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016-1041-60-000
Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: 56952 0 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: Mayer, Lynda M. I Glenwood, Town of 016-1041-60-000 CST BP1 E U . 0 0 Ins M El ey: BM Descri n� Section/Town/Range/Map No: 1 TANK INFORMATION ELEVATION DATA TYPE MANUFACT RER tCAPACITY STATION BS HI FS ELEV. Septic Bench k T3 5q a 7d�Uosing /� Alt. BM Aeration w Bldg. Sewer �.3 94 .Y3 Holding row U t Inlet .3 TANK SETBACK NFORMATION St/Ht Outlet TANK TO P/ WELL BLDG. Vent t Air Intake ROAD Dt Inlet Septic , iJ I! 12 Dt Bottom ,-`_ „ y J Dosing >9D Header/ an. Aeration id3 014n Dist. Pipe / 3 At Holding Bot. S stem TA . 7 Finkl Gr e PUMP/SIPHON INFORMATION Manufacturer Dema St Cover i Ll GPM ? O Y rp I'7�✓t 2 a / Model Number Vo H Lift Friction Los System ead / DH Ft ce mai L ia. 2, g Dist,to I 0 a--, SOIL ABSORPTION SYSTEM 4 i4W in r BED/TRENCH Width , Length / No.Of Trenches PIT Dll! N CIS No.Of Pits Inside Dia. Liquid Depth DIMENSIONS aCB� /" SETBACK SYSTEM TO P/L BLD WELL LAKE/STREAM LEACHIN anufacturer: � INFORMATION CHA OR Type O Sstem: I n f >20 F_0 �� UNIT Model Number: DIST N SYSTEM ,17A5,11 Ile d to 45b .gyp l N A Header anifold �� Distribution x Hole Siz x Hole Spacing Vent o Air Intake 9 Pipe(s)h �`__Z r �• , 3.5 ' s�3'?Y 3 / a Length 3�S Dia ( '� Len th� Dia � Spacing V Q 10<"?�. SOIL COVER x Pressure Systems Only xx Mou4br At-Grade Systems Only Depth Over Depth Over of xx Seeded/Sodded Mulched Bed/Trench Center Bed/Trench Edges Topsoil P (� 0 Yes No 0 Yes r No COMMENTS: (Include code discrepencies,persons present,etc.) Inspection#1:--7 / 7/� Inspection#2: Location: 2786 150th Ave.Glenwood Cit ,WI 54013(S 1/4 SE 1/4 18 T30N R1 5W) 40 acres Lot Parcel No!:_18 1 299 � 1.)Alt BM Description= I ' �f rt4"� M ()A!5;4— bar; 5 1 aez k� au.)e-UPc- 2.)Bldg sewer length -amount of cover= ` O C aj-1 o.n. V,l�af toK� be - - -- -T - Plan revision Required? W Yes No Use other side for additional information. Date SBD-6710(R.3/97) Insepctor s ignature Cert.No. SITE PLAN SE,SW,S18,T30N/R15W Glenwood township St. Croix county LEGEND I BNM: 1 00.0' base east side of oak tree west ofdriVeNN ?BM: 99.80' base NN-est side of oak tree �Nest ofdrnv 7ay i 3 pits w/backhoe 0 - grade elevations - contour No DSPS 383 set back problems Scale I"- 40' except where indicated ;D System Elev. 100.55 on contour 98.88' LP e)It L40 too, 7�s O-r S00- C-A I's project: MAYER page 10 of 10 County Wisconsin Safety and Buildings Division St. Croix 201 W_ hington Ave.,P.O.Box 7162 Sanitary Permit Number(to be filled in by Co.) Department Safety and on,WI 53707—7162 _ . ` r? Z Professional Services State Plan I.D.Number State Sanitary"P mit Application Trans id 2 J ( Z/ In accord with SPS 383.21(2)Wis.Adm.Code submission of this form to the appropriate governmental Project Address(if different than mailing address unit is required prior to obtaining a sanitary permit. Note application forms for state-owned POWTS are submitted to the Department of Safety and Professional Services. Personal information you provide may be used for second purposes in accordance with the Privacy / Law,sI5.04(1)m), Stats Oy I. Application Information—Please Print All Information '�K I7 d Property Owner's Name Parcel# Ms. Lynda Mayer 2' Property Owner's Mailing Address Props Qy),x 41 1034 Tamarack Place S E L° 9� 0 18 City,State Zip Code Phone Number S '/., _ New Richmond, WI 54017 T 30 N/R 15 w 99M 11.Type of Building(check all that apply) Lot# Subdivision Name X I or 2 Family Dwelling—Number of Bedrooms n 7 Pour �Block# D ao�a/ Public/Commercial—Describe Use City CSM Nufnber Village of State Owned—Describe Use X Town of Glenwood I11.Type of Permit: (Check only one box on line A. Complete line B if applicable) A. New Syst Replacement System ❑Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System B• El Permit Renewal El Permit Revision _Change of El Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Plumber Owner IV.Type of POWTS System: Check all that apply) _Non—Pressurized In-Ground Pressurized In-Ground _At-Grade _ Mound?24 in of suitable soil X_Mound<24in of suitable soil _ Holding Tank Other Dispersal Component(�j`,p}am) etreatment Devic (explain)--� L v ry V.Dis ersal/Treatment Area Information: Design Flow(gpd) Design Soil Applicatio Rate(ggdsf) Dispersal Area Required(s persal Area Prop ed(sf) System Elevation SG7/YI L l� 600 0.6 {7`// 1000.0sq.ft. ( 1505.Osq.ft. 100.55' VI.Tank Info Capacity in Total Number Manufacturer Trefab Site Steel Fiber Plastic Gallons Gallons of Units Concrete Constructed Glass New Existing Tanks Tanks Septic or Holding 1200 1200 1 Weiser Concrete X Tank Dom►g Chamber 800 800 1 combo X VII.Responsibility Statement- I,the undersigned,assugie respon 'bil' 'for installation of the POWTS shown on the attached plans. Plumber's Name(Print) Plumbe s Sign MP/MPRS Number Business Phone Number Kent Hoke ' MP224199 715/962-4155 715- 5-q> 7 - Plumber's Address(Street,City,State, Code) 2,` 200 Bremer Ave., Suite D, Colfax, WI 54730 VI X.Coon /De artment Use Only IVApproved ❑Disapproved Permit Fee Date Issued wing Agent ignature ❑ Owner Given Reason for $ Denial r ` IX.Conditions of Approval/Reasons for Disapproval ` SYSTEM OWNER: P 1,Septic tank,effluent filter and dispersal cell must be serviced/maintained ll_ s per management plan provided by plum er. I All statbick requirements must be mainCai�� iks D@r applicable code/ordinances. Attach complete plans(to the County only)for the system on paper not less than 81/2 x 11 inches in size 02/18/2014 08:27 FAX 7152654120 NORT-HWD PLUUBING f�1003 dl Od t�V vi � N � . o D f �' t. / a f �� x - a W f I , i S o tA rz, yam, ,T a G 70 �' Tn�D C 6r� nxT'.N DIVISION OF INDUSTRY SERVICES atir ��T 3824 N CREEKSIDE LA o' > HOLMEN WI 54636 Contact Through Relay 3 ` K www.dsps.wi.gov/sb/ 9� o www.wisconsin.gov A�OssroN�tis��` Scott Walker,Governor Dave Ross,Secretary March 11,2014 CUST ID No. 224580 ATTN:POWTS Inspector LORETTA LARRABEE ZONING OFFICE L AN L PERC TESTING ST CROIX COUNTY SPIA N2089 CTY RD Y 1101 CARMICHAEL RD MENOMONIE WI 54751 HUDSON WI 54016 CONDITIONAL APPROVAL Identification Numbers PLAN APPROVAL EXPIRES: 03/11/2016 Transaction ID No.2376218 Site ID No. 800228 SITE: Please refer to both identification numbers, Lynda Mayer above,in all correspondence with the agency. 150TH Avenue Town of Glenwood St Croix County SETA, SW1/4, S18,T30N,R15W FOR: Description:Four Bedroom Mound System/3%slope Object Type:POWTS Component Manual Regulated Object ID No.: 1473870 Maintenance required; 600 GPD Flow rate; 16 in Soil minimum depth to limiting factor from original grade System(s):Mound Component Manual-Ver.2.0, SBD-10691-P(N.01/01,R. 10/12),Pressure Distribution Component Manual-Ver.2.0, SBD-10706-P(N.01/01,R. 10/12); Effluent Filter The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. This system is to be constructed CON located in accordance with the enclosed approved plans and with any component manual(s)referenced above. A The owner,as defined in chapter 101.01(10),Wisconsin Statutes,is responsible for compliance with all code requirements. DEPT O No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06 PROFESSI stats. lIVISION OF M The following conditions shall be met during construction or installation and prior to occupancy or use: Reminders: &a • A sanitary permit must be obtained from the county where this project is located in accordance with the SEE co 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.Stats. • A state approved effluent filter is required.Maintenance information must be given to the owner of the tank explaining that periodic cleaning of the filter is required.Access to the filter for cleaning must be provided per SPS 384 product approval conditions. • The area within 15' downslope of the dispersal component shall remain undisturbed.Vehicular traffic, excavation or soil compaction is prohibited in this area. • A copy of the approved plans �pecifications and this letter shall be on-site during construction and open to inspection by authorized representatives of the Department which may include local inspectors. LORETTA LARRABEE Page 2 3/11/2014 Owner Responsibilities: • The current owner,and each subsequent owner,shall receive a copy of this letter including instructions relating to proper use and maintenance of the system. Owners shall receive a copy of the appropriate operation and maintenance manual and/or owner's manual for the POWTS described in this approval. • 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.SPS 383.54(1). • 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. • 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. In granting this approval the Division of Industry Services 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 and the POWTS management plan to the owner and any others who are responsible for the installation,operation or maintenance of the POWTS. Sincerely, Fee Required$ 250.00 Fee Received$ 250.00 Balance Due $ 0.00 erard M Swim POWTS Plan Reviewer,Integrated Services (608)789-7892,Mon-Fri, 7:15 am-4:00 pm WISMART code:7633 jerry.swim@wisconsin.gov cc: Edwin A Taylor,Wastewater Specialist,(715)634-3484,Monday-Friday 8:00 am To 4:30 pm H&H Plumbing LLC,(Plans mailed to) 'A Note: Effective January 1, 2012, all codes under the jurisdiction of the Division of Industry Services(formerly Safe &Buildings)will be modified. Code references with prefixes starting with"Comm"have been replaced with Safety g ) "SPS"to recognize the relocation of the Division of Industry Services from the former Department of Commerce to t Department of Safety&Professional Services.Additionally,all IS(formerly S&B)codes have been renumbered and addressed in a"300" series. For future reference,the Wisconsin Commercial Building Code will be addressed by SPS Chapters 360-366. , Private On-Site Wastewater Treatment System (POWTS) Mound and Pressure Distribution Component Design Residential application Index and Title Sheet Project Name: MAYER Owner: Lynda Mayer 150`x' Ave. � Street Address SE1/4 SW1/4 S18 T30,N/R15W Legal Description Glenwood township, St. Croix county Township/County Contents: Page 1: index and title Page 2: general information& lateral diagram Page 3: mound drawings Page 4: dose tank Page 5: pump information Page 6: tank detail jPROVe c�Y Page 7: filter information Q Page 8: management plan SAFETY AIVp Page 9: contingency plan DIVAL SERVICE'S Page 10: site plan 101JSTRY SERVICES Attachment: soil test w/state plan Designer's name and license no: Loretta Larrabee #1872-007 t t +� QENCE Address: N2089 Cty Rd. Y CpIyS Menomonie, WI 54751 s� .•• ••!y�i Phone: 715/664-8184 • IOTA a Fax: 855/619-3363 = *:. uRRABEE 1872 Cell: 715/505-1628 MENOMONIE,; Or e-mail: lanlperctesting_kwwt.net % . • WIS. OlVA V NN Designer's Signature:_:`_� x Date: March 5`h, 2014 I the undersigned submitted these plans under my authority Mound component manual for POWTS Version 2.0 SBD-10691-P(N.01/01), and Pressure Distribution component manual—Version 2.0 SBD-10706-P(N.01/01) page 1 of 10 k ;R r{ �f � _ •tr yj i SITE PLAN SE,SW,S18,T30N/Rl5W Glenwood township St. Croix county LEGEND BV: 1:(W +) hasp ofoak trcc w�c"t of oak- tree "\C-st o t'�16N C\� X— pits w/backhoe • - grade elevations —— - contour 2 8 rV\ No DSPS 383 set back problems Scale I"— 40' except, where indicated 30 b 34Q1411 System Elev. 100.55' on contour 98.88' Z _� rvo LP 4c"k 21 40 too back fa All t',' TOO Y, Soo > project: MAYER page 10 of 10 ' I PLAN VIEW OF MOUND (not to scale) ' J= 8.5' D= 1.67' (20") K= 11.0' required bed 600sq.ft A= 7.0' E= 1.87' (22 ''/2") B= 86.0' proposed bed 602sq.ft. I= 10.5' F= 0.83' (10") L= 108.0' required basel area I OOO.Osq.ft. W= 26.0' G= 0.50' ( 6") proposed basel area 1505.Osq.ft. H= 1.00' (12") observation pipe @ 17.0' Observation pipe ZZ z I J A LLI A W O O 7.0' 26' K f B-86' - - Elloy I L-108' Mound Cross Section View (not to scale) Finished grade elev.102.34' 1 Lateral invert elev.101.05' H //t2 Dispersal cell elev.100.55 //!!/ / /! lllll!ll llllllllll!!ll!ll!lIlll ----- 4 dispersal cell = 2 -------- --- -- „ Zi --- -- --- ---3 ----- ---- - Aggre ate bed 6" --- --- -- --- --- -- E -- -- -- -- -- D --- ---- -- --- ---- --- ---layer tilled layer contour 3 A% site slope elev.98.88' Numeral Key 1 topsoil cap 2 subsoil cap 1.5ft. 3 ASTM C33 sand 4in. dia. observation pipe 4 synthetic cover over cell with 1/4in slot 5 aggregate 1 0.5ft. Closest Flange to secure observation-* project: MAYER page 3 of 10 ' GENERAL INFORMATION Four bedroom home, 600ga1 DWF end fed system w/2 laterals 3.0%slope system area dispersal cell design loading rate 1.0 0.6 soil application rate linear rate 6.98 16"limiting soil factor orifice sq/ft. 10.34 1200/800 Wieser tank w/Orenco T0822-14BA filter effluent quality#1 LATERAL LAYOUT DIAGRAM (not to scale) End Fed System Number of laterals 2 orifice dia. 5/32"(0.156) Lateral dia. 1 V211 orifice spacing(X) 36" (3.0') Lateral length(P) 84.Oft. orifice per lateral 29 Lateral spacing(S) 3.5ft. lateral discharge rate 15.62gpm Manifold dia. 1 V2" total system rate 31.23gpm Force main dia. 2.0" **see page 9 of 10 Mis. Construction for turn-up detail turn-up end on lateral at manifold for access of lateral at both ends for servicing TT ♦_Valve box \ Pressure lug finish grade P irst orifice next to fitting X manif S 3.5' (42") �- Orifices located on bottom of lateral ILast orifice next to fitting Force main 2"dia. project: MAYER page 2 of 10 Dose Tank Cross Section (No Scale) . Approved Locking Manhole Cover With Warning Label Attached 14" Weatherproof Approved Warning Label Junction Sox %P%K 12" Minimum Final Grade- , 4" Minimum " Quick Di 18" Minimum '-�-- sconnect i � 1/4" Weep Hole Baffle ' Approved Joint �opaouea S � ' ` ,1 � A . v/q"ss:46 Kre Extending 3' Alarm 0 8 I Approved Joint Onto Solid Soil On 6; w/40 5440�eee I C Extending 3' ' Onto Solid Soil Elev. q0. Off 6' D ::Lw Conc. Block 3" of Beddinq Under Tank--/ _�y°Io 0w F' — t 20.0 mate_Pump and Alarm Are On Seaarate Circuits ,5 laEe�als 11, 28 M Vat d It. 30 Tank Manufacturer: CorNcnele _ �1�se yo1 q 3. 4.,; Tank Tank Size-Septic/Pump: %xo o/ V 00 s_? Gallons Alarm Manufacturer: _ hnm uR Model Number: ' its t? «.o Capacities: A ► 9 inches or 4/22,56Ga11 ons Switch Type:_ tC_0ti1_ + E— 2 inches or 4 .48 Gallons Pump Manufacturer: + C6_inches or 111, 20 Gallons Model Number- b + D 10 inches or�a�.yo Gallons Minimum Discharge ate: ..32. Total . .. . .= lei aches or goo. Gallons gal/in 2a,2 Vertical Difference. Between Pump Off and Distribution Pipe:1D,55 Feet Minimum Required Supply Pressure:. . .. . !' .:' 3 : . .. . . ._. . . .17$ 55 Feet 0o Feet of Force Main x ,.ss Friction Factor/100 Feet: + 2 s8�eet 2 Inch Diameter Force Main Total Dynamic Head:. . .= t'l.t$ Feet project: MAYER page 4 of 10 Effluent Pumps 9EH SERIES 4/10 HP i Applications 1 •Dewatering,water transfer,effluent and wastewater removal Capacity-Liters per Minute 0 100 200 300 fqatqes •4/10 HP shaded pole motor with •Upper sintered sleeve bearings; 35 10 overload protection lower ball bearings 30 9 •Designed for continuous duly •Multiple switch options for 8 •High head model automatic operation 25 •Epoxy coated cast iron housing a UL/CSA listed c 7 and Cover v 20 6 •High impact ABS base m 5 •Cad)Wceramic shaft seal 15 4 X f° 10 3 c Series Specifications 5 2 ~ Capacity:70 GPM 0 5' 6ectrical:115v,6OHz 1 (265 LPM 0 1.5 m) 230v,60Hz 0 0 Shut Off:32'(9.8 m) Operation:Automatic or Manual 0 - 10 20 30 40 50 60 70 80 Liquid Temperature:140°F(60°C) Solids Handling:3/4"(19 mm) Capacity-4ailo Discharge:1-1/2"FNPT(38 mm) rls per Minute Impeller.Closed vane polycarbonate Volute:ABS _ Made[ Item# Model Voris Cord Switch Type On Level Off Level 509350 9EH-CIA-RFS 115 Piggyback Mechanical Float 9'---14' — - v6m T 23 cm-35.6 cm — Scm-15.2 cm 509360 9EH-CIA-RFS 230 20 Piggyback Mechanical Float -- 9"-14' _ 2"-6" 6m 23 cm-35.6 cm 5cm-15.2 cm 509331 9EH-CIA-VDS 115 — ftyback Vertical Diaphragm --__14'16" 4"-6" 6m 35.6 cm-40.6cm 10.2 an-15.2 cm 509330 9EH-GYM 115 2' Manual — — 509340 9EH-CIM 230 20' Manual — — Features Cast won tipper sintered cover sleeve bearing Oii-filled \ motor housing Cast iron fwusing w/protective Motor designed corrosion to for maximum performance Lower 1.1/2•FN PT bag bearing (38 mm) Carbon& ceramic face$eal Engineered, high-* t Glass-filled ABs base dt'y allows 3/4 solids Volute/hnpeller 2•vane impe8er seal for maximum stainless steel r-or mare intomtatim call 1.800.701.7894 efficiency wear ring EFFLUENTRILTERS Sizing Siotubel Effluent Filters Flsm 4. Sum Batuae Effustf Fasts These charts show the relationship between Biotube Filter size(diameter),design flow,and mean time between cleanings.The larger the filter and the smaller the flow,the longer you can go between cleanings.For example,a typical three-year cleaning frequency would require an 8-in.Filter for up to 2,500 gpd,a 12-in.filter for up to 5,000 gpd,and a 15-in.filter for up to 8,500 gpd. Assumes a properly sized watertight tank and residential strength waste.See Orenco document NDA-FT--FT-1 for more information. 12M Residential Applications 9000 Commercial Applications == FT0822-148 s000 FT1554=3 ' ,-- 1000 -FTB1824 "� 4 .,.... FT0444- 36 a 7000 F-16 6 CL FT0436, 2$ 6000 3 750 • . ♦ �TJ041& 3 o :_ ♦ ----- FT� 0,418 0 5000 LL 625 ` �. W C %% C 4000 ;. 01 500 •; d 375 �� '••.• ` 3000 v • 250 '• ;• :;, ..` 2000 A ••••: '; 1500 125 w�:; 1000 _ 500 .. _ 0 0 _ ._, . _ _ __ _ - 3 4 5 6 7 8 9 10 11 12 3 4 5 6 7 8 9 10 11 12 Mean Time Between Cleanings Mean Time Between Cleanings (years) (years) EFFLUENTFiLTERS L: Residential Biotub&� Effluent Filters (FT) FT Series Base Inlet Model f NOMENCLATURE r r " FT❑ 22-14611 A 1 Options: J A = float bracket 3 y FSO = overflow plate Base inlet model { Cartridge height:14"standard 1 c �_ Base Mt height:22"standard t 5f Y EffluoentFdter f f' Filter diameter(inches) 08 = 8" Blank = 1/8"filtration P = 1/16"filtration Biotube effluent filter series D Z X AS 96" rn 41" REOD � z z Fn c � D W A • .. rn UP 75' UOZIO 4" n m a 1T1 cn 3" 44° 6" -q D r I m D'W fr N ti 36" O r rn m El rn A . N UP 5r v 4" CPLG W m UP 7" I 4" CAS O c a 39" m -Z+ v • a I rn � D O a a p pp- frZ rrZ a --q tGif 7ZC a0 C F, m r fT1 D -a -I 1-W m=r o W$Z Z � T+� �myz G7 C) O+*zD-sZ c��+� 0725 AVIF-O � -O CQ �p (n-j N D ]rnaLCNiQmD0 SIp*.2..110 r !!1 CO u►-r cv��cmi �� c� c� � g -'�'i�cc7� rn fn o, w -p N Z aZ \ m 4 a=te D> O<pp�wN :w I'rl O Q -i I -1m� ..O s ? n` N f.r MCA �r/� � p s v .6 =NN 0 NW NRD I D W ��9pvr 'rl s ?� 00 Dr ..� s = O 8 X u! >p $� z op m� mW Div c -0 D 0 SIC- NC o O H n �� � C ZZ �ary Wp Nm En ;a o m < A Z01 �~ 3. D .p .�p 'r O W N Z � --vim m N �� 0 X c 70 4 g rn O OD a D H g r 2? m r � M m v \ cn WLP1200/800-MR = DRAWN BY: YYCP SCALE: 1 4"=1'-0" RE-POUR: MIEIEB CCIICBETE ° z SEPTIC MANUAL DATE V OD oo IDATE:. osT-POUR � \Z W3716 US HWY 10 MAtOEN ROCK, WI 54750 ° 800-325-8456 Rm. vI Mound System Management Plan Pursuant to DSPS 383.54,Wis.Adm.Code General This system shall be operated in accordance with DSPS 382-384 Wis.Adm.Code.and shall maintain in accordance with the component manuals 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 DSPS 383.33,Wis.Adm.Code when the tanks are no longer used as POWTS components. Septic or pump tank manholes 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"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 slip off the filer when removed from its enclosure. If the filter is equipped with an alarm,the filter shall be serviced if the alarm is activated continuously. 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 personal shall advise the owner of when the next service needs to be done to maintain less than maximum scum and sludge accumulation in the tank. Pump 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 maybe 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 compaction may hinder aeration of the surface within the mound and snow compaction in the winter will promote frost penetration. Cold weather installations dictate that the mound be heavily mulched as protection from freezing. Influent flow may not exceed maximum design flow specified in the permit for this installation. The pressure distribution system is provided with a flushing point at the end of each lateral and it is recommended that each lateral be flushed at least once every 18months. When a pressure test is performed is should be compared to the initial test when the system was installed to determine if orifice clogging has occurred,if clogging has occurred orifice cleaning is required to maintain equal distribution within the 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"considered impending failure requiring additional,more frequent monitoring. Contingency Plan If the septic tank or any of its components become defective the tank or components shall be repaired or replaced to keep the system in proper operating condition. If the dosing tank or its components become defective the defective components(s) shall be immediately repaired or replaced with a component of same or equal performance. If the mound fails to accept wastewater or discharges wastewater to the ground surface, it will be repaired or replaced. Increasing basal area if toe leakage or by removing biologically clogged absorption and dispersal media and related piping and replacing components as deemed necessary to bring the system into proper operating condition. See page 9 of this plan for the name and telephone number of your local POWTS regulator and service provider. project: RUBER page 8 of 10 Mound System Maintenance and Operation Specifications Service Provider's Name: H&H Plumbing LLC Phone: 715/962-4155 POWTS Regulator's Name: St.Croix Planning&Zoning Phone: 715/3864680 System Flow and Load Parameters Design Flow—Peak 600gpd Maximum Influent Particles Size 1/bin Estimated Flow—Average 400gpd Maximum BOD5 220mg1L Septic tank Capacity 1200gals Maximum TSS 150mg(L Soil absorption component Size 602bed Maximum FOG 30mg/L Type of Wastewater Domestic Maximum Fecal Coliform >l0E4 cfu/100mL Service Frequency Septic and Pump Tank--------Inspect and/or service once every 3 years Effluent Filter----------------Should inspect and clean at least once every 3 years Pump and Controls---------Test once every 3 years Alamo--------------------Should test monthly Pressure System----------Laterals should be flushed and pressure tested every 1.5 years Mound-------------_---Inspect for ponding and seepage once every 3 years Other----------------------------Initially filter should be checked yearly to determine service schedule Miscellaneous Construction and Materials Standards 1. Observation pipes are slotted and materials conform to Table DSPS 384.30-1,have a watertight cap and are secured as shown in the mound component manual. 2. Dispersal cell aggregate conforms to DSPS 384.30(6XI), Wis.Adm.Code. 3. All gravity and pressure piping materials conform to the requirements in DSPS 384,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 6. Lateral Turn-W to finish at grade or above,enclosed in a 6-8"diameter lawn sprinkler valve box or similar product. (lateral turn-up consists of a long sweep 90 or two 45degree bends same diameter as lateral) 7. Lateral Turn-up on end of distribution laterals after the last orifice. project: MAYER page 9 of 10 t SOIL EVALUATION REPORT #91 r Nytisconsin with Comm 85 Wis.Adm.Code Page 1 of 3 Department of Commerce In accordance NORTHLAND PLUMBING,INC. Division of Safety and Buildings County Attach complete site plan on paper not less than 8'/z x 11 inches in size. Plan must St. Croix include,but not limited to.vertical and horizontal reference point(BM),direction and percent slope,scale Parcel I �/�-/Q / I or dimensions north arrow,and location and distance to nearest u Please print all information. Revie Date Personal information you provide may be used for secondary purposes(Privacy taw,s.15.04(1)(m)). . Q cn"Property Owner Property Location ;OMM RO/ ti ({M 18 T30N R15W Lynda Mayer Govt.Lot J�� Property Owner's Mailing Address Lot# Block# Subd.Name or MFM' 1034 Tamarack Place r — Village Nearest Road State Zip Code Phone Number ; City Villag � To City P New Richmond WI 1 54017 1 Glenwood 150Th Ave New Construction Use: Residential I Number of bedrooms 3 Code derived design flow rate 450 GPD j Replacement 1. Public or commercial-Describe: Parent Material Flood plain elevation,if applicable 0.7 fl General comments and recommendations: Boring# Boring 16 surface elev. 97.62 ft. Depth to limiting factor 16 in. P it Soil Application Rat GPD/ft= Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots 'Eff#t 'EfF#2 in. Munsell Qu.Sz.Cont.Color [—Gr.Sz,Sh. 1 0-7 10YR3/2 sil 3sbk mvfr a 1 .6 .8 2 7-11 10YR4/6 sil 3sbk mvfr a 2f .6 .8 3 11-16 10YR5/4 sl 3sbk mvfr gs if .6 1.0 4 16-22 10YR5/4 10YR7/8 flf spots sc 2sbk mfr gs 2 3 5 22-48 10YR6/8 10YR7/8 c1f spots sc 2sbk mfr cs .2 •3 6 48-72 7.5YR5/8 sc 1sbk mf gs 0.0 0.0 a Boring# -� Boring �;� pit Ground surface elev. 97.58 ft. Depth to limiting factor 17 in. Soil Application Rat Horizon Depth Dominant Color Redox Description Texture Structure Consistence'Boundary Roots GPD/ftz in. Munsell Qu.Sz.Cont.Color Gr.Sz.Sh. *Eff#1 -01#2 1 0-6 10YR3/2 sil 3sbk mvfr cs 3f .6 .8 2 6-13 10YR4/6 sil 3sbk mvfr a 2f .6 .8 3 13-17 10YR5/4 sl 2sbk mfr cs if .6 1.0 4 17-21 10YR5/4 10YR7/8 f1f spots sl 2sbk mfi gs 6 1.0 5 21-38 10YR6/8 10YR7/8 cif spots sc isbk mvfi gs 0.0 0.0 6 38-60 7.5YR5/8 sc isbk mefi cs 0.0 0.0 Effluent#1 =BOD?30<_220 mg/L anp TSS>30<_150 mg/L 'Effluent#2=BOD5 S30 mg/L and TSS S30 mg/L Signatu CST Number CST Name(Please Print) 267985 Michael J.Myers Address NORTHLAND PLUMBING,INC. Date Evaluation Conducted Telephone Number 2943130TH AVE GLENWOOD CITY,WI 54013 10/17/2013 7152654115 SBR-8330(K.07=) Property Owner Lynda Mayer Parcel ID# Page 2 of 3 M Boring# f Boring Pit Ground surface elev. 98.88 ft. Depth to limiting factor 16 in. `, P 9 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 1 0-6 10YR3/2 sil 3sbk mvfr a 3f .6 .8 2 6-12 10YR4/6 sil 3sbk mvfr a im .6 .8 3 12-16 10YR5/4 sl 2sbk mfr cs if .6 1.0 4 16-26 10YR5/4 10YR7/8 flf spots sl 2sbk mfi gs if .6 1.0 5 2640 10YR6/8 10YR7/8 c1f spots sc isbk mefi gs 0.0 0.0 6 40-66 7.5YR5/8 sc lsbk mefi gs 0.0 0.0 Boring# j Boring 1 Pit Ground surface elev. fl. Depth to limiting factor 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 F-1 Boring Boring# Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/f? in. Munsell Qu.Sz.Cont.Color Gr.Sz.Sh. *Eff#1 *0112 I i *Effluent#1=BOD?30:5 220 mg/L and TSS>30:5 150 mg/L *Effluent#2=BOD5<_30 mg/L and TSS<30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format,please contact the department at 608-266-3151 or TTY 608-264-8777. SBD-8330(R.07/00) NORTHLAND PLUMBING,INC. 0. T W Y Do i \J �- � 0 3 I o 3 cn o VI i • � Q M op / � F Na Cl) 41 d v o d cr L1 N d �0 ACS 00 PA -rte ST.CA COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM owner/Buyer Ms. Mailing Address 10-s TM,ar ac k " l aces 441 Pro a Address !i " � " p (Verification required from Planning&Zoning Department fi- new construction.) City/State ��/ Parcel Identification Number LEGAL DES ON Property Location�E %, S� '/e, Sec. 18 ,T 3© N R 15 W,Town of �l ,Lot# NA• . Subdivision Plat: ,Volume ,Page# Certified Survey Map# /` Warranty Deed# qZ 3 2`1 (before 2oo7)Volume ,Page# Spec house Oyesgo Lot lines identifiable)'yesOno SYSTEM MAINTENANCE AND OWNER CERTIFICATION ult in its premature faImproper use and maintenance of your septic system could resywe to handle wastes-a licensed pump what you put into maintenance consists of pumping out the septic tank every three years or sooner,if needed,by 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§SPS.383.52(1)and in Chapter 12-st Croix County sanitary ordinance. owner agrees to submit to St.Croix County Planning&Zoning Department a certification form,signed by the The properly pumper verifying that(1)the on-site owner and by a master plumber,journeyman plumber,restricted plumber or a licensed pump the septic tank is wastewater disposal system is in proper operating condition and/or(2)after inspection and pumping(if necessary), less than 1/3 full of sludge. I/we,the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth,herein,as set by the Department of Safety And Professional Services and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained e�be completed and returned to the St.Croix County Planning&Zoning Department within 30 days of the three year expiration I/we certify that all statements on this fo are deed er o tin b Register t of my/our Deeds wledge Uwe am/are the owner(s)of the property described above,by virtue of a warranty 7;Si ms DATE OF ANT(S) ent.*** ***Any information that is misrepresented may result in the sanitary permit being revoked by the Planning&Zoning Departm 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.04/12) 1IIII I I I 1 111 8172334 State Bar of Wisconsin Form 2-2003 Tx:4141878 WARRANTY DEED 983247 Document Number Document Name BETH PABST REGISTER OF DEEDS ST. CROIX CO., WI THIS DEED,made between Emerald Land,Inc.f/k/a Emerald Farmers 07/30/2013 09:52 AM EXEMPT#• N/A Exchange,Inc. REC FEE: 30.00 TRANS FEE: 798.00 ("Grantor,"whether one or more),and Lynda M.Mayer,a single person PAGES• 2 ("Grantee,"whether one or more). Grantor for a valuable consideration,conveys and warrants to Grantee the following described real estate,together with the rents,profits,fixtures and other appurtenant Recording Area interests,in St.Croix County,State of Wisconsin("Property")(if more Name and Rcturn Address space is needed,please attach addendum): & See attachment for legal description. p 1�0,36o Parcel 000 ID: Pte#D16�1- - 1-60-000 016-1038- 016-1041.30-000 Parcel Identification Number(PIN) This is not homestead property. (is)(is not) Exceptions to warranties: easements,restrictions,and rights of way of record,if any. Emerald Land,Inc.f/k/a Emerald Farmers Exchange, Dated Jut A Zq. 2O ►3 Inc. (SEAL) 4� PikS (SEAL) * *BY: William F.Schoenwetter,President (SEAL) (SEAL) AUTHENTICATION CKNOWLEDGMENT Signature:(s) STATE OF W� ) �'.. . tl. . u )ss. auftha{nt ca4, on y `� $tam ly ubltg �1�Y2-(I,� COUNTY) . Sc ons►n cTc�,l y 24 ZD 13 Personally came before me on the above-named William F.Schoenwetter,President TI TLE:.MEIv1BEI�`STAT.E BAR OF WISCONSIN ;.` r":IE lint.F ,• . ; to me known to be the person(s) who executed the foregoing authorized by Wis.Stat. §706.06) instrument and acknowledged the same. THIS INSTRUMENT DRAFTED BY: Maxfield E.Neuhaus-Attorney at Law Notary Public,State of rver Falls, My commission(is-petYttanano(expires: 3 — 2U--)-j ) (Signatures may be authenticated or acknowledged. Both are not necessary.) NOTE: THIS IS A STANDARD FORM. ANY MODIFICATION TO THIS FORM SHOULD BE CLEARLY IDENTIFIED. WARRANTY DEED 02003 STATE BAR OF WISCONSIN FORM NO.2-2003 *Type name below signatures. INFO-PRO-www.intoprolamsx= 1 of 2 i THE NORTHWEST QUARTER OF THE SOUTHWEST QUARTER(NW/.OF SW%)OF SECTION SEVENTEEN (17),TOWNSHIP THIRTY(30) NORTH, RANGE FIFTEEN (15)WEST, TOWN OF GLENWOOD. AND THE NORTHEAST QUARTER OF THE SOUTHEAST QUARTER(NE%OF SE%)AND THE SOUTHEAST QUARTER OF THE SOUTHEAST QUARTER(SE%OF SE%)OF SECTION EIGHTEEN (18), TOWNSHIP THIRTY(30)NORTH, RANGE FIFTEEN (15)WEST,TOWN OF GLENWOOD. PART OF THE SOUTHEAST QUARTER OF THE NORTHEAST QUARTER(SE%OF NE%)OF SECTION EIGHTEEN (18), TOWNSHIP THIRTY(30) NORTH, RANGE FIFTEEN (15)WEST, TOWN OF GLENWOOD, DESCRIBED AS FOLLOWS: Commencing at the East Quarter comer of said Section 18; thence S88 056'28"W along the South line of the Southeast Quarter of the Northeast Quarter 156.90 feet to the point of beginning; thence continuing S88 056'28"W along the South line 1153.02 feet to the West line of said Southeast Quarter of the Northeast Quarter; thence N00 054'14"W along said West line 375.08 feet to the Southerly line of Parcel"A"described in a Land Contract recorded in document number 931952; thence N83°20'28"E along said Southerly line 275.66 feet; thence S46 027'33"E along said Southerly line 182.92 feet; thence S09°49'09"E along said Southerly line 203.27 feet; thence S89019'1 0"E along said Southerly line 721.44 feet; thence S04009'43"W 50.96 feet to the point of beginning. Subject to 150th Avenue right of way. St. Croix County, Wisconsin. 2 of 2 Parcel #: 016-1041-60-000 03/24/2014 09:08 AM PAGE 1 OF 1 Alt. Parcel#: 18.30.15.299 016-TOWN OF GLENWOOD Current CXJ ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map# Sales Area Application# Permit# Permit Type #of Units 00 0 Tax Address: Owner(s): O=Current Owner, C=Current Co-Owner 0-MAYER, LYNDA M LYNDA M MAYER 1034 TAMRACK PL NEW RICHMOND WI 54017 Property Address(es): '= Primary Districts: SC=School SP=Special Type Dist# Description SC 2198 SCH DIST GLENWOOD CITY SP 8020 UPPER WILLOW REHAB DIST Notes: SP 1700 WITC Legal Description: Acres: 40.000 SEC 18 T 30N R15W SE SE Parcel History: Date Doc# Vol/Page Type 07/30/2013 983247 WD Plat: *=Primary Tract: (S-T-R 4oi 1601i) Block/Condo Bldg: N/A-NOT AVAILABLE 18-30N-15W 2014 SUMMARY Bill#: Fair Market Value: Assessed with: 0 Valuations: Last Changed: 09/17/2013 Description Class Acres Land Improve Total State Reason PRODUCTIVE FORST LANDS G6 21.000 50,400 0 50,400 NO MFL AFTER 2004 CLOSED W6 19.000 45,600 0 45,600 NO Totals for 2014: General Property 21.000 50,400 0 50,400 Woodland 19.000 45,600 45,600 Totals for 2013: General Property 21.000 50,400 0 50,400 Woodland 19.000 45,600 45,600 Lottery Credit: Claim Count: 0 Certification Date: Batch#: Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 Parcel #: 016-1041-30-000 03/24/2014 08:27 AM PAGE 1 OF 1 Alt. Parcel#: 18.30.15.296 016-TOWN OF GLENWOOD Current ❑ ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map# Sales Area Application# Permit# Permit Type #of Units 00 0 Tax Address: Owner(s): O=Current Owner, C=Current Co-Owner 0-MAYER, LYNDA M LYNDA M MAYER 1034 TAMRACK PL NEW RICHMOND WI 54017 Property Address(es): '= Primary Districts: SC = School SP=Special Type Dist# Description SC 2198 SCH DIST GLENWOOD CITY SP 8020 UPPER WILLOW REHAB DIST Notes: SP 1700 WITC Legal Description: Acres: 40.000 SEC 18 T30N R15W NE SE Parcel History: Date Doc# Vol/Page Type 07/30/2013 983247 WD Plat: "=Primary Tract: (S-T-R 40%160%) Block/Condo Bldg: "N/A-NOT AVAILABLE 18-30N-15W 2014 SUMMARY Bill#: Fair Market Value: Assessed with: 0 Valuations: Last Changed: 09/17/2013 Description Class Acres Land Improve Total State Reason PRODUCTIVE FORST LANDS G6 5.000 11,000 0 11,000 NO MFL BEFORE'05 CLOSED W8 35.000 77,000 0 77,000 NO Totals for 2014: General Property 5.000 11,000 0 11,000 Woodland 35.000 77,000 77,000 Totals for 2013: General Property 5.000 11,000 0 11,000 Woodland 35.000 77,000 77,000 Lottery Credit: Claim Count: 0 Certification Date: Batch#: Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 /r'��i•r�i�( I��Ilill�lllll�l�ll1��II {iliI( i l i.- 11111111' jII!' 1+! � tilill{ IIf���lllllllllill�Il��I �i�i��� t4h! + I It ��l 6 f11If ifiiili4{i{ � � ,{,1,1: Ifll�flfll�l�IIIII�flI ; ,� r�){ �Ir1`1j1�1 1•�fiflililrill .1■i.f■tllit t S- HIM . irtl{rirl y'tltltlt4't!, � f,l,','Ihhhh'i '11,111{IFiil{! f,tlririilrriltl ,t,tlt,rh,t4, 'fllllllililllll{1181!!, ;,,i,r,{ft,f,i �illr{161,1{r{ � j titlfllrllrirrtl f1+111111{1111{11 tlitftll If{fff{f{f{11. ill,{,1,1{tfifif! 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