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HomeMy WebLinkAbout014-1034-60-100Wisconsin l1e artment df Commerce ~~ 3 /~ p PRIVATE SEWAGE SYSTEM '~~~ Saf?ty ahd~3ui!.ding Givi:aion, INSPECTION REPORT GENFP~AL INFORMATION (ATTACH TO PERMIT) Personal in:ormation you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)l. 'ermit Holder's Name: City Village X Township Sunda ,Kenneth Forest Townshi :ST BM Elev: Insp. BM Elev: BM Despriptipn• f OD • V ~ 00 - d W ~ ~ - or S~-~ o~.~' WANK INFORMATION ELEVATI N DATA TYPE MANUFACTURER CAPACITY Septic ~c.~..e~ /per Dosing ~~ G~ "~~C~ Aeration Holding TANK SETBACK INFORMATION TANK TO P/L .fS~" WELL ~ BLDG. Vent to Air Intake ROAD Septi nn ,~/~ r ~ Dosing ~ ~ ~~(/~, [ v"~ - Aeration Holding _ PUMP/SIPHON INFORMATION Manufacturer Model Number TDH Lift ~ Friction Loss S' Forc~emain • Lengt ~l Dia. rL ~t ltse OIL ABSORPTION SYSTEM ~ BED/TRENCH Width ~ ( Length DIMENSIONS SETBACK SYSTEM TO INFORMATION _ DISTRIBUTION SYSTEM ~ ~~ ~ ~ x- (M Demand GPM Head TDH Ft t. to Well ~~~ ~~ ( v. vi n c~ wi Ica y P/L BLDG WE 3~t fig, vl,tr,/ D~,.~d County: St. Croix Sanitary Permit No: 420584 0 State Plan ID No: Parcel Tax No: ~ 014-1034-60- STATION BS HI FS ELEV. Benchmark .gm ~~ 5 Lf !as !o ~ ~ Alt. BM ~v 02- Bldg. Sewer sGK~(,o SW , bld (o. 0 ~`~ Z.( SUHt Inlet ~. ~~ ~/ / ~~ St/Ht Outlet l Dt Inlet ./ Dt Botto a~ 92.9(0 Header/Man. T Z ~ Z ii CGi-~4lk ~~ Dis~ ipe ~, ~~ 0 of" / V ,~ ~8 g/ Bot. S ~ ~ 9 ~. -, Final ade M,rdi~ s= y 99 ~ st co~ ~ ~~~ + l ~d °~•~ 02.• Z -~ PIT DIME S No. Of Pits CHAMBER OR UNIT oL Dia. Liquid Depth ~to ol.~'~u,o.~¢~y C( Number: Header/Manifold ~ ~ ~ Distribution / Pipe(s) (~~ /~iyt ~ !* .~ ~ / x Hole Size x Hole Spacing • Vent Air Intake / Length_ Dia_ Length ia~_ Spacing ~ ~ JVIL VVYCR x Pressure Systems Onty xY Mnunrl C]r A4.h rarlo Cvc4omc Anly Depth Over ~ ~ Bed/Trench Center ~ ~ / ~' ~ Depth Over Bed/Trench Edges xx Depth of Topsoil xx Seeded/Sodded xx Mulched ~ Yes ~ No ~ Yes ~ No ~,6 COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: 5 / ~ 3 /~ Inspection #2:~' /~/~3 Location: 2827 County Road Q Clear Lake, WI 54005 (NE 1/4 NW 1/4 16 T31N R15W) NA Lot 1~Q Parcel No: 16.31.15.245K10 i 1.) Alt BM Description = ~' ~ 0 ~~-(a~~ -<,I-<~~r~-E'~i /`~'~e,>~T_~. ~ ~ ct/LL~~ 2 J Bldg sewer length = ~ ~ ~!/ T~ ~, ~yvti`-i ~~t ~ft~,_ r~'- _/J.c~c-Q- ~~Geil / Ii ~`~K~ Kn'~- !t// ~~~gGv,.,~¢,N(/~_ - amount of cover = l ~ ~ J~~G~Z~ Plan revision Required? r~] Yes No ~ ~~ ~ ~ ,, /~11 ~ Use other side for additional information. iv~ f _ _ __ Cam' ~~,{yfi~. ~ ~ .5 Date Insepctor's Sign ure Cert. No. SBD-6710 (R.3/97) .~ Xbr-~.`~'~ !.. 5v~..y Sr, .Nw~/~ .~Fru~~% ~ pw-Yy, Sec.~`~T3~M,1', R iSw _ -~ -- "` ~- --~ f~dk- C~ » w~r.w~H .~~~~, ~+wrr ~,~ , ~ ~ "'~~"^ ~ ~ ~, ~ 4 i.o .~ V _ .' Q s~ w h O ~t W v o ~ ~a ~~ _~ +- } d ..;. ~ - ~. T _ 'R `~ ld Grti' ~-- o~ i T I ''f"'2 - /~ S~ Qp rs TZ vh.ov~e-d dewri Slob-e- ~ ~~~ /occ~r~, ~;~. ~~ Tr ~ at, ~iww~rk~~,,,,Q•• ~tiw L tv ~1n 1D0. po ~ ~vcri. + hors ~. V ~~aw ~ ~.V ~ v ~'~` e w W ~ y} I ~ ~n ~ r ~ Fs v- e.• i. a ~ }~ sv ~ P~ -- Q~'A/~t ~i~~ ~~~~,a~ "' Safety and Buildings Division County ' ae ~ ,. 201 W. Washington Ave., P.O. Box 7162 Ye/~ ~~~i~~>~ °. Madison, WI 53707 - 7162 Site Address De ~rtment of Cornrnerae !i- a 7 -oZ 3 S' ~~~~ • Sazutary Perxrit Agglieation Samtary Permit Number In accord with Comm 83.21, Wis. Adm. Code, personal information you provide ~~v ~~ ma be used for second oses Privac Law, s15. ...ar_ ~ ^ Check if Revision T. Application Information -please print All Informatio p ~ ~~ ~` mA ~t, ~.; State Plan I.D. Number _ /~ r petty Owner's Name Z ~ ~ T O (;(~ ~l~UZ ~ A ~ Parcel Number ~, nil i,st.l ..J ' r y , ~O ~~ - 6b v Property Owner s Mailing Address t ~ , ~, , •, pa /~ L/ ~ ~~,_ `:~ l ` Property Location ~ ~~ ~ 1 V C~`> Sfd~ Zap Code Phone Number ~' 'k l!f',4 ; S T N, 12JS ~J Lot N tuber Block Number /~/ r L-1~i4r ~A~ ~~ ~ 7 Subdivision Name CSM Number ~ G C7 /, oZ6 37gZ ~92 7 II. Type of Buildittg (check all that apply) ~ ,,,yh, ~">- 2 F il D - ® _ ^City 3 or am y weUiug Number of Bedro ^ Public/Commercial -Describe Use ^Village ~ / ~ ^ State Owned ? ~ ~ ~ J wnship v . ~' o 7 ~~.~/ ~~ ~ Nearest Road ' 3 3' III. Type of Fcr~uit: {Check only one box on line A (numbering scheme for internal use). Co mplete line B if applicable) A. >rSQ:New 2 ^ Replacement System 3 ^ Replacement of 6 ^ Addition to For County use S stem. Tank Onl Existin S stem B • ^ Cheott if Saaitary Permit Previously Issued P°~t Number Date Issued I'~'• TYFe ~ Kermit: {Check all that apply)(numbering scheme is for internal use) ~'~ ~ ~~~,~~,~~ . ~oa-Pressurized In.Ground 21^ Mound ~ 47 ^ Sand Filter 50 ^ Constructed Weiland C~ 3~~~.~ ^ ?2 Pressurized_ Iti~SrFOUnd 41 ^ Holding Tank 48 ^ Single Pass Sl ^ Drip Line / ~ 45 ^ At-Grade 46 ^ Aerobic Treatment Unit 49 ^ Reciicularing 30 ^ Other ~~ ~ • ~ G%K~~i ~• Dis ersallTreatutent Area Information: Destgn Flow (gpd} Dispersal Area Dispersal Area Soil Application Percolation Rate System Elevation Final Grade Rofluited ~ Proposed Rate(Gals /Da Ft /S ~ . ys q. .) {Min./Inch) Elevation VI. Tank Info Cagaciry in .Total Number anufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Tonics ~/ i7~ /~b~ Concrete Constructed Glass New F,xisting Tanks Tanks Septic or Aoldiug Tank _ ~ /~ Dosing Chamber ~OG' VII. Res iltty Statement- I, the undersigned, assume res onsibility for iastallatlon of the POWTS shown on the attached plans ' , s Name (Fruit) Plumb°r' tuna MP/MFRS Number Business Phone Number ' ~ r~ c~ 'rte 5 .-~ ~ O ~ Plumber's Address ( 4 City, State, 'p Code) S /~ ~ 6 . 2~ ~-- ~ ~~.. . , T- ~ ~ ~ i s S'III. C /I7~ ~ ent Use Oni ppmved ^ Disapproved Sanitary Permit Fee (includes Groundwater Date Issued wing ent Signature (No Scamps) Surcharge Fee) I ^ Ownes Given Initial Adverse G~ '1 ~ . ~ ~ S , 2 s/ D O( etermination D (~~i yL : , \ `~undi~tioas of Agpr~ l2e~f~ Disc proval ~ ~~. f ~ ~~7~~ ~ ~~_ / ~jr i ~"T7 ~} ~ D~ / v (iV ' ,4 ',j• G,1 J /9 7y/ ~ d ~o f ~~ii... _ ~,c~~~ ~n 10 ~~,. ~~~11e ~ ~~h,~,..._ ~~ ~i1J -O ''"+A~µ cumj,t~w Pis lto tae trounty odyPfor the systetn~on papeq/uot less than 8112 x 11 inches in size 3 ~/ SBD-539$ (R. OSt01) +t,~~ ~•~rce.~. rr~w `IIIIY~'PI~/M~MIII~/~11 ~~I~rOM~~' 1~T.Yair• ,~ fl 41.0' ~ wLo" ~s ,~ "> 15` ~~ °' ~~~ . 3 ~ ~" ~~ ~ ~ 0 v o '' 4 4 o a~ .r T ~ ® ~~pO~Ets~ w..rs ~.- . - " T - - _ .~...:d .~.._...._...~ ._...__.~ _____~_~._.. _.._~ ~;~, ~~ 'Tr ~ a.{., ~r•wrks„~•~ Srt~.l•• t (i i"'~ ~~~v.. s ~ ~ ~in IDD. ao ~ (~wcr~, ^Ir k.~r• ~. r ~. F.. ~- a ~• c. ~ ~t~ . ~ o +- 0w Wa.S 1~n ~ ~ .3Y tsa fs ~ ~D • $ 1st'*~~ ~ ~~ . S~f,O`~ ~~ i v T2 9 ~ .. /DD / ~ y a rn ~'~ .~ :y isconsin Department of Commerce INSPECTION REPORT Date of Inspection: June 5, 2003 Project Name: Sunday Property Use: New Residential Lot a,~ Legal Description: NE, NW 16, ,,,,,,,~ Site Number: ~ t~~r'`~~ Subdivision: Proposed CS Municipality; Town of Fores v~1l~! ~ County: St. Croix ~ 20~`? Jr t <v ~'.k ~ ~ r -. Plan Transaction Number: `~~= o~~_, ;~' `' Sanitary Permit Number: c.`, Wastewater Flow: 450-600 gpd Persons Present: K. Grabau, K. Sunday SAFETY AND BUILDINGS DIVISION Field Operations Bureau 13 East Spruce Street Chippewa Falls, WI 54729 www.commerce.state.wi.us Plumber Name and Address: Unknown rtified Soil Tester Name and Address: Donna J. Stark, CST 221746 276 200th Street Star Prairie WI 54026 Owner Name and Address: Kenneth Sunday 437 Third Ave Clear Lake, WI 54005 An onsite verification of soil conditions was requested by both the CST and owner because of previously unsuitable conditions observed elsewhere on the property. Additional soil pits in a new area revealed conditions that appear acceptable for a mound system installation. A soil profile for this site could be described as follows: 00-06" 10YR 3/2 sil, 2mgr, mfr, cw. 06-10" 10YR 3/2 sil, 2mpl, mfr, aw, with several small areas of f1f 10YR 4/6 Fe masses between plates. 10-15" 10YR 5/3 sil, 2mpl parting to 2msbk, mfr, cw. 15-22" 10YR 3/4 sil, 2msbk, mfr, with common 10YR 7/3 sil coatings on ped faces. It is my opinion that there is ? 22 inches of suitable soil depth in the two soil pits evaluated closest to Cty Hwy Q that would support a mound system. The design of the mound must still be conservative in that it should be long and narrow (4.5 gpd LLR) and have adequate basal absorption area to account for platy soil structure in the A2 and E horizons (0.3 gpd/ft^2). Site preparation is critical to adequate infiltration. Vegetation needs to be removed as per the mound component manual (without the use of heavy equipment) and chisel plowing to >_ 16 inches depth immediately prior to sand placement should help improve infiltration of the upper part of the soil profile. The Iron (Fe) masses observed .are not indicators of a seasonal groundwater condition that would affect treatment or dispersal, but rather appear to be induced by past activities (e.g. compaction by cattle or equipment) in the area of the second soil pit south of the Cty Hwy. These particular features were not observed in any of the other soil pits left open for viewing. I do not believe that this condition warrants further interpretation or monitoring. If there are any questions regarding this report, please contact me. 4f~ oy G. nsky, tewater ecialist Ljansky commerc .state.w~ E-mail 715/726-2544 Voice 715/726-2549 Fax cc: ®County ^ Plumber ~] CST ~ Owner ^ Other Wisconsin Department of Commerce C3avis+~,n of Safety and Buildings SOIL EVALUATION REPORT Page ~ of ni a~wwanca wrur wrnrn oa, vvis. rwm. wue ~°~"~' Ro'( x Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must indude, but not limited to: vertical and horizontal reference point (BM), direction and r t l l di i h p~ l,p. ~" ` - y l ~ - ' ~ 0O ~ pe cen s ope, sca e or mens ons, nort arrow, and location and distance to nearest road. a V ' !b 3 ' l~ _Z ~ .-~ 2.- Please print all information y03 iew by Date Personal information you provide may be used ~~r~~aw, s. 5.04 (1) (m)). / ~~~~ l L Pro pe rtyOwner Pr pertyLocati cst aoF tt.~ 1_ 1 ~ f 1 ~, V1 e,~ -'1 ~ , SV 1'~ ~ a-'' 'LQQZ Go .Lot N ~ 1 /4 N W 1/4 S J (p T 3 ~ N R ~ E Pro rty Owners Mailing Address Lot Bbck # Subd. Name or CSM# ~~ 0' OIX COUNTY City State Zip Code hone I~r qqd ity ^ Village ®Tovm Nearest Road ~lea~~~~.k~, w~ Syce ( )a~3-3~Sa "o~'~St ~ New Construction Use: ® Residential / Number of bedrooms _~_ Code derived design flow rate y D GPD © Replacement ~ Public or commercial -Describe: Parent material q ~ Q G -r~- ~ tit ~f'f- W ~(.. ~ 4. Flood Plain elevation if appligble fL General comments ~ 5V ~5 ~, , _ . pus. ,. ~ and recommendations: ~ ~ 9 3.75 r '1 R ~ IJChGS (, ~ ~ F; i 7~~4or s~ Fur ¢„e...a1n S ~ '~ t . T. _ 5 ;'~ E ~ • T . 1 97. I o ~ ~ S: -(-C. a : 3 9'~. a3 ' ~ N 0 ~ - ~-'n~- ~t.~d~ T' 7' ~ 95 . $s ~ ~ rt' y ~ ~.~. ao~ + 1 ~ ,'a ,LL_D~ wre~~ L,f2vh v .~3.•rp _ ~ Boring ~ ~ Boring # ® Pit Ground surface elev. O . S ~ ft. Depth to limiting factory in. Soil igtion Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/It? in. Mansell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 Ja-d 7,5'1RY/ ----- SL arSaK YhFr ~~ / ~ S 3 I- ~o ~,SyR~~ ~ S~ ~~fr -' -- ,5 .~ '' ~''~ / a Boring # n~ Boring 9 pEF Pit Ground surface elev. ~ 3 7 ft. Depth to limiting factor ~ ~ V in. Soil licetion Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/fP in. Mansell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'E ff#2 +' O - IO"( 3~~ a ~e /- (MFr A r- o2t-~ . S e . d ~- I3 - 3 7,5 y !~`~ } ~ -----~ S ~, ~ ""; ~-G rn ~ G~ t IF . s , 3o- 7a ~r, ~ y (~ y ----~----~ , ~'S b !2. w~~~,,-- c .,,, --- , S , 5 ?a-I,o ~, s y;~ 4J ~~f .------~ r=s ~ Fsb ~- r~~~~ - ~--- , s . g _a_ , - tmuent ~~ = BCJD > 30 < ZZO mglL and TSS >30 < 150 mg/L 'Effluent #2 = BOD < 30 mg/L and TSS < 30 mglL T Name (Please Print Signature CST Number ~~-k aal~y~ Q ~"~ tom. ,~,. Date Evaluation Conducted Telephone Number T Properly Owner 'J V n.~~, S r . Parcel ID # Page ~ of Boring # ~ Boring ® Pit Ground surface elev. q 7• D oZ ft. Depth to limiting factor D 0 in. Soil 'ption Rate Horizon Depth Dominant Caor Redox Description Texture Structure Consistence Boundary Roots GP DlfI? in. Munsell Qu. Sz. Cont. Cobr Gr. Sz. Sh. 'Eff#1 •Eff#2 ~ o _~ ~ ~R3~2 ~....~.., a F~ ~. mF~ a a F • s , 8 rg-y4 01 ~~~ ~ c~ ar-,,sbk r~f~ c.,~ l~ . ail ,tom `I y y~~ ~ .5 y RSA .-----~--~• ~ a 5 IG n~~ ~ c -- S S g-ono ~,s ~,s/ -~-----~- FS aFSbu.. ~~f•- - - . S . q th ~ star c ; ~' ~ ~`j~-~~ G Boring # ~ Boring ® pit Ground surface elev. 9 g~ 3 7 ft. Depth to limiting factor ~~ in. Soil cation Rate Horizon Depth Dominant Cobr Redox Descriptor Texture Structure Consistence Boundary Roots GP D/ff? in. Munsell Qu. Sz. Cont. Caor Gr. Sz. Sh. •Eff#1 •Eff#2 ( a-!! i o y~.3 ~ ~ aF6 2 n~~r ~.~ ~F ~• I' l-aa y R r----- e.~' ant bl~ cw 1 F . S . ~ 1 ; ^ Boring # ~ ~~ Pit Ground surface elev. ft. Depth to limiting factor in. Sal ication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/f~ 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 =GODS _< 30 mg/L and TSS < 30 mglL 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. seo-ssso (rzo~iao~ • ~ ~~• of NE %y , N~..~ /y ~ Sec. ~~,~ T3aibJ, R +s w N •_ +' _ ~0~1 D aLt t ,1 '~ • ~ ` P Patit3~~f ~Jo n vt IA 3 . S-~.I.r ~C. north 1 ~ t r ; r~ ~.. - - ------ -~~~0• `~~ t ~ ~,o s ti _., _ y Y~ ~ ~\\~\\ ~\ ~ . \~ 1 ~~~n~1 .~ h 4 SQ ~a ' . o ay Sao G,,r w a o~ ~- ~ ~ IS°, PSQ 1' / DQ J~~ ~ Q 3 ~, Y ~ ? ~QVS~ ~ ,~ ,~ 3 ~ - . a ; 1 r ~ / ~ ~ / ~ ~ / ( - .;. h v ~ ~ ~ ~ ~ ~ ~ v \ ~ ~\ ~ ~ "'_ --..... -- 49.0 ~ ,~ ~ ~ ~ ~ ~-~---~ -- -97,0' ~, s .~. 0 gn^ -r a P ~ ,iw~~K~l~. Stsa L ~ ~'~t+ t ! t ~ 'R gm ~QD. oo ' VLr ( ~. + ko~r: Z. rt F t v. t a~ C, .a~. ~1 }~ •.. E p a s A +~ ~ . ro W ~ 3 '~{ D0.Gk i+~~.. P;~,~ g 1 IaI.SL~ t~3 R7.o~~ ~~ 9~.3~ ' py 99,37' '°" ].F11~19/2~02 "1i:5? i:.526~34~31 Ohdsion ofSahty wed 8taildit'roe STRUC-fUP.~iU APP _Ptir~ PAGE 02 w~~ ~,. SOIL ~VAL.URTi01d+1 ~'tEPOR7` Pear ~ af~ twt lees Wes, a t~2 x ~ y ,.,..,_.. ,......_....._........._ ind+es in s¢e. Plan must ~ ~ ~ ~uc*~y Include. r lirao~d lo.• wrh~ and hpri>;oMst refererins point (BfA~, Qirocoor- srrd P~ ttop~, si~is of dn+wtnNOno, norti+ wraw.end +aw6or- and dlsfanoe to nsaraat reed. _" ; 3 ~''~ ~' ~ 7 - Jb ~iJ " ~.L] " b D D ~w•t ~/ WW711!lf01f. Prreo+d irdam~ion ~ piro~i0a may a vaer for ssoon4srr vrxooese tPriway hew. s. ~ S.DI f +f Gnlb t~ f / 2 ~- OrwMr ~ "'T -1 ~ . ~ V /"~ ~" P~f Govt. Lvt a # F ~i-I.~.. ~ 114 ~ t!4 S j b T .3 ( N R j E ~'_ ~ JYCdree~s tart ~ ~c Ik ~ukxl. I~~rrwr tx 1 s PF+orr Nlrnber [} (~1pr V~sge y. ~ Tows frleanest l~4atd - @~ -~+~+ 1Jaa: ®Raaid~t~i 1 Alutriar of be6nfon>f ~.,~,.._ Gaa. dMivMd aiealpr- Ilow ~ y C] FiaPiaesintent ~ Q i er ooertrerdd - Wsc+ib.: _-- -_. Pafant atafetW _~~A 4 iG, ~ [~ -,~"#" t....t rs` s Lw, ftaorf Pfain WeYSOOn d appiiosbls General aortsnmths .~ .. , 9 3 .?S ' "1 ~~ A3ck-tC ~"~'~ 1~T.~~ or ~~ ~a r s.«-..tom T ~. L95.~s"~ ~'~ i! 4~.raai" Giro tt. t : ~' 4., , ~ t3raN,tttt evrtito. eisr, f o1. ~ ~o h, t]rpln sn rnyur~ tramr r ~ ~ ;~ . sdl w:e }kltiuoon t~rfN bt~rrwyr+i C+ok~r Raalorc Deerr~tlon Te+<t+~n Strsx~e ~ Boundary Hods ttt. 61t+tirrM tiu. 8s. Copt, Cakx Gr. 5a~. Sf-. •t:ffA-1 'Ef~k2 !o Y~ 7, S'~ Y/ --"--~--' C. r~ i ~ ~ ~^r-F>"- ~. ~ f a .. '~'I`~ ^^ tt 1yy1~~ ~~ a u~rti- ~-ir~ a~ -~' e S ~ - ~ s ~ ~,~ ` ^ ~a 6a. tstt Ground surlavs eisv.~~ tt t3eplh to tarrlor ~l ~ in. SoY Rate Ffarttaott GepUs Dominant Rs~dooc Daadiptlnn Texture Strt+claxe Cortsiebertas Y hoofs GPf 7Mt kt. NAurtratl qu. Sz Gont, GWer t.r_ ss. 3h. 'Etl~'! °E IMR e ~,o ~.~ ~~. ~~ w .y-----~- ~s a s~ k ~-~~,- - -- . s , g ~~ ~ ~ c~ ~~ ~ ~~ ~ ~ ~ - tntuau +~~ = taw r ao t xza mpti arra Tss aao ~ era n+~ - t~ettern u ~ you ~ zt ano gas r au +*rpv~ iirrb ~ PrMY ,~'Q.P ~ ~ ~ t~ [~..1~~~ ~Q~ y,, ~~ valuation TtyepNOne fiWllfYer ,~~,,,~ nnrw w..nw mw++ww. _,,, 1@/@9r'2@@2 11:57 7i52633~81 ..~ w i ~~~ 1'~cha~`t, 1. t]wrw ~ue..Q~v fit. STRUCTURAL AFF INC taaerai lO A _..._. __..... _ _.. FADE 03 vas ~ ex ~_ ~u G1olaat wetlaoa atev. ~?~~ A Dapltl io Wnltkfp tarbr ~ Q tn ~~ M ^ ~~ ' . , .,,_ . ~~ FMVetion DapW tionvnant R~dme Dasadpvbn Ta~etius 3trudwe Canaalanaa Ba,rWwy Root fn. Gu. St. GxN. C.Ob- Gr. Se. 3h. 'fdMM4 'E11N~ a ~ -~ -, 3i ---~_-~-_-~~~ a F~ m~~ ~ a F ~ s , g 4 ~ -r ~.s/,~ --------~-. 4., a ~. r" r c,.~ s . 8 J 1-y'~ 0.1:.'1 ..~--~."""-, t L o?r biZ r~ fe" C~ I J . t,. ~'" I ~ s v R~ Florkatl t]eplh DoeninMk Reidou Oaapippon Tiummt Sruaurr3 Goea~aMnoa t3aundary Rook in. #Atxnail tJu. Sz. t:ant. CSdOit tat, Sz, t3h. 'EI~'1 't?~2 I I-~D r-......~... o?ry 64ti Cw 3 ~~~ ~syR t --------- ~Fs~~ r~-vfr~ r- -- ' .. / ' ' ~~ M ~ Cierxad ~ Nov. _„_,,, A. ~ b BrriMMtip favor in. PK tZate HotFaon t~h lloee$~M1t R~dmc Oaoafption Tamura SM'vCri,re+ Consia6enae 8a~si0Ary Raats N. trNnaar Qu. Sz. Cant. Gibe' tar, 5z. $h. 'FINK 'E1fN2 burr ~tH = 69D~ a 3Q ~ 7aP +~ wrd TSS x30 ~ 160 ~ ' EAueert ~ _ l10C~ 5 ~0 npA. and TS$ S 30 rnpRL Tha Deparrmant of Conunerce is as equal oppaRunity aCCviu providCr and tmployer. !f you Heed assistance to Access services or aced rlosr+esial i4 as sltanau: lwa~kr plane contact the depw7mont et 64ti-2,(>5-31! f or '~"r'1( dog-264-g777- Ie,O~ tar+wtl .. , :+.d~~ ~ . J A ~ 1~f'©9r~2a0~ 1~:~7 i.5~6:i~4~1 ~Ik:ULIUR~;L r~t'N 31~L : . ' ~,,~ Ya bF t~s~•~~ , After /,~ ~ .Stc. t~.~ T~t~', R t$ w ''~'cb.{t: ~` s ',tom' o`lOa~r~~ ~` ~ ~ w. rc e.1. 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SYSTEM SPECIFICATIONS Septic Tank Capacity, d gal DNA Septic Tank Manufacturer- ~ „~~~ p NA Effluent Filter Manufacturer ~. Q NA Effluent Filter Model ~~ ^ NA Pump Tank Capacity gal DNA Pump Tank Manufacturer , ,~ ~=- ^ NA Pump Manufacturer r cD NA Pump Model 5~ ^ NA Pretreatment Unit DNA D Sand/Gravel Filter D Peat Filter ^ Mechanical Aeration ^ Wetland D Disinfection ^ Other: Manufacturer: Model: Dispersal Cell(s) ^ In-ground (gravity) ^ In-ground (pressurized) ^ At grade D Mound ^ Drip-line D Other: hing Chain er ufacturer Model ~ - Approval Stipulation_t~ Soil Application Rate 9 ~~d/ftz Area Req. ~©O Absorption Area Credit per unites / _ ft2 Minimum Number of Chambers ^ Aggregate Design Flow/Loading Rate= ~ min Materials: all materials must comply with WI Adm. Code COMM84 and be installed per manufacturers specifications and approval letters. DESIGN CRITERIA D "W~ Ax grade Soil Absorption System, Siting, Desiga & Construction Manual" (Converse et.a1.1990) © "Wisconsin Mound Soil Absorption System: Siting, Design & Construction Manual" Converse, J.C. and E.J. Tyler. Publication 15.22 D "Desiga of Pressure Distribution Networks for Septic Tank-Soil Absorption Systems" Publications 9.6 D "Design of Conventional Soil Absorption Trenches and Beds". RJ. Otis - ASAE Publications 5-77 and "Design Manual - Onsite Wastewater Treatment and Disposal Systems". EPA 625/1-80-012 October 1980 ^ SBD -~ I0374-F {R.6f99) "At•Grade Component Manual Using Pressure Distribution" D SBD -1056? P(8,6/49) "In Ground Absorption Component Manual" D SBD -- 0705~•F (N.Ol/O1) "in Ground Soil Absorption Component Manual" Version 2.0 ^ SBD --1068--F (N.6199) "Recirculating Sand Filter System Component Manual" SBD T 10656-P (N.6199) "Split Bed Recirculating Sand Filter System Component Manual" ^ SBD - 10572-F (8.6/99) "Mound Component Manual" D SBD ~,-10691 P (N.O1101) "Mound Component Manual" Version 2.0 p SBD =:10595-F (86/99) "Single Pass Saud Filter Component Manual" ^ SBD -10657`-P (86/99) "Drip-line Effluent Disposal Component Manual" ^ SBD • 1057••-P (R 6/99) "Pressure Distt~bution Component Manual" D SBD -10706-P (N.O1/Ol) "Pressure Distribution Component Manual" Version 2.0 D Drip-liue;Effiuent Disposal Component Manual for Multi-flo Onsite Wastewater Treatment Units MAINTENANCE MONITORIlYG SCHEDULE Service Event Service Frequency Inspect condition of tanks} At least once every D months ~,yeaz(s) (Maximum 3 yrs.) Pum out contents of teak(s) When combined sludge and scum equals one-third (1/3) of tank volume inspect disposal ccll(s) At least once every ^ months year(s) (Maximum 3 yrs.) Clean effluent At least once every D months eaz(s) inspect p, controls & alarm At least once every ^ months Igyeaz(s) DNA Flush laterals and sure test At least once every ^ months t~+eaz(s) p NA Valves At least once every p months D year(s) NA Other: At least once every fl months `D years} NA Page of Q lviouild, At•Giade~I~Pressure . The. inspection chide recording the levels of ponding, if any in the observation tubes and a visual inspection for any evidence of surface seepage or discharge. Any dischazge to the ground surface must be promptly reported to the regulatory authority. Pondiug greater than 7S% of the height of the component may indicate overloading or impending hydraulic failure nec~ssatating z~ore frequent monitoring. The pressure distribution system is provided with an opening at the end of each lateral to be used for flushing. The laterals shouldbe flushed at least once every three (3) years. Pressure checks of systems with multiple laterals should be done to ensure that'equal distribution of effiuent is occurring to promote the longevity of the system. REPORTS Reports for maintenance, inspection, and monitoring shall be submitted in accordance with COMM 83.55 Wisconsin Administrative Code. When the POWTS fails and/or is permanently taken out of service the following steps shall be taken to ensure that the system is properly and safely abandoned in connpliaaee with Ch. COMM 83.33, Wisconsin Administrative Code. - All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. - The coxttectts of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator. - Aftrar pumping,; all tanks and pits shall be excavated and removed or their covers. removed and the void space filled with soil, gravel or outer inert solid material. ~CONTiNGENCY° PLAN If the POWTS rails and cannot be repaired the following measures have been, or must be taken, to provide a code compliant r~kgyA suite a area has been evaluated and may be utilized for the location of a replacement soil absorption system. e re ement area should be protected from disturbance and compaction and sho note g require mks from existing and proposed structure, lot lines and wells. Failure to protect the replacement azea will result in the need fos a new soil from exishing and proposed structure, lot lines and wells. Failure to protect the replacement area-will resin# in the need for a new soil and site evaluation to establish a suitable replacement azea. Replacement systems must ..comply with the rules in effect at that time. Q A suitable replacement area is not available due to setback and/or soil limitations. Barring advances in POWTS technology a hotding teak maybe installed as a last resort to replace the failed POWTS. Q -The site has not been evaluated to identify a suitable replacement area, Upon failure of the POWTS a soil and site evaluation musf be performed to locate a suitable replacement area. If no replacement area is available a holding tank may be installed as a l~si resort to replace the failed POWTS. Q Mound and: a -grade soil absorption systems maybe reconstructed in place following removal of the biomat at the infiltrative surface: Reconstructions of such systems must comply with the rules in effect at that time. «WARNING» SEPTIC, PUMP'AND -OTHER TREATMENT TANKS MAY CONTIAN LETHAL GASSES AND/OR INSUFFICIENT OXYGEN: I)t? NOT ENTER A SEPTIC, PUMP OR OTHERTREATMENT-TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RES~II.T: RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IlVII'OSSIl3LE.' ADDITIGINAL COMMENTS POW TS K:\VYPDATA\EHIPOV4"i'S QWNER'S MANUAL.doc POWTS MAINTAINER Name -- _. Phone LOCAL REGULATORY AUTHORITY Agency. Phone Page of • ~ • ' , ST CRCII~ COLTN I'Y • SEPTIC TANK MAIt~iTL?11.~NCE AGREEh~NT AT•ID OWNERSHIP CIrP~T1TTCATION FORM O :~merB uyer hLailing Address ~ © ~_~ ~( ~~ Prapat-t}~ Address (Verification required from Planr~ng Department for new constructio / - - ~~. City/Sr:~te __~/ti°uf~- ~~ Pared Identification Number ~ly-/0,3 ~- ~~1 1:EGAI_, DESCRIPTION Property Location ~C_ '/,, 11(W t/,, Sec. ~, T 3 ~ _N-R `S W, Town of (""D res °I~- Subdivision Lot # ~_. Certified Survey Map # L~ ~ 2 ~ lam] Volume `~r~^, Page # 3 c~ d~ ~~IATl"dAty Deed # \IOlume ,Page # Spec, house ^ yes ~ no I_ot ]roes identifiable J~ yes ^ no S'~'STEl1~i MAINTENANCE ' Improper use and maintenanceof your septic system could result in its premahue failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumpea. What you put into the system can affect the function of the septic tank as a treaunent stage in the waste disposal system. The property owner agrees to submit to St. Croix Zoning Department a certification fotrn, signed by the owner and by a master plumber, joutneymanplumber, restricted plumber or a licensedpumperverifying that (1) the nn-site wastewaterdisposal system is in proper operating condition andlor (2) after inspection and pumping (if necessary), the sepric tank is less than 1/3 full of sludge. Lowe, 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 Depamnent of Commerce and the Department of Natural Resotuces, State of Wisconsin. Cerrificatiort stating that your sepric system has been maintained must be completed and returned to the St. Croix County Zotung Office with_~e 30 days of the three year xpiration date. SIGNATURE QF APPLI ANT DATE ~'4'4'NER CER~['IFICATION I (we) certify that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owner(s) of the property described ove, by virnte of a warranty deed recorded in Register of Deeds Office. l///.~/ZtoL SIGNATURE ~F APPLI NT DATE '~"~*{~ Any information that is this-represented may result in the sanitary pertnit being revoked by the Zoning Deparhnent. **rtfit~ ** Inefude with this upplicatioa: 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 \7 3 692719 VOL 76 PAGE 4388 KATHLEEN H. WALSH REGISTER OF DEEDS ST. CROIX CO. , III ~ ~~vv m m n n f ~ rrr--i ° ~~ `S ~~ ~t : /moo a m o ~~ F ~' °_ /Q ~ o C1. 3 a Z ~ F nNOm c „C. Oyw m ~ = ~ o,Z o ` z c `\ ~ '• m~~ 3 1 ~ r I ~T' ~ ' ~ ~I 0 3 N _ ~ ~ °'~u n»4i ~ ~ ° w a I ~ a ~ z o Spuo~ pa}}oau~ 6/l MN y7 do I. I~ cn / N aya to '1O~ MN b13 ~E£ I i/L MN aya fo ~/l 3N aya }o au~~ ~saM I I ££i v ._ ,66'699 , J° LO'££=1'~ v I~ ~ o ml I~ O Irt O j r ~ a I J OIU Q ~ ' ~ ,+ Ia, a0 ~ o O --I ~ > I ~ h Qlo l ~ V I Q s I~ j O I~ ~ I S to'£s-1 0 h o O _- .66'699 _ ~ , -` ~ ~ O 3„£ ~, spuo~ pay}oau~ m X g roc '~j ~ raa ~ A V 7 v N~ ~A ~ ~~ rt A~ rt ~ ~ ~ C ~ rt y ~ rt rt ~ ~ ~ ~ ~ i C ~ o ~ r N m N I~l f ~ O r°+ ? i ° o o ~ ,. r z C ~ ~rn° t 1'9 _ ~ A ~ ~ X I. ~ ~ z N _ o I ~ rt ~ I m p G l Q ~ I I -~ I I° I~ N to 7 to cl I~ sl k IZi ``I to I~ pl I~ ~ ~I ~I~ c cal ~I~ °I ol0 1= ~ ID _ I~ O ip ~ RECEIVED FOR RECORD 0-03-2002 1:30 Piz ~RTIFIED SURVEY MAP FEE: 3.00 2 W~ ~ J7 o~T 'cnr m ~m~ J a 0 0~ tin X 00 I I ~ 13 V to a m ~" Ir 7 I~ ~ I~ to I I ~- I 1 / - i '' ~~ n 4 ~~Z I ~y~o p I ~' i;, g O J ~ ~ , ~ O ~- ` ~ ~ ~_ a ~: C~7 „m ~. ro y~Q C]~° b ~~ .~ ~ o ~ otn N1~ ~ a ~ ~ ~. C7 7 pp , W b' ~ a 'O o O ~ O ~ . W a X ~ r o o MN /l N ~ « a !o ~/I 3N ayl do au~~ ~so3 , m N . 3 O w 1 : XQym ~ ~ ° Jcz ~ N ~ i _ ~ 'a p o a cn m° a~ ~-Z-~..-- ~n~, ~ 1'+1 O ~ n -°w N ° OWpN ~ iA J D ~ ~ ,p Os O °W ~~~ Z ~ ~4 - `~- 3 ~ ~ O fD '"' ~; c. ~ 5 ,~~ rn o ' `° ~ moo -~ ~. ~ ~ ~ h.o o - yrn A ~ io ~ O ZC x ~ fi c?~ C ~. ~ °, Z7 ~ .+ ~~ ~ rn ~ -~ z -C O ~• y ~ 3 N_ `° D o fJ ~ ~ C ~ O N. O fD ~ o r ". ' CERTIFIED SURVEY MAP Located in the Northeast Quarter of the Northwest Quarter of Section 16, Township 31 North, Range 15 West, Town of Forest, St. Croix County, wsconsin. DESCRIPTION Located in the Northeast Quarter of the Northwest Quarter of Section 16, Township 31 North, Range 15 West, Town of Forest, St. Croix County, Wisconsin, described as follows: Commencing at the north quarter corner of said Section 16; Thence South 87 degrees 59 minutes 00 seconds West. aloha the nnrth r~A ~f +tio STATE BAR OF WISCONSIN FORM 3 - 2000 Document Number QUIT CLAIM DEED This Deed, made between KENNETH L. SUNDAY and PATTY I. SUNDAY, hpsband and wife Grantor, and KENNETH L. SUNDAY JR. a sinete Derson Grantee. Grantor quit claims to Grantee the following described real estate in ST. CROIX County, State of Wisconsin (if more space is needed, please attach addendum): PART OF' THE NORTHEAST QUARTER OF TIIE NORTHWEST QUARTER (NE1/4 NW1/4), OF SECTION 16, TOWNSHIP 31 NORTH, RANGE 15 WEST, DESCRIBED AS FOLLOWS: LOT 1 OF CERTIFIED SURVEY MAP FILED OCTOBER 3, 2002 IN VOLUME 16, PAGE 4388, DOCUMENT NO. 692719, ST. CROIX COUNTY, WISCONSIN. Together with ali appul•tenant rights, title and interests. Bated t is ,~a ,_ day~o-f~November, 2002. sue' * Kenneth .Sunday : __ AUTHENTICATION S ienaturef s) authenticated this day of TITLE: MEMBER STATE BAR OF WISCONSIN {If not, authorized by &706.06, Wis. Stats.) THIS INSTRUMENT WAS DRAFTED BY (Signatures may be authenticated or acknowledged. Both are not necessary.) ~oQ~ Recording Area Name and Return Address S&CBANK 1080 CORNWALL AVENUE P.O. BOX 427 AMERY, WI 54001 014-1034-60 Parcel Identification Number (PM) This is not homestead property. (is) (is not) * Patty I. Sun ay ACKNOWLEDGMENT STATE OF WISCONSIN ) ss. P~ ~~' County ) Personally came before me this day of November , 2002 the above named Kenneth L. Sunday and Patty I. Sunday. husband and wife be the person(s) who executed the foreeoins ~clcnowledeed the same. S't~t~ of Wisconsin m I rmanent. (If not, state expiration date: ~sy` - ~- t7 G 1 * Names of persons signing in any capacity must be typed or printed below their signatu iil<ti~„ O-PRO (80oxi5s-2021 www.infoproforrns.com QUIT CLAIM DEED STATE BAR OF WISCONSIN FORM No. 3 - 2000