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HomeMy WebLinkAbout018-1086-14-000Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Safety and BuildinTq Division 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 Perrault, Dale Hammond Townshi CST BM Elev: t Rs~ ~~ Insp. BM Elev: ~Is.r~r BM Description: csT g~~ z ...o.~dl TANK INFORMATION TYPE MANUFACTURER CAPACITY Septic l,~K~kS aafl Dosing ~.7"~~5 Aeration Holding TANK SETBACK INFORMATION TANK TO PIL WELL BLDG. vent to Air Intake ROAD Septic ~ 3o t t ~Z f t o/ r----- Dosing io$ ~. Q~ ~ ~' 3r - ~ ~. r ~'"' ~ f Aeration Holding PUMP/SIPHON INFORMATION Manufacturer Demand e.,..Q.t~ S o~- GPM el Number ZD•I,'~ p ,~ t>~~o 3 t 1 ~. TDH Lift Friction Lo System Head TDH Ft Forcemain Length r Dia. rt Dist. to well N SOIL ABSORPTION SYSTEM BEDITRENCH Width Length DIMENSIONS / r ?~ 7 SETBACK SYSTEM TO 1 P/L INFORMATION Type Of System: n ,` r~ I~ISTRIRl1TInN SYSTEM ELEVATION DATA county: St. Croix Sanitary Permit No: 420630 0 to Pian ID No: Parcel Tax No: 018-1086-14-000 Section/Town/Range/Map No: 20.29.17.634 STATION BS HI FS ELEV. Benchmark ~ Z) J C ~~ / ~•f~ ~~ro ~ Alt. BM • ~ b t 9 S: 9g' Bldg. Sewer `~?+SS ~.?g D Q •`~i l SUHt Inlet q, to `jo•~fSr SUHt Outlet Dt Inlet R•`~`~ 9©• II' Dt Bottom 13•`~. •O~ t Header/Man. ~.~ b6.6~t ! Dist. Pipe ~j.SZ ?~ . .~ ~ ~ I Bot. System ~~ , L~ t D 'T qs• 9 J t T Final Grade y w• ll ~e add) et _ -t c>e.~ -- ~ St Cover i . ~. Q 3•~~- RS•9g L° ~. r~ q~ 9q r o . YS ;... pv , -t~ -- No. Of Twc~sFies z1 t~~.s BLDG WELL Dia. Header/Manifold t tf Distribution t ~ t pipe(s) l 1 t x Hole Size ft r x Hole Spacng 1 Vent to Air Intake ~_ Length ~'~ Dia ~ Length fi~'crf~~Q l Dia ~ Z' Spacing 3 •~ ~ ~ ' ~~ Still COVFR ,, o.e~~,,.e c.,~*o..,~ nni., YY Mnnnrl flr Af_r~radR Systems Anly Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil 0 Yes ~ No ~ Yes ~ No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1 • ~~-F~ ,oln~pection #2: ~7~t-~ ~1) Pao -rCt) tµ {.~,~~J1 Location: 873 112TH Street Hammond, WI 54015 (SW 1/4 SW 1/4 20 T29N R177Ww) Hammond Oaks Lot 14 Parcel No: 20.29.17.634 1.) Alt BM Description = 5~<< ~ ~ '~'~-" r 2.) Bldg sewer length = -amount of cover = ~g -~ , 3.) Contour = 9~ 99r Plan revision Required? ~ .] Yes No I~I ~ ~/ Use other side for additional information. ~ • L~ __ -_ 1 1 SBD-6710 (R.3/97) ~ tee C (1 . ~ S Insepctors Signature Cert. No. Safety and Buildings Division County ~ S ~ .~ ~ 201 W. Washington Ave., P.O. Box 7162 .. , ~ -seons~n Madison, WI 53707 - 7162 Site Address De artment of Commerce /d -2'3 -v Ti 3 f ~ S'~~ # °~~'3 `'"'~ Sanitary Permit Application S'°'~`'' {2a ~~ r In accord with Comm 83.21, Wis. Adm. Code, personal information you provide ^ Check if Revision ma be used for ses Privac Law, s15. 1 m I. Application Information -Please Print All Informatio RECEIVED State Plan I.D. ber gt~o~ -T~ts lD.~ P Owner's Name ~~ Parcel Number ~~~ V ~.~ DECL 0 20 - S'~ - z - .63 ~ property Owner's Mailing Addres~N ST CROIX Property Location r ~ v ~ . COUNTY 3 ~` ZONING OF ! ~ ~ '~; S ~ N, R City, State Zip Code Pho~ um Lot Num r Block N ber I ~ ~ ~ ~ 7 S 7 ~S ~ ~ M N b er um Subdi ion Name CS II. Type of Building (check all that aPP1Y) as ~ 5 nM ^Ciry 1 or 2 Family Dwelling -Number of Bedrooms ~ ~au~fL ^Village ^ Public/Com~rc Describe Use (Township ^ State Owned ~~~~ ~ (Z ~ ~ ~ Nearest Road ~/ III. Type of Permit: (Check only one box on line A (numbering scheme for internal use). Complete line B if applicable) ',' 1 ~ New 2 ^ Replacement System 3 ^ Replacement of 6 ^ Addition to For County use stem Tank Onl stem B. ^ Check if Sanitary Petmit Previously Issued Permit Number Date Issued IiV. Type of Permit: (Check all that apply)(numbering scheme is for internal use) ~~~ /~--{oo ~_ 44 ^ Non -Pressurized In-Ground 21,.t~ Mound 47 ^ Sand Filter 50 ^ Constructed Wetland 22 ^ pressurized In-Ground 41 ^ Holding Tank 48 ^ Single Pass 51 ^ Drip Line 45 ^ At-Grade 46 ^ Aerobic Treatment Unit 49 ^ Recirculating 30 ^ Ot6er V. D rsallTreatment Area Informati on: Design Flow (gpd) Dispersal Area Dispersal Area Soil Application Percolation Rate System Elevation Final Grade Required Proposed Rate(Gals./Days/Sq.Ft.) (Min./Inch) Elevation L^~ c. ~J ~ ~ / ./) \.f~~ i - . Tank Info Capacity in .Total Number Manufacturer Prefab Site Steel Fiber plastic Gallons Gallons of Tanks Concrete Constructed Glass New Facistiag Tanks Talcs Septic or Holding Tank ~ - - Dosing Clamber -- ~ ~~ ~ VII. Responsibilfty Statement- I, the undersigned, a responsibility for installation of the POWTS shown on We attached plans. Plumber' time Tint) ~ / Plumber i Si ,. ~ MP/MPRS Number Business Phone Number 1 ~_ ~j' ~ ~ S~~ ~'~ Phunber's ddress (Street, Ciry, fate, Zip Code VIII. Coun /De artment Use Onl Approved ^ Disapproved Sanitary Permit Fee (includes Groundwater Date Issued Issuing Agent Signature (No Stamps) ^ Owner Given Initial Adverse Surcharge Fee) , r~Z~O 2 ` Determination 3zs ~ ~S~v~~ • ~C _ ~ ..,- IX. Conditions of ApprovaUReasons for Disap oval ~~ ~ ~ , r ~ i ~ 1 ~' e.t~s ~ ~ ~ s --~ ~SY-r, - ,,-~`~`1 ~tbe ~ On~~~ ryr tdC-~{~r~ ~ ~(~p O[ ~C85 {Yi~~ OLi 1 / W iii /~~ ~/~ -/ SB -61~ 39g (R. 05~01~ s~---~5 ~ _ S S 0.~~~' ,vt6-vt.4~e-tMe~t~~ ~,,b~d't~ 839' 9~~`''S~N G`~~ ~~~r/ ~~ia8 ~y~ofs ~r~~,e~a ,( ~~.~:r.~1 f1G,,~,~~ ~ f~,,o , {Sa,re~y~~.~ '/~ ~ ~,8, ~I ~.~~/,r c~ew,rl.- ,~.~ ~s'io ~ ~ o;~ ~~s /r , _~ s~~~ /s~ ~~ .r ~ ~ ~scons~n Department of Commerce December 17, 2002 CUST ID No.224263 KIM A OjCONNELL K.O. CONSTRUCTION 504 3RD AVE OSCEOLA WI 54020 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRE5: 12/17/2004 ATTN.• POWTS Inspector ZONING OFFICE ST CROIX COUNTY SPIA 1101 CARMICHAEL RD HUDSON WI 54016 SITE: Dale Perrault 162ND St Town of Hammond St Croix County SW1/4, NW1/4, 520, T29N, R17W FOR: New mound, 450 GPD Object Type: POWT System Regulated Object lD No.: 884437 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 Identification Numbers Transaction ID No. 817101 Site ID No. 654046 Pleaserefer to both :identification numbers, above, in all comes 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 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. • 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. ,~_ l~ Note KIM A O'CONNELL Page 2 12/17/02 • 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. • The bottom of the distribution cell shall be level per the Mound Component Manual. • The maximum finished slope of the mound surface shall be equal to or less than 3:1 per the Mound Component Manual. 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). Consult the Department of Natural Resources for well setbacks and exceptions to the setbacks. 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 inspector's. 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 slats 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 address .shallprovide a copy of this letter to the owner and any others who are responsible for the installation, operati or maintenance of the POWTS. Sincerely, .i'~ mod- ~`~-~--- __ 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 Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 WiSMART code: 7633 cc: Leroy G Jansky ,Wastewater Specialist, (715) 726-2544 MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Project Name: DALE PERRAULT Owner's Name: DALE PERRAULT Owner's Address: 8349 9TH ST N OAKDALE MN 55128 Legal Description: SW-NW-SEC 20-T29N-R17W Township: HAMMOND County: ST. CROIX Subdivision Name: HAMMOND OAKS Lot Number: Parcel I.D. Number: 14 Block Number: `•'~.~. J ,t... i • ~ a e. ~ I Plan Transaction No.: ~ y '~' Page 1 Index and title ,,~; ~,~~~ of coM Page 2 Data entry ;'~ saF 7 •~ Page 3 Page 4 Page 5 Page 6 Page 7 Page 8 Mound drawings Lateral and dose tank System maintenance spec cations Management and contingency plan Pump curve and specifications PLOT PLAN Designer: KIM A OCO NELL License Number: 224263 Date: 11/27/02 ~ 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 ~~1~lti~I Mound and Pr~sst~re Distribution Component Design Design Worksheet . Site Inform ation (r or c) R Residential or Commercial Design 300.00 Estimated Wastewater Flow (gpd) 1.50 Peaking Factor (e.g. 1.5 = 150%) 450.00 Design Flow (gpd) 1.50 Site Slope (°h} 95.82 Contour Line Elevation (ft) 30.00 Depth to Limiting Factor (in) 0.40 In-situ Soil Application Rate (gpd/ft2) Distribution Cell Information 75.00 Dispersal Cell Length Along Contour (ft) _ 1.00 Dispersal Cell Design Loading Rate (gpd/ft2) 1 Influent Wastewater Quality (1 or 2) Pressure Disribution information (r nr a) E Center or End Manifold 3.00 Lateral Spacing (ft) 2 Number of Laterals 0.125 Orifice Diameter (in) (e.g. 0.25) 3.00 Estimated Orifice Spacing (ft) 2.00 Forcemain Diameter (in) 45.00 Forcemain Length (ft) 85.50 Pump Tank Elevation (ft) 6.50 System Head (ft) x 1.3 10.65 Vertical Lift (ft) 0.43 Friction Loss (ft) 17.59 Total Dynamic Head (ft) Lateral Diameter Selection in. dia. o tions choice 0.75 1.00 1.25 x 1.50 X X 2.00 x _. 3.Q0 x Treatment Tank Information 1000.00 Se tic Tank Capacity (gal) WEEKS Manufacturer Note: Sand fill (D) calculations assume a Table 83-44-3 in-aibu soil treatment for fecal coliform of <_ ~6 inches. 6.00 Cell Width (ft) Are the laterals the highest oint in the distribution Y network? Enter Y or N If to above, enter the elevation ft` of the highest point. 9.00 ft2/orifice Does the forcemain drain back? ~~ Enter Y or N 7.34 Forcemain Drainback (gal) 67.38 5x Void Volume (gal) 74.72 Minimum Dose Volume (gal) 20.60 System Demand (gpm) anifold Diameter Selection in, dia. o tions choice 1.25 x 1.50 2.00 x 3.00 Gallons/Inch Calculator (optional) 1000.00 Total Tank Capacity (gal) 49.00 Total Working Liquid Depth (in) 20.41 gal/in (enter result in cell B49) Dose Tank Information Effluent Filter Information bUU.00 Dose Tank Capacity (gaij Zabel Filter Manufacturer 21.76 Dose Tank Volume (gal/in) A100 Filter Model Number WEEKS Manufacturer Project: DALE PERRAULT Page 2 of 8 Mound Plan View T 1 L ---~ -t -{ _I _l Mound Component Dimensions Down slo a toe extension made. A 6.00 ft E 7.08 in H 1.00 ft K 7.01 ft B 75.00 ft F 9.50 in z 9.00 ft L 89.02 ft D 6.OOin G 0.50ft J 5.14ft W 20.14ft 450.00 (ft2) Dispersal Cell Area 1125.00 (ft2) Basal Area Available 6.00 (gpd/ft) Linear Loading Rats 7.50 (ft) 1/10 $ fibs. ~Pipe~Placement Mound Cross Section View Aggregate Dispersal Area Finished Grade- 98:11 (ft) ----~- ~ .. ...,.~;~ ,,,,,,,,,,,,f;~,,,,,,,,,, • H G ~ ,,,,,.,,,,,,,,,,,~1~',,,,,,,,,,,,,,, 1 F Diepersai cell 96.82 (ft) Lateral 96.32 (ft) --- Invert K' ~ispersai t,eli ~~ ~ D .3. E d t Elevation : .. ".. - ~.. : 'i a ~! l , „ . ... 95 .82 (ft) Contour Elevation 1.5 % Site Slope Geotextile Fabric Cover Shading Key ~ ~ ~ ~- Dispersal Cell 1 5 f See lateral details on Topsoil dap il C """"' S b _ ~ . t ~ Page 4 for number, u so a ~~-~~~~~~ P A~TIV#-C33 S a.":~ di•td ~ ~ Q ~ ~ .' ~ - • size, and spacing of ' ~ ~ ~' - ~ , , F 5 ft Typical Lateral 0 laterats: l;:aterats ar+e ~~ ~~ Tilled Layer ~~ i.~'~ lggregate c ~ a o . ~=.i ; ~ _. ~ .:: . equally spaced from the.distribution cello ~----- q -+ centerline in the distribution calf (AxB). Project: DALE PERRAULT Page 3 of 8 End Connection Lateral Layout Diagram LatiFalsoentorp overt e & dmPnsion •=Turn-uprrtr bellvalvsorola~snoutplup .p .l All latrrrals era rdentioal IF ?(--~ I Hol as drlllad on thtr bottom of the latarar I equally spavrd S Forae main oonneotion via tQe or oross to manfiold at any point. Laterals & force main of PVC soh 40 (per CORIIM Tattle B4.'30=5j Nt,mber 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 17.59 ft Forcemain Velocity Dose Tank Information Electrical as per NEC 300 and -- Comm 18.28 WAC Tank component is properly vented WEEKS Ca acit 800.00 V:`,is;~r-~ 21.76 Mlanufacturer Gallons Dimension Inches Gallons A 22.56 490.93 B 2.00 43.52 L 4.20 91.47 D 8.00 174.08 Total" 36.76 800:00 3" ~l3aca~li ~~ a B C D Disconnect ~l _- Alarm Manuafacturer SJ ELEGTRO ~~ Alarm Model Number HW 100 -~- I'.ump-Manufacturer. G4lJLC~ _~ Pump Model Number WE0311 L Rump Must Deliver 20:60 gpm at 17.59. ft TDH 0:125 in 3.06 ft 25 9.00 ftz/orifice 3.00 ft 2.00 in 2.10 ft/sec Locking cover with warning label and locking device and sealed watertlght I 4 in. min. ~- Alternate outlet location Forcemain diameter ~~ 2 in. Weep hole or anti- siphon device P" u~ mp off elevation (ft) 86.17 D~elevation (ft) .. 85:50 Project: DALE PERRAULT Page 4 of 8 Mound SYStem Maintenance and Operation S.oecifications Service Provider's Name KIM A OCONNELL Phone 715-755-3145 POWTS Regulator's Name ST. CROIX COUNTY ZONING Phone 715-386-4680 Design Flow -Peak 450 gpd Maximum Influent Particle Size 1/8 in Estimated Flow -Average 300 gpd Maximum BOD5 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 Freauencv Septic and Pump Tank Effluent Filter Pump and Controls Alarm Pressure System Mound 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 ondin and see a e once eve 3 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 Tum-up Detail Finished ..,~~~~........, ............... Grade ~ .r 6-8" Diameter Lawn Sprinkler Valve Box Dfistrfibutizm Lateral Threaded Cleanout Plug or Ball Valve Long. Sweep 90 or Two 45 Degree Sends Same Diameter as Lateral Project: DALE PERRAULT Page 5 of 8 Mound System Management Plan Pursuant to Comm 83.54, Wis. Adm. Code General 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.01/01) and SSWMP Publication 9.6 (01181)) and local w state rotes pertaining to system maintenance and maintenance reporting. No one should ever enter a septic or pump tank since dangerous gases may be present that cotdd 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 subject to faNure must be replaced. Exposed access openings greater than 8-inches in diameter shah be secured by an effective locking device to prevent acadental 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 conterrts 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 shaA be assessed at least once every 3 years by inspection. The outlet filter shall be cleaned as necessary to ensure proper operation. The filter cartridge should not be removed unless provisions are made to retain solids in the tank that may slough off the fitter when removed from its enclosure. If the lifter is equipped with an alarm, the fitter shall be serviced if the ali~rm is acflvatetl continuously. Interinitterii fitter alamii; may indiciate iuirge flov+i3 or eri impendirifl coiitiituou"e'blarm: The septic tank shah have tts conter~ta removed when the volume of sludge and soum in the tank exceeds 1/31he liquid volume of the tank. If the contents of the tank are not removed at the time of a triennial assessment, maintenance personnel shah 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. Puma Tank The pump (dosing) tank shall be inspected at least once every 3 years. All switches, alarms, and pumps shah be leafed to verify proper operation. if an effluent fitter is installed within the tank tt shah be inspected and serviced as necessary. Mound and Pressure Distribution System No trees or shrubs should be planted on the mound. Plantings may be made around the mound's perimeter, and the mound shall be seeded and mulched as necessary to prevent erosion and to provide some protection from frost penetration. Traffic (other than for vegetative mairenance) on the mound is not recommended since soil compaction may hinder aeration of the infiltrative surface wtthin the mound and snow compaction in the winter wilt promote frost penetration. Cold weather installations (October-February) dictate that the mound be heavily mulched as protection from freezing. Influent quality into the mound system may not exceed 220 mglL GODS, 150 mg/L TSS, and 30 mg/L FOG for septco tank effluent or 30 mg/L GODS, 30 mg/L TSS, 10 mg/L FOG, and 10" cfu/100 mL for highy treated effluent. Influent flow may not exceed maximum design flow specified in the permit for this instaAation. The pr~SSUre distribution system is provided with a flushing point at the end of each lateral, artd tt is recommended that each lateral be flushed of accumulated solids at least once every 18 months. When a pressure test is performed tt should be compared to the initial test when the system was installed to determine if orifice dogging has occurred and if orifice cleaning is required to maintain equal distribution within 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 lovols above 6 inches considered as an Impending hydraulic failure requiring additlonal, more frequent monttoring. Continaency 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 immediatey 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, tt wiU be repaired or replaced in its' present location by increasing basal area if toe leakage occurs or by removing biologically Gogged absorptlon and dfepersel media, and related piping, and replacing said components as deemed necessary to bring the system into proper operatMg condition. See Page 6 of this plan for the name and telephone number of your local POWTS regulator and service provider. Project: DALE PERRAULT Page 6 of 8 ~Per~ormance Curves METERS FEET 90 25 ~ BO ~ 70 20 80 O H t5 ~ 40 10 ~ 20 5 t0 ~ 0 Submersible Effl~en't Pumps MODEL 3885 ' SIZE 3/4" Solids WE15H WE10 H° •WE07 H• WE05H WE03M WE03L i 0 ~0 2 30 40 50 60 70 80 90 100 110 120 Q PM I~o' ~~ ~ ~ ~ ~ ~ • 1`~1 t „ ` 0 20 •frO ~0 20 30 m'7h U. cAPACm ~(~', GOULOS PUMPS, INC, 5E~ECa 8415 PEW YOpc i3Nd METER8 FEET ,2o MODEL 3885 35 ~ SIZE 3/4" Solids ~,o wE~sHH 30 100 ~ ~ i I I 90 25 ~ 70 = 20 60 O 15 ~. 40 t0 ~ 5E OL 20 10 0 0 ~0 20 30 40 50 Ci0 !0 au xl iw i to ~ cv urM ae ~ ~ 0 i 0 20 30 m~/h CAPACITY e t985 Oouldi Pumps, Inc. Enecuve Juiy. 1985 ~• C)885 _ ~ ~~ ~~~ ~~~~8 // ~9 .~ ,Q~.'~~:~/ ~7%h4~1~ ~ ~ /~`O~o A!~ Scr,~/J~ ~e>CS//~7 ~,8, ~ S~ ~f C6 ~CIJ~ -.~L/CG'.O ,~ f-~,c..JG'~ /J~i~f a~'~ hf~ o r.~a~(d/~9o',ls h7 T.,1~ i~ .1'f.C /r c~an~,e~r- .E,! 9v`; ~o /~r ~,J~- ~c~n,ye~/ wxk~ls ~0/~.~ S3y,C~ ~ hiou..~o - ~r. __ „~ '. ,~ DR'i~,G~1N - _ ~~ /' 6Ar(~e `~ I i J' ~ NS/_ G~ /~goas ~~/' ~ 4p.J7+u~ ~„Jr 9S, ~7 ~~ ~~ ~ 6 ~~ T;, ~ \ ~~ y ~~ _r~ ~ ~ G' 3 h> ~.' ~~ /~ /~ v cy `J~ _~ ~G% ' ~~~cfs ~H~~ ~.r<~ ~j ~ 7r? ---- ~..~Q _ `~''d _ . ~~ /~' //J.CJ /`LSD M ,1 y Wisconsin Department of Industry, SOIL AND SITE EVALUATION Labor and Human Relations Division of Safety and Buildings in accordance s: l~R$~<09, Wis. Page / of ~°_ Attach complete site plan on paper not less than S 1/2 x 11 inches i ~~, ('Ian mukg.. ounty Jr~ C, AO'. y include, but not limited to: vertical and horizontal reference point (6M),,;directio~~8t~d !'" `~ /r /` percent scope, scale or dimensions, north arrow, and location a B distance to neatest rriait: par 1 LD. # O APPLICANT INFORMATION -Please print all information. ,;;,, ~ Fte ' wed by Date Personal information you provide may be used for secondary purposes (Privacp l.~w, s. 15.04 (t}(M~~' L Property Owner ~ V P1 Q (eD /~ ~~ ~ C ~j ,7 Q `..Property Locatidn, ~ V ~ ~o ~/l~ ~~ f ~ ~O X17 Govt.•Lot. ~,,~" ~ 1/4N~ 1/4,S 1 o T ~~ ,N,R ~ 7 !- (or) W Property Owner's Mailing Address Eot, k# Subd. Name or CSM# 332. h i UN~SoTA s1' E~1S T I y0 ~ 1!~ .+M,tio•vD ~~4••tr'S City State Zip Code Phone Number Nearest Road kJ ~'Z $T• 1~~-- M ~ . 5S/ ~ ~ (ifo.S~ )z22. • SSSS ^ city ^ village C~wn ~ ~ b [~"Wew Construction use; (~ tesidential /Number of bedrooms 3 Addition to existing building ^ Replacement ~" ^ Public or commercial -Describe: Code derived daily flow y7 d gpd Recommended design loading rate ~ bed, gpd/fi2_ c~trench, gpd/ftz Absorption area required 31,5 bed, ft2~trench, ft2 Maximum design loading rate bed, gpd/ft2 / trench, gpd/ft2 Recommended infiltration surface elevation(s) •Su ~ ft (as referred to site plan benchmark) Additional design/site considerations Parent material /~ Ets ~ Gt~ Q~N•SL~ T/ ~~f Flood plain elevation, if applicable N ft S = Suitable for system Convent~onal~ Mound In-Ground Pressure AT-Grade System in Fill Holding Tank u = unsuitable for system ^ s L~'u Ca'~^ u ^ s C~'~ ^ S ^ s p~t~ ^ S ~ Boring # t Ground ~~ el_ ev. 8b-•~ft. Depth to limiting factor ~in. SOIL DESCRI PTION RE PORT i H D th ant Color D i Mottles Structure R t GPD/ft2 or zon ep in. om n Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. Consistence Boundary s oo Bed ,Trench ~ ~- d •g • /~ l7.3 /o y,~ 3~3 /o' ~ 3~ ~ o ye 3 D G - - G ~ floTS SiG SIC S~ ~~L~ Lt,rh,~ 2 f SfJ,C ~ ~ ~ ~fS ~ GeS~, S s~ ~v w w c5 ~ ~ ~• - - ., .S :. ~ . S ' . Co • ~{ ; • s . Z~ • 3 ~•sy~ y/ Remarks: Boring # Ground • ft. ~'S e~-- Depth to limiting factor ~~in. /d L I-fs w /f .Y ; .S ~- o • ~ ~o _____ sic, ifsb,~ ~ w - . s ; . ~ 3 ----- -FI f ~o s ~ S/GL ~ ~- ~ -- -- - ' . . z ~ • 3 Hoye s~ Remarks: CST Name (Please Print) Rot3~RT- 21~4RIetiT' Signature Telephone No. ~~s• 38G • ~- ~ s Address CDate GST Number Utbricht 8 Associates ~U. Z • ~ ~ 1 ~ 2Cl 3 7 S 655 O'Neil Rd. r ;~ ' r V ~i ~ 1 ~~ L 7~'J~ SOIL DESCRIPTION REPORT Page Z" of .3 PROPERTY OWNER L-~_~ ~AHHe:l~t7 ~~ ~S S ~g~ ' PARCEL I.D.# Boring # 3: Ground elev. 9S~-ft. Depth to limiting factor ~in. Boring # Ground elev. ft. Depth to limiting factor in. ttl s M Structure t 2 Horizon De th p in. Dominant Color Munsell e o Q~i. Sz. Cont. Color Texture Gr. Sz. Sh. Consistence Boundary s Roo Bed ,Trench --. G MOT G - "_ ' Z. ~ ' s R •\ Remarks: Remarks: l Structure t R __ , GPDlft2 Horizon De th p iii. Dominant Color Munsell es Mott Qu. Sz. Cont. Color Texture Gr. Sz. Sh. Consistence Boundary oo s Bed ;Trench Boring # Ground elev. ft Depth to limiting factor in. Boring # Ground elev. n. Dapth to limiting factor in. Remarks: SBDW-6330 (R. 08/95) ~ o -~ ~ 3l yv . Lo T ~ . 2l, C. L , 2_._.~-~, ~ ~ ~5 ~~ ~ oy~° ~ ~ ~ ,- ~3 /l~j o v~v ~ S Y S Tom... ~,,,i ~, , Sc~ . L o T t.. . i 2 . Sv~v~Yo~ s ~M ~ ~ N ~ ~ ~,/~ ~ G o ~ ~D~''~`' ~ ~~~~" !~ r ~H ~S~ ~g 96 ~.So ~-~ 1 I~ '`~ / ~d~~ S ~' LOT ~~v-C` .. ~,4~~~ P; Ts 12109%0L 10:55 FAA 6517049969 PERRAULT CONST 22/091 ~0r32 09:51 71524730$8 Bi:t_ISl~ EXCA'u'ATlhisa I SkPT1C TANK MgXNT$NgNC GREEMBN7' AND C)WNFRSHIA CER'~CFICA7'ION FORM ;"1 ,. Ou~ner~'~uyer ~oz ~AGi 02 Maiiiri~ Audi-~~ /y3 ~ ~ ~ ~N ~-~. ~ ~~'kt~q l~9 SJ"i i~ Property. ,addrass LCD" /1i`~"'t~fartiL ~ K $73 ~ ~.~~ ~'~ //~~ t~'eritiCAtioti rcquixad (1~nm punning I?epartttsint fax Sit!`cY construction) Cit~+IStatc (yfdtnMofv~ InI;SCO~~~ Ptarcai idanti&cetion iJurtibar i y' ~. - ,,,,_ i'mperty Location ~''~ ~,;, IBS L'J :1., See. ? ~ , "faZt1 I~iy.R 7 W~ Town of I7'if'yI~~Y30~?~ Suhdivisidn ~~~~~t~n ~~~5 I.ot # ~ CetYtlfted Sur^vey~ MaQ # ,-,_,~.._.___.....__._,,,,.,,s.._,,.,,~ Yo~urne ~ Page ~ 'wara-atrtty Used # _,,,,_,,,,,T,~~' ~ 23 ~ , Yo~uttae 2 ° YS Pggo # 02~ Spec houst» L"7 yes ,~1 tia LDt iilt~s iciotrti~able ~" ytrs !] na ~'k'S~'EM 1~~A,~T~Ir'~NCE trnproper use and ma~ntcnanccof your septic system could sasule uY stt; pran~aatre !`ailura to handtt: wart4a, Prt3pCx snaiateaaace costsis±a cf Fumpiitg out the aeptyc tank ev-cry xhxec year3 er saonci, if n+;adt:d by a tiaengtditumpor. Whwt you put into the system een at2act the flanctiort of the septic tank as w t:eatme:nt stage in ehe wastes tfitpasal systam. Tlte: ptoperry ownesr egress to aubn,it to ,3c, Croix Zoning Derpartrstesut a certilicatYaa Toms. sf;tted by site awtter sari by is tnastex pistmbsr, journeysrtaa plumber, rt:stTictesti plutrsbe:r or a licettsat~ ptunpar verl~+ing that { t) the on-oi:e waste:watardlttpwal system is sxt proper operating cartd,•tion anNar (2} af4e:x inapettion end pympitsg {if naC6SSary}, tNe septic tank is )c®s then 113 titE7 otsludgr., ifwc, the undcrsignrd have read the above s~e°yniremonts and ogres to naisttaia tha ptivata :swage di9posal system with she standards set Earth. hercaaty as sec by tlta btspsrtment of Catxtsvterce trod the 1]etparRaaattt of Natural Raeauraas, St4te of W fsaonain. eettificatit:ts oca,siog chs; y~ ttt system has been rttatntainad must be camplt!ed a:ad ratutned to the St. Croix County Zonitsg Oflice wititir. 30 "tiara of e: yea expos " dale. SIGNATI;Tt,E OF AFPLi~AN ~' DATE S~ C~E~T,(~CA_ x'jt~N d (- cartify that atl staterrtants on this faros art: trua to tha beat of trty {dnr) knowledge. ! (we) am {am} tht: owntr(s) of rop ~ ~aa :bed oho , by virtue of a warranty deco tecetrded in Register of Daeds C3ffice" _., t2 r ~ ; ZvcZ SIGivATUR~ C3F A;•i~Li NT DnT>r •'•••' A.,y infoz~stattoxs that ,a mis-xepresenscd may result in the sanitary permit baring ravtiked by tAs Zani:ng Dtparttnegt. s~•*•* `• Xnctude: with this ss}~pt;cwtian; w stamped warranty decd From the Ragister os Deeds afiSCe a copy Cif' she amnit',ieci survay reap if raicxance is m`da in tha warranty damd ' , . ~ J S I A~ I©11.~JI~W CON flN~O~M 2.1998 WARRANTY DEED Document Number This Deed, made between Hammond Land, LLC, a Minnesota Limited Liability Company- _ ____ _ __ Grantor, artd Date Perrault Grantee. Grantor, for a valuable consideration, conveys and warrants to Grantee the following described real estate in St. Croic __,_ County, State of Wisconsin: Lot 1 Hammond Oaks Subdivision,Town of Hatnrnond, St. Croix County, Isconsin 696237 KATHLEEN H. MALSH REGISTER OF DEEDS ST. CROIX CO., MI RECEIVED FOR RECORD 11/13/2002 10:30AM EXEIWT 1 REC FEE: 11.00 TRANS FEE: 95.70 COPY FEE: CERT COPY FEE: PAGES: 1 Name and Ketum Address o l x- l ox6-to-o(xl _ Pazcel ldentscation Number (PIN) This !s not _ homestead property. (is) (is not) Exceptions to warranties: Subject to notes, easements,restrictions,covenants and tights of way of record, if any, including but trot limited to those for drainage,water retention,pontiing,and or utilities as may be shown on the plat of Hammond Oaks Subdivision recorded in Vol. 8 of Plats, page 2, 5t. Croix County. Wisconsin. 'ftte warranties of this deed, either expressed or implied are linuted by the grantor to the grantee, or anyone in the chain of title, to the consideration expressed herein, that being the sum of $31,900.00. Dared this _ 8th day of November----, 2002 Hammond Land, LLC -- --=- - Signature(s) AUTHENTICATION authenticated this day of 1TTLE: MEMBER STATE BAR OF WISCONSIN (If not, _ authorized by § 706.06, Wis. Stats.) 'll{tS 1NSTKLIMENT WAS DRAFTED 8Y Paul A. Baitlon, Attorney at Law `_ (9igna[ures may be authenticated or acknowledged- Roth are not necessary. ) . by ~~ President . Austin J. Baitlon ACKNOWLEDGMENT S"fATli OF WISCONSIN ) ss. Ramsey- _ __ County. ) Personally came before me this 8th day of November __ , 2002 the above named Austin J. Baitlon to me known to be the person(s) who executed the foregoing instrument d acknowledge the same. /`-~ PA IJL M. BAILLON ' _Pa_ul A. Baitlon or stc. InesorF __ ~--= Notary Public, State of ` '~Y :o"" ~ N' ~'~" RE~''~s'~ztfls My Commission is pcrmscuu+en(,F6woty~tRtr e~cpiral~rtfitxta'+'~' January 3l _ 2005 ) 'Names of persons signing in any capacity should be typed or printed below their signatures WARRANTY UF.EU STATE BAR OF WISCONSfN FORM No. 2 - 1998 INFOR ~tATICN PROFESSIONALS COMPANY FOND UU LAC, WI 80(1-555?021 ~. • t _._._ ..... ~~ D Q AKA ~~U~I~IVI~ I~ ~T )F THE NYrt/t ANCt TMF Sx':/4 ~ THE NTY1/4 OF SECTttFt 20. RAIVv"E 17 th~ST, ?OWN G'f HRl~faflly0, 5T. CROtX Cct1NTr, 1HSC0-~StN UNPtaTTEp ~.At:JS ~UU [~ It E IhV91~ EAST l1NE OF TNL S-ti 1 1 Cf 111E t:W 1[4 ( '.•B 78' 153.00 tS+ 08- _ +6• bs' t8s Ra' 1es bs. -- ??41 25' - ~ $ $ lOs 13 ~ LOT 14 ~ LOT 15 lOT 16 ~ LOT 17 $ "" lfl- 18 48801 50. FT. ~ 139$1 $t;, fT ~ 438'3 Sa fi ~ 47?d8 SO ~T, a 4:,745 50. fT. 9 4?.746 S0. FT, i.1T a~rg ~ . 1.03 ACRES ~ 1 C~ ACRES - 1 10 ACRES ~ 1.10 ACRES ~ t 1(1 aCRES o ~ m ~ ~ ~ ~ N M ,BC 18' _. 13500' _ ,y, ~ - ,t;s 6• -- - - - . t6! 6!' _ - t8s tS+- . _ - S+DZ3"a1-E 175334- ~?'~"+~ s w ._._. SO'T3'2t'E 1753.13' _ u tso 2,• t5o Zr tso2r -- +so r.' tia z,' ~ - - . . ~ ~ T000~ ~ -20' ORe -. ^ 1 + 1 ~ $ o°, n o ~ ~ g ~' ~ t ' ' ; lOT " ~ LOT ~ '~ r ~ lOT 37 n lOT 36 3 LOT 35 LOT 3a t t « t 44,500 (t OT AI t 43.54' $0 p T. ~ t ' ~ ~ 43.561 SOFT. ~ 43.561 SOFT. ^ 4 ; 3.56/ SOFT. n 49.361 SOFT. 8 + s .OQ ac-es . n • 1.00 oc•es ~ 1,00 oc.es t 00 oc•es ~ 1.13 acres t t$ r N ~ 1~ t t ' t as -~!__.. -500'2J'2t'E ___ +2It 68'-.. ___~__-- - --- .. ~ - ._ 1 ' 1 _ _ +!20S' :SJ.t:S' 239 ~@' ?56 9+' i, f" ~ - _ ~ .. - - - - - -n SC M • ~ =' ~ . ~j - :r a / lpi 54 ' ' LOT St i! t+?F 52 ~ lO1 53 ; ,~ 5351 SOFT. , ,~ ~ ~ •~SBe SO F1 ; ~ x3.9:3' S0 F1- s 438:7 SCAT h~ ~ 1.Z3 ACRES ~9b~ ~ ~ t ' i +.110 oCR:5 . ' 1.01 ACRES ~ 1.41 ACRE$ .: ~ a ~ ~ ~ ~ ~ ~ -5 ~ ~ ~ a5- o~ Si ~[ ~ - l0T 55 ~ ~ '~ i S35fi1 50 Ft. n r • • - z - - ~ 1.00 ACRES ,r ~ 4.e 0 +SS.J~' tSa ~~~ - •• w r ~ - ~ -... 50f1'lY 9?1 F TQt R~ re .. . S0s•s1 ~ZY 28990