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038-1015-60-000
Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 574344 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: Nelson, Stuart&Sandra Trust I Star Prairie, Town of 038-1015-60-000 CST BM Elev: Insp.BM Elev: BM Description: Section/Town/Range/Map No: / at •a /UD � V I�J-a 03.31.18.42B TANK INFORMATION ELEVATION DATA TYPE pIIANI,IFAiWER —20 r CAPACITY ` STATION BS HI FS ELEV.14 0AJAI_dC-.3� Septic ' -� Ll //00 Benchmark 1� lG�� Dosing / D ,l Alt. BM p i �y ` Aeration �• 'p (� �C/ Bldg.Sewer L o Holding S Htt Inlet y �• / TANK SETBACK INFORMATION > (aQ-,-0(,, 14ka. _ St/Ht Outlet TANK TO L, P j/ — .WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic y , Q Dt Bottom 7 / Q9Op' f (100 J6 Dosing Head an. SO Aerati J 4 g._Eipe S' ti S �Z 9Z. SO Holdin Bot.System D�- Final Grade PUMP/S IPHON INFORMATION / /OD•S Manufacturer DePmMand Co er 3 ��� S l p q,y -7 Model Number C 4s7/ 22,�7 ,v y-ol d 6 4- TDH Lift / V Frictti'�ss System/Head D�.� Ft e 0 1O ceU e t 7 Dia. �s q Dist.to well / M SOIL ABSORPTION SYSTEM h S Gtr BEDITRENCH Width �� Length No.Of Trenches PIT DIMENSIONS N .Of Pits Inside Dia. Liquid Depth DIMENSIONS �(p• Z� --� SETBACK SYSTEM TO P BLDG WELL LAKE/STREAM CHING Manufacturer: INFORMATION T O System: n H ER OR Type t �� (On / IT Model Number: i lJ DISTRIB ION SYSTEM Header a fol Distribution / x Hole SizV0, Ix Hole Spacing / IV ent Air Inta e • Pipets) 5�7/ S' % YZs 3.Z L Length Dia Length Dia Spacing ' SOIL COVER x Pressure Systems Only xx Mound r At-Grade Systems Only T 4-4— Dr Depth Over xx Depth of xx eed epth Ove xx mulch-id Bed/Trench Center Bed/Trench Edges TopsI - f�- Yes E No F- Yes No COMMENTS: (Include code discrepencies,persons present,etc.) Inspection#1: / / &Ip ection#2:- ,? / /� Location: 1138 Cty Road HH New Richmond,WI 54017(Gov't Lot 4 3 T31 N R18WW)) Dmetes&bounds Lot Parcel No: 03.31.18.42B 1.)Alt BM Description= N"� " 'y"�� / �1 I -7 5- S" 2.)Bldg sewer length= &0�/3 �/',ti�s �61 Ol -amount of cover=ty �,,ww�,�,n�,,Q Plan revision Required? U Yes No Q��i} � Use other side for additional information. — - — --- — -- Date Insepctor's ig ture Cart.No. SBD-6710(R.3/97) r^ _ __._ ___.,�_��..•.F�c�!..��hl�-.�4�.��',.e�.L,E.o�.�as --�` _��a�---; -_' -_ Ar- _ _ LU D _ .._.._- _k7/: t 3 ST. C Q I N T`� Land Use .Planning&Land Information xS'f `?i Resource Management Community Development Department September 9,2014 Stuart Nelson Trust 1138 Cty. Rd. H New Richmond, WI 54017 Determination for Land Use Permit-Parcel#03.31.18.42B,Town of Star Prairie I observed during an inspection for the replacement Private On-site Wastewater Treatment System (POWTS)that a deck on the house is under construction,apparently to replace an existing one. Accessory structures in Shoreland zoned areas must comply with structural setbacks, including a minimum 75' to the Ordinary High Water Mark(OHWM). The partially constructed deck is>75' to the OHWM and is compliant with that setback and appears to be outside/above the floodplain elevation for Cedar Lake. This letter is a determination regarding zoning permits that may/may not be necessary for your project(s) in the Shoreland overlay district. Applicable Shoreland ordinances are summarized below: Code Proposed Project Standards & Requirements References 17.30 F.4 The proposed deck will be a legal conforming accessory structure that is> 75' from the OHWM &G.1 & G.2 of Cedar Lake. The accessory structure must meet all other required structural setbacks for an A -Residential property per General Zoning ordinances. 17.30.1.2.a.1) There will be a net land disturbance(grading)of less than 2000 sq. ft. on slopes<12%within 300' of the lake's OHWM for the replacement POWTS; this amount of land disturbance is exempt from a land use permit. 17.3011 -4 There will be no net change in calculated impervious surface areas on this site after reconstruction of the deck within 300' of the OHWM. 17.30 L.1 There is existing vegetative buffer within a 35' shoreline buffer zone from the OHWM and no proposal to remove vegetation within 75' of the OHWM. At this time,your proposed construction will not require any land use permits from our department. However,the deck reconstruction must meet requirements for Uniform Dwelling Code and you should contact the town building inspector for a building permit. Please feel free to call or email if you have any questions regarding this Shoreland zoning permit determination. Pam Quinn, CDD Land Use Specialist pam quinn2co.saint-croix.wi.us Cc: Brian Wert, Star Prairie Building Inspector Phone 715.386.4680 Government Center, 1101 Carmichael Road, Hudson, W154016 Fax 715.386.4686 www.sccwi.us/cdd www.facebook.com/stcroixcountywi cdd@co.saint-croix.wi.us ctieTtt7trKlr . Count}' -. . Industry Services Division �l F 1400 E Washington Ave SntO Permit Number(io�befill(to by Co.) P.O_ Box 7162 �y { .: 'j C Madison,WI 53707-7162 — State Transaction Number _ �it App lon _ ' �1 In accordance 1tyt�t'SPS 383.21(2)r Wis.Adm.Code,submission of this form to the appropn'a1Te governmental unit ,_ .v 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 Services. Personal information you provide may be used for secondary �` purposes in accordance with the Privacy Law,s.15.04(lxm) Stats. //� 6 7-1--(/7-1--( l I. Appfication,lnformation–Please Print All Information ;Property Owner's Name ` ,Vi,, / 1- Parcel# 5'TUAleT VSAM)2A L - r Uut '7_ - . 2 3.�perty Owner`s i4lailin ress Property Location Z'7t SEA voi,� �e Lam. Govt Lot City,S to Zip Code Phone Number '114,,�/4. Section circle o T�N R Eo& f Type of Building(check all that apply) Lot t✓ I or 2 Family Dwelling-Number of Bedrooms ti� _ Subdivision Name T j ❑Public/Commercial-Describe Use Bio _ 7L 1 City of ❑State Owned-Describe Use E❑ Village of CSM Number Tocvn of i III, T e of Permit: (Check n a ne A Complete line B if applicable) A• ❑ New System Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System(explain) B ❑ Permit Renewal ❑ Permit Revision ❑Change of ❑Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Plumber Owner IV.T of POWTS System/Component/Device: (Check all that apply) � ❑Non-Pressurized In-Ground ❑ Pressurized ln-Ground ❑ At-Grade ❑ Mound>24 in.of suitable soil 'Mound<24 in.of suitable soil ❑ Holding Tank ❑Other Dispersal Component(explain) ❑Pretreatment Device e} Iaifr) V.Dispersal/Treatment Area Information: Design Flow(gpd) Design Soil Application �� Dispersal Area Require Proposed(st) System Elevation Rate(gp / O ms 7 VL ank Info Capaci_'in Gallons Total #o Manufacturer . ;, ; y Gallons Units r } r New Tanks xisting Tanks � �. G W t- Septic or Holding Tank _ � _ ❑ ❑ ❑ ❑ Dosing Chamber ❑ ❑ ❑ ❑ VII.Responsoffity Statement-I,the undersigned,assume po t ' ty for install n of the P W'fS shown on the attached plans.Plumber's MP/MPRS Number Business Phone Number Plumb s ante(Pri ) � � � _ Plumber's Address(Street City,Sta Zip Code •- VIIL CountV/De artment Use Only Approved ❑ Disapproved Pe t Fee D t Issu suing a to + ❑ Owner Given Reason for Denial S DL%,g&FL;®f�Wval/Reasons for Disapproval 1.Septic tank,effluent filter and 1 ,w W/V/ dispersal cell must bps yiQed/maintained / � �f'1 - tih V?K as per management plan provided by plumber. 2.All setback requirements must be ' e qep�lans for the system and bmit to a County only en paper n ess char 8 vz x t 1 Inches in siz /X, ��tiveeY . KIM A OCONNELL Page 2 7/8/2014 • Surface water drainage shall be diverted away from the system area per Mound Component Manual. • Materials shall conform to the requirements of SPS 384.10.No fixture,appliance,appurtenance,material, device or product may be sold for use in a plumbing system or may be installed in a plumbing system,unless it is of a type conforming to the standards or specifications of chs. SPS 382 and 383 and this chapter and ch. 145, Stats. • The existing POWTS must be properly abandoned per s. SPS 383.33 Wis.Adm. Code. • Insulate building sewer per SPS 382.30(11)(c). • Provide de frost protection per SPS 383.43(8)(c). 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. 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 Patricia L Shand rf POWTS Plan Re' wer,,Integrated Services WiSMART code:7633 (715)634-7810, Fax: (715)634-5150,M-F 8:00 a.m.-4:45 p.m. pat.shandorf @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 and addressed in a"300"series. For future reference,the Wisconsin Commercial Building Code will be addressed by SPS Chapters 360-366. p�PNTN DIVISION OF INDUSTRY SERVICES e . Tp� 10541 N RANCH ROAD OZ 1" : 3 7 HAYWARD WI 54843 y R Contact Through Relay 3 k www.dsps.wi.gov/sb/ P � ov www.wisconsin. 2 s 9 A�O`fsslox�+tis� Scott Walker,Governor Dave Ross,Secretary July 08,2014 CUST ID No. 224263 ATTIC•POWTS Inspector KIM A OCONNELL ZONING OFFICE KO CONSTRUCTION ST CROIX COUNTY SPIA 504 3RD AVE 1101 CARMICHAEL RD OSCEOLA WI 54020 HUDSON WI 54016 CONDITIONAL APPROVAL Identification Numbers PLAN APPROVAL EXPIRES: 07/08/2016 Transaction ID No.2414416 SITE: Site ID No. 803201 Sandy Nelson Please refer to both identification numbers, 1138 Co Rd H above,in all correspondence with the agency. Town of Star Prairie St Croix County NEIA, SWl/4, S3,T31N,R18W FOR: Description:Mound,3 bedroom residence Object Type:POWTS Component Manual Regulated Object ID No.: 1490029 Maintenance required; Replacement system; 450 GPD Flow rate; 16 in Soil minimum depth to limiting factor from CONDIT original grade; System(s):Mound Component Manual-Ver.2.0, SBD-10691-P(N.01 101,R. 10/12),Pressure APP Distribution Component Manual-Ver.2.0, SBD-10706-P(N.01 101,R. 10/12), SSWMP Pub.9.6; Effluent Filter DEPT OF The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes PROFESSIO and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. This system is to be constr"WISION OF and located in accordance with the enclosed approved plans and with any component manual(s)referenced above. The owner,as defined in chapter 101.01(10),Wisconsin Statutes,is responsible for compliance with all code requirements. No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145. , SEE CORK stats. The following conditions shall be met during construction or installation and prior to occupancy or use: Key Item(s) • In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard,the property owner must follow the contingency plan as described in the approved plans.In addition,the owner must insure that the operation,maintenance and monitoring duties as described in section VIII of the mound component manual are complied with.A copy of this information must be given to the owner upon completion of the project. • The mound must conform to the shape of the contour. • The bottom of the distribution cell shall be level per the Mound Component Manual. The"D"dimension shall be a minimum of 20". The maximum finished slope of the mound surface shall not have a slope ratio steeper than 3:1 per the Mound Component Manual Reminder • The orientation of the mound system must be such that the longest dimension is oriented along the surface contour per SPS 383.44(6)(a)2. • Limit activities in the area 15'beyond the down slope edge of the mound per Mound Component Manual. MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Project Name: Sandy Nelson Owner's Name: Sandy Nelson Owner's Address: 1138 CTY RD H New Richmond WI 54017 Legal Description: NE—SW—SEC 3—T 31 N—R18 W Township: Star Prairie I County: St.Croix Subdivision Name: Lot Number: Block Number: Parcel I.D. Number: — /0/ '�' � ONALLY Plan Transaction No.: .OVED AFETY AND Page 1 Index and title IAL SERVICES Page 2 Data entry UST SER ES Page 3 Mound drawings Page 4 Lateral and dose tank Page 5 System maintenance specifications Page 6 Management and contingency plan Page 7 Pump curve and specifications _SPON E Page 8 Plot Plan Page 9 Soil Evaluation Designer: Kim Oconne License Number: 224263 Date: 06/0914 Phone Number: 715-381-7917 Signature: nature: - Designed Pursuant to the Mound Component Manual for POWTS Version 2.0 SBD-10691-P(N.01/01,R. 11/12),and both 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,R. 10/12) Version 7.0(R. 11/12) Page 1 of 9 Mound and Pressure Distribution Component Design Design Worksheet Site Information (R or C) R' Residential or commercial Design Note: Sand fill(D)calculations assume a (gp ) Table 383-44-3 in-situ soil treatment for 300.00; Estimated Wastewater Flow d fecal coliform of<=36 inches. 1 50' Peaking Factor(e.g. 1.5= 150%) 450.00 Design Flow(gpd) 0 _ 3.80 i Site Slo P e(/o ) 96.204 Contour Line Elevation(ft) 16.00 Depth to Limiting Factor(in) 0.701 In-situ Soil Application Rate(gpd/tf) Distribution Cell Information 66.25'; Dispersal Cell Length Along Contour(ft) = 8.00 Cell Width(ft) 1.001 Dispersal Cell Design Loading Rate(gpd/if) 1! Influent Wastewater Quality(1 or 2) Are the laterals the highest point in the distribution Y Pressure Disribution Information network? Enter Y or N (C or E) _ E Center or End Manifold 2. Lateral Spacing (ft) If N above,enter the elevation(ft) 3 i Number of Laterals of the highest point. 0125; Orifice Diameter(in) 319' Estimated Orifice Spacing(ft)= 8.33 f2/orifice i661 1 Forcemain Diameter(in) Forcemain Length(ft) Does the forcemain drain back? Y _ 90.45 Pump Tank Elevation(ft) Enter�Y orN� 6.50 System Head (ft)x 1.3 13.86 Forcemain Drainback(gal) 7.01 Vertical Lift(ft) 75.34 5x Void Volume(gal) 0.95 Friction Loss(ft) 89.20 Minimum Dose Volume(gal) - 0.00 In-line Filter Loss(ft) 22.24 System Demand(gpm) 14.461 Total Dynamic Head (ft) Lateral Diameter Selection Manifold Diameter Selection in. dia. options choice in. dia. o tp ions choice 0.75 1.25 x 1.00 x 1.50 x _ x . 1.25 x 2.00 1.50 x x.__. 3.00 2.00 x 3.00 x Gallonslinch Calculator(optional) Treatment Tank Information 1000 00 Total Tank Capacity(gal) 1000 00 Septic Tank Capacity(gal) 36.00" Total Working Liquid Depth(in) Wieser 'Manufacturer 27.78 gal/in (enter result in cell B49) Dose Tank Information Effluent Filter Information Y 600 00 Dose Tank Capacity(gal) Ploylock Filter Manufacturer Tµ16.76' Dose Tank Volume(gaUin) 'PL 525 Filter Model Number Weiser Manufacturer Project: Sandy Nelson Page 2 of 9 Mound Plan and Cross Section Views 1/10 8 J Observation Pipe '- . . . — K o Cl A W : . . .I - B : •. . . . . . . . . . - . . . . . . . . L Mound Component Dimensions A 8.00 ft E 23.65 in H 1.00 ft K Eaft ft B 56.25 ft F 9.50 in z 11.05 ft L ft D 20.00 in G 0.50 ft J 7.97 ft W 450.00 (ft2) Dispersal Cell Area 1 1071.35 (ft) Basal Area Available 8.00 (gpd/ft) Linear Loading Rate 5.63 (ft) 1/10 B Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area Finished Grade 99.66 (ft) r; "1 rill.. t H ,.rrr.,rrrr, rnririiii.. G j I F Dispersal Cell 98.37 (ft) Lateral 97.87 (ft) : Invert Dispersal Cell Elevation Ado 96.20 ft Contour Elevation 3.8 %Site Slope Geotextile Fabric Cover Shading Key Dispersal Cell See lateral details on 10 Topsoil Cap c 1.5 ft ® -�- Page 4 for number,size, 0 rrrrrr.. Subsoil Cap 0 0 _j 0 I and spacing of laterals. ASTM C33 Sand 1° a T Laterals are equally V Typical Lateral F spaced from the Tilled Layer c 0 ft ® ; distribution ceirs © Aggregate gar o centerline in the A___} distribution cell(AxB). Project: Sandy Nelson Page 3 of 9 End Connection Lateral Layout Diagram Center the laterals*vet the A&B dimension •a Turn-up vd ba l l valve or plea nout pl u9 _J P All laterals are identical lE x—?•I Holes drilled on the bottom of the lateral 5 equally spaced laterals&forcemain Sch 40 PVC per SPS Table 384.305 s Force main connection via tee or cross to manifold at any,point. Number of Laterals 3 Orifice Diameter 0.125 in Lateral Diameter 1.50 in Orifice Spacing(X) 3.22 ft Lateral Length(P) 54.74 ft Orifices per Lateral 18 Lateral Spacing (S) 2.67 ft Orifice Density 8.33 fe/orifice Lateral Flow Rate 7.41 gpm Manifold Length 5.33 ft System Flow Rate 22.24 gpm Manifold Diameter 1.50 in Total Dynamic Head 14.70 ft Forcemain Velocity 2.27 ft/sec Dose Tank Information Locking cover with warning label and locking device and sealed watertight Electrical as per NEC 300 and — "♦ SPS 316.300 WAC 4 in.min.Disconnect Tank component is properly vented = E'— Alternate outlet location Forcemain diameter Weiser Manufacturer 2 in. Capacityl 600.00 Gallons �- Volume 16.76 gaVinch A Weep hole or anti- Dimension Inches Gallons B siphon device A 20.48 343.20 C B 2.00 33.52 Pum off elevators(ft) C 5.32 89.20 91.12 D &M 134.08 D Dose Total 35.80 600.00 tank elevation(ft) 3"Bedding under tank. F 90.45 Alarm Manuaaacturer SJ Electro Note Switches Alarm Model Number '101 HW containing mercury may not be used in Pump Manufacturer Goulds this system. Pump Model Number PE 51 Pump Must Deliver I 22.24 gpm at F 1-4-—7-0 ft T D H Project: Sandy Nelson Page 4 of 9 Mound System Maintenance and Operation Specifications Service Provider's Name Kim Oconnell Phone 715-381-7917 POWTS Regulator's Name ST.Croix,CTY Zoning Phone 715 386=4686 System Flow ow and Parameters Design Flow-Peak 450 gpd Maximum Influent Particle Size 1/8 in Estimated Flow-Average 300 gpd Maximum BOD5 220 mg/L Septic Tank Capacity 1000 gal Maximum TSS 150 mg/L Soil Absorption Component Size 450 fe Maximum FOG 30 mg/L Type of Wastawaterl Domestic Maximum Fecal Col'dorm >10E4 cfu/100 mL 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 Alarm Should test monthly Pressure System I Laterals should be flushed and pressure tested every 1.5 years Mound Inspect for ponding and seepage once every 3 years 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 mound component manual. 2. Dispersal cell aggregate conforms to SPS 384.30 (6)(i), Ws.Adm. Code. I. At1 gra*,ity a^d pressure pipsng materials conforrsa ro the requirements in SPS 384, Wis.Adm. Cade, 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 Tern-un Detail Finished .•............•• : : .............. Grade � 1 6-8" Diameter Lawn Threaded Cleanout Sprinkler Valve Box Plug or Ball Valve Distribution Longg Sweep 90 or Two 45 D ree Bends Same Diameter as Lateral Project: Sandy Nelson Page 5 of 9 Mound System Management Plan Pursuant to SPS 383.54,Wis.Adm.Code Gm This system shall be operated in accordance with SPS 382-84 Wis.Adm.Code,and shall maintained in accordance with itscomponent manuals[SBD-10691-P(N.01101,R.11112),SSWMP Publication 9.6(01/81),and Pressure Distribution Component Manual Ver.2.0 SBD- to,,y,,tem maintenance and maintenance reporting. 10 7nS-P IN,0,1/,A!,R.i CV 12)], d 1 o-ca I or state r u I e S pertaining p,-�ay be preseint `'at could cause death. t tank since dangerous qa5es No oneshould ever enter a Septic or purnD 'rn t S-7 viim 1VV_..,j__U_ oc; -Seuii,C and DURIP tarAk abandonmen I—i"e Wit w nnA j�n rr, nnen'r Acne cbve,or e corn Anny opownc;deemeC u�risourdi,defe _8 -4,pouponth plletlonofsei'Vica A ami assessmenf�:Ah �e-Al d teft 9 e hai;be S�3f ied L an 'Kina i3re muss{t-e i epiaced. enings greater Enan 85-inches in diamezei f L"i ,i'5-wv five 1OZ- -XV0,"Od op e, OF cornooneri,. d,e,,qce i.^prevent accide.mai 'F't'J he _Fmc o P.- AM M4U_1.z i I A rij.(,n be -7de The Operating condition the septictank and outlettitte. tank shall Vhe--.!;R,pof�adof in acc-ardiancevvith NR 113,Wis,, d assessed at jea:, 0 q oni7--a every I years by inspection. st uld not be removed unless provisions �ei� ;� C! on-ed as cessary to ef-ufe P "'he 11 V-1 De ne ropei.on ration. The filter cart, To t(VT --d w-tv 4 an a;an 114 tne a rr-,At-i�in rpialn solids In th-=I -removed irorn enciL thalt may sioug'OTI"n i a,RIarff*s maav,;nticzt,- 'Fill d if ihe,:9',...�rn�s Fervice- a-se- j�,� j,an!-�e a ss,ne elan advi tam". I age u5ed,1i e Vskla-""be -ns-Dro—mr D nn�sha",be tssteeq 110 ve Th=ni AI P -jDa-T-3tion, if at,effluent-fifter Jus lmstmlipd within the tank it shal!be inspeded and se—viced as neessajil. W Asitibui lioundandi? ssureD No trees or shrubs shouid be planted on the onuutid. Plaritings may be made arouna tne mouna's Pcri-=410T;and tnc mound sh.-H be ___;,4e_.__ f;_ f,^ frost penetrgti n, T ffi (n�er th;tn fnr mvp_;_r, os; P 1 M I�. 11 mast Acf!n;nnn nni. nom rn-. be, it-ier zrstajlaltions 1,10-0 - ranigori gn;d slnnw c0mpactIon,14r-i the'win—... wea4 February)dictate that the Ww� d UV llam FOG"rS I-- _ u ,fr t qa�fty ti . Mot mn�zv�z m2l; rnnii ROD, 30 E,,QiL i-UG.and Iv" —, specified in the perrnif for m*10"si nat wa oh a fi,mhingmuni=t the end or each i teraj,a(to 4 IS!eGO(nmendeci Thai each iaterai be 'he ed, eau?i nn nacnc has nn ugn-,i-,n.-f! umn- ed to V. ais sh _e relacri Hhe OWMI,8Nd at it We dispersal cell snail tie ciPieck6d aE h levels above 6 t ocilies 00risi arad as an npending hyd;aulk_,Ulwv y me_ pian hc sy-,tern in —,;pa;;-;ed Or meppla=d 4--kc-CF-t— If tne septic Wnk-of any or pro-per operatinng cond,iUDOI 11 be immediately if the doisi�tonic Mimn, nLimo controls,alann or raiated wiring berA)rnais dejective the detective comPonent(s)shal i r@riaired or replaced with a component of the same or equal performance. tj;e ground surfam,it wili t:e repaired or I z I -S e -as C Tails j�,,c or begin-s tv-'I char�, v. -tewat r to he rnound CompQrie"m "y -,;4. 1c'n by incr_-=mg-°it in its�pfase",Ca4 a5a!a«..ea if sz�FiFue 5 of,U'hii;�,4 0,V7,- l -n j _ units are attached as separate documents and are considered part of the overall management plan for this system. GOULDS PUMPS Submersible Effluent Pump PE OFWEW PUMP_ SPECIFICATIONS MOTOR FEATURES Pump—General: General: ■Corrosion resistant • Discharge:1'h°NPT • Single phase construction. • Temperature:104°F(40°C) • 60 Hertz In Cast iron body. h; maximum,continuous when • 115 volts ■Thermoplastic impeller and fully submerged. • Built-in thermal overload{gyro- cover. • Solids handling:'ho tection with automatic reset. ■Upper sleeve and lower maximum sphere. • Class B insulation. heavy duty ball bearing • Automatic models include a • Milled design. construction. APPLICATIONS float switch. • High strength carbon steel ■Motor is permanently • Manual models available. shaft. lubricated for extended Specially designed for the *.Pumping range:see PE31 Motor service lam. following uses: - service performance chart or curve. • .33 HP,3000 RPM ■Powered for continuous • Mound Systems • 12.0 Maximum amps operation. • Effluent/Dosing Systems PE31 Pump: , Shaded a design ■All ratings are within the • Maximum rapacity:50 GPM g working limits of the motor. • Low Pressure Pipe Systems , g • Basement Draining • Maximum head:25 TDH PE41 Motor N Quick disc mect der • Heavy Duty Sump/ PE41 Pump:p• • .40 HP,3400 RPM cord,2Q standard length, Dewatenng • Maximum capacity:60 GPM • 7.5 Maximum amps levy duty 16/3 SfIW with • Maximum head:29'TDH • PSC design NEMA 5-15P,three prong, PE51 Pump: PE51 Motor. 115 volt grounding plug. • Maximum capacity:70 GPM • .50 HP,3400 RPM ■Complete unit is heavy duty, • Maximum head:37'TDH • 9.5 Maximum amps portable and compact. • PSC design ■Mechanical seal is carbon, METERS FEET ceramic,BONA and stainless 40 ;eeoUets.Peat,peat,trtst Steel. PE51 33_40,.so i ■Stainless steel fasteners. r 35 + - - ; -: —► t-2 GPM 10 AGENCY LISTINGS I t f 30 PE41 l 1 FT 1 C�p 25 ® W I Pfi3_1 --- , { -- -- t t i t_ a i us u C�tD UL 778 and 4 20! Stan�rds o t k { ) oy Canaan RmWai*AMdWon 4 ; - Frye#LRM549 15F ' Goulds P a Reid F _. 1509001 101 ...:_ t..; ( y {- { $ , OL { 0 10 20 30 40 56 60 70 GPM 80 0 5 10 15 m3/h Goulds Pumps CAPACITY D T,-,. IdAt .�.�.�Jc'•-I.�},Ch�-,/0�0 4�,�i�''.:l�.�,EOG,e'a..�.}�$ -�,�fJ0.0 _- - 4? t '8 8 __- _ 1 R> Adip Property Owne Parcel ID# S/D/�'le ®f>.rl� Page �of Boring# ❑ Boring ` ® Pit Ground surface elev. ft. Depth to limiting factor // in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure aonsistence Boundary Roots GPD/ft z Ain. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. * ff#1 * ff#2 F-I Boring# F1 Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure onsistence Boundary Roots GPD/ft z in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. * ff#1 ff#2 F-I ❑ Boring Boring# Ground surface elev. ft. Depth to limiting factor in. ❑ Pit Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure onsistence Boundary Roots GPD/ft 2 in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. ff#1 102 *Effluent#1=BOD 5>30<220 mg/L and TSS>30 <150 mg/L *Effluent#2=BOD 5<30 mg/L and TSS <30 mg/L The Dept.of Safety and Professional Services is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format,contact the department at 608-266-3151 or TTY through Relay. SBD-8330(RI1/11) Wis.Dept.of Safety and Profess S r� 9e IVEDSOIL EVALUATION REPORT Page—/ of Division of Safety and Buildings in ac((cor�rd(�a1 ce with SPS 385,Wis. Adm. Code P P p P try ffi tt 8 4 County � Attach complete site Ian on a er s a 1/2 x 11 inches in size.Plan must include,but not limited to:vertical and a,,,% ce point(BM),direction and Parcel I.D. percent slope,scale or dimensi($rTs,rulr� gandpanto nearest road. - t,r,sy}TY DE Retiiewed Date PISe '� pent all mformatio �.. Personal information you provide may be used for secondary purposes(Pr' Law,s.15.04(1)(m)). � Property Owner Property Location �� Z- ,,W Govt.Lot 1/4 1/4 S T N Ror Property Ow er's Mailing Addres Lot# I Bloc Subd.Name or CSM# City Stat Zip Code Phone Number []City ❑Village ®Town Nearest Road ❑ New Construction Use: Residential/Number of bedrooms _ Code derived design flow rate GPD ❑Replacement ❑ Public or commercial-Describe: Flood Plain elevation if applicable XZ Parent material ft• General comments and recommendations: Boring# Boring � ® pit Ground surface elev.'�� _ ft. Depth to limiting factor�!/ _in. T Soil A lication Rate Horizon Depth Dominant Color Redox Description Texture Structure onsistence Boundary Roots GPD/ft : A in. Munsell Qu.Sz. Copt.Color Gr.Sz.Sh. ' *ff#1 02 9 r/ / Z4 9 r E Boring# Boring Pit Ground surface elev. ft. Depth to limiting factor _in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure onsistence Boundary Roots GPD/ft 2 in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. ff#1 * ff#2 *Effluen 1 =BOD >30:5 220 mg/L and TSS>30 <150 mg/L *E ent#2=BOD <30 mg/L and TSS <30 mg/L CST Name �t' Signature t CST Number Address Date Evaluation Conducted Telephone Number SBD-8330(RI 1/11) I I.. i i f I I I i I I , I 'l I i I I I , i I I I I I i- i I I I - I I ILl AL I --- - - --- — — -- - I E - l 1 I ---� --- - a- -- Z -- — -- -Le 1141z- I ' 1 ;I I x � rd�:9 � I r i -I � i Parcel #: 038-1015-60-000 os/2o/zoP AGE E I AM P 1 OF 1 Alt. Parcel M 03.31.18.42B 038-TOWN OF STAR PRAIRIE Current ❑X 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 O-NELSON, STUART A&SANDRA L TR STUART A&SANDRA L TR NELSON 1626 SEQUOIA LN NEW RICHMOND WI 54017 Property Address(es): '=Primary *1138CTYRDH Districts: SC=School SP=Special Type Dist# Description SC 3962 SCH DIST NEW RICHMOND SP 1700 WITC Notes: SP 8050 CEDAR LAKE/N R Legal Description: Acres: 0.000 SEC 3 T31 N R1 8W PART OF GI-4 AS DESCRIBED IN VOL 556 PAGES 422,423, &424 Parcel History: ASSESSED WITH P42A Date Doc# Vol/Page Type 04/14/2006 822836 QC 06/30/1977 541204 556/422 WD Plat: *=Primary Tract: (S-T-R 40%160'/.GL) Block/Condo Bldg: *N/A-NOT AVAILABLE 03-31 N-1 8W 2014 SUMMARY Bill M Fair Market Value: Assessed with: 0 Valuations: Last Changed: 09/13/2011 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 0.000 173,900 137,100 311,000 NO Totals for 2014: General Property 0.000 173,900 137,100 311,000 Woodland 0.000 0 0 Totals for 2013: General Property 0.000 173,900 137,100 311,000 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch#: 502 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 CD 4:w tie�a 'I�D ;0 c� ll� 100 r N D � N ZL N 1T7 I 00 'A i 150.00 r, r0 to ST. CROIX COUNTY SEPTIC TA2\K t\ ALLrT ENANCE AGREEMENT AND 0 ERSHIP CERTIFICATION FORM Gl VIWO- owner/Buyer Mailing Address ,+7yl E- property,Property Address trom Planning&Zoning Department for new construction.) - '�'erificasion required - City/State �� ( Parcel Identification Number LEGAL DESCRIPTION 1/4 , Sec. .� : T-,L_N R2 —W,Town of Property Location _ Subdivision Plat: A ' ,Lot# Certified Survey Map # Volume ,Page# i 2-00 6 F 7 2 e 007)Volume ,Page# Warranty Deed# D � / � � ore ) lum Spec house C?yes no Lot lines identifiable es 0 no SYSTEM MAT1�''I'ENANCE AND O W7NER 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(3)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 18 full of sludge. Uwe,the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forte,herein, as set by the Department of Safety And Professional Services and the Department ofNatural 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. Uwe certify that all statements on this form are true to the best of my/our knowledge. Uwe am/am the owners)of the property described above,by virtue of a warranty deed recorded in Register of Deeds Office. Num%::;;OF APPLICdANT(S)E 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.04112) KATHLEEN H. WALSH REGISTER OF DEEDS State Bar of Wisconsin Form 3-2003 ST. CROIX Co., MI QUIT CLAIM DEED RECEIVED FOR RECORD 04/14/2006 10:10AM DocumentNumber Document Name QUIT CLAIM DEED EXEMPT # 16 THIS DEED,made between Stuart A.Nelson and Sandra L.Nelson,husband REC FEE: 15.00 and wife TRANS FEE: ("Grantor,"whether one or more), COPY FEE: CC FEE: and Stuart A.Nelson and Sandra L.Nelson,trustees,or their successors in trust, PAGES: 3 under the Stuart A.and Sandra L.Nelson Living Trust dated April 28,2005,and any amendments thereto, ("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 Joseph P.Earley J See attached addendum,which is incorporated herein. Langlais&Schumacher,P.A. Q71 539 South Knowles Avenue New Richmond,WI 54017 038-1015-30-000:038-1015-50-000:038.1015-60-000 Parcel Identification Number(PIN) This is homestead property. (is)(is not) Dated August 3,2005 1 (SEAL) (SEAL) *Stuart A.Nelson i y rl v r� q` L,_,&_", (SEAL) (SEAL) *Sandrr a L.]Nelson AUTHENTICATION ACKNOWLEDGMENT Signature(s)Stuart A. Nelson and Sandra L.Nelson, STATE OF WISCONSIN ) husband and wife ss. authenticated n Au ust 3.2005 COUNTY ) Personally came before me on *J s h P. Earley I the above-named IT E: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 the same. THIS INSTRUMENT DRAFTED BY: Joseph P.Earley New Richmond.WI 54017 Notary Public,State of Wisconsin My Commission(is permanent)(expires: ) (Signatures may be authenticated or acknowledged. Both are not necessary.) NOTE: THIS IS A STANDARD FORM. ANY MODIFICATIONS TO THIS FORM SHOULD BE CLEARLY IDENTIFIED. QUIT CLAIM DEED V 2003 STATE BAR OF WISCONSIN FORM NO.3-2003 1 Fjpe name below signatures. LEGAL#1 All of those portions of Government Lot Four(4),Section Three(3),Township Thirty-one North(31N),Range Eighteen West(18W),in the County of St.Croix in the State of Wisconsin,described as follows,to-wit: PARCEL A: Commencing at the intersection of the center line of Highway H as presently laid and travelled,with the west line of said Gov't.Lot 4,which point is also 2088'North of the Southwest corner of the SE 1/4 of the SW 1/4,Section 3,T3 IN,R18W;thence N59°23'along the center line of said Highway H a distance of 724.15';thence N66°15'E along the said center line a distance of 10.29';thence N5O°5O'E a distance of 89.45';thence N44°41'a distance of 35.60'to the Southwest comer of the lot of Frederick S. Roesler and the ja tt of f beginning;,thence N44°23'W along the West line of the said Roesler lot a distance of 150.90';thence S21°42'E a distance of 147.40';thence N81°43'E a distance of 26.29';thence N44°41'E a distance of 35.6'to the point of beginning, PARCEL B: Commencing at the intersection of the East line of said Government Lot Four(4)with the Northerly right-of-way line of County Highway"H",and running thence Northwesterly by a deflection angle of seventy-four degrees thirty-four minutes(74°34')Four hundred five(405)feet to an iron pipe- monument set on the Northerly right-of-way line of said Highway"H",said deflection angle being measured from the North toward the West; Thence by a deflection angle of twenty-three degrees(23*)to the left Two hundred eight and four-tenths (208.4)feet to an iron pipe monument set on the Northerly right-of-way line of said Highway"H"; Thence by a deflection angle of One hundred thirty degrees forty-three minutes(13°43')to the right Thirty- five and six-tenths(35.6)feet to an iron pipe monument,said iron pipe monument being the POINT OF BEGINNING. Thence by a deflection angle of two degrees thirty-seven minutes(2°37')to the left One hundred twelve (112)feet to an iron pipe monument; Thence by a deflection angle of forty-two degrees eleven minutes(42°11')to the Ieft Two hundred seventy and nine-tenths(270.9)feet,more or less,to the shoreline of Cedar Lake; Thence Southwesterly along said shoreline of said lake to its intersection with a straight line drawn from the point of beginning,said straight line being drawn at an angle of eighty-six degrees twenty-seven minutes (86°27')from the Southeasterly boundary line of the tract herein described; Thence Southeasterly along said straight line Two hundred three(203)feet,more or less,to the Point of Beginning; EXCEPT THAT PART OF PARCEL B,described as follows: Commencing at the intersection of the center line of Highway H as presently laid and travelled,with the West line of said Gov't.Lot 4,which point is also 2088'North of the Southwest comer of the SE 1/4 of the SW 114,Section 3;T3 IN,RI 8W;thence 59°23'E along the center line of said Highway H a distance of 724.15';thence N66*151 along the said center line a distance of 10.29%thence N50°50'E a distance of 89.45';thence N44°41'E a distance of 35.6'to the Southwest corner of the original lot of Frederick S. Roesler;thence N44°23'along the West line of said lot a distance of 150.90'to the point of beginning; thence continuing N44°23'W a distance of 52.10'to the shore line of Cedar Lake;thence N4'01'E along the shore line of said Cedar Lake a distance of 46.25';thence S21°42'E a distance of 89.80'to the point of beginning. PARCEL C: Commencing at the intersection of the East line of said Government Lot Four(4)with the Northerly right-of-way line of County Highway"H",and running thence Northwesterly by a deflection angle of seventy-four degrees thirty-four minutes(74°34')Four hundred five(405)feet to an iron pipe monument set on the Northerly right-of-way line of said Highway"H",said deflection angle being measured from the North toward the West; Thence by a deflection angle of twenty-three degrees(23')to the left Two hundred eight and four-tenths (208.4)feet to an iron pipe monument set on the Northerly right-of-way line of said Highway"H",and said iron pipe monument being the POINT OF BEGINNING. Thence by a deflection angle of One hundred thirty degrees forty-three minutes(130°43')to the right Thirty-five and six-tenths(35.6)feet to an iron pipe monument; Thence by a deflection angle eighty-nine degrees four minutes(89°4')to the left to a point which is twenty- 670433.1 2of3 \ y five(25)feet distant from the line last described as extended when measured at right angles thereto; Thence in a Southwesterly direction along a line parallel to and twenty-five(25)feet distant from the Southeasterly boundary line of the tract hereby described to the Northerly right-of-way line of County Highway"H"; Thence along said Northerly right-of-way line to point of beginning. All according to the U.S.Government Survey thereof. Above bearings based on West line of Gov't.Lot 4 being due North and South. LEGAL#2 Part of Government Lot"4"of Section 3 Township 31 North,Range 18 West described as follows: commencing at the intersection of the center line of Highway "H" as presently laid and travelled with the West line of said Government Lot "4" which point is also 2088 feet North of the Southwest corner of the Southeast Quarter of Southwest Quarter(SE 1/4 SW 1/4),Section 3 Township 31 North,Range 18 West;thence North 59°23'East along the center line of said Highway"H"a distance of 643.45 feet to the point of beginning;thence North 21°42'West a distance of 213.70 feet to the shore line of Cedar Lake;thence North 68°12'East along the shore line of said Cedar Lake a distance of 90.01 feet to the West line of Parcel owned by Conservation Department; thence South 21°42' East along said West line of Conservation Department parcel a distance of 201 feet to the center line of Highway"H";thence South 66°15' West along said center line a distance of 10.29 feet;thence South 59°23' West along said center line a distance of 80.70 feet to the point of beginning. St.Croix County,Wisconsin (Above bearing based on the West line of Government Lot"4"being due North and South. Above description also included a part of the right of way of Highway"H".) 670433.1 3of3