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018-1089-04-000
i I I O CI N N N O S O O N 7 ~ 3 ~ iD N C N (J p -~ N N W ~ ~ C C. 3 N N d O O N O O 3 > ~ fOD O ° °' 3 0 ~ m co I °i ~ j I~ ~ ~ W N C d o C N O m0~. Z V ~- { O I N c i ~ a Z~ O C < Q (D fD 2 N 3 `G O s m .Z7 (D C m I ~ N I I ~ ~ D fD (fl fl. d ~ ~ N O~ ~ O O ~ Z ~ o O N a I ~ 0 f -a N O 7 O O O 7 O .. O (D ~ O i o ~ I °o n UJ Q ~ '0 C7 .. 3 0 ~ ei '? a v`-° "~ ~m m ~ - w 3 :.' .. !G O A r = j 0 O d ~ N Oo !09 O ~ W ~ O 7 ' ? V ~ n ~O V p O A O O 7 O N a i N C ~ ~ 2 _ ID N Q' ~ a o m N A ~ W N D ~ v ~ o °: 6 C CC CC G G G .~ ~''. ~''. m A (n ~ N N O < ~ ~ ~ ~ ~ 01 'O A ~: . 2 N ~ ~~ y N p1 W ~ .. 3 .~ D D o a N A O 3 0 m c d Q m Vl W ~ Q O O :"., 3 !~ Z (D W 1 N A Z ~ ~ ~ M A Z O •• ~ 3 Z N ~ < O A Z1 A G T C 7 a d ... A~ ~I r~3 O K A~ O A ~/0 ti ti Wisconsin Departme`?t of Commerce PRIVATE SEWAGE SYSTEM Safety and Building~Jivision INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Personal information you provide may be used for secondary purposes {Privacy Law, s.15.04 (1)(m}]. Permit Holder's Name: City Village X Township Leaf ren, Tom Hammond Townshi CST BM Elev: /D6 - a Insp. BM Elev: v ADV BM De ri tion: ~~ . TANK INFORMATION TYPE MANUFACTURER CAPACITY Septic ~4~~~~ /~ y~ y~ (~ (~ Dosing ~ ,/ ~ (/l./ ~L.Q>Q.Q/L' ~ 5~ Aeration r' Holding ~.,_-- __.._- TANK SETBACK INFORMATION TANK TO P/L S WELL BLDG. V~ Air Intake ROAD Septic ~~ ~ S 2. ~ ~ Dosing ,~~ y~/ / C i ~ J Aeration Holding PUMP/SIPHON INFORMATION ~~~ Manufacturer Demand ~ GPM Model Number S3 2-I-~ TDH Li~-„ ,/ (~j Friction L~s L System Head T~ H ~ Ft Forcemain Le th,~ ~ i Dia ~ ,t Distj wel_ Imo., ~ SOIL ABSORPTION SYSTEM ELEVATION DAT County: $t. CrDIX sanitary Permit No: 420690 0 State Plan ID No: ~~~~~ Parcel Tax No: 018-1089-04-000 Section/Town/Range/Map No: 31.29.17.709 STATION BS -, kil ~ FS ELEV. 0 . J Benchmark I~ ~~ ~ ~ Df • Alt. BM -r- Bldg. Sewer - 3 ~ /o!• 5 St/Ht Inlet o~ y~ SUHt Outlet Dt ~.a fro- 9 y Dt Bottom ~; Z 93 , (~ Header/Man. ~, ~pD Dist. Pipe ~ ~ ~~ ~~'-i~ Bot. System 1 ~ 039 • sr Final Grade i ~ /oo• s St Cover ~ ~ 03.6` BED/TRENCH Width 7 Length No. Of Trenches PIT DIMENSI No. Of Pits Inside Dia. Liquid Depth DIMENSIONS ~ U ~-- lam/ SETBACK SYSTEM TO P/L S BLDG WELL LAKE/STREAM ACHI Manufacturer: INFORMATION , -~ CHA OR Typ / ~System: ~ ~~, ~~~ //~ /) ~ r / U T Model Number. ~ ~ I W (fi DISTRIBUTION SYSTEM (O.tp O•~i ~o•~+' Header/Manifold Distribution x Hole Size x Hole Spacing Vent to it Intake i ~ // ~ 5 2 Pipe(s) e/ ~• ~ ~ ~ ~ • ~ ~ ' ~ ~d~- `~ `~" _ Length Dia Length D Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only V Depth Over ~ Depth Over xx Depth of xx Seeded/Sodded xx Mulched BedlTrench Center Bed/Trench Edges Topsoil ~_] Yes ~ No 0 Yes C1 No GL f COMMENTS: (Include code discrepencies, persons present, etc.) Inspection ~~J~~~n~~J Inspection #2: ~ / ~3'~ Location: 1505 64th Ave New Richmond, WI 54017 (NW 1/4 SW 1/4 0 Unknown) Sunny ' I~L~// ~ Parcel No: 31.29.17.70 1.) Alt BM Description = ST. ~ Z._- 2.) Bldg sewer length = ~ t{/~~ ~~~ ~~~ ~~5-~QQcl ~ ~f~-~- -amount of cover = ~ 3 / v !~ 3.) Contour = ~Q~~, Plan revision Required? [ ~ Yes No ~ 1 3 03 ii ~~,/~~~ t ~ /_ J Use other side for additional information. -_-~ ~3_~ __ ~----- - ____ _--'- --~~~,(/j/~y-`' --- L tU -- SBD-6710 (R.3/97) Date {nsepctor's Sig ature Cert. No. ` Safety and Buildings Division 201 W. Washington Ave., P.O. Box 7162 County f ~o i X ` ®~eonsin Madison, wI 53707 - 7162 Site Address Oe artment of Commerce ~ SAS ~~~- Sanitary Permit Application _ sam ~zo 6 R o r m accord with Comm 83.21. Wis. Adm. code. personal information yon provide ^ Check if Revision ma be used for seco ses Priva Law, a15. 1 m I. Application Information -Please Print All Information 'v E RECE State Plan D. Number s ~ s~ =r~.,,~. -~ Property Owner's Name 1 1 200 Parcel N r \ a~t8 - l o ~--e~( --ecg6•~~ ~~o F'a'~ N' frEB ~ Property Owner's Mailing Address NTY O Property Location F CE Slo ..~ D ~ Gr.w U ~ S ZON OG O ~i S ~ !4; S ~ T!~ N, R City, Stan Zip Code one Number Lot Number Block Number ~{..._ y~/~ 5~ ~ ~ ~ ~r1 a- f ~1'- // t ~ ' j sC 4~~ (,S ~- ~Y39- to f g ~b vision Namest fr~ / CSM Number f )I'1 OCiry II. 'i~pe of Building (check all that apPIY) ^~ 0 1/or_2 Family Dwelling -Number of Bedrooms J ^Village ^ public/Com~rc' - ribe Use ~ ®ownship (~ Nearest Roadd{_/ ~•.- ^ State Owned , r M ~~ p 4 - ~. sp'~6 " d / /~- ~ ~ ~ x ~ 1 , 6U-wt)[ III. 'Ippe of P 't: (Check only one box on line A (numbering scheme for internal use). Complete line B if applicable) A 1 New 2 ^ Replacement System 3 ^ Replacemem of 6 ^ Addition to For County use stem Tank Onl E~tis ' stem Permit Number Date Issued ~ B. ^ Check if Sanitary Permit Previously Issued IV. 'I~pe of Permit: (Check all that apply) bering scheme is for internal use) 44 ^ Non -Pressurized In-Ground 21 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 ^ irculattng 30 ^ Other V. D' tment Area Information: -lv0 Design Flow (gpd) Dispersal Area Dispersal Area Soil Application Percolation Rate System E ovation Final Grade Required proposed Rate(Gals./Days/Sq.Ft.) (Min./Inch) Elevation f''8 a~'° ~ 1~~,.~q' C ~ ~. Tank Info (~ ~ Capacity in Gallons Total Gallons Number of Tanks Manufacturer Prefab Concrete Site Constructed Steel Fiber Glass Plastic ~ E ~ ` ; "" ~ 6 New Tanks Existing Tanlcc Septic or Holding Tank _ ~ 6 ©0 ` w ~ cam[ Dosing Chamber ~ ~ /' ~'~ i VII. Responsibl7ity Statement- I, the undaratgited, assume responst~-Ility for installation of the POWTS shown on the attached plans. plumber's Natne (Print) Plumber's Signature MP umber Business Phone Number Phrmber's Address (Street, City, State, Zip Code) ~ 6 7 f~~ lv 5' I~~~Er ~s C,1.1 ~ ,s` '`~O ~ 3 ~ VIII. Count /De artment Use Onl Sanitary Permit Fee (includes Groundwater Date Issued Issuing Agent Signature (No Stamps) - ~, Approved ^ Disapproved Surcharge Fee) ^ Owner Given Initial Adverse r • ~ ~ ' Determination ~ IX. Conditions of Approval/Reasons for Disapproval s-lug. Gi~i e~ Se~` s•~s~ ~..~- ~ eu--~S~ di-~--~ {~- t-1. l..• a.~ ! 020 . o S ~+.>y.,r -~ /kll s u ~ ~o~ .1~ v~"s,~.>z-- w~•~. ~ ~s ~ a. s t~e~,~- w~ ~ ~ s~.~2-.A~ l~ i~ ctn. L . 0 1 ~ _~ r_!t ~ - n` P ~..~--. .~- ..00.. .l~ l~l.c~).1_ /nY,1wu~~ ilAOn n+ SBD-6398 (R. OS ~ ~~ Inns (to the Co~mt~ odd) for the slstem oa paper not less than 1/2 x Il Inch to size /so ~ ~r.c e~ M -_ / PrO~oo ~~ Qom a ~~' 0 A Proposed •~'-ou.~o~ ~.~ I~o.~'X /DSI.SD'cJ/S'iY90' d,-spGrsalCe~/. /-ou/'(yJ /a'LUo,/s at IYs~J~ YS! 23' W~ y8 '~vr; F~« s,~ ~~ of 3. os; ezl /: '~ I~ ^ Sa'l a va lccu,-F~o~ p: E; • E/E r/a'~i o-~ p~ ~ Sca/c: / " y(Cj, /ot ~ cf Sennyy~'/I, ice . 3 /, T . of'/+~..rrn ar~o! .56 _ 'AT~C C'o., c.Jr. a r r .~ ~ v a o. ~P~oPosed 0 B~ .- ~, 1 ' ~l ~~ ~~ ~' ropos~d ~~Sidene~- ~~ ~,~~a(,s~oP./.e. 11 (o~+cc. wa:ti ~~~ . ~-Fv~ r~is~-clafr~- ~-~ _ ~ ~ j , ~~ ~ "sc.(. yo P. ~ c. I l/ ~ ~+rK ~/ s~46¢/ ~ ~ g.a; Prop oSCd 7.5~~ ~ . /ce F~f'~u e.~ ~ pu.,~F ~6o.~,Lu: F~ /fe~,ct out/ct. ~ a~ r 8. ~ Top aF' /off 377 ' S~ . Ertt~ s 9fr3/' 8of y .;~ ~ ~ ~scons~n Department of Commerce Safety and Buildings 10541 N RANCH ROAD HAYWARD WI 54843 TDD #: (608) 264-8777 www.commerce.state.wi.us/sb www.wisconsin.gov James Doyle, Governor Cory L. Nettles, Secretary February 07, 2003 CUST ID No.222781 HENRY J NECHVILLE 967 HIGHWAY 65 ROBERTS WI 54023-8510 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 02/07!2005 ATTN: POWTS Inspector ZONING OFFICE ST CROIX COUNTY SPIA 1101 CARMICHAEL RD HUDSON WI 54016 SITE: Tom Leafgren 150TH St Town of Hammond St Croix County NW1/4, SWl/4, S31, T29N, R17W FOR: New mound, 450 GPD Object Type: POWT System Regulated Object ID No.: 890752 Identification Numbers Transaction ID No. 835156 Site ID No. 655575 Please refer to both identification numbers, above, in all correspondence with the agency. C~ ~~ The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. ~~~ The following conditions shall be met during construction or installation and prior to occupancy or use: General Approval Conditions: • 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-10691-P (N.O1/O1) and SSWMP Publication 9.6, "Design Of Pressurized Distribution Networks For Septic Tank- Soil Absorption Systems." • In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approved plans. In addition, the owner must insure that the operation, maintenance and monitoring duties as described in section VIII of the mound component manual are complied with. A copy of this information must be given to the owner upon completion of the project. Key Item(s) • The proposed pump is near its limit with the proposed total dynamic head. If upon installation, the total dynamic head increases, the proposed pump must be reevaluated and may be inadequate. It is highly recommended to install a larger pump. Note • The designer proposes to install a state approved effluent filter to achieve the requirement of wastewater particle size. Pursuant to outlet filter product approval stipulations, maintenance information must be given to the owner of the POWTS explaining that periodic cleaning of the effluent filter is required. The access opening used to service the filter shall terminate at or above finished grade with a watertight cover. • The bottom of the distribution cell shall be level per the Mound Component Manual with 6" minimum sand fill at the "D" dimension. HENRY J NECHVILLE Page 2 217!03 • The maximum fmished slope of the mound surface shall be equal to or less than 3:1 per the Mound Component Manual. Reminder • The orientation of the mound system must be such that the longest dimension is oriented along the surface contour per COMM 83.44(6)(a)2. • Limit activities in the area 15' beyond the down slope edge of the mound per Mound Component Manual. • Surface water drainage shall be diverted away from the system area per Mound Component Manual. • Materials shall conform to the requirements of COMM 84. • Maintain well and waterline set backs per COMM 83.43(8)(1). Consult the Department of Natural Resources for well setbacks and exceptions to the setbacks. A copy of the approved plans, specifications and this letter shall be on-site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of construction/installation operation. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence maybe made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter to the owner and any others who are responsible for the installation, o ration o intenance of the POWTS. r y, Fee Required $ 175.00 Fee Received $ 175.00 -~~,~ ~,, Balance Due $ 0.00 ' Patricia L Shandorf POWTS Plan Review r ,Irate ated Services WiSMART code: 7633 (715) 634-7810, Fax: ('T15) 634-5150 , M-F 7:45 am - 4:30 pm pshandorf@commerce.state.wi.us cc: Leroy G Jansky ,Wastewater Specialist, (715) 726-2544 c c MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Project Name: Tom Leafgren Owner's Name: Tom Leafgren Owner's Address: 5630 Omar Ave. Stillwater, Mn 55082 Legal Description: NW1/4SE1/4, Sec. 31, T.29N., R.17W. Township: Hammond County: Subdivision Name: Lot Number: Parcel I.D. Number: Plan Transaction No.: St. Croix ).~. '~l iCrl Sunny Hill 4 Block Number: na FNT 018-1089-04-000 Page 1 Index and title Page 2 Data entry Page 3 Mound drawings Page 4 Lateral and dose tank Page 5 System maintenance specifications Page 6 Management and contingency plan Page 7 Pump curve and specifications Page 8 Site Plan Page 9 Soil Evaluation Report Designer: Henry Nechville License Number: Date: 01/17/03 Phone Number: r,~Q: Signature: ~f~C~ $3~~5~P 222781 715-749-3322 Designed Pursuant to the Mound Component Manual for POWTS Version 2.0 SD&10691-P (N. 01/01), and SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST-SAS (01/81) Version 3.0 (03/01 /01) Page 1 of 9 Mound and Pressure Distribution Component Design Design Worksheet Site Information (r or c) R Residential or Commercial Design Note: Sand fill (D) calculations assume a _ 3 00.00 Estimated Wastewater Flow (gpd) Table 83-44-3 in-situ sal treatment for fecal _ 1.50 Peaking Factor (e.g. 1.5 = 150%) caifom, of <_ ~ incnes. 450.00 Design Flow (gpd) __ 5.00 Site Slope (%) 98.00 Contour Line Elevation (ft) ___ .32`00 Depth to Limiting Factor (in) 0.50, ~--_-_ _----. In-situ Soil A lication Rate 2 Pp ~ (gpd/ft ) Distribution Cell Information -------, ,90.00 ~~ 1.00 Dispersal Cell Length Along Contour (ft) = Dispersal Cell Design Loading Rate (gpd/ft2) 5.00 Cell Width (ft) _ Cy _ 1 Influent Wastewater Quality (1 or 2) Are the laterals the highest int in the distribution Y Pressure Disribution Information network? Enter Y or N (c ore) ~ c~ Center or End Manifold 2.50 Lateral Spacing (ft) If N above, enter the elevation ft _4 0.125 Number of Laterals Orifice Diameter (in) (e.g. 0.25) of the highest point. _ ~__ 3.00 Estimated Orifice Spacing (ft) = 7.50 ft2/orifice .0 Forcemain Diameter (in) _ _ 0.00 _ rcemain Length (ft) Does the forcemain drain back? Y _ 92.50 Pump Tank Elevation (ft) Enter Y or N 6.50 System Head (ft) x 1.3 5.50 Vertical Lift (ft) 0.41 Fric ' (ft) 12.41 Total Dynamic Head (ft) 4.89 Forcemain Drainback (gat) 81.16 5x Void Volume (gal) 86.05 Minimum Dose Volume (gal) 24.72 System Demand (gpm) Lateral Diameter Selection in. dia. o tions choice 0.75 1.00 x 1.25 x 1.50 x I x 2.00 x 3.00 x I Treatment Tank Information 1,0_00 gal. Septic Tank Capacity (gal) Wieser Concrete ~ Manufacturer -_ -. Dose Tank Information 750-36 Dose Tank Capacity (gal) 20.28 Dose Tank Volume (gal/in) Wieser Concrete Manufacturer Manifold Diameter Selection in. dia. o tions choice 1.25 x 1.50 x x 2.00 3.00 Gallonsltnch Calculator (optional) 750.36 Total Tank Capacity (gal) 37.00 Total Working Liquid Depth (in) 20.28 gal/in (enter result in cell 649) Effluent Filter Information Zabel Filter Manufacturer A100 Filter Model Number Project: Tom Leafgren Page 2 of 9 Mound Plan View ... - ~-~ . ~ 1 /1 1 ~ B :: • • • ... Observation Pipe ~u ~:~: ••••••••,•ti.ti.., •... •ti •• •• • •• . -t J1 - I A I 1 L Mound Component Dimensions A 5.00 ft E 9.00 in B 90.00 ft F 9.50 in D 6.00 in G 0.50 ft H 1.00 ft K 7.25 ft z 7.21 ft L 104.50 ft J 4.67 ft W 16.88 ft 450.00 (ftz) Dispersal Cell Area 5.00 (gpd/ft) Linear Loading Rate 1098.53 (ft2) Basal Area Available 9.00 (ft) 1/10 B Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area Finished Grade 100.29 (ft) - ,rr:: rr.... G ~ H ~ ~iifiirrrr 2 irr:rfrr.. I - ,-,,,,-, , ,,,,r,.. 99.00 (ft) Lateral F .. ; •: ; : ~ `Dispersal Cell 98.50 (ft)-~ Invert Dispersal Cell ,;•;~y's.~~ Q' ~ ~ ~'~~ ~ Elevation E ~ - D ~ : ~: 4 _ - ~~:... - -' 98.00 (ft) Contour Elevation 5.0 % Site Slope Geotextile Fabric Cover Shading Key ~ n, ~- Dispersal Cell See lateral details on Topsoil Cap o ~~ 1.5 ft ••.• . •.• .••• Page 4 for number, :~:~ ~:l:d•:;:; ~•: © ""' Subsoil Cap w ~ 5 r: rr 'frr~: size, and spacing of +~ : ~~:::: r `'r ©~ ASTM C33 Sand ~ ~ ~ • •• ~• _ - •'~ : ~ :~ ~'• ~'~ ~~ ~` F laterals. Laterals are ~• ;.' T • ical Lateral Tilled Layer ~ y 0.5 ft YP _ _ _ _ _• _~•~••~•• equally spaced from ~ .•,.••..•.••.•• 5 5 A re ate ~ ~ . ••f::: ;: ; the distribution cell's }-- A ---~ centerline in the distribution cell (AxB). Project: Tom Leafgren Page 3 of 9 Center Connection Lateral Layout Daigram Force rr~air~ connection via tee or cross to manifold at any point. r-r-- Laterals are identic al I P •=Turn-upm'ballvatveor ffX~lExf2 I xr2~l Laterals&forcemainofPVCSch40 cl es n out pl u g per COMM Table 84.30-5 Holes drilled on the bottom of the lateral. 5 Number of Laterals 4 Orifice Diameter 0.125 in Lateral Diameter 1.50 in Orifice Spacing (X) 3.05 ft Lateral Length (P) 44.23 ft Orifices per Lateral 15 Lateral Spacing (S) 2.50 ft Orifice Density 7.50 ft Lateral Flow Rate 6.18 gpm Manifold Length 2.50 ft System Flow Rate 24.72 gpm Manifold Diameter 1.50 in Total Dynamic Head 12.41 ft Forcemain Velocity 2.52 ft/ Dose Tank Information Lockin cover withwaming Electrical as per NEC 300 and -- Comm 16.28 WAC _ Tank component is properly vented Wieser Concrete Capacit 750.36 Volume 20.28 Manufacturer Gallons gal/inch Dimension Inches Gallons A 18.51 375.46 B 2.00 40.56 C 4.49 90.98 D 12.00 243.36 Total 37.00 750.36 A B C D 3" Bedding F- Aftemate otrtl~ location Forcemain diam~er ~ 2 in. Weep hole or anti- siphon device P• ump off elevation (ft) 93.50 D• ose tank elevation (ft) 92.50 Alarm Manuafacturer LevelArm Alarm Model Number DLV Pump Manufacturer Zoeller Pump Model Number 53 Pump Must Deliver 24.72 gpm at 12.41 ft TDH 9 label and locking device and sealed watertight 4 in. min. Disconnect _-~--~ Project: Tom Leafgren Page 4 of 9 Mound System Maintenance and Operation Specifications Service Provider's Name ~ H. Nechville,MPRS #222781 Phone 715-749-3322 POWTS Regulator's Name St. Croix County Zoning Phone 715-386-4680 System Flow and Load Parameters Design Flow -Peak 450 gpd Maximum Influent Particle Size 1/8 in Estimated Flow -Average 300 gpd Maximum BOD5 220 mg/L Septic Tank Capacity 1,000 al. gal Maximum TSS 150 mg/L Soil Absorption Component Size 450 ft2 Maximum FOG 30 mg/L Type of Wastewater Domestic Maximum Fecal Coliform >10E4 cfu/100 mL Service Frequency Septic and Pump Tank Effluent Filter Pump and Controls Alarm Pressure System Mound Other Ins ect and/or service once eve 3 ears Should ins ect and clean at Least once eve 3 ears Test once eve 3 ears Should test month) Laterals should be flushed and ressure tested eve 1.5 ears Ins t for ndin and see a e once eve 3 ears Miscellaneous Construction and Materials Standards 1. Observation pipes are slotted and materials conform to Table Comm 84.30-1, have a watertight cap, and are secured in as shown in the mound component manual. 2. Dispersal cell aggregate conforms to Comm 84.30 (6)(i), Wis. Adm. Code. 3. All gravity and pressure piping materials conform to the requirements in Comm 84, Wis. Adm. Code, 4. Tillage of the basal area is accomplished with a mold board or chisel plow. 5. The mound structure and other disturbed areas will be seeded and mulched to prevent soil erosion and help reduce frost penetration. Lateral Turn-up Detail Finished • .............. ................ Grade ~ . 6-8" Diameter Lawn Threaded Cleanout Sprinkler Valve Box Plug or Ball Valve Distribution Lateral 1 Long Sweep 90 or Two 45 Degree Bends Same Diameter as Lateral Project: Tom Leafgren Page 5 of 9 Mound System Management Plan Pursuant to Comm 83.54, Wis. Adm. Code General This system shall be operated in accordance with Comm 82-84 Wis. Adm. Code, and shall maintained in accordance with its' cornponent manuals [SBD-10691-P (N.01101) and SSWMP Publication 9.6 (01/81)] 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. Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Stats. The contents of the septic tank _ shall be disposed of in accordance with NR 113, Wis. Adm. Code. The operating condition of the septic tank and outlet filter shall be assessed at least once every 3 years by inspection. The outlet filter shall be 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 finer 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 tie 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, ff such products are used they shall be approved far septic tank use by the Department of Commerce. Pump Tank The pump (dosing) tank shall be inspected at least once every 3 years. All switches, alarms, and pumps;~l be tested to 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 as protection from freezing. Influent quality into the mound system may not exceed 220 mg/L GODS, 150 mg/L TSS, and 30 mg/L FOG for septic tank effluent or 30 mg/L GODS, 30 mg/L TSS, 10 mg/L FOG, and 10° cfu/100 mL for highly treated effluent. Influent flaw may not exceed ma>amum design flaw speed 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 6 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring. 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(s) 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 tce leakage occurs or by removing bidogically clogged absorption and dispersal media, and related piping, and replacing said components as deemed necessary to bring the system into proper operating condition. See Page 6 of this plan for the name and telephone number of your local POWTS regulator and service provider. Project: Tom Leafgren Page 6 of 9 HEAD/CAPACITY CURVE ~~ TOTAL DYNAMIC HEAD/CAPACITY PER MINUTE EFFLUENT AND DEWATERING 9e ta7•la9 101 lea 100 1e6 1ss 104 ley ss c..l..ir,. a.t Lo-, au t.as. ci.l Lvi c1.L Lra tilt lt>_ f3.1 Lr., clr Lr/. cl.~ Lrs... 12 n ''zi3 IDI aw loe Iol'. e, vi et 2a1: 68 -220 166 407 146 ..5n 7/ 4i '23f 79 300 100 'Z7B el 231f. el 23t 48 220 IIY 601 141 472 JJ Ib 170 M 2l2 D1 JM 60 .237 OJ '227' 68 ?20 lag SJ7 I/6 - 549 67 25 95. Je l Je e2 310: 49 .223. 40 227 60.221 130 614 I W 630 0 JO 71 .240' 47 214.'. 69 2Z}.: 68 .220 1b 484 laa 501. 66 '21E.. 66 20e': 64 12,1. 90 4M. W .::210 127 a40 127 NI. {6 .171. a4 172: 46 200. 74 293 bB ?m IC6 397 II. 431. 21 80 3J 126 41 191.. 4Y 219 68 220 90 317 100 179 14 47 aJ 1011' a0 I1Je ba 220 71 '2N, is 322 30 114 10 Jd 63 197 41 193 70 266 11 W a5 .170 Zo 100 61 .211 32 121 2 1 17 110 I0 40 21 79 7 ~. a ~ ' 2Y 24' 48' 86' 9T 7J' 114' 91' 112' EFFLUENT &DEWATERING Warning: Model 185 should not be subjected to less than 30 feet TDH. Note: For Head Capacity on Model 112, industrial column-explosion proof pump, see FM 219. H .2`/7/~~ ~. m;nimGcM S~t,~OPly ~e /'Cycc:rGa( 0 W F, ~ W W 21 7 22 ,~ 7 20 T 18 55 16 SO 14 r 45 12 L 4l 3: ,o 3( B 25 6 20 15 1 10 2 5 0 GALLONS LITERS 0 SEWAGE &DEWATERING WARNING: Model 293 should not be subjected to less than 15 feet TDH, I 0 -r-_- - t ~ . T T07AL DYNAMIC HEAD/CAPACITY PER MINUTE -_ ~ - SEWAGE AND OEWATERINO ` ~ ~ II SEHlEB 181 1K 287 20B 181 2N 191 191 191 195 - Y FT. M G01. Ltrs. Gel Llri. Gal. Lln. Gal. Llre.' Gal. Ll7i. G01. LVL Gal. Lln. Gd. LVS. Gal. Un. Gal. Ll7s. 5 1.52 BO 311 128 181 128 184 128 184 130 192 180 891 110 530 t9fi 712 225 B52 - t--.--- I _ t0 3.05 60 227 89 337 89 337 89 337 95 380 158 598 124 489 181 885 20.5 778 { 15 1.57 22.5 85 50 189 50 189 50 189 83 238 135 511 108 101 130 192 165 625 188 700 , C--_-- t- 20 6.10 10 38 10 38 10 38 33 125 108 401 88 333 119 150 150 568 168 836 ~ 25 7.82 78 288 68 257 108 101 138 Sts 153 S8~ 30 9.14 13 183 /7 178 90 340 121 15B 110 530 10 12.15 5 19 50 199 94 358 175 435 50 15.21 58 220 89 337 60 18'29 13 /9 59 223 70 21.34 25 95 _ Lock Valve 1B' 21.5' 21.5' 21.5' 28' 35' 42' S0' fit' IT' ---~ I 293 T_ ~ _ _ ~~_ 282 292 - {I __~~ 282 288, 287, 288 284 294 295 t0 29 SO 40 50 60 )0 BO I 90 100 110 120 130 140 150 180 170 180 190 200 210 220 230 ---i---- W V 8 5 0 65 ~ I I I I I I 80 160 240 320 400 480 580 840 720 800 880 ~~. ~~~ g ' 1601 ~ Wisconsin Department of Commerce SOIL EVALUAT{ON REPORT page t of ~ Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code A.C.E. Soil 8 Site Evaluations County Attach complete site plan on paper not less than 8'/: x 11 inches in size. Plan must St. Cf01X _ include, but not Ilmited to'. vertical and horizontal reference point (BM), direction and percent slope, scale or dimemsions, north arrow, and location and distance to nearest road. Parcel LD. 018-1089-40-000 _._ _ _ Please print all information. Reviewed gy Date Personal information you provitle may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Property Owner Property Location Tom Leafgren Govt. Lot NW 1/4 SW 1f4 S 31 T 29 N R I7 W __ --- _ _ _- _ __ _..----- -- -- - 4 i ~---- --------- Property Owner's Mailing Address Subd. Name or CSM# 5630 Omar Ave. Lot # Block # Plat Of Sunny Hill _-.. _._ _---- _ _.... _ _..._ _ ----- r _ City State Zip Code Phone Number _! City J Village / Town Nearest Road Stillwater MN 55082 (651)439-6185 Hammond 150Th Street i / New Construction Use'. / Residential 1 Number of bedrooms _ 3 Code derived design Harr rate _qou__ vrv ~ _~ Rep lacement _J Public or commercial - Describe: _ __ ___~__J _ __-___ _______ _ Parent material Glacial drift over weathered sandstone bedrock _ _ ____ ______ Flood plain elevation, if applicable ______ na General comments and recommendations: Install mound system at elev. 98. 50 ' at 6" above 98.00' conto ur. Previous soil eval. completed for pa rcel at time of subdivision creation -dat ed 11/16/2000, Ref. #1333. ^ Boring # _~ Boring 02 ft 8 40° in lication Rate Soil A Pit Ground Surface elev. . . 9 __ _. Depth to limiti ____ ng factor ____._ . pp Horizon Depth Dorninanf Color Redox Description Texture Structure ~ j Boundary Consistence Roots _ _. G 'Eff#1 PDIft? _ 'Eff#2 1 0-15 10yr3/3 none sl ~ _ 2fsbk mvfr cs i -- - - ~ 2f,1m - 0.5 0.9 2 _ . _ 15-21 _ _ -- - 10yr4/4 none sit i 2fsbk ~ mfr gw --- ----- I 2f I - ------ 0.5 --- 0.8 --- 3 21-34 7.5yr416 none scl ~ 2fsbk 1 mfr I cw !, 2f 0.4 0.6 4 _ 34-40 _ - _ __- 7.5yr4/6 none - gr sl ~ 1msbk ~ mfr I cw j 1f 0.4 0.6 _ _ _ __. _. __ __ _ _ ---t - --_- __- _ __ -I--- ±--- - -- , -- - ~ 5 40-44 7.5yr4/6 f2f 7 5yr5/8 gr. sl 1 msbk ~ mfr aw i - I 0 4 0.6 _ ~ - -----__ ~ _ _ _ 6 44-107 10yr8/2 m3p 7 5yr5/8 i ', fs _t Om mvfr ' - I 0 4 _ _ _ 0.6 - 2 a Borin # g __' Boring ft 8 6 .. 32 in lication Rate Soil A / Pit Ground Surface elev.. . , 0_ _ _ 9 Depth to limiti ___ ng factor _.______ • _ p p Horizon Depth Dominant Color Redox Description Texture i Structure I Consistence Boundary I Roots _ G "Eff#1 PDIft=__ __ 'Eff#2 1 0-11 10yr3/3 none sl 2fsbk !, mvfr cs ! 2f,1m 0.5 0.9 2 11-16 10yr4/4 none scl ~ 2fsbk ~ mfr 1 gw ~ 2f 0.4 0.6 _. -- . 3 16-32 7.5yr4/6 none sl I 2fsbk i mfr ~ cw 2f 0.5 0.9 4 _ 32-60 10yr8/2 m3p 7.5yr5/8 _ _ _ _ fs ( 1msbk _ _ ~', mvfr cw _. 1f i . ' 0.4 0.6 , t ;i __ - _ ~ ~ !- - ~ i _-- -- ----._ -- - - --- I i ~ - ' Effluent #1 = BOD 5> 30 < 220 mg/L and TSS >30 < 150 mg/L ent #2 = BODS< 30 mg/L and TSS <30 mg/L CST Name (Please Print) Si lure: CST Number James K. Thompson ,.~,-,gam 3602 _ - _ _. _ ----- _ --- _- - - _ _° _ -____-X=--- - -------------- -- Address A.C.E. Soil & Site Evaluations Date Evaluation Conducted Telephone Number 340 Paulson Lake Lane, Osceola, WI 20 11/8/02 715-248-7767 ` Property Owner Tom Leafgren ParceIID#.. 018-1089-40-000___..___,_ __ Page 2_ of 3 Boring # -- Boring /i Pit Ground Surface elev. ._. __.97.97,.. ,_,,,, ft. Depth to limiting factor 35" in. Soil Application Rate Horizon Depth Dominant Color ! Redox Description i Texture Structure Consistence ~ i Boundary Roots '~_:___SzP~t2 _._ ! Eff#1 'Effi#2 1 0-14 _ _ 10yr3/3 _ none _ _ sl 2fsbk ~ mvfr ! ~ cs 2f,1m ~ 0.5 0.9 2 14-18 10yr4/4 none ! sil 2fsbk mfr ' gw ', 2f 0.5 0.8 3 18-23 10yr4/4 none ~ ~I scl , _ ~ 2fsbk ~~ mfr ', ___- _ i _; cw -----} 2f ---__ '~ 0.4 0.6 - ; -- 4 -- - 23-35 - ___ 10yr4/6 _ _ _ __ _ _ none _ sl 1 msbk ~ mfr ~~ cw 1 f 0.4 0.6 5 35-39 10yr4/4 f2f 7.5yr5/8 gr. sl ' lmsbk ~ mfr aw I - 0.4 0.6 6 39-72 10yr8/2 map 7.5yr5/8 fs _ Om mvfr _, _ ____ ~ ~~~ ; ', - _ ___ r - _ 0.4 0 6 _ ^ Boring # ~ Boring _, Pit Ground Surface elev. _ _____. ft. Depth to limiting factor _ , in. Soil Application Rate i Horizon Depth Dominant Color Redox Description Texture ~ Structure Consistence i Boundary i Roots _ GP~Ift'_ r `Eff#1 'Eff#2 ~ _ _ _ __ _ . _ _ _ _ I, ~. _ I i _i _ __ ~ __ ' i __ _ __ _ _ ~ _ __ .--- t- ---r ---- _ _ ____. .. __ ^ Bonng # Bonng _._; Pit Ground Surface elev. _ _ ____ ___ ft. Depth to limiting factor _ in . Soil Application Rate I Horizon p De th Dominant Color p Redox Descri lion Texture Structure , I Consistence ; Boundary Roots ,___-SPDlfZ___ __ ' I ~ I 'Eff#1 'Eff#2 _ . _ _ _ _ - _. I { __ ~ E - ----- E - - ' ~ r _ __ __ _ _ _ _ _ ' _~ -- i _ _ - __ I i-_.--_.- r __ _ _ -_ ___ ' -- I __ -- --- _ _ . - - _ ;_ _ !~ I t _ _ Effluent #1 = BOD 5> 30 < 220 mg/L and TSS >30 < 150 mg/L 'Effluent #2 = BODS < 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. ~~~ Wisconsin Department of Commerce Division of Safety and Buildings SOIL EVALUATION REPORT .,..ate rc ..d-h !'n.nm AF 1A/ic Ar1m Crria 1601 Page 1 of 3 A.C.E. Sal & Site Evaluations ... _--- -- -- - - County Attach complete site plan on paper not less than 8'/: x 11 inches in size. Plan must St. Croix __ inc{ude, but not limited to: vertical and horizontal reference point (BM), direction and and location and distance to nearest road. north arrow scale or dimemsions ercent slo e Parcel I.D. , , , p p 018-1089-40-000 _ ~ ,0 Z3 ~p33 L Please print a po. ;~ ~'.'~ --- gy Date Personal iMormation you provide may be used r secondary purposes (Pnvacy Law, s. 15.0 (1) (m)). _~~ . lZ Property Owner ~ ~ L~o•~ Pr Location 17 W t Tom Leafgren ____~ _ Govt Lot NW 1/4 SW 114 S 31 T 29 N R Property Owner's Mailing Address ~ , Lot Block # Subd. Name or CSMIF 5630 Omar Ave. `' l , ~~. ~ ~ __ __ Plat Of Sunny Hill City State Zip C um ~ City ~ ~Ilage f/ Town Nearest Road Stillwater I MN ~ _55082 (651) 439-6185 Hammond 150Th Street /_j New Construction Use: ~ Residential /Number of bedrooms __ 3 _ Code derived design flow rate 45u ~iru J Replacement ~ ~ Public or commercial -Describe: Parent material Glacial drift over weathered sandstone bedrock _ Flood plain elevation, 'rf applic~le na General comments and recommendations: Install mound system at elev. 98.50 ' at 6" above 98.00' contour. Previous soil eval. completed for parcel at time of subdivision creation -dated 11!16/2000, Ref. #1333. Boring # ~ ~~ 02 ft 98 40" in lication Rate Sal A --- /~ Pit Ground Surface elev. . -- -- . . Depth to limiting factor _ pp C l ti n R D ri d Texture Structure Consistence Boundary Roots GP DIft' Horizon Depth Dominant o or o ox esc p e *Eff#1 *Eff#2 1 0-15 10yr3/3 none sl 2fsbk mvfr cs 2f,1m 0.5 0.9 2 15-21 10yr4/4 none sil 2fsbk mfr gw 2f 0.5 0.8 3 21-34 ~ 7.5yr4/6 none scl 2fsbk -mfr - cw Zf 0.4 0.6 - 4 34-40 7.5yr4/6 none gr_sl lmsbk mfr cw 1f 0.4 0_6 5 ~ 4 -_ 7.5yr4/6 f2f 7_ 5yr5/8 gr. sl _ 1msbk _ _ mfr _ aw - 0.4 0.6 6 44-107 10yr8/2 map 7.5yr5/8 fs Om mvfr - - 0.4 0.6 Boring # ~ Boring - U' Pit Ground Surface elev. 96.80 ft. Depth to limiting factor __ ~ ~ in~ Soil Application Rate l i t C D tion cri R D d Texture Structure Consistence Boundary Roots GP D/ftZ Horizon Depth or nan o om p ox e es *Eff#1 *Eff#2 1 i 0-11 10yr3/3 none sl 2fsbk mvfr cs 2f,1m 0.5 0.9 2 ~ 11-16 10yr4/4 none scl 2fsbk mfr gw 2f 0.4 0.6 3 16-32 7.5yr4/6 none sl 2fsbk mfr cw 2f 0.5 0.9 4 32-60 10yr8/2 map 7.5yr5/8 fs 1msbk mvfr w 1f 0.4 0.6 * Effluent #1 = BOD 5> 30 <_ 220 mglL and TSS >30 < 150 mg/L * t #2 = BODS <30 mg/L and TSS <~0 mg/L CST Name (Please Print) Si ure: CST Number James K. Thompson 3602 Address A.C.E. Soil & Site Evaluations Date Evaluation Conducted Telephone Number 340 Paulson Lake Lane, Osceola, WI 20 11 /8102 715-248-7767 property Owner Tom Leafgren __ __ Parcel ID # 018-1089-40-000 Page 2 of 3 Boring # --~ Bones 1/1 Pit Ground Surface elev. - 97.97 ft• Depth to limiting factor 35" in. Soil Application Rate C l ti R D ri d xture T Structure Consistence Boundary Roots ' Horizon Depth or o Dominant on ox p e esc e *Eff#1 *Eff#2 1 0-14 10yr3/3 none sl 2fsbk mvfr' cs 2f,1 m 0.5 0.9 2 ~ 14-18 _ 10yr4/4 none _ sil 2fsbk mfr gw 2f 0.5 0.8 3 18-23 10yr4/4 ~ none scl 2fsbk mfr cw 2f 0.4 0.6 4 23-35 10yr4/6 ~ none sl 1msbk mfr cw 1f 0.4 0.6 5 35-39 10yr4/4 f2f 7.5yr5/8 gr. sl 1 msbk mfr aw - 0.4 0.6 6 39-72 10yr8/2 map 7.5yr5l8 fs Om mvfr - - 0.4 0.6 _ _ ^ Boring # ~ Boring --- - ~ Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate D h l t C D i tion Redox Descri Texture Structure Consistence Boundary Roots __S_P_Dlft~ ____.__ Horizon ept o or om nan p *Eff#1 *Eff#2 ^ Boring # ~ Borng Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots : *Eff#1 *Eff#2 * Effluent #1 = BOD s' 30 < 220 mg/L and TSS >30 < 150 mgtL * Effluent #2 = BODs< 30 mglL and TSS < 30 mg1L 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. ! ~~l'#/poi I ~~ ~ So,'/ Q /a /cca,E,'cr~ P~' ~ • E/e /a ~« ~ p~ ~ ~ca,/c: ~ '_ yp, T aa~F ~~., roo. , .~,~ e P lptf of .Sc~.,n /~'1/, dec. 3/, Tn.o~/14~+m~ P~ p10o 5-e-c1 / awe Qo a..d ~ 2~ 0 a /SO ~ ~, .1 L ~` ' ~~ 1~ r . v. Top aF / r• S~ . E/.c f}sS cc.nedz le w = ~c~, cn; -~-. A 8~ 1 *~~q91 ~~ Im /.~ l~ I ~ `yz7J18~, az ~.~#- ~,z l,, Ib i~ 18 1. *48 ~~ 77 ' ~~ r ,~ 0 a• a 94. sus' ' ~c~o, its' P. 3 of ST CROIX COUNTY SEPTIC TANK MAII~ITENANCB AGREEMENT AND OWNERSHIP CERTIFICATION FORM OwnerBuyer ~ ~n ~ Ear ~ 4 F .~ A~' Mailing Address ~ ~ ~ O D .~-,~>a, i>- ~1J ~- Property Address ~ ~~-~ ~~ ~ ~~ 1~ ~-~ O (Verification required from Planning Department for new City/State 5f'~~a~a~'~h //6 ~1i Parcel Identification Number ~ ~ ~ ` ~~ S 2 ~--d ~ - o ©® ~, ~°q~ LEGAL DESCRIPTION Property Location ~ %4, ~ %,, Sec. ,~, T~_N R~W, Town of ,~~ o /v ~, Subdivision 11 Lot # ~. Certified Survey Map # .Volume .Page # ~: Warranty Deed # ~ ~! ~ S ~' ~- .Volume %~ o~.~_, Page # .5-~ Y Spec house ^ yes ~o Lot lines identifiable C~' yes ^ no CySTEM MAINTENANCE Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site wastcwaterdisposal 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. 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 septic system has been maintained must be completed and returned to the St. Croix County Zoning Office v~ithm 30 days of the three year expiration date. SIGNATURE OF APPLI DATE OWNER CERTIFICATION 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 described above, b virtue of a warranty deed recorded in Register of Deeds Office. ~~~ 1 ~ ~o1a~ t~ ~ SIGNATURE OF APPL 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 z g§ = A-ts 1 '~ t I ~ O A-.« I ~ ~ °-~ ~~ I ~ ~ I ~ ~ f~ 1 4J ~~ ¢¢~N c,.l ~ [- u ~¢¢ ¢~~~- ~ ==emu °_~_ F- c° c 'v u 9~ ct y Oa~:n N A `t Q `~`, O ~, S_-~-- . ,--- j .s z :a~ ~` r I I I I I A I ~~ I ~ii;~ ~ ,; . _ _ ~_ r Y-'S ' ~~ i'r .: ~., A X7 fir. .. DowmeatAGimba ,< "`t1EEDS ,., , x ';~. +se '.t~+T CROa% CQ:'~'~II~ f` :st ' ~-.'. Y 1- R Hlla r ~ ~ ''~:.,,:~<+ ~,RECE) Y E.r r (1R , EGt~, ' . ~~~ `0 2E 206' Sz3¢ Aft "'` ~:: , ~ -~ ,r ',4+d~'.,D. !t :=. } ~;,ki. vt ~s,d 1+ i i :th r.r ~ s., as Ttusta of Heitl ,'+ k : ~t ,} ~+ a~ '' ,~,~' ~,' ; sr x' .. '~f t '~'~ ' {. ~: +~ '~, - "'~ '~,_ faavdwbk g A t . ~ rREG FEE'a~ '1 ~0 `~# '' .. ; ii6Pitti Ano Lsi ~ `` AIIB F ~2 , . ,, Y r: an d`r ~4~' ~i ~*r .COPY E ~.~ CERTPY,FEE t)naax, die fotbwii~ duce • p .:. ; '~;~-. ''~ ~ L , . u ~ . P S r ~~ ,t _ " ~; ~8$ '~, ~ t ; ~'~. . .Cel1AQr Suk Of W r, ., ,,. . , `:,.- r ' ,• t ~~ AGE ~ x t . ~ rry t ", N"r u .in ~ -. ~. .. ,. Pict of toe Nort6weit Qracter ~~ ~M~(NW/U~,~otSWy~~ fe ~~~le~ Iltel~,~'~!~'~~~~ _ e~`___~±L-i P.`~2 k ''~F f`. K r +..~r~~.; ,y ,.N RanE i Wat 17 1 I ~ atr L Reoaia~Ae>ee . ~ ,„f;. ^ ' ~ ~ } '~ p : ,~.. , ,. t 4 tour RMrlA/icw"~ <., -~.c ~ ~ y. ~ "'{u * ~,.~ ~ ~,, ~ ~ ~. I+Ot ~ hit Of $YII~ ,jr, . ~~., , . ,: y ~. 7e".t -_ , * at - ~ ~xi ~ ~'`> b t .~ ; W19Mi9ti. + ~ " rt. ?~ r w+ ~ 'Yi' ~ ~, st~b4 S x x ~., ~,•,.. t " ~ r ,. ~~ fit' +,'i ~?• ~ ~ ;~e }~u ..Z.ri ~ Y~r~~4.1.'~3-c~F~.7''.s~p37~'.'~+,~e'u~+`5¢~4~. ~(` ~ ,,~~ ~~.. _~; - • cJ _ .. 11-1069-10-056 ,. ~ . ,. .- ' •r ~y. .~.1 -x r s r x ~ .. ~.C+i, }~ a~.`~' .t"~+ ~ ., ~ 5 t4,.., ~'a ~ 'yf vF ~ S~'S ~ t S -~:.?el~? ~+ s d ~ '~'uvr-s-t ~ F~ .t~. ~ `~ ~€;.~"~a ms's." ~. r.. -... ,:..,. i- < ., p y ~v '* 1Y'' -. 'S fi ~1- ~ ~k .e. ~. ~ ( ~.3 ~14~,a1 ~~ ~{i at~X~~'~ * 'a Da0td tits " ~' 3 ~ = ~~t x ~, ~.'.~S ~w~ i "''. ~ ~'~ ~ ''~''~? f ~ ~ ~ a ,. ~ , , • Henaai R Htiitroeh ^ + ,. _ . ~ +r+r~s'fia~,,xt~•, 4 *~ +~. "- Ttuuae 1 _ ~~` ,``a~ .`_ a- k AUTHF.NI7CAT10 - ~" +''`' ~ACKNOWLF.DGMENT' r ,t,~ ~ ~ '~ ,:., ~ .. ,) ~ ~ ASE r. ~ ~ r °; '? 'y • , .. awheiaeued dut day of t:~' ~` : t ~ cane elrorc m! tldt • ~ . I , t ` `" . .. . -~+.:... rt -A•"!~"*'r}y,~ai'A h, ~ pp~~~ - -. ..~.--O~~~ t'~ tJ + '~d -~ ,'~M-t-. TITLE: M6MSER STATE gpAR Oi' WiSCQNSif+i ~ ~" `~~ * , ..lr: r " , r . + .v .yam ~s~' :~,t.e (~fpot, `:t .s +,.m"d:L3-'4'diM~~"' blIC~00y+01tOt10t11! !) • ~ ~ nj~p' andarittd by f 766.06, Wa. Suu.) ~~ '4 ~..~ x .. ~ dp ~ ~ ~ :` / ~; ,`~. ~n~ 11 {.~,~ ~. Y ..sue ~.~ Al~'`'.,'$..'. '~S-[t A"C, a 'd4. ,_. w1 - - ~O :. .~ C7~"~•i :.~y.,u-l. Js~::~ THIS RVSf RUI~IEM' WAS DRAFTED BY „'r;, ~ hr-.; k ~ia~.~h ~~. . Ttama A. t+[oCerwltic '~' - ~.~r`%'.-,~ ~ , ~_' • },... D. ~r QiWwHc. WI 51002 .. 1~3.:~"^"~ ~ P+~e. Stan of WISQONSIN __ ' .` _ . ~C~~~~~ _ t~fy C it pam~nalG (lf aoR sub expinciaa diu ,~ w tS1pMIle~O~1'a i~i~aoA~) rf5,'x :•d~'.a3t' .", 4i:'d'~'R1<?:, ~-'` "• ~_'tEF ~-:r ..~ ~. p ti`~.y. -'~ ~P W~~9 ~ +QY W~4' aieu N_'~qQ~~P~A ac ptiMed Mbw •dr dpiMUl. ~ ~€T c+:;`~<,-xitTA'ROAROFW16CDt93R't~~, - .. - ', ;',.: TRUSI'EE'SDO:ED fORMNa7-]900 MIfOPRO poo)/SS2o2t wwwr.6NCprdams.eom ' • p 'L ....y.~ t ~p~~, ~ . '..$ psr +''' ,a +b . ~:~~ a~,p,.. Mai': - ,. - .t~i.~,f^sAfy'.~R!-z aw,#y±~.~.aMw. yry Yy+~'64~~p+pM1'L;Y 4' ;O+q - 'N' !!~'~SP+'~`~- .4 - .-, .~ ~~3!' ra .. ,.. .. ti~ ~~~` b. ... , , 1 h e..... ,..t.:. p~y 4 . , , r .. - ++~iT]-~' ~R . l T ~~ F + .wl~Y I~v , ~~, _ 'l x y~~. ~ 1 ' ~+ '~ t ~ .,; ~; S;, >i: _ ~t~,a~ira ~s~di ~ . ~jY~4~~' ~ ~ ~ ~ ~ ~~:~.~t~S Y~~: .:~ - ' t -' ~ ~. tir ''~'~' ~' ~ ~~ tAr~ V ~ ~ 4~''~','~`~FCyt~ti.sr~k"d'r+` ~... :~~r r ;~M! ~ y M ~ ~ I ( ~ ~ S00°15'41'E 385.88' • A5I I I ( • ~~` ~~. `~ ~, ® N ~~~ I~~ ~ ~ ~ ~1a Soo•'15'41 231.ar 231.ar ~ ~~ ~ W ~8~ • I (~ • ~ N ~ r ~ • ~ ~ N • • W ~Z . W Na ® ti • ~ b • ~• • ( ~~ Z . ~~ ~~ • • CJ LL ~ 0 m • I I • QN LL.Z ~ ,. 8 ~ ~ F ~ z GARAGE a < ~ ~ ~ m'as h• N w z ~ ~ ~- WW ^' ' M a 8~ W ~ m • ~2W a0 • W O • ~ Z ~ • ~ $ w ~ (~ ~ ~~a N ti ~. ~ r ~, 0119Ad 3H1 Ol a31MJla3t1 ~e~ nn.«,s L8'E LE L /V4 L~~Q Lo00N ~/~nnS 3H1. ~0 ~a °~ow ~~~1,5 H10~ ~ ~ ~o~ ~~~c~o ~a a a~~o ~a~ a~~ ~~ ~~~ _. ~a ~ ~~ ~ ~ ~ ~ ~~ ~~ ~ ~_~ Q ~- ~ ~ W ~s~ m ~_ ~~ ~ _Z __~,~ Wisconsin Department of Commerce Division of Safety and Buildings 1333 SOIL EVALUATION REPORT Page 1 aF 3 in ~r•rrvrlnnra with C:trnm RS Wic Aram (~[YIP_ A.C.E. Sal & Site Evaluations Courriy Attach complete site plan on paper not less than 8'/: x 11 inches in size. Plan must St. Crooc include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I D -- percentslope, scale or dimensions, north snow, and location and distance to nearest road. 4 . . 018-1069-40-050 Please print al~finfonnation. ~ Date Personal information you provide may b~(seyd fojseoondary purposes (Privacy taw, s. 15.0411) (m)). ',' ^^^ arr 1 /~ G ~ , Property Owner ~~.._v` ~' ~.T, :( ~, ~ `,J- Property Location _ Steven 8~ Rene Heinbuch Fa Tfiust ~`~-'~-~ ~ .Govt. Lot NW 1/4 SW 1/4 S 31 T 29 N R 17 W Property Owne-'s Mailing Ad r, • ir~~ ~ ~JU1J ct # Block # Subd. Name or CSM# W 1624 Co. Hwy. C °' - 4 Sunny Hill City Sate 'Zip Code B14o~ r-~_ ~ ~ City _] village Town Nearest Road _,~~~ Hammond ~ V1'/>! ,54015_ ~~~5 1 'y Hammond 150Th Street tt~' New Construction B~ ~ 12e$tderrt~ti P~lu'Y~r~l~~ ....,,ti _ 4 Code derived design flow rate J Replacement ,,;;~ Pubt-i:~er`t~rt~nliFrcl cnbe: Parent material Glacial drift over weathered sandstone bedrock Flood plain elevation, if ~plicable General comments ~~ ''~ Gf' ~~ . and recommendations: Recommended system elev. = 94.20' at 9" above 93.44' contour. 600 nor 3 ro '• GPD Boring # J Boring ~ Pit Ground Surface elev. 91.92 ft. Depth to limiting factor 45" in. Sal Application Rate Horizon Depth Dominant Caor Redox Description Texture Structure Consistence boundary Roots GP Dlitz *Eff#1 *Eff#2 1 0-12 10yr3/2 none sl 2fsbk mvfr as 2f,1m 0.5 0.9 2 12-30 10ry4/4 none sl 2msbk mfr cs 2f 0.5 0.9 3 30-45 7.5yr4/6 none Is 1 msbk mvfr aw 1 f 0.7 1.2 4 45-60 10yr6/4 f2d 7.5yr5/8 fs 1 csbk mvfr aw - 0.4 0.6 5 60-85 10yr8l2 m~f1~/2~ SSBR Om mfi - - 0.0 0.0 H#4 c;orltains 1/2" bands of Om 10yr4/4 tfs at 4" -10" intervals. Redox concentrations found in coarser sand immediatley above bands. Boring # --~ ~~ r;/ Pit Grand Surface elev. 92.34 ft. [~pth to limiting factor 27~~ in• Sal Application Rate Horizon Depth Dominant Caor Redox Description Texture Structure Consistence dary Roots GP DIfN *Eff#1 *Eff#2 1 0-9 10yr3/3 none sl 2fsbk mvfr as 2fm 0.5 0.9 2 9-16 10ry4l4 none sl 2msbk mfr cs 1fm 0.5 0.9 3 16-23 10yr514 none Is 2msbk mvfr cw 1 f 0.7 1.2 23-27 10yr5/6 none sl 1 msbk ml as - 0.4 0.6 5 27-40 10yr7/2 f2d 10yr Ifs 1 msbk mvfr ci - 0.4 0.6 6 40-59 10yr8/2 m2d 7.5yr5/8 SSBR Om mfi - - 0.0 0.0 * Effluent #1 = BOD ~ 30 <_ 220 mg/L and TSS > < 150 mg/L * uent = BODS <30 mglL and TSS <~0 mglL CST Name (Please Print) Sign re: CST Number James K. Thompson ~- 3602 Address A.C.E. Sal & Site Evaluations D Evaluation Conducted Telephone Number 340 Paulson Lake Lane. Osceaa, WI 20 11 /16/00 715-248-7767 prop~y pwner Steven & Rene Heinbuch Fatuity Parcel ID # 018-1069-40-050 Page 2 of 3 Boring # "'~~ Boring - Pit Ground Surface elev. 94.48 ft. Depth to limiting factor 29" in. Soil Application Rate D i ti T t Structure Consistence ry Roots Horizon Depth Dominant Color escr p on Redox ex ure *Eff#1 *Eff#2 1 0-11 10yr3/3 none sil 2fsbk mvfr as 2f,1 m 0.5 0.8 2 11-19 10ry3/4 none si 2msbk mfr cs 2f 0.5 0.9 3 19-29 10yr5/6 Is 1 msbk mvfr aw 1 f 0.7 1.2 4 29-44 10yr7/2 f2d 7.5yr5/8 fs 1 csbk mvfr aw - 0.4 0.6 5 44-79 10yr8/2 m2d 7.5yr5/8 & f2f 10yr6/2 SSBR Om mfi - - 0.0 0.0 Ft#5 contains 1/8" bands of Om 10yr4/4 Ifs at 5" - 9" intervals. ^ 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 *Eff#1 *Eff#2 ^ Boring # ~ ~ Boring :,~ Pit Ground Surface elev. ft. Depth to lim8ing factor in. ~ Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots *Eff#1 *Eff#2 * Effluent #1 = BOD 5> 30 < 220 mg/L and TSS >30 < 150 mglL * Effluent #2 = BODS <30 mg/L and TSS <30 mglL The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an ahernate format, please cmntact the department at 608-266-3151 or TTY 608-264-8777. -,.-.~.. . , . . /SOS $-~icct P~. 3 0~3 ~ Soi/ Obsa/'vG~o-~ l~;E ~ E/eda~im-~ Prop. sEa~ f/ei~bkcl Fa.n,~y T a~i ~O>ry~0/'opased a/4~ o, ~E. ~oiX Co ; cJ/. ~~ ~f a-~u. ~e A.cc.~ss Eas¢rn~~t 9y, o ~'s o ' 93 0, 9.2.0' l t3 2 ^ ya. r.~ 13encn wla.r~: Top o.F/ot 5~~. fESSccmfd t/ell; _ /8~.~• /' ~~ 9J~.~ 5/ooe 3y ~ 9.10• Bt AID. b.,n. Top a ~P~' ~ /.~