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Home My WebLink About018-2007-03-000Wiscon~ Department of Commerce Safely any ~tildin~g Division ;~ PRIVATE SEWAGE SYSTEM INSPECTION REPORT GENERAL INFORMA'~ION ~• (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 P.C. Collova Builders, Inc. Hammond, Town of CST BM Elev: Insp. BM Elev: BM Description: C~f VV•~I 4.r 1~~ TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY Septic ,._-- Dosing ~ ' ~t Aeration Holding TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Septic } t t Zo Dosing tl t t 'r ~ 3 I ` Aeration Holding PUMP/SIPHON INFORMATION %PN~-) 5 `0 0' Manufacturer G Demand r ` GPM Model Number ~~ D TDH Lift Friction Loss System Head TDH Ft cemain Length f ... Dia. 2 ,/ Dist. to W ell SOIL ABSORPTION SYSTEM STATION BS 2.95 H1 FS ELEV. Benchmark D al•R IOv•a Alt. BM .~ S:Za JoI. s` Bldg. Sewer ,~ ,. ~ S t St/Ht Inlet ~ ~' S Z~ i SUHt Outlet Dt Inlet Dt Bottom ~ ~/ y~. , f Header/Man. / 3 ~ o . b S' Dist. Pipe .3.1i /~ ~ O' ~ D 1.3~ ~/~~~r Bot. System ~ D ' ~ Cy~ r Fi ~ra e ~ ~ D.2 ''. ~03r15 t Cover i _r BED/TRENCH DIMENSIONS Width ~ Length ] No. Of Ts~e~m~~ 2~ PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth SETBACK INFORMATION SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING CHAMBER OR M cturer: Type Of System: ( ~/ f UNIT Mode ber: DISTRIBUTION SYSTEM / LsJ -E-c ~ 1 ~ ` ` Header/Manifold ~ ~r ~ ~ p i `1' Distribution f ~ ~ / Pipe(s) ~ O / l ~, ~ Di i g th 2A S L x Hole Size t~ 3 /j t0 x Hole Spacing Z ~ << Vent to Air Intake .~~ • a Length D . pac n eng a ~n~~ ~:nVIFR v Dreccurn Cvc4n.nc Anly vv Mm~ni1 (lr A4.P rario SVStPms t7nIV Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil i ~ Yes ~~i ~ No i ~, ~r ]Yes i No COM ENTS• (Include cod di crepencies, personpresent~ etg.) Ins ; cti~on t#~1~: ~~.. / Inspection #2: ~~L~~a ort~ 1613 tAh~ ven~ on d, In5~5 (NE 1/4~SE 1~/4 5 T29fJ R17t~) Farm Vii w Rid I Lot 3 ~ Parcel No: 05.29.17.942 1.) Alt BM Description -~/ ~ °~ •ra`F ~+'~ bv~ ~~~?!' -~ ~'~ 2.) Bldg sewer length = ~'j,y -amount of cover = y `~Z tt5ei` c~r~ ` y Plan revision Required? ! •] Yes i No lI/~ ,~,Q~ ~ ~ ~ J Use other side for additional information. i L' {~-~--~--L"r -~".~ ~ _ ___ _._ _ _ _ ___ I I 1_' ' - .-! ~ Date Insepctor's Signature Cert. No. SBD-6710 (R,3/97) ~ ~ `f~ oil gs n ' County CC ~__II /~ J 1 ^'~1 Y ~ r 201 . Washui e., 2 ~ j~ ~`~, ` J T .L ~ l3ed in by Co.} Sanitary per7nit ~ ~~ ~ ~ ~ De artment oltiCommerce Sanitary Permit Applic iortsr > ~~~~. S p1anLD.Numlx;r ~ s. o,~- r In accord with Comm 83.21, Wis. Adm. Code, personal info y ~/ ~`C d for secondary Purposes Privacy Law, s15.04( NG, OU~ b oject Address (ifdifferent than mailing address) pF e use may T I. Application Infortation -Please Print All Information lj '1 ot # Block #t 3 . steel # property Owner's Name / ~ ~ ~ ~ ~ ~ 3 " ertyOvmer's Pro 1 G • • 1 'ling Address Property 1~oca ~~. p ~` ~ 1 ~ ~ ~ ~ ~ ~/~~' ~ /., Section City, State ~ Zip Code 7 ~ ~ ~ Phone Number JJJ ~~E e w e T ~ N ( L.- ~ , b YT. Type of Building (check all that apply) ? er Subdivision Name CSM Num ~" ~ pumber of Bedrooms or Family Dwelling- ~ ^ PubliclCommerciat -Describe Use OCity Village ship of Stare Owned -Describe Use lete line B if applicable) Com A Z III. Type Permit: (Chtck only one box on fine p . ^ Treatmentlllolding Tank Replacement Only ^ Other Modification to Existing System A- ~y $ystetn ^ Replacement System List Previous Permit Number and Date Issued B. ^ permit 12enewal ^ Permit Revision ^ Change of pl ber ^ Permit Transfer to New Owner t ~ ~ ~- BeforeF~:piration um ~ l` _ ~ IV. T of POWTS S stem: (C eck all that a 1) K < 24 in. of suitable soil of suitable soil ^ Mound Z 24 in ~ Single Pass Sand Filter ~ ^ At-Grrade • O circulating Sand Filter ^ Non Pressurized In-Ground en ^ Pr urized Trt-Ground ^ Holding Tank ^ Peat Filter ^ Aerobic Tr ei (~~n y Constructed Wetland Line ^ Gravel-less Pipe Recirculating Syniheuc Media Filter ^ Leaching Chamber ^ ~P V. Dis ersaV'1'reatment Area Information: d Design Soil Application Rate(gpdsfl ) l Dispersal Area Required (sf) Dis Area Proposed (sf) System Elevation ~ . ow (gp Design F ~' ~ Manufacturer Capacity in Total Number Prefab Site Steel Fiber plastic Concrete Constructed Glass VI. TankTnfo Gallons Gallons ofUni ~~~, ~• ~~ New g Tanks Tanks Septic or Bolding Tank Aerobic TreaMU:nt Unit Dosing Chamber nsiht3iiy for installation of the pOWTS shown on the attached plans. VII. Responsibility Statement- I, the undersign nme respo bet's Name (Print) Plumber' store Pl Mp/MPRS Number Business phone Number 2 ~6 ,- CI~-/ ~~ 7J um/ ~ ~~ J o J/~-cz~~~+-~1~~ pl~~ ddress (Street, City, State, Z e) ~ ,~^ ' J ~ ~j VIII. Coon /De artment IJse Onl Sanitary permit Fee heludes Groundwater Dam Issued Lssuin Agent Signatur (No Stamps) \ ~I Approved ^ Dish --.~ / Surcharge Fee) ^~ ~-- ~ `~" ~ ' ndition C IIi "pen Reason for Denial ^ ` s o prov - 3> u,,; ~ ~yQ~,~.¢r a.... Nov . !`~~ Zaos'; o . SYSTEM OWNER: ~ sau~ ~ ~~ '''"" -'-~ :5 ,4---4~.u~r• ~ l ~-'~' ' ' 1 Septic tank, effluent filter and i d i t ~ ~ ,n~sv..n~ ~ bb ''" ~ ~ ~~~'"-"'"'"t~` ~` ne ;S v n a - - ~ , dispersal cell must all be serviced /ma ~-~ ~ "~ `~ ~ ~ .~,,,,. as per management plan provided by plumber. k~ (~ 2. Ali setback requirements must be maintained ~ ~`'_`~r rdinances / d l ~' "~` 1 - _ ~~ `~ S~ 5~ IS e-~"~~ e o e co . `~ as per applicab ~ for the system on paper not less titan 8112 x 11 inches la sire ...b.a, ~mm~lete clans (to the County only) SBD-6398 (R. 01103} ~. Collova Bldrs. inc. PLOT PLAN ADDRESS P.O.Box 489 Somerset Wi 54025 a SE 1las ' S ~ !T 29 N!R 17 w TOwN Hammond COUNTY ST. GROIX YSTEM ELEVATION 100.5' BEDROOM 3 NVENTIONAL AT-GRADE CONVENTIONAL LIFT HOLDING TANK MOUND XXX SEPTIC TANK SIZE 1000 gallon IFT TANK SIZE DOSE TANK SIZE 630 HOLDING TANK SIZE LOAD RATE 1.0 ABSORPTION AREA 456 # of chambers none BENCHMARK V.R.P. Top of Survey Iron ASSUME ELEVATION 100' Filter Zabel A-100 ^ BOREHOLE O WELL * g, R. P . Same as Benchmark 113th Ave - ~ ~ Pro 3 Bedroo The to of the mound is m going be extended due House the c f A horizon! This is why the "1" dimension is 15' Huffcutt combo tank 324' property line ~~G~ 8 1 O QO~ - ~~S ~ ~ ~ ~t` + % Slope 5 Tank is to be g _ 3 ~ properly bedded and provided with Area 15' below lockdown covers system is to with approved remain warning labels undisturbed Well is to meet all setbacks found in Comm. 83 ~ ~ ;,~"~' / Grading is to be g _ 2 done to divert run- 98' off away from B.M. * 99 y 99.5'100' s stem Property Line ~~ . commerce.wi.gov isconsin Department of Commerce Safety and Buildings 4003 N KINNEY COULEE RD LA CROSSE WI.54601-1831 TDD #: (608) 264-8777 www. commerce.wi. gov/sb/ www.wisconsin.gov Jim Doyle, Governor Mary P. Burke, Secretary November 08, 2005 CUST ID No. 226900 SHAUN R BIRD BIRD PLUMBING, INC 1008 192 ND AVE NEW RICHMOND WI ATTN: POWTS Inspector ZONING OFFICE ST CROIX COUNTY SPIA 1101 CARMICHAEL RD 54017 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 11/08/2007 Identification Numbers Transaction ID No. 1211728 SITE: Site ID No. 707019 Pc Collova Builders Inc Please refer to both identification numbers,. 1687 113th Avenue above, in all corres ondence with the a enc Town of Hammond St Croix County NE1/4, SE1/4, S5, T29N, Ri7W Lot: 3, Subdivision: Farmview Ridge FOR: Description: Proposed Three Bedroom Mound System Object Type: POWTS Component Manual Regulated Object ID No.: 1049662 Maintenance required; 450 GPD Flow rate; 26 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.O1/01); Biofilter 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 approved plans, and the "Mound Component Manual for Private Onsite Wastewater Systems Version 2.0" SBD-10691-P(N.O1/O1). • The pressure network is to be constructed in accordance with publications SBD-10706-P(NO1/O1) "Pressure Distribution Component Manual for Private Onsite Wastewater, Treatment Systems -Version 2.0" andlor the sizing methods of publication "SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST-SAS (01181)" • 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 ofthe POWTS 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 area within 15 feet horizontally below the system shall remain undisturbed. Vehicular traffic or soil compaction in this area is prohibited. • A state approved effluent filter is required. Maintenance information must be given to the owner of the tank explaining that periodic cleaning of the filter is required. Access to the filter for cleaning must be provided per Comm 84 product approval conditions. • Comm 83.22(7) - A copy of the approved plans, specifications and this letter shall be on e ur_ing construction and open to inspection by authorized representatives of the Deparment, whi lTd~iilACal inspectors. CO~'t itonally ~,PPROVE® ` ~ ~ SHAUN R BIRD Page 2 11/812005 Owner Responsibilities: • The current owner, and each subsequent owner, shall receive a copy of this letter including instructions relating to proper use and maintenance of the system. Owners shall receive a copy of the appropriate operation and maintenance manual andlor owner's manual for the POWTS described in this approval. • Comm 83.52(1)(a) -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. 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. • 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 may be 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, Gerard M. Swim POWTS Plan Reviewer -Integrated Services (608)-789-7892, Mon. -Fri. 7:30 am to 4:.15 pm jswim@commerce.state.wi.us Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 WSMART code: 7633 cc: Leroy G Jansky, Wastewater Specialist, (715) 726-2544 f L .~+1 Cover Page Shaun Bird Bird Plumbing Inc. 1008 192nd Ave New Richmond Wi 54017 715-246-4516 Date: 10/30/05 Owner:P.C. Collova Bldrs. Inc. Location:NE1/4 SE1/4 S5 T29 N,R17 W Lot 3 Farmview Ridge Hammond System type: Mound System Manuals Used: Mound Component Manual Version 2.0 (01131) Pressure Distribution Manual Version 2.0 (01/31) Page# 1. Cover Page 2. Mound Plot Plan 3. Mound Cross Section 4. Pipe Cross SectionlPipe Layout 5. Pump Chamber Cross Section 6. Pump Curve 7-8. Maintance and Contigency plan 9-11. Soil Shaun Bir Signature License n RECEIVED NCV 0 1 2005 SAF a ~6vGS DEPARTMENT OF COMMERCE tVIS10N SAfE7 AND BUItDI`GS gEE CORRES ONDENCE PLOT PLAN ,PROJECT P.C. Collova Bldrs. inc. ADDRESS P.O.Box 489 Somerset Wi 54025 IVE 1/4 SE 1/4S 5 /T 29 NJR 17 W TOWN Hammond COUNTY ST.CROIX SYSTEM ELEVATION 100.5' BEDROOM 3 CONVENTIONAL AT-GRADE CONVENTIONAL LIFT HOLDING TANK MOUND XXX SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE 630 HOLDING TANK SIZE LOAD RATE 1.0 ABSORPTION AREA 456 # of chambers none BENCHMARK V.R.P. To ey Iron ^ BOREHOLE O WELL * H. R. P. Same as Benchmark 113th Ave ~~ ~rJ ~~~ r ~ ~~~ Pro 3 ~~ Bedroom The to of the mound is House going be extended due the ck f A horizon! This is why the "I" dimension is 15' Huffcutt combo tank Area 15' below system is to remain undisturbed 6-3 98' ~ - , B.M. * 99 99.5'100' 324' property line D~~G~ ~~CSQO~ ~t4t+~~ % Slope S `~-~_ B-1 Well is to meet all setbacks found in Comm. 83 Tank is to be properly bedded and provided with lockdown covers with approved warning labels Grading is to be B - 2 done to divert run- off away from system Property Line ASSUME ELEVATION 100' Filter Zabel A-100 ''''. No Designer Date ~J Non-Woven Filter Fabric 4" Observation Pipe Perforated Below Filter Fabric SSTK G-33 Sand --~ " Topsoil ~•~ Slope ~D~stribulion• Pipe {H -~ F E ------ `~ _ fQ 'fs e d O f ~j~- 2 `Z Drain Rock r F Lowe d Layc~ D -~----~ ;• E. ~ i i F k r °_~ Force f+~ain From Pump Cress Section Ot A Mound ~S stem Usin Absorption Arta q Bed For The f ,t ~kr~u,~~ f ~ ~ Ft. ~ ~ Ft. ~..~ 7 r ,aFt.- • ~ ~ Ft. L ~ Ft. .~ ~, ~ Ft. L t d:'Obstrvation PiAe-'~` .K ~j ~_~_~- -____----------------__---------- l - °' A f , ------ 1 Force Moin a _ __ ----- •---__- ------ From Pump w _.._ ,_,_ ~ _,..., _._,. _.._ ..-- j ,w o Distribution Bed Of cK•- Z l2 0 pram Ro Pipe i ~ 40bcervatian Pipes-~~C~ Permanent Morker ,I/s~~, ;/~ ~-. ~n ~~~ipe or Rods f f t7 LS F r~,~-~ ~rJ~ P1on VitK Of Mound lSt1n A Hid For 'The Absorption Arta PAG E_,_,_. ~F.~..-- . ~ ~ka tocoted Oa $o~+orn. `Ruatty Stsoeea tR9T t;ot.L N>zxt re GennsC}i fit. Ff. dz-~~.a.,c..~c a v .~ .. _ - ~ - - ,~ l Signed: License Number: date: ~r~Ip {~ v /~y~• Hole Diameter 3l/b inch Lateral •" 2_____, Inch{es ~ Manifold 2 Ini:hes ....._ Force Main Z-. inches ~ of hales/pipe Invert ~ievation of Late>"als I~ •~ Ft... Perfcraitd ~iCS OetOii ~~ • , s S£'ECI~ FCRTIt~~s " F Cr~flSS S~CTi C:~ ~~I1 SEPTIC -SANK ~ F#3i~lz'' C;;~1B_.R ~~1~~RPR#X~F ApPRCV ED .. HY3~. Rgt3VE CRA#~E ~ ~~1~CTIfl~ $QX iHOI.E C~~-Eit ~+T ~ ~EN'T PIPE I1dIA~~O~ 4R ~I~K C~3AI~3{iIT WJ FADL~K ~ ~ ~~~,` £B4R $4flR. ~tAR-KI~IG iABE~ d ~_ FIRS .. ;' ~ GR~K i~ ,_....._--- . ~ ~:: ~ : z ~{ .. t a F t i - ~ i Z#I.ET G14,5- o teiA?£g ~ZBHT 5~~ ~ 'FIGF~T s `;~~TYI~ PE ~ SEAt- ; B ; ~ flR ~,~Q Sfllt ~" . C. ~ ~ t FF DI~tTi~ SAID. ~ ~1~? --FT _ $Etlt p~3#'IP flFI- EL£~ ' ~ I3 i ~ ~}~RCVE3J $~~~rt~ VRDF.R '~~ Cp}gCRETE PAtl 3 SEPTIC ~` D05E r I~t£ It~tCi~~Ii+~ GAL- TI~NiC ~~,IFACT~3Rf.R = ~~E ~ ~3.1J ~. ~St+iC K :~ ' ~. SAL GRL- TRIiK g;2;,~ = SEPTZ'C ~~ ~~,. -.. ~' ~J I~iGl~3ES 5 v/~ 8 = ~- FICHES = ER;= ' / f43A~ ~RtJf 1~C1'~3R ~.--'.- ~„~~D'£L. H[T~f$~ ~ ~ ~ r ~"' ~ C ~~S I3~IC'i~£S = ~~-- ~I -t-"_" X5.33 pyts~ tFwc~~~ , ~ v ~ . ,,-;~ . ~ _ ~ ~~ uzR~ ~ A5 ~F~. z ~R 9 S , ~u l~ipDEL. tNHBER' ' = _ /, ~;'NCH GDS _ ~/ Fi33'iP / "v FEET _.,E-'~- _ -'~IdN PIPE _ - ~ . /.."'~ FEET R~t3L"sIRE~ DISC~yRGE g.AT~ ~ISTRI~ _ - _ CE $~~'E£i~I p{IH£' dF F RR£ - - - I`pCT~ - pFET i VERTICA3. D;FpER£N X ~ F'F~IIIi3,£T- FRICTIbH r /~ 4c}•. ~ ~ ~INZK`~ RE~rtfl.RK ~ggLY pREgSUzZE ~Y,~~ H~ F~EitNA~ DIriEI~SICI+3S flF SFGP~EB= _ _ 4pt"= F i.ICENS~ ~MB~= _.--- _- J~ ip88 i , ~- W W ~ ~ 50 53 12 40 152 4 z v z 8 a 0 r ~5 ~,~ 1 ~ ~~~ p HEAQ CAPACITY CURVE MODEL ~ 52/153 ,~ 20 / ~b . r,. 16p $p ~ t U- TERS -0 gp ~60 240 ~~~ FLOW PER 1NUTE CONSULT ACTORY FOR SP IAL APPLICA • Timed dosin panels available. ~`" FJeCitiCal emators, for duplex systems, are available and supplied with an al .Variable level control switches are available for controlling single p ase systems. • Double piggyback variable level float switches are available for variable level long and short cycle controls. • Sealed Qwik-Box available foroutdoor installations. See FM1420. • Over 130°F (54°C.) specal quotation required. ~~r•153 Series A CAUTION Alt ;nstatlrtioo of cpntrols, protecdon devices and wiring should be done by a quatifted recent Netiol n~ Electric Code~jNEC) aad theme 0c~cuPnional Safety and Health Act (OSHA).o~ TQTAL DYNAMIC HEAD/CAPACITY PER MINUTE EFFLUENT AND DEWATEI~ING /~ ~._--MODE-L l ] 52 153 Feet i Mzters Go!. Liters 601. ~ ~ters • g 1.5 65 ~ 2b1 77 291 t 0 ~". ~ 2 70 i 265 t~ 4.6 I 53 201 61 23t 20 6.1 I 44 i67 52 97 25 ~ ?.6 129 42 t59 30 z ~ 87 33 ~ 25 ., ~ 1 ~ -- -~ 22 ~ 85 _ock Voty X8.0 ~ ~ 1.6m} 44.0 t. (13.4m) 014308 ~;'' , ~~ ~~ ' a ,r: --I ~-` .. G" 3 27/32 ~ 4 5/8-~ i ~ 3 27/32 NS --}- 3 27/32 \~ ~~ I I ! ;~ ,/a ri I ! f e ~ ~ i/ i a SELECftON GUIDE 1. Single piggyback variable level float switch ordouble piggyback variable level float switch. Refer to FM0477. 2. See FM0712 for correct mode[ of Electrical Albemator E-Pak du lex 3 3. Variable level control switch 10-0225 used as a k:ontrol activator, spedfy p ( ) or (4) float system. RESERVE POV~IEREDdDESIGN lgn of every Zoeller pump. For unusual conditions a reserve safety factor Is englnee MAIL 70: P.O. BOX 16347 Louisville, KY 40256-0347 ManuFdcturersof. . SHIP T0: 3649 Cane Run Raad E `~ Louisville KY 40211-1961 QVauTYP~~SHCE 1939° ® (50?~ 7?8-2731.1(800) 928-PUMP PUMP !,0'° FpY r502) 774.3624 ~p;/7wwwsoetfer.com p CoRyright 2400 Zoeller Co. Alt rights reserve . ..- , • R'S NIAir1UtS-L ~ ~tANAGEME~T PLAN QpvvTS owN~ SYSTEM SPEGiF[CATfONS .. _... member of 8~ro°R's ~~~ ~ O~~~aai Uniis . Est ~ (avesa9e? ~imated x 7 ~ pin ftcw (P~~ ~ So>t AFP~~Or' Ram u~ Quat'itY tnfluerlt/EM Fstsr O~ ~ Grease (~G~ Biocfiem~t OxYg~'~mSo~l~s` ~ DS Total SusPe P E{duent Qu~Y SODS? Demand ~ l3iocheT ~ S~~nded Sonds {TSSj Fecal CoGfom~ (geometric mean) mum Effluent Partide Size i-u~....-- - $erVtCe Event lnspeof condrtton of tank(s) Pump out contents of tank(s) cel!(sj Inspect dtst~~ CEean affluent f~7ber lnsped Pump. PAP COntrots 8~ atarrr+ test Flus1~ tats and P~sure ~~~ -~-~~ ,~ yv-___. Q~~~ Monthly average' S30 mgn- 4~fl mgJ1- Moniriiy average.. S30 mg11- ~30 m9n- 510` cfu/400mt ya inchdiameter $eptic?anlc ~P°`'"~ Septic Tank Man~'rsr Effluent Fitter Ma"~'• Effluent FZlter Model Pump-Tar'k ~~~ PulnP Tank ~utacturer .Pump ~~~ Pump lyodet Page of G~Z7 a1 ^ ~ ~~ ~ ^ NA ~ r'f~ o NA ~~~ 9~ n NA ~ ~ ..~ ~ ~,ti/ Q NA' J~~` p anent un.~ - 0 Peat t-itber l7 ~~ F~ter O Wetland ^ {~Iedsanlcal Aera~n ^ Other. I ^ Dlsinfef~on Qispersaa Cett(sj ~ Q round tpressurtzedj p In~ground (gravity) ~~~und ^ At-9mde ~~ 'p~,1er p vn ~- ~~ was4swatsr ~ Values tYPld ~ doe+est~ (~n~n tank effluent ~~_ .~ Values tYP~- ~ pnruested ~--^' Secvrce Frequency p months ea+ At feast once eYe'r J uals zlVhen combined sludge and scum e4 ...nnth5. At least once every At {east once every At teas[ once every AL teas[ once every At least once every AL least once every p monu~s ^ months j Ma( xtmum 3 yrs.} (ty} of tank volume ~? ~Maxlmum 3 Yrs-} D NA O ^ rnonms~ ~ •-. p months fl yearEs} ^ NA ^ months II year(s) DNA orn~ or ~ tNS~V~rypNS n ind"Nidual oarry[n9 one of the follovvfnQ GoenseS It be made by a ctar. POV1lTS f,-laintauter. ~ n $ewer: !?fl~5 to identify mrSSln9 uP MAtM'ENAN ~ ~~ and dispersal Gg1;s st+a Resbdo~ inspe arty lnsPe~ . Master Plumber; t+~Iaster plumber on of the tanks? scum and to d~ for any back ~". ns must gndude a visuat inspeW aiud9e and to check the effluent levels Senridn9 r• Tank mspedio ore the volume of combined rnspe~ nding of effluent on the ~~ or teaks. +~'~~ .r.he disper~t cell{S} shall be visually hardware. lder-t3tSr any rofmd surface- round surface. The P°' uiatorY authority or pondul9 of etftuertt on the 9 .for any ponding of effluent on the 9 {~aftion of the focal reg pipes and to chedc~ndition and re4uires the immediate noti or more of the tank volume. the k uals one-thiRi (~} ~ In accordance +~ ~- N ground surface +t-aY indlr~lte a falling rnulation of sludge and scorn in any tan e4 ~r and disposeQ when the combined arxu ~ by a Septage Senrldn9 Ot'era . entlr8 Contents ~ the tank shall be remov ~ m~~ment ~ponents; and any to Administrative Code. POWi"S components, P fif,~ pOW'rg Maintainer. 113, YYff~s ressutved ~~ by a oerb . of effluent+f+ttiers• mechanical or p event. The secYiGn9 at inter+rais fJf 12 months or less. shall be P? of comPl~t°n of any s , ofhermafntenanae or monttorin9 ~nritf'lin 1g days shall-~ ~ to the local regulatory authority muds or other A servige nf~ of painting P - treatment tanic(s~ for'the P~ eons atria STARTUP ANO OPERATION pOWTS check. erg cell(s), tf high conr~ Fa flew oons>rvctson. Pl'JOr t0 use of the mcess anNor damage the lisp rior ~ use_ chemkals that ~Y i~,pede the treatment P a septage servicing operator p detected t-ave the contents of the tank(sl removed by /' Pa~ ~r ~~-z. `" ~~ ~sii poi occur when ~~~condffions are frozen at the infiltrative surface- ~ ~~ ~ excess . Systern,start up ~ above nom highwater levels. y~hen t result in the ~,ges pt>~ ~~ cttisY cep(s) in one large dose. otterioadng the Ce~(s} and may O~~ be disr~98d ~ ~ ~~ To mid this si6uation have the contents a P umber ~ kPOWTS ~ e ~ ~~~ d~arge of eftluen tp the effluent pump ar contact t>•iatntarner to Seivic~9 Di~~ ~'th ~~ torestone nocmat }etrets within the Bump Tank, d.~~ or c~ampact, inin ntartua(l~f ng the p~F~ ~~ . ~ oval` fiatlfs5 and dispersal carts- Do not drive or ¢artc ovens ar oiherwisg po ~ drive or p~ motrrld or at-grade sari absorpfion area- the areg wither ~5 feet dowr- slope of arrY stream may improve the perfOrrnattCe and prolong tfle Gfe Redaction or~efrminafion of the folfan~vEnJ fi_nom the ewater d teasers: dental Boss: drapers: dgarette butts: condoms; ~tton swabs; e9 ; g~~. herbicides; meat of the ppWfS. ~t~io6Cs; d~-{scannP p~F~ vrater, trust and vegetable peef>izgs; g d~~ ~,nq products: pesticides: sanitary napkins; tampons: ~snd vVater softentrr brine. soaps sitati {~ taken to insure that the gBANDON~NtENT fasten vut of service the follavsrlrtg steps When the POWTS tails andtor is P~~n ~Pliance wrfh ~- Comm 83.33, t~isconsin Adrnirststr~ive Cade: system is pr,ppedy and safely abandoned and tfte abandoned Pipe openings sealed~ A!t p(ping to #antcs and pets strait ~be disoonneded p,os~ of by a Septage'Servicing Operator. . The contents of aft tanks and t~ hair be exca ~ and remo ed or U'-eir covers removed and the void space i After P~Ping, at( tanks and P fitted with soft, gravel or anattter inert solid material measures have been, ac must be fasten, ~ provide a code CONTINGENCY PLAN the following If the ppWTS fans and cannot be repaired ant system: location of a replaoerrtent soil aocnpGant ~ t-~~ hys ~n evaluated and may be uW;zed far the ~n and should not p AA sabstn ~t~ m~~ rep~Cement area should be protected from disturbance and comtsa cks from existing and Proposed s~ucture, lot Frees and welts. Failure to be infringed upon by required setba _ noted the replacement area vrtll result i s must comply rsrrth therrule~ n effect t t1'sat tirnetab}istt a siirtab e eplaeement area. Replacement system , A suitable neptacement area is not avarlable dueaio sew rt o r pace the far7ed POINTSng adwaraces in POWTS O ~ Mailed as a technology a holding tankmay a suitable replacement area Upon f2ulure of the POWTS a so~_and The site has not been evaluated bo identify t area is avaifabte a. site evaluation must be pew t° ~~ a suitable replacement area- if no reptacemen hording tank nlay be ~~~ ~ a Last resort to replace 'the failed PDVY'fS_ removal of the biorrtat at ourut and at-grade soII absorption systems may be reconstructed in ptaoe following c~ions of such systems must comply wish the rules in effect at that time. 1 tfie lnfiftrative su[~aae- R <NIfARlV/NL~~ TANKS MAY CONTAIN LETN~ GASSIrS AtolW4R tNSUFFtCtENT OXYGEN- SEPTIC, PUMP ANO OTHER TRF.ATMI=NT CU2CilMSTANGES. dEATH MAY DO NQT ENTER A gEPTIC, PUMP QR 07~-tEFt T~ATMI=NT TAKK UNDER ANY Rl»Sl1LT_ .RESCUE OF A PERSOtd FROM "r7-IE i~('rERtOR OF A TANK MAYBE DIFFICULT OR IMPOSSIBLE. AnQmoNAI. con~>~rNTS ~ . POINTS INSTALLER Name ,~~~ , / l ~~J ~ , Phone `~ ~ ,3' =,~.7 D- '7 ,,~~ POWTS MAINTAINER Name ~ a.-~-t- ~./'~ r Phone '~ 1,~' =c~ ~ _" '~~' t.pCAL REG(lIATORY AUTH4Rm SEPTAGE SERVICING OPERtITQR MPE N2me r Phone 1 ~'~' ~ ~~ ~ Phone "~ j ~i ""~- ~ 'r ~.J ~ doarment "1eNs netts and Waustiara County Zaniny and Sa»itation - 'Ctds t Ttus doarn+ent'was drafted txy, the seslfs of the Glean Lake, Mara Cede- Ilse of this doa>~t d0e5 tr0 uinements of dt. Comm 83.22(~(hHt?t~~t~ atsQ 83.56(1}, (2) 8. (jl. Wrst~onsin A6m~ ~~ (ypt} the mirvcnurrr nsq guarantee the perfotrnarsce of the pQW'rS. a: Wisconsin Department of Commerce SOIL EVALUATION REPORT Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code County (~~ ~ ~.,,.F Parcel I.D. Attach complete site plan on paper not less than 8 112 x 11 ' esin -~-a• indude. but not limited to: vertical and horizontal reference mt ~ ,,,. , r,; percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Revie ed y Please print all informati ` . ( ~ 1, P I C.~! / ~~ 1~ ll. ~ personal iMomtation you provide may be used for secondary pur es (Pri~a~l.>~w. ~. 1`5.04(1) (m)). t' n Page ~ of Property Owner ~ PFOpeJty,4oca w ~(~ ~~/ ~'~ 6~~..` 114~Y 114 S ~T ~~ N R ° ~* ~ ~ Lot # Block # Subd. Or CSM# Property Mailing Address ~~ ~~~~ t ,~ ~ l/ ~~ ~-~ ,~ ~ r p ~, ~ State + Zip Code Phone Number ^ City ~ ^ Village Town N~ea~rje~syt R~o~ Date I~ E (orkl p - -- - - '~J GPD New Construction Us Residential /Number of bedrooms Code derived design flow rate ^ Replacement ^ Public or commeraal - Descxibe: - -------- nfl. ~ / Flood Plain elevation if applicable ~ ~ ~ R Parent material ~!-y~~' s ~ _ General comments _ !'~ / ~ (~~ti~ ~. and reoommendations:.~y 5 ~~ Q (~.+, t/rriCaC.~~ ~ (~(`~ ' J ~~ 6~`~ Boring ~~ # pit Ground surface elev.j ~" ~ ft• won Depth in. Dominant Odor Munsell Redox Descxiption Qu. Sz. Cont. Color Text ~ a_ v, , ~1~ --- ~ 2 3 -z, ~ a- ~ ~ ~---- ---_ sc sc Boring / ® ~~ # pit Ground surface elev! ~~ ~ ft• Horizon Depot in. ~~ Dominant Odor Munseil 3 ~ Redox Description Qu. Sz. Cont. Cdor "',-- Tex ~, `~ ~ .C ~' y 1 ~~~ -- ~- Sc 6 c • Effluent #1 = BODR > ~ < [~u m9r~ ern, ' °" -"" - °"" ., CST Name (Please Print) S Bird Plumbing, fnc. Shaun Bird Address 1008 192nd Ave, New Richmond, WI 54017 ~ ~ ( in• factor th to limitin _. ~ g Dep ~i tication Rate nce t i C Boundary Roots GPD/f~ tre Structure e s ons Gr. Sz. Sh. 'Eff#1 "Eff#2 a ~ s ~-.. G 1••~ _,,,-L - _ - svir~ ~1 ~ , U ~ ~ Depth to limiting factor ~• $pil lication Rate ure Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/ff "Eff#1 `Eff#2 a ~ e a , ~/L ~,® ~ 1 ~ 7 ' Efttuent #2 = BOD _< 30 mg/L and TSS < 30 mg/l. CST Number 226900 Date Evaluation Conducted Telephone Number ~~ ~ ,~~ t~ 715-246-4516 ~~ N6~S~ 5 ~-~ 3 ~,~ =~ 7g I' 2- ~~~P~ ~, a Yi^Z~' /of 3 property Owner Parcel ID # Page ~ of l~ ~~ # Boring Pit Ground surface elev. _ n• Depth to limiting factor ~ ~ in. SoN ication Rate •'Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 "Eff#2 ^ Boring # U Boring ^ Pit Ground surface elev. ft. Depth to limiting factor in• Soil tior- Rsde 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 Lj Boring ~~ # Ground surface elev. ft. Depth to limiting factor in. ^ Pit - Soil ication Rate Horizon Depth in. Dominant Color Murtsell Redox Description. Qu. Sz. Cont. Color Texture Stnrcture Gr. Sz. Sh. Consistence. Boundary Roots GPD/fF 'Eff#1 'Etf#2 'Effluent #1 = BODa > 30 < 220 mglL and TSS >30 < 150 mglL 'Effluent #2 = BODS < 30 mglL and TSS <_ 30 mglL The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need materiat in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. seQUw pr.urooi .~ Soil Test Plot Plan Project Name • P.C.• Collova Bldrs. Inc. Sha Bir ,~ Address P.O. Box 489 ~°;~ Somerset Wi 54025 ~ M #226900 Lot 3 Subdivision Farm View Ridge Date 5/8/04 NE 1/4 SE 1t4S 5 T 29 N/R17 W Township Hammond [] Boring ~ Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 100 ft. Top of Survey Iron System Elevation 100.5' *HRpSame as Benchmark Alternate Benchmark Top of 1/2" Pipe @ 100.2' ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM OwnerBuyer P• C. Collova Builders, Inc. Mailing Address7~~7 i~~(i'~(Y~~ ~"J I'. i~( ~1;~ #r~ (~(YI~S{~~ ~1 c~~~~~ Pro ert Address 7 "J ~ ~ ~~ r Y +~ i,~~ (Verification required from Planning Department for new construction.) City/State Hammond, WI LEGAL DESCRIPTION Parcel Identification Number f' •-d 3 - C~ ,~ ~2> Property Location ~ '/4 , SE '/4 ,Sec. 5 , T ~9 N R 1 ~ W, Town of Hammond Subdivision Farm View Ridge Certified Survey Map # ~~~-_.~ ~ ,Volume ,Page # Warranty Deed # ~ ~~~ I ,Volume Z ~~a , Paae # 3 Spec house ~ yes ,~ no Lot lines identifiable yes ~ 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 Counry Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. I/we, the undersigned have read the above re uirements and agree to maintain the private sewaoe disposal system with the standards set forth, herein, as set by the Department o~omrr>~rC~d~t~~~~~;t~~~~es~~~~State of Wisconsin. Certification stating that your septic system has been ~a thin b o p ~~.• e C0 t oix Counry Zoning e artment within 30 days of the three year expiration date. PRODUCTION OFFICE O~n>; ~~, ~ ~ (715) 294-3245 ~~ /~~ ~~ SIGNATURE OF APPLICANT 34 260TH STR. DATE OWNER CERTIFICATION Q ~ I Uwe certify that all statements on this form ar~u~e to~ t a the owner(s) of the p op rty described above, by vi a of a warranty deed r~ rtie o e ~ ~ ~~ PRODUCTION OFFICE ~~,~~/~ SIGNATURE OF APPLICANT (715) 294-3245 DATE ****** Any information that is misrepresented may result in the sani ~ ETrlfi~iditi ~~v~ked b the Zoning Department. ****** Include with this application a stamped warranty deed from the RegOis~er o ITe~b tce and a copy of the certified survey map if reference is made in the warranty deed. U 2S36P 3~i7 ' STATE BAR OF WISCONSIN FORM 2 - 1994 Document Number i wa~xTY DEED This Deed, made between Michael B. Marshall and Dawn _Marshall husband and wife Grantor, and P. C. Collova Builders. Inc.. a Minnesota Corporation 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): See Attached Exhibit "A" 7 ~ 7'3 5'9 KATHLEEN H. iiALSH REGISTER OF DEEDS ST. CRCIIR CO.. YI RECEIVED FOR RECORD 83/29!2004 12:50P1! NARRANTY DEED EXE'IIRT # REC FEE: 13.80 TRANS FEE: 2012.40 COPY FEE: CC FEE: PAGES: 2 Recording Area Name and Return Address i iw~~ icy iii ~v~ 018-loos-6o-o00; oI8-loos-so-ooo 018-1008-90-000: 018-1010-00-000: 018-1010-10-000 Parcel Identification Number (PIN) This is not homestead properly (is) (is not) Exceptions to warranties: Easements, restrictions and rights-of--way of record, if any. Dated this li~~ day of Marsh , 2004 * s AUTHENTICATION Signature(s) Michael B. Marshall and Dawn Marshall, husband and wife ---__ -~- -- - -- t~ authenticated this ~ day of March , 2004 * Kristine land _ TITLE: MEMBER STATE BAR OF WISCONSIN (If not, authorized by § 706,06, Wis. Stets.) THIS INSTRUMENT WAS DRAFTED BY Attorne_y_Kristina Ogland _ __ Hudson, WI 54016 * Michael B. MarhsaB * Dawn Marshal! ACKNOWLEDGMENT STATE OF ) _..___-_) ss. County ) Personally came before me this __ _ day of the above named to me known to be the person(s) who executed the foregoing instrument and acknowledged the same. ___ Notary Pubtic, State of -___- _ _._ __ _ .._ My Commission is permanent. (If not, state expiration date: (Signatures may be authenticated or acYrawledged. Both are rat necessary.) .) * Names of persons signing in any capacity must be typed or printed below their signature. tnforrnation Professionals Co., Fob du [.ac, W! STATE BAR OF WISCONSIN 800-655-2021 WARRANTY DEED FORM No. 2 -1999 U 2536P 3~i8 EXHIBIT "A" Part of the NE'/. of the SE'/.and Part of the NW'/ of the SE'/. and Part of the SW '/ of the NE '/~ and Part of the SE'/ of the NE'/. of Section 5, All in Township 29 North, Range 17 West, Tawn of Hammond, St. Croix County, Wisconsin described as follows: Commencing at the Southeast comer of said Section 5; thence N00°05'29"W 1315.84 feet along the East line of the SE'/4 of said Section 5 to the aoint of beginning; thence N89°25'01 "W 2639.28 feet along the South line of the N % of the SE'/. of said Section 5; thence N00°21'34"E 2581.45 feet along the North-South'/. section line; thence N89°51'32"E 1316.00 feet along the North line of the SW '/ of the NE'/; thence S14°12'09"W 566.08 feet; thence S56°30'45"E 166.57 feet; thence S05°58'41"W 617.95 feet; thence S89°Z6'33"W 230.23 feet; thence S00°08'03"W 557.04 fast; thence N89°26'33"E 1601.66 feet; thence S00°05'29"E 758.82 feet along the East sine of the SE'/. to point of beginning. i ~ ~ ~~~ ID ~ ~~ ~ ~,~, 1 I I~ NI N po ~ ~ , V (~l C'a O W ~ Gv o ~- W ~ -P. f ~ ~~ ti ~ ~ ~ I ~ ~n cN ~ ` ~ ID ;'~ ~ = ~O ~f ~ I ~ ~ ,`s ` .4 ._,F. 06°24'13" E 323.55' ~ v,/~ ~°~ ~~•' ---_ -l . ~~ ~ ~~~ ~~ - ____ f . -~ ~ ~~- ~ ~~ ~ ~ 1, I ~ ~ r ~~ I , N O ~~~ ' Ul Ui N D C7 ~ ~ ~, (~ ~ 1 ~ ~ `~ ~ ~ ~ ~ ~ 1 ,l ` 1 z~ ~ .i i!\, • VL • lJJ ~~ Ut _ ~ N J i f ~~ ~ t3' ~,:,~ 3• _ N --~ ~ ~f1 t,r~ \ W NI co W tp, N CO o ~ -~I '' "' ~~ O~ y ~~ .~ ~ ~, ~~ ,, ~~ ~' I` ~ _____ -. ~ .~ ______. _.__._ ~ ~ r m ____ __ c}'~I -a ~~ ~ ~~~ ~ ~ ~6L'86~ M wL~,tr L. LO N o~ ~ ~' 4 ... I ~~~ ~ ~ ~ o jt ~ ~ 1 I Q ~ ~ ~a r (,d D :C7 !`~ ` c~ 9EH SERIES SUMP/EF'F'LUENT PUMP Specifications. OIODEI CAT. SOIIDS SRE ADNNNIS PEDFORNBtNCE (6PY1 @ NEAD- SNDTOEf PYiN. CRD. 1VEIONI DIMENSIONS N0. N0. llS11N6 NP YOLTS psy (~ I..1 ANPSINATTS 5' 1P 15' 20' llt.l Iffl Ns.- pl x L x nl 9EH-qM 509330 UI/CSA 4110 115 314 13.0 1000 70 64 55 41 32 13.8 20' 24 9.11 x 11.64 x 8.94 9E}t-121v1 509340 lAJCSA 4110 230 3/4 fi.5 1000 70 64 55 41 32 13.8 20' 24 9.11 x 11.64 x 8.94 9Ekl-qA-RFS 509350 UUCSA 4/10 115 374 13.0 1000 7D 64 55 41 32 13.8 20' 27 9.11 x 11.64 x 8.94 9EH-CW-RFS 509360 UUCSA 4/10 230 314 6.5 1000 70 64 55 41 32 13.8 2D 27 9.11 x 11.64 x 8.94 Continuous DutyRated-"Little Gant Wastewaterpumps are rated continuous duty as long as theyare run withinOte published ratings forthese pumps." FLOW- LI ERS/HOUR 1000 00 3000 ` 30 O"' ~,9• ~ 20 A a W Io 0 20 4 60 FLOW- GALL NS/MINUTE PUMP PERF^R ANCE Cl IISV OHZ Io 7.s w s Q W z.s 0 80 L ~~ ~,,,,,~.- www. LittleC~iantPump.com Construction Motor Housing Epoxy Coated Cast Iron Impeller Material Poly Carbonate Im eller T e Closed Vane Volute ABS Power Cord SJTW-A Mechanical Shaft Seal Nitrite with carbon and ceramic faces Fasteners Stainless Steel Shaft Stainless Steel Bearings Upper Sleeve and Lower Ball Bearings ~•R•, a`"~ '' ~~ 9 9''t, . cF Little Ctiant Pump Co. PO Box 12010.Oklahoma City, OK 73157 Phone: 405.947.2511 • Fax: 405.228.1550 E-mail: customerservice@litflegiant.com Form 995235 - 07(03