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HomeMy WebLinkAbout026-1126-20-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division ' INSPECTION REPORT Sanitary Permit No: 569519 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: 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 Parcel Tax No: Brushy Mound Partnership LLP, c.o Michael R. I Richmond, Town of 026-1126-20-000 CST BM Elev: Insp.BM Elev: BM Description: �] -r- Sectionlrown/Range/Map No: IiJ _ 65T 12.30.18.781 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic / ,}r �,i.. Z / Z S Benchmark ,/ �a,/• Alt. BM Z .S k-4 Aeration Bldg.Sewer Holding St/Ht Inlet TANK SETBACK INFORMATION St/Ht Outlet TANK TO W L/ WELL BLDG. a Air intake ROAD Dt Inlet TE v--, Septic /66 4— Z Dt Bottom ` Dosing /V Header/Man. I •Le �g, Aeration Dist. Pipe Ce • , 77 q Holding Bot.System 7-3 , 97 . PUMP/SIPHON INFORMATION Final Grade 1 I Manufacturer Demand St Cover P /67•Z Model Number TDH Li Friction Loss System Head Ft Forcemal en th Dia. o well SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No.Of Trenc-�, PIT DIMENSIONS No.Of Pits Inside Dia. Liquid Depth DIMENSIONS �I ,t SETBACK SYSTEM TO C, P/L JBLDG IWELL LAKE/STREAM LEACHING Manufacturer: C INFORMATION CHAMBER OR e Z Type f System` 3� 3( / /-V/'-//1— UNIT Model Number: q D fl J Z r o I `o DISTRIBUTION SYSTEM Header/Manifold / Distribution x Hole Size` Ix Hole Spacing` Vent to Air Intake (,•S �� , / / Pipe(s) Length Dia 14 Length Dia Spacing Eq,6 R SOIL COVER I x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over xx Depth Qf xx Seeded/S dded xx Mulched Bed/Trench Center Bed/Trench Edges � Topsoil \ s FE-] No Yes L No COMMENTS: (Include code discrepencies, persons present,etc.) Inspection#1: / / Inspection#2: Location: 1628 Waters EcloaZ rive New Richrpennd`W1 54 17(SE 1/4 NW 1/4 12 T30N R1(8_WI) Water's Edge Lot 20 Parcel No: 12.30.18j�781 TX 1.)Alt BM Description= �� C�J ��J� �a✓\, � o /tl +min.�.� 2.)Bldg sewer length= [[� 111 -amount of cover= !vv 7 71Z- Plan t l .� revision Required? Fs-1 Yes No / Use other side for additional information. L7 SBD-6710(R.3/97) Date Insepctorpigna�tur Cert.No. BRUSHY MOUND PARTNERS LLC/CRUBAUGH 1628 WATERS EDGE DRIVE NEW RICHMOND, WI 54017 (� 5 SCALE - 1"-40' SYSTEM ELEVATION - 96.3 BENCHMARK - 100.00 (TOP OF 1" PVC P PE) ALT. BENCHMARK - 100.4 (TOP OF 1" C PIPE_) t I t I / I f I / I / I � I p°l / yr 3oz I commerce.wi. Ov Safety and Buildings Division County 201 W. Washington Ave.,P.O.Box 7162 ST.CROIX sconsin Madison,WI 53707-7162 Sanitary Permit Number(to be filled in by Co.) t�iepartiment D of Commerce G�ot S J Transaction Number Sanitary Permit Application State Tran�� In accordance with s.Comm.83.21(2),Wis.Adm.Code,submission of this form to the appropriate governmental unit is required prior to obtaining a sanitary permit Note: Application forms for state-ownedJQWTS are Project Address(if different than mailing address) submitted to the Department of Commerce. Personal information you provide may be. u econdary 1628 WATERS EDGE DRIVE purposes in accordance with the Privacy Law,s. 15.04 1 m),Stars. NEW RICHMOND, WI 54017 1. Application Information-Please Print All Infor tion Property Owner's Name Parcel# '3 BRUSHY MOUND PARTNERS LLC 0 ���• � 026-1126-20-000 l � i Property Owner's Mailing AddressGO OQM Property Location P.O. BOX 445 �� GNP` Govt,Lot 20 City,State Zip Code Photo SE y NW � 12 /,, Section NEW RICHMOND, WI 54017 ��� 46-2320 (circle one) T 30 N, R 18 EorWJ 7I�*1,.Type of Building(check all that apply) Lot# tJ 1 or 2 Family Dwelling—Number of Bedrooms 0 Subdivision Name 6� Block# WATERS EDGE ❑Public/Commercial—Describe Use G- N/A ❑City of El State Owned—Describe Use CSM Number ❑ Village of 3 17 N/A Town of RICHMOND 111.Type of Permit: (Check 6nly one box on line A. Complete line B if applicable) ZO X A" New System y ❑ Replacement System ❑Treatment/Holding Tank Replacement Only El Other Modification to Existing System(explain) B. El Permit Renew Permit Revision Change of Plumber ❑Permit Transfer to New List Previous Permit Number and Date Issued Before Expiratio Owner 672- IV.Type of POW] S stem/Corn onent(Device: Check all that apply) Non-Pressurized In-Ground ❑Pressurized In-Ground ❑At-Grade ❑ Mound>24 in.of suitable soil ❑ Mound<24 in.of suitable soil ❑ Holding Tank ❑Other Dispersal Component(explain) ❑Pretreatment Device(explain) V.Dispersal/Treatment Area Information: Design Flow(gpd) Design Soil Application Rate(gpdsf) Dispersal Area Required(s Dknersal Area Propos (sf) System Elevation 600 .6 1,000 ,1,050 X6.3 VI.Tank Info Capacity in Total #of Manufacturer Gallons Gallons Units W 0 $ .2 New Tanks Existing Tanks c Z 1250 0 1250 1 WEISER n v H c5 n Septic or Holding Tank X Dosing Chamber N/A N/A N/A VII.Responsibility Statement—I,the undersigned,assume responsibility for installation of the POWTS shown on the attached plans. Plumb ei s Name(Print) Plumber's Si MP/MPRS Number Business Phone Number PAUL KOEHLER �C/ 10 715-246-2660 Plumber's Address(Street,City,State,Zip Code) 321 WISCONSIN DRIVE, NEW RICHMOND, WI 54017 VIII.County/Department Use Only Approved I ❑ Permit Fee Date LI;Ld [suing ent Signat e ❑ rven Reason for Denial 3 IX.Condi T(ft bWAl!Rmons for Disapproval /� p f i 1; Septic tank,effluent filter and PP �, ��' 1 U e ueb d'p (�1 t /�G dispersal cell must all be services!maintained t,�;LQ.. i�. S n�6: lr a.n 1°A as per management plan provided by plumber, ) 2. 'AN setpack require dust be maintainocl ats per appficabla cods i ordinaii Attach to complete plans for the system and submit to the ounty only on pager not less than 8 1/I x 1 nches in size •L �� /a/ ZZO SBD-6398(R.02/09)Valid thru 02/11 p'vPAA,"�- '`' re,I v`t re-1 CONVENTIONAL COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Project Name: BRUSHY MOUND PARTNERS/'CRUBAUGH Owner's Name: BETISITY MOUND PARTNERS L Owner's Address: P.O. BOX 445, NEW RICHMOND, WI 54017 I Legal Description: SE 1/4 NW 1/4 SEC 12 T 30 N R 18 W Township: _RICHMOND County: ST. CROIX Subdivision Name: W R"S EDGE Lot Number: 20 Parcel ID Number: 026-1126-20-000 Pagel Index and title Page 2 Plot Plan Page 3 System Sizing &Cross-Section Page 4 Filter Specs Page 5 Maintenance Information Page 6 Management Plan Page 7 St. Croix Cty Septic Tank Maintenance Form Page 8 Warranty Deed Page 9 CSM or Plat Attachments: Soil Test&House Plans Designer/Plumber: PATTT. KOEHLER License Number: 225410 Date: 03/04/14 Phone Number 715-246-2660 Signature Designed pursuant to the In-Ground Soil Absorption Component Manual for POWTS Version 2.0 SBD-10705-P(N.01/01). Page 1 lam[L 0192.0 X7.37 t,,r / 8-5/-7 C5 5f f e � � 15 f / M l _ r LA -- 1 O 5 l III ��•(`1cJ 6._c .>'._.�; I_._._ __. __ _. _._w.J a3•� 1 -T =w GI2VPaA UG i BRUSHY MOUND PARTNERS LLC/CRUBAUGH 1628 WATERS EDGE DRIVE NEW RICHMOND, WI 54017 � � 5 SCALE — 1"-40' , SYSTEM ELEVATION — 96.3 I BENCHMARK — 100.00 (TOP OF 1" PVC P PE) ALT. BENCHMARK - 100.4 (TOP OF 1" C PIPE) — f _ I I / I / I � I � t / I ! I / / J s / 0 I / �OI Qm Alo SOIL ABSORPTION SYSTEM DETAIL/GRAVELLESS LEACHING UNIT Page—Lof Project Name: aryS�,�, Y1bv,e Pot ettitPS R U 'A L) No.of Cells _ Per Cell ft Cell Width .2 Total No of It Cell Length sq It EISA Per Cell 3 It Cell Spacing p sq ft Total EISA Manufacturer Model Laying Length EISA Rating Infiltrator EZ1203H-5ft 5.0' 25.0 i EZ1203H-10ft 10.0' 50.0 Gravelless Leaching Unit Manufacturer: c Gravelless Leaching Unit Mode p „ Typical Cross Section Finished Grade i CXo ft Observation Pipe with approved cap or vent ■ Soil Backfill Geotextile Fabric n Infiltrative Surface 12 in O it ft Limiting Factor in Slotted and Anchored Vent[ Observation Pipe with Cap eaaaaaa■■aaaaaaaaa■■a■a�i�.■aaaae■■aataaaa a■aaaaaaaaaaaaaaaa■aaaaaaaaaaa■ . Plumber/Designer Signature: Pa ) oe License#: C Yl p 2 2 S J`d Date: al-e cv, 2 b RUSHY MOUND PARTNERS LLC/CRUBAUGH .628 WATERS EDGE DRIVE IEW RICHMOND, WI 54017 s :CALE - 1"-40' i :YSTEM ELEVATION - 96.3 j ENCHMARK - 100.00 (TOP OF 1" PVC P PE) .LT. BENCHMARK - 100.4 (TOP OF 1" C PIPE) f f / / f / / l � J � L SO l J � v"-s I a CONVENTIONAL COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Project Name: BRUSHY MOUND PARTNERS/'CRUBAUGH Owner's Name: _ BRUSHY MOUND PARTNERS L.L.0 Owner's Address: P.O. BOX 445, NEW RICHMOND, WI 54017 Legal Description: SE 1/4 NW 1/4 SEC 12 T 30 N R 18 W Township: RICHMOND County: ST. CROIX Subdivision Name: W R"S EDGE Lot Number: 20 Parcel ID Number: 026-1126-20-000 Pagel Index and title Page 2 Plot Plan Page 3 System Sizing&Cross-Section Page 4 Filter Specs Page 5 Maintenance Information Page 6 Management Plan Page 7 St. Croix Cty Septic Tank Maintenance Form Page 8 Warranty Deed Page 9 CSM or Plat Attachments: Soil Test&House Plans Designer/Plumber: _PATTY. KOF.HT.F.R License Number: 225410 Date: 03/04/14 Phone Number 715-246-2660 Signature Designed pursuant to the In-Ground Soil Absorption Component Manual for POWTS Version 2.0 SBD-10705-P(N.01 101). Page 1 BRUSHY MOUND PARTNERS LLC/CRUBAUGH 1628 WATERS EDGE DRIVE .� NEW RICHMOND, WI 54017 � � s SCALE - 1"-40' i SYSTEM ELEVATION - 96.3 i BENCHMARK - 100.00 (TOP OF 1" PVC P PE) ALT. BENCHMARK - 100.4 (TOP OF 1" C PIPE) ! I ! I ! � f f 1 k i 1 I ozSA � m p1t 1 � I 153 '�� k w Ll °rgz.o c17 A-cP—e5 e � r i 1 , CrN• e � M e � M IM / T I AMul,E ; .it tI VC o 1! o G12VP-aa uG H SOIL ABSORPTION SYSTEM DETAIL/GRAVELLESS LEACHING UNIT Page—Lof Project Name: Q('" ,a YY)(7 u.4 PA e'$►lt t'S L)g No.of Cells _Per Cell It Cell Width 3 Total No of ft Cell Length sq ft EISA Per Cell 3 It Cell Spacing I Z o o sq ft Total EISA Manufacturer Model Laying Length EISA Rating Infiltrator EZ12031-1-5ft 5.0' 25.0 EZ1203H-10ft 10.0' 50.0 Gravelless Leaching Unit Manufacturer: T>) -F, \ fi4 ra Y Gravelless Leaching Unit Model: 2 X�low e Typical Cross Section Finished Grade I ft Observation Pipe with approved cap or vent s - � r`�.:.i:;iii>�:i i<iiCai i�:`<i :":i:.: 'ri>:■ ■ Soil Badkfill -7 in e Geotextile Fabric e ft Infiltrative Surface 12 in � I ____ $ It Limiting Factor 1118 in Slotted and Anchored Vent! Observation Pipe with Cap e■■■er■■{{r{e{a{{{■ae■a■■{e■■■■re■■.{\■■■■■e'as■■{■■■■■■■r■■■won as man.6 . Plumber/Designer Signature: oe 1,1-r 'r License#: m p 2 2 L16(� Date: M a-e e-1 N 2 b L{ W Y W U _a 0 � � � LV E = Q N N R, o C> W o cf) a � ¢I ,d ■�fS N = p p= O Z0 � •� g 36� � � J Ch - L6 Ch Q z Q �-- � � fn O Q a- d O a' O Q' U O a a O Q Cl) U NO U R M Cl) � CO J ,M n OD O U m U J E O N co Ch to C'5 N a0 ul u J r CD d' N E to u F I T-- N O E Lo r � N H -- z O ad° v O U M = ca cn Wu Q U 11 �� N W _Z in co 2 otS CO f-- Y W Z m 2 U UO -� c U Q J O m 0 Z ui CV Z m 0 0- j LO = O a. � wz LO � � P _ W N O.. (� ® ( u ¢ I- JZW ZZLLO u- M d = 0 Q > u.) I I =) maw co O Q Z ZI- J � CVF- WC/3J00 LO M I-- = -.� Q Q O =:) a � � 20 <6 a-MWW `311A 99t,9-9Zc-008 OIOZ 'Ndf 43SVA38 0 Z \ :anod-isod : v0 oioz Aavnrmr :ova oscbs Hooa N3oroW ot H sn s�csM idnNbW OLLd3S :anod-38d] ,0-,1=,4 L :3ld�S 3WS :A8 NMdaO 3138Bull ��S��m M-001ciM N � \ H J Z N LLJ 0: W O WW� J o Z H W Q J Of Z U Q ck:U Q N N ~ O = W W Z p p WIr Jz W p U d m N V) U W H J J F O Z �. J X LL O V OJ ZqkQ z N > Z wm H f ¢ o m o 1a Lou: O Ow aQ J OM (a/1 `WO O �i0 Z m F Z w w LLI_U M QO=O °• N mQpN U �� O > ZN U O v w O w Ul rn F d �M� W I <wcn OD d ° W �? ODO z o ¢ d O LL F \r o in� mw U �& < a LO NW N O°HwJp F- I Q N- M Jd m O Q pO Z (ri~Go CN W \N� ..1NNd'J>ap 9 10 F=!9W OV Z Vf2 C9w zA N m?J .. NF: �Zcr C) Y J — Q '\ Wm a0 .;Oil: H QW °OW Q ZF-Q Vl :r WU pW �fn (n N . O � "3o Y QW w mF o ° W Z9 Y y<OOaw�°wC7° «� a�° ° o U ° Y� Z aW 23 Nm Z w3mU�=��m�3w o zoa o �$ a � .. oL Q 0 0 oa Z zy'z N° p Z Z = J UFa- U J w W N I H N Q � V W 92 «6£ ° w m w I W \ C4 �W $b� „� N 0 U- .9C do �, F m U _J It N w .9£ a W S W N Q U a SV0 „b 00 1 1 \g .0-0 do w I o w W s � w J N U Z � L� ° Z 00321 a „ti8 St/ K ZS ot Q N Y Z Q F- ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer JA � ---L5 Mailing Address Property Address V,::>-z�b -UM, ;Z:-:b�-� lJSi.�v (Verification required from Planning&Zoning Department for new c truction.) CiVState 441..f ,wa t�� A 1 Parcel Identification Number O Z.tp - %)-k4 -ZCi °- C I LEGAL DESCRIPTION Property Location ''/.a , ""V , Sec. T 3c� N R 1 W,Town of 121) 1.."Jvi a 1.6 Subdivision WIN,, , Lot#')-a Certified Survey Map# , Volume ,Page# Warranty Deed# (,::' , Volume , Page# �a Spec house L! no Lot lines identifiable yes no SYSTEM MAINTENANCE AND OWNER CERTIFICATION 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. Owner maintenance responsibilities are specified in§Comm.83.52(1)and in Chapter 12-St.Croix County Sanitary Ordinance. The property owner agrees to submit to St Croix County Planning&Zoning Department a certification form signed by the owner and by a master plumber,journeyman plumber,restricted plumber or a licensed pumper verifying that(1)the on-site wastewater disposal system is in proper operating condition and/or(2)after inspection and pumping(if necessary),the septic tank is less than 113 full of sludge. Uwe,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 ieptic system has been maintained must be completed and returned to the St. Croix County Planning& Zoning Department within 30 days of the three year expiration date. Uwe certify that all statements on this form are true to the best of my/our knowledge. Uwe am/are the owners)of the property describe above,by virtue of a w my deed recorded in Register of Deeds Office. Number o edr SIGN OF LIC (S) DATE ***Any information that is misrepresented may result in the sanitary permit being revoked by the Planning&Zoning Department. *** Include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if reference is made in the warranty deed. (REV.08105) POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page of 2, FILE INFORMATiON SYSTEM SPECIFICATIONS Owner BRUSHY MOUND PARTNERS LLC Septic Tank Capacity Permit 12 a( ❑ NE # _ (Effluent eptic Tank Manufacturer O N 4 DESIGN PARAMETERS ffluent Filter Manufacturer POLYLOK ❑ NQ Number of Bedrooms 4 13 NA Filter Model 525 ❑ NA Number of Public Facility Units NA Pump Tank Capacity gal gl NA Estimated flow(average) 450 gal/day Pump Tank Manufacturer 10 NA Design flow (peak), (Estimated x 1.5) Pump Manufacturer ) N.4 600 qal/da _ Soil Application Rate .5 al/da /ftx pump Model ID N,a StanE'Dn nt/Effluent Quality Monthly average' pretreatment Unit IR NA Fats, ail & Grease (FOG) 330 mg/L 0 Sand/Gravel Filter ❑ Peat Filter BOxygen Demand (BODE) s2z0 mg/L NA ❑ Mechanical Aeration ❑ Wetland Suspended Solids (TSS) 5150 mg/L ❑ Disinfection ❑ Other.P retrnt Quality Monthly average JNAA Dispersal Cells) ❑NA Bixygen Demand (80Ds) 930 mg/L 13 In-Ground (gravity) ❑ In-Ground (pressurized) Suspended SuGds (TSS) <30 mg/L ❑ ❑ At-Grade ❑ Mound liform (geometdo mean) 9104 ofu/100ml Q Drip-Line ❑ Other: Maximum Effluent Particle Size Ye in dia. ❑ Other ❑ NA Other: ❑ Other: ❑N,k *Values typical for domestic wastewater and septic tank effluent, Other: ❑NA] MAINTENANCE SCHEDULE ,J Service Event Service)Frequency inspect condition of tank(s) 0.At least once every: 3 rnear 8(Sl( Maximum 3 years) ❑Nit Pump out contents of tanks) When combined sludge and scum equals one-third (Ysl of tank volume 10 NA Inspect dispersal cells) At least once every: 3 IV year (s) (Maximum 3 years) ❑wt ean effluent filter At least once every- 1. 1 0 month(s) la NA- 91 [1n]spect pump, pump controls& alarm At least once eve 13 month(s) W, n`' ❑year(s) Flush laterals and pressure test At least once every: ❑month(s) X3 W. ❑ year(s1 Other. At least once every: 0 month(s) ❑ N<, Other: O year(s) ❑ NA MAINTENANCE;INSTRUCTIONS inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications: Master Plumber; Master Plumber Restricted Sewer; POWTS inspector, POWTS Maintainer; Septage Servicing Operator. Tank inspections must include a visual inspection of the tank(s)to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of combined sludge and scum and to check for any back up or ponding of effluent on the ground surfae s. The dispersal cell(s) shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a failing condition and requires ti ie immediate notification of the local regulatory authority- When the combined accumulation of sludge and scum in any tank equals one-third (Y3) or more of the tank volume, the entire contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 11:1, Wisconsin Administrative Code. Ali other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment emits, and any servicing at intervals of 512 months,shall be performed by a certified POWTS Maintainer. A service report shall be provided to the local regulatory authority within 10 days of completion of any service event. VV W V START UP AND OPERATION Page 2'of 2 For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or other ehemic that may impede the treatment process and/or damage the dispersal cell(s). If high concentrations are detected have the conter of the tank(s) removed by a septage servicing operator prior to use. System start up shall not occur when soil conditions are frozen at the Infiltrative surface. During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will I discharged to the dispersal cell(s) in one large dose, overloading the cell(s) and may result in the backup or surface discharge effluent. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restori: Power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls restore normal levels within the pump tank, Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the ari within 15 feet down slope of any mound or at-grade soil absorption area. Reduction or-elimination of the following from the wastewater stream may improve the performance and prolong the life of t) POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fit foundation drain (sump pump) water, fruit,and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; vi painting products; pesticides; sanitary napkins; tampons; and water softener brine. ABANDONMENT When the POWTS fails and/or is permanently taken out of service the following steps shall be taken to insure that the system I properly and safely abandoned in compliance with chapter Conan 83.33, Wisconsin Administrative Code: • All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. • The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator. • After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled wilt soil, gravel or another inert Solid material. CONTINGENCY PLAN If the POWTS fails and cannot be repaired the following measures have been, or,must be taken, to provide a code oomplianl replacement system: 4 A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorptkn system. The replacement area should be protected from disturbance and compaction and should not be infringed upon by required setbacks from existing and proposed structure, lot fines and wells- Failure to protect the replacement area v ill result in the need for a new sou and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rules in effect at that time. A suitable replacement area is not available due to setback and/or soil limitations. Barring advances in PO\MI'S technology a holding tank may be installed as a last resort to replace the failed POWTS. alua ' e ik e a ❑ Mound and at-grade soil absorption systerns may be reconstructed in place following removal of the biomat at the infiltrative surface. Reconstructions of such systems must comply with the rules In effect at that time. < <WARNING> > SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND/OR INSUFFICIENT OXYGEN. DO NCT WATER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY 13E Dllr"FICULT OR IMPOSSIBLE. ADDITIONAL COMMEWTS f POWTS INSTALLFA POWTS MAINTAINER Name COUNTRYSIDE PLUMBING & HEATING, INC Name PAUL KOEHLER Phone, 246-2660, Phone 245-2660 SEPTAGE SERVICING OPERATOR(PUMPER) LOCAL REGULATORY AUTHORITY Name LI QUID WASTE MANAGEMENT Name S-t-, GfZp( 2 A111V Phone F715-246-9 Phone /S' 3fer,'P- (v Z) This document was drafted in compliance with chapter Comm 83.22(2)(b)(1)(d)&(f) and a3.64(11. (21 & (3). vlriseonsin Adminlstrative Code. . . 1 431PAG.1f9 STATE BAR OF WISCONSIN FORM}-1998 60.4257 KATHLEEN H. WALSH ;emenf Number WARRANTY]) - REGISTER R DEEDS ST. CROIX CO., WI This Deed, made between Dated L. Naser, Grantor, an(i Brushy RECEIVED FOR RECORD Mound Partners,LLP,a Wisconsin limited liability partnership,Grantee. Grantor,for a valuable consideration, conveys and warrants to Grantee 06-03-1999 9:30 AN the following described real estate in St.Croix County,State of Wisconsin(The YARRANTT DEED "Property"): EXEMPT II CERT COPT FEE: See attached Exhibit"A" COPY FEE: RIHOFFEE. 12.00 4. -PAGM 2 Recardinr Ana Hendrick W.Van Dyk VA-1-M(YBOYLE&SUIR,S.C. -Post-OlAet Box 137 N#WItkhmdnd,WI$4017 Pmt of 0161037:30 000r 026-f 03f-95 000 nuY.2t�iRI1F14� ParcelIdenUctdon Number(PIN) T l$JLn"<homestead pnpsay. Excepdons to warranties:Subject to all easemejpts,restrictions.and covenants of retord. Dated this Z th day of Mav , 1999. �MDavid L.Niter e . i AUTHENTICATION ACKNOWLEDGMENT Signatures) David L. Naser STATS_OFFWISCONSIN• TJTITLE:uthondcat d thts28 hday of Ma 11999. Penonaiy came before we this day of F9 the above named . _ °ar ata : wtt tacba-dta�erson(>j-who executed the-[orego{ag- -- .Henarik-W. Vari.:..�k �_ �—�_- �. _ - — � o MEMBER STATE BAR OF WISCONSIN' (If not, 1 autharizod by§706.06,Wis.State.) THIS INSTRUMENT WAS DRAFTED BY Notary-Publici State of Wisconsin Hendrik W.Van Dyk My CommUsion ice-permancut. VAN DIM,O'BOYLE Post Offie07$oz327 -- - _3• New Ri6hmond."Aff 54017 (Signatures may be authenticated or acknowledged. Both are eot necessary.) 1431Par,[17 0 Exhibit "A" That part of the following described property lying in the SW 1/4 of NE 1/4, the SE 1/4 of NW 1/4, and the NE 1/4 of SW 114, all in Section 12-30-18 : A parcel of land located in part of the NW 1/4 of the NW 1/4, part of the NE 1/4 of the NW 1/4, part of the SW 1/4 of the NW 1/4, the SE 1/4 of the NW 1/4, the NE 1/4 of the SW 1/4, part of the SW 1/4 of NE 1/4 and part of the NW 1/4 of the SE 1/4 all in Section 12-30-18, Town of Richmond, St . Croix County, Wisconsin, described as follows: Beginning at the W 1/4 corner of said Section 12; thence, on an assumed bearing along the W line of the NW 1/4 of said Section 12, North 00 degrees 47 minutes 04 seconds West a distance of 780 .46 feet; thence North 88 degrees 43 minutes 02 seconds East a distance of 407 . 01 feet; thence to the approximate center line of Paperjack Creek, as said Creek is presently located, North 00 degrees 47 minutes 04 seconds West a distance of 335 . 28 feet; thence the following being along the center line of said Creek as presently located, North 73 degrees 13 minutes 39 seconds East a distance of 400 . 03 feet; thence North 82 degrees 14 minutes 29 seconds East a distance of 254 . 52 feet; thence North 45 degrees 31 minutes 23 seconds East a distance of 116 .47 feet; thence North 79 degrees 35 minutes, 57 seconds, East a distance of 218 . 00 feet; thence, North 33 degrees 50 minutes 42 seconds East a distance of 172 . 37 feet ; thence North 18 degrees 00 minutes 28 seconds East a distance of 176 .13 feet; thence North 73 degrees 30 minutes 33 seconds East a distance of 201. 74 feet; thence South 66 degrees 40 minutes 00 seconds East a distance of 422 . 90 feet; thence South 87 degrees 13 minutes 12 seconds East a distance of 176 . 07 feet ; thence North 86 degrees 22 minutes 15 seconds East a distance of 378 . 15 feet to the North-South Quarter line of said Section 12 ; thence, leaving said Creek, South 00 degrees 16 minutes 21 seconds East a distance of 611 . 71 feet; thence South, 49 degrees 40 minutes 01 seconds East a distance of 580 .02 feet to a point in Brushy Mound Lake; thence, along a line in said Lake, South 06 degrees 46 minutes 19 seconds West a distance of 1613 .62 feet; along a line in said Lake, South 33 degrees 33 minutes 14 seconds West a distance of 435 . 55 feet, this being the SE corner of the NE 1/4 of the SW 1/4 of said Section 12; thence, along the S line of the NE 1/4 of the SW 1/4 of said Section 12, being in parts in said Lake, North 89 degrees 37 minutes 24 seconds West a distance of 1306 . 68 feet; thence, along the West line of the NE 1/4 of the SW 1/4 of said Section 12, North 00 degrees 21 minutes 52 seconds West a distance of 1323 .00 feet; thence along the South line of the SW 1/4 of the NW 1/4 of said Section 12, North 89 degrees 34 minutes 56 seconds West a distance of 1308 . 82 feet to the point of beginning. WATERS EDGE` §` ignp u&tWuY ocated i0 pat of the SW,'/6 of the NW If,pen of the NW Je of the NW 1'/4 VA ' "=, ► f1r. :l Vfi 1K4YL4Ce1 at part of Tke NE 1rd of L"e�VW'!JI„the$E 1 JA of N NW IJl; 4 NE}f4 pt r°'� Ire SP`(4 port of the NW 1/4 of the SE t JS,ona pat of the SW 1JI of the K s�*� uep towns l� NE tlt oll in Section 12;TM A 9x lovn of Rlahmond,St,Ualr wthAcoow4 � � ' time.gn etA 9peuy,w � fW- c�. � � t t � �,N86'ffi75E J74>�. ,wo wl. =91�(fM011O►AgA;�dl �` ` '{ -+- l plr,e,tOo*Wpro �SHOMYA1t1kS� n�nm n7 waaw a �'� y/1; �r 9e;'+e�T ” n «o�I IEWRp11JIG'1MbpG d efarN I kn ep Ap r{ '� ^'mesv 9arg o€1gc a�amw W1*[ti,ba 1-MCI' _ wow a n r,eu tm row y s + i f i+ nwee .Wa bear :tar ew I b R 4R ao a [ +rlwo a NOPiH �. ? 3� /� Gf YCA.uP tt + l ♦ TO a s x r wa er[ti wn ' 91 Y A t A 4 !Ar 11 s 'a6>nY ?6lt.rots.. p pelk 9 F9r m6 rtn ng♦w S4 c,.C..y � dt il4 - m.errt ' MP>br[aiod ue dDian+w a - �, . le{:aet m e '` lok'+oe sa n y Y AL'A A 1 kf` 1 er.wgs �l ,w a e c 6n o I n - ' $ 4. $. it AIEP>`e 9E1,e f r[ w p S Mfg a'F G'lre it le t .p Ones Ira la a♦ewr^7 uum r,.- :+s`r% >4 NSb 9!ALY ♦ 46 W9latr, Y is rmm6pY row mnr..i.an ra ai♦r .9 tr _,W ♦st�roa jk'w t1Y' F l rsrnkrN r 7eitziiear'sosR l&q �4 ♦'r° W^ rt[R°r'wteut z� � sTSnc axwvane n¢w c SD uwam i� � r a �` ,'y :.. i'� _ p7� N f;?row eK 5 e;uaaVuM c sake T nR y {12T7� C1kN'N i R �o `��.J:#e 1p1E9 � � 7 X {y, � ♦+A Y- A�;s r�s 9�l >�, R R n 9t 0.Rl t6, xtas�ft ^ a s u�IM1 � 66W1 Id goy avcrsuE0Irz,CaVT4 Act-tmcik' 6OR445Mwa or,4rITID,;t T30 Abw W?15.95.x[9 7 3HA ICON'Y ry " 9 ztE.2120 �g s86pf'M2 � III R R�IR J4"R 1 b �'�� 1s�7)r• _. yppp e �'�H 5�.� Q a R i��r� � I _ � L-v sa r,z' �ey4'5 Q'I (III Iir,. o {� C 1171?9' LOT1icZ s, } �1 fie.. ANN Y(A !Y J Y WE+Po AIf4•. 4i 3 p. I a9ln san 2 T f .0X901 A FT, C aaaes px . �xirr f : T ` Nns A I vw Qfto i ' �t7TP� ' � � �§ J� e ��R♦"?��J f�o+u�'a�x � '; Ui � r I w � o ��.' r:x MNttA l srE996d �mwrn �� 4S �aamra t � xhs�srs a d { IR4Sn a � I ,reed $ ;'a .u&[wutubrnua,. W R�Ai. •';.�. e717[5p r N/° ee aes If j �I a ♦ t{ AN 6,xwr R $F S x xdaenwaaMo s SEE �StlBd E zra mA a woe a}a .COF� 712♦fyj[ � w a• :YEA 1R9gr4 �' � �2 E x � >2 1�1s AM m♦:MSQKN[EA 1 '� °° 4X[91116 3 14 try ,O '�sslli� Yf . 6 r'6°seuy' At N e ♦ w �a k�' Ealo�R� b t0T DETAL-NO SCAL �lX':: Ivry b,5t�f' 1' 9 IOTAt ! qTo kicamx ,�'� �' _mw�uck � r e<.u3sorc o!I� �? ,��2+r s�d°j � rc' .;•, QiYO loommh 1 19s+tats t5 p t +. C 4 r L t u3 Fa l9 Wri '�'f FfE N10 e � ieY. Q7do pt jR'p .� B V76�'t tx , Y i t :C Wl.C� 6fE 1616 11 AUA bl►' p++C �tl €3d�Stf 'Ut® �,. Cl 111 „.° Ftcwuc ' ATp Iti et ®.� o ` 'I �6 A'L' o r f SKET 2 AF 4 SHEEN a` 3 500-26"- - - I.W.E. 992.0 n .W L. q 15 /. or 20 TOTAL AREA, 86,765 S . F'. 1.97 ACRES F.P.E. 996.0 JR04AD s '* .e wry w Wiscons;'►Department of Industry, SOIL AND SITE E V A L U A Eli Page of< Labor and Human Relations -Di ision of Safety&Buildings >' in accord with ILHR 83.05 dm Code Qtr rid C UNTY Attach complete site plan on paper not less than 8 1/2 x 11 inches in size must i ude,but Croix not limited to vertical and horizontal reference point(BM),direction and° lope,scale r '�� PA L I.D.# dimensioned, north arrow,and location and distance to nearest road. ���1. w(► Z��� -02(}-x} APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATIO WED BY DATE PROPERTY OWNER: TY OdbATION Derrick Const. Inc. G01tgfii ;"I/ 1/4,S T N,R f(or)W PROPERTY OWNER':S MAILING ADDRESS LOT# UBD.NAME OR CSM# U/OT- 69-S 1 CITY,STATE ZIP CODE PHONE NUMBER ❑CITY []VILLAGE aOWN NEA OAD New Richmond, WI. 54017 (7151 246-2320 1 Richmond [X] New Construction Use k ] Residential/Number of bedrooms 4 [ ] Addition to existing building I ] Replacement [ ] Public or commercial describe Code derived daily flow 600 gpd Recommended design loading rate .5 bed,gpd/ft2 .6 trench,gpd/ft2 Absorption area required 1200 bed,ft2 1000 trench,ft2 Maximum design loading rate .5 bed,gpd/ft2___,_6 trench,gpd/ft2 Recommended infiltration surface elevation(s)✓ 96.30 ft (as referred to site plan benchmark) Additional design/site considerations na Parent material outwash Flood plain elevation,if applicablgka ft S=Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM IN FILL HOLDING TANK U=Unsuitable fors stem ®S ❑U la S El us ❑U US ❑U E]S [aU ❑S [au SOIL DESCRIPTION REPORT NAC Al it Two -- Depth Dominant Color Mottles Structure GPD/ft Boring# Horizon Texture Consistence Boundary Roots in. Munsell Qu.Sz.Cont.Color Gr. Sz. Sh. Bed Trends Z ....;'.::: .::.: 1 0-12 10 r $. 2 12-20 10 r 4/4 none `{ Ground 3 20-84 .5� elev. _ 99.9 ft. Depth to j limiting factor 3.2 7% 2- +84" Remarks: Boring# 1 0-9 10 r 3/3 none .5 2 2 9-24 10 r 4 4 none Sicl 2msbk mfr Lpi if �{ Ground 24-8 ,S elev. --- 100.lft. Depth to limiting factor S'rO +84" Remarks: CST Name:--Please Print Gaxy L. Steel Phone: 715-246-6200 Address: 1554 200 v . New Richm d WI 540 Signature: Date: 6-15-2000 CST Number: m02298 PROPERTY OWNER l)arrirk con-st- Tnr•. SOIL DESCRIPTION REPORT Page--2-Fof-3- PARCEL I.D.# pending Depth Dominant Color Mottles Texture Structure Consistence Boundwy Roots GPD/ft Boring# Horizon in. Munsell Qu.Sz.Cont.Color Gr. Sz. Sh. Bed Trench 1 0-11 10r3 n f .5 .6 S' 2 11-22 10yr 4/4 none sicl 2msbk mfr gw if .4 .5 �( Ground 3 22-84 7.5 r 4/4 none a .5 . •� elev. ---- 100.2 ft. Depth to limiting factor +84" Remarks: Boring Bori # 1 0-10 10 r 3/3 none 2msbk mfr cs if .5 .6 �- ti<>..4.....` 2 10-22 10 r 4 4 none sicl 2msbk mfr if .4 .5 3 22-86 7.5yr 4 none s 2msbk- f na 1 .5 i .6 Ground .S elev. wet Os mvfr na na .7 .8 100.1 - _ rc o s wca� Depth to limiting 37 factor +90" Remarks: Boring# g" = 1 0-12 10 r 3 3 none 1 2msbk mfr cs 2f .5 .6 2 12-24 10 r 4 4 none sicl 2msbk mfr if .4 .5 3 24-84 7.5yr 4/4 none ms/sl 2msbk mvfr na na .5 .6 Ground elev. l00.fit• Depth to limiting factor +8411 Remarks: Boring# Ground elev. ft. Depth to limiting factor Remarks: SBD-8330(8.05/92) r , STEEL'S SOIL SERVICE Gary L. Steel Derrick Construction, Inca 1554 200th Ave. CSTM2298 SE4Nw4 S12-T30N-R18w New Richmond, WI 54017 MPRSW-3254 town of Richmond (715) 246-6200 lot #20-Brushy Mound Lake This soil evaluation was conducted to satisfy a zoning requirement, it may or may not be suitable for your use. The location of the test may or may not be as shown as permanent lot lines were not established at the time the test was conducted. - N r1"=40' �= t�2po 1°pvc pipe C el. 10. 0.00, top of 111 pvc pipe C el. 100.40, v C 11A 13o 7 Gary L. Steel 6-15-2000 1 1� V 8O� X 88544 SQ.P .TT;.?6 ®� • 995'2 �- .03 ACRES �, ►�3 SQ. FT. 1 1 9X.7 T 5 X98 999.E ES 8— • 3930 S . FT. \ —3 B—\ 25 YEAR H.W.E. Q 0 96 19 ACRES 993.7 B-4 • 1- 0 LIMITS OF U E EASEMENT B—J Eamt B-4 • B-5 � X o o , v 994.1 0 xB_3 27 �� LOT 22 B-2 994:5 O SQ.FT'. 9 87293 SQ.FT. 2. DES 2.00 ACRES / 9 96 / B-4* Q x B-3 997.5 / 9.8 B-2 * 8-5 • 998�� E3-4 / LO B_3 / °° �. 84924 SQ.FT. -1.95 ACRES LOT ZO 0 � 85765 SQ.FT. B—:1 l 1.97 ACRES B-5 o B-1 LOT + X X 999.2 B-2 • - 80020 SQ.FT. 99��\ \ © BO3 X 998.6 1.84 ACRES i\ f 804 B-5 ox tX98 8 12' Ut���tY Easement o PROPOSED TOWN ROAD � o0 X 999.5 NOTE: The parcel(s) shown on this map is/are subject to State, County and Township laws, rules and regulations ( i.e. wetlands, minimum lot size, access to parcel, etc.). Before purchasing or developing any parcel, contact the St. Croix County Zoning Office and the appropriate Town Board for advice. . . . . . . . . . . CONTOURS ARE SHOWN AT 2 FOOT INTERVALS. ELEVATIONS ARE BASED ON AN ASSUMED DATUM. Building E HIGH WATER ELEVATION FOR PONDS ARE CALCULATED FOR A 25 YEAR STORM EVENT. (100' fron (75' from DRAINAGE EASEMENT RESTRICTIONS: NO GRADING OR CONSTRUCTION WITHIN DRAINAGE EASEMENTS. r I hereby certify that this map was prepared by m• or under my direct supwAsian, that it is true and correct to the best of my PRELIMINAR t00 knowledge and that I am a duly Registered Land Surveyor under th. law or the scot. or Wisconsin. O CONCEPT ad for and at the re