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HomeMy WebLinkAbout016-1071-40-000~ o °~' °• ~ ~ N ti O ~ I C a a ~ I N ~ H h °~ Y ~ ~ ~ ~ as ^ \ ~ ~ jv I ~ rn , ~o '~ ~ E y a i .. c I ~ o~ (r T o `~ ~ r ~ I OL O N ~ ~ N ,o o ~ `° Z f0 L (~ ~ I C L c O N E ~ w Q ~~'~ ~ f0 M d' ~ ~ ~ ili I ~ ~ Y O N LL ~ I ` Z ~ ° I € m ! I M H fA i I N ~ ~ ~ I O Z ++ ~ r I a :0 N ~ d Z ~ fq F- ~ ~~ ~ ~ ~ O Z j, a~ E ~ I `o ~ m ` E ~~ I p,A o ` ~ I •~ v ! N ~ t I C ~ I C O ~ O ~ Z Z ' ~ ~` ai I z `~ j y C N t+> ~ ~ O ~ y '~ ~ d ~ N y , . w ~ C ~ `"~J a ~ • v 0 0 0 Z N ~ oaaa v, ~ c y j °' `n `n 7 ° ° } }~ V (A ~ V C N N ~ I~ ~ rn Y O E I L o o ~ ~ ~ rn 'o m Q rn ~ N e d Q Z cA N I ~+ p I N 7 a+ ~ ~ ~ I ~ C o N y ~ IA C ~- C o v o E ro O ~~ F- ! U y c m ' ~~ o I m om' O a ti ~ o ~' ~ € E ~ .~. ~ m _ ~ N F~I O~ M C p~ N 7~ C yd _ C N O • ~ co _m O M U m I~~° a + Z~ Z~ m ~ !~ I O ~ i Q CC ~ ~ ~ y ' it ~ j ma I '~ ~ a a ~ ~ da ~ • `i~1 ++ m. E c c :: ~ I r r A ciao ;ov ci , v Parcel #: 016-1071-40-000 08/15/2oos 08:50 AM ~' PAGE 1 OF 1 Alt. Parcel #: 33.30.15.500 016 -TOWN OF GLENWOOD Current XJ 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 CaOwner O -WAGNER, CASEY L CASEY L WAGNER 1211 290TH ST GLENWOOD CITY WI 54013 Districts: SC =School SP =Special Property Address(es): " =Primary Type Dist # Description " 1211 290TH ST SC 2198 GLENWOOD CITY SP 1700 WITC Legal Description: Acres: 40.000 Plat: N/A-NOT AVAILABLE SEC 33 T30N R15W SW SW Block/Condo Bldg: Tract(s): (Sec-Twn-Rng 401/4 1601/4) 33-30N-15W Notes: Parcel History: Date Doc # Vol/Page Type 08/29/2002 688649 1962/561 WD 07/23/1997 911 /383 06/09/1997 1244/605 W D 06/09/1997 1244/599 QC 2006 SUMMARY Bill #: Fair Market Value: Assessed with: Use Value Assessment Valuations: Last Changed: 07/27/2006 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 2.000 10,500 154,500 165,000 NO AGRICULTURAL G4 35.000 2,900 0 2,900 NO UNDEVELOPED G5 3.000 1,000 0 1,000 NO Totals for 2006: General Property 40.000 14,400 154,500 168,900 Woodland 0.000 0 0 Totals for 2005: General Property 40.000 13,200 57,000 70,200 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch #: 555 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 gent of commerce PRIVATE SEWAGE SYSTEM ,ig Division o INSPECTION REPORT 4L INFORMATION (ATTACH TO PERMIT) ,ifonnation you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. ~Ider's Name: City Village X Township er. Casev Glenwood. Town of ~' BM Elev: BM El\\ev: BM Descri n: ~~1~ GS ELEVATION DATA TANK INFORMATION TYPE MANUFACTURER CAPACITY Septic t ' ~ Q~~ °t , (J /~ Dosing Ovw~p F:~i~. C~ r VC_/ Holding TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Septic ~ ~ ~/ ~ 1 ~ cJ I ~ Dosing ` ~ 1 ~~ / 5 , ~ ~ 1 ~ Aeration Holding PUMP/SIPHON INFORMATION ~ ..,,n. ~ ~,. J~`~`(~ Manufacturer ~ ~ \ Demand GPM Model Number I ~ Q 1 ~ ?,- TDH Li ~ ~ ~ Fricti ~Los~ ~ System ea~ 3 T Zg ~ 5~ Forcemain Length ~ Dia. Z f 1 Dist. to well ~ /~ ~ ~ SAII ~RSnRPTION SYSTEM county: St. Croix Sanitary Permit No: 479299 0 State Plan ID No: Parcel Tax No: 016-1071-40-000 SectionlTown/Range/Map No: 33.30.15.500 STATION BS HI FS ELEV. Benchmark ~ . 23 los, z3 /~ AI BM OJT /D .S ~ 7 ~/ Bldg. Se er 9~ ~ ~ •ol SUHt Inlet ~'~ ~~~ SUHt Outlet '~ ~ Dt Inlet ~~ ~-~ Dt Bottom ~ $ Q~ ~1 ! - Header/Man. ~,~~ ~ ~3 • Dist. Pipe ~,3 ~~~, Bot. System Q ~ , / b Z • .3Z 'nal Grade ~ 3.~ ,Ib~. g Z St Cover J ~ ~b `S 7 , BED/TRENCH Width ~ Length ~ No. Trenc PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS ~ 7C, / "~~ ~' '1 SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer. INFORMATION CHAMBER OR Type Of stem: ! `~ ~ ~ ~ ~ /~~ / UNIT Model Number: ~ OJ r11STRIRI ITInN SYSTEM [~__ J\ IUP... L.._ ~_ __ Header/Manifold ~! ~ 1 Z' Distribution , p O ~~~ i / L S i C~ th ~~ Di L x Hole Size i Z~ x Hole Spacin ~ 1 Z~ Vent to Air Intake I ~ Dia Length pac ng eng a o C(lIl R(1VFR ., o.~«...e c..~•e..,~ n.,i.. .... R7n~~nr1 (1r Af_f~rada Svefems ~nlv Depth Over ~ Bed/Trench Center Depth Over I Bed/Trench Ed es xx Depth of To soil xx Seeded/So de~ xx Mulched / ~ COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: `1 / z~ / DJ Inspection #2: / /_ Location: 1211 290th Str et Glenwood City, WI 54013 (SW 114 SW 1/4 33 T30N R15W) 40 acres Lot PCh,~` P rcel No: 33.30.15.500 1.) Alt BM Description = ~V~ ~`~~"-• ~~w~ Jas ~ ~,OG~S p~.l~w PI ~ ~ ~,, b 2.) Bldg sewer length = $2 d w ~. - amount of cover = ~ ~( ('~ [~ ~D 1 1J~-~ ~'d _ i'o ~l cv(11-e_. i tc~~ a-C/~. Pv~^~P ~St ze.. Plan revision Required? ~ °~ Yes No 1 ~~~ 1511 Use other side for additional information. Date SBD-6710 (R.3/97) W V V Q V OQ W 2 ~ ao OJ V _ ~ M ~ 3g Y M rn N n N ~ ~~ ~ N a d W Z ~ J NN ~ U WO d O p ~~ ~ ~ a Z N p J ~ ~ Q ~ M lJ W ~ 2 N M ^~ ~ ~ s x a a ~ a s ~ ~ ~ .. i i s t ~ ~~ .-~ ~ c~ ~ 7l i~ Jl ~ ~l ~ J! ~ Jt ~ Jt ~ Jt ~ ~l ~ 7~ x ~ R 7 - n s _ • t i t~ i !' ~~ ~ t i i i i ~ ~ a ~ x i i i i t i ^~ ~ t I 1 I t 9 R n s i i i i l i ~ uy ~O ~ ~ ~ ~ S~ F} ~ gg N ~p 7f ~ s e R i i i i i ~ ~ r r r $ ~ ~ ~ $ R ~ ° i i i i i ~ ° ~ ~ ~ ~ ~ ~ ~ ~ R ~ i i i i i { i ~~ ~ h D{ i1 R ~ ~ R n i i i i i i i i ^~ ~ $ s s R R S ~ s i t i i i i f i~ C a d • g 0 M r • _ O 0 ~ ~ 2 ~ ~ w ~~ ~s~ as S g 8 s O t N N N OV311 JWIYILIQ MO1 0 T O r Safety and Buildings Division I County ~~ '~ ' ` 201 W. Washington Ave., P.O. Box 7162 . S / L~ ~ ~ ' iseonsin Madison, wI 53707 - 7162 Sanitary Permit Number (to b< filled in by Co > De artment of Commerce (608) 266-3151 ~L9~j I Sanitary Permit Application State Plan I.D~/._Nu/tuber In accord with Comm 83.21. Wis. Adm. Code, personal information you provide j / I ~Q T~ 1 - T~+OS' ~ ~ may be used for secondary purposes Privacy Law, s15.04(1)(m) i~Project Address (if different thann mailing address) 1 ~1 ,1i Al is A I. Application Information -Please Print All Lnfo n nnC~ ,gyp ~""•"~- "~ "~ " Property O er's Na me (( Parcel !! .1..et-,M-` 9ioe~i~'+~-- ~S 3~ '"moo ,IUL f! ~ - o /- o-~DGS~o~ Property Owner's M cling Address /) CG I ~ Property Location ~ V I~ /" ~ ~ ~~ s;.cNoixcoi,rur ~~ I ZGNING F ~ ~ _ ~(~ ~,~ SC.!/ ~,~,Scction 3.~ City. Stain \ Zip orx um • U 't,t)d.~.: Ct Ck/~ / ~ I z ircle~e) ' T;J d N, R ~ ~E oEW ~ e of Btvltiing (check that apply) II T St.c.6~ y , ~ ~ . yp Cfr, O,~,N,S ~u,-.yt~ J . a t 1 or 2 Family Dwelling -Number of Bedrooms ~ ~ Subdivision Q nine C51ot-Num er -' ~ Q ~ ^ Public/Commercial -Describe Use T~ \\( ~ - n S br ^'~ ~ CJJ ~ • awe p~~ I ~ ' ` f---- ^ State Owned -Describe Use ( l S ,,I~- e~ , lQ~ ~ly.v5~-" cry ^V age ~ Township of t I ~ L~= ~ ~.e:~~ III. Type of Permit: (Check only one box on line A. Complete line B if app cable) A '~~tertt ~, Replacement System j TrarmendHolding Tank Replacement Only I ^ Other Modification io Ezisung System B. ^ Permit Renewal ^ Permit Revision ^ Change of ^ Permit Trarufer ro ~ti'ew i List Previous Permit Number and Date Issued i Before Expiration Plumber Owner t{ U / 1V. T of POW TS S stem: (Check all,that a 1) /p )C ~ = 12.0 •~ ^' Non -Pressurized fn-Ground fg Mound > 24 in. of suitable soil ^ Mound G 24 in. of swtable soil ^ At-Grade ^ Single Pazs Sand Ftlter , Corutructed Wetland ~' Pressunzed In-Ground ^ Holding Tank ^ Peat Filter ;~ Aerobic Treatment Unit ~J Recirculating Sand Filter ~ ^ Reurculaurtg Synthe[ic Media Filter ^ Leaching Chamber ^ Drip Line ^ Gravel-less Pipe ^ Other (explatn)~ _ r~ V il:~.,or~olrTroatmant Aron infnrmatinn• i i [~A - /i]~. Design Flow (gpd) Design Soil Application Rate(gpds Dispersal Area Required (sf) Dispersal Area Proposed (s f) !System Elevation ~ { VI. Tank Info I Capacity in Gallotu Total Galloru Numbcr ~ Manufacturer ,\ W(.Z~~ ~_~~ ~z~jr~~,tp,,~`~ of Units , _~" ' Prefab ' Concrete Site Steel I Fiber ~; PlasfiC Corurructed ~, j Glass New Tanks Existing i Tanks I I ~~.~,~. /J ~ i .-_--- --- Septic or ~ l~ a -~-- / ~ ~ e!-~e Aerobic Treatmern Unit >~y Dosing Chamber / (Y .,._ i ii ' VII. Responsibility Statement- I, the undersigned , assume responsibility for tallation of the POµ'TS shown on the attached plaru. Plumber's tin me (Print) Plumber's Si gnature `~~~ P'MPRS Number i Business Pho/n`e Number ` PI tier's Addre ss (Street, cry, State. Zip Code) ~:5`'~ ~ S T ~ L ~' -,~~~ c~'cJJz L t~ l~~ ..~y7z ~~ I VIII. County/De artment lise Onl ~y /~ Sanitary Permit Fee (includes Groundwater Date Issued '' Issue g Agent Signature (No Stamps) ~ /~ Approved ! ~ Dis oved ,! ' Surcharge Fce) -~' '- ~ ^ O ~uy~n on for Denial ~ ~ ~~~ Jc ~ ~~~~ ~~~n/~ _ A~~_~ I IX. Conditions Approv 8YSTEM OWNER: 1 Septic tank, effluent filter and dispersal cell must all be serviced /maintained as per management plan provided by plumber. 2. All setback requirements must be maintained as per applicable code/ordinances. Attxh complete ptans (w ~~` cv.A~--S • ~ only) for the system oo ps+per nol Icss than 81 R x 11 incba in size SBD-6398 (R. 01/03) l ~ ~. N ~ ao ba tJl N ~; 1j d o ° ~~ z~ ~ ~ ~ ~ ~ N ~ ~ L ~a '' ..p to ~ L d ?e~' ~ ~~' ~ P T L ~ ~ ~, ~ ~~ ~~ ~~ 2 ofd a d ?~ y ~ ~n m ~`, 8 '~ o ~-. I 'i I i ~ I ~o ~ ~ .~ ~c Q e • ~ 3 N J ~ GpP c e ao ,~ '~ N ~ ~ ~ ~ ~ ~ ~ n ¢ x ' ~ ~ c W "~ 'a w commerce.wi.gov isconsin Department of Commerce Safety and Buildings 141 NW BARSTOW ST FL 4TH WAUKESHA WI 53188-3789 TDD #: (608) 264-8777 vvuvw. com merce.wi.gov/sb/ www.wisconsin.gov Jim Doyle, Governor Mary P. Burke, Secretary July 05, 2005 CUST ID No.224617 LYLE J MYERS NORTHLAND PLUMBING 1NC E1556 STATE ROAD 64 BOYCEVILLE WI 54725 ATTN.• POWTS Inspector ZONING OFFICE ST CROIX COUNTY SPIA 1101 CARMICHAEL RD HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 07/05/2007 Identification Numbers Transaction ID No. 1150721 SITE• Site ID No. 700834 Casey Wagner Please refer to both identification numbers, 290TH Street above, in all corres ondence with the a enc . Town of Glenwood, 54013 St Croix County SW1/4, SW1/4, 533, T30N, R15W FOR: Description: Mound, 3 Bedroom Object Type: POWTS Component Manual Regulated Object ID No.: 1026126 Maintenance required; 450 GPD Flow rate; 24 in Soil minimum depth to limiting factor from original grade; System(s): Mound Component Manual -Version 2.0, SBD-10691-P (N.O1/O1), Pressure Distribution Component Manual -Version 2.0, SBD-10706-P (N.01 /01) 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. No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, stats. The following conditions shall be met during construction or installation and prior to occupancy or use: This system is to be constructed and located in accordance with the enclosed approved plans and with the "Mound Component Manual for Private Onsite Wastewater Systems VERSION 2.0" SBD-10691-P (N.O1/O1) and the "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems VERSION 2.0" SBD- 10706-P (N.O1/O1). 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 comply with the operation, maintenance and monitoring duties as described in section VIII o e mound component manual. A copy of this informafion must be given to the owner upon completion of the pe .~.~"'..~- All holding/treatment tanks are to comply with Comm. 84.25(7)(a). ~, ` ~ ~,~°~ ~, 0/i/E/~ ~~'dfc~.~~= Maintenance information must be given to the owner of the tank explaining t t periodic cf$fiMii~,~~df@1're filter is required. Access to the filter for cleaning must be provided per Comm 84 produc oval condiri~ns. SEC. ~..~ A Sanitary Pernut must be obtained from the county where this project is located in accoida~ tie with the requirements of Sec. 145.135 and 145.19, Wis. Stats. LYLE J MYERS Page 2 7/5/2005 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. 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. Owner Responsibilities: • Comm 83.52 Responsibilities. The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s. Comm 83.54(1). • Comm 83.52(2) A POWTS that is not maintained in accordance with the approved management plan or as required under s. Comm 83.54(4) shall be considered a human health hazard. • Comm 83.55 The owner is responsible for submitting a maintenance verification report acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence maybe made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Julia ALewis-Osborne POWTS Reviewer 2 ,Integrated Services (262) 548-8638, Fax: (262) 548-8614 j Lewis@commerce. state.wi.us Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 WiSMART code: 7633 Mound system Cover Page pg 1 of 6 ~_ ~D~~ ~E~'E Project Name: Wagner-Mound Owner's Name Casey Wagner Owners Address 1211 290th St. Glenwood City, WI 54013 Legal Description sw/ ~ '/,, ~sw ~ '/4 Sec 33 T 30 N, R 15 w ~ Township Glenwood County Saint Croix __~ Subdivision N/A Lot# Parcel ID# Table of Contents P9• 1 2 3 4 5 6 Cover page Mound Sizing Calculations Pressure Distribution Layout and Dynamics Dose Tank Management and Contingency Plan Plot Map total # of pages: 6 Designer Name: Lyle J. Myers MP/License #: I.D.# 224617 Date: 6/20/05 Ph. #: 7156432520 Signature: ~~,~.e~~~~-~-~~ s„A ' ~ , - ~-- ~ Mound System Design Methods Used -~~ per "Mound Component Manual For Private Onsite Wastewater Treatment Systems" (Version 2.0) SBD-10691-P (N.01/01) ~ `~%~,;, ,. ,.; vs per" Pressure Distribution Component manual for Private Onsite Wastewater Treatment Systems" (Version 2.0) SBD-10706-P (N 01%dT~~~` '~ ~; - ~L~'~ `\ Spreadsheet provided by: 3bAdvisement N12486 220th St, Boyceville, WI 54725 Ph: 715-643-6068 email: 3ba~3badvisement.~odt RECEDED JUN 2 4 2005 SAFE & BUILDINGS Mound System Page 2 of 6 Mound Sizing Calculations Project Name: Wagner-Mound Site Conditions Design of Entire Fill Cell depth at upslope edge (D): Cell depth at downslope edge (E): Distribution cell depth (F): Cover thickness over edge (G): Cover thickness over center (H): Project Type: 1 or 2 Family Dwelling ~ Slope: 5 # of Bedrooms: 3 Depth to limiting factor: 24 in. Absorbtion rate of fill material: 1 gal/ft2/day Absorbtion rate of in-situ soil: 0.6 gal/ft2/day Effluent quality Eff#1 • Max BOD effluent value: 220 mg/I Max TSS effluent value: 150 mg/I End slope width (K): Fill length (L): Upslope width (J): Downslope width (Toe) (I) Fill Width (W): 12.0 in. 15.6 in. 9.5 in. 6 in. 12 in. 8.9 ft. 92.8 ft. 6.0 ft. 9.2 ft. 21.2 ft. Design of the Distribution Cell Basal Area System Design Flow: 450.0 gal/day Basal area required: 750 ft2 Distribution cell width (A): 6.00 ft Basal area available: 1140 ft2 Distribution cell length (B): 75.0 ft Area of Distribution Cell: 450.0 ft2 Observation Pipes Contour Elevation of Mound: 101.89 ft Location from end of cell (Z): 12.5 ft System Elevation of Mound: 102.89 ft Final Grade of Mound: 104.68 ft Mound Plan View /observation Pipes Z~ ~/ K=- ~'~ C~istrib~_~tion Cell ~ ~~ A ~ k-K I Tilled ArealFill Material L Mound Cross Section Final Grade ~~ = Synthetic Fabric-r-~~ Distribution Cell ;~ "J~, ~ System Elevation ,-~ -,}' ~ a,`', ~' q Cover Material .~'~ % ,' I Lateral Fill Material-- , /r `~ ~ in+~ert Slope Observation Pipe E~ _ G _ ~-'~..~ ~; ~ ~ ~ -~ 1 ~ ~ ~; ~ - Tilled Area ~Forcemain System Contour Notes: Fill material to consist of ASTM C33 Sand Distribution cell aggregate to comply with Comm 84.30(6)(1) Synthetic Fabric covering on cell per Comm 84.30(6)(8) Distribution Cell to have minimum 6" aggregate below lateral and 2" above. Mound System Page 3 of s Pressure Distribution Calculations Project Name: Wagner-Mound Lateral Layout Lateral/Manifold Design Lateral elevation: 103.4 ft Lateral diameter: i~iz ~ In. Rows of Laterals: ~~~ Lateral spacing (S): ~ft Manifold type: center ~ Lateral to cell edge: 1.5 ft Orifice diameter: 0.125 ~ In. Lateral discharge rate: 7.83 gpm # of Laterals: 4 System discharge rate: 31.31 gpm Distal Pressure: 5 ft Manifold diameter: z ~ In. Lateral Length: 37 ft Manifold length: 3 ft Orifice Spacing/Distribution Forcemain Friction Loss Orifice spacing (X): 24.00 Inches Forcemain length: 80 ft Orifices per lateral: 1 g Forcemain diameter: 2 ~ In. Avg. ft2/Orifice: 5.92 ft2 Friction loss in forcemain: 1.678 ft Lateral Side View Manifold Lateral ~ ~ Lateral x x x x x x x x x x x x 2 2 Lateral Length Lateral Length Lateral Plan View ~- Lateral Length ~ ~ Turn-up wlball valve or cleanout plug r, ~ ~ S v n Orifices on botkom of lateral equally spaced PVC laterals and forcemain to comply with specifications per Comm 84.30(2J(e) Forcemain conneckion via kee or cross ko manifold at any point Clean Out Detail Observation Pipes Clean-out plug Final Grade or ball valve Water tight cap or plug Lawn Sprinkler Box Slot Note: Closet Collar 6" Minimum may be used in Long Sweep 90 place of 3I8" bar ortwo 45's L 3/8" Bar Lateral Mound System Septic, Pump and Dose Tank Project: Wagner-Mound Tank Information Pump tank manufacturer: Wieser Concrete Pump tank size/model: wiooo/6so-MR • Pump tank gal/inch: 17 Actual Pump Tank Volume: 646 gal Tank bottom elevation (inside): 86 ft Septic tank size/model: wiooo/65o-MR • Pump and Filter Pump Manufacturer: Little Giant Pump Model: 9EH Effluent Filter: Zabel A100 Note: Access opening of sufficient size to be provided to allow removal of filter. Opening to terminate at or above grade. Pump Tank Diagram 4 Inch Minimum Alternate Outlet Location Pump must be capable of: and head pressure of: Watertight Locking Cover With Warning Label Finish CaYB~dE Elect, per Gomm 16.28 and NEC 300 Weep Hole A or Anti- Siphon l3 Device c D 30 w ~ 20 a 31.3 GPM ~ to 25.0 Feet 0 to N 7.5 i S a x a.s 0 Page 4 of 6 Dosage Volume Forcemain drains back to tank? OQ Yes O No Lateral void volume: 15.6 gal Dosage to absorbtion Cell: 78.2 gal Forcemain volume: 13.9 gal Total dosage: 92.2 gal Total Dynamic Head Are laterals highest point? y if not, enter highest elevation: 0 ft System head (distal x 1.3) 6.50 ft Vertical Lift ("D" to lateral) 16.72 ft Friction loss in Forcemain: 1.68 ft Pressure loss from filter: ~ft Total dynamic head (TDH): 24.90 ft ~~ Ztd Dose Tank Levels 1 In. Gal A Reserve 22.6 383.8 B Pump off to Alarm 2.0 34.0 C Total Dosage 5.4 92.2 D Effluent depth for pump 8.0 136.0 Total Capacity: 38.0 646.0 FLOW- L[TERS/HOUR o zo no so eo Little Giant FLOW- GALLONS/MINUTE 9EH PUMP PERF^RMANCE CURVE I15V 60HZ Mound Sy'stem'Management Plan pursuant to comm 83.54 W. A. C. page 5 of 6 Owner's Responsibility: The component owner is responsible for the operation and maintenance of the component. The county, department or POWTS service contractor may make periodic inspections of the components, checking for surface discharge, treated effluent levels, etc. The owner or owner's agent is required to submit necessary maintenance reports to the appropriate jurisdiction and/or the department. Septic Tank: Septic tank(s) are to be inspected routinely and maintained by department approved individuals when necessary in accordance with their approvals. The use of chemical/biological "treatments" is not required or recommended. If such additives are used, make sure they are approved by Department of Commerce, Safety and Buildings Div.. Effluent filters are to be removed & cleaned as necessary, with provisions to keep solids from passing the septic during removal. No more than 1/3 of the usable tank volume may be occupied by sludge/scum. 3 year inspection: If tank has greater than 1 /3 volume sludge, tank contents must be emptied and disposed of in accordance with NR 113 Wisconsin Administrative Code by an approved individual. If the inspector does not recommend pumping of the septic tank, then the owner must be notified of when pumping should be done as to not exceed 1/3 sludge volume. Septic tank should be routinely inspected to be watertight and of good repair. Pump/Dose Tank If an effluent filter has been installed in the pump/dose tank, it must be removed & cleaned as necessary, with provisions to keep solids from passing to the mound component during removal. The pump, float switches and alarms must be inspected at least every three years for proper operation. Pump/dose tank should be routinely inspected to be watertight and of good repair. Mound and Lateral System The mound system component must remain free of ponded surface water prior to pump operation. If 4 inches or more water level is detected in the observation pipes, the owner must be notified of possible problems/failure. The designed daily flow capabilities of the component should never be exceeded. Trees and any other deep rooted vegetation should never be planted, or allowed to grow anywhere on the component. Activities OTHER than mowing/maintenance (i.e. excessive walking, pets, vehicles, etc...) could compress the component and reduce it's absorbtion capabilities and/or possibly cause it to freeze in winter conditions. Lateral distribution pipes should be flushed out/tested every 18 months using the cleanout points at each end of the component to remove scum that may clog orifices. Performance Monitoring: Performance monitoring must be done at least once every three years following the installation or at the time of a problem, complaint, or failure. Contingency Plan: If the septic tank, pump tank or any of their components therein (including floats, alarms, pumps, etc) become defective, the defective tank or component must be replaced immediately to ensure that the system can operate as designed. If the mound component cannot accept wastewater or ponds wastewater to the surface, the component must be repaired or replaced in it's current location by either: extending basal toe to provide added absorbtion area; or by removing the clogged bacterial mat,aggregate cell, and distribution piping within the mound and replacing said components in order to return system to proper working order as required. 2 9ot~- a ~- N N ~ ~ ~ ba v~ N ~ ~, ~ , .~ ~~ ~~o~ N -A • ~ G N c ~~ 0 a~ ~~~ ~~o ~ ~ P ~L ~ ~ ~ ~~ c~ p Ri' 9 ~~ ~ ~ m „'. 8 'r y o ~a ~`~ ~ ~ w ~ ~ zd o~ .I ~ ~. G~ ~ N I ~ ~ ~ ~~ I N I I u~ .~ .~ ~ ~ . c s C s • ~ y vo '~- `~; N .. vd ~ ~ N 3 ~' ~ ~ ~ ~ ~ ~ ~ n o x ~ ~ ~ ~ ~ ~ c o~ w ~ ~a w ~° Department of Commerce Division of Safety and Buildings SOIL EVALUATION REPORT in accordance with Comm 85, Wis. Adm. Code #3 Page 1 of 2 Northland Plumbing, Inc. Attach complete site plan on paper not less than 8'/: x 11 inches in size. Plan must in l d b t t li it d t ti l d h i t l f i B County St. CroiX c u e, u no m e o: ver ca an or zon a re erence po nt ( M), direction an d percent slope, scale or dimensions, north ,and location and distance to nearest road. Parcel I.D. / o 1 7"a l • Ste) ~ - t _ p ~ - t Please print + rma n. R iewed By Date Personal information you provide may be use or dary a~s ~w~e. 15.0 (1) (m)). ~ ~ I Property Owner Property cation Wagner, Casey 4 .Lot SW1/4, SW1/4, S33, T30N, R15W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# 1211 290th St. "I.CRUIXCO NT` City State Zi Phon~l9aititi~rOF .~; __ Village `_,' Town Nearest Road Glenwood City WI 54013 715-265-7667 Glenwood 290Th St. New Construction Use: ~ Residential / Number of bedrooms 3 Code derived design flow rate 450 GPD ^ Replacement ^ Public orcommercial -Describe: Parent material Glacial Till Flood plain elevation, if applicable ft. General comments ~~ a-/ ~~t~-~.~,/ < " and recommendations: ` X~S'i'Nav~~ /2•~ Sq•al~ Gam `.c,~,.~. ~ I ~ ~, Boring Boring # Pit Ground surface elev. 101.92 ft. Depth o limiting factor 26 in. Soii Application Rate Horizon Depth Dominaht Color.. Redox Description Texture Struc re Consisten Boundary Roots GP D/ft' in. Munsell Qu. Sz. Cont Color Gr. S . Sh. •Eff#1 •Eff#2 1 0-8 10YR3/2 sil - 3sbk mvfrr cs 2f .6 .8 2 8-15 10YR4/4 sil ~• 3sbk mvfr cs if .6 .8 3 15-24 10YR5/8 s Osg mfr cs .7 1.6 4 24-26 7.5YR5/6 sci lsbk m~ cs .2 .3 5 26-48 7.5YR5/6 7.5YR6/8 flf spots scl lsbk mvfi cs .2 .3 Boring # ~ Boring [] Pit Ground surface elev. 99.64 ft. Depth to limiting factor 33 in. Soil Application Rate Horizon .Depth. Dominant Golor Redox Description Texture Structure Consisten Boundary Roots GP DIft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •Eff#2 1 0-13 10YR3/2 sil ? 3sbk mvfr cs 2f .6 .8 2 13-19 10YR4/4 sil ? 3sbk mvf~, cs lm .6 .8 3 19-33 10YR5/8 cs Osg ml cs if .7 1.6 4 3-49 10YR5/8 7.5YR6/8 flf spots s Osg mvfi cs .7 1.6 5 49-60 7.5YR5/8 s Osg ml cs .7 1.6 6 60-70 7.5YR5/6 7.5YR6i8 flf spots scl lsbk mvfi cs .2 .3 • Effluent #1 = BODS> 30 < 220 mg/L and TSS >30 < 150 mg/L "Effluent #2 = BODE < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) Sign re: CST Number Michael J. Myers 267985 Address Northland Plumbing, Inc. Date Evaluation Conducted Telephone Number E 1556 State Rd 64 Boyceville, WI 54725 6/20/05 '~fs' -G~3-Z$""LU SBD-8330 (R.07/00) s Property Owner Wagner, Casey Parcel ID # Page 2 of 2 3 ^ Boring Boring # ,_ pit Ground surface elev. 101.92 ft. Depth to limiting factor 24 ~ in. ~ Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft' in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. ~Eff#1 'Eff#2 1 0-11 10YR3/2 sil ? 3sbk myfr ~ cs 3f .6 .8 2 i1-17 10YR5/6 sl 2sbk msrfr~=° cs if .6 1.0 3 17-24 10YR5/8 5 Osg rill °. cs .7 1.6 4 ~ -36 7.5YR5/6 . 7.SYR6/8 fif spots sci isbk mom. ` cs .2 .3 S 36-49 7.5YR4/6 scl lsbk s mom` cs .2 .3 'Effluent #1 = BODS> 30 < 220 mg/L and TSS >30 <150 mg/L 'Effluent #2 = BODS < 30 mg/L and TSS < 30 mg/L The Department of Commerce is an equal opportunity service provider and employer. [f you need assistance to access services or need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. SBD-8330 (R.07/00) Northland Plumbing, Inc. s ~~. ~ .~ ~ ~ ~ ~ : ° Q- ~ D ~ ~ ~ ~ ~ I ~~~~ i i ~ I i ~y i h 0 9 i^ -. p ~` ~~ ~'1 I~~l 3 a~ 0 ~ ~ m ~ ~ 3 ~ ~ ~ _~ ~ ~ r 3 o ~ f~ ~ 3 ~ a v ~ ~ ~ ~ ~ ~ ~~ j~~ Y J~~`JJJ...+++ ~C [~ {t~p `(~, e YI d Q. K \ ~ o ~ aJ ~ ~ ~J ~ ~r1 O ~ 7 ~` ~ V 0" Q, ~ - ~, ~, ~~~ ~ ~3 a ~ ~ ~ ~ !~ ~ M ~~ ~ ~ ~ ~ 4! ~~ ~~ W ..S 7 ~ U ~i A ~1 Z ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM OwnerBuyer C:. AS E`f ~R G ~I C-R. , Mailing Address Property Address (Verification required from Planning Department for new construction) City/State G tE,J~eo~ ~.t~Ty, w I Parcel Identification Number 4 l(~ - I o ~-I - ~/o - c~ ~• ~~ LEGAL DESCRIPTION Property Location Sw '/., Sw `/., Sec. 33 • T 3a N-R~W, Town of Gt,E~luJt~i-l~ . Subdivision r----- t~ , ~~_ Lot # ~~ Certified Survey Map # --'--- .Volume ~"- .Page # Warranty Deed # ~8 ~ ~ ~ ~ ,Volume ~ ~ ~ 2 ,Page # ~ ~ Spec house ^ yes [~no Lot lines identifiable Oyes ^ no SYSTEM MAINTENANCE Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. The property owner agrees to submit to St. Croix 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 wastewaterdisposal 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. Uwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification statin that yours tic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 da the thre ear expiration date. ~ ©~ / / ~~ ~ SIGNA F LICANT 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) the owner(s) of the pt~perty descrrl5, d above, by virtue of a warranty deed recorded in Register of Deeds Office. SIGNATi~LE OF x do 0 ~ a7/ DATE «*««*«(/pny information that is rnis-represented may result in the sanitary permit being revoked by the Zoning Department. ****** ** Include with this application: a stamped warranty deed from the Register of Deeds office a copy of the certified survey map if reference is made in the warranty deed U 1962P 561 I STATE BAR OF WISCONSIN FORM 2 - 2000 Document Number WARRANTY DEED This Deed, made between Paul R. Wagner and Debra A. Wagner, husband and wife, holding as survivorship marital property A Grantor, and Casey L. Wagner, a single person ~-- Grantee. -- Grantor, for a valuable consideration, conveys and warrants to Grantee the following described real estate in St. Croix County, State of Wisconsin (if more space is needed, please attach addendum: Southwest Quarter of the Southwest Quarter (SW 1/4 of SW 1/4) of Section Thirty-three (33), Township Thirty (30) North, Range Fifteen (15) West. .~ 6 8 6 4 9 REGIST R OF DEEDS ST. CRpIX CO. , MI RECEIVED FOR RECORD 08-29-2002 9:30 AK NARRANTY DEED EXl71p7 • 6 REC FEE: 11.00 TRARS FEE: COPY FEE: CERT COPY FEE: PAGES: 1 Recording Area Name and Retum Address Thomas A. McCormack 1020 10th Ave. PO Box 2120 Baldwin, WI 54002 016-1071-40 Exceptions to warranties: easements and restrictions of record. Dated this 1ti' oXi day of AN , 2002 r * --- AUTFIENTICATION Signatures authenticated this day of s TITLE: MEMBER STATE BAR OF WISCONSIN (If not, _ __ to me known to be the person(s) who executed the foregoing authorized by § 706.06, Wis. StatsJ ~ insttvment and acknow dged the same. ~IiO1htYE PtL~I THIS INSTRUMENT WAS DRAFTED BY * --gya Thomas A. McCormack ~ Nota ,State of WISCONSI Baldwin, Wl 54002 M mission is permanent. (If not, state expiration date: (Signatures may be authenticated or acknowledged. Both are no[ necessary.) ~ _) * Names of perwns signing in any capacity must be typed or printed below their signature. WARRANTY DEED STATE BAR OF WISCONSIN FORM No. 2 - 2000 INFO•PRO (e00)855-2029 www.inroproromis.eom Parcel Identification Number (PIN) This homestead property. (is) (is not) ~' ~ w * Paul R. Wagner * Debra A. Wagne~ ACKNOWLEDGMENT STATE OF WjSCONSI ) ss. St. Croix _ County ) Personally came before me this __~(p ~ ____ day of -gr- 2~2 the above named Paul R. Wag er and Debra A. Wagner, husband and wife, as _ survivorship marital property St. Croix County Map Output Page Page 1 of 1 http://72.21.230.178/servlet/com.esri.esrimap.Esrimap?ServiceName=StCroixOV&Client... 7/11 /2005