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002-1009-20-100
Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division - INSPECTION REPORT sanitary Permit No: (ATTACH TO PERMIT) 515219 0 GENERAL INFORMATION State Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: City Village X Township Parcel Tax No: Schultz, Greg Baldwin, Town of 002 - 1009 -20 -100 CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range/Map No: / OD Description: ,, I GSj 05.29.16.66A10 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER D.• y � CAPACITY STATION BS I FS ELEV. 7 N �, 7S �a i Septic Z. st / Benchmark Dosing (�✓W�2� r✓ / S 7 � J � � AI � oJ.s.�._ /4 .1S 041 AerattBrr n \. Bldg. S6wer Holding St/Ht Inlet 22.107 75. 33 St/Ht Outlet TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vjg Air jakke CAD Dt Inlet � Septic > /S / /2 /1 / 5 CJ ^ Dt Bottom Dosing > 11?) /'A 1/ / / Header /Man. Z.41 3 Aeration ../ Dist. Pipe 2, /5 1 .7.3 Holding Bot. System Final Grade PUMP /SIPHON INFORMATION , , 47 /PD • 3 Manufacturer C GPM nd St Cover Lam a0,16 Model Number /6 1 7 1 1.5 - 60 t, r 4{.1 9- 7. 2— TDH !Lift i I .'i Friction Loss System Head TDH Ft /3 . IA, 76 ----- Forcemain Length / Dia. /1 Dist. to Well / '3 70 2 126 SOIL ABSORPTION SYSTEM Width Leng� / No. Of1reenct s PIT DIMENSIONS No. Of Pits Inside Dia. I Liquid Depth DIMENSIONS '���V11J ��JJ11`` �1 ---__ 1- SETBACK SYSTEM TO P/L BLDG WELL LAKE /STREAM LEACHING Manufacturer. INFORMATION Type Ot System: j �� ' � M6 4 - ) �� CHAMBER OR > 166 X66 UNIT Model Number: DISTRIBUTION SYSTEM Header /Manifold y Distribution / �4 ,/ / x Hole Size 1 x Hole Spacing / 1 Ve to Air Intak Pi pe s ) Length Z. 5 Dia �/ � Length Z. Length 221 Dia /.5 Spacing 2 . 5 3 1 /l/ p 3.35 Q 5 * k,f{p,p,� SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only _ .�.n Depth Over / Depth Over xx Depth of rL xx Seeded /Sodded #a A be Mulched Bed/Trench Center 1 . c Bed/Trench Edges 'N ..... Topsoil ' A let-. Yes 0 No NRIZs El No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / t ) / `( / /a Inspection #2: / / Location: 2259 Cty Rd D Baldwin WI 54002 (NW 1/4 NE 1/4 5 T29N R16W NA Lot 1 St �' P rcel N 05.29.16.66A10 CI A4 J Alt BM Description = � 6-4 ` 0 " 4 -A--- ` Clha ( .n.s . Oak., OA 1 A0,1 0 2.) Bldg sewer length = //, I �5 - amount of cover = / ok A wd r •rit i a,.�. a. 2 6 ! � � G1�t� Plan revision Required? ra Yes No O 7 / 7 Use other side for additional informat or n. l f � - _ �� %_ �� -/ Date Inse. or's Sign re Cert. No. SBD -6710 (R.3/97) -- ~~ a~ # 201 W_ W Ave., P.O. Box 7152 ~ ~7~ ~, G ~~ ~ u n , ~A~ I P~No~~~~~~~~., 515 2 / Sanitary Permit Application TNamber ~ w;tb ~. comm. s3s~(zl, ~r~ Adm_ Code, sdmv~ioa ~~ fay w tl,e is regos+ed prior to o6aidng a smi~acy P~ Naoc A licai f f ' Z pp at ame ar ~o-eased PC)Kr! S are b > Add (iifdlffare t tL ' 7 su mitted to Bee Deparasmt of Co®mac4 t'ermeai you provide may be mad far secondary P a aa mar g ) m mpaty Owns s Namc , Paaod ~ e S~ ~ - 4 ~-- z. , +~ - ~ ~b4 - 2~ - ~c~ g ~ ~ a ~ 4 G~ ~ ~ J•o CR~IX COUNTY ~(o ~1 •/o • City, State ~ PLAN4~i4N ~. ~ 41 V W -1- [J ~ -4 OC' ~ IL tyfBtnlt6ng (ciiedt all tLat B l ) T~~' Id; RE~r 1 pp y ~~ A ~.J 1 or 2 Fam0y Dwelling - Number of Bedsewms ~ ~v~on Name 1 0 , ti.. ~ city of ^ Satet)wnad-i~aibe Ilse ~ ~ ~ © ~ 5 ~/ZO ~ awn- 7 S /~7 ~ j -r~~ L A\ ,`~ru IIL 1 ~pe of Perm ( ciae baz an liii~ A eoaaPkte ~ S iif ap~e:able) A ^ New System System ^ Try Taatc ltgda~mt: t?nty D E)<Iea ModiSeabi~ to F System (e~lain) B- ^ Perms Reaevnt ^ t?btmrt iReviaian ^ ~ of PibomLa ^ PmaQ Tr+a~er to New ' ~ Previoas Permit Number and Date Issued t~f are Ealraatsioa Owaer IV, t-f PO~VTS. Cluck te)I t~ n ~ ^ Nan-Pt~oriud In-Grosmd ^ Ptd la-C,~amd ^ At-(`wade ^ Momd.> 24 ~ ofsuita6le soil Mound <24 io. of sortable aoit ^ Holding Tads ^ Ot[ea Dis~as:[ CbmQoneat (esptaiH) ^ Pretsptaieor I)avica (ems) V. Dastgs Flow ($Pd) I)esrgn Soe~ Applrcahan Disp~sl Area Requa+ed (~ Atsa I (s~ Q Elevation ~~~~ ie31 e~- VL Tank Info Capatdy in Teat ~ ref New Talcs ~g Taela ~ ~ ~-J i i ~ e~6 ~ ~~° m o ~ ~ rGJ6 3eptie err Holding Taaic C3 a o~, i~ ~ O P~, ^? 6~ t r~ __ . .. t r ~ ~ ~ ~'t9ee ~' aft~e POWYS aiswat as the sdtaeLea pines. Plumber's Name (Print) ' Plumber s I,~1P/ ~~ ~~ ~ ~ ~ MPBS NumbQ teas t'Lone Nue~ba ` . t ~ as3 ~.~ ~ is-~ ,_~37 Pl ' y umber s Address (st CaY ~ ~P_code) ~- ~ ~- % v i~~ ~z, 7 ~~p~v~ Permit Fee Ike ~~ o Given ttesson ter ~ s ~2 5 . ~ , ~ y , o 1. Septic tank, ettl(t~l Piker and o ~ , ,~, ~(`d,/ ~ ~, , ,~„ o ~( dispersal cell must all be servides /maintained ~[J- ~ J as per management plan provided by plumber. W''~`- ~ ~~''`'~' ~ , 2. Rksetback requirements must be maintained asR pet applicable code /ordinances. wuace m niaas fray the s~ aaaf s~ebnit to 16e C~7 Qtly oo pspera~t tar tLae g Ill s ii S$D-6398 (R. 0?l09)'Vafid ttun 02!11 °~-~' 4 ~~.~,.. Q: (~- (t .,o ~.,~ ~. t~ V" G ``~ t~ V, ~`{`~ `~:a N ''~'{ ~.1~ a ~~ ~. -,. ~~ . , .~ ~`1-~ I', ~ I vl ~v I ~ ~ ~ `\l~ '~ ~ 3 ~h ~ V a ~- (\ \~ 4 0 ~~o N ~i .. ~ , d. ~J 3 ,4 .~ ro 3~ ~i .~ ~~ `~N 1 (~' ~~ ~~ ~~ ~ ~~~ / E ` ~ al commerce.wi.gov isconsin Department of Commerce Safety and Buildings 10541 N RANCH ROAD HAYWARD WI 54843 Contact Through Relay www. comme rce.wi.gov/sb/ www.wisconsin.gov Jim Doyle, Governor Richard J: Leinenkugel, Secretary December 17, 2009 CUST ID No. 253976 LEWIS C BJORK LEWIS BJORK LLC E7818 CTY RD E MENOMONIE WI 54751 ATTN.• POWTS Inspector ZONING OFFICE ST CROD~ COUNTY SPIA 1101 CARMICHAEL RD HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 12/17/2011 Identification Numbers Transaction ID No. 1744426 SITE• Site ID No. 753457 Greg Schultz Please refer to both identification numbers, 2259 Co Rd Dd above, in all corres ondence with-the a enc . Town of Baldwin St Croix County NW1/4, NE1/4, S5, T29N, R15W FOR: Description: Mound, 4 br res Object Type: POWTS Component Manual Regulated Object lD No.: 1249875 P•~ w~ Maintenance required; Replacement system; 600 GPD Flow rate; 18 in Soil minimum depth to limiting factor : cy~nditl~ original grade; System(s): Mound Component Manual -Version 2.0, SBD-10691-P (N.O1/O1), Pressure Distril~~ ~ ~~ Component Manual -Version 2.0, SBD-10706-P (1V.01/O1), SSWMP Pub. 9.6; Effluent Filter ~ The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. This system is to be constructe ~~ and located in accordance with the enclosed approved plans and with any component manual(s) referenced above. EE CORRI The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code S 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: Key Item(s) • 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. • The revised soil test on which this approval is based shall be recorded with the original soil test. • The designer proposes to install a state approved effluent filter to achieve the requirement of wastewater particle size. Pursuant to outlet filter product approval stipulations, maintenance information must be given to the owner of the POWTS explaining that periodic cleaning of the effluent filter is required. The access opening used to service the filter shall terminate at or above fmished grade with a watertight cover. Reminder ~ 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. LEWIS C BJORK Page 2 12/17/2009 • 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 per Mound Component Manual. • Materials shall conform to the requirements of COMM 84. • The existing POWTS must be properly abandoned per s. Comm 83.33 Wis. Adm. Code. 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 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 and the POWTS management plan to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Fee Required $ 250.00 Fee Received $ 250.00 Balance Due $ 0.00 ~____ ... Patricia L POWTS Plan Reviewer , Integra' ted Se ices WiSMART code: 7633: ~ , ~ ' ° ~ e.: (715) 634-7810, Fax: (715) 34-515 , M-th 8:00 - 4:45~~ i pat.shandorf@wisconsin.go -,. :~ r,-, ~, . `• cc: Leroy G Jansky, POWTS Wastewater Specialist, (715) 726-2544 ,Monday, 7:00 A.M. To 3:30 P.M. '~ Y~t a . ,;. ~ , `,d Notice: Starting July 1, 2009, no person or entity may engage or offer to engage in construction business in ~......,,,,, _ Wisconsin unless they hold a Building Contractor Registration, or equivalent, issued by the Safety and Buildings "° : °~ivision of the Wisconsin Department of Commerce. " "Construction business" means a trade that installs, alters or repairs arty building element, component, material or device that is regulated under the commercial building code, chs. Comm 60 to 66, the uniform dwelling code, chs. Comm 20 to 25, the electrical code, ch. Comm 16, the plumbing code, chs. Comm 81 to 87, or the public swimming pools and water attractions code, ch. Comm 90. The term does not include the delivery of building supplies or materials, or the manufacture of a building product not on the building site. For fiuther information, go to our website: www.commerce.wi.QOV/SB/SB-BuildingContractorProgram.html LEWIS C BJORK Page 2 12/17/2009 • 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 per Mound Component Manual. • Materials shall conform to the requirements of COMM 84. • The existing POWTS must be properly abandoned per s. Comm 83.33 Wis. Adm. Code. 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 maybe made to me at the telephone number listed below, or at the address on this letterhead. T'he above left addressee shall provide a copy of this letter and the POWTS management plan to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Patricia L ~ °~, POWTS Plan Reviewer, Integrated Se ices ~`,",`:'. ~• (715) 634-7810, Fax: (715),634-515 , M-th 8:00 - 4:45 . ~ ,~, ° ~ ~ # cc ~t M~J1 .itr e1 j;41~i~. ~ ~~ Leroy G Jansky, POWTS Wastewater Specialist, (715) 726-2544 ,Monday, 7:00 A.M. To 3:30 P.M. Notice: Starting July 1, 2009, no person or entity may engage or offer to engage in construction business in ~,.... Wisconsin unless they hold a Building Contractor Registration, or equivalent, issued by the Safety and Buildings • ~ "~"""°- division of the Wisconsin Department of Commerce. ~' "Construction business" means a trade that installs, alters or repairs any building element, component, material or device that is regulated under the commercial building code, chs. Comm 60 to 66, the uniform dwelling code, chs. Comm 20 to 25, the electrical code, ch. Comm 16, the plumbing code, chs. Comm 81 to 87, or the public swimming pools and water attractions code, ch. Comm 90. The term does not include the delivery of building supplies or materials, or the manufacture of a building product not on the building site. For further information, go to our website: www.commerce.wi.~ov/SB/SB-BuildingContractorProgram.html MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Project Name: Owner's Name: Owner's Address: Legal Description: Township: County: SCHULTZ -REPLACEMENT MOUND DESIGN GREG SCHULTZ 2259 COUNTY ROAD DD BALDWIN NW NE 5 29 15 WEST BALDWIN ST. CROIX Subdivision Name: NA Lot Number: NA Block Number: NA . Parcel I.D. Number: 002-1009-20-100 Plan Transaction No.: Page 1 Index and title Page 2 Data entry Page 3 Mound drawings Page 4 Lateral and dose tank Page 5 System maintenance specifications Page 6 Management and contingency plan Page 7 Pump curve and specifications Page 8 Plot plan Page 9 Septic and dose tanks Page 10 Effluent filter Page 11 Soil report J9 BV"'"'% _..-~ ~ ~~/ ~z~P Designer: Lewis Bjork License Number: 253976 Date: 11/ Phone Number: 715-308-2173 Signature: Designed Pursuant to the Mound Component Manual for POWTS Version 2.0 SDB-10691-P (N. 01/01), and both SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST-SAS (01!81) and Pressure Distribution Component Manual Ver. 2.0 SBD-10706-P (N. 01/01) Version 6.0 (R. 04/08) Page 1 of 11 Mound and Pressure Distribution Component Design Design Worksheet Site Inform ation (R or C) R Residential or Commercial Design 400.00 Estimated Wastewater Flow (gpd) 1.50 Peaking Factor (e.g. 1.5 = 150%) 600.00 Design Flow (gpd) 5.00 Site Slope (%) 97.20 Contour Line Elevation (ft) 18.00 Depth to Limiting Factor (in) 0.40 In-situ Soil Application Rate (gpd/flz) Distribution Cell Information 120.00 Dispersal Cell Length Along Contour (ft) _ 1.00 Dispersal Cell Design Loading Rate (gpd/ftz) 1 Influent Wastewater Quality (1 or 2) Pressure Disribution Infonmation (C or E) c Center or End Manifold 2.50 Lateral Spacing (ft) 4 Number of Laterals 0.188 Orifice Diameter (in) 3.75 Estimated Orifice Spacing (ft) _ 2.00 Forcemain Diameter (in) 370.00 Forcemain Length (ft) 72.20 Pump Tank Elevation (ft) 3.25 System Head (ft) x 1.3 26.33 Vertical Lift (ft) 13.33 Friction Loss (ft) 0.00 In-fine Filter Loss (ft) 42.91 Total Dynamic Head (ft) Lateral Diameter Selection in. dia. options choice 0.75 1.00 --_125__ _ _ 1.50 x x 2.00 x 3.00 x Note: Sand fill (D) calculations assume a Table 83-44-3 in-situ soil treatment for fecal coliform of <= 36 inches. 5.00 Cell Width (ft) Are the laterals the highest point in the distribution Y network? Enter Y or N If N above, enter the elevation (ft) of the highest point. 9.38 ftz/orifice Does the forcemain drain back? Y Enter Y or N 60.35 Forcemain Drainback (gal) 108.65 5x Void Volume (gal) 169.01 Minimum Dose Volume (gat) 41.94 System Demand (gpm) Manifold Diameter Selection in. dia. options choice 1.25 x 1.50 x 2.00 x x 3.00 Gallons/Inch Calculator (optional) Treatment Tank Information 764.00 Total Tank Capacity (gal) 1262.00 Septic Tank Capacity (gal) 43.00 Total Working Liquid Depth (in) County Materials Manufacturer 17.77 gal/in (enter result in cell B49) Dose Tank Information Effluent Filter Information 764.00 Dose Tank Capacity (gal) Orenco Filter Manufacturer 17.77 Dose Tank Volume (gal/in) FTBS043636M Filter Model Number County Materials Manufacturer Project: SCHULTZ -REPLACEMENT MOUND DESIGN Page 2 of 11 Mound Plan and Cross Section Views i- 1_ ................................................... '~'~ 1/10 B ;~:~:~:~'~'~'~'~'~'~'~'~'~'~'~'~'~'~ Observation Pipe ::: ' ~'~':~:. . . .... ors?o?. ?.:.: :: .:.}.: .: .: ..; .: .: .: .r." .+ .: .. .. .. .. .: :: ti}. •:r.:. .r' .. .l. B '. I Mound Component Dimensions A 5.00 ft E 21.00 in H 1.00 ft K 10.25 ft B 120.00 ft F 9.50 in z 10.74 ft L 140.50 ft D 18.00 in G 0.50 ft J 7.28 ft W 23.02 ft 600.00 (ft2) Dispersal Cell Area 1888.24 (ft2) Basal Area Available 5.00 (gpd/ft) Linear Loading Rate 12.00 (ft) 1/10 B Obs. Pipe Placement L _ --_ _ Mound Cross Section View Aggregate Dispersal Area IF 98.70 (ft) -- Dispersal Cell ~~~~ Elevation Finished Grade 100.49 (ft) ~iI~ Dispersal Cell 99.20 atera Invert ... D ::::::::::::: ~:~:~:~:~: -~=~-•- --~-"` `~` _ 97.20 (ft) Contour Elevation 5.0 % Site Slope Geotextile Fabric Cover Shading Key ~ c. ~ Dispersal Cell See lateral details on 10 Topsoil Cap ....,.,, c ~ ~ 1.5 ft ::f::~:~: ~:;?ti?;;??~?:;?.;? :: :.•.:.: ..: : ;~ "'~ `'~ :~ :~ Page 4 for number, size, and spacing of laterals Subsoil Cap ~ c ~ ': : ; .: , ? "~`"~ ? '` ' """" . Laterals are equally ©0 ASTM C33 Sand `a ~ _ " _ ~ ~~ ~~ ~~ •• ~ -~ ~' `~ • F h ®~.~~~ _ Tilled Layer ::? A re ate '•~• :• ~ = w ~ o 0 ~ .;:.;•TvDical Lateral•.._r~:~:~ ':~~~~•~~•~:~«~~~:~~:•-:•:•:•:••:•• ~ e spaced from t distribution cell's centerline in the . . A * distribution cell (Ax6). -} -~ -~ _1 Project: SCHULTZ -REPLACEMENT MOUND DESIGN Page 3 of 11 Center Connection Lateral Layout Diagram Force main conr~totityn via ttt or e~oss to manifold at any point. P i= Turn-up tirotbail vslv®or ~E X cisanoutptuy Hoits dr~td en eht bottom of tNt iattral. Number of Laterals 4 Orifice Diameter Lateral Diameter 1.50 in Orifice Spacing (X) Lateral Length (P) 59.21 ft Orifices per Lateral Lateral Spacing (S) 2.50 ft Orifice Density Lateral Flow Rate 10.49 gpm Manifold Length System Flow Rate 41.94 gpm Manifold Diameter Total Dynamic Head 42.91 ft Forcemain Velocity Dose Tank Information Electrical as per NEC 300 and -- Comm 16.28 WAC Disconnect ~- Lsterils in idtntioil . S t.attsyk ~ force main of PVC Sch 40 per COMM Tabte 84.30-5 Tank component is properly vented Coun Materials Ca aci 764.00 Volume 17.77 Manufacturer Gallons gal/inch ~- A B C D Dimension Inches Gallons A 23.48 417.29 B 2.00 35.54 C 9.51.. 1.69.01 D 8.00 142.16 Total 42.99 764.00 3" tan Alarm Manuafacturer Vector Alarm Model Number DLV Pump Manufacturer Zoeller Pump Model Number 163 Pump Must Deliver 41.94 gpm at 42.91 ft TDH .1881in 3.821ft 16 9.38 ftz/orifice 2.50 ft 2.001 in 4.281ft/sec Locking cover with warning label and locking device and sealed watertight i 4 in. min. ~ Alternate outlet location Forcemain diameter ~ 2 in. Weep hole or anti- siphon device P~off elevation (ft) 72.87 Dose tank elevation (ft) 72.20 Project: SCHULTZ -REPLACEMENT MOUND DESIGN Page 4 of 11 Mound System Maintenance and Operation Specifications . Service Provider's Name LEWIS BJORK LLC Phone 231-7375 POWTS Regulator's Name ST.CROIX COUNTY Phone 386-4680 System Flow and Load Parameters Design Flow -Peak 600 gpd Maximum Influent Particle Size 1/8 in Estimated Flow -Average 400 gpd Maximum BOD5 220 mg/L Septic Tank Capacity 1262 gal Maximum TSS 150 mg/L Soil Absorption Component Size 600 ftz Maximum FOG 30 mg/L Type of Wastewater Domestic Maximum Fecal Coliform >10E4 cfu/100 mL Service Frequency Septic and Pump Tank Effluent Filter Pump and Controls Alarm Pressure System Mound Other Inspect and/or service once eve 3 years Should inspect and clean at least once eve 3 ears Test once eve 3 ears Should test monthly Laterals should be flushed and ressure tested eve 1.5 ears Inspect for pondin and seepa a once every 3 years HAVE LEWIS BJORK LLC PUMP YOUR TANK 231-7375 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 to prevent soil erosion and help reduce frost penetration. Lateral Turn-up Detail Finished .•..•••........ ............... .............. Grade 6-8" Diameter Lawn Threaded Cleanout Sprinkler Valve Box Plug or Ball Valve Distribution Long Sweep 90 or Two 45 Degree Bends Same Diameter as Lateral Project: SCHULTZ -REPLACEMENT MOUND DESIGN Page 5 of 11 Mound System Management Plan Pursuant to Comm 83.54, Wis. Adm. Code General This system shall be operated in accordance with Comm 82-84 Wis. Adm. Code, and shall maintained in accordance with its' component manuals [SBD-10691-P (N.01/01), SSWMP Publication 9.6 (01/81), and Pressure Distribution Component Manual Ver. 2.0 SBD-10706-P (N. 01101)) 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 present that could cause death. Septic and pump tank abandonment shall be in accerdance 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 completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. F~cposed access openings greater than 8-inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into a tank or component. Septic Tank The septic tank shall be maintained by an individual cert~ed to service septic tanks under s. 281.48, Stats. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code. The operating condition of the septic tank and outlet filter shall be assessed at least once every 3 years by inspection. The outlet filter shall be cleaned as necessary to ensure proper operation. The filter cartridge should not be removed unless provisions are made to retain solids in the tank that may slough off the filter when removed from its enclosure. If the filter is equipped with an alarm, the filter shall be serviced if the alarm is activated continuously. Intermittent filter 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, 'rf such products are used they shall be approved for septic tank use by the Department of Commerce. Pumo 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 fitter is installed within the tank it shall be inspected and serviced as necessary. Mound and Pressure Distribution Svstem No trees or shrubs should be planted on the mound. Plantings may be made around the mound's perimeter, and the mound shall be seeded and mulched as necessary to prevent erosion 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) dilate that the mound be heavily mulched as protection from freezing. Influent quality into the mound system may not exceed 220 mg/L BODS, 150 mg/L TSS, and 30 mg/L FOG for septic tank effiuent or 30 mg/L GODS, 30 mg/L TSS, 10 mg/L 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 point at the end of each lateral, and it is recommended that each lateral be flushed of accumulated solids at least once every 18 months. When a pressure test is performed lt should be compared to the initial test when the system was installed to determine if orifice clogging has occurred and if orifice Leaning is required to maintain equal distribution within the dispersal cell. Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the owner, and any levels above 6 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 condition. If the dosing tank, pump, pump controls, alarm or related wiring becomes defective the defective component(s) shall be immediately repaired or replaced with a component of the same or equal pertormance. If the mound component fails to accept wastewater or begins to discharge wastewater to the ground surface, lt will be repaired or replaced in its' present location by increasing basal area if toe leakage occurs or by removing biologically clogged absorption and dispersal media, and related piping, and replacing said components as deemed necessary to bring the system into proper operating condition. See Page 5 of this plan for the name and telephone number of your local POWTS regulator and service provider. Pretreatment Units The information and schedule of mananagement and maintenance for pretreatment devices such as aerobic treatment units or disinfection units are attached as separate documents and are considered part of the overall management plan for this system. Project: Page 6 of 11 °~FFLI~+ENT ~V~P~7 "High Head" Series "HIGH .HEAD -FLOW MATE" ' ~fr f `"~~:1® PUMP !O_ Q~urrPu~sPS SacE /v`3.9~ (3rder # Model HP ' Volt/Ph `Type.. ;Description _ ZNt61 N161 1/2 HP 115/1 Manual Cast Iron 3/4" Solids, 1-1/2" Discharge ZE161 E161 1/2 HP 230!1 Manual Cast Iron 3!4"Solids, 1-1/2" Discharge ZN163 N163 1/2 HP 115/1 Manual Cast Iron 3/4" Solids, 1-1/2" Discharge ZE763 E163 1/2 HP 230!1 Manual Cast Iron 3/4" Solids, 1-1/2" Discharge ZE788 E188 1 1/2 HP 230/1 Manual Cast Iron 3/4" Solids, 1-1/2" Discharge ,~--_. n e~ N N H ]0 N 19 B 1B !B '79 M 60 60 76 W M ib 110 161 KEY CODES FOR ZOELLER PUMPS BN = w/ Float In :Box M =Auto Float Attached .(vertical) N =Non-Auto (manual) E = 230V Non-Auto (manual) List. Price 960.95 1017.71 960.95 1017.71 1264.55 FEATURES: .188 Non-clogging cast bronze Vortex Impeller. & Passes 3/4" solids (sphere). =189 1-1/2" NPT discharge standard. 2" or 3° flange available. 3 Phase models available Float operated, submersible (NEMA 6) 2-pole mechanical switch. Corrosion resistant powdercoated epoxy finish. Stainless steel screws, bolts, float, rod, handle, guard and switch arm assembly. .Automatic reset thermal overload protection, !phase only Durable cast iron construction. 20 tt. UL listed neoprene -cord and plug. egne cnrwcrrr currve ~aooet.s ws/ - ~a -165^ «~s , e R S 1 R Oat law ta" » tiat. laa 291 OY. lee. 291 1Ri gas m >s 9a m S xTr > z2a ,~ - >b w a2 70 39 2.Q 9C 91s b 1219 b0 19i r A ffi 613 29 to P ~ 316 69 2K a6 1>2 9 S21 ED 32p >S M . 1829 s" s.9r w 2t,a R 139 16 5] ~ 99 as '~ w n.a9 ro 99aa tarn tnss 761 74-4 __' ~ ~ ~~ ZZ ~~ ~~.r~Fs ~'~ ~~~ t c~sr-4, i-~ ~n~~. ~lL ~a ~ ~~~~ ~c~JN~ C~/l ~~ . rZ„l ~? ~ S • ~Y~1 ~ ~asE o~- t.,k~oc~ ~w~c. '~~~- a ,~PCq'~ Z Qom.-. e>~ ~ ~ ~...~ C ~t~ci~ ~t>L bo c ~ ~"~_ ~ ~S ~~ ~~ ,~ + `~~~ ~ <. ~A+'~- ol- 2 ~ . ~ Ge2~:_u~C_~ ,.~ ~~~1A ~~ ~ ~ Q ~~~.~.. ~' 2S 3 `~ `l Lounj'~( ~~ i a ~ S 3c~ 1 ,; ~ (,t~~~ ~~^e~~` S4~i,c Sys ~+b ~/, ti Z" ~car'LG 1~ ~ ~ti ~J 3 SD' , _,,~~~~ ~~~~ -~, ,~ `:1 ..~ ~~ Ar ~ ~ £ ~`' r ~~~ ~~ ~_ ~ ~ ri^ ~ %~ - ~, ~. ~,~~ '.`~'"~ ~~~ `a- ~ -- ~° ,; '- ~ ,. ,- ~~ 3 r, ~~ t . ~ ,,~ f __ ~-~=~ ~., _...\ .- r -_- \\\ ~~ ~ ~ ~~ ~n L~~ ~~ 11x`2012009 10:19 71.5-443-307 CMC MAR~THCtt~I DISPRTH PAGE !~2 ~IAK. 29. 2G ~~ , i : 48pM 11 i 544~3~i91 C~1TY 1~ATL~ ~At'tS~ - - ~(I. X57 P': ' s~r~rsra~ttl ~st>~l - pt~taRae~ . P.Q. Sax 7182. ii fi~i8dh4tl. b1-h- 53787 J~JI~i~J JtEa ~ Qepartrrtent ofi Cacnmerae .. : laoryL t~4tles,Soc~rY March 25, 2t}Q4 OOUNTY MATERtAt.S CARP. Bil.L MUf"c1.LER . PO SOX 1 E10 MAfiA"F't-fOtd Wi 54448 Re: t]e~r1#stion: Si.tlUA~~ Tf4.ItCt~C,S, C()NCFtEfE . -. tVlantrtacte~rer: CQUt~I'T`f MATERiRt.S CORP. ' .. i?toduct Alams: 5Et'TiClSEPTiC, ttE)I.DtNG, SEP'C'~C~P OFt SEP7'iCISfPHt~l _ . . M+~dei~i+iurnber(a}: #2541750. .. (43.5' t..L, 29.4/1?_~ C~tUiN„ ~" tii4l~tX. i]]ER~Fi t3P t~,}i~Y, S7# C} R:~. W# ~SEt3 A6 A s~PTtC1~~rtc ~ ~ t~tt4 t~.P.t~. i~F.HiTt l~:~Ea i~S A S~EFT~tPt1Mf} aR SfiPi"iC1Sii3i~tt}!~'i'J~K S&BEi~ t3N ~ s YR.'St:~tVlC.E tP+tTEF~i~IAL~tr£3R F€ESti~El~iTIAL . V1-AST~IVATER} i?induci%'ile Na. ~4t141a1~43 The specifiGatiotts afltf/or plans fot this p~rilttlhg procit~t.have l~n ~ stlti crrrtkfal3 to ba 1x3'3 ~e wi~r cha{~ters Comm 82 through &4, iitifi9aonsin Rdrttstistratisre Code, and C'~lapter8 t4T.t actc4 #66, Yitlscvs!rsin Statutes. Th® r~apar#tr-am hereby issues. art zest on #13e 1ilt~st~'tsirt ~ auerl tkae t!Y'tseor~eln gricnii~ t`cacie. 'This appmvai is'~ai#ct untii tip end at Aitgesst 21187_ _ . 7hls eppt~va! !s cantingettt upon compiianoe with the foHovvirtg st~suiatttmgs): .This ~ariuct is appmveci to use the faNowing: -'fwo inch ~heduie 4Q PSG cast try r+ser tcu elndricat wiring.. ~ `' - Pipe mater4als canst-ucted h eoctfortne~rce wi#t Tats B4<3t# 2 ~ 8*.3t1-# #. ~liis. ,Adri~iri. ~ocie pot[rae#. ts~ak zov~'oracceas-ecnrar.. __ ~;ast ,R-Seal toy Press Seai~s~esket Carp., Po17dOic !! HigtY Pt~u~ Wipe .Seal by Pcstyt~c; arsd A-F~sk ~-CeF bsr fi- i..ak Praduc>+s. Itrc. -Dual inks with are access opdrtatg ai>a~ both inlets. • DuHI In10ts with Otte access opening above each inlet. - Fttlet(s} ar5d outtet(s} on appvsfte sides of tonic. inters} at1 erM or side csf tar~ic with artist ~ ef~d o! tanit or intarror wait. . - department approved efliiuent f~tUer ittstatled ir, acacsnrtartitt~ wltl3 t~~ swat far the filter irgstudir~ a PrriY stied and located access opett #ar ssrvloe and rrraintonanr~r. • This tank must kfe designed to -~llstand the pre~stires to wltielt it wiil`be subjecte~t. . • . .~ manufapturer moist keels at th~r manr~tacturfng punt a sat cif pions a~ ~ ~ the department's stamp of apprrivat. The pions and specific:dians trust ~ open to ~ ~` ~ ~ n3~esanrttitre a2 the ctepactmant: . • When ti~fs prad,lci has art atfiuent #itter instatled tr• art inuarbr +xalt, the space hetweeil tft+a top of tiie ir-terior w~ii and bottom of the tank covet' roust tae sled with 8 maierlad that wik.withstartd the ets~ironrnent irs the tarot and trt a manor that will prevent waste tram passing cues the rcrterkx welt. . SBGtfJ~6d-E[~-tom} Flef~tt,flOG . ~' 11f 20f 2009 10:19 715-443-3072 2004 G~~c~n 2-Ga~~ar~me»~t Septic Tank a .a .~ c~ w ~_ . ~' ~~ ~' o' ~~ '~ . aj A~ .~ ~. t ~~ ~.. CMC MARATFiQ~! DISPATH PAGE ~J;i a~ ~.,,~_ °^,,.,,~ Cafaloy Search ,, ,:~ ~. Tanks, Risers, lids, and (accessories "~:, Pumping Packaij°s and fiamponertts ~,__,~_` i ~~' Emuent FHtets - oweMew - FT Series Residan6~ Biofitbe Et>kratt Filters - FT Series Sass trdet Model - Fiat Elbows - Effluent Ftker Ovetfioty Plate xa - Biot+tbe Juttf~ Effluent Furs - Biohtbe Etfltrsnt Fitter inserts - FT Series Cwnmettxal B~tube Etfluertt Fps - F~tnat Etfluertt Ftitet Basins Carrtsat Panels. PJarms. and Fbafs i ~ ~~ Treatment Systems and L~rairtFcetd SuFpres l =c , l~ddifionai Onsite Products ~_-`._ FT Sees ~esiderttiai t3iottttse cY~uent 1=iiters FT-Series Restt~ttial t3iotttbe° eifiuerrt tars are used im new ~ t.>~ inks, for boftt nErtiat and corrnrterciai aEtpGmtions. Each t comes wfitt a 8iotube ~erC9rtridge (m 4, 8-,12- ~ 15-ia drartte~ersj, PVC housing, and e>ble PVC handle. A sitrn>mled vresiort of our sfart~rd 8- artd 12-6t_ dtamefer tAtets, caDed a "base f~' is avat'lable for fo~w-profile tanks. Ap6onat alarm ba Signal a tartlchigh-level cartdttiott. whit*t maEr irte a treed tD c>eatt fire filter. Optiortaf slide rae system, available on tatger fif6ets, ssnplifies elation artd provides tardt attoess for 9- S'fide ram are +ietauired when there is ordy one atx3ess fo ttte taudc. Covered by U S_ Patients #4,439,323 and 5y49z635 Product Nomenclature b S 3~a 3b ~1 ~C)ptiutt.: Biani: = nn optiutti *~ = latia° ttzixittiaf+ttn alar4 imfa?lezl - ~ _ :?oat artck~t;tilac'trti C'artrid~~r h~i~hf: 't3° :tnci 3b" an- stwrulnrs[ 11cxt:iStg lsci~ltr: ?F atxi 4.4" to Starxktt+9 riper t~amctdr irtcires3 EE~ ~ tr'7'~;p4 ±te...l.xrtl4~t psp4 S = rata Ssindttlr 4Q otitct pipe is = 1; t r," EEtraiam Biotu':k rti=ttent f'titercrics Product Exam~e ~~~ Model Code FTSO444-361N Description f3"taibe Etfltrertt t Sritedule 40 outlet, 4-in. tfietrteter, 44-61. tteigM, 36-'frt. tail t~ttridge with dow moduletimg Platte Relatsd produt~s External E~itt~Filter Basins ¢iotttbe EfRi eni~ tnser~ Biotttbe Jttrrior ueitt~dters Home iDistributor eta I >rdeos }Product Catalog }Document Library New Producres I Fiberglass Tanks }Effluent Pumoi_rty Svsterns Advartggd_Trt~trneni.S~stems }Community Colleyion Systems Monitorln~ and Control Dgyi ems ~ information anA Training I About Orenco ~~ ~ ~~ http://www.orenco.comleaxalog/product detail.efm?FamilyII~3&ProductII~33 7!2/2009 ~aa~ Wisconsin Department of Commerce SOIL EVALUATION REPORT Division of Safety and Buildings page 1 of 3 in accordance with Comm 85, Wis. Adm. Code Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must County ST CROIX include, but not limfted 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. Please print ail information. Reviewed by Personal information you provide may be used for seconds u ( y Date ry p rposes Privac Law, s. 15.04 (1) (m)). Property Owner Property Location GREGSCHULTZ Govt. Lot ~ 1/4 NE 1/4 S OS T 29 N R 15 ~0 Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# 2259 COUNTY ROAD DD 2259 COUNTY ROAD DD Cdy State Zip Code Phone Number BALDWIN WI 54002 ( 7~ 5-215-0069 -' ~ Q Village ^ ~ Town Nearest Road COUNTY DD New Construction l1se~ Residential / Number of bedrooms 4 Code derived design flow rate 600 GPD Replacement Public or commeraal -Describe: Parent material LOESS OVER TILL Flood Plain elevation if applicable General comments ,-r*lA g and recommendations: Install standard component manual design for mound system on the 97.2'. PI Boring # ~ Boring ?~Z pit Ground surFace elev. ft. Horizon Depth Dominant Color Redox Description in• Munsell Qu. Sz. Cont. Color A 1 0-5 10YR3/2 - A2 5-12 10YR3/3 E3 12-15 10YR5/4 B4 15-18 10YR5/2 CS 18-28 7.SI'R4/6 C6 28-36 7.SYR4/4 F2FSY1t5/8,10YR6/2 F2DSY1t5/8,10YR6/2 Texture FSL FSL FSL FSL COSL GRSL Depth to limiting factor 18 in. Structure Consistence Boundary Roots Gr. Sz. Sh. 2FGR MVFR GS 1F 3MSBK ~''R CS 1F 2MSBK MVFR GS 1F 2MSBK MAR CS 1F 1MSBK MVFR GS _ 1CSBK MVFR _ _ P2 Boring # ~ Boring ~~ ~ ~ Pit Ground surface elev. ft ~ ~' 18 . Depth to limitin g factor in Horizon De pth ~n Dominant Color M Redox Descri tion P Texture tructure onsistence . Bounda R t • unsell Qu. Sz. Cont. Color Gr. Sz. Sh. ry oo s AI 0-4 10YR3/2 - FSL 2FGR MVFR GS 1F ~ 4-10 10YR3/3 - FSL 3MSBK MVFR CS 1F E3 10-13 10YR5/4 - B4 13-18 FSL 2MSBK MVFR GS 1F 10YR5/2 _ FSL 2MSBK MVFR CS 1F CS 18-28 7.SYR4/6 FzFSYxs/s,loYx6/2 COSL 2MSBK GS MVFR _ C6 28-36 7.SYR4/4 F2DSY1L5/8,IOYR6/2 GRSL 1CSBK MVFR _ _ * Effluent #1 = BODS > 30 < 220 mg/L and TSS >30 < 150 mg/L .; uent #2 = BODS < 30 CST Name (Please Print) ~; _a•.__ C BJORK ~~~ ~ E7818 COUNTY ROAD E MENOMONIE, WI 54751 Date Evaluation Conducted 11-16-09 Soil *Eff#1 .4 .4 .4 .4 Rate *Eff#2 .8 .8 .8 .8 *Eff#1 .4 .4 .4 .4 *Eff#2 .8 .8 .8 .8 -+- and TSS < 30 mg CST Number 715-231-7375 r,,,....,.,,, ,,, Property Owner GREGSCHULTZ Parcel ID # 2 3 Page of P3 Boring # Boring 95.2 19 Pit Ground surface elev. ft. Depth to limiting factor in. Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 Al 0-4 10YR3/2 - FSL 2FGR MVFR GS 1F .4 .8 p,2 4-13 10YR3/3 - FSL 3MSBK MVFR CS 1F .4 .8 E3 13-15 10YR5/4 - FSL 2MSBK MVFR ` GS 1F .4 .8 B4 15-19 10YR5/2 - FSL 2MSBK MVFR CS - .4 .8 CS 19-26 7.SYR4/6 F2FSYR5/8,10YR6/2 COSL 2MSBK MVFR GS - - - C6 26-36 7.SYR4/4 F2DSYR5/8,10YR6/2 GRSL 1CSBK MVFR - - - - Boring # ~ Boring pit Ground surface elev. ft. Depth to limiting factor in. Soil liption Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP DJff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 *Eff#2 Boring Boring # Ground surface elev. ft. Depth to limiting factor in. Pit Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structun: Consistence Boundary Roots GP D/ft= in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Etf#1 *Eff#2 * 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. If you need assistance to access services or need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. SBD-8330Test (R07/00) - f~/o~ 1~fAnl -zzs9 Cry ,~~ ~°` r ~~ ~~~~ rte, 76.z' L ~ T~ti-K7 ~~-3 ~~~~ ~ Hoc ~~ as - ~, • g~ ~ ~3AS~ ~~- ~'la~r~~c~ L.~~~~ ktocac~ ~~~ ~~ 13~, -~ Z 4 ~]. z ~~~~° t z > ~~~ ~/Lt1 ~~ ~ ~' a° ~ ~ ,~ tom- ~ ~ ~ -~"~~~ c~~ ~~? ~ ~ ~:~ ~/L ~oun~'~( ~Q J, a ~ S ~ t 1 ~'~ ~` 3®t t~n~~,s ~`~oa~ i Sc•~ ~,~ Spts~ ~.~,2 ~',.~- q~ 98 C ~,a~ L! L Wisconsin Department of Commerce SOIL EVALUATION REPORT Page 1 of 3 Division of Safety and Buildings m au:u~uantz wnn t,unun oa, vvis. r+um. wur County ST.CROIX Attach complete site plan on paper not less than 8 1/2 x 11 inches in size Plan must . include, but not limited to: vertical and horizontal reference point (BM), direction and parcel I.D. percent slope, scale or dimensions, north arrow, and location and distance to nearest road. ~Q - ~ ('~ ~ ZC5 ~°- i OC,~ Please print all infonr-ation. Personal information ou rovide ma be used for se ur 5 04 (t) (m)) Reviewed b , Date / ~j{ G/~~ f/1~/1~- ~1~ y p y . . ~ / Property Owner Pr erty Location •,, .~ GREG SCFIULT G .Lot NW 1/4 NE 1!4 S OS T 29 N R 1!~ 0~~ Property Owner's Mailing Address NO Lo # Block # Subd. Name or CSM# ~ ~~ ~1 ! ~~ /~ 2259 COUNTY ROA DD - - 2259 COUNTY ROAD DD City State Zip Code Phon~rylu~tX ity ~ Village ^ Town Nearest Road BAI-DWIN WI 54002 ~N _ OFFI COUNTY DD New Construction Use Residential / Number of bedrooms 4 Code derived design flow rate 600 GPD Replacement ^ Public or commeraal -Describe: NA Parent material ~ ~ LOESS OVER TILL Flood Plain elevation if applicable #A ~. General comments ~~ I 11 standard component manual design for mound system on the 97.2'.~~~2,~ and recommendations~~~-L~,;ZT,,r~~~~,y.~~;~ , ~; ~ ~~~~ J -,,l~-e-e. C'- c;c i urn fr''~Cc:'rn~' PI Boring # ~ Boring - - ~ ~ -~ ~ - - ~ ~ - pit Ground surface elev. 100 ft. Depth to limiting factor 18 in. Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D1fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 Al D-5 -10YR3/2 - FSL 2FGR 1VIVFR GS 1F .4 .8 A2 5-12 10YR3/ - ,. '*~ _FSL 3MSBK _ _ MVFR CS 1F .4 .8 E3 12-15 10YR5/4 FSL _ 2MSBK MVFR GS 1F 4 8 B4 15-18 10YR5/2 FSL 2MSBK MVFR CS 1F .4 .8 CS 18-28 7.SYR4/6 FzFSYRS/s,toYR6/2 COSL 1MSBK MVFR GS - - - C6 28-36 7.SYR4/4 FzD5YR5/s,toYR6/2 GRSL 1CSBK MVFR - - - - P2 Boring # U Boring 100 18 Q Pit Ground surface elev. ft. Depth to limiting factor in. Soil ligtion Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 Al 0-4 10YR3/2 - FSL 2FGR MVFR GS 1F .4 .8 ~,2 4-10 l0Y - FSL 3MSBK MVFR CS 1F .4 .8 E3 10-13 10YR5/4 ~ i,`°:~.c`t" ~'. ,tip`" ~,~ ~ ~;;~ FSL 2MSBK MVFR GS 1F .4 .8 B4 13-18 10YR5/2 - FSL 2MSBK MVFR CS 1F .4 .8 CS 18-28 7.SYR4/6 FZFSYRS/s,toYRS/2 COSL 2MSBK MVFR GS _ - - C6 28-36 7,SYR4/4 F2nsYRS/s,toYR6/2 GRSL iCSBK MVFR - * Effluent #1 = B~OD > 30 < 220 mg/L and TSS >30 < 150 mg/L uent #2 = BOD < 3Qmg/L and TSS < 30 mglL CST Name (Please Print) ~ "~- ~ ture -' CST Number LEWIS C BJORK G ~ 253976 Address Date Evaluation Conducted Telephone Number E7818 COUNTY ROAD E MENOMONIE, WI 54751 11-16-09 715-231-7375 set„/tz - /~~~ f~~~~l -zzs9 Cry ap -~~ 9rr.u _ ---- alW ivy S ~' T ~- 9 rr v~ c :6 ~..1 -T~r~rN d ~' ~~ r~~°~~°~~, ~l ZZ. S '~`~-FS ~~L 50 "¢' wEt,~, ~ BAc,~.hQ~ (~~~5 ~~ 3~d ---__ .. r~ ~lu~ ~ s ~vu,ic.~ «~1- 76 . z Tit r.1 u,. 7 ~i ~A:..- -~~~Id ~ A~~'R '~ ~ ~ Hoo 1~,~s ~ ~ Tn.nNS~}- S1~1s • 6h1 -~ ~3AS~ ~~- F'1~yy~c1 ~..A~yt wocc~ ~~~ ~a Qm -~- z 4 ~. z , S~ E.Iy ~, F" l ~ ~f 5 ~ A cG~ CkJ ~S~q n1 ~~~ ~ Goun~ ~ (~O rlr~ a ~ $ 30 i 1 `~ "`` 30 ~ ~~~5 ~ka~n.1 Sc.~ \~ S~tS ~ __ _~~ _~(DZ ~~-3 ~~^ i qs~2 ~ ~ ~---- 0 0 Sl S~° 2 q~~ ~a~ L'L K r ~~ ~ o ~3tn 5'70331 CERTIFIED SURVEY MAP i L^CATED IN PART ^F" THE NW1/4 ^F' THE NE1/4, , ~~~.~.~~ SECTI^N 5, T29N, R16W, T^WN OF BALDWIN, ..~.~ :SST. CR^IX COUNTY, WISCONSIN. ~,~ ~`1/ . c., .~--- lam' ` /i. .1: ,~ .i. • ~1 •~ ~~ ` ~ OWNER I EUGENE VEENENDALL ~~i. y,- i :; -_: ',~ '~;'~ ~ 2259 CTY, RD. 'DD' a:G:»~j.1, ~ 6+ BALDWIN, WI 54002 ~° ~~:~- ~ ~' FILED ~''~.,~i'~ ~ DEC 2 3 1997 - 2 S V iR• 8 1(A~}}lEEtd H. WALSH Register at Deers 3 ! 2/~ `/'7 L Si. Croix co. wl Nl/4 CORNER ~ SECTION 5 'r C.~ ~__._ M COUNTY ROAD "DD'. ~ N^RTH, LINE ^F THE NEI/4 PARCEL _I_N _ 149 _4F 3 N SP ---------- -"~ 58944'47"W 811.48' EXISTING DRIVE ~ oo - - - . o Z N oMO ti d' ~ a ~ GARAGE ~ i ~ o ti N o~~ ~~ ~- o ih T ARN SHED a `* i~ , rn i~ q ~ U Z o _ ~ =f~ W Jy p tiU I~ W ~w w --~ m ~ ~ ~ ~_ co w ~ ° ZT ~ o ~i c ~ N~w > i w ^ ~'~ L7~ ~ =y m m z ~' Qi ~ Cni ¢~¢ ~ J~ j.r~ ~ ~i m°z vi of N LUT 1 ;~ Q~ ~ W, p 22.221 ACRES ~ J ~ ~ ~ (n 967,924 SQ. FT. ~ i z ~? Q i CV W ~ J r O F- , ~' Z i- i Z i Q ~~ Ji i (L , z . +r.~ z ~ •,r J ~~ _ ,~ o D~'C 2 3 '97 N ~ tali{l. is t~!i ~./~ •.:t:. ~i,e`I.I?79 S89'55'S9"E 811.69' '"""`' ~'""""'"~ SOUTH LINE ^F THE NW1/4 CIF THE NE1/4 t't;lt ..~r..pNntf »att~:.t: oww.: of UNPLATTED LANDS '~"""""`'`'~`" W _ #Y/17CYUi 3hy11 Ae ;~ ;~, LEGEND ma~e'woirJ d•,°~ ALUMINUM C^UNTY SECTION CORNER ~ ~ MONUMENT FOUND S1/4 CORNER o~n 1" X 24' IRON PIPE SET WEIGHING SECTI^N 5 N ° 1.68 LBS. PER. LINEAR FOOT ~~ • 100 ROADWAY SETBACK LINE SCALE IN FEET 1' = 200' ® BERNTSEN SURVEY MARKER 100 0 100 200 300 -X--1E EXISTING F'ENCELINE Vo1.12 Page 3398 &URVSYOR' CB TTFT[•nTu I, Douglas J. Zahler, Registered Wisconsin Land Surveyor, hereby certify that by the direction of Eugene Veenendall, I have surveyed, divided and mapped a part of the NW1/4 of the NS1/4, Section 5, T29N, R16W, Town of Baldwin, St. Croix County, Wisconsin; described as follows: Commencing at the N1/4 corner of said Section 5; thence S02o43*47"B, along the north - south 1/4 line of said section, 83.08 feet to the south line of a parcel recorded and described in Volume 149, Page 463 at the St. Croix County Register of Deeds office, and the point of bs~ginning; thence continuing S02o43'47"8, along said north - south 1/4 line, 1191.63 feet; thence S89°55'59"8, along the south line of said NW1/4 of the N$1/4, 811.69 feet; thence N02o43'47"W, 1196.17 feet to the south line of said parcel in Volume 149, Page 463; thence S89o44'47"W, along said south line, 811.48 feet to the point of beginning. Above described parcel contains 22.221 acres or 967,924 Sq. Ft. and is subject to all easements, restrictions and covenants of record. I also certify that this Certified Survey Map is a correctly dimensioned representation to scale of the exterior boundary surveyed and described; that I have fully complied with the provisions of Chapter 236.34 of the Wisconsin Statutes and the Land Subdivision Ordinance of the County of St. Croix and the Town of Baldwin in surveying and mapping same. Douglas J. Zahler "`~ ~OUGLASJ. ~~ Registered Land Surveyor ~ ZaHLER ~ *' S 224.5 S & N Land Surveying HUDS+~~, 7~ 212 Walnut St . !,~ yylg, ~, Hudson, WI 54016 ~ ~......~rOS-d~ ~~5~9'7 Each parcel shown on this map (plat} is subject to State, County and Township laws, Hiles and regulations (i.e_, wetlands, minimum lot size, access to parcel, etc.). Before purchasing or developing any parcel contact the St. Croix County Zoning Office and appropriate Town Board for advice. Vo1.72 Page 3398 ~. SEPTIC or HOLDING TANK SERVICING CONTRACT /-~ ~~' ~ / ~ This contract is made between the Tank Owner(s) Name(s) / / and Pum`per's Name /~ We acknowle~e the installation of (a) septicJholding tank(s) on the following pP6perty: (Provide legal description): 1. The owner agrees to file a copy of this contract with the local governmental unit (St. Croix County Planning & Zoning Department) to document maintenance by a certified septage servicing operator as required in Comm 83.52(1)(c)2. Wis. Adm. Code and the approved Component Manual. 2. The owner agrees to have the septic/holding tank(s) serviced by the undersigned pumper and guarantees to permit the pumper to have access and to enter upon the property for the purpose of servicing the septic/holding tank(s). The owner agrees to maintain the access road or drive so that the pumper can service the septic/holding tank(s) with the pumping equipment. The owner further agrees to pay the pumper for all charges incurred in servicing the septic/holding tank(s) as mutually agreed upon by the owner and pumper. The pumper agrees to submit to the local governmental unit (St. Croix County) a report for the servicing of the septic/holding tank(s) on a monthly basis. The pumper further agrees to include the following in the monthly report: a. The name and address of the person responsible for servicing the septic/holding tank; b. The name of the owner of the septic/holding tank; c. The location of the property on which the septic/holding tank is installed; d. The sanitary permit number issued for the septic/holding tank (if lrnown); e. The dates on which the septic/holding tank was serviced; f. The volume in gallons of the contents pumped from the septic/holding tank for each servicing; g. The disposal sites to which the contents from the septic holding tank were delivered. 4. This agreement will remain in effect until the owner or pumper terminates this contract. In the event of a change in this contract, the owner agrees to file~a copy of any changes to this service contract or a copy of a new service contract with the local governmental unit named above within ten (10) business days from the date of change to this service contract. s) Name(s) (Print) ~cL~ ~~~~ ~4z Pumper's Name (Print) ~ ;~ Pumper's Regis ration Number Owner's Signature(s) Subscribed and sworn to me on this date: ~ - ~- i~> Today's Date 2~~n"~ ~ ~~",""~ ~I kl~ livt Public Signature --a Notary Public State of Wisconsin . • UNOFFICIAL COPY .~ ' SPECIAL i~VARRANTY DEED Document Number Mail Tax Statements To: Greg Schultz Z25~ ~~~N-rv ~~ ~3pt_l~wt-v f~Jl S'{t)02 THIS DEED, made between FEDERAL HOME LOAN MORTGAGE CORPORATION, GRANTOR and GREG SCHULTZ, asingle/married/unmarried man, GRANTEE. Dated this 23 day of~~K~+~ , 2009 This property 4/ iuyiigiNi~ininiiiasuiai~ii~iuaiiii 892,62 BETH PABST REGISTER OF DEEDS ST. CROIX CO., WI RECEIVED FOR RECDRD 04J08/2009 02;25PM SPECIAL 4lARRANTY DEED EXEMPT a 2 REC FEE: 15.00 PAGES: 3 Are ~5/ After Recording Return to: TCT#: 1099400 $,; G /ure /Sanp~ TRANSCONTIidENTAL TITLE CO. RECORDING DIVISION 2605 ENTERPRISE ROAD STE#200 CLEARWATER, FL 33759-9973 io- s23 y8y 3 PARCEL ID NO. {PIN) 002-1009-20-100 is is not homestead property. THIS indenture, made between FEDERAL HOME LOAN MORTGAGE CORPORATION, with a business address of 5000 Plano Parkway, Carrollton, Texas 75010, GRANTOR, does hereby convey, sell and warrant to GREG SCHULTZ, a single/married/unmarried man, GRANTEE residing at 225 ~ ~ y u NTy ~'• , 3A-~~w aV W 1 ~ '-t• 00 Z. _ , for the sum of SIXTY NINE THOUSAND and 00/100 ($69,000.00), the following tract of land in St. Croix County, Wisconsin: ,.,.- v ~~.J...~. ' LOT 1 OF CERTIFIED SURVEY MAP RECORDED IN VOLUME 12 ON PAGE 3398 AS DOCUMENT NO. 570331 BEING A PART OF THE NORTHWEST QUARTER OF THE NORTHEAST QUARTER (NW 1/s OF NE'/s), SECTION 5, TOWNSHIP 29 NORTH, RANGE 21 WEST. Page 1 of 3 1 of 3 UNOFFICIAL COPY PARCEL II: AN EASEMENT OVER THE SOUTH 50 FEET OF THE NORTH 83 FEET OF THE NORTHWEST QUARTER OF THE NORTHEAST QUARTER (NW '/, OF NE '/), SECTION 5, TOWNSHIP 29 NORTH, RANGE 16 WEST, LYING NORTH OF LOT 1 OF CERTIFIED SURVEY MAP IN VOLUME 12 ON PAGE 3398 AS DOCUMENT NO. 570331 AS MORE PARTICULARLY DESCRIBED IN THAT CERTAIN DEED TO WISCONSIN-MINNESOTA LIGHT AND POWER COMPANY RECORDED IN VOLUME l49 OF DEEDS ON PAGE 463, TOWN OF BALDWIN, ST. CROIX COUNTY, WISCONSIN. THIS CONVEYANCE IS MADE SUBJECT TO ALL RESTRICTIONS, EASEMENTS, RIGHTS OF WAY, COVENANTS AND CONDITIONS CONTAINED IN THE DEEDS FORMING THE CHAIN OF TITLE TO THIS PROPERTY. BEING THE SAME PROPERTY AS CONVEYED TO FEDERAL HOME LOAN MORTGAGE CORPORATION BY SHERIFF'S DEED DATED AUGUST 19, 2008 AND RECORDED SEPTEMBER 8, 2008 AS DOCUMENT NUMBER 881073 IN ST. CROIX COUNTY, WISCONSIN. PROPERTY ADDRESS: 2259 County Road, Baldwin, Wisconsin 54002 The legal descripfion was obtained from a previously recorded Instrument. This deed warrants title only against claims held by, through, or under the grantor, or against encumbrances made or suffered by the grantor, and it cannot be held to warrant title generally against all persons. Grantor does further covenant and bind itself, and its successors and assigns to warrant and forever defend the title to the property to the said Grantee against the lawful claims of all persons claiming by, through or under the Grantor, but no further or otherwise. THE Grantor hereby covenants with said Grantee that the Grantor is lawfully seized of said land in fee simple; that the Grantor has good right and lawful authority to sell and convey said land, hereby specially warrants the title to said land as noted herein and will defend the same against the lawful claims as stated hereinabove, and that said land is free of all encumbrances. Page 2 of 3 2 of 3 . ~. UNOFFICIAL COPY IN WITNESS WHEREOF, Grantor has hereunto set its hands and seal the day and year first written above. WITNESS First Witness ~. ~s~ ~ Print ame lc, v Second ess Print Name FEDERAL HOME LOAN MORTGAGE CORPORATION Its N~Olr6n l°zve 1 r~ Authorized Signer of National Default RED Services, a Delaware Limited Liability Company doing business as First American Asset. Closing Services ("FAACS'), as Attorney in fact and/or agent. STATE OFT ti I ! ~ rn ~ ~ } COUNTY OF d tit~~ } ACKNOWLEDGED AND EXECUTED BEFORE ME, on the Z3 day of r'-0~0rv , 2009, the undersigned authority, personally appeared /~~t/I k/~elr/1 , who is he Authorized Signer of National Default REO Services, a Delaware Limited Liability Company doing business as First American Asset Closing Services ("FAACS"), as Attorney in fact and/or agent for FEDERAL HOME LOAN MORTGAGE CORPORATION, on behalf of said corporation, with full authority to act for said corporation in this transaction, who is known to me or has shown as identification, who after being by me first duly sworn, deposes and says that a/she has the full binding legal authority to sign this deed on behalf of the aforementioned corporation. T~CRY PUBLIC ~' ;r1THONY PNAN My Commission ExpiresS~~ ~~ y~~ ~ ~. n-,M. #1584892 ~ °~ : 'y ~ ;• Public • California o ~'. 'aange County { Expires Jun. 4, 2009 ..... ...,-~-e-~+~.-- The preparer expresses no opinion as to the title the Grantee(s) will receive. The preparer has not had any contact with the Grantor(s) nor Grantee(s) herein. No legal advice was given to any party herein. Information contained in this instrument was provided to preparer by an agent for said Grantor and/or Grantee. No title search was performed on the subject property by this preparer. The preparer of this deed makes no representation as to: the status of the title; property use; any zoning regulations concerning described property herein conveyed; or any matter except the validity of the form of this instrument. No boundary survey was made at the time of this conveyance. PREPARER IS NOT RESPONSIBLE FOR CLOSING, the collectioa of taxes oor the recording of this instrument. The conveyauce amount was provided to preparer any agent for Grantor. Prepared under the supervision of: Robert W. Silvestri, Esq Waukesha, WI 53186 By: Law's Specialty Group, Inc 235 W. Brandon Blvd, #191, Brandon, FL 33511 866-755-6300 Page 3 of 3 3 of 3 ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIl' CERTIFICATION FORM OwnerBuyer `--~ r ~ `'\ ~ ~ ~ ~ ~ ~ Mailing Address ~ Z ~ ~ ~ ~ ~~ ~ ~ \~ P~~ ~yl~``~ `/lS ~~ Property Address ~/rr,% (Verification required from Planning & Zoning Department for new construction.) City/State ~ ~ 1 n) ~~ Parcel Identification Number LEGAL DESCRIPTION ,,,, \\ , Property Location '~Y~1.~ '/4 , ~~ '/4 ,Sec. ~, T ~N R l ~W, Town of ~ ~,( a~~ ~ ~'~ Subdivision Plat: Certified Survey Map # Warranty Deed # Spec house ^ yes~o Volume ,Page # (before 2007)Volume ,Page # Lot lines identifiable ^ yes ^ no SYSTEM MAINTENANCE AND OWNER CERTIFICATION Lot # 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 §Comm. 83.52(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 forth, 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. 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 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. Uwe certify that all statements on this form are true to the best of my/our knowledge. Uwe amaze the owner(s) of the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. Number of bedrooms GN~TURE OF 1 /~ llv 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. 09/07)