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HomeMy WebLinkAbout018-1086-11-000Wisconsin Department of Commerce Safety and Building Division 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 Evenson, Joshua K. Hammond Townshi CST BM Elev: Insp. BM Elev: BM Description: ~ ~ o S~ TANK INFORMATION TYPE MANUFACTURER CAPACITY Septic ~ D~ Dosing ~j 0 C~ Aeration ~ ,. Holding TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Septic Dosin 9 ~ / /-,.~. tG / 1~~ /~ ~ ~~ 1 Aeration Holdin PUMP/SIPHON INFORMATION Manufacturer G-~LJ ~ Demand GPM Model Number TDH Lift 2Z • Friction Loss System Head o (o~~ TDH Ft .(v Forcemain Leng ' Di~~7 Dist. to Well ~/ J SOIL ABSOR TION SYSTEM ELEVATION DATA County: St. Croix Sanitary Permit No: 408253 0 State Plan ID No: Parcel Tax No: 018-1086-11-000 STA ION BS HI FS ELE v Benchmar z ~ Z . 3 /a .3 bo Alt: ~Yc~it J6 ~~Q/L_ Sr ~~ j i . ?S Bldg. Sewer 93.37 t Inlet St/Ht Outlet ~ D~ 90 ~~ Dt Inlet ~ O ~ Dtftot'(m~ .~S ~O / ~ . D Heade~r/Mt ant a- d ~ ~ ~ , ,~ Dist. Pipe l 0' ~ ' - (). (~i 3 g.7 I ,r1 °, 3. Z Bot. System c7 3 g .3 S 92. ~~ Fin rad l~du°~i- - ~S~-• 9 . ~f b St Cover ~/• S~ / /3 z3 3.~3 g jd zsOZ. L /~!. y .i I L ~ 63 4~l ; 3-~ 3:3 q2.(c BED/TRENCH Width r Length No. Of Tr ches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS ~ ~7 S I / / SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEA anufacturer: INFORMATION CHAMB T Of S t / ype em: ys / 2r ry~ ,r \ ~~~ i ~ IT Model Num U1.7 I RIDV I rV1V J T J I CIYI ~a>/ oj-h-zow~,~ i (~`+ ~,yy Header/Manifold Length / Dia 2 a Distributi~on/ ) ~ L n gth / ~' t Dia I ~ ~ /' Spacing x Hole Size ~ ~ `/ x Hole Spacing ~ ' V/e~nt,t~o~A/iryl ~~ ke " " - `" ' SOIL COVER x Pressure Systems Only x~Mour~d~r At-Grade Systems Only (0 ~ fps.. -~YcSH-. ids Depth Over ,+- Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center / ~~ - 4 6 BedlTrench Edges Topsoil i~ Yes o ~ Yes o ~ COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1:~/ j ~~ Inspection #2: / / ' Location: 885 162nd Str~{e~t~~Ham,~m~ondl,~W/I 54015 (NW 1/4 NW 1/4 2/0 T29N R17W)1Hammond Oaks/~ of Parcel No: 20.29.17.631,,~ / 1.) Alt BM Description ~~~`~"""-"~'v~-~'r ~ r ~~ 7~e sr~t~ IWQf yW( ~k~~~~~ 'dvr ~9~p~w„y 0~... l%L5~ Z , /t1 ao 2. Bld sewer len th = ~iSL~i~nrGO Y~te.-e WG/~- X~e e~/'Yl~-5 orf ~it~ ~7~ ~ f 9 9 ~t1 t ~ ~G SF r~r - -amount of cover = j ~ /( ~-- ~ /~~ ~"i~cf f'jo~ d63~r yt~.`n.,_ ~j ~([Or IM~t wt~ ~ 1~~ ~ 'T eb vcvr`k /'tJQ4i 3.) Contour = ~ ~ / ~`f~ Y~.~~,~}~~ ` ~ 0. W..G S S Cc~ ~ jU ~~ ~~ ~ ~s • al , l / ~.L 0-y~, jOl'ZS~ _ _ I / _.._- - - - -- --- --- - - - Plan revision Required I Yes ,_ o (/ ` ~ r - information. III ~' 1 ~ ~ _, ~~(i!/Vt/yr - - ~ ~ `S S~ _- Use other side for additional ___ ~ _ __ _ _ __ Date ~( ~.~, Insepctor's Signatu e l `/ Cert. No. 8D-6710 (R.3/97) (/ J - _ _ / ~C b!~-E~- ~,~-~J~ ,~1~j~---~` e Q_ ,,,, (~t~/ ~f1(~- .~~ Safety and Buildings Division COt1°ty 201 W. Washington Ave., P.O. Box 7162 n ` ~CO~~~+/N Madison, WI 53707 _7162 SiteAOddGress Mrs' De ~ tment of Commerce - 0 Z .j-S~j~ oo's ~~Z' Sutitary Permit Number Sanitary Permit Application ~ g2~ In accord with Comm 83.21, Wis. Adm. Code, personal information you provide ^ Check if Revision tna be used for seco ses Privac Law, a15. 1 m State plan I.D. Ntunber I. Application Information -Please Print All Information 2 9 ~ t. /9.-~ property Owner's Name RECEIVED Parcel Number Property Location / ~ I property Owner's Mailing Address J U L 1 6 2002 ' (p' ~ ~ L~l City, Statc Gip Codc S . ~I~I~E>)P~NTY Lot Number k3lvck N tuber ONING OFFICE _ . _. , . _. ,,,,,, ,,.._~_ II. Type of Building check all that apply) ^Ciry -Number of Bedrooms ~ lli D i ^Village ng we ly 1 or 2 Fam ib U ^To~~P sc e ^ publiclCotnme ial -Descr ' cl 1 t tt ^ State ~~ ~A ~ L _ _ _ ~ q"3 , 3 l~`-~l ~,,n~ " p~ g3 I l Nearest Road lII. Type of rmit: (Check only one box on lin A (numbering scheme for internal use). Complete line B if applicable) A I ~ New 2 ^ Replacement System 3 ^ Replacetnem of 6 ^ Addition to ' For Cottaty use Ta nk Onl sum Eris S stem Date Issued B. ^ Check if Sanitary Permit Previously lssued Permit Number oO ~ IV. Type of Permit: (Check all that apply)(numbering scheme is for internal useNt; I 44 ^ Non -Pressurized In-Grotmd 21~ Mound 47 ^ Sand Filter 50 ^ Constructed Wedand 22 ^ Pressurizcd In-Ground 41 ^ Holding Tank 48 ^ Single Pass S1 ^ Drip Line 45 ^ At-Grade 4f7 U Aerobic Treatrnent Urut ay u KU:uwiauug - - V. Dis rsal/Treatment Area Infotvnation: Design Flow (gpd) Dispersal Area Dispersal Area Soil Application Percolation Rate System Elevation Final Grade Elevation Required proposed Race(Gals./Days/Sq.Ft.) (Min./Inch) , ~ Tank Info Capacity in Total Number Gallons Gallons of Tanks Site Manufacturer / Prefab f ~_ ~ '/~,~° Concreu Constructed Steel Fiber Plastic Glass New Existing Tanks Tanks Septic or Holding Tank ,- Dosing Clamber 4 .~ _ R nsibIlity Statement- I, the undersigned, rtispoasibility for installation of the POW'I5 shown on the attached plans. VII . Plumber's nine ) Plumber' Signs MP/MPRS Number Business Phone Number /S - m s s '..~I ~ PI bet's ddress ( t, Ciry, State, Zi odc) VIII. Count /De artment Use Onl Sanitary Permit Fce (includes Groundwater Date Issued lssui Agem Signature (No Stamps) Approved ^ Disapproved Surcharge Fee) ~ / ~- ~9 ^ Owner Given Initial Adverse c 2 ' J ' Determination . ~ IX. Conditions of Approval/R aso for tap nova ~,~ e~-~~~ - ~`~o ~~-~~ pt~,..-b Sys. ~ ~~ ' ` ~ [~, - ~- t ~ Y~tl.l C9Y f r"~ ' t'~ t ~ ~ S.4~IOOu " ' ,, n ~ Q, /~ ~,.~ne , r , / .._ ~_.._~ __~..~ . .~ ..d.m nn eaoe~ not less than EI/2 x 11 Iacha iv size /1 ~~ r ~- ~~~~ '~'. `tea"' I~tA. _ ~ ~ ~ ~ ~„~ SBD (R. 05/01) spec` 'C S , I f ~S lr ~, \~~~ \ h L .~ ~ ~ o~ v ~ ~ ` ' ~ 4 V ~c r~ ~ Z~ ~~ ~~ R i ,d ~ ~ ~ ~~ A ~~ \1 ~ ` v a ~ ~v ~_ ~` h, ~ ~' ~O Tr, c ~ ~ ~~ ~ ~ ~ y~~ •L, .. ~. ,.,, ~ J ~ [..{, ~\ \ v, ~, ~ k"~., r ~ ~~ h n; ~~ G. c \~ c ~" ~:, ,,. >_ ti v fJ 1 v ~ ~ ~scons~n I~EC~i~~~~ Department of Commerce °°i-'~ 0 9 2002 ST. C~tiii_k CUUi~; j ~ ZONING O~ Fi~~ July 09, 2002 CUST ID No.224263 KIM A O'CONNELL K.O. CONSTRUCTION 504 3RD AVE OSCEOLA WI 54020 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 07/09/2004 SITE: Joshua Evenson Hwy 12 & 160TH St Safety and Buildings 10541 N RANCH ROAD HAYWARD WI 54843 TDD #: (608) 264-8777 www. commerce.state.wi. us/sb www.wisconsin.gov Scott McCallum, Governor Philip Edw. Albert, Secretary ATTN: POWTS Inspector ZONING OFFICE ST CROIX COUNTY SPIA 1101 CARMICHAEL RD HUDSON WI 54016 :Identification Numbers ~ Town of Hammond St Croix County NW1/4, NW1/4, 520, T29N, R1 Transaction ID No. 762969 Site ID No. 646723 Please refer to both identification numbers, above, in all correspondence with the agency. FOR: New mound, 450 GPD Object Type: POWT System Regulated Object ID No.: 857852 The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. The following conditions shall be met during construction or installation and prior to occupancy or use: General Approval Conditions: • This system is to be constructed and located in accordance with the enclosed approved plans and with the "Mound Component Manual for Septic Tank Effluent for Private Onsite Wastewater Systems" SBD-10691-P (N.01/01) and SSWMP Publication 9.6, "Design Of Pressurized Distribution Networks For Septic Tank- Soil Absorption Systems." • In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard, the.property owner must follow the contingency plan as described in the approved plans. In addition, the owner must insure that the operation, maintenance and monitoring duties as described in section VIII of the mound component manual are complied with. A copy of this information must be given to the owner upon completion of the project. • 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. KIM A O'CONNELL Page 2 7/9/02 • Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stats. • The maintenance plan for this system must be given to the owner of the POWTS. Key item(s) • A copy of this approval letter and index sheet shall be attached to plans that correspond with the copy on file with the Department. Changes to the approved plan must be submitted for review and approval. Failure to properly attach the approval and index page to plans that match the copy on file with the Department may result in enforcement action under s. 145.10, Stats. Note • The designer proposes to install a state approved effluent filter to achieve the requirement of wastewater particle size. Pursuant to outlet filter product approval stipulations, maintenance information must be given to the owner of the POWTS explaining that periodic cleaning of the effluent filter is required. The access opening used to service the filter shall terminate at or above finished grade with a watertight cover. Reminder • The orientation of the mound system must be such that the longest dimension is oriented along the surface contour per COMM 83.44(6)(a)2. • Limit activities in the area 15' beyond the down slope edge of the mound per Mound Component Manual. • Surface water drainage shall be diverted away from the system area per Mound Component Manual. • Materials shall conform to the requirements of COMM 84. • Maintain well and waterline set backs per COMM 83.43(8)(1). • Provide frost protection per COMM 83.43(8)(c). 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. 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, KIM A O'CONNELL Patricia L Shandorf POWTS Plan Reviewer ,Integrated Services (715) 634-7810, Fax: (715) 634-5150 , M-F 7:45 am - 4:30 pm pshandorf@commerce.state.wi.us Page 3 719/02 Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 WiSMART code: 7633 cc: Leroy G Jansky ,Wastewater Specialist, (715) 726-2544 „ r S - _ ! ' ~ ~ ~scons~n Department of Commerce Safety and Buildings 10541 N RANCH ROAD HAYWARD WI 54843 TDD #: (608) 264-8777 www.commerce.state.wi. us/sb www.wisconsin.gov Scott McCallum, Governor Philip Edw. Albert, Secretary July 09, 2002 CUST ID No.224263 KIM A OjCONNELL K.O. CONSTRUCTION 504 3RD AVE OSCEOLA WI 54020 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 07/09/2004 ATTN: POWTS Inspector ZONING OFFICE ST CROIX COUNTY SPIA 1101 CARMICHAEL RD HUDSON WI 54016 SITE: Joshua Everson Hwy 12 & 160TH St Town of Hammond St Croix County NW 1/4, NW 1/4, S20, T29N, R17W FOR: New mound, 450 GPD Object Type: POWT System Regulated Object ID No.: 857852 Identification. Numbers Transaction ID No. 762969 Site ID No. 646723 Please refer. to both: identification numbers, above,. in all: cones ondence with,the a enc . The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. The following conditions shall be met during construction or installation and prior to occupancy or use: General Approval Conditions: • This system is to be constructed and located in accordance with the enclosed approved plans and with the "Mound Component Manual for Septic Tank Effluent for Private Onsite Wastewater Systems" SBD-10691-P ( N.O1/O1) and SSWMP Publication 9.6, "Design Of Pressurized Distribution Networks For Septic Tank- Soil Absorption Systems." • In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazazd, the property owner must follow the contingency plan as described in the approved plans. In addition, the owner must insure that the operation, maintenance and monitoring duties as described in section VIII of the mound component manual aze complied with. A copy of this information must be given to the owner upon completion of the project. • A Sanitary Permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.135 and 145.19, Wis. Stats. • Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stats. • The maintenance plan for this system must be given to the owner of the POWTS. Key Item(s) • A copy of this approval letter and index sheet shall be attached to plans that correspond with the copy on file with the Department. Changes to the approved plan must be submitted for review and approval. Failure to properly attach the approval and index page to plans that match the copy on file with the Department may result in enforcement action under s. 145.10, Stats. G~ SEI T 1 KIM A O'CONNEI.L. Page 2 7/9/02 Note • The designer proposes to install a state approved effluent filter to achieve the requirement of wastewater particle size. Pursuant to outlet filter product approval stipulations, maintenance information must be given to the owner of the POWTS explaining that periodic cleaning of the effluent filter is required. The access opening used to service the filter shall terminate at or above finished grade with a watertight cover. Reminder • The orientation of the mound system must be such that the longest dimension is oriented along the surface contour per COMM 83.44(6)(a)2. • Limit activities in the area 15' beyond the down slope edge of the mound per Mound Component Manual. • Surface water drainage shall be diverted away from the system area per Mound Component Manual. • Materials shall conform to the requirements of COMM 84. • Maintain well and waterline set backs per COMM 83.43(8)(1). • Provide frost protection per COMM 83.43(8)(c). 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. 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 Siiy others who are responsible for the installation, operation or maintenance'of the POWTS. ' Sincer f, Fee Required $ 175.00 _. ~ " Fee Received $ 175.00 ~._. % - ~; - Balance Due $ 0.00 {_,..---~ ~~ 1 %""~at~i"cia L Shandorf ~"~ POWTS Plan Reviewer , Integr ed rvices WiSMART code:'7633 (715) 634-7810, Fax: (715) 634-5150 , M-F 7:45 am - 4:30 pm pshandorf @ commerce. state. wi. us cc: Leroy G Jansky ,Wastewater Specialist, (715) 726-2544 MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Project Name: JOSHUA K EVENSON Owner's Name: JOSHUA K EVENSON Owner's Address: 818 SUMMIT LANE NORTH HUDSON WI 54016 Legal Description; NW-NW SEC 20-T29N-R17W Township: HAMMOND County: ST. CROIX Subdivision Name; HAMMOND OAKS Lot Number: 11 Block Number: Parcel I.D. Number: Plan Transaction No : ~IZC~ltlO Page 1 Index and title Page 2 Data entry tTMENT Rt Page 3 Mound drawings Y BUILT Page 4 Lateral and dose tank Page 5 System maintenance specificationSRRESPO EN Page 6 Management and contingency plan Page 7 Pump curve and specifications 7~0~ G Page 8 PLOT PLAN Designer: KIM A OCO NELL License Number: 224263 Date: 06/16/02 Phone Number: 715-755-3145 Signature: Designed Pursuant to the Mound Component Manual for POWTS Version 2.0 SDB-10691-P (N. 01/01), and SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST-SAS (01/81) Version 3.0 (03/01/01) Page 1 of 8 Mound and Pressure Distribution Component Desinn Design Worksheet Site Inform ation (r or c) R Residential or Commercial Design 300.00 Estimated Wastewater Flow (gpd) 1.50 NeaKing ractor (e.g. 1.b = 15U~/o) 450.00 Design Flow (gpd) t.vv vnv vlvNo ~ /v/ 93.30 Contour Line Elevation (ft) 25.00 11Rnth to 1 imitinn Fart~r (inl 0.40 In-situ Soil Application Rate (gpd/ft2) Distribution Cell Information 75.00 Dispersal Cell Length Along Contour (ft) _ 1.00 Dispersal Celi Design Loading Rate (gpd/ft2) 1 Influent Wastewater Quality (1 or 2) rressura uisrii~uiion inionnaii~n (c or e) Center or End Manifold I3 nnl f~ I ~4crfll Cn~/+inn /ff1 .. ,.r,.......~ ~../ 2 Number of Laterals ~~~°` 0.125 Orifice Diameter (in} (e.q. 0.25) 3.00 Estimated Orifice Spacing (ft) _ 2.00 Forcemain Diameter (in) ~j2"' / S 55.00 Forcemain Length (ft) ~ 83.80 Pump Tank Elevation (ft) ! 6.50 System Head (ft) x 1.3 .~ 9.92 Vertical Lift (ft) 0.53 Friction Loss (ft) 16.95 Total Dynamic Head (ft) Lateral Diameter Selection in. dia. ,o tons choice 0.75 ~~ 1. uu 1.25 x A C!1 I.VV A n 2.00 x 3.00 x Treatment Tank Information 1000.00 Septic Tank Capacity (gal) WEEKS Manufacturer Dose Tank Information VVV.VV ..rvuo 1 GI If\ VGr./GVI.r ~aGl/ 21.76 Dose Tank Volume (gal/in) WEEKS Manufacturer Note: Sand fill (D) calculations assume a Table 83-44-3 in-situ soil treatment for fecal col'rform of <= 36 inches. I I 6.00 Cell Width (ft) Are the laterals the highest oint in the distribution Y ~ iaiwui k % Enter Y or N If AI ~Ir+_yc cntcr 4hw ulc~io4i:n /fF1 ~, . of the highest point. 9.00 ft2/orifice Does the forcemain drain back? Y Enter Y or N 8.97 Forcemain Drainback (gal) 67.38 5x Void Volume (gal) 76.36 Minimum Dose Volume (gal) 20.60 System Demand (gpm) Manifold in. dia. Diameter nations Selection choice 1.25 x '1.511 2.00 x 7 (11'1 V.VV Gallons/Inch Calculator (optional) 800.00 Total Tank Capacity (gal) 37.00 Total Working Liquid Depth (in) 21.62 gal/in (enter result in cell 649) Effluent Fitter Information 7..L...1 C:I{~.r ~ A.. r.. d•.w{..-... LGVGI 1 Illpl 11IIG1 141GV~M1 OI A100 Filter Model Number Project; JOSHUA K EVENSON Page 2 of 8 Mound Plan View T ~ 1 ~ L Mound Component Dimensions Down slo a toe extension made. A 6.00 ft E 13.88 in H 1.00 ft K 8.49 ft B 75.00 ft F 9.50 in I 9.00 ft L 91.97 ft D 11.00 in G 0.50 ft J 5.92 ft W 20.92 ft 450.00 (ft2) Dispersal Cell Area 1125.00 (ft2) Basal Area Available 6.00 (gpd/ft)' Linear Loading Rate 7.50 (ft) 1110 B Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area Finished Grade .- 1F 94.22 (ft) ---- -- uispersai Geii Elevation n. Shading Key ~ ~ ~ ~~ r-, U i opsoii Gap , S :~ i .5 i`i © """"' Subsoil Cap ~ ~ rn ~ ~: ,;gT~~ C33 Surd ~ ~ ~ ~ . 0 5 ft Tilled Layer ~ I . ~ 11 n ~ Aggregate ~ 1 Project: JOSHUA K EVENSON ~I Dispersal Cell ---- A f 94.72 (ft) Lateral Invert 30 (ft) Contour Elevation /"` Geotextile Fabric Cover ,/ See lateral details on T Nage 4 for number, size, and spacing of r r I..~.....I.. 1 a.. I.. IQ101 q10. L.Q lOrQ 10 OI O equally spaced from tha diatrib~ition calla -~f- centerline in the distribution cell (AxB). Page 3 of 8 4.0 °~ Site Slope End Connection Lateral Layout Diagram Laterals centered aver the dimension ~ =Turn-up wVbell value or oleanoutplup `I All laterals are idsntioal ~F }~--,1I Hol •s drillsd on the bottom of the lateral 1 squally spaoed S FOrOQ main oonneotion pia the or oross to manifold at any point. Laterals & forov main of PYC Soh 40 (per COMM Teble 84.30-ti) Number of Laterals 2 Orifice Diameter Lateral Diameter 1.50 in Orifice Spacing (X) Lateral Length (P) 73.44 ft Orifices per lateral Lateral Spacing (S) 3.00 ft Orifice Density Lateral Flow Rate 10.30 gpm Manifold Length System Flow Rate 20.60 gpm Manifold Diameter Total Dynamic Head 16.95 ft Forcemain Velocity 0.125 in 3.06 ft 9.00 ft2/orifice 3.00 ft 2.00 in 2.10 ft/sec Dose Tank Information Electrical as per NEC 300 and ---- Comm 16.28 WAC Disconnect Locking cover with warning label and locking devioe and sealed watertight 4 in. min. Tank component is properly vented WEEKS Ca acit 800.00 ~ \/nli_rrl_a ~ 21 7F~ Manufacturer Gallons r~gl/inch -r A B --~- T D Dimension Inches Gallons A 18. 403.57 B _ 2.00 5 43.52 C 4.22 9 9 D 12.00 261.12 T - ~ - ~ ( rural ( A 36.r'ol I1l~I~ I\I~ ouu.vul '~" Rcrlri Alarm Manuafacturer SJ ELECTRO Alarm Model Number HW 100 Pumn Manufacturer (~(~l 11 nS Pump Model Number (WE0311 L ~~~ Pump Must Deliver 20.60 gpm at 16.95 ft TDH Project: JOSHUA K EVENSON E- ARemate outlet location Forcemain diameter ~ 2 in. Weep hole or anti- siphon device ~ Pump off elevation tt) u D~, ose tank elevatlon tt) _ RR Rr1 Page 4 of 8 Mound System Maintenance and Operation Specifications Service Provider's Name (- KIM A OCONNELL Phone 715-755-3145 POWTS Regulator's Name ~ ., ST. CROiX COUNTY ZONING Phone 715-386-4680 Svst~ Flow and Load Parameters Design Flow -Peak 450 gpd Maximum Influent Particle Size 1/8 in Estimated Fiow -Average 300 gpd Maximum BODS 220 mg/L Septic Tank Capacity 1000 gal Maximum TSS 150 mg/L Soil Absorption Component Size 450 ft2 Maximum FOG 30 mg/L Type of Wastewater Domestic Maximum Fecal Coliform >10E4 cfu/100 mL Service Frepuencv Septic "and Pump Tank Effluent Filter Pump and Controls Alarm Pressure System Mouno Other Ins ect and/or service once eve 3 ears Should ins ect and clean at least once eve 3 ears Test once eve 3 ears Should test month) Laterals should be flushed and ressure tested eve 1.5 ears Ins ect for onoin and see a e once eve ~ ears Miscellaneous Construction and Materials Standards 1. Observation pipes are slotted and materials conform to Table Comm 84.30-1, have a watertight cap, and are secured in as shown in the mound component manual. 2. Dispersal cell aggregate conforms to Comm 84.30 (6)(i), Wis. Adm. Code. 3. All gravity and pressure piping materials conform to the requirements in Comm 84, Wis. Adm. Code. 4. Tillage of the basal area is accomplished with a mold board or chisel plow. 5. The mound structure and other disturbed areas will be seeded and mulched to prevent soil erosion and help reduce frost penetration. Lateral Turn•up Detail Finished ...,~~~.,~,..... •~~~~~~~~~~~~~• Grade ~ ~1 ................. 6-8" Diameter Lawn Threaded Cleanout Sprinkler Valve Box ff Plug or Bali Valve uiauiuuuvii ......."....... ....".......... Lateral Lonp Sweep 90 or Two ~ ~ ~ 45 Degree Bends Same Diameter as Lateral Project: JOSHUA K EVENSON Page 5 of 8 Mound System Management Plan Pursuant to Comm 83.54, Wis. Adm. Code ~~ This system shall be operated in accordance with Comm 82-84 Wis. Adm. Code, and shall maintained in accordance with its' component manuals [SBD-10691-P (N.01l01) and SSWMP Publication 9.6 (01/81)) and local or state rules pertaining to system maintenance and maintenance reporting. No one should ever enter a septic or pump tank since dangerous gases may be present that could cause death. Septic and pump tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the tanks are no longer used as POWTS components. Septic or pump tank manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subJeot to failure must be replaced. Exposed access openings greater than 8-inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into a tank or component. Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Stets. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code. The operating condition of the septic tank and outlet filter shall be assessed at least once every 3 years by inspection. The outlet filter shall be leaned as necessary to ensure proper operation. The flRer cartridge should not be removed unless provisions are made to retain solids in the tank that may slough off the filter when removed from its enclosure. If the fitter is equipped with an alarm, the fitter shall be serviced if the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an impending continuous alarm. The septic tank shall have its contents removed when the volume of sludge and scum in the tank exceeds 113 the liquid volume of the tank. If the contenrts of the tank are not removed at the time of a triennial assessment, maintenance personnel shall advise the owner of when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank. The addition of biological or chemical additives to enhance septic tank performance is generally not required. However, if such products are used they shall be approved for septic tank use by the Department of Commerce. Pump Tank The pump (dosing) tank shall be inspected at least once every 3 years. AA switches, alarms, and pumps shall be tested to verify proper operation. If an effluent filter is installed within the tank it shall be inspected and serviced as necessary. Mound and Pressure Distribution Svstem No trees or shrubs should be planted on the mound. Plantings may be made around the mound's perimeter, and the mound shah be seeded end mulched as necessary to prevent erosion and to provide some protection from host penetration. Traffic (other than for vegetstlve maintenance) on the mound is not recommended since soil compaction may hinder aeration of the infiltrative surface within the mound and snow compaction to the winter will promote frost penetration. Cold weather lnstaAations (October-February) dictate that tine mound be heaviy mulched as protection from freezing. Influent quality into the mound system may not exceed 220 mg/L GODS, 150 mg/L TSS, and 30 mg/L FOG for septic tank effluent or 30 mglL BODE, 30 mg/L TSS, 10 mglL FOG, and 104 cfu/100 mL for highly treated effluent. Influent flow may not exceed maximum design flow specified in the permit for this installation. The pressure distribution system is provided with a flushing point at the end of each lateral, and it is recommended that each lateral be flushed of accumulated soNds at least once every 18 months. When a pressure test is performed it should be compared to the Initial test when the system was instaded to determine if orifice dogging has occurred and if orifice leaning is requMed to mafMatn equal distribution witl~in the dispersal cell. Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the owner, and any levels above 6 inches considered as an impending hydraulic (allure requiring additional, more frequent monitoring. CoMinaencv Plan If the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep the system in proper operating condition. If the dosing tank, pump, pump controls, alarm or related wiring becomes defective the defective componerrt(s) shall be immediately repaired or replaced with a component of the same or equal performance. If the mound component fails to accept wastewater or begins to discharge wastewater to the ground surface, it will be repaired or replaced in its' present location by increasing basal area if toe leakage occurs or by removing biologicaly dogged absorption and dispersal media, and related piping, and repladng said components as deemed necessary to bring the system Into proper operating condNlon. See Page 6 of this plan for the name and telephone number of your local POWTS regulator and seMce provider. Project: JOSHUA K EVENSON Page 6 of 8 -~ Performance Curves METERS FEET r 25 ~- t UJ ~ i !U S 2U 60 o i 5U t5r ap t G i- 30 2U 5 - ,, 0 ~~aamers~t~~e ~ttt~uer~ Pumps , ' r M O D E L 3885 ~ - --,- -- ~ , " Solids SIZE 3/ __-- I L__ '_. ~ a WE15N ~--` -~-~-~ - ,.. ., ._. --- .~ _. ... __~_ ... - T ,...._ - '~.. I .. - --- ~ ~~ i I ~WFU5i~t __.1~_,1 ....__. _._ ~ I WE03L ~ ,_._. ,_.. -._~ _1 ---~-r ~..~_T.,_ ~_.-_.____-~ ~ r__..._._.__.._ I i I 2C r. 50 60 70 80 SO 100 110 12C GPM 0 ~ 0 20 ~0 m'/h - CAPACITY ~GOULDS PUMPS, INC. SB~EU pus raw rCCx urn METERS FEET i2 35 It ~0 30 ~- I 9 25 !- N Q 7. I 20 r J r 60 O I 50 t5j- a0 I t 0 ir- 30 i 2U 5 t0 0~ 0 ; _-- - ,__. ~__. __ I _~_.,_-..i ~--. __. .-;.... ,._. _..~.... _~.~. M 0 D E L 3885 SIZE ~/," Solids ... ,_~ f '.. ,_ ,. I__. 1 ._ _ _ ..,_.._, F--~--- i--r--~- ~ -t--f-- -,----i ._ , _._ - ~-_ --f - ~ ^---r i wEOSHH ~~- -,-_j~_ ~ ~ t C --,.. ,_ I_., __. ~ __ ~.~_...~ ..__,_~~ I h.. _.,___~- i .._ i ... -~- ---~-- ......L_. ... __.._ ~ .. ._. . i -°- r'-~ --~--i- . .~ -" f _~I 0 n 0 '~0 U --.. n1885 (300109 Pumps, Inc. cv w Qv ou tiU 70 80 90 100 110 120 OPM _...-- .__.. __ .0 ,._...__.._..._.._._..._ ___..__.._..._._l-,.._ ~ 2U 90 m~/h CAPACITY EflK7Y~~ Jvry. 1 io: ~• ~ c~a_: ------- ~ 3 G \ ~ ~' ~- ,~~~~~ ~~~z .~ ~~ ~~~~ ~. ~ \ r `~~~ y*~\ ~~ V ` R. ~. ~, ~~ ~' ~~' `'~ ~ ~ ~U C,~ a~ ~ ~ ~' b ~~, ~ +~, h~ ~~ ~ ~; \J h C- ?\ V ,~ Wisconsin Department of Industry, Labor and Human Relations Division of Safety and Buildings SOIL AND SITE EVALUATION in accordance with ,Hf$ 8~.q'~ Ni'is. .' ,, ~ . ' ,.~ Couniy.. Attach complete site plan on paper not less than 8 1/2 x 11 inches in size Trust,., , ,. _ `: include, but not limited to: vertical and horizontal reference point (BM), rec~n and " ~• ~ ' ~, percent stops, scale or dimensions, north arrow, and location and dista ce to nearest road. ~ r parcel I.D. ( t , ;- ~ _ _ i ... _ APPLICANT INFORMATION -Please print all information. ~ r , ,;; Reviewed i t . , ~,'~~1'' ! -~' ~ Personal information you provide may be used for secondary purposes (Privacy La '"§. 18.04 (1 ~(rr~ ~: - ., SOIL DESCRI PTION RE PORT Horiz n De th Dominant Color Mottles Structure d R t GPD/flz o p in. Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. Consistence ary Boun oo s Bed ,Trench ~ o•y /oyR 3(3 - L / fS~bi~ S w /f ~ .S f. 3 ~ - SiC• Z sb~ ds~. - . s ~ • ~ ~ !L Page / of • YU • CTCJ .s[7 • ~~ Date Property Owner t.,~ V H Q ~ E-p L~II~ Q b C~/p~ 'Property Locatw~,n~ - ` .. u f • ovt,4ofi _ f~ ` ~/r 1/4,S ~ T~~ ,N,R /, E (or) W Property Owner's Mailing Address Lot # Subd. Name or CSM# 332- h i ~N~SoT~4 ST• E~15 T I yo ~ ~ l ~M~toND o~'1-~j' City Staute Ziep~Code Phone/Number ~ Nearest Road kJ ~ ~.. ~JT• (,~ ~- /-r Ili . J s~ 0 I ~ SOS! )2 Z Z • S~SS ^ City ^ Village Town qt,~ (~I d [+~'fJew Construction Use: L~rresidential /Number of bedrooms 3 Addition to existing building ^ Replacement ^ Public or commercial -Describe: Code derived daily flow y5'v gpd Recommended design loading rate • ~ bed, gpd/ftz 's trench, gpd/fl2 Absorption area required bed, ft2 trench', ft2 Maximum design loading rate bed, gpd/ft~ ~ trench, gpd/ft2 Recommended infiltration surface elevation(s) Su J ft (as referred to site plan benchmark) Additional design/site considerations ,/ Parent material ~D E'sS ~ Ua~ QEN.SL~ T/ ~~f Flood plain elevation, if applicable N~T ft S = Suitable for system Conventi~on/al Mod In-Ground,P~resys re AT-Grad~e,~ System in Fil/l Holding T~ U = Unsuitable for system ^ S L/I U U s ^ U ^ S L~'U ^ S Lr1 U ^ S L~'U ^ S Boring # -- Ground elev. '3.~ft. Depth to limiting factor ~~in. Boring # Z~ _..: Ground elev. 5 ~ eft. • Depth to limiting Remarks: ~ • / 3 SQL z~s ~.. . S ; . ~ vii ! v SGG d ,~. .~~. - LiPOi ~ ~/~' ~ factor Z,.~_in. Remarks: g, {~ CST Name (Please Print) R~l3~RT Ntl~~lG~~' Signature Address Telephone No. ~~s• 38G • ~~ ~ •s Ulbricht >3< Associates Private ew 655 O'Neil Rd. ~ ~^~ Q Date CST Number ~it1, l ~ /S'S~ ~z.4375 ',~ U~'1 ~ 1 ~~ `~'~~ SOIL DESCRIPTION REPORT „3 PROPERTY OWNER Page ~' of '' ,-~ cSi4 ~ S S n g fl PARCEL I.D.N G ~ I ~/ " AH 0 ~~ Boring # `3 Ground elev. ~y att. Depth to Limiting factor ~~in. Boring # Ground elev. tt. Depth to limiting factor in. Boring # Ground elev. tt. Horizon Depth Dominant Color Mottles T t Structure i C t Bo d R ts 2 in. Munsell ' Qu. Sz. Cont. Color ure ex Gr. Sz. Sh. ons ence s un ary oo Bed ,Trench f ~8 / 3 ~ ~- I ~s ds w ~-F ~ , s z io / s~ -~ ~S - ~ . s / . 2 ~---- $! ~ L !o Vii" G . . S.. ~ ~ L . Remarks: Remarks: Horizon Depth Dominant Color ' Mottles Structure C i B d t R GPD/tt2 in. Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. ons stence oun ary s oo Bed ,Trench • .--~- Depth to limiting factor in. Boring.# Ground elev. ft. Depth to limiting factor , ,, ---'n' Remarks: sBDw-s33o (R. ot3/95) Remarks:_ ~~ ~~.3°-F3 Ulbricht 8 Associates Private Sewage Consultants 655 O'Neil Rd. Hudson, Wis. 54018 ~sTz~3~S L-O T // scf}G~ . ,~ l7 / • / =3 J s ~~~ ~3 r • - 88 ~ Z . ~ 2~ - -------- . ~'. L . ~~/'' ~ N ~a Zl ~.3 30 ~ ~ 3 0 (~ r M D U.uv Sys T' ' w ''S~,u~ ~y, 3v ~ # 2 st r /~- _ ~o I~ ply ~y 1'2~13,t2661 6t3:~32 715'2473638 BEEISLE EXC~U~TING I PHGE 61 ~ ' ' ~T tv'R~IX .COUNTY SEPTIC TANK -M~IN'~`~I~i,~I~(CE .~GiFC1~M~N? AND UWN_E-FtSHIP TIFTCATI~N -P(3-RM OwnerBtayer ~ ~Q~/'t~l,~' K, . [~ U ~d^l:S© N Mailing, -Acldress -U d~Z BUD l~,S //Il<.z' , .~ PrQpetxy Adores QtS.~ ~/~ ~p ~~ v (Ytrificatipr rewired faom Pian~i~ II~par4~t~~nt ~'pc nc~v con~truction:)~~ ,,.,, CitylStaire~fJL~I.?~'~Patrel idenzificaiiat:I~Iumber ~,~`„~Q,~'~ ~ /~ O~ PT Property Lorttticus -'/~, „~,~, '~, -Sec. , T Iii-R W, ~'o4vn tzf _.~~i~xzA~....-,,..• _- ~~rttf9ed Sisrv~y -l~iap # '~" ; Yoltrrrrc _.---, Page -# V~darr-aaty Domed -# _ ~c+~"~ 33i V~I~n?e ~ ~3 Page # Z! ~ -- x Spec -house !] ~~s~~i no Lsrt ;trines i~errtif.ablc~yes C~ s~o 9Y3T~1~ A~~IN~'~l~t~N Improper uszandmaintcnanceof your septic s3~sce~t coukt result-in its-pre:rtaturc faiiurf to-handle w~sses,prnpsr maintenance consists of pumping out tht septic tank every three years or sogncr, ii needed by a licensed pumper, Whit you -put into the system can afioet the function of the septic tank as a treatment stpge in tha waste disposal system. The property owner agrees fa submit to St, Croix Zoning Depat'tmeut a cct~ifiaation form, signed by the owner and by s truster pturtf(7er, jaurntymttn plumber, restrictedplurnber er ri licensed pumpef verifying that (1} the an•sitt: wtstewaterdigposal system is 'tnpropcz epcratingcvnditior anti7or {~) aPrer i>tspection and pumping jif neccssary),7he sapric tanlq is iassthan !!~ fttti sf sludge. Uwe, the tzadcrsigned.havercad thettbove-rrquireme~ts-ard-a-gr-ae to rrsairttaisl-the _pri~ate se~vaga disposalsi+steai .vita the standards set forth, herein, as set by the Department of Cammtrss and tho Depgrsxt~t Q!'Nattual Rescttress, .State of Wisconsin. Gertiftcatiga stating that your septic system has been maintained roust be completed and returned to the St, Croix County Zoning Office within 34 days of the flue year expiration d S NATO flF APPLICANT _, -DATE t)VY~1~~,~'gT ~ rA1`Ii3N 1 (we} certify -that aH statements ar, -this -t'vrm arc trove to thhe best of my {our) knowledge. I (wc} am -{are}the vwnarfsj of ~s' Iuoi~ny llesoribtd ab~vue, bar i~irtuc of a warranty t~ect i~cc~Tded in Register ~f I3eo~#s Of#`tca. ~iQTdAT'Ctt~ aF APF'I.ICANT I 1 LATIr ~'*~*' Any infattttatian that is miy-represented may resvlt in the sanitary permit-being rtvtskcd by the Zoning pepartment. "'t~** «t I!lClLdt N'~ift tAjS Ap~iC-4t19q: a statnpvd wartaaty deed fcpm the Register of Acsds vt'fiGC a rapt' A-i xhs xtrtii"tcd suta~ey trap ii -crier-ettce -is -made -rn the warranty -dcecl U 1993P 215 STATE BAR OF W ISCONSIN FORM 2 • 1998 WARRANTY DEED Number This Deed, made between Hammond Land, LLC, a Mlnaeaota Limited Liability Company Grantor, and Joshua K Evensoa Grantee. Grantor, for a valuable consideration, conveys and warrants to Grantee the following described real estate in Sk Croiz County, State of Wisconsin: L9t.1-!' Hatnrnond Oaks Subdivision,Town of Hammond, St. Croix County, Wisconsinr------~ KA67'HLEEM H3MALSH REGISTER~OF DEEDS sT. cROIx co., xI RECEIVED FOR RECORD 05-17-2002 10:00 AM WNPoiWlTY DEEP EXEMPT t REC FEE: 11.00 TRANS FEEL 68,70 COPY FEE: CERT COPY FEE: PAGES; 1 Noma sad Relum Addrcas ~'r'~, G 018-1086-I I-000 Pucel Identifu;ation Number (PIAt) This ~ mt homestead property. (is) (is not) Exceptions to warranties: Subject to notes, easements,restrictions,covertants artd rights of way of record, if any, including but not limited to those for drainage,water retetttiogponding,and or utilities as maybe shown on the plat of Hammorxi Oaks Subdivision recorded in Vol. 8 ofPlats, page 2, St. Croix County, Wisconsin The warrdruies of this deed, either expressed or implied are limited by the grantor to the grantee, or anyone in the chain of title, to the consideration expressed herein, that being the sum of S 22,900.00. Dated this 9th day of May 2002 Hammond Land, LLC AUTHENTICATION Signature(s) authenticated this day of TITLE: MEMBER STATE BAR OF WISCONSIN (If not, authorized by § 706.06, Wis. Stets.) THIS INSTRUMENT WAS DRAFTED BY Paul A. BailloD, Attorney at Law (Signatwes may be authenticated or acknowledged Both are not necessary.) • by l t' President . Austin J. Baillon ACKNOWLEDGMENT STATE OF WISCONSIN ) ss. ~~Y County. ) Personally came before me this 9th day of May ,2002 the above named Austin J. Baitloa ' to me known to be the person(s) who executed the foregoing ittatrumeat and acknowledge the same. R ^ .. 'Paul A.Beillon +~~• NOTq;,vP~d~IC+l.MNESO'fA rnr corxN Notary Public, State of My Commission is permanent. (If not, state expuahoa January 31 2005 .) ii 'Names of persons signing in any capacity should be typed or printed below (heir signatures WARRANTY DEEO arAT6 rtAR O- WUCONSM POltai No. 2 • 199a DJPORMATION PAOFHSSIONALS COMPANY FOND DU LAC, WI 800-655-2021 ~ ~ ~ ~3 ._ ~ N ~ W H O ~~ Z ~~ IY ~~ o ~~ N ~ L i~ ~ z v I ~~ ~ ~C 1 3 Z . ~ ~ ~ • ~ ~ ~ ~ 00 ~, 5 =~ ~`V~ ~ ~~ -~ ~~ ~ '~ 5'' ~ ' i .6 w O ~.~,~ M , 1 ~i '' ~^ ~ ~ ' • ~ ~ rr j M ~ ~ ~ . ~ ~ E 'r ~`~s%~ ~ ~-~ ~ " w U~ ~ ~ n ~' ~ ~~~~~~ f ~~ ~~ ,00 C6t M.Gf,9C.66 S ~ ~ 8 (Wy Q ^' r/r ~ 8 ~ i h O V_f ~O a . ,ao 06L M_6C.9C.69 S ~. nor r ~ ~ lJ a ~, Q 0 ~= 0 ~ H ~p ~D ~ J ~ ,~ tl ,00 06L M.6t,9C.bp S ~~ w Cif N< n o ~~ _ _ ~, ~ a ,00 Obi M,6~,9S.6G 5 -t11pr G~ W '~ HQ r «i p ~ ~ • ~ u i a ,OO~oe2 M.8~.9f.69 5 r ~~ W ~pQ 1~ 0 ~' ~~ 0 ;r, rr O _ __ ... ~ ~,0006L M,6f.9C.e9 5 •~ V S` W p, O D± r V1 . ~_ ~ .v "f N ~= L~\OC ~~0 65 ~' ~~.i1 V N a ~U / M u~ h r U a rJ O M ~ O Y /~ ~ h J ~ ~ N ~ .ry n f r ~ • ~ p t71 i ,0006E M_CL,S~, • rv li, N v ~~ n o v~r U ~''1 e h ~' N V V ~ O V p ,/+ .1 U ~ ~ o o~~ J ~ s iNigr ,oo•osz M_ct.s..bvs ~` u A ~ H ~ a 9i ~O ~ U J /1 f ti ~' u `~ O ~ v ry ? d r ip O oulo J ,^ .~ r 'r r~ , ~ r~ ~~ < N C ~` ~. ~. ~ O ~ ~ H H ~ i ,ra (~L ),6f,OL0Y5 i ^ h .x • p Y , ~ ~ ~' e ~ i v . `,` i 1 i ~s R ~' ~aC' :a ,~ •_ n