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HomeMy WebLinkAbout016-1045-90-000c N Oi "~ 4p N ~ tl~ C ~~ O O N ~'i O .; ~~ Q `Q i ~'~RJ •~ N .~ _~ ~, C O © ~ w C • ~~ `~ +~ A c 3 LL c ~+ ~ ' ~ I I U fl (6 ~ a i ~ ~ Yl ~ W ~ + C ~ (n ' = O ~ i £ ~ Z '' d O ° w ' d a m j N H (/~ i O Z N H I, C ~'' ~ Z Z h ~ ~ .. lQ :: C N M ~ ~ aS O ~n N w d y '~ a ~ D D a` ',. ' ~ ~ a ~ a 0 a a , ' a i ~ ~ o v i a`i !p J O ', (~ 0 0 i, N N i N O N M l17 ~ ! ~ 0 0 s o d _ N ~ ~ ~ N N N i o Q ~ , ~ O O M I ~ ? O O 3 > ~ N ~ O M ~ ~ Y r N ~ O N U' ' f~ M O ~. ~ ' , , . ~~ £ d a a E ~ ` ~ ' ~ a; ~ c ~ jv - a , ~ j ~ l' ; o O to v ~ 00 i O ~ ~ C O ~ ~ N O Z m c 0 Q I i C O ro c Z E ~ ~ m .~ N = C O I O w 0 Z ~ C y N L U_ ~ ~ ~ 00 ~ c p N O N ( w _3 d ~ N O z O ~ ~ ~ I .~ Q ~ } O Z ~ ~ m a- N 4 ~ n ~ o, E ~ ~ ~ ~ ~ ca a o ~ ~ ~ C ~ N ~ Q~l N 'O ~ (/~ "'" ~ ~ N 00 C3 71 O 0 _ ~ U ~ Z ~' Z ~ U1 Parcel #: 016-1045-90-000 04/05/2007 04:19 PM PAGE10F1 Alt. Parcel #: 20.30.15.331A 016 -TOWN OF GLENWOOD Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): O =Current Owner, C =Current Co-Owner O -ESCHENBACH, RONALD R RONALD R ESCHENBACH C -LAMBERT TIFFANY D LAMBERT TIFFANY D 21008 RED WING BLVD HASTINGS MN 55033 Districts: SC =School SP =Special Property Address(es): ' =Primary Type Dist # Description ' 1422 290TH ST SC 2198 GLENWOOD CITY SP 1700 WITC Legal Description: Acres: 20.000 Plat: N/A-NOT AVAILABLE SEC 20 T30N R15W E 1/2 OF SE SE BlocklCondo Bldg: Tract(s): (Sec-Twn-Rng 401/4 1601/4) 20-30N-15W Notes: Parcel History: Date Doc # Vol/Page Type 09/21 /2001 657161 1722/551 W D 07/23/1997 944/457 07/23/1997 476/236 2007 SUMMARY Bill #: Fair Market Vafue: Assessed with: 0 Valuations: Last Changed: 10/06/2003 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 2.000 12,000 94,600 106,600 NO UNDEVELOPED G5 7.000 10,500 0 10,500 NO PRODUCTIVE FOR ST LANDS G6 11.000 22,000 0 22,000 NO Totals for 2007: General Property 20.000 44,500 94,600 139,100 Woodland 0.000 0 0 Totals for 2006: General Property 20.000 44,500 94,600 139,100 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch #: 120 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Tota I 0.00 0.00 0.00 N ~ Q ~ ;' U . 3 ~ ~ S 0D ~ ~ ~ 1 w 7 N o ~p z ID ~ ` , T O r~ ~ ~' o r ~ H l y 7 a c ra a .. ro N ~ l~ fD 0. re -~ m ~ ` T 1 O ` v fD Z ~. n ~~ ._. r _ o o~' < < <J or, 0. 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I { 1 1 ~ l 1 ~ f I j ~ ! i t ~ ~ ~ { I I ~ ~ Iy.~ P ~ ~ ~ f { ~ ~ + + ~ ~ 1 ~ I i ~ i ~~~ ~ ~ i ! i I I - 1 t i 1 ~ I ~ j ~ 11 - - 1 7 l l ; ~ ~ ~ ~ ;~ (~~1 I ~ _ ~ i f ~ ~ ~ , I ~ ~ ~~ t ~ , ~ ~ ~ I + ~ ; ~~ !~ ~ ~ I ~ I ~ ~ ~ i i C r i ~ I ; i ~T~ f ~ 1 ~ ~ ~ j ' ~ f ! j ~ ~ i + + i i 1 I i 5~~~ ~ ~ f ~~~ ~ ' ' ~ { ~ I ~ ~ i { J i I a ~ j~{ i i ! ; ~ 1 j j ~ _- -. l i ~ ~ ~ ~ ~ ~ ; ~ ~ I ~ i ~ 1 j I ~ 1 ~ ' { f- - ~ I ~ ~ t ~ ; ' ~ + , ~ f ` I { ,, ~i ~ ~ ~ I o ~ 1 ' { ~ ~ ~ ~ _ , ~' ~ i !I ~j~ -~~ ~~f ~~ i ! j! ~ ~ ,I ~ ~ ~~ +~ I ~~~-~~i ~ i ( ~, i ~ i ~ , _ { ( ' Ir I Y ~ 1 ~ ~ i i f ~ ~ ~ i { i. ~ ' I j i. ! ~ k ~ ~ ; ~ i j I ~ ` ~ I I . ~ ' _ ~ ,~ -~ ~~,~ ~ .~ f ~ + ~ ! ! i ~ ! ~,,,, iii,;{i ~ ~~~~j~ - { - ~ i ~{ i~ ~ , { I i ~ i _ ,~ ,~ ~ ; ~ ~ ~ { ~ ~f,j, ~ - { ~ ;,I } ~ ~ ~ ~ ~ ~ I , ~ { ~ ~ ~ { { ~ { ~ s { ( ~ ~ ~ ~ j I I j ~~ ~`' ~ {_ ~ ~ f ~ 3 ~ i ~ ~ I' i i' ~ a j ~ f 1 i 1 ~ ~ 1 { ~ ~~ ~ !! ~ L: , ~ ~ ~ ~ ~ ~ ~. ~ ~ ~ ' f I ~ i ~ ~ j j r I ~ ~ t ~ , , ; ~ ~ i , ~ II ~ i ! , I i 1 I 1 i ~ , i i ~ ~ ~ i ; j ~ ' f j ~ i ~ ~ ~ 1 ~ i ~ ~ ~ ~ I { i ; ~ ~ { ~ ~ f 1 i ~ ~ f - f ~ j ~ ! I { ~ r I ~ { ~ ~ j 4 1 ! j ~ ~ a ~ i ' ; i ~ ~ i i ~ ~ i ~ t f i { s o { ~' ~ t' ~ ~ ~ ! 1 j I l~ 111 ~~ ~~ ! ~ ' ~ i ! i j } 1 ~ . r . I ! ~ f z ~ ' j j ~ ~ i ` a ~ ~ ~ ~ ~ I ~ E ~ i Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Safety and Building Division , INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) 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 Briskie, Walter Glenwood Townshi CST BM Elev: / Insp./BM Elev: BM Description: u / / ~ r d TANK INFORMATION TYPE MANUFACTURER CAPACITY Septic ZJ <<sP~- z Sv Dosing I I W t~ Holding TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Septic ~~dd ~ 7~ ~ y~0 ~ Dosing ` J'~DO ~ _ 5 S~~ ~ ~ do Hol ' PUMP/SIPHON INFORMATION Manufacturer ~ Demand GPM Model Number ~ ~ Z 3 ~YQ TDH Lift ~ 3 Friction Loss System H~ T ~ Ft Forcemain Length , Dia. Dist. to Well 3~ z., SOIL ABSORPTION SYSTEM BED/TRENCH Width ~ Length DIMENSIONS ~ /QV ~ SETBACK SYSTEM TO ` INFORMATION Type Of System: DISTRIBUTION SYSTEM Z y ~sr7,z.~~ 7 ~ ELEVATION DATA County: St. CrOIX Sanitary Permit No: 395142 0 State Plan ID No: Parcel Tax No: 016-1045-90-000 STATION BS HI FS ELEV. Benchmark goy Alt. BM ~ t IZO. Bldg. Sewer ~ ya z.~ t Inlet a 0 - ~t7 2, , S t Outlet ~ 9. i. Dt Inlet ~.e ~o~l Dt Bottom /d d 9 Header/Man. * 2.6 6 (~ Dist. Pipe 1. S / O `/~ Bot. System 3- yy Final Grade St Cover r~ ~ i a~ 3 ~ o 0 ~ iS `~P# I .P . y /0 ~.3 IONS No. Of NB€R OR UNIT Header/Manifold Distribution rt ~ ~ x Hole Size t ~ x Hole Spacing Vent to Air Intake Length ~ Dia Z /~ Pipe(s) ~ Length 9P ~' Dia ~ Z Spacing_~ ~ ~ ~ ~Z SOIL COVER Y Prucs~~ra Svs4pms C1nly YY Mnund Or At-Grade Svsterns Only Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bedlfrench Center Bed/Trench Edges Topsoil (~ Yes +~ No ^ Yes [] No COMMENTS: (Include code discrepancies, persons present, etc.) Inspection #1: ~ /~/~ ~~ inspection #2:~_/ I } / "/ Location: 1422 290th Street Glenwood City, WI 54013 (SE 1/4 SE 1!4 20 T30N R15W) NA Loj Parc//el No: 20.30.15.331A 1.) Alt BM Description = `f' ~~b.~., t7C St`c-'~` y ~ (,~C~ ~ I~tCc~ fe yi /'t ~(~~~ ~~~ ~.~ 2.) Bldg sewer length = /0~ ~ / l S /w ct et/ 5~,~ ~ - amount of cover = 7' ~/ ~ 3.) Contour = fe , (, G ,: ~ 4 - Plan revision Required? ^ Yes ~ No ~ ~ Use other side for additional informatidn. ~~ ~~ ~ ~'' ~~ _ -~ Date Insepctor's n ure Cert. No. SBD-6710 (R.3/97) --~ _ V' • ~d~Y /Y ~ Sanitary Permit Application - - - Safety et Buildings Divisi A~ ' ~ In accord with Comm 83.21. V1'is. Adm. Code 201 W. Washington PO Box 73 ~ `~ Scc reverse side far instructions for completing this application Madison, Wl 53707-73 SC~ns~~ c Personal information you provide may be used for secondan' purposes (Submit completed form to eourtry if t ommerce Department or [Privacy Lav+'. s. 15.04(1) nt state owne Attach com late Ions (to the count. co ~ only) fo tc tt5lt'~})~;_ e t Icss than 8-I/2 s I I inches in size. County , State Sanitary Pemtil Number C)'Ch~ck-ifievision top io~s lication State Plan I. D. Number t~. U j . ~ Gw ~. i. A lication Information -Please Print all Information c_~'' Location: Properly Owner Name -: 'i ` t ~? - i ~ ~~~~ ~ ~ Propertp L-oealion T ~IJ ~ / S S ~ ~~ . ~ ~ .... - ~w ~ w- ~~ ~ r ~ G I 4. ,N. R E or 1 /4 --w . Property Owner's Mailing Address ~,~ S~ N~ ,! ^~ Lot Number Block Numbe ` Ciry. State Zip Code ~ • P e mbcr ~'4r • r ~ - ~ ~ Subdivision Name or CSM Number J,. \ ~f II Type of $uildin (check one) D City a vtl 1 or ?Family Dwelling - No. of Bedrooms;_.~ wn of ^ Public/Commercial (describe use): O State-owned ~'"' w t''" III Type of Pmrr.:it: {Check orrly one box on line A. Check boa en line S if applicable) Nearest Road ~ ~,~ ~ ~~ A) 1. O New System ~eplaccmcnt 3. D Replacement of 4, D Addition to Parcel Tax Number(s) ' ' / to Tank Onl Existin 5 stem p c~1= D- ~~~ J - C I3) Permit Number Date Issued ^ A Sanita Permit was rc~iousl issued IV. Type of POWT System: (Check all that apply) '~ ' /~ ' !/ 42 ' ~ ' ~ and D Sand Filter O Constructed Wetland O Non-pressurized In-gro d r Tank ^ Single Pass ^ Drip Line ') ^ 1-foldin I d ~( $ g n-groun D Pressuri2ed ~~j.2 ( ' g ^ Other. IS, circular D ^ Aerobic T cat ant Unit ^ At- rode r tl g ~ rnt A • ~~~ ~' ~ k/ t~ V Dis ersal/['reatm nt Area Information: I. Design Flow (gpd) 2. DispersalArea 3. Dispersal Area 4, Soil Application 5. Percolation Rate 6, System Elevation 7. Final Grsdc Eleva ti on Required Proposed Rare (Gals./day/sq. R) (Min,/inch) // ~~ //~~ VI Tank Capacity in Total >y of Manufacturer Prefab Site Steel Fiber- Plastic Information Gallons Gallons Tanks Con- Con- glass , crctc structcd Ncw E!cisting Tanks Tanks ~_ ^ ^ O D D ^ D D ~,~ Y VII Responsibility Statement rho undersi ned assume res ensibilit far installation of tht POWTS shown on the attached laps. 1 , Plumber's Name (print) Plumber's Signature (no stamps): PRS No. Business Phone Number Plumbers Address (Street, City, State, Zip Code) , VTII Counry/Department Use Only ^ Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued I ui Agent Si Yre (No stamps) ~4pprovcd ^ Owner Given Initial Adverse Su arge Fee) 325 ~ ~ 2bfll - au~~ . Determination YX. Conditions of Approval /Reasons for Disapprovaal: ~ ~ -~C~ ~~ v~ GQsiDM-.~v+A~~.+~Jtu~m. S~Q~t.'~1+L~,~1~`~-" ~~' GPD .~.. vV~b'wU-~ SHA6398 (R 0?/00) Wisconsin~epartmeni of Commerce SOIL AND SITE EVALUATION Divi9ion~of Safety and Buildings Buretl~`of Integrated Services in accordance with s. ILHR 83.09, Wis. Adm. Code Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must County include, but not limited to: vertical and horizontal reference point (BM), direction and percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D. # APPLICANT INFORMATION -Please ail ih~dr ~~ Rev wed by '4 Page ~ of 3 ~y~-cam Date Personal information you provide may be used for sec d urposes (Privacy L~ 1 (1) (m)). ~ ~ Z~ ~ Prope O er n., operty Location ~' !' ~ ~ '~~~~~" vt Lot 1/4 1/4 S T N R E (or~ ~s ~ . ` ~ , Property Owner's Mailing Address I c,~ ; ' ~ ~ # Block# Subd. Name or CSM# I ._-i ~~, r ~ ~ ~-~ G ~ ~ t~~ ~ ~ ~: City Stag Zip Cod S' Ph ~ r ~ City ^ Village [?] Town Nearest Roams i ^ New Construction Use: ~ Residential / Num a edrooms Addition to existing building Replacement ^ Public or commercial -Describe: Code derived daily flow ~_ gpd Recommended design loading rate bed, gpd/ft2~~trench, gpdm2 Absorption area required 590 bed, ft2 S19~) trench, ft2 Maximum design loading rate ~~bed, gpd/ft2T_ ~ trench, gpd/ft~ Recommended infiltration surface elevation(s) /O~'.!~ / ft (as referred to site plan benchmark) Additional design/site considerations "A !' ~ f - n a Parent material ~ ~D ,~-,~~ ~ /~ Flood plain elevation, if applicable ft S = Suitable for system Conventional Mound In-Ground Pressure AT-Grade System in Fill Holding Tank U = Unsuitable for system ^ S U ®S ^ U ^ S ®, U ^ S ,~ U ^ S ®U ^ S f ~ U SOIL DESCRIPTION REPORT Horizon Depth Dominant Color Mottles Structure i t C d B ts R GPD/ft2 in. Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. ons s ence oun ary oo Bed ,Trench - 3. ~ 5 ,, - t ~ S 3 "'7 ~ r--- ; -S ~ Remarks: Boring # ~.~ Ground elev. ~~ft. Depth to limiting ~~ n , ~~.5`~~ - .~ fact Remarks: CST Name (Please P ' t) , Signature ~ Telephone No. fit, ~ ~ S~~- .~ Address Date CST Number PROPERTY OWNER js, - SOIL DESCRIPTION REPORT PARCEL I.D.# Boring # Ground elev. ~. Depth to limiting factor ~. Boring # Ground elev. ft. Depth to limiting factor in. Boring # Ground elev. ft. Depth to limiting factor in. Boring # Ground elev. ft. L Page ;.~ of ~~ Horizon Depth Dominant Color Mottles Texture Structure Consistence Bounda Roots 2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. ry Bed .Trench ©- ~~ ' ,~ -3 J ~'T ~' - ~ , Remarks: Remarks: Horizon Depth Dominant Color Mottles T ture Structure nce Consist Bounda Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color ex Gr. Sz. Sh. e ry Bed ,Trench Remarks: Depth to limiting factor 'n' Remarks: SBD-8330 (R. 07/96) iy~a ~29e'``~s~ ~l~ w~ ~~~ Gv~~ s'"~O/3 ~~~ ~ ~~ ~x,s~~~ s~s~~ o~~~/~, ~~, 3 G/~,~~ ~~ ~~~~ ~~ ,~ ,~,~~/ /II~~~/~ .~~ o~/~~~vG -~1~AO,0 ~~~~°G -~ ~ /d3. 7d2 s-/s 99' ~D.~-~~ -I C ~~ _~ __ _ ~~ _' _ >~y' ~~~~ ,,~K 98,a,~ - - - ~- --~ _~ //, ., I i ~ 1 1 i t 1 '/, i o f ' j , _ ! •, ~ .. , ~ 1 ..- t I ' , ~ ~ I / .~ w~ ~ I ~ m .aSie. h ~ I ^5 ,- 1 2 ~ ; ~~ , _ 7 c ,,,~ , t ~ ~' _~-~-• ~_~_- -- I I ~~~~ .~~ ru r~ I ! ! ~ ~ t i t , . ~ I I ~ - ,/ I ~ _r. ~ , i ~ i I • ,N ; . , /~ ~ i , , i . ; --,_ .. _, f ~ ~ L_ . --- -- ~ - !. .I I ! j _ I III ~ ~t ---- I-- ; -~- '-t '-- .eye I I- ., ~. sa. i _ ' _ ~ .- -~ - ~- I-- - L-- -~--f----~--~--- - --.f._._ i._ _ - i , ~V I I ( t .-_ I _ ~ I .. ICJ ~ ~ '. ~ !. ~ _ j_. - i - 1 _ •-f -~I-. _ _- -. ~_.I--_. ~"' _ -` -. _ - ' ._ • C' , ~_ .i I i. '- ' ~ ~ _ . - , - - --, ~,;.~ _ ~~ c- - - __ - - --- - ---~-- _I--- - ~--- -- - I ~ t ' ~ I D ci ~ ~ ' ~~ r.., j U..el r i TL~, ~I -~ l 1_ I 1 _ _ _ __ -b- _. -- - - - - --- --- - t ' i I ` ' elf ~ ~ (4 ~ ~" C ~j~ I UI; [. Q I - .. , __ _._ ._ ~ -_ ~ - '- -.. j_ _. _ L - - -D UC r 4 ~ ~ i ~ _. _ Tv .s 4 C I -~ 1 ' -- -- - ---I - -- --I - ---- t O+[ v ~1 J , ~ , ~ I ._ 1 1 t f -~__ I .rt ~ ~ ~ iscons~n Department of Commerce i i ~ -~~ h\~~ ~!' July 06, 2001 .,y;' _,.c CUST ID No.225150 MICHAEL E WILSON HILLTOP EXCAVATING 400 STATE ROAD 46 AMERY WI 54001-4019 C? 7 ~^~ ~`` s ,~, . ~` CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 07/06/2003 Identification Numbers Transaction ID No. 656301 Site ID No 631972 SITE: Please refer to both identification numbers, WALTER BRISKIE 1422 290TH ST above, in all cones ondence with the a enc . TOWN OF GLENWOOD, 54013 ST CROIX COUNTY SE1/4, SE1/4, S20, T30N, R15W FOR: REPLACEMENT MOUND, 600 GPD OBJECT TYPE: POWT SYSTEM REGULATED OBJECT ID NO.: 799247 The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. The following conditions shall be met during construction or installation and prior to occupancy or use: General Approval Conditions: • This system is to be constructed and located in accordance with the enclosed approved plans and with the "Mound Component Manual for Septic Tank Effluent for Private Onsite Wastewater Systems _ SBD-10691-P (N.O1/O1) and SSWMP Publication 9.6, "Design Of Pressurized Distribution Networks .For Septic Tank- Soil Absorption Systems." • In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazazd, the property owner must follow the contingency plan as described in the approved plans. In addition, the owner must insure that the operation, maintenance and monitoring duties as described in section VIII of the mound component manual are complied with. A copy of this information must be given to the owner upon completion of the project. • 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. • The maintenance plan for this system must be given to the owner of the POWTS. Site Specific Conditions: • The orientation of the mound system must be such that the longest dimension is oriented along the surface contour per COMM 83.44(6)(a)2. • Limit activities in the azea IS' beyond the down slope edge of the mound per Mound Component Manual. Safety and Buildings 10541 N RANCH ROAD HAYWARD WI 54843 TDD #: (608) 264-8777 www. commerce.state.wi. us/sb www.wisconsin.gov Scott McCallum, Governor Brenda J. Blanchard, Secretary v ~~~ ~ ~ ~ ~ ATTN.- POWTS Inspector ' J2~~ f' . ~ 'cl ~ ~~ ~~~ : - ~' ZONING OFFICE ~~ ~ ST CROIX COUNTY SPIA 1101 CARMICHAEL RD -' ~~i' HUDSON WI 54016 • Surface water drainage shall be diverted away from the system azea. .,~ MICHAEL E WILSON Page 2 7/6/01 • Materials shall conform to the requirements of COMM 84. • Abandon failing system per COMM 83.33. • The designer proposes to install a state approve outlet filter to achieve the requirement of wastewater particle size. Maintenance information must be given to the owner of the tank explaining that periodic cleaning of the septic tank outlet filter will be required. The outlet filter shall be installed per product approval stipulations. • Anchor tank as necessary to negate buoyant forces per COMM 83.43(8)(8). 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. Sincerely, M_- ~, ~ , ~ cam.-"~------...-~"L~ t PATRICIA L SHAhTbORF POWTS PLAN REVIEWER, EGRATED SERVICES (715) 634-7810, FAX: (715) 634-5150 , M-F 7:45 AM - 4:30 PM PSHANDORF@COMMERCE. STATE. WLUS FEE REQUIRED $ 175.00 FEE RECEIVED $ 175.00 BALANCE DUE $ 0.00 WiSMART code: 7633 cc: WALTER BRISKIE o ~ iscons~n Department of Commerce Safety and Buildings 10541 N RANCH ROAD HAYWARD WI 54843 TDD #: (608) 264-8777 www. com merce. state.wi. us/s b www.wisconsin.gov Scott McCallum, Governor Brenda J. Blanchard, Secretary July 06, 2001 CUST ID No.225150 ATlN.• POWTS Inspector MICHAEL E WILSON ZONING OFFICE HILLTOP EXCAVATING ST CROIX COUNTY SPLA 400 STATE ROAD 46 1101 CARMICHAEL RD AMERY WI 54001-4019 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 07/06/2003 Identification Numbers Transaction ID No. 656301 SITE: Site ID No. 631972 WALTER BRISHIE Please refer to both identification numbers, 1422 290TH ST above, in all cones ondence with the ' enc . TOWN OF GLENWOOD, 54013 ST CROIX COUNTY SE1/4, SE1/4, S20, T30N, R15W FOR: REPLACEMENT MOUND, 600 GPD OBJECT TYPE: POWT SYSTEM REGULATED OBJECT ID NO.: 799247 ~•~ II I~ ¢;i r _'~. '~' The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes i and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. The following conditions shall be met during construction or installation and prior to occupancy or use: General Approval Conditions: • This system is to be constructed and located in accordance with the enclosed approved plans and with the "Mound Component Manual for Septic Tank Effluent for Private Onsite Wastewater Systems _ SBD-10691-P (N.O1/O1) and SSWMP Publication 9.6, "Design Of Pressurized Distribution Networks For Septic Tank- Soil Absorption Systems:' • In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approved plans. In addition, the owner must insure that the operation, maintenance and monitoring duties as described in section VIII of the mound component manual are complied with. A copy of this information must be given to the owner upon completion of the project. • 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. • The maintenance plan for this system must be given to the owner of the POWTS. Site Specific Conditions: • The orientation of the mound system must be such that the longest dimension is oriented along the surface contour per COMM 83.44(6)(a)2. • Limit activities in the area 15' beyond the down slope edge of the mound per Mound Component Manual. • Surface water drainage shall be diverted away from the system area. MICHAEL E WILSON Page 2 7/6/01 • Materials shall conform to the requirements of COMM 84. • Abandon failing system per COMM 83.33. • The designer proposes to install a state approve outlet filter to achieve the requirement of wastewater particle size. Maintenance information must be given to the owner of the tank explaining that periodic cleaning of the septic tank outlet filter will be required. The outlet filter shall be installed per product approval stipulations. • Anchor lank as necessary to negate buoyant forces per COMM 83.43(8)(g). 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. , , ,' Sincerel _ f PATRICIA L SHANDORF ~_/' POWTS PLAN REVIEWER ,INTEGRATED SERVICES (715) 634-7810, FAX: (715) 634-5150 , M-F 7:45 AM - 4:30 PM PSHANDORF@COMMERCE.STATE. WI.US FEE REQUIRED $ 175.00 FEE RECEIVED $ 175.00 BALANCE DUE $ 0.00 Wi$MART code: 7633 cc: WALTER BRISKIE MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Project Name: Owner's Name: Owner's Address: Legal Description: Township: County: Subdivision Name: Lot Number: Briskie Walter Briskie 1422 290th ST. Glenwood City, WI. 54013 SE1/4--SE1/4--SEC.20--T30N-- R15W Glenwood ~ ~'' St. Croix • ~ ~ ~y ~, + ~ .y ., n/a Block Number: n/a l r ! ~ r_r'~` `^ t Parcel I.D. Number: 016-1045-90-000 Plan Transaction No.: Page 1 Page 2 Page 3 Page 4 Page 5 Page 6 Page 7 Page 8 Page 9 Page 10 Page 11 Index and title Data entry Mound drawings Lateral and dose tank System maintenance specifications Management and contingency plan Pump curve and specifications Site flan Lift Tank Cross Section Filtration Spec. Septic Tank Cross Section Designer: Michael E. Wilson License Number. 225150 Date: O6/14/01 Phone Number. 715-268-6626 Signature: ~ ~.. ~/~.~. Designed Pursuant to the Mound Component Manual for POWTS Version 2.0 SDB-10691-P (N. 01/01), and SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST-SAS (01/81) Version 3.0 (03/01/01) Page 1 of 11 Mound and Pressure Distribution Component Design Design Worksheet Site Information (r or c) R Residential or Commercial Design Note: Sand fill (D) ca~ulations assume a 400.00 Estimated Wastewater Flow (gpd) Table 83~4A-3 in-situ soil treatment for fecal 1.50 Peaking Factor (e.g. 1.5 = 150°~6) colifom, of <= 36 inches. 600.00 Design Flow (gpd) 8.00 Site Slope (%) 98.28 Contour Line Elevation (ft) 14.00 Depth to Limiting Factor (in) 0.50 In-situ Soil Application Rate (gpd/ft2) Distributio n Cell Information 100.00 Dispersal Cell Length Along Contour (ft) = 6.00 Cell Width (ft) _ 1,00 Dispersal Cell Design Loading Rate (gpolft2) 1 Influent Wastewater Quality (1 or 2) Are the laterals the highest int in the distribution Y Pressure Disribution Information network? Enter Y or N (c ore} a Center or End Manifold 3.00 Lateral Spacing (ft) If N above, enter the elevation ft) 2 Number of Laterals of the highest point. 0.125 Orifice Diameter (in) (e.g. 0.25) 3.50 Estimated Orifice Spacing (ft) = 10.34 ft2/orifice 2.00 Forcemain Diameter (in) 50.00 Forcemain Length (ft) Does the forcemain drain back? Y 90.28 Pump Tank Elevation (ft) Enter Y or N 6.50 System Head (ft) x 1.3 9.67 Vertical Lift (ft) 0.64 Friction Loss (ft) 16.80 Total Dynamic Head (ft) Lateral Diameter Selection in. dia. o tions choice 0.75 1.00 1.25 1.50 x x 2.00 x 3.00 x Treatment Tank Information 1250.00 Se is Tank Capacity (gal) wieser's Manufacturer Dose Tank Information 750.00 Dose Tank Capacity (gal) 20.27 Dose Tank Volume (gal/in) wieser's Manufacturer 8.16 Forcemdtn Drainback (gal) 90.43 5x Void Volume (gal) 98.59 Minimum Dose Volume (gal) 23.89 System Demand (gpm) Manifold Diameter Selection in. dia. o ions choice 1.25' x 1.50 x 2.00 x 3:00 Gallons/Inch Calculator (optional) 750.00 Total Tank Capacity (gal) 37.00 Total Working Liquid Depth (in) 20.27 gaUin (enter result in cell B49) Effluent Filter Information Zabel ~ Filter Manufacturer A100 Filter Model Number Project: Briskie Page 2 of 11 Mound Plan View 1_ . 1 /~~ 0 B Observation Pipe ,,•. B - - - - - '- '-- --__ • ~• . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . L'J - .\ . H 1.OOft K 11.60ft z 14.23 ft L 123.19 ft J 7.56 ft W 27.79 ft 2023.03 (ft2) Basal Area Available 10.00 (ft) 1/10 B Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area Finished Grade 101.91 (ft) --~ I ...,~,~, ................._.. ,,,,, F Dispersal Cell 100.61 (ft) Lateral 100.11 (ft)--- - ~ : ~ Invert Dispersal Cell ;~ ~ ~ :D ~' ~ ~ : ~ Elevation E. ~ ~~ .... ... .. .. ... ... ....• ... . ..... ... . . ... ... .. ,• 8.0 °~ Site Slope Shading Key 1~ _ Topsoil Cap © ~"'J Subsoil Cap • ASTM C33 Sand ® [~j Tilled Layer ~5 1'':.':r': Aggregate I L Mound Component Dimensions A 6.00 ft E 27.76 in B 100.00 ft F 9.50 in D 22.00 in G 0.50 ft 600.00 (ft2) Dispersal Cell Area 6.00 (gpd/ft) Linear Loading Rate ~ a o ~ 1.5 ft ~ o ~~ ~ ~ 0.5 ft 0 Dispersal Cell Lateral A 98.28 (ft) Contour Elevation /~ Geotextile Fabric Cover -/ See lateral details on Page 4 for number, size, and spacing of F laterals. Laterals are equally spaced from the distribution cell's centerline in the distribution cell (AxB). _} _} _~ -I Project: Briskie Page 3 of 11 End Connection Lateral Layout Diagram ~arenxs cencerea Dyer m~ P All laterals are identical IE X-~~ Holes drilled on the bottom of the lateral 3 eQuaNlspaced ~ Force main connection via tee or cross to tnatlifold at ang point. Laterals & Force man of PYC Sch #0 [per COFAVI Table 8#.30-5J Number of Laterals 2 Orifice Diameter 0.125 in Lateral Diameter 1.50 in Orifice Spacing ()C) 3.52 ft Lateral Length (P) 98.56 ft Orifices per Lateral 29 Lateral Spacing (S) 3.00 ft Orifice Density 10.34 ft2/orifice Lateral Flow Rate 11.95 gpm Manifold Length 3.00 ft System Flow Rate 23.89 gpm Manifold Diameter 2.00 in Total Dynamic Head 16.80 ft Forcemain Velocity 2.44 ft/sec Dose Tank Information ~~~ ~,~i~„~ram,ng label and locking device and sealed watertight Electrical as per NEC 300 and --i Comm 16.28 WAC Disconnect ~ 4 in. min. ----.,.~ • ~ Turn-u p wilts II +eahro or d~noutplup Tank component is properly vented wieser's Ca acit 750.00 Volume 20.27 Manufacturer Gallons gal/inch A B C D Dimension Inches Gallons A 21.00 425.67 B 2.00 40.54 C 6.00 121.63 D 8.00 162.16 Total 37.00 750.00 tank. Alarm Manuafadurer S.J. ELE. Alarm Model Number 101 H.W. Pump Manufacturer Zoeller Pump Model Number (98 T Pump Must Deliver 23.89 gpm at 16.80 ft TDH E-- Aftemate outlet location Forcemain diameter ~ 2 in. Weep hole or anti- siphon device Pump off elevation ft) 90.95 Dose tank elevation (ft) 90.28 Project: Briskie Page 4 of 11 Mound Svstem Maintenance and Oaeration Specifications Service Provider's Name Hill To Ex. Phone 715-268-6626 POWTS Regulator's Name Polk Count Zonin Phone 715-485-9279 Svstem Flow and Load Parameters Design Flow -Peak 600 gpd Maximum Influent Particle Size Estimated Flow -Average 400 gpd Maximum BODS Septic Tank Capacity 1250 gai Maximum TSS~ Soil Absorption Component Size 600 flZ Maximum FOG. Type of Wastewater Domestic Maximum Fecal Coliform Service Frequency Septic and Pump Tank Effluent Filter Pump and Controls Alarm Pressure System Mound ether 1/8 in 220 mg/L 150 mg/L 30 mg/L >10E4 cfu/100 mL Ins ect and/or service once eve 3 ears Should ins ct and clean at least once eve 3 ears Test once eve 3 ears Should test month) Laterals should be flushed and ressure tested eve 1.5 ears Ins ect for ondin and see a e once eve 3 ears Miscellaneous Construction and Materials Standards 1. Observation pipes are slotted and materials conform to Table Comm 84.30-1, have a watertight cap, and are secured in as shown in the mound component manual. 2. Dispersal cell aggregate conforms to Comm 84.30 (6)(i), Wis. Adm. Code. 3. All gravity and pressure piping materials conform to the requirements in Comm 84, Wis. Adm. Code. 4. Tillage of the basal area is accomplished with a mold board or chisel plow. 5. The mound structure and other disturbed areas will be seeded and mulched io prevent soil erosion and help reduce frost penetration. Lateral Turn-up Detail Finished • .............. ................ Grade 6-8" Diameter Lawn Threaded Cleanout Sprinkler Valve Box Ptug or Ball Valve Distribution Lateral Long Sweep 90 or Two 45 Degree Bends Same Diameter as Lateral Project: Briskie Page 5 of 11 Mound System Management Plan Pursuant to Comm 83.54, Wis. Adm. Code t3erteral This system shall be operated in acx:ordance with Comm 824 Wis. Adm. Code, and shall maintained in accordance with its' component manuals [SBD-10891-P (N.01iD1) and SSWMP Publication 9.6 (01/81)] and local or state rules pertaining to system maintenance and maintenance reporting. No one should ever enter a septic or pump tank since dangerous gases may be presets that coukl cause death. Septic and pump tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the tanks are no longer used as POWTS components. Septic or pump tank manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the compietbn of service. Any opening deemed unsound, defective, or subject to failure must be replaced. F_xposed access openings greater than 8-inches in diameter shall be secured by an effective kx:king device to prevent accidental or unauthorized entry into a tank or component. Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Stets. The contents of the septic lank shall be disposed of in accordance with NR 113, Wis. Adm. Code. The operating condition of the septic tank and outlet fitter shall be assessed at least once ev rs by inspection. Th out fill hall be cloned as n r o ration. The fitter cartridge shook! not be removed unless provisions are made to re m solids in the tank that may slough off the filter when removed rom its enclosure. If the filter is equipped with an alarm, the fitter shalt be serviced if the alarm is activated continuously. Intermittent fitter alarms may indicate surge flows or an impending continuous alarm, The septic tank shall have its contents removed when the volume of sludge and scum in the tank exceeds 1 /3 the liquid volume of the tank. If the contents of the tank are not removed at the time of a triennial assessment, maintenance personnel shall advise the owner of when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank. The addition of biological or chemical additives to enhance septic tank performance is generally not required. However, if such products are used they shall be approved for septic tank use by the Department of Commerce. Pump Tank The pump (dosing) tank shall be inspected at least once every 3 years. All switches, alarms, and pumps shall be tested to verify proper operation. If an effluent finer is installed within the tank tt shall be inspected and serviced as necessary. Mound and Pressure Distribution Svstem No trees or shrubs should be planted on the mound. Plantings maybe made around the mound's perimeter, and the mound shall be seeded and mulched as necessary to prevent erceion and to provide some protection from frost penetration. Traffic (other than for vegetative maintenance) on the mound is not recommended since soil compaction may hinder aeration of the infiltrative surface within the mound and snow compaction in the winter will promote frost penetration. Cold weather installations {October-February) dictate that the mound be h~viy mulched as protection from freezing. Influent quality into the mound system may not exceed 220 mg/L GODS, 150 mglL TSS, and 30 mg/L FOG for septic tank effluent or 30 mg/L BODS, 30 mg/L TSS, 10 mglL FOG, and 104 cfu/100 mL for highly treated effluent. Influent flow may not exceed maximum design flow specified in the permit for this installation. The pressure distribution system Is provided with a flushing pats at the end of each lateral, and tt is recommended that each lateral be flushed of axumulated solids at least once every 18 months. When a pressure test is performed tt should be compared to the initial test when the system was installed to determine if orifice clogging has occun'ed and if orifice cleaning is required to rnairrtain equal distribution within the dispersal cell. Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding k3vels shall be reported to the owner, and any ksvels above 8 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring. Contingency Plan If the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep the system in proper operating condttbn. If the dosing tank, pump, pump controls, alarm or related wiring becomes defective the defective c~rr-ponent(s) shall be immediateh- repaired or replaced wtth a component of the same or equal performance. If the mound component fails to accept wastewater or begins to discharge wastewater to the ground surface, tt will be repaired or replaced in its' present location by increasing basal area if tce leakage occurs or by removing biologigly ck>gged absorption and dispersal media, and related piping, and replacing said components as deemed necessary to bring the system Into proper operating condition. Sae Page 8 of this plan for the name and telephone number of your kx~l POWTS regulator and service provider. Project: Briskie Page 6 of 11 N HEAD CAPACITY CURVE 3 ~/8 -• s 1/4 MODEL "98" ~ 5/8 30 s a 2 I 3 SJe 6 m - -l- -._. .{. O _ 15 ~ 3/16 4 .. 9 _~ 10 - '- 2 t 1 1/Z- 11 1/Z NPT 5 . x V_ 0 d ~- i ~ 1 I r 0• U.S. G LITERS 1 O 201 30 80 t 160 FLOW PER MINUTE TOTAL DVNAMN: t1EADtFIOW PER MINUTE EFFLUENT AND OEWATERiNG CAPACnY NEAD UNITSMt1N FEET METERS GALS lTRS 5 1.52 72 273 10 3.05 6t 231 15 4.57 ~S 170 20 6.10 25 95 lock Valve 23 • 60 70 80 240 CONSULT FACTORY FOR SPECIAL APPLICATIONS '16 • Electrical alternators, for duplex systems, are available and Variable level float switches are available for coMrofling sine supplied with an alarm. and three phase systems. • Mechanical alternators, for duplex systems, are available with or Double piggyback variable level float switches are available for without alarm switches. variable 1eve) long cycle controls. Cf~nrtarri all rnedels -Weight 391bs. -'/~ H.P 98 Series M ConVol Selection Model Volts•Ph Mode Am Sim lox Du lez M98 115 1 Auto 9.4 1 or 1 d 7 --• N98 t 15 1 Non 9.4 2 or ~ 6 3 or 4 3 5 098 230 1 Auto 4.7 1 or 1 6 7 -- E98 230 1 Non 4,7 2 or 2 b 8 3 of 4 d 5 p~iypybedc~eWe L~1 ~eh~sKF-M~77,ENetefe~ Nt'irmta. FM04e8; MKh~Ned ABM 5~`: la, FM0495: Alarm Pedtege. FM0513: SunplSewege Btains. FM0467; end Simpler Cardtot ttor, FMO7u. SEIECTN)NeiiU1DH 1. InteprN IIoN operated 2 pole nledlenkal ttwNd-, ao e~xantN txtMrot npnksd• 2. Sklple plpgyback vtltlettN letrel Ilo~t tlwllch a tkluble plpp~,k vMMbN MAI, ftoN swikll. Rorer to FM0177. 3. Mechenk,N dNmNor 10-0072 a 10-0075. 4, See FM0712, for correct modN of EktehieN AMrnebr,'E-Pak'. 5. Control tlvdlcA 10-0225 used as a control egiwtor, spetdy duplex (~ a p) Ilwl system. 8. Fow (1), ItoN'J-Pak', Il,rte8on box. ror weNrtipM eon,leeMon o- wtredalt skttplex o- dupletl ope-ntton,10-0002. 7. Two (2) IION'J•Pak•, ra wNsrUpM aortnee0on or npNoet. CAUTION An h»teNetleo of eentrole, Pre~~~e eMtel,NtOtttMMAMtNeer/ eMe1MN Ileeneed NeeMetM. An NeefFleel end eetletlr eedn etwdd tN IONwH IeelydltM M» tweet neent Netlenel ENeMe Cede (NEC) end tM OeapslleeM •elYll end Nsstlu Ael loaNA). RESERVE POWERED DESIGN For unusual conditions a reserve safety factor is engineered into the design of every T,oeUer pump. MAR T0: P.Q BOX tlff7 LaIInMR KY 102lidNl A~trlslu~ssrsd. . SI pP TO: 3619CaneRun /Dosd ~Q ~~ la,~y.IrylOpif•11t1f ~Itt~I/r~Rdgl.S'AN:T ~• PUMP !D ~71F,~'~;,~ ;sect', Qr,'S /C,~t P4 ~ 0~ ~ f ',_ ~ . h~~~~~ .,ts,~~s~r~k. sue/ s,~l~!- sx~"- r..3~,r/'~'is'aJ i ` ` , ~~ ~ ~ ~ ~ ~ j I t i -. , ~ ~ I ' I i I i ~ ~ ,_ , + ~ ~ ~ , ., ~, ' ~ , i ~ ~> w / .u ,~ ~~~ ~ ~ t ,~~ i~ ~" ~N -- -- - -- /c,wsrt -, - t~" , ~ v i S,~l 7~ - ~ jj ~--; I _ ~ ~~ i i ,~j , I I!~!; ~ I !- 1.xi1 ~ ~ i i ~ ~ _ i . t I i I I I I Sys,., *'k : s ~ Tti T - i _ ! i ! ~ ' I i9 Jii.(j-/a~ h t J 1'- f' z C`/~/"''O r-~ ~ ~ - ' i ' - I I ~ j ' I 4 i i ~ .. i - i I ~ ~ 1 i ~ ~ I I 1 i r i ~ I ~ ~ ~ I ~ i I i ~ ~ i i i ! ~ . I ~ ~ I ;- i ~ _ _ __ -- • - - -- .- ~ I - ~, i (+ ~~ ~ ~ ' r ~ ~ . i.. _I _ ~ .I_ I- --.. _ 1 , ~-~, u h ~ C,~ I I ~ ; ~i D I J'' ~- --~ I i /~I I / i I I I 1 J ~ ~ ~ ~ ~K _~_._ _ .... .t... i i -- _.. - - -- I _ I i - - 3 "Y r _. , . _ ~ i ~._ ~ ~ t- -~ ~ ~ ' + i I I ~ i I ~ I+ i I -:_. _._ ~~ I t ~ I ~ i ~ 1 ~ 1 I I 1 I _ t_. _ .t _ ~l_ . I ~ i I ~ ! 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Dm N -D.1N~ N~~ ~f--1~ 0~ N mm -+_ ~o_ n 0 O ~C OND (n~@ D~ N sN~7 0 ~ ~ ^ ' c c~i c~ mmir'-i N~ o~ " T~ D ~~ r n r~ r p °~ ~ N c-~ ~ z Da w ~ ° O ~ D ~~ OQ p D r ~. O c -r - O T. f A O N O I V' ~ ~~ O m m ~ UC. ~m z 0 _~ Pr~'LLIr°c.~• : ~i~'i s /~ r e Ps ~J' D-~ 1 / I '~ /1'100-~Z Fiittradon 7~16~ • The original Zabel Filter for waste flows from 3,000gpd to 4,500gpd. • Disc dam design is proven to reduce TSS and BOD in residential and commercial waste flows. • All A100-12 filters come ready to accept the Zabel SmartFilter Alarm. • Easy to install either in the tank or outside the tank in a Zabet Basin Assembly. • Extension handle included with every filter. Commerc Filter Package asoa~2x~~ Certified to ANSI/NSF Standard 46 ,~ ,, A~oo-AOA Reducers are included with all A100-12x30's they are optional on A100-12xi6 Filters ~I l Handle Parts Included A=112" Tee (SLIPxSLIPxSLIP) B =1/2"Female Adapter (MIPTx SLIP) '~' 0 C =112" Schedule 40 pipe ~. in Rth ~Mer o - e oonti r °Ve- I ~~ V" _ - ~ ,. ~ ~_ ~n~nerein-nTCQ CII T~RC 1L ~f:[:FSSnRIES ~ sVOOs~~ ~-~~~~ ..r...,~~............. .- •---- ----- - • 1 1 1 ~ ~ ~ A100-12x16 . ~~ •.- 12" x 16" Case and Cartridge 169.95 133.00 108.00 102.00 98.00 A100-12x30 12" x 30" Case and Cartridge ~ 208.95 174.00 158.00 152.00 148.00 . ~ ..- A101-12x16 12" x 16" Replacement Cartridge 97.95 81.00 54.00 A101-12x30 12" x 30" Re lacement Cartrid a p 9 137.95 115.00 104.00 • A100-12x16-FP A100-12x16 and 26" Basin Assembly 293.95 191.00 A100/300-RHEK-SF •- SmartFilter Retrofit Handle Extension Kit 7.45 4.75 4.50 4.40 4.30 A100/300-RHEK Retrofit Handle Extension Kit 7.45 4.75 4.50 4.40 .4.30 A100/300ADA Extension Apapter 29.95 95 9 19.00 00 9 18.00 17.00 00 00 7 8 16.00 6.00 FC100 Flow Control/Maintenance Plate . . . . A II 7nt,nl Cillero ern cmarfFi~tar rpa~~. a~td X75.00 to the once of any f ilter or filter package to add the SmartFilt er Alarm. 10 PS /o o ~ ~ I A100-12x16 A~OO-1Zx30 r Y 1 • • ~ 72M 50" ~ A s m z -i [ ]n„ ~ N ~ ~ ~ m fv 3„ 56 ~„ ~ 4„ m ~ 0 ~_ S I A m A ,~ C ~ II . c 14"' N m" X a ~ _' ~+ Z ~ (_n 53"mi ~ ~. 0~1 °` ~ y J ~ r N .- :r; x ~ ~ - ~' x ~ `~~ ~'!u ~ i~ ~ ~ ~ ,~ -[ C r, ~ u ~ o c~ r r rt ° -i N 0 0 ~ ~ ~ m ZO ~ DOS ~ ^O~D G)?D ~'ppmomrziDno ODN p ~~'~ v ~np Nip "~~~OT2~ -~irZ 7C I ~ DiZ D mop mOO ,-=ip~" i-i0~ ~ ~ N r-i~ c~ ~ZC ;-~~c r-oo m n' Z =. ~ N~ m ~ morn J.. A I Do ~zm ~~m w~m .o NN 'om\ r~~~ ~ f ~r DDS D ...r Or~O~ A rbN u V Dm N ~N N~.. O O 7 p~ O ~ a, m m -i p n m m ~ ~~ ° ~ ~ m ~' ~' ~ n ~' m ~ w b °v czi i' ~'0 m~ a~ z ~ c~ mom Nov ~ o ci=4' ~/~~ CAN ~ oUvU ~ rnp Z D m~ ~~ O = 1 ~ ~r~o D G7 ~ Op ~'O O~ N o 1~-'~`-~J r~* ~ ~ 7~ AA ~z~c. p O ~~ VI'~ ~ ~Q N z 00 o N m m Z -, ~ ~ ~ F r~ n ~- Cs~ cam., ~ °' U~ ~z ~~ o • .~ f CROIX Cl~i1NTY SEPTIC T;'.NK MAINTENAI'vCE AGREEMENT ' ~ AND OWNERSHIP CERTIFI~:'ATION FORM Buyer LJ~; t!~ T~ ~ ~: ~, ~ /c , : ~ ___. Mailin Address ~„ ~ G' T~ Property Address ~~.4-- -.. ~~~ <~~'~ .~~.~.,. - (Verification required from Planning Department ibr new construction) City/State ~+-~~c..~:u~ e :7-, CJ~ Parcel IdenliGc;t;urn Number [~~~-- %0 yS = SG- -,=~ ,;i SYo/3 I,F..GAL DESCRIPTION Property Location S C '/,, -~~ '/,, Sec. ~? ~~ , T .-~c~ N-R_~, Town of , f~.1',,ie__ ~ ~.~.~~ Subdivision ~~/~~ _ ,Lot # Certified Survey Mup # ~- _, Volume __.- ,Page # Warranty Deed # ~~' / ~S~ , ``olume 4' ~~/ ,Page # ~7 Spec house ^ yes ~rto I,ot lines identifiable ^ yes ^ no SYSTEM MAINTF,NANCE Improper use and maintenanccof your septic system coup! result in its premature farlure 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 ur~:~ the system can affect the function of the septic tank as a treatment stage in the waste disposal system. The property owner agrees to submit to St. i:roix Zoning Department a certification form, signed by the c ,ter and by a master plumber, journeyman plumber, restricted plumher or a licrnscd pumper verifying that (1) the on-site wastewaterdi:.posal system is in proper oper;Ming condition and/or (2) after inspc~: lion and pumping (if necessary), the septic tan): is less than 1/3 full of sludge. (/we, the undersigned have read the above rcquiremc-~ts and agree to mscintairt tltc private sewage disposal system with the standards set forth, herein, as set by the Department of ('ornmcr.:e and the llepartntent of Natural Resources, State of W isconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Otfice within 30 days of the three year expiration date. ~ ~~~ SIGNATURE OF APPLICANT /~~/ c?/ DATE OWNER CERTIFICATION ' I (we) certify that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) rice owner(s) of the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. a.~ ~ ~ SIGNATURE OF APPLICANT _?-~ / DA'I u ••'"«* Any information that is mis-represented may result in t}te sanitary permit being revoked by the Zoning Department. •••••• •• Include with this application: a stamped warranty deed ft,nn the Rcbistcr of Deeds oflicc a copy n!' the certified survey map if reference is made in the wan~anty decd` OOGUMENT NO. w a 481'~~4 WARRANTY DEED STATF. BAR OF WISCONSiiQ 1~'ORM ~-19Bt t1~ER ~~~P~cF 45'7 i TN18 BRAG[ R[S[RV[D -OR R[GORDIM9 DATA RESISTER'S OF~=lCE .ad-.rar.d F. Ja.cok~s. and .Lorna. J.. ,7acohs,~ ~~~~ ~ ~~ .. ~ -- . .... ~ R~c'd kr ~toond ._hnsband...and. wife. as ..joint_.tenants .._ ................. APR1 O 1992 .............................. _ ............... -- ................---•- a .. _ -- ........ ...._. _ ....... ....... ......•---•---...-.... A. M ~~ -_... conveys and warrant8 to ....Walter-. A.- B.Yis.ki~--and........... 8.~ ....Deborah A-.- Br-iskie~,_ husba-nd -and ~fi~fe - --- ---~••~- ~ n ............................ _ ...... - - ............... Rpi>~et d Dreg . ~I RETURN t~ R~i~, .. ....... .. ... .. .. ..... .. ....-... t'+ .... VA,I.~. ,.~ ,. .. .......... . _ ~r S` :n~• ,~ 30 ,y1 ... -- -- 1 (~ E' ~~- ~_ ----- - thc folluwing described real estate ~n .......St .--.L:rO~X .................County, ~_- _ ~~i3~ -- - ~tate of Wisconsin: ~~ hrr•'X Taz Parcel No:..----•---• ................... E~ of SE's of SE's of Section 20-30-15, Town of 3lenwood, St. Croix County, Wisconsin. ~ i"\.~ ~ S ~O ~~ __ _: _ 'Ko~23~ Thi_ 1 S (ia) lis not) t:xccp[iou b. u•.In-un±ie~ ..~ Ih+u•.1 this r d:lp .,C ~~ ~LL4'w4 (SF'AL) Edward FfJacobs (SEAL/ AUTHENTICATION Si^nntnr '.,) ~vr~Z~~ t=-. Jf-~C:i'r~ i. i a, i .. i_- i- ,,_~~I~~~:,te•,t a:i= - :;.1; ,. Apr i 1 t., 92 i Kristira Ogland Ti-CI ':: Ai F:JIIiER ~T.~TE E3AR (~. ~1''~t'O~SI\ i(~ not, aut'~nrized S~- ; ;Oh A6, Vt'i~. ~tat~,) ,.~iNUti'FNT SV iS LHIFTFD FiV P~ristina Ogland Attorney at Law i ~1~•nac~;rc~: .~:1}• he a:at},r.ntic;ltrd ~ . a, kn~nclo~i_:o,1. I'I~t!t Inc not nrl•e!sar}•.) hnmcacalt i,n•pert~. April easements, restrictions and rights-of•-way of record, if any. ~~~ P~ , yam'/~ ~" ~~i t.+ 92 / L ,.~ ~ ~ J~;{~A / r~YrGi. ` ~.Y}::1 I . r Lorna J. Jacobs ACgNOWLEDGMENT STATE OF WISCONSIN ~ ~ s. ~~ i'ei<,~naiie.c;uue be:~lr~ nu' ti:~s line o' f: ~ iJ the aL.n•e s:em~•~i in si~~ knnu a to Le the' pe r. nn ui~o exec,ltrd the funsoin;t instrunu•nt and :u•kno~clcd,e ti:c ~;un~. 1rt:~.,., I'uh!ic l'~I~.Intc. ~t'i<. ~i~~ 1'.,nnui~;il~n nortr.,;;,~nr., It not. >tn?i~ .••:nr.. Srtc: 1? i