit # Permit Type 00 0 Tax Address: Owner(s): O =Current Owner, C =Current Co-Owner MICHAEL J MURTHA O -MURTHA, MICHAEL J 1754 130TH AVE HAMMOND WI 54015 uistricts: SC =School SP =Special Type Dist # Description SC 2422 ST CROIX CENTRAL SP 1700 WITC Property Address(es): * =Primary * 1762 130TH AVE ~egai uescription: Acres: SEC 28 T30I~R17W PT SW SE BEING CSM 15/4209 LOS 2)2.000AC 2.000 Plat: 4209-CSM 15/4209 012/01 Block/Condo Bldg: LOT 02 Tract(s): (Sec-Twn-Rng 401/4 1601/4) 28-30N-17W SW SE Notes: Parcel History: Date Doc # Vol/Page Type 2006 SUMMARY Blll #: Fair Market Value: Assessed with: 0 Valuations: Last Changed: 11/07/2005 Description RESIDENTIAL Class G1 Acres Land Improve Total State Reason 2.000 30,000 0 30,000 NO Totals for 2006: General Property Woodland 2.000 0 000 30,000 0 30,000 . 0 0 Totals for 2005: General Property Woodland 2.000 0 000 30,000 0 30,000 . 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch #: Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 +~ ~ ~ ~ BATH BAR' tyR ~ nSCQ1r81t(--'t`7~9F,; l,'- DCCU11EN7 N0. ~ ~: ,~ ~ ., . . r .~ .. ~AM+WTY DlEO . ~ •: ' ~~ ~ L] L~ ~ O C~ ~oa~ 5~ '~t^~,E~~ THIS S~ArF ItE6FpVE0 FOIL RECCRWMG DATA '~ 7'1d$ D~Eb, mrde brlweoe Walter j~... PxenP,~ ~ne;l Otfs.~r~v 1aSd ar ~. GRdllx~„ WtB. ~' .~Lu~??.a..an~i~e •- - • - - -_ Reseed thi~.~~. ' ~ ~ - _ _ _._ Raid iu[ _ .... Creetot stay Or..l .If~t].19~ and ~t-heel J• h8~ a sine Q_~p_ ~ ~ ~, ~... ,,.-..-_ T-_ ..,.. _...... .. __ . .. ~raolse, W i to o s A e t!1. That the said Greeter far a ralurblr coeaWeratloa-F3XA....., T I ' Thousand Three Hundred Savant Five and No 100 W --.......------ -. .Y_ _..-~..._ ~-~:.. ~ conveys to Grantre the loliowing deeerlbed real rpt:+lr to _.~.L._...E.TOjZ.~• County, r tt~~t~VtpNLT~o T ' StaLC OI tYl6GO~>:in: 1Y11C~da1 J'. t~11~tt7a ' Bax 305 The,t certain parcel of land or tract oP real testate Impnd Wi, 54G15~ ' described in the Certified Survey tdap t'+scoxded iri 'Poluma I of Certified Iarld Sure !~i s oi~ T~ aey ~'" ~ P Page 104 1n Lhe office zhla ca net hasestaad peeperty. of ohs 5;,. t.roix County tZegister of Jeeds Part of SY SE of 26-30-17 i '~ SF~ i ~ ~~ ~, ;i ' Together with alt and singular tfitr horeditemcnts ^nd appyrteeaneeta tLsretelta heloogJng a [a enT rise appertafnletg; '~ Aod-_..._----- ... .... ' ' 1 warrants that the has ie good, indvteatalh4 w fce yimplo and true wad cloar of eecumbrances except ,_TTenP _ __ ~I ~~-----'~ II and wi11 wsrrsnt sad defoed the same. ~I _..t~YC.~2,lLt~ .~1 ;• Execatad ^e __ 'I ' SIGNFA AND SEALED pY PRP.SR>t4cE GH this idt6+ti r,.._ day et, A?s'~ , >,9~. „a *~~ .~ ~~,''; ' 1'~ ' '~ ~ I,I -~ '~ rsEAL) i, ~~ r (SEAL) ~~ Andre ~ ~ I ' (31:AL) Ii ...~M'.~m•tu'7~..... `O Lw 3iQnntures of .,__~81!r,i'. ~.-~~Pr@~ .~IIa ,~-11~~1' p~r~ ~ ~ ~'~~w ~ authentic^ted this ~ ,,, 1411± ;,,{ d.Y ar -... April 14~: •• ~'~~~e' +(~-~~~~~ ` , ' rN !' . .,.. .~ '!'fete: 1letnber State bar of •iseunaln oe OtAec Party ~~ . ' ~ Avthorized tatder Sac. 906.66 vts. :~ '. j' •. ; ~+ STA78 OF r19C0l151P1 ^~!;. :: l ,' 1 !I taanty. '~ . ,I -.uy aamo balsas sae, lhls'~ ---~. 14th ":.,,.~ day ~ :;t9~5.',, ~:.,;,,~ ~•~~' 'a' ~ Walt.ar H_ P1A'nwr.~n~l.~Q •• 1~', `,.` ' ett to be t!w orsonFL~' srtpq'eiecutet the lea >n (estrtmwnt ml,ttckneartedRrd el,e sates . '~ . .' ~•• ~ 8a33a 30 931t Oa xi0x~ s5 LB9~ 9B6 •Sit Xti~I EE tTT i2i~ 9002/TZ/r0 663141 N.ATHLEEN H. WALSH f~EGISTEf~ OF DEEDS 5T. Cf.OIX CO. WI RECEIVED FOR RECdRD = 11-26-2001 1:20 PM ~ ~ 9 COPY FEE: 3.00 ~~p~ U ~~~ ~~, ` ~ ~ PAGESDING FEE: 23.00 ~ L~-,~1~1D~_ ~ ~ ~L L' L1~Z /V~~9f~~5 Lo00N ~ D ,~ •bZ ,si•9GZ IQ lr~ G 11 ~ ID hiOV ~ fr ) 1()1 1~7I~ _~ mw I~m f I~ to Z m~ OZ 1~1 ~ I~ ~ C I;~ ~ ~~ D~ Iz „~ llt!sy3< ~~ ~0~~ Im ° Idl~° W ~ZC~ I Z..I~I~ ~, o o ~ m~ ~ o~ I v I~ I~ Z O ~' I N I 1 I to ~~ D oN ~ d C m ~ W ~ O I w '~~ ~ ~~ _W ~/ ICS ~ ~ w OZ~ a ~ I~ Z ~ I ~ N ~'~ -' I ~ 00 m ~ ( W Z I~ W Om ~ ~N171 NNO ~ Q"~ "~ W~~ ~~ ~ VI D~~ ~O i I co ~° o rn I N N y N ~ A°~ m 'n .. 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Bh1 Elev: BM Description: IANK INrVKMAIIVN TYPE MANUF Septic Holding TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Ven to Air Intake ROAD Septic Dosing Aeration Holding PUMP/SIPHON INFORMATION Manufacturer De n M Model Number TDH Lift Friction Loss System Head TDH Ft Forcemain Length Dia. Dist. to Well SVIL. At35VKr I wN 5Y5TEM / ELEVATION DATA County: St. Croix Sanitary Permit No: 430603 0 State Plan ID No: Parcel Tax No: 012-1062-20-200 Section/Town/Range/Map No: 28.30.17.431620 STATION BS HI FS ELEV. Benchma ~-- It. M Bldg. Sewer SUHt Inlet St/Ht Outlet Dt Inlet Dt Bottom Heade an. ' t. Pipe Bot. System Final Grade St Cover BEDITRENCH DIMENSIONS Width Length o. Of Trenches PIT DIMENSIONS No. Of Pits Inside Liquid Depth SETBACK INFORMATION SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING CH Manufacturer: Type Of System: AMBER OR UNIT Model Number: UIJ 11[IDU I IVN JT5 I tM / Header/Manifold Distribu ' n x Hole Size x Hole Spacing Vent to Air Intake Pipes Length Dia Lengt Dia Spacing ~7VIL VV V GR x Prpscura Svsfamc [lnty vv 1111 i..~n'1 Ar AI_/'_`.~.Is C..~~..... ~. A..6. Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bedlrrench Center Bed/Trench Edges Topsoil ~ Yes [~ No _:_ Yes ~ No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / / Inspection #2: / / Location: 1762 130th Avenue Hammond, WI 54015 (SW 1/4 SE 1/4 28 T30N R17W) NA Lot 2 Parcel No: 28.30.17.431620 1.) Alt BM Description = 2.) Bldg sewer length = -amount of cover = r- ------- --- -- -- -- Plan revision Required? f ; Yes ~i No Use other side for additional information. ~___ __L ~ ~ _ _ _ ~ ~ I__~ 1 SBD-6710 (R.3/97) Date Insepctor's Signature Cert. No. 1;/05/2003 11:00 152 IV~D HALLE BUILDERS INC PAGE 01 ~, T 1 DEC 0 9 2003 + "' ~ `'nv~ OOUNT$aibty nd 13uild(ngs vtvlston counry ZONIN OFi• w ington nvc-. P.Q. Box 7082 ~" • ~ 1r0 I [ %~~~~~~~ WI 53707.-- 7082 Sanitary Permit Numbs ko be filled in by Co.) De artment df Commerce (608)261-6146 Q ~0 SSnit~l»"y Permit Application sate/P-ntt I.D. Numbs ~ ~, D In tueord with Comm 8321, Wis. Adm. Cade, personal infotmntion you provide to to ~ .~0 ~ / / may be usod Ibr aocondary purposes Privacy Law, s15,04(1)(m) P rng addraasJ i. Applicatiotl anformatian -Please Print All Information ~,, F~ 4 Property Oumcr's Name f.P Pt+t'CCl >X Lai q Block tt yvt ~ K~..a. ~b ~t1 ~~ ~~iz - faG z - zo 8. ~ Permit Ratewal ^ Permit Revision ^ Change of ^ Ptxmit Transfer to New List Prewcus Permit Number sad Date Lssttcd J Before Expiration PlurnbM gwner 3~~ ~~ ~ ~ !~~~/ J Propcny Owrter's Mailing Address Propary Loeatton 1""15 13~ ~.. LOT 1~ 'y3i~'/° I'J lL~ ~ ~{~.1~ ~'h, J ~h, sactiono? City, State ` t Codc Ahyanc Number ~j l""~ ~ W 1 ~ ~ ~ 5 ! (S` 7~ ~ 25 ~ ~-a (~irclep~gqe> T,~ N; R~ 7 e arUii~ Ii. Type of Building (check sll first aPPIY) ~ -ny~~ j (~l or Z Family pwelling- Numbtx of Bedtrxrms Gj,(~y~6~C' i,Q~/Y~vt~i1 Subdivision Name M Number / ^ PubliclCommercial - Desen'be User ~ ~ ~ ~ r~ ~ ~p ~ ~" / ~ ~ G~ ^City~ Village ~1'ownshipof irrj~r, [rfDltri~ ^ State Ownod - Acscribe Use i III. ~ypt of Permit, (Check only on z on li a A. orrtp a line B Ef applicable) ~`' ~ New Syttent Q ReplaCCntcnt Systcttt ^ Tr~tmeoNHolding Tank Rcplat<mtnt Ottly ^ t7titcr Modification to Existing System 0 - - ^ Nos -Pressurized In-Ground ^ Mound> 24 in, of suitable soil ~nund < 24 ln- of suitable soil ^ At~Gradc ^ Singk Pass Sand Filtct ^ l;onstructod Weiland {] Prcrsumed In-Grotmd ^ Harding Tank ©Peat Filter ^ AerobiG't>•caiment Uoit D RccircuLitinR Sand Pifler ^ Rocitetdating Synthetic Media i:iher Q Leaching Chamber ©Drip Litre ^ Grave{-]ess Pipe Q OthCr (explain} V. Dis ersaU'l'reatmentArea Information: Mc;an F1na lvod) Desien Snii Aontiwtien RatelaodsfS Disottxa! Arca Required (sf) Disptxsnl Area Proposed (sf) Syslcm Elevatitm - - . _ - - ~ -- - - -~'-e~_ B~u. i VI. Tank info Cappeity in Total Number Manufektur« ~ Prefab Site 3toe1 Pi Gallons Gallons of Units ~Jl~~~ ~Q Concrete Constructed Ol+ss AetobicTreatmetnUsie / ~ r DcsingChatttbcr ~ _ 600 _ YII. Ices onsibiiity Statement- !, the undCrslgoed, assume responslbllify for Inst f the POWTS shown os the attached plans. Plutltbtr's Natnc {Print) P a's Sigtlnture M P umber Business Phone Number . ~ ~~ 22 iv~l ~~~~a6~'GG3Y Plumber's Address (Street, City, State, Zip Code) ~Sz. ~ yv rt S T I~~n ~ •' y Gv 1 S y0o l - Sanitary Permit Fcc (includes C,rouo<twatcr tncc us ea ssmng ~gcm ~gnaau,c t~~~ ., f Approved ^ Disapproved ~j a SurchargeFoc) ~ C'_/1 ~Z~ G~i~'~~ ~ Q t3wo+!r Given Reaagn ftrt Denial i7 ~ ~' IX~COtldltifln;~O~'-pproral/l2CasonsppforAisapproval 1~ ~ ~~ $eptiC tank, effluent filter and W ~~ • ~3-SZ ~~ ~.,r~ dispersal cell must all be serviced /maintained ~~ (m~ a"~4n~ S~~r-el~~-ta~~ as er mbar. ~~ 7S, _.~~a:~:,~t.~l' ~~ ~~~ Gl~ ~ C'~~-- se ack requirements must be maintained ~ ~;~ ~ as per applicable code/ordinances. -~ .~,?~, y~l~h / ~ j ~n~ C~ ~• .~ y ~ ~ // r ~i AtGth eanpkte pons (tit eMgty oag7 •~' the *T`sren a/n paper sot INS than !It!! Y tl IM6es In slat l,fX-t' °~ ~ r~ ~G'~~4ivytl~ ~i~t>`' S~~-Q- ~ /~rycl.~-''`` SBD-6398 (R. 08/02} ~'` ~ UU'~ ~ ~~Z~.Gt/~~ d 0 v C ~o m O m O D 0 0 z z G~ m r O C Z G) J O •Z VJ C O Z 1 O Z r D z m ~ D~~-~ ~v~~ ~° o `o_ ~' ~~~ c r~ ~? .~ ~~ W^~ r ~ ~m~ Z ~~ ~~ .~ ~~ ~_ ~~ o ~s m o ~ ~~ 1 erg g O O 'a Z O r c 00 rn 70 r n N 1 0 z m ~~. c ~~a~""d~~~~~~ ~= pd~~ ~ ~~~~a ~~~~ a ~° ~"~~~~Bao~_~~ ~ ~ .°. d ~~ g`Z B ~ ~ n~ ~ ~ ~ o~~$ ~ ~ ~ d ~ ~ ~ G ~~ ~ ~ ~ ~~ ~~ N ~jx0 N M 7 ~ m m z rn D r ~o rn ..... O ~C r cn z 0 m ~o ~ i3 _l A Z ~1 y Z a VJ ~i n m~ ~~ D z D '0 mw .. __. _..~. ~! -- ~.__ -- -- - ter- - ---- . _ __ ~.__.._ .:__ _._r ~._r ~~,J -- .~. ~'~ __ yi __. 12/1?/2003 09:45 7152687080 GILLE TRUCKING z ~ i < r • ; 1 /• ' • Qbaervetion Pfipe ~ • J . 1••i~'r•:t•t~ r~f.j.r•r•~rw~w • i i.i•,-••~..k y`4+4•'4r•5r+1r•'~+ •V S, ~ ti.ti.ti f+ti+„„+1,. •ti• ;,,~~ 5 ~'ti~;S~SaS~•tir4~.rjr r-r•r.r•r~ . ' ,~.r`:' • • • ' •' ti"'1,•~i.•wr•.•1,1.`• S.•.w ,.~ ylR~w•rwJ~ S J~wd' 1'..•.r.r"f rwr•~w A W .~'+r,r,rwr•r•r•r•.• f."'•t•f• j.,~jf•r.ri~~if ./•wfi'frw•~•rSiK•~ i• :~~~ •w j1~+. fy~~. • •=_ -- • g ,_, ~ T -. . , .•. L Mound Component Dimensions esq. ~ A 4.50 ft ~ 20.00 in hl 1.00 ft K 10.31 ft cps " ~ B 100.00 ft P 9.25 in z 8.81 fk L 120.63 ft D 20.00 in G 0.50 ft J 8.81 ft W 22,13 ft 450,00 (it=) Disp®rsal Cell Area 2212.50 (ft2) Basal Area Available 4.50 (gpd/ft) Linear Loading Rate 10.00 (ft) 1/10 B ODs. Pipe Placement Mound Cross Sec~lon VIeMt Aggregate Dispersal Area Finished Grade 102,54 (ft) ~/si 100.77 ft -~~ ~ Oispers-a C j~ : ~:: ~:: elevation Mound Plan View -I H t?ispersel Cell 101.27 (f#) Lateral Invert D' ~ : 1 99.10 (ft) Contour elevation 0.0 % Sil;e 51ope Geotextile Fabric Cover Shading Key 8. ~ pisp®rs81 Cell See lateral details on 1[] ~ Topsoil Cap a 1.5 ft Page 4 for number s~i~e Q~ Subsoil Ca e o 1 5 S "~- w ...~• "~"' .r .: and spacing of laterals. ASTM '33 S !s ~°r•r~r. r:~` stir:' .,r°~.~:• Laterals are ual C and :e ,, •:ti:tiz :.:~-,..."•-'Lw~. ~ IY Tilled l..a er a O.S ft w'~'Typtcal Lstenal ;%~f;• F spaced from the •ti,ti•ti A99 eg Y ... x a~~~~;.="r':?~:~.::~:r:r•r- J•1• • r ~t® a p ~ •S•1+1+w.•1•-. ~y•y4•L 5 - ~ disbrbution Cell s r rww••••wr•r•••^ .r.r.,:• centerline 1n the ~"' A ~~ distribution cell (AxB). Project; RICK WALDSCHMIpT Page 3 of 7 PAGE 03 12r12/2003 7152687080 1, . l PAGE 02 GILLS TRUCKING Wound and Pressure Distribution Component Design Design Worksheet (r or c) ~~h e) ~.~5 f ~~ _ ~iY ~ 1 s~~ ~~~ r. Residential or Commercial Design 100.00 Estimated Wastewater Flow (gpd) 1.50 Peeking Factor (e.g. 1,5 = 150°rb) ~50.D0 Design Flow (gpd) 0.00 Site Slope (96) 99.10 Contour Line Eleva#ipn (ft) 16.00 Depth to Limitin® Factor (in) 0.40 fn-situ Soil Application Rate (gpd/ft~) Distribution C®II information 100.00 Dispersal Cell Length Alon® Contour (ft) 1.00 Dispersal Call Design Loading Rate (gpd/ft2) 1 Influent Wastewater Quality (1 or 2) Pressure Dlsrlbutlon Information C Center or End Manifold 2.25 ateral Spacing (ff) 4 Number of Laterals 0.125 Orifice Diameter (in) (e.g, q,25) Z.50 sti Orifice Spacing (ft) 2.00 Fornemain Diameter (in) 100.00 ForCemain Length (ft) 88.OQ Pump Tank Elevation (ft) Treatment Tank Information 1000.00 Septic Tank Capacity (gal) HUFFCUTT Manufacturer Bose Tank Information 600.00 Dose Tank Cape~city (gal) 14.29 Dose Tank Volume (galfin) HUFFCUTT Manufacturer Note: Sand fll (D) aalPUtativns assume a Tggle 83-44-3 in-situ soH treaUnent for fete) oorrorm of c. 36 indles. 4.50 Cell Width (ft) Are the tterals the highest oint in the distribution y network? Enter Y or N If N above, enter the elevation ft of the highest point 5.63 ft2/orrfiCe Does the forcemain drain bade? Y Enter Y or N 16.31 Forcemain Drainbadc (gal) 62.87 5x Void Volume (gal) 79.18 Minimum Dose Volume (gal) 32,95 System Demand (gpm) Manifold Diameter Selection in. dia. o tiona cho' 1.25 x x 1.50 x 2,00 3.00 Callons/lnch Calculator (optional) 600.00 Total Tank Cs~pacity (gal) 42.00 Total Working Liquid Depth (in) 14.29 gal/in (enter result in cell B49) Effluent Filter Information Zabel Filter Manufacturer A100 Filter Model Number Project: RICK WALDSCHMIDT Page 2 of 7 8.50 System Head (ft) x 1.3 12.77 Vertical Lift (ft) 2.31 Friction Loss (ft) 21.57 Total Dynamic Hesd (ft) 12/12/2003 09:45 • 7152687080 GILLE TRUCKING . , Faroe maln oonneotion v;a tse or Dross to rt-snield at any poine, ~~.-~~ ~ f - P - ~, •¢ Yurtwp ndbdl salve or 'EX--'1IE olgnouf,plug Hol.~c ArNad on drt bottom vl the IalaaL Number of Laterals Lateral Diameter Lateral Length (P) Lateral. S acing (S) Lateral Flow a e System Flow Rate Total Dynamic H®ad l#hrals aro bontlcal S Laterals tr lotus rna(~ of PYC Soh 4 pet COMhA TiW- 6{,~0-6 4 Or~ce piam®ter 1.25 in Orifice Spacing (X) 49.34 ft Or~ces per Lateral .25 ft Orifice Density 8. gpm Manifold Length 32.95 gpm Manifold Diameter 21.57 ft Forcemain Velocity Dose Tank Information Elecp•Ical ae per NEC 300 and -•-~ Comm 1(3.28 WAC Disconnect Tank component is propeAy vented HUFFCUTT Manufacturer # Ca acl 600,00 Gallons T Volume 14.29 gslrnch A B C D 3" Bedding u~ er tank. Alarm Manuafacturer LEVEL ALARM Alarm Model Number DVL Pump Manufacturer ZO~LLER Pump Model Number 140 "~"' Pump Must Deliver 32.95 gpm at 21.57 ft TDhI Project: RICK WALDSCHMIDT 6ooking cover with warning label and IookNtg device and sealed wattsAlg-rt i 4 in. mirt. ~-~-- AlteRiate otltle~t looatlon Foroemaln diameter ~ 2 in. Weep hole or antl- siphon device P~(f ekvadon 88.50 Dose tank elevetbn ~- 88.00 Page 4 of 7 PAGE 04 i Cllr ~~ PAGE 01 .~ ~ ~ 352 1,40, STREET AMERy, WI 54001 P{~ontE: (715) 2b$-bb37 1"AX: (715) 26g-70$0 Fax 12f12f2003 09:45 7152687080 To: ~~,,~ Fran: Qt~~'I/7 i~ S , ~~° Date: Phvwvm Pagss (includes cove= Ro: CC. Urpen! ^ For Revlenr [»7 Please Ce:1:ngert ^ Piaase Ike P4- ^ P1e~ue pe~!-ala *Co:nment~o GILLE TRUCKING . `New ~eparareerrt ot'corrxrrerce SOIL EVAI~UATiQN REPORT- ~ / ~~ 4~±sionacset~tyara _ _ __:: _ - ~ ' ~ _ . _ - ~ acoordanoe with cairun as: w~: nay. c«~e ' Aitactr ~P~ arr PaPecrrotlesg-than 8 1 " " mum --=- - - - - . - ir~ude, .but not Grra'bed to: vertical and. hotfaornal P~ (eM). and - . _.... - Parr~i •t.D. .^ penxnt sbpe. scale or dimensions. north and distance read, ... _ .. . \_.i ' r Please print a i' ~ © -: ~ t Re ' _ ~ Date Personal inforrrauon You provide may bs used ~+dary ( s.15}.~( (m)). ~/ i~ ..O P ? p :- • s `~11 ~ ,.,~y~ 7 3 0~ /~ zdN`~'G State Zp Code '', ~ w~ Y~/s~ c~~ i f ~ i/4 1/4 S l.ot Block # Subd Name ~' o_ City ge Town ~ ~ /7 T3Q N R 17 E ~~~ ~ /Q Nea t Roams C~ 0 ~ New Corrsbvdion Use: ~ Residential 1 Number d bedrooms Code derived design flow rate ' 7 ~~ GPD ^ ~ ~ ubli r ommenaal - Descr~e: Parent materiai F7a'r.'-Al~ elavatbc if fie. recorruriendations: C~r-+~.r„~.. Fib `19.1 ~ s ~ boo. y 7 , S . ~..=. do ' sue- ~ ~ ~ . ~d eorirrg # GG^,,~~ Ground surface elev ~• Z 1t © c P ~ Vo - . . Y it Depth b rsnitmg factor _ in. u~ ~~ •_---. ...,,,-. ~~•a~••~~ Ruaw~uesurpoon iexaire saucure cow Botmda ry Roots GP D/ft= in. M u nseq t1u. Sz Cont. Color Gr. S z Sh. ~ ~, p ~ ,/ `r ~ C I[ f 41~ ~~/ ~ ,l0 •3~ . ~~RS t ,S' ,PS C L vEQ ~ ...~ ~wK,111 pcr.r, o ~ Boring # ^ ~ ~ Pit Ground surface elev. / 7• ~ 1t. tin, to smiting 1 ~_ ~,. ~ ~ Horizon Depth Dominant Redox Desaiptian Texture SUnrdure Consistence Boundary Roots GP D/tTr ' in. MunseU G1u. SL Cont. Color Gr. Sz. Sh. 'E Sys l '-" C i/ SQ /~wF 4 v ' - i .s-i ~- c ~ _ ~ ~ v~ •ri ~/ z~s ~/ CL ~ -~ ~.~ onuCn~ rs ~ = nVU > :7U < ZZO rixyL and TSS >30 < 150 mgfL ' Effluent #2 =BOO < 30 rriglL and TSS _< 30 niglL CST Name (Please Print) lirt9 - CST Number F`~'i1iS ~,~/ ZL/ Y7'/ ~~ Date Evahrat~op Condrx:ted Teleptwne Number ~ .. 37z rya S7 14n,~~ w.z- syao s-~o..d% ~ ,~"16~ 6637 u ~# ~ -~..~ - cad ® Pit Ground sutiaceelev. /mss // }t, pe~h to rig tailor ~f~ in. Horizon Depot Dontirtant Redox Description ~ - Textte in- MurtseQ Qu. Sz Cont. Color ~ Boundary ROOD Gr. Sz Sh. `~- .SY s/3 `-~ CL K v ~ aw vF 3 6 -30 ~.~'xRs/3 ec ~Aa~t' ~uF,~ .~ ~ # p Bonng Pit Ground surface elev. ft. Deptft to Irr~drtg factor ~, Horizon Soi ~ ~ Rate Depth Dominant Redox Oescripton Texture Strucdme Consistence Boundary Roots GPD/fF in• M~efl t]u. Sz Cant. Color Gr. Sz Sh. .~ .E~ Boring # ^ Borin9 ^ Pit Ground surface elev. ft. ~ to I&ttit'rtg facer in, Horizon Depth Dominant Color Redox Sofl Rate Description Texture Stnx~ure Consistence Boundary Raots GPDRt< ~ Mtntseq Qu. Sz Cant Color Gr. Sz Sh. 'Etf#1 I 'Eff#2 'Effluent #1 = BODS > 30 < ~0 ~, and TSS >30 < 150 mg/L 'Effluent #2 = BODs < 30 rny~ and TSS < 30 ng/L The Department of Commerce is an equal opportunity service provider and employer. [f:you need assistance to access services ar need material in an alternate format, please contact the department at 608-266-3 t 51 or TT'Y 608-264-g777. seo.aw t~oJ :' ~,, ~ 1 T...._ ..r.-.._~-.-_• Y -)7I/y~/ t i ~' a,f, - ~. _ I i ~ ~ ~ I ~- j,7 ~ ...- -- Z s ~ r i ' wwf ~ 1 _ : 1 'W ~._.__...-__ ._....r_...__ art.-j.~_~.}-.__....'.. _.. ~.~__-_T ~..___.,~........_... ___. .-. _ _._ ~. _._~1.-~_.~.- '.-,..-r I I ; ! ~ A 1 i -.. ...-- i 1 ~~ --~--- 1 1 1 i - - ~ ~..~ , -- ~ _ --- ,. i - _, _ . ~ . • } ~ _ .• _ ~~ ~,~ ; ~ 1 ~~p 7 ; _ ,~ _ . ; .. _. _ ~ _ /^'~'~'. ~1t7~.r`? 1 _w.T_.- l ~~i. d •~. ~. ~ T-i-"'-"b""_T'_""+~...j_...-..-~.__.~_.....j-._._ i i ./ . ~3.~,a ~ , . ~ ~ 1 i i ~, '` r _a.-'_-• + 'T 1 ---r-- .a..__ ..-.__L. ._.J.,._.--F--.....j.._. 1_.-.-.~.---T_..._.L..---•.~---I---j..._ '~w- _.y'--."j'_._'_'^ ....._... __._ ~ _ ._._ I __ ..1.._._....1.._.~ _.. .-..J~... 1'_...r..n....._ i -~. ~i_._ _ i i I ~ i i _:.......... ~ ~ ~ -~ I ~, - i • .~ I ...__-•- _._.~_-I . ~ ~ 1 1 .__....-.._ .1..._... _._ __.._ __... ...._~._. .__. . Wisconsin Departrt~ent of Commerce Safety and Build;,ng Division a v ~ GENERAL INFORMATION r PRIVATE SEWAGE SYSTEM INSPECTION REPbRT (ATTACH TO PERMIT) rersonai inrormation you provide ma be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: City Village X Township Murtha, Mike ie Erin Prairie Townshi CST BM Elev: sp. BM Elev: BM Description: TANK IN FORMATION TYPE MANUFACTURER CAPACITY Septic Dosing Aeration Holding TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Septic Dosing Aeration Holding PUMP/SIPHON INFORMATION Manufacturer Demand GPM Model Number TDH Lift Friction Loss System Head TDH Ft Forcemain Length Dia. Dist. to well wl~ r\aavrcr 1 Ivry 1T5 1 tM BEDITRENCH Width Lengl DIMENSIONS SETBACK SYSTEM TO INFORMATION Type Of System: DISTRIBUTION SYSTEM P/L Of LEVATION DATA County: St. Croix Sanita it No: 399 5 0 State Plan ID No: Parcel Tax 012-1062-20-000 STATION BS HI FS ELEV. Benchmark Alt. BM Bldg. Sewer SUHt Inlet SUHt Outlet Dt Inlet Dt Bottom Header/Man. Dist. Pipe Bot. System Final Grade S over PIT DIMENSIONS No. Of Pits Inside Dia. LAKE/STREAM LEACHING Manufactu CHAMBER OR UNIT Mnrlwl Nun Header/Manifold Distribution x Hole Size x Hole Spacing Vent to Air Intake Pipe(s) Length Dia Length Dia Spacing CAiI /~A\/CD Depth Over Bedrrrench Center Depth Over Bedlrrench Edges xx Depth of Topsoil xx Seeded/Sodded xx Mulched ^ Yes ^ No ^ ® Yes No \.vlnlrl~ly 1 ~: (Include code discrepencies, persons present, etc.) Inspection #1: / / Inspection #2: / / Location: 1754130th Avenue Hammond, WI 54015 (SW 1/4 SE 1/4 28 T30N R17W) NA Lot 1 Parcel No: 28.30.17.4318 1.}Alt BM Description = 2.) Bldg sewer length = - amount of cover = 3.) Contour = Plan revision Required? ^ Yes ^ No Use other side for additional information. SBD-6710 (R.3/97) Date Insepctor's Signature Cert. No. • . ' '' Sanitary Permit Application - Safety & Buildings Division ~ ~ + !n accori v.~ith ,:Amm 83.~'.I, Wis. Adm. Code K 201 W. Washington Ave. PO Box 7302 . ~ ~~ ~~~CQ See reverse stde far tnstructtons for completing this application Madison, W[ 53707-7302 L + t]epartmant of t.orttmetce Personal information you provide may be used for secondary purposes [Privacy Law, s. 15.04(Ixm)J (Submit completed form to county if not state owned. Attach co lete cans to the coon co onl for. the stem, on a er not less than 8 - I/2 x 11 inches in size. Corut~ ~ State S i P it/ um~ ^ Check if ievi ~ n to pieviou5 application l(J O State Plan I. D. Number CO ~SC~ C~ I. A lication Information -Please Print alt Information Location: Property Owner Name ~~,~ ~ ~ ~~ L ,-,~~/ \ !, _ ._.!__.t ~ i~ .vC..L.,,~ 1" ~~~ ~1 ~~ on ~ ~ ~ 7 ~ •~ 13 d /~ N of t f` 1/4 _ " v_"` ~-, '- , , r . . Property Owner's Mailing Address ~ / t Block Number - C• ,.State Zip Code Phone N ivisi e o . ! S ~~ . ~{ti,( ~ ~ II. Type of Building: (check one) ~ 'GOON ~ f B d lli N ~ ~1~ f:~'~~ b rooms : e o. o ng - ^ 1 or 2 Family Dwe ' ~\N Tow ` ^ public/Commercial (describe use):_ ^ State-0wned --7 Parcel Taxi g t~ml~r(~) III. T .~ of Permit: heck onl one b x n li ox o e B if a licable L'$ . 3~• I ~. `+ 11 A) 1. ew 2. ^ Re rem t aceme 4. 5. 6. ^ Additioii to Existin S stem S stem S ste ank On emrit Number Date Issued li) ^ A Sani Permit was issu ~ C?2~a a~ ~'S~ IV. Type of POWT System: ( ec all th appl ^ Non-pressurized In-ground Mound ^ Sand Filter ^ Constructed Wetland ^ Pressurized In-ground ^ Holding Tank ^ Single Pass ^ Drip Line ''77~~ it ^ Recirculatin ^ Other: ' Gtr ~~~ t U T t bi n rea men c ^ At- de Aero V. Dis ersaUTreatment Area Info ation: H r rn. a 1. Design Flow (gpd) 2. Dispersal 3. Dispersal Area 4. Soil Application 5. Percolation Rate 6. System Elevation 7. Final Grade Required Proposed Rate (Ga1sJ /sq. R) (MinJinch) Elevation ~/~~ L/~~~ .; ~ < l' o ~ /oo .7~ a 2, rye Tank VII Capacity in Total # of Ma ufacturer Prefab Site Steel Fiber- Plastic . Information Gallons Gallons Tanks Con- Con- glass Crete structed New Tanks Existing Tanks e~ ~~ ~ ~ ^ ^ ^ ^ . ~ /OD ~ ^ ^ ^ ^ ^ tit) / (~~ VIII. R ponsibitity Statement I, the undetsi ed, assume res onsibili for installation of the POWTS shown o hed lans. Business Phone Number Plumbers Name (print) P be Signa o stamps): RS ZG$'-~~ ~ 7 ZZ/~7/ 71J= ~ . l/~ ~hni S Ci• Plumber's Address (Sneer, Citx..State, Zip Code) ~ii~C S ~/ ~ ~ C 0 Z yQ S 1 , M-(~ ~,(JJ IX. County/Department Use Only ^ Disapproved Sanitary Permit F (Includes Groundwater Date Issued Issuing Agent Signature (No stamps) l ~ J ~ / d ^ Owner Given Initial Adverse Surcharge Fee)~ ~ C pprove ~~ 1 ~ ~ O ~ Y~ VY1i` c- // "`777 o J ~ p Determination X. Conditions of Approval /Reasons for Disapproval: 5 • ~(OaP ~t~rl2 '~~'r _ ~~~.,~~,,~' ~~cl~c~ /~ h.d)•r•-GPT~,..e~.:tq i1La~~~r,~~~i~ _ ~-~ ~ c~~ z `li+vf~ ~9'~~~- - ~ ~ ,~, . ~{ s d -~ ~ ~- ~ ~ Pawl 71~ i Z J G7 ~ ~~ KJ I N,.t~r~-~ ~ M~ F~~i~ "`'' 2,2~'~ / ^o o~'~YZ f ~ ~ 5 ~ . t1 ~ ~ ~ ~ wr, ~s ~" +^^,c,, ~ h ~u,; n ~- tT e c0 ~~ ~-~S ~ ~ ~ ~ C~ -- -~Oo .~'c~- Irv ~..1~f~e ~`$ -' ~ ~ isconsin Department of Commerce Safety and Buildings 4003 N KINNEY COULEE RD Y ' LA CROSSE Wf 54601-1831 TDD #: (608) 264-8777 www.commerce.state.wi. us/sb www.wisconsin.gov Scott McCallum, Governor Brenda J. Blanchard, Secretary August 08, 2001 CUST ID No.221471 A7TN: POWTS Inspector ZONING OFFICE DENNIS J GILLE ST CROIX COUNTY SPIA 372 140TH ST 1101 CARMICHAEL RD AMERY WI 54001 HUDSON WI 54016 CONDITIONAL APPROVAL - PLAN APPROVAL EXPIRES 08/08/2003 Identification Numbers Transaction ID No. 667500 SITE: Site ID No. 634092 DEBBIE MURTHA Please refer to both identification numbers, 130TH AV above, in all cones ondence with the a enc . TOWN OF ERM PRAIRIE ST CROIX COUNTY GOVERNMENT LOT(S) 2, S28, T30N, R17W FOR: DESCRIPTION: THREE BEDROOM MOUND SYSTEM OBJECT TYPE: POWT SYSTEM REGULATED OBJECT [D NO.: 805982 The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. 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 Systems VERSION 2.0" SBD-10691-P (N.01/01) ,/ and the SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST_SAS (O1 [n 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. [n addition, the owner must insure that the operation, maintenance and monitoring duties as described in section V[[[ of the Mound manual, and the pressure distribution component manual are complied with. A copy of this letter including instructions and information relating to proper use and maintenance of the system must be given to the owner and each subsequent owner upon completion of the project. • The well must be a minimum of 25 feet from any POWTS tank, and a minimum of 50 feet from the absorption area. • Limited activities are allowed in the area l0 feet around the parameter of the component area. Soil compaction, excavation, vehicular traffic and other similar activities that impact the treatment and dispersal are prohibited. • 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). [n addition, 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. • 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. ' ~ DENNIS J GILLE Page 2 8/8/0 t • Comm 83.52(3) The activities relating to evaluation and monitoring mechanical POWTS components after the initial installation of the POWTS in accordance with an approved management plan shall be conducted by a person who holds a registration issued by the department as a registered POWTS maintainer. • 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), V19is. 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 construct ion/insta I lat ion/operat ion. 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. Sincerely, Charles L Bratz POWTS Plan reviewer II- Integrated Services (608) 789-7893, Mon.-Fri. 7:45 AM to 4:30 PM cbratz@commerce. state. w i. us cc: DEBBIE MURTHA FEE REQUIRED $ (75.00 FEE RECEIVED $ 175.00 BALANCE DUE $ 0.00 WiSMART code: 7633 • , s r ~ ~ Y • ~ MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Project Name: DEBBIE MURTHA Owner's Name: DEBBIE MURTHA Owner's Address: 1754 130 AVE HAMMOND WI. 54015 Legal Description: S28 T 3o NR 17 W RECEIVED Township: ERIN PRAIRE JUL 3:12001 County: ST. CROIX S~E'1'Y & BUGS DIV Subdivision Name: R ~ Lot Number: ~ Block Number: Parcel I.D. Number: Plan Transaction No.: Page 1 Index and title Page 2 Data entry COlt~lt[OTtQ~! Page 3 Mound drawings APPR~VE~ Page 4 Lateral and dose tank Page 5 System maintenance specifications DEPI-RTMENTOFCOMMERCE Page 6 Management and contingency plan 6WN 0 MII vu.ul Page 7 Pump curve and specifications 4 SEE CORRESPONDEN ... License Number: 221471 Date: 07 /01 ~ Phone Number: 715-268-6637 Signature: ,~h-,.-~ Designed Pursuant to the Mound Component Manual for POWTS Version 2.0 SDB-10691-P (N. 01/01), and SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST-SAS (01/81) Designer: DENNIS GILLE Version 3.0 (03/01/01) Page 1 of 7 Mound and Pressure Distribution Component Design Design Worksheet Site Infor mation (r or c) R Residential or Commercial Design 300.00 Estimated Wastewater Flow (gpd) 1.50 Peaking Factor (e.g. 1.5 = 150%) 450.00 Design Flow (gpd) 0.00 Site Slope (%) 99.10 Contour Line Elevation (ft) ~ 16.00 Depth to Limiting Factor (in) 0.40 In-situ Soil Application Rate (gpd/ftz) / ~~(c ore) "U~ ~~~ ~~'U ~~ Distribution Cell Information 100.00 Dispersal Cell Length Along Contour (ft) _ 1.00 Dispersal Cell Design Loading Rate (gpd/ftz) 1 Influent Wastewater Quality (1 or 2) Pressure Disribution Information C. Center or End Manifold . 1.13 Lateral Spacing (ft) 4 Number of Laterals 0.126 Orifice Diameter (in) (e.g. 0.25) Note: Sand fill (D) calculations assume a Table 83-443 in-situ sal tn~atrr~ent for fecal cdifomt of <= 36 inches. 4.50 Cell Width (ft) Are the laterals the highest point in the distribution Y network? Enter Y or N If N above, enter the elevation (ft) of the highest point. 2.60 Estimated Orifice Spacing (ft) = 5.63 ftZ/orifice . 0 Forcemain Diameter (in) 100.00 Forcemain Length (ft) Does the forcemain drain back? Y 88.00 Pump Tank Elevation (ft) Enter Y or N 6.50 System Head (ft) x 1.3 12.27 Vertical Lift (ft) 2.31 Friction Loss (ft) 21.07 Total Dynamic Head (ft) 16.31 Forcemain Drainback (gal) 64.36 5x Void Volume (gal) 80.67 Minimum Dose Volume (gal) 32.95 System Demand (gpm) Lateral Diameter Selection in. dia. options choice 0.75 1.00 x 1.25 x X 1.50 x 2.00 x 3.00 x Manifold Diameter Selection in. dia. o ions ch ' 1.25 x X 1.50 x 2.00 3.00 Gallonsllnch Calculator (optional} Treatment Tank Information 600.00 Total Tank Capacity (gal) 1000.00 Septic Tank Capacity (gal) 40.00 Total Working Liquid Depth (in) HUFFCUTT CONCR Manufacturer 15.00 gal/in (enter result in cell 1349) Dose Tank Information Effluent Filter Information 600.00 Dose Tank Capaaty (gal) Zabel Filter Manufacturer 12.00 Dose Tank Volume (gal/in) A100 Filter Model Number HUFFCUTTCONCR Manufacturer Project: DEBBIE MURTHA page 2 of 7 _. . Mound Plan View 1- 1_ • 1/1 0 B • ••••'•••••••'•'• • • ' • • ~ • • • ~ Observation Pipe ' 3Q ' • ' • ' m`~ti`+ "r+'4o"s~`.~'.m~~~w'.aR,'~gnpen.f. .'.~+`eay.y~^y`.. ::'~.""•,:':."m~:%E•;•"'q~"~°`::,;.,..,,".yaw, ;,;":~.;,, . `"."`•""e'°'.°~`.••:."oa°r:^:.d+.~..J°•`f..".,Tar ~e,f~®".~~r',s~.e®>, ~.s,.;me .•,°n ~'d`e~'r'`' `- L i Mound Component Dimensions A 4.50 ft B 100.00 ft D 20.00 in E 20.00 in F 9.25 in G 0.50 ft 450.00 (ft2) Dispersal Cell Area 4.50 (gpd/ft) Linear Loading Rate -. -+ _fi -1 H 1.00 ft K 10.31 ft z 8.81 ft L 120.63 ft J 8.81 ft W 22.13 ft 2212.50 (ft2) Basal Area Available 10.00 (ft) 1/10 B Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area Finished Grade 102.54 (ft) fr~r~~ F 100.77 (ft) --- - Dispersal Cell • • ..3 .. ~ . ~ . ' ... :~.~. . Elevation ....... ... .. ........... .. --- .,rrrrrf.... * H {~~r.~rr.~.f~:{r~r~rf.. G •1 . . cispe~i-ceii :::::: ; ::: ; :: 101.27 (ft) Lateral Invert 'p ~ ~ ... ... .• .• . . . . .. . .. • . .• .. .• ....... • .... • •• .......... ... 0.0 % Site Slope Shading Key Q ®Topsoil Cap Q ~',~f,• Subsoil Cap © '•:'~~•': ASTM C33 Sand ® Tilled Layer 05 rt:::° Aggregate Project DEBBIE MURTHA 'o ` 1.5 ft a o ~~ 0 `~ ~ 0.5 ft Dispersal Cell ipical Lateral ,~ge.Y„•°, sj~,t, .ga,~a~,~~A„p 5 A --~ 10 (ft) Contour Elevation Geotextile Fabric Cover See lateral details on Page 4 for number, size, and spacing of laterals. Laterals are equally spaced from the distribution cell's centerline in the distribution cell (Ax6). Page 3 of 7 Center Connection Lateral Layout Daigram ~c /~»~ ~~~~ o1~C2// Forcemain connection via tee or cross to maru'fold at ang poirN. Laterals ate identical IE P •= Turn-up wal ball vahre or I~ x--;•IExF2 I xr2~` Laterals & Force main of F'VC Sch 40 aleanoutplug per COMM Table 84.30-5 Holes dri8ed on the bottom of the lateral. Number of Laterals Lateral Diameter --lateral Length (P) --Lateral Spacing (S) Lateral Flow Rate System Flow Rate Total Dynamic Head Electrical as per NEC 300 and -~ Comm 16.28 WAC _ Tank component is properly vented rifire Diameter i O 'face Spacing (~ 50.51 rifices per Lateral Orifice Density 8.24 gpm Manifold Length 32.95 gpm Manifold Diameter 21.07 ft Forcemain Velocity Dose Tank Information Manufacturer Gallons _r gal/inch A Dimension Inches Gallons A 28.23 338.74 B 2.00 24.00 C 7.77 93.26 D 12.00 144.00 Total 50.00 600.00 HUFFCUTT CONCR Ca acit 600.00 Volume 12.00 B C D Disconnect 3" Bedding un er tank. Alarm Manuafacturer LEVEL ALARM Alarm Model Number DVL Pump Manufacturer ZOELLER Pump Model Number 140 Pump Must Deliver 32.95 gpm at 21.07 ft TDH Project: DEBBIE MURTHA ~a u it:e N,hy So na,~-J? Locking cover with warning label and locking device and sealed watertight 4 in. min. ~ Alternate outlet location Forcemain diameter ~ 2 in. Weep hod or aMi- siphon device Pump off elevation (ft) 89.00 D~ ose tank elevation (ft) 88.00 Page 4 of 7 _, , Mound System Maintenance and Oaeration Saecifications Service Provider's Name DENNIS GILLE Phone 268-6637 POWTS Regulator's Name Phone System F wand Load Parameters Design Flow- Peak 450 gpd Maximum Influent Particle Size 1/8 in Estimated Flow -Average 300 gpd Maximum BOD5 220 mg/L Septic Tank Capacity 1000 gal Maximum TSS 150 mg/L Soil Absorption Component Size 450 ftz Maximum FOG 30 mg/L Type of Wastewater Domestic Maximum Fecal Coliform >10E4 cfu/100 mL Service Freauencv Septic and Pump Tank Effluent Filter Pump and Controls Alarm Pressure System Mound Other Inspect and/or service once every 3 years Should inspect and clean at least once ev 3 ears Test once eve 3 ears Should test monthly Laterals should be flushed and pressure tested every 1.5 years Inspect for pondin and seepage once every 3 years 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 mound 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 mound structure and other disturbed areas will be seeded and mulched to prevent soil erosion and help reduce frost penetration. Lateral Turn-up Detail Finished •~~~~~~~~~~~~~• •~~~~~~~~~~~~~~• Grade 6-8" Diameter Lawn _~ :. Threaded Cleanout Sprinkler Valve Box ~ Plug or Ball Valve Distribution • Lateral Long Sweep 90 or Two 45 Degree Bends Same Diameter as Lateral Project: DEBBIE MURTHA Page 5 of 7 ---~..:-..._.__..._..._...w_.._ ....~ ____...; n 1 . • r "• r i J ..W ti _ ...~ - n: ' 3nu au ~~ au .~~U - ___. _. .~.. i1! 4.Yi7 Y8 ~Ui3 n 4 tpq •t~tJ~1t•~~'~t•v W~ ~r,.Trr ifll ;1B7 ~ ~ t61.1 NW tFIIS ., ~ ,,. ~... 4f} 7'1.9U 'tY 7n cv t:1,T-0 _ U ~~ 111 _+. ~.,... Ltmlu Vo19W, q,r. .rr. .... _..~U yr, ,.~ un ,_ ~ Eaa ru ~ . i cw i ~i u :eu xan r•I.nw Wt;tt eaaa[rT~ ~,u ,~ uywwu • r:1c~c:t,ic;;:Ilaltwrnafall~,1~•r ,~pl~x.sy~,$lr~rs,~.Qau6itHbleanc~supptledwlril ort Hlartn. r 11ll~Tnh>:tnt~~pEaffarrvators, PI? •~uplwdxtt}3flurle,arl~ nval[uGtew1111arwtChnai ~tldnn;~. ~arrtrl~! at~tti71 eylatam,~ a[Iw ev~IlraC+l~ xdr° T pt+ase }wrrip~a ~fri~Jrl hi slrrlplex c~y>ab~,'n. hrao ~~7~~. ltertnhlalavaiaardloisw•3t~~tTtasar~ l~>,~Ilatal~'fE:rrc,~sntmttirrg~ngla~tu~.~ • L~UUtbta p1~,8eaCr vrsrt'i~ ~+, inveF iL°~ ry~f~piar~ arc avriJlaF~1e 1Y~rv~rtabla teut~ tar~,q ayale aanfrata ° S!~>3fac~ Ctwik°13ox taVa~Etat~b~ ~'nrr;u:•3uar 1na(r~ttelEtans. k~e~a FN1442I?. C1V4u' ~:3tt°F, (~a4°C.,~ s¢r~c [i i! gtil5>9~ fG: tr teggtrarl. ° ~f~rtc'1lxMtid05far~(1C'° I'. >ap,dR-rr ~I.yrte, Yfcq~3i,r113~~•si:EJ~~ ~'t~n:2er1n1y-t~lhr;. --`--r-.~....~___._._.. ~iae~zaurUai~ acct r~p.~ - c~„n~l _s ~ a I ~°~ ~ Mnda ~~J "T~itltr76'" ~- ~.. , __,~_.. ' .o ~ w' 9 s s a nrft lAd a _ I~4 ttx t i ...~.. ~'.~o .~:~" a ur a WlwlutruuuYt[dni[IuwW'r.u>u[mauwulV unumuuu.r9nWl~uu~WltWku'rlllhtitunfdaUluAiNkM/-9d+'Nl~dgtl,r unnua: reu„n(n, I .. a ,~, ~... ~ ire •'--~ ., ...t ~~ lil~g._.. ...-~ >pa r ...., ` I/flii 1/p - 11 9Pd hF4' f~..., ! t 9~ n/n .. '. ~ !~!. it,M.W~:; ;. . ~, I 8'4~ ~~-+ nru-+! I . i'~, . P r -rs,, 1 !I ~ ~ 1,4 ~;~ " '1 "1 1 l _~: ..L.., ....... N ::9 ff„ { •r: [t uxrwr ~N,~d,"4-I i~$@ d$IYI ~I E ~:y ,~. e-c~>s~na ~. ~tllyfm pfiygyFanun~r,ulli6lt31suat4J~E.s~a[Imhex d.,W>repiggyhgnPx+~istrTsir~w~l lrbat awltl,iJ. l~fi3r to ~Mt7~7'7. ~. INraullsntual sfl~rnRlnr M•C'att 9~I.L'~ "2 tor'Etb 1D'~, a ~ rMt)71.~ !'nr r;orret¢ rtlartal ~N @;(te~rlo8{ u>l~r 1k. 4. Uflr~>h1'eiev~tonttblswttah~itt-srt'r[i;nauree: e,,ntratrt~~rap~~;Y C~1w'~4•f iTn~t~l~m. !i. Faur (4) flilln ,I~lurllc, ji-rur~Tq b,aM. a:r 1 uA ~~~ xnlr~snUori arwlrert~in s[mplar 11r x lsurnp npa~p(,yl, q~(Jiyl, ~~~+a1~'c.~if ~~IKYI~CfI~ dal ~ ~ ta~arla•~~drar!lluala ~ quu;~lJ~ Ntr~lrl~it:~tG:fara. ~~#~ I cal lautr~r~ a .~ + s~ ~ 4it,~iuuerA i~fatugrl~ traa~t 8'~Ul1'1t !ul~liurlral ~[ , ~ ~ ~itut»tl :"~' fdYrr[~ ~'ik~1,14a°? r9:I~f~1~q~, ~"4a~I "~~ A"0/1krYa1'~~M.~ ~+dyP4~1u9r ~'`~ ~ Jn,>s<J,~r, ~nr~dlt~ons ~ roc~arfrr~ ~"I~ty Yac~CsJr Ea ang~tt~rer3 info lie ci~Jf~ra of r~vt~ry Za~et' lt: • parr, ~. .w11y _..___ bfi4tL't17: kU. SOX xi~V47` ~._._.~.......v.u.~.................._. _ ---.~_...__ '~~/ Ltudbulatr, KY dDY.t~.,A'1?/ SiKY70:5tidDQeuualirrnRam! ~!'1s=rcttllra»a! . '~ lsrdulr~ 1tY dUiH4.9Rd9 w, __..~.._,...._.._.~ ...•..~..~.. '~`. ~°~.,~9i°' .C11: t~llyri~.z'rar•q{~nu~u~cr~tr~~ ~.~;,~.~- ,p~^ ...,-.W_...-.w.~.r....,.,~.,.~_..-..w---~.._._.......,..._w. ~ Y1'YkA~une~ +G4d9 ld7t:7A~ `..~~ Mound Sys~em,~fA~lnagBment Plan Pursuant to Comm 83.54, Wis. Adm. Code General This system shall be operated in accordance with Cantu 82-84 Wis. Adm. Cade, and shall maintained in accordance with its' component manuals [SBD-10691-P (N.01/01) and SSWMP Publication 9.6 (01/81)] 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 case death. Septic and pump tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the forks are no longer used as POWTS components. Septic or pump tank manhde risers, access risers and covers should be inspected far water tightness and soundness. Access openings used far service and assessment shall txx sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. F~osed access openings greater than 8-inches in diameter shall be secured by an effective loddng device to prevent accidental or unauthorized entry into a tank or component. Seotio Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Stets. 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 fitter shall be assessed at least once 3 tom. - The outlet filter shall be leaned ~ rx~say to ensure proper operation. The finer cartridge should nct be remxyued unless provisions are o n sdids in the tank that may sioug i from its enclosure. If the filter is equipped with at alarm, the filter shall be serviced if the alarm is activated continuously. Intermittent filter alarms may indicate surge flaws or an impefxling continuous alarm. The septic tank shall have its contents remioved when the vdume of sludge and scum in the tank exceeds 1/3 the liquid vdume of the tank. ff the contents of the tank are not remxr~ned at the time of a triennial assessment, maintenance personnel shall advise the owner of when the next service needs to be pertomred to maintain less than ma~amum scum and sludge accumulation in the tank. The addition of bidogical err chemical additives to enhance septic tank perfomnance is ger~ly nct required. However, if such products are used they shall be appraaed for septic tank use by the Departrrrent of Cornrrrerce. Pumo Tank The pump (dosing) tank shall be inspected at least once every 3 years. All switches, alarms, and pumps shall be tested to operation. If an effluent filter is installed within the tank ft shall be inspected and serviced as necessary. ~y Proper Mound and Pressure Distribution Svstem No trees or shrubs should be planted on the mound. Plantings may be made around the mound's perimeter, and the mound shall be seeded and mulched as necessary to prevent erasion and to provide same protection from frost penetration. Traffic (other than for vegetative maintenance) on the mound is mat recarrrrrended since sdl compaction may hinder aeration of the infiltrative surtace within the mound and snow carripactiai in the winter will promote frost penetration. Cdd weather installations (October-February) dictate that the mound be heavily mulched ~ protection from freezing. Influent quality into the mound system may not exceed 220 mg/L GODS, 150 mglL TSS, and 30 mag/L FOG far septic tank effluent err 30 mg/L BODS, 30 mg/L TSS, 10 mg/L FOG, and 104 cfu/100 mL for highly trued effluent. Influenrt flanr may not exceed ma~dmum design flaw specified in the permit for this installation. The pressure distribution system is provided with a flushing print at the end of each lateral, and ft is rewmrrrended that each lateral be flushed of accumulated sdids at least once every 18 months. When a pressure test is pertomied it should be compared to the initial test when the system was installed to determine if once clogging has occurred and 'rf once cleaning is required to maintain equal distribution within the dispersal cell. Observation pipes within the dispersal cell shall be ct~eciced for effluent ponding. Parading levels shall be reported to the awrxe•, and any levels above 6 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring. If the c tank or an of its Contingenov Plan ~ y components become defective the tank or compa'tent shall be repaired or replaced to keep the system in proper operating candifian. If the dosing tank, Pump, pump cormds, alarm or related wiring becarr~es defective the defective component(s) shall be immediately repaired or replaced with a component of the sane or equal perforrr~ce. If the mound component fails to accept wastewater or begins to discharge wastewater to the ground surtace, it will be repaired or replaced in its' present location by increasing basal aea 'rf tce leakage occurs or by removing bidogically clogged absorption and dispersal media, axi related piping, axt replacing said components as deemed necessay to brim the system into proper operating condition. See Page`. of this plan for the Wane and telephone numrber of your local POWTS regulator and service provider. .~` Project: DEBBIE MURTHA Page 6 of 7 . ,` ST CKl7Ik COUNTX S)~.1'TIC '; 'ANK .MA~I~''T'I';NANCE AGR.EEMI;NT A~1I) OWr, ERSHIP CE.RT~II~ICAT1pN P4 ativntrr/Buyer ~~--~s.. ~- ~ 1~. -e,b b ~'~ lvfailirtg Address ~ ~ ~~-( X30 •{~•. ~,.«.,..d,.d. ~ ~ ~fl lS - . ~_~.-.,. ~ .~.~...~_..M Property Address _~..~f~.~....~y~_W~,-...:~.~..~ ~.,,~, w-o~--~( (Vs~titiootacsu regaircd tzoa~ i Punning Dapartrnent for new constnterion),~ ' ~ r City/Sttitc ~~._1~.~.. Pazcet Identi£icarian Ni~nber ~ ~ Z~~ b~,- 2Q -- ©©_~ LEGAL bESCI7IPT~(y~ 01 a' I n d ?s Z o- Z 0 0 i., 5s= ~,, Si.c. ~B . T_ 3a o ~F3 I f3 - Zo Property z,acatiom 51nJ _ x -- ` _...~-~_.1.~.W. Town of ~,-~ ti ~--~:~vi ~. Subdivision ~S M .,~„~o I. [ S;~ci c~2__ --- `~ a o °I _ ~ )_.ot # ~ w_ Certified Survey Map # ~~' 3 ~ ~'trolume I_S` ~~ 12agc # ~o1Qc'1_. ~Varranly Deed # "~z> ~ ? ~ ~ Vatume J~ ~ T, Page # ~qy~~,,~_._. Spec lxolase CI yes l~ nc~ Lot lines identifiable ¢~J yes ^ no ;~~ SYSTEM MAII~I'I`E1~IANCE improper 1i~e and ma{ntenanaeaf your eel ~pc system enuld result in its premature failuuG to handle wastes. Prapcrmaiureaance consists of pttzztping out the septic tank every tlir~ a year ar sooner, if tteedod by a liconscd pumpax. What you put into the systean ran affect the function of the septic tank as a trr- went stage {n the waste d{spnsal systari. Tixe property ctwuer agree to subxnut to St, ~[t?ix Zonistg Department a cnrtif{catiu~a form, signed by ttic tirrttcr snd by a mastet•pluml~r, joumeyma~npltamber, restr{ctedpl~ ixtrber or n lioense~dls~ampar verifying that (1) the art-site wastGwaterd{sposalsy~tem is in ps`opesr operating condition andJor (2) after in.'pection a,ad pumsing (if aeaessary), the septic tsualc is less thw 113 full of sludge. Ilwe, uric uttdcrsigaed have read t}ae above rcquirc~ harts aad agxeo t~~ maintain the private sewage disposal system with tba standards _ set forth. hcreiut, as set by the >~apartmettt of Cau`~ amerce ensl Sze L~epart:~ont a7~ Nattual Resattrcea, State of WisQOns{n. Ct:tti~dAtian stating that your septic system Lea been maintainel I i9:l.U9t !ie completed and eaturn~ed to the St. Croix Ceuaty Zoning dffiCe vpithn 30 days of the three year expiration date. ~ . SIGt~IAT(JR$ OF AkP111GAIrI'C ~A~ OWN'~It (;IuRT.Ik'~C TA ION I (tive) caz~tifY that all statpmants on this : -rm arcs true M drd bast of my (our) lcmow-edge. T (wc) am (.are) fhe owner(s) of the pr~2ert'y described above, by virt-,e of a wam~ 1ty decd recdrde;i its Rtgistrr of Deeds ot~ice. SIGN,1TURI. (UF APpLICANT~ ~A.I.~ '"`~'. ""4""" Any ittfozmation that is tnis-represented re ay result in the sanitary pCrmit being revoked by the Zomimg 1?epartment. "''***` "' Include with ttKis Applicstion~ a stainp~d wart•lrity deed from ti~a ltegistcr of heeds affSre, a cony of tttC e~ rt{fled sttrvmy rn~ap it' re;frrcace {s made „n the warranty deed ' DOCUMENT N0. i f STATE BAR OF WISCONSIN-FORM 1 - f ~ [' I ~ C,~1 p~`f ~.3~ eoa~ 3~638~j ~ ~ . WARRANTY DEED I TMiS St'4CE RESERVED tOR RECOttO1NG DATA '` r .. . , r2EGk5TER5 OFFlG , THIS DEED, made betvreen Wd1t@=_H._.~IegE~.-ancl -Audre~c._ Pieper ST. CROIX CO•. 1fV13. _ Hus-band. axl LNife _ ___-. __ .---. ____..----_---..-----________._ _ ~t~ l. Reed for Record this__~ _ _._. ___ _ .___.____- -_. ___. Grant.>r f_-- -------0.Q.19~~ day o Aril and -__ Lichael J. .:urt~~~„ a su',~le_!tlacl_______ __ __ - - t_~ 5 .~4~~. M• _ _ -- __ _., -- Grantee. __ _ _ W i t n e s a e t h , i hat the s u~.1 Grantor for a val uablr cons rderat um Five _ (ftit(}Qt~/ Of Qlna{ Thousand 'ihree ttuidc•e~i .:evenly Five and ,'Jo/l~,v(.~j,~7~.t.~,) conveys to Granter the foli•::v.'!n1 ~;escrttx:dreal estate m Jt. ~rCiX C~,uo<S'• NETURN TO State of Wis::•~nsin. M1Ch3el .~. Mnrtha 'Phat certain Ya:•ce_ o.' land or tract of real estate Box 305 Hammon~.VYi._54Q15 __-______ described iri the e: tiiied ~t,lrvey rfap recorde_a irl Voiur.:e I oI Certified i.ard :survey daps on page 1c;4 in tee office Tax Key ,_.-_ .._ ___ _ _____ ._ . t Ot T h d Of t;le t. l:rG1X '~~~:sty ,tegister OI ..Deeds i _ his is omestea property. Fait of S",-SF o' %~-jC-17 TR``~i`((; ~~~;'R w,y,!Z~_ `° +L.~` Together wtth all and ~crn;;ular the hcredttaments and appurtenances thcremnto herlnn~;ing or in any wise appertaining; And _ _ _ __ _ __ - _ _. _ - _ _ ._._ . ----- - - -- -_ _ warrants that the ti_1r is ,;,cud, tndefeastble in fee simple and free and clear cif encur.:~bram•es e><cept ~:OIIe__ --_.___ and will warrant and d.•Lrnd the •:ame. Executed at River Falls,_..1h.'i. _... SIGNED AND SEALED I~ PRESENCE OF th;ti .14th day ~,f _ .~ril_ ____.__-_ . t9 L5-- ---~ ~ ~-- ~ ~ • G T Walter. li. Pieger~.__ ____ __ ._. - rsEAL> 'n Signatures of - tiV'alter. H.._Piege.>r_anti._Audr~~- Piager-._-_-_____.._-_-_______.... authenticated thts -_._. __ 14th._- ._.._ day of ____AnriL __ __- . I9.Z~.. ~ ~% _ ~~~~-.• S to . • ~. yY j -- _~~~~e ~ t ~ . .. r Title: Member State Aar of Wisconsin or Other Pany Authorized under Sec. 706.06 viz. ._.___ _-_______ -___ _.____ i~; STATE OF WISCONSIN i ~ ~ s s. _ --~t. ~roix._.---- ...._ --- --__County. - ,: I~ Personally came before me. this _.` 14tH ._-._._ day of _ _._~L3,1------- , -. 19-~- ~ ~d1tBr I~ the above named A ~ ~1E ~ l ~3 __._. __ _ ._- _ ~8Z-dAC t23[-- Ep0I- _.. tlt ----------.-_.____ 1` to me known to be the person S__- who executed the (oreQoinE instrument and ,l f; acknowledged the same. a !4 -hia instrument was drafted by i4 Mi1t011..D...~1C1vt~C - . ~' 't~alph E, Senn atto 3 -- -_.___~__. ._a_. -~,.e --~_.__._ 5t~_~rt]iX_ y Pubuc__ Not~r co~ety, Nls ~~ ; l~.1Yer 1''`81.1x, lilrtj.SCUL18 id1 , ~~ The use of witnesses is optional. My Comm;ssiert (Expires) r1s) .~ ~~$-_ ' t: i _.. ._ - ~ - _ _.._._. ____. _ _ - - - Y _ _ .. _....__-_-__ ~.~. _ . -°-_- - ---- ------ _._..~.._.___..._r,_._ I Names o[ persons signing in any eaip~city aht~uid be typed os printed below th - eir signatures. 1lGtMrwl:aep~r~ t k - lAR1iANFY DEFtt_STATE BAR OF 1ILRCON'iiPi, F083t MO. 1 - {9)3 -R Audrey. Pieper, -~___T.___.__----__._. .~ ,.~~ ~; 326198 . ~~ ,,, -'"'1 CERTIFIED SURVEY MAP Part of the SW 1/4 of the SE 1/4 of Section 28, Township 30 North, Range 17 West, Town of Erin Prairie, St. Croix County, Wisconsin. Y1fcs~ 880 00' :~ $O Na ~` S.OS Acrds ~ ~ r -~ Nogrss~s~ ~ L J N '~ a I .D ~ ~n •a O 2 I w "7'owrs R vQOI ~~ P.K. S %¢ Gorrltr Ssc Z8~ 7'3oN~ .e l7 N! S. /isa ftc Z8. S y • Indicates iron pipe stake 30" long weighing 1,,;13#/ft. R Seale: 1" 200' Description: That certain parcel of land or tract of real estate located in the SW 1/4 of the SE 1/4 of Section 28, T 30 N, R 17 W, Town of Erin Prairie, St. Croix County, Wisconsin, more fully described as follows; Beginning at the south 1/4 corner of said Section 28, thence go N 90° 00' 00" E (assumed bearing) along the south line of said Section 28 a distance of 880.00 feet; thence N O1° 25' 00" W a distance of 250.00 feet; thence N 90° 00' 00" W a distance of 880.00 feet parallel pith said south line of Section 28; thence S 01° 25' 00" E a distance of 250.00 feet to the Point-of-Beginning, the above described parcel containing 5.05 acres, more or less, including the south 33.00 feet thereof presently used for Town Road purposes. Certification I hereby certify that I hPVe surveyed and divided the lands shown hereon and that the map and dese~iption shown hereon area true and correct representation and description of the lands as divided; and that I have cooplied with all provisions of Chapter 236.34 of the Wisconsin Statutes in surveying, dividing, mapping and describing said lands for the owner, Walter Peiper. Dated : 31 March 1975 ~`~ ~~~~ James L. Murph Registered Land Surveyor Vol. I Page 101 Certified Land Survey Map, St. Croix County, Wisconsin 32~19~ ,4, ,~ ~ ~~ Fft E® 71PR 1 1975 ~AAEi G' CONNELL Volume I ~ age 10l~ ... ~~ ~ . ~ l rr ~edc y ~ ~~ ~ 663141 KATHLEEN H. WALSH kEGISTEk OF DEEDS ST. 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