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HomeMy WebLinkAbout018-2003-01-000Department of Commerce 3uilding Division 1 PRIVATE SEWAGE SYSTEM ~~ INSPECTION REPORT uENERAL INFORMATION (~TTACki 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 P.C. Collova Builders, Inc. Hammond Townsh CST BM Elev: Insp. BM Elev: rM Description: TANK INFORMATION UO~v TYPE MANUFACTURER CAPACITY Septic d~~ Dosing ~~~ Aeration Holding TANK SETBACK INFORMATION ~~.~- -ftI00 ~t lam' TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Septic 2 ~ Ylz ~ ~ 7Z ~ ~ ~ Dosing Aeration Holding PUMP/SIPHON INFORMATION Manufacturer Demand ~C) ~ ~ GPM Model Number `~~~2 TDH Lift / Friction Loss System Head TDH 1 $.3 v.8 3. (2.~ 0 Forcemain Leng Dia. Dist. to well ~ ~ a t/ SOIL ABSORPTION SYSTEM ~ ELEVATION DATA county: St. Croix Sanitary Permit No: 453273 0 State Plan ID No: Parcel Tax No: 018-2003-01-000 Section!'rownlRangelMap No: 18.29.17.895 ~Pvr! 1~lNR-~ STATION BS HI FS ELEV. Benchmark ~L /b~- bOV , ~ Alt. BM ~ ~ •~U //p, Bldg. ewer 7• ~D~• St/Ht Inlet ro OD.~ SUHt Outlet __.. .-. J ^ Dt Inlet _ _ _ _ Dt Bottom z.6 y Header/Man. .a (b~f•3 Dist. Pipe ~Pil~t ~ 4.3 ~ ~ ~ • 3 Bot. Syste 2~ .5. I 5- l ~~ Final Grade loS , St Cover ~ . ~~ 3~ ~~Y. ~ 3.5 /UL-~ S-(~~ l0~-(0 ~-~ BED/TRENCH DIMENSIONS Width ~ 7 Length (-~/ / J No. Of Trenches / ~" P IMENS NS f Pits In ~ Dia. Li De SETBACK INFORMATION SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHIN C OR cturer. Type Of System: ~ 1,~^ y• `t1~1. ,tv ~~ ~ f I~ ~ n o ~ / ,il Model Num DISTRIBUTION SYSTEM Svv~_ Header/Manifold Len th Dia oZ Distribution Len th Dia ~ S acin x Hole Size 3 x Hole Spacing Ventnt toe SOIL COVER ~y~ x Pressure Systems Only zx Mound Or At-Grade Systems Only ~'•~~A~-tre~.ted( Depth Over Depth Over xx Depth of 1. xx Seeded/Sodded xx Mulched Bed/Trenc Topsoil f~ y~ ~ ~ O~ Lc~l/fl es ~ No `Yes ~ No I,`y.COMMENTS: (Include/code discrepencies, persons presept, etc.) Inspection #1:_~/ ~ / 6~ • E~-• Inspection #2: b~/ ~ / 6 y C- • C Location Unl~n wn (N 114N,11E 114 18 T29N R 7 ) Crlck Bottom Overlook Lot 1 Parc/e~ l No//: 18.29.17.895 1.) Alt BM Description = ~~"U ~ ~- ~ ~ ~~ ~~ - ~%eILC.Vi^C~/• ~~~ ~ D Gvice-fy. e ~U•w~'~- ~ 2.) Bldg sewer length = G~~ 7 `" L` ~~Jv~-' ~" d1"- D~""~` ~``' ~~ - amount of cover = ~ :Z f (,4~ ~ V e-~v~t-cQ- Cs~ D }-~ l o~~ 3.) Contour = ~ ~ ~ ~ ,~,.,~ plc~,,.< <.1." 4xC~~ P`~(' l ~>~ c;1~`c.~,~-~cc~- . Plan revision Required? Yes ~ No ~ ~ ; ~ ~ Use other side for additional informatidrN ~~~ b I_ _ ~_ _ ' _ ~ _, ~ U ~l__~ SBD-6710 (R.3/97) Date Insepctor's Signature Cert. No. ' ,,, ~ • Safety and Buildings Division 201 W. Washington AvH., P.O. Box 7162 County ~~ ~ ~ ~ ~seansrn Madison, WI 53707 - 7162 Sanitary Pemut Number (to be filled in by Co.) De artment of Commerce (608) 266-3151 ~~ Sanitary Permit AppIieation Sate Plan I.D. Number In accord with Comm 83.21, Wis. Adm. Code, personal information you ptovi~ ? 1 /~h~ ~ ~ J / =Ti~4NS. /C. may be used for secondary ptrtposes privacy Law, s 15.04(lxm) Project Address (if differrrtt than mailing address) L Application Information -Please Print All Information y r ~ ~ ~ ) ~ u N (~ 1 2 ~ ~ ~. ~ # Lot # Block # ` ~ ~,/~,~ Property 's Mailing Address )~~~ ~~ ZONINGOrFICE Pro Location ~/ r ' Ci tare ~ Trp Code Phone Number /a, / ib, Section ~-1'~ (~J ~~v • ~~ ~~ ~trde one) N: E or W II. of Building (check all that apply) Ora ~.er 5 ~ S bdivision Name CSM Number r 2 Family Dwelling - Number of B ms ~ u PublidComraerr,9a1-Describe U '~' ~ L/ 1 t w p. Stale Owned - Drscdbe Use O S ~ City Village T f - ,o III. T ype of Permit: (Check only one box on line A. Co p ere line B if applicable) _ ,ZQp ~ _ O/ - dt7D , .S A' New System Replacentettt System TtreatmertNHoiding Tank Replacement Only Other Modification to F.xis6ng System B • Permit Renewal Permit Revision t7tange of Permit Transfer to New Ltst Previous Permit Number and Date Issued Before F.xp""nation Plumber Owner IV. T of POWTS S s tem: (Check ' Non -Pressurized In-Ground curd 24 in. of suitable soil Mound < 24 in. of snitable soil At~Grade Single Pass Sand Filter Cortstruaed Wetland Pressurized In-Ground Holding Tank Peat Filter Auobic Treatrnent Unit Recirculatiog Sand Filter Recirculating Synthetic Media Filter Leaching Chamber Drip lane Gravel-less R Other (explain) V. Di rsal/rreatment Area Information: Design Plow (gpd) Design ~Oi~lication Ratie(gpdsfl Dis '~f A`rra~ `t~eg/yired (s~ Dispersal Area Pro System Hevation VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steil Fiber Plastic Gallons Gallons of Units Concrete Constructed Glass New F.zis6ng Tanks Tanks Septic or bolding Tank AeroMc Trcatmwt UNt Dosing Chamber ~ G VII. Res risibility Staten ,the and a asibility foe iasfanation of the PORTS shown on the attached late PJu ante (Print) Plumber's store MP/MPRS Number Business Phone Number Plumber's Addres Ct't~State, ) ' s ~ Q~J f VIII. /De artment Use Onl Approved Sanitary Permit Fee (includes Groundwater Date Issued Agent Signatu (No Stamps) r Given Reasan oc Surcharge Foe) 7 ,_,..~~ ~. 7~ CJ ~ r ~ 7 ~ IX. Conditions of Approval/Reasons for Disapproval SYSTEM OWNER; 1 Septic tank, effluent filter and dispersal cell must alt be serviced /maintained as per management plan provided by plumber. 2. All setback requirements must be maintained as per applicable codelordinances. Atfach complete plans (to the County only) for the system on paper not less than 81f2 x 11 inches in size PLOT PLAN .C. Collova Bldrs. ADDRESS P.O. Box 489 Somerset Wi 54025 /4 NE 1/4S 18 /T 29 N/R 17 W TOWN Hammond COUNTY ST.CROIX 5/17/04 BEDROOM 3 RS Shaun Bird 226900 DATE CONVENTIONAL AT-GRADE CONVENTIONAL LIFT HOLDING TANK MOUND XXX SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE 630 HOLDING TANK SIZE LOAD RATE 1.0 ABSORPTION AREA 454 ~ of chambers none BENCHMARK V.R.P. Top of Survey Iron ASSUME ELEVATION 100' Filter Zabel A-100 ^ BOREHOLE O WELL *H,R,p, Same as Benchmark SYSTEM ELEVATION 102.6' Scale = 1 /4" = 10' 1 AAaI. A..., - D.M. ° a. commerce.wi.gov i ^ ~scons~n Department of Commerce JUN d 1 200 r. cROlxc~~rrr~ ZONING OFF=ICE= Safety and Buildings 4003 N KINNEY COULEE RD LA CROSSE WI 54601-1831 TDD #: (608) 264-8777 www. com merce.state. wi. us/sb www.wisconsin.gov Jim Doyle, Governor Cory L. Nettles, Secretary May 28, 2004 CUST ID No.226900 SHAUN R BIRD BIRD PLUMBING, INC 1008 192 ND AVE NEW RICHMOND WI 54017 ATTN.• POYIjTS Inspector ZONING OFFICE ST CROIX COUNTY SPIA 1101 CARMICHAEL RD HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 05!28/2006 SITE: Pc Collova Builders 998 158th Street Town of Hammond St Croix County NW1/4, NE1l4, S18, T29N, R17W Lot: 1, Subdivision: Crick Bottom Overlook Identification Numbers Transaction ID No. 1004331 Site ID No. 684184 Please refer to both identification numbers, above, in all corres ondence with thew enc . FOR: Description: Proposed Three Bedroom Mound System Object Type: POWTS Component Manual Regulated Object ID No.: 960593 Maintenance required; 450 GPD Flow rate; 24 in Soil minimum depth to limiting factor from original grade System(s): Mound Component Manual -Version 2.0, SBD-10691-P (N.O1/O1), Pressure Distribution Component Manual -Version 2.0, SBD-10706-P (N.O1/O1); Biofilter The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, stats. The following conditions shall be met during construction or installation and prior to occupancy or use: • This system is to be constructed and located in accordance with the approved plans, and the "Mound Component Manual for POWTS -Version 2.0" SBD-10691-P(N.O1/O1). The pressure network is to be constructed in accordance with publications SBD-10706-P(NO1lO1) "Pressure Distribution Component Manual for POWTS -Version 2.0" and/or the sizing methods of publication "SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST-SAS (01/81)". • A Sanitary Permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.135 and 145.19, Wis. Stats. • Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(2)(4), Wis. Stats. • The area within 15 feet horizontally below the system shall remain undisturbed. Vehicular traffic or soil compaction in this area is prohibited. • A state approved effluent filter is required. Maintenance information must be given to the owner of the tank explaining that periodic cleaning of the filter is required. Access to the filter for cleaning must be provided per Comm 84 product approval conditions. • Comm 83 22U - A copy of the approved plans specifications and this letter shall be on-site during construction and o en to ins ection b authorized re resentatives of the De artment hich ma include local ins ecp tors. 'j~ ~• C'~~z~iti~- jzally ~~~e~-., SHAUN R BIRD Owner Responsibilities: Page 2 5!28104 • The current owner, and each subsequent owner, shall receive a copy of this letter including instructions relating to proper use and maintenance of the system. Owners shall receive a copy of the appropriate operation and maintenance manual and/or owner's manual for the POWTS described in this approval. • Comm 83.52(1)(a) -The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s. Comm 83.54(1). • Comm 83.52(2) - A POWTS that is not maintained in accordance with the approved management plan or as required under s. Comm 83.54(4) shall be considered a human health hazard. In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approved plans. • The owner is responsible for submitting a maintenance verification report acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, ~~c.~.~- ~~ _ ~ 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 WSMART code: 7633 Cc: Leroy G Jansky, Wastewater Specialist, (715) 726-2544 Cover Page Shaun Bird Bird Plumbing Inc. 1008 192nd Ave New Richmond Wi 54017 715-246-4516 Date: 05/17/04 Owner: P.C.Collova Bldrs. Location:NW1/4NE1/4 S18 T29 N,R17W 998 158th St. System type: Mound System Manuals Used: Mound Component Manual Version 2.0 (01 /31) Pressure Distribution Manual Version 2.0 (01 /31) Page# 1. Cover Page 2. Mound Plot Plan 3. Mound Cross Section 4. Pipe Cross Section/Pipe Layout 5. Pump Chamber Cross Section 6. Pump Curve 7-8. Maintance and Contigency plan 9-11. Soil Shaun Birc .~~„ ~ ~, - ,,,:,tA4t7tdENT OF COh4MERCE piVIS!QN OF SAFETY AND BUILDINGS SEE GORRE NDENCE Signature License ni RE~Et11~D MAY 2 4 ZQ~1~ SAF~TIC & BLDGS D1~t~' PROJECT P.C. Collova Bldrs. NW i/4 NE 1/4S 18 /T 29 PLOT PLAN ADDRESS P.O. Box 489 Somerset Wi 54025 N/R 17 W TOWN Hammond COUNTY ST. CROIX MPRS Shaun Bird 226900 DATES/17/04 BEDROOM 3 CONVENTIONAL AT-GRADE CONVENTIONAL LIFT HOLDING TANK MOUND XXX SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE 630 HOLDING TANK SIZE LOAD RATE 1.0 ABSORPTION AREA 454 # of chambers none BENCHMARK V.R.P. Top of Survey Iron ASSUME ELEVATION 100' Filter Zabel A-100 ^ BOREHOLE O WELL * H. R. P. Same as Benchmark SYSTEM ELEVATION 102.6' Scale = 1 /4" = 10' 100th Ave 158th St. Tank is to be properly bedded and provided with lockdown covers with approved warning labels Pro 3 Bedroom House Grading is to be done to divert run- off away from system 10 2' B-3 B- Well is to meet all setbacks found in Comm. 83 5% Slope Huffcutt Combo Tank 101.6 Area 15' below 101' system is to remain undisturbed " pipe C~ 100.0'8-2 351' Prone B.M. ~~,~-~--R-. _. %`P~ __ ,,:: No Designex Date y Non-Woven Filter Fabric 4" Observation Pipe Perforated Below Filter Fabric ASTK C-33 S o n d " Topsoil .. -- -----~' ~~ t e ~ ,~ 1 ~DiztriDution. PiQe ~~ ~ H :__- ~~_ --- 0 _ ~ ~• S1ope ,Bed Of r 2 ~~ Force Moin #I~ ~2 From Pump Drain Rock Cress Section Of A Mound S ste____~ ~?i^_9_, A ged For The Absorption Area ____--- q Ft. g ~- Ft. I ~ Ft.~ - ~ ~ , j Ft. . K~~ F t . . __ k, aC ~ Ft F iowe d LnytPr~, "p __E_~ i ~ f .~~ F T G !~_ ~~ h ~_..~- L l '_"'__ 4~Observafion PiPe-~ --K J Lr e ~ __`_~l (~ _.. - -- - - .r ----~.~ ~~--.-r.~--..---~---..----~---..-..-..r-~~~ - , ~ ~ ' D. A ~ _ Force Mo n ~ ./r _ _ _------------------- ~ From Pump V) o ~. . ~ t ~ ~f ° Distribution Bed Of /Z - 2 2 ~ ~ Droin Rock Rips I ~„ 4 Obzervotion Pipe °~rx.~~cx, Permonent Mocker ~~S~r ~~ ~'j ~'i~r~ 6v~~~,~sPip° or Rods Plon Yiew 0f Mound UcinQ A Bed For The Ab3orption Areo PAG E,_„ OF Cl~a Locoted Qn $olton+. Sayplty Soocea ERST t1o1.L Ngx'{ era Cartr-sc}Ron Ft. ~~. Signed: License Number: date: . ___.,~ inches Yv~ Inc.he5~ Hole DiameterInch Latera3 ~" ~ .Inch{es~ Manifolc ~ Inches Force Main ~- Inches ~ of hote5~pipe ~ Invert Eievdtfon of i.ateral~J..~,/ Ft... pcr¢orate4 Pip! Detoii ~,Nt"3 SP~C~i ICAT;OTC G?~ E zUMF' C~~A~$£R CRASS 5£CT ` SEYTZC TANK ~EAxN£RPl2f~F ApgROV FD 4BpvE .GRADS ~ J~13~CT~4i~ $QK MpA(NOLE COMER „ M~w.4R W€T~ Cc*~:DUI2 W~ F'ADL{KK 5 ~,~ G ~£pT pIP£ }~j}+T13 y,~pRNI?iG LAHEL FROli D4QR. FRESH SIR ;PITfiKE . iQ f~,.` ~~' ~, ~ ~(o sr" :~ t T ~ it° IN.• ~ 3 '. s , INLET .. _'~ GNT' ~` ~atniTS Yi7li wAT£R 'SIG f~iT SEA J ~. s j ' AL,K 3. +FiLT£~ 8 . i C ~ t FF App~~ q ~-- Fi~E 3` 1~ £L£y • t ~~ 1-FT • D ~' PL3?~FP Op'F St3 Y ED BEO~~N~ V i~~ TANK ~i ONCgETE FAO ~ ~ APPRti f i ~ ~ ~'~; "'"'....,..~- £R DAY Nt,ii,48ER ~pSES `7. s 7. J GAL- ~ ~ DOSE ~E v~:~NE Z~tCt.~~I3+~G S~ SMAMIFAC~R£R= CAL. FL~~ ~ ,J G1+L- SEPTIC~ GAi. - ~ ~~ > ;N;CNES TANK g;Z£S= DDSE CAphC~TZ~• A ~ gAy. ~ -~" 8 c l' Z~gES .o ~ ALARM 2'~',~FAC~g~'c ~.._. _ ~ ZNCHES = ~;,~-~~..,,,~+L. MpDEt+ ~~PE ~ ~ C ~ - ~_~•- ~ ~•~ y1AC TttRF.R = PER I LHR PUKP ~E ~xgER: ' '~ K ~„T2AZi~ ~ ~~ , ~ ~ ~ AL,AR FED ?'~O3 ~;fig TYPE= ...z ~~ P~Si'fP ~ bZP£ 1/ ~- ~~ ..~ ~ REt3132~tEn aISCKA$GF BATE ANB-DZS•~}tZB~ ., F ET .- !S CE SE'~EEN pu~4P Oi £ - FACT{?R J % ~---" FEE7 F;tZGTSaN~C kI~ ~ ~Z ~ vER42G ~ IiE~flR gUPP~~ 5= ~Tl ~~Q • F~fl~'AL ~7YN~ + ~ HIV OIp~yETER -'.---- + ~+ FEAT FO'RZ~ ~ - ~ZDT1r ~~ P TANK ~ ~,sNG ~ ~~~ y~ . i.Z~`~; ?£gNAL DI1~E~~;DI~~ DF ~~ I ~1 4A-~£: =188 °¢ w 2 v a z 0 0 LITERS 0 80 160 X40 320 FLOW PER MINUTE CONSULT FACTORY FOR SPECIAL APPLICATIONS • Timed dosing panels available. ~" - • Electrical a-ternators, for duplex systems, are available and supplied with an alarm. • Variable level control switches are available for controlling single phase systems. • Double piggyback variable level float switches are available for variable level long and short cycle controls. • Sealed Qwik-Box available foroutdoor installations. See FM1420. • Over 130°F. (54°C.) special quotation required 15y153 Series 1521153 MODELS Control Selection Model Volts•Ph Mode Am s Sim lex Du lex N152 115 t Non 8.5 1 2or3 BN152 115 1 ;Auto 8.5 Included 2 or 3 E152 230 1 Non 4.3 1 2 or 3 BE152 230 1 Auto 4.3 Included 2 or 3 N153 115 1 Non 10.5 1 2 or 3 13N153 115 1 Auto 10.5 Included 2 or 3 E153 230 1 Non 5.3 1 2 or 3 BE153 230 1 Auto 5.3 Included 2 or 3 O CAUTION All installation of controls, protection devices and wiring should be done by a qua{ifSed licensed electrician. All electrical and safety codes should be followed Including the most recent National EIecVIc Code (NEC) and the Occupational Safety and Health Act (OSHA), TOTAL DYNAMIC HEAD/CAPACITY PER MINUTE EFFLUENT AND DEwATERfNG MODEL ~ Feet Meters 152 Gol. Liters 153 Gai. Liters S 1.5 69 261 77 291 10 3.1 61 I 231 70 265 15 4.6 53 201 61 231 2G - 6.1 44 167 52 197 25 7.6 34 129 42 159 30 9.1 23 I 87 I 33 125 35 10.7 -- -- 22 85 40 12.2 --- -- 11 42 i Lock Volv2~ ,38.0 Fi. (11.6m) 44.0 F't. (134m) - 3 27 32 32 l i 1 ` 1z 1/e ~ I [ _L SELECTION GUIDE 8 sxzoeo 1. Single piggyback variable level float switch or double piggyback variable level float switch. Refer to FM0477. 2. See FM0712 for correct model of Electrical Alternator E-Pak. 3. Variable level control switch 10-0225 used as a control activator, specify duplex (3) or (4) float system. RESERVE POWERED DESIGN For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump. MAIL Tor P:O. BOX 16347 Louisville, KY 40256-0347 Manufaefurersof.. Z SHIP TO: 3699 Cane Run Road . ~ Louisville, KY 40211.1961 Queurr/~~i~a9 Sacf /939" •s ,/,~ ,/ ~f (502) 778.2731.1(800) 928-PUMP htip;//www.zoel/er.com ~~/~a'/~ ~~I FAX (502) 774-3624 © Copyright 2000 Zoeller Co. All rights reserved. NEAR .CAPACITY CURVE MODEL 152/153 C~ w 50 153 2 40 152 30 8 I ~ 20 4 10 0 20 40 60 80 GALLONS w 100 ,~ EKT PUN p~NER'S MANUAI.8~ i~tANA sPE iftcp7ioxs pO1NTS SYSTEM t~tY cp~dc tank t:aPa Niunber of Be°rov{~~ gilts Nu ~ ~~~ . Esifimsted f1o~ t~"~`` aced x 1.5) UesiQn ffw+r (P~'b~ tam Son NPPOcatJ°" t~ ~~~ Quatlty Fats,.0i(& Grease (~~') en pemand (800 i3iocheT~ S~pencFed t~otids (TSS) p~reated Effluent CluaCdy gODs) Biod~em~l QXygen Demand Total Sanded Solids {TSS) Fecal Cpiiforrn (g~rnetric mean) Maximum Effluent Particle Sete vu~.. ~. _ Seryioe )event inspect oonditl°n of tank(s) Pump out contents of tank(s) Inspect disPe~ cell(s) clean fluent filter inspect pun~P~ Pump COnuo-s 8~ alarm flush fabersls and pressure test Page of _~ I ~`~ ~ c Tank Mar-u}pw..... " ti _ ~--' c' ser eitt t tamer Ma~-ct ~u ~ ~j ~~ ---'--"~' Effluent Fttet Model ' , . ~ ~ ~- ~ Tank Capa~Y Pump-. al `~ pump T2lrik Manufa~rsr ' ~? slid ~J~ at/d ~•, . Pump ~~ ,~ J ' ,~ aUda /t°t2 Pump Mode{ Pretr~e+atR-ent U ~ . p Peat Flltet Monthly svera9e n ~ p ,andlGrBv~ ~anical peratian ^ Wetland S30 m9 - 5220 mglL p M ^ Disinfection p ether. ^ f+lA fVA Q NA DNA ~E7 t+lA ,ANA s , ~,,, •.. - - •---- ~l Gett(s) ressurized) Nlonshh average''' t7 1 -ground (gravity) ^Ino rodund (P S30 m9n- Q At-grade ' ' ^ O~Rer 530 m9n- p pri ine 510 ~,/10pm1 non•wrt~rt+e~'~ y,~staratar and vatues ~ploal for domes Y inchdiameter ~etltuent er. ..~ Ys a~ ~pgal for Om~Eated wastewat Service Frequency eat(s) (Maximum 3 yrs.} p months At feast once every ua[s one-~i~ (~) °f ink volume When combined sludge and scum eri rts) (Maximum 3 ym•) the a At feast once every ~ p mon `-~' D rnon~$ r(s) At feast once every '~ ^ months r(s) p NA At Least once every p month s) p (YA At feast once every p months Cj year(s) ~ NA At Least once eve? o months ~ yes) ^ NA At yeast flncs every __--- other: GOenses or CE INSTRtJCT10NS an individual cartYln9 one of the followi~~Miner, Septa9e ks and disPe~i setts shaft be made, ~ Sewef' ppyYTS tnspector: POSI'+N'i'Sany missing or broken ~ 1 sp ~ ~ r Plumber R~ on of tfie tank{s) to ~~~ for any back uP ~: Mater Plumber. Maste sW a and scum as-d to Check t levers r. Tank;r,spedions must indude s visual insp~ ~ sheds the effluen Service ~~ ~ packs or teaks rT'fe~ uThe ~~~~} Cell(s) sh~I ~ usually ~~~ ponding of effluent on the round surfs nding of effluent on tfte ground surface• ulatory author+tY• ~orharidw ~ of effluent on the g for any >~ pipes and to check nand requires the lmmedistg notification of the local r+eg in the oar indicate a failing condi6o or mdre of the tank volume, ~ NR groom a and scum in any tank eQuals one-third (K) ~ of In axordan~'"'~' d1' When the combined aceuR'ulation of siudg a $epta~ Servicing Operator and dispos entire ~~~ of ~ tank shall be removed by t Rent components, and any sin AdministratNe Code. onents, pretrea p , Maintainer. 113, Wlscon animal or pressurized POWTS comp ~~~ ~, a ~~ fled POWTS The servicing of effluent ~i tees, mew of compietinn of any service event or monRoring at intenrais of 12 months or less shalt be other mafMenanoe •~ to ftte local re9ulat°ry authority wifflin 'f Q days A ~~ report shall be l~ roduds or other 0 OPERA'nOiV for the presence csf Painting trdtions are START WP AN S c~tsdc treatment tank(s) eta cell(s). If lush conoen For new construuc~ion, prior to use of the POWr s andlor damage the lisp rice to use- ~ e the ~atrrtent ero ~ by a Septage servicing operator p ChemICdys that may ~ t~ detected ~,Ye the contents of the tank(s) Page,,,,~of-^.- t _ ~^ _ .tl ~ ~i-conditions are ~irozen at the infiltrative sur#ace- is restored the excess ~n P~ sand may result in the gy~em start up mall not occur ~ friSy a{~otile normal ne Sat ter }eveis. the cell( ) ~~ ~ e dose, ovQr{oadingf the pun'-P tank temorred by a Ourin9 °~fles Pum ~ ~ ~e dcsPB~ ~ti(this scWation have the ~n~nts $ Plumber or pQWTS Maintainer to wastewateu,"~ be di'ge of et8~!b To aYO tp the effluent pump or contact tanl~ backup or s"`taoe discl'ar8 xo.~dng power in the P~mP , . e 8enrsdr-9 oPe~tioc ~' GIs 1A restore normal tenets v~ over, or o~~erwLSe disturb or compact, ~t ~uapy op~attng the Pump °oit Do not drive or paw ~ vets ~~ thnlcs and disPe~ ~• lion area- po not drive or pa rnottnd or at~rdde sail absarP ~~~ and prolong the Gfe the area ~'~' '15 feet down slope of any~m the wastewater stream may impro d~ere-asets; dental floss; dia seers; Redc><cti~,~.ermtnation of fhe folfa+~9 dgarefre butts; oandoms; cotton swings; g~~* g~e~" herbiades; meat antibiotics: ~Y ~Pffi~ v~rater, fruit and v®getabte pe ~ soiterter brine. of the POVt(TE= ~~daGon dFaln (stxnP pump) na (tins: tampo~'and wale dsinfectanfis: fat ling products; pe~ddes; sanitary P g«~s; rnedtc~tions~ ~ ~ ~ insure that the Shari tae taken to pgpNDONM6Nt1'iT taken out of service the fottaw<n8 Step' in Adminis~~e Code: faits and/or is pe~a~n~" wig ch_ Comm 83.33,1Ms~s ~1en fl1E Sand safety abandoned in ootnPi~~ - Wings seated. ~~ ~ proP~y its shad be disconnected and the abandoned P Pe of ~ a Septa9e Setvietng Operator. An piping to finks and p ~ shall be removed and propefi' disposed . -rf,e contents of ail tanks and nS Shan be excavated and removed or their rovers rSnoved and (fie void space Hfter pumping, all tanks and P filled with snit. Sravel or another inert solid material. ttse following measures have been, or must be rotten, to Provide a code CONTINGENCY Pt.AN ment soil if the POW'~S faits and Cannot be t+ePatred utilized for the Location! of a reps and should not c;ompCtant rePta~Bnt'yatem- has been evaluated and may be from disturbance and compa p A suttable ~P~ement•area ment area. should be protected ~, [ot tines and welts. Failure to a~rpflon system. The r~eP~Ce tics from existing artd proposed structu $~ vriii result in the need for a ~~ thefrules ineffectuateon to establish a suitab e be infringed upon by n;qulred setba at that time. prote~ the rePta~ment ms must comply w~ advances in p05NY'S replacement area. Replacement sYS~ le re laoement area is not ava-tabie due to setback and/or soil timitabons. B o th as a fast resort to replace (fie ~~~ pp~NTS. a POVVTS a so-l and O A surtab P be installed n failure technology a holding tank roay ~ identi fy a suitable replacement area. Upo not been evsiua~d ~ mate a suitable repta~ement area. if no repiacenzent area is avatiable a. e site has Slie evaluation must be petforTn~ tare f0tlCnAlin~ nrcnoYal Of the biomat at be installed as a isst resort to replace the fatted POYYi"S. holding tank may -rs may be reconstructed in p c*ions of such systems must comply ~ fl7e rotes ?n et~fed at that time_ Mound and atgtade soli abso~n ~e the infittratlve surf>aoe. Reoon~ gES pNDlOR iNSUFFICtEIYT OXYGEhI. <cWARNING» Z'h(ENT TANKS MAY COhITAiN LETH~- C'ASCIRCUMSTAt~iGES. D(Jl-TH MAY SEPTIC, PUMP AND OTHER'7~A. TMENT TANK UNDER ~~ OF A PERSON FROM THE rNTEi310R OF A TANK MAY BE DIFFiCUL.T OR iMPQS3IB 00 NOT ENTER ~- $»TiC' PUMP OR OTH~ TREA RESt1LT.. RESCUE ApOtTiONAL COMMENTS P0111(TS iNSTALr. R Name _ ~, ~-~,-) Phone ,.,3=- t, ~ ~"y~ POVVTS Mpl~piNER Marne u1~/ •~' ''. Phone ~/~-.' ERpTOR PUMPER LOCAL REGtILATC~RY A!P'MORtCY SEPTAGE gERYECING OP Agency ~ ~.-'~ Name n..~ ~ t~~ ~, Pfians ,?/J'°'~~?~ Phone '--- ~ 6 ~ ~J ~ This document meets uatte and Waushara County Zoning and Sanitation; aset~~ the stafits of the Glean ice, Mara ~ Cede. Use of this dap~ment does not This aoannenttvas drlttad l7y t and 83.5a(t). (2) 8 (3). Weoonsin Adminlstra~ G~ t~-) me minimum ,reQuineMents of cfi. Comm 83.22C1J(bK X~adfl guarantee the performance of the POYY'rS. wain Department of Commerce ~QIL EVAL' UATION REPORT Page of Division of Satiety and Buiidu-gs in accordance wan t;mnm ts5. wrs. fwm. ~.aae t Pl i C~ ~ _ c ~ ~ an mus ze. Attach oocttptete site plan on paper not less than 81/2 x 11 inr ~- s indude, but not limited Uo: vertical and horizontal reference point (BM). direction and percent slope, scats or dimenstorrs, north am~v, and location arrd distance to nearest road. Parcel I.b. O 18 - vo 3 - o l " ~'O ~ • ~ S • Please print all irrfdrmatron. ~ ~ ~~ Peru urtamedon Y~+ P ++~Y be used>~ seoondery pisposes {Privacy Lew, s.15.04 (1) (m)). ~ > ~~- P~~ ~~ ~ ~ POKY locatwn ~ T N R E (or W , ~ ! ~ ~ 1/4 ~ 1/4 S prop~y t~wrrer' Mailing Address ~ lot # # Nance or GSM/F L d lG ~ City Tp Code Phone ^ Vipage Town tVearest Road New Construdiorr Use: /Number ed design flow rake .~ 0 GPD ^ Reptaoement ^ ~ a - Descnbe: ~ ^ j'`~) ~ tl Flood Plain eteva#iorr H applicable Parent material General corrrnerds ~~ v~~~ ~ ~~ ff Gtr~I~ ~~~ ,~ ~S # 9 n Pit Ground surface e~v~ / ft. Depth tD INniting irr. SoN Ra®e Horizon De th Gom6rant Redou Description Texture Strucdxe Consistence Boundary Roots GP D/n` p in. Murrse6 Glu. Sz Corrt. Cobr Gr. Sz Sh. 'E1F#1 'E ff Gr d ~~ ~ - S . .~ c / ~ /~ ~+~r 2 ~~ ""'^7i # e+'' Pit Ground surface elev 1 tt. Depth ~ Gmitin9 c~ Rate tioriaArr Depth DorMnent t2edox Descxiptiorr Texhue Stnid~xe Consistenxe Boundary+ Roots GP DRt= in. Mur>selt Qu. Sz Cont. Color Gr. Sz Sh. 'Etf#1 'E ~ ~'~1U ~--'--- f~ ~. L ~ m + S ' ~ ,s''' -`' rn n a r'l a ~ 3 s- ' Eflhierrt #1 = BOD > 30 < 22D rrgil and TSS >30 < 7 ' tmuerrc aF[ = esuu = ~t- m9-~ ana r a~ ~ ~, ~~y~ ( p~ CST Number )r Adds Bate Evaluation Cvrrducted 7eleptrtxre Number ~~t/ Parcel ID # n Pace of d Ground surface elev. Depth to Nmiting factor Sod Ram Horizon Depth Dominant Redaa Descxiptian Texture Struc~e Consistence Boundary Roots GP DAF in. MunseU Qu. Sz. Cont. Golan Gr. Sz. Sh. 'Eff#1 'E8#2 ~ .- w 1 ~ , ~~/f ~' ~ n = 3 ~ s~ a ^ Pit Ground surface elev. @. Oeplh to fntitatg factor in. # ° ~~ Sod Rabe Horizar Depth Dominant Redox Description Texi~se Strtx~ure C~sistence eour~ryr Roots GP DIfF &r. Mures flu. Sz. Cord. Color Gr. Sz Sh. 'EtT#1 'Eff#2 ^ Pit Ground surface elev. >t. Depth to factor in. a# ~ ~~ Soa ~ Rye Horizon D~th Dominant Redox Desaiption. Texhas Strrx~e Consists Boundary Roots GPDJfE in. MunseB flu. Sz. Conf. Color Gr. Sz Sh. 'Eff#4 'Etf#2 • Effluent #1 =BODE > 30 < 220 mglL and TSS >30 < 150 mglL • EfllueM #2 = BOD3 ; 30 mglL and TSS < 30 mglL The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608-266-3I S 1 or TTY 608-264-8777. s~wae.6roo> ~ i R . Soil Test Plot Plan Project Name P.C. Collova Bldrs. Inc. Sha ' d Address P.O. Box 487 Somerset Wi 54025 ~ TM #226900 Lot 1 Subdivision Crick Bolton Date 12/4/02 1/4 NE 1/4S 18 T 29 N/R17 W Township Hammond Boring 0 Well PL Property Line County ST. CROIX ~B r VRP Assume Elevation 100 ft.~- Top of Survey Iron System Elevation 102.6' *HRpSame as Benchmark Alt. B ;,Top of 2" Pipe @ 100.0' ~---~ 100th Ave 30 1 5°Io Slope 40' B-3_ 102' 101' 80' B-2 _ ~- 100' 351' Line ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM OwnerBuyer P. C. Collova Builders, Inc. P O Box 489 Somerset, WI 54025 Mailing Address r Property Address ! ~ l (Verification required from Planning Department for new construction) u City/State ~t~~'1c~1~ C~ parcel Identification Number o/~- Z~ ~ - o I - ego ~ ~.S-~ LEGAL DESCRIPTION Property Location %,, ~%,, Sec. ~ T~N-R~~, Town of 0~' 1'TG Subdivision _ ~~~~~ ~~ 1~ ~'3~T _ .Lot # ~--: Certified Survey Map # ~- Volume .Page # Warranty Deed # ~~~i ~~ Volume ~ °~ ,~ .Page # ~~ Spec house yes ^ no Lot lines identifiable yes ^ no SYSTEM MAINTENANCE Improper use and maintenance of your septic system could result is its prematurafailure 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 masterplumber, journeyman plumber, restrictedplumber or alicensed pumper 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 1/3 full of sludge. Uwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth,. herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin, Certification stn ' that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 da a ar expiration date. P. C. COLLOVA BUILDERS, INC. (715) 247-2742 ~/~ 7 / ~ Y S GN OF APPLICANT SOMERSET, W SCONSIN 54025 DATE that all statements oa this form are true to the best of my (our) knowledge. I (we) am (are) the owner(s) of above, by virtue of a warranty deed recorded in Register of Deeds Office. p• C. COLLOVA BUILDERS INC. ~ /f ~/ ~ ~ SIGN RE OF APPLICANT (715) 247-2742 ' DATE ****** $QMERSET W SCONS N~ Any information that is mis-represented may result in a samtary ~e 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 1950P 528 ~ t~ ~~ SPATE BAR OF W ISCONSIN FORM 1-1998 C' 8 ~ 2 42 KATHLEEN R. MALSH WARRANTY DEED g Er'' I $p X T C CO ~I RECEIVED FOR RECORD Document Number This Deed, made between I^hn J Dalton and Carolvn G Dalton 08-16-2002 9:00 AM husband and wife .Grantor, and P C Cdiova Builders Inc. .Grantee. for a valuable consideratlon corneys to Grantee the fdlowing t G 1>® or, ran described real estate in St. Croix County State of ~ Wisconsin (the "Property'): REC FEE: 13.00 TRANS FEE: 1155.0@ COPY FEE: CERT COPY FEE: PAGES: 2 Recordin Area Retum Address P CoNova Buuders,Ine. x Avenue mood , WI 54013 %'~~~-J-9t~O9 078-1039-20--000 / 018-1039- 018 1039 80 000 Penal {dentlticetbn Number (PIN) Thla la not homestead property. (IS) (Ia not) Sae Exhibit A attached hereto Together with all appurtenant lighis, tEUe and Interests. none Grantor warrants that the title to the Properties good, indefeasible in simple fee and free and clear of encumbrances except Dated this 15th day of oust. 2002. (SEAL) hn J. lton (SEAL) Carolyn G.Aalton (SEAL) • ACKNOWLEDGMENT Stats of Wiseonaln, } ss. SL Cnobt County (SEAL) • p lQ~~a(i -: i~TE OF WISCO~~ Signatlue(a) ~AFE~~S~Y s"' ~ r(N~ authentlcated this N~ ~C $T- A~Ei~--' TITLE: MEMBER STATE BAR OF W 1SCONSIN (If not, authorized by §706.08, Wis. Scats) THIS INSTRUMENT WAS DRAFTED BY t;,oldwell Banker Bumet 1301 Coulee Road Hudson, WI 54016 2-32470 (Signatures may be authenticated or acknoNrledged. Both are not necessary.) • Nwmna of oe,wena ekmina in am/ C80aCIN must be typed Personalty came before me this 1 ~ day of Auaust ~0~ the atwve med J a and rol It ban nd Wlf ~ L~ ~kz ~ Notary Public, State of Wisconsin My commbsbn U pe anent (If not, state expiration date: ~~5 ~y .) C2(~ ~ ~-d''1 ~U E ~L„b C•~ C o l~ 2 STATE BAR OF WISCONSIN Wisconsin Lego! Blenk Co. Inc. yyAyr,Rq~y pip FORM No.1-1998 Milwaukee, Wis. . .. ;i~. , `1.9.5. ~ , P , 5 ..~,~..,.~, . A part of the NE ~/. of the NE '/. and In part of the NW '/• of the NE Y and fn part of the SVb!'/. of the NE '/. of Section 18, Township 29 North, Range 17 West, Town of Hammond, St, Croix County, Wisconsin and more partlarlerty described as: Begicming at the Northeast comer of said Section 18; thence 589'33'31"W 372;01 feet along the North line of the NE'/. of said Sectlan 18; thence S89'33'31"tN along the North tine of the NE '/. of said Section 18 775.94 feet; thence S00°52'23"E 250.00 feet; thence S89'33'31°IN 966.24 f+sefy thence S00°52'23"H 420.00 feet; thence S89'33'31'1N 528.00 feet; thence S00°52'23'E along the North-South Quarter Section line of said Section 18 1311.77 feet; thence N89°33'39°E 629.33 feet; thence N00°3i'25"W 330,23 feet; thence N89°33'Z4'E 692.78 feet; thence N00'S2'23"VV song the East line of the SW % ~ the NE '/. 330.31 feet; thence N89°33'24`E along the South 11ne of the NE '/. of the NE '/.949.09' fit; thence N00'S2'24°W 1321.19 feet to the Polnt of Beginning. ~-~ cam, g~~M 6VE~Z~vk 2 or- ~, J 89'33'31" E 1494.24' NORTH LINE OF THE NE 1 /4 M ~ M tO N 89'33'31" E -I 1 /4 ~R, z ~ --- ~,----~ 66 0' ON 18, ~ f ~ o o I cn z R17w. 0 0 o LOT 1 0 o o N ~ .76566 S. F. ~! o l o °- w o l 1.76 Ac. ~ °o_I $ I $ SMALL TRACT ~ ~~ m I ~ N 89'33'31" E 242.05' -~ L0 T 4 76393 S.F. ;,, 1.75 Ac. O 1~ N .~ J .~ f iO _ i ~-- 16, ~- -" N 89'33'31" E 351.20' v l v w ~ o0 N N 89'33'31 " E 240.14' o 193.38' ~ ~' Q Q ~ o LOT 3 N $ LOT 2 / ~ ~: 72277 S. F. ~ 69148 S.F. / 1 1.66 Ac. 1.59 Ac./ ~ ~ / // w ~ / ~ / 3/ 3 33 ~ OD N / 6 ; 775. ~` a.~ _ ._ - 0 ~o N gc I ~ I N gc I _ 6` / / / / / / / ~. ~ / ,~~ / y 89 33~ i ~' /~i -_ ©~ LOT 29 S 89'33'31 W 2 ~~~~rrww~~~e ~ 7022= S. F. N 89 33'31" E ~D '~ ~`'-'~~, ~ 1.61 Ac. 119.46' ' ~ , ' ~ ~ ~'~`'~. __. ~ ~ ~ ~~ ~\ --` ~ 19 LOT 24 ~ ~ , ~ \ S~ 69518 S. F. / /'~ \.o. ~i \ „ UNPLATTED LAN~4 N 89'33'31" E 775~t' a`