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HomeMy WebLinkAbout018-2021-22-000]i1/JSCOnSIn Department of Commerce PRIVATE SEWAGE SYSTEM safety ano Building Division INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Personal information you provide may be used for secondary purposes [Privacy Law, 5.15.04 (1)(m)]. Permit Holder's Name: City Village X Township Hammond Hills Estates LLC, c/o Oranzo Oeve Hammond, Town of CST BM Elev: Insp. BM Elev: BM Description: /D (~ -3 GST TANK INFORMATION ^1. ELEVATION DATA TYPE MANUFACTURER ~/~ CAPACITY 3 ~ Septic ~- ' ~: t ~.,. , t 5 l~ Dosing (( ~ / CO d vw to Aeration 1~ `~ ~~ ~~~ Holding ~°:-s•~.- ,~ ,,, TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD ~ '*~~... Septic -_,~ .,r 1w .%. .,~.~ Dosing ~ .. Aeration f Holding ruinrrv~rnv~~ n~a v~~mr+~w~. Manufacturer ~ / Demand ~~ ,, ~ ..~, GPM {{ ,, Model Number ~ ~, ,~ ~ .'~c` TDH Lift., -f,~" -Friction Loss System Head TDH~; ; ~ Forcemain Len~th Dia. °+` Dist. to Well ~ . f, ~ a t '~;; ~ ~ SOIL ABSORPTION SYSTEM county: St. Croix Sanitary Permit No: 515061 0 State Plan ID No: Parcel Tax No: 018-2021-22-000 Section/Town/Range/Map No: 08.29.17.1303 STATION BS HI FS ELEV. Benchmark 8 -3 GS +D~• f / lP l Alt. BM ~` 0.3~- S ~ ~,Q v ~Q2 . Bldg. Sewer .3 I6, ~ Z2 / d SUHt Inlet ~, ~, 5 > ~rq ~ G~ / / D SUHt Outlet Dt Inlet o_ `_._ Dt Bottom , 1. Z ~ r ° .~ C. lc Header/Man. ~. ~ z / U Dist. Pipe L ° J!5 J 'D~ - Bot. System ' ~ 'ur j r Final Grade ~ , ~ O~ • O st coyer ~ . ! 6 Cowko~r (~,Z col, BEDITRENCH Width Length J' No. Of Jrenc ! PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS ^~~ ~ ~ (~ ~.~_ .. "~ SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer: O INFORMATION CHAMBER OR T e Of S st m: ~ YP f UNIT l b )~ < ~ ~ ~ ~ ,., 7 t+ ~-,~ er: Mode Num ~ y ~ ~ R nISTRIRI ITI(~N SYSTEM t..~1 - .y v`~~', 1 ~la` °. ~ /°hk -~-- -- Header/Manifold Distribution r"? i , i e x Hole Size ~' x Hole Spacing ~ V t o Air Intake ~'' -~ Y` S i - ~ . Dia Length T pac ng Dia y Length - Crlll Rfl\/FR ., o...~~...., c..~F,..,,~ n..i.. .... IlAnnnrl n~ d*-f:raria Systems only ~-'~""" "'"~%`~" - Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center /1 W~ Bed/Trench Edges \ Topsoil ~ y'~I ; ~'~~ es ~ No x€s i] No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: ~ / ~ ~/ ~ 7 Inspection #2: / / Location: 1031 166th Street Hat~mond, WI 5401 §,(LSV'I 1/4 SE 1/4 8 T29N R17W) Hammond Hills Estates Lot 22~ Parcel No: 08.29.17.1303 1.) Alt BM Description = ~~` ~ ~ low v ~-o~ 2.) Bldg sewer length = ~•~{ J - amount of cover = ~ ~ (({{``,, ~~- - / ~~ W..... ~~ 4~u~. Plan revision Required? ~ Yes ~ / ~ C, Use other side for additional information. L__~__ ___ (-- Date Cert. No. SBD-6710 (R.3/97) p0ud N~A.+~in~ Fc~ commerCe.wi.gov Safety and Buildings Division County ~ , G ~-` ~ ~ 201 W. Washington Ave., P.O. Box 7162 . , of k ' ~~O ~ ~' ~ Madison, WI 53707-7 Sanitary Permit Number (to be filled in by Co.) f C D rt nt ~ 5 epa me o ommerce ` ; ~ 5 Sanitary Permit Application n Num be r ransactio / ~ / ~~ 3 / ~ In accordance with s. Comm. 83.21(2), Wis. Adm. Code, submission of this form to the appropriate governmental 7 !~ unit is required prior to obtaining a sanitary permit. Note: Application forms for state-owned POWTS aze Project Ad if different than mailing address) submitted to the Depaztment of Commerce. Personal information you provide may be used for o ~~3 / oses in accordance with the Privac Law, s. 15.04 1 m , Stats. -~h ~ / o rt L L ~ ~ S*" (~ I. A lication Information -Please Print All Information Property Owner's Name ~ Q ,.,yr /m tl ti j ~ s ~, ~ Pazcel # ~EVE,~.'N ~~~s ~~.C E o~8 `ZoZ1 ~ zz.-ooo Property Owner's Mailing ddress Property Location / /~ '\ C • lJ d o l ~ c_ Kn~ r2 • Govt. Lot Ci State Zi Code P Phone Numb r , ~ 8 St.~.~ /., S~ /., Section j- ~D !J F ..._ S ,~ ~ ~ ~ ` ~ ycJ 'L 3 ST CROIx tr~u"' ~ i N1NG O (circle one~l., ~~- / N; R ~ E ocC13P II. Type of Building (check all that apply) Ok ~ ^ 1 or 2 Family Dwelling - Number of Bedrooms ~ Z ~ Subdivision Name ff / j~ ~ I Bl ~ /7'i/s 4 s%4~E 1 L ~ _ ~~ oc . »./h, Oti t9JYL- ^ Public/Commercial -Describe Use J ^ Cit of a1 y ^ State Owned -Describe Use CSM Number ^ V illage of 8 x ~~ ~ ~fG ~ Town of Q ~+~+~+•~ d ~- III. Type of Permit: (Check only one box on line A. Complete line B if applicable) `~' ew S stem ~-N y - e p y ^ Re lacement S stem ^ Treatment/Holding Tank Replacement Only ^ Other Modification to Existing System (explain) B. ^^ Permit R newal ^ Permit Revision ^ Change of Plumber ^ Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Owner ~ IV. T e of POWTS S stem/Com onent/Device: Check all that a l ^ Non-Pressurized In-Ground ^ Pressurized In-Ground t-Grade ^ Mound > 24 in. of suitable soil ^ Mound < 24 in. of suitable soil ^ Holding Tank ^ Other Dispersal Component (explain) ^ Pretreatment Device (explain) V. Dis ersallTreat ent Area Information: Design Flow (gpd) Design Soil Application Rate(gp Dispersal Area Require f) Dispersal Area Fropo (sf) System Elevation YSo ~ 1, 9Yo 750 ~ ya ~Z / ~ ~ • 70 VI. Tank Info Capacity in Total # of Manufacturer o Gallons Gallons Units ~ ~ ~ New Tanks Existing Tanks y c ~ ~ y ~ m `~ r Holding Tank J"C UO V ~ a..w sing C er K (p0v VII. Responsibility Statement- I, the umdersigned, assume responsibility for installatiom of the POWTS sho n the attached plains. P tier's Name (Print) s ' C ~ ~ ~ Plumber's Signature MP Number ~ Business Phone Number n, , Ct a~-t kE : ~ ~"LL8 y7L-~~LI Plumber's Address (Street, City, State, Zip Code) zt~~~ /~~ ~`' ~uc~ ~ ~~'.~3 VIII. Coun /De artment Use Onl Approved d Permit Fee $ Date Issued Issuin ent Signs ~ ~ c Z ~ ~ p sl ~ $ O l n Reason for Owner al tQ J IX. Conditi ons o f Approval/Reasons for Disapprov al [r / S 7 C~ ' ~(J f ~Pi • (Pl g ~ ,. p R~ ~~,~.~~ ~ ~r ..~, +.t c~ ! ..S ~j ~O "' / U SY9 ~itM vW~1tE n t. saw tarn, efflulnt finer and 3~ Oaf / Uet~PloPo~. ~a Prop ,' d2.~. ~I,t~.~ ~oc.~~a,`.. dispersal cell must all be services /maintained I + ~, ~. J M ~ f ~~ ~' ~^ r 2. Afi 8e®eclC f$QUt(@mBfliStacb_tn complete olsacfor the system and submit to the County only ontpaper not less tlfan S 1B x 11 inches in size ~ ~ ~ toile ~ o ~` ~~` ~-.` o~ i n.. S ~c. - n r G~ SBD-6398 (R. 02/09) Valid thru 02/11 5' , Iv ~~ ~(~ s~, L_ ~ 7 /lJ 1f 7fL "~. ~°~.Q. ,rw ~~ ~~ ~^~- d~C1 _,.~ ~ v "~ p~'~ ~ o ~ ~ -~ o ~ o w 3 ~-- ~ o ~ ~ ~ 0 -3. ~ ~ ~ ~ !~ ` ~\ ~ 4 ~ ~ ~ ~ `~° r t~ `~, {`. C ,ti liy 1 s ~ ~ ~ ~ ~~ ~ ~ 3 ~ ~ ~ a ~ d Y c'-~ ` _ ~' ~ 1 ~- ~ v ct ~ ~ N ~M ~ a A F ~ ~ ~~ .~ ,~ 3 ~ y ~ ~~ °. ~ ~ r ~ 0 Q ~ 3 Z ~~ ~ ~ ~ ~ ~ ~. o ~ N ~ m~ ~ v~ ~ 4 v, ~ ~ b -- ~ a4 ap ~ J ~.~ ~ ~ ~ ~ ~ v Q ~ "' ~ ~ ~ ~ ~ w q ~ - w ~ ~ ~ ~ ~c~~~r.~ pp ~ ~ O ~ °' ~ 04 ~~ ~ a ~ F ~ ~ e ~ o w v ~- -~ w ~ w _ 3 e {~ °0 1 M °~ ~ ~ v: ~, ~ -~ 0 ('~ '~ . ~ ~' ~ o ~ A ~ ~\ ~ ~ ~ .ter -~ ~ ,~, ~ 4 L ~--- ~! ~ ~ ' `? ~ ~ cy. _ / ~ ~ ~' ~~ ~ ° ~ ~ 1 ~ ~ ~ ~ ~- " J at e.~ ~ _ T ~ 4° ~ o j~ ~ ~~ ~ o "' ~ -~. ~ ~ s 9.. J ~ ~ ~ ~~ 3 ~'~ ~~ 4- ~ 0 3 ,~ ,~ w ~ '~ ~ ~ ~ w - ~ ~ ~ ~ T p ~ N ~ m~ ~ ~ N ~ ~ ~~ t' ~ ~ ~ ~ or .v ~ `~ ~ may,. Q ~ - c.,,, ~. ~ o 0 J ~0 3 ~ ~ ~ d U ~ n -~. ~ ~~ u commerce.wi.gov iscansin Department of Commerce Safety and Buildings 141 NW BARSTOW ST FL 4TH WAUKESHA WI 53188-3789 Contact Through Relay www. commerce.wi.gov/sb/ www.wisconsin.gov Jim Doyle, Governor Richard J. Leinenkugel, Secretary May 13, 2009 CUST ID No. 222872 JACQUE M HAWKINS HAWKINS SOIL TESTING & SEPTIC SYSTEMS 2659 150TH ST ;LUCK WI 54853 ATTN.• POWTS Inspector ZONING OFFICE ST CROD~ COUNTY SPIA 1101 CARMICHAEL RD HUDSON WI 54016 yCONDITIONAL APPROVAL t'~LAN APPROVAL EXPIRES: 05/13/2011 SITE: Oevering Homes Lot 22 Lot 22 Hammond Hills Estate Town of Hammond St Croix County SW1/4, SE1/4, S8, T29N, R17W Lot: 22, Subdivision: Hammond Hills Estate Identification Numbers Transaction ID No. 1664503 Site ID No. 747612 Please refer to both identification numbers, above, in all comes ondence with the enc . FOR: Description: At-Grade, 3 bedroom Object Type: POWTS Component Manual Regulated Object ID No.: 1225113 Maintenance required; 450 GPD Flow rate; 38 in Soil minimum depth to limiting factor from original grade; System(s): At-grade Component Manual, SBD-10570-P (R.6/99) The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. This system is to be constructed and located in accordance with the enclosed approved plans and with any component manual(s) referenced above. 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 with publication SBD- 10570-P (R. 6/99) "At-grade Component Manual Using a Pressure Distribution System for Private Onsite Wastewater Systems". The pressure network is to be constructed in accordance with publications SBD-10573-P(R. 6/99) "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems" an~th~O sizing methods of publication "SSWMP Publication 9.6 Design of Pressure Distribution Network ~• (01/81),. ~~ ~~ ~~'I!~ ti~S,~,ogR A O In the event this soil absorption system or any of its component parts malfunctions so as reate a~al'>~,~~~°.~.`' the property owner must follow the contingency plan as described m the approved plans. Ina the o~st comply with the operation, maintenance and monitoring duties as described in section VIII o ade component manual. A copy of this information must be given to the owner upon completion of ct. 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. JACQUE M IIAWKINS Page 2 5/13/2009 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 Sea 145.20(2)(d), Wis. Stats. A copy of the approved plans, specifications and this letter shall be on-site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of construction/installation/operation. Owner Responsibilities: • Comm 83.52 Responsibilities. The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s. Comm 83.54(1). • Comm 83.52(2) A POWTS that is not maintained in accordance with the approved management plan or as required under s. Comm 83.54(4) shall be considered a human health hazard. • Comm 83.55 The owner is responsible for submitting a maintenance verification report acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Beginning October 1St, 2008, small wastewater holding tanks with estimated flows less than 3,000 gpd that are based completely on approved POWTS component manuals must be submitted to the appropriate governmental unit and will no longer be accepted by the Safety and Buildings Division for review. Please refer to s. Comm 83.22, Wis. Adm. Code for further information. 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. S' rely, Julia Lewis-Osborne POWTS Reviewer 2 ,Integrated Services (262) 397-6005, Fax: (608) 283-7481 j ulia.lewis@wisconsin.gov Fee Required $ 250.00 Fee Received $ 250.00 Balance Due $ 0.00 WiSMART code: 7633 RESIDENTIAL AT-GRADE DESIGN Pressurized -sloping site INDEX AND TITLE SHEET Project Oevering Homes At-Grade Lot 22 Hammond HiNs Estates Owner peering Homes _ Address P.O.Box 179 New Richmond WI 54017 Legal Description SW1/4 SE1i4 Sec. 8 T29N-R17W Township Hammond County St. Croix RECEIVED Subdivision Name Hammond Hills Estates t_ot No. 22 Parcel ID Number Plan Transaction Number Index sheet Calculations At~rade drawings Laterals and dose tank Specfications Management 8~ contingency. plan Pump Curve Plot Plan Designer JatxLue Hawkins License Number Signature J Phone Number Date 04/30/09 Page 1 Page 2 Page 3 Page 4 Page 5 Page 6 Page 7 Page 8 MAY ° 4 2009 SAFETY & SUIT. MPRS# 222872 (715) 472-2421 S r4l Design~l pursuant to: ,~'~ At-grade Component Manual for POWTS SBD-10570-P (R.G/99), and ~o SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST -SAS (01/81) q~Yp'hyi~, VBrsiOn 3.11 05!01 P e 1 of A eG'`~~GS t ) as ~'O `~ticF PRESSURIZED AT-GRADE DESIGN At-grade Design Worksheet -Sloping Site Flows and Site Data Entry. (r or c) r Residential or commercial? 300.0 Estimated wastewater flow (gpd) 450.0 Design wastewater flow (gpd) 6.00 9t, Site slope 102.20 Contour elev. below lateral (ft) 38,00 Depth to limiting factor (in) 0,60 In-situ soil applicatan rate (gpd/ft^2) Distribution Cell Information (1 or 2) 1 Influent wastewater quality 10.00 Linear loading rate gpd/ft 8.00 Effective absorption width (ft) 10.00 Max. effective width permitted (ft) __94,00 Aggregate length (ft) Pressure Distribution Data Entry (c ore) c Center or end lateral connection 2 Number of laterals 0.188 Orifice diameter (in) e.g. 0.188 Not a final calculation 2.00 Estimated orifroe s m ft) l~ g ( 2.00 Forcemain diameter {in) 3.23 Forcemain flow velocity (ft/sec) 60.00 Forcemain length (ft) ` tr. 92.00 Pump tank elevation (ft) . t '`. ~ ~`E i • 3.25 System head (ft) x 1.3 ~~, 9.70 Vertical lift (ft) ' 1.28 Friction loss (ft) a ~ `~ 14.23 Total dynamic head (ft) Lateral Diameter Selection Designer must select one lateral diameter Pipe diameter Design options Design choice 1 in 1.25 in 1.5 in x x 2 in X 3 in X Gallons/inch Calculator (optional) Total Tank Capacity (gal) Total Working Liquid Depth (in) Gain (enter result in cell G46) Treatment Tank Information 1000 Se tic tank capacity (gal) Skew Concrote~ Manufacturer Effluent Filter InforrrtaDon Dose Tank Information Best Filter manufacturer 642.0 Dose tank capacity (gal) GF-10 Filter model number 16.5 Dose tank volume (gaUin) Skaw Concrote Manufacturer -~ ,_ t ~ ~ ~-~~ ~~ ~~J._ ~~, ii ~~-/ ~; .Y~~. y or n Does forcemain drain back? y or n Are laterals at highest point? NA 9.8 Forcemain drainbafck (gal) 42.0 5x Lateral void volume (gal) 51.8 Minimum dose volume (gal) 31.6 System demand (gpm) Projeck Oevering Homes At-Grade Lot 22 Hammond Hills Estates Transactign Number: Page 2 of 8 AT-GRADE PLAN VIEW D ..__.t 1/6 B Olsservetion pipes (2 typical} A D ~ B 1/6 B C W ~ D v f3 W AxB L =Total aggregate ceN A x f3 C~ =Plowed area L x W ,Es ~P Typical obs. pipe. Slotted in the lower 6", and anchored rey s° AT-GRADE CROSS SECTION Synthetic fabric cover Lateral invert elev. 102.70 ft ~+ E Surface contour 102.20 ft C A ,---~..~ and system elevation ® = 12 in. topsoil and subsoil over aggregate and tapered to toes. = 6 in. aggregate below pipe(s), and 2 in. above pipe. ft Finished grade elevation ~- Observation pipe at aggregate toe ~~6 % S% Slope `~ D -~ \ Plowed layer bebw L x W Project: Oevering Homes At-Grade Lot 22 Hammond Hills Estates Transaction Number: Page 3 of 8 PRESSURE DISTRIBUTION AND DOSE TANK taterai Specffications t P I i I~ Last hole drilled rxxt to end cap Moles dr111ed on t he bottom of tl~e lateral, equally spaced Laterals & force main of PYC Sch 40 (per COfaNvl Table 84.30-5J ~ =Turn-upwPMllvah+soralwnoutplug 0.188 Orfice diameter (in) X 1.95 Orifice spacing (ft) 24 OrifiaesJlateral 15.8 Lat. discharge rate (gpm) 31.6 Sys. discharge rate (gpm) 14.23 TDH (ft) Weather-proof junction box Final grade --~ E_atsraE Dlagrl~m -Center Connection Center Lateral connection point 2 Number laterals P 45.83 Lateral length (ft) 1.50 Lateral diameter (in) 2.00 Forcemain diameter (in) 60.00 Forcemain Length (ft) Typical Pump Chamber Layout tank component is P~dli vented c .4 A m B E C o D Totals Electrical as per NEC 300 and Comm 16.28 WAC Inches Gallons 21.8 359.2 2.0 33.0 3.1 51.8 12.0 198.0 38.9 642.0 Tank full A Ala1m on Pump on ~E3 93.OQ ft I `' Pump off D Approved manhole cover with warning label and belting daubs disconnect 4" Alternate ~..~ ot~bt - /^~locatbn 18" min. s -Approved outlet ~ joint Provide 114" weep hole or antisiphan device. 3" Bedding under tank I ~_ 92.00 ft Goulds ~ Pump manufacturer S.J.Electro Alarm manufacturer EP04 Pump model number Tank Alert Alarm model number Project: Oevering Homes At-Grade Lot 22 Hammond Hills Estates Transaction Number. Page 4 of 8 At-strade Systern Mainfier~ance and Operation Sa~ciflcatiQns Service Provider's Name ~~ Tri-County Sanitation Phone 715-386-0114 POWTS Regulator's Name ~ St. Croix County Zoning Office Phone 715-386-4880 Svstem FIQw and Load Pammeters Design Flow -Peak 450 gpd Maximum Influent Particle Size 1/8 in Estimated Flow -Average 300 gpd Maximum BODS 220 mg/L Septic Tank Capacity 1000 gal Maximum TSS 150 mg/L Soil Absorption Component Size 750.0 ftz Maximum FOG 30 mg/L Type of Wastewater Domestic Maximum Fecal Coliform >10E4 cfu/100 mL Service Franuencv Septic and Pump Tank Effluent Filter Pump and Controls Alarm Pressure System Mound Other Ins ect and/or service once eve 3 ars Ins and clean at least once eve 3 ears Test once eve 3 ears Should test month Laterals should be flushed and ressure tested eve 1.5 ars Ins for ndin and see a once eve 3 ears l ..j • ~ ,l! ~i!.+1. u ~ ~.. 1. Observation pipes are slotted and materials conform to Table Comm 84.30-1, have a watertight cap, and are secun3d in as shown in the at-grade component manual. 2. Dispersal cell aggregate conforms to Comm 84.30 (e)(i}, Wis. Adm. Code. 3. All gravity and pressure piping materials conform to the requirements in Comm 84, Wis. Adm. Code. 4. Tillage of the basal area is accomplished with a mold board or chisel plow. 5. The at-grade structure and other disturbed areas will be seeded and mulched to prevent soil erosion and help reduce frost penetration. 8. Areas within 15 feet of the downslope toe will be protected from compaction. 7. Alt other construction details are as per the at-grade component manual SBD-10570-P (R. 6/98). Lateral T..~rn-u~ Detail Finished ••.........•.. ............... Grade ~~ 6-8" Diameter Lawn -r Threaded Cleanout Sprinkler Valve Box Plug or Ball Valve Distribution Lateral ~~i Long Sweep 90 or Two 45 Degree Bends Same Diameter as Lateral Project: Oevering Homes At-Grade Lot 22 Hammond Hills Estates Transaction Number: Page 5 of 8 At-grade System Management Plan Pursuant Lo Comm 88.54 Wis. Adm. Code This system shaft be operetad In axordanca with Comm 82-84 Wis. Adm. Code, acrd shall maintained in accordance with its' component manuals [SBD-10570-P (R. 08/99) arKi SSWMP Pub. 9.fi (01/81)1 and kx~l or state rules pertaining to system maintenance and maintenance reporting. No one should ever enter a septic or pump tank since dangerous gases maybe present that could cause death. Septic and pump tank abandonrrretrt snail be iri axordance with Comm 83.33, Wis. Adm. Code when the tanks are no longer used as POWTS components. Septic or pump tank manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings used for serve and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defek~ive, or subject to faiure must be replaced. Exposed aneess openings greater than 8-inches in diameter shall be secured by an effedlve locking device to prewent aocdental or unauthorized entry into a tank or component. ~i~ Tank The septic tank shall be maintained by an indNidual certified to service septic tanks under s. 281.48, Slats. The contents of the septic tank shall be disposed of in acxorclanoa with NR 113, Wis. Adm. Code. The operating condition of the septic tank and outlet fitter shall be assessed at least once every 3 years by inspection. The outlet filter shall be cleaned as necessary to ensure proper operation. The filter cartridge should not be removed unless provisions are made to retain soUds in the tank that may slough off the fUter' when removed from i~ encosure. If the tiger is equipped with an alarm, the fiker shall be serviced ff the alarm is activated continuously. Intermittent fiker alarms may indicate surge flows or an impending continuous alarm. The septic tank shall have its contents removed when the volume of sludge anrJ scum in the tank exceeds 1!3 the liquid volume of the tank. N the contents of the tank are not removed at the tirrre of a triennial assessment, maintenance personnel shall advise flee owner of when the next service needs to be perfomred to maintain less than maximum scum and sludge accumulation in the tank. The addkion of biological or dremical addithres to enhance septa tank performance is generally not required. htowever, if such products are used they shall be approved far septic tank use by the Department of Commerce. sumo Tank The pump (dosing) tank shall be inspected at least once every 3 years. All switches, alarms, and pumps shall be tested to verify proper operetion, if an effluent filter is installed within the tank it shall be inspected and serviced as necessary. At-urade and P-e~urs Distribution System Na trees or shrubs should be planted on the at-grade. Plantings maybe made around the at-grade's perimeter, and the at-grade shall be seeded ar-d mulched ss necessary to prevent erosion and to provkie some protection from frost peneUrodion. Traffic (other than for vegetative maintenance) on the at~yrade is not rewmmended since soU compaction may hinder aeration of the intUbative surface within the mound and snow compaction in the winter will promote frost penetration. Cold weather installations (October-February) dilate that the at- grade be heavily mulched as protection from freezing. Influent qualify into the at-grade system may not exceed 220 mglt BOD5, 150 mg~L TSS, and 30 m9fi-FOG for septic tank effluent or 30 mg/1.80D5, 30 mgl1. TSS, 10 mg/L FOG, and 10~ duH00 rot, for highy treated effluent. Influent flow may not exceed maximum design flow specified in the permit for this installation. The pressure distribution system is provided with a flushing point at the end of each lateral, and it is recommended that each lateral be flushed of accumulated soikls at least once every 18 months. When a ptessure test is performed it should be compared to the initial test when the system was installed to determine N orifice dogging has occurred and if orifice leaning is required to maintain equal distribution within the dispersal cell. Observation pipes within the dispersa(ceil shall be checked for effluent ponding. Pooling levels shall be reported to the owner, and any levels above 4 inltes considered as an impending hydraulic failure requiring additional, more frequent monitoring. ~Sg53Lntrencv Pian if the septic tank or any of its componerntss become defective the tank or component shall be repaired or replak~sd to keep the system in proper operating oorxifiion. If the dosing tank, pump, pump controls, alarm or related wiring becomes defective the defective component(s) shah be kr-rrredtetety repaired or replaced with a component of the same or equal performance. If the at-grade component fails to accept wastewater or begins to diadrarge wastewater to the ground surtace, ft will be repaired or replaced to its' present location by Increasing basal area if tae leakage Occure ar by renovating the biologically clogged absorption and dispersal media, installing new piping, and replacng other components ~ deemed necessary to bring the system into proper operating condition. See Page 5 of this plan for the name and telephone number of your k-cat POWTS regulator and service provider. Project: Oeveiing Homes At-Grade Lot 2.e Transacction Number: Page 6 of 8 Page 7 of 8 ~GOULDS PUMPS 1 "Q! FEET 30 ~~' 2s ~`'~--~_ 20 1s 10 . .~. ._.. . 5 V APPLICATIONS SpecificaAy designed for the following uses: • Effluent systems • Homes • Farms • Heavy duty sump • Water transfer • Dewatering SPECIFICATIONS • Solids handling capability: '!a" maximum, • Capacities: up to 60 GPM. • Total heads: up to 31 Feet. • Discharge size: 1'li' NPT. • Mechanical seal: carbon- rotary/ceramic-stationary, BUNA-N elastomers. • Temperature: 104°F (40°C) continuous 140°F (60~C} intermittent. • Fasteners: 300 series stainless steel. • Capable of running dry without damage to components. Motor: • EP04 Single phase; 0.4 HP, 115 or 230 V, 60 Hz, 1550 RPM, built in overload with automatic reset. • EP05 Single pphase: 0.5 HP, 115 V or 230V, 60 Hz,1550 RPM, built in overload with automatic reset. • Power cord: 10 foot standard length, 16/3 SJTOW with three prong grounding plug. Optional 20 foot length,16/3 SlT4V with three prong grounding plug (standard on EP05). • Fully submerged in high grade turbine oil for lubrication and efficient heat transfer. Available for automatic and manual operation. Auto- matic models include Mechanical Float Switch assembled and preset at the factory. FEATURES ^ EP04 Impeller: Thermoplas- tic Semi-open design with pump out vanes for mechanical seal protection, METERS ~o 9 s ~ 7 x v 6 s } 0 a a 0 3 z 1 0 °0 10 Submersible Effluent Pump 3871 E~5 ~,.~, ^ EP45 Impeller: Thermoplas- tic enclosed design for improved performance. ^ Casing and Base: Rugged thermoplastic design provides superior strength and corrosion resistance. ^ Motor Flousing: Cast iron for efficient heat transfer, strength, and durability. ^ Motor Cover: Thermoplastic cover with integral handle and float switch attachment points. ^ Power Cable: Severe duty rated oil and water resistant. ^ Bearings: Upper and lower heavy duty ball bearing wnstn~ction. AGENCY LISTING Carmdiarl5Yarldenls assoaacion (CSA Tasted mode! numbers end in "C" or "F".) colrasvt.rlpsaasosom . wi 0 2 4 6 8 10 12 frN/h ca-PnaTv Goulds Pumps ® 2001 Goulds Pumps (~/`J ITT Industries Effective May, 2001 ""v 83871 ' ~. WisoonsinDepartmentofCommerce SOIL EVALUATION REPOR~°'"~"°~~~~~M~~ page of Division of Safety and Buildings ur acxuruauw vnu~ wrnrn oa, rns. iwm. ~.uuv COUnty ~~` ~ r~ Plan must Attach complete site plan on paper not less than 8 112 x 11 inches in size . inducts, but not limited to: vertical and horizontal reference point (BM), direction and py~ l,p. perrerlt stops, scale or dimensions, north arrow, and location and distance to nearest road. Please print alt information. Revie by Dat Personal irrfomration you Provide may be used for seco ~. 15.04 ) (m)). ~~ ~J ~ 7 Properly Owner P ny ocation ~~ l ? ~ /^!i ft p r3 ~- ovt. Lot - 11 ~ 1/4 ~ T ~ ~ N R 1 E ( W P rty Owner's Ma' Address L lock # .Name Or CSM# ! City tale p Code N City ^ Yllage Town Nearest Ro New Construction User Residential / Number of bedrooms ~ Code derived design flow rate J~ GPO ^ Replacement `/~y~ ^ Pu/h/Iis or cornmerdal - D tribe: ______ __ _ _.~ _ Parent material .~tl/~r, G'~...Cl~'C~lr~c.c.~ Flood ((Pl1lain elevation if appligble '~ _ R Generalcorrrrter><s ~p n,..C~a~r- ~~L/tn.~ ~'e ~..., i n t^ar~,~-4~te. and reconvnendations: Q / CG>;- System Type - System Elevation Sorirg # Bonng / pit Ground stufaceelev.-l ft. pepth to limiting factor in. Soil ication Rate t•lorizorr Depth Dominant Color Redox Description Texture Structure Consistence Bounddary Roots GP D/fF _ in. Munsep Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 ~ -~ ,- 31~ ~---- S _ L' ~~' ~ ~ a 2 --1/ ~ ----- ~ ',~~ ~ l ,; s -, s l -m- ~~- - a # o eori~ ~/ ;~ Pit Ground surface elev. ~O"' ft. Depth to limiting factor -"`r-_ in. Soil ication Rate tiorimn Depth Dominant Redox Description Texture Structure Consistence Boundary Roots GP D/f't= in. Munseq Qu. Sz. CoM. Color Gr. Sz. Sh. 'Eff#1 •Eff#2 f r, ~ 3 ,~. ~. c s ~, o ~ "1 ~ H~ F ~ / ti - ~ - n r Efiuent #1 = BOD > 30 < 220 rrglL and TSS >30 < 150 ' Efl1ueM #Z = BOD < 30 mglL and T55 < ~ nglL CST l~larrts (Please print) Sf CST Number Bird Plumbing, lnc. Shaun Bird 226900 Address Date Evaluation Conducted '• Telephone Number 1008 192nd Ave, New Richmond, WI 54@1/ ~ ~_ ~ ~ 715-246-4516 Property Owner Parcel ID # ~ ~/ Page of i Born # a Bor,ng Pit Grourid surface elev. D~ 1.0 ft. Depth to limiting factor '^• Sob Rate i th D inant D Redox Description Texture Stricture Consisterroe Boundary Roots GP Dlff zon Hor ep in. om Mansell Qu. Sz. Coat Color Gr. Sz. Sh. 'Eff#1 'Etf#2 i0 r 3~2 --- s i Zm r ~ z~ ~ ~ /. 0 Z- -- 33 f ~ r / S i ~' ~ ~ . ~ ^ B°ri"g # ^ ~~ ^ Pit Ground surface elev. ft. Depth to limiting factor in. ~ ~~ Rate Horizon Depth Dominant Redox Description Texture Strucxure Consistence Boundary Roots GPDlfP in. Mansell Qu. Sz. Copt Color Gr. Sz. Sh. 'Eff#1 'Et[#2 r ~~ # ^ Bonng G ^ Pit ~ vu~ ~u aw yaw v~a~. n. wN.u w ~....~ y .o...... .. Sort Rate Horizon '>~ Dondnant Redox Description. Texture S1nx~rxe Corsisterrce Boundary Roots GP QifE in. Munsetl Qu. Sz. Cont. Color Gr. Sz. Sh. 'EtT#1 'EB#2 _; . . ' Etl~errt #1 = BODa > 30 < 220 rttglL and TSS >30 < 150 mg1L ' Effluent #2 =BODE < 30 m~L ar>R1:~TSS < 30 rrrglL 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. sewawcRSroo~ . .- • Soil Test Plot ] Project,Name Oevering Homes LLC Address p.O. Box 179 New Richmond Wi 54017 Lot 22 Subdivision Hammond Hills Estates Dat_ S W 1/4 SE 1/4S $ T 29 N/R17 W Township Hammond Boring ~ Well PL Property Line County ST. CROIX BM or VRP Assume Elevation .100 ft. Top of 3/4" pipe System Elevation 102.2' *HRPSameasBenchmark 166th St. Scale is 1" = 40' unless otherwise noted 436' Property Line 20' 90' 5 ~ B-1 20' 40' 60' B_3 6% Slope B.M. 110' Please note: survey was not complete at the time of testing, installer must check all setbacks prior to installation. Y02.5' 101.5' 144' Property Line .- ~ ~ ~ o r ~, '-+~'. ~~~ '~^Q~.-- '~•~~o~ 4°' ' 1 ~~ ~ F-C7~ y.,l\V ~~~WM .J ~o w 0 w F-- cn f--~ W ~i ~~~ 66 's'. ~ i cJ D~ •~c0 N. W w °~ ~_ ~z ~CDWW ~ ~ ~ N ~ Z W N U Q N O W H r ,,,~~o D~ D~ cV ~ z ~ ~ z O N ~ N ~ ~ wo ~~ ~ ~ ~ 0~ m o w Q O ~ m ~ o a ~ cn , v, .~~ .~ ~ W w •~j1~ ~~ ~ 0~ 6~'b~`~b a w o o ~ m z ~ ao i o z ~ } O ~ j FW- ~ S a J~ o W Q ~PNO, ~~Wo~~ ~ 0 ~~E~ ' ~ 0 ~ ~~ .o ~ z -~ _ __ ___~ _ - ~ ;\~o,~o ~~ ~ ~Q o ~ ~C~ O oN m / g ~ ~~ m ~~ of ~, i s~ ~. ~~ ~ .~~ /`' .~ Z~ ~.~ ~. ~~. ~~ ` ~ . , '~~ V ,, :,~ `,. ~ O~ ~ ~~ ~~ O Op . \ ~ U ~ ,n N o ~ ~ ~\ O \ ~` \ ~ ~ ~ ^ ~ < ~ ( tf') ` `.' ~ ~l p ~ ~ O J 6 J ~ ~ . ~7 ~ .-\~ 8 O ~ ~ Q ~_ ~\ "~ ~, „^~ ~ 8~ . \ ~T ~~ S e--I 0 8~ s8 ~sZ ~ ~~ U ~ O °~ ~ ^~ ~ a ^O, o~ Q h ~ o E-~ ~o O r ~ r 9~ ~~ hh ~~ .--~ ~ ~ U h~ r. Q F~~~ .~*~, C ;, . , ~ ~~ ~~I;~~I~~I~III~I~GII~I~~ s 69'2o'SS w 444.ao' -619161 ~~ I?'~ ~: COl1NTY PLAT OF: 1~.0; ".GD ! +44.C0 f S iFl a ,I u I i JI p r~.a'~uP~~; AEI ~ ~ ~ ~ 1 1 ~ ~~~ I 6.29' 15ggD )JT2,0j" tlraltTZ~ ~'usrM I W (Ai~TI aUi IJ i I 516,6g~ NNP~a?Ee ~~ncs ~1: a 2€F 2': I PNzS: i 5C S 8920'10" W 217.62' k ~ ~IS~ a~ ESTATES ~ LOT Z~ LoT = ,Z 25j- 14 ~~ 15 ° ~ ° LOT 16 lOG1E0WPARi LFTNE MY 1110E THE SE 114, THE SW iM OFTHE SE > 5, a. of <. c 6F_1 ~ o v ~9• v 1'03 114, THE NE 1140F1HE 5W'.IdpIJf1TNE SE 1140E iNE SW 11d OF SECTION > .I ~' ° LOT 17 Iy ///~J 49, p _ 811 8, 129N, A1NJ,lOWN OFHAAAIO'~, Si.CR01R COUNtt.YWRC0451N. o q~ ~ --`- r ~v~aar.~Gfi ~+ vrc ',S6 c Fi I [:k I r/ ~' ° LOT 18 - ~ - - .. / ~ ~o,° LOT ,.21 ~ J c ii . ,. _ I' ~I I ~ `~~ I° ~ , ~~ ; p `~~ ~ DRAINAGE I ASEMENT NOTE ~ I ` ~I ~" I m u, A W NOOVYNER OR Rt SIOENr ShullLWANYIHJNG I'viNCNW0UL0 WYERFERE WI7H I j ~` ~ I i, I° ~0 a~,F // Gad ~ a 1 OR CHANGE THE OPEAAPCN OF TNEAPPROVED COMPRENENSA'E ~ - i CU + -- !: e` / ~ ~ >:- S 5'00.MWAiERMeNAGEMENTP!AN,GFANffNi AND ER0910NCONiROIPUN 1 1 i ~''~ I r n `esq. _° '~ ~ / ' ~ IG FOR iHISPlAi, 7HIS WCLUOES, SUMS NOi LMdIlFD io, BVh01NG UPON, ~ QD -t1 t I -/ © \ 1?r OBSiAUC11NG, ALiFRiNG FILLING,EKCAVAi1NG, OR PLANTING IN ANY ORAIN4GE ~ I -~i I 2/ LQT 20 ~ ~r V Wj,4 f` EAEEMENiS, SioRMWATERPOND5. WATER pR.AIN4GEDIiCHES,WAtER /,: I / ~ O . OD r _ ~1,, ftUNWAYS,WATERCULVERiS09 BEPMS. ~ ., :. ~ ~J j-^. a c O ~~1F - r f4 GENERAL NOTICE STATEMENT: , E ~~__ _ - -- ~ ~ q», ~ LOT 22 ,. sl~yo ---------- ° ~, ~ w EACH PAACELSNOWN ON THIS McP~PlA1JtS SUSlECiTOSiAIE, 5 a92C 53 W 51.C ' .~'~- OD ~ qSC ns ~, p W' CWNn,MDTOWN lAW5,ALlESANDREGULATNWS Q.E ~ -~-~ 99 WETLAND,MWPUUM LOTSIrf.ACCE55 TO PARCEL E*C.1 BEI-0RE / ~ S,C~C. 2e, ~,.-.: > \ .g V.S<~ ~ 0 wRCIUSINCOROEVE~wINCU+rLOTaFLANO,coNrACrixE SC y l,, ~ ' \ .~ ~ ~ 0 4. ~ \2 z LOT Sl9 ~m 2 y~V o. CROIXCOJNttPLANNINGALONING DEPARIMENTWIOif&TOWN ~ ,u i ... __ .__ .. ~Z ,: F:. ° -7, ' aFwwMDnoeoARDFaftwulcE. ,r ! x ! 0 ~"- I NO D e"> ~ ~ Q" ': °"~ I ~~ S~, ~ ~,g q~, ,g ~ ^ ~ LOT 23'` UTILITY EASEMENT NOTE: ° ` ~"~' ~ ~ ~ ~ ~ g2' ~ °b - ~~ D s, Ja . ___ --.. rE zcr„ne, i~ ! q, NO POLE OI4BUAIEDCAI'AESARETO BE %ACED SUCH iHATiHE ~ z, I WT ~ b~ 4 2"~ ~, ~~ ° ~ P sv. ~~, INSTALtATiON WOULDOISNRBANYSURNEY SiAME, OA O&SiRUCi LOT ~ ~ of LOT 11 og\. qgg °y /r7~0 sos _. vinovuoncu+vLOruNEOasm~ruNEn+~D~ruaawcE 13 °I ~ 12 u~ ~ ~ N Esc >, ~ ga ~ ° ~, ° ° ~. ~ ~ ' OFASURVEY SYAI(E BY ANYONE ISAV!OlA-ON OFSECiION ZTS.St ~ ~I ~ `" ~ Qp OG ,P''nag V " ry' ~,~ Wq '-~`- ~ E 'NISCONSIN SiAYUiE5. U1Wn EASEMENBAS HEAIEN SET FORTH c..u ~ g 2 r0 °s ~ ZD AREfORTHE USE OF PUBLIC BODES ANO?RNATENUAIIC ° ~ I £ ` ~. ~ LOT 24 ~ d6~~gA bS LD".6 urhAIESHAm4cAa~cMrasERVET~nR~ I- ~ ~, 1 LOT 10 / D ,r ~~3 ~ A i a ;7 I P57 c- 0 0 ~ p /ff 0 NOTES: ~ ~ ° ~ I o_5 o I rF z ~ ~ •s ~, o ~ ~ m ~ Nsq, FRONTGEiBACN~55'IUNIESS OTHERWISE NOiEOI 0"v i I N ??5 Z ~ /,, r~ SIDE SEI9ACI(='25'RB'COMSWEDI 19 U ~s.- ~ ° ° 1 1 L1T 25 eg94 °~ f ~ ~ 5 _C REARSEIBACK=rS I b ~ " LOT 9 ~° W WE?LPMJ SEiBACN=IB h o r ~. ~ ,g' ~ ~ 0 0 p !$ F ~ .-. pet 'FRONT SETBACNAYJSUREO FROM 0.-0W ~ C~17 de i ~, h h 'OO,aH~ ° 1.. S n~. h ~~ r ~' "VA / rn c, AllBUADWGSTOAE CONSiAULiE01N RLO%0.1RYWNH[PAAWCf ~ ~~ -~' ~ d`' ~ ~ ~'. ~ - ~ ~"°'°C / 6N I C-~~ ! ~ : q - h ,y 1 500' Li,°'175.x' LryiST ~ uvT 6 ~ .C v aq, `qo., W EABQ~IEEMSSfN1LW1VEALOWESiBUhDINGOPENING0AWM90W 07. , ~ h h~' L v r iA l y WFLLE4FVAiKWNOTIESSiWW IWOFEEi AAOVEIHEHIpi Nan ro ~ N 89'2D6 ~.E 42557..- ~ ° F~ ~ 9E11 h ; 9 Q 6ggq ~ % ,~ WATER EI£VAiIONSH ~ ~ rDl~ I ~~ qg Z ~H~a'~ LOT 26 ~ W'° y IAT4 m ~ a ~~ I roxd/O~rN I ~ z ° . 42 S.. A ____ I~ IgDtAltllOl LOCATIGNMAP: ~ ~~: ' ° 2g~ ~"~,' sD.° e _ [ he N A L. "q' fit N16~ (NOT TOSCALEI v i_ I,OT_6 ~N 6G~4Sg~Op. ~~~ry r>4`~ x7 /~n `o-. ~ ~6i ~~ p~p~ SECTION 6, T29N, RI7W, 1 ~ I-i X95 k ~. R u 5- ~ Cu qq4 O ~ ~Oi " y LOT 27 ~!i wb~ ~2 ~ umH 4VFNJE I ~ ~'' Iv nV_~ ~E Q~' VgO. ~.~` ~. Ryq. N 1! ~~--!~ ~ '1~ . LOT 7 Po' ; ti u~T D ~,, 1~ ~ sii ~ ~ ' ~ ° ~ ~~0 ® I z~ ~~~ Iti I,i~'~;il 00 ~~ ~" ~ "E ~~° °q•N d~ I ~., ;, 'r>/T,; ~ ._.~ cry ~, > _OD d 4c45F. ~,~~ ~~ ~i Sy ~~ , i - ~a` ~ ° ! ., R ~ , ,• ~ ~. a0., „ ] ~ ~~ ~ ~ ~ ~IR ~ AF°`A ~ 8974' 2 E. 6 ,N LOT 26 ~~ cps a. -s a:!a ~w: ~~,. nue[nR114csAREAEFEa[NCaDro ~ ~ ~ ~I ~ ; ~ -- - lO1SP AVENUE ,L '~ 1 'o ~Sa a ~~ °~ 0'16° THE SOUiHLINEOF THE S.E.1I40F I ~ ~ P94'la'&20 a~ C' - ~ - (~ SECTION S, i29N, Ri7W, AS51Rk0 ~ ~aTx wNE \ , QD' ~ ~5. °pg~ - TOBFA0.N69'a'ITEISi.CROUf I ~ ~~ ~ ~ 12661' 7981 - - `Q 4 I CWNn COOADWAIE SY&iEMI L _; ~ ~ ~ °~ N 89'41'16' E i TAT 2 PLAT L004TION LOT 5 ~ Q ._ ,. " y ~ @ T 2UE.a9' ~ A, ~277,5c o ____ .cE h ~ JC '1 ° ~ A3P3 a~ _ ~ 'N I ME b"aA +~ 0.0 I ' Y`'I ~ Q p Y) ~ LEGEND: any og5 dvo~~ ~ z1 `~,~no°s, m 'Iw °I SPRQaD5E1&1CKONE .-._._ 1 Iy T ~ FOU19J11N'IRON PIN ~ d~ p } 0l -I J ~~~ n *,P _ _ _. lrummBASEMENr n'''A le ~ LOT 1 ''''~ ~ LOT 29 jn a'I UMESS OTHERWGENOlEO SET11N'BY 1611 FlNW[A.ITr n ¢ I I ~ LOT 3 '. `~ -- ~' LBShT. ~ ~~~ LOT 2 ~ ~ ~,: ~~ ~ :, . ~ :s dl t SEi 94'BY 161RW!%NWf.1.50 LOT 4 A I ',.. ° V .:.Y I -OAAINAGE E45EMENiLINE .~. nc ° ~~ N ~' n ~2 < ~ v '. .~,,,. c --- FENCE LINE ~. L99.ffL AiP1L0iHEft LOT Iti `li u~~ `~ ~ WP1 CORNEAS ., ~~ I ---- '3 c i 2 ~~ w. ~ ~, t 'i NIGHWATER ELEVATION ~ PROPOSED CRNEWAYIOCAiNM ° 1 ~ m `~ ~ 1GtNP ,^ ~ I _ P. 6° I ~ 'F -E 3 i cV tI1Vl ,. LOWEST BUhDWG OPENING ® I ~" ~I c I -~ '' - _ FW4 'Nlr P0.0POSED JOINTORIVEWAYEOCATION 1 ..... -_ .. - ... - _ { - _. 'i 1 \ £ ~ t _.' .,..29 ,fi L' .Ai COUNfYMONUMENT i- 2A,.,a _..S 85'Y;2o : 6E351 DO ~.:=116.6 ~21[',_ 21556'' }E 7?L9T 33.1;4' _ !FOUNDASNOiEDI __.- 46°~ S u~1] 8' ,~ jBM' BENCHMARK n a 9 d~f," E _ _. ,'-'.3.OC ~ - 1a30.i4 ~~ 7 Iy I C 100TH AVENUE N 69'04'17 E 111.74' oRrFTEDeY: ~EFFM~a.4 su ~ W a ,~ onr+Al~LO LAUDS _ _ ; , - ~Wi ~-5,.r1 Lv a r;[ sE _ SHEET 10F2 FcuND c~~N,Y se ,. a scnov a S 89'54'26" E 653 66--- F~°nD c,J+'~ ral " a -, aA a Lo' S ura ~NNa - ceia,,ann i~a' - -- „r SURhYNAIL) R~RV[Y PAIL) P L A ~al'.P R A 4 I E H~.O N '' .. ___~.. c06 -____ .' _... _ _______ .q ~!_ _____ __ _____ , ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND nOW~1E~SHIP CERTIFICATION FORM a ern Ef -~ l ~5d-c~,G~ u,,C, Owner!Buyer ~~ V >< ti ~ r s. Mailing Address ao I Property Address ~~~ City/State Parcel Identification Number O /8 ~ d Z / ~Z G10 L> LEGAL DESCRIPTION Property Location ~~^-' '/~ , S~ '/~ ,Sec. 8 , T ~ ~ N R i `7 W, Town of /~a~,~,., o~¢ Subdivision Plat: )~ct.,•~..,t„~o~,..d ~j~s ~~f~ ft 5 ,Lot # Z L. Certified Survey Map # Warranty Deed # e' K tea. ~. ~ ~1 a ~ /~~ ~~ f '~ S Spa (Verification required from Planning & Zoning Department for new Spec house yes 1~.r-o Lot lines identifiable ~ yes no SYSTEM MAINTENANCE AND OWNER CERTIFICATION Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed, by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. Owner maintenance responsibilities are specified in §Comm. 83.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance. The property owner agrees to submit to St. Croix County Planning & Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pamper 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. 1/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 Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Planning & Zoning Department within 30 days of the three year expiration date. I/we certify that all statements on this form are true to the best of my/our knowledge. I/we am/are the owner(s) of the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. Number of bedrooms .3 SIGNA URE O APPLICANT(S) s ~•y,o~ DATE ***Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Department. *** Include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if reference is made in the warranty deed. Volume ,Page # (before 2007)Volume ,Page # (REV. 08/05) POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page of X11 F INFARMATI~N Owner ~~ Vf,,~ ~, N ~ o.~n ~'~ Permit # DESIGN PARAMETERS Number of Bedrooms ^ NA NLr-:ber of Public Facility Units 13"~A Estimated flow (average) ~ ~J~ gal/day Design flow (peakl, (Estimated x 1.5) 3 7 ~ al/day Soil Application Rate ~ al/da /ft2 Standard Influent/Effluent Quality Monthly aver age" Fats, Oil & Grease IFOG) 530 mg/L 20 L < " Biochemical Oxygen Demand (BODE) _ 2 mg/ C~ NA Total Suspended Solids ITSS- _<150 mg/L Pretreated Effluent Quality Monthly average Biochemical Oxygen Demand (BOD51 530 mg/L Total Suspended Solids (TSS) <_30 mg/L ~ Fecal Coliform (geometric mean) 510° cfu/100m1 Maximum Effluent Particle Size YB in dia. ^'"1~A Other: B-(~A 'Values typical for domestic wastewater and septic tank effluent. SYSTEM SPECIFICATIONS Septic Tank Capacity / d®® gal ^ NA Septic Tank Manufacturer S ~ ~~,.~ ^ NA Effluent Filter Manufacturer ~ l~~f /1.~ ^ NA Effluent Filter Model /*jcS t / 0 ^ NA Pump Tank Capacity ~oQ d gal ^ NA Pump Tank Manufacturer s ~' ~,~,~/ ^ NA Pump Manufacturer 0 ,,t, ~~$ ^ NA Pump Model ~'~O 0 ^ NA Pretreatment Unit ~ 5Q~ ^ Sand/Gravel Filter at Filter P O Mechanical Aeration ^ Wetland `ate ^ Disinfection ^ Other: ^ NA Dispersal Cell(s) ^ In-Ground (gravity) ~At-Grade ^ Drip-Line ^ NA ^ In-Ground (pressurized) ^ Mound ^ Other: Other: ^ NA Other: ^ NA Other: ^ NA ww w wr~w~ w wV+c CI~tJCf1111 G ~rwu~ ~ ~ne+~wa. vv.........-~ Service Event Service Frequency Inspect condition of tank(s) At least once every: ~ ^ month(s) (Maximum 3 years) ^ ear(s) ^ NA Pump out contents of tank(s) When combined sludge and scum equals one-third IY31 of tank volume ^ NA Inspect dispersal cell(s) At least once every: Z 'year{ Ilsl (Maximum 3 years) ^ NA Clean effluent filter At least once every: lp month(s) ^ year(s) ^ ~ Inspect pump, pump controls & alarm At least once every: ~~ ~ ^ month(s) `$'year(s) ^ ~ Flush laterals and pressure test At least once every: Z ^ month{s1 .g-yearls) ^ NA Other. .. At least once every: ^ monthlsl ^ year(s) ^ Np, Other: ^ NA MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells shalt be made by an individual carrying one of the following licenses or certifications: Master Plumber; Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer; Septage Servicing Operator. Tank inspections must include a visual inspection of the tank(s) to identify any missing or broken hardware, identify any cracks or leans, measure the volume of combined sludge and scum and to check for any back up or ponding of effluent on the ground surface. The dispersal ce111s) shall be visually inspected to check the effluent levels in the observation pipes and to check for any pon~g of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a failing condition and requires >d1e immediate notification of the local regulatory authority. When the combined accumulation of sludge and scum in any tank equals one-third (Y31 or more of the tank volume, the enAiaa contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 11~, Wisconsin Administrative Code. All other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatmait units, and any servicing at intervals of 512 months, shah be performed by a certified POWTS Maintainer. A service report shall be provid to the local reg~ulat~ory~,au~thority within 10 days of completion of any service event. G~'~--'~-' "'- S ~ Z Ll1 7 2- GMW (4A1: State Bar of Wisconsin Form 1-2003 WARRANTX DEED Document Number ~~ Document Name THIS DEED, made between D&B E ui men LLC A Wisconsin Limited Liabili Com an ("Grantor," whether one or more), and Hammond Hills Estates Development LLC ("Grantee," whether one or more). Grantor, for a valuable consideration, conveys to Grantee the following described real estate, together with the rents, profits, fixtures and other appurtenant interests, in County, State of Wisconsin ("Property") (if more space is needed, please attach addendum): See Attached PINS: part of the following parcels 018-1016-50-000; 018-1017-00-000; 018-1017-30-000; 018-1017-40-000; 018-1017-50-000; 018-1017-50-001 This IS NOT homestead property. (is) (is not) Grantor warrants that the title to the Property is good, indefeasible in fee simple and free and clear of encumbrances except: Roadways, Easements, Restrictions, and Rights of Way of Record Dated ~ ~ ~ ~~ ~~ (SEAL) (SEAL) * Ronald C. Bonte, Member * Steven M. Dalton, Member AUTH Signature(s) authenticated on * TITLE: MEMBER ST \y0 uaL.IC (If not, ~~ authorized by Wis. Stat. § 706.06) THIS INSTRUMENT DRAFTED BY: be Richard K.Y. Lau - Redmon Law Chartered Notary Public, State 2217 Vine St., Ste. 204 -- Hudson, WI 54016 My Commission (is Ililll 11111 IIII1 iilll i1i11 Iliil II11 i1i111 IIII 111f * 8 5 0 4 1 8 2 850418 KATHLEEN K. WALSH REGISTER OF DEEDS ST. CROIX CO., WI RECEIVED FOR RECORD 05/11/2007 03:15PM WARRANTY DEED EXEMPT 1 REC FEE: 13.00 TRANS FEE: 1333.20 PAGES: 2 Recording Area Name and Assured Title, LLC 1810 Crest View Drive, # 1 B Hudson, WI 54016 Parcel Identification Number (PIN) ACKNOWLEDGMENT STATE OF WISCONSIN ) ,* ) ss. St. Croix COUNTY ) ~1~ 0'7. Personally came before me on the above-named Ronald C. Bonte and Steven . Daltoi s) whc~ executed the foregoing the e. • ->P . in (expires: ~ d ~) (Signatures may be authenticated or acknowledged. Both are not necessary.) ~ NOTE: THIS IS A STANDARD FORM. ANY MODIFICATIONS TO THIS FORM SHOULD BE CLEARLY IDENTIFIED. WARRANTY DEED ®2003 STATE BAR OF WISCONSIN FORM NO.1-2003 * Type name below signatures. 1 of 2 Property Description: A parcel of land located in part of the Northwest Quarter of the Southeast Quarter (NW'/4 of SE'/), the Southwest Quarter of the Southeast Quarter (SW'/4 of SE'/4), the Northeast Quarter of the Southwest Quarter (NE'/a of SW'/4 and the Southeast Quarter of the Southwest Quarter (SE'/4 of SW'/a), Section 8, Township 29 North, Range 17 West, all in the Town of Hammond, St. Croix County, Wisconsin, and more particularly described as follows: Commencing at the Southeast corner of said Section 8; thence on an assumed bearing of 5.89°04' 17"W., along the South line of the SE'/a of said Section, a distance of 1830.54 feet to the point of beginning of the land to be described; thence N.O1°42'49"E., a distance of 572.10 feet; thence N.29°05'43 "E., a distance of 549.73 feet; thence N.68°22'03"E., a distance of 144.43 feet; thence N.21°37'57"W., a distance of 510.00 feet; thence S.68°22'03"W., a distance of 100.55 feet; thence Southwesterly, a distance of 200.76 feet, along a tangential curve, concave to the Southeast, having a delta of 18° 10'20", a radius of 633.00 feet and a chord bearing of S.59° 16'53 "W.; thence N.49°49'36"W., not tangent to said curve, a distance of 333.73 feet; thence S.89°20'10"W., a distance of 217.62 feet; thence N.73° 12'01 "W., a distance of 516.69 feet; thence N.89°20'53"W., a distance of 444.00 feet; thence S.00°39'07"E., a distance of 1808.96 feet to the South line of said SE'/4 Of SW'I4; thence 5.89°54'26"E., along said South line, a distance of 653.68 feet to the South i/a comer of said section; thence N.89°04'17"E., along said South line of the SE'/4, a distance of 771.74 feet to the point of beginning. 2 of 2 _ ~ 4 ~ a• ~ ,~ ~ ~ 0 0 `a 9 ~~ ~m ~s ~~ ~Q ~~ ~ ~ ~m U ~ z 0 ~ ® ® ® ® ® ® ~ i 0 } w w Q ~ ~ 9 m 4 ~ `a ~ = a O a o z~ z~ ~S LL ~ _z ~Q ~w ~ ~ a ~m s O } u~ o 4 ~ -• ~ 's ., m s ~~ E ~ a u ~pq _ S a r w U O „~.EOI-,9 S on C"H"7~ • x „9il-,B ~ O ~I ~~ i i 1 I II ~ ,~ _ , ~ I II ii ,i , q z D ~ ~ ° ~ I~ ~~ o ~ e• . •sla a t~ „asp . •sl V ,~ ~~ m ~~ W i ~ ,U „£',S „14',4 ~ i Z .f~ i i ~ V~ W ~ ~ ~' V , f Q ~ f LL Q 0 U~ m " ~ u ~ O ~ ~ ~ LL ^ 0 ~ '' Q Z N LL •F • ~ ii W L ~ W m ~ i ~ p ~ } O , 1 } l7 ~' U w ,~ z ~~ a°a~ ~ m z Z u+ i ~ LL Q ~ ~~ ~ m aj i C'H'O'2U C"H'~'2!J , 3 Lf gyp' i „gtl-,8 .510-,8 ~ ip ~~,~ x ~ „Sp01-,9 „~60h,9 Q~ r ~IF-~- ~ W Q r0? is t4pQQ2du^} w w" V ~Y~3 Z_ mQ ~9 W W ~ rZ ~ 0- ~Q ~ AZ Q ~ ~Z~l1 C• ~j~ Z T ~ BJ~~ LL ~ ~ ~ ~ Q u ~ > Q m ~ ~ ~ m O C~ Q ^ F ~ ~ u Q w'yrg'~ ~cj_-~ ~ •s~ ~~O'°oz v0 w/LL~ ~~d4 Z)~ w` a ry 1O ~ x~ Q x~ ~ v ~~ N V ~' ~ ~ ~ ~ 3 ~ \ 1L ~ lV r in H ~ ~ ~ lV 3 - • Q r 9 ~ . ~ . ~ -Q F~ ~~ z~ J O Qy () 7LL 2 j A~e> \~ ,o-,¢ .r.ra ~{ ~ .o-x ,o-,n o ~l ~ ,qr,t ,SIE•,6 U ~~ o ~ ,Q r ---------------------------•-•----___-----------_______-•--------------- !S8/,OJ "7"O,ZE! w O 1 I I 1~ J i •Y ~ 3 ~ 6acslmt aoov . t I I I I 1 sSrc~~ 9 ~ m ~m I II Q ~~~1 ~45 4 ~I L^ m I II ~ V ~ 11 ~~~ - ~~ §~ Z a it ~ j~ aj° 4 p t 1 II ~Q e~R ~~ ~ p ~T~ I 11 4= row W . $1 d ~ ~ri~a_~\'~ n~ Q Q n I . 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