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HomeMy WebLinkAbout018-1098-31-000 Wisconsin Department of Commerce Count PRIVATE SEWAGE SYSTEM St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No (ATTACH TO PERMIT) 453153 0 GENERAL INFORMATION I State Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, j.1, 5.04 (1)(m)]. Permit Holder's Name: City Village X Township Parcel Tax No: McCabe Homes Inc. Hammond Township 018 - 1098 -31 -000 CST BM Elev: Insp. BM Elev: BM Description: Section /Town /Range /Map No: fat O .3/111 f f PV C , 1 30.29.17.838 TANK INFORMATION ELEVATION DATA ! 5 I TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark 8m 7,0 / ,D7,91) AM eD Dosing t n, r� 6..^.IL r e..c - -.� .i,.., .� f Alt. BM _c'.Cc ► S_`�/ Aeration Bldg. Sewer Holding St/Ht Inlet St/Ht Outlet TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic �'L, _ Dt Bottom 1 `j �L 5 Dosing Header /Man. �• i v - 1 1 5 Aerajsm Dist. Pipe w S 3ti ro 3 8 ti C 3L o -3 Holding Bot. System 6 (j m 5 -Z ti E G c) Final Grade PUMP /SIPHON INFORMATION Manufacturer �t Demand St Cover C,• lcs-S GPM Model Number TDH Lift Friction Loss System Head TDH Ft c� , / <, . e_.,4_, Forcemain Length Dia. D l -( C, 11 SOIL ABSORPTION SYSTEM BED /TRENCH Width Length ql( No. Of Trenches PIT DIMENSI No. Of Pits Inside Di Liquid Dep DIMENSIONS SETBACK SYSTEM TO P/L BLDG ` WELL LAKE /STREAM LEACHING anufacturer: INFORMATION CHAMBE Type Of System: Model Number: h21�1� DISTRIBUTION SYSTEM _ ;� • t . L 3 i + �l `i + I S Header /Manifold Distribution x Hole Size x Hole Spacing Vent to Air Intake 2 Y. Pipe(s) y C( I i r k Length 7 Dia :Q Length Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only Depth Over Depth Over xx Depth of ded xx Mulched Bed /Trench Center xx Seeded /Sod f` c, Bedrrrench Edges Topsoil V .`� Yes No Yes No COMMENTS: (Include code discrepencies persons present, etc.) Inspection #1: Wo /_ aL Inspection #2: t r2 L—/ Location: 1525 73rd Ave Unknown (NW 1/4 SW 1/4 30 T29N R17W) Emerald Acres Lot 31 Parcel No: 30.29.17.838 1.) Alt BM Description = + % • v� • c �� Vi4 m k,- p la" s yS�Cilsti ©yt 102. Z S Covu0r" &,q,kU_ 47; 2.) Bldg sewer length - amountofcover= ia;� �� h� �"" `� { `✓ wt'n IS TL'.Q (I• "30 ' A100Y1• S ShO�cCr��l L-- F kK01 r (VI or - �cv,^(r fc 4t • 0 Z's 37 �vu.� bvr►n 8 � - a Plan revision Required? Yes No L -z G - ^� 1 / (s / /' Use other side for additional informatio _ ��''` _ L/ SBD -6710 (R.3/97) 4ate Insepctor's Signature Cert. N o Safety and Buildings Division County ' ` 201 W. Washington Ave., P.O. Box 7162 r iseo nsin Madison, WI 53707 Sanitary Permit Number (to be tilled in by Co) Department of Commerce 60 1 453 LS 3 Sanitary Permit App ca k.. La T te Plan I.D. Number gl2.z -T 'cti 'in In accord with Comm 83.21, Wis. Adm. Code, personal nformation you provide nn} may be used for secondary purposes Privacy sl5.*P#) 2 7 �U«4 Protect Address (if different than mailing address) 1. Application Information — Please Print All Information c (it�ln vut 3 �J eJ t I E Ci Property Owner's Name arceI # of # f310C.L',# Property Owner's Mailing Address Property Location 93 s 40t5 ° NW y., 5W '''A, Section 3o City, State Zip Code §. y� O cncle� e) N; R T E II. Type uilding (check all that apply) Subdivision Name CSM Number I or2 Family Dwelling- Numbero edrooms Q l n �y A El Public /Commercial - Describe U(1 • j t✓ �'� ❑ State Owned - Describe Use / K /CD ❑City ❑Village lkowns 'p of - .O 2 III. "Type of Permit: (Check only one box on line A. Complete line B if applicable) A. New System ❑ Replacement System g p Y ❑ TreaunenUHoldin Tank Replacement Only Other Modification to Existing System El Change of ❑Permit Transfer to New List Previous Permit Number and Date Issued B. ❑ Permit Renewal ❑ Permit Revision Before Expiration Plumber Owner IV. Type ofPOWTS System: C ❑ Non - Pressurized In- Ground Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil ❑ 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. Dis ersal/Treatment Area Information: Design Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal Area Required (sf) Dispersal Area Proposed (st) System Elevation N'1. Tank Into Capacity in Total Number w � 7 e r Mamtta urer Prefab Site Steel Fiber Plastic Gallons Gallons of Units / Concrete Constructed Glass New Existing Tanks Tanks Septic oi Holding Tank Aerobic Treatment Unit �•J�O�'�'� Dosing Cliambei ' R CD j VII. Responsibility Statement- I, the undersigned, assume responsibility for' tallation of the POVVTS shown on the attached plans. Plumber's Name (Print) plum be Sig ore MP PRS Number Business Phone Number Plumber's Address (Street, C t I State Zi Code) VIII. County/Department Use Onl Approved El Disapproved Sanitary Permit Fee (includes Groundwater Date Issued 1 suit Agent Signature (No Stamps) Surcharge Fee) ❑ Owner Given Reason for Denial 7 ` j� I\. Conditions of Approval /Reasons for Disapproval SYSTEM OWNER: 1 Septic tank, effluent filter and dispersal cell must all be serviced / maintained as per management plan provided by plumber. 2. All setback requirements must be maintained as per applicable code /ordinances Attach complete plans (to the County only) for the system on paper not less than 8I/2 x I I inches in size SBD -6398 (R. 01/03) PLOT PLANN Page 3 cf Scale 1"=50 ' n I z.Zy O S�_A _L u J 7 J � � a ti ? �� - 15�OF Z "p�xr•'`1. ?1.Pt JS 3fte PVC.LPF 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 \Z /600 gallon capacity manufactured by W \ �` Z - cbti tmL ( Lp \ /goo H Z) 06 yo Z N R tJx 4. Bench mark S: S WL ►43 0 V F 5. Divert surface water around system to prevent ponding at the uphill side. Safety and Buildings 4003 N KINNEY COULEE RD commerce LA CROSSE WI 54601 -1831 - TDD #: (608) 264 -8777 isconsin FI��F�'' www.commerce.state.wi.us/sb Department of Commerce www.wisconsin.gov APR 2 6 2004 Jim Doyle, Governor Cory L. Nettles, Secretary ?ONING OFFICE April 23, 2004 .�...�s.�.......,� CUST ID No.267341 ATTN: POWTS Inspector ARTHUR L WEGERER WEGERER SOIL TESTING & DESIGN SERVICE ZONING OFFICE 421 N MAIN ST a ST CROIX COUNTY SPIA. PO BOX 74 1101 CARMICHAEL RD RIVER FALLS WI 54022 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 04/23/2006 Identification Numbers Transaction ID No. 992244 SITE: Site ID No. 682217 McCabe Homes, Inc Please refer to both identification numbers, 173RD Ave L above, in all correspondence with the agency. Town of Hammond St Croix County NWI /4, SW1 /4, S30, T29N, R17W Lot: 31, Subdivision: Emerald Acres FOR: Description: Four Bedroom Mound System Object Type: POWTS Component Manual Regulated Object ID No.: 954199 Maintenance required; 600 GPD Flow rate; 36 in Soil minimum depth to limiting factor from original grade System: Mound Component Manual, SBD- 10572 -P (R.6/99), Pressure Distribution Component Manual, SBD- 10573 -P (R.6/99); 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 C chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. N PI?? 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. Q 0,RTNIV( 0 The following conditions shall be met during construction or installation and prior to occupancy or use: General Approval Requirements: see COR! • This system is to be constructed and located in accordance with the enclosed approved plans and with the "Mound Component Manual for Septic Tank Effluent for Private Onsite Wastewater Systems" SBD- 10572 -P (R.6/99) and the "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems" SBD- 10573 -P (R.6/99). • Per manual cited above, limited activities are allowed in the area 15 feet down slope of the component area. Soil compaction, excavation, vehicular traffic and other similar activities that impact the treatment and dispersal are prohibited. • The well must be a minimum of 25 feet from any POWTS tank, and a minimum of 50 feet from the absorption area. chs. NR 811 & 812c • A Sanitary Permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.135 and 145.19, Wis. Stats. ARTHUR L WEGERER Page 2 4/23/04 • Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stat • Comm 83.22(7) A copy of the approved plans specifications and this letter shall be on -site during construction and open to inspection by authorized representatives of the Department which may include local inspectors. Owner Responsibilities: • Comm 83.52 Responsibilities. The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s. Comm 83.54(1). • Comm 83.52(2) A POWTS that is not maintained in accordance with the approved management plan or as required under s. Comm 83.54(4) shall be considered a human health hazard. • Comm 83.55 The owner is responsible for submitting a maintenance verification report acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. All permits required by the state or the local municipality shall be obtained prior to commencement of construction /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 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, Fee Required $ 175.00 Fee Received $ 175.00 Z Balance Due $ 0.00 Charles L Bratz POWTS Reviewer II, Integrated Services WiSMART code: 7633 (608)789 -7893 , 7:45 am - 4:30 pm Monday -Friday cbratz@commerce.state.wi.us cc: Leroy G Jansky, Wastewater Specialist, (715) 726 -2544 TITLE SHEET Page of MOUND SYSTEM FOR A _L4 BEDROOM RESIDENCE This plan has been prepared in accordance with the Mound Component Manual SBD 10572 -P and the Pressure Distribution Manual SBD - 10573_ -P CCZ. b_l gcl� C 2. b l d g j LOCATED IN THE N)"- � /4 OF THE '--- 1/4 OF SECTION 30 ) T 1 9 N, R 1 W, TOWN OF � J yv1k.I u � � St-_ ^ bZU \}� COUNTY, WISCONSIN. L.DT 1 -1 or- INDEX PAGE 1 of 7 TITLE SHEET PAGE 2 Of 7 SYSTE I MA NAGE'1ENT PLAN PAGE 3 of 7 PLOT PLAN PAGE 4 of 7 PLAN VIEW -CROSS SECTION PAGE 5 of 7 DISTRIBUTION PIPE LAYOUT PAGE 6 of 7 PUMPING CHAMBER CROSS SECTION PAGE 7 of 7 PUMP PERFORMANCE CURVE RECEiv,cl PREPARED FOR S' APR 19 2004 tom', c C �E' V- - VA �r B �3 L o S��� ►� DGS pfv .arty PREPARED BY Q ED WECCEFr<EF2 SO Z L TEST S NG COMMERCE AND iLDtN DES I GsV S1EF2V I CE ;PONDEN P.O. Box 74 421 N.Main St. River Falls, WI 54022 Phone 715- 425 -0165 Fax 715 - 425- 6864+`;�.�•• ••..`��!�, • Y.f- ELLSW O RTH I G } L4 _ -()y JOB NO. QLy —L4 (� Mound System Management Plan page z of -7 Pursuant to Comm 83.54, Wis. Adm. Code Septic c Tank The septic tank shall be maintained by an individual ceftified 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. PUmu 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 tem No trees or shrubs should be planted on the mound. Plantings may be made around the mound's perimeter, and the mound shall be seeded and mulched as necessary to prevent erosion and to provide some protection from frost penetration. Traffic (other than for vegetative 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 BOD5, 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. 6199)] and local or state rules pertaining to system maintenance and maintenance reporting. 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 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. Contingency 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 P g said com on n operating condition. P e is as deemed necessary to bring the system into proper Questions about the operation or maintenance of this system should be directed to: The County Zoning Office at 1�j_ 3 8 6 - l[ Ij Pic The system installer at 6 The tank manufacturer at a4S6 VIAk�s The effluent filter manufacturer _ Z er at L� Z i The pump manufacturer at 30 _C62O_L4 y(4 �jOU�.D ^> • PLOT PLAN ' - Page 3 cf � Scale 1"='30 ' n zZy \SOTn4- 0 r I CO I � V r ;a �- ,o)O \av cC � a� 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 \ 1A0 /800 gallon capacity manufactured by W x CAL z -Cb%\j c2j'TIF ( Lp \zou /900 M R) ivy 6 - tti (30 z "IZ- Fa cTt�R 4. Bench mark 5 S Wt pr 0 V F 5. Divert surface water around system to prevent ponding at the uphill side. Pace LI Of Approved Synthetic Covering ASTM C33 Distribution Pipe Medium. Sand Topsoil r=_H — W F G Elev 1 OZ . 5 3 , I , b Slope Distribution Cell of Force Main Plowed z" to 2- Aggregate From Pump Layer - Ft. E \ Ft. CROSS SECTION OF A MOUND SYSTEM F 0,5 Ft. G O. S Ft. A C Ft. H 1_y Ft. Linear Loading Rate = 6- DGPD /LN FT 8 1 00 Ft. Design Loading Rate = U • /SQ FT i Z Ft. J G Ft. K C) Ft. -A t o —R&& 444.o n L Ft. af' -FAR -- W Z y Ft. I j - Observation Pipe i3 r K - - - - - -- - --- -- - --••� �A t - ------------- - - - - -- - - - - -- - - - -- - Sax O W -- - -- - -- - - - -- Force Main 7_ . Distribution `--- Cell of ' " to � 2 1, 2 1' Pipe \ aggregate Observation Pi P e� (Anchor ze c=ely) PLAN DIET OF A MOUND SYSTEM Distribution Pipe Layout Pace S of Place the 'roles at the bottom of the distribution pipes at' equal spacing. Remove all burrs from the pipe and 'holes. Extefd the end of each Iate.al up with the use of Iong tars or 45' f rL:ng to a point within sa inches of the foal grade. Te:ninate the ends of the Iate.-aIs with a valve "threaded can or . threaded plug. Provide access from foal grade for the valve; threaded eap or threaded plug. T�F L L"LzSS Q ,j rvC F`ac avC Lateral — MarircId Lateral x x x x2 I x2 x x x x Lateral Lencth L Lateral Lenath — 'P OieHhut cn Une 07 �R= RyAj P Ft. Note Diameter Inch S 3 Ft. Lateral " I 1/ 1 Inches) X Z V Inches Manifold Z- Inches Force Main " Z Inches #of holes /pipe ZS Invert Elevation of.Laterals Ft. - Z S.x o - q = 10.LS x q= ql.0 6Phj _ - Combination Sepuc;Tank and PUMP CHAMBER CRO55 SECTION AMD 5PECIFICATIONS ' PAGE OF - VENT CAP WEATHER PROOF ►JSZPSt - '1'4 _u `1. = TfL - - JuUCTIOU BOX . '1 C.I. VCKIT PIPC APPROVED LOCKING L'- �?►^�Y"'_Ws�'C' NJ�WT' jQ' FROM ODOR. T MOMOLE COVER kVIV •.iIU00w OR FRESH wARtJIUG LP.gEL.. A.LR IUTAKE yMIN. - 1 Z t T 1 / I L f . AM. -- r- JPNIs+i"-> 6fzftE !8'/y111l. z z': X3 Pt r.L c ���. -_ "_ PROVIDE - I I i I T AIRTIGHT SEAL I II+ I I Z Pt'SLV- : L`Et-i'O1 I I Approved, ` 1000 ..a I I�� Approved joint w/ I I I I joint w/ PVC pipe ALARA PVC pipe •i I I I PUnP -' - -�^ b OFF D CO►JCRETE - I DLOCK RISER EXIT PERP11 T_ ED GIDL'zj IF TAN MAJJUFACTURER HAS SUCH APPROVAL 3" SEPTIC F SPECIFICATIOUS LOSE TA,WKS MAW U FACT URCR: AILIMbER OF DOSES: U q PER CA TAAJK 51ZE: yZ-VU 1VUfO GALLONS DCSC VOLUME 1 A LARM MAIJUFACTL _S\ I'S MICLUDIMG aACKrLOW X y �ALtDI�: MODEL ►DUMBER,: lug kJ LAJ CA, ACITIC.,: A= a ° ` � V IuCHCS OR ') DD ' 3 GALLOrr: SWITCH TZIPC: NE'MCyR`T B= Z IJJCHES'OR y (4-S G{LLOQ5 PUMP t G ULJ\_NS C= INCHES OR \3l GA MODEL NUMBER: D- p ZZ.Z_ INCHES OR GALLONS SWITCH TYPE: 1"�� IZCU� MOTE: PUMP ANO A ARM A TO DC MINIMUM DISCHARGE - RATE o'o (;F/A INSTALLED ON SEPARATE CIRCUITS VERTICAL DIFFERENCE OETWEEIJ P UMP OFF AUO..DISTRIBUTION PIPE. - VI FEET + fAIWIMUM METWORK SUPPLY PRESSURE , , , , 6•SID FEET C .p x 1.3� -f• , S FEET OF FORCE MAIN X �'� �0ELFKICTIOU FACTOR.. • FEET TOTAL OtIIJAMIC HEAP FEET As per manufacturer Z Z _ZY gal /in. Liquid depth 36 �� Gouldsjc Submersible Effluent Pump f; EPO4 38 EP05 APPLICATIONS • Fasteners: 300 series • Fully submerged in high ■ Motor Housing: Cast iron Specifically designed for the stainless steel. grade turbine oil for for efficient heat transfer, following uses: • Capable of running lubrication and efficient strength, and durability. • Effluent systems dry without damage to heat transfer. ■ Motor Cover: Thermoplas- • Homes components. tic cover with integral h andle Motor: Available for automatic and • Farms and float switch attachment • Heavy duty sump • EPO4 Single phase: 0.4 HP, manual operation. Automatic models include Mechanical points. • Water transfer 115 230 V, Hz, 1550 Float Switch assembled and ■ Power Cable: Severe duty • Dewatering RPM, , built in overload with automatic reset. preset at the factory. rated oil and water resistant. • EP05 Single phase: 0.5 HP, ■ Bearings: Upper and lower SPECIFICATIONS 115 V, 60 Hz, 1550 RPM, FEATURES heavy duty ball bearing Pump: EPO4 built in overload w ith construction. • Solids handling capability: a ■ E PO4 Impeller: Thermo- utomatic reset. plastic Semi -open design /4 maximum. • Power cord: 10 foot with pump out vanes for AGENCY LISTING •Capacities: up to 55 GPM. standard length, 16/3 SJTO Total heads: up to 24 feet. with three prong grounding mechanical seal protection. G Canadian Standards Association • Discharge size: 1 plug. Optional 20 foot ■ EP05 Impeller: Thermo- • Mechanical seal: carbon- length, 16/3 SJTW with plastic enclosed design for (CSA listed model numbers rotary/ceramic - stationary, three prong grounding plug improved performance. end in "F" or "AC ".) BUNA -N efastomers. (standard on EP05). ■ Casing and Base: Rugged • Temperature: thermoplastic design provides 104 °F (40 °C) continuous superior strength and 140 °F (60 °C) intermittent. corrosion resistance. • Fasteners: 300 series METERS FEET stainless steel ° I • Capable of running - - - -- —' -- - - - - -, -- — -- _ dry without damage to 9 30 _ �4 5 GPM components. —> Pump: EP05 8 - - - -- 'Lz Fr • Solids handling capability: 0 25 3 /4 maximum. w z ' • Capacities: up to 60 GPM. • Total heads: up to 31 feet. 6 20 • Discharge size: 1 NPT. z 5 -�— — +- - - - • Mechanical seal: carbon- V 0 15 I rotary/ceramic - stationary, a a BONA -N elastomers. EPOS -- • Temperature: 3 10 104 °F (40 ( continuous (_ e 140 °F (60 °C) intermittent. 2 —T - - - -- I -- 1 5 1, 0 0 10 20 30 40 50 GPM 0 2 4 6 8 10 12 m�/h CAPACITY c 4 � 1,.95 Gculds P m Inc. u Ds. Apr 09 04 07:23a Steel's Soil Sevice Inc. 715 -246 -9372 p.2 1408 Wisconsin Department of Commerce SOIL EVALUATION REPORT Page I of 4 Division of Safety and Buiidings in accordance witn Comm 85, Wis. Adm. Code Stee Soil S ervice Inc. Attach complete site plan on paper not less UK i 8' /x x '.1 inches in sae. Plan must County include, bit not limited to: vertical and horizonl it reference point (BM), direction and _ St. Croix — percent slope, scale or d+memsions, north arm r, and location and distance to nearest road. Parcel I.D. Please print all h iformation. - - - - -- _ - - -_— __ ..-- __ - - -- _ - -- Perscn;3 irkrmation you provide maybe uFd for! ;condary purposes ;Privacy law. s. '15.C4 (1) (m)). Reviewed By Date Property Owner Property Location Mc Cabe Homes In — - _ _ !Scut. Lot na NW 1 SW 114 S 30 T 29 N 17 W Property Owners Mailing Address - i Lot # Block # Subd. Name or CSM# 935 Osolrey Blvd _ - _ 31 na _ Emerald Acr City State Zip Co(a Phone Number _ City ' Village se Town Nearest Road Bayport I MN 5500: 651 351 - 1018 _ Hammond 173 Ave N ew Construction Use: yz Resider Gal / Number of bedrooms _4 Code derived design flow rate 600 GPD _ -- Replacemen' Public c • commemciai - nescribema - -- - - -- Parent material Rid ges of groun mora es und erlain by weathered Flood plain elevation, if applicable na General comments -- — '- and recommendations: Mound design,syst am elevation 102.65ft based on contourline elevation 101.65ft. Boring # __ Boring V Pit Ground SL dace eay. 102.85 ft. 44 Depth to limiting factor —._ in. Soil A r pp rAon Rate Horizon Depth : Dominant Color 1 R ox Description F Texture Structure Consistence I Boundary Roots GFD/th in. Munsell + Qu.:z. Cont. Color i Gr. Sz. Sh. ! "Eff#1 ' ff#2 - 1 - 0-14 10yr3.3/1 n one ! sil i 2msbk i mfr cis 1v1` .6 .8 2 14-39 10yr4/4 none siG i 2msbk mfr cis n a 4 6 -- -- . - -- f 3 1 39_44 7.5yr4/4 none sl om mfi di ! na .2 6 4 4479 10yr4 /4 fl f 7.5yr5/6 j scl om mfr cis I na .0 . 5 79 -100 10yr8 /2 c2 i 7.5yr5/6 'andstone residumm 5— na nal .0 .. —�_S_ i .0 E�] Boring # _.. Boring ✓ Pit Ground Su face elev. _ 102..85 ft. Depth to limiting factor __ 5Q__ in. Sal A pp6gtion Rate [forizof Depth j Dominant Color Red )x Description Texture Str Consistence Boundary 'I Roots m Munsefl C}u.:z. Cont Color G, 3, Sh. i''Eff#1 `Eff#2 1 0 1 none sil 2msbk mfr CS if .6 .8 2 24-36 I 10yr4l4 none Sid 2msbk m � i mfr I w n a .4 .6 3 36 -50 7.5yr4/4 none sl ! 2msbk mfr i i gw na .6 ! 1.0 4 1 50-89 ! 7.5yr4/4 c2.17.5yr5J6 ndston re i� - -- s dumm I mfr I na na .0 i .0 - - - - -------- ' I Effluent #1 = BOO > 3 < 2 mg/ and TSS -30 � 150 mg /L • Effluent = SOD <_30 mg /L an d T S S S30 mg/ CST Name (Please Print) �) Sic nature: �- CST Number David J. Steel t 2489 Address � , ✓ � -�.,._ - -- - -- -- . _. Steels Soil Service Inc. - r Date Evaluation Conducted Telephone Number 1564 CR GG, New Richmond, WI 54C 17 4/9/2004 715 246 - 5085 I t 4r +: k5 owt 1408 • Wisconsin Department of Corn erce 't' 01 JISOIL EVALUATION REPORT P age 1 of 4 Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code Steel's Soil Service Inc. County Attach complete site plan o d %&n- 0%x1t'rticffee§ in s e. Plan must St. Croix include, but not limited to: vertical and horizontal reference point (BM), direction and percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D. Please print all information. Reviewed By Date Personal infonnalion you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Property Owner Property Location McCabe Homes Inc. Govt. Lot na NW 1/4 SW 1/4 S 30 T 29 NR 17 W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# 935 Osprey Blvd 31 na Emerald Acres City State Zip Code Phone Number I City _j Village 1/ Town Nearest Road Bayport I MN 1 55003 651 - 351 -1018 Hammond 1 173 Ave 16 New Construction Use: 11 Residential / Number of bedrooms 4 Code derived design flow rate 600 GPD J Replacement J Public or commercial - Describe: Parent material Ridges of ground moraines underlain by weathered Flood plain elevation, if applicable na General comments and recommendations: Mound design,system elevation 102.65ft based on contourline elevation 101.65ft. Boring # I Boring iI Pit Ground Surface elev. 102.85 ft. Depth to limiting factor min• Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0 -14 10yr33/1 none sit 2msbk mfr cs 1vf .6 .8 2 14 -39 10yr4/4 none sicl 2msbk mfr cs n a .4 .6 3 39 -44 7.5yr4/4 none sl om mfi di na .2 .6 4 44- 9 10yr4/4 f1 d 7.5yr5/6 scl om mfr cs na .0 .0 5 79 -100 10yr8/2 c2d 7.5yr5/6 sandstone residumm mvfr na na .0 .0 Boring # I Boring i/ Pit Ground Surface elev. 102.85 ft. Depth to limiting factor — 0 — in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft= in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0 -24 10yr3/1 none sil 2msbk mfr cs 1f .6 .8 2 24 -36 10yr4/4 none sicl 2msbk mfr gw n a .4 .6 3 36 -50 7.5yr4/4 none sl 2msbk mfr gw na .6 1.0 4 50 -89 7.5yr4/4 c2d 7.5yr5/6 nandstone residumm mfr na na .0 .0 * Effluent #1 = BOD? 30 < 220 mg /L and TSS >30 < 150 mg/L * Effluent #2 = BOD < 30 mg /L and TSS < 30 mg /L CST Name (Please Print) Signature: CST Number David J. Steel 248956 Address Steel's Soil Service Inc. Date Evaluation Conducted Telephone Number 1564 CR GG, New Richmond, WI 54017 4/9/2004 715 -246 -5085 Property Owner McCabe Homes Inc. Parcel ID # Page 2 of 4 Boring # Boring Pit Ground Surface elev. 99.65 ft. Depth to limiting factor 36 n. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots PD in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0 -21 10yr3/1 none sil 2msbk mfr cs 1f .6 .8 2 21 -36 10yr4/4 none sicl 2msbk mfr gw 1vf .4 .6 3 36- 8 10yr4/4 f1f 7.5yr5/6 scl om mfr na na .0 .0 ❑ Boring # Boring _) Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 F-1 Boring # I Boring Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDtftl in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 * Effluent #1 = BOD? 30 < 220 mg /L and TSS >30 < 150 mg /L * Effluent #2 = BOD < 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. Page 3 of 3 STEEL'S S ®IL SERVICE INC. David J. Steel 1564 Cty Rd GG CST -POWTS McCabe Homes Inc. New Richmond,WI 54017 Lic. #248956 SW1/4,NW1/4,S30,T29N,R17W Bus.(715) 246 -6200 Town of Hammond, St. Croix Co. Fax (715) 246 -9372 Emerald Acres Lot, 31 Legend 1" = 40' 43 genchmark Ele. 100.00ft op of -3/4" PVC Pipe Alt Benchmark Ele. 101.35ft op of 3/4" PVC Pipe ❑ = Borings Boring Elevations B 1 = 102.85ft B2 = 102.85ft B3 = 99.65ft B4 = 00.00ft 2V ` a ' 5l� , V3` Z a F ,n� 6 L � j N` O l t & fi r "qf7 i D 91- In� 5 f G� aq /73 y_v y �z so4-1` 40� ti,u— �� ^4 1 � i - N OD ol � I I N 1 I ` t ' I ) i103�10 N H ! r N V- 0 ! I ! r 1 t4 ! 8 W LL 1 ` ; 0 W W V N F N CD oj { N 1 � � 0 � ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP C12"RTIFICATION FORM Owner/Buyer C- �� N Mailing Address Property Address 1 2- 3 !7�' (Verification required from Planning Department for new construction) City/State W-T Parcel Identification Number AD 31— �. ) LEGAL DESCRIPTION Property Location NU!' 1 /4, 5 1 /a, Sec. : T -4N -R Town of Subdivision Lot #. Certified Survey Map # Volume , Page # Warranty Deed # 3S°I GIZ Volume 2 SS I , Page # ?0 Spec house ❑ yesK no Lot lines identifiable( yes ❑ no SYSTEM 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 masterplumber, journeyman plumber, restricted plumber 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 1/3 full of sludge. I/we, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards 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 day�the a yea r expiration / SI A APICANT DATE OWNER CEATMCATION I (we) certify that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owner(s) of the property ribed above, b of a warranty deed recorded in Register of Deeds Office. `'S NATURE OF AP LICANT DATE * * * * ** Any information that is mis- represented may result in the sanitary permit being revoked by the Zoning Department.****** ** Include with this application: 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 r Wisconsin Department of Commerce SOIL EVALUATION REPORT i°� Page of 3 --blaision.of Safdly and Buildings in accordance with Comm 85, Wis. Adm. Code County 4. Cr0/ Attach complete site plan on paper not less than 8 1/2 x 11 inches in size: Plan must include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Please print all information. Re iewed by Date o Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). d Property Owner Property Location Q � i Govt. Lot /V L,) 1 /4_<Zd 1/4 S :jC1 T Z Ct N R ( E (or) ( Property Owner's Mailing Address Lot # I Block # Subd. Name or CSM 1 5 3 ee - 5marQ)d Acr City 1 State Zip Code Phone Number ❑ City ❑ Village [R Town Nearest Road ® New Construction Use: Residential /Number of bedrooms Code derived design flow rate GPD Replacement ❑ p ❑ Public or commercial - Describe: Parent material _ ��' (� Flood Plain elevation if applicable ft. General comments -It *VA e ( { 0. and recommendations: Boring # ❑Boring � � � � R41 F 7 1 ® Pit Ground surface elev. .,. Depth to limiting factor Soil tication Rate P Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary 'Roots- - -- ` GPD /ftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. �-+ *Eff#1 *Eff#2 6- & 1 3 1Z --- S Zma.bk ►' 4v- 6-5 1 v� .5 Z 1 IU 1 i cl k rnFr c5 – 3 Lit I C2 •5 �f !o /• 2 F-2-1 Boring # ❑ Boring o -7 2�, ® pit Ground surface elev. / 7`r 3v ft. Depth to limiting factor Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 I *Eff#2 I 0-I2 !0y r312 — n Z&iabk m-rr G lV4 S 8" cal s i rn 3o Sn 10 COP 7.6 �Y * Effluent #1 = BOD > 30 < 220 mg /L and TSS >30 < 150 mg /L * Effluent #2 = BOD < 30 mg /L and TSS < 30 mg/L CST Name (Please Print ignature CST Number L - mo-ker -- 2 53.309 Address Date Evaluation Conducted Telephone Number 2113 h :54, 3 Zme Sep �I ` 6Z 5 I Z - �� - o / C7 - yoo� Property Owner S4,0 Parcel ID # Page 2 - of PSI Boring # t❑ Boring G� D' . Lr Pit Ground surface elev.- '- Depth to limiting factor 3/ in. _ Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 -Eff#2 Z ro 31 c/ Z►r.sbk C- -- - t - 44 CZ 7 r `t/ S (� S m f -- — - 7 I. 2 F-1 Boring # ❑ Boring pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 F Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPO /ftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 * Effluent #1 = BOD > 30 < 220 mg /L and TSS >30 < 150 mg /L ' Effluent #2 = BOD < 30 mg /L and TSS < 30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608 - 266 -3151 or TTY 608 - 264 -8777. SBD -8330 (R.07 /00) PAGE OF -3 NAME �fO LOT# LEGAL DESCRIPTION _Aiw XSw Z,S 30 T Z `l .N.R. 17 E(or)V i SCALE: I"= yQ BM 1 ELEVATION O BM 1 DESCRIPTION lbea -f / ' UUC BM 2 ELEVATION q ,? 3 0 BM 2 DESCRIPTION k5,0 O - sec . 3 G SYSTEM ELEVATION IG• ro SYSTEM TYPE oouncQ CONTOUR ELEVATION `�G • G d l a *"Z- 00 a u o 9�.0 oc Ir SIGNATUR /l - DATE U 2 5 5 1 P 19 8 -7 s99a!8 KATHLEEN H. WALSH REGISTER OF DEEDS ST. CROIX CO., VI STATE BAR OF WISCONSIN FORM 2- 2000 RECEIVED FOR RECORD Document Number WARRANTY DEED 04/16/2004 10:30AN THIS DEED, made between Scott Sievers, a/k/a Scott C. Sievers and WARRANTY DEED Sara R. Sievers, husband and wife, Grantor, an d-� e ee s, Inc., a EXEMPT ii Minnesota Corporation, Grantee. REC FEE: 13.00 Grantor, for a valuable consideration, conveys and warrants to Grantee TRANS FEE: 153.00 t Ilowing described real estate in St. Croix County, State of Wisconsin: COPY FEE: CC FEE: of 31, lat of Emerald Acres, Town of Hammond, St. Croix County, PAGES: 2 m. Recording Area Name and Return Address: Edina Realty Title, Inc. 400 S. 2' St. — Suite 115 D Exceptions to warranties: Hudson, WI 54016 f Easements, restrictions and rights -of -way of record, if any. 426122 018 - 1098 -31 -000 Parcel Identification Number (PM) This is not homestead property. Dated this 16th day of April, 2004. * Scott Sievers, a/k/a Scott C. Sievers * Sara R. Sieve AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF WISCONSIN ) V r T. CROIX COUNTY. ) ss. authenticated this 16th day of April, 2004 0 Personally came before me this April 15, 2004 the above named Scott Sievers, a/k/a Scott C. Sievers, married to me * known to be the person(s) who executed the foregoing TITLE: MEMBER STATE BAR OF WISCONSIN, instrume nd acknowlledged the same. o pro authorized authoriri zed by § 706.06, Wis. Staff THIS INSTRUMFNT WASR�`4`SG 'Cheri Brown ��VV Notary Public, State of Wisconsin Peterson, Fram & Bergman — St #£Bruns My commission is permanent. (If not, state expiration date: 50 East Fifth Street, St. Paul, MW 55101 3/11/2007 ) (Signatures may be authenticated or acknowledged. Both are not necessary.) 'Names of persons signing in any capacity must be typed or printed below their signature WARRANTY DEED STATE BAR OF WISCONSIN FORM No.2 -2000 U 25 1P 199 State of WISCONSIN County of St. Croix ss. On April 16, 2004 before me appeared Sara R. Sievers, married to me personally known to be the person(s) described in and who executed the foregoing instrument and acknowledged that they /he/she executed the same as their /his /her free act and deed. Notary Public DIANE M. 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