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Home My WebLink About018-2003-08-000Wisconsin Department of Commerce Safety and Building f~ivision r PRIVATE SEWAGE SYSTEM 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 P.C. Collova Builders, Inc. Hammond Townshi CST BM Elev: Insp_ BM Elev: BM Desc p 'on: GDU ~- b l UD ~ ~ ~ ~'- ~~ TANK INFORMATION TYPE MANUFACTURER CAPACITY Septic Dosing l~^,I~ Y~'1/~ p l0 5 U Aeration Holding TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Septic so' ~- -~ c% zs' Dosing ~ ~ ~ 7 Aeration Holding PUMP/SIPHON INFORMATION ELEVATION DATA County: St. Sanitary Permit No: 453038 Plan ID No: I Parcel Tax No: 018-2003-08-000 Section/Town/RangelMap No: 18.29.17.902 STATION BS HI FS ELEV. Ben mark 2 *j ~2 •~~ ~ D 0~~ Alt. BM Bldg. Sewer /~r-., ~ 7' ~- SUHt Inlet ~(! ' ,S St/Ht Outle ~- ~ Dt Inlet ~~ Dt Bottom ~-- ~, ~0 ~~ Z . ~ Header/flan. ~ 7- ~`'; i Dist. Pipe Z , /-7 ' ' x.33 Bot. System . l1 ~fS'. Final Grade ~~- St Cover ~ l i/• 3 .v qs~~ ~,. _ s~' . ,.. ~ s ,~ U~ ci , nufacturer GPM Model Number ~~•r-~ :-~,,~ tS-,'x 1L("~ TDH Li r- ~ Friction Loss System ead TDH t Forcemai Len th ~ ia. ~ t, Dist. to Well -7 SOIL ~ l U. p BED/TRENCH Width ~, ~ Length No. Of Trenches PIT DIMENSIONS No. Of its Inside Dia. Liquid Depth DIMENSIONS ~r v SETBACK SYSTEM TO t BLDG WELL LAKE/STREAM LEA Manufacturer: INFORMATION C MBER OR Type Of S tem: n { ~ ~~C% ~~, C ~ ~~] UNIT ., Model l~Lumber ~a~~ N L C~/ DISTRIBUTION SYSTEM ~ ,! Header/Mani old Distribution x Hole Size x Hole Spacing ~ Vent to Air Intake Length Dia Pipe(s) ~ y „~- Length Ci Dia ?' Spacing ~/ 3 1, ~ -~J SOIL COVER x Pressure Systems Onlv xx Mound Or At-Grade Svstems Only Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center ,~-- Bed/Trench Edges Topsoil-__ Yes No Yes No ~~, J COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: ~ / ~ 2 U Inspection #2: ~. / Y~ / Location: 990 156th Street HammoCnd, WI 54015 (NE 1/4 NE 1/4 18 T29N R17W) Crick Bottom Overlo 8 Parcel No: 18.29.1~p7.~90j2J 1.) Alt BM Description = ` ~.~ ~ ~ ~ ~ ~'~~l~ ~~ ~ / "~ ~2~ ~°`~ f7~~!iWiL 2.) Bldg sewer length = Z,S'/ E'~t c: ,~ ~~ ~~~r~~~ J ~ t ~X...S ~ ~'~tr~'~C?-~~ie ~ yd,•~' `~~uvn. - amount of cover = r, `~ ~ /~L~~ ~~~ ~/ ^5~~~ Plan revision Required? 'Yes No / ~i _ ~ L/' `~~ /--------__ ~~~ ~?'~ ~~- Use other side for additional informs ~ ~J Date Insepctor'sSignature ,h) Celt No. SBD-6710 (R.3/97) /~, /~/` ~ ~. ~ ~; ~ ~ ~~' j7lc~P,r/~~ t ~ Safrty and Buildings Division CO1Dty ~ ~ ~ ~ p 201 W. Wgghingtoa Ave., P.O. Bax 7082 Pptnit Number (to be hued in by Co.) ~~CO I~Iadisoa, WI s ~I~` (608)261 546 eat ~ ~s3 0 38" Department of Commerce mit Application ~ P Sta[c P LD-Number 20 4 9~ 30 = (["'~s. ~'~ ~ er Sanitary ro>;~i~P w n i , o y P to accord with Comm 83.21, Wis. Adm- Code, P~~ iafottnat econdary purposes Privacy I.aw, x15.04{ l j( ) d f project ess (if different than ttt~ling s) ~-~ i~~ e~ . Q Q or s be use ~y cT Ci:JIX CO O ' Ui~ T , I 1 ?ONit,;G Cr-SIC `r_ I. Apptieatlon Information -Please Print All Information - - -- -~ parcel # t # Property Owner's Name /~ ~ L ~ --~ ~^ ~, b ~ Property Location propet~pwnpr's Mailing Address ~ ~ . ~ ~ ber ~ y., i %., Section a City, Stale Zip Code Phone Num ~,~~.s//~ ~1 (~ N~ ~~Eclr w ~ V I 1 -L-- II. Type of Boil rag (cheek al that aPPly) S w`` su svision N c CSM Numbs 1 0 Family Dwelling -Number of Hed s ~~ / ' ~ ~ ^publicJCommercial-DcscritxUs ^~, _n_ ~ ~ ~~ ~- q ' ^Ciry ~Village`~6+tmshipot Vt. . -- 0 K ^ state owned- lkacttbt vse _...~I t) III. Type of PertNt: (Cheek only one best on Ilse A. Complete llne B if applicable) A• w System ^ Rcplaceatent System ^ TreatateadHoldiag Tack Replacement Only ^ Other Modification to Existing System List previous Permit Number sad Date Issued ^ Permit Renewal ^ Permit Revision ^ Change of ^ Permit Traztsfcr to Ne+*' B . Before Expiration Plumber Owner IV, T e of POWTS 3 stem: Check all that a 1 ^ Non -Pressuttized in-Ground ^ Mound ? 24 in. of suitable soil ^ Mound < 24 in. of suitable so' -Grade ^ Single Pass Sand f iltcr O CotlattLLCted Wetland ^ PrtsSUtiT.ed 1n1itoemd ®Holdiag Tank ^ Pat Filter ^ Aerobic Tr eat Unit ^ Recirculating Sand Filler O Laocbia Chamber ^ Drip Line ^ Gravel-Ices Pipc ^ Other (explain Reeitculatia Synthetic Media Filter V. Dla ersal/Treatment Area Information: Area proposed (s~ System anon ~ ign Flow (gpd) Design Soil Application Rate(gpds!) Dispersal Area R qui ~(s~ ~ iSP~/ es D / / Capacity in Total Numbs zeta Tank Info VI Prefab Site Steil Fiber Plastic Concrete Constretcted Glaze . Gallons t3allons of Units New Existing Tanks Tanks Sepeie or Holding Tank Aetotsk 7reatmeot Unit aoswi Chamber j VII. RaapoasiblU Statement- I, the uaden[gne some reaponstbillty for iaatallation of the ppWTS shown on the attached plans. iness Phone Nu Bur PI ame (Priest) - Plumber' re M~pu" ~ l ~/ J `~' Plumber's Address {Street, Ciry, State, Zip ode} ~,^ l ~ / ~ VIII. Cozen / D artmeat Use Oal Sanitary Permit Fee (includes Groundwater Date Issued is uin gent Signatu (No 5tampaj Approved ^ Disapproved Stucharge Fm) ~ ^~~ .~-- 7 23 ~ \ D Owner Given Reason far Denial . IX. Conditions of ApprovaUReasoas for DIsapprovai SYSTEM OWirEf2: 1 Septic tank, effluent filter and dispersal cell must aN be serviced /maintained as per management plan provided by plumber. 2. All setback requirements must be maintained as per applicable code/ordinances Attach toatpkte plat (ta the County only) for the system es paper not kss than il/2 s l l lecher in size ~~~~~ ~~ SBD-b398 (R. 48102) ~, ~~~~ '' ~ PLOT PLAN P.C. Collova Bldrs. Inc. ADDRESS P.O. Box 489 Somerset Wi 54025 ~1 i a NE 114S 18 ~T 30 NiR 29 W TOWN Hammond COUNTY ST. CROIX 3/10!04 BEDROOM 3 ~~~ PRS Shaun Bird 226900 DATE CONVENTIONAL AT-GRADE )OOC CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE 630 HOLDING TANK SIZE LOAD RATE .5 ABSORPTION AREA 900 # 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 96.8' B.M. Alt. B.M. Top of 2" pipe @ 100.0' Scale = 1 /4" = 10' B- 8% Slope Grading is to be done to divert run-aff away from system -3 Area 15' below system is to remain undisturbed Well is to all setbacW 420' found in C~ Property Line ~-__ _ t , 420' Property Line 9 8' 97' System is being designed 96.8' under Comm. 83 loading B - 96, rates set prior to Feb 1st. 2004 Huffcutt Combo tank Tank is to be properly bedded and provided with lockdown covers with approved warning labels ,., . . Pro 3 ~~~ ~~ ~~~ "~ Bedroom ~ •] House LCD/, ~ c ~, ~v ~~" , ~~ ~'~~ isconsin Department of Commerce Safety and Buildings 4003 N KINNEY COULEE RD LA CROSSE WI 54601-1831 TDD #: (608) 264-8777 www. commerce. state.wi. us/s b www.wisconsin.gov Jim Doyle, Governor Cory L. Nettles, Secretary March 17, 2004 CUST ID No.226900 SHAUN R BIRD BIRD PLUMBING, INC 1008 192 ND AVE NEW RICHMOND WI 54017 ATTN: POWTS Inspector ZONING OFFICE ST CROIX COUNTY SPIA 1101 CARMICHAEL RD HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 03/17/2006 Identification Numbers Transaction ID No. 976830 SITE: Site ID No. 671645 P.C. Collova Builders Please refer to both identification numbers, 100TH Ave ~ above, in all corres ondence with the a~enc . Town of Hammond, 54002 St Croix County NEl/4, NEl/4, S18, T29N, R17W Lot: 8, Subdivision: Crick Bottom Overlook FOR: Description: Three Bedroom At-Grade System Object Type: POWTS Component Manual Regulated Object ID No.: 946282 Maintenance required; 450 GPD Flow rate; 36 in Soil minimum depth to limiting factor from original grade; System: At-grade Component Manual, SBD-10570-P (R.6/99), SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST SAS (01/81), 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. COY: 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. DE ARTM The following conditions shall be met during construction or installation and prior to occupancy or use: ~!'Ij9f~N 0~ General Approval Requirements: J$EE COF • This system is to be constructed and located in accordance with the enclosed approved plans and with the "At- grade Component Manual Using a Pressure Distribution System for Private Onsite Wastewater Systems" SBD- 10570-P (R.6/99) and the SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST_SAS (01/81) • Comm 84.25(5). Wisc. Adm. Code Venting. Each tank, ..,shall be provided with a means of venting gases formed inside of the tank to the atmosphere. The tank vent shall terminate in accordance with s. Comm 84.40. • The location of the closest road (100` Ave.) is to be noted on the plot plan, and the distance from the site. • Per manual cited above, limited activities are allowed in the area 15 feet down slope of the component area. Soil compaction, excavation, vehicular traffic and other similar activities that impact the treatment and dispersal are prohibited. • The well must be a minimum of 25 feet from any POWTS tank, and a minimum of 50 feet from the. absorption area. chs. NR 811 & 812c SHAUN R BIRD Page 2 3/17/04 • 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. Stat • 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 rnaY include local inspectors. Owner Responsibilities: • Comm 83.52 Responsibilities. The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s. Comm 83.54(1). • Comm 83.52(2) A POWTS that is not maintained in accordance with the approved management plan or as required under s. Comm 83.54(4) shall be considered a human health hazard. • Comm 83.55 The owner is responsible for submitting a maintenance verification report acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. All permits required by the state or the local municipality shall be obtained prior to commencement of construction/instal lation/operation. 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, Charles L Bratz POWTS Reviewer II ,Integrated Services (608)789-7893 , 7:45 am - 4:30 pm Monday -Friday c bratz@c omme rc e. 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 Cover Page Shaun Bird Bird Plumbing Inc. 1008 192nd Ave New Richmond Wi 54017 715-246-4516 ~9,~F~Y~gFCF~pFO ~e~O~so i~ Date: 03/10/04 Owner: P.C. Collova Bldrs. Location:NE1/4NE1/4 S18 T29 N,R17W Lot 8 Crick BottomOverlook Hammond System type: At-Grade Manuals Used: At-Grade Component Manual version 1.0 SBD 10570-P (R.6/99) SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST- SAS (01 /81) Page# 1. Cover Page 2. At-Grade Plot Plan 3. At-Grade Cross Section 4. Pipe Cross Section/Pipe Layout `'~'-~~:~' 5ti,'': , t '+~ 5. Pump Chamber Cross Section • ~ ~` EO~F,CpMMERC~ 6. Pump Curve y"" ~~oiNCS _ 7-8. Maintance and Contig cy plan _SpONpEN 9-11. Soil test Shaun Bird Signature license number 'PROJECT P.C. Collova Bldrs. Inc NE ' 1/4 NE 1/4S 18 !T 30 PLOT PLAN ADDRESS P.O. Box 489 Somerset Wi 54025 N!R 29 W TOWN Hammond COUNTY ST. CROIX 3/10/04 BEDROOM 3 MPRS Shaun Bird 226900 DATE CONVENTIONAL AT-GRADE >OtX CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE 630 HOLDING TANK SIZE LOAD RATE .5 ABSORPTION AREA 900 # 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 96.8' B.M. B.M. Top of 2" pipe C~ 100.0' Scale = 1 /4" = 10' B- 8% Slope 420' Property Line Grading is to be done to divert run-off away from system -3 Area 15' below system is to remain undisturbed Well is to meet all setbacks found in Comm. 83 420' Property Line 9 8' 97' System is being designed 96.8' under Comm. 83 loading rates set prior to Feb 1st. B-2 96' 2004 Huffcutt Combo tank Tank is to be properly bedded and provided with lockdown covers with approved warning labels Pro 3 /~~ t/~ ~`~r House m ~'h , c ~~ ~ ~ty ,~ ~~~'~~' 'T'Q (~ ~~ L PVC FOR€,E.MAI h! ....~ ~ G t ~ 2 s ~..~FURt~~' L.~ pS~~ J ,~ ._~ ~~... ; t ~-- DtSrRt~'z~:.~TtatJ i.a~rE.aaL -{ A ~ STA$tt.t ~£D O®£y ~RTtO~s WELL _f__. ~---- ~~ ~..-.- --- ---~ ~ ~~t B ~~s ~ ~i !!f B ~ A = ~ ~~. B = ~{. L = C3T..g ~{, ~- Z~ Ft. Ac 4 P Rt»i E D SY t~1Tf#ETl C. Ftl ~7 r s C '~- ST~Bc~i~~~ Qbservotion-----...,.,~ ilVe ! ! ~ I I/68 I _I/2B t~ ~ >, CE ~. L o ~ !z ~ Z IZ AGGR>rG arE Distribu;iOn #~osera! _.i" SOi1 COVer ~t ~.j:. ~ 6tt ^y: +.\ ill ` ~o ` $l,avVED La~E.~Z t ~ I la SLOQE, Plan Viav and Cross Section o£ Wisconsin At-grade Uttic iritls a Single Ahsorptzr~n Area on a Sloping Site C j(artATu KE.: t.,1C~.~15~ ~~ -- Page Of Distribution Pipe De~ai7 for Lateral l~eLwork * Last Hole Should 8e Next To ruRr~-UP .. ~fTuRK -uP~~ ~CL,~NOeit~ --~ PYC Force Hain ;"7'~"'f PYC ifistribution Pipe •~_.____._._. _. p ---~ ~QCCes~ 1~j ~DX P ft- Hole aia~neter ~//.~~ ItKh X~`~ Inches Laterai 1iameter ~ Inch(es) YC7~ ~ Inches force Main Diameter ________ Inches ~ Of Hal es/ I' i Pe -~ invert Elevation Of Laterals ~t ~ ft. Signed; License ~tttmber: Date: C' CROSS SECTiCN AKD C 2ANK ~ PDMF C~iRMB£R SEE CORRESPONDENCE ,. l,,~YM . ABOVE ~(,RADE ~ ~„ G~ 1t ENT PIPE ~WINI}fl~ 4R FRES~~ -CIA i~tTAifE fit' ~'~' c~~ ::~ : ~`~.D GRADE L ~, / ~~m, g FIl~I _ i ~- ,., , zs" I~. ' Ii~LET ~ _ . . WATER 'S'IG HT SEALS ~iLTf~R . '"~- ~.. ''ee .r.~~ f7~~~7~ T F 354LI0 _ C ~#P OF~F• E LEU - ~___--`~ FT • D ~~~' ~ . ..._.._ P£Cji YCATIt?NS t~~ATNE#tPR~F J~3AiCTIC~ $flX w~'TK CONDUIT =.D ~: , _. i ~ f ~~ GAS- i ~, •rI{,HT j • SEAL ; ' 1r i T 2 i i.M ApFRpV ED MANHdLE cavF~ Wl PADLi1Cx ~ WARKING LABEL _~++ MZN. ApB~£pig PE 3~OD ~Il ~+~ APPRO'~~ BEDDI2~t6 UI+TDER TAAIK . // C CRETE PAD /-lS ~~ SpECIFICATZpNS r- '~ t4BER DOSES P£g DAY : ,~..---- . SEP1'~C f DdSE ,~~ ~ TANK NAt~t?FACTDRER~ ~°' npSE yC;,UME ZNC BACrK~--' ~ GAL. TANK SIZES: SEPTIC ~~ `~ may. - FL4u "~ ,,j'6AL• DOSE ~~t~•"""~ ~ ,r ~-.j IHCfiES = ~ GAFACITIES' g GAL- RLARn ?SA~I'AC~11tER.? 8 = „~, ~_ IHC~IES = _,~1._"--- .._~.- MpDEL ~1KS£R • - j° 7 ~ ~~GAL• SSiITCH TYPE = C t~ ~ a INCHES = ! W ~ ~ 2HCHES = ~/ ~L~ PtJIiP MP+~fwCTt~R£R = ~'~ - D "~"' KODE1. N[Tl48ER : - vJ ' _ ~ , ~ 15.23 ~C ~ITCS TYPE= ~ pCTl4P M idIRZfiR3 AS PER ILHR L~_ GPM £ A~R ~(~ FEET DISTRSBU'~ZON PIPE ,~-____' REtW;RED DISCHARGE RATE ~.s-.-° . • ~~ FEET pUMP OFF ANi3 ' FEET vERT3CAL DIFFERENCE SETWEpRESSURE ~ -FR;C'T'ION FACTOR - _ • v~ f£rET + MINIhU~t HE'Y'~TORK SLtPFi.Y ~ I'T! Zp 0 ~ I'T. / f ~ FEET FflRC£HAIN ~ ~ TOTAL DY~~''=~C MEAD- ._.:.---=- °'' - WIpTH ~ _, DIAMETER ~..._--- L£NGTH ' J ~, f, PUMP 'fAItitK : L.I~U ID ' L1~?ER1~AL DiMENSIOi~S f3F S;GPtED: _ 4A':~• LIC'£I~SE Nt3M8LR = if~8 Vii'' i t! L 1 ~G- i} 1 12-j 40• ;~ i 30' r i; i z ~ ~_ ~Q :7 ! T tC tv1~~~tL 152 153 153 ~~ /~ [TEriS ~ iru 1 EtJ i4G 320 FLOVI rLR Pv!LQUTt CONSULT FACTORY FOR SPECIAL APPLICATIONS -limed dosing panels available. ' ~ lied with . Eiectrcal alternators, for duplex sys"terns, are available and supp ~n alarm. . Variable level control switches are available for controlling single p ase systems. • Double piggyback variable level float switches are available for variable !eve! long and short cycle controls. c~ea!ed Qwik-f3ox available for outdoor installations. See FM1420. • Over 13d°F. (54°C.~ special quotabon required. 1521153 Series J1 CAi1710N AI? installation of controls, protection devices and wiring should be done by a qualified licensed electrician. All electrical and safety codes should be foiand Heal h A.~t (oSHA)o~ recent National Electric Code (NEC) and the Gccupationa! Safety ;0'~: ,rjyiuF.Ed:; F!c;,GjC.APA~;T'~ Pik >S:tiU~~ i 1 DAOD`=~ ~ - ..`iL ~ , ~3 . 555} - 'I _ C i 31 I iG ' 26? I 1~ ~, ^ ~ - ---- ~- ` - --_--- -- -- ! i ?~ ~- I ,: ,~~, .~ i i i 9 ~xz~. SELCTION GUlt7E 1. Single piggyback variable level fwa*. switch or double piggyback variable revel floaI swifch. Refer to FR9U°77. ?. See FPti90?12 for correct mode! c% E':ectrcai Alternator E-Pak. 3. Variable level control switci:10-0%25 used 3s a control activator, specify duplex (3} or (4) f;oat sysiern. RESERVE POWERED DES(~N For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump. MAIL F0: P_0. 20X 1637 -""``~' ~ ~ ,~ ,.~ ~~` Louisvillle, K'f 50256-0347 >'Aanct,"acfurersoi. . ~# SHIP 70: 3649 Cane Run Road ~? r7 u • " Louisvi4le. KY 4Q`L'i]-1561 ~jQ/1"TY~4~~PS ~NG'L- f.JnJ •® (502) 77E-273] • 1(8U0J 92Q-PUMP .,. '"~;'': ~ Pl/MP' ~~= F„xrs~zi?74-,s2Y .:~:.~ ~p:1/www.zoeJler.com - '-` r~ f nrnrrinhf ~i]OO Zoeller Co. H.!l rights reserved. a ENT PLAN Page or POWYS OWNER'S MANUAL 8~ MANAGEM rcrCeTIONS F[LE INFVtcrw+<<~" Owner ~- Permit #. t Service Frequency Service Event .~, D monthsyear(s) Maximum 3 yrs.) Inspect condition of tank(s) At least once every When combined sludg ~ e and scum equals one-third (Y,) of tank volume Pump out contents of tank(s) ever p months ~yeaKs) (Maximum 3 yrs.) Inspect dispersal cell(s) y At least once ^ months -year(s) • Clean effluent filter At least once every . j p months ear(s) ^ NA lnsped pump, Pump controls 8~ alarm At least once every --7 p months ear(s) DNA Flush laterals and pressure test At feast onve every ^ months O year(s) O NA ~~ At least once every p months ^ Year(s) ~ NA _ . At least once every N{A!M'El~iµNCE INSTRUCTIONS n one of the following licenses or tnspedions of tanks and dispersal cells shall be made >7y an individual carryi 9 etor, POWYS Maintainer, Septage certifications: Master Piumber, M ores must i Gud~a v-s~ Sn pedio ~O 1~e ta~{s) to identify any missing or broken Senridng Operator. Tank inspecxi ed to check the effluent Levels hardware, kfentif3r any Cracks or leaks, measuThe dispersal cel[{~s) shalt~beivisually respect and to check for any ac up or ponding of effluent on the ground surface ndin of effluent on the ground surface. The ponding of effluent on the in the observation pipes and to check for any Po 9 round surface may indicate a failing condition and requires the immediate notif ~tion o mo ~f the tank voiume ti'1e 9 When the Combined acctrmufa6on of sludge and scum me Semi ~ Ouaeratore0~nd disposed of in accordance with ch. NR entire contents of the tank shall be removed by a Septag 9 P 113, Wisconsin Administrative Code. ~ retreat ment components, and any The senriang of effluent filters, mechanical or pressurized POWYS components, p rformed by a certified POWT5 Maintainer. other maintenance or monitoring at intervals of 12 mon~ s or 1 ~ shah be ~ of completion of any service event q SeMCC report shall he provided to the local r ^ ul~ato authori within 10 days ON `' resence of painting products or other START UP ANO OPERATI if hi h concentrations are For nearer cons~uction, prior to use of the POWTS~ and trdam ge the dsspersai ce1KSl- g chemicals that may impede the treatment emo , y a septage servicing operator prior to use. detected have the contents of the tank(s) ~_. • Values typical for domestic (non-mmmerolaZl v~stewatar and septic tank eftiueni ..,. Values typical for Pretreated wastewater. MgINTENANCE SCHEDULE ~ _ -~-" Page of i System startup shall not occur when soil conditions are frozen at the infiltrative surface. r outages Pump tanks may fill alwve normal highwater levels. When power Is restored the ex~oess During powe rsat cells to one 1 e dose, overloading the Ceti{s) and may result in the wastewaterwiil be discharged to the dispe (} ~ ~ um tank removed a " backup ~ surface d'~scharge of etflPerat To avoid ~~ situation have the contents of the p p by . Sep!dge .Servicng Operate Prior t~o~restortn9 power to the effluent pump or contact a Plumber or POWTS Maintainer to ', gssist in manually operating the pump controls to restore normal levels wethen the pump tank • ~ ~ drive ~ p~ y~~~ over tanks and dispersal rails. Do not drive or park over, or otherwise disturb or compact, the area within 1S feet down slope of any mound or at-grade sot( absorption area. rtnance and rolon the Gfe rfo Reduction or•eCurlination of the following from the wastewater stn:am may improve the pe P 9 of the POWT'S: antibiotics: baby wipes: d9arette butts; condoms; cotton swabs; degreasers: dental floss: diapers; disirtfetXartts; fat fouridatton dcaen (sump t~P) water, trait and vegetable peeCings; gasolene; grease; herbiades; meat soaps; medications; oil; Painting prodt#s; pesticides; sanitary napkins; tampons; and water softener brine. AaaMnoNMMENi- When the POVYTS falls and/or es permanently.taken out of service the following steps shall i~a taken to Insure that the system es properly and. safety abandoned in compliance with ch. Comm 83.33, Wisconsin Administrative Code: • All piping to tanks and pits sha!(dye disc_ onneded and the abandoned Pipe openings sealed. The contents of all tanks and pits shall be removed and property disposed of t3y a Septage Servicing Operator. After pumping, ell tanks and pits shat! be excavated and removed or their covers removed and the void space filled with soil, gravel or another inert solid material. CONTINGENCY PLAN If the POVYTS faits and cannot be repaired the follov+rtng measures have been, or must be taken, to Provide a code compliant replacement system:. ~ A suitable replacement'area has 'been evaluated and may be utilized for the location of a replacement soil absorption system. The replacement area should tie protected from disturbance and compaction and should not be infringed upon by required setbacks from existing and proposed structure, lot lines and welts. Failure io prated tFie replacement area wilt result in the need for a new soil and site evaluation to establish a sortable replacement area. Replacement systems must comply with the rules in effect at that time. O A suitable replacement area is ~ idled as a fast resort to replarce the failed POWTSng advances in POWTS technology a holding tank may The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluation must bB performed to locate a suitable replacement area. If no replacement area is available a holding tank may be ensfatled as a last resort. to replace the failed POWTS. ound and at-grade soil absorption systems may be reconstructed in place fotlowin9 removal of the biomat at the infiltrative suiiaoe. Reoonstrtidions of such systems must comply with the rules in effect at that time. «WAIZ(YING» SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES ANDIOR INSUFFICII_NT OXYG=EN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT.. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY 16E DIFFICULT OR IMPOSSIBLE. AODtTIONAL COMMENTS , r.....rrc• ru CTwt r CO rv~~.v,.. Name ... r+........ ,,,~ ~ .~f~. Phone ~,/.,s ~ ~, ,-- ._3 / Powrs MaNTaNER Name .~/l ,~ " ,~,+~ Phone ~i Z •- Y ~/ SEPTAGE SERVICING OPERATOR PUMPER LOCAL REGULATORYAU7NORff•Y ~ Name U2,.,...~ Agency J -. ~9~ j ~ Phone Phone ~,,~-r a~ ~°~ This document meets This document was dratted by the stars of the Groan Lake. Marquette and W aushara County Zoning and Sanitation agendas. the minLnum requirements of ch. Comm 83.22{Z)(bl(1?(dM~(t) ana 83.54(1), (2) & (3), wl(tsconsin AdmtnlsMatHre Code. Use of this doarment does noG t~ lam„ guarantee tl~e performance of the POWTS. ' ~ s VVfisoonsin Department of Commerce Division ~ Safety and Buildings SOIL EVALUATION REPORT Page of in accortlance wrtn [;omm ts5. vvis. lam. was ~, T - r ' _ fl 1 ~ Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must include, but riot limited b: vertical and horizontal reference point (BM), direction and Parcel !.D g- 3 - O $'- ouo ~• 902 percent slope, scale or dimensions. north arrow, and location a RECEIVED d b i R Date Please print ail iMorma6on. y v ewe Personal in/amafion Irou P~~de meY be used ~ saoa~ary twrposes PrrvacY ~• s.15.04 t~) (m11. ~ -r ~ T Property Owner O/ ~~ l Govt. Lot 1 ~ 1/4 S ~ T N R E( W property Owner Malting Address ~ Z F # Name or CSA~F ~ f/~ City state zp code Phone Nun~er ^ Oily ~ Vipage Town ~ ~•l~ ril~J ( ) , New Construction Use: ! Nurr~ of berkooms Code derived design flow rate ~ ~ GPD ^ Replacement / ^ or, Descr~e: ~ ~~ ---- y`~ ! 1~- tt Flood Plain elevatw Parent material ~ /`Cr ~IG n ff applicable CserreralwrrrnerMs /~d~~' ~/ r,~ ana ~ 5~ ~~~.,.. e ` ~a . J Boring # onng ~ , pg Ground surface elev. l ~ ft. Depth to rrmGn9 facer ~ ie So~~ is-ation Rate t ° Fwd -~ Pit Ground surface elev ~- ft" Depth to 1'imiting factor ~ Sod Rate ®# ^ Ftorimn th De Dominant Redox Description Texbue Stncdure Consistence Bourxlary Roots GP D1flt p in. Mur~seN Qu. Sz. Corti. Color Gr. Sz. Sh. 'Eff#1 'Efl#2 i l ~J' f ~ /~ 3 '~ a m " f' ihiGt~- C' 01 h~ + , ~ ~' ~~ ~ C, e~ rn / . , J / .C1 ~$ -(~ ~' ~ ~ 5 r y/tm it ~~ - n, - n a . 3 : S ~----- EfNuent #1 =Boo > 30 < 220 mgll and TSS >30 - `Effluent #2 =Boo <_ ~ mglL and TSS _< 30 mgA. per) ji CST Number A Date Evaluation Corxiucted Telephorte Nr+~ L o+8 Parcel ID # Page of ~g # ^ Boring Pit Ground surface elev. l it. Depth m limiting factor in. S~ Rate Horizon Depth Dominant Redox Description Texture Structure Ctence Boundary Raots GP D/fF in. Munseq Qu. Sz. Cont. Color Gr. Sz Sh. •Eff#1 •Etf/f2 ^ Pit Ground Surface elev. ft. Oepih b uniting factor in. SOi Rate Fforizon Depth Dornnant Redox Description Texture Strtx~rre Carsist~oe Boundary Roots GP D/ft? in. Munsefl Qu. Sz. Cord. Cotor Gr. Sz Sh. 'Eff#1 'Etf/!2 a ^ Pit Ground surface elev. tt. Depth b unilig factor in. # ~ ~~ Soil Rate Horizon Depth Dominant Redox Oescxipflorr. Texdse SUUC1We Consistence Boundary Roots GP DAt? in. Munse9 Qu. Sz. Card. Color Gr. Sz. Sh. 'Efi#1 'Eff/f2 'Effluent #1 =BODE > 30 < 220 mgll. and TSS >30 < 150 mgll 'Effluent #2 = BODs _< 30 mgA. and TSS _< 30 mglL The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. seu~sa3o(R.6+~) Soil Test Plot Plan ~' Project Name P.C. Collova Bldrs. Inc. Shaun Bir Address P.O. Box 487 Somerset Wi 54025 C #226900 Lot 8 Subdivision Crick Bolton Date 12/4/02 1 /4 N E 1 /4S 18 T 29 N/R17 W Township Hammond Boring Q Well PL Property Line County ST. CROIX B or VRP Assume Elevation 100 ft. =Top of Survey Iron stem Elevation 96.8' *HRPSame as Benchmark =Top of 2" Pipe @ 100.0' C -"~'-~r J °~ at}~:- G~ ~ RE. Ql 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 Property Address _ '~ S~- (Verification required from Planning Department for new City/State ~L~ ~~ . Parcel Identification Number '~ ~~~ ~ ~ ~ l.r ~~ ~~ LEGAL DESCRIPTION Property Location %,, %,, Sec. ~ To2 N-R W Town of /~- ~ ~. , Subdivision c , J~ ~ ~ ~~'Y) ~(ilQ/( ~,,~'~~r~~ Lot # Certified Survey Map # .Volume ,Page # ._..- Warranty Deed # C~~ ~ t~ 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, journeymanplumber, restricted plumber or a licensed pumper verifying that (1) the on-site wastewaterdisposal system is is 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 stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 the thr ar expiration date. P. C. COLLOVA BUILDERS, INC. / ! / b y SIGNA OF APPLICANT (715) 247-2742 DATE P.O. Box 489 SOMERSET, WISCONSIN 54025 OWNER CERTIFICATION I (we) certify that all statements oa this form are true to the best of my (our) knowledge. I (we) am (are) the owner(s) of th rty de ed above, by virtue of a warranty deed recorded in Register of Deeds Office. SIGNA OF APPLICANT ~~ ~~ COLL(705A BU~L~DERS, INC. 3 / UY P.O. Box 489 DATE ««««s« SOM~RSET, WISCONSIN 54025 «««««« Any information that is mis-represented may res t m the sanitary pemut 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 1950P S2.8f STATE BAR OF WISCONSIN FORM 1-'1998 wAt~uwnr ol:eD I Document Number This Deed, made between John J Dalton and Carolyn G Dal husband and wife .Grantor, and P. C. Cdlova Builders. Inc. . Gn Grantor, for a valuable consideration corneya to Grantee the fo11oN described real estate in St. Croix County State of Wisconsin (the "Property'): 667242 RA7'NLEb7t H. YALSR REGISTER OR DEEDS ST. CROIX CO.. YI RECEIVED FOR RECORD 08-1ta-2002 4:00 AM EYDPT tt ~ REC FEE: 13.00 TRANS FEE: 1155.00 COPY FEE: CERT COPY FEE: PAGES: 2 Aree CaYOVe Builders, Ina x Avenue mood , 4yi 54015 ~~~~ 9s~a 9 O)8-1039-20-000 / O1 018 1039 80 000 Pared {dentlflcatbn Number (PIN) This la not homestead property. (is) (Is not) Sw Exhibit A attached hereto Together with all appurtenant rights, tfUe 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 August. 2002. (S~) (SEAL) hn J. Iton arolyn G. alton (SEAL) (SEAL) 'I~~ICi ACKNOWLEDGMENT A -, is ~?E OF WfSCO Signature(s) State of Wisconsin, errTiT~.p~'gSr" ' 1It~~ authenticated tfi $TJti~E~i`~6, . TITLE: MEMBER STATE BAR OF WISCONSIN • (If not, authorized by §706.08, Wis. Slats) St Crotx County } ss. t~ Penwnaly came before me this 1 ~ day of Aucust ~0~ the above amed J a and I ! ban nd W If • WA ~ ~WS-~Z~iW~ Notary Public. State(of Wisconsin THIS INSTRUMENT WAS DRAFTED BY My commission is pe anent. (If not, state expiratbn date: Cddwell Banker Bumet A 115 V y } 1301 Coulee Road Hudson, WI 54016 2-32470 (Signatures may tie authentkated ar aclcnowiedged. Both are not necessary.) WARRANTY ot;~D STATE BAR OF 11YI5CONSIN FORM No.1-1998 Wisconsin Legal Blenk Co, Ina Milwaukee, Wis. Ci2~ccc P~ 1-~ ~U ~ (2~-b OK l of 2 :~ - ~>:• ,~ ~.~~; . ~: ~ ~ ~~ Apart of the NE'/. of the NE y. and In part of the NW y. of the NE'/, and to part of the S1Af Y. of the NE '/. of Section 18, Township 29 North, Range 17 bleat, Town of Hammond, St. Croix County Wisconsin and more particularly described as; Begtgning at the Northeast comer of said Section 18; thence S89°33'31`W 372:01 feet along the North line of the NE'/. of said Section 18; thence S89'33'31"W along the North line of the NE '/. of said Section 18 775.94 feet; ttaance S00°52'23"E 250.00 feet; thence S89'33'31'IN 968.24 fiee~ thence S00°52'23"E 420.00 feet: thence S89°33'31"VII 528.00 feet; thence S00°52'23'E along the North-South Quarter Section fine of said Section 18 1311.77 feet• thence N89'33'39°E 826,33 feet; thence N00°31'25"W 330.23 feet; thence N89°33'24'E 692.78~feet: thence N00'S2'23"VII stbng the East line of the SW % q~ NE '/. 330.31 feet; thence N89°33'24`E along the South line of the NE Y of the NE '/° 949,09 feet; thence N00'S2'24°W 1321.19 feet t0 the Pofnt of 8egtnntnp, C~ cif, gu~N, 6V E~ZL..~vil 2 or- ~ ~i . J I .. QI ~~- ~r ` ~- O J ~~ N ~ ~ ~ ~ ~ ° M N I o o ;'7 CO ~ Z ~ rn ~I n z Q N ~ ~O I ~ w J ~I J ~I - Q ~ ~I W ~ I ~ (/') NI N QI H ~ W ~I ~ ~ - N ~I p~ ,fz;;, a ~,~, ~ ~ ~ s ~~° W ~' ~ Q \ \ / ~ ~ ~ M ~ 1 I ~ ~ ~ ~ ~ 1 ~ N ~ J1 \ F z 402.85/ \ \ ~ ~ S 12~~5„ \ ~ F- ~' ~~ ~ \~ _- ~ Q 89~ o o `° ~ " gb\ \\ ~Z o ~ \ ~ ~ f,l~`\\ / ~ N `~ ~ ~' Q ~ S ~ ~ ~ ~~~' ~ ~ M ~ ~ ~ ~ \ ~ ~ ~ ~ ~ 0~~ ~ ~ ~~ g O a 9 9~ ~~ ~ 32 N Z ~~ /~ ~ ~ ~ ~ Q N E~ ~ ~ (n U ~`~/ ~ ~ Q ~ O ~ Q ~,~ N ON I ~ ~ N r- 0~ r7 / ~ ~ ~ O N W a ~ ~~ L ~0 M ~ .'~ ~ ~~ / ~ / (~ ~ 01 / ~ ~ a. ~ 95.30' 324.70' N 00'52'23" W 420.00' S 01'01'4: N 01'01'4 f M Q ~ ~ - O ~ "' ~ z o00 W o ~ ~ ~ L~ ~ J a ~--I ~ U ~p w Q N z zo N O CO Ln m~° a ~ N r-