HomeMy WebLinkAbout016-1000-90-200 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix
Safety and Building Division
INSPECTION REPORT Sanitary Permit No:
569576 0
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:
Kno s, Jamie Glranwood, Town of /)/17—/ -
CST BM Elev: Insp.BM Elev: BM Description: Section/Town/Range/Map No:
/66 1 1 0 1M 01.30.15.
TANK INFORMATION ELEVATION DATA ~
TYPE MANUFACTURE CAPACITY STATION BS HI S ELEV.
: 3 103•
Septic Benchmark
Zoo 3.31 163.31 1.6 C
Dosing j Alt.JA
Soo r4 V Ga 3.33 �7.
Bldg.Sewe
; I
Holding St/Ht Inlet
St/Ht Outlet
TANK SETBACK INFORMATION \
TANK TO P/L WELL BLDG. ent t Air Intake ROAD Dt Inlet
Septic 75 54 qZ Dt Bottom 8"5
Dosing 760 / Header/Man.
��77 �t z 5h� Z .9 f Sao ..5Z.
Aeration Dist.Pipe
Z .`i
Holding Bot.S,y 3.57 Ite
PUMP/SIPHON INFORMATION Final Grade ' /
Manufacturer C (� Demand St Cover e�
,x-.0 v GPM 3. 33 /O
7,-
Model Number F//E 5 ' ,`1'4"/
TDH Lift Friction Loss System Head TDH Ft
16,e9 Z-15 6 0 51) 9, 14
Forcemain Lengthy/ IDia.7 11 Dist.to Well 5 J
SOIL ABSORPTION SYSTEM -!S*.'j Z, 60,6$ o Z. y8 3,$ S. 9
BEDITRENCH Width Length / No. Tren es PIT DIMENSIONS No.Of Pits Inside Dia._ Liquid Dept`
DIMENSIONS M
SETBACK SYSTEM TO VV P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer:
INFORMATION CHAMBER OR
Type stem: 1� UNIT
60 4 ?5 55 N Model Number
DISTRIBUTION SYSTEM Al Ce,
Header/Manifc3ld / IDistribution[q a �/ / x Hole Size x Hole Spacing /r Ven Air Inta
Length 3 Dia Z Length / / / Dia �' Spacing_y� 3 Z/• &
�....�
SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only 6Wwt��
Depth Over Depth Over xx Depth of xx Seeded/Sodde� xx Mulched
Bedlrrench Center Bed/Trench Edges Topsoil
• � �1 � Yes s No es [] No
COMMENTS: (Include code discrepencies,persons present,etc.) Inspection#1: Y /Zly / Inspection#2:
Location: 1749 Cty Rd X Glenwood City,WI 54013(NW 1/4 SE 1/4 1 T30N R1 5W) NA Lot 1 CIA,fj,�� Parcel No: 01.30.15.
1.)Alt BM Description= ��' vu' 610_�n�s/�e�''�'_ POW 6k-
2.)Bldg ewer length= 1..)4a
9 9 6 )
-amount of cover= (S� 1 &A ���y
('44) P
Z
Plan revision Required? ❑ Yes No
Use other side for additional information.
SBD-6710(R.3/97) Date Insepctor's Si ature Cert.No.
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commerce.wi.gov Safety and Buildings Division County 7)
201 W.Washington Ave.,P.O.Box 7162 { • l n r0 I�C
G op C'n (vladison,WI 53707-7162 Sanitary Permit Numb (to be filled to by Co.)
t1v�e 7 �7
P ar Commorce i
{ State Transaction Number
Qy CIO Permit Application Zyvo�yFl
{ Ina ordrdYs.Comm.83.21(2),Wis.Adm.Code,submission of this form to the appropriate eovernmental
unit is P��j``'ty+�d poor to obtaining a sanitary porn t. Note: Applicattnn forms for state-owned POtsTS are Protect Address(if di..ere..than mailing address)
sube "�the Department of Commerce Per nnai information you provide may be used for secondary i � ,!
u accordance with the Privacy La y,s. "t(')(m) Slats L/L
1. lication Inforinntion—Please Print All urination
Prci erty Owner's Name ♦ T J!� I Parcel A n///��� /71/�l D�f��D'—A J Yl
Property Owner's Mailing Address Property Location Ql(� �Q��_ �
?,v, ray 35 Govt.Lot J
City,State { Zip Code Phone`lumber NW v., Section
q . LU t I J,lb/3 T20 / (circle&I
��-GKwo ((,,;;�� T t �; R w
fi.Type of Building(check all that apply) Lot'
/ Subdivision Name
i 01 or 2 Family Dwelling-Numher of Bedrooms
cub Block
El Public/Commercial-Describe Use � ❑ Cih of
C Sg n cr 1 ❑ Village of
❑State Ow ned-Describe Use ® ��
C 1---�� 777 Of ( Town of r.Xu /,~
Ill.Type of Permit: (Check only one box on line A. Complete line B if applicable)
A' , ew System ❑ Other Modification to Existin System(explain)
Il�N y � ❑ Replacemen:Systrnt I ❑Treatment Tank Replacement Only B y p )
I List Previous Permit Number and Date Issued
B. ❑ Permit Renewal i ❑ Permit Revision ❑ Change of Plumber ❑Permit Transfer to New
Before Expiration ` Owner
iV.Type ofPOWTS System/Corn onent/Device: Check all that apply) - r
❑ Non-Pressurized In-Ground ❑ Pressurized hr-Ground ❑At-Grade ❑ Mound>24 in.ofsuitable soil Mound<24 in of suitable soil
❑ Holding Tank ❑Other Dispersal Component(explain) ❑Pretreatment Device(explain) Ld
V.Dispersal/Treapment Area information:
Design flow(gpd) ( Design Soil Application Rate(, dst) j Dispersal Area Required(st) Dispersal Area Propose sQ System Elevation /
/Soo jt ✓
(Qb0 • y { � � /so• � /02.00
Vi.Tank Info Capacity nt Total #of Manufacturer B
Gallons Gallons Units
to V U D
tiew Tanks Eyi<tu:g Tanks ' 7:
° .0 B
rn H
a U
1
Septic or Holding Tank
rinsing Chamber 8'QU i
VII.Responsibility Statement- I,the undersi;ne assume responsibility for installation of the POWTS shown on the attached plans.
Plumber's Name(Print) Phi ber's Signa rc MN.\4PRS Number Business Phone Number
2�?985 2/5-2G5- 7//i5
Plumber's Address(Street,City.,rate.Zip Code)
rnc.�a��i acl/ Sf d
j V[i ounri/De artment Use Only
Approved ❑ 1714-0 Permit Fee.1 Date 1 sued Issuing nt Signature
❑��woeC.L�++v eason for Denia: S �L � � ��
IX.Condi easo s for Qisapproval 3)
t. Septic ank,effluient>itter ana t a1S
j dispersal cell must all be services i maintained (71 I( �] �J �^,
as per management plan provided by plumber.
. : .tkXoqurraments must be:main4ait�bci
t as per app�dlbla eods 1 ordir>�es"
Attach to cmnpieic plaoi fnr the system and submit in the County only on paper not less than 9 Iri x 1 I inches in size
SBD-6398(R.01/07)Valid thrtt 0 1/09
MICHAEL J MYERS Page 2 5/14/2014
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.
I
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
Gerard 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
f Note: Effective January 1, 2012, all codes under the jurisdiction of the Division of Industry Services(formerly
Safety&Buildings)will be modified. Code references with prefixes starting with"Comm"have been replaced with
"SPS"to recognize the relocation of the Division of Industry Services from the former Department of Commerce to
the Department of Safety&Professional Services.Additionally,all IS(formerly S&B)codes have been renumbered
addressed in a"300" series. For future reference,the Wisconsin Commercial Building Code will be addressed
by SPS Chapters 360-366.
9EVAR DIVISION OF INDUSTRY SERVICES
3824 N CREEKSIDE LA
Uo� 1P� HOLMEN WI 54636
3 d K Contact Through Relay
9 p www.dsps.wi.gov/sb/
ow www.wisconsin.gov
oA�Os'sroN��s�� Scott Walker,Governor
Dave Ross,Secretary
May 14,2014
CUST ID No. 267985 4 POWTS Inspector
MICHAEL J MYERS ZONING OFFICE
NORTHLAND PLUMBING INC ST CROIX COUNTY SPIA
2943 130TH AVE 1101 CARMICHAEL RD
GLENWOOD CITY WI 54013 HUDSON WI 54016
CONDITIONAL APPROVAL
PLAN APPROVAL EXPIRES: 05/14/2016
SITE: Identification Numbers
Jamie Knops Transaction ID No.2400148
County Road X Site ID No. 801973
Town of Glenwood Please refer to both identification numbers,
St Croix County above,in all correspondence with the agency.
NWIA, SETA, S1,T30N,R15W
FOR:
Description:Four Bedroom Mound System/2%slope
Object Type:POWTS Component Manual Regulated Object ID No.: 1483947
Maintenance required; 600 GPD Flow rate; 18 in Soil minimum depth to limiting factor from original grade
System(s):Mound Component Manual-Ver.2.0, SBD-10691-P(N.01 101,R. 10/12),Pressure Distribution
Component Manual-Ver.2.0, SBD-10706-P(N.01 101,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
and located in accordance with the enclosed approved plans and with any component manual(s)referenced above. COA
The owner,as defined in chapter 101.01(10),Wisconsin Statutes,is responsible for compliance with all code �A
requirements. De
No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, PROFESS
stats.
ow1SiOy OF 1
The following conditions shall be met during construction or installation and prior to occupancy or use:
Reminders:
• A sanitary permit must be obtained from the county where this project is located in accordance with the Afevcaom
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.
• All POWTS component piping material shall be SPS 384,Wis.Adm.Code compliant.
• 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,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.
MICHAEL J MYERS Page 2 5/14/2014
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
at intervals appropriate for the component(s)
maintenance tracking purposes. Reports shall be submitted
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
Gerard M Swim
POWTS Plan Reviewer,Integrated Services
(608)789-7892,Mon-Fri, 7:15 am-4:00 pm WiSMART code:.7633
jerry.swhn@wisconsin.gov
cc: Edwin A Taylor,Wastewater Specialist,(715)634-3484,Monday-Friday 8:00 am To 4:30 pm
Note: Effective January 1,2012, all codes under the jurisdiction of the Division of Industry Services(formerly
Safety&Buildings)will be modified. Code references with prefixes starting with"Comm"have been replaced with
"SPS"to recognize the relocation of the Division of Industry Services from the former Department of Commerce to
the Department of Safety&Professional Services.Additionally,all IS(formerly S&B)codes have been renumbered
ail addressed in a"300" series. For future reference,the Wisconsin Commercial Building Code will be addressed
by SPS Chapters 360-366.
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Mound System ;DES Cover Page 5 rRY
ystem SERVICt.S
11,MIEIEI OONGRETE
Project Name: Knops-mound
Owner's Name Jamie Knops
Owners Address P.O. Box 35
Glenwood City WI 54013
Legal Description Nw y� Y., �E Y. Sec 1 T 30 w
N, R 15
Township Glenwood 101710
County j saint Croix � FPROVEd L�
SAFErr
Subdivision ONAI h_ AND
Quay v�oES
Lot# 1 'NYS�RV`�''FS
Parcel I D#
Table of Contents
pg-
1 Cover page
2 Mound Sizing Calculations
3 Pressure Distribution Layout and Dynamics
4 Dose Tank
5 Management and Contingency Plan
6 Plot Map
7 /-,VmP C$o-yc..
total#of pages: 6
Designer Name: Michael J. Myers
MP/License#: 267985
Date: 5/5/2014
Ph.#: 7V-265-4115
Signature:
Mound System Design Methods Used
per"Mound Component Manual For Private Onsite Wastewater Treatment Systems"(Version 2.0)SBD-10691-P(N.01/01)
per"Pressure Distribution Component manual for Private Onsite Wastewater Treatment Systems"(version 2.0)SBD-10706-P(N 01/01)
Spreadsheet provided by: 3bAdvisement N12486 220th St,Boyceville,WI 54725 Ph:715-643-6068 email:3ba @3badvisement.com
S
Mound System Page °`s
Mound Sizing Calculations
Project Name: Knops-mound
Site Conditions Design of Entire Fill
Project Type: 1 or 2 Family Dwelling • Cell depth at upslope edge(D): 18.0 in.
% Slope: 2 % Cell depth at downslope edge(E): 19.5 in.
#of Bedrooms: 4 Distribution cell depth (F): 9.5 in.
Depth to limiting factor: 18 in. Cover thickness over edge(G): 6 in.
Absorbtion rate of fill material: 1 gal/ft2/day Cover thickness over center(H): 12 in.
Absorbtion rate of in-situ soil: 0.4 gal/fe/day End slope width (K): 10.1 ft.
Effluent quality �Eff#1 • Fill length(L): 120.2 ft.
Max BOD effluent value: 220 mg/l Upslope width (J): 8.0 ft.
Max TSS effluent value: 150 mg/I Downslope width (Toe)(1): 9.4 ft.
Fill Width (W): 23.4 ft.
Design of the Distribution Cell Basal Area
System Design Flow: 600.0 gal/day Basal area required: 1500 ft2
Distribution cell width (A): 6.00 ft Basal area available: 1540 ft2
Distribution cell length(B): 100.0 ft
Area of Distribution Cell: 600.0 ft2 Observation Pipes
Contour Elevation of Mound: 100.50 ft Location from end of cell (Z): 16.67 ft
System Elevation of Mound: 102.00 ft
Final Grade of Mound: 103.79 ft
Mound Plan View
�
Observation Pipes
J z---IT
W K
B k–K
I Tilled Area/Fill Material
L
Mound Cross Section
Final Grade ! Observation Pipe
Synthetic Fabric b G
Distribution Cell #
System Elevation a Oe`n• F t
Cover Material `L r ...
3�q� Irtvert`
Fill Material
Tilled Area
——Slope �``�-Forcemain System
Contour
Notes:
Fill material to consist of ASTM C33 Sand
Distribution cell aggregate to comply with SA x}4.30(6)(1)
Synthetic Fabric covering on cell per.5n d84.30(6)(g)
Distribution Cell to have minimum 6"aggregate below lateral and 2"above.
Mound System Page 3 of s
Pressure Distribution Calculations
Project Name: Knops-mound
Lateral Layout Lateral/Manifold Design
Lateral elevation: 102_.5 ft Lateral diameter: In.
Rows of Laterals: �2 j• Lateral spacing (S): ft
Manifold e:
typ �Center � Lateral to cell edge: 1.5 ft
Orifice diameter: o.i25 �► In. Lateral discharge rate: 1
#of Laterals: 4 System discharge rate: 46.14 gpm
Distal Pressure: 5 ft Manifold diameter: 2 v In.
Lateral Length: 49.5 ft Manifold length: 3 ft
Orifice Spacing/Distribution Forcemain Friction Loss
Orifice spacing (X): 21.60 Inches Forcemain length: 80 ft
Orifices per lateral: 2g Forcemain diameter: L2 __L7j In.
Avg. ft2/Orifice: 5.36 ft2 Friction loss in forcemain: 3.438 ft
Lateral Side View
Manifold
Lateral Lateral
x x x x 11, x 11 x x t x I x x x x
2 �
Lateral Length Lateral Length
Lateral Plan View
( — Lateral Length Turn-up w/ball valve or cleanout plug
o °T
S
n n
Orifices on bottom of PVC laterals and forcemain to comply with
lateral equally spaced
specifications peg SPS 384.30(2)(e)
Forcemain connection via tee or cross to manifold at any point
Clean Out Detail Observation Pipes
Clean-out plug
Final Grade or ball valve
Water tight cap
or plug
Lawn
Sprinkler
Box
Slot
Note:Closet Conan
6"Minimum may be used in
� place of 318"bar
Long Sweep 90
or two 45's 3j8"Bar
Lateral
Mound System Page 4 or 6
Septic, Pump and Dose Tank
Project: Knops-mound
Tank Information Dosage Volume
Pump tank manufacturer: Wieser Concrete Forcemain drains back to tank? OQ Yes O No
Pump tank size/model �W12CVlioo-MR Lateral void volume: 20.9 gal
Pump tank gal/inch: 20.6 Dosage to absorbtion Cell: 104.6 gal
Actual Pump Tank Volume: 783 gal Forcemain volume: 13.9 gal
Tank bottom elevation (inside): 83 ft Total dosage: 118.6 gal
Septic tank size/model: i Wi2800-MR
Pump and Filter Total Dynamic Head
Pump Manufacturer: Goulds Are laterals highest point? y
Pump Model: PE51 P1 if not, enter highest elevation: 0 ft
Effluent Filter: Pol lock 525 System head (distal x 1.3) b
Vertical Lift("D"to lateral) C1
Note:Access opening of sufficient size to be provided to allow Friction loss in forcemain: 3.44 ft
removal of filter opening to terminate at or above grade.
Pressure loss from filter: �ft
Total dynamic head (TDH): 28.77 ft
Pump Tank Diagram Dose Tank Levels
�WatertightLockingCover In. Gal
4 Inch With Warning Label 22.3 458.4
Finished A Reserve
Minimum Grade
B Pump off to Alarm 2.0 41.2
Alternate C Total Dosage 5.8 118.6
outlet -� D Effluent depth for pump 8.0 164.8
Location Elect.per Comm
16.28 and Total Capacity: 38.0 783.0
NEC 300
Weep Hole A
or Anti- B
Siphon
Device
C
D
Pump must be capable of: 46.1 GPM
and head pressure of: 28.8 Feet
Mound System Management Plan pursuant tc sax `x83.54 W.A.C. page 5 of 6
Owner's Responsibility:
The component owner is responsible for the operation and maintenance of the component. The county,
department or POWTS service contractor may make periodic inspections of the components,checking for
surface discharge,treated effluent levels,etc. The owner or owner's agent is required to submit necessary
maintenance reports to the appropriate jurisdiction and/or the department.
Septic Tank:
Septic tank(s)are to be inspected routinely and maintained by department approved individuals when
necessary in accordance with their approvals. The use of chemical/biological"treatments"is not required or
recommended. If such additives are used,make sure they are approved by Department of Commerce,
Safety and Buildings Div.. Effluent filters are to be removed&cleaned as necessary,with provisions to keep
solids from passing the septic during removal. No more than 1/3 of the usable tank volume may be occupied
by sludge/scum. 3 year inspection: If tank has greater than 1/3 volume sludge,tank contents must be
emptied and disposed of in accordance with NR 113 Wisconsin Administrative Code by an approved
individual. If the inspector does not recommend pumping of the septic tank,then the owner must be notified
of when pumping should be done as to not exceed 1/3 sludge volume. Septic tank should be routinely
inspected to be watertight and of good repair.
PumplDose Tank
If an effluent filter has been installed in the pump/dose tank,it must be removed&cleaned as
necessary,with provisions to keep solids from passing to the mound component during removal.
The pump,float switches and alarms must be inspected at least every three years for proper
operation. Pump/dose tank should be routinely inspected to be watertight and of good repair.
Mound and Lateral System
The mound system component must remain free of ponded surface water prior to pump operation. If 4
inches or more water level is detected in the observation pipes,the owner must be notified of possible
problems/failure. The designed daily flow capabilities of the component should never be exceeded. Trees
and any other deep rooted vegetation should never be planted,or allowed to grow anywhere on the
component. Activities OTHER than mowing/maintenance(i.e.excessive walking, pets,vehicles,etc...) could
compress the component and reduce its absorbtion capabilities and/or possibly cause it to freeze in winter
conditions. Lateral distribution pipes should be flushed out/tested every 18 months using the cleanout points
at each end of the component to remove scum that may clog orifices.
Performance Monitoring:
Performance monitoring must be done at least once every three years following the installation or at the time
of a problem,complaint,or failure.
Contingency Plan:
If the septic tank, pump tank or any of their components therein(including floats,alarms,pumps,etc)
become defective,the defective tank or component must be replaced immediately to ensure that the system
can operate as designed. If the mound component cannot accept wastewater or ponds wastewater to the
surface,the component must be repaired or replaced in it's current location by either:extending basal toe to
provide added absorbtion area;or by removing the clogged bacterial mat,aggregate cell,and distribution
piping within the mound and replacing said components in order to return system to proper working order as
required.
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MGOULDS PUMPS Submersible
Effluent Pump
PE
""W PUMP
SPECIFICATIONS MOTOR FEATURES
Pump—General: General: ■Corrosion resistant
• Discharge: 11/2"NPT • Single phase construction.
• Temperature: 104°F(4000 • 60 Hertz ■Cast iron body.
maximum,continuous when • 115 and 230 volts ■Thermoplastic impeller and
fully submerged. • Built-in thermal overload pro- cover.
• Solids handling:Y2" tection with automatic reset. ■Upper sleeve and lower
maximum sphere. • Class B insulation. heavy duty ball bearing
• Automatic models include a • Oil-filled design. construction.
APPLICATIONS float switch. • High strength carbon steel ■Motor is permanently
Specially designed for the • Manual models available. shaft. lubricated for extended
• Pumping range:see PE31 Motor: service life.
following uses: performance chart or curve. • .33 HP,3000 RPM ■Powered for continuous
• Mound Systems • 115 volts operation.
• Effluent/Dosing Systems PE31 Pump: ■All ratings are within the
• Low Pressure Pipe Systems • Maximum capacity:53 GPM • Shaded pole design working limits of the motor.
• Basement Draining • Maximum head:25:TDH PE41 Motor: ■Quick disconnect power
• Heavy Duty Sump/ PE41 Pump: • .40 HP,3400 RPM cord,20'standard length,
Dewatering • Maximum capacity:61 GPM • 115 and 230 volts heavy duty 16/3 SJTW with
• Maximum head:29'TDH • PSC design 115 Or 230 volt grounding
PE51 Pump: PE51 Motor: plug.
• Maximum capacity: 70 GPM • .50 HP, 3400 RPM ■Complete unit is heavy duty,
• Maximum head:37'TDH • 115 and 230 volts portable and compact.
• PSC design ■Mechanical seal is carbon,
METERS FEET ceramic, BUNA and stainless
4
- �
el.PE31,PE41.PES,; se
HP:.33,.40..50 ■Stainless steel fasteners.
35 --- ---
10 2 GPM I
AGENCY LISTINGS
30 - - 1 FT -
= 25 i -- C US
Q 20 Tested to UL 778 and
-- _ .. _ CSA 22.2108 Standards
� __.�.----- ------•__--- _-- •_-: .- -----.. -.-—_ � . ; ;
By Canadian Standards Association
File#LR38S49
-- `---
Goulds Pumps is ISO 9001 Registered.
10
5 i --- L
CIL 0 0 10 20 30 40 1 56 60 70 GPM 80
o s 1'0 ;'S m3m Goulds Pumps
CAPACITY
0 2004 ITT water Technology,Inc. ITT Industries
Effective June,2004
BPE31/41
ST. CROU\ COUNTY
SEPTIC."FANK NIAINTENANCE AGREEMENT
AND
OWNERSHIP CERTIFICATION FOR1VI
\/Iailitig Address
Property Addres-s --- 4t 1 74 9 �� k
(Verification required from Planuin &Zoning Department for new constluctit)nj-- �L
City/State _gnu'—a�°SC � Parcel Identification Number
0,a--
LEGAL DESCRIPTION /QOO— y
Property Location ,44(a) 1% , 5& `:a , Sec. j T -SO N R /S W. Town of G �enwcool
Subdivision Plat: , Lot#
Certified Survey Map# 3 , Volume y(D , Page
Warranty Deed # � (before 2007)Volume Page# _
Spec house yes o 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 certiticatiou form.signed by the
owner and by a master plumber.journeyman plumber. restricted plumber or a licensed pumper verifying*that(1)the on-site
waste�yater disposal system is in proper operatingz condition andior(2)after inspection and pumping(if necessary).the septic tank is
less than 13 full of sludge.
liwe,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 Planning&
Zoning Department within 30 days of the three year expiration date.
tiwe certify that all statements on this orm are true to the best of my/our knowledge. I/we am/are the owner(s)of the
property described above,by virtue of a wary tty deed recorded in Register of Deeds Office,
Nnm f he=EOF SG
CANT(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.
RED`.08/05)
996309
BETH PABST
REGISTER OF DEEDS
ST. CROIX CO., WI
RECEIVED FOR RECORD
CERTIFIED SURVEY MAP Os/2 EXEMP ><: PM
EXEMPT #::
PART OF THE SW 1/4 OF THE NE 1/4, AND PART OF THE ROC FEE: 30.00
COPY FEE: 3.00 ;
NW 1/4 OF THE SE 1/4, SECTION 1, TOWNSHIP 30 NORTH, PAGES: 2
RANGE 15 WEST, TOWN OF GLENWOOD,
ST. CROIX COUNT Y,WISCONSIN.
UNPLATTED
LANDS
C_'r_H. X - - _ _ _ — _
`� -- centerline
-— S86'02'04"E
r) 490.00'
33.00'
Cp
North 1/4 corner �i o 490.00'
S86'02 0 "E 4 3 _ 33.00'
Section 1-30-15 zl o soil _
Aluminum Cap <; �°, test o
eost—west quarter line o
LOT o °
I
-I � Ca.1 ,Ln 147,000 sq.ft. 130,830 sq.ft.
.1 °N° z I o 3.37 acres 3.00 acres
�I o Z incl. r—o—w excl. r—o—w
, CIO n
z ..,
F _320_37'_ No
�N89-31'01"E N86'02'04"W
M I� 490.00'
co I00
1`N UNPLATTED
N Io _ — — —— _
I z LANDS
PREPARED FOR:
Jamie & Jessica Knops
South 1/4 corner PO Box 35
Section 1-30-15 Glenwood City, WI
2.5" Iron Pipe
NOTES: Each parcel on this map is subject to State and County 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 Town Board for advice.
DRAFTED BY:
Joel A Brandt
G�NS/�
JB SURVEYING LLC 110ft.A.''
* ' WtANDT k
3-2M
SCALE: 1" - 120' -.QLSWJ0c1D cxtr,.:
0' 120' 240'
North is referenced to the
LEGEND
north-south quarter line e.........Found Government Corner (as noted)
of Section 1-30-15 a..........Set 3/4" x 18" Iron Rebar weighing
which bears N00°28'59"W 1.52 lbs. per lineal foot
(St. Croix County Grid System) Sheet 1 of 2
St.Croix County 996309 Page 1 of 2 Vol 26 Page 6014
STATE BAR OF WISCONSIN FORM 7— 1998 I�II�I�II�IIIIII����II����II1�1
r TRUSTEE'S DEED $ 2 1 9 2 0 3
Tx:4179918
Document Number 993896
Gordon T. Adams, as Trustee of The Gordon T. Adams Revocable Trust BETH PABST
dated January 26 2006 , for a valuable consideration conveys without REGISTER OF DEEDS
warranty to Jamie K. Knops and Jessica M. Knops husband and wife as ST. CROIX CO., WI
survivorship marital property, Grantee, the following.described real 03/24/2014 10:17 AM
estate in St. Croix County State of Wisconsin: EXEMPTV. NA
REC FEE: 30.00
TRANS FEE: 515.70
PAGES: 2
Recording Area a'
Name and Return Address
01610 09010 16100180000
016100190025
0,16-1001 -90-400. Ion Number
This is riot homestead property.
01.6-1 0'01 –90-300 (is) (is not)
01 6-1 001 – 00
See Exhibit A attached hereto n
Dated this 14th day of March 2014.
(SEAL) (SEAL)
i lei"'
Gordon T. Adams, Trustee
(SEAL) (SEAL)
AUTHENTICATION ACKNOWLMNIMTF I;eUAD®R ]
PROVINCE OF GUAYAS ]
CITY OF GUAYAQUIL
Signature(s) State of RAL OF THE ]
UNITED STATES OF AMERICA J
County
authenticated this day of
Personally came before me this 14 t hda�.of
MaiMarc�h —.20-14't a bove'named
Gordon T Adam's,T'us 04317-the Jordon T A ams
Revocable TnIsfWated clew a .2 6+-+.20
TITLE: = ` + , XaIIdra G. Shema
(If not, -v` r .T
706.06, Wis. Stats i
y § ) - (�� 'aA c�trc� 4 O nit e�d States of America
authorized b
Notary Publl St_at�o� t; + 1
THIS INSTRUMENT WAS DRAFTED BY
Coldwell Banker Burnet/Robert Nicholson My commis'sion_t slate expiration date:
J :+
1301 Coulee Road N
Hudson, WI 54016 \`
14-00737
(Signatures may be authenticated or acknowledged.
Both are not necessary.)
i
'Names of persons signing in any capacity must be typed or printed below their signature.
I STATE BAR OF WISCONSIN Wisconsin Legal Blank Co,Inc.
TRUSTEE'S DEED FORM No.7—1998 Milwaukee,Wis.
St.Croix County 993896 Page 1 of 2
EXHIBIT"A"
Legal Description
File No. 14-00737
Parcel 1:
Government Lot 8 lying south of County Trunk Highway "X", except that part described as
Lot 1, Certified Survey Map recorded in Volume 10, page 2914, as Document No. 528249,
all in Section One (1),'Township Thirty (30) North, Range Fifteen (15) West, Town of
Glenwood,St.Croix County,Wisconsin.
Parcel 2:
The Northwest Quarter(NW 1/4) of the Southeast Quarter(SE 1/4)of Section One(1),
Township Thirty (30) North, Range Fifteen (15)West, Town of Glenwood, St. Croix County,
Wisconsin, except that part described as Lot 1, Certified Survey Map recorded in Volume
10, page 2914, as Document No. 528249.
Parcel 3:
The Southwest Quarter(SW 1/4) of the Southeast Quarter(SE 1/4)of Section One (1),
Township Thirty (30) North, Range Fifteen (15)West, Town of Glenwood, St. Croix County;
Wisconsin,except that part described as Certified Survey Map recorded in Volume 22,
page 5313, as Document No. 839020.
Parcel 4:
That part of the Southwest Quarter(SW'/4) of the Southeast Quarter(SE 1/4) of Section One
(1),Township Thirty (30) North, Range Fifteen (15)West, Town of Glenwood, St. Croix
County,Wisconsin, described as Lot 4 of Certified Survey Map recorded in Volume 22,
page 5313, as Document No.839020.
Parcel 5:
Part of the Southwest Quarter(SW 1/4) of the Southeast Quarter(SE 1/4) of Section One (1),
Township Thirty (30) North, Range Fifteen (15)West,Town of Glenwood, St. Croix County,
Wisconsin, described as Lot 3 of Certified Survey Map recorded in Volume 22, page 5313,
as Document No. 839020.
Parcel 6:
That part of the Southwest Quarter(SW 1/4) of the Southeast Quarter(SE 1/4) of Section One
(1), Township Thirty (30) North, Range Fifteen (15) West,Town of Glenwood, St. Croix
County,Wisconsin, described as Lot 1 of Certified Survey Map recorded in Volume 22,
page 5313, as Document No. 839020.
St.Croix County 993896 Page 2 of 2
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need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777.
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wscons,n Ue Com EVEI)ATION REPORT Page /_of 3
Drvisien of Saf d B s
Adm. Code County -
Attach complete site plan on paper not less than 8 112 x 11 ncnes to size.Plan must Si
,,ri'rlo ic! ver!!ca!and nor!zon!a!WeQR0w!0' �ZENr
c!ton and Pafwi i.D.percent slope,scale or dimensions,north�'���� sanest road. Review Date
Please print all information. by
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Personal intomation you provide may be used for secor0ary purposes(Privacy law.s 15.04(1)(m)).
Prn�crt�!`y,:nar
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