Loading...
HomeMy WebLinkAbout042-1004-70-700 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 574347 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: Roscon Properties LLC, c/o Richard Stout I Warren, Town of 042-1004-70-700 CST BM Elev: Insp.BM Elev: BM Description: Section/Town/Range/Map No: b 4 M GS\Y 03.29.18.38A80 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER `�S CAPACITY STATION BS HI I FS ELEV. Septic :;:% 3 �d00 Benchmark u mow// ,a,,, /ae Dosing GD rwldd S �00 Alt.BM el Amman p� Bldg.Sewer Holding /.1 SUHt Inlet TANK SETBACK INFORMATION St/Ht Outlet TANK TO t_P/�, WELL BLDG, en to Air Intake ROAD Dt Inlet `. l�� f Septic A* q5 Dt Bottom 2Z.9 '93 . �1 Dosing IJA— 45 57 Header/Man. ,/.8Z 16/, Aeration Dist. Pipe Holding Bot. System s l� PUMP/SIPHON INFORMATION Final Grade 3. 8 `f$ Manufacturer Zb 1• ( GPI nd St Cover I 11 t C 9 • Model Number ` 1 2�•3 r 5 .7 Sao. co TDH Li Friction Loss System Head TDH Ft Forcernain Length Dia.L of Dist.to Well �t� J� SOIL ABSORPTION SYSTEM S.? BEDITRENCH Width Length No. ren s PIT DIMENSIONS No.Of Pits Inside Dia. Liquid Depth DIMENSIONS c �_ �. �L 1� e SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer: INFORMATION Type O S stem . / CHAMBER OR ( /V� UNIT Model Number: DISTRIBUTION SYSTEM ea�d- Header/Manifold Distribution I it x Hole Size I t x Hole Spacing Vent Air Inta e � Pi�`S' '�S �z \. ?/37 z- z Length Dia Length Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center I gg Bedfrrench Edges \ Topsoil ' �. No es No / q 1] ' COMMENTS: (Include code discrepencies,persons present,etc.) Inspection#1,:: / ! /LJ Inspection#2: Location: 1219 119th Ave Ro erts,WI 54023(NW 1/4 NW 1/4 3 T29N R1 8W) NA Lot 6 la p� r0 Parcel No: 03.29.18.38A80 F•I�- Gem— I 1.)Alt BM Description= � C( t �� PIO l.✓ V k 2.)Bldg sewer length= SZ l'Q" --5 -amount of cover= �nC-IZ� ✓`- Plan revision Required? [] Yes No j I I� Use other side for additional information. Date Insepcto Signatur Cert.No. SBD-6710(R.3/97) PLOT PLAN PROJECT Roscon Properties ADDRESS 1353 Awatukee Trail Hudson Wi 54016 NW 1/4 NW 1/4S 3 /T 29 N/R 18 W TOWN Warren COUNTY ST.CROIX MPRS Shaun Bird 226900 DATE 7/29/14 BEDROOM 3 AT-GRADE XXX IN-GROUND PRESSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE 630 HOLDING TANK SIZE LOAD RATE .5 ABSORPTION AREA 900 # of chamber s none BENCHMARK V.R.P. Top of survey iron ASSUME ELEVATION 100' Filter BEAR Filter ❑ BOREHOLE O WELL *H.R.P. Same as Benchmark SYSTEM ELEVATION 100.0' 1 19th Ave Scale = 1 /4" = 10' 2.0 Acre Parcel Well is to meet all WDNR setbacks All piping shall be SDR 30/34,within 10' of tank, piping shall be Schedule 40. /! 7 � 3 Pro 3 Bedroom Tank is to be properly bedded House Area 15' belo and provided with lockdown system is tore ain covers with approved warning undisturbed labels 98 5, 6% Slope B-2 B- 1 M,* Huffcutt Combo Tank ❑ 99.5' 100' B-3 100.5' Grading is to be done to divert run-off away from system 453' Property Line PUMP PERFORMANCE i 9- •� PUMP EFFLUENT MO Em MEN Em ImmgmEmomomm JIM mm"Emmmmmm WE"" ■E EE■■E o�veevee�v©oo�■m�oo�v�©� ELIE ©�.sai�soe�so�soe000 -x 0�v�0� . �■■■■■■�o�■ooe000ee■�ooe�■�oev�v® o®oeevooeiseooeo�ooee�■o ■�■■■N o®00000eo�sooeooaooai000 o�isoeiseoov000eveveoai�so ■■,� ®eeeeooaeee�soeoveeove \\\����■■E■■■■■■■ \�■11Is\■■■■NONE x !■� N\■111 ■\■O■O■N■ oo.oE=mm oa000000 HIM\,11�1�■■NN■■E■ o©0mmm°a°Mo ®®vvo°©m ov�av0maaoo0m®®©0 11 W oil 10 10 0,03, NONE Mom Him"Em ` 111■■■■ ae®©v0©MMHEEM o°©m ■\�\1111►\■■■■N■NE eaeeo0000�®�aomv� � aeea0oeaomo�m■®0©m N5/■■■1►1IIE■■■■■■NE eaeeaeee®®©ov00� ®`■■I�1��■■■■■■■■■ aeaeaeeA0oaa0ov® aaveavaao®eaeav� R � � �� � aaeeaaaeaaseeavo \�\II►�\■ ■E■■NE aaaaee■�eeaaaasmio - ���\Id\I\\■■E■\ENE �"���. �.�.� ■\ �\i�\1\\'� MOWN 11001,21,■■11012■1O\►R\NOON■ ®o000E7mmmm oo©o©o©©o©©o©o©o©o©©©00000 o®omo®�vo°�ovoomvo�ossoo©o voo.0o00000000vov®00000©omo :, �■NOON®0o®oo.v�0000©000�ovomv°o°o omssasonmvoovm©ovvo©vv°v°o omsssosssasso0ovoo©vvv©�°° SEWAGEAND DEWATERING omsssassassassasoovv000�°� ,m■■MEN o®s°s°s°s°sss°sasses°ss°sssasovoo NEWS■■■■m®®s°sas°00000°ss°ss°sssasov '.■„■■ ■■ ■��!�■■.�■■■■mom■OMEN ■■■ v■\►OWN�M■MNNMN■■■■■■ so\■■M►\E►\O■■■■■ IOM.■■n ■N■■N■■■NN t"\\►\t■W\;ANN■mom N■No , . . . , . NEON ONNE aw OEMEl' subjected to less than 15 feet TDH. Safety and Buildings Division County ' 201 W.Washington Ave.,P.O.Box 7162 Sanitary Permit Number(to be Si>� by�O) Madison,WI 53707-7162 / / q'T GO, Oe S>nuc✓Transacti�Nambor terry Permit A 1' 2 yy � drys Adm Code,submission of this form m the apptvpriate governmental unit in accordance 21(2). m Protect Address Cif different than mnal�ing address) is required for a sanitary pemrit. Note:Application fiorms for state-ovvr►cd POWTS are submitted '/ Dv the afety and Professional Saws Personal information you provide may be used fnr seoondarY oses m acoardance with the privacy Law,s.15. 1 m Stets. L licatioa Information-Please Print All Information parted# Property owner's Name -7) D 14 Z- 16o4 7d - 700 s Property Lrwon / A - To JIL property Owner's Mailing Address � C � 3s Govt Lot 2 City.State Zip Code P&w Number &k.Z y., '/ J © N: R E W Lot# Type of Bui{ding(check all that apply) Subdivision Name 1 or 2 Family Dwelling-Number of Bedrooms_ _ a-- 6 k ad {LO- )n-o O-W-- Block ❑PublicCm macial-Describe Use I p�'a v`' ❑City of CSM Number 0 0 V-mw of ❑State Owned-Descrtbo Us� ^ , + Town of/,I C F Lam✓ III.Type of ermtt (Check only one box on line A. Complete line B. applicable) Z O ee- A. New System 0 RePlsoement System ❑Treatment/Fiolding Took Replacement Only ❑Other Modification to Eushng System(explain) B. ❑Permit Renewal ❑Permit Revision ❑Change of Plumber ❑Permit Transfer m New List Previous Permit Number and Date Issued Before Expiration Owner IV. e of POW IS S Com neat/Device: Check all that a i ❑Noa-Pressurized>n Ground Pressurized Im C>r«md Grade ❑Mound>24 m of suitable sort Mound<24 in of suitable soil [I tber Holding Tank ❑O Dispersal C-Moncnt(explain) ❑Pretiratrnaat Device(explain) V.Dis VT rea t Area Information: ( Dispersal Area prod System Elevation eli D Flow(gpd) Design Soil Application Dispersal Area Required �J� Manufacturer �r' VI.Tank Info Capacity in Totsl #of u o Gallons Gallons Units I � �� V New Tanks wog Tan �✓ BBCK. Septic or Holding Tank Dig cbsmber X d 8 VIL Responsibility Statement-1,the undersigned,assume aeitnlrtY for installation of the POWT S almwvo on the attached Pleas pltmmber's (print) ` Plumber's M,Q/MPRS Number Business Phorc m Nuber J Plumber's Add (>Z-•5 t ) /L/S,-,/ ` VIII.Conn artment Use On Permit Fee Date Issued Issuing igaaUne v Approved Disappro S Given Reason for Dental Y Yet IX Condit6m ns for ' . proval \ g l ' per( a J` 1 ='$eptc'tenk,effluent filter i 3 J nn.a •-�^.a••c.>Z. dispersal ce8 artust aft be services f rtiaintairt l fir.o,Me.o wv-�- l J► as per management plan provided by plur�T, i r.4. ' I /� ,2. A0> - / ��' b✓x d'! t`^ JAI L nor✓.Q, Aaaeh to eoompift Plans for tie s�stam and submit to Coaatr oolp on PaPa�� 11 iae�n u 7®e art SBD-6398(R.11/11) ti,pARTUE� DIVISION OF INDUSTRY SERVICES 5��9 s Toy 2331 SAN LUIS PL STE 150 ooh 9� GREEN BAY WI 54304 3 KS Contact Through Relay www.dsps.wi.gov/sb/ wvmmisconsin.gov Ossr°NnLS� Scott Walker,Governor Dave Ross,Secretary August 14 2014 CUST ID No. 226900 ATTIC•POWTS Inspector SHAUN R BIRD ZONING OFFICE BIRD PLUMBING INC ST CROIX COUNTY SPIA 1432 120TH ST 1101 CARMICHAEL RD NEW RICHMOND WI 54017 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 08/14/2016 Identification Numbers Transaction ID No.2444141 SITE: Site ID No. 804937 Roscon Properties Please refer to both identification numbers, Lot 6 119TH Ave L above,in all correspondence with the agency. Town of Warren St Croix County NWl/4,NW1/4, S3,T29N,R18W Lot: 6, FOR: Object Type:POWTS Component Manual Regulated Object ID No.: 1497488 Maintenance required; 450 GPD Flow rate; 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 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.145.06, CONOITIC stats. APPRIi The following conditions shall be met during construction or installation and prior to occupancy or use: DEPT OF SA Reminder(s): PROFESSION) „SION OF INDQ • The depth of aggregate distribution cell at distribution pipe must be a minimum of 6 inches below and 2 mi c es above the pipe plus the normal diameter of distribution pipe. • The mound system and septic tank must be set back from a well by a minimum of 50 feet and 25 feet respectively,per SPS 383.43,Wis.Adm.Code. 2&4SEE CORR • Maintenance information must be given to the owner of the tank explaining that periodic cleaning of the filter will be necessary. 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. SHAUN R BIRD Page 2 8/14/2014 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 This Amount Will Be Invoiced. 4, When You Receive That Invoice, Rachael E Huempfner Please Include a Copy With Your POWTS Plan Reviewer,Integrated Services Payment Submittal. (920)492-7728,M-f 7:45 am To 4:30 pm WiSMART',code:7633', rachael.huempfner @wisconsin.gov cc: 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. I F LT IER CARTRIDGE INSTRUCTIONS y, '8 OS TM Installation STEP 1 Dry fit the filter case onto the end of the outlet pipe to ensure it is centered under the access opening. If not, then either insert more pipe into the tank through the outlet or solvent weld (glue) additional pipe onto the outlet pipe. STEP 2 While the case is still dry fitted on the outlet pipe, measure the length of 3/4-inch pipe needed to brace the filter to the tank end wall if utilizing the optional supplemental side support. If side support method is not utilized, proceed to step four. STEP 3 For installations utilizing the optional supplemental side support: solvent weld the 3/4-inch pipe onto the filter case. If side support method is not utilized, proceed to step four. STEP 4 Solvent weld the filter case onto the outlet pipe. Insert the filter cartridge into the case, pressing down until the filter locks into the bottom of N °' the case. ' STEP 5 If a VRS switch is utilized: insert into the filter and lock by turning clockwise 900. Maintenance 1. The effluent filter should be cleaned every time the septic tank is serviced. 2. Open the outlet access opening to inspect the tank and filter. 3. Pump the septic tank completely, making sure to remove the sludge layer on the bottom of the tank and not just the scum and effluent. 4. Once the effluent level has been lowered below the invert of the outlet pipe, firmly pull up on the filter handle to dislodge the cartridge from the case. 5. Slide the cartridge up and out of the case for cleaning. 6. If a VRS switch connected to an alarm is present,the switch ; should be removed by turning counterclockwise 90°and cleaned with water only. I 7. While holding the cartridge on its side (large flat surface facing down) over the access opening, rinse off the cartridge with water F� only, making sure all se to a material is rinsed back into the tank. Y. 9 P 9 8. If VRS switch is utilized, replace by inserting into filter and turning clockwise 900. 9. Insert the filter cartridge back into the case, pressing down until the filter locks into the bottom of the case. 10.Replace and secure the access opening on the tank. BEAR ONSITET FILTER CARTRIDGE-FIVE-YEAR LIMITED WARRANTY Bear Onsite filter cartridges are warranted to be free of defects in material and workmanship for five(S)years from the date of consumer purchase. BEAR ONSITET"Filter Case-Lifetime Limited Warranty Bear Onsite warrants the filter case will be free of defects in material and workmanship during normal use for the period of time the original purchaser owns the product. If a defect is found in normal use,Bear Onsite will,at its election,repair,provide a replacement part or product,or make appropriate adjustment.Damage to a product caused by accident,misuse,or abuse is not covered by this warranty.Improper care or malfunctions resulting from units not installed,operated,or maintained in accordance with instructions provided will void the warranty.Proof of purchase(original sales receipt)must be provided to Bear Onsite with all warranty claims.Bear Onsite is not responsible for labor charges,removal charges,installation,or other incidental or consequential costs. && A In no event shall the liability of Bear Onsite exceed the purchase price of the product. • R&CEIVED AUG -12014 Cover Page INDUSTRySERV J icEs Shaun Bird Bird Plumbing Inc. 1432 120th St. New Richmond Wi 54017 715-246-4516 Date: 7/29/14 Owner:Roscon Properties Location:NW1/4 NW1/4 S3 T29 N,R18W Lot 6 119th Ave Warren Manuals Used: At-Grade Component Manual version 2.0 SBD 10854 (N. 03/07) Pressure Distribution Manual version 2.0 SBD 10706-P(N. 01/01) Page# 1. Cover Page 2. At-Grade Plot Plan 3. At-Grade Cross Section 'SIALLY ✓ED 4. Pipe Cross Section/Pipe Layout 'JED AND 5. Pump Chamber Cross Section L SERVICES 6. Pump Curve 3TRY SERVICES 7-8. Maintance and Contigency plan i(J 1- 1/y 9-11. Soil test ,PON ENCE 12. Filter Specifications Shaun Bird Signature License number 22 0 PLOT PLAN PROJECT Roscon Prooerties ADDRESS 1353 Awatukee Trail Hudson Wi 54016 NW 1/4 NW 1/4S 3 /T 29 N/R 18 W TOWN Warren COUNTY ST.CROIX MPRS Shaun Bird 226900 DATE 7/29/14 BEDROOM 3 AT-GRADE XXX IN-GROUND PRESSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE 630 HOLDING TANK SIZE LOAD RATE .5 ABSORPTION AREA 900 # of chambers none BENCHMARK V.R.P. Top of survey iron ASSUME ELEVATION 100' Filter BEAR Filter ❑ BOREHOLE O WELL *H.R.P. Same as Benchmark SYSTEM ELEVATION 100.0' 1 19th Ave Scale = 1 /4" = 10' Well is to meet all WDNR setbacks 2.0 Acre Parcel All piping shall be SDR 30/34,within 10' of tank,piping shall be Schedule 40. Pro 3 Bedroom Tank is to be properly bedded House Area 15' below and provided with lockdown system is to remain covers with approved warning undisturbed labels 6% Slope 98.5' B-2 6- 1 B.M. Huffcutt Combo Tank 99.5' 100' B-3 100.5' Grading is to be done to divert run-off away from system 453' Property Line II 1 1 1 ra 4 jryTL 4'1 6 aT Tk ♦ k 4 k 4 �f Sa.�7a}A�Y>, 4� ,,��,,,p,+a Yx�sJ'♦J�aa + r #a. -+a1 Ji aae ii Ak.1?i�{airrl`,t+s�a�ikar4r alLl��*4*X"La�� —� ��*:�+l�+aP rar'h!e� �` hs�` �La{ti.-+� a +r'af yJ?�tJ�J4X4a i�at#fvx Nkta4J*�l1tx. tr r.rata.f r4_Sif x ♦`;r} 6r �;Via+ x r - ,r C rh a�%?K*Lr�ff 4.�+ lr+ ,. rd's � .�, 'ht �4{\• Y�`FaS F"`ASx 4b• 4f a a4 i - h s . r,.�.r � yr+*�*��Y r Ff Y�r1 x .n. 1 ( r �r r;♦ r�Py r -4 ar4 } a v**P'L?i x a.Y i 7 `* tiXr��a4i'+-i7a�i+ *<�l+J�J .• ..Xa Xasa«t �,X'aa+-i'�sl t! X�ar_+�J1a 'F.+,t . • i r #4A 4AK4f h.+a Y < 4 yr;#y.�,r4T}l�A tit 4r�rh• f�f rhr r; i` i t} y a ya P�•Ft i�.` a +Ja rsX'} TPa-a'4+♦?Ja i i � {a�lw ef+*a. � t4r1+-PS�f FI'iA��+S yr4.1`L i�ti f�.74f ♦ .. : sf,'�4r�Y�t..Y.►ai.��4 4 r.,41♦ r'I�f�'d�dS �. x $i 1a+". w• f1€SJ i 1 t 'y a J 7Xi-x X # X ♦ • . _1X ar fy.f4 h+Y}f4 4f4ri r�y.°'a r4.Ci*1. � Lr P. tPai 4�ir�# {4aJ}`ap �r��'0.1�1�, 44 �yl}F' y4J} 4jrTYJrt+X J'eJ 1A+r 4Ji.d f+Y � P' 'R 1,Jt}X r4-ra }r4;`a-y' iy L Lao 4 •� r-+.tw r� ♦�` {qs r�ara r4aifn �d�v y�a r.'4i,rL a� - �#� / ' { atµ x1=X 1�+ ta-t{ sjr � asy a s tTa*P � ' a♦ 'Mw a+-Fier it tX'X'Hr ,t x r r-sr�-R.ar a-Y. �ar4 {yy}���{jjjfi.l` Y•r{�'�y �y}i'aX4.i4X'•-X'aX�a-}XX+TJh x•a.f��'a1iX f7X�X a...h�9 J'�XF.�v.r.Y > ra ".� 1 LL`+++#1'4 wr'41y�.�y,}�L ara rtr"'"`444r k•sr4 4r4 -- +• y } ..{'��X�{t2�'�, �ay�a1 `iati�� ►�L'.r-4�wLrpA yt��IaFIp P�i1 �� P<Lt 4r4 ��k X� Jr;rti`P%tP'Fp'.P tr i'y'K a�4r ry-•+ r"r� ��ai .y f �� � # •p'a�:aa�,�i.�r1{'LX4 X}. 4.P a�Xit'MaX+t +1 r'y.X,l-Jq RJ?,AS pY a� J'Y b-X�f+a a YXkJ4 4Y1. >d S;t� 7 a` tr `, Lr4ra-1.V r�)i.ra{_Lf L1 V ryrf aY}r rLr � NkP T6}'4r6d br {d I}{L 1�\-r M� 4�4 r.e Fr Oda +X+d'.wi` ar+-X l+x ,�aa§JMaa JS asw-i+e X+xs i r-I +: i�4 +4�a♦?F-7r9/ f X'r,e•` Yafi;r � rh#•�.:J r fi-{y1 yy� r.•i+ p+sr rafaPafiaP;Yh�i }�`i-'tr'y ry�.P,P;6;Y4 `i r� §* vF�YtX a+x X' a'1;Fa 4J 4pti F$d TsX PX x"a lP s r PpV i,y xr xM} Fawr X1e Xi t,1iyY*F 44?�, KRA ifi4� 14X `*J?at�fta4F?F;x'R+a rAAi `f`ry..5x ♦ 'ad i1 JY�4f+ ♦J k.a'.d-Y J'i�f?JkJf%#L+4+J�i, r 1 • • • . . . . r is+n�x�j*:r y4r �i{yfi fi raa` r • • • . 1 r J 11 +F e`•, 4Pa 1 J-+Xw'lSJ+Ja+1ds.. k #a • 4}yN; SiLP fi�YL`r LY 44f aY(,fi-(.fti. r4*'> v ,♦ Rxaa t{P d1 xfa+�+.b Tb1t 1b�wJ+-d Y.t a.�r � �•1F � w7 — 'i7fI OaYaa�14 rN. F� • 1 • {Xi air Fy�aJi Ft�.aai�a lli����������������������* ���-�-�•ti►1ti►1nti�1�111�11111ti r1...fi.ra�•{��r4r r� 111►11`11171 11�•11�r1���ti Is Pressure Lateral Layout One Lateral — End Manifold f---Threaded Cleanout Lateral Turn-up ----► Plug Force Main X Long L Sweep 90 Bend:- Pressure system Construction Distribution Network S iftstionln. Laterals are construe of Schedule 40 PVC Lateral Diameter fin. pipe. Orifices are drilled perpendicular to orifice Diameter the pipe with a sharp drill bit and face down. X Orifice S in g Ft: Lateral turn-ups terminate with a threaded L ateral L cleanout plug and are enclosed in a 6-8 inch diameter lawn s Force Main Diameter In• pdnkler valve box accessible Force Main O Ft' from finished grade. • • • • • Grade 6-8 Inch Lawn Sprinkler Valve I Box s` i Page of_------ 03/0519i cross Section And Pump Performance specifications Septic-Dose 'dank. _ Alan �•� Pum Model Number '� .?7_------ Tank Model Number Alarm NLa • Total Tsak C�Pt3' ply Model Number <✓ Max•Bury T rth switch TyPm Total Dynamic Head(TDH�-Feet Filter Manufacturer Elevation Head Nwnber Filter Modal �� = , S � utred Fme Main Loss - — & ;o pump#'ecformec Ro • �y� GPM. �c Ft TDH Total --T Outlet Manhole NOM C Above Grade With Manhole Min.4-Above Grade Locking Device. Inlet Mwbole Seaamly Mom With Locking Device <b.,$slow Grade SOdW Water6gh' Weatlrar-proof 1 jmctiou lCit Finished�e •. .r — t Vent Min. 12" Discomecx Above Grade Mews • With VeI t Cap (hact Fib" Inlet :. A and IZ� eary . Switch andReearve Weep Tank.Volume= GPI Hole B Dimension. Inchon Volume Gal- (reserve)A: q. ltd (alarm) B 2 _D Ft U � C 7 ottOlY (dom ' .. i D Elevatiia p' .\� '� Total 02 � ,•, ♦.:::;•::::i:1;:::i:::::.i•/•.i�:,I,I►/:i,s,s,•,•i r ii/,i i•a 1`1h;`a/.•►f`►`:.1`,:.�►`I 1 1`:1; ;•i::►a:::r:::::•:::::::, •aaa:..aaa.,a as aaa as a.aa a• aaaa as as aa.a,ai• ..ataaa as a•.a.sa,.,. t ♦/s,//t11�,1ta,/Ia/ aa/a GENERAL INSTALL LATION: The septiddow teak is bedded and back MW in accoedarrce with the manufscturces product approval aPGOI . Mumm depth of bwy r!s qwftd by the manufisch"r may not be exceeded vritlxwt Approval- lvhaoN&covers exposed to grade have set efective 100kiug device(Padlock) installed. PiPiag at ft iNet and outlet is of approved material, wooded to the tm*with waard�t fktin@% and laid on stabO soil to Prevent setttittg of ssU►8• TU force main is skoved with 4"Sob.40 PVC to Midge the tank excavation @, d the s1..vs is sealed w0ertight. Elec*A W►iM ca Ojos Whb NBC 300 and X6.28. 02/051) Page of Effluent a _.-_ oj �L� POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page of 11.E INFORMATION SY8TtJlll SPECIFICATIONS Owner C Septic Tank Capacity O NA Permit# Septic Tank Manufacturer 0 NA SIGN PARAMETERS Effluent Filter Manufacturer 0 NA NA Number of Bedrooms 0 NA Effluent Filter Model 0 Number of Puble Facility Onits Pump Tank Capacity NA Estimated flow(WWW) �' Ida Pump Tank Manufacturer Design flow(peak),(Estimated x 1.5) .) aUda Pump Manufacturer ❑NA 0 NA aUda ltt2 Soil Application Rate Pump Model r 42 Standard influent/Effluent Quality Monthly average Pretreatment Unit Fats Oil 8 Grease (FOG) 530 mg/L 0 Sand/Gravel Filter 0 Peat Filter Biochemical Oxygen Demand (BODE) 5220 mg/L 0 NA O Mechanical Aeration 0 Wetland Total Suspended Solids (TSS) 5150 nrg/L 0 Disinfection 0 Other !Pretreated Effluent Quality Monthly average Dispersal CON(S) ❑NA BkxhwrkW Oxygen Demand (BODs) 530 mg/L 0 In-Ground(gravity) 0 In-Ground(pressurized) Total Suspended Solids (TSS) 530 mg/L Grade 0 Mound Fecal CoNf=(geometric mean) 5104 cfu/1 0 Drip-L-ine 0 Other: NA iMaximum Effluent Particle Size 36 in dia. 0 NA Other. Other. NA Other: Other. C NA 'values Wool for domestic wastewater and septic tank sf wt. NTENANCE SCHEDULE 1P Service Event Frsqusncy s (Maximum 3 years) O NA linspect condition of tank(s) At least once every: s pump out contents of tank($) When combined sludge and scum equals one-third(Ys)of tank volume O NA months) (Maximum 3 years) 0 NA Inspect dispersal oeil($) At least onus every: s 0 NA clean effluent filter At least once every: l! s Inspect purr,pump controls&alarm At least once every: 0 s(*) 0 NA onlh(s) NA I:Iush laterals and pressure test At least once every: r(s ?thef At least once every: 08(s) NA ! 0 A I�th.r: s MAINTENANCE INSTRUCTIONS by an individual carrying one of the following IEcenses or certifications: ate iinspections of tanks and "cells shall be made S Tank inspections mus Plumber,Master Plumber Restricted Sewer, POWTS Inspector,POWTS Maintainer,Septag e erAcing Operator. include a visual inspection of the tank(*)to identify any missing or broken hardware, identify any cracks or leaks,measure the volume o Wmolned sludge and scum and to check for any bads up or ponding of effluent on the ground surface. The dispersal call(s) shah be j visually inspected to dredc the effluent levels in the observation pipes and to check for any ponding of effluent on the ground surface The ponding of effluent on the ground surface may indicate a failing condition and requires the immediate notification of the loce Iegulatory authority. When the combined accumulation of sludge and scum in any tank equals one-third(%)or more of the tank volume,the entire contents c j:he tank shay be removed by a Septage Servicing Operator and disposed of In accordance with chapter NR 113, Wisconsn Administrative Code. i All other services, including but not limited to the servicing of effluent filters, medWical or pressurized components,pretreatment unit: jI"any servicing at Intervals of 512 months,shelf be performed by a certified POWTS Maintainer. A service report shall be provided to the local regulatory authority within 10 days of completion of any service event. Paps_.•_.of other of the pOWTS check treatment tank(s)for the presence of Painting Products have the contents of the are START UP AND OPERATION For new construdton, prior'o use the dispersal 0e11(s)_ If high 6NOWItmoons may impede the treatment Process and/or damage to use. tank(s)removed by a Sep"servicing operato Prior Systern start up shall not occur when soil condemns are frozen at the irdittrabve surface• is restored the excess w9stewater will lots tanks may fill above normal hWwn ter levels. When power of GMuenit• During Power outages Pub a dose,overloading the cell(s)and may naac�t in the backup or surfaceng to thle discharged to the dispersal c (s)in one contents o the pump tank removed by a Septage Servicing O upera� to rest" normal levels To avoid this «situation h Plumber or POWTS Maintainer to so" in manually operating the Pump effluent pup the area within within the pump tank. park Over,Or OtIWwWe disturb Or Compact. Park vehicles over tanks and dispersal Deus. Do not drive or J5 feet down Or of any mound or at-grade soil absorption area, � and prolong the life of the POW T,$: stream may improve Ute Pe ts'. fat; foundation drain Reduction«elimination of the following from the ; dam; dental floss; diapers; dishfectan products; antibiotics; baby wipes; cigarette buds condoms; herbicides; meat sc mps: medications; oil; Painting m water, fruit and vegetable peelings: gene; grease' (sump pump) n �;tampons; and water softener brine. Pesticides;sanitary napkins; ABANDONMENT taken out of service the following steps shall be taken to insure that the system is propeity When the POWTS falls and/or is perrwith chapter 33,Wisconsin Administratrve be and safely abandoned in Compliance with chapter. to tanks and pits shall be disconnected and the abandoned P openings sealed. • A11 piping disposed of by a Septage Sung Operator'The contents of all tanks and pits shall be removed and properly moved and the void space filled with 8011.After pumping, all tanks and puts shalt be excavated and removed or their covers gravel or another inert solid material. CONTINGENCY PLAN red the following measures have been, or must be taken, to provide a Dods c;Ompli�rnt If the POWTS fails and cannot be reps replacement system: Of a replacement soil absorption systefrr. A suitable replacement area has been evaluated and may be d for the and Could not be infringed upon by requioed area should be protected from disturbance ed the replacement area will result In the rAW The replacement sirvdure,tot lines and wells. Failure to prat systems must comph with the ruled Ir setbacks from existing and proposed t area. Replacement for a new soil and site evaluation to estabilsh a suitable replace effect at that time• in pOWTS technolo9H replacement area is not available due to setback and/or soil limitations. Barring advances ic 1] A suitable repl the failed POWTS. olding tank may be Installed as a last resort to replace a suitable replacement area. Upon failure of the POWTS a sou and a installed aI The site has not been evaluated to Identify area• !f a replacement area is available a holding tank may be performed to locate a suitable replacement a lset resort to replace the failed POWTS. removal of the biomat at the infutrativ Mound and at-grade 3011 absorption systems may be reconstructed with th rule in place at that ti . Reconstructions of such systems must c«r►Ph+with the rules In effect at that time• «WARNING» SEPTIC,PUMP AND OTHER TREATMENT TANKS MA K UNDER LETHAL GM3TANCEB�DEATHUMAYIREBUL REE��O� ENTER A SEPTIC,PUMP OR OTHER TREATMENT TAN PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. _ ADDITIONAL COMMENTS pOWTB NWWAINER POMITS INSTALLER Name - Name Phone Phone / — ' LOCAL REGULATORY AUTHORITY SEPTAGE SERVICING OPERATOR PUM R Name Name _ � Phone Phone — Adminfatratire Code. This document was droW in compliance with cheptsr SPS 383.22(2)(b)(1)(d)")and 383.5K1),(2)6{3),VVlscwnsh t . Wisconsin Department of Com SOIL EVALUATION REPORT Page ( of_3 Division of Safety and Builr in accordance with Comm 85,Wis. Adm. Code pp County �1 Attach comple it n�on ss than 8112 x 11 inches in size.Plan mRkFe,include,but ed t rizontal reference point(BM),direction and percent slope, e o dimensions,north arrow,and location and distance to nearest road. D. 2-/QU Y- 70- Ptease ,print aH information. JUN 26 Revie ed by //�r,� Date Personal information you provide may be used for secondary purposes(Privacy Law,s.15 (1)(m)). 13 `��`',✓ 'L 17/1 13 Property Owner Property nn ") 1 _ /y O L D r/ ) ( J Govt.Lot f f f�1/d A),d 14 S 2 N R E(or Ptperty Owner's Mailing Aodress Lot Block# Subd. Na M# City State Zip Code Phone Number CI city ❑Vil a ,Town d Meares Ro d�t New Construction Usre esidential/Number of bedrooms Code derived dersign Now rate d _ GPD ❑Replacement • Public 0 imercial- scribe: �— Parent material /„t ,P&� g �;1�•rt gd l,f r�.� Flood Plain elevation if applicable _f✓/1 ft. _ __ General Wmnients z2_.e(Z P and recommendations: -� System Type ./4/- System Elevation-/ aP1 ��# ❑ Borinl� �- / Pit Ground surface elev.�ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Domlrurrtt Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff In. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. "Eff#1 `Eff#2 1 -,3 gz_ Z /3-38 1-r1191 P �9# ❑ Borin:l .� Ja Pit Ground surface elev. J ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Ccrnsistence Boundary Roots GPD/ff In. Mumiell Qu.Sz. Cont.Color Gr.Sz.Sh. 'Eff#1 'Eff#2 1 0 3 sr 2 m 01 r_s Q.� . t 1,6 2 y 3 G r / c Q,n < rnfr �'' r •y Y7 F9 Effluent#1 =BOD >30 1:220 mg/L and TSS>30<150 flluent#2=BOD5<30 mg/L and TSS<30 mg/L CST Name{Please Pnnt) Sig a CST Number Bird Plumbing, Inc. Shaun Bird 226900 Address Date Evaluatioi Conducted Telephone Number 1008 192nd Ave, New Richmond, WI 540 . o�/ - 715-246-4516 Property Owner i_ __ Parcel ID# Page of Boring# F] Boring �( 2 K-Pit Ground surface elev.� aft. Depth to limiting factcr cJ in. Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDM in. Munsell Qu.Sz. Cont.Color _ Gr,Sz.Sh. 'Eff#1 °Eff#2 ©- crs a� . S• . o 3 "A d v F1 Boring# ❑ Borinc _. __._. — ❑ pip Ground surface elev. ft. Depth to limiting fact yr_._ in. Soil licalion 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 ❑ Boring Boring# Ground surface elev. ft. Depth to limiting fact(�r_______in. ❑ Pit - Soil Application Rate Horizon 'lepth Dominant Color Redox Description. 'Texture Structure Consistence Boundary Roots GPD/fF m. Munsell Cu.Sz. Cont.Color Gr.Sz.Sh. "Eff#1 •Eff#2 Effluent#1 =13UD5>30<220 m91L and TSS>30<150 mg/L 'Effluent F2=BODE<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. SOD-8330((-W) Soil Test Plot PJSn Project Name Roscon Properties LLC Bird Address 1252 Awatukee Trail Hudson Wi 54016 STM #226900 Lot 6 Subdivision --------- p 6/24/13 NW 1/4 NW 1/4S 3 T 29 N/R18 W Township Warren Boring Q Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 100 ft. Top of survey iron System Elevation TBID *HRPSame as Benchmark 119th Ave Scale is 1" = 40' unless otherwise noted 184' 6°Io Slope B.M.* B-2 110' B-1 15' 98.5' 30' 99.5' 50' JJF B-3 100.5' 453' Property Line ST. CROIX COUNT'" SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer./120s--a),, Mailing Address Property Address (Verification required from Planning&Zoning Department for new construction.) City/State � Parcel d 4 Z 00 — Identification Number / � 7a 7 4 6 LEGAL DESCRIPTION 3 'T A- —SO— Property Locatior;/Kc-) L/4 ,/4J '/4 , Sec. N 1j W, Town of Subdivision Lot# �o , Certified Survey Map# l 70 C) , Volume ,Page# Warranty Deed# b� 2 L/ _, Volume , Page# Spec house& no Lot Iine,, idenfifiab yes no SYSTEM MAINTENANCE AND OWNER CERTIFICATION Improper use and maintenance of your septic system could result in its pre-mature 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 wasee disposal system owner maintenance responsibilities are specified in§Comm. 83.52(1)and in Chapter 12-St. Croix County Sanitary Ordinance. The property owner agrees to submit to St.Croix County Planning&Zon:mg 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 Commerce and the Departircent 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 arrdare the owner(s)of the property described above,by virtue of a r deed recorded in Register of Deeds Office. Number o edroom, SIGNATURE OF APPLICANT(S) DATE ***Any information that is misrepresented may result in the sanitary permit being rovoked 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.08/05) 0 984101 BETH PABST REGISTER OF DEEDS CERTI FI EM S V RVEY MAP ST. CROIX CO., wI RECEIVED FOR RECORD LOCATED IN PART OF THE FRACTIONAL NW1/4 OF THE 08/12/2013 2:41 PM NW1/4 OF SECTION 3, T29N, RI 8W, TOWN OF WARREN, ST. EXEMPT *: . CROIX COUNTY, WISCONSIN; INCLUDING PART OF LOT 1 REC FEE: 30.00 OF CERTIFIED SURVEY MAP RECORDED IN VOLUME 24, COPY FEE: 3.00 PAGE 5737, DOCUMENT NUMBER 924510. PAGES: 2 OWNER SURVEYOR ROSCON PROPERTIES,LLC EDWIN C FLANUM 1252 AWATUKEE TRAIL I NORTHLAND SURVEYING,INC. THIS INSTRUMENT DRAFTED BY EDWIN FLANUM HUDSON,WI 54016 i P.O.BOX 152 JOB NO.13-41 DATE 6-19-13 AMERY.WI 54001 LOT 1__!_ L_OT 2 NW CORNER SECTION 3 I C.S_M_ - VOL 119, PG. 4852 N1/4 CORNER SECTION 3 ALUMINUM MONUMENT FD. —I — _ - STATE BAR OF WISCONSIN FORM 2 - 1998 ` 11111111111111111111111111111111111111111111111111 WARRANTY DEED * 8 9 2 4 4 0 6 Document Number 892440 BETH PABST REGISTER OF DEEDS This Deed,made between ST. CROIX CO., WI RICHARD O_ STOUT and JANET P STOUT, RECEIVED FOR RECORD husband and wife 04/03/2009 01:OOPM Grantor, WARRANTY DEED and ROSCON PROPERTTESI, T.T.C, a Wi nnsin EXENPT it 15S Limited Liability omgany REC FEE: 21.00 PAGES: 6 Grantee. Grantor,for a valuable consideration,conveys and warrants to Grantee the following described real estate in St. Croix County, State of Wisconsin: Recording Area ` Parcel C: see attached legal; ii Name and Return Address Dick Stout and 1353 Awatukee Tr Parcel F: see attached legal; Hudson, WI 54016 and Parcel G: see attached legal; 042-1086-10-025 ar14 and Parcel Identification Number(PIN) Parcel H: see attached legal; This 1S not homestead property. and (is) (is not) (0 y-)- 166Y- -76 -07S Parcel I: see attached legal. 64-7)_ 10,'S- 30-66 G 01� D - io�9- c`��� - lo6g- �3o-ors Exceptions to warranties: easements, restrictions, rights—of—way and covenants of record. Dated this 25th day of March 2009 k4 (SEAL) �f^-� /'�` (SEAL) Richard O. Stout Janet P. Stout (SEAL) (SEAL) AUTHENTICATION ACKNOWLEDGMENT Signature(s) State of Wisconsin, r//t� � Ss. 'Cu t C 1 X County JJJ^^••�� authenticated this day of Personally came before me this cps day of ! AAav-&L— a-0 0 , the abo a named (2;r_IAaL A 0. to,a at.�l 3a1AL.1 P�• �1'9 TITLE:MEMBER STATE BAR OF WISCONSIN to (If not, me kno to be the person C, who executed the foregoing authorized by 5706.06,Wis.Scats.) inst m t and acknowledge the same. ParnOlfa A. yyl THIS INSTRUMENT WAS DRAFTED.BY ��ma� ���6�«-g Notary Public �- Janet Stout State Gf 'Ni 1 353 Awatukee Tr SCORSIn Hudson, WI 54016 Notary Public. State of Wisconsin My commission is permanent. (If not. state expiration date: (Signatures may be authenticated or acknowledged. Both are not necessary) 'Names of Persons signing in any capacity must be typed or printed below their signature. 1 of 6 STATE BAR OF WISCONSIN Wisconsin Legal Blank Co.,Inc. WARRANTY DEED FORM No.2- 1998 Milwaukee,Wis. 042-1086-10-025 PARCEL C 904 67TH A PARCEL OF LAND LOCATED IN PART OF THE NW1/4 OF THE NW1/4, PART 0 F THE SW1/4 OF THE NW1/4, PART OF THE SE1/4 OF THE NW1/4, PART OF THE SW1/4 OF THE NE1/4 AND PART OF THE NW1/4 OF THE NE1/4 OF SECTI ON 31, T29N, R18W, TOWN OF WARREN, ST. CROIX COUNTY, WISCONSIN; DE SCRIBED AS FOLLOWS; COMMENCING AT THE WEST QUARTER CORNER OF SAID SECTION 31; THENCE N 01 016138"W ALONG THE WEST LINE OF THE NORTHWEST QUARTER OF SAID SE CTION 31 A DISTANCE OF 1479.01 FEET TO THE POINT OF BEGINNING; THE NCE S85011118"E A DISTANCE OF 452 .65 FEET; THENCE S55°43134"E A DI STANCE OF 1501.30 FEET; THENCE S84 038139"E A DISTANCE OF 1293 .10 F EET; THENCE N56 053 '56 11E A DISTANCE OF 1187.27 FEET; THENCE NO2 000' 11"E A DISTANCE OF 284.22 FEET; THENCE S74034120"W ALONG THE SOUTH ERLY RIGHT-OF-WAY OF INTERSTATE HIGHWAY 1194" A DISTANCE OF 716.96 FEET; THENCE S40 050129"W ALONG SAID RIGHT-OF-WAY A DISTANCE OF 618 .54 FEET; THENCE N84038139"W ALONG SAID RIGHT-OF-WAY 4 A DISTANCE OF 1189.39 FEET; THENCE N48 014111"W ALONG SAID RIGHT-OF-WAY A DIST ANCE OF 1586.55 FEET; THENCE N70 013 '35"W ALONG SAID RIGHT-OF-WAY A DISTANCE OF 66.43 FEET TO A POINT ON A 5594.58 FOOT RADIUS CURVE, CONCAVE SOUTHWESTERLY, WITH A CENTRAL ANGLE THAT MEASURES 05°0312 4", A CHORD THAT BEARS N72°45117"W AND MEASURES 493 .59 FEET; THENC E WESTERLY ALONG THE ARC OF SAID C URVE A DISTANCE OF 493 .76 FEET TO SAID WEST LINE OF THE NORTHWEST QUARTER; THENCE S01 016138"E ALONG SAID WEST LINE A DISTANCE OF 606 .36 FEET TO THE POINT OF BEGINNING. PARCEL CONTAINS 35. 07 ACRES. SUBJECT TO ALL EASEMENTS, COVENANTS, AND RESTRICTIONS OF RECORD. .l 2of6 .,1 J W 1 UZ e� m I I � I A Oi»nD3YOrOaYV P=` : 93N1IfVM�MY. � It I t u L I I i i 1 i `R b I a s I y A'It -~� A•A Z dii A-J At C- A'd J•a j i b. � J•A. I I -� R 1 SIX i sf w aaz�mma Eaazxnn I x JI a-s 4 4 .RCS x , I r i I �! I e A-S J-A J'A{ A'el —........._..... _e-........_. ........—... f z loll, loo Will IsHill fly ............. ..................... .................. ............ J.................... -------------- -------------------- ---------- 1 ................ ................ I r--I ----------- -------------------- - ----------