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Home My WebLink About018-1087-66-000The Permit System Addressl: 1633 87th Ave. Addressl: City: Hammond State: WI Zip: 54015 Phone: Cell Phone: Fax: Email: Other: Comments Page 4 of 4 . Date of Scheduled Pumping: 11/8/2007 . Date of Scheduled Pumping: 8/24/2010 1. Issuer: Not determined ~ Inspector: Ryan Yarrington ~ As Built: NA ~ Plumber: Hoke, Kent ~ Money Owed: 0 ~ Inspectors Signature: Yes 2. 3. 4/3/2009 1. owner called to say he has had mound freeze up (still) over winter and had tank pumped several times. Checked and found only about 2" of cover over pipes! Called Kent Hoke to come look at system and he must arrange to have excavator builder make sure at least 12" cover per code. Related Documents Maintenance Events 8/24/2007 Date Pumped http://172.17.128.79/landregulation/editvsp.aspx 4/3/2009 Parcel #: 018-1087-66-000 04/03/2009 03:47 PM PAGE 1 OF 1 Alt. Parcel #: 20.29.17.686 018 -TOWN OF HAMMOND Current ;_X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type # of Units 00 0 Tax Address: Owner(s): O =Current Owner, C =Current Co-Owner O -BATHER, JACOB M & JENNIFER K JACOB M & JENNIFER K BATHER 1633 87TH AVE HAMMOND WI 54015 Districts: SC =School SP =Special Property Address(es): * =Primary Type Dist # Description " 1633 87TH AVE SC 2422 ST CROIX CENTRAL SP 1700 WITC Legal Description: Acres: 1.000 Plat: 08-025-HAMMOND OAKS 1ST LTS 60/85 018-00 SEC 20 T29N R17W PT SE NW HAMMOND OAKS Block/Condo Bldg: LOT 066 1ST LOT 66 1.000AC Tract(s): (Sec-Twn-Rng 401/4 1601/4) 20-29N-17W SE NW Notes: Parcel History: Date Doc # Vol/Page Type 03/26/2008 871541 W D 02/26/2008 869443 WD 08/29/2005 804676 2876/122 WD 08/02/2004 770428 2628/551 AGREE more... 2009 SUMMARY Bill #: Fair Market Value: Assessed with: 0 Valuations: Last Changed: 11/04/2008 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 1.000 23,100 184,600 207,700 NO Totals for 2009: General Property 1.000 23,100 184,600 207,700 Woodland 0.000 0 0 Totals for 2008: General Property 1.000 23,100 184,600 207,700 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch #: Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 The Permit System Page 1 of 4 Permit Number: 8613 Permit Type: New System County Permit Number: 0 State Permit Number: 463171 State Plan Id: Application Date: 11/1/2004 Revision: NO WISC Fund: NO Prior State Permit No: Prior Permit Date: Applicant Id: 15656 Owner Id: 15659 Project Address: 1633 87th Ave. Project Municipality: Hammond, Town of Project Zip: 54015 Quarter-Quarter Section: NW Quarter Section : SW Section Number: 20 Township Number: 29 Township Direction: N Range Number: 17 Range Direction: W Government Lot: Lot: 66 Block: Subdivision Name: HAMMOND OAKS 1ST ADDN Nearest Cross Road: 160th St. Primary PID: 018-1087-66-000 Parcel Map Number: 202917686 Additional Parcel Numbers: Building Type: 1 or 2 Family Dwelling http://172.17.128.79/landregulation/editvsp.aspx 4/3/2009 The Permit System Page 2 of 4 Number of Bedrooms: 3 Building Use: Building Use Note: Non-Pressurized In-ground: Aerobic Treatment Uni Pressurized In-ground: Sand Filte At-grade: Single Pa: Mound >= 24 in. X Recirculating of Suitable Soil: Mound < 24 in. Holding Tan} of Suitable Soil: A+0" Mound: Constructed Wetlanc Other: Drip Ling Note on Other: POWTS Type: Mound POWTS Detail POWTS Pre-treatment Design flow (Gallons Per Day): 450 Soil Loading Rate 0 (gals/days/sq ft): Dispersal Area Square 450 Feet Required: Dispersal Area Square 450 Feet Proposed: System Elevation 97.80 (feet above sea level): Final Grade Elevation 99.60 (feet above sea level): Septic Tank Type: S Septic or Holding Tank 1000 Capacity (new tanks): Septic or Holding Tank Capacity (existing tanks): Total Gallons Septic 1000 (sum of the tanks): Number of Septic Tanks: 1 Manufacturer Septic Tanks: Wieser W 1000/600 Septic Tank Material: Prefab Concrete http://172.17.128.79/landregulation/editvsp.aspx 4/3/2009 The Permit System Page 3 of 4 Dosing Tank Type: L Dosing Tank Capacity 600 (new tanks): Dosing Tank Capacity (existing tanks): Total Gallons Dosing 600 (sum of the tanks): Number of Dosing Tanks: Manufacturer of Dosing Tanks: Dosing Tank Material: Plumber Registration Number: Kent Hoke - 29 Inspector: Ryan Yarrington Inspection Date: 11/8/2004 Conditions Outstanding: Conditions Met: Approval Date: Co-Owner: CSM: Original Auulicant First Name: Last Name: Jim Henry, Inc. Business: Jim Henry & Al Nyhagen Addressl: 2217 Vine Street #200 Addressl: City: Hudson State: WI Zip: 54016 Phone: Cell Phone: Fax: Email: Other: Current Owner First Name: Jacob & Jennifer Last Name: Sather Business: http://172.17.128.79/landregulation/editvsp.aspx 4/3/2009 ®~~ ~ ; 3. ~, Code Administratir 715-386-4680 Land Information F Planning 715-386-4674_:. Real erty 7 6-4677 R cling 386-4675 i ~~} . RE• ~ ~,~ ~~~~ '` 3Sa~ "'"~ ~...J - -- G~C~t- PZ@CO.SAINT-CROIX WI US F,a-x MEMO DATE: ~ J .-- FAX 1`IUMBER: ~~ ~ ~-~y~~y~-~~ FROM: GL,,,_ .' ~~/J~ ~ y( FAX NUMBER: 715-386-4686 PHONE NUMBER: ~ F~~ -, .y~~:~ NUMBER OF PAGES, INCLUDING COVER SHEET: G~ v yet-~'Zr~ ~ - / 6 3 ~ ~ ~ 0~ ST CROIX COUNTY GOVERNMENT CENTER 1 101 CARM/CHAFE ROAD, HUDSON, Wl 54016 __~~ ~~~ 715-386-4686 FAx WWW.CO.SAINT-CROIX WI US Wisconsin Departnl3nt of Commerce w PRIVATE SEWAGE SYSTEM Safety and Building Division INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Personal information you provide maybe used for secondary purposes [Privacy Law, s.15.04 (1)(m)). Permit Holder's Name: City Village X Township Hen ,James Hammond Townshi CST BM Elev: Insp. BM Elev: BM Description: • ' /oo. aC'i ~ ~~ ~ I ~~ \ TANK INFORMATION TYPE MANUFACTURER CAPACITY Septic Dosing CG~ O Aeration Holding ~r : -~-cc3 TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Septic rr l~y -7 Z V ~ o-T J Y~ A ~ ~ ~ , Dosing ~ ~~ ~ / ~ > / 2 '- Aeration Holding ~1G roi.-~ fyt.. ~o Oµp,e v~C S C/Y PUMP/SIPHON INFORMATION P~~ras~L~ Manufacturer ~~ul) ~ Demand t' a,,,_, GPM Model Number ~ N 1 S2 ,~~ T -~, T Lift 'ction Loss tem Head TDH Ft I1..9 /.8 3.Z~ 21.45 Fo Dia. Dist. to Well Q N o 'T Srlll ARCr1RDTIr1N CVCTFM ~t'.+~R County: St. Croix Sanitary Permit No: 463171 0 State Plan ID No: Parcel Tax No: 018-1087-66-000 Section/Town/Range/Map No: 20.29.17.686 ELEVATION DATA STATION BS HI FS ELEV. Benchmark /~ I ol.l /bp Alt. BM- 5 I - CjbV ~/ Bldg. Sewer ~5'y 85.2 SUHt Inlet is 3 8S /~ SUHt Outlet Dt Inlet Dt Bottom ~~, 9 g V, ~ 6 Header/Man. Z , o ~i ~, ~L Dist. Pipe nl S Z. o Z . 0 qfx yL 48, yG Bot. System E" Z..? ~• 76 Final Grade St Cover Ca.vrl~..,{ 8 r~(v 9 ~ 9 3c+ S BED/TRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits In ' Liquid Depth DIMENSIONS ~ 7 S SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEAC NG Manufacturer: INFORMATION CHAMBER OR Type Of System: t '~ rJO T UNIT Model er: DISTRIBUTION SYSTEM Header/Manifold t~ Distribution t~j x Hole Size x Hote Spacing C`~ Vent to Air Intake Length_,~_ Dia ~ ~ Pipe(s) t " 3 ' Length 3? Dia i ~z Spacing o . t 88 ~ oZ $ . 3? .. 1_ SOIL COVER r pfPSS11rP_ SVA}iP_mS Anly YY Mound Or At-Grade Systems Only i Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center Bed(Trench Edges Topsoil Yes o ~ Yes No o~ COMMENTS: (Include code discrepencies, persons present, etc.) Inspectir>~i #1: /~ / 5 / ~ ~ Inspection #2:!L_/,~f~,/~ Location: 1633 87th Ave. Hammond, WI 54015 (SW 1/4 NW 1/4 20 T29N R17W) Hammon Oaks 1st Add Lot 66 Parcel No: 20.29.17.686 1.) Alt BM Description = '~~ Cs.~t w ~,,e ~,~,~ b r. ~~ ~ 1~ ~~'`J 2.) Bldg sewer length = ~''~~` c.~ ~" -.'¢'~' 'L'°°„t...~R`~ ~~'~-~ tf' T ~ds,- w+..~re Ts~..'t -+r i ~••~ 'd'am- Go f tJ to - amount of cover = io "7 Plan revision Re uired? Yes No TI 4 ~ ~f ~ LD Use other side for additional informat o ~__~__, .__ Date SBD-6710 (R.3197) 1 ~.- V-w+.~0 ~~ vJ ~ `~ Ln~ l Cert. No. Insepctors Signature Safety sari Buildings Division 201 W. Washington Ave., P.O. Box 7162 County /' ~• ` 2 D r ~ Madison, WI 53707 - 7162 ~r `+/~ Sanitary Penmit Number (to be filled in by Co.) 0~~~~ ^~7V '; (608) 266-3151 3 De artment of Commerce Sanitary Peanut Applic ti IVE D State Plan LD. Number rovide ou f tion l i d d D ~ S n e, persona m. Co In accord with Comm 83.21, Wis. A maybe used for secondary Purposes Privacy law, p y 15.Q4(H(m~ ~ g 2 O O ~ Project Address (if different thap prailin addtnss) L Application Information -Please Print All Information ST. C R 01 X C O U N ~ Y 7- io (O., D property Owner's Name ~--- 1 3 a Parcel # t # Block # ~ 6 p ~~^'~ff !N/' > property Owner's Mailing Address Property Location s ~ ~(J O 2 2 ~ l1 / tirC 5 j , Sv r ~ 2 ~ v $1,.~ ~~,, ,J~iti section Z ~ Sta` City Zip Code er Phone Numb y~ ~"! ~dSON ~ sy0 h ~~~" /60'(),D~ T~-N. Ream l - y) ~~ II. Type of Building (check all that app ,te$1~1 lyumber , Su 'vision Nam for 2 Family Dwelling -Number of Balrooms .~_ ~ G~' ~~~ ( ../~/ f!„i//C % ` ~ - ^ publidCommcrcial - Describe Use ~-7 ~ ~ ~ ~1~ ~~- ~ ~ X ^City ^W71age'~1'bwnship of / ^ State Owned -Describe Use III. T of Permit: (Check only one box on line A. Complete line B if applicable) pe y A" , ~ ~ Flew System ^ Replacement System ^ Treattner-t/Iiolding Tank Replacement Only ^ Other Modification m Fadsting System B. ^ Permit Renewal . ^ Permit Revision ^ Change of ^ Permit Transfer to New List Previous Permit Numbs and Date Issued Before Expiratiton Plumbtr Owner' IV. of POWTS S em: Check all that a d Filter ^ Sa ^ Si P l ^ e n ass ng At-Grade ^ Non Pressurized In-Ground ~ound >_ 24 in. of suitable soil ^ Mound < 24 in. of suitable soil Constructed Wetland ^ Pressurized 7n-Ground ^ Holdm$ Tank Peat Filter ^ Aerobic Treatment Unit ^ Rocirculating Sand F~lttr Rocireulating Synthetic Media Filter ^ Leaching Chamber ^ Drip ine ^ vel-less Pipe ^ Other (explain) ~` 1 ~ V. D' rsal/Treatment Area Information: G{.D- Dtsign Flow (gpd) Design Soil Application dsf) al Area R red (sf) Dispersal Area Prop (sf1 System Elevation s ~~ 1 VI. Tack Info Capacity,i Total Number Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Units Concrete Constructed Glass New Existing Tanks Tanks Sepdc or Iioldiag Tank Dd d ~ ~ f fS R- Aerobie Treatment Unit ,. (i(~ S /~ 7'w^ r Dosing c>~ ~ U ,~ VII. Responsibility Statement- I, the undersigned, assume responsibltity for installation of the POVV'TS shown oa the attached plans. Plum 's Name ( " t) //,, Plumber's Si re MP/1VIPRS Number Business Phone Number PI 's Address (Street, City, State, Zip Cod j ~o,~ ~ ~o ~~~ tai .~ 73 c~ /De artment Use Qni roved ^ Disapproved Sanitary Pemut Fee (includes Groundwater Date Iss ed ~ ng Agent S attire (N ) Surcharge Fee) ~ ~ ~ a 4~ ~ /i ^ Owner Given Reason for Denial (~ ~ w ~ IX. Conditions of Ap ovaUReasons fo~proval Z~;~ - ~Q~~~ ~. ' ~S7 F1L - ~ .~~~~~~ Septic tank, effluent filter and ~,~jfVyYWt- ~ 3 `~~ ~~~ t~•- ~l'~ dispersal ceN must aN be serviced /maintained ~ ,/o ~~L~ ~ ~ ~',, ~ ~ v as per management a 9"'"`"~ 2. se ac requirements must be maintained as per applicable code/ordinances Attach complete piaof (to cue t,onney omy~ tvr cut s]sacw vu y.yca .,,,..w~ W-•• -~- - _.._~ SBD-6398 fR. 01/031 4 t 1 11 r Q _O tL u i i 1 Il I i, 1~ %~ ~ /~$ TQ i i i v :~ ~_ v- ~ ''O^ 8 ~' W^` W ~~ C~ O g~~ ~~ s ~~ ~~_`~ m~,5 ms's o -`EiC~i=ra5'a a " N I co ~ 'd i~ ~ ~ LL ~ ~~~1~' ~~ ^~ J ~ ~ '° o = x ai .g ~ ~ ', , .- ~ is g~ ~ 1 ~' ~r' ~" ~ ' 1~ 1 m~ Y ~ (U _~ ~ ~ ~ ~ ~t ~ ~ ~ ~ fA zs ~ ~ ~ ~ ~~ ~q ~ ~ ~~-~ ~ ~-. m o 0 m F- ~ ~ b b' ~~~~ ~ ~ ~~ ~<L n LLg~~ } ~ ~ mW ;U ~~ ~~ „ m m ^~Ga ~, m commerce.wi.gov ^ ^ iSCOnsin Department of Commerce Safety and Buildings PO BOX 7162 MADISON WI 53707-7162 TDD #: (608) 264-8777 www. commerce.wi.gov/sb/ www.wisconsin.gov Jim Doyle, Governor Cory L. Nettles, Secretary October 14, 2004 CUST ID No.227618 THOMAS GUSTUM GUSTUM SEPTIC SERVICE N13450 937TH ST NEW AUBURN WI 54757 ATTN: POWTS Inspector ZONING OFFICE ST CROIX COUNTY SPIA 1101 CARMICHAEL RD HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 10/14/2006 Identification Numbers Transaction ID No. 1069255 SITE• Site ID No. 690914 Jim Henry -Dwelling Please refer to both identification numbers, 87TH Ave above, in all corres ondence with the a enc . Town of Hammond, 54015 St Croix County SE1/4, NW1/4, S20, T29N, R17W Lot: 66, Subdivision: Hammond Oaks 1ST Addition FOR: Description: New Mound System / 450 gpd Object Type: POWTS Component Manual Regulated Object ID No.: 986382 Maintenance required; 450 GPD Flow rate; 24 in Soil minimum depth to limiting factor from original grade; System(s): Mound Component Manual -Version 2.0, SBD-10691-P (N.O1/O1), Pressure Distribution Component Manual -Version 2.0, SBD-10706-P (N.O1/O1); Biofilter 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. No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, stats. 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 approved plans and with the component manuals listed above. A copy of the approved plans, specifications and this letter shall be on-site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of construction installation/operation. In granting this approval, the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence maybe made to me at the telephone number listed below, or at the address on this letterhead. ~p l DEP 01VISt SEE C 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. THOMAS GUSTUM Sincerel p ,~ eter E Pagel Private Sewage Plan a ewer ,Integrated Services (608)266-2889 , M - F, 0630 - 1500 Hrs pepagel@commerce. state.wi.us cc: Leroy G Jansky, Wastewater Specialist, (715) 726-2544 Page 2 10/14/2004 Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 WiSMART code: 7633 pg 1 of 6 Cover Page Project Name: Henry 450 GPH mound system Owner's Name Jim Henry Owners Address 2217 Vine Street Suite 200 Hudson, WI. 54016 (715)381-4904 Legal Description ~ sE~ %<, , Nw ~ %4 Sec 20 T 29 N, R 17 w ~ ~ Township Hammond County Saint Croix Subdivision Hammond Oaks 1st Addition Lot# 66 Parcel ID# -®F ., W/,Se Table of Contents Q . ~:' ~'1~ 1 Cover page 'TH~~'~• Z 2 Mound Sizing Calculations t1') G,~ST 3 Pressure Distribution Layout and Dynamics ~ 120~t ;~ ~ 4 Dose Tank /Pump Curve ~ ~`~/ j;S. ' f 5 ~~ 6 O • • Management and Contingency Plan Pl t M d~`ip jZU~ ly . ~~ ~ GN o ap ~~`._ NT C ~~ ER BUIL I total # of pages : 6 ~F-;ESPp ENCE Designer Name: Tom Gustum License #: D1201 Date: 10/4/2004 Ph. #: 715-658-1344 Signature: Mound System Design Methods Used per "Mound Component Manual For Private Onsite Wastewater Treatment Systems" (Version 2.0) SBD-10691-P (N.01/01) per" Pressure Distribution Component manual for Private Onsite Wastewater Treatment Systems" (Version 2.0) SBD-10706-P (N 01/01) 3bAdvisement N12466 220th St, Boyceville, WI 54725 Ph: 715-643-6068 email: Mound System Mound Sizing Calculations Project Name: Henry 450 GPH mound system Site Condition Project Type: 1 or 2 Family Dwelling °I° Slope: # of Bedrooms: Depth to limiting factor: Absorbtion rate of fill material: Absorbtion rate of in-situ soil: Effluent quality Max BOD effluent value: Max TSS effluent value: I z41 m. 1 gal/ftz/day 0.5 gal/ft2/day Eff# 1 ~ 220 mg/I 150 mg/I Design of Entire Fill Cell depth at upslope edge (D): Cell depth at downslope edge (E): Distribution cell depth (F): Cover thickness over edge (G): Cover thickness over center (H): End slope width (K}: Fill length (L): Upslope width (J): Downslope width (Toe) (I): Fill Width (W): Page 2 of 6 12.0 in. 16.4 in. 9.5 in. 6 in. 12 in. 9.0 ft. 93.0 ft. 5.9 ft. 9.8 ft. 21.7 ft. Design of the Distribution Cell Basal Area System Design Flow: 450.0 gaUday Basal area required: 900 ftZ Distribution cell width (A): 6.00 ft Basal area available: 1185 ft2 Distribution cell length (B): 75.0 ft ~~ Area of Distribution Cell: 450.0 ~ Observation Pipes Contour Elevation of Mound: 96.80 ft Location from end of cell (Z): 12.5 ft System Elevation of Mound: 97.80 ft Final Grade of Mound: 99.59 ft Mound Plan View ~ /Observation Pipes Z %~ VV K=~~ <' taiStributior'~ Celt ~~}, A ~I -_ _ _ _ _- _ __ _ -- ~ B ~^ ~ Tilled ArealFill Material IL Mound Cross Section Final Grade _- - 5~rnthetic Fabric _ '' ~, Distribution Cell---~~ -_-~- 5~rstem Elevation ~.,~ Vin, a, d CQVer h~laterial-?~ ,'~ E Latero.l Fill Material ~~--~ -~- I .Invert ~~ Slope _~Qbseruatian Pipe ~ `--~ G D 3 Tilled Area ~'`~-Farcemain System Contour Notes: Fill material to consist of ASTM C33 Sand Distribution cell aggregate to comply with Comm 84.30(6)(1) Synthetic Fabric covering on cell per Comm 84.30(6)(8) Distribution Cell to have minimum 6" aggregate below lateral and 2" above. 5 Mound System Page 3 of s Pressure Distribution Calculations Project Name: Henry 450 GPH mound system Lateral Layout Lateral/Manifold Design Lateral elevation: 98.3 ft Lateral diameter: 1'iz ~ In. Rows of Laterals: 2 ~ Lateral spacing (S): ~ft Manifold type: center + Lateral to cell edge: 1.5 ft Orifice diameter: o.1ss ~ In. Lateral discharge rate: 11.86 gpm # of Laterals: 4 System discharge rate: 47.44 gpm Distal Pressure: 2.5 ft Manifold diameter: 2 ~ In. Lateral Length: 37 ft Manifold length: 3 ft Orifice Spacing/Distribution Forcemain Friction Loss Orifice spacing (X): 25.37 Inches Forcemain length: 35 ft Orifices per lateral: 1 g Forcemain diameter: 2 ~ In. Avg. ft2/Orifice: 6.25 ftZ Friction loss in forcemain: 1.584 ft Lateral Side View ~larrifold Lateral ~ Laferal x x x x x x x x x x x x Z Lateral Length Listeral Length Lateral Plan View Lateral Len in Turn-up w/ball valve or cleanout plug O O ~ PVC Manifold S ^ o orifices on bottom of PVC laterals, forcemain and manifold to COm I with lateral equally spaced pY specifications per Comm 84.30[2] Forcemain connection via tee or cross to manifold at any point Clean Out Detail Observation Pipes Clean-out plug Final Grade ar ball valve Water tight cap ar plug Lawn Sprinkler Box Slot Mate: Closet Collar 6" Minimu~ may 6e used in Long Sweep 91] place of 3/8" bar ^riwo 45'sL 3J8" Bar Lateral 1 , Mound System Septic, Pump and Dose Tank Project: Henry 450 GPH mound system Tank Information Pump tank manufacturer: Pump tank size/model: Pump tank gal/inch: Tank bottom elevation (inside): Septic tank manufacturer: Septic tank size/model: Skew Precast 642 16.23 89 ft Skaw Precast 1000 Page 4 of 6 Dosage Volume Does forcemain drain back to tank? I YI Lateral void volume: 15.6 gal Dosage to absorbtion Cell: 78.2 gal Forcemain volume: 6.1 gal Total dosage: 84.3 gal Pump and Filter Total Dynamic Head Pump Manufacturer: Little Giant Are laterals highest point? Pump Model: gE if not, enter highest elevation: 0 ft Effluent Filter: simtec STF 110 System head (distal x 1.3) 3.25 ft Vertical Lift ("D" to lateral) g,gg ft Note: Access opening of sufficient size to be removal of filter. Opening to terminate at or above grade. FriCtlOn IOSS In fOfCemaln: 1.58 ft Pressure loss from filter: ~p ft Total dynamic head (TDH): 13.72 ft Pump Tank Diagram Watertight Loc4cing Gover ~ InchWith Warning Label Minimum Finishi . ~. Grade Alte rnate ~ Outlet Location Elect. per Comm 16.28 and •cem in IJEG 300 ~ Weep Hole ~'' a r Anti- 5iphon B Device C D Dose Tank Levels In. A Reserve 27.4 B Pump off to Alarm 2.0 C Total Dosage 5.2 D Effluent depth for pump 5.0 Total Capacity: 39.6 Pump Curve: 9EH FLOV- LITERS/HOUR 0 1000 2000 3000 30 Pump must be capable of: 47.4 GPM and head pressure of: 13.8 Feet W 4 20 i A =10 D Gal 444.1 32.5 84.3 81.2 642.0 10 N 7.5 W W Z s q w x 2.5 0 Little Giant FLOW- GALLONS/MINUTE 9EH PUMP PERFORMANCE CURVE 115V 60HZ Mound System Management Plan pursuant to comet 83.54 W. A. C. page 5 of 6 Owner's Responsibility: The component owner is responsible for the operation and maintenance of the component. The county, department or POWTS service contractor may make periodic inspections of the components, checking for surface discharge, treated effluent levels, etc. The owner or owner's agent is required to submit necessary maintenance reports to the appropriate jurisdiction and/or the department. Septic Tank: Septic tank(s) are to be inspected routinely and maintained by department approved individuals when necessary in accordance with their approvals. The use of chemical/biological "treatments" is not required or recommended. If such additives are used, make sure they are approved by Department of Commerce, Safety and Buildings Div.. Effluent filters are to be removed & cleaned as necessary, with provisions to keep solids from passing the septic during removal. No more than 1/3 of the usable tank volume may be occupied by sludge/scum. 3 year inspection: If tank has greater than 1/3 volume sludge, tank contents must be emptied and disposed of in accordance with NR 113 Wisconsin Administrative Code by an approved individual. If the inspector does not recommend pumping of the septic tank, then the owner must be notified of when pumping should be done as to not exceed 1/3 sludge volume. Septic tank should be routinely inspected to be watertight and of good repair. Pump/Dose Tank If an effluent filter has been installed in the pump/dose tank, it must be removed & cleaned as necessary, with provisions to keep solids from passing to the mound component during removal. The pump, float switches and alarms must be inspected at least every three years for proper operation. Pumpldose tank should be routinely inspected to be watertight and of good repair. Mound and Lateral System The mound system component must remain free of ponded surface water prior to pump operation. If 4 inches or more water level is detected in the observation pipes, the owner must be notified of possible problems/failure. The designed daily flow capabilities of the component should never be exceeded. Trees and any other deep rooted vegetation should never be planted, or allowed to grow anywhere on the component. Activities OTHER than mowing/maintenance (i.e. excessive walking, pets, vehicles, etc...) could compress the component and reduce it's absorbtion capabilities and/or possibly cause it to freeze in winter conditions. Lateral distribution pipes should be flushed out/tested every 18 months using the cleanout points at each end of the component to remove scum that may clog orifices. Performance Monitoring: Performance monitoring must be done at least once every three years following the installation or at the time of a problem, complaint, or failure. Contingency Plan: If the septic tank, pump tank or any of their components therein (including floats, alarms, pumps, etc) become defective, the defective tank or component must be replaced immediately to ensure that the system can operate as designed. If the mound component cannot accept wastewater or ponds wastewater to the surface, the component must be repaired or replaced in it's current location by either: extending basal toe to provide added absorbtion area; or by removing the clogged bacterial mat,aggregate cell, and distribution piping within the mound and replacing said components in order to return system to proper working order as required. /1 i~ M ~ S ~ I ~ i 1 I I I ' I 1 _ , ' , ~ ; i i i i i i i i i i ifs ~~ 7 ~ Q to ~-+ _~ )i ~I n tr J .~ :~ ~ ~ ~ 0 ~~ ~~ o ~ ~ ~ ~~-~ ~ m ~yg'~ ~i ~ ~i :~' G~~~ ~~ ~ a ~~~ Z~-~~ c~ m 1 W ,~ ~ O 'O ~ O ~ ^W^`` ~ W ~ ~ F ~m°EN~a z~ m~=~ may`--=s3. _~~ ~ ~Z = -~ ly1 - ~L~N=F~6Q; N 7 C1 7 0. ~~ IM I~ I~ °- ~ a _ ~ ~ R ~ co ~ o O o ~ _ d' ~ o ~ ~~ m ~b b.. o ~g gW Z m ~ m ~ ~~ n ~ mW ~U . - ~~ tn o ' m ~ ~ ^~ ~ I~ OCT-25-0004 09:09 FROM: T0:171538157z0 P.2 ST: CROIX CQUNTY SEPTIC TANK MAINfiENANCE AGREEMENT AND OWNERSI~P CERTlFICATIQN FORM OwtseT/8uyer J ~ /''~ t-! ~N t2-Y / n~ c. . Mailing Address Z Z r `Z v l n~ ~ s t ~'` Z a~ - f/ e>'!~ S ~ ~ w I ~ G/O /{~ Property Address ~ ~ 3 7 ~ ~ - ,y !+/t r+~t nJ v w + S `-~ a I ~ (Vet7ficatian required from Planning Department for new construction.) ~ CitylState H~3 M(~ ~IZTh,~. W,~ Parcel Identification Nutni~et c7 ~ ~ ~ ~ ~7~7 ...~z - 06u L~\.f1'LRd bE$CRIPTIarr ProperrylAaation SE '/ , ~ %a ,Sec. ~C)_, T Z~N R~@~I, Town af_ ~/~n~n~t c7~V~b subdivision ~1 ~ ,~,~,~~ o p k~- Iat # 6 6 , .___ Cert~ed'~urvey 11+Iap # _ _ Volume .Page # Wa~rr:3nty 1)et~ # ~ ~() ~ ~-- `~ . Voltuae a o ~ Page # s -..~~.- Spec house ~ no Lot Imes idantifiablo ~ ,np SYSTEM 1VIAlNTENANCE Improper use and maitrtenancc of your septic system could result irl its prCmatura failure bo handle wastes. paper mainttaanee consism ofpumping out the septic tank every three years or sooner, if»eeded by a licensed pumpci•. What you put into the system can af~bct the function of toe septic tank as a treatment skate in the wagte disposal system, l7vvner maintetlenCe responsibilities are speeined in § Coma $3.52(1) and in Chapter 1 Z - Sz Croix County Sanitary Qrdirurace. The property owner agtGes to submit to St. Croix County 7anigg Departttrertt a certifieaaon fotrn, sigtud by the owarr and by a tnas~ter plumber, joarncyman plumber, restricted plumber or a ticrnsed pumper verifying that (I) the onsfta wastewater d~4posal system is in proper operating condition and/or (z) after inspection and psanping (if necessary), the septic tanl~ is less than ]13 full of sludge. Tlwe, the undersigned have read the above requirements and agree to maintain the private stvrege disposal system wiW the standards act forth, herein, as set by the 17epattnxut of Cotntntrce and the Department of Natural Y~eaeurecs, State of tiNt'iscaasirl Certification stating that your septic system has ban maintained must be completed and retttttrcd Za the St. Croix County Zoning Depart<ueat wi days of the three year expiratiae date. io1~,51 ~~/ TGNATURL t}F AP .AIVT DATE hWN.EII CFRTIFICATIQN ~ - - ~. w...-~.r.~.~r I/wc certify that alt statements on this form are true to the base ofmy/our Irnow~edga. I/we am/are the oWeer(s} oftl~ pro bed a v by virtue of a warranty decd recorded in Register of Deeds Office SIGNATURE PLICANT DATE ''~"'*"• Any inforlna loa that is misrepresented may result in the sanitar}r pertmt bang revoked by the Zoning Depattment, *++*+~• Include with this application a stamped warranty dt~cd firom t3te Register of Reeds Office and a copy efthe c~fied stoves ttffip if reference is made in the warranty deed OCTl2~~2004 0:09 FRQ~: T0: 17153815720 P.2 ~T. C~OiC~ G~i3Y'ri'~'~' sac ~ ~~~ ~,~~~ +17~N~RS1~ ~R"OATII~N FORM '~~ .~1 n~ ~-,+~~ k?Y Irv ~.. . N~aili~g A.dc ~ ~. r -7 v I n,~ ~ ~ j ~ ~ ~~ - f! U 1`] Sbr~ ~~ l ~5~~ !~, ~ Ad+~ss r~ /~ r~ City/State n~2 t+~ ~ Parrx~ ~e~ti~ic~f3oa ~ ~. ~ ' ~ `7 ~~~ ~~~CRX~;~'IQ~ ~3-~oaation ~ y , N ~ ~r, , Sic„ Z~ , T Z9 N ~t~w, Tawu o~ ~/Ar+rtr+R r~r~t~ $ubdivisiva ~~ r~ rn,~,.,~,~ b ~, Lat # 6 6 . C~rtiBed S~txvey M~tp # tTa~tume _ ..~^ P~ # ,- ~., t~vty D~ !~ Va111~ .,,~ ~: p~ ~ Spcx banes ~ n8 ~ Iurus id~t,~iatste ~ s~s't'~nR ~~~ maete aousisca ofd na~dc 4f your septfc 8~'e~eds could raeult to tta ptuno fh;lutre 4a 1~udlc ror. Pmpar ~udp~g out iho tend ems' tamer y~ os aoala!~, ~r~ded 6y a lieaneact tkts syet~ cao a~EEat the taonctyvn oaf tbo acp~c tank ^s a t~tameat style id ETkt vr~tC ~~ ~ i~ txspQnsibititxes axe speci~e~ ixt ~ Cosam $3.32(1) add m Cbnpter YZ - 5t< CruiR ~ttry . ' ~ mar agnges b to St, Qroix COuuty ~ ~ c+pt~ivn~ 6y a ».teit plwtibeeiowrnexnwaa pfwdber, r~inbad r nr a tl pdmpes ~ ~ ~~ ~ says0em. Lt m ~npe:r a~paafing c~didou sddkrr (~ ~ ~~ pu~a1-iag (ifaeees~y), tlpe sep4c hmle m h~ ~ 113 full o~ TJa~e, the imderai~pod ba+~ rtaa the ebave ~, rind to maiatam tl~e pTIYBte d18~ sJpi0ellu 1vltTf ~fC atandar~ls err Sorb 4 ~ sce ~ Esc ~t a~Camtr,~,ae atsQ tie ~ o~ Nat~apl ~aoyn+esas, Smme of 1iVi option etati og tisst y~ ~e h~ bean nn+~ bs caxdpietcd add ~ ~c 3k Croix Caun~ty ,g ~~ of t5c t~ ye.,' ~ireblcm ~i tA'TCJRE t~~ AF fd,_~c5/ z]ATE ~b ~ tlwe cc~#~r tdat au 6taamnadta ~ d,ia ~ ~ due to me Dese ~'mylour 1~oar~dga. rtwe e4aJaee rbe a e 1~ , ~ g' ~3'v~e ofs +vat~rsnty deed mcorded i~a ]R,eeisocr a~F,D~c a 3 oftbE ~.-~ ~,IGi~A'I7JR.g ~LYC,AN'~' ~? 1?5l o~ I~47"$ mow;'"*• ~, won that is ~iaept+esentied ~ i~u1t ~ tie ~dllst~r ! t~Oked a7'the ;~, **s+~ Idcldr,~ wlth ~[is applicatia®a werradty deed ~ „ ~~tb- OBice ~ a oolry ~ft$e tecr~fied e~vay myr if r~ is,mad~e is ~ w~gr died. Wisconsin Dea3rtmentofCommerce SOIL AND SITE EVALUATION Page 1 of 3 Division of Safety and Buildings in accord with Comm 83.05, Wis. Adm. Code Guslum Septic Service Attach complete site plan on paper not less than 8'/ x 11 inches in size. Plan must County inGude, but not limited to: vertical and horizontal reference pant (BNI), direction and St. Croix percent slope, scale or dimemsions, north arrow, and loc,~iert arrdrdista[-ce to nearest road. ~. Parcel LD. APPLICANT INFORMATION - P/eas~~r~nt all informatwn. - 6 ~ - ~ G ~, Personal information you provide maybe used for s~6ondary purpose~~rivacy Law; s. 15.04 (t) (m)). ~~ wew ,~~~,~ Da~ /2 „_/~' Property Owner j i ~ .~ .: - - ~ Property Location Humbird Land Corporation Govt ~,ot n/a SE 1/4 NW 1/4 S 20 T 29 N,R 17 W Property Owners Mailing Address - ^.,~ F t Lot # ~ Block # Subd. Name or CSM# ~- ~ ~- .~ Street, East 1404 i :- 332 Minneso ta ~~ n/a Hammond Oaks Addition __ _ _ __ __ City State Zi~ode Phone~iFHhti~r Y ^ ity ^ Village Town Nearest Road Saint Paul MN SS 11' 65~~ ll~' ~5~~~ -~ Hammond 160Th Street ^ Resided ~urrr of`ti~te6ms 3 ^Addition to existing building ^ New Construction Use: ^ Replacement ^ Public or comm~cribe Code Derived daily flow 450 gpd Recommended design loading rate •5 bed, gpd/Rz .6 trench, gpolftz Absorption area required 900 bed, ft2 750 trench, ftZ Maximum design loading rate " .5 bed, gpolftz .6 trench, gpolff? Recommended infiltration surface elevation(s) _ atop 96.8' contour ft (as referred to site plan benchmark) , Additional design I site considerations s>vt 2 = 97'1 ~ Z `~ SGi/ft d ! ~ Parent material ground moraines Flood lain elevation, if a livable n/a ft S=Suitable for system Conventional Mound In-Ground Pressure AT-Grade System in Fill Hokfing Tank U=Unsuitable for system ^ S ®U ®S ^ u ^ S ®U ^ S ®U ^ S ®U ^ S (~ ~ SOIL DESCRIPTION REPORT A, d I1DJL l d Boring# 1 Ground elev 97.1' ft Depth to limiting factor 24" 2 Ground elev 94.7' ft Depth to limiting factor 26" Horizon Depth in. Dominant Color Munsell Mottles Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consisten Boundary Roots GPD B ;Trench 1 0-7 10yr3/2 none sil 2msbk mvfr as 2flm 0.5 0.6 2 7-16 7.Syr4/4 none gr. sil 2msbk mvfr cw if 0.5 0.6 3 16-24 7.Syr4/6 none gr. sil 2msbk mfr cw - 0.5 ~ 0.6 4 24-30 7.Syr4/6 c275~5/87/1 gr.sil 2msbk mfi - - 0.5 0.6 Remarks: 1 0-10 IOyr3/2 none sil 2msbk mvfr as 2flm 0.5 0.6 2 10-13 7.Syr4/4 none gr. sil 2msbk mvfr cw if 0.5 ~ 0.6 3 13-18 7.Syr4/6 none gr. sil 2msbk mfr cw - 0.5 0.6 4 18-26 none gr. sl 2msbk mvfr cw - 0.5 0.6 5 26-34 7.Syr4/6 L o2 ~ S ly ~ g7/2 gr. sil 2msbk mfi - - 0.5 0.6 Remarks: CST Name (Please Print) SignatureC~ Telephone No. Tom Gustum 71558-1344 Address Gustum Septic Service Date CST Number Ref# N13450 937th St., New Auburn, WI 54757 3/1/00 227618 1187 ~(~ Y~' PROPERTY OWNER: xumbird Land coryoration__--.-__ SOIL DESCRIPTION REPORT PARCEL LD.# 3 ~ Ground elev 97.1' ft Depth to i limiting factor 26' „a~ Page - ?'- °f - 3 - Gustum Seiilie: Service Honzon Depth Dominant Color Mottles Texture Structure sistertce Bounda Roots GPDlftz in. Munsell Qu. Sz. Cont Color ~ ~ ~ ry Bed ~ Trench 1 0-9 10yr3/2 none sil 2msbk mvfr as 2f,lm 0.5 0.6 2 9-16 7.Syr4/4 none gr. sil 2msbk mvfr cw if 0.5 ~ 0.6 3 16-26 7.Syr4/6 none gr. sil 2msbk mfr cw - 0.5 ~ 0.6 4 26-35 7.Syr5/6 7.gy~/g•. gr. sl 2msbk mfi - - 0.5 ~ 0.6 ._ Ground elev Depth to limiting factor KemarKS: Remarks: Remarks: .' ,. ~~~ ~~ ~~~ ~ ~ ~ ~ ~3 n _ ~ ~~ ~ ~ .~~' ~ (\ S ~ ~ ~ ~ ~ ~d \ d ° ~ ~ ~ ~ ^ ~~ ~ _ .~ rt ~~ 3 N ~ ~ ~ ~ 0 -n ~ C{~ ~ o~ 0 r mil 1 \ ~1 ~, s rt ~ ~ O ~~ C aF- c ~ Z .1..:2628 ~' 550 STATE BAR OF WISCONSIN FORM 2 - 1998 WARRANTY DEED This Deed, made between Merlin Land, LLC, a_ Minnesota Limited Liability Cam~rany___._T ____-_ Csrantor, and James D. Henry Grantee. Grantor, for a valuable consideration, conveys and warrants to Grantee the following described real estate in St Croix ~,-^___ County, State of Wisconsin: Lot 66 Hammond Oaks 1st Addition Subdivision,Town of Hammond, St. Croix county, Wiscorlsirt ~~~~~~ KATHLEEN H. MALSH REGISTER OF DEEDS 5'!'. CROIX CO. , MI RECEIVED FOR RECORD BS/02/20G4 11r00A1[ MARREX~TYt # E£D REC Fffi : 11. ®0 TRANS FEE: 101,9A COPY FESt CC FEES PAGES: 1 end Return Addross 018-1087-66-000 Parcel IderriiFcation Number (PIN) This ~ not homestead property. (is) (is not) Exceptions to warranties: Subject to notes, easements,restrictions,covenants and rights of way of record, if any, including but not limited to those for drainage,water retention,ponding,and or utilities as may be shown on the Alai of Hammond Oaks 1st Addition Subdivision recorded in Voi. 8 of plats, page 25, St. Croix County, Wisconsin. The warranties of this deed, either expressed or implied are limited by the grantor to the grantee, or anyone in the chain of title, to an amount not to exceed the consideration expressed hereir; that being the stmt of S 33,900.00. Dated this _~ 29th ~_ day of July , 2004 Merlin Land,LLC AUTHENTICATION Signature{s) authenticated this _` day of, * by_ (~~,~,~~ ~ ~y~11,pdjt Vice President , + Caroline B. Bowersox ACKNOWLEDGMENT STATE OF WISCONSTN ) } ss. Ramsey County. ) Personally came before me this 29th day of July , _2004 __ the above nazned Caroline B. Bowersox~ 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.) to me known to be the person(s) who executed the foregoing instruts3ent and acknove4ed>;e the same. NOTARY Ptf84GlWYaIF8p7A " Paul A. Bailion urco+w~ssioN¢xwtvES+staoos Notary Public, State of Wiscors' ivfy Commission is permartent. (lf not, state expiration date: January 31 ~ 2005 _) +Names of persons signing in any capacity should be typed or printed below their signaturos WARRANTY DEED 9rA7E BAR OF WISCONSIN FORM No. 4 - 3595 INF'ORN1ATfON PROPESSIONALJ' COMPANY FOND D[f LAC, WI ROO-655-20:1 M `O -~ z o -~ rn r m D -1 O z N_ 9 ~<~ ~. ~ r 4 -c ~ z r 3 r N ~ 0 ;- ~ -~ I' r r ~ ~ ~A c ~p n i. 1 ~ > ; z s. ~, ,, ,~ ~~, z a ,, s n 0 A -i rn r m A 1 O z E- - ~rn ~~ D A 0 rn ~~ ~D -i O Z !' I~ 1~-- -=T '~ ~-- ~~ ~i~ ~~ rn u ~' ' I o_ II rn it rn r iy -~ ~ -, ~ it i Z I r- ~I ~r- N 0 ~, __ 6.-0.. ___~` _- . _ _ ____ 25•'0" _ __ ' _" -_ I _- I~~ V5D 6068 XO _ _. __ -_.._.. -__.__..._ _I. __._ k __ ~ _-_.-_ __ ~'~ ~ I _ 50I550R RnOF TRU55E5 29" O.G. _ O I z __ o ~ i o ~ c I~ J y m, O ..... __.__.__~ u~-_ P ~ ~ z ~' S g ,, ~n D RAILING _ _ ~ ~. _._ ~ ~ ;,, ~.- _... ~I T ~, I -- ~- ~I m to v+~i ~i ~ ~ " ~ -- ~ ~ a ~~; .: ~ - d - w N ~ ~ m ~` ~ <~ p=~~ ~ o ~ ~ z ^ ~ 1.. R85 RRS ti n, 7 ~ , __ ! / in .: _ _ ~ V t i~ - 4ti I_J ~~ i ~ ~ '. I ~~ _~ i ~„ I pr ~Q Orn c '~ ~~, o ~ ," 0 3 N '' j ~ i A I z> ~ 1 ~ > °o I ~m A oe N y b „_ ~ o ~'~ A rn p L_ o J 5044 i t ~ ~ a I I II b N I I I _. ._.-__ _. ___._ ' _ ' I- ~' _ _ I. _ _. ... ~.-- _ I pa ~ I U _._. I~ b_ ~ ~ o X 'I i ~ __..._ I~ ~ ; N ~ ~~ I 'i I x [ _~ ' ~ 'ice ~ ROOF TR 55E5 p, ~ A2 0 .. _._....__ - ... __ __... m 1 Z 24" r),G_ n y ~ I~ o I z o - a j ' .. I • it 1~.0. ,~_y'_.._ _._ _'__-.__-_ 21'0"'-_ - - _,_-.~ _.._..- --45'0^.-_ ___ ._ _...-_. / ~ _____ .. AIA N n _ W N ~ Z O ~ ~ ~ W m o ~ 0 A v i O T A l7~ N' r ..~ o I A