HomeMy WebLinkAbout008-1077-10-020 cousin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix
afety and Building Division Sanitary Permit No:
INSPECTION REPORT 574322 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:
Erdahl, Julie I Eau Galle, Town of 008-1077-10-020
CST BM Elev: Insp.BM Elev: IBM Description: Section/Town/Range/Map No:
'� "ro 1� p,E' 27.28.16.401A-20
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER ���y 5 L CAPACITY STATION N64 MA 5-05 S ( HI FS t tE�LEEV.
Septic G , Q 100 Benchmark 1, Z �D3 106
`"�
Dosing �� AIt.BM jbg6' YVtkj .� 2-15 jag.
Co �o
Bldg.Sewer
�TSe Li�Ct'4-irk J
Holding St/Ht Inlet q.7 75
SHtft-6attet-- �-
TANK SETBACK INFORMATION
TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dtfrftl=t-- �-
1 O Q
Septic t
Dt Bottom
Dosing " Header/M an. �2 b.1.r,D5 O t'Ll,
,
L
_ Dist. Pipe 2.0(3 (6Z.12-
Bot. System `t ?j, lot,cly
Final Grade
PUMP/SIPHON INFORMATION I 10 3
Manufacturer -zoh� D mand St Cover
GPM
Model Number J7 q 9 ,
TDH Lift` f Friction 6os System Head , TDIH ' Ft
OI
Forcemain Length t Dia. �y Dist.to well
SOIL ABSORPTION SYSTEM
BEDITRENCH Width 1 wr Length No.Of Trenches PI I�MENSIONS Pits a Dia. L th
DIMENSIONS �-1� �15 r _+�
SETBACK SYSTEM TO P/L BLDG IWELL LAKE/STREAM LEACHING Manerfaetwflp�
INFORMATION CHAMBER OR
Type Of System: t `1 �1 s t� 1► n UNIT Mode'Plwm
DISTRIBUTION SYSTEM N
x Hole Spacing Vent to Air I�t e
Header/Manifold Distribution x Hole Si c M�
9 l _ Pipe(s) Lj►�(�a 1 t �r� /,�r y ' I �Q I Ip�t1AV
Length Dia Len th Dia t J Spacing J
SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only (p!#,"
1� Depth Over D Over xx Depth of xx Seeded/Sodded xx Mulched
Bed/Trench Center I I BedlTre dges Topso ( �es No Yes No
COMMENTS: (Include code discrepencies,persons present,etc.) Inspection#1: �7 / nn! Inspection#2:
Location: 198 250TH ST Woodville,WI 54028(NE 1/4 E 1/4 27 T28N R16W) NA Lot 2 �,���.�L.. p'p arcel N 7.28.16.401A-20
dv,p r,k r�►e�l a s 4cv-1- � p cl �� 6lc_
1.)Alt BM Description= �- ^6., Jd,-z
2.)Bldg sewer length= 2tp M�nl
-amount of cover= � bature 7) Ck Plan revision Required? Yes No
Use other side for additional Information. Date Insepctor's Cert.No.
SBD-6710(R.3/97)
r
ti
V � �
� rte
v cn �1
j � ,( �
CPA
County
Industry Services Division
� �' , t,,l $ •, 1400 E Washington Ave Sanitary Permit Number(to be filled in by Co.)
' P.O. Box 7162
f COUNTY Madison,WI 53707-7162 i/���
" T.CROIX T
SJNITY DEVELOP NT
Sanitary Permit Application State Transaction Number
In accordance with SPS 383.21(2),Wis,Adm.Code,submission of this form to the appropriate governmental unit
Z4 2,T 3 9
is required prior to obtaining a sanitary permit. Note:Application forms for state-owned POWTS are submitted to Project Address(if different than mailing address)
the Department of Safety and Professional Servies. Personal information you provide may be used for secondary �J. /
u ses in accordance with the Privacy .zF Law,s. 15.04 1 (m,Stats. 0
I. Application Information-Please Print All Informs ' .S d'��
Property Owner' in ! Parcel#
rn a- JJ Llik ErA,V,\ 0 08 — 10-1 — 10 — 020
Prope Own is Mailing Address Property Location
R I 25'O ~ S} Govt.Lot
(
City,State Zip Code Phone Number OW y, W VJ /4, Section Z.1
no�vi��.� (!.1 Sy 0Z$ -its -L9C ^Z-911 (circle one,.
T ZH N; R _Eo
II.Type of Building(check all that apply) Lot#
R I or 2 Family Dwelling-Number of Bedrooms Subdivision Name
I Block#
El Public/Commercial-Describe Use IGC�.
❑City of
❑ CSM Number O El Village of
State Owned-Describe Use I
To.of 9&0 Gall,_
Ill.Type of Permit: (Check only one box on line A. Complete line B if applicable)
A. ❑ New System ReplacemHSystem Treatment>Hol ding Tank Replacement Only ❑Other Modification to Existing System(explain)
B. ❑ Permit Renewal ❑ Permit ReChange of Plumber ❑Permit Transfer to New List Previous Permit Number and Date Issued
Before Expiration Owner
IV.Type of POWTS S stem/Com onent/Device: Check all that apply) A O
❑ Non-Pressurized In-Ground ❑ Pressurized In-Ground ❑At-Grade ❑ Mound>24 in.of suitable soil ®Mound<24 in.of suitable soil
❑ Holding Tank ❑Other Dispersal Component(explain) ❑Pretreatment Device(explain)
V.Dis ersal/Trea ent Area Information: ,C
Design Flow(gpd) Design Soil Application Rate(gpds Dispersal Area Required(so Dispersal Area Proposed(sf) System Elevation
(1000 , 10 boo U 1300 1 107- 0 V
VI.Tank Info Capacity in Total #of Manufacturer
Gallons Gallons Units c ='
New Tanks Existing Tanks
a. U c � a in j N N
w Lr� w °
H ii (7 ii.
Septic or Holding Tank 1466
Dosing Dosing Chamber X OAt� (,�c X
VIII.Responsibility Statement- 1,the undersign re si i l instal ti n of the POWTS shown on the attached plans.
Plumber's Name(Print) Plumber's Sin MP/MPRS Number Business Phone Number
Le,w�s R .<->- 'LS'SON1 b 'j 1s-231 —15-15
Plumber's Address(Street,City,State,Zip Code)
E-1 v8 c QA C o"IQ nILA_ W 1 fS7LAISml
Vlll. oun /De artment Use Only
Approved tsappro L Permit Fee DatZued/
Iss uing ent Signature
$ L❑ r Given Reason for Denial /
IX.Condit0Y93MWPMlffRtasons for Disapproval 3
1. Septic tank,effluent filter and �!
dispersal cell must all be seryIRe1 I maintained n e- t.✓1 �6^'I
riper management plan provided by plurriblf.
Z. 'M Mf ippliCibl�COdr/OIdI1MyIOIN �� to 1� �-,A
Attach to complete plans for the system and subm t to the County only per not le's than 8 112 x 11 inches in size
G.a 4P
SBD-6398(R0313)
" 9"PART DIVISION OF INDUSTRY SERVICES
5�' ron 2331 SAN LUIS PL STE 150
< ' GREEN BAY WI 54304
Contact Through Relay
www.dsps.wi.gov/sb/
y� Ga
` www.wisconsin.gov
A Q;,
�O 'ssroNAtiS� Scott Walker,Governor
Dave Ross,Secretary
I
July 16,2014
CUST ID No. 253976 ATTN POWTS Inspector
LEWIS C BJORK ZONING OFFICE
LEWIS BJORK LLC ST CROIX COUNTY SPIA
E7818 CTY RD E 1101 CARMICHAEL RD
MENOMONIE WI 54751 HUDSON WI 54016
CONDITIONAL APPROVAL
PLAN APPROVAL EXPIRES: 07/16/2016 Identification Numbers
Transaction ID No.2425397
SITE: Site ID No. 804005
Tom&Julie Erdahl Please refer to both identification numbers,
198 250TH St above,in all correspondence with the agency.
Town of Eau Galle
St Croix County
NW1/4,NW1/4, S27,T28N,R16W
FOR:
Object Type:POWTS Component Manual Regulated Object ID No.: 1493432
Maintenance required; Replacement system; 600 GPD Flow rate; System(s):EZflow Mound Component Manual,(R.
7/12); 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. CON
owner,as defined in chapter 101.01(10),Wisconsin Statutes,is responsible for compliance with all code
requirements. DEPT OF
No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145:06, �!R(�FEg$I
stats. DI'NlSHM OF IN
The following conditions shall be met during construction or installation and prior to occupancy or use:
Reminder(s):
• This system is to be constructed and located in accordance with the approved plans and with the EZflow Mo
Component Manual,(R 7/12) $EE CO
• The changes made to this plan were discussed with and approved by the system designer and reviewer.
• All manhole covers terminating above grade must have effective locking devices.
• The approved Tuf-Tite Septic Tank Riser and Lid approved by the state is 24 inch.The product review letter has
been attached to the stamped plans.
A copy of the approved plans, specifications and this letter shall be on-site during construction and open to
inspection by authorized representatives of the Department,which may include local inspectors. All permits
required by the state or the local municipality shall be obtained prior to commencement of
construction/installation/operation.
In granting this approval the Division of Industry Services reserves the right to require changes or additions should
conditions arise making them necessary for code compliance.As per state stats 101.12(2),nothing in this review
shall relieve the designer of the responsibility for designing a safe building,structure,or component.
LEWIS C BJORK Page 2 7/16/2014
Inquiries concerning this correspondence may be made to me at the telephone number listed below,or at the address
on this letterhead.
The above left addressee shall provide a copy of this letter and the POWTS management plan to the owner and any
others who are responsible for the installation,operation or maintenance of the POWTS.
Sincerely, Fee Required$ 250.00
Fee Received$ 250.00
Balance Due $ 0.00
Rachael E Huempfner
POWTS Plan Reviewer,Integrated Services WiSMART code:7633
(920)492-7728,M-f 7:45 am To 4:30 pm
rachael.huempfner@wisconsin.gov
cc: Lewis Bjork LLC
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
and addressed in a"300" series. For future reference,the Wisconsin Commercial Building Code will be addressed
by SPS Chapters 360-366.
Mound and Pressure Distribution Component Design
Design Worksheet
Site Information
(r or c) r Residential or Commercial Design
400.00 Estimated Wastewater Flow(gpd)
1.50 Peaking Factor(a-g. 1.5=150%)
600.00 Design Flow(gpd)
4,40 Site Slope(%)
100.00 Installation Contour Line Elevation(ft) 125.00 Contour Length Available(ft)
12.00 Depth to Limiting Factor(in)
0.60 In-situ Soil Applicafion Rate(gpd/ft )
i
Distribution Cell Information
8.00 Cell Width(ft)3.4. 5, 6.7, 8, 9 or11 0 Only F I 00.001 Dispersal Cell Length(ft)
1.00 Dispersal Cell Design Loading Rate(9polfe)
1 Influent Wastewater Quality(1 or 2) Are the laterals the highest point
In the distribution =Yy
Pressure Oisribution Information network? Enter Y or N
(c or e) a Center or End Manifold
3 Lateral Spacing(ft) If N above,enter the elevation ft
l 2 Number of Laterals of the highest point.
i
0.156 Orifice Diameter(in)(e_g_0.25)
6 4.00 Estimated Orifice Spacing(ft)= 12.00 ff/otiftce
2.00 Forcemain Diameter(in)
30.00 Forcemain Length(ft) Does the fbrcemain drain back? Y
<12 91.00 Inside Pump Tank Elevation(ft) Enter Y or N
0.00 Forcemain l=itter Loss(ft)
4.55 System Head(ft)x 1.3 4.89 Forcemain Drainback(gal)
10.83 Vertical Lift(ft) 90.29 5x Void Volume(gal)
0.48 FrictlQn Loss(ft) 95.18 Minimum Dose Volume(gal)
15.86 Total Dynamic Head(ft) 26.93 System Demand(gpm)
Lateral Diameter Selection E2.00 Diameter Selection
In.dia_ options choice in options choice
0.75 x
1.00 x x
125 1.50 x x
2.00 x
3.00 x
2 Gallonatinch Calculator(optional)
Treatment Tank Information 700.001 Total Tank Capacity(gal)
1"�� 1400.00
Septic Tank Capacity(gal)' 37.141 Total Working Liquid Depth(in)
Lewis Bork IManufacturer 18.85 gaUn(enter result in cell 1349)
Dose Tank Information Effluent Filter Information
7011-001 Dose Tank Capacity(gal) Life Time t=iller Manufacturer
18.851 Dose Tank Volume(gaUn) ILT9 lFiller Model Number
Lewis Bjork Manufacturer
} 12 13
Project: Tom&Julie Erdahl-Replacment ound Pagexof TI,
SO/Z0 30Vd O-M60fESZM3-1 9L8LZ8Z91L 8Z:80 VIOZ/91/LO
End Connection Lateral Layout Diagram
•=TUM-UprlKOag valve 43Frtean.outptu8
tar Ces pokt up Bpi every M s
aria pok is rt wo for drainW-
Forcvmain connM011 via t09 M aosstl)MW M at 4W-POW- taceratsrk tace�main af> sci� o
Ail laterals idatcal With oriftCs egw9y Vey- per SIM Table M.30-
Number of Laterals 2 Orifice Diameter 0-156 in
Lateral Diameter 1.50 in office Spacing(X) 4.10 ft
Lateral Length(P) 99.20 ft Orifices per Lateral 25
Lateral End(Z) 0.80 ft Orifice Density 12.00 fe/orifice
Lateral Spacing(S) 3.00 ft Manifold Length 3.00 ft
Lateral Flow Rate 13.46 gpnr Manifold Diameter 1.50 in
System Flow Rate 26.93 9pm Forcemain Velocity, 2-75 ft/sec
Dose Tank Information Lodsengcuvar with warning
label and looking device and
seated waterfght
Electrical as per NEC 3 00 and ^--►
SPS 316.300 WAG Disco 4 in-min.
nnect
Tank component is property vented E Alternate outlet
location
Foteemain diameter
Lewis Bork Manufacturer �T ; 2 in.
Capacity 700-00 Gallons
Volume 18.85 galfinch A
Weep hole or anti-
Dimension Inches Gallons B siphon device
A 22.09 416.32
B 2-00 37.70 C Pump off elevation(ft)
C 5.05 95.18 91.67
D 1 8-00 150-80 D
Total 37.14 700-00
Dose nk elevation(ft)
Bedding And Ba"I As Per Manufacturer 91.00
Alarm Manufacturer SJE-Rombus
Alarm Model Number TAAB-01
Pump Manufacturer jZDhler
Pump Model Number 1152
Pump Must Deliver I 26.93 gpm " at 15.86 ft TRH
Note-Switches containing mercury may not be used in this system.
Project: Tam&Julie Erdahl-Replacment Mound Page)Lof'401.
E0/E0 39bd 0--1AdJUsSIM3-1 ScELTEZSic eZ:80 VTOZ/K/LO
M
' vFyp RTb{E1' DIVISION OF INDUSTRY SERVICES
ys' Toy Plumbing Product Review
U�2 P.O.Box 2658
3 ;r Madison,Wisconsin 53701-2658
TTY:Contact Through Relay
q w
Scott Walker,Governor
A�OSSIONAti' Dave Ross,Secretary
May 21, 2013
TUF-TITE
TED MEYERS
1200 FLEX CT
LAKE ZURICH IL 60047
Re: Description: SEWAGE TANK COVERS, LIDS, RISERS
Manufacturer: TUF-TITE
Product Name: SEPTIC TANK RISER AND LID
Model Number(s): 24" RISER AND LID
Product File No: 20130080
The specifications and/or plans for this plumbing product have been reviewed and determined to be in compliance
with chapters SPS 382 through 384,Wisconsin Administrative Code, and Chapters 145 and 160, Wisconsin
Statutes.
The Department hereby issues an approval based on the Wisconsin Statutes and the Wisconsin Administrative
Code. This approval is valid until the end of May 2018.
This approval supersedes the approval issued on 3/17/08 under product file number 20080159.
This approval letter shall be incorporated with your previously approved plans and/or specifications approved under
product file number 20080159.
This approval is contingent upon compliance with the following stipulation(s):
• The manhole cover must be secured to the riser using screws which are not standard or phillips head to be
considered an effective locking device.
• Joints between riser sections shall be seal with butyl mastic sealant and secured with a minimum of four screws.
The department is in no way endorsing this product or any advertising, and is not responsible for any situation which
may result from its use.
Sincerely,
Glen Jones
Public Swimming Pool Plan/Plumbing Product Reviewer
phone: (608) 267-5265
fax: (608) 266-2602
email:glen.jones@wi.gov
SBD-10564-E N.10/97 File Ref:13008001.DOC
� r
i
EZftaw® MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN
Residential Application
INDEX AND TITLE PAGE
Project Name: Tom &Julie Erdahl- Replacment Mound
Owner's Name: Tom &Julie Erdahl
Owner's Address: 198 250th street
Woodville WI 547028
715-698-2979
Legal Description: NW NW 27 28 16W
Township: Eau Galle
County: St.Croix
Subdivision Name: NA
Lot Number: - Block Number: - 'TIONALLY
Parcel I.D. Number: 'ROVED
--SAFETY AND
Plan Transaction No.: NAL SERVICES
Page 1 Index and title JUSTRY SERVICES
Page 2 Data entry
Page 3 EZflow mound drawings
Page 4 Lateral and dose tank cSPONDENCE
Page 5 Distribution media
Page 6 System maintenance specifications
Page 7 Management and contingency plan
Page 8 Pump curve and specifications
Page 9 Plot pan , Plot plan Legend
Page 10 Attchments, Septic/Dose tanks , Manhole Risers , Soil n
Page 11 Effluent filter,
Designer: Lewis Bjork _ License Number: 253976
Date: 06/27/14 Phone Number: 715-231-7375
Signature:
Designed Pursuant to the
EZflow Mound Component Manual Ver.August 20,2007,
SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST-SAS(01/81)and
Pressure Distribution Component Manual Ver.2.0 SBD-10706-P(N.01/01)
EZflow Mound Version 3.0(R. 3/1/12) Page 1 of
Mound and Pressure Distribution Component Design
Design Worksheet
Site Information
(r or c) r Residential or Commercial Design
400.00 Estimated Wastewater Flow(gpd)
1.50 Peaking Factor(e.g. 1.5= 150%)
600.00 Design Flow(gpd)
4.40 Site Slope(%)
100.00 Installation Contour Line Elevation (ft) 125.00 Contour Length Available(ft)
12.00 Depth to Limiting Factor(in)
0.60 In-situ Soil Application Rate(gpd/ft)
Distribution Cell Information
6.00 Cell Width(ft) 3, 4, 5, 6, 7, 8, 9 or 10 Only 100.00 =Dispersal Cell Length (ft)
1.00 Dispersal Cell Design Loading Rate(gpd/ft2)
1 Influent Wastewater Quality(1 or 2) Are the laterals the highest point
in the distribution F Y
Pressure Disribution Information network? Enter Y or N
(c or e) a Center or End Manifold
3 Lateral Spacing(ft) If N above,enter the elevation ft
2 Number of Laterals of the highest point.
0.156 Orifice Diameter(in)(e.g. 0.25)
4.00 Estimated Orifice Spacing(ft)= F 12.00 fe/orifice
2.00 Forcemain Diameter(in)
30.00 Forcemain Length (ft) Does the forcemain drain back? Y
91.00 Inside Pump Tank Elevation (ft) Enter Y or N
0.00 Forcemain Filter Loss (ft)
4.55 System Head (ft)x 1.3 4.89 Forcemain Drainback(gal)
10.67 Vertical Lift(ft) 90.29 5x Void Volume(gal)
0.48 Friction Loss(ft) 95.1 Minimum Dose Volume(gal)
15.69 Total Dynamic Head (ft) 26.93 S em Demand (gpm)
Lateral Diameter Selection Manifold Diameter Selection
in. dia. options choice in. dia. options choice
0.75 1.25 x
1.00 1.50 x x
1.25 2.00
1.50 x x 3.00
2.00 x
3.00 x
Gallons/Inch Calculator(optional)
Treatment Tank Information 700.00 Total Tank Capacity(gal)
1400. 0 I Septic Tank Capacity(gal) 38.00 Total Working Liquid Depth (in)
Lew' k Manufacturer 18.42 gain (enter result in cell B49)
Information Effluent Filter Information 1
0.00 Dose Tank Capacity(gal) Life Time Filter Manufacturer
GD C� 16.76 Dose Tank Volume(gal/in) ILT9 I Filter Model Number
St`s, Lewis Bork I Manufacturer
Project: Tom &Julie Erdahl- Replacment Mound Page 2 of 11
Mound Plan View
1/10 6 :::.::: : : : : : : : : : : : : : : . . : : : : s : ::: J
:Observation Pipe : : : : : :..Q. .
': : : : : : : : : . : : : : . . . . . . . . . . . . . . . . . . . . .
K . tir r r tir yr;•fir r 1r1 f1r f1�r1 1r r f�r1r11r r r r r r f y1 1 r r j
•r•r•r•:. r•:•r•r•;•r• •r•r•:•;•;.;•;•:•r•:•r; r;r.r.;.r.r.r.r.r.r.r.;•:•r. r.:.r.r.. A
. . . . . . . .
•ti.ti.ti....ti.ti.ti....y....1. ti.•..ti.•..•..•..ti.•..1.•.. .5.ti.ti.y.1..•.ti..•..,..... ..1.ti L..•.
•'r:r.r..•.1'.J'.r.r1r •:r.r.r.::r:r.r.r:r�:::.:.::;1r:1.::;~r.'•:�r1r• r•;•:•;•r••
W f, 1.. . .
. . . . . . . . . . . . . . . . . . . . . . .
B �.
-.3-:..•:
: .:-: :-:•:-:-:-:•:•:•:•:•:•:•:• • • •:•:•: .:•:•:•:•:•:•:•:•:-:•:• :•:•:•:•:•:•:•:• I
L
Mound Component Dimensions
A 6.00 ft E 27.17 in H 1.00 ft K 12.40 ft
B 100.00 ft F 12.00 in 1 13.01 ft L 124.79 ft
D 24.00 in G 0.50 ft J 9.28 ft W 28.28 ft
600.00 (ft2)Dispersal Cell Area 1 1900.92 (ft2)Basal Area Available
6.00 (gpd/ft)Linear Loading Rate 1 10.00 (ft) 1/10 B Obs. Pipe Placement
Mound Cross Section View
EZflow Dispersal Area
Finished Grade 104.00 (ft) 11
.111,;,/„111M�Y,111,1,,,,.. G
F Dispersal Cell 102.50 (ft)Lateral
I _ ”
102.00 ft —� ==6 Invert Elevation
( )
;:;: 3 ::::;:::::: . .. . .i.i.i.i c : i'c i i.i'i=:
Dispersal Cell •.•.[ •.•.•.•.•.•. . 1
Elevation .E.. ; D ; ; s
. .•.-.•. .•.-. .
_ :• `:
_;; ::
] ] >;
�� .k 1. �l ,'• ✓�,.� � AAA. � .-
100.00 (ft)Contour Elevation
4.4 %Site Slope
Typical Dispersal Cell
Shading Key See Page 5
Q_ Topsoil Cap >o a
a.2 !1111!/ Subsoil Cap v a c 2.0 ft Approved Geotextile Fabric Cover
ASTM C33 Sand -r
is
4 Tilled Layer •r•r•ti . . f•.r r i •r•
W r:•• r
}r••r r•
r
F
EZflow Media
r.r•r.r• •r•r•r•r•r•r• r•r•r•r•r•r•
.r.r.r•r• r.r•r. .r.r.r.r.r
w 0 0.5 ft
See details on page 4 for number,size,and spacing of laterals.
Laterals are located in the 4"gravity distribution pipes as shown on page 5.
Project: Tom &Julie Erdahl- Replacment Mound Page 3 of 11
End Connection Lateral Layout Diagram
0x Tarn-upv4ball V21VOOf ClssnOUlplug
P
I Orifices�up a every�' S
1.3t orifice kacaNed ed Z 1{-X--4 am pis for drainage•
Force mails eormetion via tea of cross to mean om a<ang Pte• Laterals&face main of PVC Sch 30
AN is ads identical with orifices e cd par SPS Table�&4.304
126.93 Orifice Diameter 0.156 in
Number of Laterals in orifice Spacing (X) 4.10 ft
Lateral Diameter 25
Lateral Length(P) ft Orifices per Lateral
ft Orifice Density 12.00 W/orifice
Lateral End (Z) Manifold Length 3.00 ft
Lateral Spacing (S) ft
Manifold Diameter 1.50 in
Lateral Flow Rate Forcemain Velocity 2.75 ft/sec
System Flow Rate gpm
Dose Tank Information Ling cover with warning
label and locking device and
sealed watertight
Electrical as per NEC 300 and -- 4 in.min.
SPS 316.300 WAC Disconnect
E-- Alternate outlet
Tank component is properly vented location
Forcemain diameter
2 in.
Lewis Bork Manufacturer
Ca aci 700.00 Gallons
DVolum e 16.76 g al/inch
A
Weep
hole or anti
_
im
sion Inches Gallons B
siphon device
22.00 433 52 C Pump off elevation(ft)
O� 91.83
5.68 95.18
167.60 D
Total 41.77 700.00 Dose tank elevation(ft)
Bedding And Backfill As Per Manufacturer
91.00
Alarm Manufacturer SJE-Rombus
Alarm Model Number TAAB-01
Pump Manufacturer JZohler
Pump Model Number 152
Pump Must Deliver 26.93 gpm at 15.69 ft TDH
Note: Switches containing mercury may not be used in this system.
Project: Tom &Julie Erdahl- Replacment Mound
Rage 4 of 11
L6
Uf/owo Distribution Cell Media Layout
6.00 Cell Width (ft) 1.50 Sidewall to Lateral (ft)
Distribution Cell Cross-section Arrangements
(@(SQxD1n
6 ft W ide
pode
Component Legend
SR1-7A Bundle-5 ft or 10 ft lengths
SRI-12A or EZ 1201A in 5 ft or 10 ft lengths
SR3-12H or EZ 1201 P or n^ , in 5 ft or 10 ft lengths
O 4"Perforated Distribution Pipe With Pressure Lateral Inside
Turnup Enclosure — — — — — Pressure Lateral
Bundles are covered with approved geotextile fabric as per the their product approval.
Distribution Cell Plan View Layout -Typical
6.00 Cell Width -A(ft) 100.00 Cell Length -B(ft)
Center Connection Lateral Layn,it n;anrnm
Force Main
6ftWide - - - - - - - - — — — — — — — — —
End
Manifold
— — — — — -— — — — — —
Project: Tom &Julie Erdahl-Replacment Mound Page 5 of 11
Mound System Maintenance and Operation Specifications
Service Provider's Name ILewis Bork LLC Phone 715-231-7375
POWTS Regulator's Name ISt. Croix County I Phone 715-386-4680
System Flow and Load Parameters
Design Flow-Peak 600 gpd Maximum Influent Particle Size 1/8 in
Estimated Flow-Average 400 gpd Maximum BOD5 220 mg/L
Septic Tank Capacity 1400 gal Maximum TSS 150 mg/L
Soil Absorption Component Size 600 ft2 Maximum FOG 30 mg/L
Type of Wastewater Domestic Maximum Fecal Coliform >10E4 cfu/100 mL
Service Frequency
Septic and Pump Tank Inspect and/or service once every 3 years
Effluent Filter Inspect and clean as necessary at least once every 3 years
Pump and Controls Test once every 3 years
Alarm Should test periodical)
Pressure System Laterals should be flushed and pressure tested every 3 years
Mound Inspect for ponding and seepage once every 3 years
Other Lewis Bork Pumping 715-231-7375
Miscellaneous Construction and Materials Standards
1. Observation pipes are slotted and materials conform to Table SPS 384.30-1, have a watertight cap
and are secured in as shown in the EZflow Mound Component Manual Ver. August 20, 2007.
2. Dispersal cell media conforms to EZflow products approved for use with the EZflow Mound Component
Manual Ver. August 20, 2007. Media is covered with an approved geotextile fabric.
3. All gravity and pressure piping materials conform to the requirements in SPS 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.
Lateral Turn-up Detail
Finished Grade\
L/
6-8"Diameter Lawn Threaded Cleanout
Sprinkler Valve Box Plug or Ball Valve
Lateral Ends at Last Orifice Where
Variable Length Cleanout Begins
Long Sweep 90 or Two
45 Degree Bends Same
EZflow S thetic Media Diameter as Lateral
2.10 Feet
Distribution Lateral Lateral Cleanout
Project: Tom &Julie Erdahl- Replacment Mound Page 6 of 11
Mound System Management Plan
Pursuant to SPS 383.54,Wis.Adm.Code
General
This system shall be operated in accordance with SPS 382-84 Wis.Adm.Code,and shall maintained in accordance with its'component
manuals[EZflow Mound Component Manual 8/20/07,Pressure Distribution Component Manual Ver.2.0 SBD-10706-P(N.01/01)and
SSWMP Publication 9.6(01/81)]and local or state rules pertaining to system maintenance and maintenance reporting.
Septic and pump tank abandonment shall be in accordance with SPS 383.33,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
filter shall be serviced if the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an impending continuous
alarm.
The septic tank shall have its contents removed when the volume of sludge and scum in the tank exceeds 1/3 the liquid volume of the
tank. If the contents of the tank are not removed at the time of a triennial assessment,maintenance personnel shall advise the owner as to
when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank.
The addition of biological or chemical additives to enhance septic tank performance is generally not required_ However,if such products
are used they shall be approved for septic tank use by the Wisconsin Department of Commerce.
Pump Tank
The dosing(pump)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. If the force main has a weep hole,it
should be noted if it is functional during pump operation,and if not,it should be cleaned.
*****No one should ever enter a septic or dose tank since dangerous gases may be present that could cause death.'"*"
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 BODS, 150 mg/L TSS,and 30 mg/L FOG for septic tank effluent or 30
mg/L BOD5,30 mg/L TSS,10 mg/L FOG,and 104 cfu/100 mL for highly treated effluent. 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 of accumulated solids at least once every 3 years. When a pressure test is performed it should be compared to the initial test when
the system was installed to determine if orifice clogging has occurred and if orifice cleaning is required to maintain equal distribution within
the dispersal cell.
Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the owner,and any
levels above 4 inches considered as an impending hydraulic failure requiring additional,more frequent monitoring.
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 toe leakage occurs or by removing biologically 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 &Julie Erdahl- Replacment Mound Page 7 of 11
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PUMP PERFORMANCE EC
CURVE
MODEL 1511152/153
50
14 45 153
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12 40
OrL,
w 35 152
s 10
30
o $ 25 351
0
f- 6 20
15
4
10
2
5
0
10 20 30 40 50 60 70 80 90 1"00
GALLONS
LITERS 0 40 80 120 160 200 240 280 320 360
FLOW PER MINUTE 014908
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Plot Plan Legend
1 4" PVC ASTM D 3034. 42"Min. Cover where snow is not removed.
2 24 inside diameter plastic manhole brought min.4" above
surrounding grade. Concrete/plastic covers screwed down.
3 Precast concrete septic tank.
4 Effluent filter location.
5 4" PVC ASTM D3034. 18" Min . cover . Effluent piping or building
sewer where tank is within 30'.
6 Precast concrete dose/pump/filter tank.
7 12-2 OF-B Power conductor . 14-2 OF-B alarm circuit conductor.
Both wires are UL listed A-2057
8 2„ PVC ASTM D-26 65 -09 Schedule 40 Pipe Force
main.
9 4” PVC ASTM D-2665 -09 Schedule 40 Pipe . Entering and exiting
concrete tanks min 10' in length.
10 Carlon All weather pvc junction box. UL listed # A-241
11 treatment/dispersal cell
12 Inspection wells
Project: Erdahl Page 9
24.0
DAFT LE o _
INLET --- ° OUTLET
LIGUID LEVEL �. OUTLET.
tj FILTER °
o ° °
q In N ° ......_._.._FILTER"...
1� �
SEAM'_..;
0
tri
(_ 72.0 64A
r"
72.0
I
SECTI❑N A--A wrYL SEALANT END VIEW
18.0 36.0 18.0
LB 700
FILTER TANK SPECIFICATIONS
4' REINFORC'D CON:. WALLS
4' REINFORC'D CONC. COVER
A I I A 4' REINFORC'D CONC.BOTTOM
MANHOLE, 24' PRECAST RISER
t°u INLET OUTLET HIEGHT, 54. O.D.
LENGTH- 72' O.D.
WIDTH- 72' D.D.
INLET INVERT- 41'
I OUTLET INVERRT- 38' (LIQUID LEVEL)
4 I LOADING DESIGN, 8'-0' UNSATURATED SOIL.
16
M
18.85 GALLONS PER VERTICAL INCH INSIDE TANK.
FOR USE AS PUMP/SEPTIC/HOLDING TANG.
MORE INFORMATION AVAILABLE CONTACT, LEWIS DJORK
64.0
72.0
PLAN VIEW -- TOP SLAB
LEWIS B J ❑ R K , L L C NOT TO SCALE AUGUST 20, 2012
MENOMONIE, WI DRAWN BY: JCP
Tuf-Tite Riser System
ET _
Sf� ITI p�� 11
Tuf-Tite makes a full line of Risers and
accessories for Pre-Cast applications.
Riser Lid-with Molded-in gasket.
Available in 12", 16",20" and 24"
diameters. Green Only.
Concrete Lid -with handle. Use the Safety
Pan to cast your own concrete lids.
Safety Lid- May be used in place of
concrete lid. Fits 24" Riser Pan only. Black
Only.
Safety Pan- Safety PanTM available for 16",
20" and 24" Risers. Green Only.
6" Tall Riser- For septic tanks. Stackable
in 6" increments. Available in 12", 16",
20" and 24" diameters.
12" Tall Riser- For septic tanks. Stackable
in 12" increments. Available in 20" and
24" diameters. Black Only.
Tank Adapter Ring- For mounting riser or lid to tank when casting-in is not an
option.
1 �
2014004aA
\ !� LFG,9c!e:a � Ce f":1-'.'�,✓'' F%a' 1N- r'wz
f
Installation and Maintenance Instructions
Installation
Step 1 Dry fit the filter case onto the outlet pipe going to the drain field. Ensure it is centered directly under the
access opening.(If outlet pipe is already in a fixed position,additional pipe may need to be added)
Step 2 If utilizing the additional single side support and the two bottom supports: While the case
is still dry fit to the outlet pipe, measure and cut 1"schedule 40 pvc pipe to the length needed to extend from the
hubs that are pre-molded into the case to the side wall and the inside floor of tank. solvent weld pipe into the
hubs that are pre-molded onto the case.
Step 3 Solvent weld the case to the outlet pipe.Insert the filter cartridge into the case pressing down on the
cartridge until It locks into place at the bottom of case.
Step 4 if utilizing a vertical read switch:Insert switch into the hole pre-molded into the top of the filter.Press
straight down until it locks into place
Maintenance
1) Remove the access lid of the tank, Note:To ensure undesirable solids do not exit the tank and into the
drain field,the tank should be pumped out until the level of effluent is below the outlet level of the tank.
2) To remove the filter cartridge from the filter case,pull up firmly on the handle of the cartridge dislodging
it from the case.(if utilizing a vertical read switch,removal of switch is optional)
3) Using an ordinary garden hose,rinse the filter cartridge ensuring all visible septage material is removed.
4) Place the filter cartridge back into the filter case pressing down on the cartridge until it locks into place.
5) Place the access lid back onto the tank ensuring it is secure. RE-:CBVED
FEES 6 2014
SAFETY
Lifetime filter has a lifetime limited warranty:
Lifetime filter LLC warrants the filter will be free of manufacturing and workmanship defects during normal use for the period of
time the original purchaser owns the product.Lifetime filter will provide a replacement filter in the event that the original filter was j
not damaged during the Installation or maintenance process.Damage to this product caused by accident,misuse or abuse will not
be covered under this warranty.Improper care or malfunctions resulting from product not being installed,operated or maintained
property will void this warranty.Lifetime filter assumes no responsibility for labor charges,removal charges,installation or other
Incidental or consequential costs.
Contact:mike@lifetimefifterlIc.com Phone:502-724-2231 �
r
/p,�ararC�,T DIVISION OF INDUSTRY SERVICES
Plumbing Product Review
P.O.Box 2658
Madison,Wisconsin 53701-2658
(t TTY:Contact Through Relay
Scott walker,Governor
IONA
Dave Ross,Secretary
March 12, 2014
LIFETIME FILTER LLC
MIKE HORNBACK
146 CLIFTON HALL COURT
SHEPHERDSVILLE KY 40165
Re: Description: SEWAGE TREATMENT APPARATUS, EFFLUENT FILTER
Manufacturer: LIFETIME FILTER LLC
Product Name: LIFETIME EFFLUENT FILTERS
Model Number(s): LT 118, LT 1/16, LT 1/32 AND LT 1/64
[SEE ATTACHED TABLE OUTLINING: FILTRATION SIZE AND RATINGS IN GPD]
Product File No: 20140048
The specifications and/or plans for this plumbing product have been reviewed and determined to be in compliance
with chapters SPS 382 through 384,Wisconsin Administrative Code, and Chapters 145 and 160,Wisconsin
Statutes.
The Department hereby issues an approval based on the Wisconsin Statutes and the Wisconsin Administrative
Code. This approval is valid until the end of March 2019.
This approval is contingent upon compliance with the following stipulation(s):
• Installation and servicing of this product must be in accordance with the manufacturer's instructions. A copy of
the manufacturer's installation and servicing instructions must be given to the owner of the system.
• Maintenance information must be given to the owner of the tank explaining that periodic cleaning of the filter will
be necessary,
• A manhole extending to grade must be provided over the filter,
• MAINTENANCE: Clean filter at inspection/pumping interval.
• Additional information is included as attachment(s)to this letter; see attachment A.
The department is in no way endorsing this product or any advertising, and is not responsible for any situation which
may result from its use.
Sincerely,
Glen Jo®roc�
POWTS Reviewe r
phone: (608)267-5265
fax: (608)267-9723
email: glen.jones @wi.gov
I
SBD-10564-E(N.10/97) File Ref:14004801.00C
i
ST. CROIX COUNTY
SEPTIC TANK MAINTENANCE AGREEMENT
AND
OWNERSHIP CERTIFICATION FORM
Owner/Buyer TO m k Cr dd a%.\
Mailing Address 1°l 8 2 SO '' S W o o J'j I 11 W S y 0-L T
Property Address l q t Z SO S W o o " 'AL'_ W 1 5''1 d 1-1
(Verification required from Planning&Zoning Department for new construction.)
City/State W o a dv i Ik W \ Parcel Identification Number d 0 g - 10 7-1 - 10 - OIS)
LEGAL DESCRIPTION
Property Location W4 '/4 , NW 1/4 , Sec. V1 , T 7-0, N R \b W, Town of Fa,) (a a lk
Subdivision Plat: ,Lot
Certified Survey Map # b 2- , Volume 3 , Page# �s
Warranty Deed# -! l (before 2007)Volume , Page#
Spec house❑yes❑no Lot lines identifiable❑yes❑no
SYSTEM MAINTENANCE AND OWNER CERTIFICATION
Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper
maintenance consists of pumping out the septic tank every three years or sooner,if needed,by a licensed pumper. What you put into
the system can affect the function of the septic tank as a treatment stage in the waste disposal system. Owner maintenance
responsibilities are specified in§SPS. 383.52(1)and in Chapter 12-St. Croix County Sanitary Ordinance.
The property owner agrees to submit to St. Croix County Planning&Zoning Department a certification form,signed by the
owner and by a master plumber,journeyman plumber,restricted plumber or a licensed pumper verifying that(1)the on-site
wastewater disposal system is in proper operating condition and/or(2)after inspection and pumping(if necessary),the septic tank is
less than 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 must be completed and returned to the St.Croix
County Planning&Zoning Department within 30 days of the three year expiration date.
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,by virtue of a warranty deed recorded in Register of Deeds Office.
N b of bedrooms S
C 1 0 D/ (4 A7 flpe�t�_
SIGNATURE OF APPLICANT(S) DATE
***Any information that is misrepresented may result in the sanitary permit being revoked by the Planning&Zoning Department. ***
Include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if
reference is made in the warranty deed.
(REV.04/12)
r G�
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Wisconsin Departm�ommercg rLoN SOIL EVALUATION REPORT Page 1 of 3
Division of Safety an Buildin `�
��
0,% 90 with Comm 85,Wis. Adm. Code
GO 0p County St.Croix
Attach complete site plan o N�than 8 1/2 x 11 inches in size.Plan must
include,but not limited tgSre iffhorizontal reference point(BM),direction and Parcel I.D.
percent slope,scale or ' Ions,north arrow,and location and distance to nearest road. $ /b 77 " /Z5 ^ d Z
'� Please print all information. Revi ed by Date
Personal information you provide may be used for secondary purposes(Privacy Law,s.15.04(1)(m)). 7 2�
Property Owner Property Location Ej Tom&Julie Erdahl Govt.Lot NW 1/4 NW 1/4 27 T 28 N R 16 E(or)®
Property Owner's Mailing Address Lot# Block# Subd. Name or CSM#
198 250th street 2 - 884312
City State Zip Code Phone Number DCity rj Village ■ Town Nearest Road
Woodville WI 1 54028 ( 7)15-698-2979 250th street Eau. cial.1-ju-
® New Construction UseEj Residential/Number of bedrooms 4 Code derived design flow rate 600 GPD
E)Replacement Public or commercial-Describe: NA
Parent material Loess cap over till Flood Plain elevation if applicable ft.
General comments Install 24"mound on the 997 contour,.6 basil Soil pit range from A+5-7" ,I think the sandy clay loam in the
and recommendations:front yard has enough course sand in it to not be massive,has some structure to peds and provide enough drainage
of horizon 1 and 2
F T] Boring# 0 Boring
Pit Ground surface elev. 997 ft. Depth to limiting factor 12 in.
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF
in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. *Eff#1 *Eff#2
1 0-5 7.5yr3/3 sil 2fsbk mvfr cs 2f .6 .8
2 5-12 7.5 r5/4 sil 2msbk mvfr as if .6 .8
3 12-15 5yr5/3 c2f1oyr6/2 scl Ifsbk mfr - - -
4 15+ free water
2 Boring# El Boring 13
99.7
0 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/fg
in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. *Eff#1 *Eff#2
1 0-6 7.5yr3/3 sil 2fsbk mvfr cs 2f .6 .8
2 6-13 7.5 4/4 sil 2msbk mvfr gs if •6 •8
3 13-16 5yr5/6 c2f10yr6/2 scl lmsbk - - - -
4 16+ _ Free Water
*Effluent#1 =BOD,>30<220 mg/L and TSS>30<150 ffluen 2=BOD <30 mg/L and TSS<30 mg/L
CST Name (Please Print) CST Number
Lewis Bork 253976
Address Date Evaluation onducted Telephone Number
E7818 County E Menomonie WI 54751 6-17-2014 715-231-7375
r
Tom&Julie Erdahl 2 3
Property Owner Parcel ID# Page of
3 ] Boring# 11 Boring 99.6 15
E] 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/ff
in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. *Eff#1 *Eff#2
1 0-5 10yr3/3 - sil 2fsbk mvfr cs 2f .6 .8
2 5-15 7,5 4/4 - A 2msbk mvfr as if .6 .8
3 15- 5yr5/4 c2flOyr6/2 scl lmsbk mvfr - - - -
4] Boring# Boring 98.5 I S
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/fF
in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. *Eff#1 *Eff#2
1 0-9 10yr3/3 - sil 2fsbk mvfr cs 2f .6 .8 -
2 9-15 7.5 4/4 sil 2m mvfr as if .6 .8
3 15- 5yr5/4 c2fl0 6/2 scl Imsbk - - - - -
Boring
F-1
Boring# Ground surface elev. ft. Depth to limiting factor in.
Pit [Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF
in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. *Eff#1 *Eff#2-
*Effluent#1 =BOD,>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.
SBD-8330Test(R.07/00)
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884312
KATHLEEN H. WALSH
REGISTER OF DEEDS
ST. CROIX CO., WI
CERTIFIED SURVEY MAP 11/14/2008 FOR RECORD O OPM
CERTIFIED SURVEY MAP
PART OF THE NORTHEAST'-1\4 OF THE NORTHEAST 1/4, VOL: 23 PAGE: 5583
BEING LOT 2 OF CERTIFIED SURVEY MAP, VOLUME 11, PAGE 3117, REC FEE: 13.00
LOCATED IN SECTION 27• TOWNSHIP 28 NORTH, RANGE 16 WEST, COPY FEE: 3.00
TOWN OF EAU GALLS, ST. CROIX COUNTY,WISCONSIN. PAGES: 2
UNPLATTED LANDS
20th AVE 2679.92'
_ _ _ {sa7 14'54"Q (2680.02')
— S87'21'-"06"E 670.00' centerline
-- 2009.92' S8721'06'E dj 276:.04' S87.21'0 6"E Northeast Corner
S87'21'06"E— 33.04 - O7 393.96' POB
_ _ 33.04' _ Section 27-28-16
North 1/4 Corner S87 21'06'E y 275:98' _ — — — — -? Fd Aluminum Cap
Section 27-28-16 S87'21'06"E 360.92'
Fd Aluminum Cap 636.90' L OT 2
building setback line o 174,661 sq.ft. No I
- - -
rn 4.01 acres _ N O Ln N
rn incl. r-o—w ° I 9 I°° o
0i M O house °rndwY.� cr (rn °o_
sheds Ln m I m 8
_ LOT > °
so, tests P rri I I
LO"i' 1 '
270,310 sq.ft. well septic! e° I UNPLATTED
4' O area I -
-——— —— 6.21 acres w I S LANDS
'`t incl. r-o-w 148,090 s ft.
� q• r--100'—I w
U! 3.40 acres i _ °
excl. r—o—w I `Z3° I ry
I rn
z z 253,877 sq.ft. 360.96' 33.04 66 iP
°o 00 5.83 acres N87'13.30"W 394.00' rn Ln I rn_°r'-
rn N excl. r-o-w co I�
_ °
Q1 I N
driovewoy
tests N i
I
' I j
- - 635.76' 33.04 o
N87'1 3'30"w 668.80' I
PREP.'-.RED FOR: (N87o7'1s"w} o
° I to
Julie Pfendler LOT 3 °rn V
198 250th St --- - M
Woodville, Wi 54028 CSV1 #:3117 v Icc
r*i
Note Eac,I) p;,rr el. an this map is subject to State and County laws, Q�
ruie_. and regulations ii e. wet?ands, minimum lot size, access to
parcel, etc.). Before purchasing or developing any parcel, contact East 1/4 Corner
St. Crcix County Zoning Office and Town Board for advice. Section 27-28-16
Fd Aluminum Cap
���n LEGEND DRAFTED B
JOEL BRAND T
...__Government Corner (as noted) JB SURVEYING LLC
o_ Se` :3\4" x 18" Iron Rebar weighing a
minimum of 1 50 lbs per lineal foot ��BC0N,
iN _ _ _ Found 1" Iron Pipe JOELq• �
c ) __Recorded Data * ' �
5-3003
;011.11111111111111000 CJTY,
North is referenced to the
East tine of the Northeast �A
Quarter of Section 27-28-16 SCALE 1"' = 150'
wnich bears S00°06"1S"E Sheet 1 of 2
'T f Croix County Grid System) 0' 150' 300'
%/-I �� o- 5 83
8206855
State Bar of Wisconsin Fonn 3-2003 Tx:4170681
QUIT CLAIM DEED 991651
Document Number Document Name BETH PAB$T
REGISTER OF DEEDS
ST. CROIX CO., WI
THIS DEED,evade between Julie A.Pfendler 01/17/2014 2.51 PM
("Grantor,"whether one or more), EXEMPT#: 1
and Julie A.Erdahl REC FEE: 30.00
PAGES: 1
("Grantee,"whether one or more).
Grantor quit claims to Grantee the following described real estate,together with the
rents, profits, fixtures and other appurtenant interests, in St.Croix
County, State of Wisconsin ("Property") (if more space is needed, please attach Recording Area
addendum): Name and Return Address
Julie A.Erdahl
27-28N-16W NE NE 198 250th St.
198 250th St. Woodville,WI 54028-7222
PLATT:5583-CSM 23-5583 008-200
BK/CONDO: Lot 02
SEC 27 T28N R16W PT NE NE 008-1077-10-020 27.28.16.401A-20
FKA LOT 2 CSM 11/3117 Parcel Identification Number(PIN)
(10.215 AC) BEING CSM
23-5583 Lot 2 (4.01 AC) This is homestead property.
t 0'.w o� L 0.ul
�«C . Ct�a.� Lo..�i-1 4t)� (is)(is not)
\ 1
Name Change ONLY,NO Real Estate Transfer per Statute 77.21 (1)
ll
Dated
(SEAL) (SEAL)
�— (SEAL) (SEAL)
UTHENTICATION ACKNOWLEDGMENT
Signature(s) `9' STATE OF WISCONSIN )
s$.
authenticated on 0 V-1 ya l �1 . ��`I X COUNTY )
Personally came before me on
the above-named )t i 2 T✓d_a4,1. _
TITLE:MEMBER STATE BAR OF WISCONSIN
(If not to me known to be the person(s) who executed the foregoing
authorized by Wis. Stat.§706.06) instrument and acknowledged rthe nsa�mme.
THIS INSTRUMENT DRAFTED BY: „",Q 6,
Notary Public,State of Wisconsin
My Commission(is penuan`npp�,,ti��l
(Signatures may be authenticated or acknowledged. Ilnlh are not t fyi). • - • -
NOTE: THIS IS A STANDARD FORM. ANY MODIFICATIONS TO THIS FORM SHO
FE C 1"YDL�f r[F•IED.
QUIT CLAIM DEED CL 2003 STATE BAR OF WISCONSIN �� � N� /��4/'• Nr�j14 NO.3-2003
'Type name below signatures. _
PUBLIC • ,�
St.Croix County 991651 Page 1 of 1 :,r`f�9 •, • • .•�C��``
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