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HomeMy WebLinkAbout018-2007-07-000Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Safety and Building Division ~ INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. ermit Holder's Name: City Village X Township P.C. COllova Builders, Inc. Hammond, Town of ST BM Elev: Insp. BM Elev: BM Description: lam' a I ~ - ~ ~+~ ~ C;S S ~. TANK INFORMATION TYPE MANUFACTURER CAPACITY Septic ~ J~~ Jr.' / Dosing ~~ ~ y W-~C~,~ ~ ~ !. Holding TANK SETBACK INFORMATION TANK TO ~ P/L WE LL BLDG. Vent to Air Intake ROAD Septic ~ r ' ~ 1 , ~~ . Z+ / ~~ Dosing ~ ~~ / ,~~ ~ ~~ / r, Aeration ~3 Holding PUMP/SIPHON INFORMATION L Manufacturer Demand e ~ GPM Model Number /f ` ' /V ~ ~ (~ ` TDH Lift Friction Loss System Hea TDH F ~~S 3. F c main Len o Dia., / Dist. to well / t /% C 11 ARCnRPTI[1N CYSTFM ~ O /.~ L S tr. ELEVATION DATA County: St. CroiX Sanitary Permit No: 463402 0 State Plan ID No: Parcel Tax No: 0'I 8-2007-07-000 Section/Town/Range/Map No: 05.29.17.946 S~T~f~ ~BS FS ELEV. Benchmark 1,+~ j0,7+~ /~ Altn(~. BM`,, ` p k"JO ~`(OYv\ a~ c7 actE ~ /t~ /~4 Bldg. Sewer ~-, Z /d3- Z, SdHt Inlet 5'q, /~~ i SUHt Outlet Dt Inlet - ~ ~ Dt Bottom ea / ~~ •-~ ~3 ~3.~ Dist. Pipe 2 .3 d 3 - ~ Bot. System ~ ~ 3 . ~ a 3 , -~ Fina~ ade ~ O ~ ~ b Y- StCover r ~` ~~ ~ / d1 BED/TRENCH Width Leng$Li 1 No. Of Trenche PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS ~ ~ (J ~ ~ SETBACK SYSTEM TO P/L BLD WEL LAKE/STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR ~- TypeOfS stem: ~ / ~ ~ ~~1 UNIT Model Number: ~ t71STRIBIIYV~N SYSTEM ~Ll(// c~ /ZY i(.~. f ~ / ms's 1.. l ~ l~Y,h /l • n. /10.D l Header anifold ~ ! d Length Dia Distribution ~~ / 7/ ~ Pipe(s) Lam/ ' Length Dia Spacing x Hole ¢e ~jyl,~ - x H le Spacin ~ 2`~~/" Ve o Air take SOIL COVER x Pressure Svstems Only xx Mound Or At-Grade Systems Only ~ -- - - _ Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center I Bed/Trench Edges Topsoil/ ! Yes ! No Yes No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1:~/~/~_ Inspection #2:~/~/ ~ s Location: 1136 167th Street Hammond, WI 54015 (NW 1/4 SE 1/4 5 T29N R17W) Farm View Ridge Lot 7~. y Parcel No: 05.29.17.9. 1.) A!t BM Description = 1-~0 ~O+N~. ~ ` JK~ ~ I`q }/f ~- ~t,1, ~~e(~ ~--~ ~a~ 2.) Bldg sewer length = ;~ i J + ~S ~ j ~~ -amount of cover - / tIl ~ ~ ~p JQr~ ~ ~ P~ ~~ _____ r s _ _ _ ~: Plan revision Required? ' ,Yes ~,' No -~ ~ (C( 6 5 6 ~~~ Use other side for additional information. I ___ - ___ _ ! _ - Date Insepctor's Sig aturG Cert. No. SBD-6710 (R.3/97) Safety aria Buildings Division 201 W. Washington Ave., P.O. Box 7162 Counh'~ I /~ ~'f- c in Madiso :, Wl 53707 - 7162 is Sanitary Permit Number Bo be filled in by Co.) eons (608)266-3151 Department of Commerce ~ -_ n ECEI A ' i to Pl I. .Number wo R pp t Sanitary Perm ~ ~~Z ~ q~~ io provide ersonal i oY d C Wi Ad e, p m. o s. In accord with Comm 83.21, may be used for secondary purposes Privacy Law, s -. ( ~ e ~ ~ject A dress (if different than mailing address) J 3 ~ ~~~ S~ i ~' ~ on I. Application Information -Please Print All Informat CROIX CO NTY } __ _ Property Owner's Name ZONI /~ / t # Block # ~ Prope Owner's Mailing Address ~r~o~per)ty Locat~i^on City, State _ C/~/~ p Zip Code ~Q~~ _~ _ Phone Number ~ (irc ) ~ N; ~E r II. ype of Building (check all that apply) ~~ /~v ~ Subdivision Name CSM Number __ _ . __ or 2 Family Dwelling - Nwnber of Bedrooms - ~z ~+ 1~~ ^ Public/Commercial - Describe Use}, ,~, 0-'~- ~~/ ~ ~' /r S ~ /r' ^Vill own ~ f ^City _ W w~1- ^ State Owned -Describe Use ` 4 rw III. Type of Permit: (Check only one box on line A. Complete li-ne B if applicable) A' New System ^ Replacement System ^ Treatment'Holding Tank Replacement Only ^ Other Modification to Existing System List Previous Permit Number and Date Issued B• ^ Permit Renewal ^ Permit Revision ^ Change of ^ Permit Transfer to New Before Expiration Plumber Owner IV. T e of POWTS S stem: (Check all that a 1 ~ _ _ ^ Non -Pressurized In-Ground ^ Mound > 24 in. of suitable soil Mound < 24 in. of suitable soil ^ At-Grade ^ Single Pass Sand Filter ^ Constmcted Wetland ^ Pressurized ln-Ground ^ Holding Tank ~ 1 Peat Filter ^ Aerobic Treatment Unit ecrrculating S~ Filter ~ f ~~ l h i )/-7 O er (exp a t Recirculating Synthetic Media Filter ^ Leaching Chamber ^ Drip Line Grave ess Pipe t V. Dis ersal/1'reatment Area Information: Design Flow (gpd) Design S/oil Applic tion Ra gpdsf) Disper area Requi (sf) D//s//persal Area posed (s~ System ev on / VI. Tank Info Capacity n Total Number Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Units Concrete Constructed Glass New Existing Tanks Tanks _ _ _ Septic or Holding Tank ~ ~ , Aerobic Treatment Unit ~ ~-j ~i i- ~ ~ Dosing Chamber ~ ~ ~~ VII. Responsibility Statement- I, the undersigne some responsiltility for installation of the POWTS shown on the attached plans. siness Phone Number B u Plumber's Name (Print) Plumber' afore MP/MPRS Number Plumber's Address (Street, City, State, Zip e) ,~ ' J n '~ ~ vU P ~ / VIII Coun /De artment Use Onl ~_- Sanitary Perm. t 1~ ee (includes Groundwater Datg Issued I mg Agent ign a ps)~ Approved ^ Disapproved Surcharge Fee; ~J ~ hh, OV tf/~g O ~-fi VU Given Reason for Denial ^ Owne r ` IX. Co~ f Appyr'~t".~" easons for Disap ro~ / , ~ ~ ~" ~ ~-d _ SYSTEM OWNER: ~! -_` .Septic tank, effluent filter and /~ ~ ~ ~ , ,,, ~ ~ - - L~ v dispersal cell must all be serviced /maintained W ' `~ ~ as per management Ian provided by plumber ~ vvi ~~~~~ / ~~ 2. All setback requirements must be maintained ~ J'Gp9 ~ ~ ~ ~ ~~ pp ~~ __ ~®n o ~ ~ ~ __ __ as per applicable code/ordinances. -t--~~~fel~it e ~ a.o., n r r r :.,~t,~ ~ a~~ a __L wttacn comp~e~e pwus tw wo ..o......r w., , .................~ ....,r-~- -- SBD-6398 (R. 0 U03) G~ `'~~ .3~ ~~ls D ~L2~~.~-0'~- ll.Q.ce~ ~5 . PLOT PLAN PROJECT .P.C. Collova Bldrs. Inc. ADDRESS P.O. Box 489 Somerset Wi 54025 NW 1/4 SE i/4S 5 /T 29 N/R 17 W TOWN Hammond COUNTY ST.CROIX SYSTEM ELEVATION 102.9' 1.7' sand lift ! 3 BEDROOM 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 454 # of chambers none BENCHMARK V.R.P. Top of survey iron ASSUME ELEVATION 100' Filter Zabel A-100 ^ BOREHOLE O WELL *H.R.P. Same as Benchmark Property Line(not to scale) /10 ~ H - 1101.2' -; a~ 167th St. Property Line Area 15' below system is to remain undisturbed Well is to meet all setbacks found in Comm. 83 Grading is to be done to divert run-off away from systems B-3 B.M. *~g r Slope ""~- ~ 'v`" v ~~1~~~ ~~ Scale = 1 /4" = 10' Tank is to be properly bedded and provided with lockdown covers with appr~gved warning labels 3 302' Property Line (not to scale) ~~I~JD~Y ' 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 April 13, 2005 CUST ID No.226900 SHAUN R BIRD BIRD PLUMBING, INC 1008 192 ND AVE NEW RICHMOND WI 54017 ATTN: POWTS Inspector ZONING OFFICE ST CROIX COUNTY SPIA 1101 CARMICHAEL RD HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 04/13/2007 Identification Numbers Transaction ID No. 1125969 SITE: Site ID No. 696933 PC Collova Builders Inc Please refer to both identification numbers, 1136 167TH St above, in all comes ondence with the a enc . Town of Hammond St Croix County NW1/4, SE1/4, S5, T29N, R17W Lot: 7, Subdivision:.Farm View Ridge FOR: Description: Three Bedroom Mound System Object Type: POWTS Component Manual Regulated Object ID No.: 1013242 Maintenance required; 450 GPD Flow rate; 16 in Soil minimum depth to limiting factor from original grade; System: Mound Component Manual -Version 2.0, SBD-10691-P (N.01/O1), Pressure Distribution Component Manual - Version 2.0, SBD-10706-P (N.O1/O1); 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, C03ZdJ stats. The following conditions shall be met during construction or installation and prior to occupancy or use: RARTMENI Approval Requirements: N~ G l ~'' ' • This system is to be constructed and located in accordance with the enclosed approved plans and with the SEE CORRE "Mound Component Manual for Private Onsite Wastewater Systems VERSION 2.0" SBD-10691-P (N.O1/O1) and the "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems VERSION 2.0" SBD-10706-P (N.O1/O1). • This pressure distribution system is designed with a minimum distal pressure of 3.0 feet and a network pressure compensation of 3.9 feet. • Per manual cited above, limited activities are allowed in the area 15 feet down slope of the component area. Soil compaction, excavation, vehicular traffic and other similar activities that impact the treatment and dispersal are prohibited. • The well must be a minimum of 25 feet from any POWTS tank, and a minimum of 50 feet from the absorption area. chs. NR 811 & 812c • 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. SHAUN [2 B[RD Page 2 4/13/2005 • Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Slat • Comm 83.22(71 A copv of the approved plans specifications and this letter shall be on-site during constnzction and oven to inspection by authorized representatives of the Department which may include local inspectors Owner Responsibilities: • Comm 83.52 Responsibilities. The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s. Comm 83.54(1). • Comm 83.52(2) A POWTS that is not maintained in accordance with the approved management plan or as required under s. Comm 83.54(4) shall be considered a human health hazard. • Comm 83.55 The owner is responsible for submitting a maintenance verification report acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. 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 slats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence maybe made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Charles L Bratz POWTS Reviewer II ,Integrated Services (608)789-7893 , 7:45 am - 4:30 pm Monday -Friday cbratz@c ommerce. state. wi. us Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 WiSMART code: 7633 cc: Leroy G Jansky, Wastewater Specialist, (715) 726-2544 Cover Page Shaun Bird Bird Plumbing Inc. 1008 192nd Ave New Richmond Wi 54017 715-246-4516 q~c~~~ qP,~ 12 EO SA~F~ Zoos ~ ~~®~®i Nis Date: 4/8/05 Owner: P.C. Collova Bldrs. Inc. Location:NW1/4 SE1/4 S5 T29 N,R17W Lot 7 Farm View Ridge Hammond System type: Mound System Manuals Used: Mound Component Manual Version 2.0 (01 /31) Pressure Distribution Manual Version 2.0 (01/31) Page# 1. Cover Page 2. Mound Plot Plan 3. Mound Cross Section 4. Pipe Cross Section/Pipe Layout 5. Pump Chamber Cross Section 6. Pump Curve 7-8. Maintance and Contigency plan 9-11. Soil test . /1 Shaun Bird / Signature License num er 26900 ~~~~py ~~ ~ aNV na~~cE _ ~!PlYGS ONDENC • ~ PLOT PLAN PROJECT .P.C. Collova Bldrs. Inc. ADDRESS P.O. Box 489 Somerset Wi 54025 NW 1/4 SE 1/4S 5 /T 29 N/R 17 W TOWN Hammond COUNTY ST.CROIX SYSTEM ELEVATION 102.9' 1.7' sand lift ! 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 454 # of chambers none BENCHMARK V.R.P. Top of survey iron ASSUME ELEVATION 100' Filter Zabel A-100 ^ BOREHOLE ~ WELL *g,R,p, Same as Benchmark Property Line(not to scale) Scale = 1 /4" = 10' 167th St. Property Line Area 15' below system is to remain undisturbed Well is to meet all setbacks found in Comm. 83 Grading is to be done to divert run-off away from systems B-3 10 B.M. *~B- 101.2' B-2 _ 100' Tank is to be properly bedded and provided with lockdown covers with approved warning labels Pro 3 Bedroom House Huffcutt Combo Tank 302' Property Line (not to scale) 8% Slope ,---" Designer No Date ASTM C-33 5 c n d ---~ " Tapt:oli ~ `- Non-Woven Filter Fabric 4" Observation Pipe Perforated Below Filter Fabric 7. Stvpe 6 e d O i =f~-- ~ 'z Drain Rock ~pistribuli0n. Piet ---- :~'- Far c e Frvm G c a ~-- Mo-n ~~ F iowe d Pump Cress Section Ot A 1~aund S stem Usin A ged For The Absorption Area l~ F n. 0 W "y L 0 0 6 ~ Ft• I Ft.~ ~ ~-= Ft. _ k, ~ Ft. v l.aYer `O ,. E t~1-- F , ~5.~ G ~~ i t~ l•s ~~ 1~f~.3~ z ~~/~ ~~ / ~ -- -~1 -~~Observotion Pipe-~ O ~ ! w _ _ ._ -- ` -~~---- K f` -_~ r r ~___----~_~---- _-------------- ~ - . _---- A ~ ~ ~ Force Main y-------jj''-------------- --------------------- ~ From PvrnP t ~. Distribution Bed Of /Z -' 2'Z Pipe 'Drain Rdtk I +' Permonent Morker 4 Observation Pipt =-:aCc3 '~~~,~^- ~~,~'~ ,~,~ ~r~r~-~ .E~~~-~~r~~ ° pe or Rods Plan Vitw Of Mound Uiin A Bed For Titre Absorption Areo PAGE,,,,,, ~~~.- C~~Q ~ota~ed Qa 8c,rom. ~quaPy Spored iRSS tld.L utmx't' rc Gartntc}ion ~ r~ ^ ! Signed: ~.i~ense Numhpr: Oa~te: ~~. R ~ ~~, X ~ Inches 5-~°~` ~ ~ ~ ~` ~ ~ ~ Q ., Inches Hole Diameter 3~ Inch Lateral ~" ~ ~ Inch{es) Manifold Z Inches Force Main ~- Inches of ?roses/wipe Z Invert ~levatiott o#` Laterals ~~~ Ft, ,~ Pertera!ed ~°C! OetOii :~~ ~~~ SFEL~r IGpTIt?n~ • C TANX E FtJ!~P Ci:PiiM$£R £r~{?SS SEAT` SEPTI ~r ~~~ . ~~~~ ~ ~RADE rL. ~ e~ G ~ E1+iT pI,PE ~~I j~~}Ofi) 4R > ~~' ~'ROlS D4flR. 9 SIR ;t+tTA1C~ ~~(.°~:!•^- ,~~v FR£S~Y ~,G r i ~ ~yr~ f E t ~. '~i PYRE"~_ ~:'~%~ ~~ _~~ rb 3.8" Iii- ` t._._- INLET .. ..: _ i~AT£R TIG fi'F S CAI.S _ A ~fLT~.R `~._ -~" B Q ~`~ PIS 3 5QIl. p~2fP fl ~ ; ~i£ATN£~P~F ,3~ i~CTC~hDt~fl?' ~ I'TH __ _, ¢ _. j. `. ~ , G,t4,5- ~ T'I6H'F , cj£A L ; : T s ~, 4 S ApFRQV ED ~fHOLE CO~)Eit W/ pppLOIAK ~ _ _..rk" HI1~ - ;8~ ~++~- D '~ DRIP PE L?s N SID AIL ~ ~ ApPRQ~ ~ gEt?DZ R'G V ~~ TA~'~~ CpNCitETE PAi7 ~r l Jl Pc~ (l 1/+"~ gpyCI:FZCA;Z{3N5 r SEPTIC 1 DOSE ~L{.~t7='~''"" • DZ~ 7 ~ ~ GAL- ip,Ai~C 3SA[R1~'AC'3~JREEi. GAi.- _ Dt35£ 3t~~~£ ~I.fl~SAC1C= _ ~ ~' -) ~'AL- s~pTZC ~ ~~.. ~ L~ ~sr~cx~s - ~...----- TAIiK SZZ£S = pflS£ 6At-- ALARK ;"tA~FACZt3REFt,: ! ~~~` _ ~~;NCKES / ' J ~~. ~pD£L 1~SER~- l~/ ~Z,i.CH TYPE : C ~~ p~~FACTUR~ = ~ d ' ~ I ~iR 15. Z3 WAC KOI3EL t+t[3B'~SER: a ~„~ ~,iZ8Z1~G AS PER SiiTTC~ '~;'£' ~~ ~ - PULP £ p,L.~ - ~~ F6ET g,pTE ~ T~ p{~} PIPE - EET R£QUTii£n DZSCHAR~E T1~S'FgISV _ _ ~"~---~`~E£T pUt4P flEP f.NI3 _ GGFEET VER'f1CAL DIFFER'ENC£UPP~£PRESSUs~£ - • Eg;C'TTQN FACTOR • - -/ ~.. ~ MIN~~ tiE~~RK S X , 3 ~''T~ Ii3 fl - fT • ~Y~~~~ ~I~U p£ET .FOR~~~ ~-----' ~'£3`T~L ~ ~, DIp~yE'T~ ---'" ~IMEp5I0Y~S ~F FUME ~ I,~~~TD ~~-------''"'_"- FpT£Rl~AL :1 ~~ W g 12 °¢ w x U Z 8 0 J Q 0 ~- 4 TOTAL DYNAMIC NEAD/CAPACITY PER MINUTE EFFLUENT AND DEWATERING 0 20 60 '80 100 GALLONS LITERS 0 80 i60 240 320 FLOW PER -MINUTE CONSULT FACTORY FOR SPECIAL APPLICA710NS • Timed dosing panels available. ~`~' Electrical alternators, for duplex systems, are available and supplied with an alarm. • Variable level control switches are available for controlling single phase systems. • Double piggyback variable level float switches are available for variable level long and short cycle controls. • Sealed Qwik-Box available for outdoor installations. See FM1420, • Over 130°F..(54°C.) special. quotation required 152!153 Series 1521153 MODELS ' Control Selection Model Yolts-Ph Mode Am Sim lex Da !ex N752 115 1 Non 8.5 1 2 or 3 BN152 t15 .1 Autn 8.5 included 2or3 Et52 230 1 Noh 4.3 1 2or3 BE152 230 1 Auto 4:3 Included 2 or 3 N153 BN153 115 1 115 1 Non Aulo 10.5 10.5 1 Included 2 or 3 2 or 3 E 153 230 t Non 5.3 t 2 or 3 BE153 230 1 Auro 5.3 Incuded 2 or 3 MODEL 152 153 ~, Feet Meters Gal. Liters Gol. Liters 5 1.5 69 261 77 291 10 3.1 61 231 ~ 70 265 15 4.6 53 201 61 231 20 6.1 44 167 52 197 25 7.6 34 129 42 159 30 9.t 23 ~ 87 33 i 1;?5 35 10.7 -- ~ -- 22 85 40 12.2 -- 11 42 Lock Vclve: 38.0 Ft. (i i.6m) 44.0 Ft. (13.4m)J 3 27 ~- i 1z ~/s 1 ~--.- .2 ---.. ;2 sKmw SELECTION GUIDE iable level float switch or double piggyback variable level float k b var ac 1. Single piggy snitch. Refer to FM0477. o cauTlaN 2. See FM0712 for wrcect model of Electrical Alternator E-Pak All installation of controls, protection devices and wiring should be done by a qualified 3. Variable level control switch 10-0225 used as a control activator, Specify duplex (3) licensed electrician. AU electrical and safety codes should be followed including the most Cr (4) float System. tric Code (NEC) and the t7ccupational Safety and Health Act{pSHR). l El N i recent a ec ona t RESERVE POWERED DESIGN For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump. MALI T0: P.O. BOX 16347 _ Louisville, K'r" 40256.0347 ManufacGuefsof. . j SHIP 70: 3649 Cane Run Road 0 Louisville, K1' 40211-1961 ~~? qp ® Q!/QUTYPUMPS J'NCE ~~iJc/ Y ~~ (502} 778.2731.1(800) 928-PUMP Mtp://www.zoellercom PUMP ~,~. FAX (50~j T14-3624 © Copyright 2000 Zoeller Co. All rights reserved. ..,cnQMATtON S OY+INER'S MAt+iUAL 8~ MANAGEMEI~tT PEnAnts pOWT ;L'.'L~ Permit. ~ I/~~. trS1ON PAR~ET~s Number of ~roortis eta Units Number' ~ ~~ Fstima~ flow (a'~~~ (Estimated x 1.5} 0esign flow lp~~ son ApP~1Ot' I~ lnfluerrt~E~Ue~ Qua~Y Fatsf Oil li< Grease (FOG1 Biochem~t Oxygen Demand (BODs) .i.~ ~peRded Sotids {TSS} gm~ted Effluent QuafdY ~ B'iocttemigl Oxygen Demand (BODs) Total Suspended Sotids (TSS1 Fecal CoGform (geometric mean) Maximum Effluent Particle Size M~~EN~CEr, EDULE Service Event Inspect cond~on of tank(s) Pump out contents of tank(s) Inspect dispersal Oetf(s) Cieart ~effluent fitter Inspect p~mP~ pump controls 8~ afann Flush laterals and pr~ure test NA j ~ '~ aaUday>` Monthly average' S30 mgn• 42fl mgr~- s15a R'gIt' Monthly average" 530 mg/L- 530 mg/1_ 5~ ~/100m1 Yg inchdiarneter Ai Least once every yVh ne'mbined sludge At least once every qt otteas nce every At least once every At (east once every At lea ost hoe every At least ante every Page / of Service Frequency p month ear(s) (Maximum 3 yrs.} oars one- ~rd (K) of tanK volume scorn eq n~ ear(s) (Maximum 3 yrs•) ^ month ~.,__=__.__ ^ month ear(s) O NA p rttontt-s ear(s) O (~tA p m no thsthe fl yearEs) 0 NA p months II year(s) ~ NA n one of the following licenses or ~~NANCE INSTRUCTIONS r pO~y-1-S ~ntainer, Sspia9e lip oftanl~ and dispel fills shall be made by an ind•Nid~~~ inspect • m~ng or broken Master Plumber, Master Plumber Restricted Sewe identify any oertir>~ns, for any bads uP ttg Operator. Tank inspections must include a visual inspection of the tae and scum and to check t levels hardw~. ~~ any cracks or leaks. measure'the volume of combined sludg ~ ~~ the effluen round sufiatx• The dispersal sett{s) shall be visually inspected nding of effluent on the or pondin9 of eftiuent on the g nd;ng of effluent on the ground surface. The P° for any Po lion of the local regulatory autho~Y~ in the observation P~ and to check ground surface may indicate a failing condition and requires the Immediate noti or more of tfie tank volume, ti1e m in any tank equals one-third l~ NR mutation of stodge and scu rater and disposed of in avc:ordance with ~'- When the combined accu a 5eptage Servicing Ope entire Contents of the tank shaft be removed by ~ retreat ment camponents~. and any i13, Wisconsin Administrative Code- ~ onents. P f M~iainer. apical or pressurized POWtS comp ed by a certified PO'~S The setvic;ing of effluent filters, mach ~ service event. ~~ maintenance or monitoring at intervals of 12 months or less shall be Pz~ completion of any A sertige report shalt be provided to the local regulatory authority within 't Q days POWTS Check treatment tank(s) for the Presence of painting p~u~ or other 57'ART UP AND OPERATION if hi h concenbabons are For new oo[tstrucfion, Actor to use of the cal! s im a the treatment process and/or damage the dispersal ~ rior to use. chemicals that may Ped removed by a septage servicing operator p detected have the contents of the tanks} • Values typical for domestic (~~'~1TO`a'a•~ •.°"'.~----- - - ~~ tank Etryuent .• Yalues typl~l far Pretreated +Kaste-vater_ ~ / Page„~af~/ f --~ w nditions arr= frozen at the in6tttattve surface_ .-' ~ so"a!' w is restored the excess . System s~~ up shaft not occur when the ae~(s) and may result in the es pump tanks maY ~ above norma~ tirghwater levelosYe~ dng DuriAg t~~ ~ wed to the d"rs{seisat Oett(s} in one large dose. cirtt tank removed by a ,,,~~ervater discharge of effluent To avoid this situation have me ~n~ a P ~rnber or POWTS Ma[ntainer to bac~arP ~ srirfaoe ript,t0 rPSl3onnS Pow to the effluent pa P um tank age gervidn9 Opp F ufn -~trnts to restore nomtal levels within the p . P assist in manually oP~b"g ~ P P .. Do not drive ar pant over, or atttetwise dstltrb or compact. y over fianics and dispersal cxils_ po not drive or patk slo of anY mound or at-grade sot? abstarption ar~ea- the area ' ~5 feet dawn pe a the petformanoe and prolong the fife fiat of the t+ollaMVlr-g tom the wastewater stream may imp1f°v dental floss; dtaper~ Reduction or~elimina tte butts; condoms; cotton swabs; degrea5em: of the POWTS: antiblottcs:.~ w1Pas- d~ } y,~ter, ftuit and vegetable peelings; gasoline; grease; Herbicides; meat d~sanfe eons; ~ ~ {~ ~P Pesttades` sanitary napkins; tampons;'and water sooner bone. scxaPs' ABANOO[~l~1tAENT taken out of service the following steps shat! l~ taken th Insure that the When the P01fJTS falls andlor is petmanentiY system is prop~y artd safely abandoned in ~ompl'tance with ch_ Comm 83.33, Wisconsin AdminLstratnre e: shat! ~ ,~soonneded and the abandoned Pipe openings sealed_ Aft PIPin9 to tanks and pits tl be removed and property disposed of by a Septage Serviang Operator. .. The contents of aft tanks end pits sha • After' ptrmping, al[ tanks and Pits shall be excavated and removed or their covers rsmo+red and the vo space ,~~ y~ soil, grave! or another inert solid material COPITtNGENCY Pt;~4t+! measures have been, ar must tee Taken. to Provide a code if the pOWTS fails and cannot be repaired the following c~mp@ant replacement systert>: p A suitable repiacement'art~ haste arealshou!d be protectedtifrom d sturbance~and cornpactro~n and should not absorption ~thm' The r~eptace from existing artd proposed sirvcture, lot [fines and welts_ Failure to be infringed upon t>)r reQuired setfiadcs _ ported the replacement area wilt ties ems must! Comply vrith the~rutes n! effect at thatttime~btish a suitab e fep{acement area_ Replacement cyst >] A suitable replacement area is not a~tll~ as a las resort to replace !the failed P01NTSng advances in POYYTS ethnology a holding tank may be insta th identify a suitable replaaernent area. Upon failure of the POWTS a soiland e site has not been evaluated site valuation must be performed to locate a suitable replacement area_ If no replacement area is avai(ab a a. . to re nd and at~rade SorT absorption systems may be reconstructed in Rlace following remora! of the blomat at the in Itrative surfiaoe. Reconstruc~ns of such systems must comply with the rules in effect at that time. <cWARNING» T,4NKS MAY CONTAIN LETI~iAI- taAS3ES ANDfOR INSUFFIC[EWT OXYGEI+I. SEPTIC, PUMP AND OTHER TREATMENT _ DO NOT ENTER A SEPTIC, PUMON~ROM THE 111TER10R OFTA TANK MAY B °E 1FF1C LIT OR IMPO S B ~Y RESULT_ .RESCUE OF A Pt=.RS ADOiTtONAL t:OMMEN7~ POWTS INSTALLER "~ NamelG LG ~ , ~ !` _ Phone j J.~r'""~~ ~'~ / POWTS IVtAIRTT'AiNt:R Name cu .%/ Phone ~~ - Z ~'~/ LOCAL REGULATORY AU7NORJTY SEPTAGE SiRViClAtG QPERATOR PUMPS Name / Phone ~.1~' _~ ~ ~ =~l Phone J~r~'. ~b '' This document rtus document wds draRed by tha staffs of the Oteen ~1Ge. Marquette and Waushara County Zoning and Sanitation agendes. me minimum re<tuieements of dt Comm 83.72(2)(6Ht3f~&(t1 and 83.54(1}. (2j 8 {3}, Wisrnnsin Adirtlrtlstratiw Cade. Ilse of this doeymenl does nGrvtw (~i) guarantee tine performance of the r~OWfS. r Y y Wisconsin Department of Commerce SOIL EVALUATION REPORT Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code County Attach complete site plan on paper not less than 8 112 x 11 inches in size Plan must indude. but not limited to: vertical and horizontal reference point (BM) direction ands.-.- Parcel LD. percent slope, scale or dimensions, north arrow, a~dT~ca'~~~~e~s ~ road.S f` f. ` ~ viewed Page ~ of ~. Q~d ' ~~ ~~ Date Please print all rnfgrmabon. ~°~ ~ ~ /~.~f Personal iMormation you provide may tie used for aecon¢ary purposes,{Privacy Law. s. 15 (111 {1 ~ (m)).y, ~~~"' '~ r " OPedv 4ocation PropertyOwner~ n ~~~~~~ 3 /~ CJ .Govt. Lot 1/4 ~1/4 S 7 p(9 N R pro r1v Mailing Address f ~~;~ ~. ~ ~ ~ ~, ~- ~ ~LOt # Block # Subd. me or CSM# ~',`( P~' `7 ~ ~ -""'-'"°- [~, r M- yr 1G ~ /`~ V°" ~ Staley Zip Code Phone Number ^ City ^ Village Town Nearest Ro<' C~ /~ r7 / 7 n.~ New Construction Us Residential / Number of bedrooms ~_ ode derived design flow rate ~~ ~ L' ^ Replacement ^ Public or commerdal -Describe: ------ -- / Flood Plain elevation if applicable f~ r Parent material ~'-'~`-'I -`' k~ ~ s j~ , /~ D C~~ General oornments O r9 / v/~- `2 and recornmerxiations:.~ y~ ,~ y~z, Q (~, ~r,,t.iUt-H.~ ,~ L ' 9 ~~/ ~j~,a s~r~ ~ ~ _. / - r ~ ~~ ~~ ~~~ <SQ-w + r~ ~ r-r Boring ~~ # Ground surface elev. I I~- ~• Pit Horizon Depth Dominant Cdor Redox Description Tex in. Munsetl Qu. Sz. Cont. Color 2 2-J~ S ~ ate--- ~f Depth to limiting factor ~ in. ure Structure Consistence Bound E GPD ft. (2`' Bonng L Boring # ® ~ ~ Z' ft. Ground surfaceelev.~, ____ in• Depth to limiting factor _ Soil licatlon Ra Horizon Depth pit Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff 'Eff#1 `EfF#2 in. Munsell Qu. Sz. ConL Color Gr. Sz. Sh. ul ~ ~ iyl.r • Effluent #1 = BODE > 30 <_ 22(1 mglL and TSS >30 <_ 150 ~'[ Name (Please Print Bird Plumbing, Inc. Shaun Bird Address 1008 192nd Ave, New Richmond, WI 540 'Effluent #2 = BOD < 30 mg/L and TSS < 30 mglL CST Number ~~ 226900 Date Evaluation Conducted Telephone Number ~, ~ ~~ t/ 715-246-4516 ~f ~ Property Owner Parcel ID # Page ~ of u ~~~ ~~ # ~. Pit Ground surface elev. ~ ft. ''Horizon Depth Dominant Colo Redox Description Texture in. Munsett Qu. Sz. Cont. Color d,,1L r3I2 ._.~^ _~--. Depth to limiting factor in• Structure Consistence Boundary Gr. Sz. Sh. ~.S^ Roots ~{ 1"nation Rate GPDIfP 'Eff#1 'Eff#2 ^ ~~ng # p Boring ^ Pit Ground surface elev. ft. Depth to limiting factor in. ~ ~~n Rate i ti p Texture Structure Consistence Boundary Roots GP D/ff Hocimn Depth in. Dominant Color Munsell p on esa Redox Qu. Sz Cont.-Color Gr. Sz Sh. 'Eff#1 'Eff#2 Boring ^ Pit ~~ # Horizon Depth Dominant 1 in. Munsell Ground surface elev. ft. Depth to limiting factor in• Redox pesaiption. Texture Stricture Consistence. Boundary Roots GPD Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 • Effluent #1 =GODS > 30 < 220 mglt. 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 material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. seo•ssw ee.~rooi .. • Soil Test Plot Plan Project Name P.C. Collova Bldrs. Inc. Sha ird Address P.O. Box 489 Somerset Wi 54025 M #226900 Lot ~ Subdivision Farm View Ridge Date 5/8/04 N W 1/4 SE 1/4S 5 T 29 N/R1 ~ W Township Hammond Boring Q Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 100 ft. Top of Survey Iron System Elevation 102.9' *HRpSame as Benchmark Alternate Benchmark Top of 1/2" Pipe @ 100.2' C _ _1 _ 111 Al~7 Alt. B.1\ P~• 3_ ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHII' CERTIFICATION FORM OwnerBuyer P. C. Collova Builders, Inc. Mailing Address PO Box 489, Somerset, WI 54025 Property Address ~~ (Verification required from City/State Hammond, WI Department for new construction.) Parcel Identification Number ©~~"o~OlJ~'"r~~" -f.Y~U LEGAL DESCRIPTION CCLL ~ ~7~ Property Location ~~'/.: , SE `/4 ,Sec. 5 , T 29 N R 1 ~ ,Town of Hammorid Subdivision Farm View Rldge ,Lot # ~~ C h~~ Su~~rve~ y Map # ,Volume ,Page # t l arranty Deed #~ ~ 5~ ~ ~~ ,Volume °~ 53 ~ ,Page # 3 `~ Spec house -~~ yes'~,i no Lot lines identifiabie~L' yes c 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 County 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) afrer inspection and pumping (if necessary), the septic tank is less than I/3 full of sludge. I/we, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of W isconsin. C 'fication stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning ep rtment within 30 days of the hr e year expiration date. _/_/_ SIGNATURE OF APPLICANT DATE OWNER CERTIFICATION Uwe certify that all statements on this form are true to the best of my/our knowledge. Uwe am/are the owner(s) of the p erry de ribed above, b vi of a warranty deed recorded in Register of Deeds Office. _/_/_ SIGNATURE OF APPLICANT DATE ****** Any information that is misrepresented may result in the sanitary permit being revoked by the Zoning Department. ****** Include with this application a stamped warranty deed from the Register of Deeds Office and a copy of the certified survey map if reference is made in the warranty deed. Document Number U 2536P 34? STATE BAR OF WISCONSIN FORM 2 - 1999 WARRANTY 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 Counry, State of Wisconsin (if more space is needed, please attach addendum): See Attached Exhibit "A" 757959 KA7HLEEH H. 1TALSH REGISTER OF DEEDS sT. cROIx co. , MtI RECEIVED FOR RECORD 03/29/2004 12:50P11 NARRAHTY DEED EXEMPT # REC FEE: 13.00 TRAKS FEE: 2012.4 COPY FEE: GC FEE: PAGES: 2 Recording Area Name at-d Return Address ols-loos-6o-o00; ols-loos-so-ooo ols-loos-9o-o00: ols-loco-oo-ooo: ols-logo-lo-ooo Parcel Identification Number (PIN) This is not homestead property (is) {is rwt) Exceptions to warranties: Easements, restrictions and rights-of--way of record, if any. Dated this ~~~ day of March , 2004 AUTHENTICATION Signature(s) Michael B. Marshall and Dawn Marshall, husband and wife authenticated this ~ day of March , 2004 * [{ristina land - . ~0~ ---- --- - ---- TITLE: MEMBER STATE BAR OF WISCONSIN (If not, authorized by § 706.06, Wis. Stats.) THIS INSTRUMENT WAS DRAFTED BY Attorney_Kristina Ogland Hudson, WI 54016 --- -- --- (Signatures may be authenticated or aclmowledged. Both are not necessary.) * Michael B. Marhsall _~' _ a..w`~r Mme- _ __-__ * Dawn Marshall 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 Public, State of _ _ ___ My Commission is permanent. (If not, state expiration date: •) * Names of persons signing in any capacity must be typed or printed below their signature. tnformazion Proressionats Co., Fond du Lac, wt STATE BAR OF WISCONSIN 800-655-2021 WARRANTY DEED FORM No. 2 - 1999 U 2536P 3y8 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 Town 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°26'33"W 230,23 feet; thence S00°08'03"W 557.04 feet; thence N89°26'33"E 1601.66 feet; thence S00°05'29"E 758.$2 feet along the East line of the SE'/ to point of beginning. N ., . r. ~:.~, CO .. 8323 S. F. I ~ 79963 S: F. N r.. ~, ' ~ _ .~. ~.; 1.80 Ac. I _ 1.83 Ac. 0 66473 S.F. ~/ ~ r~ I '~ 1.52 Ac. ,,~r0 HWE =1099.6 I n d- ~ / LBO =1101.6 ~ ~ o ~w o ~ 41 (v HWE =1.099.E z I -- - - -.~ ~ / ', ~~ I c~ LBO =1101.6 ~ ~ C 1 1 ~ 65994 S.F. ~ oo ~ ~ 1 D~i~___ ___ 2 t.52 Ac, \ ~ 9 ~ ~ ' ~ , - (v ~ c,~ 26 ~~ / ~~ 3 ~ 42.32 N ~Z9 , 23 Wi 9 ~ g , ~- ~~. ~• - S , ~ ,,, ~ ~ ~ ;v ~ , - ~~~ 23 6~ .34 - ~ ~ ~~ ~9. ~ ~''', -~- ~ ~4° _, 1 ' ~ ~ ~~' ~ \ 5~ ~2 9 ~ J 70631 S. F. - - - ' ~ ~ 6.5 ~ ~ 1.62 Ac. ~S~ ~~ C4.8 ~ I CPI B.M. TOP OF 3/4 ,~ / / ` ~( - -~ ~ ` W IRON PIN ELEVATION lr f+ ~ 1093.89 / Uh / ~ / ~ ~: j of ~N 89°55'16" E 301.56' / ~ ~~, ~ ' ~ ~,1 -~ / ~ ~ / 9 I I 65635 S.F. ~ wl ~ N / ~/ / 1.51 Ac. I I ~ ~ ~/ ~ / ~ ~ N 6 ~ ~i 1 , ~ ° 5'01" E IN ~~ I 67998 S. F. / i 8130J N 89 2 _ ~ ~ ~ ' ~Z/~i t.97 Ark w~ _ ~~ ~I rnl 1.56 Ac. o ' "; orn X141.10' 8 ~ I 'ol ~, ~ ~ ° N 2 86 54~ CP CP / N -P \ o I ~ 73590 S.F. ~ L2 _ , ~ I o ~ ~ I U; TO CENT --~ I co OF f ASEM~ o I o 1.69 Ac. I HWE =1086.7 II ~ I ~ ~ ~ ~ ~I I ~-- ~ LBO =1088.7' i ~ _ 3.81 289.52 ~a 243.68' ~ ~ ~ 7, 30.Oi DRAINAGE J EASEMENT LANDS 80' TEMPORARY CUL-OE-SAC EASEMENT. TO BE REMOVED UPON SOUTHERLY EXTENSION OF ROADWAY. / 66.00' S 89'25'01 " I W 2639.28' SOUTH LINE OF TIE N 1 /2 OF TAE 11~TTT~Tr ~''nA~f1l~TmmLiL~ rn~T~n~ n mn