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010-1077-30-000
k kba -ao « @2 ;162- ))\2 § § \ 4) 0-0 $ )k 0v �o e . � � /\ =cL\\) �£N\f2 ES22E a #2 � a] e } k/) [0 § m ?I c 0 LL ) S&� » ■« / §- 0 < <aEw£= � § } B ) E / a R / § CL E � § CD \ E o z ._ t $ : / { Ecr \ k )\ I � J22 � c � \ z z C t k a Q ® § o m ) LO k k k L ., \ o 0 0 , % y a a a k U) - u w 8 § > a a / a 2 < 2 / o o E § ) = @ a < A ) _ N \ ) ° C \ k _ � / } 0 $ ƒ w c k § 2 / - \ \ W \ o ) k } } ) \ � a � k L � k " a # E & ) k a § $ u a 2 0 2 J . DepartmentofCommerce PRIVATE SEWAGE SYSTEM County: St. Croix d Building Division INSPECTION REPORT sanitary Permit No: 574368 0 GENERAL INFORMATION (ATTACH TO PERMIT) � ��� 34te Plan ID No Personal information you provide may be used for secondary purposes[Privacy Law,s.15.04(1)(m)]. VD 7 Permit Holder's Name: City Village X Township Parcel Tax No: Keyser, Tyler J. Emerald, Town of 010-1077-30-000 CST BM Elev: Insp.BM Elev- BM Description: Section/Town/Range/Map No: / O t ,C) I /p Q . �� I- 32.30.16.4668 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS FS ELEV. 7, 2 Septic / � `1 Bencrark D Dosing wU Alt. B r 5� T� l/� 3 Bldg. ewer ( / y.p 'Z y Holding -� S t Mufs r 2 . 94,u- S Outlet, 95---f T' TANK SETBACK INFORMATION 2 �'- t./ © C - TANK TO � P/L L WELL BLDG. entto irintake ROAD I / Septic l J yl Dt Botto 'ern J �/ �� Dosing 2 B - Header/ ary , � � .ka71 2.� L eration , LLL ti Dis Pipe S 4,y4', .3? Holding Znal. �Syst / � • D 0`K 3.�5 D1. 5 Gra e PUMP/SIPHON INFORMATION Manufacturer j Demand Wiver �t GPM trl.. Model Number S �� TDH Lift 3 Frictio Loss Ft 6� `� / System H d TDH .�'•�� 1 Forcemain Leingth / Dia. �7 Dist.to Well i ) 30 �— > S—Z SOIL ABSORPTION SYSTEM ,=ems BED/TRENCH Width r Length No.Of Trees nches, PIT DIMENSIONS No.Of Pits Inside Dia. Liquid Depth DIMENSIONS �^ �I� ' :1 \ SETBACK SYSTEM TO / . P/L Vj JBLDG WELL LAKE/ REA LEA C1141 Manufacturer: INFORMATION CHAM OR Ty Af,S,ystem:/ � i r IT Model Number: DISTRIBUTION SYSTEM Heade amfgjd r istribution z x Hole Size�/ x Hole Spacin Vent to Air Intake / Pipe(s) tj /r _J �f/d L� �1 hn>�%4'CfZ Z 1'� Length Dia Length---L--/-!— Dia—L' Spacing SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only � - Depth Over Depth Over xx Depth of✓ xx Seeded/Sodded xx Mulched BedlTrench Cente Bed/Trench Edges/ Top 4 'Thl Y 1 Yes No ] Yes No COMMENTS: (Include code discrepencies,persons present,etc.) Inspection#1: Y Inspection#2:�1 Location: 2275 130th Ave. Emerald,WI 54013(NW 1/4 NE 1/4 32 T30N R16W) NA Lot 1 Parc No: 32.30.16.466B t;, SIG(C-±t "��C. 1---j—A J 1.)Alt BM Description=� 2.)Bldg sewer length= �4v 1.� �� �l Q�/4 204 4�rLt� �h I�iT rl� �� -amount of cover nYePlan revi n Req�ui�te�? � No Use diona ation.� --- -- Date Insepctor's Signature _ Cert.No. SBD-6710(R.3/97) �'� -' / ✓vim 07 .._: d T Ile b r W e �-vART,L{g DIVISION OF INDUSTRY SERVICES O��ti2 p P 10541 N RANCH ROAD HAYWARD WI 54843 Contact Through Relay 9 CE IVED hftp://dsps.wi.gov/programs/industry-services �3 www.wisconsin.gov 4 � 'SSIONAtiSw OCT 0 9 2014 Scott Walker,Governor Dave Ross,Secretary :,OMMUNIN DEVELOPMENT October 02,2014 CUST ID No. 253976 A-TTN.POWTS Inspector LEWIS C BJORK ZONING OFFICE LEWIS BJORK LLC ST CROIX COUNTY SPIA E7818 CTY RD E 1101 CARMICHAEL RD MENOMONIE WI 54751 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 10/02/2016 Identification Numbers Transaction ID No.2460437 SITE: Site ID No. 804972 Tyler Keyser Please refer to both identification numbers, 910 Ush 63 above,in all correspondence with the agency. Town of Emerald St Croix County NWI/4,NE1/4, S32,T30N,R16W FOR: Description:Mound,3 br res Object Type:POWTS Component Manual Regulated Object ID No.: 1497643 Revision;Maintenance required; 450 GPD Flow rate; 18 in Soil minimum depth to limiting factor from original grade; System(s):Mound Component Manual-Ver.2.0, SBD-10691-P(N.01/01,R. 10/12),Pressure Distribution Component Manual-Ver.2.0, SBD-10706-P(N.01/01,R. 10/12), SSWMP Pub.9.6; 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, stats. The following conditions shall be met during construction or installation and prior to occupancy or use: Key Items) CONDITIO • In the event this soil absorption system or any of its component parts malfunctions so as to create a health APPRO 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 DEPT OF SA mound component manual are complied with.A copy of this information must be given to the owner upon PROFESSION completion of the project. DIVISION • This approval is for a revision to previously approved Transaction number 2444484. Reminder • The orientation of the mound system must be such that the longest dimension is oriented along the surfa SEE CORRE 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. • 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 LEWIS C BJORK Page 2 10/2/2014 'a is of a type conforming to the standards or specifications of chs. SPS 382 and 383 and this chapter and ch. 145, Stats. • Maintain well and waterline set backs per SPS 383.43(8)(i).Consult the Department of Natural Resources for well setbacks and other regulations and exceptions. • Insulate building sewer per SPS 382.30(11)(c). A copy of the approved plans,specifications and this letter shall be on-site during construction and open to inspection b authorized representatives of the Department,which may include local inspectors. All permits p Y P 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$ 85.00 Fee Received$ 85.00 Balance Due $ 0.00 Patricia L Shandorf - WiSMART POWTS Plan Reviewer,Integrated Services '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. AAA I MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN ryppli a lon INDEX AND TITLE PAGE Project Name: Tyler keyser Owner's Name: Tyler keyser Owner's Address: 910 US highway 63 Baldwin,WI 54002 715-215-1111 Legal Description: NW NE 32 30 16 W Township: Emerald County: St. Croix Subdivision Name: NA Lot Number: NA Block Number: NA Parcel I.D. Number: Plan Transaction No.: Page 1 Index and title Page 2 Data entry 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 Page 8 Septic and Dose Tanks Page 9 Plot Plan Page 10 manhole Page 11 Effluent filter SALLY Page 12 Soil Report JED Designer: Lewis je License Number: 253976 :ETY AND Date: 09/1 /14 Phone Number: 715-231 S Signature: ;TRY ICES Designed Pursuant to the Mound Component Manual for POWTS Version 2.0 SDB-10691-P(N. 01/01),and both SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST-SAS(01/81)andPON N Pressure Distribution Component Manual Ver.2.0 SBD-10706-P(N.01/01) Version 7.0 (R. 03/2012) Page 1 of 12 r-161, ` 7 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 300.00 Estimated Wastewater Flow(gpd) Table 383-443 in-situ soil treatment for 1.50 Peaking Factor(e.g. 1.5= 150%) fecal colifonn of-36 inches. 450.00 Design Flow(gpd) 5.00 Site Slope(%) 100.00 Contour Line Elevation (ft) 18.00 Depth to Limiting Factor(in) 0.60 In-situ Soil Application Rate(gpd/ft) Distribution Cell Information 75,001 Dispersal Cell Length Along Contour(ft) = 6.00 Cell Width(ft) 1.00 Dispersal Cell Design Loading Rate(gpd/fe) 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) a Center or End Manifold 3.00 Lateral Spacing(ft) If N above,enter the elevation ft 2 Number of Laterals of the highest point. 17 0.188 Orifice Diameter(in) , 4:80 Estimated Orifice Spacing(ft)= 11.84 fe/orifice Forcemain Diameter(in) . 0 Forcemain Length (ft) Does the forcemain drain back? 94.00 Pump Tank Elevation(ft) Enter Y or N 3.25 System Head (ft)x 1.3 4.89 Forcemain Drainback(gal) 7.00 Vertical Lift(ft) 67.38 5x Void Volume(gal) 0.41 Friction Loss(ft) 72.28 Minimum Dose Volume(gal) 0.00 In-line Filter Loss(ft) 24.90 System Demand(gpm) 10.66 Total Dynamic Head (ft) Lateral Diameter Selection Manifold Diameter Selection in. dia. options choice in.dia. options choice 0.75 1.25 x 1.00 1.50 x x 1.25 2.00 1.50 x x ! 3.00 2.00 x 3.00 x Gallons/inch Calculator(optional) Treatment Tank Information 700.00 Total Tank Capacity(gal) 1400.00 Septic Tank Capacity(gal) 37.14 Total Working Liquid Depth (in) Lewis Bork LLC Manufacturer 18.85 gal/in(enter result in cell B49) Dose Tank Information Effluent Filter Information 700.001 Dose Tank Q.Vacity(gal) I Life Time Filter Manufacturer 18.851 Dose Tank Volume(gal/in) LT 1/8 Filter Model Number Lewis Bork LLC Manufacturer Project: Tyler keyser Page 2 of 12 Mound Plan and Cross Section Views _ 1/10 B : . . . . . . . . . . . . Observation Pipe . _ -...Q:-:• J K —� r r - r rsr tir t t �r. �r e e°r 5 r Ar r r ';°.atet�. . . . . . . . ...•.` . . . . B :'. L Mound Component Dimensions A 6.00 ft E 21.60 in H 1.00 ft K [Aft ft B 75.00 ft F 9.50 in z 10.91 ft L ft D 18. in G 0.50 ft J 7.28 ft W 50 (ft)Dispersal Cell Area 268 38 (f?) Basal Area Available .0 gpd/ft)Linear Loading Rate 1 7.50 (ft) 1/10 B Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area Finished Grade 103.29 (ft) P. .,..., ,,,.,,.. ♦ H z G..,...,,,,,.. G 1 F spe�l cell 102.00 (ft)Lateral 101.50 (ft)--* — _ Invert Dispersal Cell ' • �--:•:•:::•:-. :-:.:•:•:•:•:-:-:.:•:•:•: .::.: Elevation E D : = 17• •A• ,..k.�.s4/�:{.{ 3 y �"} �1 1 1`l {I lv't a�{? i ~ 1.F�`�,k���_:_{J. �A.�� �� { �4 5 `•= .{ (F +{}`�-. X,k.{;1.t��:'` .?.l.�y`�4�*`i�l.i { �. -'ti:, -:�;..''�-. 1'1'x" ,� .c'.lc"v`<�C�.�•{.�l-j,..J:': 100.00 (ft)Contour Elevation 5.0 %Site Slope Geotextile Fabric Cover Shading Key m a T Dispersal Cell See lateral details on Q® Topsoil Cap c = 1.5 ft q 4 Page 4 for number,size, Subsoil Cap c .± t ^_: and spacing of laterals. © r- ASTM C33 Sand `� Laterals are equally ® P Tilled Layer 0 ft vp F spaced from the m T scat Lateral -." Aggregate c distribution cell's r.r.f f `°• •' centerline in the �---A distribution cell(AxB). Project: Tyler keyser Page 3 of 12 End Connection Lateral Layout Diagram a-aaai,Igcarkrrasov-HH 'roc A., a�=TL,n-up-rdbsII�, fve c-clas,noutpl_3 rli r3kf1 `S 3rP i32nkiCel ] —YI 'i-iJIES-filled GA:".fie rcStom r, *,e laic.-al j aq!aallu.:paced L Forae Hain ecnnzetion via tEri ar ere:�s to t can?oiC ae anu«dint. Laterrs:=F fc!--ema°I Sch 40 P?�C per S'PS-able a3)4.30-5 Number of Laterals 2 Orifice Diameter 0.188 in Lateral Diameter 1.50 in Orifice Spacing (X) 4.08 ft Lateral Length (P) 73.44 ft Orifices per Lateral 19 Lateral Spacing (S) 3.00 ft Orifice Density 11.84 ft 2/orifice Lateral Flow Rate 12.45 gpm Manifold Length 3.00 ft System Flow Rate 24.90 gpm Manifold Diameter 1.50 in Total Dynamic Head 10.66 ft Forcemain Velocity 2.54 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 Lewis Bork LLC Manufacturer 2 in. Capacityl 700.00 Gallons T Volume 18.85 gal/inch A Weep hole or anti- Dimension Inches Gallons B siphon device A 19.30 363.82 B 2.00 37.70 C -d Pump off elevation(ft) C 3._83 72.28 95.00 D 12.00' 226.20 D Total 37.14 700.00 Dom se tank elevation(ft) 3"Bedding under tank. 94.00 Alarm Manuafacturer Alarm Model Number 520-002A Pump Manufacturer Pump Model Number 152 )" Pump Must Deliver 24.90 gpm at 10.66 ft TDH Project: Tyler keyser Page 4 of 12 County ,., Safety and Buildings Division St Croix 4 201 W.Washington Ave.,P.O.Box 7162 Mad 162 V4, .1 1 Sanitary Permit Number(to be filled in by Co.) �� i 5 State _7 Number/ 7 ``� nary Permit Application Z I/ In accordance wit� �E3.21(2),Wis.Adm.Code,submission of this form to the appropriate governmental unit is required prior t6 obtaining a sanitary permit. Note:Application forms for state-owned POWTS are submitted to Project , the Department of Safety and Professional Services. Personal information you provide may be used for secondary Address(if different than t�ilinR s) /i purposes in accordance with the Privacy Law,s.15.04(1)(m),Stats. —7-2-75 1--36 m /C I. Application Information-Please Print All Information -L''��, Property Owner's Name Parcel# Tyler Keyser 0/0-/0 7 7 _ Property Owner's Mailing Address Property Location-7- 910 US Highway 63 Govt.Lot City,stat Zip Code Phone Number NW%, NE v., section 32 Baldwin, WI 154002 715-215-1111 (circle one) IL Type of Building(check all that apply) Lot# T 30 N; R 16 West X l or 2 Family Dwelling-Number of Bedrooms 3 I This proposed system will serve one 3 bedroom residential Home. Block# Na ❑City of CS Num -33, 3 ❑V,4 o Vv Emerald Q _ l F9 Town M.Type of Per ' • (Check only one boa on line A. Complete line Y, ap ' a A. ("New System Replacement System Treatment/Hold' ' Tank Rep nt Oni ❑Other Modification to Existing System(explain) X B. ❑Permit Renewal 11 Permit Revision ❑Change f Ph ber t T ter to New List Previous Permit Number and Date Issued Before Expiration IV.Type of POWTS S stem/Com nenvDevke: Check all thata 1 Non-Pressurized In-Ground ❑Pressurized In-Ground ❑At-Grade Mound<24 in.of suitable so' � Holding Tank ❑other Dispersal Component(explain) ❑Pretreatment Device(expl ) / V.DispersaVIrreatment Area Information: Design Flow(gpd) Design Soil Application e(gp&t) Dispersal Area Required(s Dispersal Area Proposed sf) System Elevaton 450 .6 ' ,t sc � sow sq ft Z 145. sq ft Iq V1.Tank Info Xitpacity in Total f Manu&cturer Gallons Gallons Units V o v New Tanks Existing Tanks (�( 1 t►L ( :,t c aj a Septic Tank X 700 gal 1400 2 Lewis Bjork x Lift Tank X 700 gal 700 1 Lewis Bork x VII.Responsibility Statement-1,the undersigned,ass®e res for' tion of the POW FS shorn on the attacked plans. Plumber's Name(Print) MP/MPRS Number Business Phone Number Lewis Bjork 1253976 715-231-7375 Plumber's Address(Street,City,State,Zip Code) E7818 County Road E Menomonie, WI 54751 VIII. OUR /De partmentUse Only proved ❑Disapproved Permit Fee / Date Issuing. Si J ❑Owner Given Reason for Denial UL Conditions of Approval/Reasons for Disapproval ;' ; , . �;�.(i a✓tXJ SYSTEM OWNER: 1.Septic tank,effluent filter and J`7 dispersal cell must be serviced/maintained as per management plan provided by plumber. ` 2.All setback requirements must be maintained as per applicable co a or inance . /�t,�f.l-G-�rt 7Ya;t-,� �� .�-G�yn,�:tZ�"� .�r.�,.,!-�t,��";•2i�r�'"�"i2.7��-},. pIVAR DIVISION OF INDUSTRY SERVICES 10541 N RANCH ROAD HAYWARD WI 54843 .� Contact Through Relay p wwwAspsmi.gov/sb/ www.wisconsin.gov ror atis�� Scott Walker,Governor Dave Ross,Secretary September 02,2014 CUST ID No. 253976 ATTN.•POWTS Inspector LEWIS C BJORK ZONING OFFICE LEWIS BJORK LLC ST CROIX COUNTY SPIA E7818 CTY RD E 1101 CARMICHAEL RD MENOMONIE WI 54751 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 09/02/2016 Identification Numbers Transaction ID No.2444484 SITE• Site ID No. 804972 Tyler Keyser Please refer to both identification numbers, 910 Ush 63 above,in all correspondence with the agency. Town of Emerald St Croix County NWIA,NEIA, S32,T30N,R16W FOR: Description:Mound,3 bedroom residence Object Type:POWTS Component Manual Regulated Object ID No.: 1497643 rrODIT1O Maintenance required; 450 GPD Flow rate; 18 in Soil minimum depth to limiting factor from original grade; Syste�i ss)ApPR EZflow Mound Component Manual,(R. 7/12),Pressure Distribution Component Manual-Ver.2.0, SBD-10706-P (N.01/01,R. 10/12), SSWMP Pub. 9.6; Effluent Filter DEPT OF SA PROFESSION The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative CC d `ON QF IND and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. This system is to be con 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. 06, SEE RRE 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 gravelless system components must be installed in accordance with the manufacturer's printed instructions, the plan approval,and SPS 383 system sizing criteria. If there is a conflict between the manufacturer's instructions and the plan approval,the plan approval and code requirements will take precedence. 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. • Surface water drainage shall be diverted away from the system area per Mound Component Manual. LEWIS C WORK Page 2 9/2/2014, • 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. • Maintain well and waterline set backs per SPS 383.43(8)(1).Consult the Department of Natural Resources for well setbacks and other regulations and exceptions. 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 WSMART code:7633 Patricia L Shandorf POWTS Plan Reviewer,Integrated Services (715)634-7810, Fax: (715)634-5150,M-F 8:00 a.m.-4:45 p.m. u p 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. f EZflow® MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Project Name: Tyler Keyser-New Construction Mound Owner's Name: Tyler Keyser Owner's Address: 910 US Highwau 63 Baldwin WI 540002 715-215-1111 Legal Description: NW NE 32 30 16w Township: Emerald County: St.Croix Subdivision Name: NA 4,I-ij Lot Number: - F' Block Number: ANp Parcel I.D. Number: � G —� �- � �` '? '3 L SERV� $ C , - R� E Plan Transaction No.: I L{(� ' y d/ ^ Page 1 Index and title Page 2 Data entry NpENC Page 3 EZflow mound drawings SPO Page 4 Lateral and dose tank Page 5 Distribution media Page 6 System maintenance specifications !� Page 7 Management and contingency plan Page 8 Pump curve and specifications Page 9 Plot pan , Plot plan Legend Page 10 Attchments, Septic/Dose tanks , Manhole Risers , Soil n Page 11 Effluent filter, Designer: Lewis Bjork License Number: 253976 Date: 08/ Phone Number: 715-231-7375 Signature: Designed Pursuant to the EZflow Mound Component Manual Ver.August 20,2007, SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST-SAS(01/81)and Pressure Distribution Component Manual Ver.2.0 SBD-10706-P(N.01/01) EZflow Mound Version 3.0(R. 3/1/12) Page 1 of Mound and Pressure Distribution Component Design Design Worksheet Site Information (r or c) r Residential or Commercial Design 300.00 Estimated Wastewater Flow(gpd) 1.50 Peaking Factor(e.g. 1.5= 150%) 450.00 Design Flow(gpd) 5.00 Site Slope(%) 1 Installation Contour Line Elevation (ft) 125.00 Contour Length Available(ft) 12.00 Depth to Limiting Factor(in) .60 In-situ Soil Application Rate(gpd/ft) Distribution Cell Information 6.00 Cell Width (ft) 3,4, 5, 6, 7, 8, 9 or 10 Only 75.00 =Dispersal Cell Length (ft) 1.00 Dispersal Cell Design Loading Rate(gpd/ft2) 1 Influent Wastewater Quality(1 or 2) Are the laterals the highest point in the distribution F Y Pressure Disribution Information network? Enter Y or N (c or e) a Center or End Manifold 3 Lateral Spacing(ft) If N above, enter the elevation (ft) 2 Number of Laterals of the highest point. 0.188 Orifice Diameter(in)(e.g. 0.25) 4.00 Estimated Orifice Spacing (ft)= 11.84 ft2/orifice 2.00 Forcemain Diameter(in) _ 30.00 Forcemain Length(ft) Does the forcemain drain back? 94.00 Inside Pump Tank Elevation (ft) Enter Y or N 0.00 Forcemain Filter Loss(ft) 3.25 System Head (ft)x 1.3 4.89 Forcemain Drainback(gal) 7.83 Vertical Lift(ft) 67.38 5x Void Volume(gal) 0.41 Friction Loss(ft) 72.28 Minimum Dose Volume(gal) 11.50 Total Dynamic Head (ft) 24.90 System Demand (gpm) Lateral Diameter Selection Manifold Diameter Selection in. dia. options choice in. dia. options choice 0.75 1.25 x 1.00 1.50 x x 1.25 2.00 1.50 x x 3.00 2.00 x 3.00 x Gallons/Inch Calculator(optional) Treatment Tank Information 700.00 Total Tank Capacity(gal) 1400.00 Septic Tank Capacity(gal) 37.14 Total Working Liquid Depth (in) Lewis Bork -Manufacturer 18.85 gal/in (enter result in cell B49) Dose Tank Information Effluent Filter Information 700.001 Dose Tank Capacity(gal) Life Tim J Filter Manufacturer 18.851 Dose Tank Volume(gal/in) ILT9 I Filter Model Number Lewis Bork IManufacturer Project: Tyler Keyser- New Construction Mound Page 2 of 11 Mound Plan View t 1/10 B .... . . . . . . . . . . . . .... 3 J .-Observation Pipe i t K tfti r::' •t................t..,:.,aa:.,.t..,..,..,. . .,., t..,..,.t.t.t..,..,,t..,,., ,ta:.,: .;.;.;.r.r.:.r.r.:.r.:.:.;.;.r.::•}:i.r.r,;.;.}.}.:.:.:.:.;.r.;.r.:.• .}.r.:. .1•r.;.:... :.:.:.:.r.:.• .;.;.:.:.r.:.:.;.. •.r,r; r;f.r.:.:.:.:.;.r.: .:.r. :;r.r.r. A .............t.t.t.t.t.t. 6 :,....t....t.t.t.t...: .t.t.......t....t.......t. .t t t• :•f:f:f�f:f�f:f,�:�,• :,f:,••:�,�,��f:f,f:f:�,���:�,���,f�,'.,�:f���f,��,'•,f, f:f,���,f,' W . ./.....•.•.•. .-.-.•. B . . . .. . . . . . . . . . . . . . . . : . :•.•:•:•:•:-:-:-:•:•:•:•:•:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.: L Mound Component Dimensions A 6.00 ft E 27.60 in H ffl 00 ft K EU28.54 ft B 75.00 ft F 12.00 in z 41 ft Lft 24.00 in G 0.50 ft J 13 ft W ft 450.00 (ft)D ispersal Cell Area 1455.88 (fl?) Basal Area Available 6.00 (gpd/ft)Linear Loading Rate 1 7.50 (ft) 1/10 B Obs. Pipe Placement Mound Cross Section View EZflow Dispersal Area Finished Grade 104.00 (ft) ► H .,/f1I111/1// 2 F : : Dispersal Celi 102.50 (ft) Lateral 102.00 (ft)--► — 6 Invert Elevation Dispersal Cell ::: 3 : : : : : Elevation E D 3 . . . . . . . . . 100.00 (ft)Contour Elevation 5.0 % Site Slope Typical Dispersal Cell Shading Key See Page 5 Efl® Topsoil Cap >S Q• 2 Jf1/111 t�Subsoil Cap cm.222 c 2.0 ft Approved Geotextile Fabric Cover ASTM C33 Sand ° 4 Tilled Layer •a o L tF.r. t•t•t+ t.�yrjt. '..t• t•t•t• t• t•L 7�h•L•t t F r•r•r• :•l•:• r•l r•r• •l r•r•r• ti't•t.t• Mow Media C 1},;•rtjti... ti.t.t. t.t•1 5.1 t.t.t. t fp r•r• r•r•r•r•r•r• . .:r r• Ht•t•t•t• t•t•t•t•t• t•tK•t•t• N 0 0.5 ft r•:• r•:•r•r• r.r.r.r•r t•t• •t•t•t• t•t•t• 1— 0 A See details on page 4 for number,size,and spacing of laterals. Laterals are located in the 4"gravity distribution pipes as shown on page 5. Project: Tyler Keyser-New Construction Mound Page 3 of 11 End Connection Lateral Layout Diagram P •=Tum-upw4ballva"atalsanoutplup Z X11 st orifice bested at z k-X —}) Wx;ees Rofft up excW every 5th 5 arse poi ft di r far dramge. Force 1*COIMWCtKM iMa t44 O(CfM tO lflitMf0it1 at.illy pOOR. Laterals&hxoe main o!PVC Sar 40 AM IsteratS ideattical with oriftCes ecueiy spaced. par SPS TaWe 364.304 Number of Laterals 2 Orifice Diameter 0.188 in Lateral Diameter 1.50 in Orifice Spacing(X) 4.08 ft Lateral Length (P) 74.22 ft Orifices per Lateral 19 Lateral End (Z) 0.78 ft Orifice Density 11.84 ft2/orifice Lateral Spacing (S) 3.00 ft Manifold Length 3.00 ft Lateral Flow Rate 12.45 gpm Manifold Diameter 1.50 in System Flow Rate 24.90 gpm Forcemain Velocity 2.54 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 4V.- Alternate outlet location Forcemain diameter Lewis Bork Manufacturer � 2 in. Capacity 700.00 Gallons Volume 18.85 gal/inch A Weep hole or anti- Dimension Inches Gallons B siphon device A 23.30 439.22 B 2.00 37.70 C d Pump off elevation(ft) C 3.83 72.28 94.67 D 8.00 150.80 D Total 1 37.141 700.00 Dose tank elevation(ft) Bedding And Backfill As Per Manufacturer 94.00 Alarm Manufacturer SJE-Rombus Alarm Model Number TAAB-01 J Pump Manufacturer JZohler Pump Model Number 1152 Pump Must Deliver 24.90 gpm at 11.50 ft TDH Note: Switches containing mercury may not be used in this system. Project: Tyler Keyser-New Construction Mound Page 4 of 11 Ufiowo Distribution Cell Media Layout 6.00 Cell Width (ft) 1.50 Sidewall to Lateral (ft) Distribution Cell Cross-section Arrangements (O(boxodn 6 ft Wide Component Legend ® SR1-7A Bundle-5 ft or 10 ft lengths SR1-12A or EZ 1201A in 5 ft or 10 ft lengths SR3-12H or EZ 1201 P or SR3-12H in 5 ft or 10 ft lengths O 4" Perforated Distribution Pipe With Pressure Lateral Inside . Turnup Enclosure — — — — — Pressure Lateral Bundles are covered with approved geotextile fabric as per the their product approval. Distribution Cell Plan View Layout -Typical 6.00 Cell Width -A(ft) 75.00 Cell Length -B(ft) Center Connection Lateral Layn,it M-4nrnm Force Main 6ftWide — - - - - - - - --- - - - - - - - - - - - - - End Manifold -- - - - - - -- - - - - - - - - - - - - - - --- Project: Tyler Keyser- New Construction Mound Page 5 of 11 Mound System Maintenance and Operation Specifications Service Provider's Name Lewis Bjork LLC Phone 715-231-7375 POWTS Regulators Name ISt. Croix County Phone 715-386-4680 System Flow and Load 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 1400 gal Maximum TSS 150 mg/L Soil Absorption Component Size 450 ft2 Maximum FOG 30 mg/L Type of Wastewaterl Domestic Maximum Fecal Coliform I >10E4 cfu/100 mL Service Frequency Septic and Pump Tank Inspect and/or service once every 3 years Effluent Filter Inspect and clean as necessary at least once every 3 years Pump and Controls Test once every 3 years Alarm Should test periodical) Pressure System Laterals should be flushed and pressure tested every 3 years Mound Inspect for ponding and seepage once every 3 years Other Lewis Bork Pumping 715-231-7375 Miscellaneous Construction and Materials Standards 1. Observation pipes are slotted and materials conform to Table SPS 384.30-1, have a watertight cap and are secured in as shown in the EZflow Mound Component Manual Ver. August 20, 2007. 2. Dispersal cell media conforms to EZflow products approved for use with the EZflow Mound Component Manual Ver.August 20, 2007. Media is covered with an approved geotextile fabric. 3. All gravity and pressure piping materials conform to the requirements in SPS 384, Wis.Adm. Code. 4. Tillage of the basal area is accomplished with a mold board or chisel plow. 5. The mound structure and other disturbed areas will be seeded and mulched to prevent soil erosion and help reduce frost penetration. Lateral Turn-up Detail Finished Grade 6-8"Diameter Lawn Threaded Cleanout Sprinkler Valve Box Plug or Ball Valve Lateral Ends at Last Orifice Where Variable Length Cleanout Begins Long Sweep 90 or Two 45 Degree Bends Same EZflow S thetic Media 2.06 Feet Diameter as Lateral t--Distribution Lateral 0 Lateral Cleanout Project: Tyler Keyser- New Construction Mound Page 6 of 11 Mound System Management Plan ' Pursuant to SPS 383.54,Wis.Adm.Code General This system shall be operated in accordance with SPS 382-84 Wis.Adm.Code,and shall maintained in accordance with its'component manuals[EZtiow Mound Component Manual 8/20/07,Pressure Distribution Component Manual Ver.2.0 SBD-10706-P(N.01/01)and SSWMP Publication 9.6(01/81)]and local or state rules pertaining to system maintenance and maintenance reporting. Septic and pump tank abandonment shall be in accordance with SPS 383.33,Wis.Adm.Code when the tanks are no longer used as POWTS components. Septic or pump tank manhole risers,access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound,defective,or subject to failure must be replaced. Exposed access openings greater than 8-inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into a tank or component. Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s.281.48,Stats. The contents of the septic tank shall be disposed of in accordance with NR 113,Wis.Adm.Code. The operating condition of the septic tank and outlet filter shall be assessed at least once every 3 years by inspection. The outlet filter shall be cleaned as necessary to ensure proper operation. The filter cartridge should not be removed unless provisions are made to retain solids in the tank that may slough off the filter when removed from its enclosure. If the filter is equipped with an alarm,the filter shall be serviced if the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an impending continuous alarm. The septic tank shall have its contents removed when the volume of sludge and scum in the tank exceeds 1/3 the liquid volume of the tank. If the contents of the tank are not removed at the time of a triennial assessment,maintenance personnel shall advise the owner as to when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank. The addition of biological or chemical additives to enhance septic tank performance is generally not required. However,if such products are used they shall be approved for septic tank use by the Wisconsin Department of Commerce. Pump Tank The dosing(pump)tank shall be inspected at least once every 3 years. All switches,alarms,and pumps shall be tested to verify proper operation. If an effluent filter is installed within the tank it shall be inspected and serviced as necessary. If the force main has a weep hole,it should be noted if it is functional during pump operation,and if not,it should be cleaned. **—*No one should ever enter a septic or dose tank since dangerous gases may be present that could cause death.**** Mound and Pressure Distribution System No trees or shrubs should be planted on the mound. Plantings may be made around the mound's perimeter,and the mound shall be seeded and mulched as necessary to prevent erosion and to provide some protection from frost penetration. Traffic(other than for vegetative maintenance)on the mound is not recommended since soil compaction may hinder aeration of the infiltrative surface within the mound and snow compaction in the winter will promote frost penetration. Cold weather installations(October-February)dictate that the mound be heavily mulched as protection from freezing. Influent quality into the mound system may not exceed 220 mg/L BODS, 150 mg/L TSS,and 30 mg/L FOG for septic tank effluent or 30 mg/L BOD5,30 mg/L TSS,10 mg/L FOG,and 104 cfu/100 mL for highly treated effluent. Influent flow may not exceed maximum design flow specified in the permit for this installation. The pressure distribution system is provided with a flushing point at the end of each lateral,and it is recommended that each lateral be flushed of accumulated solids at least once every 3 years. When a pressure test is performed it should be compared to the initial test when the system was installed to determine if orifice clogging has occurred and if orifice cleaning is required to maintain equal distribution within the dispersal cell. Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the owner,and any levels above 4 inches considered as an impending hydraulic failure requiring additional,more frequent monitoring. Contingency Plan If the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep the system in proper operating condition. If the dosing tank,pump,pump controls,alarm or related wiring becomes defective the defective component(s)shall be immediately repaired or replaced with a component of the same or equal performance. If the mound component fails to accept wastewater or begins to discharge wastewater to the ground surface,it will be repaired or replaced in its'present location by increasing basal area if toe leakage occurs or by removing biologically clogged absorption and dispersal media,and related piping,and replacing said components as deemed necessary to bring the system into proper operating condition. See Page 6 of this plan for the name and telephone number of your local POWTS regulator and service provider. Project: Tyler Keyser-New Construction Mound Page 7 of 11 Page 1 of 1 cn [C � w PUMP PERFORMANCE CURVE MODEL 151/152/153 50 14 45 153 12 40 Q 35 10 152 30 a 0 8- 25 151 r o g 20 15 �L\L 4 10 _ 2 5 0 10 20 30 40 50 60 70 80 90 100 GALLONS LITERS 0 40 80 120 160 200 240 280 320 360 FLOW PER MINUTE 014508 https:Happ.gleapahead.com/rtp/tools/93928-63.gif 8/26/2013 T � t� 4 j ti IA 1516 ) Plot Plan Legend 1 4" PVC ASTM D 3034. 42"Min. Cover where snow is not removed. 2 24" inside diameter plastic manhole brought min.4" above surrounding grade. Concrete/plastic covers screwed down. 3 Precast concrete septic tank. 4 Effluent filter location. 5 4" PVC ASTM D3034. 18" Min . cover . Effluent piping or building sewer where tank is within 30'. 6 Precast concrete dose/pump/filter tank. 7 12-2 OF-B Power conductor . 14-2 OF-B alarm circuit conductor. Both wires are UL listed A-2057 8 2" PVC ASTM D-2665 -09 Schedule 40 Pipe Force main. 9 4" PVC ASTM D-2665 -09 Schedule 40 Pipe . Entering and exiting concrete tanks min 10' in length. 10 Carlon All weather pvc junction box. UL listed # A-241 11 treatment/dispersal cell 12 Inspection wells Project: Keyser Page 9 2 BAFFLE o Bi.ET - LBiIIB LEVEL p�TLET ^� OLRlE7 o - A M- - -- - -- - - - - - - - - f] FL.TER o Cl 0 0 0 v N �..-._��` L7 h m SENT h L72.0 .� 64.0 7M SECTION A--A END VIEW 180 36A 18A -- - LB 700 FILM TANK SPECIFICATIONS 4' REDNFURC'D COW- WALLS CONL COVER A A 4- RE 'D IHOTT13M o MANHOLE, 24' PRECAST RISER n L M.ET OET� HIEGHT- 54• O.D. LENG K 72' O.D. WIDTMb 72, O.D. INLET INVERT- 4r i OUTLET INVERRT- 38' (LIQUID LEVEL) i ° LOADING DESIGN W-0' UNSATURATED SOIL M 1825 GALLONS PER VERTICAL INCH INSIDE TANC. FOR USE AS PUMP/SEPTIC/HOLBIMG TANG. MORE INFORMATION AVAILABLE CONTACT- LEWIS RJORK 64.0 72.0 PLAN VIEW -- TOP SLAB LEWISB J R K , L L C NOT TO SCALE AUGUST 20, 2012 MENOMONIE, WI DRAWN BY.- JCP 2 r O O fDfD ob o D �• o � O d fD 1F N a m IT 0 0 3 3 x CD uu 1� O O lD n. v °o Q O m A Tuf-Tite Riser System Tuf-Tite makes a full line of Risers and accessories for Pre-Cast applications. a Riser Lid-with Molded-in gasket. Available in 12", 16",20" and 24" diameters. Green Only. r r � I - Concrete Lid-with handle. Use the Safety y Pan to cast your own concrete lids. r Safety Lid-May be used in place of concrete lid. Fits 24" Riser Pan only. Black Only. Safety Pan- Safety Padm available for 16", 20" and 24" Risers. Green Only. 6" Tall Riser-For septic tanks. Stackable in 6" increments.Available in 12", 16", 20" and 24" diameters. 12" Tall Riser-For septic tanks. Stackable in 12" increments. Available in 20" and 24" diameters. Black Only. Tank Adapter Ring-For mounting riser or lid to tank when casting-in is not an option. 20140048A I t e i m 1:j 45 - installation and Maintenance Instructions Installation Step i Dry fit the filter case onto the outlet pipe going to the drain field.Ensure it is centered directly ufrder the access opening.(If outlet pipe is already in a fixed position,additional pipe may need to be added) Step 2 If utilizing the additional single side support and the two bottom supports: While the case is still dry fit to the outlet pipe,measure and cut 1"schedtde 40 pvc pipe to the length needed to extend from the hubs that are pre-molded into the case to the side wall and the inside floor of tank. solvent weld pipe into the hubs that are pre-molded onto the case. Step 3 Solvent weld the case to the outlet pipe.insert the filter cartridge into the case pressing down on the . - cartridge until it locks into place at the bottom of case. step 4 if utilizing a vertical read switch:insert switch into the hole pre-molded into the top of the filter.Press straight down until it locks into place Maintenance 1) Remove the access tad of the tank. Note:To erasure undesirable solids do not exit the tank and into the drain field,the tank should be pumped out until the level of effluent is below the outlet level of the t-enk. 2) To remove the filter cartridge from the filter case,pull up firmly on the handle of the cartridge cligo'ciging it from the case.(if utilizing a vertical read switch,removal of switch is optional) 3) Using an ordinary garden hose,rinse the fitter cartridge ensuring all visible septage material is removed. 4) Place the filter cartridge back into the filter case pressing down on the cartridge until it locks into place. 5) Place the access lid back onto the tank ensuring it is secure. RECOVER FEB ti SAFETY&BUILL,-1 r-.j • iifetine filter has a 6tetirie(united warr�ty: Ufetime titter U C warrants the fiber will be free of rnanufacturing and workmanship ddkb during normal me lambs period of tieie the original purdiaser owns the product ilfetime titer will provide a replacement fitter in the event Hot the ork foal Oterwas not damaged during the Installation or mice process.Damage to this product caused by aeciden%misuse or abuse wig not be covered under this warranty.tmpropercwe or malfunctions resulting from product not being mstaped,operated or mmntained properly wig void this warranq.Uhnime Mw assumes no responsibility for labor charges,removal charges,imstabtion or other Incidental or consequential oasts contact;rni Phone:502--724-2231 N - Wisconsin Department of Conjgfke"~`�p�-��� rI�E�� SOIL OVA REPORT Page 1 of 3 Division of Safety and Building!P" , F #i,�866rdance with Comm 85,Wis. Adm. Code ,,A �,(p County St.Croix Attach complete site plan , ' not less than 8 1/2 x 11 inches in size.Plan must include,but not limitedhical and horizontal reference point(BM),direction and Parcel I.D. percent slope,scale or dimensions,north arrow,and location and distance to nearest road. — 077 36-6166 Reviewed by Date Please print all information. 1 , Personal information you provide may be used for secondary purposes(Privacy Law,s.15.04(1)(m)). Property Owner Property Location ■ Tyler Keyser Govt.Lot NW 1/4 NE 1/4 S 32 T 30 N R 16 E(or)W Property Owner's Mailing Address Lot# I Block# Subd. Name CSM# p 910 US HIGHWAY 63, 2 - VU I - o q City State Zip Code Phone Number rjVillage Town Ndarest Road BALDWIN WI 1 54002 ( 7)15-215-1111 7� 30th ave New Construction Usela Residential/Number of bedrooms 3 Code derived design flow rate 450 GPD ®Replacement Public or commercial-Describe: NA Parent material Loess cap over till Flood Plain elevation if applicable IAA ft General comments Install 18"mound on the 100 contour, .6 basil and recommendations: ORIGINAL Boring# D Boring El Pit Ground surface elev. 100 ft. Depth to limiting factor 18 in Soil A lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. *Eff#1 *Eff#2 1 0-6 7.5yr3/3 sit 2fsbk mvfr cs 2f .6 .8 2 6-12 7.5 5/4 sit 2msbk mvfr as if .6 .8 3 12-18 5yr5/3 scl 2fsbk mfr _ - ,4 .6 4 15-20 5yr5/3 c2f1oyr6/2 scl lmsbk - - - - - a Boring# S Boring 99 18 Pit Ground surface elev. ft. Depth to limiting factor in. =Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence EBoundary Roots GPD/fft in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. *Eff#1 *Eff#2 1 0-6 7.5yr3/3 sit 2fsbk mvfr 2f 6 8 2 6-13 7.5 4/4 sit 2msbk mvfr if •6 .8 3 13-18 5 5/6 scl 2msbk mvfr gs _ 4 .6 4 m 18-24 5yr5/6 c2floyr6/2 scl lmsbk - *Effluent#1 =BOD >30<220 mg/L and TSS>30<150 mg, *Efflu t#2= ODS<30 mg/L and TSS<30 mg/L CST Name (Please Print) Sign CST Number Lewis Bork 253976 Address Date Evaluation Conducted Telephone Number E7818 County E Menomonie WI 54751 6-17-2014 715-231-7375 Tyler Keyser Page 2 of 3 Property Owner Parcel ID# 9 Boring# ® P t ing 100 18 Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. *Eff#1 *Eff#2 1 0-6 10yr3/3 - sil 2fsbk mvfr es 2f .6 .8 2 6-15 7.5 4/4 - sil 2msbk mvfr as if .6 .8 3 15-18 5yr5/4 - scl 2msbk mvfr - - .4 .6 4 18F24 5yr5/4 c2f10yr6/2 scl Ifsbk - - - - - Boring# Boring ORIGINAL Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. *Eff#1 *Eff#2 Boring E Boring# Ground surface elev. ft. Depth to limiting factor in. Pit Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Qu.Sz. Cont.Color Gr.Sz.Sh. *Eff#1 *Eff#2 *Effluent#1 =BODS>30<220 mg/L and TSS>30<150 mg/L *Effluent#2=BODS<30 mg/L and TSS<30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. SBD-8330Test(R.07/00) w � Lb Vi Suwon o Q 0 0 U U 01 PKID GO 80 UN a ST.CROIX COUNTY 1130031 ftCook tea► sISRVFYOR'S RECORD W YNOa CERTIFIED SU RVEY MAP I, Arthur L. Wegerer, registered land surveyor, hereby certify: That in full compliance with the provisions of Chapter 236.34 of the Wisconsin Statutes and under the direction of George Collis , owner of said land, I have surveyed, divided, and mapped said parcel of land, that such plat correctly represents all exterior boundaries and the subdivision of the land surveyed; and that this land is located in the NW4 of the NE4 and the NE4 of the NE4 of Section 32, T 30 N, R 16 W, Town of Emerald, St.Croix County, Wisconsin, to-wit: Commencing at the Northeast corner of Section 32; thence West along the Section Line a distance of 1234.401 to the point of beginning; thence South 466.691 ; thence West 466.691 ; thence North 466.691 ; thence East 466.691 to the point of beginning.; The above described parcel contains 5.000 acres of land subject to the Northerly 331 being reserved for town read purposes . Dated this 2nd. dad`° �Q.�p / ' �'75 . � w •• Arthur L. Wege r C ARTHUR 1. '. Wis. R.L.S. No. S-963 C WEGE'2ER { E S-963 `t ELLSWORTH = NE CORNER 'C WIS. •. •.� •: SEC. 32, T 30 N, R 16 W • . . • • • . . • . • . . • . • • • . •RIB T .�IVV� ��i,. • . • • r . • • . . • TOWN• s' +rr��r�rr► ROAD •` EAST 466.69` • • • 7 � � co f WEST 1234.40' 900 466.69' OO' o OP M M _ LOT I 0 5.000 ACRES � 0 z 0 � O = I"X 24" IRON PIPE WEIGHIN( I.l 3 LBS./ LINEAL FOOT 900 OHO �0, WEST 466.69' N 1 NW - NE NE- NE w O Volume 1 Page 169 ,�I Sep 03 2014 02:53PM Keyser Trucking 17156882463 page 1 09/09/2014 10; 06 FAX ST. CROIX CO. CLERK 1Q 001 `���-c..-�V iv v�..iv hri ��. `i Ylw �4Y9G] *'lan/YOrnn9 Y L7•JED'9Oa0 ` 1/1 ST.CI OEX CGUNW �3EFTl('TAt4K MAINM- ANC-E A0 t$EMfFtff AND O'MRSlM CBMx wnmq pow Owner/Buya-- -?"u,10 r Kt--q.-,pr Mnmr4,4&ktu 4 tvar,Ga►tson requa�d nom PkmtnU a zoning >tMW cvaatruotio�) Gity/sttttc 1d_w;.. � _ Pvicel Identification Number 10-7-7— 30-66O 2009MON 5Z?/ PMP rry L-vcstitnt) V;• tl£ ir.,Ste, _.T :�O_N R �q W.Tt:wtt of fM area,( d Subdivwon Plot: .Lot , cUdw Brrvey,Mtep �U6 3 I Vafnme Page�! / Watrra"DMd# ct q 3 -7-7 .. (be:fvt:ti�3)vcls:�e Par spa t vtm '� LM Stns rtat k Ao I�t�tree and es�yo!or a+P�ayhetam aodd�I't is ib ptttm.hp,t�$duet m 6emdihs waata,t. Praprr to bftM M aMdit of pUtWittt out the t WHe task way th>MM YN"a•oeaar,lt aowd-4 by a lieahrtaad pu Pw- Wbat y"pus ire ft*"=cm saw tba owed"of the tt P*MAO LiMUeaet 1hV to tz oak dhpnW ayhta M OWW WAdot�thaee tespwm'bfWw ane qWA'fiMd in fCama.83=1)tud in Chip*17-St Cwbc Coumy 8Wub*Dcdiminot, I'MPOW7~091W Vo V bM%lD St.l[ jx CbM7$mrie P�Io. *r— DIPDUM 4 WrfFA%ft rta Bylaw a. toisptattbr.f oul lwyrtmt Pk4wwr.'ar l"%wnba ar a tlegrar d;apv net ify t=ttw i t 1 ft awn-atte wa leeater dt>qmai>YOU., lnnlrer operaei.�g Boa weXVart21 after tr„gp=tots wa pumping of IMice satyr.fie ILIft:ink is bm dt n i!3 fbiivfthftedge. Hare. a oaddaeaiggad bws ewd tbs abohre ta4it�aataoas aestl sRe+a tr tetwati ie ahntrya AWPNW Sys %*h the a da&ea,thr4k'i,aai&asam bytt a DapsolCnamWAM40ddo sovzt�rwt$uds.fWUMM0166 Cafsdieatioht ssrtt>Ittt that�vuraaytionyttem ym J dmMUt Jsa oa aytitudsmd iaRamad to dwSe am6e Cahj*W 30ao:Aite6 Zooktt a bisa 30 dap of the rhea p w mgjadm dabs. L*m oordfy tM all attteindtb 00$tie AM 8M trite b tie belt of aLYhw kmowleim lAve aovM the MWW(o)Of 16 prcwatY dweidbed tbM br vJr=of•wurenbr decd Mmdod In P4jbW of Dowil Mom �ltttdbOr�#'lt'adt+oowe�� N mss) DA Atq iafar,ttatihm that is miers�gmead spay fwelt is the�rY permit 6e�cetrott>Ad tba dt sss �' ZaaittrDapeVOttaett bnowe with WC Rrpacakm a eeweded wraerwty&W A*=dw Ra kiw ofDaada Oltics and a can Odo oftfle"VA"Y rMw It fal"mace li meat trA dw ww=ty head. IRTV,QwM NJ'.L-c.W-&W IV vo.QU cvrtrnq .F r� 366`4CSaO 9f� ST.CMXX COUNTY SEPTK"TANK MAINTENANCE AQREMENT AND OWNERSW CERTIFICATION FORM Owner/Buyer :2�„(O r Key se-f- Mailing Andreas P 10 L S L-L to 3 ' -a �- I-364 Property (vnriticadatn mquhvd from Pig I 7ming naparwiad fbr ack cWskWcEj G� ce city/State ��dt�;� �.. tJ 1. ParcelIdentil;cation lumber 010 -_ 10-7-7— 3O-6�)C Pn4XVy Lou tian 110 V4 . a E Y.,Scc,,3,,T_ 6 N R W,To"of �y e-r(z d Subdivision Plat. Lot# . Certl$e Stu gMap# '3 vainnm L_. =Pale# Wwrstefy Daed 4 g q -37 -7 1 (bt:fom 2007)vt # Sw h om •ya Lm Him itfattiibdk no SYSTEM bWMNAMM AND 0"ER CMMCATION Improper use ad MBhftMM of Your septic system COW Milk in its peematt M MM to handy at XdM Prager ntainttuxm consWi of pumping out the mptic tack way three yearn or waster,It am"by a i'roMWW Pumper. What you put into the system sate aifett the Amedan of On sapdo tank as it aeatmmt atsge In dw waft dlgmW system. Garner uWaite:om rtr'biliilam are in n1.$3.31)and ii! apilar ix-St.traix3' uulaty OCditlArtCt;. r*pra"ny ownct qMm to submtt tb St.t-miA Carnaty PIsautfinS tic Zcm ant a certlfiraria h thin.UPW by ripe owm rind try a lzaasCerpim t ar,j=ncyman gtamtrer, art tiommedpumpervv i"S that it t ttte an-site waatewatet tiffs ml BYstetn u fn pmW operattng comiidon unft i 3f aftar fnspertion and lmmptng tff necessu r.$7t:smak eagle it itha than V3 fuii ofstadp, Ywe,eke amterm pW have md do abwm raqAk*mm aed qpu to mainink else prhvm awes die oW system with tha *mad"m fork UWm,asa d by the Dep=Uamt of0momem4nd As DopmIUMM OMMUM RWOUMM SW Of Wes. t��tstficatioa your saptia sysem bm boo,m2int-ined masse be co3osd and reamed to Sae St.Croix C4=tyPlumkS& Zoning Dep meat wWm 30 days afthe these year axpbdm dabs. Iiwe certify the all staternaats on this farm am trae to the best of mykw knowledte. Ywe anV&e tle ownerW of the prope*described above,by virtue of a wananty deed reamed in Register of Doak OffloL Number of bWrwm SIGNATURE OF ANTS) DATE ***Any iaforamtioa that is meted may result in the ma my permit being mvobd by the Plasz ft&Zodn Deparwamm;** inabde with dais appiiaadw a recorded warrmty steed Rim Miffs Register OF 0866 t fret snel a adpy of the oft'd;ed ttut M map if refermne is merle in the warranty deed. (REV.005) 11.1111111111 l l l l II l 1 1111111 II 11 2 8 $ Tx:41879615 1 993779 STATE LIAR OF WISCONSIN FORM I -2000 BETH PABST REGISTER OF DEEDS Document Number WARRAN'T'Y DEED ST. CROIX CO., WI. THIS DEED,made between Vickie L. Collis,Grantor,and'I'yler J. 03/21/2014 10:06 AM EXEMPT#• N/A Keyser,a single person, Grantee. REC FEE: 30.00 TRANS FEE: 90.00 Grantor, for a valuable consideration,conveys to Grantee the following PAGES: 1 described real estate in St. Croix County, State of Wisconsin (the "Property"): Part of the NW%s of NE'4 and NE% of NE4 of Section 32, Township 30 North, Range 16 West, Town of Emerald, St, Croix County, Wisconsin, described as follows: Lot 1 of Certified Survey Map filed October 30, 1975, in Volume 1, Page 189, Document No. 330031, of Certified Survey Maps in the office I of Register of Deeds for St. Croix County, RccordingArea Wisconsin. Namc and Return Address: AgStar Poe 3Uo 9.ca u n t.ol 5'A00') Together with all appurtenant rights,title and interests. 010-1077-30-000 Pnrcel Identiricafion Nundrer(PIN) This is not homestead property. Grantor warrants that the title to the Property is good,indefeasible in fee simple and free and clear of encumbrances except reservations,restrictions and easements of record,if any,and public highways,zoning and building regulations. Dated this aO�hday of March,2014. Vickie L.Collis N K AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE Or WISCONSIN ) COUNTY. )ss. authenticated this Personally came before nae this a� day of Marcli, 2014 the above named Vickie L.Collis to me known to be the — person(s) who executed the foregoing instrument and TITLE: MEMBER S'I' NOTARY vVf acknowledged the same. (If not, SIN R :authorized by§706.06,Wis.Stats.) � ,��' THIS INs'rRUMENT WAS DRARTED BY Notary Public,State of Wisconsin My commission is permanent. (If not,state expiration date: Michael 1I.rorecki,Attorney (Signatures filly be nutherlficated or acknowledged. Both are not necessary.) *Names or persmrs signing in any capacity must be typed or printed below their slgrwture WARRANTY DYED STATE BAROG WISCONSIN FORM No.1-2000 St.Croix County 993779 Page 1 of 1 Parcel M 010-1077-30-000 09/02/20P AGE E 1 PM P 1 OF 1 Alt. Parcel M 32.30.16.466B 010-TOWN OF EMERALD Current )Xj 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-KEYSER,TYLER J TYLER J KEYSER 910 US HWY 63 BALDWIN WI 54002 Property Address(es): *=Primary Districts: SC=School SP=Special Type Dist# Description .(�lXfvr` `Y��LG�[ SC 0231 SCH D BALDWIN-WDVILLE SP 8020 UPPER WILLOW REHAB DIST Notes: SP 1700 WITC � Legal Description: Acres: 5.000 SEC 32 T3-ON R16W 5A IN N1/2 NE1/4, - CSM VOL QTFMACCESS EASEMENT TO L Parcel History: JUHN-0UN 1 D Doc# Vol/Page T e 03/21/2014 993779 WD 07 Plat: Primary Tract: (S-T-R 40%160%+GL) Block/Condo Bldg: *0189-CSM 01-0189 010-75 32-30N-16W LOT 01 2014 SUMMARY Bill M Fair Market Value: Assessed with: 0 Valuations: Last Changed: 10/19/2004 Description Class Acres Land Improve Total State Reason PRODUCTIVE FORST LANDS G6 5.000 12,500 0 12,500 NO Totals for 2014: General Property 5.000 12,500 0 12,500 Woodland 0.000 0 0 Totals for 2013: General Property 5.000 12,500 0 12,500 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch M Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00