HomeMy WebLinkAbout018-1083-40-000/ PRIVATE SEWAGE SYSTEM
INSPECTION REPORT
GENE~RAiL INFORMATION (ATTACH TO PERMIT
Pwsonal k~tortltation you P~~ ~Y be used for seoondsly PwPo~ [P~aoY Law. s.15.0~ (1xm)].
s Name: V~ owe :
Hammond Townshi
I++sP. BM E v : 8M Oescnptan: ~ p
00.0 trA ~ f5fl .c~ ' -- n1E'dl'c.~,.,arsi~-~-
TANK INFORMATION
TYPE MANUFACTURER CAPACITY
Septic .(~
Dosing
Aeration
Holding ,
TANK SETBACK INFORMATION
TANK TO P/L WELL SLOG. ventto
Airlntake ROAD
septic , 9D' ~~s' as ' --. NA
Dosing NA
Aeration NA
Hd
PUMP /SIPHON INFORMATION
SOIL ABSORPTION SYSTEM
ELEVATION DATA
ounty:
St. Croix
Sanitary Permit No.:
384192
rate P n IO No.:
Parc Tax No.:
,~.
STATION BS HI FS ELEV.
Benchmark .22 10(.22- oo,o'
A Z.r 9Q. 08''
81dg. Sewer ~4 S q6.2 ~'
St / Ht Inlet ~' 8 a ~ ~$', ~2 `
St/ Ht Outlet S 9~- qs: 25'
of Inlet
Ot Bottom ~-
Header/Man. g • Z° g3.O2. ~
Dist. Pipe '~ • r~.o R3.OZf
Bot System ' ~~ q / • ~~ `
Final Grade ~~
oW ~' 98.58''
- - '
ENCH Width ~ Length i
93•~ No Of Trendhes
~~ PIT No.Of Pits Inside pia. puid Depth
l
C SYSTEM TO P/ L SLOG WELL LAKE/STR f-EACHING n cW~er- ST~w ~s~"
SETBA
K
INFORMATION ype
System: ~ !+ ~ ~ I ~ (~ ~
---~ CHAMBER
OR UNIT a Num er.
c
f11STRIRlITIC1N SYSTEM
H . er / Mani o U Distribution Pipe(s) x Hole Size x Hole 5 sing Vent To Air Intake
/ S ~
length ~C.{~ Oia. Le Oia. Spacing ~lv
acturer Oema
Model N ber GPM
TOH 'coon S em TOH
amain length Oia. at. Towed
SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only
Depth Over Depth Over xx Depth Of xx Seeded /Sodded xz Mulched
Bed /Trench Center Bed /Trench Edges Topsoil Q Yes Q No Q Yes Q No
COMMENTS: (Include code discrepancies, persons present, etc.)
Inspection #1: ~/ °~ / o I Inspection #2: ---t-1-
Location: 990 172nd Street, Hammond, WI 54015 (NW11/4 NW 1/4 16 T29N R17W) 16n2917~612
Pheasant Hills -Lot 40 ~e.Y.~' (~~Pt~r{~ r„o~r^ ~'~~°~`' `'~
1.) Alt BM Descrlptlon ~eP~ s f ~.e~
2.) Bldg sewer length = Zfo u
-amount of cover = ~~ ~1i3 + a~-~`~~.
Plan revision required? ^ Yes ~J No
3) se ptl~er~de~ additional information. oti ° ~ ° ( ~ ~ S~ ~cM. No.
1 Bgp~ Q ~r~~ c Gate _ •~ tnspecta(~"s~S~ig~n~at e ~ J ~~ ~
-~,,(<-- ~ w ~ f* ~e a~' I Z u ~ / ~ " ~ GGGGcovrr u~ d-~~ `'.~
.,~(. -
~~ ~ 1 O'-n
~~~ . ~'12~~ Sk
Sanitary Permfit wpp,Li,estlon Safety&BoOdlttSSDlvision
In accord widf Cotatri B3.:cl, Wis, P.dts[. Cadc 201 vt-, WeaNnaoon Aw,
~~~
~
~ See revenc side !of ihsvuctions far toatptcgpg this application PO SoL 7303
Oopsran
etrt ~
Ce,n's:.a P~pn~ i~O~e~~ Yoy provide may be ue[ed for 6xonday p~¢poc~ f~faduao. WI 597A7-302
• (Riwry Late, t, 15.t~(1)(tn)) (5uba-ft cotoplotcd fog m ~rY ifbot
Attach e4~ l
r~ o[r inns w
C017ti ~O on )for the SrE~ pp D tr not less tllitl 9 ltaie etvslod.
.112 X 1 ] ;e_ty.- in tda.
~„y. State Sanimry P N~w~Ler C7incE [t envtaoA to p[evio4a npphePtien
CrGI C tart Jut
_ _ _ -,
I. A llcatloa I>tfosmadoe ~ pleaae 1;'17nc aI1 It{iortpa<t{on L
Pev
e[ty Owoq Nees oa[[tiolt:
p
e
114 ~'rlls
S ~~ T/a
~
ropcrf/ wnas Mlaihny ~.~ .
N
/ N
£
~ ~
• D
ry, Smm
Godr Phone Nomhx
5~
~
' &ubdivisioaNarpn or T11t[riber
~ ~.
~(.r
- a P~f~~s~~~/f
Type of Bu11d1ug: (cheek one)
1 car 3 Firyiy Avellaig - lVo. of 8edr4ams : . ~ C C;o,
^ ~h71s,Se /~/A~
PublldCo~~~~a1(deserlbe use)`,
O 5nta-Or~cd l~Tawn aT
/f(f~
~
/ Neacnt Road
X 9 3 • ~s'
a 3
~ P
wa, Tmt
IIt- a or ermfc: Check Qyly one bo= oa Ii[te A. Check boat online 8 iP a I~t:sble
/~) 1. New Z. ORoplaer[zamt ). Replac$neaato 4• 6
IL gauto
51'ctrm 5 'atom Tin]c Only .
S
B) A S pestnntt wet rcvionsf++; mc, om r
3 i 9z '~[°
Type of P09VT System: (Check ell tltac app1Y) .~ lvp
Non-pressuri~ Ys~-6ra~m~d p l;>K~ttnd Tic ~ S9nd Fs~ter
D Ptetnatzed In ga+owd d+ns Single Pass D CQeaavaed Wetland
^ Drip Lane
O Aa ^ Aerobic Treatment Unit ^ Ronirarlacii • O d•J>a:
V. Dtt e>rsalrtfeRtsame.lregleLolmatfo
l . pa ~' CJ~1 ~- [sP'~~ A~ epsese! A~ +. Soil A~4taaoa e[ro 4o[I Rare
e Re0[arr+d Preposod 1[ati• (C+dsJdiy/rq. R) ~.tm.4neh)
atan
Y
on 7~~en
~s~ s~~ ~~ ~ r ~ Q
g
°
s
I / (
L
vII. Tame Capacity in Tetra] M of Ma[tvfaenatr F~tfab S.[e S[oe1 Fs~ Plesnie
lnfortaatian [3ollor[3 t3allonS Tanks Cqn- Cpt1r ~~
7~L1,~ ~'aw6eg crere eml~[ee
e
aE~T/L 000 ~i00 f~~j/r ~
~ ^ ^
'1~III. RespotaslblLsy SterNbenr
Y the ta~dersi as6atae 'b7i or iast[1latio[s o e POWT s}-own on rJfe atpcbmd Ian6,
1 Na[aG [ p a B: AtP a ~~ ~
eD N z ~ 9s/ Z ~-~"~S
4fa[ebers ACC~s 9ttoe4 Ctny, S
~
S o ~ ib
~ Gldl~rl!/N~E r ~ 7.T7
IX. CouecyJDeparppetar IIse Only
^ Dltapyioveil So[dmey Pe2tppt F.s Qneh[dac Groaodas[er Dsa: rca~o3
1~Appruocd Q Owner Qivm inidal Adverse p ~
Ads (No carpps)
~
Dereratmttxan C~ S U ~O I
R Condlt:l6ns ofnnApyroysl /Aetasona >;olr Dfr~p ravel: ' 1 n t-~ ,~ _n
~ ~'~- d~~JL 'C'~~~ __--~ e~.QPti ~~ (~Qlr~'C_ . 1"'~U~ S~.Jt 'l~i~ 1~CQtu~ ~ ~.~~
•~ to~E,l, ~ w~.u.s~_tn~.~t.t~ew,o~ an ~ ~.(~.a~ c~. ol,cQ,c~t,o~.ce~ ,
sn~. Asa mroo
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T.L. Sinz Plumbing Inc.
ES609 708th Avenue
Menomonie, WI 54751
FAX TRANSMITTAL
pate: 6- y~oi
Phone: (? 15) 233-2644
Fax: (? 1 S) 235-2592
No_ of Pages:
(including cover)
To:
Attn: ~~i~J~
From: / ®br~ ~~"~
Subject: /~ 6'!'1
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T.L. Sznz Plumbing Inc. N ~,~- ,v w ~ e ~ 4 ~ ~ w !~ ~ ~ n
E5609 708th Ave. - Phone: (715) 235-2644
Menomonie, WI 54`151 Fax: (715 235-2592
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E5609 708th Awe. - Phone: (715) 255^2644
Menomonie, WI 54751 Fax: (715) 235.2592
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SOIL EVALUATION REPORT
tNrsoonain ~p~rr+ent ~ CorrKrrerce
• Division of Safety and Bu~d'~ ~ in accordance with Cornet 85. Wis. Adm. Code c
Canty '.T
Attach complete site plan an per not less than 81/2 x 11 ~ size. Plan must
indude. but not lurri6ed fo: vertical and h (BNn, dKecdon and Paroei LD.
percent slope. scale or dimensions, north . ` a oe ~ nearest road.
Please priniit nfar~atlon. ~`
P~aonar i~orrnar;on you P ~ t-e . rr.l6.oa (1) im))•
property Owner Property LACatron
on i3on '~~ 3 2001 w Govt. tit tiw ua ti~ va s
PropeAy owners fiAaraiGrrg Address _ ~.' `~ S~ cCJ~ ~ l_ot # t3lodc # subd. Name ~
~ do Ph a
Page ~ ~.~
~r'~.l ~L
Date
T~-_____l~~T--
T Z ~1 N R / ~ E (orI 0~D
U 1 ~ ~ 7d ~ S ~ -
l ~ ~ ~ ~~ ~~ Nearest Road
State Tp
~
t' 7Z ~ S
Stu M vn...,.w'~ ~ ~
cJ 1 Sal o/ d fib m w~'r.
4'sd /GOP GPD
® New Gonstrudiwr tie: l'~ Residerdiat / Neanber of bec~ooms
H Code derived design flaw rate
3 -
Replacement ^ Public w - ~ Fbod Plain e~ratiorrr if applicable +v~~' ft.
Parent material U U ~•w R- ~ ~ -~r Y 3• •~
Ua
Gerreral comments s y s f ~ w~ c Jt V• lb~ ~y. GO w
and reoornrrrerrdatiorrs:
^ BOA
a ~~ # [~ Pit Ground surface elev. 9 ~ . ~~ _R Depth to grrMm9 facer (._ ~ in. ~ Ra
Horizo n Depth Dorrrinant Redox Oescriptior- Texlrue Structure Consistence Boundary Roofs GPD/f~
in. MunseU flu. sz- ~- cobr C ~
~ . 5
1 b- ~ io 13 -- S i l Z v
-
5
9
2 -Zo l0 y 14 - 5 Zrn ,
c.5 . .
3 --- L 5 Z m m-~r ~ S • ~ ~• 2
2q _y (O
~ ,
-- LS Z S GS ~ • ~ / •Z
5 o (p
4
-
sc
l~ 5 L 3 m sb K m-Fr -- - -~ . 9
u
o
r
91~~
a#
Groundsurfaoeelev. q~ • ~ ft. Depth fo Grruting
®Pi
° ~~
factor I ICS in. Sod Ram
Horizon Depth t
Dorrdnarrt Color Redox Description Texture Stnrcture Considence Boundary Roots GPDVf~
'Eff#1 ~~
in. Munseq Qu. Sz. Coat Cabr Gr. Sz Sh.
S' I cs ~~~
2 $- ~~ Jy "' Sil 2rrrc~b rn~r cS - 5 • 8
3 ~n-inn 1[~.,r3JCo SL 3rr~5bk m-~~ -• _S .9
• Eflp~t #1 =
CST Nam (Please t?rint)
2f1.~ ~~
> 3p < ~p r~ and TSS >30 < 1 W mgtL • EtBuant ff2 =GODS < 30 mglL and TSS _< 30 mgiL
// ' ~~ ~ Number ~i
Signature
Y,~l KPY` Date Evaluation Conducted Telepttorre Nurrtl
art-Y,r~-~.~-. u ~I ~-z-I~?-~ y- Z ~ - ~ ~ t 5) 241-U
~~ 3ar,-4 e_ Patcef IDS
~ z ~ 3.
fl Pit Ground surface elev. ~ Sod ~ Ra
dooc Desaip4on
R Te>dure Struchxe Car~idenoe Bound/ Rods GPD/t~
e
Horizon Depth DorrriruMtt
~,. Murrseil fltr. Sz Cont Cobr Gr Sz Sh. •Eff~1 'Eif#2
. 5 . $
~
~
SIB Zr,~ m~ CS v
O-Ib ld r
~ ~--
2 ~ 2 m5 k r c w 5 . ~i
_2 ~
3
0 41 L S Im5 v-~ L5 ' , ~~ 2
zi4-~ l - . 5 .9
3a
~~ U
Ground aurfaoe elev. tt. Deptlr b 9 ~~ in. Soil Rate
^ Pit
T
ture Shrx~xe Corua~noe Borx~ary Roofs GP DNf
Horizon Depth
in. Domin~rl
MurrseY Redaor D
(lu. Sz. Corn. Color . ex Gr. Sz. Sh. •Eff1F1 'Eif/~2
n n $«~
~9 ~ Ground Suriaoe Nev. R uepm m iammg ra~wr ~~ ~_
^ Pit
~
~ ~~
Horizon Deptlr
in. Dom+raarrt
Mansell Redcor Desaipfiar
(lu. Sz. Cont. Cobr Te~xe Stnx~ure
Gr. Sz. Sh. Cence Boundary Roots GP
'EifiF'1 D/li?
*Etf#2
• Elmierrt 1R'I =HODS > 30 < ?20 nrgfL and TSS >30 <_ 150 mglL ' EIINrern ~ = t~Ds ~ ~ ~• and TSS ~ ~ ~"
The Deparlmerrt of Commerce is an equal oppordmity service Provider and employer. tf you need assistance to access services or
need material in an alberrmte format, Please oorrtact the departrnent at 608-2G6-3151 or T'CY 60&264-8777.
sena3xt rRO~~oo~
PAGE 3 OF 3
NAME 13a n ~t LOT# y~ LEGAL DESCRIPTION ~/ w '/4 N~4,S F6 TZ Y ,N,R / ~ E tor) ~I }
SCALE: I"= y~ ~
BM I ELEVATION /~Q .~
BM I DESCRIPTION~pe-~ / ~ r ~o ~ ~1PG
BM 2 ELEVATION 9 ~• /~
BM 2 DESCRIPTION ~o ~ a ~ ~'Drc P~ G ~
SYSTEM ELEVATION~o,o 9yD~ G«,v~r r3 5Q
ALTERNATE ELEVATION if//~
CONTOUR ELEVATION 9~I oo 9'.f- 6G
N
I x
~ ~ Pc . /6
8--~1 I
0
a
~~
SIGNATURE ~O~ /1 C' ~^- ~ DATE ~-30 -a~ ~ _
F r, ~ s
~',~ ` ' ,~ ~ ~~ F ~~
r ~~ ~ n .
~~ /
Ct. 's Wf'
~, d`M` ~..~_ k
'. ~ `~ ~\av , ~ c,•; Sanftaxy Per1RA~t Apklfea#ioa Safety &'Buildinga Ilivision
ri , ,4U , In accord with Comm 83.21, Wia. Adm. Code 201 W. BVas6,ington Ave.
`:.'See revctsa side far ittstruetions for coati application P(7 Box'7302
b0partr .qa,n~~ . P'etsanat izsformadon you provide may be used for aecandary purposes , WI 53707-7302
~~ ~~ Madison
_....__-__ -- jpriuacy Law, s. 15.04(1)(m)j (Submit completed form in couaty if»oc
Attsc corn tare tans tot a coon co onI forrhe a stem, on er tfot less than 8-112 x I inches in sits. smote awned
/Jp~ , ,~ 3gtta ~ ~ Q1cC 7 rt'v1.StotA W amnoua avohesdnn Ceorn 9~ .....ti..
~~VS~/1~ ~'Yi$D7~
~
att
ro
we v rwwiauw,
~i~a
lJl~a s ~'f~1
N
ors
p
y
e g Ad
I~// 7D ~'ST ~
~
l
Ci Slate Dade
~~~ ~ S
~ b
Sejb~divisionyldam orC8~M~bar
,~ 7 l D /'~T~~O~///s
II. '1<'ypc of Building: (c)lack )
ty
^ 1 or a Family Awnllittg - No, o ooms ;~ Q Val
sge fJ1y!/NOXID
^ I'ttbliclCornmerciai (deserlbe vse)` J~(Towq of
~ Stato-dwned ^'- D 7~tf~-
, 1 1
) ~ x ~ ZS
C
2 Nearest
- ors -~o-o~ao
.
. F
TIX. '~ o of Peranit: Chock ottl one box o 'rte A. CilecYc bax an ' B if a lacable
,q,) 1. ew 2. Rcpls+xnaetit ~ lacement of 4.
S steam S 5. 6. m
t»m
B) omit ~
P 'twos 'ov 1 issued
r
V.
T~+ge of l~OW',t $yrStcm: (Clteck ail that apply)
~
,r
~r +~an'P~~ed In-gmttad ^ 0
.
^ Pressurized In-gt+trund D kio g Sank 0 COnsuu edetKi
p s D 17
i
O ~ ~ ^ A Treatr»ent Unie r
p L
O O Other
V. Di ersaUTlreatanent Axes Iniotmariotw: _
1 • gtt w Cpd} ispersnl Area 3. I?isperaal a. 1 Applicuhon
lzequiexl Propoxtl R 1 on
~
rude -
i q~t
a RJduy/aq. tL)
~O o SaD ~
~
~
--~ ~ p f--
V II.7nnk Capacity in To # of facturcr 1'rctgu el Ftlicr- piastfc
Information Gallons G Tanks Con- B~9
New Lxistittg
Taas3CS Tanks cTGtG StlnC
!~' ~P~L POD --- DD / ~~~ ~
,o v ^
VIII. Respattaibiliiy Sinten~ottt
Fmtnixt'c Adam (sa+~r. Cis, state, ~;
609 ?n~ ~£ ojtl/~'J~~ !,~/2" S~7S/
IX. County/Department Use Ny
^ Disapprove Sanitary Permit Fee (Includes droundwatar Date leased g AYCtu Si rme (Na stamps)
~.API~'~ ^ U.tvsier Initial Adverct: S Fx ~
1]etttrtani ~ ~ ' ~ 2 26th j
X. ~Ci Batts ~f Approv$i l~Itcasona for Dissppraval: .
S.x~. ter S ~M^, -' ~ ~- H otW ~S~ (%~ ~, ~ia'''`ti` inn, 83,_
SgY7 98 R
CX~~~ ~tMut. a'~ ~... ~ r~e-C~.~x~eti~.~t~t~et~t5 .
Tea/Taaf~j Z1dI5 aaaz Ftf Jhi~da'I~Q d.Li~llaa N.-Il1Q 660I Zl:Z STL T %E'3 Sg:~t dl7.L aaaz~6T~TT
~. 'Wisconsin Department of Commerce ORIG~~ND SITE EVALUATION Page I of 3
- Division of Safety and Buildings in accord with Comm 83.05, Wis. Adm. Code
Certified Soil Testing
Attach complete site plan on paper not less than 8'/z x 11 inches in size. Plan must COUnt
y
include, but not limited to: vertical and horizontal reference point (BM), direction and St. Croix
ercent
l
scale or di
msion
rr
ii'a
t r
rth
d'
oc
-f
"
ddi
t
t
d
p
s
ope,
me
s, no
a
ow,,.~n
(
a
t
o
)l
ance
o neares
oa
.
s
LD
#
Parcel
.
APPLICANT INFORMATION - P/
ase print all information
.
b
Personal information you provide may be used ~>*Secondary,Rurpd~ba (Privacy Law 5;15.04 (1) (m)). I@Wed By Date`
Property Owner $~ ~ Property Location
Bonte, Ron ~ Lot NW 1/4 NW 1/4 S 16 T 29 N R 17 W
G'vt
~.
<- e .
Property Owner's Mailing Address `' `' `` ° Lqt # Block # Subd. Name or CSM#
1011 170th St. ~' ~>7L%~'~ ~ 40 Pheasant Hills
City State ~i Codez~p
H
d WI
1
71 96
24
4p ,~] City Village ®Town Nearest Road
d 170Th St
~
ammon
0
-5
5
0
S .
unmon
^ New Construction
~ ResiTerjtiaf / Number of~drooms 3 ^Addition to existing building
Use:
Replacement ^! Public or commercial describe
Code Derived daily flow 450 gpd Recommended design loading rate •3 bed, gpd/ft2 •4 trench, gpd/ft2
Absorption area required 1500 bed, ft2 1125 trench, ft2 Maximum design loading rate •5 bed, gpolft2 •6 trench, gpd/ft2
Recommended infiltration surface elevation(s) 24" below contours ft (as referred to site plan benchmar
Additional design I site considerations install 2 - 5' x 112.5' shallow trenches for 3 br
Parent material till Flood lain elevation, if a licable NA ft
S=Suitable for system Conventional Mound in-Ground Pressure AT-Grade System in Fill Holding Tank
U=Unsuitable for system ~ ^ U ®S ^ U ®S ^ U ®S ^ U ^ S ~ U ^ S x U
~7VIL IJC~7VR11- I IVIY RGrVI[ I
Boring#
1
Ground
elev
99.0 ft
Depth to
limiting
factor
> 60"
2
Ground
elev
100.0 ft
Depth to
limiting
factor
> 64"
H
i Depth Dominant Color Mottles T
t Structure Consistenc Bounda Roots D/ft2
zon
or in. Munsell Qu. Sz. Cont. Color ex
ure Gr. Sz. Sh, ry Bed ~ Trench
1 0-3 7.SYR 2.5/1 - sl 2 m gr mvfr cs if .5 .6
2 3-7 7.SYR 2.5/1 - sl 2 f sbk mvfr cs if .5 .6
3 7-22 7.SYR 4/4 - sl 2 m sbk mvfr cw if .5 .6
4 22-60 7.SYR 4/4 - Is 0 sg - dl - - .7 .8
9~ ~ / •~ sst.~~
1 `f• `l 50~ `1
Remarks: consrtlerable gr/cob/st below ~"
1 0-3 7.SYR 2.5/I - sl 2 m gr mvfr cs if .5 ~ .6
2 3-1 I 7.SYR 2.5/1 - sl 2 f sbk mvfr cs if .5 .6
3 11-29 7.SYR 4/4 - sl 2 m sbk mvfr cw if .5 .6
4 29-46 7.SYR 414 - sl 0 m mfr cw 1 f .3 .4
5 46-59 7.SYR 4/4 - is 0 sg dl cs - .7 .8
6 59-64 SYR 4/4 ~ ~ sl 0 m mfr - - .3 I .4
~-
24 ~ b2 `fo
i
Remarks: nonzon 4 nas occasronai i.~ r tC 414 Is mcrustons (u, sg, alb; consraerable grroobist below y
SST Name (Please Print) Signature: Telephone No.
Henry F. Grote _ 715-665-2681
address em ~e of eshng Date CST Number Ref #
P.O Box 57, Knapp, WI 54749 4/13/2000 222774 1050
'~
.S
PROPERTY OWNER: Bonte, Ron SOIL DESCRIPTION REPORT
PARCEL I.D.#
Ground
elev
Page 2 of 3
Certified Soil eT stmQ
Horizon Depth
in. Dominant Color
Munsell Mottles
Qu. Sz. Cont. Color
Texture Structure
Gr. Sz. Sh.
onsistence
Boundary
Roots GPD/ftZ
Bed Trench
1 0-3 7.SYR 2.511 - sl 2 m gr mvfr cs if .5 .6
2 3-8 7.SYR 2.5/1 - sl 2 f sbk mvfr cs if ,5 .6
3 8-27 1 OYR 4/3 - sl 2 m sbk mvfr cs 1 f .5 .6
4 27-33 7.SYR4/4 - sl 1 msbk mfr cs if .4 .5
5 33-39 7.SYR 4/4 - Is 0 sg dl cs - .7 .8
6 39-60 SYR 4/4 - sl 0 m mfi - - .3 .4
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2 5-11 7.SYR 2.5/1 - sl 2 f sbk mvfr cs if .5 .6
3 11-28 l OYR 4/3 - sl 2 m sbk mvfr cw 1 f .5 .6
4 28-39 7.SYR 4/4 - is 0 sg dl cw 1 f .7 .8
5 39-60 SYR 4/4 - sl 0 m mfi - - .3 .4
r~en~airts. ------------- o- --- .._ .._..... _ .
1 0-4 7.SYR 2.5/1 - sl 2 m gr mvfr cs if .5 .6
2 4-13 7.SYR 2.5/1 - sl 2 f sbk mvfr cs if .5 .6
3 13-36 l OYR 4/3 - sl 2 m sbk mvfr cs 1 f .5 .6
4 36-54 7.SYR4/4 - is Osg dl cs if .7 .8
5 54-64 l OYR 4/4 - s 0 sg ml - - .7 .8
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~ '~' ~~ Pr~~~te Onsite Wastewater Treatment System Management P{an
~~-;
~eptic.,Tank And Gravity In-Ground Soil Absorption Component
> .~<~,,
p,~'su n€ Comm 83.54 Wis. Adm. Code each Private Onsite Wastewater Treatment
SysterP shall include information and procedures for maintaining the system within the
~..` :piata~~e, omm 83 and 84, and the conditions of approval by the department, agent, or
2jau ~.rni`~-er5 al unit. The approved plans and permits for system are on file at the county zoning
or health department.
This management plan complies with Comm 83.54, Wis. Adm. Code, and the In-Ground
Soil Absorption Component Manual for Private Onsite Wastewater Treatment Systems SBD-
Table 1: System Design Specifications
Sanitary Permit Number
Number of Bedrooms
Design Flow -Peak (gpd) $D
Estimated Flow -Average (gpd) ~$~, a'p
Septic Tank Capacity (gal) BDp ,
Soil Absorption Component Size (ft2) /Spp ,lam'
Type of Wastewater Domestic
Table 2: Soil Absorption Component -Limits of Reliable Operation
Septic Tank Component Soil Absorption Component
Design Flow -Peak (gpd) dD0 vrpd ~'
Maximum Influent Particle Size (in) NA 1/8
Maximum BODS (mg/L) NA 220
Maximum TSS (mg/L) NA 150
Maximum FOG NA 30
Table 3: Maintenance Schedule
Septic Tank Inspect and/or service once every 3 years
Outlet Filter Should inspect once a year and clean once every 3 years
Soil Absorption Component Inspect once every 3 years
Septic Tank
The septic tank shall be maintained by an individual certified to service septic tanks
under s. 281.48, Stats. The contents of the septic tank shall be disposed of in accordance with
NR 113, Wis. Adm. Code (Servicing Septic or Holding Tanks, Pumping Chambers, Grease
Interceptors, Seepage Beds, Seepage Pits, Seepage Trenches, Privies, or Portable
Restrooms).
every 3
operation. The filter cartridge should not be removed unless provisions are made to retain
so ids in the tank that may slough off the filter when removed from its enclosure. If the filter is
equipped with an alarm, the filter shall be serviced if the alarm is activated continuously.
Intermittent filter alarms may indicate surge flows or an impending continuous alarm. The septic
The operating condition of the se tic tank and outlet filter shall be assessed at least once
years by inspection. The utlet tilte shall be cleaned as necessar~to ensur ~r
Management Plan for a Septic Tank and Soil Absorption Component
tank shall have its contents removed when the volume of scum and sludge in the tank exceeds
1/3 the liquid volume of the tank. If the confenfs of the tank are not removed at the time of an
assessment, maintenance personnel shall advise the owner of when the next service needs to
be performed to maintain less than maximum scum and sludge accumulation in the tank.
Manhole risers, access risers and covers should be inspected for water tightness and
soundness. Access openings used for service and assessment shall be sealed watertight upon
the completion of service. Any opening deemed unsound, defective, or subject to failure must
be replaced. Exposed access openings greater than 8-inches in diameter shall be secured by
an effective locking device to prevent accidents! or unauthorized entry into the tank.
No one should enter a septic or other treatment or holding tank for
any reason without being in full compliance with OSHA standards for
entering a confined space. The atmosphere within the septic or other
treatment of holding tank may contain lethal gases, and rescue of a
person from the interior of the tank maybe difficult or impossible.
Tank abandonment shall be in accordance with Comm 83.33, Ws. Adm. Code when the
tank is no longer used as a POWTS component:
Soil Absorption Component
The soil absorption component serving this structure is designed to accept domestic
wastewater from a residential facility. The limits of operation of this component are shown in
Table 2.
The longevity of a soil absorption component depends greatly on proper and timely
maintenance, and system use within or below the limits of reliable operation. Good water
conservation practices by all occupants and the installation of water conserving plumbing.
fixtures are key factors in extending the useful life of this component.
The soil absorption component's operation must be assessed by inspection at least once.
every three years. The inspection shall include recording the levels of ponding, if any, in the
observation pipes, and a visual inspection for any evidence of surface seepage or discharge
from the component. On steeply sloping sites, areas of erosion should be identified and
reported to the owner for repair. The surface discharge of domestic wastewater or sewage from
the system is prohibited and considered a human health hazard.
Traffic around or over the soil absorption component should be avoided particularly
during winter months. The compaction or removal of snow cover over the component may lead
to hydraulic failure by freezing. This type of failure is usually temporary, but is difficult or
impossible to repair until weather conditions improve. In general, soil compaction over this
component will reduce diffusion of oxygen into the soil and dispersal cell, which may lead to
more intense, and earlier, organic clogging of the soil.
Plantings of deep-rooted trees and shrubs directly over or within ten feet of the
component should be avoided since root intrusion into the component may obstruct wastewater
flow.
2
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t~tierBuyer ~~
Mailing Address _' ~ ~ ~
ST CROIX COUNTY
SEPTIC TANK MAINTENANCE AGREEMENT
AND
OWNERSHIP CERTIFICATION FORM
~. C Idar
~~~` S~t
l,y~ ~~~
Property Address ~ 1d 7a ~ S~ Q
(Verification required from Planning Department for new construction) ~~
City/State ~IM ~O ~~ ~ ~ Pazcel Identification Number ~ I g / ~ 3 ~~~~
LEGAL DESCRIPTION
W I ~ ~ ~ ~ ~ T N-R I ~ W, Town of ~0.VYI VY~O~ .
property Locatton ~ /4, /4, Sec.
Subdivision ~ ~~~`~~
Lot # ~.
Certified Survey Map # ,Volume ,Page #
t
Warranty Deed # ~~ ~ ~ S~ ~ .Volume Page #
Spec house '6~ yes ^ no Lot lines identifiable' yes ^ no
SYSTEM MAINTENANCE
Improper use and maintenaaceof 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 Zoning Department a certification form, signed by the owner and by a
mast~rplumber, journeymaaplumber, restrictedplumber or a licensedpumper verifying that (1) the on site wastewaterdisposal system
is in proper operating condition and/or (2) after 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 Wisconsin. Certification
stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30
da of the year a iration date.
SIGNATURE OF APPLICANT DATE
OWNER CERTIFICATION
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
property cubed ab~ojve, by virtue of a warranty deed recorded in Register of Deeds OfI"ice. o
SIGNATURE OF APPLICANT DATE
««««««
«««««« Any Formation that is mis-represented 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
a copy of the certified survey map if reference is made in the warranty deed
.,~
„~k1.15O1P~~E372 620963
KATHLEEN H. WALSH
REGISTEk OF DEEDS
5T
CROI
W
.
X CO.,
I
RECEIVED fOR RECORD
Dine M. Bonte, as Trustee and Ronald C. Bonte
first alternative
,
Trustee of the Karl M. Ulferts and Katharina G. Ulferts Family 04-10-i:00o 10:30 tVl
Trust, for a valuable consideration conveys without warranty to TRUSTEES DEED
Ronald C. Bonte and Dine M. Bonte, husband and wife, Grantee, EXEMPT N
CERT COPY fEE:
the following described real estate in 5t. Croix County, State of COPY FEE:
Wisconsin: TRANSFER FEE: 240.00
RECORDING FEE: 10.00
PAGES: 1
Name and Relum Addn
Thomas A. McCormack
1020 1 ty" Ave.
Baldwin, WI 54002
01&1034-60, -70
(Parcel Identification Number)
The North Half of the Northwest Quarter (N % of NW %.) of Section Sixteen (16), Township Twenty-nine
(29) North, Range Seventeen (17) West.
Dated this 24t;hday of March , 2000.
AUTHENTICATION
Signature(s)
authenticated this _ day of
signature
type or print namc
TITLE: MEMBER STATE BAR OF WISCONSIN
(If not,
authorized by § 706.06, Wis. Stats.)
THIS INSTRUMENT WAS DR,rr~E {~ J
Thomas A. McCor a ~ '' ~'
Baldwin, WI 540d~' 0 ~ ~ ± ; .,
Q ,i .
.~dO`....:~t't~
YC~11~'' S~~ ~ ~
'Dine M. Bonte Trustee
'Ronald C. Bonte Trustee
ACKNOWLEDGMENT
STATE OF WISCONSIN
ST. CROIX COUNTY
Personally came before me this 24t-hiay of Ma='Ch
2000 the above named Dine M. eonte, Trustee and Ronald
C. eonte, as first akemative Trustee of Karl M. UNerts and
Katharina G. Ulferts Family Trust, to me known to be the
person(s) who executed the foregoing instrument and
acknowlr}dge tttp, same. _
signature
type or print name Dale ~, Jensen
Notary Public St. Croix County, Wisconsin.
MyOc~mlrr~is~iQn is permanent. (If not, state expiration date:
11 LL UU~_33 .)
'Names of persons signing in any rApacily should be typed or
printed below their signatures.
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- - .... - _ _ UT l t I TY EASEA~'NTS
i_ NO POLE CR BUR?E0 CABLES ARE TO BE PLAtE9 SUCti THAT T-+E
INSTALLATrON AouiO OrS>'URB ANY SURVEY STARE. QP OBSTRiKT VJ3fC~i
4LOMG ANY LOT LINE OR STREET ! INE.
bb THE DISTURBANCE OF A SURVEY STARE BY ANY !S A YIOLAT!.:. OF
SEC11oN 238.3£ OF WISCONSIN STATI'TES. UTt~+TY EASE~ENtS Aa ME3E +N
+~ sET FORTH ARE rat THE USE OF PUBL:C B00(ES AhD ~RrVArE uTILIT!ES
MAYtNG THE RIGHT TO SERVE TO AREA.
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O SET 2'X30• 1RdY PIPE MfrGHtVG
3.63 LBS. PER l (NEAR FOOT
NOTE SET 1'x21• IRON PIPE rEtSHrI~
!. +3 LBS. PER L rNFAR F00T AT ALi
~ OTHER LOT CORNERS
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T. L. Sinz Plumbing Inc.
E5612 708th Ave.
Menomonie, WI 54751
Phone: (715) 235-2
Fax: p~~ (715) 235-2592
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