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HomeMy WebLinkAbout018-1086-56-000Wisconsin Department of Commerce Safety and Building Division INSPECTION REPORT PRIVATE SEWAGE SYSTEM 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 Gies, Christo her Hammond Townshi CST BM Elev: Insp. BM Elev: BM Description: TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY Septic b Do Dosing ~, a v Aeration Holding TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Septic 2 ~ / J ~. ~5 ~ ' / ~ ~ I Dosing Aeration Holding PUMP/SIPHON INFORMATION Manufacturer Demand PM Model Number w b ~ ~ ~ ~ , 3 TDH Lift ~ ~ Frictic ~ ' ^^^ / System Head TDt' ~• ~. f .l ~ , 23, 0~ Forcemain Len t©~ Dia. a /~ Dist. to Well 7r®~ ~ SOIL ABSORPTION SYSTEM County: $t. Cf01X Sanitary Permit No: 430605 0 State Plan ID No: Parcel Tax No: 018-1086-56-000 Section/Town/Range/Map No: 20.29.17.676 STATION BS HI FS ELEV. Benchmark BSI?#~ 5.lo IeS,la /coo. v Alt. BM Bldg. Sewer 15.. (v5 ~~, SUHt Inlet '~,y l 9.~Q St/Ht Outlet .~ __. Dtlnlet Dt Bottom p 'O •~0 ~~~ Head r/Ma 3 ,2.0 /©~, a Dist. Pipe 3,L,S / p~ /O~•U;~ Bot. System o C /. ~ ,~. Z Final Grade St Cover ~/ 11 bU tic. K a ~/-t ,,~. 3 S s"la lDc7 ~S /~ r BEDITRENCH Width / Length No. Of Trenches PIT DIMENSIONS No. 0 Li uid Depth DIMENSIONS '7~ / ~~ SETBACK INFORMATION SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING CHAMBER OR Manufacturer: Type Of System: ~ ~/ ~~ / ~ /.~~ / UNIT Model Number: DISTRIBUTION SYSTEM Header/Manifold ~~ i [ // Distribution ~ Pipe(s) jj 5 ` 71 2 / x Hoie Size t~ er x Hole Spacing ~ ~ / Vent to Air Inta e C~ Length ~ Dia,~~ ~ Length iP ° Dia I Spacing ;J ~ G SOIL COVER x Pressure Systems Only Depth Over ~ Depth Over ~ Bed/Trench Center Bed/Trench Edges I COMMENTS: (Include code discrepencies, persons present, etc.) a- a s , xx Mound Or At-Grade S to ~ ~ ~ ~~, xx Depth of / SeededlSodded xx Mulched Topsoil _~ Yes ;j No Yes No Inspection #1:,~/ / Inspection #2: /~/ O ~~¢,~.~~ Location: 866 161st Str~e~et~Hj~a-mmond, WI 54015 (SW 1/4 NW 1/4 20 T29N R17W) Hammond~/OaksQLot 56 Parcel No: 20.29.17.676 1.) Alt BM Description =~ ~ ' "~~n' q~ 1A~,~K ~(~^L~ 2.) Bldg sewer length = ~ ~ b~l ~ ~ ~'t"/ / -amount of cover = (~ / C. ~ + y~{~ ~ ~ - - -- -- -. -cyr~ Plan revision Required? C~ Yes No t j~ [,~ !~ J n/~/~ 8 u I ~.9 Use other side for additional information. v ~ _ _ __ _V__I__ (' __ _ ___ __ , SBD-6710 (R.3/97) Date sepctor's Signature Cert. No. Safety and Buildings Division _ County ~ 201 W. Washington Ave., PA. Box 7162 S'?'`Cy~ r' lscons~n Madison, WI 53707 - 71b2 Sattitary Permit Number (to be filled in by Co.) Department of Commerce (~8) 266-3151 p6 ~- Sanitary t Application C I (~a~te P~lanQ~I/.DQ. Number ~ ° ~ ~s ' n accord with Comm 83.21, Wis. Adm. Code, personal information you provide ~ 1 / LO `~D ' may be used fur secondary purposes Privacy Law, sl ECEIVED roject Address (if different than mailing a dress) I. Application Information -Please Print All Information s~ ~ ~. ~~6~ 16I I Property Owner's Na me ~ arcel N 1 Lot I! Bleek-,~-~ n ` u ~ ~f1Yt:S _ l~Jr' ST.CROIX000NTY' ' `' ~pA /" / ~'~' Prope rty Owner's M ailing Ad dress roperty Location ~ ~ Q ~J -.---~-~~---1~a I't r ~~Z? L-c~.t/ .L SG'~ ~ ~~ ~ f Ci St t ,4. ,4,Section oI f ty, a e Zi Code Phone Number - .~sl,~~ (circle one) 9 II, Type of Buil ng (check alt that a 1 PP Y) o T ~ N; R~~E ~1 or 2 Family Dwelling -Number of edrooms ~__ ~ Swb+~^~~ Subdivision Name CSM Number 1~. .Public/Commercial -Describe Us c f ^ State Owned -Describe Use ~ S -I~-__ ~~ `~~~ ~ •o IZ / City ^Village Township of /s~.~ ssr bs6rG~LI III. Type of Permit: (Check only one box on line A, Complete line B if applicable) p f -. f7 ~ _ >rb .. ~ . 6 ~(p A' New System 1 ^ Replacement System ^ Treatment/Holding Tank Replacement Only ^ Other Modification to Existing System I B • ^ Pernnt Renewal ^ Permit Revision ^ Change of ^ Permit Transfer to New ! List Previous Permit Number and Date Issued Before Expiration Plumber ~ Owner Tt'. T e of POWTS S stem: (Check a!1 that apply] ^ Non -Pressurized In-Ground Mound > 24 in, of suitable soil ^ Mound < 24 in. of suitable sail ^ At-Grade ^ Single Pass Sand Filter ^ Constructed Wetland ^ Pressurized In-Ground ^ Holding Tank ^ Peat Filter ^ Aerobic Treatment Unit ^ Recirculating Sand Filter ^~_„ Recirculating Synthetic Media Filter ^ Leaching Chamber ^ Drip Line ^ Gravel-less Pipe ^ Other (explain) V. Dispersal/Treatment Area Information: Design Flow (gpd) Design Soil Application Rate/gpdsf) Dispersal Area Required (s~ j Dispersal Area Proposed (st) System Elevation VI. Tank Info Capacity in Totai Number Manufacturer Prefab Site Steel Fiber PlastlC Gallons Gallons of Units I Concrete Constructed Glass ~ New Existing Tanits Tanks Septic or Holding Taak , fjG'a .`CSC r (~ Aerobic Treatment Unit Dosing Chamber ~s,~ r I VII. Responsibility Statement- I, the undersigned, assume respotuibility for ins aUation of the POWTS shown oq the attached plans. Plumber's Na me (Print' Plumber's Si gnature MPRS Number Business Phone Number ' Plumber s Addre ss (Street, City, State, Zip Code) i 7 S'c c , VIII. Count /De artment Ilse Onl Approved D Disapproved Sanitary Permit Fee (includes Groundwater Date Issued Iss i gent Signature (N Stamps) Surcharge Fee', ~ ~ ~~ _~- ~ ^ Own Gi R er ven eason for Denial ~S ?lam IX. Conditions of Approval/Reasons for Disapproval SYSTEM OWNER. 3) a.(,L„ ~ ~ (t:Nq,, ~~ f / ,/1. o ~ ~oL V~` h ( '"'~ 1 Septic tank, effluent filter and dispersal cell must all be serviced /maintained .~ S Z,~ er ~L Y I l d b b ~'dJD ~ ~^'~ er. , ~ / um y p as per management plan provide d Co-h ~ w a t ~o ~ i t i b . . ~t .. ~ e ma n a ne 2. All setback requirements must __QQ,,,, ` •~- ~ as per applicable code/ordinances. ~,~e,~IMl1p.~• IM~1` vJ•~ ~OC~iR ~~ ~~ ~- n h . ~ Attach complete o ens rm thn Cn., r., ..nisi r . ,tie ..,~........_ _..__- _-• '_-- -~ -- ...v_ . - . - _ ~S w.~.~~ f a--6 e . - - - --, • -- ---- -5 -•-~v» wr•-• .. `j ..~„ ~,..., ~ x ~ne~rtn size SBD- 8 R. O1/03) `tj' -~`"_ _ - ~~ ,~~ ,. Scale 1 "_ ~~ ' 2 pr o ~ m ~"'~'~1 _ ~. ~oo.o' cam, viz."r,13 . r~r- ti..~w _ _ Co~2.~v~ oF- ~u~- 2q -:- 43~^'1i-FZ - ~.~1Q.~b'oN ~Q.O~__PrT__Stti.~: _.._ C~uZ~,~J `3`(Z OF I.lJT S b - _ _.. ~~._i~ 3~-~ SOS ~12of'~ 1~1Uvp~~_ ~' ~,~°~ D.o tv oT ~i~.~?~~-T c~ 2 ~ ~9 ~ ~6Z.1~ 'T~t'1 S ~tts`(q . a~ S`M~~ . }3!n tt? ~ CAL i7~ -S F1C ''~'~ e <,~ . ~ ~~ p ~~' c~~ '~' F- i 4 ~~~ ~ ~ i \1S b~ z`~ ~v c F•~ . $ ,~ ~ '' ,6 \~ \~~ v '~-- ~1'~ ~1~^Z c" ~ o,-~ ~ Coti'''N d ~- U~ ~p~.0 ~. _~, ti . ~/~/ Page ~c~ ~ `~~ NOTES : ~orZq 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 10uo~(oSD gallon capacity manufactured by w~~~~~ Cu~•,c~-~-~~.,~,~ iuou 16so -r-~~2 w/ ~- t8n~ ~?~c3~Z.. ~~~ 4 . $ench marks = S~ oVC 5. Divert surface water around system to prevent ponding at the uphill side. RECEIVED .~ ~ isconsin Department of Commerce NO V 2 0 2003 ST. CROIX COUNTY' ZONING OFFICE Safety and Buildings 4003 N KINNEY COULEE RD LA CROSSE WI 54601-1831 TDD #: (608) 264-8777 www.commerce.state.wi. us/sb www.wisconsin.gov Jim Doyle, Governor Cory L. Nettles, Secretary November 18, 2003 CUST ID No.220254 ARTHUR L WEGERER WEGERER SOIL TESTING & DESIGN SERVICE PO BOX 74 RIVER FALLS WI 54022 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 11/18/2005 ATTN: POWTS Inspector ZONING OFFICE ST CROIX COUNTY SPIA 1101 CARMICHAEL RD HUDSON WI 54016 SITE: Chris & Aimee Gies 161st Street Town of Hammond St Croix County SW1/4, NW1/4, S20, T29N, R17W FOR: Description: Proposed Three Bedroom Mound System Object Type: POWT System Regulated Object ID No.: 931590 Identification Numbers Transaction ID No. 942868 Site ID No. 668525 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 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 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" SBD-10706-P (N.O1/O1). • 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. • A state approved effluent filter is required. 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 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. • Comm 83.22(7) - A cony of the approved plans specifications and this letter shall be on-site durine construction and open to inspection by authorized representatives of the Department which may include local inspectors. l~7ZCE d~`Ic7IP~t c~~ ARTHUR L WEGERER Page 2 11/18/03 ,~ Owner Responsibilities: • Comm 83.52(1)(a) -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. 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. • The owner is responsible for submitting a maintenance verification report per Comm 83.55, that is acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Gerard M. Swim POWTS Plan Reviewer -Integrated Services (608)-789-7892, Mon. -Fri. 7:30 am to 4:15 pm j swim@commerce. state.wi.us Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 WSMART code: 7633 cc: Leroy G Jansky, Wastewater Specialist, (715) 726-2544 -, ~~YG'~GD TITLE SIIEET Page ~ of NoV, ' 7 LUO~ 'r~OUND SYSTEi°I 3 FOR S D11t A BEDROOr1 RESIDENCE . SAF & BLDG ~ is plan has been Manu l prepared in accordance with the Mound Co.m on p ent a SBD-10691-P and the Pressure Distribution I•Ianual SBD-10706-P (N.O1/Ol) (N.Ol/O1) LOCATED Ii~1 THE S~ 1 /4 OF THE ~W 1 /4 OF SECTION ~ , T ?~ N, R 1-1 W, T0r~i1 OF ~~'tilV'~~'t`T~ ~ ~1-, ~~~..~~`~ COUilTY WISCOdSIId , . Lb l S~ ~F 1`l~'t'l~U ~~ ~S INDEX PAGE 1 of 7 TITLE SHE%T PAGE 2 Of 7 SYSTEif I-IAi~AGEi~1?NT PLAiv PAGE 3 of 7 PLOT PLAN PAGE 4 of 7 PLAN VIE~7-CROSS SECTION PAGE 5 of 7 DISTRIBUTION PIPE LAYOUT PAGE 6 of 7 PUr•IPIIdG CHAiiBER CROSS SECTIO?v PAGE 7 of 7 PUMP PERFOR%1AiVCE CURVE REPARED FOR NC~~13V1Z-~-1, 1~~1N SS\Z,S PREPARED BY LVEG#=)F~SR SL7 ~ L . TEST S NG At~tD . DES ~ Glht S~RV = CE P.O. Box 74 421 II.i°Iain St. River Falls, !dI 54022 Phone 715-425-OI65 Fax 715-425-6864 ~" nn r`~ 7 F ~ 3~, ®~ ~~ ~~fM..w..•~. y~,. '' '~r ` k <~ ~.flfFR~4 ~ u91~G EiLSSY'OFI;M i /~~.. •,y~ ~/ . IG DEPARTMENT Of~COMMFRCEA DNISIpN DF FETY AND BUILDINGS '~ SEE CORRES ONDENCE t t ~ .-03 JOB NO . 03 -ZdZ Mound System Management Pian page ? 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 c,eaned 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 S stem No tress 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 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 BODS, 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 - - S}] arid local or state rules pertaining to system maintenance and maintenance reporting. SB-p 1,0~,~ _ ~ No one should ever enter a septic or pump tank since dangerous gases may be present that could cause death. Septic and pump tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the tanks are no longer used as POWTS components. Septic or pump tank manhole risers, access risers and covers should be inspected far 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 faits 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 ~ l~j _ 3$-~j_ ~b~o C~`~--, C~J~X The. system installer at `~ZS - 3~6_ 31Z( ~,~''i-j'C~1A12~ The tank manufacturer at ~~'`~ZS-~~Sb ~1.~;3L12 The effluent filter manufacturer at - ~(~~-~..Z~_S~~Z Zr~~C The pump manufacturer at ` ~ 3(~_ ~'Z;~`~(_~C~~~. !,.~UL~C PLOT PLAN Scale 1 "= SO ~~ .~ ~3v~-~1-~.: tioo~o'a•, viz"r.~. ~r-~w ~ ~ Co ~ ivy. per.. ~- Z ~ _ o r - ___ ~ 5~ ~ z - ~ . ~1 q .ya' ors ~ Q~~ t~sfi`_ St.~.~ _ '~ CO dZ.b~J `3YZ U F LU'r S io _ _. ___ i b~ sT. ST. . ~~~ - .? _ Z S , ~zrc~ w1 ~~k _ -- '~ ~~ e ~ !~ ~ ~ ~ ~l `'hv C ~ l ~~ q°v A1S b~ ayZ D~9~Z.1~ -~ ~' `C'oY1 S ~LL1`(`1 q4~ " ` ,6 ~~ ,~~, D ` /~~ , . ~ .Z 25 ~/ ~'~. I~ V~0 _=1 ~°~o I Page ~cf `7 ~~z~ , NOTES : LorZq 1. Elevations shown are existing ground elevations unless otherwise noted. 2. Install 4" observation pipes with approved caps. ( ~ required). 3. Septic tank to be 1puo~(oSD gallon capacity manufactured by w~~~z Cu~,c~1~ ~w~~ ouu l6so -~-z w/ ~- ~~a~ -ZPt~~Z ~Fi~~ 4 . $ench marks ? S~ pUC 5. Divert surface water around system to prevent ponding at the uphill side. r • Approved Synthetic Covering PaaE ~~ Of' -' AST~1 C33 I Distribution Fipe Medium. Sand Topsoil ~- -H-- W tF G Elev.1 v ~_- C7 ~i p 3 E ~~ 1 - / ~. 4 n b ~{ % Slope - Distribution Cell of Force Main Flawed ' Z" to 2 Z" Aggregate From Fump ~ Layer D 1. C7 Ft . E 1 •Zy Ft. CROSS SECTION OF A MOUND SYSTEK ~ F D- 8 Ft. C O- S Ft. A ( Fi. N 1.0 Ft. Linear Loading Rate= ~ -~GPD/LN FT 6 ~ S Ft. . Design Loadi_*~a Rate=0;33GPD/SQ FT I \ Z Ft. ,] ~ Ft. K q F~. ~1 o~rn~i-n Dn~~+' `°T`~'~~ L ~J 3 Ft. --e~-- --F~r~e-P4~-~-- W ~ S Ft . ~" . U -Observation Pipe $ - ~ K (-'------- ----- ----~ ~Acctss C~-~•--------------------- --------------- ----- ~3oX W -a-~-------T------ -------- ---------------------'~ Force Main --- _. _ -. J ~ PT --- ----- ~ t C~vD Distribution ~- Cell of Z" to 2%" p?pOS z Pipe ~ aggregate Observation Pipe (P-sidscr securely) PLAN PIETd OF A MOUND SYSTEI4 - Extend the end of each Iatz-aI up w?th the rase of lon, tern or -f' ~r,.;IIg to a point v,rith?a sI.; inches of the fnai Q*ade. Te.~inaie the ends of the late.-als with a valva,~thre:ded c:n or . threaded ply. Provide aces from final ~.de for the vaIye; threade3 cap or threade3 pIuQ. Place the holes at the bottom of the distri~ution pipes at~equal spacing. Remove aII burrs from the pipe and holes. T~ ~1cr-, L ~~~SS .s, ;ZEN - rvc ~ F`ac Svc Lateral - ,14aniioid 1 ~ ,-- Later) r' ~-'J+ C- - ~~- LF`• rte; ~j \ `~ Distributicr Pipe Layout Pale S o ~ ;rC~~S 5pX -~ ~R~~"~ J'~ ~'ri~J G- _ _ , --a - ~~'~~ P__ Ft. - Nole Diameter ~~`~ Inch ~ ---- S 3 Ft. ~ Lateral ~ I InchEes) X ~ 5 i;nchPS Manifold l~~y Inches ~- ~ ~ Force Main " 2 Inches - - ;, # of holes/pipe 13 - . Invert Elevation of.Laterais ~~~~~ Ft. 1~~c.~.~~1_ S,33~ ~ _ Z~.3L Sri t .._.__ .._. _.__... _. - Combination Septc~Tank and ~~ 'y PUMP CHAMBER CROSS SECTIOtJ AAIb SPECIFICATIOAIS ' PAGE ~ OF -VEU7 CAP ~ WEATHER Pit00F • .1tl-JCTI01.! 80X . Y~C.Z. VEA17 PIPC ~ APPROVED LOCKII:IG ~ lO' FROM DOOR., MAIJHOLE COVER s'vllx :~IuDOW OR FRCSH ~ tti.~P`R.rJi-JG LP.6EL. "~'3p~Gto-J PIPE A~IUTAKE ~ co~p~`Ir w lr~ttZZl a ttT ~sP ~, ~ , •• _ i~ i ' F1NlS~ 6`riw. ~ i / I Y~HU.1. ~L. of ~ -t ~ I ~~~ ~ ~. ~ ~ `-_ ~ I~.MIU. .~; • -- - ; ' 11~ I1.ILET ~" PROVIDE I - ___ . ,, ••;,'~ ~AtRTIGHT SEAL I III .~ B+tFrL~ I II I Approved z>~8~.t ~~~ ~~ ~ ~ ~ I I Approved joint ta/ ~_~~pp I joint w/ PVC pipe b ~I i~ ALARM PVC pipe I r . I f o-~ c I CLEY. ~`'~ FL TI ~ I I PuKP -~ --~ I ~ OFF D RISE4t EXIT Pt=RMITrf=D O>.1Ly IF TA-JK MA~;UFACTURER HAS SUG,H APPROVAL~3NAA~F^_ ~DDsrv4 SCPrIC E ~ SPECIFiCATfOf`IS . DOSE TA~.J-tS MAlJUFACTURCR: wL~~~ ~O~1C-4~-~~ j,~~lyER OF DOSES: 5' l l~o~ I6so PER °~,~ _ TA1~K :,IZE : _ GALLOAJS DCSC VOLUME r ' ALARH MA1.tUFACTUfZCR; S• J' ~~`t'lZO S`'LS~T~"1_S I-JCLUOIIJG 6ACKFlDW: 1~ ~' GAILOhi;. MODEL -JUMBER: ~~ t ~w CAPACITIES: A= 1 - IAICHCS OR ~ ~ ~ CALLOUS SWITCH TyPC: ~~ZCU~-~ ~4/ 8 = _ ~ IfJCHES'OR ~_ G(~LLOUS HUMP MAAlUFACTURCR: GOU`-~S C= ~ IAICHES OR ~~~- w~~~ ~f CALLOUS MODEL uUFIBER: 0= c,, ZZ IRICHES OR Z ~ GALLOIJS SWITCH ~TyPE: ~ ~-~~T 1JOTE: PU11P AAIpLARM At R 0 6E M!lS1MUM DISCHARGE RATE Z~'32 GpM INSTAlLEO OA1 SEPARATE CIRCUITS VERTICNL DIFFEREfJCE DETWCEU PUMP OFF A-,1D..DISTRIBUT101J PIPE..Z~'S~ FEET ~- r'SII.IIMUM 1~lETWORK SUPPLY PRES`StURE , b-SO FCET ~5.~ kl. 3~ ~" _ 11S FEET OF FORCE MAIIJ X ~~ ~ T F~0 Ft FRICTIOU FACTOR' ~, ~ T I ~ I ~j ~ ~ ~ ~I - C~ TOTAL DylJAMIG HE:AO =_~' ~R FEET ~As per manufacturer l`1.p gal/in. Liquid depth 3 &~` J , ~~~~~~~~ ~~ l1 1~/J 3885 APPLICATIONS Specifically designed for the following uses: • Homes • Farms • Trailer courts • Motels • Schools • Hospitals • Industry • Effluent systems SPECIFICATIONS Pump • Solids handling capabilities: 3/4° maximum. - • Discharge size: 2"NPT. • Capacities: up to 128 GPM. • Total heads: up to 123 feet TDH. • Mechanical seal: silicon • Overload protection must be provided in starter unit. • Shaft: threaded, 400 series stainless steel. • Bearings: hall bearings upper and lower. • Power cord: 20 foot standard length (optional lengths available). Single phase: •'/3 and''/2 HP -16/3 SJTO with 115 V or 230 V three prong plug. • 3/4-1'/~ HP -14/3 STO vdith bare leads. Three phase: •'/z-1 Yz HP -14/4 STO with bare leads. On CSA listed models - 20 foot length SJTW and STW are standard. carbide-rotary seat/silicon FEATURES carbide-stationary seat, 300 ^ Impeller: Cast iron, semi- series stainless steel meta{ parts, BUNA-N elastomers. open, non-clog with pump- s Temperature: out vanes for mechanical seal 104°F (40°C) continuous protection. Balanced for 140°F (60°C) intermittent. • Fasteners: 300 series METERS FEET ~ 90, stainless steel. • Capable of running dry z5 without damage to components. Motor a 20 Single phase: •'/ HP,115 V, 200 V, 230 V, ~ 60 Hz, 1750 RPM; %i HP, 15 z 115 V,$0 Hz, 3500 RPM; o '/z HP -1'/ HP, 230 V, o 60 Hz, 3500 .RPM.. io • Built-in overload with automatic reset."` ~~ • Class~B insulation. 5 'Three phase: ; • z HP-.1Yz HP 200/230/ o `46A~%, 60 Hz, 3500 RPM. `• Class 8 insulation.' '` ' - ~ ©1995 Goulds Pumps, Inc. smooth operation. Silicon bronze impeller available as an option. ^ Casing: Cast iron volute type for maximum efficiency. 2" NPT discharge adaptable for slide rail systems. ^ Mechanical Seal: SILICON CARBIDE VS. SILICON CARBIDE sealing faces. Stainless steel metal parts, BUNA-N elastomers. ^ Shaft: Corrosion-resistant stainless steel. Threaded design. Lockout on three phase models to guard against component damage on accidental reverse rotation. ^ Motor: Fully submerged in high-grade turbine oil for lubrication and efficient heat. transfer. ^ Designed for Continuous Operation: Pump ratings are within the motor manufacturer's recommended working limits, can be operated continuously without damage. ^ Bearings: Upper and lower heavy duty ball bearing construction. ^ Power Cable: Severe duty rated, oil and water resistant. Epoxy seal on motor end provides secondary moisture barrier in case of outer jacket damage and to prevent oil wicking. ^ 0-ring: Assures positive sealing against contaminants and oil leakage. AGENCY LISTINGS SP Canadian Standards Association lj~ Underwriters Laboratories 80 70 so 50 40 30 20 10 I 10 20 30 40 0 SERIES: 3885 SIZE: 3/; SOLIDS RPM: VARIOUS GPM Fr 60 70 , 80 90 100. 110 120 130GPM CAPACITY 20 30 m~/h Effective May. 1995 f A ~, v Z Wisconsin Department of Industry, SOIL AND SITE EVALUATION Page ~ of Labor and Human Relations Wis. Division of Safety and Buildings in accordance ~(vith s. ILHR 83.09, /' it _; ~ t , . ' . - n CoUn ~' `''~; ST: C'iP0/ ~ Attach complete site plan on paper not less than 8 1/2 x 11 inches m' iie~ Plan must ` include, but not limited to: vertical and horizontal reference point (BM~Slirecti(~ and -- • percent slope, scale or dimensions, north arrow, and location and di~tan¢e to ~Aarest'Foad `~r~~ parcehl. . # O • f. APPLICANT INFORMATION -Please print all inform i~., .~i~~ ~,~..~E Revs. ea by Date tl 1'S Personal information you provide may be used for secondary purposes (Privacy La s 5~4„(1) (m)). ' , t Property Owner ~ V N Q l LSD _ G1AJl') ~ C b ~ % ~ ~ e tr N N•/l~ ~7~ 1 ~ ~~ ^J' Go W 1/4 w1 /4,S Z d T ~+ i ,N,R / 7 ~ (or) W Property Owner's M~ng Address Lot # Block# Sutxl. Name or CSM# 332. !1 i uN~SoTAI ST: E~15 T I y0 ~ Sim ~•,HMOwD oi¢~s'. ~~~ Nearest' Road w ~ Z City State Zip Code Phone Number ~ City ^ Village L"J i own ~ (y [~ ST• Pnu~ ~ 1Hu. i SSIo I c~o5/ ~zaz •5555 ~tesidential /Number of bedrooms 3 Addition to existing building [~'1;lew Construction Use: ^ Replacement ^ Public or commercial -Describe: Code derived daily flow ~_ gpd ~~ Recommended design loading rate bed, gpd/fl2~trench, gpd/ft2 ?, trench, ft 2 Maximum desi n loading rate bed, gpd/f1? ~ trench, gpd/ft2 Absorption area required 31~ bed, ft2 + g Recommended infiltration surface elevation(s) S~ ~ ft (as referred to site plan benchmark) Additional design/site considerations N~T ft Parent material ~~ ESS ~ ~~ OFNSF T~ ~~f Flood plain elevation, if applicable Conventional Mound In-Ground Pressure AT-Grade System,i~n Fill H~oldS g Tank S = Suitable for system ~., / r-,/_ ~ U ~ S ~ [] g (~ ^ S Lf ~ U = Unsuitable for system ^ S ~l1 L'SS SOIL DESCRIPTION REPORT Boring # 1 m ._~ Ground elev. /n/1 • ~ft. 1(N Depth to limiting factor `min. Boring # ~~ 2 Ground elev. I'I ~~d~ ~tt. Depth to limiting Remarks: / •l1 /oY, z •/ /a, .z~ /o v ~ . !/, ii 3 ____- __.--- ~'~ f ~toTS o /z lL Remarks: ~ {gyp - CST Name (Please Print) Roa~RT 2~~4R~ctiT Signature L /~s ,~ S cs !f ~Y ~. S 'L !~ C Z Telephone~N~ •~ )-(' ye,,.~J his • 3 gG • a _~_. Date _ _ : ~ ~,:~ 1M ~. ~ ~,,~ $ i ,gyp C ~aJ SOIL DESCRIPTION REPORT PROPERTY OWNER ~i ~ ~ S' s O g DoT 5~ ~~~ho~~ PARCEL I.D.# Ground elev. n. Depth to limiting factor • in. -- -- Remarks: Horizon Depth Dominant Color in. Munsell Boring # _---- Ground - elev. ft. Depth to limiting factor --'n• Remarks:. • -- Boring # _-- Ground elev. n. Depth to I:...ilinn Page ~' of Structure I Consistence) Boundary~Roots Bed ` Mottles Texture Gr Sz Sh qu. Sz. c,om. ~~~~~ ~ ~ J `' O ~!~ ~, i ~~ ~ -' ~ ' ~~i ~~ N ~~ ~ 7- ~' i w o -• ~ 4`~ py ~- ~ ~° .~ ~j w s 0 ~ ~ u ~ 4 d' ~ ~ - c ~ ° c ~ G ~~ ~ c~ ~ ~ ~ ~ ~ 0 0 ~\~ ~ ~ ~ Q o ~ ~ ~ ~ ~ "~ ~+ ~ o ~ ~ c ~~ ~ ~~ ,, N n ~. s ~ ~ ~ ~~~ Q C ~ ~ g o° N man C ~ o ~a ~ ~ ~' ~~ ~p a © ~ Z ,~, ,, ~~ / S~ ~1 v t ST CROIX COUNTY SEPTIC; "TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM OwnerBuyer __~/~~- f's' ~•` eS Mailing Address ~~~ ~G~s ~ ~ Property Address (Verification required from Planning Department for new construction) W'.% ~~ City/State Parcel Identification Number LEGAL DESCRIPTION Property Location SGJ '/., ~~ '/., Sec. ?~J_, T 2 1 N-R l ~ W, Town of ,~a f~ ~ ~'-~d Suhciivision __ ~a`ie ,~rd,.~~ ~~!~( ,Lot # ~. Certified Survey Map # ,Volume ,Page # _ Warranty Deed # ~0~~'~~~ ,Volume 2o`fl ,Page # 3~3 Spec house O yes t'~-no .Lot lines identifiable O yes ~ no SYSTF,M MAINTENANCE Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system, The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restrictccl plumber or a licensed pumper verifying that (1) the on-site wastewaterdisposalsyscem is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge Uwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standares set forth, herein, as set by the Department of C'ommercc and the Department of Natural Resources, State of Wisconsin. CertiTcat~on stating that your septic sys em has been matnt;uncd must be cnmpleled and returned to the St. Croix County Zoning Office within 3G days of the three year c ration date. GNATURE OF APPLICANT DATE OWNER CERTIFICATION 1 (we) certify that all stacmcnts on this form arc trite to the best of my (our) knowledge.. 1 (we) am (are) the owner(s) of the property describe oyc, by virtue of a warranty deed recorded in Register of Deeds Office. ~~~~ G~ / ~; d 3 SIGNATURE OF APPLICANT DATE """ Any information that is mis-represented may result in the sanitary permit being revoked by tl~e Zoning Department. •'•"' " Include with this application: a stamped warranty decd from the Register of Deeds office a copy of the certified survey map if reference is made in the warranty deed 'J 2041P 373 • ~ STATE BAR OF WISCONSIN FORM 2 - 1998 6 9~ H 1 ~A~H WARRANTY DEED REGISTER OF DEEDS Document Number ST' CRDIX ~' s YI This Deed, made between Hammond Land, LLC, a Minnesota RECEIVED FOR RECORD Limited Liability Company 11-11-20@2 12:30 PM ~ Ip~i DEID EXE Grantor, and Christopher J. Gies and Aimee Gies, husband and wife REC FEE: 11.00 TRANS Ffifi: 92 70 . COPY FEE; CERT COPY FEfi: Grantee. PAGES: 1 Grantor, for a valuable consideration, conveys and warrants to Grantee the following described real estate in St Crou County, State of Wisconsin: Recordin Area Lot 56 Hatnmond Oaks Sttbdivision,Town of Hammond, St. Croix Cotrnty, Name and Retum Address 018-1086-56-000 parcel Identification Number (PIN) This is not homestead property. (is) (is not) Exceptions to warranties: Subject to totes, easetcents,restrictions,covettants and rights of way of record, if arty, including but not limited to those for drainage,water retetttion,potRling,and or utilities as may be shown on the plat of Hammond Oaks Subdivision recorded in Vol. 8 of Plats, page 2, St. Croix County, Wisconsin The warranties of this deed, either expressed or impiit:d ace limited by the grantor to the grantee, or anyone in the chain of title, to the consideration expressed herein, that being the sum of 530,900.00. Dated this 4th day of November 2002 Hammond Land, LLC r AUTHENTICATION Signature(s) authenticated this day of , TITLE: MEMBER STATE BAR OF WISCONSIN (If not, authorized by § 706.06, Wis. Stets.) THIS INSTRUMENT WAS DRAFTED BY Paul A. Baillon, Attorney at Law (Signatures may be authenticated or acknowledged. Both are not necessary.) by ~~y,L, ,~ President Austin J. Baillon ' ACKNOWLEDGMENT STATE OF WISCONSIN ) ss. Ramsey County. ) Personally came before me this 4th day of November , 2002 the above named Austin J. Baillon to me known to be the person(s) who executed the foregoing instrument and acknowledgethe same. ~. a PAULA BAILLOtt Paul A. BRlllon ~~' ~ MOTAAV PUBLIC MMNESOIP ' ;~: Notary Public, State of Wi ~" ~~ My Commission is permattdltY"('I4'lC6l"'Il^a a ra o January 31 2005 .) 'Names of persons signing in sny capacity should be typed or printed below their signatures WARRANTY ORED 9TAiE 9AR OP WISCONSIN FOAM No. t: - 1991 INFORMATION PROFESSIONALS COMPANY FOND DU LAC, WI 800-655-2021 in N 52 . SQ.FT. 3 CRES ~ a a v ,~o j ~ ~ / LOT 53 43812 SQ.FT. h3 // 1.01 ACRES .a / ,, / 2~O / 24' - - .- t .63' w ' W ~ W _ ~» NO'32'23"W 135.20 i i0 -~-- N I LOT 59 3 1,821 SQ.FT. 1. ACRES LU I ~'+ 53751 SQ.FT. 1.23 ACRES ~1g6~ ~~ a ~~~~~ ~ LOT 55 / ~ 43561 SQ.FT. 1.00 ACRES 4 42"E 299.98 S05' 2' 80.00' RAD.~ ', LOT 56 43,603. SQ.FT. 1.00 ACRES ~\ ~ _ ~ LOT 58 ~A9, 43561 SOFT. ~~ 1.00 ACRES_ - S?6 48 S8 w 3S? S4 . LOT 57 47500 SOFT. 1.09 ACRES .~, ~ I LOT 31 ~ 44,640 SQ. FT. ~ 1.02 ACRES N rn 0 3 (V M N N ~ ~ m o, ~ ~ ~ ~ I I I SO'23'21"E 290.00' LOT 30 44,640 SQ. FT. 1.02 ACRES I SO'23'21"E 290.00' LOT 29 I 44,271 SQ. FT. M ~ I 1.02 ACRES N ~ I " I N~21029 W 296'40' ~ - _LOT 28 I 44985 SQ. FT. o~ o N N I 1.03 ACRES rn o N ~~' ~ ~ 1 0 ~ -- 916.20' -- 162.35' - - 290.00' _ _ - _ 183.40' _ _ 280.45' _ _ _ _ _ _ --_ - -_ - - ~ ._ - - - -"' _ - N00'24'S9"W 2535.04' ~'`~ --- ., -~-l--_ WEST LINE OF NW 1 /4 OF SEC. 20 - N00'24 59 W 2518.50' - i~ GENERAL NOTICE STATEMENT EACH PARCEL SHOWN ON THIS MAP (PLAT) IS SUBJECT TO STATE, COUNTY AND TOWNSHIP LAWS. RULES AND REGULATIONS (I.E. WETLANDS, MINIMUM LOT SIZE. LANDS CONTAC R THE STC C OIXOCOUNTYCZONING OF CE AND ITHE APPROPR AT ~ ESS SHOWN TOWN BOARD FOR ADVICE. THE TH, RANGE W. PRIVATE SEWER SYSTEM RESTRICTION THE PRIVATE SEWER SYSTEM FOR ALL LOTS ARE RESTRICTED TO A MOUND TYPE SYSTEM DUE TO AVAILABLITY OF SUITABLE SOILS. THIS MOUND TYPE RESTRICTION MAY ONLY BE REMOVED BY THE DEPARTMENT OF COMMERCE, AND ONLY IF ENTATION IS PRESENTED THAT SHOWS THESE LOT(S) MEET COMM 85 UTILITY EASEME~ NO POLE OR BU WOULD DISTURB OR STREET LINE VIOLATION OF SI HEREIN SET FOR UTILITIES HAVIN( NOTES: THE COUNTY RE INCLUDING DOWP DOCUM INDIVIDUAL LOT CRITERIA FOR SOME OTHER TYPE OF PRIVATE SEWAGE SYSTEM. ~ MUST BE PROTI ~_ ._