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HomeMy WebLinkAbout018-1086-44-000Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Safety a ~d Building 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)]. 'ermit Holder's Name: City Village X Township Cameron Home ,Inc. Hammond Townshi ST BM Elev: ~ j Insp. BM Elev: BM Description: ~.5'~ (,L~-Cv - ~ ~' C o (J v C , 'AAII! IAICA~IIAATIAAI CI Cf,/ATIA[il r1ATA TYPE MANUFACTURER CAPACITY Septic -e s~ ~0 ~ d Dosing O ro ~-~ Aeration _ _~._--- Holdin TANK SETBACK INFORMATION TANK TO P/L WE L BLDG. t to Air In~t~ke ~/' . -"~ ROAD Septic f ~ ~Y 3 Z ~ ~ ^_ Dosing ~ 3 7 , ~~ f js ~ - _~-- «----- Hol ' PUMP/SIPHON INFORMATION ,~ ` GPM Model Number ~ ~~ TDH Lift~~ Friction Los System Head TDH/ tt Ft Forcemam Length Dia. ;~ Dist. to we~~ ~ - •r ~ ~ t) In ~~" County: St. CrOIX Sanitary Permit No: 399624 0 State Plan ID No: Parcel Tax No: 018-1086-44-000 STATION BS HI FS ELEV. Be chma ~ AIL ~ ~~;r `, tip ttf 2. Z 3 Bldg. Sewer ~ ~ j Cs S Ht Inlet 3 ~'' SUHt Outlet Dt Inl Dt Bottom I3> ~9 3` ~ Header/Man. _3> ~ Ol . /r Dist. Pipe 2,t1~~tD , L ~ .~1~ C~;./ Bot. System~~ ~'"~15/~. al ~ ~x „~ G'D. '~ . Final Grade /~ ~~~ ii1, U~ • 7~ St hover _ <~ ~ f ( ~ ~ / , "3 fir.. ~ ~~ j, ~ . HeadedManifold /1, .l Length I N Dia ~ Distribution pipe(s) / Length_~ X - Dia ~ // ~ ~ Spacing x Hole Size I ~ ;1 x Hole Spacing 'Z Vent to Alir Iptake ~ J . f.' SOIL COVER x Pressure Systems Onlv xx Mound Or At-Grade Systems OnIY ep'HyOver t B d/T h C ~ i ~ / Depth Over dlr h Ed B xx Depth of To soil i xx Seeded/Sodded xx Mulched enc en er e ( renc ges e p k t, -.~ ~ Yes ~ No ®Yes ~ No rt' ~l COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1:~/_3/~ Inspectio -~ /~ ~ / L~ Q ~,,~ Location: 1603 89th Avenue Ham ond, WI 5015 (NW 1l4 NW 1f4 20 T2~ R17Y.~ Hamnhond Oaks s Par I ~: 20.29.17.644 1.)AItBMDescription~3~ /°bl~ ,,E' W~~1"1C.~G'V~r~'r S'" Nd (aiLt'~ 9h ~~(j2/Z~ 0~ / / // ~/1 2. w r len th = z2 ' irL2ec~ -~'~~~^`~S (~ •~ ~` GO-1J'rGtr~~r' bf Su bn~.I'T~~~ r 1" `+1y°~~j Bldg see g ~ ~ ~ ~ / P~/, -amount of cover = ~/ ~'( ~t ~ 0 W h.f r 5 (,~tV ~ %ti 6G ~or~ (~,~,~,...~ GIl}. 57ru C~~~., 3.) Co~ntour = Pla/n r'evisl~~Re~dire~? ~ Ye~ No l ~~ ~~ , ~, t~ Use other side for additional information. ~ `~` ~ ) ~ ~ ' '~ ~'~` ~" ~~ ~ ' ' y t ~^~ SBD-6710 (R.3l97) Date Insepctor's Signature Cert. No. DISTRIBUTION SYSTEM / ;~ Safety and Buildings Division County . ' ~~~Z `~~ ~ ' 201 W. Washington Ave., P.O. Box 7162 -~ - / ~ ~ I~~O~SI'n Madison, WI 53707 - 7162 Site Address ~ Department of Commerce ~l-~-t.f- Oa07~f G f~-G' _~ C-~c~ L~~ Sanitary Permit Application Sanitary Permit Number '~ In accord with Comm 83.21, Wis. Adm. Code, personal informati tl~T~~~_._L ~ ~ 3q z_~ Check if Revision ( ma be used for secondar ses Privac Law, s15. 1 ~' ~ , I. Application Information -Please Print All Information ~ \ '` -'' 'State Plan LD. Number ~~~ ' ~~, Pro Owner's Name P el Number ,,170. a`j, . t_ ~ 7 C.~;w~- ~v~ ~~lT}'Y~~ ~', ~' , ~Q11 ^ ~ 2001 ~- - -- C~ - ~'%~ Prope Owner's Mailing Address ~- ST `~. ~ iCE ~ = ~ ~ 'P`r rty Location ,I ~ ~ ~ li ~ ~ L' ~ F 2pyi t:a / ~ ' ? ~ ~ ~-. ~ N, R T ~ ;` - S4 / b ; S City, State Zip Code h ber ,~ ~-.. % ' t N ~~ Block Number 1 ~y • ` / L ~' S Subdivision Name ~C. M N~be~ / y~~ ~ , ~~ V-~f jI. Type of Building (Check all that apply.) `~ ^ City 1 or 2 Family Dwelling -Number of Bedrooms ~ - ^ Village ^ Public/Commercial -Describe Use (/ U ~ T~ Townshi ^ State Owned ~~ / ~arestad l ~ III. Type of Permit: (Check only one box on line A. Numbering is for internal use.) (Compl ete 6ne B, if applicable.) A. 1 New S stem 2 ^ Replacement System 3 ^ Replacement of Tank Onl 6 O Addition to Existin S stem For County use B' ^Check if Sanitary Permit Previously Issued Permit Number Date Issued IV. Type of POWT System: (Check all that apply. 1~J.tabbering is for internal use.) 44 ^ Non -Pressurized In-Ground 21 Mound / 47 ^ Sand Filter 50 O Constructed Wetland 22 O Pressurized In-Ground 41 ^ Holding Tank 48 O Single Pass 51 ^ Drip Line 45 ^ At-Grade 46 ^ Aerobic Treatment Unit 49 ^ Recirculating 30 ^ Other ~ a ~ ~ ~~ V. Dis rsaUTreatment 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 SaMO! ~sG' y~~- ~s ~ /. o ~dl~. a ~ ~ ~, G~,,~S - VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Tanks Concrete Constructed Glass New Existing Tanks Tanks Septic or Holding Tank ~-y.~~ -~^ C~.~ ~ t ' (/`~-'" - Dosing Chamber ~7 ~ ~~ ~ VII. Responsibility Statement- I, the undersigned, assume responsibility for ' tion of the POWTS shown on the attached phu>.s. Plumber's Name (Print) Plum s Sig /MPRS Number Business Phone Numbet Plumber's Address (Street, City, State, Zi C e) r ~ ~ ~~ ~ ~-~ ~5 ~U ~ VIII. Count 1De artment Use Oni ~ o Approved Disapproved ^ Owner Given Initial Adverse Sanitary Permit Fee (includes Groundwater Date Issued Is~Agent Signature (No Stamps) Determination Surcharge Fee) ~ ~~ oo ~ Z~ !~. -~ I ~ O I 1X. Conditions of ApprovaUReasons for Disapproval 1%' (~q;W~= qtr "~ ~' ~ • -~ 5 nle ~ Z, ~+~~ Ct, .qM ~i~~~ ~ay~~lx~,•~-~w i~~ +~th~'J i~.. `~1~e. CL1D u~c `~'~a_ ~~,a/ (~ ~y~ ` ' ~/_ /~- ~C (1 u V atpt~. ~ L ~MOIuL ~rrd E ~ ` ' ' -w-P ~- ~. ~-ca4 ~n7 'u..~~..4 d~`~ L~~.t ko-r..~Dh-~ ib t p .~, j ~~c/'/l.t.( ~•C.a Hut~tv.lca ~'hit,lJl.J c:,~jZ~j~ ~ Q ~ ~ ! cr/, ,csw -b•~c-~s' tZoy,wt e 3, M~tv~~t wct2 .,..,Q ~vul ~.`~3~'~L~). ' ~4 ~ ~,~• c~+.wFiw~~e. vuv~~- ~••u~ (~ - y ~ s-6~ ~SWTS r~ - Attach complete plans (to the County oNy) for the system on paper not Less than etrz x ii mcnes m size r ~, j' ,r ~~ ' ~~ ,' ~~ ~ 'v ~ ~ , --- - NOTES : / ~ -- 1. Elevations shown are existing ground elevations unless otherwise noted. 2. Install 4" observation pipes with approved caps. ( Z required). 3. Septic tank to be LoopL650 gallon capacitp manufactured by w t ~C~2. CO~Je~z~ w/ ~ loo ~a~,z.. ~~~ ~ 4. Eench mark S , S~ ~o~~~ 5. Divert surface water around system to prevent ponding at the uphill side. PLOT PLP.N Scale 1"=yp '~ Page 3 of ~ _ 8 °L `~F (~rV L r isconsin Department of Commerce Philip November O1, 2001 OUST ID No.691727 ARTHUR L WEGERER WEGERER SOIL TESTING & DESIGN SERVICE PO BOX 74 RIVER FALLS WI 54022 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 11/01/2003 SITE: Berent Larson 89TH Ave Town of Hammond, 54015 St Croix County NW1/4, NW1/4, 520, T29N, R17W Lot: 44, Subdivision: Hammond Oaks FOR: Description: Mound, 3 Bedroom Object Type: POWT System Regulated Object ID No.: 818784 Identification Numbers Transaction ID No. 685970 Site ID No. 638343 Please refer to both identification numbers, " above, in all correspondence with the agency. 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: This system is to be constructed and located in accordance with the enclosed approved plans and with the "Mound Component Manual for Private Onsite Wastewater Treatment Systems" SBD-10572-P (R.6/99) and the "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems" SBD-10573-P (R.6/99). 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 mound component manual are complied with. A copy of this information must be given to the owner upon completion of the project. Maintenance information must be given to the owner of the tank explaining that periodic cleaning of the filter is required. Access to the filter for cleaning must be provided per Comm 84 product approval conditions. A Sanitary Permit must be obtained from the county where this project is located in~ccordance with the requirements of Sec. 145.135 and 145.19, Wis. Stats. ~ C~I~~~~~ ~ Inspection of the private sewage system installation is required. Arrangements fri>i~ a~~ie made with the designated county official in accordance with the provisions of Sec. 145.2Q~i)~dS(a~s 4ry EMS CF~~C J/ S~F ~ ~,~,. Safety and Buildings 401 PILOT CT STE C WAUKESHA WI 53188-2439 TDD #: (608) 264-8777 www.commerce.state.wi.uslsb www.wisconsin.gov Scott McCallum. Governor ,~ ~ ~~ / ~,~' ~EcE~v~O ~, t`. ~ ATTN: POWTSInspect ~ ~~~;~ ~ 6 ~~Q~ ~" S7 CHOIX ,r~ ~~' ZONING OFFICE `i~ GOUN'f`t ~ .,., ~ ST CROIX COUNTY SP ZONINGOFFIG~ ,, ~ 1101 CARMICHAEL RD ~S'% i HUDSON WI 54016 ' ~ + ;..~ ARTHUR L WEGERER r Page 2 11/1/O1 A copy of the approved plans, specifications and this letter shall be on-site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of construction/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. Asper 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. Sincerely, Julia aLewis-Osborne POWTS Reviewer 2 ,Integrated Services (262)548-8638, Fax: (262)548-8614 j Lewis@commerce. state.wi.us Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 WiSMART code: 7633 TITLE SIiEET I~OUND SYSTEM FOR A 3 BEDROOM RESIDENCE Page 1 of ~ This plan has been prepared in accordance with the Mound Component Manual SBD-1057 P and the Pressure Distribution Manual SBD-10573-P CCZ. blgq~ CtZ, b14R~ LOCATED IN THE -VW 1 /4 OF THE NW 1 /4 OF SECTION ~-O, T Z-°1 N, R 1~ 6d, TOT~Jid OF l`~"R-1^i11~1()YV~ ST'. C[2.¢) 1..)C COUNTY, WISCONSIN. LnT __44 :._.C~t= -L-}-~=Y~!l.J~lC1I~1D=_ O>}1z5- __..._.-. INDEX PAGE 1 of 7 TITLE SHEET PAGE 2 Of 7 SYSTEII rIAIQAGEi~IENT PLAid PAGE 3 of 7 PLOT PLAN PAGE 4 of 7 PLAN VIE~d-CROSS SECTION PAGE 5 of 7 DISTRIBUTION PIPE LAYOUT PAGE 6 of 7 PUI.4PING CHAi1BER CROSS SECTION PAGE 7 of 7 PUrlP PERFO_RI•iANCE CURVE PREPARED FOR cl o _ C~ ~~>v tiUwl ~ _: =_ ~~-0. 13UU t (,~ _ _ . PREPARED BY WEGEE=~cEFZ SOIL . TEST S NG AND . DESIGN S~F2V I CE P.O. Box' 74 421 Id.rlain St. River Falls, tdI 54022 Phone 715-425-0165 Fax 715-425-6864 ~~ .~ ~ ~ s~~`y~ ~ .* V+ ARTF"JR ~ WtfiERER D-N75 ~ EtlSM'ORT}. ~,/% ~`'c''~~~I G `' t'~~_~ ,.,~~-Z3-OI ~.. •p v L `,i4~ NO . ~~~ 1- Z 6 .:~.. ~`,,,~ -~ Mound System Management Plan Page Z- of -]. Pursuant to Comm 83.54, Wis. Adm. Code Septic Tank - The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Stats. 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 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 filter when removed from its enclosure. If the filter is equipped with an alarm, the filter 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 1/3 the liquid volume of the tank; If the contents 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, Safety and Buildings Division. Pump Tank The pump (dosing) tank shall be inspected at least once every 3 years. All 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 maybe 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 maintenance) on the mound is not recommended since soil compaction may hinder aeration of the infiltrative surface within the mound and snow compaction in the winter will promote frost penetration. Cold weather installations (October-February) dictate that the mound be heavily mulched for frost protection. Influent quality into the mound system may not exceed 220 mg/L GODS, 150 mg/L TSS, and 30 mg/L FOG. 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 solids at least once every 18 months. When a pressure test is performed it should be compared to the initial test when the system was installed to determine if orifice clogging 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 levels above 4 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring. General - This system shall be operated in accordance with Comm 82-84 Wis. Adm. Code, and shall maintained in accordance with its' component manual [SBD-10572-P (R. 6/99)j acid local or state rules pertaining to system maintenance and maintenance reporting. -_ , . . No one should ever enter a septic or pump tank since dangerous gases maybe 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 subject 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. Continaencv 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 component 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 biologically clogged adsorption and dispersal media, and related piping, and replacing said components as deemed necessary to bring the system into proper operating condition. Questions about the operation or maintenance of this system should be directed to: The County Zoning Office at _ ~ ~ $_ 3 ~Ej- 41~O ~-D g,r Le ~ ~.~( The system installer at -11.S - Z68 - 6ggs yTGA~i.I> The tank manufacturer at $'00=3\ZS-$~Sb VVI~~ The effluent filter manufacturer at `sUU-ZZ.~~ S7~jZ . Z,p~-gam __. __ - ---- The pump manufacturer aE -- -- - --- ~,3Q _ gZ,p= t[ PLOT PLP.N Scale 1"=yp' Page 3 of ~ _ ~q `~-I- ~VL zo~b3, so' , s ~ k, U~_ `~~ \~ ~`- ~~ n~aYa~ ~` ~~ ~ ~~~ ~~ ~~E 3010 . ~ /6~j \ 23 S~ pn N a~ ~ /~~ ~ ~ ~ ZS, of ~ .s `, ~ , / ,~ ~~ ~« PvC ~~ g~, ~oF i~ / ~ ZK PV C F. w1. \`~ S' ~'~, pp NOT COrit~ ~A't-T ,G~ / a ~Z O lS'N~i2..0 ~ ~~5/ 'Rtts f'~6~1~ W a°t' L5 , ~-'ws-`' ~,~ o~ `°° ~`'" __--- l~~"'.Z3y`~_- _~?-__.48.60' p+J ~t'_' _ C'~_~-P[FF _ _ _ . ~ ~~ i'~ ~yJT ~ ~ ~~ ~~ ~`~, i 'o _ i NOTES : -- ~ -= 1. Elevations shown are existing ground elevations unless otherwise noted. 2. Install 4" observation pipes with approved caps. ( Z required). 3. Septic tank to be L~UU L65pgallon capacity manufactured by 4. $ench mark S ; 5.~; 1°n3o~~ ~. Divert surface water around system to prevent ponding at the uphill side. Pane ~~ Of ~ Approved Synthetic Covering ASTM C33 Medium. Sand Topsoii L -~~ E 3 ~ % Slope s Distribution Cell of i" to 2Z" Aggregate istribution Fipe F D G Elev. lOQ ,Z,S e Farce Moin From Pump CROSS SECTION OF A MOUND SYSTEM Linear Loading Rate= 6 , 0 GPD/LN FT Design Loading Rate= p,33GPD/SQ FT A C~ Ft . B ~ S Ft. I 1 Z Ft. J ~ Ft. K 8 Ft. L q.l Ft. W Z ~ Ft. L Flowed Layer --_ ~0 0 • S F . E o. 6Q, Ft. F 0-8 Ft. G 0.5 Ft. H 1- 0 Ft. . ~ ~~ Observation Pipe 8 --~--- K (- ------------- ----~ ~Qcc~s c3-~-•--------------------- --------------- ------- Bax ~. A ~--'~~ t - ° - - W L ~•---=-- -------- ----------------------~ Force Main ~ ~ I'~r' . Distribution ~--Cell of z" to 2%" .oPPosl ~~ Pipe aggregate z Observations Pipe (]tisc:tbr securely) , PLAN VIET~T OF A MOUND SYSTEt4 ' Distribution Pipe Layout Pace 5 of ~ Place the holes at the bottom of the distribution pipes . at'equal spacing. Remove all burrs from the pipe and holes. Extend the end of each IateaI up with the use of IonQ turn or 4f° fitting to a point within six ~~ inches of the f naI g.*ade, Te.~inate the ends of the IateraIs with a valve,:threaded cap or threaded plug. Provide aces from final grade for the valve; threaded cap or threaded pIuQ. " -Lcc`.ss aoY._ . ~- -_,. ~ ~s~.~c~ L LZOSS .s~`~g1v FV C FU - PV C Laterl-1 ~ Manifold r- Laterl i ~ X X X X XIZ xfZ X X X X Lateral Lenoth - ~ Lateral Length - P Distribution Line F ~ r~c~s sox a- _ ~ ~ . -~ }'~ t1,1 \ FJ~ S W RCE r'+ Rim] p.._ ._ - -•C1 P 3-7 Ft. S 3- Ft. X ~ ~ Inches . .. ' Hole Diameter ~ ~$' Inch --- Lateral ~ 1 InchEes) Manifold Z• Inches Force Main " Z Inches - ~ of holes/pipe ~`~ ~ . Invert Elevation of.Lateraisln b:tSFt. _. ~• Combination Sept,3c~•Tank and • PUMP CHAMBER CRO55 SECTIOIJ AAlO SPECIFICATIOAIS ' PAGE C~ .. .._ • -VEU7 CAP ~ . WEATHER Pit00F JUUCTI0IJ BOX . ti C.Z. VE1DT PIPC ~ APPROVED LOCKIiDG ~ lO' FROM ODOR, ~MA3JHOLE COVER wt~ ;iItJDO>^I CR FRESH ~ u-'Ap,tJl-JG LA.gEC.. t-.~ sP ~c-o>J P tpE w ~}Ytcz-ll s p~ r.~p • FI iei tgNfl G ~c'o E f 18'~/'IIN. . IAI L E T Approved joint w/ PVC~pipe AJR IIJTIIKE t ~ coraDutT .. . _ ~- I - 6~+nw• i / I .~~ ~O ~ L__ IZ~B~.. 'Ft~.~l OF ~7. ~r' xlu. 18'!4111. 1f ~`~ ---------- \\~~ -•- - ~ ~ l ~-~ PROVIDE I ,•~. ` '' ~AIRTIGH7 SEAL I III •^~ I I _.,,~ I III CLEY. a~•0D f~ I III I I I ALARM a ~I II I r I f ou c •I I PUMP ~ r ~ Ft` 1 OFF I D CouCRETE . Z~ ~, Q Q J BLOCK-- 1 Approved joint w/ PVC pipe RISER EXIT PERMl1T'ED OIJLy IF TA-JK MAIDUFACTURlCR HAS SUCH APPROVAL~3"AAPQotiFp Br<pa c tv4 SEPTIC E SPECIFICAT10l\1S DOSE TA-,lKS MAlJUFACTURCR: WL~~Z ~ ~~~T~ IJL(Mg EA OF DOSES: ~-9 PER OAS TAAJK :,IZE: 1~d0 L 65U GALL C1Ai5 DCSE VOLUME z ALARM MAIJUFACTURLR: _S •S~ ~~TRU S s`r't~IS INCLUOIAIG aACKfLDW: `OZ GALtONS MODEL -JUMBER: I O ~ ~w CAPAC ITIES: A= ~'~ -uCHCS OR ~d ~ CALLOUS SWITCH T~PC: M'~~Uz'Y $ _ ~' 1lJCHES'OR =L G PUMP !"IAfJUFACTURCR: _- ~U~--~~' _ (~LLDA1$ / C= b 10 ~ MODEL }DUMBER.: - ~$~ I• ~D4. uJCHES OR - GALLOIJS 1'Z Z04 ~~~°CJ(Z-CJ SWITCH TYPE: D= IAICHES OR GALLOAJS RM AR ~6 _ WOTE: PUriP AUD ALA TO 6 M1l,IlMUM DISCHARGE RATE 31.1 GpM INSTALLED OAI SEPARATE CIRCUITS VERTICAL DIFFEREIJCE BETWEEU PUMP OFF AUD..DISTRIBUTIDIJ PIPE.. G' `1S FEET 7' ~- A1tFN~IM I~IETWORK SUPPLY PRESSURE . ... 6•SO FLET C S.uxl.3~ -I- 6 S EET OF FORCE MA11D X ~'~~ F~ FRICTIDL! FACTOR ~' ~ b ~ .. o FL FEET ~ ,0 ~ TOTAL Oy1.lAMIC HEAD = ~~'' 6) FEET r, ~; ~ ~ . ., As per manufacturer i`~--0 gal/in.' Liquid depth 3$~y `r"1~' P~Ff~R~~1C~. GU`~V ~. uou~as $~~i~~~'S~~~~ ~~~~~e~~ P~~~ 3871 EP05 APPLICATIONS • Fasteners: 300 series Specifically designed for the stainless steel. following uses: • Capable of running • Effluent systems dry without damage to • Homes components. • Farms Motor:... • Heavy duty sump • EP04 Single phase: 0.4 HP, • Water transfer 115 or 230 V, 60 Hz, 1550 • Dewatering _ RPM, built in overload with automatic reset. SPECIFICATIONS •EP05 Single phase: 0.5 HP, 115 V, 60 Hz,1550 RPM, Pump: EP04 built in overload with • Solids handling capability: automatic reset. - 3/a" maximum. ' • Power cord: l0 foot /- ~ Capacities`. up to 55 GPM. t ) ~~ - standard length,l6/3 SJTO , otal heads: up to 24 feet. with three prong grounding y ~ ~-Discharge size: l'/z"NPT. plug. Optional 20 foot • Mechanical seal: carbon- length,l6/3 SJTW with rotary/ceramic-stationary, three prong grounding plug BUNA-N elastomers. (standard on EP05). • Temperature: 104°F (40°C) continuous 140°F (60°C) intermittent. • Fasteners: 300 series Me-reRS FeEr • Fully submerged in high grade turbine oil for lubrication and efficient heat transfer. Available for automatic and manual operation. Automatic models include Mechanical Float Switch assembled and preset at the factory. FEATURES ^ EP04 Impeller: Thermo- plastic Semi-open design with pump out vanes for mechanical seal protection. ^ EP05 Impeller: Thermo- plasticenclosed design for improved performance. ^ Casing and Base: Rugged thermoplastic design provides superior strength and corrosion resistance. ~E ~ or ~ ^ Motor Housing: Cast iron for efficient heat transfer, strength, and durability. ^ Motor Cover: Thermoplas- ticcover with integral handle and float switch attachment points. ^ Power Cable: Severe duty rated oil and water resistant. ^ Bearings: Upper and lower heavy duty ball bearing construction. AGENCY LISTING SA• CanadianStandaNsAssociatian (CSA listed model numbers end in "F" or "AC".) stainless steel. 10 ~ I ~ ~ • Capable of running dry without damage to s 30 ~ ~ ~ ~ ~ I ~, ~ ~ ~ ~5~~' components. ~ ~ ~ ...Pump: EP05 $ ~ ~ _ ; _ . L'~ . • Solids handlin ca bilit 5 g pa y::. c z ~ /" maximum. W ~ • Capacities: up to 60 GPM. ~ ~ • Total heads: up to 31 feet. , g s 20 • Dischar e siz l'/ " ~ g e: ~ NPT. z 5 I ~ ~. • Mechanical seal: carbon- c 15 .rotary/ceramic-stationary, ~ 4 l ~ I ~ BUNA-N elastomers. ` ~ 0 eP'" 0 5 • Temperature: ~ _ ~ 3 10 .104°F (40°C) continuous ~ 31.t6 140°F (60°C) intermittent. 2 'EPO a , 5 r' ~.. 1 0 10 20 30 40 50 GPM ~~ 0 2 4 6 8 10 12 m~/h CAPACITY Wisconsin Department of Commerce Division of Safety and Buildings SOIL EVALUATION REPORT Page ~ _ of 3 rn accordance witn Comm ts5, wis. Ham. voce County n m t i Pl h si e S 112 11 i a us nc es n z . x Attach complete site plan on paper not less than include, but not limited to: vertical and horizontal ~'Ference point (BM), direction'and percent slope, scale or dimensions, north an-ow~and Iocatio~ndQt~tance to near t road. Parcel LD' 018-1044-40-00 Please print all ~rfgrm ~ ~~ ~ f `§ , ~ Reviewed by Date ~ Z~ ~~ ~ 15.04 (1) ( )). oses (Privacy ~' ei;ar~dary pur Personal information you provide may be used for j ~ „r Property Owner '~ ' ~ e ~ ~ PropertyL lion 17 29 W NH1 20 - 5~ -''"° HUmbird Land to `` ~ (or) N R T 1/4 S vt. Lot f`~W 1/4 Property Owner's Mailing Address ~ ,; ~ LoC#; ~ Block # Subd. Name or CSM# 332 NID1. St. E. 1404 ~~%°~•,,_ ~. `>'~44 ' na Hammond Oaks City State Zip Code Phone ~ '~` ~ ~ ' ;'City ^ Village ®Town Nearest Road St. Paul 1~M1 55101 (651) 222- 89th. Ave. Hammond [}c New Construction Use: ® Residential / Number of bedrooms 3 Code derived design flow rate 45O GPD ^ Replacement ^ Public or commeraal -Describe: Parent material loess ovr~r t i 1 1 Flood Plain elevaflon if applicable ~~ _'~,. General comments ;lQ',`• ~ l '~ ~ and recommendations: f ~•`r ~~~~© ~ mound @ el. 100.40', based on contour line of el. 99.40' fY-~' ~ + Boring ~ ' a Boring # ® Pit Ground surface elev. 1 00.20 ft. Depth to limiting factor 36 in. ~~~ ~ ~,' Snil licati ~t Horizon Depth in. Dominant Color Munsell Redox Description Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary ~t 1 / ff#2 1 0-15 10 2 2 none L 2msbk mfr cs 2f 5 2 15-30 10 4 4 none 1f .5 .8 3 30-36 7.5yr4/4 none scl 2msbk mfr 4 36-70 7.5 4/6 c2d 7.5 5 6 sl 2 bk Boring # ~ Boring ® pit Ground surface elev. 1 OO.20 ft. Depth to limiting factor 38 in. Soil lication Rate Horizon De th Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff p in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 _ mfr cs 2f 5 2 10-23 10 4 4 none .4 .6 3 23-38 75.yr4/4 none is Os mvfr 4 38-60 10 6 6 c2d 75 5 6 k' Osg na n n 'Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 mg/L ' trrwern rrz = a u ~ au myi~ anu ~ ~~ _ ~~ ~,~~~ CST Name (Please Print) Signature .CST Number Gar L. Steel ~ 02298 Address Date E aluation Conducted Telephone Number 1554 200th. Ave., New Richmond, WI. 54017 9-26-2001 715-246-6200 Property Owner Htunbird Land Corp. Parcel ID # 018-1044-40-000 Page 2 of 3 a 3 Boring # ^ Boring ~ Pit Ground surface elev. 98.90 ft. Depth to limiting factor 41 in. Soil liption Rate Horizon Depth Dominant Color Redox Description Texture Sbvcture Consistence Boundary Roots GP D/fP in. Mansell Qu. Sz. Cont. Color Gr. Sz. Sh. `Eff#1 `EtT#2 1 0-14 10 2 2 none cs 2f .5 .8 2 14-2 10 5/4 nOt~ sil 2msbk 3 26-41 7.5yr4/6 none sl 2csbk mfr 4 41-70 7.5 4/4 c2d 75. 5 6 sl M Boring # ^ Boring ^ pit Ground surface elev. ft. Depth to limiting factor in. Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDlfg in. Mansell Qu. Sz. Cont. Color Gr. Sz. Sh. `Eff#1 `Eff#2 Boring # ^ Boring ^ Pit Ground surface elev. ft. Depth to limiting factor in. Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP DlfP in. Mansell Qu. Sz. Cont. Color Gr. Sz. Sh. `Eff#1 `Et1#2 ` Effluent #1 =GODS > 30 < 220 mg/L and TSS >30 < 150 mg/l. `Effluent #2 = BODS _< 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. S8D-8330 (R.b/00) .. STEEL'S SOIL SERVICE Gary L. Steel CSTM2298 Humbird Land Corp. MPRSW-3254 NW4NW'-~ S20-T29N-R17W town of Hammond lot #44-Hammond Oaks N 1"=40' BM.= top of 1" pvc pipe @ el. 100.00' alt. BM.= top of 1" pvc pipe @ el. 98.60' n~ --t~ ~ . , .~-~ 1554 200th Ave. New Richmond, WI 54017 (715) 246-6200 ~,~. A .~f~=,,~,~RG e ,~ • ~ i* Wisconsin Department of Industry, SOIL AND SITE EVALUATION page ~ of ~' Labor and Human Relations %'' -~ Division of Safety and Buildings in accordance '~.~rll_HR 83.0,: Wis. l~ ~ ~~ ~, ~' . ~, Attach complete site plan on paper not less than 8 1/2 x 11 inches in @: ~an mnst..•1,-,ri dun 5'~'; ~~a~• ~ include, but not limited to: vertical and horizontal reference point (B .direction aixi . .. 'J , ~, /~ • percent slope, scale or dimensions, north arrow, and location and di tar~oe to nearest road f./~ parcel_L~. # O • r R ew by Date APPLICANT INFORMATION -Please print all inform tton. '~~R ~+!. , Personal information you provide maybe used for sec8ndary purposes (Privacy 'N. g`~5•01'.~(~ OFFICE ,' Property Owner M t 2D L>~N D ~ d ~ joperty Loc~~~ti~~~ ~, .E or W f}V a Gdvtlt~bti~%'G~' 1/4NN/1/4,SZt~ TZ.Q ,N,R i1 ( ) (~ '~ Sdt'1'IJ ~~ li 1~0a Property Owner's Mailing Address Lot # Block# Subd. Name or CSM# 33Z~ M i uN~soTA ST. E~15 T I yo ~ hM.tio•vD oi4'~s' Ci State Zip Code Phone Number ~ Nearest Road w ~ ~- ty C ^ City ^ Village .Town ~ ~ d 5r• Pnu~ ~ N~.~i SSIoI (~S/ ~z2Z •555 '~ [residential /Number of bedrooms 3 Addition to existing building ['(Jew Construction Use: ^ Replacement ^ Public or commercial -Describe: ~_ gpd Recommended design loading rate bed, gpd/ft2 • ~ trench, gpd/ft2 Code derived daily flow M ~I~ Absorption area required bed, ft2 •7 `~ trench, ft 2 Maximum design loading rate r bed, 9Pd/fl~ ' trench, gpd/tt2 Recommended infiltration surface elevation(s) s~ ~ ft (as referred to site plan benchmark) Additional design/site considerations ft Parent material ~~ E><S ~ ~~ ~~NSL°" T~ /~f Flood plain elevation, if applicable N~T-- Conventional Mould In-Ground Press re AT-Grade System in Fill ~ ~ds 9 C S = Suitable for system ~~ •-~/ ^ U ^ S U ^ S f~ u ^ S ,L-~J-,'u/ U Unsuitable for system ^ S Ll U L'J S BOring # Horizon Depth Dominant Color in. Munsell ~ ~ / 0.1±3 /oyR slz y 3 •~ /oYR 3l? Ground 2 ~© R y el~n. ~/ ~ •% /Oyi2 y~~ i Depth to limiting factor ~in. Boring # 2 Ground elev. !~. Z~ft. Depth to limiting Remarks: SOIL DESCRIPTION RE Mottles Texture Qu. Sz. Cont. Color G -' PORT Structure Gr. Sz. Sh. hFSh~ Consistence ~ ~P Boundary Roots w ~ GPD/ft2 Bed ,Trench s . ~ ~ . 3 Z~ . s Y c ~f ' ~w+fi a.c . ~ . L~ islZ S ~~ s/ .i /o ~ 3l3 - ~o - s~ a Mi'X off' S Sl ~ b s y2 s~ ~ in. Remarks: ~~p ~ 7~-' ) RoQ~R.T.. ~`f]p~G~'T" Signature ~k~5 Telephon~i.g Name (Please Print R 171F~ ) / ~•S • 3 p ~I Date CST Number Address .niJ ? 1 IOG~•1 22~t37s ;~. ~y,~ 8 I ~Q ~ ~al~ SOIL DESCRIPTION REPORT PROPERTY OWNER ~/(~ ~~ ~ ~^ S (7 g PARCEL I.D.# ~iD ~ f / ~~ M h 0 ~~ ..7 Remarks: ' Horizon Depth Dominant Color m. Munsell Boring # Ground elev. n. Depth to ,limiting factor in. Boring # Ground elev. ft. Depth to limiting factor ..• Page Z of Mottles I Texture I Structure I Consistence) Boundary I Roots Bea Qu. Sz. Cont Color Gr Sz Sh l i i a' s ct ~~ N y 1 ,V ~-- 1~ ~' .. W `1 1 p'I 1 S y.~ ~~ ~~~ ~ I,o V 'N v- I~ ~__._ ~ V\ N m. ---~• ~ •,. ~~ • W `v ~_ T ~ ~ ~ ~ ~ ~ O C~ r Z ~ ~ V 1 ~ M ' 1 3 ~'. 1 M M ~.` ~~ m M `-° U ~ ~' N wa~~ e~m3 N s ~' ~~~~ ~ 3a` of V ~h~ l o~ 1 SAM ST CROIX COUNTY SEPTIC TANK MAINTBNANCE AGREEMENT ~~ OWNERSHIP CERTIFICATION FORM OwnerBuyer r~~N=~'~ v'~ ~'~ ~`~ C n ,, M 'tin Address ~ P U , 8~k ~~ ~ `~ ~. l N v L A-k-~~,1 ~ ,./ ~ ~tl; .S-.SZ~ ~~ ~. ai g Property Address (Verification required from Planning Department for new ~~~- v~. ''~ a ti ~ ~ ~ Pazcel Identification Number ~ ~ ~ - ~ ~' `~ ~ - yU _ 0 ~ City/State LEGAL DESCRIPTION property Location ~~ ~'/., ~ - ~~'/., Sec. Z~ . T z9 N-R /'7 W, Town of ~~-~~ ~ d ~ 4 Subdivision ~~ ~^^- ~"'~ ° "~ ~ ~'q- ~~ s .Lot # ~ ~. Certified Survey Map # ,Volume _ .Page # Warranty Deed # ,~~~~ ~ ci ~' oZ ,Volume ~ Page # -S Spec house ^ yes ~ no Lot lines identifiable yes ^ no SYSTEM MAINTENANCE Improper use and maintenance of your septic system could result in its premature failure to handle cyastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a masterplumber, journeymanplumber, restrictedplumber or a licensed pumper verifying that (1) the on-site wastewaterdisposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than I/3 full of sludge. Uwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standazds set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 da f the .year iratio te. /l~i~,o SIGNATURE OF APPLICANT DATE OWNER CERTIFICATION I (we) certify that all statements on this fornm are true to the best of my (our) knowledge. I (we) am (are) the owner(s) of the roperty cribed abov y virtue. of a warranty deed recorded in Register of Deeds Office. / // l /~~P / L7 SIGNATURE OF APPLIC DATE t/ **s««* ««*«*« Any information that is mis•representedmny result in the sanitary permit being revoked by the Zoning Department. *• Include with this appllcatlon: a stamped warranty deed from the Register of Deeds office a copy of the certified survey map if reference is made in the warranty deed Document Number voi. ~ ??1 Pa~E 115 STATE BAR OP WISCONSIN FORM 2 - 1998 WARRANTY DEED This Deed, made between Humbird Land Corporation, a Minnesota Corporation Grantor, and Cameron Homes Inc, a Minnesota Corporation ~/ Grantee. Grantor, for a valuable consideration, conveys and warrants to Grantee the following described real estate in St. Croix County, State of Wisconsin: (~ Lot 44 Hammorxi Oaks Subdivision,Town of Hammond, St. Croix County, Wisconsin 662952 I~.ATHLEEN H. WALSH kEGISTEk OF DEEDS 5T. CROIX CO., WI RECEIVED FDR RECORD 11-i'6-2001 8:30 AM WARRANTY DEED EXEMPT li CERT COPY FEE: CDPY FEE: TRANSFER FEE: 71.70 RECORDING FEE: 11.00 PAGES: 1 N Nam/e~and Return Address i v~ 018-10861t4-000 Parcel Identification Number (PIN) This is not_ _ hornestead property. (is) (is not) - - - _~ I '~"_'-------~~,r- -- ~! NORTH '"-' - _ - _ ; ~ ~ ~ .£9'tfZ - - - ~ '" w - - - - - - - - --+ _ UNE- OF THE-Nw 1/a OF S o • ~ ~ ~' ~ "' $ ^, ~4g w 264.3?' U $. _HIGHWA _ _ . ~ 0~4 ~~ ~ C "' ~ .°u' ~ ~L66` 'i9~ G~i- /~ ~ +70.00• ~ _ _ _- _~60.JI ~z ~ ~ z _ _ td G N~ ~ + O O~ 7 T°° nAI ~R1P y ~ ~ g - ~ Z i„ ~ t t Pte: ~yLS • ,~ ~ .._ Y+1, 6 ~ ~ ~ w ~ pQ~ 1 /rr~l -1 ~ `~ I j -+ ~Ql ~ -- (•~ ~~ ~04 .'-/~ W~ ~-.. _.._ N ._._ ~ 8__ ti~ pN~ NZ y' $ ~ ~ (M I14 IJg~ \ ~ ~QN ~ V`. A~ W Oi n0• yZZZ ~~B ~ ~CC ~ _ _ I ! 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