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HomeMy WebLinkAbout018-2003-22-000Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Safety and Building Division INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Personal information you provide maybe used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. 'ermit Holder's Name: City Village X Township P.C. Collova Builders, Inc. Hammond Townshi ;ST BM Elev: Insp. BM Elev: BM Description: ~ 8 C~ ~.-y /~OVI ~ ~ o ~ ~ TANK INFORMATION EL NATION D TA TYPE MANUFACTURER CAPACITY Septic ~ /~, Dosing / C~ c:, / ~D~ Aeration n _ /~ /~- Holding TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Septic SAP , )~ /~ J ~f~ ~ I ~f L~ ~ .i Dosing Cif ~ ~~}S~ lclL}r / Aeration Holding PUMP/SIPHON INFORMATION Manufacturer Demand GPM Model Number / ~ ,~ ~~ TDH Lift Z I~~ Friction Loss 2.0~ System Head ~~~ TDH Ft 1~~~~ Forcemain ~ngth ~ Dia. f~ Dist. to Well ~ ^ {'~ ,Sc01~ ABSORPTION SYSTEM County: St. Cr01X Sanitary Permit No: 453329 0 State Plan ID No: Parcel Tax No: 018-2003-22-000 Section/Town/Range/Map No: 18.29.17.916 ie S! 7 STATION BS ~.7 HI FS ELEV. Benchmark ~; a ~b~ /~ Alt. BM C, Jf'.. ~.o. ¢.~. Bldg. Sewer p c~ SUHt Inlet r/~ , IL J q, ~ . I SUHt Outlet ~ ~ Dt Inlet Dt Bottom ~•~ c~-7 /C Header/Man. -~ /OS ~7 Dist. Pipe 3.~ ~d5 -7 Bot. System ~: i~lo IaS. a~. al Grade ~ ~-~ Z ~ ~~ / ~ 10 St Cover ~ ~v4/ ~ Cv(~,~v.J~ ~ . Z X03:8' ~f L RENCH Width i Length No. Of Tr ches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS ~` -7 X ~ / ' \ SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer INFORMATION CHAMBER OR Type System: j ~ Z.7 ' I ~ J ~ ~ ~ f UNIT Model Nurrtber: vv ~ DISTRIBUTION SYSTEM Header/Manifold Length Dia ~ Distribution Length s Dia Z Spacing x Hole Size x Hole Sp7acing ~-"~ Vent/to) Air Int e O SOIL COVER Y PrPSSIIr'P Svstams Anly YY Mnund (1r Ot.Grade Systems Only Depth Over Bed/Trench Center Depth Over Bed/Trench Edges ` xx Depth of Topsoil xx Seeded/Sodded xx Mulched ~ COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: ~ / Z-Z/~ Inspection #2: / / ~b~ f>~. Location: 1585 97th Ave. Hammond, WI 54015 (NW 1/4 NE 1/4 18 T29N R17W) Crick Bottom Overlook Lot 22 Parcel No: 18.29.17.916 1.) Alt BM Description = ~'~' Co~C~.^-- C ~_ ,~ Laces-S ~C'a~' ~a ~~ 2.) Bldg sewer length = ~ ~j~ -amount of cover = ~ f ~ ~ I J ~,~ i S r- Plan revision Required? I~ Yes ~- No I ~ ~ ~ ~ ~ / ~ >f Use other side for additional information. ~___ _ ~__ _ _ __ _ _ ____ __-_. Lto 'l SBD-6710 (R.3/97) Date In Actor ignature Cert. No. Safety and Buildings Division 201 W W hi County ~ (~ ~ j ~ J 1 ~ ~ - . as ngton Ave., P.O. Box 7162 ~ ~, ,~C O~S,~ Madison, WI 53707 - 7162 Sanitary permit Number (to be filled in by Co ) (60g) 266-3151 . De artment of Commerce ~3 . Z Sa itar Pe it A li ti State Pla l•D.Number n y rm pp ca on In accord with Comm 83.21, Wis. Adm. Code, ptxsona) information you provide ~ p ~~ 1 ~® ~P 0 ~3 maybe used for seooudary Purposes Privary Law, s 15.04(ixm) ~ yD Project Address (if different than mailing address) L Application Information -Please Print All Information ~~-- /s B S ~/ 7 - ~ ~~-- Property Owner's Name ~ // Parcel # Block # property Owner' . ing Address f~ .m Property I~ocstn ~ --~ S i ~ ~ " "`~ t ~ C;iry, State Zip Code Phonc Nu ed oa , • , `,/ 1Q. of Building (check aII Wert apply) r, a (lP ~ JG Fi=! ' ~ ~ Sub ivision CSM Nua~er ~ 2 Family Dwelling - Number of Bedroo AtbGdCommerttial -Describe Use r ~ ~ `~ `~ - StateOwned -Describe Use ~ I~T. ~( S7 City_ Viltage-f~owasbip of ,- ~ 1IL t ype of Permit: (Check only one box online A. Complete line B if a livable) A' System Replacement Sysoan TreahtrerrtiHolding Tack Rep t Only Other Modifigtioa to Bxiadng System B • Permit Renewal Permit Revision Change of Permit Transfer to New List Previous Permit Number and Date issuod Before Expiration Plumber Owner IV. T e of POWTS S m: (Check all that a 1) Non -Pressurized in-Ground d Z 24 in. of suitable soil Mound <TA in. of suitable soil At-Grade Singk Puss Sand Filter Constrocted Weiland Pressurized -Groin~uud Holding Tank Peat FdOer Aerobic Ttsannetrt Unit Recacttla6ing Sand Filter R Synthetic Media Filter Drip lame Gravel-kss Pipe Odrer ( ' ) V. Di trneat Area Informatio "Z ~S Design I~ow (gpd) Design Soil Appli Rate(gpdsf) Dispersal Area Required (sf) Di Area posed (s~ System Hlevation ~ ~J~ au- ~ D ~' ~J~ p0 `?-~~ 1151 ~ ` j , VI. Tank Info Capa« in ToW Number Manufacturer Site SOcel Fiber Plastic Gallons Gallons of Units Concrete Consttucoed Glass New Existing Tanks Tanks Sep6ror Holding Taak I AerobicTreatmwtUnit 1~ ,f1 _, [i7" ii U °°ri°gtata,aber 3D VII. Responsibility Statement- I, the sad ed, bility for installation of the 1'OR"is shows on the attached Pl s Name (Print) Plarni6er's S' MP/MPRS Number Business Phone Number plumbers Address (Street, city, state, zp ~ ~t~ ~ ~ VIII. Corm /De artment Use Orel A ro ~~ veil ~ ~PPro Sanitary Permit Fee ('includes Groundwater Sarrhar e Fee) ^ ~ nte Issued /D saiag Agen Satnne ) ~ g - ~ ~ `~ ~" a ~ f ~ 0 Owner Given Reason for Denial IX. Conditions of Appy9K~-~~for lli~/a^i~ ^ , ~r ~^ , /~. //' 1~~~ ~'JlGyl %~~`(,~i Qc/i STEM OWNER: ~ /'iX~-~ I"r ll roc/ / C. ~' 3Y~ .~-- O ~ep is a~`"f"nk, e~uenTTilter and n ~,,~~-; dispersal cell must all be serviced /maintained ~~~~s ~ s_~~~he-v~-~` ~~~"`'' as per management plan provided by plumber. ll~ /~~~~ 2. All setback requirements must be maintained Cjj~,i2. (iy~ r~ ~ "'"`• as per applicable code/ordinances ~ 3 • ~ 63 _~ ~ ~~~~ f.'~t/'` Attach tomptete plans (to the County only) for fhe system on paper not less than i1/L x 11 inches is size ~ ~- ~~ PLOT PLAN PROJECT P.C. Collova Bldrs. ADDRESS P.O. Box 489 Somerset Wi 54025 NE 1/4 NW 1/4S 18 /T 29 N/R 17 W TOWN Hammond COUNTY ST.CROIX MPRS Shaun Bird 226900 DATE6/2/04 BEDROOM 3 CONVENTIONAL AT-GRADE CONVENTIONAL LIFT HOLDING TANK MOUND 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 ^ BOREHOLE O WELL *H.R.P. Same as Benchmark 97th Ave SYSTEM ELEVATION 104.6' 1001 $S 3 Pro 3 Bedroom House ASSUME ELEVATION 100' filter Zabel A-100 Huffcutt Combo Tank Tank is to be properly bedded and provided with 555' lockdown covers Property with approved warning Line labels Grading is to be done to divert run-off away from system Alt. B.M. is top of survey iron @ 97.5' B-3 Area 15' Below system is to remain undisturbed 1 B-1 103.6 Property Line J ~~,,Y 1 l~".r- Well is to meet all setbacks found in Comm. 83 493' Property Line .. - R SP N~E~``'~ g~E GO ~~~ ~_ ~ ` '~ 102' 3' 6. ~~~~J~ Scale = 1 /4" = 10' 1 a ~ commerce.wi.gov i ^ ~scons~n 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/sb www.wisconsin.gov Jim Doyle, Governor Cory L. Nettles, Secretary June 11, 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: 06/11/2006 SITE: P C Collova Builders 1585 97TH Ave Town of Hammond St Croix County NE 1 /4, N W 1 /4, S 18, T29N, R 17 W Lot; 22, Subdivision: Crick Bottom Overlook Identification Numbers Transaction ID No. 1006853 Site ID No. 684756 Please refer to both identification numbers, above, in all cones ondence with the a enc . FOR: Description: New 3BR Mound Object Type: POWTS Component Manual Regulated Object ID No.: 962577 Maintenance required; 28 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.01/O1); Zabel A100 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. ~~~ a 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: Reminders • This system is to be constructed and located in accordance with the approved plans and with the "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems Version 2.0" SBD-10706-P (N.01 /01). • This system is to be constructed and located in accordance with the approved plans, and the "Mound Component Manual for Private Onsite Wastewater Systems Version 2.0" SBD-10691-P(N.O1/O1). A copy of the approved plans, specifications and this letter shall be on-site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of construction/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. r-~ SHAUN R BIRD Page 2 06/11/2004 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, Dennis R Sorenson Wastewater Specialist ,Integrated Services (608)785-9336 , dsorenson@commerce. state.wi.us Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 WiSMART code: 7633 Cover Page Shaun Bird Bird Plumbing Inc. 1008 192nd Ave New Richmond Wi 54017 715-246-4516 Date: 06/2/04 Owner: P.C.Collova Bldrs. L ~"'C to sgFF gF~F~~Fp ry&e~0~soi 4. Location:NE1/4NW1/4 S18 T29 N,R17W 1585 97th Ave Crick Bottom Overlook lot 22 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 Co tigency plan 9-11. Soil test ~~ Shaun Bird Signature .n 4 ~ . 4 '4 r ,~ ~ -2~ t, .. . ~ ~~ , I. ~, ~ ~ rd t «~.~"G ~ 5 ` ! "p u ~~/~ -''y~~3'3 ~ _ ~`~~ ~`~~~ , ~- : ~ . y,t,,~ License number 226900 PROJECT P.C. Collova Bldrs. NE i/4 NW 1/4S 18 PLOT PLAN ADDRESS P.O. Box 489 Somerset Wi 54025 /T 29 N/R 17 W TOWN Hammond COUNTY ST. CROIX MPRS Shaun Bird 226900 DATE6/2/04 BEDROOM 3 CONVENTIONAL AT-GRADE CONVENTIONAL LIFT HOLDING TANK MOUND 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 97th Ave SYSTEM ELEVATION 104.6' Pro 3 Bedroom House Well is to meet all setbacks found in Huffcutt Combo Tank Comm. 83 Grading is to be done to divert run-off away from system B - 3 Alt. B.M. is top of survey iron @ 97.5' Area 15' Below system is to remain undisturbed 1 103.6 Property Line Tank is to be properly bedded and provided with B -1 555' lockdown covers ~ Property with approved warning Line labels 493' Property Line ~1v~~~ s e ~~~~ ks .~: . ~ b ~ ~p~~ ~~~ _~ c~~1`~ ~°~ 3' ::~~~E GO Scale = 1 /4" = 10' ~-2 102' '=~,,,'~ - _ No Des#.gaer Date 4" Observation Pipe Perforated Below Filter Fabric ASTM C-33 5 o"d'\ "Top:o11 _ J ~ y Non-Woven Filter Fabric ~DistriDution. Pipe i G 4~ _. c /~_ ~~• Scope ~' Force Noin tom/ ~e a Ot 4J~ 2 ~2 From Pump Drain Rock Section Of A Mound ' S' stem Usin CrC55 A Bed for The Absorption Arta ~ r~ o~ 0 W ~ 3 0 p ~ Ft. g '~ Ft. I ~ Ft.- ~ ~~ Ft. . ~ ~~~ Ft. . ~ L ~ Ft. __ wa~~ ~ Ft: Flowed Loye% ~n ~~ ~= F.-~_ h ~.~ L ~- 4~Observotion Pipe-~ ~ E ___---------- - - - ~~ - K ~-------'--~.---r----•~-..---•• - Moin A ~ ------- ` 1 Force `~-~..~_,------------- -------------_+~_ From Pump ~ ~• ~DistributioR Bed Of /Z - 2 2 Drain RocK Pipt I 4 Obcervotion Pipe-~lryC.~.~© Permonent Mocker ~l~s~•- ~ ,~ ~r~rn~ bv~~-,~sP- i pe or Rods Plon Vievr Ot Mound Ucfn A Bed For The Absorption Areo PAGE~OF..r~ /~~ t.ototed On Borrom. ERya~ty $ROead .R9T 1+IOI.L ~tsxT re CenntG},Dn Ft. Ft. Signed: f.icense Number: ~Da to X ~ Fnc~es Y Fnches Hole Diameter Inch Lateral ~" 2 ;Inch{esl ~!an i fol d ~ Inthes_ Force Main inches ~ ~f hoteslpiAe~ Invert ~ievation of Late~als~Ds=~Ft Perforated pipe Detoii r • .. ADD gP~s:~ p'T~D--~=- CR45S S~CT`G~ TZC TANK ~ gt]MP C~~AMS~ Sip wEA~~~R~F .GRADE ~ ApFgpVED 2~* .KYN- ABOVE J133~CTI~3~ $OX Kppi~{pLE COYE~t W~TM CCtU;T W/ PAAL~K ~ s u" G} YfNT P;PE Zir~INi3aw 4~ WpRtiIM6 i.ADE.. R~~`; 4R}Z~;IdTh~E y/P `fin ~i 4st KI}1. FRESI~ ..~'T E ~~ ~, j~~rY°~ r ~ P Z~i~ ~~ ~ ' %~ GR~ ~ ~" sy s'a•' tg'~,ws,~• :z - ~~ ZS ~ sF1sL `. Ji1Y~~~~~ ~A•i`ER 'SIGHT 5Ea ~ J AI.Ii 3, 0~ .""~"'"' -~-- : ,, ,pN g(f,TC Spit ~fLTf~~ $ ..~-- C ~ ` 1 FF ~P~~ ~-- P 354L~D ~g pF'F' ELF ' ~--=j F?- D SOTL ~ ~ BE~gIriG V~Eg. •tAN/ Oi~Cil£TE pAD ~ a AppROY /~ / S~GL:~~!w ~av SPECZFICATYaNS._-~- ~riBEg DOSES ?£R DCS£ SI {Y ~ ME Z ~C ~~ ~ ~ ~L SEPTIC f DOSE FL~`~K• ~~ 7~OAL• g ~ ~,~ 3 ZNGHES T1-Nit SIZE ~ SEPTIC 6~'+L j 17 GAL• flpSE ~ GApACI~I'~• 8 = ,..~-- INCHES = ~--~-+"' ALARri ~~FAC ~s~,• ~ /" C _ -6 SINCKES - /r.----~G~- c~2?~! ~ ~ ~ x ~g 15.23 W' AMP ~~FAC'1'V~tF3Z= .Vl~~ M ~128I~ ~ P£R K~;TC~TT~ ~ r~ ~ ~ A~ ~ FEET ~ ~ ~PK PUri~ ?=FE FEET 4.~ D 1 gTR 1 BU's I ~ ~ .3 • AE~+IRF~ DISC~'RGS ~-?E EEN pU3~1P pi F ANO . _ - - '' FEET FACTOR • , ' ~ ` FEET C£ 'ate pR f55U,RE FRZCT~~;£ ~~ i ~ v~t'!'I~~ ~p~p£RNK SU?Pik ~ ~T/].04-£~flTAL ~'~ ,~ ~ DYpriET~ ,-~-- L~Q~I~ KAL ~ IMEp5I0i~~ ~£ ~ M? I1~T'£f . p AT £ LI CEt~~ ~ FMB "~ •. -""~~--~"-~-- :188 w w °a w s v a 8 0 0 4 - TOTAL D YNAMIC HEAD/CA PACITY PER MINUTE EFFLU ENT AND DEWATE RING MODEL t52 153 feet Meters Gol. Liters GaI. Lifers 5 1.5 69 261 77 291 10 3.1 61 231 70 265 15 ~ 4.6 53 201 61 231 20 - 6.1 44 I 167 52 197 25 7.6 34 129 42 159 30 9.1 23 87 I 33 125 35 10.7 I -- -- 22 85 40 12.2 -- -- 11 42 Lock Valve: 38.0 f,. (tt.6m) 44.0 ft. (13.4mj '- otia5os LITERS ~ 80 160 240 320 FLOW PER MINUTE CONSULT FACTORY FOR SPECIAL APPLICATIONS • Timed dosing panels available. ~"' • Electrical alternators, 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. • Seated Qwik-Box available foroutdoor installations. See FM1420. • Over 130°F. (54°C.) special_quotaUon required. 1521153-Series 3 27 sz 32 `i2 t/8 ~~ 5 1/ t ---1- 8 sKZOSa SELECTION GUIDE o caunor+ All installation of controls, protection devices and wiring should be done by a qualified licensed electrician. All electrical and safety codes should be followed including the most recent National Electric Code {NEC) and the Occupational Safety and Health Act {pSHA). 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. &fAIL 70: P.O. BOX 16347 Louisville, KY 40256-0347 Manufacturersof.. Z SHIP TD: 3649 Cane Run Road p~' Q ® Louisville, KY 40211-1961 ~JVaL/TYPUMPS ~NCE ~ifsJih° /, ~ (502) 778-2731 • 1(800) 928-PUMP htfp://www.zoeller.com PUMP ~O FAX(502)774-3624 4 Copyright 2000 Zoeller Co. All rights reserved. ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM OwnerBuyer P. C. Collova Builders, Inc. Mailing Address Property Address P O Box 489 Somerset, WI 54025 City/State ~M.•mrn-~cQ ~~ Parcel Identification NumberQ/~ - ~Od3 - ~ a -{x~(~ LEGAL DESCRIPTION • qi~ Property Location '/,, ~ %,, Sec. ~~ . T~q N-R ~~' W, Town of ~~~ .. Subdivision ~~t G~. ~(s~'c~~ ~ c,-r Lot # _C~. Certified Survey Map # .Volume ,Page # ~ ^q Warranty Deed # _ ~ ~ ~" c'Ly v` - Volume ~ Page # ~~_. Spec house yes ^ no Lot lines identifiable yes ^ no SYSTEM MAINTENANCE Improper use and maintenance of your septic system could result in its prcmaturafailure 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, nestrictedplumber or a licensedpumperverifying 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 Head the above requirements and ague to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 da of the threc~e expiration date. P. C. COLLOVA BUILDERS, INC. (715) 247-2742 / / (~ _ A O PLICANT P•O. Box 489 SOMERSET, WISCONSIN 54025 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 ~roperty described a ve by virtue of a warranty deed recorded in Register of Deeds Office. / / / _ SI ATURE ~ F PI;ICAIVT ATE ****** Any ini`ormation that is mis-represented may result in the sanitary permit being revoked by the Zoning Departrent. ****** r"" ** 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 ~ ~ oiiiicauon rcgwrca from riannmg Deparmment Ior new construction) ENT PUN .. pwl+lER'S MANUAL 8~ MANAGES POWYS SYSTEM gPEGffIOATIdNs Number ~ Bedf~s Number of Coml Units , Esdf tlow (~~ E~mated x t_5) Des~n lbw (P~+ ( , Soil ApP~^ Rs~ ffluectt Quat'dj' lrlftuatlYE FafBr Oif 8 Crease (FOG) Biocherttkal OxYO~ Demand (gOD~) •r~tat SttaPeR~ gplida ('f'SS) Pry Effluent GluaGty Biochemi~l pxygen Oemand TCNdI guspended Solids Fecs31 Cotif°n't (98Ometric Maximum Effluent P_~ Size NA ( (rSS) c.~ /_ ~ aaVdaY Monthly ~~~e. ~i0 mgn- SI20 mg/L Monthly average" S30 mgn- 530 mg/1- y8 inchdiameter 'l, •• •- tea! for domestic (nonsom""erda9 vrastewatar and V~ ~C eAfusnt Va alu~ss typtesl for O~~a~ "nste+~ter. ors licenses or CE INSTRUCTIONS an ind'Nidual carrYin9 one or POfoV~ Maintainer, Septa9e rsat cEffs shalt be made by r ~w-r•g inspecno~ ~~~y any m~s~9 pr broken tfr~ of tanks umber. Master Plumber Restricted ~ e • on of the tank(s) m ~d to dteck for any ~~ uP e and scu Is dons: Master' ns must indude a visual inspecti spected ~ ~~ the effluent lave SerYld~ ppenat~or• Tank mspedio measure ttte volume of combined sludg ~ ~lfuent on the ~~~• ide~Y ~,y packs or Teaks. The dispersal cell(s) shall be visually in ,~ Pond'utg round surface- nding of effluent on the ground surface. I utatory autltor''AY• or ponding of effuent on me 9 for any Po lion of the foca re9 and to check uires the immediate "°titca in the obser+ra~n PIF~ cpnd'~tion and req or more of the tank volum ~ NR ground surface may tnd~cate a failing a and scum in any tank equals one-third (~ seQ of in accordance +~ uiation of sludg b a Sep~9e SeiYicing Operator and dispo When the combined a~ Shall be removed Y and any entire contents of the tan rettratfrnent comPonents~• 113,1Nisconsin Administrative Code. chants, P a oettified POYYTS Maintainer. ressurized POVYTS Comp ~rrned aY The servicing of effluent tillers. mechanical or p ~ event. at intervals of 72 months or less within Q ~ of ~mP1etiPn of any 5emce other matntenanfae or monitoring ulatory authority A sefvk~e t~eport shaft be provided to the local rag rodutxs or other D OPERATION PODS check treattneni tank(s) ~ ~e presence of painting P START WP AN eat cell(s). if high conoentist~ns are For new oonstruction• 1~or to use of the s and/or damage the disc rator prior to use. chemicals that may impede die ~atrnent pro ~ by a septage servicing pe dfiteCted have She portents of the tank(s) Septic Tank Cale SeQtic Tank Manfer Effluent Filter Manut~+~ter Effluent Ftter Model Pump~T~k CapadtY Pump Tank ~clufac~urer .Pump Manu'Mdu~ Pump Model ~GrBvel~Eilts'r ~ Peat Fitter p Med'tanicai Aera~n ; ~ H(etiand ^ Outer. ^ Disrnfedion Page~of F! ^ h1A ~] 14A ~ TEA O Qat~t~7, NA ~~~ `~ NA ~~ S~ ~ NA Oisp"^" Q~ CeU(s) ^ 1 round (pressurrQeed) t7 In•9 rroade i9mvtty) and ~ ~"g __ O Other Page _,~,,,, cf,,,~. ~~ , - . ,.^._ . ~ infiltrative surface- _ .. t-conditions are frozen at Uie is restores rile excess 1 not occur when ~ ~ ti hwater levels. When routs) and may resttlt in the System startup shy tas~ks~ ~~~ Ve nomnal ~S ~ ~ removed b7r a ~~~ pip cattle) in one large dose, oYerSoading roc ppVYTS Matntafier to ourv+9 Per tae dischar~9~ ~D To avoid tt'-iS g'ttuation have the contents of the P F wras ~ urge of etri~!t ~ poyYer tp the effluent pump cr cone ~ a Pitltttte g Opp ~~ s to resoort; normal {wets with backu a Servtcdn ~ P~ m~ ~ contra amp tank.. manualy opar-at<ng the P p .. iJo not drive or park aver, or othenhnse d!sbutb or compact, ash veh~ over tanks and dispersal t~s- tion area- Do not drinre or park slo of any mound or atgrade soil absQr'R Ve the perfdrmanoe and prolonq the life the arw wltt-in 15 feet do`"R' ~ irom the wastewater stream rnaY impri0 ,dental floss; d'taperr of the folk>n~9 ~~~ butts; condoms: cotton y-gabs; deQf+essets' Redu~ort or~efunination gasolirt~; grease herbiddes; meat wipes' arable pe antibiotics; ~Y . ~ trait and veg eftngs; t softener brine. flf the POINTS= mp) water ns; ~ertd wale disirtfectan~~ ~~ oil: ~5 g p~~~p~ades; sanitary napkins; bmpo _ ' mad .stets-s si'u~ ~ ~~ to insane that the ENT ~ntty.laken out of setYice the fot[ovrln ~scortsin Administrative Code: AgAN00N~M fails and/or is pem''t !'tatnCe with ~. Comm 83.33, V~Iten ue pr,ppedy and safeM a~ndaned in ocrrP ndoned Pipe openings 5eated• system be disc_ onneded and the aba disposed of by a ~P~ge $ervicing Operator. AU Piping to tanks anti pits shell ~ shall be removed and propel'h . .t.he ~n~,ts of alt tanks and ~ Shali be Q~~~ and removed or their covers re'~O`/ed and the void space after pumping all tanks and p filled ~nrtttt soft, grave! or another inert solid material. CY PLAN a foltowln8 measures have been, or must be taken. to Pnmde a code CONTINGEN th If the POWI'S falls and cannot be repaired coon and should not compliant t~eplaoernent'ystem_ has been evacuated and may be utilized for the Location! of a replacement soil p A suitable reP~~~nt'area meat area. should be protected from disturbance and comps absorP~n system. ,~ replace sari s~cture, tot fines and wells_ Failure to aired setbadss from Existing and ProPo be infringed upon by ie4 ~-~ fesult in the need for a new soi! and site °eval st that: tirn tablish a su'tfab e protect the reP~ement at~ea s must romptY ~~' the rules in effect Replacement system replacement area- not avaitable'due to setback andlor s~o~ ~ ~ po~sng advances in POVYT p A suitable r~t:placement area is be inserted as a iast resort to Tapia n failure ~ the POWTS a soli and technology a holding tank may ~ identify a suRabte replacement area. Upo t area is available a. been evacuated If no reptac~men not a suitable replacement area. site has to . e to Coca. site evaluation must be per'~~ Taal resort ~ replaces t'i're tailed POVYC'S f removal of the biomat at holding tank may ~ instaJied as n systems may be reconstructed ;n pta~ o[lov+Rn3 nd and at-grede Soil a~~ctYotts of such systems must comply with the ivies in effecx at that time. dace. Recon e su the infiftradv GASSES AN~lOR lNSUFFICIJ`MT OXYGEN- <cWARNIN©~ ~~• TANKS MAY CONTAIN LETHAL. C[RCUIIdISTANCES. DFILTN MAY SEPTIC, PUMP AND OTHER TRF-A t30 NOT ENTER A SEPTIC. PUMP OR OTHER TREA'TMEj'iT TANK UNDER SON FROM THE INTERIOR oP A TANK MAY 13E pIFFlCUL.T OR IMPOSSIBLE. RESULT. , RESCUE OF A PER , gpplTIONAL COMMEN'T'S POIKTS 1NSTAI-I- R Name ~- 4 y/ s ~ _ Phone ~J J`r' ~-~~ ~ 7 `J '~ POWTS iVIAtNTA1NE.R Name ~ k "'' ~ , Phone ~ -- Z '' `S ER LOCAL REGULATORY A~O~ , SEPTAGE SERYtCtttiG OPERATOR PUMP A9encY ~~~ c ~~ /~ Name .~ a? ~ ~~ D ~~ Phone ~I,1"- -~ ~ This document meee Phone % ~ c~ ~` ~ - ~ Qoaiment does not QnrRed by. eha starts of the Green Lake. Marttuotfe and Waushara County Zoning and Stnifation' agendas. and 83.5s(i), (2) ~ (3), yyisaonsin,aomtntsVaflva C.c:~c- use of tt+ts t~ (~tl rnis doam1ent was . the minimum ~,;rert'tents of dt_ Comm 83.Z~xlx~a(fl guarantee tl+e perforrnanoe of the P01Krs- w~sin Departrnetrt of commerce SOIL EVALUATION REPORT Page of nivismn of Safety and BuildinQS - in axordanoe with Comm ts5, wls. twin. was ...+ ~ ' r ~ 9 gttach rxxnpiete site plain on paper not less than 81/2 x 11 inch ins ~~ V E D iru~de, but trot tirnikd to: vertical ~d horizontal reference point north arrow, and locat'ron a scale or dimensions e ercent slo M), dit8die distance to nearest road. I.D. (~ - 3 ~ ZZ -dCD ~ • ~ I (O , p , p Please print all information. MAY 0 1 2 0 0 ~ Oate ` Personal ~Onnatan yar prwlde may be used tar serandary PurP~~ ( i.aw, s. 15.04 (1 } (m)). -/ ^~.., ~ . ~ T wu ProperfyOwner C, ~ D/ Q~ ~ S OFFICE 1/4 S~ T N R E (or W Property Owrl~ fuleilirtg address ~ Lot # Block # Nam or CSMq L//G ~ ~ State ~ Cock Phone Nun~er ^ City ^ Vigage Tavn Nearest Road New constrtldion Use: ~ Numtrer of bedrooms Code derived design flow rate -~ Q GPD ~ Reptaoernent ^ , ~. al -Describe: ~' -` - I'`~ 1 ~}' fL d Plain elevation if app~cabie Flo o ~ arKl nscomrrlendations: ~~ v7'~Zr.- ~ ~~ dGC~ l ~ ` ~ I . fJ C ~J c1 e . :.~,... ~ p, !yl n ~~ ~ ~.1~ --~ ..~nct~2 ~ ~.d~ ~ tC o • 6 ~ r~ S c~,•~d~ .,-. ~, ~. ,~,~-. - - - - - - re a~t>7 - ~ ..--- l ~~ Pit Ground surface elev. V Zr tt. ,b f Soil Rabe xture T Shudure Cor~sister-ce Baaldanr Roots G Horizon Depth in. Dominant Munseq Redox Descxiption t1u. Sz Cont. Cobr e Gr. Sz Sh. ~ft#1 ~~ z rZ-aa /----- ms~~ s~ ~ ~ ~' > S~dr Pit Ground surface elev. ~ ~ 1t Depth to lirrli6ng factor ~ in. ~ Rate ~ ~ t ti n D Texture S1nuAure Corrsisterrce Bourx>asy Raots GP D/Pf horizon pepth H-. D-t Dominant Munt~ ~~ 3/Z ~°/Z o escx Redox p t1u. Sz Cont Color F ~/ v s Gr. Sz. Sh. rn r - m' ~, n a. rn n /mot ~ ~ ~ , 3 ~~ .q , S • Effluent #1 = B~ > 30 < ~0 mglL and TSS >30 _< 1 50 ' Eflluer~ #2 = BOD <_ 30 mgA. and TSS <_ 30 mgfL ( ~~ CST Number Cc~J~~ ) Addtass Die Evaluation Conducted Telephone Humber f ~~ Property Owner Paroel ID # Page of Pit Ground surface elev. ft. Depth to funitin9 factor ~ in. Sod Rye ® ~9 # O ~ --~~-F-4 Horizon th De [)ondnant Redox Descxiptian Texhse 5tnrcUne Consistence Boundary Roots GP D/ff p i n. Munse~ Qu. Sz Cont. Color Gr. Sz Sh. #1 'Eff •Eff#2 ' n rn S ~ la r ~ F' y ~ v 5 -- ~ - rn F/ n -L n ~ 3 S a# ° ~~ o Pit Ground sum elem. • Effluent #f = BOD, > 30 <_ 720 mgll, and TSS >~ < 150 nplL • Effluerd #2 =BODE _< 30 mgA. and TSS 530 mgll. The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or seed material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. ~~ ssoa3mt~- ^ Pit Grotma surface elev. a# ~ ~~ c . , Soil Test Plot Plan Project Name P.C. Collova Bldrs. Inc. Shaun Address P.O. Box 487 /r Somerset Wi 54025 CS~ #226900 Lot 22 Subdivision Crick Bolton Date 12/4/02 1/4 NE 1/4S 18 T 29 N/R17 W T wnshi Hammond Boring 0 Well PL Property Line BM or VRP Assume Elevation y00 ft. o p County ST. CROIX Top of Survey Iron B.M. System Elevation 104.6' *HRpSame as Benchmark U 1950P 52.8 I STATE BAR OF W ISCONSIN FARM 1-1998 • I WARRANTY DEED I -This Deed, made between John J ualton ana uarolvn ~ uanv~ husband and wife .Grantor, and P C Cdlova Builders. Inc. .Grantee. Grantor, for a valuable consideration corneys to Grantee the fdlowing described real estate (n St. Crobt County State of Wisconsin (the "Property"): ~~ 687242 KATNLEfiR R. YALSH Rls'GI57'fiR OF D6ED5 ST. CROIX CO.. YI RECfi1YSD FOR RECORD 08-16-2002 9:00 AM EI{ DPT~# ~ REC FEE: 13.00 TRANS FEE: 1155.88 COPY FEE: CERT COPY FEfi: PAGESs 2 P' CfColbva BuUdara. Inc. x Avenus mood . WI 54015 ~~'~ 9~D 9 O18-1039-20-000 / 018- 018 1039 80 000 Parch {dentl5atlon Number (PIN) Thla Is not homestead properly. (Is) (is not) Sw Exhibit A attached hereto Together wlth all appurtenant rights, title and Interests. none Grantor warrants that the title to the Properties goad, indefeasible in simple fee and free and clear of encumbrances except Dated this 15th day of Auoust• 2002. •~4b{, hn J. Iton (SEAL) (SEAL) D. ~ ~~'i •~ lyn G. alton (SEAL) (SEAL) ACtCNOWLEDGMENT State of Wlseoneln, } ss. St. Crobc County Personally came before me this 1,~ day of Auowt. ?~0? the above amed a and rot 0 It an nd Wif A„ ~- I pY ~C Signature(s) authentlcated this N~ 31.~C TITLE: MEMBER STATE BAR OF WISCONSIN (if not, authorized by §706.06, Wis. Stars) Notary Public, State(of Wisconsin THIS INSTRUMENT WAS DRAFTED BY My commission is pe anent. (If nok state expiratlon date: t;oldweil Banker Bumet ~~~V~ •) 1301 Coulee Road Hudson, WI 54016 2-32470 (Signatures may be authenticated or acttnowledged. Both aro not necessary.) . u-......d ....,..,... "M,,,Inn In env rannrlly muss be tvoed Or Drlnted belOW tltelf Sk]natUre. _ e/L[Cs~ ~ ~~''1 ~U E ~~.bOK l of 2 STATE BAR OF WISCONSIN Wisconsin Legal Blank Co. Ina WARRANTY PEED FORM Na 1 -1998 Milwaukee, Wis. ;.ti , . ... .I~. i `~, 9 S 0 P , 5.2,x.,.,:; . .. ~ . ', .,, ..............:.:.::...rW x:yea."a.",,,,r„~,.w~p;;nr„~'~lx~,, ,. .. ... `. .~ A part of the NE'/. of the NE y, and In part of the NW '/. of the NE'/, and in part of the Sy1f. +~ of the NE Y. of Section 18, Township 29 North, Range 1T Weat. Town of Hammond, St"Croix County, Wisconsin and more partkularty described as: 8egitnting at the Northeast comer of said Section 18; thence S89.33'31"W 372:01 feet along the North tine of the NE Ys of said Sectlq~n 18; thence S89°33'31"W along the North line of the NE / of skid Sectfan 18 775.94 feet; thence S00°52'23"E 250,00 feet* thence S89'33'31'UV 988.24 thence S00°52'23"E 420.00 feet; thence S89'33'31"W 528.00 feet; thence S00°52'23°E along tltie North-South Quarter Seaton ilne of said Seaton 18 1311.77 feet; thence N89'33'39°E 828.33 feet; thence N00°31'25'11V 30.23 feet: thence N89'33'24"E 692.78 feet; thence N00'S2'23"W atong the East line of the SW % ~{ NE ~/. 330.31 feet; thence N89°33'24`E along the South line of the NE '/. of the NE '/.949.09 feet; thence N00'52'24'V1l 1321.19 feet to the Point of Beginntng. 6 V ~2-L.~v~ 2 or- ~ /~Uy"I 5.r. 1 \ 1.65 Ac. ~ , ,, - - -'~ 1 - 37'S3'40" W ~ ~ ~~ S 819 46.1 W 2 Ot~~1~ 34.26 / ~ ~ ~ N 89'33'31" E 17 ~ ~`1~~~ ~ / ~ ~ 1s 119.46 ~ NORTH // /~~ __ _ _ -~ ON 18, ~ / / ~ E. ~ ~ ~ ~ ~ ~ ~ LOT 2~ PROXIMITY / / ~ \ s~ 69518 S. E A // s \~ ,~. 1.60 Ac ATION NOT ~ ~~ \~. ~Q,, WATER ~ ~ `~ °• \ F 'H r~ ~ LOT 22 r,1 >T~ ~'•• LOT 23 `~`~s ~ 93180 S. F. ~ \F` 68872 S. F. ~~p. ~ ~, \ o. 2.14 Ac. _ ~ ~ 1.58 Ac. \ ~ P~~ s /a O \ ~ /LOT 21 ~~., 102328 S.F. F \ ~ \s o 2.35 Ac. s~, ~~ ~~< ~ HBO = 1020' `~~. '`~ o~ ~S \ / `~`' ~E THE \•• AN FOR THI F \ ~ ~ ry 121 FILLING, G~~ tia ~ SQg, 1~0~ ~~~, ~ ~, 2 gTER r ~ `S \s ~ G LYNN. ~ \ PHREY ~ ~ HwE=101 a' ; &2188 ~s \ ~~ WOODVlLLE ~~ \ ,gyp L_ 468.25' `,H ..,W~S.~~~ ~~ ~ 218.45' 122.76' ,,.~*'~ N m SOU TF 0~ N o LOT 20 1SHIP LAWS, ~ ° -~ D .) BEFORE \ `~' ~,, 89098 S. F. r- ZONING ~ 2.05 Ac. m ~ z \ ~ LBO = 1007' O p o ~,,, ~ W Q o ~ -~ o N ~ LOT °' m ~ N ; 81'3x'11 ~ ~ . W _ 170.59' 33 7, 75 • (/) ~ ~ 167.1g' ~ 1'tl W ~ ~'py -~ w ~ ~ /~~9 ~ O • N (~J O1 C~ O ~ ~ N ~ N _ ..... ?