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HomeMy WebLinkAbout018-2007-45-000Wisconsin 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)J. Permit Holder's Name: City Village X Township P.C. Collova Builders, Inc. Hammond Townshi CST BM Elev: Insp. BM Elev: BM Description: TANK INFORMATION TYPE MANUFACTURER CAPACITY Septic ~ J ~~~ Dosing ( Ca ~`o ~ / lE~ Aeration Zc..~X ~. I Holding TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Septic ~/ w I /~ - ~ ~ ! ~ a / Dosing y / . / /- ~/ J~' ~ ~~ / .- Aeration Holding PUMP/SIPHON INFORMATION Manufacturer Demand ZU ~ ~,~,, GPM Model Number ~ L Z. J '~°j/'~1~~ TDH Lift fo a r Frictio `Loss„ System Hea TDH Ft / I r ~ Forcemain Length ~ Dia. Z ~ r Dist. to Well SOIL ABSORPTION SYSTEM ELEVATION DATA county: St. Croix Sanitary Permit No: 453474 0 State Plan ID No: "~ Pao ~ x No~~ ^ ~ VW Section/Town/Range/Map No: 05.29.17. STATION BS HI FS ELEV. Benchmark .~ ' , id3. ~ 9 Alt. BM S .tom Z.3 ~~~~ Z Bldg. Sew r $. I ~ 9S,' ~~ SUHt Inlet y ~ - ~4, ~ St/Ht Outlet ~ ~ Dt Inlet Dt Bottom I Z . 8 rJd . 7 Header/Man. / q. Dist. Pipe ' 1 ~ / ~ ~ ' Bot. System r Final Grade 0 •z5 /0~ • ZS t Cover Z • 3 /. ~ ~ ,tip--~., r- 3 ,9 I'~~ 4 BED/TRENCH DIMENSIONS Width / Length ~ ' No. Of Tres PIT ENSIGNS No. Of Pits Inside ia. Liq epth ~ 5 ~ e SETBACK SYSTEM TO P/L BLDG WELL LAKElSTREAM LEACHING Manufacturer. INFORMATION CHAMBER OR Type Of S m: / I ~ / ~ /~ ~ ~ UNIT Model Number. a ~ DISTRIBUTION SYSTEM Header/Man~old ~ /~ Distribution ~ t Pipe(s) ~ -Z ~ x Hole Size I I x Hole Spacing / ~ Ven~nt to Air Intake Dia Z Length Length Dia Spacing ~ ~ 7s rJ r SOIL COVER x Pressure Systems Onlv xx Mound Or At-Grade Svstems Onlv ,~ ~, Depth Over / Depth Over xx Depth of xx SeededlSodde xx Mulched Bed/Trench Center ~ ' ~~ Bed/Trench Edges ~ Topsoil 1 ' Yes ~ No Yes ~ No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: f / ~ / D Inspection #2: / / ~~dr 1. Location: Pending Unknown (NE 1/4 SE 1/4 5 T29N R17W) Farm View Ridge Lot 45 I ~ w~ Parcel No: 05.29.17. 1.) Alt BM Description = Se,~-:~ CuJ~ nief~.. !V~^-~k, IJ~~ ~`~b~ 2.) Bldg sewer length = ~ `3 ~oI{°/1 ~%~1"~-~- `~ ~ ~ ~'`p ~~ ~~~% v~"~` - amount of cover = : -~~ '~~`~ ~ ~5 ~ ~ B-y1 y~,(,tl Ctfl't~ y~~ 5 ram 0~~ `~ Plan revision Required? ~ Yes No I ~ ~ Use other side for additional information. ~ ~ i ~ ~ S J SBD-6710 (R.3/97) Date Inseocto Sianat Cert. No. 227.68' _ ~ 42 ~ 65358 S.F. 1.50 Ac. 1 -w ~~ ~ I~ N II `- - - J I 237.14' .. 1286.64' UNP~ATTED LANDS I - - - - --~ 1~ I N PENDING CSM OWNED BY PLATTER I II i o _ _ _ _ _ J N I II I ~' N 00'23'36" W Q HI Q J a zl m 7.00' ~ I~ I S 89'57'53" E S 89'S7'~3" I~ I N ~ 'c 84.70\ - 135.3' I ~ w 3I ~I~ o Sri. oIM zl 5~ 53' w w I z J N Q W pN~' O~ ~ O H ~x ~ I~ ~ ~ I~' I''~ .~ SE CORNER, SECTION 5, F SURVEY NAIL N 89'26'33" E 1258.42' UNPLATTED LANDS _ Safety and Buildings Division County ~ ~ ` 201 W. Washington Ave., P.O. Box 7162 ~ ,~,~ ~+- ~ .Madison. WI 53707 -'1162 Sanitary Permit Number (to be filled in by Co.) r~~j~n~7,~ (608) 266-3151 cFCj-3 c f.~- De artment of Commerce Statc PLanLD.N Sanitary Permit Application 10 Zs~ ^ ~ ~--,)s , ,~~ In accord with Comte 83.21. Wis. Alta Code, pusorral infomtation you provide project Address (f difftte+rt than mailing address) tnay be used for secondary PutP°~ Privacy Law, s15.04(lxm) _ L Application Information -Please Print All Inf n~ ~~~ _~ ~ a ~~ - ~ ~ ~ ~ ~ ~3 r. ~~.~ N I tk Lot S Block i t ~ ,;i`;~ „j , 1, ~p ~ ~ l~~ cv 1 . property Ownu's Mailing Address , Pro ~ ... . ,~ ~... . _~....... -~ ,~, ,~, Section ~ sF~ ~ ~ City, State T.tp Code _" ..._ Phone Number ,~ ~ ~j ) ~.`.)'~ - ~ 'Q ~ 3' Tom- / N; R B or II. Type of Bailtiing (check all that apply) `i 5 Subdivision Name CSM Nut a 5 . ~~ ~o[ 2 Family Dwelling - Nattrber of Bodrootns _.,. ---- ~~, /i't~ I !) - PublidComroercial - Dc:cn'be Use ~tY_ y~e ~o~hjp of State Ownod - Descn'be Use III. Tppe of Permit: {Check ody one box on line A. Complete line B if applicable) A Sys Replant System Tteahrrwt/iioldiag Tack Replacement Only Odra Modification to Existing System B. Permit Renewal Permit Revision ~ age of ~ ' Permit Transfer to New Beforo Expiration Plumbs 0+;'>~' - IV. a of POW15 S Check aII that a 1) K 5 Mound ~ ?A in. of suitable soil /~aund < 24 is of witable soil At-Grrde Single 'an Non -~Ptessutized Lr-Ground _ _ Coasttucted Wedand Pressurized 1n-Ground Holding Teak Feat Ftlha Aerobic Treatment Unit ~ ~ ~ eta ~ ~~ Recirc S othetic Meths Fillet' t'arantber Dti Liao Gravel-less Pi Odtet (ea lain) v. Di anent Area Information: Area pro~~ (s yysem Elcvatio~ Design Plow (gpd) Design Soil Applie»~on Rate(gpdsf) Dispersal Area Regairod (sf) >hspcrse< /v/ 2 ~ / ~ ~J~~J pro~b Site 5tee1 Fiber Plastic VL Tank Ltfo Capacity in Total Nutnbet M~n~E~~~ / Constiirded G~ Gallons Gallons of Units i„(~~~Q„ k -rao Concrete Plwnbec's Address (Street, Gty, 5ta[e, uP ~ l~ ~ ~ VIII. Coa /De t Use Onl Sanitary Permit ~e Approved Pro Surcharge Fee) 'Owner Given Reason for Dent IX. Conditions of Approval/iteasonsfcr Disapproval SYSTEM OWNER: i Septic tank, effluent filter and dispersal cell must all die serviced /maintained as per management plan provided by plumber. 2. All setback requirements must be maintained as per applicable code/ordinances. ~" (!. shown on the ~ r ~~~~s~-~ des Groundwater Date issued arguaru-c ~~ ~..~.t.-. 35~~ .~3 ~,. (.mac ~ ~ e-tC Ca~` ~ ~s~ ~c,~ v-r- (~ 3~ CSa^ _ 99. S Attach k pleas (to the County Daly) for the system oa paper act less than 81lL:11 inches in size . PLOT PLAN ollova Bldrs. Inc. ADDRESS P.O. Box 489 Somerset Wi 54025 E 1J4S 5 /T 29 N/R 17 W TOWN Hammond COUNTY ST.CROIX :, ' ~ ~ S Shaun Bird 226900 7/18/04 BEDROOM 3 DATE ONVENTIONAL 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 SYSTEM ELEVATION 101.2' 1.3' sand lift Line 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 Alt. B.M. of 1 /2" 100.2' __ _- 6-2 B- ^ ~ B-3 Pro 3 Bedroom House Scale 1 /4" = 10' 292' Pr ert Y Line i" Pro Town Road (-f~ 170th St ) • .commerce.wi.gov ^ M isconsin Department of Commerce Safety and Buildings 4003 N KINNEY COULEE RD LA CROSSE WI 54601-1831 TDD #: (608) 264-8777 www.commerce.state.wi. us/sb www.wisconsin.gov Jim Doyle, Governor Cory L. Nettles, Secretary• July 28, 2004 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: 07/28/2006 Identification Numbers Transaction ID No. 1025686 SITE: Site ID No. 686931 Pc Collova Builders Please refer to both identification numbers, Town of Hammond above, in all comes ondence with the a enc . St Croix County NE1/4, 5E1l4, S5, T29N, R17W Lot: 45, Subdivision: Farmview Ridge FOR: Description: Proposed Three Bedroom Mound System Object Type: POWTS Component Manual Regulated Object ID No.: 970798 Maintenance required; 450 GPD Flow rate; 20 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/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, 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" and/or the sizing methods of publication "SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST-SAS (01/81)" • A sanitary permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.135 and 145.19, Wis. Stats. • Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stats. • The 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. E? ~,~.'r ~. Conditioy~aldy . OEPAR7MEN7 Of COMMERCE ~1(ISIQN OF SAFETY nun...... __ SHAUN R BIRD Page 2 '7/28/0A • Comm 83 22(71- 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 DeRartment which may include local inspectors. 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 and/or 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 j swim@commerce.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 RECEI r J ~~D . ~ ~ ~ SgFE ~~ z z Zoo4 . TY&BC Cover Page ors D/~ Shaun Bird Bird Plumbing Inc. 1008 192nd Ave New Richmond Wi 54017 715-246-4516 Date: 07/18/04 Owner: P.C. Collova Bldrs. Inc. Location:NE1/4SE1/4 S5 T29 N,R17W Lot 45 Farmview Ridge 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 Conti ncy plan 9-11. Soil test Shaun Bird Signatu License number SEE CORRESP DENC~ PLOT PLAN • PROJEET P.C: Collova Bldrs. Inc. ADDRESS P.O. Box 489 Somerset Wi 54025 NE . 1/4 SE 1/4S 5 /T 29 N/R 17 W TOWN Hammond COUNTY ST.CROIX MPRS Shaun Bird 226900 DATE?/18/04 BEDROOM 3 CONVENTIONAL AT-GRADE CONVENTIONAL LIFT HOLDING TANK MOUND X)OC 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 SYSTEM ELEVATION 101.2' 1.3' sand lift Line 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 Pro 3 Bedroom House Scale 1 /4" = 10' B-2 B.M. Alt. B.M. is t~ of 1 /2" pipe 100.2' ~B-1 > ^ Huffcutt Combo tank B - 3 292' Property Line Pro Town Road (To 170th St.) ~ ~ ~-~"" ._ o N Designer Date 4" Observation Pipe Perforated Below Filter Fabric ASTM C-33 5 o n d ~, " Topsoil - J ~ E 7. Slope Bed 0 i {f~- 2 'z Drain Rock Section Ot A Moundt o usin sAr~ Cress A Bed For The n Absorp o ~ ,, r ~k ~,~ i Ps J °7 A a 0 W N - L 3 O D I y Non-Woven Filter Fabric ~pistriDution Pipt ~= o H Force Noin From Pump A ~ ft. s ~ Ft. I ~; s Ft.~ ~ ~.:~ Ft. K_ ~ t:t. ~ ~~Ft. ~,~~ ~ to Ft. 0 Fiov~ed Layer n~ ,~ % :~ 3' E . l~ ~ F G ~~ h ~_ Y L 4~Observotion Pipe- e ---" ~ - _ _...._.....~-- K ~ - --__ 1 Force Main l~ _...~ - ~_.. ----- ------T_ --_._..---- From Pump o _.,.....--- .._..-.- Distribution Bed Of %2~- 2'2 Pipe Orrin Rock ,. 4 Obt-ervotion Pipe'~C'~t~c~ Permonent Marker %5~-- ~ j3 ~'r~~ bv~~.~sP'~pe or Rods Plon Vitw Ot Mound Usin A Bed For The Absorption Areo PAGE_ ~F t.oca~s4 On Bottom. Egyany Spoeeo ~'/,°-~x Rsr rsa.= kcxY t o Cenelte } ier Ft. F•~. Signed: i.icense Number: Oa to n X ~ inches Y ~-L_.,_ Inches Role Diameter~3~~~Inch Lateral .u ,~_,_,_' Inchtes) Manifold " ~ Inches_ Force Main C-- inches Hof hotes~pipe Invert elevation o#' Later~als/l~/7Ft.~~ Pertoroted D+Oe pstoii IC TANK ~ Pt3Ms Ct~A~B _~ ----' ~cR A~~ SpECTiTCA?lone CR05S SECT PE I~" ril3'~ . ABpvE GRADS ~ 4++ G} vENT PI t~INDa~ 4~. FRF.~~ •.` E tG ~i~~fw~ 18" IM,' y , INLET .. .: ~ wAT£R T16HT SFA ~3LSE"R J DICE 3~;D ~ ~1~..1--FT " ~ pU~P OFF ELF SOIL uEA~R~ROOF ~~~cr~~~ $oX WITH Cp~DUIT GRS- --,~-- T~~x, A SQL $ - C ~~_ . s. ~ _, :, +• ~ '•- I~ j ~ r i ppFROV ~C0~1 Ei~ ~c~o~.E w! FAp~K 6 ~ ~pRtiING U1BE.. IB~,M~~• ~..~- ~p~~=giPE • ~I~~SOIt V ED S~~T~G V ~~ TAi+~K fi ~' ~tC3~LETE F~ ~ ~ ppPRO _ ~ i f s~c~,~'~ j p~CIF CP'.IO~ ~ . p£R ~3AY = 1 ~KbE~ OpSEs ~" VflU~ME ~RCLay $pC1C~"- ~, ~ GAL- sEpTSC ~ na5£ . - ~os£ ~ .ra'AL- SZZ£5= SEPTIC I~ ~. GA _ TtUiK .DOSE GAgACITI~ ~ A r 2 ZI~iCHES = ~~ A~. ALA MppEL ~l'ts£R' '/~'` ~ 'C = /~~~~ ~x,lcg gY~-E= ~ _ ~ Z~~cEs ~g~~IRF.R = !~ ,~~ i3 - __----~ PER 15.23 WAC .- _ I L.~ R7lSP ~°' ~~gEli : • i,,f ~,JIR~IJG KODEL ZYP£= ~ PUMP £' ASR FEET y'WZT'C'H ';~~ ~PK IBUT.Z~ gIPE ~~•~~FEET RF.n ~ISCHI-RGE g~TE ~r f3IS'TR _ - FE£ FACTOR FEET REt?~3Z C£ $ET'~EEN Pt1tr4P Or £ AN13 PREggURE FRIC•r~IC MAD = % DIwM£TER ...-•-•.- vER'FIC~-L~ IiEZ'~"~ ~ ~~`TAL DY ~ IHiJfU ORK S~I~ X JY ~ FT! l~ ~? FT" ~~ ~~~~~ L~Q~ID f{AL DL1~EN5101'~'S ~~ ~~F I NTH ~ IGAtED LTCE~~~ HU~g~" fl, ~,'= £ :f8ff TOTAL DYNAMIC HEAD/CAPACITY PER MINUTE FFFLIJENT AND DEWATERING 1 °a MODEL \ 752 153 Feet Meters Gol. Liters Gal. Liters 5 10 15 20 1.5 3.1 4.6 6.1 69 61 53 44 261 231 201 167 77 70 61 52 291 265 231 197 25 7.6 34 129 42 159 30 9.1 23 87 33 125 ~. 10.7 -- -- 22 85 40 12.2 -- -- 11 42 Lock Volve: 35.0 Fl. (11.Em) 44.0 Ft. (13.4m) w r- w g w 2 U Z f3 O J 0 4 100 LITERS 0 80 160 240 320 FLOW PER -MINUTE CONSULT FACTORY FOR SPECIAL APPLICATIONS, • 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. 15?J153 Sedes 1521153 MOD LS Control Selection Model Volta•Ph Mode Am s Sim lex Du lex N152 115 1 Non 8.5 1 2 or 3 BN152 E 152 115 1 230 1 Auto Non 8.5 4.3 Included 1 2 or 3 2 or 3 BE752 230 t Auto 4.3 Included 2or3 105 1 2or3 3 27/ 32 32 t I i ~z t/a 5 t/ 1 --~- a stczoa+ N153 715 1 Non SELECTION GUIDE BN753 115 1 Auto n N 70.5 3 5 Included 1 2 or 3 2 or 3 back variable level float Single piggyback variable level float switch or double pi99Y 1 E153 230 1 o . . BEt53 230 1 Auto 5.3 Included 2or3 switch. Refer toFM0477. See FM0712 for correct model of Electrical Alternator E-Pak. 2 o caurlorv rotection devices and wlrinp should be done by a qualified ntrols f i l . 3. Variable level control switch 10-0225 used as a control activator, specify duplex (3) , p co at on o All inaW Ail electrical and safety codes should be followed including tha most ician lect d stem 4) float s r License r e . f d H alth Act (OSHA) . y ( o recent National Electric Code (NEC) and the Occupational Sa ety an e RESERVE POWERED DESIGN For unusual conditions a reserve safety factor. is engineered into the design of every Zoeller pump. .MAIL TD: P:O.80X 16347 Louisville, KY 40256-0347 Mantrfacttuersof.. SHIP T0: 3649 Cane Run Road voo `O Louisville, KY 40211-1961 QUgUrYPUMPS SNCE ~9ali9tl a. ® (502) 778-2731.1(8001928-PUMP http;Uwww.zoeller.com PUMP CO. FAX (502) 774-3624 © Copyright 2000 Zoeller Co. All rights reserved. Page of iri Ine rdaA tsr a+d Ydues rypicaf for dorttest~ (no~^O sep~ tzntc etlluent ~~„rater. Values typ~tf for pr°t~1°stod o~ licenses or n one of the felfowiMngaintainer, Seplage IylpI~NANCE 1NSTRUCY'IONS Its shalt be made by an indiv(duPa-p~,S f~~~r. POYYrs m~~g or broken of tanks and dtspe~l ce clad Sews identify arty eck for any ~j~ els Inspe~s plumber. Master Plumber Rests ua1 inspecdon of the tank(s) to m and Do ch bons: Master ns must i^dude a vis sludge and scu ~ ~~ the eMuen p fir, Tank inspect asure.~1e volume of combined ~ e{fiuent on the SenAdng Pera or Ieaks, me Tt~e dispel cell(s) shalt be visually insP Ponding autf+orbY. hardwar+a, identlN any ~~ round surface- of effluent on ttte ground surface- ~ pond'u~g of effluent on the g for any ponding bon of the Iocal n~gulato+Y lame. the and to check cites theImmediate notific~ a rank vo in the observation P t~ cond'Rion and re4 trd or more of ~ with ~,. NR ground surface may indcate a failing min any tank equals one-ttI' ~S ~ s~ of In accoman~ r^uletion of sludge a^d ~ 8 c~~Gng Ope~~r and d- P° When the combined a~ Shall be mmoved ~' a Septag and any retreat#ment components; eptire contents of the tan ~mpone~~~ ~ a celtffied POW'tS Maintainer. 113, W9consln Administrative Code•anicaf or pressurized pOWTS sent. n of effluent filtef's. mew is of 12 months or less. shall be ~ of comPiQdon of any service She setvlci 9 at interva au~ority within 10 d2Ys other maintenance or monitof a~ to the local re9u~tory ~u~ or other A~service roport shall be p~ nce of painting P s for the Prase if high concen~tions are STARTUP ANO OPERAnON S deck treatment tank() cp(s). or to use of the P0~ a the dispef~ ~ prior to use. For new oonstrut~on, Pn a the treatment proveSS anctlor d ~ ae servicing ape chemicals thatthe ~ t~ of the tank(s) removed by a sap g detected have NACEME~T PLAN p01NTS p~lyER'S MANUAL 8~ MA sP~clt=ccA-noNs _ SYSTEM ~__'~ Page of J ,~ _ ~~ ~ ~ • - five surfacQ. ~ - - -t conditions are frozen at the infii men is ~~ ~ S shall not occur wt'ten ~ h hwater levels. the oeg{s) and may result in the m startup till shove nottnal ~ overloading Syste r outa9~ pump tanks rnaY ~ cattle) in one large dose. ~ the pip tank cettoved by a ~~ ~~ situat)on have the conten Ouc;n9 P~ discharged to the dlsPe d $ Plumber of I~OWTS Malntatner to v,rastewater'!~t ~ d.e of effl~t To to the effluent pump or °onta tank or surface n9 t~pwer is wrthtn the pump ~~e Servictir-s oi'~'g g ~ P m ~tmts to restore norms[ fete ~ over, or otherwise dis~rb or compact, asses ~ manu~ Yehdes over tanks and dispersal cells- Do sot drive or pa mound or at-grade soil at~sorption area- po not drnre ° Pa rove the performance and prolong the Gfe the area within 15 feet down slope of amy Rt the vrastewater stream rnaY imp degreas~~ dental floss; diapers; Reduction or-ei""unlnation of the ttotlon++rlnS fro ~ butts; condoms; cotton swabs: ;~oline; gt~;, herbiddes; meat antibiotics; ~Y ~~~ ~ vt-atter, twit and v®getabte peeCings; g r ~~~ brine. of the POWTS: sump P na tuns: tampons: and ware dsinfectants: fztt: foundation dralrt ( des: sanitary P . ~~ oll; Painting P~~' ~~ = sue: shat! tie taken to lnsura that the AgANDONMMF~T ~ntiy.taken out of service the fottor~v[ng~is sin Administrative Coder When the POtNT3 falls and/or iS P~ i'iance with ch_ Comm 133.33, i open s sealed. fie abandoned in comp ndoned P Pe ing system is prvped3' artd Sa N disconnected and the aba sad of by a Sepla9e $erndng Operator. All piping to tanks and pits shall be _ dispo . ~ si•,all be removed and Prot~'fi' ~ r~,~,~.8nd the void space The contents of aR tanks and ~ Si7sif be eXtravated 8nd removed or their cote After pumping, alt tanks and P filled w[th sot[. grdvef or mother inert solid material- PLAN following measures have been, or must be taken, to Provide a code CON1TiNGEt~iCY sited the tf the POWTS falls and cannot be rep taoement soil c°mpGant replaoeRtent system- en evaluated and may be utilized for the locatron of a rep~n and should not from disturbance and comps O A suitable ~~cement'area has ~ tot F•inss and wetts_ Fa7ure to absorpban system. The roP~Cement area should be Protected sect structuro• uired setbacks fTOm eXisting artd PfOP° be infringed upon by t'e9 ~ result in the need far a new~e~rules n effecttat that time~blish a su•Rab e prated the replacement area tams must comply with not available due to setback and/or some ~`i~ PO~Sng advances fn POD replacement area- Replacement sys O A suitable replacement area ~ be installed as a last resort to reP~ce n failure of the POWTS a soil and ology a holding tank may a suitable replacement area- Utr~ ~cernent area is available a. to identify The site has not been e~iuate ~ ~ mate a suitable replacement area. If no rep s evaluation must be peter" a last mSOrt to repiace the failed POVYTS. removal of the biomat at olding tank may be installed tlon Systems may be reconstructed in place fioilowing ns of such systems must comply with the rules in ailed ~ that time. ound and at-gBde sot( absorP the i fiitrative surface. Recons~~O . <cWARNING» 77ViEiJ'r TANKS MAY CONTAIN L ND~ ~ ClRCIJMOSOTANCES~ CF~Tff MAYG~. SEPTIC, PUMP AND OTHER TRFA p0 NOT ENTER A SEPTIC, PUMP OR 01'1HER TREATMENT TANK U SCUE OF A PERSON FROM "riHE INTERIOR of a TANK MAY BE DiFFiCULT OR tMPOSSIBL RESULT. , RE ADDITIONAL COMMENTS POWTS iyiAINTAI ER ` POWTS INSTALLER Narne ctA JJ b Name .~ ,-/ Phone f J =~" ~ ~f Phone '~ J J =- ~ •~'" •r1 ~ ULA'CORY AUTHORfTY , LOCAL FtEG SEPTAGE SERyiCING OPERATOR PUMPER Agency ~ . •~ Name ~ Phone ~/.~ ' -~ ~ ~ d~R,ent meets Phone a ~ ~ ~ ~ . Th the stems dthe t3reen I..rke. Marquette and Waushara County Zonln9 and Sanriatron agencies- men[ does not and 83.54(1). (2) ~ (3)• ~/sconstn gdrrtintst~Y° Ccde• use of this docu GtunN ryotf this oonument was dialled by . the minimum n,quirertlents of dL Comm 83.~)[b?(t )~d1~f1 . guarantee d+e performance of the pAVYTS• . Wisconsin Department of commerce SOIL EVALUATION REPORT Page -L.- of Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code County ~ ~• th 8 112 x 11 inches in size. Plan must Attach complete site plan on paper not less an inducts, but not limited to: vertical and horizontal reference point (BM), direction and d location and distance to nearest road. Parcel I.D. percent slope, scale or dimensions, north arrow, an R ewed by Date Please print all information. Paraonal irrforrnation you provide may be used for secondary Purpos n Law, s. 15.04 (1) (m)). Property Owner i ~ .'1~~ ".~" ` ` ~~ Property Location ~/ ~ ~~ 14 S ~T Govt. Lot 1l4 /~ 9 O(/ N R E r ~~ CJ ^. ,. Property Ohs Mailing Address s Lot ~, Block # ,_, Subd. me or CSM# ~ ~, !<^- ~, ~ , ~ ~~ State+ Zip ode ~i;.; Q Crty ~ ^ Vllage .Town Nearest ~ Code derived design Row rate ~ ~ GPD New construction Us Re t'0~' ~ 6~i~oms __ ^ Replacement ^ Public or commerdal -Describe: ------ ~ _ nd. a Flood Plain elevation if applicable ~~ ~ J - ft. Parent material ~ nE'_ s S~ General comments _ /~~ ~ ~~ and recommendations: ,~ y ~ y~z ,e (~ ~~~~ ~, :~ b1r~ N"~ ~ t~ t J .j G~ n. n Boring pit Ground surface elev ' ft. Depth to limiting factor n• Soil lica6on Rate Boring ~ / f~ ®~n9 # ~ ~U ft. ce elev~ f d r Depth to limiting factor ~• Soil ligtion Ra pit Grou sur a n Boundary Roots GPD/ftt Horizon Depth Dominant Cdor Redox Description Texture Structure Consistence ,Eff#1 'Eff#2 in. Munsell Qu. Sz. Cunt Color Gr. Sz. Sh. ---- si s~k ~ ~ -~ • Effluent #1 = BODE > 30 <_ 220 mglL and TSS >~ < 150 CST t4ame (Please Print) Sil Bird Plumbing, Inc. Shaun Bird Address 1008 192nd Ave, New Richmond, WI 5401 ' Effluent #2 Date Evaluation Conducts ~-~~v`/_ < 30 mg/L and TSS < 30 mgll CST Number 226900 d Telephone Number 715-246-4516 a 70~ Property Owner Parcel ID # Page ~ of Boring Q Boring # in. .Pit Ground surface elev. ~ ft. Depth to limiting factor Soil ~~ ~~ Structure Consistence Boundary Roots GPD/fg ''Horizon Depth in. Dominant Color Munsell Redox Description Qu. Sz. Cont. Cdor Texture Gr. Sz. Sh. 'Eff#1 `Eff#2 `" 3 w- l - z ~ I - ~~ - ~. ~~ I ~. ^ pit Ground surface elev. ft. Depth to limiting factor ~n• Soil ication Rate Horizon Depth Dominant Color Redox Desaiption Texture Structure Consistence Boundary Roots GPD/(1? in. Munsell Qu. Sz. Cont.-Color Gr. Sz. Sh. `Eff#1 `Eff#2 U Bonng ~~ # Ground surface elev. ft. Depth to limiting factor in. ^ Pit Soil ication Rate . Horizon Depth Dominant Col Redox Description. Texture Structure Consistence. Bourxiary Roots GPD/Pa? in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. `Eff#1 `Eff#2 • Effluent #1 = BOD > 30 < 220 mglL and TSS >30 <_ 150 mglL `Effluent #2 =BODE <_ 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. sao-u~o dt.~oo- ' ~ Soil Test Plot Plan ~~ 3 Project Name P.C. Collova Bldrs. Inc. Sha it Address P.O. Box 489 Somerset Wi 54025 C M #226900 Lot 45 Subdivision Farm View Ridge Date 5/8/04 NE 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 101.2' *HRPSameasBenchmark Alternate Benchmark Top of 1/2" Pipe @ 100.2' ~. R. Scal unl e note 7 ;rty Line u- ~d -0T ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIl' CERTIFICATION FORM OwnerBuyer P. C. Collova Builders, Inc. Mailing Address PO Box 489, Somerset, WI 54025 Property Address X~ X ~-o~D~~9C-,~~~ ~Lc~ ~(~~ ~„~ L~-% .~ J~_ Q 1 J (Verification required from Planning Department for ne construction,) City/State Hammond, WI parcel Identification Num er LEGAL DESCRIPTION Property Location ~ r/4 , SE '/4 ,Sec. 5 , T 29 N R 17 W, Town of Hal<nmOrid Subdivision Farm View Ridge ~ ~ ,Lot # ~. Certified Survey Map # ~~-- ,Volume ;Page # ~~ Warranty Deed # ~s~ ~~ ,Volume ~3 ,Page # 3 Spec house U yes U no Lot lines identifiable 1J yes iJ 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 mastec 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 113 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 Zoning D artment within 30 days of the three year expiration date. . C. COLLOVA ~~11L~ERS, INC. l~/~/ o~( SIGNATURE OF APPLICANT (715) 247-2742 DATE P.O. Box 489 SOMERSET, WISCONSIN 54025 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 perty described above, b virtue of a warranty deed recorded in Register of Deeds Office. ~` /~/SLt SIGNATURE OF APPLICANT p, C. COLLOVA SIiILIt:Ii~~~ qNC. DATE (715) 247.2742 ****** Any information that is misrepresented may result in the sanita Eln~Di~ revoked by the Zoning Department. ****** SOMER, WISCO IIV 5402' 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. - ~ U 2S36P 3y ? ' - 757 359 STATE BAR OF WISCONSIN FORM 2 - 1999 KATHLEEN H. iiALSH WARRANTY DEED REGISTER OF DEEDS Document Number ST. CROIX CO., WI This Deed, made between Michael B. Marshall and Dawn RECEIVED FOR RECORD Marshall, husband and wife Grantor, 03/29/2004 12:50Pt! and P. C. Collova Builders. Inc.. a Minnesota Corporation MARRANTY DEED Grantee. El(EI~T # Grantor, for a valuable consideration, conveys and warrants to Grantee the following described real estate in St. Croix County, State of Wisconsin REC FEE: 13.00 (if more space is needed, please attach addendum): COPYSFEE~~ 12.40 See Attached Exhibit "A" CC FEE: PAGES: 2 Recording Area Name and Retum Address i iw,~r iiy iii ~v~ 018-1008-60-000; 018-1008-8x000 018-loos-9o-o00; 018-lolaoo-ooo; ols-lolalo-ooo Parcel Identification Number (PIN) This is not homestead property (is) (is not) Exceptions to warranties: Easements, restrictions and rights-of--way of record, if any. Dated this ~i~~ day of March , 2004 * * Michael B. MarhsaU ---- - - - --- - --- * * Dawn Marshall AUTHENTICATION Signature(s) Michael B. Mat_s_hall and Dawn Marshall, husband and wife ^~~~tlti authenticated this C~LO day of March * Kristina Ogland---_---- _ .--- TITLE: MEMBER STATE BAR OF WISCONSIN (If not, authorized by § 706.06, Wis. Stats.) 2004 THIS INSTRUMENT WAS DRAFTED BY Attorney Kristina Ogland__ __ _ _ Hudson, WI 54016 (Signatures may be authenticated or acknowledged. Both are not necessary.) STATE OF ACKNOWLEDGMENT _..._. _ ) 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: .) 1j * Names of persons signing in any capacity must be typed or printed below their signature. [nforrnation Professionals Co., Fond du Lac, WI SPATE BAR OF WISCONSIN 800-655-2021 WARRANTY DEED FORM No. 2 - 1999 r U 2536P 3y8 EXHIBIT "A" Part of the NE'/. of the SE'/.and Part of the NW'/ of the SE'/s and Part of the SW't~ 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'/ of said Section 5 to the aoint of beginning; thence N89°25'01 "W 2639.28 feet along the South tine of the N %Z of the SE'/. of said Section 5; thence N00°21'34"E 2581.45 feet along the North-South'/. sect[on line; thence N89°51'32"E 1316.00 feet along the North line of the SW '/ of the NE '/.; thence S14°12'09"V1l 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 feat; thence N89°26'33"E 1601.66 feet; thence S00°05'29"E 758.82 feet along the East line of the SE'/. to point of beginning.