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030-2131-39-000
Wisconsin Department ofCommerte PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division Sanitary Permit No: i( INSPECTION REPORT 561005 .-mL GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: City village X Township Parcel Tax No: Oeverin Homes LLC, aka Oeverin Pro ertie St. Joseph, Town of 030-2131-39-000 1 )9 Insp. BM Elev: BM Description: Section/Town/Range/Map No CST BM Elev: rj"r 23.30.20.1093 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER S CAPACITY STATION BS HI FS ELEV. Septic Benchmark Yu We,,, /ate S.3 Dosing Lo M ~d v / S ` (i 6(0 Alt. ~ I 3• Z7 ~6Z . O Awraben Q Bldg. Sewer /06 • 7 ems- ,N3. 7 ~P Holding St/Ht Inlet St/Ht Outlet TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic -;7' X60 y /06 1 Dt Bottom 3 j SZ . Dosing 7 X60 _ Header/Man. L Aeration Dist. Pipe Z , all /0l- Holding - 12- Bot. System .y~► 3A 160, t PUMP/SIPHON INFORMATION Final Grade a49 /6 2. I Manufacturer L W--,- bt a~ Demand St Cover ~I Ir K 103 2 2~ /D Z, O Model Number c1E )i IdA v 3 TDH Lil~ Friction~oss System Head TDH Ft r Forcemain Length `Q / Dia. of Dist. to Well s lit Z 9 SOIL ABSORPTION SYSTEM BEDITRENCH Width Length No. Of Tren s PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS /z CQ SETBACK SYSTEM TO / P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer: INFORMATION Type Of System: n r CHAMBER OR Model Number: /_j UNIT fa.0L¢ #19 ~a~ ~Co DISTRIBUTION SYSTEM 41ers1~ Header/Manifold Distribution / x Hole Size x Hole Spacin jver~)o Air Intake Length Dia \ Length aU Dia Spacing ntn ✓ / SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over xx Depth of 7eeded/Sodded xx Mulched BedlTrench Center 7 • aL Bed/Trench Edges ` Topsoil \ J Yes No Yes N. COMMENTS: (Include code discrepencies, persons present, etc.) Inspe n #1: I / 1-7/ Z, 0 P Inspection #2: /31 /o..J Ok Twi~; 0V Location: 113 Heritage Trail Houlton, WI 54082 (NW 1/4 SW 1/4 23 T30N R20W) Settler's Glen L/9139 Parcel No: 23.30.20.1093 1.) Alt BM Description = r' ( L` 6L.4a.-a 2.) Bldg sewer length = /06 Pa..~ 'vk`,,, e(~) - amount of cover = I G ~Ca O J e~ E. e,. (p ~J ~Y10(tiQ~ y r / d b~6 14 30 o~ ~Z if 11I~e~n oJ~,~ 4~ 0✓` re5 Plan revision Required? FQ~ Yes t1K No I Use other side for additional information. 11~1 Date Insepctor' Signal Cert No SBD-6710 (R.3/97) Corl merce.W1.9oV Safety and Build' Di' si County 201 W. Washing Je., P. 0. $D~ 7 42 / Madison, t3707-7162 Sanitary Permit Number (to be filled in by Co.) consin 4)(- Dep buetrt of Cot roo 5(,.1055 Sanitary Permit Application State Trausactioon Number In accordance with s. Comm. 83.21(2), Wis. Adm. Code, submission of this farm to the'4aj~j to governmental Z2-116-721 unit is required prior to obtaining a sanitary permit. Note: Application farms r state- OWTS are Project Address (if different than mailing address) submitted to the Department of Commerce. Personal information you provid ij* be usftt~kee ndary u oses in accordance with the Privacy Law, s. 15.04 1 m , Stats. 1. Application Information - Please Print All Inform atio 3 Property Owner's Name 'c; Parcel # Property Owner's Mailing Address w , Property Location I a 9 C 0/' , L7 1/1 ? L Govt. Lot s -7 71 City, State Zip Code Phone Number -1-) 1, .Sectio 4 to( II. Type of Building (check all that apply Lot # - T (si N; R _ E gf wJ ~Qor 2 Family Dwelling-Number of Bedroo _ Q Subdivision Name t.a. C i Blo # ❑ Public/Commercial - Describe Use 1 t~ti ❑ City of ❑ State Owned - Describe Use CSM Number ❑ Village of t r Mown of / 2 k 90 III. Type of Permit: (Check only one box on line A. Complete line B if applicable) A. w System ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only El Other Modification to Existing System (explain) IN B. ❑ Permit Renewal ermit Revision ❑ Change of Plumber ❑ Permit Transfer to New List Previous Permit Number and D Issued Before Expiration Owner S 1~ /[1 2 IV. Type of POWTS S stem/Com onent/Device: Check all that a l _ ❑ Non-Pressurized In-Ground ❑ Pressurized In-Ground t-Grade ❑ mound > 24 in. of suitable soil ❑ Mound < 24 in, of suitable soil ❑ Holding Tank ❑ Other Dispersal Component (explain) ❑ Pretreatment Device (explain) it jo lie V. Dis rsal/Treat nt Area Information: Design Flow (gpd) Design Soil Application (gpdsf) Dispersal Area Required (s Dispersal Area Pro d (sf) System Elevation VI. Tank Info Capacity in Total # of Manufacturer Gallons Gallons Units sss~~~ U N ~v New Tanks Existing Tanks a~ i✓ t U in A W C7 0. Septic or Holding Tank - Dosing Chamber 3 U VII. Responsibility Statement- 1, the undersigned, assn sponsibillty for installation of the POWTS shown on the attached plans. Plumber's Name (Print) , Plumber' ' ature MP/MPRS Number Business Phone N/urn or Plumber's Address Street, City, State, Zip Code VIII. _County/ De artment Use Only Approved DisappGi Permit Fee Date Issued Issuing e t Signature or Reason enial P -1:5- -Ij~// 3 IX. Conditip%t Wagon for Disa roval ~tJ r l ^ / /I o 1 $eptic tank, effluent fitter and 3) n e,,-J tdispemal cell must all be services / maintained YC •S te'a' as per management plan provided by plumber. 2. A11,is968ck reclwements must be maintained IA. ArM,r,,,1~of~, . F, - Attac tdcomplete p aas Me system and submit to the C/o'unty o' on paper not less than 8 In x 11 lac in sIn n r 4 1, • tL; rt. 5 i 'S>~It ~D~ ('atlwJ~ c. Lys SBD-6398 (R. 01/07) Valid thru 01/09 & -e~ PLOT PLAN PROJECT Oeverina Homes ADDRESS 1433 Cernohous Ave Suite A New Richmond Wi 54017 NW 1/4 SW 1/4s 23 /T 30 N/R 20 W TOWN St. Joseph COUNTY ST. CROIX SYSTEM ELEVATION 100.0' BEDROOM 3 CONVENTIONAL AT-GRADE XXX CONVENTIONAL LIFT HOLDING TANK 1000 gallons DOSE TANK SIZE 630 MOUND SEPTIC TANK SIZE HOLDING TANK SIZE LOAD RATE .5 ABSORPTION AREA 900 # of chambers none Ilk BENCHMARK V.R.P. Top of survey iron ASSUME ELEVATION 1001 ❑ BOREHOLE O WELL * H. R. P. same as benchmark Heritage Trail 360' Property Line 3 Acre Parcel Scale _ 1 4° = 10' B.M. 99.5' 100' 100.5' Grading is to be done B-1 to divert run-off away from system 2% Slope Pro 3 ? C~1 Bedroom House B-3 Huffcutt Combo Tank Tank is to be properly p bedded and provided with lockdown covers B-2 with approved warning Area 15' below system labels is to remain undisturbed 36' Property Line rRx Q~era gam' ~Q~ Safety and Buildings of ; a 141 NW BARSTOW ST FL 4TH WAUKESHA WI 53188-3789 - Contact Through Relay t q , ow www.dsps.wi.gov/sb/ t www.wisconsin.9ov A Q~SSIONAL~ Scott Walker, Governor Dave Ross, Secretary February 22, 2013 CUST ID No. 226900 47-TN.- POWTS Inspector SHAUN R BIRD ZONING OFFICE BIRD PLUMBING INC ST CROIX COUNTY SPIA 1432 120TH ST 1101 CARMICHAEL RD NEW RICHMOND WI 54017 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 02J22J2015 Identification Numbers Transaction ID No. 2211574 SITE: Site ID No. 786677 Oevering Homes Please refer to both identification numbers; 113 Heritage Trl above, in all correspondencewith the Town of Saint Joseph a encv. St Croix County NWl/4, SW1/4, S23, T30N, R20W Lot: 39, Subdivision: Settler's Glen FOR: Description: At-Grade, 3 bedroom Object Type: POWTS Component Manual Regulated Object ID No.: 1405086 Revision; Maintenance required; 450 GPD Flow rate; 37 in Soil minimum depth to limiting factor from original grade; System(s): A2 grade Component Manual, Version 2.0, SBD-10854 (N.03/07), Pressure Distribution Component Manual - Version 2.0, SBD-10706-P (N.01/01); 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 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: This system is to be constructed and located in accordance with the enclosed approved plans and wig e i?'l~lound Component Manual for Private Onsite Wastewater Systems VERSION 2.0" SBD-10691-P (N.0I/ tle, "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment S to SI(1d.1" r rl• SBD-10706-P (NA1/01). The building sewer and distribution network piping shall be of material listed in Tabi d. 384.30-5, Wis. Adm. Code. In the event this soil absorption system or any of its component parts malfunctions so as to create a h6lth hazard, the property owner must follow the contingency plan as described in the approved plans. In addition, the owner must comply with the operation, maintenance and monitoring duties as described in section VIII of the mound component manual. A copy of this information must be given to the owner upon completion of the project. All holding/treatment tanks are to comply with SPS 384.25(7)(a). SHAUN R BIRD Page 2 2/22/2013 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. A Sanitary Permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.135 and 145.19, Wis. Stats. Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stats. Owner Responsibilities: • SPS 383.52 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. SPS 383.54(1). • SPS 383.52(2) A POWTS that is not maintained in accordance with the approved management plan or as required under s. SPS 383.54(4) shall be considered a human health hazard. • SPS 383.55 The owner is responsible for submitting a maintenance verification report acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. A copy of the approved plans, specifications and this letter shall be on-site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of construction/installation/operation. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number 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 $ 85.00 This Amount Will Be Invoiced. When You Receive That Invoice, Julia Lewis-Osborne Please Include a Copy With Your POWTS Reviewer 2, Integrated Services Payment Submittal. (262) 397-6005, Fax: (608) 283-7481 WiSMART code: 7633 j ulia.lewis@wisconsin. gov cc: Charles L Bratz, POWTS Reviewer II, (608) 789-7893, 7:45 am - 4:30 pm Monday - Friday 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. RECEIVED Cover Page FEB 19 2013 INDUSTRY SERVICES Shaun Bird Bird Plumbing Inc. 1432 120th St. New Richmond Wi 54017 715-246-4516 Date: 1/10/13 Owner: Oevering Homes Location:NW1/4 SW1/4 S23 T30 N,R20W 113 Heritage Trail St. Joseph System type: At-Grade Manuals Used: At-Grade Component Manual version 2.0 SBD 10854 (N. 03/07) Pressure Distribution Manual version 2.0 SBD 10706-P(N. 01/01) Page# 1. Cover Page 2. At-Grade Plot Plan 3. At-Grade Cross Section 4. Pipe Cross Section/Pipe Layout 5. Pump Chamber Cross Section 6. Pump Curve 7-8. Maintance and Contigency plan 9-11. Soil test 12. Filter Specific i ns f Shaun Bird j , Signat License number 226900 '?r PLOT PLAN PROJECT Oeverina Homes ADDRESS 1433 Cernohous Ave Suite A New Richmond Wi 54017 NW 1/4 SW 1/4S 23 /T 30 N/R 20 W TOWN St. Joseph COUNTY ST. CROIX SYSTEM ELEVATION 100.0' 3 BEDROOM CONVENTIONAL AT-GRADE XXX CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 gallons DOSE TANK SIZE 630 HOLDING TANK SIZE LOAD RATE .5 ABSORPTION AREA 900 # of chambers none BENCHMARK V.R.P. Top of survey iron ASSUME ELEVATION 100' ❑ BOREHOLE O WELL * H. R. P. same as benchmark Heritage Trail 360' Property Line 3Acre Parcel Cale = 1 /4" = 10' B.M.* 99.5' 100' 100.5' Grading is to be done g _ 1 to divert run-off away ❑ from system 2% Slope Pro 3 Bedroom House B-3 Huffcutt Combo Tank Tank is to be properly ❑ bedded and provided with lockdown covers B-2 with approved warning Area 15' below system labels is to remain undisturbed 36' Property Line At-grade System Sloping Site Cross Section and Plan View I, r t D_imens_ion -Feet - ' yy+R•yrR y.yR•R•RrR•~•,•'■ti R•~•'tr µ■w•y.~r~■~■~■i iw'. ~.~.y.~.R.R R R•R■L y yr A - Z- ~•twt•t•:'•1'•t•J■t■■r■t•t t a t ■I' 1' t t t 1'•i i i i i i i i i•i t•i■Rt t t•t•t t t yrR•R•R+R R•R•R•R yLA■r•■•yy•R•y"yR R •,•R 4 R R L R "V• R 1+ R R R■4 R 'Lj0••R••• R+R• _ _ ~ :'L+•'L1'L•.''y'~i:'6':iL~'L:S:'L:'L~1.~ti•'1.~'•ii:L~R:'L~'L•r'k~y~'R+'R:'L'~'L'~R+''S'•'4+~'R'~y'I'■yrLt'1'•LtRtRry'~RtRtyxR• r•t•r■t•r•r•t•t+t• fW1r•t•t•r•1+,r■{■r•1rt•r+t•r•r•1•f•t•r•r•r•t■r•J•t•,!•r•r•t■d'+t■t■r•t•a 0 fL~L f~ f'■J~~~~•.y,~J'R1''~d''J''~Ti~'yl'~fif~J'~J~~'L•I'~~'~~'••I'1■••~~''~t~•J'~t+~~'~J~1'•S++diJy • _ 1/h B 4•+L•y■L•yL•S•,L~■R■,y■~wrR■yrR■'L■yr•.•5••R•R•'1+•L•'L•R•R•R•R Rw'L•4•L•L.L•yt•y+R•yL•R•L•L ,M+r.t•r•r r•r•r•r•t•t•t•t•t•t•l'•+'•f'•t•r•J•.M1J•r•J•t•■•r+r•r•t+r•r-t-t•t•r•J•J•J•r+r• •R•y■L•R•'L•'fi•R•'6•"••y.t•y'S+yyyL•RrL•L■L■L■R•R■L+R•R•R■R•'1i•1~■R•y'L■yrR•'h+•L•'. 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J,•.I,•r■Jyt■r•r■t■t•t•J+■1'•J'•t,r•1'•J•t d'•r•t•r■r•t•t••f'•r•J•t•f•r•r•t•r•t•r•J•r•r•r•J•r• 1.r.P y.•y,.'L•'L,'L.y.y■ '~••R■yy•R■•L■y ! ! l V •R•R•'L•L.y•y.y. .R■y■y■R•R.L.R■R••,■R•y■R•R• •R•R■Rr k r r • • ■ yrLrL•L•L■R■R■R ■R•R•R•R•R+R•R+_ ' t•J•r•r+t•Jrt t•J r t t t t t+t t•t•t•r t r•t•■ 7 •L•yL•L•L•L■'. •yR•R•R• yR•R•R•L•yL•'~4•• L•L •r•r+J+t•t•J•r• r•r•t•t•t■t•t• ~ l 1/6 B ~rl W _ - S•9.m -------..d--~+...------- . t' Sloe---I_ z..__,. gate Clean aggre 0 4 in. sch. 40 pvc 1- `I = plowed M.m%;. 1 basal ilrea 1/z to 2 ~/z in, dia. observation pipe Lateral with 2" 'T'opsoil Cap aggregate over pipe Observation Pipe Geotextile V With Cal) Fabric •r r:}~.•r.t • /Ov. 5 Ft Lateral Invert _ r r r .M•1■t■1•■ t•r+t•r~.lrJit Jet ~j~ Topsoil Cap ■y+y■by1~•'I.•RrRrR y.y.y■■,,.yyr•■•'L R y R 1 •r•t•ti f•t•t•trt■t•t ~"rt•t■t+t•t•t•t•t•t•t•tr ~L r: 1i~7 ~ t' yR R R•R•L•R•7. W yR•yR•R•y~•y R R y L R i . ■.1 ■t+ ~•.r. r 7+•d'+ •t t•trr•r! rlr, r_, l•J! rhl'! t t!{ 'y • •J5 •t•t•t■rrr•r■-•'i Ft Cori N, R ■-6,L+ •L ■r•r+r t■if'•■"■rrr,t ^,Jt R:R 14 C ,:.X 'd':t•r'M4~1+%R~1rL~4~'b~iL~R~I4tR:R~Rr y `Plowed Surface Slope Direction GENERAL INSTALINrION: The at-grade area is staked out along the design contour. Existing vegetation is snowed and raked off the site. The basal area (l_, x W) is staked out and plowed with a moldboard. or chisel plow. Plowing may not proceed if the soil is wet er.tough at the plow depth to form a '/A inch soil wire when a sample is rolled between the palms of the hands. The A x B area is covered by clean aggregate deposited overhead by a backhoe. Special. tare must be used when placing the aggregate to minimize compaction of the plowed surface. After the topsoil cap is placed, the entire at-grade is seeded and mulched to promote vegetative growth, limit erosion and protect from freezing. The observation pipes are perforated in the lower 6 inches and secured in place. 03/05 lgy Page of Pressure Lateral Layout One Lateral - End Manifold l 4------ 't'hreaded Cleanoui Lateral "Tlrrn-up Plug Force Maur L Long; Sweep 90 Bend Pressure System C 011structiou - Distribution Network S ecifcations Lateral lliamete , Laterals r are constructed of Schedule 401'VC pipe. Orifices are drilled perpendicular to Orifice Diameter i ~ In. --r-~ In. the pipe with a sharp drill bit and face down. X (Orifice S aciui Lateral turn-ups terminate with a threaded L (Lateral Len th 2 in. cle4u~octt plug and are enclosed in a 6-8 inch Force Main Diameter diameter lawn sprinkler valve box accessible Force Main Len h 0 Ft. - - from finished grade. • w • • • Grade 6-8 Inch. Lawn sprinklerValve Box I - II Page of 03/fly lfj i Septic-Dose Tank Cross Section And Pump Performance Specifications PUMP LA r aatarer Tank Manufacturer 112~_7 VFank P✓iadel Number Pump Model Number Total Tank GapadtY Alarm Maur r Alarm Model Numb lVYa7t. duty Dep~ f ~ 7 Suntrh Type Total Dynamic .Head (TDH) Peet _ Filter / ~ Filter Model Nntnhear ; Elevation l•Tesd Network Loss Minimum Pump Required Force Midn truss - Ft TDR Total ~S. 3 on" Manhole lb irx. 41' Above Gr9de With Manhole Min. V Above Grade Looking D04100, inlet Manhole Seourel~r 1Vlaaeted With Looking Device " B6YOW Crrade Seal Watertight 'Weatherproof' Junotion Boys. Finished Cwade IaY~a ..Yw ~I Vent Min. IT' DiSGOMOU Above Grade Means with Vent cap ' Y Y~Y . Y Y Y Y{`1Y{~i`aYJYYYa`ayVriYJYYYa~.yaYYYYYiY.YVyYya yaY +~~YIYa~Y~•YJ arV`J~a~.~a~ ~ayV.a YVY aYJ~ Y~ •t• outlet Filter Inlet Yi ~ +Y a Y`ra .YV~ A.. JY y/dY1 .I.Y .ese ~i ~a'J>tY1O[!y4V {Y i IYyY OOP switch iJ {~f''1'y(+yYVT+.'• J Iri ,Jr .yY ~y `+Y` S Yi .L YY~ i+Y 11V1V Tank Vo ion; Inches volume Gal. (reyyserve}A' off Elevation. ~.,y C; ala i7 /o0, ~ Ft ly+~ Bottom Y Y 1J Y • 1 /7I 1 J (dose) C D PElev//yyation a Y Y Y+~ ~t, (dead) YTatal~, `'j'am . Ya ~ YY+. y a s y♦ a J a J i r{ f 1 1 r a i a a+ r J l a. i+ i< ay Y•tt+ _i"i_'c . 1 . • . ' ' _ Y: Y Y+Y Y Y+. Y Y Y+Y+YVYi aiayVYJyi 'lY'{ ay.yV\ Y+Y Y+Y+.aY arV I aY'+ - •`a jaba.aYJr+e•Y+YJYa Yee; . Y. . ai ai ri V J a J V Y J < JYaY aYI J + yti s Y. Y Y. r Y.r Y\ Y Y Y Y O Y Y Y`Y ► Y Y Y YYr r l . Ir tY a•a IYJ < a. t I t a a Y V Y a a{ t Y~/ Y< Y{+ i r J Y r ~ 6 t/ f Y f i Y i a . ~E tank. is bedded and bads filled in wcordaunce with the c/do l'~E~L YNSTIUNy The num ol" bury es sp i t b~'the loerttattufaetnrer nnay not '~1li++k++~ ck) ys roduet approval specifications. Max` rnannfacturer p rmdl. Manhole corers exposed to grade have an effec&O at t device (padlock) fittings, and be exceeded without prior " t`i d cotmwed to the tank. with. ~uatertigh at the inlet and outlet is of approved mate w9Y Sch. 40 p~Vc to bridge the tank installed. p'ipi'ng -nm force main is 91mved with N Lamm 16.2~- laid on stable soil to p alt sealing or stt 8• l serrvice complies with NEC 3011 a0d ecavatiotl and the . sleeve. is ~vatrertigl<t. Luca page _ of -w . 02/05 U h v Lassriet 3100, l 11b bb:" UW/ ; may-o-vu a-ourm) uy. E H SERIES '..r' U MwM P/ E M= F"L U E NT PUMP 9 11.65 CJ Specifications - - tr.~ - t "mm wax rf~Il~Ieu~nrltralli sltrl+e W, IK1 W1 Ixetatq MDxw US R It WS WO.W r ,r 1!r' sr oil 13.d W 7R ~ 9.99 r99.6xdy4 t- 5pg3,yd IN,~C$A 41to 195 314 13.0 low 70 rA 55 41 41 3y 13.0 2e 9.11 x t 1.s4 s d.9tl 508340 W04 4116 133 39 6.5 I 70 64 55 41 V 13.5 2D' 27 9.11 x 11.54 x 9-94 400 49 21 8.11 X111Ax1.94 yg1(yAf45 50895fl UUC5A 4P'U 115 V 3f4 4 19.0 ION 00D 70 04 55 Ore Sb 1000 74 W ~q ~ 93. ~_~Irr ,;twrxn D14~ 4+"0 I3u edtalkrxslrxf9resuWarsios: Gorfinsaus 0rrly►~~--w.xtks~mwss9elvamrOmar,sffirraafdeoalinxaustirsYAStonpistlrDYaretunwill~krlMl~~ Construction VLUW- LITERSMIUUR - E Ry Coated CJast Trca11 UlOD 2000 M110 J%Dtor I-iolltiltl . D Pol Carlwns~Itc _ j_- l- _1 1_.. Impeller Material - _ ~ _ - Itre eller 1 4 Closed Vane - 30 volute 7.1 Nitrite wit11 ua141on arnd Mechanical Shalt Seeal rv s Stainlesm Steel ers Fasten Stainless Steel 1 to- - e-s Upper sleeve and bower etlratgs 4 Hall Bearings U"' TCl U 2p 40 t 0 8U n. FLn'N- GALLtINS/MINUTE PUMP PEiFaRMA13CE I iiVE ittiC isot Pwmp r-0. r VO Sax 12U" • Ompikomx City, OK 73157 tt5v 6UH2 ( ptroav:405."7.3Stt -F":405.220.1550 l aoail cuf loWetslwlce(a tlttlsgirot-Coto Ftxm 495235 g7ttl3 Ww lf.,ittleGia"trulr>ZxP, ICOM 1 pO WTS OWNER'S MANUAL & MANAGEMENT PLAN SYSTEM SPECIFICATIONS FILE INFORMATION Septic Tank Capacity - al ❑ NA owner f Lpenit Septic Tank Manufacturer p NA Effluent Filter Manufacturer ❑ NA - DESIGN PARAMETERS Number of Bedrooms , ❑ NA Effluent Filter Model ❑ N,4 Number of Commercial Units) A NA Pump Tank Capacity 6 gal 13 NA Estimated flow (average) nallday pump Tank Manufacturer _ DNA NA Design flow (peak). (Estimated x 1.5} gal/day Ppump manufacturer i El at d ~ DNA Soil Application Rate al/d Pump Model - - Monthly average' Pretreatment Unit 'N Ni Influent/Effluent Quality 13 Sand/Gr4vel Filter ❑ Peat Filter Fats, Oil & Grease (FOG) 530 mg/L ❑ Mechanical Aeration Wetland Biochemical Oxygen Demand (BODE) 5220 mg/L p Disinfection El Other. Total Suspended Solids (TSS) 5150 mq/L Manufacturer Pretreated Effluent Quality "NA Monthly average"" Dispersal Cell(s) s30 m /L ❑ In-ground (gravity) ❑ In-ground (pressurized) Biochemical Oxygen Demand (BODE} 9 -grade ❑ Mound Total Suspended Solids (T-9$) s30 mg/L rl Other _ Fecal Colifolm (geometric mean) 510' cfu/100ml O Driire Maximum Effluent Particle Size Y inch diameter " Values typical for domestic (non-commerclaq wastewater and septic tank etfiuenl. Values typical for pretreated wastewater. MAINTENANCE SCHEDULE _ Service Event - Service Frequency a months ear(s) (Maximum 3 yrs.) Inspect condition of tank(s) ~ At least once every Pump out contents of tank(s) When combined sludge and scum equals one-third (Y3) of tank volume - At least once every t3 months )~"ear(s) (Maximum 3 yrs.) ~-------J---- Inspect dispersal cell(s) Clean effluent filter At least once every - 1 ❑ months J year(s) _ - Inspect pump. pump controls & alarm At least once every (I months-/'kyear(s) ❑ NA L7 months~--year(s) 0 NA - - At least once every Flush latibrals and pressure test _ . - At least once every 0 months Q year(s) ❑ NA r At least once every ❑ months ❑ year(s) ❑ NA MAINTENANCE INSTRUCTIONS of the fallowing licenses or Inspections of tanks and dispersal cells shall be made by an Individual carrying one certifications: Master Plumber; Master Plumber Restricted Sewer, POWTS Inspector, POWTS Maintainer; Septage Servicing Operator. Tank inspections must include a visual Inspection of the tank(s) to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of combined sludge and scum and to check for any back up or, ponding of effluent an the ground surface. T dispersal g of efBuents on the lground slurface. The pond ng oflfeeftluent onethes in the observation pipes and to check for any pondin ground surface may indicate a failing condition and requires the immediate notification of the local regulatory authority. When the combined accumulation of sludge and scum in any tank equals one-third (K) or more of the tank volume, the entire contents of the tank shall be removed by a Septage Servicing operator and disposed of in accordance with ch. NR 113, Wisconsin Administrative Code. components , and any The servicing of effluent filters, mechanical or pressurized o pOWT shall be performed by atc.ertified POWYS Maintainer. 'I other maintenance or monitoring at intervals of months lotion of anservice event. A service report shall be provided to the local regulatory authority within 10 days of comp any START UP AND OPERATION For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or other chemicals that may impede the treatment process and/or damage the dispersal cell(s)- If high concentrations are detected have the contents of the tank(s) removed by a septage servicing operator prior to use. Page of START UP AND OPERATION For new construction, prior to use of the PO S' check treatment tank(s) for the presence of painting products or other chemicals that may impede the treatment process and/or d rnage the dispersal cell(s). If high concentrations are detected have the contents of the tank(s) removed by a septage servicing operaior prior to use. oystern start up shall not occur when soil conditions are frozen at the infiltrative surface. During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will be discharged to the dispersal cell(s) in one large dose, overloading the cell(s) and may result In the backup or surface discharge of effluent. to avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to restore normal levels within the pump tank. Do runt drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area within 15 feet down slope of any mound or at-grade soil absorption area. Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat; foundation drain (surrip pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting products; pesticides; sanitary napkins; tampons; and water softener brine. ABANDONMENT When the POWTS fails and/or is permanently taken out of service the following steps shall be take, i to insure that the system is properly and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code: • All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. • [tie contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator. • After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil, gravel or another inert solid material. CONTINGENCY PLAN If the POW1T8 falls and cannot be repaired the following measures have been, or must be !:akeri, to provide a code compliant replacement system: Cl A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption systm. The replacement area should be protected from disturbance and compaction and should not be infringed upon by required setbacks from existing and proposed structure, lot lines and wells. Failure to protect the renlacement area will result in the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rules. in effect at that time. El! A suitable replacement area Is not available due to setback and/or soil limitations. Barring advances in POWTS technology a holding lank may be installed as a last resort to replace the failed POWTS. The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluation must be performed to locate a suitable replacement area. If no replacement area is available a holding tank may be installed as a last resort to replace the failed POWTS. and and at-grade soil absorption systems may be reconstructed in place following rtsrlioval of the biomat at the infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that tinte. -;<WARNING>T SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND/OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT 'TANK UNDER ANY CIRCUMSTANCES. DIFATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLER POWifS MAINTAINER Name r Name Phone -r Phone SEPTAGE SERVICING OPERATOR LIMPER LOCAL REGULATORY AUTHORITY Na►ne '7C,~'r~-~ -Name Phone J . i t° t Phone I his document was drafted in compliance with chapter SPS 3133.22(2)(b)(1)(d)&(f) and 383.54(1), (2) & (3), Wisconsin Administrative Code. lWisdbi sin Department of Commerce SOIL EVALUATION REPORT Page of Dlvisiorr of Safety and Buildings in accordance with Comm 65, Wis. Adm. Code - - - County c Attach Wrrplete site plan on paper riot less than d 112 x '11 inches in size. Plan must include, but not limited to: vertical and horizontal reference point (BM), direction and Panel I.U. ri percent slope, scale or dimensions, north arrapw, and location and distance to nearest road. C~ J, 7 0 -1!7 Pieasn print all information. Reviewed by Date Persond infomwrian you provide may be used for secondary purposes (Privacy taw, s. 15.(4 (1) (n)). Property Owner Property Location J~/t( 7c ~r ~7q Govt. Lot 114,,ro114 S j T N R C Property Ownor's Mailing Addr s W ~ Lot # 81oc is # Subd. None CSM# 5' LAN'/','1 t~/~~:yLC c.yty [r ?/i~~r~✓~ Gty -State :'gip Code Phone Number rl , C7 City ❑ Village Town Nearest Road Sl {Its ~7 , ( ✓ : lily, - Construction Use- Residential 1 Number of bedrooms _ Code derived design flow rate UK) ❑ Replacement Public or corranerclal - Describe: Parent material Flout Plain elevation if applicable rf ft. General comments and recommendations: 5ystem'fype 5ystum E1uvation Boing # rnE] Boring L! J Ire pit Ground surface k Depth to limiting factor in. Soil A0plication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Root% _ 1-lutif _ in. Munsell Qu. Sz. Cont. Color Gr. 5z, Sh. 'Eff#1 °Etf#lY j f uz"'e 'Ate Boring # RBoring 1 / Pit Ground surface elev.! Depth to limiting factor, _C in. - Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary _ Roots GPDKV In. Munsell tau. Sz. Cont. Color Car. Sz. Sh, *Eff#1°Eff#2 ^ rr Effluent #1 = GODS > 30 ~S 220 mg& and TSS >30 < 1150 ~Effluent #2 = SODS < 30 rng/L and TSS < 30 mWL CST Nam (Please Print) _ Sip a CST Number Bird Plumbing, Inc. Sharon Bird 226900 Ac#ress Dale Evaluation Conducted Telephone Number 1008 192nd Ave, New Richt-pond, WI 54017 , 715-246-4516 VIP JK LTEvft CARTPJDGE INSTRUCTIONS to InstwinNon sT'+ x Dry lit the fitter case -into this wW of the outlet pipe to ensure it is centered under the access opening. If not, then either insert rflors pipe into the tank through the outlet or solvent weld (glue) additional pipe onto the outlet pipe. u+FP ? While the rase is still dry fitted on the outlet pipe, measure the length of %-inch pipe "waded to bracrY the filter to the tank and wall if utilizing the optional supplemental side support. If side support method. is not utilized, proceed to step four. S• r i;.i* For installations utilizing the optional supplemental side support" solvent weld the %-inch pipe onto the filter case. If side support Method is not utilized, proceed to step four. i i. solvetit weld the filter case nnta the outlet pipe. Insert the filter cr+ ,r'i cartridge into the case, pressin i down until the filter locks into the bottnn, of this case.. If a AS switch is utila AA: insert into the fitter and lock by turning clackwise 90". Maintenance 1. The effluent niter should be cleaned every time the septic tank is serviced. { z. open the outlet access operYing to inspect the tank arid filter. s. pump the septic tank completely, making SUN to rerrusve the siudgu layer on the bottom of the trunk and not just the strum and effluent. 4. once the effluent level has Leon lowered below the invert of the nutlet pipe, firmly pull up on the filter handle to dislodge the cartridge tram the case. 5, slide the cartridge up and alit of the cage for cleaning. 6. if a Vlts switch connected to an alarm is present, the switch should be removed by turning crwrrtsrciockwise 901, and deaned with water oniy.„' While holding the cartridge on its side (large flat silrftee facing A.. t down) over the access opening, rinds off` the cartridge with Water only, making sure all septaltu material is rhrsed back into the tan& s. If vRs switch is utilized, reprice by inserting into filter aril ` turning clockwise 90". 9. Insert the filter cartridge back into the case, 1,+ r pressing down' until the filter locks into the hattoun of the case. Lii' v' 1O.Replace and secure the acavs up hing on the tank. ~3n i:'•Y'Y ,...,+t x•111"R:fHri° r4~,'l',,...'1r."tir•4t•i.A'. :N:i};f1.1.V'.. rwww bearensite.com 877-MLPILTZRS (6531-45 /2._Yz- s. Wiscconsin Department of Commerce SOIL EVALUATION REl O Page - of 3 Division of Safety and Buildin !rj in accordance with Comm 85, Wis. Adm. Code County C/ Attach complete site plan on pa rilole han 8 1/2 x 11 inches in size. Plan must f` include, but not limited to: vel' and horizontal r rpnce point (BM), direction and Parcel I.D. percent slope, scale or dimerisions, north ~y1'd location and distance to nearest road. 07 C Plefqp~lrnt aZ" all information. Re we Date . Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). (g Property Owner Property Location Govt. Lot 1/4,fo1A S2 T N R Z Q E (co Property Owner's Mailing AddrdWs Lot # Block ubd. Name CS M# ,-%-Y-3 ~'E'~ /f o a two 3~ TS, /91-1-1 City State Zip Code Phone Number ❑ City ❑ Village Town Nearest Road ONewConstruction Use' Residential /Number of bedrooms Code derived design flow !kQ:2 GPD ❑ Replacement Public or commercial - Describe: Parent material - Flood Plain elevation if applicable ft. General comments v~ J and reoommendations: System Type System Elevation 0 1771 Boring # E] Boring 2 0 pit Ground surface elev Z ft. Depth to limiting factor ~J 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 •Eff#2 -I /0,/,-31z- 2- I- 7 zv S S; 114 Seel "1)19 Boring # RBoring pit Ground surface elev. 1411V1 Zft. Depth to limiting factor in. ff*Eff#l lition Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fl? in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. `Eff#2 Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 ' Effluent #2 = BOD 130 mg/- and TSS < 30 mg/L CST Name (Please Print) CST Number Bird Plumbing, Inc. Shaun Bird Si 226900 Address Date Evaluation Conducted Telephone Number 1008 192nd Ave, New Richmond, WI 54017 715-246-4516 Property Owner _ Parcel ID # Page of Bori ❑ Boring 15 Nng # pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 I o - Ja V!, - 9. Boring # ❑ Boring F-1 ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil lication 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 ~I III I F-1 Boring # 1:1 E] pit Boring Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon ')epth 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 = BOD5 > 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-8330 (R.6=) Page Of_ Parcel ID F'rcgrerty Owner goring limiting factor lei iticeYion Rate Boring # Pit In. C-1 (;round surface elev. Depth to -Roots _ ----•-4 - _ - Structure Consistence Boundary r DorrHnant Color Iledox Description Texture Gr. 5z. 51r AW `E H#2 F lorizon Dept) TAW-. Sz. Cont. Color In. Munsell _ 4 e r.. Boring # Boring in, Depth to lirrplirrg factor__-----J Soil A riication Rate L_ 1 Ground surface elev. ft• oots (,PDtW Pit -Structure Consistence Boundary R - ion exWre °Eff#'f `Eff#7 Horizon Depth Dorranant Color t2edox pescript' Gr. Sz. Sh• _ - - _ Ctu. Sz. C.ont. Color in. Munsell Depth to Ilrniting fartor tJ Boling ft. irr. _ Soii icalwn liz+te Boring # GroUn+9 surface elev..__.. Hoots - GPDIii El Pit f7e---Deseription. Texture Structure Consistence Boundary •Fff#1 •Y--ff#2 Horizon '7epttr Dominant Color Gr. Sz. Sh. in. Munsell C]U. 5z. Cori, Color Effluent W = BO136 < 30 mg1L and 1 SS ; 3o nrg1L Effluent #1 = Boor y 220 nrglL and TSS 5-30:S 150 001- 30 ass ,islance , to access mercy is an equal opportunity service provider and OOw, rt at 6 8-'266-3151eo -1-1-Y 608-264 8777 services Of The pepartrnent of Com lease contact the depa need material in an alternate format, p ser~aarotµ.wuul Project Name Oevering Homes LLC Bird Soil Test Plot Ael/10/133 Address 1433 Cernohous Ave Suite A New Richmond Wi 54017 #226900 Lot 39 Subdivision Settler's Glen DNW 1/4 SW 1/4S 23 T 30 N/R20 W Township St. Joseph Boring Q Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 100 ft. Top of Survey Iron System Elevation 100.0' *HRpSame as Benchmark Scale is 1" = 40' unless otherwise noted Heritage Trail 360' Property Line 3 Acre Parcel B.M.* 99.5' 100' 100.5' B-1 2% Slope B-3 B-2 336' Property Line --C-~ - commerce.vW.gaw Safety and }3uildings llivision County. 201 W. Washington Box 7162 Madison, W1 53707-7162 A Yunail Nwmb.:r (W Vv n}lvcl iu by De~pertmeYtt of Commerce C~ Sanitary! Permit Application ' state lrauiestdlouNumber b, accordance with s. Comm. 83.21(2). Wis Adm. Code, submission of this form to the P aj i PnAkte goverum-s L V / / Co unit is required prior to obtaining a sanitary permit. Note: Application farms for state-owned POW-T5 a' Project Address (if different than mailing atidri ss} - submitted to the Department of Commove. Personal information you provide may be used ffto"t-uponda7q Wises in accordance with the Privacy !,Ls. 1 S.tl4(1)(m), Stats. / ^ r Application informatfotl - Please Print All Information Property Owner's Name Parcel # P.-opertyOwner''s Mailing Address Property Lucutioll / O r Govt. ul city, state Gip Cue Phurte Num /I- ~tjv,, section ^ 0~ -~j"irc.le one) V i. Type of Building (check all that apply) Lot # 2 Family Dwelling - Number of Bedroo - Subdivision N U CC~~ 1- lilac - E Public/Commercial - Describe Use _ City of StateOwned-Describe Usty A/) ! CSM er / f 1; ~ Covenuf-,~`/-- ' S~ 111. Type of Permit: (Check only one box on line A. Complete line B if app le) _ _ eve System U Replacemamt System U Treatment/Holding T tx;ment Only El Other Modification to Existing System (explain) B. U Permit Renewal U Permit Revision C Be, of'XkIb J Permit Transfer to New List Previous Permit Number and Date issued Before Expiration Owner I\r. Type of POWTS System/Component/Device: C 11 1 L.~_ . ❑ Non-Pressurized In-Ground U Pressut ized In-Ground -G a and > 24 in. of suitable soil U Mound < 24 in- of suitable soil ❑ Holding "rank U Other Dispersal Cow ponult (explain) Pretre nt evice (explain)- V, Dis ersal/Treattnent Area Information: D :si Plow {gpd) Design Soil Applieal.i0r to{g dsl) Dispersa Area Fiequir (st Dispersal Area Pro ed (st) S stern Elevation 7~ V 1. Tank Info Caaacity in Total # of Manufacturer c U (iallons Gallons Units Now Tacks Existing Tanks (Je a & a' n w C~ rr~ rn ti. C~7 CL Septic or Bolding Taut - Dosing Chtaaber - 3 V EL Responsibility Statement- I, the undersigned, assn a risibility for installation of the POWTS shown on file attached plans. Plumber's tune (Print} Plumber' lure MP/MFRS Number Business Phone Number Plumber's Address (Street City, State, Ztp (ode} A VIII. Count 1De artment CJse OYti _ _ - Permit Fee Date Is ued Issuing t Signature Approved Disa 1p2-5 'ivenRe far Denial $ / Is I'l.Coed Reasons for Disapproval 3 J+, `e t,~~ erg .6"be4 1. Septic tank, effluent filter and rt _ r~ dispersal cell must all be services I mafn* Md tom. ; sJ q,; XAe, K UL- .management plan provided byplurnber as per 2. All setback requirements must. W*a1attaiMBd ` as per eppble ctade I 1 / , `~1 r ✓ PZI a - Attach to campiete plans for the systam aad submit to the Cuunl tonly on pal less t n ra r< 1 i'~~" t f✓1 Alt SBU-6398 (R. 02109) PLOT PLAN PROJECT Oeverina Homes ADDRESS 1433 Cernohous Ave Suite A New Richmond Wi 54017 NW 1/4 SW . 1/4s 23 /T 30 N/R 20 W TOWN St. Joseph COUNTY ST.CROIX,, SYSTEM ELEVATION 95.5' BEDROOM 3 CONVENTIONAL AT-GRADE CONVENTIONAL LIFT HOLDING TANK MOUND )OCX SEPTIC TANK SIZE 1000 gallons DOSE TANK SIZE 630 HOLDING TANK SIZE LOAD RATE 1 .0 ABSORPTION AREA 456 # of chambers none BENCHMARK V.R.P. Top of nail in tree ASSUME ELEVATION 100' ❑ BOREHOLE O WELL * H. R. P. same as benchmark Heritage Trail 3 Acre Lot Scale = 1/4'1 = 10' 450' Property Line Pro 3 Bedroom k is to be properly Hu a edded and provided with lockdcwn covers with approved warning labels Wel I is t al I WDNP set cks Area 15' below system is to remai n undisturbed Grading is to be done to divert run-off away B-2 from system B-1 95 2% Slope ~ B_3 System is to be installed 94.5 along the contour 94.5' 94.4 B.M.# 1 N B.M.02 Property Line 220' ~ ~,vE,xrng~ o~ Safety and Buildings T 141 NW BARSTOW ST FL 4TH o~ WAUKESHA WI 53188-3789 Contact Thro#Relay wvvw.d"wv#4ov/sb/ www.wisconsin.gov o ssfM4 Scott Walker, Governor Dave Ross, Secretary December 10, 2012 CUST ID No. 226900 ATTN: POWTS Inspector SHAUN R BIRD ZONING OFFICE BIRD PLUMBING INC ST CROIX COUNTY SPIA 1432 120TH ST 1101 CARMICHAEL RD NEW RICHMOND WI 54017 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 12/10/2014 Identification Numbers Transaction ID No. 2184716 SITE: Site ID No. 786677 Oevering Homes Please refer to both identification numbers, 113 Herirage TrI above, in all correspondence with the Town of Saint Joseph a encv. St Croix County NW1/4, SW1/4, S23, T30N, R20W Lot: 39, Subdivision: Settler's Glen FOR: Description: Mound, 3 bedroom Object Type: POWTS Component Manual Regulated Object ID No.: 1405086 Maintenance required; 450 GPD Flow rate; 24 in Soil minimum depth to limiting factor from original grade; System(s): Mound Component Manual - Version 2.0, SBD-10691-P (N.01101), Pressure Distribution Component Manual - Version 2.0, SBD-10706-P (N.01/01); 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 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: 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)d the Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems I x,2.0" f SBD-10706-P (N.01/01). r The building sewer and distribution network piping shall be of material listed 30-3 and 384.30-5, Wis. Adm. Code. OOK In the event this soil absorption system or any of its component parts malfunctions so as to eate a health hazard, the property owner must follow the contingency plan as described in the approved plans. In addition, the owner must comply with the operation, maintenance and monitoring duties as described in section VIII of the mound component manual. A copy of this information must be given to the owner upon completion of the project. All holding/treatment tanks are to comply with SPS 384.25(7)(a). 1 SHAUN R BIRD Page 2 12/10/2012 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. A Sanitary Permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.135 and 145.19, Wis. Stats. Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stats. Owner Responsibilities: • SPS 383.52 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. SPS 383.54(1). • SPS 383.52(2) A POWTS that is not maintained in accordance with the approved management plan or as required under s. SPS 383.54(4) shall be considered a human health hazard. • SPS 383.55 The owner is responsible for submitting a maintenance verification report acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. A copy of the approved plans, specifications and this letter shall be on-site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of construction/installation/operation. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number 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. Sin y, Fee Required $ 250.00 This Amount Will Be Invoiced. When You Receive That Invoice, Julia Lewis-Osborne Please Include a Copy With Your POWTS Reviewer 2, Integrated Services Payment Submittal. (262) 397-6005, Fax: (608) 283-7481 WiSMART code: 7633 julia.lewis@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. Cover Page Shaun Bird Bird Plumbing Inc. 1432 120th St. New Richmond Wi 54017 715-246-4516 Date: 12/ 5/12 Owner: Oevering Homes Location: NW1 /4 SW1A S23 T30 N, R20 W 113 Heritage Trail St. Joseph System type: Mound System Manuals Used: Mound Component Manual Version 2.0 (01/31) Pressure Distribution Manual Version 2.0 (01/31) Page# 1. Cover Page 2. Mound Plot Plan 3. Mound Cross Section 4. Pipe Cross Section/Pipe Layout 5. Pump Chamber Cross Section 6. Pump Curve 7-8. Maintance and Contigency plan 9-12. Soil test 13. Filter Specifications and r s section Shaun Bird= Signature` License numbe 6900 PLOT PLAN PROJECT Oeverina Homes ADDRESS 1433 Cernohous Ave Suite A New Richmond Wi 54017 NW 1/4 SW 1/4S 23 /T 30 N/R 20 W TOWN St. Joseph COUNTY ST. CROIX SYSTEM ELEVATION 95.5' 3 BEDROOM CONVENTIONAL AT-GRADE CONVENTIONAL LIFT HOLDING TANK MOUND XXX SEPTIC TANK SIZE 1000 gallons DOSE TANK SIZE 630 HOLDING TANK SIZE LOAD RATE 1.0 ABSORPTION AREA 456 # of chambers none BENCHMARK V.R.P. Top of nail in tree ASSUME ELEVATION 100° ❑ BOREHOLE O WELL * H. R. P. same as benchmark Heritage Trail 3 Acre Lot Scale = 1l4" = 10' 450' Property Line Pro 3 Bedroom Tank is to be properly House bedded and provided with lockdown covers with approved warning labels Wei I is to meet al I WDNR setbacks Area 15' below system is to remain undisturbed Grading is to be done to divert run-off away B-2 from system 13 B-1 95 2% Slope 0 B-3 System is to be installed 94.5 along the contour 94.5' 94.4 N B.M.*2 Property Line 220' Mound System Goss Section and Plan. View Dimension Feet J t A .77 _ r t 1 t r ..Y •y r • Yy• r+, r .'y.y. y A ri`~rr ;F{wi.{iy y};!' ri y~3t {iZr}'1i i}r } ti. t }1 '('(7 r • 7}7F r•{ ` -r-$• '{7F r : S}+~ R} •{+'L$ti"~C+~}5;~.{wr'~. `i.~ {.}ZF .,~.r}~j ~ r - .I/ ~..e V'✓ ~r~ i ~ 1. G. r I M 7 f C- rr l I M I 7 r 1C r .r _ - Y ..r _ 10 K ----B b 7 r 't'opsoil M-77! -71 =ASTM C-33 MAN, Cleats aggre ate g 4 in. sch. 40 pvc L Cap Material sand fill 0 !/2 to 2 %Z in. dia. observation pipe Geotextile - Fabric ( jy yy~y ~}Z1. D i •r Ft Contour I'lowed Surface Slope Direction GENERAL INSTALLATION: vegetati The mound area is staked out along the design contour. 1xisting on is mowed and raked off the site. 'The mound basal area (L x W) is plowed with a moldboard or chisel plow. Plowing may riot proceed if the soil is wet enough at the plow depth to forrn a %4 inch soil wire when a sample is rolled between the palms of the hands, ASTM C-33 quality sand is placed immediately after plowing. Sand is placed with a tracked machine keeping 12 or more inches of sand under the tracks or is placed overhead by a baclthoe. Special care must be used when placing sand of less than one Foot thickness to minimize compaction of the plowed surface. After the topsoil cap is placed the entire m Dune is seeded and mulched to promote vegetative growth, limit erosion and protect from freezin b The observation pipes are slotted in the lower 6 inches and secured in place with rebar or a closet flange. ! 0/071 Page of Pressure Lateral, Layout Two Laterals End Manifold lLl 4 Threaded r (.'.leanout Lateral Turn-up Ir Plug b Manifold OIL M X Force Main ;one; Sweep 1 90 r Bead _Distribution Network S cifications pre5sarc System Construction Lateral Diameter o2L Manifold Diameter- _ C In. Laterals are constructed of Schedule 4( l PVC _ Orifice Diameter pipe. Orifices are drilled perpendicular to X Orrtl p Spacing) the pipe with a sharp drill bit and lace dowry. L~Latal Len th Ft er . Lateral turn-ups tertnitiatc with a threaded M (Manifold Leah) - --l"t. cleariout plug and are enclosed in a 6-8 inch Force Main Diameter In. diameter lawn sprirdder valve box accessible Force Main Lerit th Erom 1:inisheA grade. •v, •ee Grade 0••••0• r••U►•• 6-9 Tneh Lawn Sprinkler Valve, Box 03/05 lgl Page of septic-Dose *caank Crass Section And Pump Performance Specifications -:l arils Manufacturer Pump Marrufbcturar lank Model N tunber E, V Plump Model Number ' t Total 'lards, Capacitor -Alarm Manufacturer 09 Nlax. Bury Df rtlt Alwm Model Number Switch Type 1~"filter Vlartufiwtu~rer - Total Uynra,rnic Head (TY)I-T) Y"eet Filter ROW Dintat Pressure Network. Loss _ _ _ Minirnrxrri Pump'er>Cormtuuse lR.equirecl_ l'oree 1VCain l ,ogb / Outlet: .Manhole 4n. 4" Above Grade With Manhole Min. 4" Above Grade, Looking Iayiee:. inlet 1V thole 6" Below Ch*&c Sealed Watertight C sewrely Mounted - With Looking Device Weather-proof Junction Box `II Ydr rYr. 4.Iw rrr la lttrshed Grade r r+ rrr ur rr Wr I.fr 1~+ Vani Mitt. 12" Disconnect Above Grade Means With. vent cap I <Y; ~ ~;I /,Y Y Y Y r 1 i,Y ),r i , 9^'f7"r^►y►'f - Y-".+ / Y Y Ya.`~4irrY 1 Y Y ~ 4 4 1 Ya + r 4 4 L 1 1 4 Y Y Y Y 4 Y 1 4 ;"r p,,'i : r ~ iY. a ~ Y Y `Irl; l`YY YYY I,YlY4Y4i a •°i r4r4r`i r•IYi+r+iYi I;rY Yr4 4 r •i i Y' 1 gJur:lei; Filter r;•, Inlet .,r . w--- Inlet Baffle 1~a a " rYir p 1 I.4 W Itch 4 Tarrlr.'Volume a J (JP1 X: Weep l3itnenaiun: lrcclxes Volume Girl. Hole (reserve) A ( ' 'leva ion IYIr (dead) D. Bottom X- l3levatiorl r a al"Tf~[-4-.i'G"[~-1-f~i'-~-4TT• L'il a i a 1 i~3-1'T-I-TY'4"4Tr-i'1" V' ! 4 I,i~ a41yr4,f,Y, y,Yir~ y~ t,`~ f+. i iY!`e <s f. i;< v~l•i Ya+ Y<y 1~Y~r~Yy.~" } briY4 ri,Y 41f iY+YYYi Y+b4 Y4r 1•. i V 'IYI 1 Y e IYI•I+i i i {'T"i'C.i-L-'L'Y ~ ` Y i Y v Y Y Y b i i V f/ l ~.~'~l...a .'~+--3Y.~3-YYr,1,.r1 1 i• +,,4 Li~r~fi41•r4 IYii IYiiY Y<iiY~I ViYYIY kll"4•i1 .Y.YI, <,1 v 1 1 Y 1 i 1 Y 1 1•YI '_^~-~.J - a j.,tly.a<."1 y".rwYYd,V r i/ 4 t i Y i•Y y i Y V•1•I rr11411iiYYY4rY,l Yi Yr"ri Yri GCNLIR,AC.1 lrl1157'AEf,jr.A: i'Y'O:IV': rnarrnitactuThr s~ticldarre trnlr is bedded and back filled in accordance with the be exceeded without Prior rtlrroval. 1Viar>tcale covers of bUry as a i~d hY the rnanafacsturer may not grade instailled. Piping at the inlet wW Outlet is of approved exposed material., have an effective lacking device (p~pack) laid on stable sail to prevent wttliug 01. sagging. The Force Main is sleeved to the lank with fl PVC watertight gs, arld excarraticFri and the s~l4ae~re is sealed 'watertight. l?leotrical service cnmplles With NEC 300 and Comm l bY2 tank 02105 I.il N 'iP Laser•Jet 3100; t fib bbe else nmuy-o-vv e.ouy-Wo, Nam 9EH SERIES SUMP/EFFLUENT PUMP a • Spis mm ~ um or W4 910fi7NE 4 0 sanM~rtct19nr1grl~ >illYNli w tlrltcsr IINNI wom 00 IYa Nw.W UMIOAm 0 t0 li' H~ It! Al 00 IN,ION 98!-0IN %mm UiN21A 4110 Ob V 4.0 low 16 64 55 0 32 13.8 2v 24 9Rt1 711.tA x 9.94 wR4w 590240 WM 41A 0 aid 6.5 1m0 79 w 55 M 32 110 w It 8,11 s 11mv 9.94 MR-0468 500>50 DIM 400 '114 914 49.0 109II 70 94 55 A 9II 129 20' 27 9.11 x 11.64 x 0.94 g2I fl 9 z so . u low 3 rA _ 55 A y tie V, - $1 0.11111,gA LI't 0orthuorsNulyfLle4-`lit9e f~ilhsuwaletiwnvps~rabdr.nldrlabutd+Ny~ltbnpxlsl9uyareruna~fn~r45r+001a'11Ie0eWar109 " rLUW- LITERS/HUM Constmatlon 0 woo 2009 AWN Motor Haub R _ F,bx~! Coated Cast Imn _1__I..._~ impeller Matettttt Ipoly cWhotlatc W ~J au IU Irt4pelbrr i . _ _ Closed Vme.. Volute A08 ,.5 Power Cord W W4 u- Mtsckunical Shaft Seat Nitrite with carbon and - s ceramic laces l:tisttmler>s Srainlelss 5telel 10 Shaft stainl s Steel l3~earan$s Upper Sleo'ac and Lower ~a119earinp 1 n ~,1I ~v o LU44 sc H9 rLOW- GALLaNS/WNUT11- PIJMF+ PERFORMANCE c:1►xzy time Giant Pump co. UStI 69HX 110 mom j2v10. OIsImm" t.ft OK'13157 x those: 411947.7911 • For: 405.rs5.1550 www.LJttIeQIamtftm +com i'+-tRltlk t'1if11YMfd'i~YV~o atf lYYt gWn c1'3 Fwm 996234 OIAM POWTS O'WNER'S MANUAL & MANAGEMENT PLAN Page Of_-_ FILE INFORMATION SYSTElw~ SPECIFICATIONS OZe "i Septic: Tank Capacity L1 NA l? pCJryr - - / l.T dal-- Septic 'Tank Manufacturer l-1 NA _16- Ll -4 DESIGN PARAMETERS E=ffluent Filter Manufactrrer ❑ NA Number of Bedrooms Number- droo U NA Effluent Filter Model Number of Public Facility Units `------0 NA A Pump Tank Capacity Ct NA gal (average) - rump Tank Manufacturer NA Design flow (peak), (Estimated x 1.5 tont ~ Pump Manufacturer i ~ So[I Application Rate - - - - - Pu mp Model IJ NA hly averageW Unit 0 NAFats, Oil Grea,,ie (Fmg/L 0 Sand/Gravel Filter U Peat Filter Biochemical Oxygen Demand (BOD5) 5220 mg/L_ El NA M Mechanical Aeration U Wetland fatal Suspended Solids (TSS) 5150 mg/L El Disinfection U Other: Pretreated Effluent Quality Monthly average Dispersal Celt(s) Cl NA Biochemical Oxygen Demand (BOD,) 530 mg/L CI In-Ground (gravity) ❑ In-Ground Suspended Solids (TSS) 1 530 mg/L .NA 0 At-Grade (pressurized) Fecal Coliform ound _ (geomeai9 mean) s10y cfu/100ml LJ Drip-Line [7 Other: Maximum Fffluent Particle Size - - in die. ❑ NA Other: _ LI NA Other: - _ CJ NA Other: 0 NA Values typical for domestic wastewater and septic tank effluent. Other: f.'1 NA MAINTENANCE SCHEDULE Service Event Service Frequency Inspect condition of tank(s) At least once every.- 13 month(s) (Maximum 3 years) NA Pump out contents of tank(s) _ When combined sludge and scum equals one-third of tank volume I 1 NA Inspect dispersal cell(s) - - Q months At least once every: ) - (Maximum 3 years) 1-1 7 NA Clean effluent filter ) At least once every: CI months) - - - n NA • earls; NA Inspect pump, pump controls & ah;rrtn At least once every: ❑ rnonthis} ar(s; 0 NA Flush laterals and pressure test At least once every: Brfthsls) U NA Other: least once every: d monthi s) Other: - _ IJ year(s) IA NA I161AINTENANCE INSTRUCTIONS L] NA Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or cx3rti ficatiorrs: Maste Plumber; Master Plumber Restricted Sewer, POWTS Inspector; POWTS Maintainer; Septage Servicing Operator, 'Tank inspections must r include a visual inspection of the tank(s) to identify any missing or broken hardware, identify any cracks or leaks, measure the volume combined sludge and scum and bi check for any backup or ponding of effluent art the ground sr rrface. The dispersal cell(s shall visually inspected to check the effluent levels in the observation pipes and to check for an fa of The pending of effluent an the ground surtace may ) be regulatory authority. y indicate a failing condition and requires thr , ~ immediate effluent nooti the tlficat ore c of the surface. When the combined accumulation 'A sludge and scum in any tank equals one-third of le the tank shelf be removed by a Septage Serrricin Operator and disposed of inoaccorr-danol with chapter tNR 113, cWiscor say Alf other services, including but nol limited to the servicing of effluent filters, mechanical or pressurized components, retreat and any servicing at intervals of 51,E months, shall be performed by a certified F'OWT'S Maintainer. P meet units. A service report shall be provided to the local regulatory authority within 10 days of completion of an.v service event. START UP AND OPERATION Page - of For new construction, prior to uses of the POWFS' check treatment tank(s) for the presence of painting products or other chemicals that may impede the treatment process and/or damage the dispersal cell(s). If high concentrations are detected have the contents of the tank(s) removed by a septage servicing operator prior to use. System start up shall not occur when soil conditions are frozen at the infiltrative surface. During power outages pump tanks may till above normal highwater levels. When power is restored the excess wastewater will be discharged to the dispersal cell(s) in one large dose, overloading the cell(s) and may result in the backup or surface discharge of effluent. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Orerator prior to restoring power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the Bump controls to restore normal levels within the pump tank. Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area within 16 feet down slope of any mound or, at-grade soil absorption area. Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss.; diaptirs; disinfectants; fat; foundation drain (sump pump) water; fruit and vagetable peelings; gasoline; grease; herbicides;. meat scraps; medications; oil; painting products; pesticides; sanitary napkins; tampons, and water softener brine. ABANDONMENT When the POWTS fails and/or is permanently taken out of service the following steps shall be taken to insure that the system is property and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code: • All piping to tanks and pits shall be disconnected and the abandoned pipe openings seale':1. • The contents of all tanks and pits shall be removed and properly disposed of by a Septagr ~ Servicing Operator. • After pumping, all tanks and pits shall be excavated and removed or then covers removed and the void space tilled with soil, gravel or another Inert solid material. CONTINGENCY PLAN If the POWTS tails and cannot he repaired the following measures have been, or must be taken, to provide a code compliant replacement system: ❑ A suitable replacement eawa has been evaluated and may be utilized for the location of a replacement soil absorption system. The replacement area should be protected from disturbance and compaction and should not be infringed upon by required setbacks from existing anti proposed structure, tot tines and wells. Failure to protect the replacement area will result in the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rules in effect at that time. ❑ A suitable replacement area is not available due to setback and/or soil limitations. Barring advances in POWTs technology a holding tank may be installed as a last resort to replace the failed POWTS. ,The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluation must be performed to locale a suitable replacement area. If no replacement area is availrble a holding tank may be installed as a last resort to replace thca failed POWT'S. Mound and at-grade soil absorption systems may be reconstructed in place following rfinoval of the biornat at the infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time. <WARNING>> SEPTIC, PUMP AND OTHER TRI' ATMENT TANKS MAY CONTAIN LETHAL GASSES ANDlOR INSUFFICIENT OXYGEN. DO NOT I=NTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDE=R ANY CIRCUMSTANCES. Dh_:ATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR ID A TANK MAY BE DIFFICULT OR IMPOSSIBLE. /,,DDITIONAL COMMENTS h'OWTS INSTALLER - - - _ - _ _ POWTS MAINTAINER Nance Name Phone / - - Phone ti J rv SE;PTAGE SERVICING OPERATOR ' DUMPER) t OCAL REULATORY AUTHORITY =NN -yy~,y7_-~ _ Name C 7 - ~ ~ E---- l ~ . Phone ' Thus document was draited in compliance with chapter SPS 383.22(2)(b)(1)(d)&(f) and 383.54(t , ) & (3). Wiscoi isin Administrative Code. PILTER CARTRIDGE Installation !ATE P 1 (Jr ~i Y fit the cantata Niter case onto the end of khe -U li d under the tank access upenin tlet pipe to rnsure it is pipe- through the Outlet or sxalvent weld a not, than either insert are pipe into the - if l (glue) additional pipe m onto the outlet while the t of Y4.inch ase is sdry ffttef nn the nutlet plpr, measure the length u t'io pipe needed to bra, the filter to the tank er+ wall if Utilizing the p hal supplemental side sttppurt, If side supper i rnethud is not rttliiz4 Proceed to slap four t , -i For Installations utilizing the sojvent weld the YAhch pipe , Orrt the filtierncase ff de tal side support: UPPIL utilized, proceed to step fncir plort Method is not re fit... r, Solvent weld the fiiter' case the ntrtle!_ ri t:art'ridgg into the r onto ase, the pressing down until i fil ' tlkr frlt'er iocksliht' Oi the bottorn se. Of IF' a VRS :switch is utilized: insert into clockwise 90 , ° the filter and lack fry turning 1.. •F he effluent filter should he cleaned . serviced every time tile septic tank is ()pen the Outlet access opening to Inspect the tank atrd filter: j'urnp the septic tank romPfetely, making sure to reprove the ;judge layer on the bottom of the tank and not Just the scum and effluent. 4. Once the nutlet P Peefflufient level has heerr lowered below the invert of thr, r , rmly JAM up Orr the fiiter• handle to cartridge from the case, dislodge the S, slide the cartrld e u l " 4 hand Out of the case for- r_ 4, If i VRS' switch connected to ari alarrry is leaning, r should tie removed by turninrp r..ourrterclncitw cry t. the Switch with water only. Klu and cleaned 7- While holding the cartridge nr. its side (large Hat surfar:e fac down) averthe lnrr r•, w:• A, do access opening, rinse oft titre cartridge with water r r"" only, making sure all septage material Is rinsed back. into the tank. H. It VRS switch is utilized, replace by insertin turning clockwise 911°. II iota filter and 9. Insert tite filter cartridge back into the $ the filter lodes into the bottom of the casee, Pressing dawn unfit 10. Replace and secure the access O Pening on the tank. wwiiie.bearunsite-COM R77-MUILTIRRS• (653-4593) ST. CROIX COUNTY SEP'T'IC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer ._._~Q mJ Q f_~ / L Mailing .Address__ Property Address ('Verification. required from PI truing & Zoning Department for new construct(on.) Parcel :Identification Number City/State LEGAL DESCRIPTION Property Location /4 , '/a , Stir - T C9 N R._ OW, Town of Lot # _r_ _ - Subdivisioll..~ CS's Certified Survey Map # Volume - Page # Wxrrauty Deed # -_-----__..,+Volume Page # Spec house es no Lot lines identifiable ~ 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 pat into the system can affect the fiinction of the septic tank as a treatment stage in the waste disposal system, Owner maintenance responsibilities are specified in §Comm. 8352(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-sine 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 C:onunerce 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. I/we certify that all statements on us form are true to the best: ol: rrry/our knowledge. Uwe amlare the owner(s) of the property described above, by virtue of a rranty deed recorded in Register of Deeds Office. Number of bedrooms- ~ - IGNA O:E' APPLICANT(S) T- 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 reap if reference is made in the warranty deed. (REV. 08/05) 0*1 W4 --2W 19154' v t7L l 3 b I ~ i • b Z a a tin - - I I fill Ii ll lllllliilil 11111111 8 Tx 4088897 7. DOCUMENT NO. . LIMITED WARRANTY DEED 968918 BETH PABST REGISTER OF DEEDS THIS DEED, made between OR 2 Realport LLC ("Grantor" whether one or ST. CROIX CO., WI more) conveys and warrants to Oevering Homes. LLC ("Grantee", whether one or 12/06/2012 11.30 AM more), the following described real estate in ST CROIX County, State of ' Wisconsin: EXEMPT#: NA REC FEE: 30.00 Lo 39 d 40, SettIees Glen, according to the recorded plat thereof, St. Croix County, TRANS FEE: 105.00 Wisc PAGES: 1 RETURN TO St. Croix County Abstract & Title Co. Inc. 219 S. Knowles Avenue New Richmond, W1 54017 Tax Parcel No: 030-2131-40-000.030-2131-39-000 This is / is not homestead property Seller to convey the title by limited warranty deed without covenants of the title or the equivalent for the state the property is located. Seller makes no representations or warranties, of any kind or nature whatsoever, other than those set out above, whether expressed, implied, implied by law, or otherwise, concerning the condition of the title of the property prior to the date the seller acquired title. Grantor warrants that the title to the Property described above is good, indefeasible, and free and clear of encumbrances arising by through or under Grantor, except: NONE. Dated this !may of November, 2012. O Realpo LLC B . Timo rown AUTHENTICATION ACKNOWLEDGMENT Signatures authenticated this day of STATE OF MINNESOTA 20 COUNTY OF ss. TITLE: MEMBER STATE BAR OF WISCONSIN Personally came before me this 12'Pday ofNovember, 2012, the (If not, above named OP 2 Realport LL-C-, by Timothy J. Brown to me authorized by § 706.06, Wis. Stats.) known to be the person(s) who executed the foregoing instrument and acknowledge the same. THIS INSTRUMENT WAS DRAFTED BY Robert L. Loberg / Loberg Law Office * ~tlo0/c~'1 L . !D !-O~A24Yt V Notary Public ff _county' MA. 1212532 / abn ZOIS My Commission is permanent. (If not, state expiration date:.1 Is/ (Signatures may be authenticated or acknowledged. Both are a~ "5'° DEBORAH L. R I D G E W A Y not necessary.) vi< `~r) Notary Public-Minnesota LDIIITED WARRANTY DEED ~'t"/t~1y commission Expires Jan 31, 2015 Form No. 1-2003 1of1 14 a 1 a N rl t A 1 - - , AVM r d T ' a M J~~ L 9 1 N aid M ff dl ~ ~ as 'now AN , N ~f M-Wa Wisconsin Department of Commerce SOIL EVALUATION REPORT Page of Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code County - ro 1 Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. percent slope, scale or dimensions, north arrow, and location and distance to nearest road. --0 36 -3 ~,E] Please print all i Rev' wed b - Date Personal information you provide may be used for daryipbm'&ft (Ari38 r, s. 1504 (1) (m)). 311316-3 Property Owner Pr rty Location //-3 i~ f ' no Go I. Lot AID 1/41/4 S Z 3 T 30 N R ZCl E (or)40 a Property Owner's Mailing Addres Lot Block # Subd. Name or CSM# (.0-7 ~ lllv.~a~e <eH er's G/g city State Zip Code Pff on City ❑ Village figTown Nearest Road S, 2 ( h 4 -22414 _ -w 3s ® New Construction Use: R Residential / Number of bedrooms Code derived design flow rate ,41Sa /C, Cl 0 GPD ❑ Replacement ❑ Public or commercial - Describe: Parent material I Flood Plain elevation if applicable ✓✓%//l~ ft• General comments ~Pm (q and recommendations: Y s e •Sd n ~ ~o Boring # ❑ Boring n / © Pit Ground surface elev. 9 ft Depth to limiting factor in. Soil Application Rate P /ft2 Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots G D in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 b--16 31 Z- SL `~mSbk rn~~ c I y 5 ~ q k 91 2 1 Ica s 14D CZP -7.5 s-C--L 2rf- K r L4 - ❑ Boring Boring # Ground surface elev. 0 ft. Depth to limiting factor '7 in. pit Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 4 3 10, sl CZ P-7. co 5(-i_ 2n-f---bk - - LA Effluent #1 = BODs > 30 < 220 mg(L and TSS >30 < 150 mg/L ' Effluent #2 = BODs < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) Signature CST Number .5CkL) oj(jer' 2,'S--3 30 Address Date Evaluation Conducted Telephone Number 11 z1/3 &0r-h 56r" I t Cc~( 5`fD ►g'o 71~~Z,f7-`h6cY Property Owner Of~f V `lv 5 Parcel ID # Page of Boring #~❑1 Boring : ~7' Pit Ground surface.elev. ft, Depth to limiting factor 2 in. ou8 nda Soil Application Ra Horizon Depth Dominant Color Redox Description Texture Structure consistence ry Rook GPD/ft2 In. Munsell t]u. Sz. ConL Color Gr. SZ Sh. •Eff#1 •Eff#2 i -IZ I 12 SL C5 l v. 2 ►2-24 1 3 - L. r c 3 2 - ICS P1 ~5 LI Sc~ k v m e4 Boring # ❑ Boring ❑ ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rai Horizon Depth Dominant Color Redox Description.., .Texture -Structure Consistence Boundary Roots GPD/ftz In. Munseil Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 'Effit2 Boring fi ❑ Boring ❑ Pit ' Ground surface elev. R Depth to limiting factor In. Soil Application Rats Horizon fln.t' Dominant color Redox Description Texture Structure Consistence Boundary Roots GPD/tz Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 •Eff#2 - ' Effluent #1 = BODS > 30 < 220 mg/L and TSS >30 < 150 mgA- • Effluent #2 = GODS < 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. SBb1330(RO7/00) F y Dec-04-2012 11.52 AM St. C_'raix County Plan/Zoning 715.386.4686 2/3 r Properly Owner C )p ~ Parcel ID N Pape ~ of 9orinn 0 ~nq , v ' pit Grntard sUdAc9.dw. w' ft. Depth W lEmiUng faCtar In, Sail llcatforl Ru Horizon Depth DeminsnI Color Redox Dssariglion Texture Swdum Consistanas Boundary Roots GPDffI' In. Mansell Ou. ft ObhECotor Gt.Sz. Sh. •i:ffltt •Effur -12, 15 2 I~ TY~ C ) r C .44 Rotinq if ❑ Doting ' ❑ Pit around sudgm elev. R. Depth to imlling factor In. Fail Ap Iwtlan flue Horizon Depth . Dornlnanl Color Redox Description,,, Texh re , -$tnroture Consistence tloundery Rook GPDRtr In. Mansell Ou. Sx. Owl. Color tar. SL Sh. •Effff! •Eff#2 Baring fi ❑ Boring , Bor • Ground surface alav, ft. Depth to llmidnp factor In. Sail Annlieallon Rall Horizon Depth Dominant Color Redox Deectiptlon Texture s1 ucGue Conalslense 9oundary Roots GPDlftt In. 1111unsell Oti. Sr. Cont. Color Or. Sz, Sh. 'HtfN1 9110 - • Ef ant tll x B0I) s 3t} c 22o rm1L and TS5 }3o c 150 mwL " Effluent U2 a 6DDs i 30 m04 and TSa < 30 moll. -Me Department of Commerce 1s unequal opportunity service provider and employer. Iryott need assislenea to access services er need mAterlsl in an alternate fbtmat, please contact the department at 61184266-3151 or TTY 6011-764-13777, esarrwtRo7+oQf ~ t • PAGE-OF NAME Cc / ~c¢ LOT#3 ` LEGAL DESCRIPTION 4)w X SCU`a S Z T . N B C-J WICZ) SCALE: I"= ~U BM I ELEVATION DU. U _ q, t 'fie r BM I DESCRIPTION 13M 2 ELEVA'T'ION fDv• O BM 2 DESCRIPTION i SYSTEM ELEVATION `I S• S a SYSTEM TYPE c» A_ck fi S CON 'OUR ELEVATION Cl - 0 c~ SIGNATURE DATE 3 - ~Z