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HomeMy WebLinkAbout030-2008-80-050 County Safety and Buildings Division 57;, CO/ k x i ~F201 W. Washington Ave., P.O. Box 7162 Sanitary Permit Number (to be filled in by Co.) / Madison, WI 53707-7162 -72 it A State Transaction Number Application r. In accordance with SPS 3 1 is. Code, submission f this form to the appropri~~,,$$o,vernmen is required prior to obtain j i permit. Note: Application forms for state-owned POIV/, ar u miffed to roject Address (if different than mailing address) ~ the Department of Safety o essional Servies. Personal information you pro ide may be used t) eTjdary u ses in accordance with the Privacy Law, s. 15.04 1 m , Stats. ' "t Pz 11~ i 1. Application Information - Please Print All Information Property Owner's Name OUP Parcel # N/ -5-0-11-1` 11 ©,3O - ZeP D ~3 - 6 --Q,~CO Property Owner's Mailing Address Property Location 35 4 5 \ 6 y& CC) U y 12 Govt. Lot O J E City, State Zip Code Phone Number WI., Section rcle one) 14 w5 ~j T ~ N; R _ E or&V H. Type of Building (check all that apply) , / Lot # 1 or 2 Family Dwelling -Number of Bedrooms ~T Subdivision Name 1 Block # ❑ Public/Commercial -Describe Use l ❑ City of CSM Number El El State Owned -Describe Use 5 7~, [ Village of y- / v0 244 P~ [g Town of SZ ' ~J os e/~f i 6, LL5 l~ t`L C(OLJ Ee.a 1 (o III. Type of Permit: (Check only one box on line A. Complete line B if applicable) A. ❑ New System 19 Replacement System El g Treatment/I-Ioldin Tank Replacement Only Other Modification to Existing System (explain) B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of Plumber List Previous Permit Number and Date Issued rEl Permit Transfer to New Before Expiration w ner tY L ~ltS"s ` IV. Type of POWTS S stem/Com nent/Device: Check all that apply) )0 Non-Pressurized In-Ground ❑ Pressurized In-Ground ❑ At-Grade ❑ Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil ❑ Holding Tank ❑ Other Dispersal Component (explain) ❑ Pretreatment Device (explain) V. Dis ersaUTreatme t Area Information: Design Flow (gpd) esign Soil Application Rate(gpr Dispersal Area Required (sfJ Dispersal Area Proposed (s System Elevation Cf6, L Vf ® 1 o ✓ AZt '0 ZOO VI. Tank Info Capacity in Total # of Manufacturer Gallons Gallons Units D U 0 y V U rA vJ New Tanks Existing Tanks tC 1 4 0 Y, 5 C) /O a U w C7 P. Septic or Holding Tank x Dosing Chamber 7370 ~F s VII. Responsibility Statement- I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) PlumbeM-j MP/MPRS Number Business Phone Number JOHN Sc~i'«tl r7 ZZ Z,~ ° 745-, 7lo0 -dYg Plumber's Address (Street, City, State, Zip Code) VIII. Coun /De artment Use Only Approved El D ved Permit Fee Date Iued l Issuing A t Signature ❑ wn ~ en Reason r Denial $ at, 161 Z3/ ,3 IX. Condit WilAfteasons for Disapproval n kr~tank, efi9tiltent filter and `3 6k 6y6~e dispersal cell,must all be services I maintained J as per Management plan provided by plumber. I 2. stll~tadk requirements must .be maintained j !Q°LI+~,.?i►t I /'r 0.v~ ~j J 3 "-4T as per applicable code 1 ordinances: / Attach to complete plans for the system and submit to the County only on paper not less than 81/2 x 11 inches in size SBD-6398 (R. 11/11) CONVENTIONAL COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Project Name: Schley 4-Bedroom Septic System Owners Name: Michael & Stephanie Schley Owner's Address 646 Cty Road E Hudson, WI 54016 Legal Description: NE1/4, SW1/4, S34, T30N, R19W Township St. Joseph County: St. Croix Subdivision Name: NA Lot Number: 1 Block Number Parcel I.D. Number 030-2008-80-050 Plan Transaction No. Page 1 Index and title Page 2 Plot Plan Page 3 Septic Tank Tank Specifications Page 4 Effluent Filter Information Page 5 Dose Tank Specifications Page 6 Dose Tank Cross Section Page 7 & 8 Pump Specifications and curve Page 9 System Sizing & Cross Section Pagel0 EZ Flow Information Page 11 & 12 Management and contingency plan Page 13 Septic Tank Maintenance Agreement Page 14 Warranty Deed Page 15 CSM Attachment Soil Evaluation Report Designer: John Schmitt Licnese Number: MPRS 223760 Date: 10/18/2013 Phone Number: 715-760-0486 Signature: In-Ground Soil Absorption Component Manual Version 2.0 SBD-10705-P (N. 01/01) PLOT PLAN N Schley 4 Bedroom Septic System Project Name Legal Description: NE114, SWUM, S34 T30N, R19W P.I.D: 030-2008-80-050 Subdivision Name: NA Lot 1 SCALE: 11. `40. Township: ST. JOSEPH Parcel Size: 7.467 Acres County: ST. CROIX System Elevation: T1=95.00' Proposed 60' EZ Flow Trench Slope: 5% T2=95.40' Proposed 60' EZ Flow Trench BM1 Elevation: 100.00' To of 2" PVC pipe T3=95.80' Proposed 60' EZ Flow Trench BM2 Elevation: 102.28' To of garage floor T4=96.20' Proposed 60' EZ Flow Trench Backhoe Pits: 2 inch Sch 40 -ASTM D1785 NOTE: Existing septic system to be abandoned as per code. 4 inch Sch 40 -ASTM D2665 4 inch 3034 - ASTM D3034 OZ OOP-TN P20f)EjT ~ L/NL 139 BKt ( ~pLE S i4 r>1 "M T3 iZ TI G J H fl R ® 5 9~ , 13 j3q R3 ~ 1 s loQ E 1 I W ELL ®bZ -J BM L ~ ~ 60 ~ / ~C iU ea. 6ARA66 ~N O 7$f `gLLO 01 PCHAmg ~u 3 125 0 ~~L~o~ SrIPro c %~J ~Z5 i`x~sT~Nb 5•~' ~ House Iu I)q s\ pR~l W r LL D Z N m 52r AS 84" REQD D Z c 41" m 0 r N n'1 G O I UP 40" ` N 1 4" CAS D N x 3" 44r 5- p D m I 1 v m N 36" co :!g IT! rn r co 0 m UP 38" o N 4" CAS m ;u I g p m z vi 39" m n D co I D 1 N m D r c DO D Z r0 x C Z Zr I x x D ° _c n In m D -I o v_ --I --I Z 0x N0 D9z Z DOZ v D C)-%z srW*1~rr*mmy00DN T N x m Zr7C nC0 C1 O9Z D sZ ~rvZ- O cv vX acv vrtn m ~ > ~~v ;K xp~ Oxx~Or(AA N r QQ c ~izan_ 1X ZQ xN m z y0 -qi? f7I ~AF •NN m\ m N -iN -W Ov Dp2 OD Dm w DN'.1 N ID ~ p(; ~OO~~ X11 D z OOD Z D A m p 0-V :106 A m y I CD --I rA ~ 0 -T7 v I U (A/f C) U) = C N v m D r = s v W 5 D m m 0 580 C N ~m D rnDm mW b pv~ v v mo nCD K rl+ 0 D Nv j mrZ -g 0 m< o m.. Z 0 ;0m ~O 51 G7 Z ~Om mo EA O '11 20 v g m n U) O m N c o 0 o,o Z 3 ~ ; 2 O~ ON uZi m r Z D 0 r 0 ~ -I $ O H ~ A N Z M z F \ N WLP1250-MR DRAWN BY. SME SCALE: 1/4"=l'-O" PRE-POUR: X NIERER ° m SEPTIC MANUAL COCCBETE REV. \ Z W3716 US HWY 10 MAIDEN ROCK, " 54750 DATE: JANUARY 2010 DATE:. POST-POUR: ° REVISED JAN. 2010 800-325-8456 FILE: ■MM-W Inc, ~KINSTALLATION INSTRUCTIONS Innovations in Precast, Drainage , AaOvvision of P*Iok Inc. PL-525/PL-625 FILTER Products & Wastewater INSTALLATION INSTRUCTIONS Center filter with opening e WE J N Z) a:0 s ~ e Additional pipe or Polylok Extend & Lok- Glue for centering. Step 1: Step 2: Step 3: (A) Locate the outlet of the septic tank. (A) Before installation, place the (A) Glue the filter housing on the (B) Remove tank cover and pump tank filter housing on to the outlet pipe. outlet pipe. if necessary. (B) Make sure that the housing (B) Insert the filter cartridge in the is positioned so the filter can be housing, making sure the filter removed from the tank for cartridge is properly aligned and maintenance and service. completely inserted in the housing. MAINTENANCE INSTRUCTIONS Y~ y '9 1 I ` l4 1 Step 1: Step 2: Step 3: Locate the outlet of the septic tank. (A) Remove tank cover and pump (A) Insert the filter cartridge back if necessary. into the the housing making sure PLUMBING DO NOT USE (B) Pull the filter out of the housing. the filter is properly alighed FILTER WHEN REMOVED (C) Hose off the filter over the septic tank. and completely inserted. USE RUBBER GLGMS Make sure all solids fall back into the (B) Replace septic tank cover WHEN CLEANING FILTER septic tank. a z U) z m z 61" 84" c D 8 ;a 42" v ~ m m 4" UP 41" I / \ CAS v 3" 37" 4" N r D I_ co UP 39" ( 1 o D 4" CAS \ m ;u m / n i \ N I V ~ C X g -n U5 --71 0 40" r v < 0 DZ mDr y co or- op to m m ~U;u o r mm x~ m D Z C) m C DO D Z _ Z Z N ZA Z D r, C m m rrn 1 X ~ g 0 Z ~m Z M Z v~N czi ~0~ D oNO N~o ' goC ~xrow*w zp5 ~Fz Cv v =J W m mDD D m0 KD 0I ,-=1 ~ N Z v1~ mm n m D C/) ~r Z 0 ~ZC ~1nC m N --4 M aaZm u) CDC p OD mD N D(n~ ~D~ ; ~m~ N r- > v no D z OOD Z D P1 m O ~n cnmrn a) -4 U) D I m GL" M O0~ m CA K) U) c (n 0 r- En cyl I 'o 0" r m m w --I n mp -D -4 Z R,4 0 my ~O oCD ~ c) D W m Z 0W x c (n A O D 00 r =rz r0 W~n I ' D a m< o m Z ~ m ~ p z M ~ r Z -oz a O D O r C r v r O m ~sG n 7o m w 0 n R0 v o s p z 0 -0 ;v D z A -94 0 mD c A Z ;a m r m N > p g H z 0 Z m A z Fn \ cn WLP750-MR DRAWN BY: SME SCALE: 1 4"=1'-0` PRE-POUR: m MISER n -4 SEPTIC MANUAL W3716 US HWY 10 c MAIDEN ®n ROCK, WI ceETE 54750 DATE: JANUARY 2010 DATE:. POST-POUR: \ P REVISED JAN. 2010 800-325-8456 FILE: UPM-M DOSE TANK DETAIL Owner's Name: Michael & Stephanie Schley 93.8 ft Inlet Elevation Weatherproof Manhole with Locking Device Junction and Warning Label Quick disconnect fitting mass Alternate forcemain outlet Sim/Tech Filter Dimensions Inches Gallons res (a) a 20 405.6 alarm on separa n (b) b 2 40.56 C 5 101.4 dose Vol a (c) pump on d 10 202.8 Total 37 750.36 pump off d (d) 9o.46ft Intake Elevation Tank Manufacturer Wieser Concrete Pump Manufacturer Zoeller Tank Model 750 Pump Model 53 Tank Capacity 750 gal Alarm Manufacturer SJE Rhombus Tank Volume 20.28 gal / in Alarm Model AB Filter Manufacturer Polylok Filter Model 525 DOSE VOLUME CALCULATIONS TOTAL DYNAMIC HEAD CALCULATIONS Design Flow (DWF) 600 gal / day Min Network Supply na ft Number of Doses 5 /day Passive Vertical Lift 7 ft - (Header/D. Box elev. - Pump intake elev.) or Max. Dose Volume 90 gal Friction Loss 1.5 ft Factor)/1 00 + Filter 00 Length x Friction Loss Filter Friction Loss Drain Back 7 gal Total Dynamic Head 8.5 ft Design Dose Volume 97 gal Min Discharge Rate 20 gpm NOTE: Pump and alarm are to be installed on separate circuits. INTERNAL DIMENSIONS OF TANK 20.28 gallons/ inch Diameter 81 in Liquid Depth 37 in Plumber/Designer Signature: License 223760 Date: October 18, 2013 /O~7p SECTION: 2.20.010 QViIL/TY ~UMP9 SNCE FM0493 0311 Product information presented ® ® Supersedes here reflects conditions at PUMP l0810 time of publication. Consult factory regarding discrepan- cies or inconsistencies. MAIL TO.• P.O. BOX 16347 • Louisville, KY 40256-0347 visit our web site: SHIP T0: 3649 Cane Run Road • Louisville, KY 40211-1961 www•ZO@/ler com (502) 778-2731.1(800) 928-PUMP • FAX (502) 774-3624 COMPARE THESE FEATURES 53 - 57 Cast Iron Series • Non-Clogging vortex impeller • Float operated, submersible (NEMA 6) 2-pole mechanical 55 - 59 Bronze Series switch & variable level long cycle systems available • UL Listed 3-wire cad plug; 9 ft. standard for automatic, 15 ft. standard for nonautomatic (For Pump Prefix ldentirication see News & Views W52) • Corrosion resistant powder coated epoxy finish • No sheet metal parts to rust or corrode i 'M I G H TY-MATE" • Stainless steel screws, switch arm, guard and handle • No screens to clog SUBMERSIBLE PUMP • Watertight neoprene "O" ring between motor and pump FOR housing U DEWATERING (SUMP) • Solid buoyant polypropylene float Te*%d to UL • Motor - 60 Hz, 1550 RPM, oil-filled, hermetically sealed, sanawd uLris. OR automatic reset thermal overload protected EFFLUENT (SEPTIC TANK SYSTEMS) • Upper and lower sleeve bearings running in bath of oil • Entire unit pressure tested after assembly c us PASSES SOLIDS _Lt • Carbon and ceramic shaft seal nesWwUU78aoe 1'/Z' NPT DISCHARGE • Maximum temperature for effluent or CsA222108 Sw"ds) dewatering-130eF (54°C) AUTOMATIC • Passes W inch spherical solids MODEL • 1W NPT Discharge. • On point-7%4" • Off point-3" • Major width-10 3/32" • Height-101/16" SPECIAL MODEL FEATURES: MODEL 53 MODEL 55 Cast iron switch case, motor & Bronze switch case, motor & pump housing pump housing Engineered thermoplastic base Engineered thermoplastic base VORTEX TYPE Engineered, glass-filled, plastic Engineered, glass-filled, plastic IMPELLER impeller with metal insert impeller with metal insert Stainless steel guard & handle Stainless steel guard & handle Bearing - lower & upper oil fed Bearing - lower & upper oil fed cast iron bronze MODEL 57 MODEL 59 All cast iron construction All bronze construction Stainless steel guard & handle Stainless steel guard & handle Bearing - lower & upper oil fed Bearing -lower & upper oil fed cast iron bronze Cast iron impeller Bronze impeller ALL MODELS ARE COMPLETELY SUBMERSIBLE POWDER BN MODEL HERMETICALLY SEALED COATED TouaNn Watertight - dust tight. Permanently oiled bearings. MODELS AVAILABLE VARIABLE LEVEL CONTROL Autowtic or Nonautomatic SYSTEMS AVAILABLE "53 - 57" - .3 HP,115V or 230V "55 - 59" - .3 HP,115V or 230V Note: The sizing of effluent systems normally requires variable level BE531BE57 & BN53/BN57 available packaged float(s) controls and properly sized basins to achieve required with Piggyback Variable Level Float Switch pumping cycles or dosing timers with nonautomatic pumps. 0 Copyright 2011 Zoeller Co. All rights reserved. TOTAL DYNAMIC HEAD/FLOW LU W PUMP PERFORMANCE CURVE PER MINUTE MODELS 53/55/57/59 EFFLUENT AND DEWATERING 0 6 20 MODEL 53/55/57/59 Feet Meters Gal. Liters c=) 5 1.5 43 163 g 15 10 3.0 34 129 4 15 4.6 19 72 a 10 Shut-off Head: 19.25 ft.(5.9m) 0 H closes] 2 37/8 83118 rj 4 818 11/2 -11 12 NPr _T 0 3 718 10 20 30 40 50 i GALLONS O LITERS 4 0 80 160 FLOW PER MINUTE i i i i i i CONSULT FACTORY FOR SPECIAL APPLICATIONS • Variable level float switches available • Variable level long cycle systems available • Available with special cord lengths of 15', 25', 35', (50'230V only) 10 116 i i • Alarm systems available i • Duplex systems available ; 33132 SELECTION GUIDE 1. Integral float aerated mechanical switch, no external control required. 2. Single piggyback variable level float switch or double piggyback variable level float switch. Refer to FM0477. 3. Mechanical altemator "M-Pak' 10-0072 or 10-0075. 4. See FW712 for correct model of Electrical Alternator. 5. Variable level control switch 10-0225 used as a control activator, with "Easy assembly" (pump Electrical Alternator (3) or (4) float system. gins pipe not sin* seal control Selection l isti ngs Model VeltS Phase Mode Amps Si x Duplex CSA UL M53155 & M57/59 115 1 Auto 9,7 1 Y Y N53/55 & N57159 115 1 Non 93 2 3 or 4& 5 Y Y BN53 115 1 Auto 9.7 Y Y ON57 115 1 Auto 93 N Y BE53/57 230 1 Auto 4s Y Y OPTIONAL PUMP STAND P/N 10-2421 1)53155 & D57/59 230 1 Auto 4.8 1 Y Y Reduces potential clogging by debris E53/55 & E57/59 230 1 Non 4.8 2 3 or 4 & 5 Y Y Replaces rocks or bricks under the pump single piggyback switch included. Made of durable, noncorrosive ABS CA°"0N • Raises pump 2" off bottom of basin All installation of controls, protection devices and wiring should be done by a qualified • Provides the ability to raise intake by adding sections of 1'h" licensed electrician. All electrical and safety codes should be followed including the most recent National Electrical Code (NEC) and the occupational Safety and Health or 2" PVC piping Act (OSHA). • Attaches securely to pump For information on additional Zoeller products refer to catalog on Piggyback Variable Level Accommodates sump, dewatering and effluent applications FloalSw4dtes, FM0477; ElectricalAllermtor, FM0486; MednanicalAlternalor, FM0495; Sump! NOTE: Make sure float is free from obstruction. Sewage Basins, FM0487; and Shp Phase Simplex Pump Cowol/Alarm Systems, FM0732. RESERVE POWERED DESIGN For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump. 0 Copyright 2011 Zoeller Co. All rights reserved. SOIL ABSORPTION SYSTEM DETAIL / GRAVELLESS LEACHING UNIT Project Name: Michael & Stephanie Schley 4 No. of Cells 6 Per Cell 3 ft Cell Width 24 Total No 1203H 60 ft Cell Length 300 sq ft EISA Per Cell 3 ft Cell Spacing 1200 sq ft Total EISA Manufacturer Model Laying Length EISA Rating Infiltrator EZ1203H-5ft 5.0' 25.0 EZ1203H-10ft 10.0' 50.0 Gravelless Leaching Unit Manufacturer: to INFILTRATOR Gravelless Leaching Unit Model: 1203H Typical Cross Section Finished Grade 100.50ft Observation Pipe with approved cap or vent : Soil Backfill 42 in • ■ ■ Geotextile Fabric ■ ■ ■ -'96.2', 95.8', 95.4', 95.0' ft Infiltrative Surface 12 in ~ it 92.26 ft Limiting Factor >36 in Slotted and Anchored Vent/ Observation Pipe with Cap ...■■■■■■■■■■■■-■-:::00a a-;,■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■■.■■■■■■■■■■■■■■■■■ Plumber/Designer Signature: License MPRS 223760 Date: October 18, 2013 Wisconsin Department of Commerce, Safety and Buildings Division, 5. The Absorption area (SF) necessary for a given site shall be has reviewed the specifications and/or plans for this product and sized based on maximum daily sewage flow (GPD) and the determined it to be in compliance with chapters Comm 82 through Permeability for the site. If certain criteria is met, the EISA 84, Wisconsin Admin. Code, and Chapters 145 and 160, Wisconsin sizing can be used in Wisconsin, resulting in a 40% smaller Statutes. All sites must meet the Site & Soil Conditions & Location & Isolation distances as noted in local regulations, drainfield. The approved products are 1203H (3-12" bundles with pipe in cen- 6. Place EZJIow bundle(s) in the EZJTow configuration approved ter bundle in 5' or 10' lengths) and 1203HP (3-12" bundles with pipe by system design permit specified for the particular site. The in each bundle in 5' or 10' lengths. top or center-most bundles containing pipe are joined end to A single pipe bundle contains a four inch perforated pipe surround- end with an internal pipe coupler. Any additional aggregate ed by EPS aggregate and is held together with polyehtylene net- only bundles that may be required, should be butted against ting. A single aggregate bundle contains aggregate only and is held the other aggregate-only bundles and do not require any together with polyethylene netting. type of connection. Materials and Equipment Needed 7. The top of each GEO cylinder contains a filter fabric pre-manu- • EZJlow@ Bundles factured in between the netting and aggregate. The fabric • EZJIow Geotextile Fabric is inserted to prevent soil intrusion. The installer shall make • EZJIow Internal Pipe Couplers sure the the GEO is positioned upward and is in contact with • Pipe for Header and Inlet the fabric contained in the adjacent cylinder before backfill- • Backhoe/Excavator ing. Installation Instructions 8. The EZJZow Drainfield Systems should be installed in a level The instructions for installation of EZJlowo products are given be- trench in all directions (both across and along the trench low. This product must be installed in accordance with state rules bottom) and should follow the contour of the ground surface defined in chapters Comm 82 through 84, Wisconsin Administrative elevation (uniform depth), with all continuous adjoining Code, and Chapters 145 and 160, Wisconsin Statutes, as well as the 10-foot cylindrical bundles placed end to end, with central local health department's current design manual. bundle distribution pipe interconnected, without any dams, stepdowns or other water stops. 1. After the local health department has determined sizing, con- figuration, and layout for the EZJIow systems, stake or mark 9. The trench top shall be graded such that water will not pond. with paint the location of trenches and lines. Be careful to set Backfill should be seeded or sodded immediately after correct tank, invert pipe, header line or distribution box and completion to reduce erosion. trench bottom elevations before installation of pipe bundles. 10. EZJIow EPS bundles are flexible and can fit in curved trenches 2. Remove plastic EZJIow shipping bags prior to placing bundles as may be necessary to avoid trees, boulders, or other in the trench(es). Remove any plastic bags in the trench be- obstacles. fore system is covered. 11. EPS aggregate is lighter than water, therefore, it might be 3. This product must have geotextile fabric that meets require- expected that natural buoyancy forces would tend to cause ments of s. Comm 84.30 (6) (g), Wis. Adm. Code, installed EZJIow assemblies to float out of ground when ponding oc- directly on top of the product and extending down along the curs. Field experience has shown, however, that this is not a sides of the product to a point at least six inches from the problem when systems have a minimum of 6" of soil cover as bottom of product. recommended by manufacturer. n 1203H-GEO 4. When installed in a trench the trench should be dug to a width of 36 inches. This not only saves labor in excavation, Geotexdle but also provides better load-bearing capacity after backfill- BarrierMaterial ing is complete. ,r W&YIrN. PPC XRl% Top I- EVZow Ring Industrial Group P: 1-800-649-0253 30 Industrial Park PERFORMANCE. QDOES IT.s F: 1-866-279-9203 Oakland, TN 38060 Ringlndustrial.com 1044101008 0 2006 Ring Industrial Group, LP POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page-of FILE INFORMATION SYSTEM SPECIFICATIONS Owner: Michael & Stephanie Schley Tank Manufacturer: Wieser Concrete r NA Permit # oZ Septic E: Dose E Holding Volume: 1250 gal DESIGN PARAMETERS Tank Manufacturer: Wieser Concrete F NA Number of Bedrooms: 4 r NA C: Septic E Dose E: Holding Volume: 750 al Number of Public Facility Units: F NA Vertical Distance Tank Bottom (s) to Service Pad:_10 ft Estimated (average) Flow: 400 gal/day Horizontal Distance Tank(s) to Serivice Pad: 25ft Design (peak) Flow = estimated x 1.5: 600 gal/day Specific servicing mechanics must be provide if vertical is>15 feet or if In Situ Soil Application Rate: 0.5 gal/day/ft2 horizontal is > 150 feet. Specific instructions to be provided on back. Standard Domestic InfluentlEffluent Monthly average Effluent Filter Manufacturer: POLYLOK F NA Fats, Oils & Grease (FOG) :530 mg/L Effluent Filter Model: 525 Biochemical Oxygen Demand (BOD5) :5220mg/L r NA Pump Manufacturer: Zoeller F NA Total Suspended Solids (TSS) 5150mg/L Pump Model: 53 High Strength Influent/Effluent Monthly average Petreatment Unit Fats, Oils & Grease (FOG) 530 mg/L Manufacturer: Biochemical Oxygen Demand (BOD5) :5220mg/L (J NA r Mechanical Aeration r Peat Filter P NA Total Suspended Solids (TSS) :5150mg/L r Disinfection r Wetland Petreated Effluent Monthly average r Sand/Gravel Filter r other: Biochemical Oxygen Demand (BOD5) 530mg/L Soil Absorption System Total Suspended Solids (TSS) s30mg/L IV- NA V In-Ground (gravity) f In-Ground (pressure) r NA Fecal Coliform (geometric mean) !5104cfu/100mi r At-Grade r Mound Maximum Effluent Particle Size: % in dia. F r Drip-Line r Other: Other: F ther: T: NA MAINTENANCE SCHEDULE Service Event Service Frequency When combined with sludge and scum equals one-third of tank volume Pump out contents of tank(s) When the high water alarm is activated month(s) Inspect condition of tank(s) At least once eve : 3 V year(s) Maximum 3 ears) r NA month(s) Inspect dispersal cell(s) At least once eve : 3 ✓ year(s) Maximum 3 ears) r NA I- month(s) Clean effluent filter At least once eve : 1.5 IV year(s) r NA month(s) r Inspect pump, pump controls & alarm At least once eve : 1.5 rr Y-(s) r rmrnms) Flush laterals and pressure test At least once eve : r year(s) r✓ NA -M(S) Other: At least once eve : r year(s) r NA 1Other: MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications: Master Plumber; Master Plumber Restricted Sewer; POWTS Insepector; POWTS Maintainer; Septage Servicing Operator (pumper). Tank inspections must include a visual inspeciton 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 a check for any back up or ponding of effluent on ground surface. The dispersal cell(s) shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding of effluent on the ground surface. The ponding of effluent on the ground surface may indicated a failing condition and requires the immediate notification of the local regulatory authority. When the combined accumualtion of sludge and scum in any treatment tank equals one-third 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 chapter NR 113, Wisconsin Admininistrative Code. All other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, petreatment units, and any servicing at intervals of 512 months, shall be performed by a certified POWTS Maintainer. A service report shall be provided to the local regulatory authority within 30 days of completion of any service event. (Rev.2/05) Page of START UP AND OPERATION For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products, solvents or other chemicals or sediment that may impede the treatment process and/or damage the soil 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 extended 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 and may overload them resulting 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 not 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 (sump pump) discharge; 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 taken to insure that the system is properly and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code: • All piping to tanks, pits and other soil absorption systems shall be disconnected and the abandoned pipe openings sealed. • The 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 POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide the opportunity to obtain a sanitary permit for a code compliant replacement system: ❑ A suitable replacement area 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 and proposed structure, lot lines 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 the time of their permit issuance. ❑ A suitable replacement area is not available due to setback and/or soil limitations. If the soil absorption system cannot be rehabilitated and barring advances in POWTS technology, a holding tank may be installed as a last resort. El 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. ❑ Mound and at-grade soil absorption systems may be 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: TREATMENT TANKS AND HOLDING TANKS MAY CONTAIN POISONOUS GASSES AND LACK SUFFICIENT OXYGEN TO SUPPORT LIFE. NEVER ENTER A TREATMENT TANK OR HOLDING TANK UNDER ANY CIRCUMSTANCE. DEATH MAY RESULT. ESCAPE OR RESCUE FROM THE INTERIOR OF A TANK IS VERY DIFFICULT. ADDITIONAL INFORMATION: POWTS INSTALLER POWTS MAINTAINER Name: John Schmitt Name: John Schmitt Phone: 715-760-0486 Phone: 715-760-0486 SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name: Owners Chace Name: St. Croix County Zoning Phone: Phone: 715-386-4680 This document is intended to meet minimum requirements of Ch. Comm 83.22(2)(b)(1)(d)&(f) and 83.54(1), (2) & (3), Wisconsin Administrative Code. Use of this document does not guarantee the performance of the POWTS. (Rev. 2/05) ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM OwnerBuyer Michael & Stephanie Schley Mailing Address 646 County Road E Property Address Same (Verification required from Planning & Zoning Department for new construction.) City/State Hudson, WI Parcel Identification Number 030-2668-80-656 LEGAL DESCRIPTION Property Location NE '/4 , SW '/4 , Sec. 34 T 30 N R 19 W, Town of St. Joseph Subdivision Plat: , Lot # Certified Survey Map # / 2(a Volume , Page # Warranty Deed # q301 & (before 2007)Volume , Page # Spec house E lyesElno Lot lines identifiable Elyes[]no SYSTEM MAINTENANCE AND OWNER CERTIFICATION Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed, by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. Owner maintenance responsibilities are specified in §SPS. 383.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance. The property owner agrees to submit to St. Croix County Planning & Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. I/we, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Safety And Professional Services 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. l1we certify that all statements on this f are true to the best of my/our knowledge. I/we am/are the owner(s) of the property described above, by virtue of a warra deed recorded in Register of Deeds Office. Number of b ooms 4 - 10/1813 "tYGNATURE OF A&PLIC~NNT(S) DATE ***Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Department. Include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if reference is made in the warranty deed. (REV. 04/12) 8 0 1 6 9 0 4 State Bar of Wisconsin Form 1-2003 Tx:4012933 WARRANTY DEED 930161 Document Number Document Name BETH PABST REGISTER OF DEEDS ST. CROIX CO., WI THIS DEED, made between John T. Schottler and Georgina M. Schottler, 01/06/2011 4:06 PM EXEMPT#: S husband and wife as survivorship marital property REC FEE: 30.00 TRANS FEE: 300.00 ("Grantor," whether one or more), and Michael J. Schley and Stephanie M. Schley, PAGES: 1 husband and wife as survivorship marital property ("Grantee," whether one or more). Grantor for a valuable consideration, conveys to Grantee the following described real Recording Area estate, together with the rents, profits, fixtures and other appurtenant interests, in Name and Return Address St. Croix County, State of Wisconsin ("Property") (if more space is Leo A. Besk r needed, please attach addendum): Rodli, Beal r, Krueger & Pletcher, SC Lot 1 of Certified Survey Map filed November 12, 2010, in Val. 24 of C.S.M., pg. 5744, LRIve North aln Street - Box 138 as Doc. No. 926688, located In part of the NE1/4 of the SWIM of Section 34, r F s , WI 54022 JC~ Township 30 North, Range 19 West, Town of St. Joseph. o?~--21W, S -~C)--cam Parcel Identification Number (PIN) This is not homestead property. (is) (is not) Grantor warrants that the title to the Property is good, indefeasible, in fee simple and free and clear of encumbrances except: easements, restrictions, and rights of way of record, if any. Dated eC' ~I a (SEAL) ~ (SEAL) + Joojhn T. Schottler (SEAL) rJr t one/ % i/!`/tti (SEAL) * Georgina M. Schottler AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF WISCONSIN ) ) ss. COUNTY) authenticated on ~~ddeen1.) r4.=2940--- Personally came before me on the above-named John T. Schottler and Georgina M. Schottler TITLE: MEMBER STATE BAR OF WISCONSIN (If not, to me known to be the person(s) who executed%the. fdregomg authorized by Wis. Stat. § 706.06) ins *yb d edged the same. , THIS INSTRUMENT DRAFTED BY: . ni-CgKeVII H c Leo a t3 akar No, Stat e of Wisconsin 31. Rodli. Beskar. Krueger & Pletcher. SC My commission (*gwnflunm) (expires:'1r7'0` J '•.rTl }Y (Signatures may be authenticated or acknowledged. Both are not necessary.) NOTE: THIS IS A STANDARD FORM. ANY MODIFICATION TO THIS FORM SHOULD BE CLEARLY IDENTIMP. WARRANTY DEED (02003 STATE BAR OF WISCONSIN FORM NO. 1-2003 `Type name below signatures. INFO-PRO- Legal Forms • (800)6552021 • infoprofams.com 1 of 1 Sst~ -.;~euib,~wr Department of #1725 y , SOIL EVALUATION REPORT s = Safety and in accordance with Comm 85, Wis. Adm. Code Page 1 of 3 Professional Se(VICeS Schmitt Soil Testing, Inc. County Attach complete site plan on paper not less than 8% x 11 inches in size. Plan r~lnst_ St. Croix include, but not limited to: vertical and horizontal reference point (BM), direction and' percent slope, scale or dimensions, north arrow, and location and distanc" nearest roa k him I.D. Please print all information. 030-2008-80- 50 Revi By Date VTs`15.04 (1) /3 z3 Personal information you provide m4MM used for secondary purposes (Privacy Lai Property Owner PropettycfQn Schley, Mi IS A anie Govt. Lot NE1/4, W1/4, S34, T30N, R19W Property Own ai' ress Lot # Block # Subd. Nam or CSM# 646 Cty Rd E 1 CSM 24-6744 City State Zip Code Phone Number ❑ City Village ❑ Town Nearest Road Hudson WI 54016 651-271-0920 St.Joseph 64Th St ❑ New Construction Use: ❑ Residential / Number of bedrooms 4 Code derived design flow rate 600 GPD Replacement ❑ Public or commercial - Describe: Parent material Outwash (Jewitt series JSB) Flood plain elevation, if applicable NA ft. General comments Replacement area is suitable for a conventional system with a 0.5 gpd/sgft rating. Possible systm elevation is T1=95.0', T2=95.4', and recommendations: T3=95.8', T4=96.2' F1 Boring F-1 Boring # FX] Pit Ground surface elev. 99.66 ft. Depth to limiting factor 103+ in. 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 1 0-8 10yr3/3 none I 2msbk mfr gw 1vf 0.6 0.8 2 8-22 7.5yr4/6 none vgrls lcsbk mvf Cs ivf 0.5 1.0 3 22-44 10yr5/6 none fs/sl icsbk mfr gw 0.4 0.7 4 44-63 7.5yr5/6 none gris lcsbk mvfr Cs 0.7 1.6 5 63-103 10yr6/4 none s 1 0sg ml 0.7 1.6 91p. 2 1 22 44" HAS 1" BOF 7.5YR4/4, SL, 1MSBK ❑ Boring 2 Boring # Pit Ground surface elev. 99.11 ft. Depth to limiting factor 105+ in. 9 Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDM2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-6 10yr3/3 none sil 2mgr mvfr as lvf 0.6 0.8 2 6-30 10yr5/3 none sil 3msbk mfr gw 1vf 0.6 0.8 3 30-46 7.5yr5/6 none vgrsl lmsbk mfr gw 0.4 0.7 4 46-55 7.5yr5/6 none vgds 1Csbk mvfr gw 0.7 1.6 5 55-105 10yr5/6 none grlfs lcsbk mvfr 0.5 1.0 * Effluent #1 = BOD? 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BOD5 <_30 mg/L and TSS <_30 mg/L CST Name (Please Print) Signature: CST Number 227429 Thomas J. Schmitt Address Schmitt Soil Testing, Inc. Date Evaluation Conducted Telephone Number 1595 72nd Street New Richmond, WI 54017 10/11/2013 715-760-1978 San-8330 (a07/00) Property owner Schley, Michael & Stephanie _ Parcel ID # 030-2008-WO50 _ Page __2 _of 3 Boring # 01 Boring Pit Ground surface elev. 102.26 ft. Depth to limiting factor 120+ in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft' in. Munson Qu. Sz. Cont. Color Gr. Sz. Sh. -Etfffl -Eff#2 1 0-6 10yr3/3 none SO 2fsbk mfr as 2f lvf 0.6 0.8 2 6-21 10yr4/3 none SO 2msbk mfr gw 1Vf 0.6 0.8 3 [28-#K0 -28 7.5yr4/6 none si 2msbk mfr 9w ivf 0.6 1.0 4 10y6/6 none fs 0s9 ml 0.5 1.0 F41 Boring # L J Boring Z Pit Ground surface elev. 102.44 ft. Depth to limiting factor 105+ in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/R' in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. -E11#1 -Eff82 1 0-11 10yr3/3 none 1 2mgr mfr cs 2vf 0.6 0.8 2 11-22 10yr5/3 none SO 2msbk mfr gw 1Vf 0.6 0.8 3 22-50 10yr4/4 none sil 2msbk mfr Cs 0.6 0.8 4 50-71 7.5yr4/6 none grlfs icsbk mvfr cs 0.5 1.0 5 71-105 10yr5/6 none grls 0s9 ml 0.7 1.6 - T 2 7;_ ,i Boring 5 Boring # Pit Ground surface elev. 96.23 ft. Depth to limiting factor 109+ in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft' in. Munson Qu. Sz. Cont. Color Gr. Sz. Sh. -Eff#1 -EfW 1 0-18 10yr3/3 none sii 1rnp1 mfr as 2vf .4c .6 2 18-26 10yr5/3 none sil 2fsbk mfr gw 1Vf 0.6 0.8 3 26-51 10Yr4/4 none sil 3msbk mfr gw 1Vf 0.6 0.8 4 51-79 7.5yr4/4 none grsl Om mfi gw 0.2 0.6 5 79-109 10yr5/4 none grsl Om mfi 0.2 0.6 ` Effluent 01 a 8005> 30 < 220 mg/L and TSS >30 <150 mg/L " Effluent 92 = BOD5 < 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. Sduva swl Testing, rnr- 58L1.8330 (R.07l06) Page 3 of 3 `Ce6dneted by: -Conducted ~-or- . We ScWey • _ - - Schmitt Soil Testing, Inc Name: Michael & S Thomas J. Schmitt, CST 227429 Address: 646 Cty Rd E -9595 tzrrd St: --Dity, State zil )4ad5'0-. r=✓~'_. ~f _ New Richmpnd~ Phone: 71 bQ-1978 PID: 030-2008-80-050 Lot r CSM 2-4;mrt l V.467-Ac-ft si)_ na~u _ Date K! - lega1.Descriptiont:__NE1/4SWV-tS34-T-3uhi_RI- SW _ - A-Ben ~-liltarfi TownShip County St. Joseph, t. Croix County -fiEC-fiDQ.0i3rT6p oi"PVC7pipe.-- - - door - BP Mark2EL 102.28' Top-of garegefl=-at.north garage_ - - - - Slope= 5% A ~/o rN P(C o yt-Q r11 L 144 - - - 1 _ 2 - _ - - - - st~f _ - -jLL - - - q~ / ~C3u~t0~'iloN 36' k{III{IIIIIillilllllllil 8 0 1 2 4 5 4 Tx:4009542 926688 BETH PABST REGISTER OF DEEDS ST. CROIX CO., EIVED OR RECOIRD CERTIFIED SURVEY MAP REC LOCATED IN PART OF THE NE 1/4 OF THE SW 114 OF SECTION 34, T30N, 11/12/2010 12:59 PM R19W, TOWN OF ST. JOSEPH, ST. CROIX COUNTY, WISCONSIN. EXEMPT REC FEE: 30.00 PREPARED FOR: PREPARED BY: COPY FEE: 3.00 JOHN AND GEORGINE S'CHOTMER S & N LAND SURVEYING PAGES: 2 1374 COUNTY ROAD I 2920 ENLOE ST. STE. 101 SOMERSET, WI 54025 HUDSON, WI 54016 Each parcel shown on this map is subject to state, county and NOTE: NORTH 114 township laws, rules and regulations (i.c., wetlands, minimum LOTS MAY BE SUBJECT TO CORNER lot size, access to parcel, etc.) Before purchasing or FUTURE SPECIAL ASSESSMENTS SEC710IV 34 developing any parcel contact the St. Croix County Zoning FOR ANY UPGRADES AND Office and the Town of St. Joseph for advice. IMPROVEMENTS TO THE ROAD. C4 UNPLATTED LANDS OF OWNER N S89'59'53"E 599.83' IRON PIPE IS - - 589'59'53"E 0.41' FROM CORNER THIS LOT CONTAINS SHORELAND - WETLAND AREAS AND IS SUBJECT TO SHORELAND ZONING. A r..._..._...~• LAND USE OR SPECIAL EXCEPTION PERMIT MAY BE REQUIRED FOR GRADING AND/OR CONSTRUCTION ' ACTIVITIES. CONTACT THE ST. CROIX COUNTY ! LANDS UNDER ONING OFFICE FOR FURTHER INFORMATION. / NAVIGABLE WATER ARE SUBJECT TO THE Ir i WISCONSIN PUBLIC I TRUST DOCTRINE I v, - '0NO COIV / w 00 -tj :41 4Ln -ft- -75 4 C) DODGE SHED Q O N V - t7 S-2484 € BARN o rrf 1. CLEAR LAKE,..- too APPROXIMATE WI Y-~ POND SHORE _ ~y • I id N SL1R~ O~~_t1-t 1. Ln Q ~C lO ~ o p o TOTAL AREA: ICS SEPTIC TANK ~jfp0 325,270 SQ. FT. 7.467 ACRES cn C IRON PIPE IS • '53'E 0.50'FROM LINE 00 o QL J ~ ~ \1! ~ 0.50' I "ENT RECEIVED 9 ~41 Cn r ~ - I I co APR 2 1 2 1011 84.59 ~=1 515.24' N89'59'53"W 599.83' I ST. CROIX COUNTY m i I I UNPLATTED LANDS OF OWNER SURVEYOR'S RECORD u ----TED LANDS O - N n a o i I I- 66 - FOOT WIDE PRIVATE SOU7H 14 c ~I I ACCESS EASEMENT TO CORNER y g I 2Itn I I COUNTY ROAD "E" TO BE 5£C710N 34 g o I I o I CONVEYED WITH LOT 1 o I CI I (SHOWN FOR REFERENCE) C r1i x I rrnnl I SCALE IN FEET 1" = 100' > 64TH- STREET ` > U p ni I I I I 100 0 100 I I 49.5 - FOOT I cV,+ I RIGHT-OF-WAY TO s I I I~ I ( BE DISCONTINUED LEGEND m I ( FOUND ALUMINUM COUNTY I I I CENTERLINE OF TH. E SECTION CORNER MONUMENT AS TRAVELED O SET 1-1/4" OUTSIDE DIAMETER BY 18" LONG IRON PIPE, WEIGHING 1.68 LBS. PER LINEAR FOOT -E+ O FOUND 1-1/4" OUTSIDE DIAMETER IRON PIPE THIS INSTRUMENT DRAFTED BY. DOUG ZAHLER JOB NO. 6991-001 DATE: 10/15/10 SHEET 1 OF 2 SHEETS 1 of 2 Vol 24 Page 5744