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HomeMy WebLinkAbout012-1037-30-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division Sanitary Permit No: INSPECTION REPORT 574348 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: Ter Rae Farms, Inc., c/o Dennis Mitchell Erin Prairie, Town of 012-1037-30-000 CST BM Elev: Insp.BM Elev: BM Descriptio - Section/Town/Range/Map No: G6-r 15.30.17.235D TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION c,633 /0 I FS ELEV. Septic I /D� Benchmark 4 /Q Z, bra Dosing j Alt.BM ;Il.�Bldg.Sewer z3 M n, 1j � 0✓l �lO�L► 95. r� Holding SUHt Inlet k -94. 7— D k' '5Z VIR�I. TANK SETBACK INF RMATION St/Ht Outlet TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic 51 �� _ Dt Bottom Dosing i Header/Man. e! 4 s44 Aeration Dist. Pipe / Z17 Add O Holding Bot.System 3V. 3 Gq Final Grade L •Z 16 ,I /r Vol PUMP/SIPHON INFORMATION 7 Manufacturer / o J`D� GPrin�and St Cover�'� � 5. 1 /01, 2� Model Number V 6PO44 1-3, Co 4-. r 13- 3 '=t-1 •3 TDH Lift ZS Friction Los System Healds t TDV7 ,4 Forcemain Length / Dia. i/ Dist.to Well x;/ 5 SOIL ABSORPTION SYSTEM BED/TRENCH Width r Length No.Of nch PIT DIMENSIONS No.Of Pits Inside Dia. Liquid Depth DIMENSIONS —7 7Z • SETBACK SYSTEM TO P/L JBLDG WELL LAKE/STREAM CHAMBER OR Manufacturer: INFORMATION Type Of ystem:� 157 ' 1 G 7 /_ � UNIT Model Number: � DISTRIBUTION SYSTEM Wei IA.Q0A-' �7 x Hole Size x Hole Spacing Ve Air Intak Header/Manifold Distribution 9J `_ Liz- SOIL �/Len th Dia Length a Spacing COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center A -7? Bedlrrench Edges Topsoil , � Yes �] No T� Yes f;J No COMMENTS: (Include code discrepencies,persons present,etc.) Inspectio;#l,: 9 / / ' Inspection#2:Location: 1864 Cty. Rd.G , e Richmo d,WI 54017(SW 1/4 SE 1/4 15 T30N R17W) 18, ounds L Parcel No: 15.30.17.235D 1.)Alt BM Description= / 2.)Bldg sewer length= 51 -amount of cover Plan revision Required? Yes No - Use other side for additional information. Aj Date Insepctors Sign re Cert.No. SBD-6710(R.3/97) I P 528 ft. PE age 8 of 8 Sanitary Site Plan For: Dennis Mitchell Ter-Rae Farms Inc. Parcel in the SWI/4-SEI/4 Sec. 15 T30N-R17W o so 40 Town of Erin Prairie-St. Croix County i G-phio Sank (Feet) 1 inch= 40 R Proposed Tx 72'At-Grade Mound Cell w/a System Elev. of 99.30' Proposed Wieser Concrete WLP1000 1600 Gal. Combination Tank w/a Poly-Lok PL-525 Filter Power Pole 1.5 Acre Parcel Garage cQ" BM Abandon failing system per SPS WELL 383.33 S ` Existing 1 Septic 495 ft. Two Bedroom Home \ Proposed 4"Sch. 40 Bldg. Sewer 100.00 proposed 2"Sch. 40 F.M. #2 Note:Provide frost protection per SPS 383.43(8)(4)c and insulate bldg. sewer per SPS 99.00' 382.30(11)(c) Cemetary 98.00' Tree Line A BM=Top of 11/411 Iron Pipe 495 ft. BRP=Same ASSUMED ELEV.= 100.00' /L FN#1864 County Rd. G , =Backhoe Pit ® Telephone Ped Elevation Data P/L A BM#2 B#1 =99.40' B#2=99.40' C/L of County Rd. G B#3 =98.20' BM#2=Top of Telephone Ped Elev. =99.60' Top of Septic Vent= l OL2.10�„' `�� Y County A7 Safety and Buildings Division , +, ;, No 'y4�,� '�� 201 W.Washington Ave., P.O. Box 7162 Sanitary Permit Number(to be filled in by Co.) '; ► Madiso W�57-7162 -7113 �/J' _ Si.r ,Sa11- tar f Lffinit Applica ion State Transajctio Number In accordance 383.21(2),Wis.Adm.Code,submission of this form to the appropriate governmental unit / 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 / purposes in accordance with the Privacy Law,s.15.0 1 m,Stats. L Application Information-Please Print All Information Property Owner's Name Parcel# l r "�/l ! tiG- ,_ G�e Q? ..nom -DO Property Owner's Mailing Address W Q� 3"2— Property Location 235-0 Govt.Lot City,State Zip Code Phone Number y y, Section (circle one IL TX.pe of Building(check all that apply) Lot# T N; R /T7 E o or 2 Family Dwelling-Number of Bedrooms — ( /,S A Subdivision Name t:XIsT-/A�r" ,� /VJO lock# .4 _b/Z4.11 ❑Public/Commercial-Describe Use El city of ❑State owned-Describe Use CSM Number El Village of ` E Town of C-/'L07 d III.Type of Permit: (Check onl o online A. Complete line B if applicable) A. ❑New System a lacement System y p y ❑Treatment/Holding Tank Replacement Only El other Modification to Existing System(explain) B. ❑Permit Renewal ❑Permit Revision ❑Change of Plumber ❑Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Owner V�/it�V OJVFII-' IV.Tvve of POWTS S stem/Com onent/Device: Check all that app,1 ❑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(explai ❑Pretreatment Device(explain) V.Dis ersaUTreatment Area Information: Design Flow(gpd) Design Soil Application Rate(gpdsf) Dispersal Area Required(sf) Dispersal Area Proposed(sf) System Elevation VI.Tank Info Capacity in Total #of nufacture Gallons Gallons Units U y New Tanks Existing Tanks c y ° a 0 Septic or Holding Tank 0 C-) 0OD r Dosing Chamber C70 m VII.Responsibility Statement-I,the undersigned,assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name(Print) / Plumber' 'Signa MP//MPRS�JNumber Business Phone Number A/C s A n 4e 0 /f Qq Plumber's Address(Street,City S te,Zip Code) f 9s1� 1 Z=S VIII. otm /De artment Use Only Permit Fee Date Issued suing Agent S pproved ❑Disapproved $ _ 77 ,/ ❑Owner Given Reason for Denial IX.Conditions of Approval/Beasons for Disapproval SYSTEM OWNER; 1.Septic tank,effluent filter and t/t11i1/� dispersal cell must to 1 rv_iced/maintained 3,r3- 3 as per management plan provided by plumber. o - C;.y{L(tif� �lid f��p I o p stem and submit to the County only on paper not less than S Liz 11 inches in size as per applicable co a or inances. SBD-6398(R. 11/11) KEITH E KNUDTSON Page 2 7/29/2014 , Owner Responsibilities: • The current owner,and each subsequent owner,shall receive a copy of this letter including instructions relating to proper use and maintenance of the system. Owners shall receive a copy of the appropriate operation and maintenance manual and/or owner's manual for the POWTS described in this approval. • The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s. SPS 383.54(1). • In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard,the property owner must follow the contingency plan as described in the approved plans. • The owner is responsible for submitting a maintenance verification report acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. In granting this approval the Division of Industry Services reserves the right to require changes or additions should conditions arise making them necessary for code compliance.As per state stats 101.12(2),nothing in this review shall relieve the designer of the responsibility for designing a safe building,structure,or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below,or at the address on this letterhead. The above left addressee shall provide a copy of this letter and the POWTS management plan to the owner and any others who are responsible for the installation,operation or maintenance of the POWTS. SiOerard ely, Fee Required$ 250.00 • This Amount Will Be Invoiced. M Swim When You Receive That Invoice, POWTS Plan Reviewer,Integrated Services Please Include a Copy With Your (608)789-7892,Mon-Fri, 7:15 am-4:00 pm Payment Submittal. jerry.swim @wisconsin.gov WSMART code:7633' cc: Edwin A Taylor,Wastewater Specialist,(715)634-3484,Monday-Friday 8:00 am To 4:30 pm I' 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. pEyART.4IgN DIVISION OF INDUSTRY SERVICES g3° Toy 3824 N CREEKSIDE LA HOLMEN WI 54636 Contact Through Relay www.dsps.wi.gov/sb/ 'y + www.wisconsin.gov �OssroN�tis� Scott Walker,Governor Dave Ross,Secretary July 29,2014 CUST ID No. 648443 ATTN:POWTS Inspector ZONING OFFICE KEITH E KNUDTSON ST CROIX COUNTY SPIA 927 150TH ST 1101 CARMICHAEL RD ROBERTS WI 54023 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 07/29/2016 SITE: Identification Numbers Dennis Mitchel Transaction ID No.2434987 1864 County Rd G Site ID No. 804193 Town of Erin Prairie Please refer to both identification numbers, St Croix County above,in all correspondence with the agency. SW1/4, SE1/4, S15,T30N,R17W FOR: Description: Two Bedroom At-grade System/8%slope Object Type:POWTS Component Manual Regulated Object ID No.: 1494243 Maintenance required; Replacement system; 300 GPD Flow rate; 40 in Soil minimum depth to limiting factor from original grade; System(s):At-grade Component Manual,Version 2.0, SBD-10854-P(N.03/07,R. 1/12),Pressure Distribution Component Manual-Ver.2.0, SBD-10706-P(N.01/01,R. 10/12); Effluent Filter The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. This system is to be constructed CONO17-1 and located in accordance with the enclosed approved plans and with any component manual(s)referenced above. APPRI The owner,as defined in chapter 101.01(10),Wisconsin Statutes, is responsible for compliance with all code IDEPj OF SA requirements. 01V PROFESSIONA No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.14 SON OF 1,V t stats. The following conditions shall be met during construction or installation and prior to occupancy or use: AEE C RRES P • A sanitary permit must be obtained from the county where this project is located in accordance with the O 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. ♦ r RESIDENTIAL AT-GRADE DESIGN Pressurized-Sloping Site INDEX AND TITLE SHEET Project Ter-Rae Farms Inc.Re tacement At-Grade Mound Owner Dennis Mitchel Address 1530190th St. New Richmond WI 54017 715-246-5514 Real Property Address 1864 County Rd G Legal Description Part of the SW1f4-SE1/4 Sec. 15 T30N-R17W NALLY Township Erin Prairie County St.CrL](. n Subdivision Name Lot No.�ETY AND J Parcel ID Number 012-1037-30000 'TRY SERVICES Plan Transaction Number _ Index sheet P ENGE Calculations Pag At-grade drawings Page 3 Laterals and dose tank page 4 Specifications Page 5 Management&contingency plan Page 6 Pump curve&specificatioon� ns Page 7 Plot Plan Page 8 Designer Keith n tsan License Number MPR#648443 Signature Phone Number Date 06/22114 Designed pursuant to: At-grade Component Manual Ver.2.0 for POWTS SBD-10854-P(N.03107),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) Version 7.0(03112) Page 1 of 8 PRESSURIZED AT-GRADE DESIGN At-grade Design Worksheet-Sloping site Flows and Site Data Entry. (r or c) r Residential or commercial? 200.0 Estimated wastewater flow(gpd) 300.0 Design wastewater flow(gpd) 8.00 %Site slope 99.301 Contour elev. below iateral(ft) 40.00 I Depth to limiting factor(in) 0.60 In-situ soil application rate(gpdtft42) Distribution Cell InformatIon (1 or 2) 1 Influent wastewater quality 10.00 Linear loading rate gpdtft T.00 Effective absorption width (ft) 10.00 Max. effective width permitted(ft) 72.00 Aggregate length(ft) Pressure Distribution Data Entry (c or e) c Center or end lateral connection 2 Number of laterals 0.188 Orifice diameter(in)e.g. 0.25 Not a final 2.00 Estimated orifice spacing(ft) calculation 2.00 Forcemain diameter(in) 2.43 Forcemain flow velocity(ft/sec) 15.00 Forcemain length (ft) y or n Does forcemain drain back? 91 AO Pump tank elevation(ft) y or n Are laterals at highest point? 3.25 System head(ft)x 1.3 NA 7.80 Vertical lift(ft) 2.4 Forcemain drainback(gal) 0.19 Friction loss(ft) 32.0 5x Lateral void volume(gal) 0.00 In-line Filter Loss(ft) 34.4 Minimum dose volume(gal) 11.241 Total dynamic head(ft) 23.8 System demand(gpm) Lateral Diameter Selection Gallons/inch Calculator(optional) Pipe diameter Design opum Design choice Total Tank Capacity(gal) Designer 1 in Total Working Liquid Depth(in) must select 1.25 in x Gal/in (enter result in cell G46) one lateral 1.5 in x x diameter 2 in x Treatment Tank Information 3 in x 1000 Se tic tank capacity(gal) Wieser Concrete Manufacturer Effluent Filter information Dose Tank Information Pol -Lok 1 Filter manufacturer 603-41 Dose tank capacity(gal) PL-525 Filter model number 16.8 Dose tank volume(gain) Wieser Concrete Manufacturer Project: Ter-Rae Farms Inc.Replacement At-Grade Mound Page 2 of 8 Transaction Number: r , AT-GRADE PLAN VIEW D A 7. 1/6 B Observation pipes(2 typical) 00 ft D B 722..00 ft 1/6 C 12.00 ft T T 9.00 ft W c D 5.00 ft E 2.00 ft L 82.00 ft D B W 19.00 It A x B 500.00 ft1%2 L T E--- Cap Typical obs.pipe. =Total aggregate cell A x B slotted in the lowers~,and 0 anchored securely. =Plowed area L x W s^ AT-GLADE CROSS SECTION Svnthetic fabric cover 101.09 ft Finished grade elevation Lateral invert elev. 99.80 ft '' . -- Observation pipe at aggregate toe E ` 8 %Slope Surface contour 89.30 ft C A and system D —+ elevation = 12 in. topsoil and subsoil plowed layer over aggregate and tapered to toes. below L x W 6 in. aggregate below pipe(s),and 2 in. above pipe. Project: Ter-Rae Farms Inc.Replacement At-Grade Mound Page 3 of 8 Transaction Number: PRESSURE DISTRIBUTION AND DOSE TANK Lateran olagram-Center Connection i P x1241 Laterals&force main of PVC Sch 40 Ust hole 0110d r*A to end cap per SRS Table 304.4.6 Holes dnlkd onthebottomOfthelateral. • Turn-up wtbailvelvsoral®enoutplug eVa4 sp ed Ltltefali 5pec"witions meter in Center Lateral connection point 0.18$ Orifice dla ( ) X 1.99 Orifice spacing(ft) 2 Number laterals 18 Orifices/iateral P 34.83 Lateral length(ft) 11.9 Lat.discharge rate(gpm) 1.50 Lateral diameter(in) 2.00 Forcemain diameter(in) 23.8 Sys. discharge rate(gpm) 15.00 Forcemain Length (ft) 11.24 TDH (ft) Typical Pump Chamber Layout Approved manhole cover with Weather-proof warning label and locking device junction box 4„ Final grade disconnect Tank component is Alternate property outlet Y vented location 18" min. Electrical as per NEC 300 and /r Approved SPS 316.300 WAC owe Tank full joint Inches Gallons JA Provide 114" A 19.9 333.8 weep hole or o Alarm on antisiphon Float Options .m B 2.0 33.6 Pump on B device. C 2.0 6"3*4 _ C Ax 18®43" 308.89 gal. � D 13.0 201.6 92.00-ft-�- B= 211 33,52 gal. 's- b Totals 35.9 603.4 Pump off C = 3.57" 59.83 gal• 7 D D = 12ty 201.12 gal. 3"Bedding under tank ~— 91.00 ft Goulds Pump manufacturer SJE Rhombus Alarm manufacturer EPA Pump model number Tank Alert 1 Alarm model number Project: Ter-Rae Farms Inc.Replacement At-Grade Mound Page 4 of 8 Transaction Number. Akgrade Svstem Maintenance and Operation Specifications Service Provider's Name Powers Sanita&oni�n �� Phone F71 5-246-5738 POWTS Regulator's Name St Croix Coun Phone 5-386-4680 Svetem Flow and Wgd Parameters Design Flow-Peak 300 gpd Maximum Influent Particle Size 1/8 in Estimated Flow-Average 200 gpd Maximum BOD5 220 mg/L Septic Tank Capacity 1000 gal Maximum TSS 150 mg/L Soil Absorption Component Size 500.0 ftz Maximum FOG 30 mg/L Type of Wastewater Domestic Maximum Fecal Coliform >10E4 cfu/100 mL Servi__ ce Freauoncv Septic and Pump Tank Inspect and/or service once every 3 years Effluent Filter Inspect and clean at least once every 3 years Pump and Controls Test once every 3 y ears Alarm Should test month Pressure System Laterals should be flushed and ressure tested eve 1.5 ears Mound Ins ect for ondi and seepage once eve 3 ears Other 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 at-grade component manual. 2. Dispersal cell aggregate conforms to SPS 384.30(6)(i),Wis.Adm. Code. 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 at-grade structure and other disturbed areas will be seeded and mulched to prevent soil erosion and help reduce frost penetration. 6. Areas within 15 feet of the downslope toe will be protected from compaction. 7. Ali other construction details are as per the at-grade component manual SBD-10854-P (N. 03/07), Let oral Turn ugl Detall Finished 0*60960060006*0 Grade of . . . . . . . : Threaded Cleanout 6-8 Diameter Lawn Plug or Ball Valve Sprinkler Valve Box Distribution _�► Long Sweep 90 or Two 99.80 ft ____ ----� ----� 45 Degree Bends Same Diameter as Lateral Project: Ter-Rae Farms Inc.Replacement At-Grade Mound Page 5 of 8 Transaction Number. At-grade System Management Plan Pursuant to SPS 383.54,Wit.Adm.Code Gemral This system shall be operated in accordance with SPS 382-384m.Code,and shall maintained in accordance with its'component 7 SSWMP Pub.9.6(01/81),and Pressure Distribution Component Manual Ver.2.0 SSO-10706(N.01101)] B 10854-P N 0310 ), manuals[S D- 1 rules pertaining to system maintenance and maintenance reporting. and loco or state perta tng death. dangerous axes ma be pres present-that could cause u tank since g Y No one should ever enter a septic or pump 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 oomponeMS. 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 shalt 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 efti9ctive locking device to prevent accidental or unauthorized a"Into a tank or component. I Sic TA.-L The septic tank shall be maintained by an individual certified to service septic tanks under s.281.48,State T se tic The contents of the p 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 bast once every 3 years by inspection. The outlet fitter shall be deemed 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 fitter is equipped with an alarm,the ' ntfilter alarms may indicate surge Rows or an impending continuous filter shall be serviced if the alarm a8 activated continuously. Intermrtte Y alarm. The septic tank shall have its contents removed when the volume of sludge and scum in the tank exceeds 1/3 the liquid volume of the tank. If the contents of the tank are not removed at the time of a triennial assessment,maintenance personnel shall advise the owner of 1 when the nerd service needs to be performed to maintain lass 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 Department of Commerce. PUrnu Tank The pump(dosing)tank shall be inspected at least once every 3 years. All switches,alarms,and pumps shall be tested to verify proper operation. If an effluent filter is installed within the tank it shall be inspected and serviced as necessary. rode s meter,and the at-grade shall be No trees or shrubs should be planted on the at-grade. Plantings may M mare grunt the all-grafts part , seeded and mulched as necessary to prevent erosion and to provide some protection from frost penetration. Traffic(other than for vegetative maintenance)on the at-grade 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 at- grade be heavily mulched as protection from freezing. exceed 220 m SODS 150 m /L TSS,and 30 FOG for septic tank effluent or 30 Influent quality into the at-grade system men not exoe g/L 9 m8/L mg/L SODS 30 mg/L TSS,10 mg/L FOG,and 104 cfu/100 mL for highly treaied 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 and of each lateral,and it is recommended that each lateral be flushed of accumulated solids at bast once every 18 months. When a pressure test is performed it should be compared to the Initial test when the system was installed to determine If orifice clogging has occurred and If orifice cleaning is required to maintain equal distribution within the dispersal cell. Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the owner,and any levels above 4 inches considered as an impending hydraulic failure requiring additional,more frequent monitoring. Continaem Plan If the septic tank or any of lts 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 some or equal performance. If the at-grade component falls 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 renovating the biologically clogged absorption and dispersal media,installing new piping,and replacing other components as deemed necessary to bring the system into proper operating condition. See page 5 of this plan for the name and telephone number of your local POWTS regulator and service provider. Project: Ter-Rae Farms Ina.Replacement Transaction Number: Page 6 of 8 Page of 8 [RGOULDS PUMPS Submersible Effluent Pump 3871 EP04 EP05 APPLICATIONS •fully submerged in high ■EP05 Impeller:Thermoplas- ■Bearings: Upper and lower grade turbine oil for tic enclosed design for heavy duty ball bearing Specifically designed for the lubrication and efficient improved performance, construction. following uses: heat transfer. ■Casing and Base:Rugged • Effluent systems thermoplastic design provides AGENCY LISTING • Homes Available for automatic and superior strength and corrosion • Farms manual operation.Auto- resistance. Candim standards Asmaanon • Heavy duty sump matic models include Motor Housing:Cast iron (CSA listed model numbers end • Water transfer Mechanical Float Switch reset at the for efficient heat transfer, in"C"or"F".) • Dewatering assembled and th,and durability. factory. strength, ins SPECIFICATIONS ■Motor Cover:Thermoplastic co PIMP is 50 soot AmOswed FEATURES cover with integral handle and •Solids handling capability: — fioat switch attachment points. 'f4'maximum. ■EP04 impeller:Thermoplas- m Power Cable:Severe duty •Capacities:up to 60 GPM. tic Semi-open design with rated oil and water resistant. •Total heads:up to 31 feet. pump out vanes for mechanical •Discharge size:1'12"NPT. seal protection, •Mechanical seal:carbon- rotary/ceramic-stationary, BUNA-N elastomers. • Temperature: 104`7 (40%)continuous METERS FEET 140°F(60°C)intermittent. 10 •Fasteners:300 series _ stainless steel. 9 30 s ornn •Capable of running dry without damage to a 2.5 rT , components. 25 a Motor: 6 20 •EP04 Single phase:0.4 HP, — 115 or 230 V,60 Hz,1550 s l RPM,built in overload with o 1 s -- automatic reset. 4 a , •EP05 Single phase:0.5 HP, o 115 V or 230V,60 Hz,1550 3 10 1 RPM,built in overload with EP04 automatic reset. z •Power cord:10 foot s standard length, 1613 1 ...__.. SJTOW with three prong ..... grounding plug.Optional 20 0 00 10 20.... 30 40 so GPM foot length,1613 SlfW with three prong grounding plug o 2 4 6 e 10 12 m3/h (standard on E1305). CAPACITY Goulds Pumps ®2001 Goulds Pumps <& ITT Industries Effective May,2001 93871 528 ft. P/L Page 8 of 8 Sanitary Site Plan For: Dennis Mitchell Ter-Rae Farms Inc. Parcel in the SW1/4-SE1/4 Sec. 15 T30N-R17W o so 40 Town of Erin Prairie-St.Croix County Graphic Miele (Peet) 1 inch 40 & Proposed Tx 72'At-Grade Mound Cell w/a System Elev. of 99.30' Proposed Wieser Concrete WLPI000 1600 Gal. Combination Tank w/a Poly-Lok PL-525 Filter Power Pole 1.5 Acre Parcel Garage cQ� BM Abandon failing system per SPS 383.33 WLLL as Existing Septic 495 ft. B Two Bedroom Home \ ` Proposed 4"Sch. 40 Bldg. Sewer 100.00 proposed 2"Sch. 40 FM #2 Note:Provide frost protection per SPS 383.43(8)(4)c and insulate bldg. sewer per SPS 99.00' 382.30(11)(c) Cemetary 98.00' Tree Line A BM=Top of 1 1/4"Iron Pipe * HRP=Same 495 ft. ASSUMED ELEV.= 100.00' FN#1864 County Rd. G ' =Backhoe Pit P/L Telephone Ped Elevation Data p/L A&BM#2 B#1 =99.40' 13#2=99.40' B#3 =98.20' CIL of County Rd. G BM#2 =Top of Telephone Ped Elev. =99.60' Top of Septic Vent= 102.10' ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer Dennis Mitchell _,, T�-� - 1(e�C reel-n s Mailing Address 1530 190th St. og q q() jjb-W (Z rc/a/ty AJ D Property Address 1864 Co. Rd G (Verification required from Planning&Zoning Department for new construction.) /D 3 7 -3a-060 City/State New Richmond Wi. parcel Identification Number LEGAL DESCRIPTION Property Locatiorcj�'/a, 5-2�%a , Sec. T N R_Z2 W, Town of Subdivision Plat: ItIZ464 tS4 t1;'U0 o Lot# Certified Survey Map# ,Volume ,Page# Warranty Deed# : 0 (before 2007)Volume 3 ,Page# 547 Spec house 17yesEho Lot lines identifiable Qyes[3no 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 1.2-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. Uwe,the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth,herein,as set by the Department of 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 owners)of the property described above,by virtue of a warranty deed recorded in Register of Deeds Office. Number of bedrooms 2 /o /z! / 13 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. 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Pad 5 gall c (� i VW 45 h a a� a = s s RX 01w,'LLOATION FUR YAANSFER OF PAOPEOTY U� JOINTTENANT, L-IFE TENANT,0R.REMAtMQERi AM1f ($erttsn 8tt7,04, 3tlist orasin Statutes) Aff* Wlkacton aad S10 Fee with Regisrer•of Der?ds:' fl8'E$T}iE PROPERTY LISTED BELOW CONSTITUTE ALL-OF ¢- THt PRO&TY. WHICH'AE DECEDENT OWNED AN:Y - #NTE tE$T AT THE DATE OF DEATJ4? Q Yi:S 9NQ ,- cleat Dite of Deeih'. Soo' Sec*ity Nut}itier y>` __Anna J. !death 11 9 73 Address of Decedent at Date of Death City - State cyip Cods x ° �� d W.1.. 540 w R:°chm o e 1 Rut -s of t'S xrvir n ins Tenants,Life Tenants or Remainder men and Relatia!�ships to �dd ress of One:urvivind.Joint Tenant lift I"ena+st or Re:�ttstnder t i arnde an n indi to tenant a assts rtr) f Decedent t ca e m.er Rae Fates Inc. ' Remain'derma.n oute.A Walter F. Meath, Surviving. Life Tenant New Richmond, WI ; 5�44'1� �.�. w y � 1. Stacks,bonds,navings and checking accounts.List rate)Y givintj certficate W' sl �at`Datie Basset br Account F t,X, u and account numbers tit more space is needed,attach schedule!. Number`, of peach r" ifftr; rv� Title to said following described li..fe- estate " ` a held in Walter F. Pleath, as sole owner of the { .real estate: T Life Estate retained in that certain land contract to Ter-Rae Farms, Inc, , dated December 7, 1971 and recorded January 11, 1972 in Vol. 480, 'page 197, Document No: 3018525, on following described property: Commencing 520 feet from SW corner of 'S .4o of F . SEr of Sec. 15-30-17; thence N 1:, rods; thence E 1 rods; x�e� xQdq- f--hane-e W I rods-- point of he ToWValue . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . S jAssessed Valuation Equalized VaNe (Recording Data N "I3 See Above_ 2. Real FA-_W,i�a a uatwn — Equalized Value Recordirg:Data Estate _ Valuation — Equalized Value Recording Data DECLARATION It is declared that on the date of death the above-named deceaent and the undersigned wart,joint tenants,life tenants or remaindermen;.that this application is, to the best of my (our)knowledge and belief,true,correct and complete and is in conformity with the provisions and limitations of the Wisconsin Statutes and does no!release•any tax:(iabilities. iQt�Tenant,,Life Tenant,Remainderman Signatures(all must sig Date c. � •.� y ,�'(�(�,' 6,,-� +ttJ r Tnc. r Remainderman b SIGN:;:sa `" t:h, Surviving Life Tenant, by Patrick J. HER p �/ -rte' 11/30/84 �;> 01 &7 lJ �-Ct�f u, 3� r I certify that 1 have mailed or delivered copies of this r.'� 1984 application as provided in s.867.045(3)Wis.Stats.on Date Not , by �,. t. `Croi C ty f �'• St.� Croix County of Register of peels Reirstra, Van Dyk & Needha_p(, S.Q. This application was r1raf ted by (print or type name) New R4 chmond, :+JI 54017 --- ' k,Iniv�l A t Parcel #: 012-1037-30-000 11/15/2013 08:11 AM PAGE 1 OF 1 Alt. Parcel#: 15.30.17.235D 012-TOWN OF ERIN 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-TER-RAE FARMS INC TER-RAE FARMS INC 1490 190TH ST NEW RICHMOND WI 54017 I Districts: SC=School SP=Special Property Address(es): *=Primary Type Dist# Description *,15394Q@T4-8T' SC 3962 SCH DIST NEW RICHMOND SP 8020 UPPER WILLOW REHAB DIST N SP 1700 WITC I cription: Acres: 1.500 Plat: N/A-NOT AVAILABLE EC 1;SVW, 30N R17W SW SE OM 520 FT E Block/Condo Bldg: CO RNER .7 N 15 RDS, E 16 RDS S 15 RDS,TH W 16 RDS TO POB 1.5 Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) AC 15-30N-17W Notes: Parcel History: Date Doc# Vol/Page Type 07/23/1997 703/566 2013 SUMMARY Bill#: Fair Market Value: Assessed with: 0 Valuations: Last Changed: 09/01/2009 Description Class Acres Land mprove Total State Reason RESIDENTIAL G1 1.500 15,000 76 000 91,000 NO I Totals for 2013: General Property 1.500 15,000 76,000 91,000 Woodland 0.000 0 0 Totals for 2012: General Property 1.500 15,000 76,000 91,000 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch#: Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00