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018-1098-33-000
I I I I ~ ~ 3 M I ~ ~ ~ O Q. I ~ ~ c m ~ 3 ' O I ~ I ~ a i o I c N a I Z 0 I I ~ 0 I ~ I W I n Z ~ ~ '1 I ~ I I I I I I I I I I I I ~ ~ 3 ~° °~ ~ ~ aina~ 3 ~•d o s~ m ?o,~.•o g w m ~' 0 3 =~~ w w~~'-oa3 ~-- W~ ~.a ~ -o a3f°~ m ~ c v ~ ~ C ~~ o~3"~aW qty m m v3 ~~ am 3w ~•m m ~ ZN W aC ~(p .~5. O ~' c N W d ~ (D m y O < ~ _' ~ w ~ o m m c ~ Z y ~ D o. O Z 0 ~~ c 3 x N 07 3 O s m m c N 3 N N a a o' m ~z 0 y 4 I~ (F °O a c ~ ~ ~ W ~ ~ ~ :•. ^' O ~? (n °g ~ =' J T obi G. ~- C v a N a a `~ ~ coo 3 v°~+ ~ c N N ~ S N N ~~~~ oooa ~~~~ ~ v v ~ ~ a o ~ ~ ~ ~ d 3 °-' ~ .. 7 ~ 0 0 ~ c c n n 3 ~ c ~ n 3 n ~? v i ci m ~ ~' = W O ~~~ o ~ c°o a ~ w o ~ k' °o y O -o N ~ a 3 .~ w m m w n n m N a_ ~ (A A Z n -• ~ r. A Z O .. ~ W ~ ~ m ° a ~ ~ Z ~ A ;U O '~ (A V !n Z ~ A A T a Id ~. R to ~~ O C ~1 0 ~• O ~• e y A f~0 a oa 1 W O w ~w 'r v 'V, Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Safety and Building Division INSPECTION REPORT GENERAL~NFC7RMATION (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 Stout, Richard Hammond Townshi CST BM Elev: / Insp. BM Elev: ~ BM Description: TANK INFORMATION TYPE MANUFACTURER CAPACITY Septic ~ ~~t2_ Zc?() /~ Dosing C u Aeration Holding TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Septic / ~ Dosing t,c ~~ ..r -~~ Aeration Holding PUMP/SIPHON INFORMATION Manufacturer Demand GPM ~ Model Number ~ ~ ~ ~~.,0 v p' H Lift Friction Loss System Head TDH Ft ~~~ 2 ~ (~ • 5~ o Forcemain Length "\ ~ Dia. ~ ~i Dist. to Well ~~ -` SOIL ABSORPTION SYSTEM ELEVATION DATA County: St. CroiX Sanitary Permit No: 420551 0 State Plan ID No: Parcel Tax No: 018-1098-33-000 ~, ~~ STATION BS HI FS ELEV. Benchmark (p. ~ tel. ~O q ~ 1 • Td Alt. BM 2.9a I ~~,ob Bldg. Sewer St/Ht Inlet D-35 93 SSA SUHt Outlet Dt Inlet Dt Bottom 13 ,~ D 90 , ~ f Header/Man. ~ 9G t ~•l~l Dist. Pipe S. D 9S• ~ Bot. System 5'• e o ~ ~, ~ , Fi al Grade ~~ ~,,:ll loe_ ~t 12 t -- St Cover SS" 9~-3Sf '~. a , v ~T4 . qa , BED/TRENCH Width Length No. Of~seRehee PIT DIMENSIONS No. Of Pits Inside Dia. Li ui DIMENSIONS ~ f / _ ~ f lv 6, (~ /S . (p,( - SETBACK SYSTEM TO P/L BLDG ELL W LAKE/STREAM LEACHI nufacturer: INFORMATION CHAMB Type Of System: I SI f I ~ "1C / ~- IT Mo r: DISTRIBUTION SYSTEM /o,~ ~ ,~ 131-f~,~,~~_(r,Q ~ Header/Manifold Distribution 7 x Hole Size t I x Hole Spacing Vent to Air Intake ~~r /_ ~,/ 1 ~~~ L ~ ~~ ~' ~ ~ I if Length Dia ength Dia Spacing SOIL COVER x Pressure Systems Onlv xx Mound Or At-Grade Svstems Onlv erl .~ Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil Yes ~ No ~ ~~ Yes Ll No ~~o~~gQEN S: Include code discrepencies, persons present, etc.) Inspection #1:~/~/ ~~ Inspection #2: /n~'Y/~ ~~ ~i E w~ Location:) 1517 '73rd Avenue Hammond, WI 54015 (NW 1/4 SW 1/4 30 T29N R17W) Emerald Acr~ oft ~ 3 ~ Parcel No: 30.29.17.84 ~~',.~~ 1.) Alt BM Description = ~' ~ +~rrsb~r ~~ ~°~'~ ~-/W ~~ ~~ 2.) Bldg sewer length = ,,.. Igp~ - amount of cover = 3. Conto r = 9(0 • q o ~+,~ ;~ Plan r Sion Required. ~~ Yes fNo Use other side for additional information. __,_ ._ ~ __ _ _.___ _______ L-.-~'~_~__-~' to _ (1 ~S Insepctor's ignature Cert. No. SBD-6710 (R.3/97) «.I(~,, Safety and Buildings Division 201 W. Washington Ave., P.O. Box 7162 1 isconsin Madison, WI 53707 - 7162 de artment f Commerce i ~~ 51-o z- ~ ~ z 9 ~ Sanitary Permit Application Ia accord vrith Comte 83.21. Wis. Adm. Code. personal information you provide yu, ~ used ~ sea Privet Iavv a15. I m Application Information -Please Punt All Fnfot'taatlon Properey Owner's Name Property t)vvruer's Mailing Address ~~>~~ ~ C_iw_ scare Zip Code Ph County j''~~-/c Site Address Sanitary Pomilt Number ~{•zo 551 ^ Clseck if Iteviaioa State Plan I.D. Nttmbar ~ ~92.57(v ~ Parcel Number/' ~i~a~..~~"~ Prope i_f ~' e Number I,ot N S' ;; ' SIX COU'~i ~ ' . ; . ~Oi~'~NG OFFICE Subdt II: Type of Building (cheek ai! that apply) cw ~tt/ 4 N,.° {t~=1 or 2 Family Dwelling -Number of Bedrooms ~~'"`e-. S . ^ Publfc/Commercial - scri ,Use • o ^ state owned ~"` `tc ~ . 2S t I S " III. Type of Permit: heck only one box on line {atunbering scheme for internal A' I New 2 ^ Replacement System 3 ^ Repiace~nt of 6 ^ ~Addisioit to stem Tatilc Onl Existiu S stem Permit Number B. ^ Check if Sanitary Permit Previously Issued Date IV. Type of Permit: (Check all that apply)(nttmbertng schemets for internal use) ?~-ta.~~ ~r~.~-~ ~ • ~~ 44 ^ Non -Pressurized In-Ground • ~ Mound 47 ^ Sand Filter 50 ^ Constructed Wetland 22 ^ Pressurized In-Ground 41 Holding Tank 48 ^ Single Pass 51 ^ Drip Line 45 ^ At•Grade 46 ^ Aerobic Treatment Unit 49 ^ Recirculating 30 ^ Other V. Dis ersaUTreatment Area Information: ersal Area Dis l A Soil Application Percolation Rate System Elevation dc El rea Design Flow (gpd) Dispersa Required p proposed Rate(Gals./DayslSQ.FE.} (lvlln.Mch} evation ~0 ~GD ~ ~ ~ ~.- ~~= ~S" f~4- /D i . VI. Tank Ittfo Capacity in ,Total Number Manufacturer Prefab Site Concrete Cottstnscted c Steel Fiber Plast Glass Gallons Gallons of Tanks i Sepsic or liotding Tank _ ~~~~ .~, G~ Do:lag Chamixr a OQ / ~ ~' ~S'c VII, Res onsibiHty Statement- Y, the undrreigaed, assume responsibility for tion of the FOWTS abown on the attached place. Plumber's Name (Print) Plumber's Signature PRS Number Business Phone Number •ll 'u ,-n Sc Plumber's Address (street, city, State. Zip code) lil. LO , Ue 8ni Vse v Sanitary Permit Fee (includes Groundwater Date Issued Issuing Agent Signature o tamps Approved ^ Diaappmvad t Initial Adverse Gi ^ O Surcharge ee} - ~~/ S~p~ . vet wner 325 , Detenmiaadon G Conditions of ApprovaUReasons for Disapproval . ~,~-p,~a, , . ~e¢._ ~. ~^ - - e r oalA~et' aoeTea ~ sus s u mcaerm Q _ ~ ~n ^ V Q ~ ~ ~,,e~c.te~-?mss, _ ,~-~ ~~~a+%~ S~~w.. od P.e~ w~a~na~e tnn~•-~ i-•1.0'~°~eY (Y~U'.~ SBD-b398 (R. 05!01) I ,_ A~~ 9~ ;~a~~ /~ ~ ~'' -- y Laca~ion `~ , ~-J!~ S4; S~0 mbar ~~ F i 1 eY gyres ^City ~. ownshi iH. O~/ l/` Ne st Road ~.SO fif _. . Complete line B to applicable) r Counri use. ~• • PLOT PLAN •Page ~ of / Scale 1"= 5~' z~ ~ Z z isconsin Department of Commerce October 08, 2002 CUST ID No.267341 ARTHUR L WEGERER WEGERER SOIL TESTING & DESIGN SERVICE PO BOX 74 RIVER FALLS WI 54022 CONDITIONAL APPROVAL PLAN .APPROVAL EXPIRES: 10/08/2004 SITE: Robert Spear Town of Hammond St Croix County NWt/4, SW1/4, S30, T29N, R17W ATTN: POWTS Inspector Safety and Buildings 4003 N KINNEY COULEE RD LA CROSSE WI 54601-1831 TDD #: (608) 264-8777 www. commerce.state.wi. us/sb www.wisconsin.gov Scott McCallum, Governor Philip Edw. Albert, Secretary RFcE EV D ZONING OFFICE ACT 1 ~ 20p2 ST CROIX COUNTY SPIA ST. C~~U~X ~~ 1101 CARMICHAEL RD ZONING OFFI(,E.Y HUDSON WI 54016 Identification Numbers Transaction ID No. 792516 Site ID No. 651072 Please refer to both identification numbers, above, in all corres ondence with the a enc . FOR: Description: Four Bedroom Mound System Object Type: POWT System Regulated Object ID No.: 872480 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 Cond 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: App I DEPARTAAEI 0~ SA General Approval Requirements: ~~'_ /. i 9 • This system is to be constructed and located in accordance with the enclosed approved plans and with the SEE CORI "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-]0573-P (8.6/99). • 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. • 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. ARTHUR L WEGERER Page 2 10/8/02 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, ~~ Charles L Bratz POWTS Reviewer II ,Integrated Services (608)789-7893 , 7:45 am - 4:30 pm Monday -Friday cbratz@commerce. state. wi. us Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 WiSMART code: 7633 cc: Leroy G Jansky ,Wastewater Specialist, (715) 726-2544 TITLE SHEET Page ~ of -] BOUND SYSTEi~1 FOR A ~ BEDROOM RESIDENCE This plan has been prepared in accordance with the Mound Component Manual SBD-105 7 P and the Pressure Distribution Manual SBD-10573-P CCZ. blgq CR- b144~ LOCATED IN THE N~ 1 /4 OF THE S~ 1 /4 OF SECTION .3 0 , T ~.9 N, R ~ 6d, TOWi1 OF _ ~,~ln/~Yy~~yU~ Si C~Z.OIX COUNTY, WISCONSIN. INDEX PAGE 1 of 7 TITLE SHEET PAGE 2 Of 7 SYSTEM riAI~JAGEMENT 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 PUI.IPING CHAP•iBER CROSS SECTION PAGE 7 of 7 PUriP PERFORMANCE CURVE ° PREPARED FOR ~E1V~ p 1 `~ `L002 ~oQ~~zr sP~R y o o s. sez.Ur~ sr. ~-v~s~riJ , w ~ s y~ l~ PREPARED BY WEGE~EF2 SOIL . TEST S NG AND . . DESIGN S~RV I CE P.0. Box- 74 421 N.~Sain St. River Falls, WI 54022 Phone 715-425-0165 Fax 715-425-6864 ~~ally -~~EA ~ ~MMERCE BUILDINGS ,PpNDENCE ~~ti ~ M ~ i~.~ f~+ 3 ti;,t.,~q, .I w't"".;;~ HEA o-~~s r E1.l5riORitr. i W~ .~~ r++t+. r? .°< ~ ~ q'--Ib -oZ. JOB NO OZ-ZD IlAound System Management Plan Page Z. of 7 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 orice 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. Pumo 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 System 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 BODS, 150 mg/L TSS, and 30 mg/L FOG. Influent flow may not exceed maximum design flaw specified in the permit for this installation. The pressure distribution system is provided with a flushing paint at the end of each lateral, and it is recommended that each lateral be flushed of accumulated solids at least once every 18 months. When a pressure test is performed it should be compared to the initial test when the system was installed to determine if orifice clogging has occurred and if orifice cleaning is required to maintain equal distribution within the dispersal cell. Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the owner, and any levels above 4 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring. General This system shall be operated in accordance with Comm 82-84 Wis. Adm. Code, and shall maintained in accordance with its' component manual [SBD-10572-P (R. 6/99)] arid 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. Continaencv Plan If the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep the system in proper operating condition. If the dosing tank, pump,. pump controls, alarm or related wiring becomes defective the defective component shall be immediately repaired or replaced with a component of the same or equal performance. If the mound component fails to accept wastewater or begins to discharge wastewater to the ground surface, it will be repaired or replaced in its' present location by increasing basal area if toe leakage occurs or by removing biologically clogged adsorption and dispersal media, and related piping, and replacing said components as deemed necessary to bring the system into proper operating condition. - Questions about the operation or maintenance of this system should be directed to: The County Zoning -Office at _ ~. ~S-3~6-y to8o S`C'. et~lx The system installer at The tank manufacturer at __ ~~~ =~~.5 ,.$'LLS b l~ LL~'3 The effluent filter manufacturer at $p~- Z~Z,j -S-1~ Z -- ~3~ The ----- - p p _. um manufacturer at __ ----~3o~-gam-~~ g __-Gdvws -- • PLOT PLAN ` Page 3 of 7 Scale 1"= S~' ' % ~o~~ . ~; • ~ so mot-- s r, . ~ • P r fir 3~ L,OT 3 3 l,~t- 3 Z ~ ~ v Sv 6 G ~~~® x w `no~J ~ ~I -3p r~v~ ~M ~. 8 '~t° V~ B• 9$, s, \~ ~0 o,J ~~q BD~nF 4~PUC Mtty _ 47,k W U~ ~~' ~ 0 F ~. ar'1 ~ z~ Svc F_w~. '~ % '~ t _~_ ~ , _ I 3~' 3 ` ls' B~ 399 ,I is ~ _~ , --`. __, ~`~93 ~. ~ ~ -SOT ~ ~ ~-~.1- Zyy~ Page ,~~-,• Or" Z P_pproved S 1nthetic Cove, ing ASTi~i C33 ' Medium Sand Topsoil -" . _, , ~~ ~ E Distribution Fipe is F, D ~~ b . % Slope Distribution CeII of ~ Force Main 2" to 2 2" Aggregate From Pump CROSS SECTION OF A MOUND SYSTEa A ~ Ft. Linear Loading Rate= G • D CAD/LN FT B L~ -1 Ft Design Loading Rate=D•36C:D/cQ FT j /(o Ft. J (~ Ft. . ~ K _~ Ft. _ . L n L 89 Ft. ~i ev. ~-! g. Z S Flowed Layer 0 1~Z-SFi. E Z•o~6Ft. F ~.~3 Ft. G U.S Ft. H 1• ~ Ft. ' ~ I ~ .. I ~ ~ -Observation Pipe -- E -- I --- - -~ ~ K A c-~----~------- --------- -------------- ------ _ 16.8 _ ..~.~, Force Main ------ - $ c~s OL pu S !h"~ ~7 . Distribution ~ ~ :~~ to 2%" Pipe Cell of z 2 ~ aggregate Observation. Pipe ~ , (7lachoz setuzely ) ' ' - PLAcT ~IETd OF A MOUYD SYSTEj4 •- Distribution Pipe Layout Page S of ~ Place the holes at the bottom of the distribution pipes at equal spacing. Remove all burrs from the pipe and holes. Extend the end of each lateral up with the use of long • turn or 4~ ° fitting to a point within six inches of the final Bade. Terminate the ends of the laterals with a valve,~threaded cap or • threaded plug. Provide access from final grade for the valve, threaded cap or threaded plus. ' Tit P.1 Ct~ L . ~,~5 S . S°Z..`(1Q?y PVC Lateral Manifold ~~ C Lateral x x x x xQ xfl x x x x 'Lateral Length - Lateral Length - p ~~~ v~E,~, -- • P -~ ~ &cL..ss sox a- - ~ ` -~ M rs->J ~ Fo ~ a- -- ---0 PVC wQC~ y~ ~ O- - - - ~q ~ C P 33 Ft. ~ ~ ~ Hole Diameter ~~$ Inch ~• -- . S 3 Ft. - Lateral I ~ Inches) X _ ZY Inches Manifold Z- Inches ' - ~ Force Main " Z Inches _ ~, # of holes/pipe 1'7 Invert Elevation of.LateraTsga-~SFt. . 1'1X'u.~l = 6.4~x 6 = ~t~.az ~~~ _. ~ - Combination Sep.t.~c~.Tank and PUMP CHAMBER CRO55 SECTIOtJ AtJO SPE[IFICATIOUS ' PAGE ,~ OF .._ . -VEU7 CAP ~ WEATHER PROOF Jtl>JCTIOIJ 80X . `I C.I. VEIJT PIPC ~ .lPPROVED LOCKIiuG ~ IO' FROM DOOR, hlA1JHOLE COVER wi'~'1 :i~uDOw oR FRESH ~ wattratuG t_agEL, t,.~sv~,cctn>J PIPE A.>R -uT~IKE ~ co,.~twtr • wlrYtt~llsttT' ~? ~ t , tl I ' _ ~ t i Ft i~ tgt}© 6 .mow . '~ q, s .~ . ~ ~ Y~ liU1. GCE ~ I `- - ~ 18' hIIIJ. 18'/'41A1. ~ ---------- ~~ ~ .. t1JLET ~" PROVIDE I -- •,~ ~j'"AtRTIGNT SEAL I III "' ., I ~ s~~~c I I I Approved z~~t u~~ '~'~ ~ ~~I Approved joint ca/ >r~-_LB~~o I joint w/ PVC pipe i II ALARM PVC pipe Is ~I tE , I t I ( ou c •I I l I LLEY.~~3fT. __~ PUKP ~ OFF D - COUCRETE Lr'LI:TV 8~ • b ~ 1 ~ DLOGK ti: RISER EXIT. PERMIT(ED OI,1Ly IF TA~tK MAf„UFACTURER HAS SUCH APPROVAL 3"AFP>2otiFD ~8F00tN4 SEPTIC f SPEGIFICATIOt`15 005E - TI,tJK MA-JUFACTURCR:~I~~ ~-crVC~~'~= S Q / AJLlMtiEA OF DOSES: ` PER DAB TA~JK SIZE: 1 ~D L $C~ GALLOIJS DOSt< VOLUME I ALARY- MAiJUFACTURC.R: S•S• ~-~~TRO 5~~`T~Q INCLUOIAJG 6AGKFLDW: ~ ~3 3'~ GAItON: MODEL 1JUM8ER: UPI L loll CAPACITIES: A= ~~ 11JCHC50R ~u~•3GAlLOVs SWITCH TyPC: - ~ ~-C1~Z-~J 8 = _ Z' IAJCHES OR ~I ~L.S G~.LLOUS PLINhP MAIJUFACTURCR: GOVT-i~S C: ~ IUtHES OR 1'3 3' yGALLOl1S MODEL f,IUMBER: ~ C!S o= 1 O IA~I'C'pHES~O~R ZZZ' y6ALLOtJS SWITCH TYPE: - ~"~L lZ.~°U~u WOTE: PUMP ANO ALARM AR'E TO 6C MItJIMUM DISCHARGE RATE ~1~• ~~- CpM INSTALLED OAI SEPARATE CIRCUITS VERTICAL D-FFEREWCE DETWCEU PUMP OFF AIJO..DISTR-8UT10-J PIPE.. ,~•q?FEET t httttlMUM AIETWORK SUPPLY PRESSURE , , , (,-SOF~ET (S-D>t. L- 3~ • TOTAL Oy1JAMIC HE:AO = Z~' ~17FEET As per Manufacturer ~-~-Z~ gal/in. Liquid depth ~ 3 b h . `;" ~t ,~.. r APPLICATIONS Specifically designed for the following uses: • Effluent systems • Homes • Farms • Heavy duty sump • Water transfer • Dewatering Goulds Submersible Effluent Pump i~E -1 c~ MODEL 3871 EP04 EP05 Fasteners: 300 series stainless steel. • Capable of running dry without damage to components. Motor: • EP04 Single phase: 0.4 HP, 115 or 230 V, 60 Hz, 1550 RPM, built in overload with automatic reset. • EP05 Single phase: 0.5 HP, 115 V, 60 Hz,1550 RPM, built in overload with automatic reset • Power cord: l0 foot standard length,16/3 SJTO with three prong grounding plug. Optional 20 foot length,16/3 SJTW with three prong grounding plug (standard on EP05). SPECIFICATIONS Pump: EP04 • Solids handling gpability: 3/a' maximum. • Capacities: up to 55 GPM. ~-.~ • Total heads: up to 24 feet. • Discharge size: l'/i NPT. • Mechanical seal: carbon- .rotary/ceramic-stationary, BUNA-N elastomers. • Temperature: 104°F (40°C) Continuous 140°F (60°C) intermittent. • Fasteners: 300 series stainless steel. • Capable of running dry without damage to components. Pump: EP05 • Solids handling capability: ~/a' maximum. • Capacities: up to 60 GPM. • Total heads: up to 31 feet • Discharge size:l'fi' NPT. • Mechanical seal: carbon- rotary/ceramic-stationary, BUNA-N elastomers. • Temperature: 104°F (40°C) continuous 140°F (60°C) intermittent METERS FEET 10~ 9 ~- 3~ e z~ o ~ a W x U 6 21 5 ~ 1; '~ 4 N 0 3 1( 2~ G 1 ' ~1 / '.~ ?~ ./ . ~QQ ®1995 Goulds Pumps, Inc. • Fully submerged in high grade turbine oil for lubrication and efficient heat transfer. Available for automatic and manual operation. Automatic models include Mechanical Float Switch assembled and preset at the factory. FEATURES ^ EP04 Impeller. Thermo- plastic Semi-open design with pump out vanes for mechanical seal protection. ^EP05 Impeller. Thermo- plastic enclosed design for improved performance. ^ Casing and Base: Rugged thermoplastic design provides superior strength and corrosion resistance. ^ Motor Housing: Cast iron for efficient heat transfer, strength, and durability. ^ Motor Cover. Thermoplas- tic cover with integral handle 'and float switch attachment points. ^ Power Cable: Severe duty rated oil and water resistant. , ~ Bearings: Upper and lower heavy duty ball bearing construction. AGENCY LISTING SP• Canadian Standards Association (CSA listed model numbers end in "F" or "AC".) ~.,,_ 1 ~ ~ i ~ , ~..:~ ~ A ~'- sG ' ~ I ~ i ~.. .~ ~ i ---- -- ----- ~- _~ . ~ a . i Zu.yl i _,_ ' , 8 ~ ~ - i EP0 ~,.., 5 I i - 00 0 w N 3U 2 4 6 8 CAPACITY ' au ~ 50 GPM I1a 12 m°m Erfective May, 1995 63871 i i : 5.'.i EG I NAI ;EALTY y 9425686-^, +~$cs~taep'r"nento>= SOIL EVALUATION REPORT D~resio., of Safety and t9u~tfings ~ eooordartce with Comm 85, Wis. Adm. Code Ati~Ch +panalele alto plan an c'O1"~ paper not 1 rss umn 8 1/2 x t t trudtes to size. Mon must Vrdude, but rtat lkrtttecl to tretflc3l and h '~f¢onMdl -eterertae point (BM}, direction and Paroel I.1]. percent slope, scale or dbrten9~r+s, non t ampw, and tocxt6on and dJstanoe m nearest road. ~&?ttiA p~ t a~ /!1/O/T/ifi>`/OA. Reviewted by ~ Y~+ ptnt:os meY be ue~ d Ibr seco^darY plapottq (PriwcY Law. ~. t3.e4 (1 t {mii. SPA tJ0.1e5 Da? r d ~o Pape ~ of .~ late F1' IZ Govt, Lot ,~jt,.i vs,~ t~4 s 3o rz ~ N a 1 ~ ~ t«;4oa Lot ti 81pgt tl Sutxt. Name or CSM ~• 3 3 ~~ es tartorte Number ^ City VlNape ~ Totm Nearest ~1d a t715 ~ -(a7~ ~~ ~.~, lszs t.~ S~ -- _,.-. ~, .,...,.~~~ ~, ~• , ~.w~iwa ~t r~wtflvrns ~ --r c,ooe oBnveO aes~gn T,Ow rate ~ x~ i ct. vu GPD [~ Rep~csment ^ PubAc o ~ cornrnen9at - Dcsaibe:. ,`_ - Parent material . - .~~ ~ ( _ Fbod Plain elevation If appitgble sG~/.. "~ ~ i ~ ~. Caneral ~mmentsr~, y s},t~ ~ E l t J ~ ~~' ,fib 't J~. ~~- and reCpmn~rtClations: r r .1•`i\ Boring # ^ 9Cfif>g I r 1 ®Irc Ground sut ace t~ev. q.i~y0 e. '~ s~~~ - ~ no~rr, M ~tn.:d~„ rti..t,,: ~ ~ `',_ • , ,rxeiMG~~ . _+: I'to~t t'aepth Dnmialent C,oipr --- iedox DBSr7lptlott - - ; -: Tetth~re Stv~re Cnnsislenoe eourraary• . aoat5. Soil Apps ca n iP ' GA[7t>t~ rn. ~4u7se~ < u. Sz. Cant. Gb1p' Gr. Sz. Sh. "Efik2 9teirrg is U dO""e I~ZS Rid Ground sur arm olou- Q ~. d/l7 a ne..u. ~.. tt..,:e~,.. ~..~... ~.1 ~~+ Deplh Dominant Color T---•---- - -r -- -- --- - ~ - ~ ~ De~iption Texlute Shucture Cnnalstence Beur~ary Rants Soit App~catlrn R3t~ GPOhi~ in. t4tunseli t w. Sz Cont. t.,dor Gr, Sz Sh. '~1 tt~2 'E ~ 2 Q~ 7-ZI t0 J~ a< --~ r' ~' J S,'c1 ry~r- ~ C~ C~ ~V~ -- ~ ~ cj p . 0 ~ , • CRL.nw i NI .. AAA --- ••~ ' •••• = ~v i ~ ~t:M'r atv t a7 rau c 7.7: fll9lL ' f:I1111@ril rig = KUU~ t 30 mg!(, end TSS < $0 r7iglL G ..Name (plexae Print t~[~ ~y r3ipnatura CST^~N4~nbgr Rddress Qate Evalua pn Conducted Yefeptmne Numt~r 2l~3 ~~. ~rr~rse~ r ~~2 sZ-~~--o i C~,s~zy~-y~o~' r Wisc6~sin Department of commerce SOIL EVALUATION REPORT /' d ~~~Page / of -.3 Divisio,. of Safety and Buildings in acxordance with Comm 85 Wis Adm Code County i C Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must ro x 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 ail informatfon. Re 'wed by Date ~' Personal information you provide may be used for se~ndary purposes (Privacy Law, s. 15.04 (1) (m)). (~S OZ Property Owner Property Location ~1CJ >..1~~ "{' Govt. Lot .U4/ 1/4~ 1/4 S 30' TZ ~ N R l ~ E (or)~3 Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# I' S3 ~ee ~- 3.3 ~maralc~ res City State Zlp Code Phone Number 7~ ~15 ~ I J~-I01~ 5~9-C ^ Ciy ^ Village ~ Town ~ Nearest Road ls~ ~ S~ ( o ) a rn ,~~ ~ New Construction Use: ~ Residential /Number of bedrooms 3 -Y Code derived design flow rate `1' Sa /r!o GO GPD ^ Replacement ^ Public or commercial -Describe: Parent material Tr' ~ ~ Flood Plain elevation if applicable General comments Sy s~~ ~ e I e J ~ ~~~ ~JO and recommendations: ~U,~-bu r^ a cV ~ ~~O%~"~ f ~ ` ~ ft. ~~ ~ ~ ~~ ~ ~ Boring # ^ Boring ® Pit Ground surface elev. ~ 0 ft. Depth to limiting factor Z ~ iq. ~11ffG ' / - Soil Applica ' n Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary ,Roots . ' G /ftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 1 'Eff#2 1 p-g ,. / _... 3t1 Zm~bk r ~5 Ivy • 5 2 $-Z ~ -- Sic/ ZmSbfC -~ r c s -- . ~ 3 r - a'r •-~ s-~ NP ~P Boring # ^ Boring Z ®Pit Ground surface elev. ~ ~, u. Depth to limiting factor 21 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 *Eff#2 2 7-Z~ ~ ~" S;cl ~C n-r~r cS - • c! - ~ 3 I- l -- s'rc. l " - - - rvP - tmuem a:~ = rsuus > 3u < z1U mg/L ano T 55 >30 _< 150 mg/L 'Effluent #2 =GODS < 30 mg/L and TSS _< 30 mg/L CST Name (Please Print Signature CST Number aclan-, um~ker ~.~ ~"~-------, Z s3.~9 Address Date Evaluation Conducted Telephone Number 2113 ~p~'~- ~mer5e~r Cc.)/ `5~fo25 /Z-~~_a / C'~~s)Zy~-yao~ ~• Property Owner s~-o v~ Parcel ID # Page 2- of 3 Boring # ^ Boring ~ / ' [J3' ,pit Ground surface elev. ~ ° -~ ft. Depth to limiting factor~.t' in. Soli Application Rate Horizon De th Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2 p in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. `Eff#1 `Eff#2 I Z - ~ ( --- s.c1 mfr c~-s - • 4 -~ (' _' r- (t C - ~ -- tV N P Boring # ^ Boring ^ pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Ho izon De th Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ftZ r p in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. `Eff#1 "Eff#2 Boring # ^ Boring ^ Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon th De Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ftz p in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. `Eff#1 `Eff#2 " Effluent #1 =GODS > 30 < 220 mg/L and TSS >30 < 150 mg/L ` Effluent #2 =GODS < 30 mg/L and TSS < 30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. SBD-8310 (R.07/00) . ~' PAGE 3 OF 3 uT D~ ~~c3T LOT# ~ T AL D S RIPTION Nlsl e45W i4 ,S ~ T Z4' ,N,R. /~- E(or~ SCALE: 1"= y0 BM 1 ELEVATION /(1O • G BM i DESCRIPTION~~ o ~ / ~,pi/C BM 2 ELEVATION ~I ~~ yO BM 2 DESCRIPTION ~jp Q -~ ~ ~~ ,~G P SYSTEM ELEVATION) ~-~ Sd SYSTEM TYPE Yh ov n c~ S,/S,~e m CONTOUR ELEVATION ~f'G, S O 9 ~__ ~,.i m 150 N ~tl B"~7 ~~a~~d~ ~~ .ta. CJ SIGNATURE ~ ~~-- ~~~ DATE, ~m~ --= ~~~ ~ ~ g~^ z s--- i~ ST CRU1X COUNTY • SEPTIC TANK MAII`TTENANCE AGREEMEhTT AND OWNERSHIP CERTIFICATI(3N FORM Owncr/Buyer ~- c ~ ~~'~ ~ ~o ~'~ Mailing Address ~~ ~•~ `v ?` y ,f ~~°•`~ ` `~' ~ ~ Property Address /? 3/QcQ ~/-e- ~~ ~~/ (Verification roquired from Planning Department for new construe 'on) City/State Parce3 Identification Numb Property Location d~~ '1e, ~ '/,, Sec. ~, T ~` N-RAW, Tewn of Subdivision ~`n ~.~ ~ l~ ,;~ c y~_ .Lot # r---- Certifled Survey Map # , ~- , Volume ~.~ Page # Warranty Deed # ~S'~'~ '`l ~ _ .Volume ~~ ,Page # D ,~ _,...: Spec house ~ yes ^ no Lot Lines identifiable ''yes ^ no gysT~ FNANCE Improper use and maintenance of your septic system could result in its pternature failure to handle wastes. proper maintenance consists of ptttnping out the septic teak every throe years or sooner, if needed by s licensed pumper. What you put r~nto the system. eau affect the functiaa~ of the septic tack as a treatment stage in flee waste diapoasl system. The property owner agrees to aubmst to St. Croix Zoning Department a certification form, signed by the owner and by a mastarplurnber. journeyman phunbar,restrictedplumber or a iicensedpusnpec verifying that (1) the on-site wastewaterdisposal system is in proper operating condition and/or {2) after inspection and pumping (if accessary), the septic tank is less thaw 113 full of sludge. I/we, the uadorsigned leave read the above requictments and agree to aaaiatain the private sewage disposal syatea3 with the standards set forth, herein, ae net by tl~ Department of Commerce and the Department of Naturat Resources, State of W'fsconsin. Certification stating that your septic system bas been mainmiaedmust be completed and returned to the St. Cmix County Zoning Office within 30 days of the three year expiration date. ~~~~ IGNATURE fJF APPLICANT .~.r I (we) certify that all statements oa thin form are true to the best of my (our) knowledge. the erty dascn'bod above, by virtue of a warranty dead recorded in Register of Deeds 4ffic~. SIGNATURE OF ~~ ~~~ DATE i (we) sm (are) the owner(s) of l~ i 6~- DATE ****** Any information that is mis-represeatod may result in the sanitary permit being revoked by the ?zoning Department. ****** *'~ Include with thin application: s stamped warranty deed from the Register of Deeds office a copy of the certified our~~ey map if reference is made in the warranty deed ':-~.1732PA~r (14 • STATE BAR OF WISCONSIN FORM 2 - 1999 • 65824 8 N;AiHLEEN H. WALSH Document Number WARRANTY DEED F;k''GISTEF DF DEEDS CkOIX CD WI ' ;T ., . . This Deed, made between Amos M. Schultz, kECEIUED FOR RECOkD 30 AN 30-Ok-2001 A : WARRANTS DEED Grantor, and Richard O. Stout and Janet P. Stout, husband and wife EXEMPT N CERT CDPY FEE: --- - - _ COPY FEE: _ TkAN~ER FEE: 1905.00 RECORDING FEE: 11.00 GAGES 1 --- Grantee. : Grantor, f'or a valuable consideration, conveys to Grantee the following described real estate in St. Croix County, State of Wisconsin (if more space is needed, please attach addendum): Recording Area Namy and Return Address SE'/,ofNW'/.;N%:ofSW'/.andSW'/.ofNW'/.ExceptLotlof / C I Certified Survey Map in Vol. 7, Page 1917, Doc. No. 432271, all in Section l ~~1 q y 1 D 30, 'township 29 North, Range 17 West, St. Croix County, Wisconsin. 1 ~„ r ~ ~ 'U\ - ~~~ 018-1067=70, 018-1067-30,018-1067-40,018-1067-50 Parcel identification Number (PIN) Tltis is not homestead property. ~) (is not) Exceptions to warranties: Easements, restrictions and rights-of--way of record, if any, Dated this ~ day of October 2001 Amos .Schultz V A UTHENTICAT[ON Signature(s) Amos M. Schultz, authenticated this day of October 2001 • Krishna Ogland _ __ ____ TITLE: MEMBER STATE BAR OF WISCONSIN (If not, ___ _ _ authorized by § 706.06, Wis. Stats.) 'T'HIS INSTRUMENT WAS DKAFTED BY Attorney Kristina Ogland _ Hudson, W1 54016 (Signatures may be authenticated or acknowledged. Both are not necessary.) Names ot'persons signing in any capacity must be typed or printed below thei WARRANTY PEED t ACKNOWLEDGMENT STATE OF WISCONSIN ) ss. County ) Personally came before me this day of the above named to the known to be the person(s) who executed the foregoing instrument and acknowledged the same. . ___ Notary Public, Stag of Wisconsin My Commission is permanent. ([f not, state expiration date: ---. •) nature. Inlarmation Professbnah Canpeny. Fono tlu Lec, WI eca~sszozr y 1G~/ STATE BAR OF W ISCONSIN FORM Na. 2 - 1999 10~30i200t 15:03 EDINAREALTY •~ 93863121 N0. 135 D12 EMERALD ACF~ES ' ' ~~ , uwnrrrNnernaw~wan~e~rvwt+,nw+ewor e . ~ 1N~MY1M.14ANM1d~tiM ~f~IN~+M~1i+Y~111Mr~ ~ • ~1Y1M M'~tf1pN~1.Rw,InTM.faMwnMlW~rv~o. - , • ~~I~CiMItiMfoMw • • ~waree+.wrwu rw.r ' N!!`~d'0!"!!1! ~ «rr•~.rr....w r.•.rwv - + + • • `` ~"' • ~ ~ + • •r ~ ~ ~ ~D i ~ . ~ _ . + ,• •. ' ~~+ ~~~ ~ ~ , ~ ~ .,Prier ~ ' N84'~4'i9"E 493.OOr ~' ~ ~ ' k . ' ~ . ~~ ,~. ~ }~ ~ ~ +~ 1 wra• •~i Y r • r I ~ r + + ~ . ~~ • ~ ~ ' +~ ~ ..'•'~"' •. :t' ~+ a, ~.. ~ .r..n~r /tart a i # .t • ..r .." - ~` . im~ '~ i ` u •, i ~ ,, rtiy ~ ~ •~ r r~iwr~ ^Mr11~tleM ~ }~ .r- - ' 1, ~~ 1 . 10.'30.'2002 15:03 EDINA~EALTY ~ 93863121 - - w ~~ ~I~'9 ~~ py~uM00 /~11R I~iEAE11CF` ~1~~50wMY~0~0'~iL~oK N !~ ~ ~ ~MI ~~ ~~~ ~~ 82 ~~ ~~ ~~~ ~ • ,°~ ~' ~ ~~ ~~~ Oit a ~ ~ °4 -o i ~~ ~o ~~ i~ N0. 135 D11 ,as•~ ~~ ~ ._.._... -~~ _ 1 ei~ ~ R i r', .Z_ ~ ~ ~ . 8 ~ -I~ rr ~~ ~ ~ ~ ~ $ . r ~' ~--ooo~k r' ~ g a ~ 1 ~ . ~ ~~ -i~ ~~ ~ 1 ,oaf $ , I .~`~ I m ~, ~e ,f~ ~__-----a---- i i ~ ~ ~ ~ ~ ~ ~ ~.~ ~ ~ ` ,, , 1,.~' yy j]J $ ., C tt N ~ P ~ ' 1 ~ ~ ~ ~~ ~ ~ o ~ ~ ~~ ~ I~ ~ ~ ,, M ~ ... o ~ s ~ ~ ~~ ~ .~~ m~ ~ ~ ~ ~ ~~ ~ ~ ~~ ~ ~~ ~ ~ x~~ ~ ~ ~ ~ ~~ ~ ~ . ~I ' i `~ ~ ~ L I~ ~--~ooti ; ~ 4 ~ ~ ,p0'lAS~•tabP•.00s ~ ~~ ti I i j oa 1 () ~ A NN , a •`R i , i 1 r ~~ ~~- ~~ i I ~~ 1 ,~ iw~ I"