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Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Safety and Building Division 4.. ~ INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: City Village x Township Blok, Brian K. Hammond Townshi CST BM Elev: Insp. BM Elev: BM Description: ~ Z. 3 ~ 02.3 ~~Z ~l~Q w.~~.e~.. cST TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY Septic / D Dosing ~b• l~ ` Aeration Holding TANK SETBACK INFORMATION TANK TO P/L ~t5~ WELL ~ BLDG. Vent to Air Intake ,r ` ROAD Septic ~~ ~/~ ~ f ~ / 1 7 Dosing > (17D Aeration Holding _ PUMP/SIPHON INFORMATION Manufacturer Demand ps GPM Model Number ~0 TDH Li ' Friction Loss System Head TDH Ft ~ r a. Forcemain Len th ! Dia. y Dist. to well 2 tsDT r ~ ~ ~ JVIL AtSJVKt' I IVN ,TJ 1 CM T County: St. Croix Sanitary Permit No: 405072 0 State Plan ID No: Parcel Tax No: o! - U3 ' -/4 STATION BS HI FS ELEV. Benchm% 3' ~~ ~ / O.2 r 3 Alt. BM ~^~/ ~~- Bldg. Sewer ~. ,~ Z ~G-s St/Ht Inlet ~ ~1~ ~- - ~ 9 St/Ht Outlet ~- .~--- Dt Inlet~~ r Dt Bottom ~ ' O d Header an. `> ~~ D ~~ G/ Z Dist. Pipe `~ ~ Bot. System / G., Final Grade / !~/ _ ~~ 9 St Cover ~T (ror. -r g. 2 ~7 - ;h t7' BED/TRENCH Width t Length i , No. Of Tre p~hes ~ PIT DIMENS~NS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS /-CJ // ( / ~~ SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM L CH Manufacturer: INFORMATION CHA R OR Type Of S stem: I S ~// / / , ~ U Model Number: > I ~ DISTRIBUTION SYSTEM (~('~~( ~ Header/Manifold r t ~ Distribution Pipe(s) ~ ~ x Hole Size ~ l I x Hole Spacing ~l ! Vent Air Intak !i L th Di ~ th Di ~ S L i ~ L/ eng a eng a pac ng SOIL COVER ' x Pressure Svstems Only xz Mound Or At-Grade Systems Only / o1f,,,,~~y,,, y~v1.oG_r Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mu ched Bed/Trench Center 1 f fi ,n ,1QJLJ Bed/Trench Edges Topsoil ~ Yes [~ No I~ Yes [~ No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection` #1: $ / (~0,~,/,V(Z Inspection #2:~/~/ O ?/ Location: 978 160th St Hammo..nd~,, `WI/54015 (NE 1/4 NE 1/418 T29N R17W) NA Loth "` /~ `~ ~"""~~arcel No: 1.) Alt BM Description = ~T~~'~~`'' 2.) Bldg sewer length =~ ! - amount of cover = ~ ~ / ~~ 3.) Contour = Gt s, 3 {{ _ ~--T-- -- ----- ~ Plan revision Required? ICJ Yes ( No ~ ~ ~ ~ o~1 ,,, G~ ~~(~c~[w: Use other side for additional information. _~ _!~ _ _-_ SBD-6710 (R.3/97) Date Insepctor's ignature Cert. No. • Safety and Btuldings Division City ` ~ ~ 201 W. Washington Ave., P.O. Box 7162 ~~ . p ; isconsln Madison, wI 53707 - 7162 Sia A De artment of Commerce ~`-~ ~ -~Z- `~- Sf. n~oxc~ Sanitary Permit Application ~~' Pernut Number In accord with Comm 83.21, Wis. Adm. Code, personal informatio ~/ k if Revision yO~D~ ° ma be used for sea Privac Law, s15. m I. Application Information -Please Print All Information S Plan I.D. Number ta,., s 7~, / 33 5 ~ tie rp a 83 Property Owner's Name 2 ~ 0 P 1 Number ~3 ri an ~K • B o ~d 0.~ ,~. ~.~ 018 - l 0 3~ - l 0 -- Property Owner 's Mailing Address ZONING OFFICE Pro m' I'Oceaon A / .~{, ~CD ~ 1 y QI)1 ~ ~31 ~ , it o~ 1~ C i4 IJt~ 54: S $ T ~~I N, R ~ 7 City, State Zip Code Phone Number Lot Number ~ / Block Number ' l i ~ r T ` ' ~ $~''' ~ ~'`~ ( ~~~ ~ ~ 8 ~ 9 g Subdivision N an ~ 1 , CSM umber O ~ b , '' a~ '7 3 ~ II. Type of Building (check all that aPP1Y) / .(J~/ ^City 1 or 2 Family Dwelling -Number of Bedrooms J7 1/ ,~~ .Q.Q,~tn~ ~ ~~ ^Villa e ^ Public/Commercial -Describe Use r g (Township ~-Wl ~, 1~.. L.. L• ^ state Owned jj/,ST' ~CZC. ' O ~L'p Nearest R ~ ~ Zj- ~'4 ' /G.Pr):, SOD - ~'tdrr , III. Type of ermit: (Check only one box on line A (numbering scheme for internal use). Complete line B if applicable) A' 1 New 2 ^ Replacement System 3 ^ Replacement of 6 ^ Addition to For Coumy use stem Tank Onl stem B. ^ Chcck if Sanitary Permit Previously Issued Permtt Number Date Issued IV. Type of Permit: (Check all that apply)(nam6ering scheme is for internal use) 44 ^ Non -Pressurized In-Ground 21~ Mound 47 ^ Sand Filar 50 ^ Constructed Wetland 22 ^ Pressurized In-Ground 41 ^ Holding Task 48 ^ Single Pass 51 ^ Drip Line 45 ^ At-Grade 4b ^ Aerobic Treatment Unit 49 ^ Recirculating 30 ^ Other V. D' rsal/Treatment Area Informati on: Yjt 07~(~ caQJ G~/L2.t..-= S~ ~ht~t. Z 3 Z Design Flow (gpd) Dispersal Area Re uired Dispersal Area Pro osed it Applicafion Rac~ ~s /Da FtJ slS Percolation Race (Min /Inch) Syste Elevation ~}'~" ~ ~ ~/~/ Z ~~ Final Grade Elevation q / p ~ ` a q. y D f" . . ~ J k 75 /v .S~e/ ..Srh( f ~ ./ VI. Tank Info Capacity in .Total Number Manufacturer Prefab Site Steer Fiber plastic Gallons Gallons of Tanks ~~ ~ _~~~ Concrete Constructed Glass New Existing Tanks Tanks Septic or Holding Tank _ ~~. ~e ~ Y nosing t~amber x G / ~ , e C VII. Responsibility Statement- I, the undersigned, assume responvbility for n of the POWTS shown on the attached plans. Plumber's Name (Print) Plumber's Signature MP RS Number Business Phone Number Plumber's Address (Street, City, State, Zip Code) ~v Sc o 7`.f ~i ~ ~ ~f sa GJ ~ ° S'Yd/ G~ Cotm /De artment Use Onl Approved ^ Disapproved ~~Y Permit Fee (includes Groundwater Date Issued mg em Signature o Stamps) ^ Owner Given Initial Adverse Surcharge Fee) JZ7 3~ S ~ .~/i y a _ u~/y Determination IX. Conditions of roval/Reasons for Disa royal a/ PP n,`' ~~' „D '~Z-~ ~"~Oat'k,f Ce'»+.,,+. ~3'~~.t' .~vt B2Q.Ph17~ ~ Yt, Q w tA~~ t L (~ /`9 A . i . - tG .Y./. _ 0~, • ~j e Cd~t.`~!~ tM.. ~'C. /^~ ~ ~K!'>'/ lno7tin-dj '7-?u,~~ ,~L ~t,~f' dY~ ' S -~i.,~..Q. ~i~iv L!iG~G^s~-- ~Ty~, ~iw ~ 7~Y~U.Q.f ' ~~ - ~ ~~~~° mot. sf ! ~2~~,~ - Attach ~°~pyplde~°°' (to the t ly) for the ayst not than 81/2 z 1 Iacy« ih~~GGO~"C7;I~~OY'~i t~` G/.~ ~,¢~22~a' ~. /~ ~ ~-~~O SBD-6398 (R. OSJOl) ten- J~-~-~ ~~'~'~a-~'~'^O'`~-/'~~~ ~ ~ iscons~n Department of Commerce RECEIVED APR 1 1 2002 ST. CROIX COUNTY ZONING OFFICE 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 Scott McCallum, Governor Philip Edw. Albert, Secretary April 08, 2002 CUST [D No.267341 ARTHUR L WEGERER WEGERER SOIL TESTING & DESIGN SERVICE PO BOX 74 RIVER FALLS WI 54022 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 04/08/2004 SITE: Karen Ostby /Brian Blok - 160TH St St. Croix County, Town of Hammond SE1/4, NE1l4, S18, T29N, R17W FOR: Description: New Three Bedroom Mound System Object Type: POWT System Regulated Object ID No.: 835276 ATTN: POWTS Inspector ZONING OFFICE ST CROIX COUNTY SPIA 1101 CARMICHAEL RD HUDSON WI 54016 f ~/~-f~~ I T~y~tJS b'~'Z~ Identification Numbers Transaction ID No. 721333 Site ID No. 642783 Please refer to both identification numbers, above, in all correspondence with the agency. 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. The following conditions shall be met during construction or installation and prior to occupancy or use: General Approval Conditions: • T~~s system is to be constructed and located in accordance with the enclosed approved plans and with the V"Mound Component Manual for Septic Tank Effluent for Private Onsite Wastewater Systems" SBD-10572-P (R 6/99) and the "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems" SBD-10573-P (R 6/99). • 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. • Comm 83.22(7) - 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. Owner Responsibilities: • 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. P.O.W T.S. Conditionally ARTHUR L WEGERER Page 2 4/8/02 Owner Responsibilities Continued: • The owner is responsible for submitting a maintenance verification report per Comm 83.55, that is 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 slats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence 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, ~/ C --__~ Gerard M. Swim POWTS Plan Reviewer -Integrated Services (608)-789-7892, Mon. -Fri. 7:30 am to 4:15 pm j s w im@co mme rc e. state. w i. 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 TITLE SHEET I~OUIdD SYSTEM FOR A 3 BEDROOr1 RESIDENCE Page 1 of ~ This plan has been prepared in accordance with the Mound Component I4anual SBD-1057 P and the Pressure Distribution Manual SBD-10573-P Cam. blgg~ C~~. b14~~ LOCATED Ii~1 THE SC 1 /4 OF THE N~ 1 /4 OF SECTION 18 , T Z°1 N, R ~~' [d, TOi~]i1 OF ~W}h~UJuD , S'T'- °L~L~( COUNTY, WISCONSIId. INDEX .PAGE 1 of 7 TITLE SHEET PAGE 2 Of 7 SYSTEII I~IAdAGEi~iENT PLAPv PAGE 3 of 7 PLOT PLAN PAGE 4 of 7 PLAN VIEW-CROSS SECTION ,PAGE 5 of 7 DISTRIBUTION PIPE LAYOUT PAGE 6 of 7 PUI~IPIP]G CHATiBER CROSS SECTION PAGE 7 of 7 PUriP PERFORMANCE CURVE PREPARED FOR _ -I c..i~c1Z~ O S T"B 7 / B Cam[ ~J Q l.A 1-c I b Z:o N ~ ~ ~~12~G0~ ST . ~ Z ~~:Sv~l , ~ f S4 v l ~ PREPARED BY WEGEE~ER SQ I L . TEST S NG AND . . DES = G~i S~RV = CE P.O. Box 74 421 Id.ilain St. River Falls, G]I 54022 Phone 715-425-0165 Fax 715-425-6864 ~~~~~~~~ DEPAR7rMENT OF COMMERCE DNISION OF ET A D BUILDINGS SEE C ~ RRESP .DENCE 9~ '9~0 ~ `~ ~, C ~~ ~ ~4 °o~ ~~ OC ~~ ~~1 k+ RFlT/+!J5; ~ •~ Y4'ciiti?kri D-~i5 9 EILSWOFTH 1 ®.~~'~~IG~'~~' ~~ 41_ t _v2 JOB N0. ~Z_lq Mound System Management Plan Page Z of Pursuant to Comm 83.54, Wis. Adm. Code Septic Tank '. The septic tank shat) 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. Theo eratin condition of the s tic tank and outlet filter shall be assessed at least once every 3 years by inspection. The outlet filter shall be cleaned as necessary to ensure ro er o era ion. e i er ca ri e s u no a remove unless rowsions are ma a to retain solids in the ta- n- k that may slough off the filter when removed from its enclosure. If the filter is equipped with an alarm, the filter s a e serviced if t e a arm is acv continuously. Intermittent filter alarms may indicate surge flows or an impending continuous alarm. The septic tank shall have its contents removed when the volume of sludge and scum in the tank exceeds 1/3 the liquid volume of the tank; If the contents of the tank are not removed at the time of a triennial 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. The addition of biological or chemical additives to enhance septic tank performance is generally not required. However, if such products are used they shall be approved for septic tank use by the Department of Commerce, Safety and Buildings Division. Puma 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 operation. If an effluent filter is installed within the tank it shall be inspected and serviced as necessary. Mound and Pressure Distribution System No trees or sh rubs should be Ian ted on th m ~~~" p e ound. Plantings may be made around the mound's perimeter, and the mound shall be seeded and mulched as necessary to prevent erosion and to provide some protection from frost penetration. Traffic (other than for vegetative maintenance) on the mound is not recommended since soil compaction may hinder aeration of the infiltrative surface within the mound grid snow compaction in the winter will promote frost penetration. Cold weather installations (October-February) dictate that the mound be heavily mulched for frost protection. Influent quality into the mound system may not exceed 220 mg/L BODS, 150 mg/L TSS, and 30 mg/L FOG. Influent flow may not exceed maximum design flow specified in the pemlit for this insta{lation. 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 solids at least once every 18 months. When a pressure test is performed it should be compared to the initial test when the system was installed to determine if orifice clogging has occurred and if orifice cleaning is required to maintain equal distribution within the dispersal cell. Observatiori pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the owner, and any levels above 4 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring. General This system shalt be operated in accordance with Comm 82-84 Wis. Adm. Code, and shall maintained in accordance with its' component manual [SBD-10572-P (R. 6/99)) acid local 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 abandonment shall be in accordance 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 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 accidental or unauthorized entry into a tank or component. Continaencv Plan If the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep the system in proper operating condition. If the dosing tank, pump,. pump controls, alarm or related wiring becomes defective the defective component shall be immediately repaired or replaced with a component of the same or equal performance. If the mound component fails to accept wastewater or begins to discharge wastewater to the ground surface, it will be repaired or replaced in its' present location by increasing basal area if toe leakage occurs or by removing biologically clogged adsorption and dispersal media, and related piping, and replacing said components as deemed necessary to bring the system into proper operating condition. Questions about the operation or maintenance of this system should be directed to: The County Zoning Office at -l l~J - 3~ fp_ _ l~ ~g p ~~ C-V?U 1.!( ' The system installer at 3R~hs C N'U ~ The tank manufacturer at ~(~~ ~ 3_~S ,~ySb 1.J 1.~t?12 ' The effluent filter manufacturer at 8-~0 - Z.~f S7~Z Z~L~ The pump manufacturer at ~30 - ~ ZQ _ if ~(~~' ~jpuL,~g Scale 1"= ~0 ' Z S ' ~~ T1ftwlz --=? ~ ~- `r v~swP~ sl~~. o~ ~, wl.clv-~~ w~t°M Q~ ~! tLL ~ ~ D~ L RED `fi0 8 ~~vl~ `.~1"~ S `iST~~"7 ~FV`~l - _ _ __ __ ~~ l..P~~ SCf}-PE - _ _ . _._ ~Nv'` ~~ ~0 ~~ ~(° ~ ~ loop b>~ U ~~ ~v ~ ~--.~ , y ~' cau~Z Page 3 of `7 3 ~•. ~~' ~ ~~~T 1,.D ~' L 1 N Z, IBC, LUZ~ o a sv or eow~ ~ ~-e..r OZ a1.Slvy~-l3 a3 ~ ~~ 1~ 3 -was _ 13r"1 t4 1 - -LLB L00.0 ~ O~V ~Z.`~'~~f1t-L ~ 3!~' Tom! 41 ~ -L3 Pr1'Z- -`~! Ukfil¢, i3~'"I. L'[ Z - ~tSU . LO Z- 3 ' c~-v 1V1'~tL l'l"_iDj~'iOU~ 6tuJUN!~ _1ti1-~"--C2J.~~ 1Z~ J i rwl i<#-Z s-~t~- ~ ~ ~ ~ ~~~ 9 3. U o ; ~ F- ~~ 1 ~y ~aD ~/~~o NOTES : ~ ~- 1. Elevations shown are existing ground elevations unless otherwise noted. 2. Install 4" observation pipes with approved caps. ( Z required). 3. Septic tank to be ~000/65~ gallon capacity manufactured by 4. $ench mark~_ S .. ~30V E 5. Divert surface water around s stem to . y prevent ponding at the uphill side. ©oT~ Oc-- .LAC-- ~b.o B . ~. J 7 S°lo 1.5~ bi= q3~ s g' ~' z`}~ ~i3' ~ s i • , Paoe ~ OT 7 Approved Synthetic CGVering ASTiK C33 ~~;~ Medium. Sand Topsoil.--` ; ~__ ~ __ ~~ ~ ~ 3 +t j %~Slope Distribution Cell of ' Z" to 2z" Aggregate Distribution Fipe ~--~"q(0.5~ F G Elev. ~ ~j. Q e Force Main From Pump i ~~ Flawed Layer D 1.0 Ft. ~./ E t-3 Ft. • F ~.~ Ft.---- )0~ rz O - S Ft CROSS SECTION OF A MOUND SYSTEM Linear Loading Rate= 6. 0 GPnir.u FT ~~ B ~ S Ft. Design Loading Rate=p~~D~cO gT I 1 Z Ft. J C~ Ft. K cI Ft. ~ Position ~ °l3 Ft. or' Force Main W ~ Ft. .. L + I ~ ~ I . ~} + -Observation Pipe ~'~ °~6 " -- ~ ~ ~ K G--~-•------------ 7- ---- --------------- ------- BoX O A I ' ;/~ ~-~ - - 3 ~ -- -------- -~ w ~ -~ - --- -------- -----~, ~Distribut~an ~-- Cel %" :~~ . I of z to 2 Z Pipe aggregate _ - Qbservation~ Pipe (Andzbr securely) PLAN VIETrl OF A MOUND SYSTEI4 . Distribution Pipe Layout pace S of ~ Place the holes at the bottom of the distribution pipes . at'equal spacing. Be~ove aII burrs from the pipe and holes. Extend the end of each Iate-a.I up with tie use of Ion, turn or 4f° $ttna to a point within six ~~ inches of the foal ~*ade. Terminate the ends of the Late.-als with a vaIve,:threaded can or • threaded pIu?. Provide aces from final ~zde for the vaiye; threade3 c :D or threade3 pIuQ. " T`-t F 1 cr, L ~,ZDS s _s ~`.;zg ty rv c ~`ac ~v c Latent -1 ~- Maniiald ~ Laterl x ~ x I x I x xrZ I xfZ x j x ~ x ~ x =Lateral L=nQth - ,~, ~ Lateral LenCth - P tom- Lt'rt~ V \ ~~,J ~ ----~+ 4- - ?'1 Y`i.l 1 F~ ~.: ~_ P ~_ Ft. s 3 Ft. ~ X Z4 Inches . , i}C CAS SflX - -o --~ Hole Diameter 1 f ~ Inch ~ ` Lateral ~ 1 Inches) / Manifold Z• Inches Force Main ~- Indies #of holes/pipe l~ Invert Elevation of.Later- s `~ 6~s Ft. ... 1 ..~ ... .. _. ~.~ _.... Combination Sept~.c~•Tank and 'PUMP CHAMBER CRO55 SECTIOtJ AA1D SPECIFICATIOIJS ' _ PAGE G _. _ • VE-J7 CAP ~~ WEATHER PROOF 4-r~ . - ~- .lU1JCT101.! 80X . SEPTIC f DOSE TA Al KS ''~ H~t ~s dU-T"~a, p dr RISER EXIT PERMITtED O-JLy IF TA-JK MAlrUFACTURER HAS SUCH APPROVAL SPEC.IFICATIOt~I$ ti C.Z. VENT PIPt ~ lO' FROM OOOR. ~Itv00W OR FRESH AlK ttJT~IKE -i x• .','I',n ~ ~ _ fin; ~ .lPPROVED LOCKING MAIJHOLE COVER wi'iH wAR.N1IJG l.P.gEL• OF 7 ~3" ApPl2fl'.FD 6E0~? s a,t4 MAfJUFACTUiZCR: wI,FS "~ CU~.rc~Z ~ uuMr3EA OF DOSES: `''S PER OAS TA1JK :,fZE : ~ DUO ~ 6 S 0 GALLO-1S DCSF VOLUME r ALAR1~1 MAISUFACTUR.)`R: S ' J ~ ~-~-71Z0 S~SZ3ti"13 IAlCLU01AJG 6ACKFLOW: `~ Z GALLON: MODEL 1JUMBER: 10 ~ H'W CAPACITIES: A= ~ $ ~ O ~j IAICHES OR V CALLOUS SWITCH T~PC: y" ~~ZCC.J[~~ 8 = _ ~ 11JCHES'OR ~ T GthLL0U5 PUMP !"IAIJUFAGTURCR: GyUl.1,~S C = ~ IUCHES OR l ~ ~"' WILLOl15 MODEL 1JUMHER: - ~0~ 0 = ~ Z I-1C HES OR ZO GALLOIJS SWITCH TYPE: y"1~12-~/R~J / 1JOTE: pL1MP AUD ALARM ARE~TO 6C~~ MtWtMUM DISC>{AR6E RATE 3i- Leo CpM/ INS ILEO OA! SEPARATE CIRCUITS VERTICAL DIFFEREfJCE DETWCEIJ PUMP OFF AtJ0..D157R16UT10-J PIPE. ~' SO ~ ~~'4'' • FEET~G'ltil:E + MlflIMUM I.tETWORK SUPPL PRESSUR ~?~~ S y E .... . .... .. • S 0 FEET <S ,0 x. l . 3~ _.~,j'i~-~~~ ~- ~ FEET OF FORCE MA-N X ~. 0~ F~o FCFRtCrlou FACrOR..~~ FEET $fl vl Off. Ok.~ TOTAL Oy1JAMiG HEAD = ~y ' ~~ ET -__ As per manufacturer 11..0 gal/in. Liquid depth 3 $" Goulds Submersible S~ E ~1 0 ~= -7 Effluent Pump '~ u 3871 EP05 _' APPLICATIONS Specifically designed for the following uses: • Effluent systems • Homes • Farms • Heavy duty sump • Water transfer • Dewatering SPECIFICATIONS Pump: EP04 • Solids handling capability: 3/4 maximum. • Capacities: up to 55 GPM. • Total heads: up to 24 feet. • Discharge size: l'/2"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. Pump: EP05 • Solids handling capability: 3/4 maximum. • Capacities: up to 60 GPM. • Total heads: up to 31 feet. • Discharge size:l'r~°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 phase: 0.5 HP,. 115 V, 60 Hz, 1550 RPM, built in overload with automatic reset. • Power cord: l0 foot standard length,16/3 SJTO with three prong grounding plug. Optional 20 foot length,16/3 SJTW with three prong grounding plug (standard on EP05). METERSIIFEET tOF 0 a TAT U a 0 0 TU 2U 30 40 50 GPM 0 2 4 6 8 10 12 m~/h m 1995 Goulds Pumps, Inc. CAPACITY • Fully submerged in high grade turbine oil for lubrication and efficient heat transfer. Available for automatic and manual operation. Automatic models include Mechanical Float Switch assembled and preset at the factory. FEATURES ^ EP04 Impeller: Thermo- plastic Semi-open design with pump out vanes for mechanical seal protection. ^EP05 Impeller: Thermo- plastic enclosed design for improved performance. ^ Casing and Base: Rugged thermoplastic design provides superior strength and corrosion resistance. ^ Motor Housing: Cast iron for efficient heat transfer, strength, and durability. ^ Motor Cover: Thermoplas- ticcover 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 construction. AGENCY LISTING S P' Canadian Standards Association (CSA listed model numbers end in "F" or "AC".) 30 ~ ~ ~ ~ +~~SGPM -t Uy I 2s ~ _ e ~ , . ~ ~ _ j i i 20 ' ___ ~.. l 0 ~ y~~ ~ - i ~ --- -- ~ ~ i - EP05'; -- + i ~ 31. L 6 EP04 s ~ ~ I o_ I Effective May, 1995 63871 Wisconsin Department of Commerce Division of Safety and Buildings SOIL EVALUATION REPORT -7 Page 1 of 3 in accordance with Comm 85, Wis. Adm. Code ~ (~ ~~~ ~?' r,,. ~„fi, Httacn complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must ~ `~ ~ C inGude, but not limited to: vertical and horizontal reference point (BM), direction and parcel I D ~ ~~l IIJG . . percent slope, scale or dimensions, north arrow, and location and distance to nearest road. (~ 7~t 73 Please print all information. iew by Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). ~~ /j (3 D Property Owner G~ZPfI..L7 1--~~'12t3 ~ Property Location $U`~-1 ~Z-S - ~~Z-~~N ~S~l Q~ B~(.1~"Y~1 ~L.U(`~'C r` ... ~ ..~ ~`~ 1/4 N~'. 1/4 S 1 8 T Z~ N R ~7 E (or~ P roperty Owners Mailing Address Lot # Block # Subd. Name or CSM# ~ 62 0 -v~'NI ~~-Gory ~~- ~ Z . p~-o~aU S ~ City S c. s . wi . tate Zip Code Phone Number ^ City ^ Village [~ Town ~~ 3 d-v w i s ~o ~ ~ (zLS , 3 8- I ~ ~~,~, 8 ~ L-~ ~ ~. v w Nearest Road ~bo `>"t+ sr. .,~ New Construction Use: ® Residential / Number of bedrooms ~ Code derived design flow rate S - ~ . - GPD ^ Replacement ^ Public or commercial -Describe: - -L- Parent material _ 't'L LL. t~V ~_ bOt-Ok'[ i`n~ Flood Plain elevation if applicable h' '" ~ - 't'~ - PR~$ General comments Nlv - 5~ , and recommendations: Y/~vU~M,7 w / 6 ' X ~. S ~ -~~ g`n~ Q U ~„~ u ~ ~31..~... ~~ ~ / -^-'l ~ N L ~l U ~, t L" ®~ S Prfi..y~ F1. L.L =- 3 ~ -~,~y,c~ ,~' Boring # ^ Boring /~~ci~4..:~a.Q. ~ yyr~LC~,,,el / _ SRI Pit Ground surface e1 ~ 3. 3 ff ne..,ti .,, r...ow.... s..,.._. ~'1 Horizon Depth i Dominant Color Redox Description Texture " Structure Consistence ~~~' Boundary Roots Soil Application Rate GPD/ft2 n. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 1 a -< ~~`~ IZ 31 z_ ~ sl l Z~s bk w~-~- cw - •s . 8 Z lS Z7 I D ~-l 2. ~I 6 - s i I Z M S b k wl,'P--- c-rv - - S - g 3 z~-3 ~.S't2-~[y - 1S 1 c9b~ rnV`E'~ e-s - .z ~_z 3~} ~~ ~-S~ifL3ty _ S os9 W11 eS - .z ..Z- S ~p-eo ~.s~2~/b - LSBR - - - .p .o a Boring # ^ Boring / IBC Pit Ground surface elev. ~ ~• S ff ne..~h ~., ~:..,;~,.,,. ti,,..,.. U 1~ ~/ ' ~ "" Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots Soil Application Rate GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 ~ o_t~ 1py~3tz - sit Z~sb1z rn`F-- ~ - ..s .~ Z l~ 3~, to y ii 31.E - s i I Zmsbk mph C.I,V - . s -~ 46-S$ ~.SyR~l6 - LSBR - - - .~ -o 'Effluen t #1 = BOD_ > 30 < 220 mn/1 anri TSC man ~ 1 rn m.,A . om....... am _ nnn - - --- -...n._..........._.......a... CST Name (Please Print) Signatu CST Number Arthur L, tdegerer -•- 0~---19 220254 Address [~ e g e r e r S o i l Testing &, D 2 S i g ri S e r V i C e Date Evaluation Conducted Telephone Number 421 i1. I~iain S} . River Falls, [7I 54022 2_ ~_p 2 715-425-0165 Property Owner _ Boring # ~ ~h3~ / [3 ~u chi Parcel ID # Boring ® Pit Ground surface elev. ~ • 1 ft. ~~ l~V~ 1 h/ G Depth to limiting factor Z y in Page 2 pt 3 Horizon Depth i Dominant Color . Redox Description Texture Structure Consistence Boundary Roots Soil Application Rate GPD/ft' n. Munsell Qu. S:t. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 a -8 L o~ R-- j L2 - 5l 1 Z`~s ~ h ~'~.- cS - • S .B 3 Z~ 42 -o~~~~ - LS~IZ - - - •~ .o ^ Boring # ^ Boring ._ ^ Pit Ground surface islev. ft. np~r-, rn limifinn f.~n1... Horizon Depth in Dominant Color M ll Redort Description Texture Structure Consistence Boundary Roots Soii Application Rate GPD/ft~ . unse Qu. Sz.. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 ^ Boring # ^ Boring Pit Ground surface elev. ft. Depth to limiting factor r~ Horizon Depth i Dominant Color Redox Description Texture Structure Consistence Boundary Roots Soil Application Rate GPD/ftz n. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 • Effluent #1 = BODa > 30 < 220 mg/L and TSS >30 < 180 mg/L 'Effluent #2 = BODa < 30 mg/Land TSS < 30 mg/L The Department of Commerce is an equal iapportunity service provider and employer. If you need assistat)ce to access services or need material in an alternate format, please contact the department at 608-266-3151 or TTY G08-264-8777. SBD-8330 (R.6Po0) PLOT PLAr1 Scale 1' = yp' Page 3 of 3 t~ b#-Z. 8.3 O g~lo ?~ ~ a3~ 5,0~ ? J p y 2~k' V 00T~ - L` *LL ~ ~ -~ EZ. `~6.0' zy~ q3' is 1 ~ ---~ ~ Z 1~C I.UT~ o a t Off- '~k'l P Pre.}' a 3 ~- _ I oZ a~s~vrz~ `x-15 Q'C`2~"A ' ..13)'".1-~`j--F -'LZ~ IQO.Q ~ _ON _.~Z.`~TP~t.I~..~ 3I~':D1 K1...:~-i3 A~_: N/ LJ~. Qw r~ z ` ~,v . do Z = 3 ' r~-v r~.~ L . _1~"_P~ov ~=G u`==ice, ~. CST Signature _. __ __ Z-~3 _oZ 715-425-0165 220254 pZ- ~ 9 Date Telephone hTo. CST A1o. Job P10. Wisconsin Department of commerce SOIL EVALUATION REPORT Division of Safety and Buildings . in accordance with Comm 85, Wis. Adm. Code Page ~ of 3 Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must County S~-. inGude, but not limited to: vertical and horizontal reference point (BM), direction and C..~ 1 percent slope, sple or dimensions, north arrow and location d d' Parcel I.D. ~~1~V~1 ll/G an istance to nearest road. Please print al! information. Reviewed by Personal infom~ation you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Date ,p.,~ ~ BU~ ~-S ~ ~~"~~ OS~Y B~~r I r~-+ ~~'Z . ._r _..~ -............ 6e~t-het- S ~ 1/4 NE 1/4 S 1 g T Z~[ N R ~7 Property Owners Mailing Address E (or W 16 2 o tv~w1 ~~~ urv sr ~ z Lot # Block # Subd. Name or CSM# ~ City State Zip Code Phone N b ptiz.o~ s ~ c. s . ~-r . um er ~~gd~ ^ City ^ Village ~ Town ~ Nearest Road w ~ s~o ~~ (,~s, 3s-I-~~,`le ~~~~~w X60 `I~+ sr, New Construction Use: ® Residential / Number of bedrooms 3 Code derived design flow rate C.~ SQ GPD ^ Replacement ^ Public or commercial -Describe: Parent material _ 1"1. LL OV ~ _ ~OLUh~I ( - Flood Plain elevation if applicable fV A ft General comments • and recommendations: Y~/~v V~7 ~ / 6 ' X ~. S • ~~ g~~ Q U ~ ~ y~ v~31.L . I^'1 LfV tlv~, U-"1 L Z`' d F S r~y~ ~.c.L-, ... C-c~-~J h~u2 L'Z-~ . q 5. p ~ - ~ ~ .. _.... Boring # ^ Boring ® Pit Ground surface elev. ~ 3. 3 ft, Deoth to limitino factor ~~~ i~ Horizon Depth Dominant C l in• - o or Munsell Redox Description Qu. Sz. Cont. Color Texture ~ Structure Gr. Sz. Sh. Consistence Boundary ~ a -l lD'-t R.- 31 i.. ~ S 1) Z~s btz wl`~1^ Ctv Z - ~s Z~ i ~~t cz.: X16 -- s i p z M s b k ~1.'~b- aw 3 2~-39 ~sYrz~cy - 1S 1~Sb~ YnV'~ ~S 3o1-7p ~.S`i231y - S O S9 h'i~ e.S S -~o-eo ~.s~lzy/6 - L.SBR - - r•--~ r , Z Boring # LJ nonng ® Pit Ground surface elev. ~ ~• S ft r)Pnfh to limitinn fnr+nr U L. Roots GPD/ftz •Eff#1 'Eff#2 - •S .6 - _s -$ - .~ ~. Z - .-Z ~ , Z - •o -o Horizon Depth Dominant C l R Soil Application Rate in o or M edox Description Texture Structure Consistence Boundary Roots GPD/ft2 . unsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 1 0-~~ 1p~tIL3lZ - sil Z`Fsb1z ~rn`F~. e~ - .s .~ Z 17 3b I.D `~ )Z 31.E - S 1 I Z.~'--1Sbk yy),~'}.. C.1,~ - . 5 •9 3 36-~j(, ~ SY(~3! - is 1.~sb r~v`P1~- cS - .~ ~. Z gib-S$ ~.Sy2S~l6 - t.SBR - - - - .o .o 'Effluent #1 = BODa > 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BODS < 30 mg/L and TSS _< 30 mg/L CST Name (Please Print) - . , ~.. - Signatu CST Number Arthur L: tde~erer 02-=19 ~ 220254 '~df e~ W e g e r e r S o i 1 Testing &, Design S e r v 1 C e Date Evaluation Conducted Telephone Number 421 I1. Main St. River Falls, (•1I 54022 2_ ~_Q? 71 5-Ll~5-ni ~S ~~~~ Property Owner _ a Boring # 09~3`-i l t~~uc~ Parcel ID # ^ Boring ® Pit Ground surface elev. ~ • 1 ft. ~~ ~.YV~7 11~J G Depth to limiting factor Z'y in Page 2.. of 3 Horizon Depth in Dominant Color M ll Redox Description Texture Structure Consistence Boundary Roots Soil Application Rate GPD/ft~ . unse Qu.:tz. Cont. Color Gr. Sz. Sh. "Eff#1 •Eff#2 D -8 l o~ R j I,z _ s l I Z ~S ~ ~ w1~~Y- ~S - . S ,B Z $-Z.y ~-Sk ~--3 - s j 1 Z~ Kok h'1 ~- C S - • S . 8 3 Z~l-4 Z I o ~ ~ ~ L3 - LS6 ~z - - - ,~ , p Boring # ^ Boring n Pit Ground surface elev. a no.,-ti -„ ~,..,,t,.... ~..,..,.. Horizon Depth in Dominant Color M ll Redox Description Texture Structure Consistence Boundary Roots Soil Application Rate GPD/ft~ . unse Qu. S::. Cont. Color Gr. Sz. Sh. •Eff#1 'Eff#2 ^ Boring # ^ Boring Pit Ground surface elev. ft. Depth to limiting factor :„ Horizon Depth in Dominant Color M ll Redox Description Texture Structure Consistence Boundary Roots Soil Application Rate GPD/ft2 . unse Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •Eff#2 'Effluent #1 =GODS > 30 < 220 mg/L a,nd TSS >30 < 150 mg/L • Effluent #2 = BODS < 30 mg/L and TSS < 30 mg/L The Department of Commerce is an equal c-pportunity service provider and employer. If you need assistat)ce to access services or need material in an alternate format, please contact the department at 608-266-3151 or TTY G08-264-8777. SBD-8330 (R.6/00) PLOT PLAr1 ~ Page 3 of 3 Scale 1' = yp' c3w1 bl•-Z r 8~)t~( ~ 1 • 8.3 O silo J I i ~~' as J ~~ ~ 24' V f ~T_ Or Q~,(_, ~ 0 -~ ~-- `t 6 , o ' z4 ~ q3' ~ s S rf 1 r.~~L~ST _ _ _ -- LoT l..lN ~ g~Z i~S' --- 'e'.1 _~q'3 i ~~- Z Inc ~T~ oo >v or e.ow,,~,~-e.~- oZ atslvrz.~ a3 _ I `CIS QC~"Q - ---~~_~-~~__~~ .tQ~•O ~ -8N - ~Z.`!~~L..:~ 3l8':Dl_fA -=~-Q PC]Z_ t~?/ ~-1~'f-}~, Q~ tfZ:__ .~ZL'V -:- LO Z:.3' C-~1 JV-~L:_1`l"-PtSoV~ G-- CST Signature Z-~_OZ 715-425-0165 .220254 OZ._!9 Date Telephone ITo. CST A1o. Job P10. OwnerBuyer Mailing Address Properly Address ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM J as Ova n.~~Q ~, ,~~° ~~ ~d ~ , (,~ ~ S ~o/~ (Verification required from Planning Department for new City/State ~~~~ ~~ Parcel Identification Number ~~~~~ ~~~ ~/03?-!d 7iQ./}~tt`Sft'7PaC~~ t ~2d~», fGE1E'l~G~°- o ~ SJ~6~24a ~ LEGAL DESCRIPTION properly Location /~~ '/., ~ '/., Sec. / f . T~_N-R~_W, Town of ~~ ~~ ~~ ~ ~° ~~ , Subdivision Lot # -~. Certified Survey Map # ~ 7 7 ~ ~ 3 ,Volume / ~ , ,Page # `~a 8 a" Warranty Deed # G°~iPD~~ ,Volume Page # S' l~ Spec house ^ yes ono Lot lines identifiable ~ yes ^ no SYSTEM MAINTENANCE Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a mastorplumber, journeymanplumber, restrictedplumber or a licensedpumperverifyingthat (I) 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 1/3 full of sludge. Uwe, the undersigned have read the above requirements and agrce 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 Rnthin 30 days of a three year ex iration date. GNATURE OF APPLIC 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 the prope described above, by virtue of a warranty deed recorded in Register of Deeds Office. ~ ~ Oa SI NATURE OF APPLIC DATE *****~ ••*~*« Any information 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 U 188yP 516 STATE BAR OF WISCONSIN FORM 2 - 1982 WARRANTY DEED DOCUMENT NO. Gerald F Kerber and Michele R Kerber, Husband and Wife conveys and warrants to Brian K Blok and Karen E Ostb~, both single persons, as point tenants the following described real estate in S t . Croix County, State of Wisconsin: Part of the NE1/4 of NE1/4 of Section 18, Township 29 North, Range 17 Wes' St. Croix County, WI described as follows: Lot 4 of Certified Survey Mai filed April 25, 2002 in Vol 16, page 4282, Doc~'l~0 677173 PARCEL IDENTIFICATION NUMBER This i s n o t ', (is) (is not) Exception to warranties: Dated this 3 r d homestead properly. day of May AUTHENTICATION 6 7 8 0 9 6 KATHLEEN H. MALSH REGISTER OF DEEDS ST. CROIII CO. , MI RECEIVED FOR RECORD 05-06-2002 8:15 A WARRANTY DEED EXEMPT # REC FEE: 11.00 TRANS FEE : 6.00 COPY FEE: CERT COPY FEE: PAGES: 1 THIS SPACE RESERVED FOR RECORDING DATA NAME AND RETURN ADDRESS Kareh. O~y /6~o Na.-~~ ez, S-S~~~- ~Ldson , w i s~o/~ __ __ 018-1039-10 A.D.,2i~ 0 2 (SEAL) '~ ~ (SEAL) Gerald (F~. ~K~erber (SEAL) X~c ~~ L ±~Yl - i~ ~.~~ '~ (SEAL) • Michele R. Kerber Signature(s) authenticated this day of , 19 k ACKNOWLEDGMENT State of Wisconsin, ss. ~~"_ CY2a t ~ County. Personally came before me this ~K'~ day of fltls-'~t , ~Zthe above named `~ Grp F ~ P.f ElG/' a~[~ w • l f ~ ./~ . / _ _ ~_ r Jane Hansen From: Mary Jenkins Sent: Friday, April 19, 2002 3:32 PM To: Jane Hansen Subject: Soil test Jane: We have a soil test filed by Art Wegerer for the Gerald Kerber property, Karen Ostby & Brian Block, buyers, that Art has described as being in the SE-NE-18-29-17, Town of Hammond. IT should be NE-NE-18-29-17. Could you please change the original as per phone call with Art today? Thanks ~- ~scons~n Department of Commerce RFCF F APR p 8 20 p2 ST, CR =NG ~~VNTY Apri108, 2002 CUST ID No.267341 ARTHUR L WEGERER WEGERER SOIL TESTING & DESIGN SERVICE PO BOX 74 RIVER FALLS WI 54022 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 04/08/2004 SITE: Karen Ostby /Brian Blok - 160TH St St. Croix County, Town of Hammond SE1/4, NE1/4, S18, T29N, R17W FOR: Description: New Three Bedroom Mound System Object Type: POWT System Regulated Object ID No.: 835276 Identification Numbers Transaction ID No. 721333 Site ID No. 642783 Please refer to both identification numbers, _above in all cones ondence with the a enc 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. The following conditions shall be met during construction or installation and prior to occupancy or use: General Approval Conditions: • This system is to be constructed and located in accordance with the enclosed approved plans and with the "Mound Component Manual for Septic Tank Effluent for Private Onsite Wastewater Systems" SBD-10572-P (R 6/99) and the "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems" SBD-10573-P (R 6/99). • 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. • Comm 83.22(7) - 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. Owner Responsibilities: • 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). 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 Scott McCallum, Governor Philip Edw. Albert. Secretary ATTN: POWTS Inspector ZONING OFFICE ST CROIX COUNTY SPIA 1101 CARMICHAEL RD HUDSON WI 54016 • 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. ARTHUR L WEGERER Page 2 4/8/02 Owner Responsibilities Continued: • The owner is responsible for submitting a maintenance verification report per Comm 83.55, that is 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 VOL ~ E PAGE 42$2 KATHLEEN H. -lA~,.SH RfiGIS?6R 4F DfifiDs ST. CROIX CO. , WI RfiCfiTVfiD FOR RECORD 04-25-2002 9a3A A?! CERT I F !ED SURVEY MAP co~YFFEEt 3300 L OCATED ! N THE NE ! i4 OF THE NE ! i4 OF SECTION ! @, T2SN, R 1 TW, TOiMIf.'D6 c HAMMC~D, ST. CROI X GOUNTY, W/SCONS /N. (8E !NG LOT 2 OF THE CERT /PIED SURVEY MAP VOL. 9, PAGE 24 /O). PREPARED FOR: GERALD AND MICHELE KERBER I N / i4 CORNER OF SECTION IB (FOUND BERNTS6N SURVEY NA l t ). . UNPL ATTED LANDS --- NORTIM LINE OF THE NE I ~4 N89° 54' 44" E ~ ~ N@9~64r 44' E X72. O I' ~, --~_-~2PT0. 13' ~-- r REC. As 22TO. a5~) $. ~, :'~-1 :o :r :p ,~„ LEGEND o - SET I " (o. D.) X 24' IRON PIPE WE IGNING I. I3LBS PER L I NEAR FOOT. • ~ 1" IRON PIPE FOUND. DR/YE g g .z . ............... <C,^C~J ° WEL L v HOUSF @' : T POLE SHED :A Z. : '! Q Q w r .. ~ .y O : rT $~'rE,~ 2 : ~ ~~ ~ LOT 3' ~, W 404, 340 SQ. FT: 8. EO AC. E'XC RR~lY saT, aea 50: FT : ~ w_ . _, N ~ cu N m m I Oo' 8~ • WI m~ M I wE ~! mf ~i -.~ 100' NE CORNER OF SECTION I8. fFOUNO !' IRON PIPE). I A y I ~ I~ $I W~ ~_t A ~'{ ~) N ~o~ I NBS-a4.47-E aT2. ol• t ._ • 3. 00 (: ~ N OT 4= N N :o A RE -~~w (~ (~ _ 1. 82 AC. EXC. = R/W cNS_+}vNi SOUTN LING OF THE NE-NE ..................... 1 ,,........... .. are. L,OT / C. S. M. VOL . 9 • PAGE,.2410 •• ••~..•.•- E I~4 CORNER OF SECTION 1@. (FOUND 1= IRON PIPE ). 1 " ^ 200' o loo Qoo 40o SHEET 1 OF 2 2002012 TN / S lNSTRtlMENT DRAFTED BY JIM WEBER Vol. 7 6 Page 4282 .' o /~ ~ ~ ~~ ~'~ N IW ii ... ~i~ BEAR/NC3S ARE REFERENCED TO THE EAST t I NE OF THE NE /4. C RECORD BEAR /NG ). ca :~ :z :y APPRf3 ~ tru ST. CROtX COUNTY Planning Zoninn anA Pa•~! f;^mmatn.+ APR 2 5 2002 IF not rooorded v~ntnm 3U Days o+ approval date approval 6f1ai1 be null wnd void .~` ~~G O~,-S o~, `~~f....~\'~ ~' JAMES M. weeEa ~ 8 - it)04 8PR1NC3 VAt.LEY ~ wis. ~ ~ " ttt_ 9. _ .v. .~`_ . O t ANDMARfCNO~~M71G, L L C DATED _Z -Z`Z-~ Z `~f . CERT /F 1 ED SURVEY MAP LOCATED l N THE NE I ~4 OF THE NE ! i4 OF SECT 1 ON f 8, T28N, R / 7W, TOWN OF HAM~MDND. S T. CRO ! X COUNTY, W 1 SCON31 N. (BE f NG LOT 2 OF THE CERT 1 F I ED SURVEY MAP VOL. 9, PAGE 241 O ). 1~FSCRIPTION A parse! of land being Lot 2 of the Certified Survey Map recorded in Volume 9 of Certified Survey Maps, Page 2410, located in the NE '/+ of the NE '/. of Section 18, T29N, R17W, Town of Hatar-rtt~ond, St.Croix County, Wisconsin, more fully described as follows: Beginning at the NE corner of Section 18, T29N, R17W: Thence SOO°31' 19"E along the east line of the NE %., 1321.19' to the southeast corner of the NE t/. of the NE '/. of said Section 18; Thence 589°54'4T'W along the south tine of the NE ~/. of the NE 1/4, 372.01'; Thence N00°31' 19"W 1321.18' to a point on the north line of the NE'h of said Section 18; Thence N89°54'44"E along said line 372.01' to the point of beginning. Contains 11.28 acres (491,481 sq.ft.) subject to 100s' Avenue and 160v' Street right-of--ways and any and all additional easements, right-of-ways or conveyances of record. SURVEYOR'S CERTIFICATE I, lames M. Weber, registered land surveyor, hereby certify. 'That in full compliance with the provisions of Chapter 236.34 of the Wisconsin Statutes and the provisions of the St.Croix County Subdivision Ordinance and under the direction of Gerald and Michele Kerber, J have surveyed, divided and mapped the k~ereon described parcel of land and that this map is a correct representation of the boundaly, thereof. •°~ Dated then Z~-N ~ day of G~~.~~-~ 2002. ~~. ,,-~ ..• , ~ - . James M. W ber S-1804 "~ '`: ; ~ • .. ^ ~~ . . . Landmark Surveying, LLC ~ ~ s `-, ~ k - ~' A ~. NOTE: The parcels shown on this map are subject to State, County, and 'T'own laws, rules and regulations (i,e. wetlands, minimum lot size, access to parcel, etc.). Before purchasing or developing any parcel, contact the Sc,Croix CountyZoning OfFice and the appropriate Town Board for advice. AF''Pfi+U v ~ ~,, ST. CRO1X COUNTY P1aMfng ZOllinq anq Parke C~mmdter APa z s 2002 If not reooroea wun,~~ ou oaya Ur ePProval Cate aPP~ovaf shad De Ae/!t tend vgfd SHEET 2 OF 2 2002012 This instrument drafted by Jim Weber Vol. 7 6 Page 4282