Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
018-1086-40-000
n.v Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Safety and Building Division t ~ ~ INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. i Permit Holder's Name: City Village X Township Steen, William Hammond Township CST BM Elev: Insp. BM Elev: SOU • a /DD -a TANK INFORMATION rw~-z ~S~u-'~.~-o,.~ c~ ELEVATION DAT TYPE MANUFACTURER CAPACITY Septic ~~TT //~ Dosing ~n ~~ ~ l~, Aeration Holding ,-- TANK SETBACK INFORMATION county: St. Croix sanitary Permit No: 420657 0 tats P an ID No: Parcel Tax No: 018-1086-40-C)00- STATION BS HI FS ELEV. Bench ark ~ •~ ~ r~~ .~ 1 ~OD . T 4! Alt. BM 3 ~ -o~ ~-• ~i ~, Z Bldg. Sewer 7.3 ~ L St/Htlnlet ' ~ ~~ ry~ Q SUHt Outlet ~- Dt Inlet Dt Bottom O ~ ~~~ i!~ ~ p Z _ ( Header/Man. /~ w ' ~ I• Dist. Pipe ,Q ~, f~0 )~' • s-~, ~ Bot. System d ~ 32 Ibp' t~ . Q I' Final Grade t Cover ~ .-- / D ~~ ~ ~ 6 3 ~~.t3 ~ too •9 fi i i TANK TO T ~'/L' J W~E~ BLDG. Vent~ntake ROAD Septic S'/ ~~ 7 T/ V ! / Dosing 3 ~ ~r~, Aeration Holding ___~' PUIVIPISIPHON INFORMATION Manufacturer Demand ~ lrL~~ GPM Model Number ~- ~~ v SZ TDH Lift Friction Loss System Head TDH Ft ')•So Forcemain Length . Dia. ~~ Dist. to Well ~P~ e SOIL SORPTION SYSTEM ENC Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS ~ ( ~~ ~ ~ ~ f SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING nufacturer: INFORMATION Type O~f System: t ~/j r CHAMB ~ D1 Z-f ~ ~~ IT I Number: I ~.. {.o e DISTRIBUTION SYSTEM -~. t..>.Si' P/L ~ -'+~-~ Ir~a~ . _~._.., I~t {. r.•~ f,~,Q Header/Manifold Distribution x Hole Size x Hole Sp cing Vent to Air Intake Pipe(s) f ~r ~- Z ~'~ ~~ 532 ~ ~ p s ~. Length Dia Dia Spacing Length SOIL COVER x Prawcure Svstems Only YY Mound Or At-Grade Svstems OnIV r" i (.~Ee i.wx nab d Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched BedlTrench Center BedlTrench Ed es g To soil p I ;;~ Yes ~ No ~f Yes ~ No COMMENTS: (Include code discrepancies, persons present, etc.) Inspection #1:~/~/~ spection #2• ~ /~~ Location: gg2 162nd St H~m~ nd,ytJ~ 54015 (NW 1/4 NW 1/4 20 T29N R17W) Hammond Oaks lILSSO~~f 400 ~~~ Parcel No.:r: 2b 2 .17.660 1.) Alt BM Description = S/ ' ~G~ + 2.) Bldg sewer length =~ ~ ' - amount of cover = ~ 5' ~'~'~'"~ ~ ~p,s~ ~~ 3.) Contour =_ ~~ ~ --- Plan revision Required? L-1 Yes -No ~~ ~ -- ~ Use other side for additional information. I_ I ~ _ _J ~_____ ___ _ J ~_ ____ SBD-6710 (R.3/97) Date Insepctor's Signature Cert. No. Safety and Buildings Division ~ ~„ 201 W. Washington Ave., P.O. Box 7162 ~i~SC~~~~'~ I Madison, WI 53707 - 7162 Depi3rtment of Commerce L Sanitary Permit Application 7n accord with Comm 83.21, Wis. Adm. Code, personal info urovide may be used fot secondary purposes Privacy Law, s I. Application Information -Please Print All Information blame ~ ~ City,. State .04 1 -. ,i,~"~~ 2 2 7003 ZONING OFFICE 1 County (~ J /' _ ~ Bgz 16Z~` Sanitary Permit Number Check if Revision fate Plan I.D...Numbez:.. 'arcel 'roperty Location T~ttS~~-~~- ~ v yv vi 'k; Phone Number Lot Nyirppb~t Block Number ~~ 1 ~~' ~~ Su 'vision Name CSM Number Type of $uilding (chec all-that apply) ~ ~ ^City 1 or 2 Family. Dwelling -Number of Bedroo ^Village ^ PubliclCommerc' s - D e cri be Use S w~ t ~ ~ ~~ ~~ ~~ ~ ~ wnshi ^ State Owned Vt~~+' ~ ' Ne st Road III. Type: of Pernui : (Check only one box on line (numbering scheme for internal use). Complete line B if applicable) ~'' 1 New S stem 2 ^ Replacement System 3 ^ Replacement of Task Onl 6 ^ Addition to Existin S stem For County use B. ^ Check if Sanitary Permit Previously Issued Permit Number Date Issued IV. Type of Permit: (Check all that ap ly)(numbering scheme is for internal use) 44 ^ Non -Pressurized In-Ground 21~Mound 47 ^ Sand Filter 22 ^ Pressurized In-Ground 41 ^ Holding Tank 48 ^ Single Pass 45 ^ At-Grade 46 ^ Aerobic Treatment Unit 49 ^ Recirculating 50 ^ Constructed Wetland 51 ^ Drip Line 30 ^ Other V. Dispersal/Treatment Area Information: ~- Design,Plow (gpd} Dispersal A ispersal oil Application Percolation Ra System Elevation ' Final Grade Required 5~ Proposed SDI ate(Gals./Days/Sq.Ft.) (Min./Inch) tl~ ~loD Elevation ~~ ~ ~1~~ l y ~ ~ ~! 7~~ 3 103 . . VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber plastic Gallons Gallons of Tanks Concrete Constructed Glass New E.xistiag Tanks Tanks Septic or Holding Tank _ 1 / Dosing Chamber 1 1 VII. R onsibility Statement- I, the undersigned, assume respo ' ' y for installation of the POWTS shown on the attached plans. P}y~per's Name (P ' P r' , _ ---- - MP/MPRS Number Business Phone Number /~/1/~~~ ~ ~/~D ~C , - f't~~.0!1 ~ ~~C)'t,L '7th . ~ i~~~_ i i ~ VIII. Count /De artment Use Onl C ~ ~pproved ^ Disapproved Sanitary Permit Fee (includes Groundwater Date Issued Issuing ent Signature (No Stamps) Surcharge Fee) ^ Owner Given Initial Adverse . 3ZS-~ ~ Deten~nination 7 , Z ~~' ~Ut~ 1X. Con tions of ApprovaURe ons for D' approval ~ ~. A•l~ ~~~ You-.s~~ ~MawTtt+l.~vt 'C° ~K ~~ ~ ~.~l.il 4 Din- ~ o.-. ~ ~ P~ o;~(,rce-Q>,2.~ e,o ~~a-•cces . Se.'~,w~ru.c~,o.$ tae per; ~ ~.uoL -{~ 57 a ~,... 1 ~ wee ~~ fi'q &~' s~.~ t.B~ cam,,., f, C a~ce,~,~.t~ k Wit, ~~ . t l~ 1~ ,,,~- I~.,,~-~'~~Q s sue.. tks~~QA.~,~-~, . ~~lete plen~ : e ountyLnly) or the syste n page not ` Ethan 81/Z x 11 Inches in stT t ~ ~` -~ !~'~QOtar.,ef- wwn~- cA¢ ~ ,: "_~ .~.~ `he"' ad ~„ot~ ~ 5~ c.t, `c,~s SBD 398(~ . OS/Ol ~ ~ ~~ c~° ~~~ ' vwu,.'~t s~~^ ~c~er w~ r d 0 rr ~ ~ ! f , e J (~ ~ 1 t ~~ Q ~ 3 °z f 0 --~- 0 J d J j 3 ~~ ' p V ~ w 9 i ~ 0 d tK 7 ~ .i0 q~ r ~ .~ ~ s~~ #~ ~~ fl . ~~ ~ ~~ !~ ~- o . v ~ ~ ~ ~ ~~ r'~ d ~s n s 'J .N d r ~ czj ~ > '~ ..t ~ '~ ~n N s ~ s ~. ~ c ,,, , .J ~. c ~~ .ice °'~ .s ;~ ~~ ~~ n` t S^ tP ~~- z t S /~ A ~, '~ N ~ 9 ~ H 1 ~ E- _ N ~ r d ~ A Vr~ ~, \ ~w `~ ~,, ~.. ~~ .. ~ J S`p Y s ~ ~ r~ i" ~ .~,i x ~ ~, '~ ~ o .-i ~Qp .mob 'I n ~ ~ c c 6( 1 i e a ~~ 0 ~~ ~ U nl 6 ?~ a d q~ °~1. ~_~ ~ ~ ~1 ~ d-o j 0 d+~Z t.,. d- c p~ ~ ~ ? ~~ r /f O ACT' <1 ~ V ~ OI J? ,~~ 1 8 - '4 ~ :J : • ~~ ~ ~~1 _ c~~ 52---- r ~ ~ iscons~n Department of Commerce Safety and Buildings 4003 N KINNEY COULEE RD LA CROSSE WI 54601-1831 TDD #: (608) 264-8777 www. commerce. state. wi. us/sb www.wisconsin.gov Scott McCallum, Governor Philip Edw. Albert, Secretary January 02, 2003 CUST ID No.225094 MICHAEL P ROGERS ROGERS PLUMBING N4563 320TH ST MENOMONIE W4 54751 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 01/02/2005 ATTN. POWTS Inspector ZONING OFFICE ST CROIX COUNTY SP[A 1101 CARMICHAEL RD HUDSON W 154016 SITE: William Steen Residence Crocus Hill Rd Town of Hammond, 54002 St Croix County NWl(4, NW1/4, 520, T29N, R17W Lot: 40, Subdivision: Hammond Oaks FOR: Description: Three Bedroom Mound System Object Type: POWT System Regulated Object ID No.: 886589 Identification Numbers Transaction ID No. 824815 Site [D No. 654546 Please refer 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 Condi) chapter 101.01(]0), Wisconsin Statutes, is responsible for compliance with all code requirements. ~i~~~ The following conditions shall be met during construction or installation and prior to occupancy or use: p~p~TyElIT General Approval Requirements: C~~OF • This system is to be constructed and located in accordance with the enclosed approved plans and with the g~ CORRE "Mound Component Manual for Private Onsite Wastewater Systems VERSION 2.0" SBD-10691-P (N.O1/O1) and the "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems VERSION 2.0" SB D-10706-P (N.01 /01). • Per manual cited above, limited activities are allowed in the area 15 feet down slope of the component area. Soil compaction, excavation, vehicular traffic and other similar activities that impact the treatment and dispersal are prohibited. • The well must be a minimum of 25 feet from any POWTS tank, and a minimum of 50 feet from the absorption area. chs. NR 811 & 812c • A Sanitary Permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.135 and 145.19, Wis. Stats. • Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stat • Comm 83.22(7) A copy of the approved plans, specifications and this letter shall be on-site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. MICHAEL P ROGERS Owner Responsibilities: Page 2 V2/03 Comm 83.52 Responsibilities. The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s. Comm 83.54(1). • Comm 83.52(2) A POWTS that is not maintained in accordance with the approved management plan or as required under s. Comm 83.54(4) shall be considered a human health hazard. • Comm 83.55 The owner is responsible for submitting a maintenance verification report acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. All permits required by the state or the local municipality shall be obtained prior to commencement of construction/instal lation/operation. [n 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. t2(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Charles L Bratz POWTS Reviewer 11 , [ntegrated Services (608)789-7893 , 7:45 am - 4:30 pm Monday -Friday cbratz@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 Henry F Grote ,Certified Soil Testing . ~ William Steen -Mound Transaction # Construction Materials and Techniques All materials must comply with Comm 84 and be installed in accordance with manufacturer's specifications. Construction methods must comply with the following Component Manuals: Mound, SBD-10691-P (01 /01) Pressure Distribution, SBD-10706-P (01 /01) Location: Lot 40, Hammond Oaks NW 1/4, NW 1/4, Sec. 20, T 29 N, R 17 W Town: Hammond County: St. Croix Date: December 23, 2002 Owner: William Steen Address: 4165 Shirlee Lane, So. Shoreview, MN 55126 Plumber: Mike Ro ers ~~ry Signature: _.. /"` i/ ~ /~~ OMMERCE License # MP 2250 4 D NGS Attachments: 6748-Plan Approval Application JNDENC~ `'` SBD-8330 page 1: 2: cover design criteria & calculations RECEIVED 3: plot plan 4: system cross section DEC 2 6 2002 5: plan view, lateral detail 6: pump tank exit detail SAFETY & BLDGS D-V. 7: pump curve 8: system management page 1 of 8 Design Criteria ~ ~ Residential Wastewater Contaminant Load: 30 mg/L < BODS < 220 mg/L Anticipated septic tank effluent 30 mg/L < TSS < 150mg/L Fecal Coliform > 10,000 cfu/100 mL Fats, oils, grease < 30 mg/L ~ Bedrooms x 100 gal/bedroom/day x 1.5 ~~ gallons/day hydraulic load In situ designed loading rate Depth to estimated high ground water Depth to bedrock Cross slope at system Force main length Manifold/header length Drain-back Lateral length ~ Lateral elevation Lateral hole size S~SZ in. ~~ holes/lateral Design Calculations o ~ Z~ gallons/sq. ft. per day ~, z~ in. ~r , ~.~ ~g ~~ 6t•.~b ~ 04~~ ~o~•\ 35 ~4 3~ Lateral volume ~ ~'~ ~'~ 8 Total lateral discharge rate Zo.s'Z Network pressure compensation losses ~'O ~ Elevation difference ~ o,;S Friction loss `~'Z-g Total dynamic head t ~~t g Pump/sip~ion 4' 4' gpm ~a Z Manufacturer ~ ° Q-~ ~ II'`~ Dose volume Q 3.Oslo Lift/sip~ton tank ~ ~ ~'-~ ~ °i''~ -t° ~ ~~~ Septic tank ~' ~~ Effluent filter ~w~.°Q ~ -`~ Measurement pump on and off ~• t•D Height alarm from tank bottom ~ 3.b Reserve capacity 3~~ + specs.cales.res tn. ~•.a~ ft. of Z in. ft. of - in. gallons ft. of Z in. ft. @ bottom of lateral in. ( Z• `~ 3~'~ ft.) Spacing holes total gallons gallons/minute @ 3 • ~~ ft. head ft. ft. ft. @ ~' ~ gallons/minute ft. ft, of head Model # ~ ~ Z- gallons ~ v~ gallons ~ `~'`h"~ gallons tn. m. gallons Page Z of g d Q oS 0 S i 0 r.f f ^./ l'~ 0 d J S 3~ ~' s ~; , ~- ~~ ~ 6 ~ i 3 ~ ~r0 L P V ~ i; J 9 i ~ 4 0 6 '~ -~ ad ~ ~~ J ( J' V .~ ~ ~ ~~ ~ ! x ~ r'~ ~~ s ~~ "~ ~ d s s~ ~~ ,~ I~~ 1n~, J.L C ~~ d 9 ~~ 3 ~ ipp ~• J 3 ..r ,moo ~ ~~ p4 4 r v+ a ~, o~' o_ ~ s ,J ~N y J ~ y ~ ~, ~~ ~ o ~' o ~ ~ .s ~ ~ s ~~~ c ~ ` ~' ~ (~ _ ~y ..r ' ~ N J So t ~ ~ ~ "~: xr+~ ~" ~.-~ o ~ ~ ,~ s~ ~ ~ ~ ~ ~ ~~ ~ ~ ~ s ("`^ ~ f 'q N rn 9 ~'' h ~ ~_ -- ~ s ~ ~ ,, ,, c/1 A v"^~ k ~ i o /" C / ~ "''. -_ i ~, ~~ 0 ~~ tljfU ~J a ? j `.~~~ Y °~ ~.J' ~J [ ,~j}~~ J 1 {{rte~' ~~~~ CJ" l ~~VV O d + ~ Z :_.. c ~ J ~ ~~ 0 f c~ a ~" ~4 J ' ~' °?p t ~ °s J ~ `/.r ~=~1 V ~ ~ Z,. 3 0. Yt ti4t ~~~ ~~t.lOw Y o~~ ~.e~a ~~~ ~ ~ I.t7~ ^~ ~1.~ ~ O..Y l t?v' iq ~wN'' 12 n ~ .i ,, ~.,..~ \ ~ b s~~co; i~y~ o.~ ~.~ Z ZI..,}' o~~~, ~ oc1~ ~o.a.:X ~~~~ = a.g 3~ -J' s-~ _-~ o ~ ~-, f f' r s ~_ ~ M~~ ~•S' ._.~._ d f~--~18' --~' ~ s.z' ,~ g ~g~ -~ 1110.1 ~ O ~' ~~ °~ S Q-~. ~..~ oM wa S o ... o Y o.. ~ Z ~~ 1'v c sue. 4ti=, .~..~ V CC. ....p:. h ,. 4c~ ~ .,1. a.,..Q ,, 3S X14 ( 3S`14~ ( , 3s'1.4.~ 135`/x." 1 1 10 '8 •'~ ' TNYk (N~~ `„y .~.hri~11~ (i ~„~9Q ~ L: "~w\ /yv~~'1~S 1°vO'Y4L ~~ ""+' V H\ V4. ~Ok~ l~~ 44 ~i.J a~.\O~+.l • /'~Z ~Ol +t~ Oh ' ~.~ 2y~ Gllw~. ~'Y ~r• O~O`ti. l.wC ~ .i J,/4.' pl W~ (Z ~Z SS~ ~~ s o~ g ___. .+ Cr ~ k-c a~ (NYC ~ ~'ti 4° PIPE 3' no 4NolsluaEFO \ S+J1 >r i~ r c~A' cwvc.D sicFr 3brrT-J L P I.1L rwEC.TIo1+S ~e~ ~ go.~~ ~~~ ~p•p LL)CK-NG~GOV6R --1 Ct/A~N iNG •( /~BE~C . avlcK oi•co.wricT--~ 1L,"~b. ScPTIc E _ SPEC~FICATIOIJ$ oosC ~ ;~~~ T~u~.S MA-lUFACTU0.CR: IJUMBER OF DOSCS TA1JK SIZ ~~'~"~~ ~•~ ~~ Foa~t N.a.~~, WEArHERPRp~c ('~ ,TL N CT I c ~ l ~. ~ CoN~JPE'1"c b~oGK T j7/~7i",,'7 o~ .~. G" 4 ~ i ~, .. ~,' `: ~- lam' IY'~ - - -r .'___ ~- ~ `~= WLi~ / N c,:.c j ~ /:, I ~ '~ ~`~ 3' o-r c I ~~.'.+t:.. I i „:..; ~'.: 3~". i ~ ~ P wlP ~ I ~ 1~~.. ~• O ~ ~~ ~ ~. K ~ A C • _ \ GALL01J5 S J ~x~ OOSC VOLUME ~3•~~~ ~c.,i~ s A~ARrh hl/WUFACTVf>,CR; Y ItJCLUOII~ICa OAGKiLOW~ ;,.,_;,ti hOOCL UUIh+DCR: \ ° I ~~ ` `~ CAPAGlTIES; A= Z•Z•4 IUCNES Ch ~}S'~ : : ; 1 ~rrITCH TyPC; w-Q.~...~~ w\~j ._ ,,: _. ~3•SZ. ~ ~°'~ ~` .:MF /1A-JUFACTURCR: " !ra S•b iUCNCS GH~3•BS~O;, .._,, , ~t MODEL 1JUMpCR: ~S•Z . ~ \~•S(a . 0~ I SWITCH TyPC; ~a'~""~ " N~HE~ GR ,;~„_ __ IJOTE' PUMP AWD ALARM ARC TO BC M11JII~tUM DISCHARGE RATC ~•~O G<•M INSTALLED 01J SEG~R~r[ C,~._ ~_ VCRTIC^L DIFfC0.i1JCf pCTWCCU PUMP pif /-UO OIJTRIDUTIOIJ PIPC.,`~~~~' FECT + M~uIMUM ~1ETWORK SUPPLY PRCCLUR E . 3•~' FCCT+~•o~~ T, / + '2$ FEET OF FORCC MAIIJ X ,_~ i/p0 /t FRICT101J•FACTOR. ~~Z•'~ FEET ~~ I' ~ _ TOT/,L Dy-JAMIL NE^p 1 S, ~ g ~ ~. fEEr IIJTER-JAL DIME1.16101JC 'OP TA1JK: LEAIG7H ~~T ;W,pTH ~g f ' LIQUIC DEPTH 3 I 6 a ~ t~ - au~ --____ -~ ,. ts.4 Alm pN 5 ~ b,. Uc~ ~„ 6'~ ~ I 4 ~, W I •~ .~ HEAD CAPACITY CURVE MODEL 152/153 W~ ~W W ~ ~ 50 53 12 40 1 0 Q w ~, 30 z 8 r 20 0 a 10 0 20 40 60 80 100 GALLGNS _ITERS 0 80 160 240 320 FLOW PER MINUTE CONSULT FACTORY FOR SPECIAL APPLICATIONS • Timed dosing panels available. • Electrical alternators, for duplex systems, are available and supplied with an alarm. • Variable level control switches are available for controlling single phase systems. • Double piggyback variable level float switches are available for variable level long and short cycle controls. • Sealed Qwik-Box available for'outdoor installations. See FM1420. • Over 130°F. (54°C.) special quotation required. 152/153 Series Model _ iouroa mvucw Volts•Ph Mode Am s ~omroi Sim lex aetecnon Du lex Nt52 _ tt5 1 I Non 8.5 1 2or3 _ BN 152_ t 15 1 I Auto 8.5 Included 2 or 3 E152 _ _ __230 1 Non 4.3 1 2or3 _ _ BE 152 230 1 I Auto 4.3 Included 2 or 3 N 153 _ 115 1 Non 10.5 1 2 or 3 53 _ 5 0 TOTAL DYNAMIC HEAD/CAPACITY PER MINUTE EFFLUENT AND DEWATERING MODE'.. i 152 I j 153 j l Feet Meters I Gci. Liters Ge:. Liters 5 ?.5 69 i 26t 77 29t 10 3.1 I 61 I, 231 'I 70 , 265 15 4.6 53 201 i 61 231 20 6.1 4a i ? 67 52 I 197 25 7.6 34 129 ~ 42 ~ ' S9 ~' 30 9.1 23 87 ~ 33 ', t 25 I 35 I iC.7 ~- ~ --~ 22 s5 a~ 1~ ~ I -- -- :~ , ~ r Lock Voive~ i38.0 F! (1?.6m;'de0 ~; `,'~<m~ otasoe --~ .~ _ • ~ ~~ '~~ ~ _ J_____ '' i i 1- sKZOSa _ atst _ _ tt _ t Auto t .5 Included 2a3 SELECTION GUIDE Et53 230 t Non 5.3 1 2 w 3 1. Single piggyback variable level float switch or double piggyback variable level Float BE t 53 _230 t ~ Auto 5.3 Included 2 or 3 switch. Refer to FM0477. A CAUTION 2. See FM0712 for correct model of Electrical Alternator E•Pak. All installation of controls, protection devices and wring should be done by a qualified 3. Variable level control switch 10-0225 used as a control activator, specify duplex (3) licensed electrician. All electrical and safety codes should be followed including the most recent National Electric Code (NEC) and the Occupational Safety and Health Act (OSHA), or (4) float System. w~~. ~ ~ ~ ~ RESERVE POWERED DESIGN ~ 0 For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump. ~-' MAIL TOr P.O. 80X 16347 Z / ~` ~'~e Lowsville, KY 40256.0341 ~ , SHIP T0: 3649 Cane Run Road Manufacturers of . • ~~ ~ %~~,~~ Louisville, KY 40211.1961 /~ O /7 Qva~irr P~A+PS SNCe /9,99 http://www.zoelleccom "~ ~ ~lJ~/- ~Ll, f~2) 7 FAX(502J 7143624 PUMP ©Copyright 2000 Zoeller Co. All rights reserved. ~A Y;~ ' System Management Management of this system is critical. As a condition of approval of these plans this system management section must be reviewed with the owner, and the owner must be provided with a complete set of plans including this management section. If problems develop with the adsorption system or any other system components, the installing plumber, Rogers Plumbing, 715-235-1 132, or the St. Croix County Zoning Office, 715-386-4680, should be contacted for assistance. General Proper functioning of an on-site disposal system, "septic system," is significantly dependent on the volume of water which flows into the system and the level of contaminants in that volume. The lower the volume of water and the lower the level of contaminants, the better and longer the system will function. Typical system components include a septic tank or compartment to settle out solids and contain greases and oils, a filter on the outlet of the septic tank to retain small particles of the same density as water, a pump tank or compartment to allow a dose to be accumulated, a pump and controls, and finally some type of soil adsorption cell to recycle the water in a manner to protect ground water quality and public health. I . If the septic tank is installed prior to sheet-rock and/or painting, pump the septic tank before normal use begins to ensure adherence to contaminant load design criteria. 2 Install water-saving appliances whenever and wherever possible. 3. Repair even small water leaks as soon as possible. 4. Never pour grease or oil down any drain or stool. 5. Garbage disposals are not recommended; if you must have one, use it sparingly. 6. No paper products other than tissue should go into the system. 7. No chemicals should go into the system. 8. Avoid surge flows of water; try to spread laundry throughout the week. 9. Septic tank effluent must be less than or equal to the design criteria specified in page 2 of these plans. I U. If septic or pump tanks are no longer used, they must be properly abandoned. I I . If construction timing and weather could create a frozen infiltration system, weather-proofing with plastic sheeting and heavy mulching may be required to maintain a functional system at start-up. Maintenance I . The septic tank must be inspected every three years by a properly licensed person. 2. If necessary, the septic tank must be pumped to remove solids and scum; pumping is required ifthe combined scum and solids volume equals one third of the tank volume. 3. When the septic tank is pumped, any solids in the bottom of the pump tank must be pumped, and the filter must be back-washed into the septic tank to remove accumulated material. 4. Periodic observation pipe inspections should be made by the homeowner to examine the state of the in-situ soil adsorption cell. Quarterly inspections are recommended; a licensed plumber should be notified if effluent is consistently ponded in the adsorption cell. ~. if this system contains specific treatment components other than those mentioned here, maintenance requirements will accompany their specifications. 6. The pumping components for this system include an alarm which must be installed and remain on a separate circuit from the pump. If the alarm is activated, minimize water use and notify a licensed plumber for service as soon as possible. The system allows reserve capacity to accumulate some necessary flow until normal service can be restored; this volume is minimal, and no more than one or two days should pass before any necessary repairs can be made. 7. Avoid compaction such as vehicle traffic within I S' down-slope of the adsorption system. 8. Avoid disturbing the system itself such that might encourage erosion or disturb the required seeding of the system. 9. Particularly avoid winter traffic such as sliding or snowmobiling which might compact snow and lead to increased frost depth. I U. Surface drainage must be diverted around the system; avoid landscape changes which might send surface run-off into the system area. I I . Warning: Do not enter septic, pump or other treatment tanks; death may result because they may contain lethal gases or insufficient oxygen. Contingency Plan Wastewater monitoring of volume and quality is not a normal requirement for low effluent strength systems; such monitoring inay become necessary if problems develop. Any necessary monitoring shall be done in accord with the requirements of Comm 83.E=t (2). Pumping and hauVing of wastewater may be necessary while analysis and repairs are implemented. Additional testing, designing. and.ior installation of additional treatment components or conversion to a holding tank may be necessary. Page 8 of 8 J .Y .. ... ~flRIG11~AL 1669 Wisconsin Department of Commerce RT Page 1 of 3 Division of Safety and Buildings Certified Soil Testing Attach com lete site fan on ounty P P P St. Croix include, but not limited to: verf percent slope, scale or dimems arcel -. D. Pleas viewed By Date Personal information you provide Property Owner Humbird Land Corp. 1/4 NW1/4 S 20 T 29 N R 17 W Property Owner's Mailing Address ubd. Name or CSM# 332 Minnesota St., East, 1404 Hammond Oaks City Sta ",-- Town Nearest Road Saint Pau! I M ~ Crocus Hill Road /' New Construction Use: ~ d design flow rate 450 GPD Replacement Parent material loess over till Flood plain elevation, if a plicable NA General comments RE(~~'~/Cn and recommendations: install 4' x 112.5' rock cell mound on 99.2 contour as upslope ed of roc w a 111 for br goring # ,..~ Boring Pit Ground Surface elev. 99.2 ft . Depth to limiting fa or ~ • LINTY S Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consi GP DKt' in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. `Eff#1 'Eff#2 1 0-8 10YR 3/2 - sil 2 f sbk mvfr cs 1f/m .5 .8 2 8-20 10YR 4/4 - sl 1 m sbk mvfr cs 1 m .4 .6 3 20-41 10YR 4/4 - Is 0 sg ml cs 1 m .7 1.2 4 41-43 10YR 4/6 - fs 0 sg ml cs - .5 .9 5 43-53 2.5Y 4/4 c1d 10YR 6/2 scl 0 m mfr - - 0 0 Boring # ;Boring V'. Pit Ground Surface elev. 97.9 ft. Depth to limiting factor 20 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/ft' in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. `Eff#1 *Eff#2 1 0-8 10YR 3/2 - sil 2 f sbk mvfr cs 1f/m .5 .8 2 8-20 10YR 4/4 - sl 1 m sbk mvfr cs 1f .4 .6 3 20-45 2.5Y 4/4 f2d 10YR 6/2 scl 0 m mfr - - 0 0 horizon 3 mottling becomes cap 10YR 6/2 - 7.5YR 518 below 22" ' Effluent #1 = BODS> 30 < 220 mg/L and TSS 30 < 150 mg/L * Effluent #2 = BOD < 30 mg/L and TSS < 30 mgr CST Name (Please Print) Sig at re: 4 CST Number Henry F. Grote ~ 222774 Address Certified Soil Testing Da a Evaluation Conducted Telephone Number E. 4366 353rd Ave., Menomonie, WI 54751 11125/2002 715-233-0398 Property Owner Humbird Land Corp. Parcel ID # Page 2 of 3 Boring # Boring - Pit Ground Surface elev. 99.2 ft. Depth to limiting factor ~~, in, Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots ' in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. `Eff#1 `Eff#2 1 0-8 10YR 3/2 - sil 2 f sbk mvfr cs 1f/m .5 .8 2 8-16 10YR 4/4 _ sl 1 m sbk mvfr cs 1f .4 .6 3 16-24 7.5YR 4/4 - Is 1 m sbk mvfr cs 1 f .7 1.2 4 24-28 7.5YR 4/4 f3p 7.5YR 5/8,5/3 Is 1 m sbk mvfr cs 1f .7 1.2 5 ~ 28-53 10YR 4/4 f2p 7.5YR 5/6,5/3 fs 0 sg ml - - .5 .9 i horizon 5 has inclusions massive sl Boring # ~ Boring ! Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots ' in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. `Eff#1 `Eff#2 Boring # ~ Boring Pit Ground Surface elev. ft. Depth to limiting factor in. Sod Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots ' in. Munsell Du. Sz. Cont. Color Gr. Sz. Sh. `Eff#1 `Eff#2 I ~ I 'Effluent #1 = BODS> 30 < 220 mg/Land TSS >30 < 150 mg/L "Effluent #2 =GODS < 30 mg/L and TSS < 30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. SBD-8330 (R.07/00) Certified Soil Testing d 0 s -~ 0 s .~ ~~ 0 `-.'~" i i rt ar ! cJ e 0 ~' ~ ~ f 3~ ~° ,f, x i J _ _ _. _.. ._ _ _.. .__ .___.. ... f' . ~ ~ s _' ~ _ 9 i .. y v ~~ __~ c ~f ~~ N v~P L dJ ~ ~A ,jj a ~ ~ r~ `n ~ r! /, i .~. u ~ ~ ~ .~ 5 D S1 < ~ ~s ~~~//~~ 1"~" 1 { 0 ~ -'1 r`^ ~ ~ tN r Y ~ ~_ ~ s d _- c/1 U 9 h o `r+ ~ J` ~ ~! ~~ ~. ~ ~ ~~'- J ~_ c ~~ S S ..i 1 ~~ 1 ,~ ~ L/ c ~ ~ ~c ~' u ~ ~ ~ ~ ~S ~"~--$ Y o~ ~~ i ...-Y 3 .f ~~~~ ,~ s o ci+QZ u Q' rt S .,~ ~~ y r 4 !!! VVV ~ r( V `~ ~ Z ~ J ~ ;O ~ f / i ~_, a ~k'wv~~T ~___ - __- _; <Y~= __»>- T~_: _ y~trf-y,.~. h ~. Private On-Site Wastewater Treatment System (POWYS) Index and Title Sheet Owner: ~~1J ,r(~(,4,(LC Project Name and System Type: Location: Street Address > Legal Descripti~ Township/County Contents: Page 1: Page 2: `~ / I ~) ~~(.U Page 3: ~.~~~lQ /ti.`L~ Page 4: Page 5: Page 6: Page 7: Page 8: Page 9: Attachments: PlumberlDesigner: .Credential Number. POWTS OWNER'S MANUAL MANAGEMENT PLAN PII,E Ilv O TION Owner Permit # o(os DESIGN PARAMETERS Number of Bedrooms 100gpd/bedroom ^ NA Number of CommercialUnits ~--- NA Estimated flow (average)* gaUday Design flow. (peak), estimated x 1.5* gaUday Soil Application Rate gaUday InfluentiEffluent Quality (NA^) Monthly Average** Fats. Oil & Grease (FOG) 5 30 mg/L Biochemical Oxygen Demand (BODs) S 220 mg/L Total Suspended Solids (TSS) 5 250 mg/L Pretreated Effluent Quality ^ Monthly Average*** Biochemical Oxygen Demand (BODs) S 30 mg/L Total Suspended Solids (TSS) S 30 mg/L Fecal Colifarm (geometric mean) <10+cfu/100m1 Maximum Effluent Particle Size 1/8 inch diameter * Wastewater Flow Verification on and calculations: (Other than bedroom based) * * Values typical for domestic: (non-commercial wastewater and septic tank effluent. ***Values typical for pretreated wastewater. SYSTEM SPECIFICATIONS Septic Tank Capacity gal ^ NA Septic Tank Manufacturer ^ NA Effluent Filter Manufacturer ^ NA Effluent Filter Model ^ NA Pump Tank Capacity gal ^ NA Pump Tank Manufacturer ^ NA Pump Manufacturer ^ NA Pump Model ^ NA Pretreatment Unit ^ NA ^ Sand/Gravel Filter ^ Peat Filter ^ Mechanical Aeration ^ Wetland ^ Disinfection ^ Other: Manufacturer: Model: Dispersal Cell(s) ^ In-ground (gravity) ^ In-ground (pressurized) ^ At-grade Mound ^ Drip-line ^ Other: ^ Leaching Chamber Manufacturer Model Approval Stipulatio n Soil Application Rate~gpd/fl Area Req. Absorption Area Credit per unit ft Minimum Number of Chambers p Aggregate Design Flow/Loading Rate= ~ min Materials: all materials must comply with WI Adm. Code COMM84 and be installed per manufacturers specifications and approval letters. DESIGN CRITERIA p "Wisconsin At grade Soil Absorption System, Siting, Design & Construction Manuat" (Converse et.at.1 yyu~ ^ "W,isconsin Mound Soil Absorption System: Siting, Design & Construction Manual" Converse, J.C. and E.J. Tyler. Publication 15.22 ^ ."Design of Pressure Distribution Networks for Septic Tank-Soil Absorption Systems" Publications 9.6 p "Design of Conventional Soil Absorption Trenches and Beds". RJ. Otis - ASAE Publications 5-77 and "Design Manual - Onsite Wastewater Treatment and Disposal Systems". EPA 625/1-80-012 October 1980 ^ SBD -10570-P (8.6/99) "At-Grade Component Manual Using Pressure Distribution" ^SBD -10567 P (8.6/99) "In Ground Absorption Component Manual" ^SBD -10705-P (N.O1/Ol) "In Ground Soil Absorption Component Manual" Version 2.0 ^ SBD -10628-P (N.6/99) "Recirculating Sand Filter System Component Manual" ^ SBD -10656-P (N.6/99) "Split Bed Recirculating Sand Filter System Component Manual" SBD • 10572 P (86/99) "Mound Component Manual" SBD -10691 (N.O1/O1) "Mound Component Manual" Version 2.0 SBD =10595-P (8.6/99) "Single Pass Saud Filter Component lvlanual" p SBD - 10657 P (8.6/99) "Drip-line Effluent Disposal Component Manual" p SBD -10573 P {R 6199) "Pressure Distribution Component Manual" ^ SBD -10706-P (N.O1/O1) "Pressure Distribution Component Manual" Version 2.0 p Drip-line Effluent Dispersal Component Manual for Multi-flo Onsite Wastewater Treatment Units iuranvrFtveNf`F. MnNTI`nRTN!~ ~[~uF.niT(.F. Service Event Service Frequency Inspect condition of tank(s) At least once every ^ months ear(s) (Maximum 3 yrs.) Pump out contents of tank(s) Inspect dispersal cell(s) When combined sludge and scum equals one-third {1!3) of tank volume At least once every ^ months year(s) (Maximum 3 yrs.) Clean effluent filter At least once every ^ months 3 year(s) inspect pump, pump controls 8c alarm At least once every ^ months year(s) ^ NA Flush laterals. and pressure test At least once every O months ^ year(s) ^ NA Valves At least once every O months ^ year(s) ^ NA Other: At least once every D months = ^ year(s) ~ NA rage~_ol~ JTART UP For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or other chemicals that may impede the treatrnent process and/or damage the dispersal cell(s). If high concentrations are detected have the contents of the tank(s) iemoved by a septage servicing operator prior to use. System start up shall not occur when soil conditions are frozen at the infiltrative surface. OPERATION The property owner is responsible for the operation and maintenance of the POWTS and submission of required reports. The quantity and quality of the wastewater stream will affect the performance and longevity of your POWTS. The installation ofwater-saving appliances and fixtures along with prompt repair of leaks reduces the wastewater volume. Also the brine or waste from water softeners, iron removal units, other clear water treatment devices and foundation drains should be discharged to the ground surface whenever possible. Note: this does not include laundry waste, showers, dishwater, etc. This system is designed to handle domestic strength wastewater, however the disposal of food based greases and oils, vegetable/fruit peels and seeds, bones, and food solids such as those produced by a gazbage disposal should be minimized. Toilet tissue is the only paper that should be discharged into the system. Other non-biodegradable items such as baby wipes, tampons, sanitary napkins condoms, cigarette buns, dental floss, and cotton swabs should not enter the system. Chemicals such as petroleum products, paint, disinfectants, pesticides, antibiotics, solvents, etc., should not be flushed into the system as they can seriously damage your POWTS and contaminate your drinkiag water supply. Maintaui a regular steady flow by spreading launary washing throughout the week. Avoid vehicle traffic over all system components. Compaction of snow over the dispersal unit may cause it to freeze up. ^ Valves Valves shall be operated in the following manner: ~q Alarms / `Alarms should be tested on a regular basis by the home owner. If an alarm sounds, contact an individual licensed to service POWTS, There is normally a 1 day reserve under regular operating conditions, however water shauld be conserved until any problems with the system are corrected to prevent back-up of sewage into the dwelling or surfacing. Inspection shall be made by an individual carrying one of the following licenses or certifications: Master Plumber, Master Plumber Restricted Sewer, POWTS Maintainer or Septage Servicing Operator (per the attached Maintenance Schedule). C~ Septic Tanks Component /, Tank inspections must include a,visual inspection of the tank to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of combined sludge and scum and to check for any backup or ponding of effluent to the ground surface. Access openings used for service or assessment shall be sealed and/or locked upon completion of service. Any defects shall be promptly corrected. Exposed openings greater than 8 inches in diameter shall be secured with an effective locking device to prevent accidental or unauthorized entry into the tank. When the combination of sludge and scum in any tank exceeds one-third (1/3) or more of die tank volume; the entire contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with Chapter NR113, Wisconsin Administrative Code. Th outlet 51 s) shall be inspected and cleaned to remove an accumulated soli ac u sp cations. ProvLSions aze to be m to retain solids in the tank. Filter cleaning maybe necessary at more frequent intervals than stated in the maintenance schedule to keep the system operating. p Pump Chamber/Treatment Tanks Component The inspection must include a test of all electrical equipment such as pumps, alarms and floats. A visual check must be made for leaks, backups, surfacing, missing or broken security devices and other hardwaze and the condition of the. filter. Any service needs or repairs shall be promptly taken care of. ^ In-Ground Gravity Component Dispersal Cells The inspection shall inchide recording the levels of ponding, if any in the observation tubes and a visual inspection for any evidence of surface seepage or dischazge. Any discharge to the ground surface must be promptly reported to the regulatory authority. Ponding at depths greater than 75% of the height of the component may indicate overloading or impending hydraulic failure necessitating more frequent monitoring. Page ~-of~ ~_. Mound, At Grade, In-Ground Pressure The ins 'an shall include recordin the levels of ondin if an in the observation tubes and a visual ' ms ' PeC~ g p g, y pechon for any evidence of surface seepage or discharge. Any dischazge to the ground surface must be promptly reported to the regulatory authority. Ponding greater than ?5% of the height of the component may indicate overloading or impending hydraulic failure necessitating more frequent monitoring. The pressure distribution system is provided with an opening at the end of each lateral to be used for flushing. The laterals should be flushed at least once every three (3) years. Pressure checks of systems with multiple laterals should be done to ensure that equal distribution of effluent is occurring to promote the longevity of the system. REPORTS Reports for maintenance, inspection, and monitoring shall be submitted in accordance with COMM 83.55 Wisconsin Administrative ~ Code. ABANDONMENT When the POWTS fails and/or is permanently taken out of service the following steps shall be taken to ensure that the system is properly and safely abandoned incompliance with Ch. COMM 83.33, Wisconsin Administrative Code. - All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. - .The. contents of. all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator. - After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil, gravel or other inert solid material. CONTINGENCY PLAN If the POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide a code compliant replacement system: ^ A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system. The replacement area should be protected from disturbance and compaction and should not be infringed upon by required setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result in the need for a new soil from existing and proposed structure, lot lines and wells. Failure to protect the replacement azea will result in the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rules in effect at that time. ^ A suitable replacement area is not available due to setback and/or soil limitations. Barring advances in POWTS technology a holding tank may be installed as a last resort to replace the failed POWTS. The site has not been evaluated to identify a suitable replacement azea. Upon failure of the POWTS a soil and site evaluation must be performed to locate a suitable replacement area. If no replacement area is available a holding tank may be installed ort to replace the failed POWTS. Mound an t-grade soil absorption systems may be reconstructed ~n_place following removal of the biomat at the infiltrative s nstruciions of such systems must comply with the es m effect at that time. «WARNING» SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTIAN LETAAL GASSES AND/OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP. OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR I1VII'OSSIBLE. ADDITIONAL COMMENTS. POWTS,INST. Name K {~(`5 ~1-'l Lt.rl`UUI l~~ ~: • Phone ~ `,1~_a~rj-~+ SEPTAGE SERVICING OPERATOR (Pumper) Name Phone K:IWPDATA\EHU'OWTS OWNER'S MANUAL.doc POWTS MAINTAINER Name Phone LOCAL REGULATORY AUTHORITY Agency 5't- , t~C t`~~.NTY ~e N / rs Phone S-. 386. 8'D Page 3 ~ of ~ 12f10f2002 0$:a0 6515015666 INSTANT HOME EQUITY FRAM ROG~RS PI.UMBtNG FFUC N0. :715 2~5 0867 Oct. S~Pri'tc; T~4 h~irrrl:rdA?~Cn A,t`tRT;~t~'1~AI'l~ AN'>' ~..._. oWryt':~ts~3rn CC:)xT1F';c~~orr t"o~ vwrtarl8uyer Mx3lisr~g 4ddr~ ~~~ Prtsperty Addt~sr ZS oZ. l0 ~• •~ t -. (Vcrifteuier requir/c3~t'tam Plas-atng tZ~parnnent far new canscvatl~pa7} /~ 1,~ ~ Cit~f/$ii1t~ L~'+~~ ~bzcel fdentifiC9tioa Nurnlo~r ~-/~~/~`7~~;,,,~7 ~~--CIC..~ €b'C~kL DE9C81P'~ION property L.acatidzy~l., ~/,> 3ec.,, 'Y',N-R~"W, Tawz~ of ~t'lD//.i' Sul~divissoa ,,,,,, ~,L_„_S~S" Lot ~f ~~ ~--, CertttYcd Survey map ~ r„ _....,.,.`~ Volume .Page # 1~'arraatty Deed # ~02~~2 ,Volume ~~`f , page # ZZc~ Spec ~in~a ~ yes ,~1 no Lot iin,~6 id~rttx~-ble .~ yec L7 ric? ~aproper use sad maktuentacaa!f your aeptlc aysteta could result !a fts pramaruxe f3s:lurc to batsdle wa.atcs. Proper maiureaarsaa roasisti Of ptampla~ out the taeptic tt+alt evory three yeses or aaoael,, if nesdad by a licor•tod pua~por. West ynu pat iato the system '. oae rtfoat the ltanctioa of the aeritic tnatG as ; te+ataaarst atago ita clip westa dEapdaal aystesu. '1"laa property e~owadr rgtees to awbmit to 6'G Creix zotsing`Drparhssent a sestificatioa farm, sigoad by thz ~wacr aad by n taa,SC*3r plutaber, )ou+~sytnaap[wmbec, t'e~ictcd ptumbarai a licrt~ pumper VCtifyi ng thali (I) the as-site v~asitwxYes d"sapoeal syatc~u #si pzQpar opt:ttsi~g CGttdidae ladles (3) a~tCr iranpactit-n and pamtrih~ (if ncct:aaaty), the aeritie tur~k is teals ttaau 113 full of sludgy, Ilvre, the uadaratsaed tyava teal tht: wave tcqu3rcmepta aad agree to ~nuttnttiifl tStt ptfvat~e savage drsaossl system with rise st~„4ktds set ~s'~ ]tereia, as set by ma Dsparirnont of Corntttcrce and tlfc Dcpattti-enr o£Nattuxl Resources; State of'~N'isCOnsin.. GertitiGariou g th;i your sapt'i4 had been. msiata~iaed must be ce+rnpleted `sd ratwrned to dta Sit. C:+a~ Cawnty 2 acing Oi~iea wichv:: S~ _ ~~~ "TJdate. m,,. +.~~ ~- Off. , r'' S'EQrAU~'i'LTQ.~ 0~' APPLTCAI~I't' DA'Z'E a~~ c~z~'ic .~ x ) CC7t'i i till t+t~tC1SIEpig oa thifi fCtltt ~tb ttL111 tQ [hn best cf 11~y (olio') t~awtadgt. I (wa) atn (sse} tae atiYDat(p; of ti des~cn'ha e, by~,ri~t of a waexan,ty decd rctx~rdcd in 1t.egisaer of Deeds Of.~ice. BATE •,•'•* N!y ictt:ttrlat3ost that is ttus-reprasenrc3"trsay re:salt in rke aets~mr/ parenis'bting:cvokedhy tt+e,',~oai~g 1Saparttnax~t, "•'~""" PAGE 02 23 2002 04:32,~ P2 • ^ tnciudt tritA tGis appticettoa; a. skimped wotra~xty deed Prgrn t6o Register o£ Ddeda o~ict a, copy of the ccttiGed survey leap if teFerettae Es nladc in the wastatuy deed r ~ • ;~' Wisconsin Department of Industry, SOIL AND SITE EVALUATION tabor and Human Reiations g, Wis. Division of Safety and Buildings In aCCOrdanC F-~~'-~ IL.~IR~B ~ ., ~. Attach complete site plan on paper not less than 81/2 x 11 inches' s Piai?.tnu~° ~,.~}} s~: G/PD% /`, include, but not limited to: vertical and horizontal reference point ~; irection,~~ f `". ° J '' percent slope, scale or dimensions, north arrow, and location an dist~lnce to nearest road. ~Rarc I I.D. # O DE:, ~ ~"~9 - a~ • is T INFORMATION -Please print all info '~ ion. sT ~ ~, ';x ~~' wed by APPLICAN ~~~'a~ Personal informarwn you provide maybe used for secondary purposes (Priva s. 1 c5'c~ Property Owner,. ~ (~ tN ('~ 1 eD L>Al~ O ~ b Property Property Owner's Mailing Address Lo 33Z hiiUN~S©Ta sT. E'~15T lyo~# y0 City State Zip Code Phone Nu~mr2e? •555 ~ City ST• P,w~ i J~~. SSIo~ c~Sl Page , of Z •yv•uv • so • ora i1~l~l 4 on 1 /4 N fM/4,S ZV T L .N,R ~ ~ '~ (or) ~ck# Subd. Name,or CSM# , Nearest Road ~ ~ ~ ^ Village ~ ~ - o~ 1 (LO (~ [~iesidential l Number of bedrooms ~ Addition to existing building [~]'fJew Construction Use: ^ Replacement ^ Public or commercial -Describe: r Recommended design loading rate Z• bed, gpd/tt2 •~ ~ trench, g~/ft2 Code derived daily flow y5'o 9Pd 2 ~ ~ C 2 4 _~~bed, ft J trench, ft Maximum design loading rate " ~'` bed, gpd/fl2~trench, gpd/ft2 Absorption area required Recommended infiltration surface elevation(s) •su 3 tt (as/r~eferred to site plan benchmark) ~ Additional design/site considerations /1~/ rT.., tt Parent material ~4 EtS ~ V ~ O NSA ~ Flood plain elevation, if applicable Conventional Mou In-Ground Pres AT-Grade System in Fill Holding T S Suitable for system ~../ ~ ~ U ~ S U ^ S U ^ S I~sYuf ~ S () ~ Unsuitable for system ^ S LJ U SOIL DESCRIPTION REPORT Boring # ~) Ground elev. ,oy.~tt. Depth to limiting factor ? ~ -in. Boring # ~, •, . Ground elev. /p~/~.2,..ft. Depth to limiting factor ~ ~ c., •f, pp. CST Name (Please Print) RpBarizT' ~1L17F'C,~T Signature r..-,..- ~is• 3gG • ~ ..~T ,.,....,,,e. uare ---- Address /~ G,~.. 2.4 _ ~ 4 ~ 5 ~ ~•4 3 7 5 Remarks: ,_~,,,,,,,, ,,,,, r ~ ;,~` 4 , 1 V,r.~ Q ~ ~[~ L ~a~/ SOIL DESCRIPTION REPORT page ~' of 3 PROPERTY OWNER ,~cc,, ~~ ~ # ~ ~ ~y ~~ M M O ~~ D EL I ~ S ~ (~ v . . PARC i 2 ~ Mottles BOring # Horizon Depth Dominant Color Color Cont Sz Qu Texture Structure Consistence Boundary R~~ Gr. Sz. Sh. Bed ,Trench 3 . . , in, Munsell 3!3 - w Sri ~f s ~ ~~ • i.. 3 ~ Y~ 2,w~ s SAC - ,~f c . ~ . s ' ~~ I Z • ~ ~o ~ 3~ . SAC Z ~ 6 ~-~'i ~ _ 1 . S • ~ and x ! ~ ~ , •-~ ele G Q ~~LL s ' ~~ " ~ ~ Depth tb /O ~ , limiting factor in. ' a Boring;i~ ~' ~' Ground el'e~ n. Depth to limiting -factor in. - ~ Remarks: GPDIf12 ~ ` " ~ Mottles Horizon Depth Dominant Color Q Color . Sz Cont Structure Texture Gr. Sz. Sh. Consistence Boundary Roots Bed ,Trench U . . in. MunseN '~3oring # - r •~ Ground ' elev. ft. r---` - - - +Dep~,i to limd~~'QQg • ' fact~ in. -- ~ -- p~ ~,;8~'ing # ~i , ` V ; ~. Ground elev. ft. Depth to tf-nitin9 factor '~~ N uH g ~ f2p ~ ~a~ SOIL DESCRIPTION REPORT PROPERTY OWNER ,r, !1 N ~ ~ ~y HAHH O w~ L LD ~~ ~ S' .S ~ v ~ • PARCE . Boring # Mottles Structure Horizon Depth Dominant Color Texture Gr. Sz. Sh. Munsell Du. Sz. Cont. Color i n. wy~t 3!3 -- SiC !-~s Z , ~ /~ ~ ~` s!C 2,r« S Ground Q ~_ SAC Page ~- of 3 :onsistence Boundary Roots Bed ,Trench ~ w !.~' , Z' . 3 IT~/• ~ i • ~/ 1 ~ T .. ~ .-.~ Remarks: Structure g~ , Trr Horizon Oepth Dominant Color Mottles Texture Consistence Boundary Roots Munsell ~~. Sz. Cont: Color Gr. Sz. Sh. in. ~ , ,~„ ..Boring # Ground elev. n. ~_ -- Depth to limiting ~ ' 'factor , ' fn. Boring # Ground elev. tt. Depth to limiting factor I"• Remarks: ~nnul_o i7n !R. nA/951 r - v ~M ~ / _ , s/r~PVF y6 Q ~5 Yy ~~ :~ ~3 ~ ~ w c.a T cod a,~ . ~ ~ p t~ , = /ao. 0 .. I ' i ~o q~ ~~ ~b~~ C 56 3S ~ 3/ S3 I po . Lo, T ~ - 1, ~~~ J ~~ ~~ ~~ ~~ '~ ~ ~ ~ ~~ ~h ~ U 4 O ,~ f'- I~#~~w ~I~ (~~ b ~- ,~ Y IAN c~ ~- ~' sj~ Y~ M I~~a~ 5 ysT~ ~i,~v , w~ ia'' s~~p ~% it Lb T- ~(-0 Sd , ~o T- Li%~~ CLVT 39~ Ulbricht 8 Associates pAvata Sewage Consultants 655 O'Neil Rd. Hudson, Wfs. 54G18 ~Sr22 ~c~7S z y'e • z3~ ~ ~ 1 ~ d S~l~ r ,~ f l i ~, i st .i~lf•n~f~neie~i •i~it•l~i 1 rlrlalrl' 1 ~ 7Rn a ~c~ ~ srntt nnn os• w,vct,vyrr+ r•uRna a • iT38 1YrIRRANTY DEED f 1,0,1 rrynl N ~ mFc~- ~ , ~, ~- Thlia Aeed, medn benvesn Hammnnd Land, LLC, a Minncea#a t,imiicsl Liabi),'iy Company- ~'. ---_ .-- Grnmor, and...., tNiAiam n Grunrei~ -,..--- ..,._.._- Crrdrttor, fOr a vpiuablc cq[riidcratipn, Convcyq aad wnrr.~nt9 ;U Gramcc the following deaaribcd re,ll cst¢lc in 9t Croix CoUnla, 5t¢tc of Wiicontin' -' "' Lol JI) Nainmond Onks Suhdivisosl,Town ~F!•tern~rond. St. Cr_~,~ ^olmly Wisco[s6in laud eau lulaiu Bull lu '""~"~ !1 asvisy~~a nF a&~s ST. CRDIX CO. , xI &fCBIVEA FOR RECORD >Zrlb/2802 08r30r1i1 EXE><DT iF ~~ ~'~t ss.0e 7'RAN FES : 94.70 ~~~~~i FEE R rdin rsn r end nnum ~,O.hon} nI9-i98G~IG•atxr Pnrwt tderilii'iaeiina Namhcr (P!4) ~ '- This is tipf Iw;;rocrosd pmpeny. (is) (i! npt) 8tioeprions co warrpmiCt Snbjcct to nolca, caxmcras,rt:strictioaR.cavenants and nghts:oftiv~y of roconi, if any, including bul not limitcd Io those fordrai[mge,rvater rote[uton,ponding.iind or aritities as may be shown on r.lro plat of Nenitrmrd Onks Subdivixion rocorded i,n Vol, R of Plats, psigc Z, SL CtCix County, Wjye:drtain. The warrnnlie3 of This decd, eu:h:r arytcs.RCd or impllcd arc limitcd by tLC grnntorto tyre ~tnnlec, or ;uiyunv in the chitin of title, to llle ptrnsidCrution cxprccsCd htrrein, tlt~rr I:eing Lhc sum aC.T, ~1,990.0b. lailwd ibis ,_,• 0th dry of Deccniper ,,,_ x402 Hammond Lands LLG ~t.Tttrti~yrtcArlon - - tt; ilUl P[CI3) nutlienricnrctt thla :I:rv ol',, ,, ` b1...~.~, PrLwidpit • Au.IGa J. BaiNtrn - ~~~ ACKNOWLBDGMttNT + ~7nT15 Gf wiSr_'srvSlN I S5. Ro.mseY . _ Co,inry, ; Persnrtully cnmo bcferc utc this; 61h` dnyaf DeccmhCl' ~ 2001 lhC nborc nnmcd AuDln1.... , Boillon _.. . 'I'I'1T.,~: MF?M111;K STrI i F PoAR OF WISCONSIN (I I' nv[, ,:~~wunaaiu uv g n~o.uo. N't~.'Stliis'J..'_.....__., ,run iriu•rpt,Mari~r Wa,u uarn•rrn n7 Paul A. Boi110n, Attoltr4y A! Lmr (Sft[nasuraa may he nudlcn[un[r_vt er aekr~r aekYUwledtto,i. DctJt ac nm ncocaaery ) to tMU knoum ;a W: die (7eTA0n(s) who exee,[trnd the fctegoin~ ilLRtfltmenl and nn4nnwl~ 1{7~ 7r ~ ee~..~. Pa_~i6;.f.1~,~iwr;t'S'~. ~t+i~n.i.rr. rvOW'y YL bli„ SlatC Ot~~iMearTli[" L P~fy COiiun:xxinn iuperniwirnt.E•iL'an2; xlata.en+r;:n+[imnielcr+~. Januaty_31 .. 2505 r ~ uu .1 la'I • \ om M eY pm~aana alga ha in v,y sapeeiiy .h~ nrJ he ryPC tl n r >+rintod below r.40ir Yignn[urc n 7}nNNAA rY 11615A erATx a,^ nr w7,~ppYfty f:: rt9iMn7ii+N PRM`f'.mm~Nn; s r'Ot.QPnVV t•nHn pp LnC, wi imm~.ee}-qn,i ~rilrlrrrr rr .r ulu~~rrr ~Inatlll~ li~l^ ^nn~lr ^i~^ rr i ~ r. ~ N 134'~1'~7` E 757,7?• ~ ~ ~•, of ~' Na9'~,•+~7' E x'57.54, ~ ~ ~ .~ -;~~ ~, 1~ ~ • / s0 1 ~ ti`s _ 1 ~~• ' ~ '~ ~ I• / d ~ ''i If t r 3 ~ J ~, I,,O.~ ~ ~ • ly ~ ~ to ~~ w ~ ~!1 ~- I ~ ~ r I r" r * + ~ ~ ~ r f D~~ ~~'~~~ f ~ ~ I f ' ~ ~ 1.' j ~ ~ ~. i; ~ ~ ~~ ~ ,, r rt ~ ~ r ~' .~ 1~ ~ ' ' ~ • ~~~ M ~ R y ~ ~ L: n v „ ~ w r !~t t r, ~ u ~ ~ ~ ~ t'1 s ~ 4D ~ +~ U1 "rl ~ , . ~ ~ ~f N~ I' C ~~~~~ ~~ ~ r~ "F~ . ~ I ~/I SIN. i"r ~r ~ • ~M ~ t y I~ I III ~~ ,,JJ r ~y~ ~ r ~I ~^~• 111 °- r~!-n ~G /"^ SpJ~/Z'0'd ~~# r"s:LT '[L"TS'cO~Z ~I a- cur.. ~~O ~ ~ .. w ~ I i i t i 3 M rM f6' ~" tit W _~ c . ~ 1 . gi •i ,~ Ir r ,~ ~~O .~~ 4 ~ ~ ~. , .y1 ~ y ~ f se9 as'~~'K l9D.C0' JOIrvT i. P 0~ :~ r a ~ D • f ~ ~~ ( h ~ ~ +~I~harnLMwW67f7rti: pls7f"T 1 ~ i "7.~~'uL~i+n"i r7 •..~ •.~•~*•• .,•~ ••~r. 9@trL 9bZ STL QNOWW02~f MOH alt`1'tl tRJIG3: MOiisl ,~ . .. - ~ HA MMo ND 0 i I PART OF THE NW1/4 OF THE NW1/q TOWNSHIP 29 NORTH R ~ i , ANGE 17 WE; 235.75' I EAST LINE OF THE NW 1 /4 OF THE ' t\~W 1 /4 OF SEC, 2p I I I 127' 39' I 187.98 154.08' ---~- 1st.5s' 168.28' o I I O W I o S g LOT 9 I ~ ~ I ! y I LOT 10. as N LOT 11 o N N 311 SQ, FT, ! ~ W ! 54513 SQ. FT ; LOT 12 LOT 13 .20 ACRES ! M ~ I i , 1.25 ACRES M 44683 SQ. FT. M 46852 SQ. FT, ~ 48802 SQ. FT 1.C3 ACRES ~ ? I I I ~ . M 1.08 ACRES 1.12 ACRES I oo °' I ~ I ~, I z I _~ a~ __ ~ ` o I _ ___ ~. 115.65J- - ~ I ~--- - - 187.98' _ _ 154 08' _ _ _ ~ - - -- ~ ' ' ~® ~ . -- -- -- 161.56 -- __ __ _ _168:28' __ ~ ~' - ; 84.54' _ _ i ' - - - - -- 156.91 1241.45' -- - - 150.21' _ 150.21' - - - - - - - - - ' rt _ .- _ _ - - - Z 150.21 151 -- I - -p ____ a I l o S o ~ ~ I OT 42 O N O N O ~ a W I ~I of 3 LOT 41 3 96027 S Q.FT. N 43,561 SQ,FT. N 4 LOT 40 LOT 39 3 LOT 3,561 SQ.FT N 43,561 SQ FT ml 2,20 acres ¢ 1.00 acres ~ : , . 43 561 1.00 acres ~ 1.00 acres 1 00 H I ~ pp N ~ N . a p1 I 39~f N 41 S•S7' I 7a~. RAINAGE & UTILITY \\ ~ 164.p4' / ~-'- - ~ 150.21' ------- -----__ 150 21' ' - - - - - - S. EASEMENT ~, v! \ '~ 1s3.os' . 150.21 150.21 . 256 55 , ~ ~ \ ~~ . 1,53.05 ~ ~~ HIGH WATER ~ `~; \ \~~~ RFUru-. a o~ ~! 3vc~ C7 o c ~ 0 c 3 `i1 3 ~D ~ i . N 9 ` ' A7 I 'Z ~ : ~ c - :: I 3 ~ ~ ~ ~ ~ ~ O n ~ ~1 ~ can O O A fn N S N o `~ . 0 ~ rn n ~ m ° r°n O ~ c°n ? 3 IV O 3 S° ~ ~ C3 . °' ~ ~ = i ° V ~ ' ~ °' ~ I i o ~ ~ n rn ` 1 °o o ~ ° ~ °' ~ ~ ° 0 3 ~ ° I ~ y ~ N C N ' o T p ~ t~ v I v cn Z D d a rn ~ O 9 m co A ~' a ~ v I 3 ° W 0. s a I o cn ~ ` o ~ `~I ~ i. ~ °~ w ° 0 o ° a l y c oW w ~ 3 a • i a ~ Z o ~ ~ ~, o ~ _ ~ uJ~N~ °d 3 Q ~ ~ovv j ° ~ ~ N ~ ~ ~ o d I m i D 3 y O N ~ .. ~ ~ y ~ Q K Z •• O ~f 7 fD p n _ I ~ ° ~ 3 ~ o' o, ~ ~ N ~ N C p~ W ~ 7 N Z m ? -+ ~ N I ° ° N c A Z T ~ ~ LS Q A' ~ N (Z ~ N N .. W ~ <Z N O G ~O o, ~ -. Z Z '~ C %* ~ I ~ i z ~ W A I ~ ~ a ~ I < _a o I ° °' w c U1 ~~ o a ° o ~ 1 N a x I Q ~ o y I ~ a a ~ ~ d I ~, O ~ ~ ~. O ~ :q ~ DO V ffl ~ V ~ O ° ~ ~' o i ti