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HomeMy WebLinkAbout018-2003-23-000I ,in Department of Commerce • PRIVATE SEWAGE SYSTEM and Building Division INSPECTION REPORT FERAL INFORMATION (ATTACH TOPERMI~) onal information you provide may be used for secondary purposes [Privacy Law, s415.04 (1)(m)j. mit Holder's Name: City Village X Township '.C. Collova Builders, Inc. Hammond Townshi ST BM Elev: Insp. BM Elev: BM Description: l CSO. 0 1 ~D . ~ To TANK INFORMATION ELEV T N DATA TYPE MANUFACTURER CAPACITY Septi Dosing w ~ ~D Aeration Holding TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Septic ~ ~ (1.~Ll~W ~~q ~ ~5~ 7 Dosing I ' I ~, .t- ~2~' I r t Aeration Holding PUMP/SIPHON INFORMA IT ON ~~ toy Manufacturer Demand GPM Model Number ~~ (~ Z ~~•~ TDH Li •~~~ Friction Lossr System Head ~ TDH t Forcemain Length Dia. Dist. to well _ ' v2 r ~ -'1D~ l/h~ SOIL ABSORPTION SYSTEM BED/TRENCH Width Length ,~ No. Of Trenches •~ DIMENSIONS (Or i;_ r, ~ _ SETBACK SYSTEM TO INFORMATION Type Of System: h,pl..ll" DISTRIBUTION SYSTEM county: . St. Croix Sanitary Permit No: 453141 0 State Plan ID No: R 87 ~ Parcel Tax No: 018-2003-23-000 Section/Town/Range/Map No: 18.29.17.917 STATION BS HI FS ELEV. Benchmark b r j YYl `7.0 /O?. v ~ C5'0 . O Alt. ~ i o F .5~~ a /0 6. Bldg. Sewer ~0.6~ /vow St/Ht Inlet I I.3~ .6~ St/Ht Outlet _ _ Dt Inlet Dt Bottomr L ~ ~ 'f X5,,0 9~, a ea er an. `f•SS (o 1. ~'S w Dist. Pipe ~ ~t~ss !~ r Bot. Syst S3 Iba• ~ Final ra e _ L ~ •x.~ ~ 3 ~(~~ L St Co er 6 ~ - y. s /o z. S '~ 9er+ c-In mot, a~.te. ~ ~ ~ 5 ' 1 D S. ~ I Da . o ~ ~ 5.3 1ob~ ~ PIT DIMENSIONS, No. Of Pits Inside Dia. Liquid Depth P/L BLDG WELL LAKE/STREAM 5' X200' Si-F~ ~' aot+ ~ ~ r,aGQe CRAM Manufacturer: Header/Manifold Distribution ~ x Hole Size x Hole Spacing ~ Vent to Air Intake /y~,Q~ o- - Pipe(s) r~ ~ ~-' r ~1 3 Z a~ rr --~ Length is Length Dia Spacing SOIL COVER x Pressure Systems Onlv xx Mound Or At-Grade Svstems Onlv ~~C' b b~-CVVCG( E.t,, Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulche Bed/Trench Center Bed/Trench Edges Topsoil I ~ Yes No Yes No COMMEN~TtpS/:~ (Include cod discrepen~crie~sp, person present`etc.) Inspection #1: 1 /~/~C•L Inspection #2: / / Lo ati~on X589 97th Av~known ( 1/4 NE 1/4 18 TQ9N 17~ttom Overlook Lot 23 Parcel No: 18.29.17.917 1.) Alt BM Description ~b~Q ~~~w./'~GTat,~.~ `~, f f! ~N ~ "`-'c- ~~ ~//Z! ~- . ,_ ~~ ~T Z~ 2.) Bldg sewer length = ~ ~5 ! ~~p~p yi ~pr Zy ~ " ~ Si~i-~ 'T~w°~ -amount of cover = ~~y~. (..Q.w~- ~ „D.,._ D.,. Q f- y~G~R-- 7 .~ Gu-~-Q-t" /'~i,~fA.~C¢_ ~e.Q~t10 a~'ftdy.•~ I'~___~~' 0 • Plan revision Required? Yes I No -- ' - ~ ~~ ___ _ , . Use other side for additional information. ~~ ~~ ~ O~ - ~ i Irisep~tor's Signature ~ ~~ SBD-6710 (R.3/97) No. Wisconsin Department of Commerce PRIVATE SEWA Safety and Building Division INSPECTION P.EPOki' ~ (ATTACH TO PERMIT) GENERAL INFORMATION ~ ,r 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. Ham and Townshi CST BM Elev: Insp. BM Elev: BM Descripti~ Db L~ /~~ a ~i~ TANK INFORMATION TYPE MANUF Septic ~ Dosing Aeratiol~ Holding TANK i TANK T - ~~ /. ~/ ~ ~~~ . ((( C~ '~/ L ~ p~ 2 v~~ _ ~~~/. r I ` ~'%?L,C~ Manufacturer Model Number ~ TDH Liff~ , Fricti n Loss Sys te He: ~ . I / c(_~ Forcemain Length '' Dia. ,r ~- Dist. to , SOIL ABSORPTION SYSTEM BED/TRENCH Width Length yc t DIMENSIONS / p rL, ' SETBACK SYSTEM TO P/L INFORMATION Type Of System: ~~. ~,- c~~t~,~-~ County: St. Croix Sanitary Permit No: 430667 0 State Plan ID No: Parcel Tax No: 0/ ~ ZED 3 -' 2 .-ocL~ Section/Town/Range/Map No: 18.29.17. ~/ ELF~~"TION DATA ~ CAPACITY ~ CATION BS HI FS ELEV. 3L c~ ~, ~ 21,~,v. • P5 ioY ~ VDU ~ v ~,L ~ ~ ~ 5'T-. Cd ~ , v 03 d'.s ~~ v' 9 ~~36/o y - v~L~, ~vl~ ~ won Lof 23 _ _ o~~ ski ~<<~~ _ t~ LU f - U2.~- _ _ _ . --- ---- _ - -- rc~-e i1,~.e.,~ -- _ ~_ -- ~~~ ~'~ ~d .~ ~ - .~T' No • l~ S DISTRIBUTION SYSTEM Header/Manifold ~, ,~„~, Distribution ~- Pipe(s) Length Dia Length ~' C~ Dia_ SOIL COVER z Pressure Depth Over Depth Over Bed/Trench Center ~_ <_: Bed/Trench B COMMENTS: (Include code dis regencies, pe Location: 1593 97th Avenue Ha mond, WI 540 1.) Alt BM Description = 2.) Bldg sewer length = ~~ ~ -amount of cover = ~' ~ .~_ _~:. Plan revision Required? Yes No Use other side for additional information. SBD-6710 (R.3/97) (,> I ~; (~ Date _ ~ ~~'~ _ ~ .-"- - Insepctor's Signature _ u~c _. Cert. No. PUMP/SIPHON INFORMATION Safety and [3uildings llivision Cot'nty~ 201 W. Washington Ave., P.O. Box 7162 ~~ r' ~ ~ ` ~ ~ Madison, Wl 53107 - 7162 r Sanitary Permit Number (to be tilled in by Co.) ~scons~n (608) 266-3151 W !~(~ Department of Commerce State Plan l.D. Number Sanitary Permit Appl cat _ T s. D~ In accord with Comm 83.21, Wis. Adm. Code, personal , formation you provide oject Address (if diftierent than mailing address) may be used for secondary purposes Privacy La?ty, s I S.Oq,(H(fp) c) O ?00 A 1..4pplication Information-Please Print All Information ;iT CR01XC~l1NT`s/ ~ ~ ~ ^ vim' ~, arcel # Lot 1~ Property Oumer's Name ~J / = ,,~-, St( ~ ~ __,/ C ~D ~(Q r/c~/ ~ C' Prope Loca Property Owner's Mailing Address /~~ p~L v~(. `/7/ / ~ C. ~/.,/., Section City, State Zip Code Phone Number ~~ ~ /~ C /~ircle ne ~~ S T ~/- N; Jp''/ E o W II. Type of Building (check all that apply) ~ ~ S Su ivision Nate CSM Number ~r 2 Family Dwelling -Number of Bedrooms ~'S ' ~ ~ , ^ Public/Commercial -Describe Use I - ^City_^Village~Township of /I~.Q ^ State Owned -Describe Use ~ a ]Il. Type of Permit: (Check only one box on line A. Complete line B it'applicable) - - rtl~l• ~7~ 'a' w System ^ Replacement System ^ TreatmendHolding Tank Replacement Only ^ Other Modification to Existing System List Previous Permit Number and Date Issued B. ^ Permit Renewal ^ Permit Revision ^ Change of ^ Permit Transfer to New Before Expiration Plumber Owner P'. T e of POWTS S stem: Check all that a 1 ^ ^ Non -Pressurized In-Ground ^ Mound > 24 in. of suitable soil ^ Mound < 24 in. of suitable soi Grade ^ Single Pass Sand Filter Constructed Weiland ^ Pressurized In-Ground ^ Holding Tank ^ Peat Filter ^ Aerobic Treatment nit ^ Recirculating Sand Filter ^ ^ Dri Line ^ Gravel-less Pipe ^ Other (explain) Recirculating Synthetic Media Filter ^ Leaching Chamber V. Dis ersal/Treatment Area Information: S~ -'~ o.S' = 9c7o d Desi n Soil A Itcation Rate(gpdsf) Disp rsal Area Requir Dispersal Area Proposed (sf) System Elevation Desi n FI w (gp) g PP M. ~ urer Pretiab Site Steel Fiber Plastic VI. Tank Info Capacity in Total Number Concrete Constructed Glass i Gallons Gallons of Units New Existing Tanks Tattls Saptic or Holdin,_ "tank AerobicTreannent Unit Dosing Chamber ~~ _ VII. Responsibility Statement- I, the undersign some responsibility for installation of the PON'TS shown on the attached plans. Plumber's Name (Print) ~ /~ Plumber's store MP/MPRS Number Business Phone Number Plumber's Address (Street, City, State, Zip ode) ~ ~ % VIII. Count ~/De artment Use Onl Sanitary Permit Fee (includes Groundwater ~ aSF sued Issui Agent Signatu (No Stamps) Approved ^ Disapproved Surcharge Fee) ~ ~-+S1 ~ ~2 .~ D ^ Owne ven Reason for Denial ..~~IIJJ la. Conditions Approva I SYSTEM OWNER: 1 Septic tank, effluent filter and dispersal cell must all'^9 ~°~+iced i maintained as per management plan provided by plum~er• 2. All setback requirements must be ml~int~ined as per applicable code/ordinances Attaeh complete plans (to the County only) for the system on paper not less than 81/2 x 11 inches in siu SBD-6398 (R. 01/03) ~P.C. Collova Bldrs. Inc. /4 NE I/4S 18 /T 29 i Shaun Bird 226900 ENTIONAL AT-GRADE 4/12/04 BEDROOM 3 DATE XXX CONVENTIONAL LIFT HOLDING TANK SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE 630 MOUND HOLDING TANK SIZE LOAD RATE .5 ABSORPTION AREA 900 # of chambers none ,BENCHMARK V.R. .Top Of Survey Iron _ g~ ~ I ASSUME ELEVATION 100' Filter Zabel A-100 ^ BOREHOLE O WELL * H, R, p , Same as Benchm j SYSTEM ELEVATION 100.5' 97th Ave PLOT PLAN '• ` _ ADDRESS P.O. Box 489 Somerset W 54025 N/R 17 W TOWN Hammond COUNTY ST. CROIX System is being designed based on loading rates prior to Feb 1st. 2004 Well is to meet all setbacks found in Comm. 83 Scale = 1 /4" = 10' 395' Property DIVISION OF SAFETXAND. BUILDINGS Tank is to be properly bedded and provided with lockdown covers with approved warning labe 493' Property Line ~pP Pro 3 Gradf~is'~'t~`'", ",• "-'•"'' Is 101' Area 15' below system is to 100.5' 2% remain Slope undisturbed .gam 100.0' 6 -1 ~) .. ~i~ ~ Bedroom done to divert run- House off away from system Huffcutt Combo Tank ^ B -= commerce.wi.gov 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/sb www.wisconsin.gov Jim Doyle, Governor Cory L. Nettles, Secretary April 19, 2004 CUST ID No.226900 SHAUN R BIRD BIRD PLUMBING, INC 1008 192 ND AVE NEW RICHMOND WI 54017 ATTN: Rod Elsinger ZONING OFFICE ST CROIX COUNTY SPIA 1101 CARMICHAEL RD HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 04/19/2006 SITE: Pc Collova Builders 1589 97TH Ave Town of Hammond St Croix~ounty IJ ~ :r~Jr-~4,-~iE 1 /4, S 18, T29N, R 17 W Lot: 23, Subdivision: Crick Bottom Overlook Identification Numbers Transaction ID No. 987158 Site ID No. 682122 Please refer to both identification numbers, above, in all corres ondence with the a enc . FOR: Description: New 3BR ATG Object Type: POWTS Component Manual Regulated Object ID No.: 953705 Maintenance required; 45 in Soil minimum depth to limiting factor from original grade; System(s): At-grade Component Manual, SBD-10570-P (R.6/99), 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. PRi\j{~TE SE 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 ~1S0pN 0~ S. • 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-107061'~.L_.-~--~ (N.ol/O1). $EE COR • This system is to be constructed and located in accordance with the approved plans, and with publication SBD- 10570-P (R. 6/99) "At-grade Component Manual Using a Pressure Distribution System for Private Onsite Wastewater Systems". 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/installation/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. SHAUN R BIRD Page 2 04/19/2004 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, y~ ~~ ti 3 ` 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 ~. Shaun Bird Bird Plumbing Inc. 1008 192nd Ave New Richmond Wi 54017 715-246-4516 Date: 04/12/04 Cover Page ~~ ~~~ ~ ~ . ~~ ~~ ~~~ ~~o~ s,~~~ Owner: P.C. Collova Bldrs. Inc~Za ~\ Location:NW 1/4NE1/4 S18~~1,R17W Lot 23 Crick Bottom Overlook 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 5. Pump Chamber Cross Section 6. Pump Curve 7-8. Maintance and 9-11. Soil test Shaun Bird Signatu plan ~~~~ly '`~ r ,; ~~ ;,~~ ~3t~~~~S .~P®1VD~NCE License number PLOT PLAN PROJECT P.C. Collova Bldrs. Inc. ADDRESS P.O. Box 489 Somerset Wi 54025 i~1W 1/4 NE 1/4S 18 /T 29 N/R 17 W TOWN Hammond COUNTY ST.CROIX MPRS Shaun Bird 226900 DATE4/12/04 BEDROOM 3 CONVENTIONAL AT-GRADE XXX 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 g~ #k I ASSUME ELEVATION 100' Filter Zabel A-100 ^ BOREHOLE O WELL *H.R.P. Same as Benchmark SYSTEM ELEVATION 100.5' 97th Ave System is being designed Scale = 1 /4" _ ~ ~~ based on loading rates prior to Feb 1st. 2004 395' Property Line Well is to meet all pFti TE Si=1lIfAGE S TE setbacks found in Comm. 83 ~® (,~~t~~'~ r1 D1VISi0N OF SAF ANA BUitCiE40S Tank is to be properly bedded and provided with lockdown covers with approved warning labels 493' Property Line Pro 3 Gradiftg`is`~Cti'~`~~ Bedroom done to divert run- House off away from system Huffcutt Combo Tank -2 .~~ 101 ' i~'N` Area 15' below system is to 100.5' 2% remain Slope undisturbed 100.0' B - 1 s~~~t~~1 ~~/ ~j~M~ \ g~ ~ - ~ ?5` ~ 5r > 5r B >_ 5' PYG FOAGEMAZ N .~.~ r ~- = Z t _. ~TuRr~- u PSN `.... ~.~- -~ .z 1„_ t-- DcSTISt~~tiTtcwt tATf~RRL "{ /STJ-Btr.r QED oBa~ :~ttTtaai WELL ___.____ 1/C B ~ A=~ ~'f• 8 = ~ ~ ~t. L - !~ ~t. vJ = ? ? ~t. l4 P~ Rc+tE D SY *tTHrEt3L. Fa b rsc - STae~~.i~~~ Observa#ion------..,` We! t ~cc~ • ~~ . ~~~ SLOP _._____ I/68 ~I/2B .~ ~ Dss#ribu#ion ~.a#eral Soli Cover 2" ;..~ r ,~ .I A 2~~ ~I.bVV£.D LaYEtt ~~ ~ r 2 ~ _5 Plan View and CrOS$ Section of ttiseoz:sin At-grade Unic with a Single Absorption Area on a Sloping Site Rage Of Distribution Ripe Oetait i•or Lateral Hetworlc * Last mole Should 8e Next To t1~-RN•UP •~ Tut~i`t - uP~~ ~C~n~cut~ PVC forte Main '"~'~ ~ i'YC Oistributian Pipe .~_.... P ------= Arre rc' ~o~ J ~~ Hole Diameter ~____ Inch p Ft. X _~:1..___ Inches Lateral i~iameter 2 Inchtes} ,` ~ Y ~ 7 inches Force Main Diameter , Inches "~ Qf Holes/Pipe Invert Elevation Of Laterals ~~ ft. S9gned; License Number: Date: _ .~~.~ a~ ~~~ SF~Lii I-; PIMP C3~4AMS'F-~ Cr~OSS 5£CTi E S~gTZC TA~~ uFJ-~~i~RDt3~ APgSQV ~ COY ER .. AB~vE ~RAD£ ~ '~~TM~CCMOUIT MpP(~fOLE ZZ Ndi~ "¢~ K ~ » ~ v~NT pYpE ~i~ND W WwAR~~ ~~~~ r D44R • ~ Gl FROM FRESH -- . E + ~ ~r~Y-'" ~ t~l L '~ - ~ :1 .._ •s INLET , . -~ - ~ ~G~T i ~. .iDj~ ~Ip;FE SdAS~ TIGHT S~i.s A ~~' ~ ~ ALt"~ •"~- s s • ED C ~ FF tiM~D ~1D pt#ifP {yFF EL£ti - .~.--- D SE1IL 4 BEDDI N6 V I+TDEg ''~~/ I S~ _ j J r-fli3C3~ETE PAfl 3 ~ ~,PgpY ED ! / t)h~ SP~CZFZCATIOi~s ! . P£g 33AY = l NU3'IB~R DOSES DOSE I~tCi+~~I1+iG ~ , ,j GAL- SEpTSC f ~£ vO~nE FI,aHSACK= ~d ~~'AiC'3Ult~ER % OAi.. ~.~AL• Tl~AiK .5~33~1CHES z SEPTZC ~~''" ~ -~~ fS = Jvr L. TAIiK SZZ£S ~ DOSE C~ dj'~O CAPACITI~ ~ A _ 2 ILK 8 "' ALA 1"~i~FAC~3$~~; : ~s ~ ;NCEfES = ~~2-°~'L yy~xTC n ~ srzc ~ FACZVR~ _ _ A5 PFR X LtIR 15.23 p~+p N~;E~,~~~ : p ~~~~ Ptli"YF £ ~ ~''~'RH ~ RI p£ F~ Sit 7~ , ,3 ~ •~; pt~t Fr as sc~~E g~,T~ =~""'_ a~ sTx s ~ _ y REQti3=RF.fl ~£~££N PUMPEOPF ~'NB _ FACTQR • _ •~ FEET vflt'l2CAL DIFF£R'ENCS PPLY X1iE, 3 FTl ~~p.FT • . Fg;DYM~~C ~~ ~ / ' D~K SpRK ~ Iii ~ T£3TAS• ~ DIAI"~ET~ -= + M p£g~ .FORCE!' FNT'~~U-L DLMENSIOI~S OF L~CE~S~ ~MB~~ , __--- 4ATr_ st88 TOTAL DYNAt~tiC HEAD/CAPACITY PER MINUTE EFFLUENT AND DEWATERWG 0 a z 0 Q 0 p ~ ' ' S7 I 1 3 i MOCEL ~ I 1 ~ Fzzt i Mztzrs Gni. Liters I -- Gal. Litzrs 5 i.5 69 ~ 261 77 291 ? 0 I 3.1 , ~~ I 4 6 61 53 231 201 I 70 61 i 265 231 . ( 2~ 6.? I i a4 I i67 ~ 52 I 19' 25 i 7.E I 34 ~ 129 ~ 42 i ': 59 3p ~ 9. t j i %3 ~ 87 33 I 125 ~~ i ,,~ ~ _- ' --- 2~ 85 4p I 1L.2 ~ --- ~ -- ~ 11 42 Lock Volvc ~.p `,. (it.6m)I44.Q Ft. (13.4m) -~-- ~ G7i5Ge ,~, 2~ 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. • Sealed Qwik-Box available foroutdoor installations. See FM1420. • Over 130°F. (54°C.) special quotation required. 1521153 Series _~- il 1 12 t/3 I i i ~- sKZOa+ SELECTION GUIDE O CAUTION All installation of convols, 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 tNEC) and the Occupational Safety and Health Act (OSHA). 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 conVol 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 T0: P.O. BOX 16347 ,~t~'~, LouisviUe,KY40256-0347 Manufacturersof.. ~- SHIP T0: 3649 Cane Run Road ~+ 7 ~ `` ~ ~® Louisville, KY 40211-1961 Q[/r1(/TY PUMPS J/NCE /999 Z ~j ~~~~ ~~ (502) 778-2731 ~ 1(800) 928-PUMP FAX f5D2) 774-36L4 hip://www.zoelle~. corn ©Copyright 2000 Zoeller Co. All rights reserved. 32 ~z U uu •~~ ' ENT PLAN Page of VV-I•S OWfNER'S MANUAL 8~ MS EM SPA IFICATtONS O Y ^ NA , P " S Septic Tank Capacity al NA Ft[.E INFORMATION ® optic Tank Manufacturer ~ NA p,i,mer Effluent Filter Manufacturer O ~ Permit #. Efryuent Fitter Model DESIGN pARAM~s Pump Tank Cale ~ J at O NA Last of (Bedn~s Num n'>me~al Units C ~ NA pump Tank Manufacturer NA ~ 0 NA o Numt~er of ~~~ Aow {avel~age) aUda ~-- -- 7 J i.~ aVd ,Pump Manufact<+rer ~ ~ ~ ~.._-~ p NA Esbrttatrad x 1.5) Oesign flow (P~), ( ~ ~ ,~aVd /ft Pump Modal tment Unit PIA ~~ App cation Rate lit Monthly average' Pro~ ~ ~~/Gravel Filter ical Aeration O peat Filter O Wetland y lnfluent/Effluent Qua Oil b Grease (~G) Fats S30 mgn- 42fl mglL ^ Mechan ^ Disinfection p Other. , mir~l Oxygen Demand (BODs1 Bioche n~ Solids {'rSS) tal Suspe T 5150 m /L e" ra Manufacturer Dispersal ~t(ra O In-ground (pressurized) o nt Quality ~ etreated Efftue P g Monthly ave S30 m91L vtty) ^ n-ground (9 At~rade p Mound Other r GODS) en Demand ( B'locheT tai Suspended Solids {TSS) o mg/L ~o< cfu/tio0ml ins ^ ~ domes ^ non-~R1Cfd~'"~'st°vr't°r'nd o Fecal Coliform (geometric mean) y, inch diameter valuestyP-rrl for s~ tank etftuent ~St811,rater. eated Maximum Effluent Particle S¢e .~ Values typical far pretr _ MAINTENANCE ScHEDU~a Service Event Inspect cond~on of tank(s) Pump out contents of 'tank(s) Inspect dispersai Cell(s) Glean effluent filter rap. pump Controls 8. a1a~ Inspect t~ rats and pressure test Flush late Service Frequency Max;mum 3 yrs.) --~ p months ear(s) ( At Least once every a uats one-third (~) of tank volume yyhen combined sludge and scum 4 near(s) (Maximum 3 yrs.) - the At feast once every At Feast once every At Least once every At feast once every At least once every At least once every ^ mon ~ ^ months Jn-Xes~ ~~, ^ months eaKs) O NA ~ ^ months Yeas) O NA ^ months ^ year(s) O NA ^ months ^ yeaKs) O NA ott>ef licenses or CE INSTRUCTIONS an ind'Nldual canMn9 one of ppfoVYTSMaintainer, Septage real Cells shah be made by ~ ppyVTS tnspedp~ an missing or broken ~~~oftartks and dispe r Restricted Save on of the tank(s) to identify Y for any flack uP m and to check Inspeaionss: Master plumber, Master plumbs a and scu t levels cerbfxxt ' ns must inducts a visual tnspec'd to ~~ the effluen p tor. Tank inspectio asure the volume of combined etude of effluent on the hardwam~ ~ ~Y ~~ or leaks, rrte The dispersal Cell(s) shalt be visually inspe~ ponding round surface, of effluent on the ground surface- ulatory authority. ,~ pondin9 of effluent on the 9 for any ponding lion of the local reg in ttte observation PiPeS and to checkCOnd•Rion and requires the immediate notifica or more Of the tank volume, the ground surface may indicate a failing min any tank equals one-third (~ sect of in accordance'""d' ct'- NR e and scu O stator and dispo When the combined accumulation of slud9d by a Septa9e ~rvtcing p retreatfinent components, and any entire oonUents of the tank shall be remov wed POWTS Components, P 5 Maintainer. 113, Wisconsin Administrative Gode. fessu rformed by a certified POWT n of effluent filters, mechanical or p of completion of any service event The secv>a 9 or monitoring at intervais of 12 months or less shall be other maintenanve t r uiatory authority within 10 days A servl~e feP~ shat) be prrnnded to the IoCa e9 nting Products or other s for tits presence of pal S check treatment tank() eclat Celt(s). tf high ~centra6ons are START UP ANC OPERA 00 o usQ of ~e POWT S and/or damage the lisp For new consizucaon, ~ atrnent p for prior to use, e the tre row to a servicing opera chemicaFs that may impel removed by a sep 9 detected have the contents of the tank(s) f -• Page or._,.__ . ,..- - r~ - ~ ~ nditions are frozen at the infiltrative surface- -s restored ~e eXOeSs °tf °o evels. men Pow result in the System start ~P snal! not occur when 5 ~ above nom~al titghwater } the cep(s) and may overloading um tank removed by a ~~ges Pump tanks diyz real cell(s) in one li3rge ddSe. a Plumber or pOWTS Maintainer to ~~„Y,'11 be discharJ of ef~fluent.pTo ~Oid this situation have me ~n~ ~df tl1e P P ~ ~rfaae d'-sc~ar9 _r,~Or'in9 power to the effluent pu P - in the pump ~~-. backup ppecabor pcto<.~ .. g to restore normal levels wrth at ~ mass ~ ~y °pe~~ng ti7B pump control mss. po not drive or park over, ar athenMSe disturb or compact, ~ yehides over tanks and dispersal lion area. Do not drinre or pa down sloppe of any mound or at-grade soil absorF rformance and prolong the Gfe e,et im ve the Pe 15 f m may Pf ° the area within from the ~tewater strew degr,easem: dental floss: diapers, ReduGaon or el"urination of ttte foita~'9 ~e butts: condoms; cotton swabs; line; gn~-se: herblddPS: meat of the POVYTS: antibiotics:baby wipes: d~ }water, fruit and vegetable peelings, 9 n drain (sump P ns;'and water softener brfine. ~~s~ °i1; paroling p~oduds: pesttades; sanitary napkins: tampo'_ taken out of service the fo[towfng steps shall ~ taken to insure tfiat the ' AgANt)ONMM~T falLS and/or i5 p~anently ch. Comm 83.33, Wisconsin Administratrve Code: YVhen the P'OWTS abandoned in compliance with Wings sealed. system is propedY end ~~~ a Sepfage Servidng Operator. i in to tanks and pits shall be disconnected and the a)sandodned PSG dopey • Ail P p 9 ~ shall be removed and properly Po The contents of all tanks and P shah be excavated and removed or tfieir covers removed and the void space After pumping, alt tanks and P~ Riled y~ soll, gravel or another inert solid material. in provide a code CONTINGENCY PLAN Sired the following measures have been, or must be taken, If the POWfS fails and cannot be rep compliant replacement system: been evaluated and may be utilized for the location of a replan a d should not lacement area should tie protected from disturbance and com p A suibbie replacement area has bon system. The rep sect stnrdure, tot lines and welfs_ Failure to absorP aired 5e~cks from existing and propo be infringed uP°n by n~ III ~,sult in the need for a new soil and site eval a~ that ~m tab~h a suitab e protect the ~Piacernent area stems must comply with the rules in effect a is not available due to setback and/or soil (imitations. Barring advances in POWT replacement area- Replacement sy laCe the failed POVYTS- p A suitable replacement are technology a holding tank may be rnstailed as a fast resort to rep n failure of the POVYTS a coif an ~ to identify a suitable reptaoe~Ttent area Upo ~~e site has not b~ nbee!ral~uated~ ~ locate a suitable replacement area. If no replacement area is available a / site evaluation m l~ a last resort to replace fhe failed PO ace ~liowing removal of the biomat at balding tank may be installed as lion systems may be reconstructed iI Pi~vith the rules in effect at that time. Mound and e s rfaoe.oReoons>~~Ons of such systems must comp y e infiltrativ <cWARNING» -~E~]T TANKS MAY CONTAIN L p~ ANA G RC~MSTpNCES~ DEATH ~YGEN. SEPTIC, PUMP AND OTHER Tir2EA t)O NOT ENTER A Sf°PT'IC, PUMP OR OTHER TREATMENT TANK UN F A PERSON FROM THE INTERIOR OF A TANK MAYBE DIFFICULT OR IMPOSSIBLE RESULT. ,RESCUE O ADDITIONAL COMMENTS _ . POWTS MaNTA1NER POYYTS INSTALLER Narne cam- ) ~ ~~ ~ Name Phone ~/ ~ Phone ~ ~ . `~ =- ~-"t ~ -~ / PUMPER LOCAL REGULATORY AUTHORf~ ~ SEPTAGE Sl=RyiCING OPERATOR Agency Name ~ ~^ ' ~ Phone 7 / ~~ J ~ , Phone ~ ~ ~- ~,,`C b ~~ ~ ~ Thls doament meets ~ sfa~s ~ ~ C[een eke, Manquotte and Waushara County Zoning and San" ~ agende ~ th>s d~rment does not This aocUmenirrds draR9d by t ~ and 83.54(1}. (2) & (3}. Wisconsin Adminis~'re GMw tyot) the mutimum ra4uirements of ch. Comm 83.22{~N)< )~~ ffl guarantee the Performance of the POV1rrS• .ti wrsoonsin Departrnent of Commerce SOIL EVALUA'fiION REPORT Page of t]ivisian of Safety and BuildinAS ___ in actx>roance with ' m. woe --t ~ ~~~ E ~ 'D' r Attach oomptete site plan on paper n~ less than 81/2 x 11 i es in include, tart not flmited to: vertical and horiz~tal reference (BM), direr ion and I.D. 3 - ' 3 ~ ~" est road. o scale or dimensions nortlr arrow, and location dis ercent slo e - Z ~D p B 2 - a~ O p , p M AY ~ 2 ~ ~ ~ ~ ~~ Please print all information. ~ Porsonal i~om,atioo You Provide may be used for secondary ( s. 15.04 (1) (m)). , ~ ZO ~ ~ Uon ~ ~ T N R E{ W , 0/ Q~~ ~ /4 114 S Property Owner' Making address ~ lot # Block # .Name or CSMfE - L~ `~3 0 - r;c City ~ State 7.~ Code Phone Number ^ Cily ^ Viflage Town Nearest Road jtl~ ( ) New Construction tJse: ! Ntarrber of be~ooms Code derBred design tbw rate S O GPD ^ Replacement ^ ~ bflc~ ~ 1- Descn'be: ~) ~" ~ Petard rrr~etial Flood Plain elevation if ap plicable Gerreralcanrrrerris / /a and rtrc>ammeridations: ~~' ~ vT ~.v e !~ d ~ ~ ~ ' S c/ Jl v~`~ Pit Grourxi surface elev. ~ ' Depot to rxn~-9 faces ~~ ~ ~ ~• •a ti l T xture Stnxiure Cortsi Boundary Roots tflorizari ~„ Depth in. ~. „~ DorNriarft Mur~efl r on Redcoc Desa p Qu. Sz Cont. Cobr -- e L.~ Gr. Sz Sh. ~ S~it'~ ~ ~ ~/tea 1 ~ ~~ •-j /~ Pit Ground surface elev R Depth to g factor Soit Rate i ti D R d Texture Stnrcture Corisisteru:e Boundary Roots GP D/PF Florizorr Oeptlr in. Dominant Murrsefl on esa ox p e Gitr. Sz. Cont. Color Gr. Sz Sh. `Eff#1 ~tf#2 ~- 3/Z ~- C, ~ rn~r e,s a ,5 ~'~ ' 2 ,' y ~- c (., k m ~' u, 1~ ~ 2 , 3 ,. y ~- ~~ ~ m ~ m Fr . ~,.~ ~ ~' ~ 5 f q • Effluent #1= BOD > 30 _< 220 m9ll-and TSS >30 < 150 • Effluent ~2 = BOD <_ 30 mgA. and TSS <_ 3t) rrtgH- t ~) csT Number i~ Address Date Evah~ation Condix~ed Teteptgrte Nurttber `~~- o i z Property Owrrer ~efi~~ Parcel ID # Page of ~~ # ^ Boeing ~~~~ Pit Groundsurfaoa elev~%~~'~ ~ it D~th to fimiang factor "r• Solf Rye t~rizon Dep>h Dontinant Redox Description Texhae Sblx~ure Consistence Boundary Roofs GPDItf in. Munseti Qu. Sz Cont Color Gr. Sz. Sh. 'Faf#1 'Elf#2 2 6-xg ~ ~ L ~ ~ a -~~ ~ z `~/~ - m- m F n/~ n . 3 . S # ^ e~ ^ Pit Ground surface elev. ft Depth to limif;ng factor in. Soil man Rate tioriron Depth OomktaM Redox Description Texture Structure Cors;ist~ce Botmdary Roots GPDJIt~ &~. Mur~seN Qu. Sz Cont. Cdor Gr. Sz Sh. _ 'Eff#'t 'Eff#2 oso~# ^ ^ Pit Ground surface elev. ft De~h to limiting factor ~. Rate Fioriaon Depth Oatrmrant Redox Description. Texture SUtx~xe Carsister>ce Bourxiaxl- Roots GPDIfF ~. MunseN llu. Sz CoM. Color Gr. Sz. Sh. 'Eff#1 'Etf#2 • Ettluerrt #1 = BOD, > 30 < 220 mglL and TSS >30 _< 150 mglL ' Etlluerrt #2 =BODE < ~ 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, pleax contact the department at 608-266-3 } 5 } or TTY 608-264-8777. s~es3etrtaoo~ ." ' Soil Test Plot Plan Project Name P.C. Collova Bldrs. Inc. ~ ~ Sha ' d Address P.O. Box 487 Somerset Wi 54025 M #226900 Lot 23 Subdivision Crick Bolton Date 12/4/02 1 /4 NE 1 /4S 18 T 29 N/R17 W Township Hammond Borin 0 Well PL Property Line County ST. CROIX BM RP Assume Elevation 100 ft. =Top of Survey Iron ._-- tem Elevation JOB ~ ~ ~ *HRPSame as Benchmark ~lt. B~_ Top of survey iron @ 9~ R 493' Property Line 395' Property Line 177' Property 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 Property Address (Verification required from Planning Department for new City/State ~,t~.m,~-.~ ~~ Pazcel Identification Number m/g~ 2r1o3 -- 2-3-~~ 9i~) LEGAL DESCRIPTION /C1 ~ ~~ Property Location '/,, %,, Sec. ~,~ . To2q N-R ~ ~' W, Town of ~aar~ Subdivision Lot # Sj~ Certified Survey Map # .Volume ,Page # ~- Warranty Deed # ~ ~ ~' ~U v~ - Volume ~ Page # o"~ - Spec house ^ yes ^ no Lot lines identifiable ^ yes ^ no SYSTEM MAINTENANCE Improper use and maintenance of your septic system could rrsnlt 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, restrictedplumber or a licensedpumperverifying 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 studge. 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 Deparmient 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 the thr expiration date. ~~ P. C. COLLOVA BUILDERS, INC. (715) 247-2742 '~ / / SIGMA OF APPLICANT P•O. Box 489 DATE SOMERSET, WISCONSIN 54025 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 th rty de c ed above, by virtue ofd w~rra~~1ed~~ordrd~~; ~f,pGeds O>~ice. (715) 247-2742 I~v~t+: `( P.0. Box 489 / ~ / SIGNATURE OF APPLICANT SOMERSET, WISCONSIN 54025 DATE ****** Any information that is mis-represented may result in the sanitary permit being revoked by the Zoning Department. ****** ~.. ** Include with this application: a stamped warranty deed from the Register of Deeds office a copy of the certified survey map if reference is made in the warranty deed U 1950P 5281 STATE BAR OF W ISCONSIN FORM 1-1998 WARRANTY DEED I husband and wife .Grantor, and Grantor, for a valuable consic described real estate In St, ~ Wisconsin (the "Property': he following State of Rstum Address P Colbva 8ulbera. Ina x Avenue mood , wl 5401s ~~~ 9~0 9 O)8-1039-20-•000 / 018-1039- 018 1039 80 000 Percal{dentlficetlon Number (PIN) Thls Is not homestead properly. (le) (IS not) Sea Exhibit A attached hereto Together with all appurtenant rights, tlUe 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 Aucust. 2002. ~~ hn J. Iton (SEAL) (SEAL) f AI~~1C -~ %aTE OF WISCO~ Slflnature(s) authentlcated this N~ ~l.(C STA~EI~~--' TITLE: MEMBER STATE BAR OF WISCONSIN (if not, authoNzed by §706.06, Wis. Staley THIS INSTRUMENT WAS DRAFTED BY Cddweil Banker Bumet 1301 Coulee Road Hudson, WI 54016 2-32470 (Signatures may be atrthenticated or aclcrwvvledged. Both are not necessary) • Names of txrsons aktninq in any capacity must he typed or •~ ~,.,.~ arolyn G. alton ACKNOWLEDGMENT t~J 687242 KATHLEEIi R. MALSH REGISTER OF DEEDS ST. CROIX CO.. MI RECEIIBD FOR RECORD 08-16-2002 9:00 AM iIRRRRANIY ~ ~IODT f< REC FEE: 13.00 TRAAS FEE: 1155.00 COPY FEE: CERT COPY FEE: PAGES: 2 Recording Area Stets o} Wisconsin, (SEAL) (SEAL) } ss. St. Croix County Pensonaliy came before me this 1~ day of Aucust. ~0~ the above amed J a and rot D It ba nd Wif w~kL r~ Notary Pubtic, State of Wisconsin My commission u pe anent. (If not, state expiratbn date: ~~5 ~~ .} e2~~ ~~ ~ of 2 OC STATE BAR OF yISCONSIN Wlaconsln Legei Blank Co, Ina yyAy~A~y pF FORM No.1-1998 Milwaukee, Wis. ' ;:; ... ti. ..V.:~r.u'.r1i+." '~'y"""A: iYYV teCfljy. •' , .t ~1'~~~'1Lf11~~f~~I~iSr lY~YMq A part he NE'/. of the Ni= / and I paR of the NW Y. of the NE'/, and in part of the SVb'.'/, of , the N '/. of Section 18, T 29 North, Range 17 West, Town of Hammond, St.Croix County, re partkularty described as: f3 g Section 18; thence S89'33'31"W 372:01 feet a{ang the No thrllne of the NE'r/.thof said Sectl~ 8a thence S89'33'31"W along the North line of the NE % of avid Sectlvn 18 775.94 feet; tlyence S00°52'23"E 250.00 feet; thence S89.33'31'IN 968.24 f+sef:, thence S00°52'23°E 420.00 feet; thence S89'33'31"W 528.00 feet; thence S00°52'23'E along the North-South Quarter Section line of said Sectbn 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°52'23"W NE '/. 330.31 feet; thence N89°33'24`E along the South Ifne of thee NEE% ofithe NE '/. 949 9 feet; thence 1N00'52'24'VI/ 1321.19 feet to the Point of Beg{nnfnQ. c~ t~ g~~M 6 V F~z.L.c~c~ ~ 2 or- ~ °~ /ti~O ~ ~, 5 °S~ ~ ~ ~~ ~ o~~ ~ I ~ ~ / ~~ ~ C / ,~ . 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N N N O ~ -o -o m yy~~f N oy~oQ f~A O 4 7 O O N ~ ~ a ~ N p'7 N n N A N m 3 3 C O~'~.(n7 G7 O fD (n 7 O O S ~ ~ ~ N O j O 7 fD 6r> O O O L ~ ~ o c °: ~ 3 ~ ~ ~ 'o o ~ ~ W C7 ~ n O O N W c m ~ ~ a c. ~ °P cn N W V ~ N W V O ? ~ D m ~~~~ ~ N y j ~ v v a co ~~_+. ~ ~ d ~ K N A ~ O 7 CT M C Z Z ~ D D 0 3 ~ o 3 ~ 3 ~ v m J 0 3 fO o 7 O V d W Q ~ W ~ O ~ o N S fA O C '' 3 'Y 5 .. N n W ~. 0 0 N 8 p Z n ~ ~ M _ ~ ~ .. m ~ 00 W ~ c ~ z a ~ I o ^* 3 z m C~ N ~ ~ ~ < W T C 7 a d :r ~I L7 O '7 O ~• O PVC 1 A fi fp ti ti N O A A ti O pq O~ ~ ~ ~. ~p a ti