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HomeMy WebLinkAbout020-1433-03-000AUG-02-2004 12:54 PM A.C.E. Soil & Site E~al 715 248 7764 ~~ ~,[~..fie~ 1J~ive Z--~ ~/y ~ Sal ~~ +oa+flar-~o,~ • !~'i~fl ryi.dt t~ • Loca.~E'~d ~Ir~o. strt~ ~~ P. 01 •~- ,a ~ ~ . r ~ f ~ r°> .. ~, ~}o~s~cl d ~~r.~sk Et~t. r~~ ~,JPtW ~+C• ~1'~Mxd ~If ' 1 w(.p ~/b~ ^RR ~ KYK4 f ~~~ ~~ ~ ~ ~ ~ B~ o~P ~ under cr.. ~ i .~ ~ \ l f D ~ r 3 7opa/'~~ Ste. \`~f~:l ~k1~` n ~ 73~ S.~ t -~~ ~~ v Pyo,~«,K..,~ ~ •, ._ ~~;~ ~~~J ~~ e.kr~ s/d~B.~7.~ I ~ 3 i ~ N N ~ ~_ ~ I °' a m O ~ O v C W I ~ ~' m I ~ c ~i L I i i o i ~ o I ~ I N ~ ~ Q Z I p i N O I 3 ~ a 2 0 ~ ~ I I I I I ly o ~ ~ y N o y O 7 Cn Z N ~n D I~ o. W O Z O _ -o ~~ a ~ m v m N ~ N ~ 7 CD ~- y N ~ N a a~ ~ ~ v X ~ c _ ~ ~ ~. c "• > >_ ~ O O N O C y A N 77C ~ ago ~ a~ O n n `~° d 3 .M O N CscnO~ c :: ~ ~ ~ ~ j v =r o ~ ~ ', W C ', ~ y co ~, . ~~ O S 7 rt y Q° tD a o a o, J i ~_ O O ~ I ~ ~ W Q A A ~ ~ (D v ooo~ a vv, eo ~' ~° ~ °: . I 3 m v, f ~o _ ~ rye O ~ I C 00 Z O ~ ~ ~ !i C O ~ C ~ N O. ~ ~ D o c n ~I W ~ a ~ Q M ~! Z f W 01~ a ~ • o. ~. m ~, ~ N ~ > > ~ 0 O F ~? C m D o ~ a N d N < (p vi a O 'O 7 C ~r ~~ m 0 ~n O O 7 N O O ~- 3 m o ~' ~ ~ ~_~~ _ -• o -+ N N ~ Q ~ ~ W ..~ <° ca O N O ~ W N ~ O ? O N O C 3 .. N W 0 c a m ~7 N -~ ~ fA ? Z n A ~ ~ ~ "'~ .a ~ ~ ~ _~ ~.. (~ m ~ A d r: HI O ~1 0 ~• ~• O A a a N 0 0 A Cn d0 ~ ~ N b V AUG-02-2004 12:54 PM A.C.E. Soil & Site Ea~al 715 248 7764 ~' ~--'~ Ala ^ Sa"/ trk rea~arl~4~"~ • !Ea'i~$n~~Malt ski' • located ~Ir~p. s ~t, q-a p.s~d d ts~rt+ak u8t. ~oPes~t ~rtw Grrc, p-'+~~d ~+( l wL,P IG~/6aD ~cQ CdMitn,R+6io+,sr./p.~~ Derr. ~~,eka,.~.r; 1R • '~ gb~dro~+ns~KOe j ~ ' ~~ ~ rp°. ~ ~ ~ i~ ~ ~ r ~~M 3o~~i!~e. `~ _ ~ r ` ftl~ ~M~•' `~~~Z~,~~~6 ~~ r Top e{'~6~ S~a,(¢. ~Ae~ ~ f~L 7S" • - .+ ~ ~ ~ ~ 1 ~4~~a ~ "1-. - ...• ~,.,;~ ~~,^~rJ ~~`: P. 01 F~~~F~~1 H'. >.) ~ 2004 • +~• ~~ a~ lrwes~ (~crv f. ,4ssa•nad ' ~~ ~` ~ S r.7/ 2 ~ c ~Q it '~ .vim ~ ~~ Safety and Buildings Division County ~~ ' 201 W. Washington Ave., P.O. Box 7162 ~ Y O/ - ~ ~seans~n ` Madison, WI 53707 - 7162 (608) 266-3151 Sanitary Permit Nu ber (to be filled in by Co ) y~ ~ ~ 9 Department of Commerce , State Plan 1.D. Number Sanitary Permit Application - ' N " tt`JHSLipr~vidC~ M1it ersonal infjrt Adm Code 83 21 Wi i h C d ~ ~ , p . . , s. w omm In accor t may be used for secondary purposes Privacy Law, SieS'04C1)(ht) g address) in Project Address (ifdifferent than mail " ~ ~ I. Application Information -Please Print All Informati n ; n ~ ~, 1 JJtr' > ~/~~ ~ ..JA Propert O)H~ier's Name ~~I Y~. - Parcel # Lot q Block # -- o 0 Property Owner's Mailing Address ~/- ~~- --- ° '~ ~~ .J`` ~ ~~,/~~ ! ~J/ ~ s Pro/pe~rty Location ~W %, ~'/., Section // City, State /~/7 Zip Code Yj gPhone Number j~ *~ ~ (} ~~ II. Type of Building check all that apply) ~/ 1 or 2 Fami{y Dwelling -Number of Bedrooms Subdivision Name CSM Number ~ ` ~ ~ ~ C , Qt~n / S A e W ^ PubliclCommercial -Describe Use 2 ~ • ^Ciry_^Villa ownship of r.C 0 iti/ ^ State Owned -Describe Use `o ct+ Z Or III. Type of Permit: (Check only one box on line A. Complete line B if ap cable) 4 '+' New System ^ Replacement System ^ Treatment/Holding Tank Replacement Only ^ Other Modification to Existing System B. ^ Permit Renewal Permit Revision ^ Change of ^ Permit Transfer to Ne~v O List Previous Permit Number and Date Issued / ~? ~"~~ - p y Before Expiration Plumber wner ~ I N l ~ ///J 1 ~ IV. T of POW`TS S stem: Check all that a I d Filter ^ S i l P ^ an ass ng e S Non -Pressurized In-Ground ^ Mound > 24 in. of suitable soil ^ Mound < 24 in. of suitable soil ^ At-Grade Constructed Wetland ^ Pressurized In-Ground ^ Holding Tank ^ Peat Filter ^ Aerobic Treatment Unit ^ Recirculating Sand Filter (- ' Recirculating Synthetic Media Filter ^ Leaching Chamber ^ Drip Line ^ Gravel-less Pipe ^ Other (explain) ~ Y u V. Dis ersallTreatment Area Infortation: Design Flow (gpd) Design Soil Application Rate(gpdsf) Dispe~rs/al Arepa Required (sf) Disper~s,~a(l Area Proposed (sf) stem Elevation ~ VI. Tank Info Capacity in Total Number Manufacturer Prefab Site St Fiber Pla I~~Q ~. --/c7p Concrete Constructed Glass Gallons Gallons of Units ~ New Existing .~~Qr: Tanks Tanks t Septic rx Holding Tank .~~ `P~ c C Aerobic Treatmem Unit Dosing Chamber VII. Responsibility Statement- I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Business Phone Number Plumber's Name (Print) Plu is Signature MP/MPRS Number a~~ ~. Nwt~sor~ ~ Z,ZO~~~ ~i~--fig -3.3'18 Plumb©er's Address (Street, Ciry, State, Zip Code) VI[I. Count /De artment Use Onl `Approved ^ Disapproved Sanitary Permit Fee (includes Groundwater Date Issued Issu'ng Agent Signature (No Stamps) F h ~ S urc arge ee) ~~~ ~~ . ^ Owner Given Reason for Denial ~~ -~.e 7-~ml.~. .~+. So IX. Conditions of Approval/Reasons for Disapproval 3~ ~r ~ ova C~v ~ ~~ SYSTEM OWNER: 1 Septic tank, effluent filter and '+~ S ~~`" J~ ~~ ~a.e_ ~ ~p dispersal cell must all be serviced /maintained S-~L + ~Q,sw-~ rn~e_ ~$^*°'"`r `~° ' ~"0 as per management plan provided by plumber. ~~s o.~- ~ t~ l~ o ~.~e P rs c, 2. All setback requirements must be maintained li ~ ~"~ Z ~~ '^~'~' ~ as per app cable code/ordinances. • w..-ofn .. ff :.... .iw .isw wuacn camgncac paam rau aaac ..an...y „uyr .... ___ ____ <¢.,~, tr dl~ ~ . s'i= 5z ~~ SBD-6398 (R. 01/03) Safety and Buildings Division 201 W. Washington Ave., P.O. Box 7162 County ` nsin Madison, WI 53707 - 7162 i Sanitary Permit Number (to be filled in by Co ) seo (608)266-3151 Department of Commerce State Plan I.D. Number Sanitary Permit Application rovide ou mation fo l i d d C p y r n m. e, persona o In accord with Comm 83.21, Wis. A Project Address (if different than mailing address) may be used for secondary purposes Privacy Law, s15.04(1 xm) L Application Information -Please Print All Information Parcel # Lot # Block # Property Owner's Name OZ!I- 0 Property Owner's Mailing Address Property Location ~ 2~ 6 %., %., Section Ciry, State Zip Code Phone Number (circle one) T N; R E or W II. Typpof Building (check all that apply) ~ ~ n ~ ~ ~ K~ Subdivision Name CSM Number or 2 Family Dwelling - Number of Bedrooms ^ PublidCommercial - tribe Use ^Village ^Township of ^City ^ State Owned -Describe _ III. Type of Permit: (Chet my one box on line A. Complete line B if applicable) A' ^ New System ^ R ce t System ^ Treatment/Holding Tank Repl ment Only ^ Other Modification to Existing System List Previous Permit Number and Date Issued B. ^ Permit Renewal Before Expiration ermit R 'ion ^ Change of Plumber ^ P it Transfer to New O er ~~~ ' (~j b ~. N. T of POWTS S tem: Check sll that 1 ^ In-Ground ^ Mound > 24 in. of itable soil ^ ound < 24 in. of suitable soil ^ At-Grade ^ Single Pass Sand Filter ^ Non -Prtxsurized „ Constructed Wetland ^ Pressurized In-Ground ^ Hol ' g Tank ^ Peat Filter ^ Aerobic Treatment Unit ^ Recirculating Sand Filter ^ Recirculating Synthetic Media Filter ^ Leaching Chamber rip Line ^ Gravel-less Pipe ^ Other (explain) V. Dis ersal/I'reatmeat Area Information: Design Flow (gpd) Design Soil Application Rate(gpdsf) is I Area Required (sf) Dispersal Area Proposed (sf) System Elevation Vl. Tank Info Capacity in Total umber Manufacturer Prefab Concrete Site Constructed Steel Fiber Glass Plastic Gallons Gallons of Units New Existing Tanks Tanks Septic or Holding Tank Aerobic Treatment Unit _ Dosing Chamber VII. Responsibility Statement- I, the ndersigned, assume responsibility for insWlla n of the POWTS shown oa the attached pleas. Plumber's Name (Print) lumber's Signature MP/MPRS umber Business Phone Number Plumber's Address (Street, City, Sta ,Zip Code) VIII. Count ~/De ailment se Onl Sanitary Permit Fee (includes Groundwater Date Issued Issuing Agent Signature (No Stamps) ^ Approved ^ Disapproved Surcharge Fee) ^ Owner Given Reason for Denial IX. onditions of Approval/Reasons for Disapproval ~~l _ - ^ - / 0 ....e b.. N..n at2 :11 iehea io sire Athch eompkte p4m (to the Caualy only) for the system on Pap" SBD-6398 (R. 01/03) ~. Wisconsin Department of Commerce Division of Safety and Buildings SOIL EVALUATION REPORT in ~nrrnrri~nro weFh r:nmm RS Wia AAm CcxiP 1806 Page 1 of 3 A.C.E. Soi18 Site Evaluations Courrty Attach complete site plan on paper not less than 8'/ x 11 inches in size. Plan must St. Croix include, but not limited to: vertitxtl and horizontal reference point (BM), direction and and location and distance to nearest road. scale or dimemsions north arrow percent slope Parcel I.D. , , , 020-1433-03-000 Please print ~./nf,~rtnation. _.. _ _.....- _ ~ Reviewed By Date Personal information you provide mey be usld for se~~~r, s. t~.04 (1) (m)). Property Owner PFoperty Location John F. & Dorothy L. Wuksinich ~ ~`~°~ s ~ a ~~ , Govt. Lot SW 1M NE 1l4 S 11 T 29 N R 19 W Property Owner's Mailing Address ' is"'~ Ldt # Block # Subd. Name or CSM# 2034 Silver Street ~ ~ ~t ~~; ~,,;; ~ ~~ 3 Plat Of Mound View City State Zi _Code ~t't~iii~iNut3ibfeK ! M " of City J village i~ Town N~rest Road Waconia ~ MN 55387 952-442-3270 Hudson 1063 Daniel Drive ~3 . C~ U C' ~~.r ~-~.~~ New Construction __- Use: ti~ Residential / Number of bedrooms 3 Code derived design flow rate 450 GPD Replacement J Public or commercial -Describe: Parent material Glacial outwash Flood plain elevation, if applicable na General comments and recommendations: Install two trenches at elevation = 95.50' using 22 leaching chambers. Previously permitted system area to be used as replacement system area, requiring dose chamber. Boring # ~ Boring 2 >97° i t R ft Pit Ground Surface elev. 100.5 /J n. . Depth to liming factor Application a e Soil Horizon Depth Dominant Cobr Redox Description Texture Structure Consistence Boundary Roots GP 'Eff#1 DIfF "Eff#2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 1 0-9 10yr32 none sl 2fsbk mvfr as 2f 0.6 1.0 2 9-16 10yr4/4 none sl 1fsbk mfr cs 2f 0.4 0.7 3 16-29 10yr5/4 none is 1 msbk mvfr cw 2vf,f 0.7 1.6 4 29-42 10yr5/4 f2f 7.5yr5/8 sil 1 msbk mvfr ai 1 vf,f 0.4 0.6 5 42-97 10yr516 none s 0 sg ml - - 0.7 1.6 4 •o Z~/~o Z~ Comm. 85.30(3)3 applied to discount redox. concentrations identified in H#4. Boring # ~ Boring ~~ Pit Ground Surface elev. 100.28 ft. Depth to limiting factor ~ in. Sal Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/ft~ in. Munse{I Qu. Sz. Cont. Color Gr. Sz. Sh. *EtT#1 *Eff#2 1 0-9 10yr3/2 none sl 2fsbk mvfr as 2f 0.6 1.0 2 9-27 10yr4/4 none sl 2msbk mvfr a 2f 0.6 1.0 3 27-48 10yr5/4 map 7.5yr5/8 sil 1 msbk mvfr ai 2vF,f 0.4 0.6 4 48-56 7.5yr4/6 none Is 0 sg ml cw 1vf,f 0.7 1.6 5 56-96 10yr5/6 none s 0 sg ml - - 0.7 1.6 Comm. 85.~lied to discount redox. concentrations identified in H#3. ~ le * Effluent #1 = BOD ~ 30 <_ 220 mg/L and SS >30 < 150 g/L fflueM #2 = BOD <30 mg/L and TSS <~3p mg/L CST Name (Please Print) Signature: CST Number James K. Thompson ~- 3602 Address A.C.E. Soil & Site Evaluations Date Evaluation Conducted Telephone Number 340 Paulson Lake Lane, Osceol , 154020 6/142004 715-248-7767 Property owner John F. 8: Dorothy L. Wuksinich Parcel ID # 020-1433-03-000 Page 2 of 3 Boring # ~ Boring 1I` Pit Ground Surface elev. 102.00 ft. Depth to limiting factor > 114" in. Soil Application Rate Horizon Depth in. Dominant Color Munsell Redox Description Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots *Eff#1 *Eff#2 1 0-10 10yr3/2 none sl 2fsbk mvfr as 2f 0.6 1.0 2 10-16 10yr4/4 none sl lfsbk mvfr a Zf 0.4 0.7 3 16-31 10yr5/4 none sil 2msbk mvfr aw 2vf,f 0.6 0.8 4 31-39 7.5yr4/6 none Is 0 sg ml cw 1vf,f 0.7 1.6 5 39-114 10yr5/6 none s 0 sg ml - - 0.7 1.6 Boring # J Boring _,_J Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth in. Dominant Color Munsell Redox Description Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots *Eff#1 *Eff#2 ^ Boring # ~ Boring J Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth in. Dominant Color Munsell Redox Description Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots *Eff#1 *Eff#2 * Effluent #1 = BOD y> 30 < 220 mg/L and TSS >30 < 150 mglL * Effluent #2 = BODS<30 mg/L and TSS ~ 30 mg/L The Department of Commerce is an equal opportunity service provider and employer. >f 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. Z -~'~ /c:/~~ SOiI ¢ /Q uQ'~JOi1 P~ E. ~ E,~'/S{7nq~jr'ade 2/CK' ~ Loeaft/c7 fingo. s~t.C/~ ` ~^ ~ B ~o~ ~( ~a° ~ ~' %'~~ ~ ~- .~' ~ ~ 8' 1 d e~K I ~o ~ ~j o L..._,J v ~. ~, ~, ,- ;, /~ P '`C P-opcsed III o ~~q~ ~ ~ ~ L----- ri ~ , ~ _ ~ 3 bedra~m /Y~tnct '~?go, ` ~ $ ~ p, ': ~ ~ ur~dtr Ccn sb^Kc,6~nr-_.._. ~/~. ~S.M. = TFd~'/a~ Stns. E~e% = 9B7s. ~~_--- _ , ~ r ~ ~ ~ ~ \ \ i i .' a E /ocues~ L~e/~f . ~4 ssu.n e ever` . ~oo.~z,, ~- t~, 30{'3 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Safety and Building Divisio~~ ' INSPECTION REPORT GENERAL INFORMATION ~ 3~4°O~ b (ATTACH TO PERMIT) Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)j. Permit Holder's Name: City Village X Township Wuksinich, John & Doroth Hudson Townshi CST BM Elev. Insp. BM E1ev: BM D scription: SOU. f-Cj > ~ ~ ~) \ ~J ~O~ CrtT'C t -~S`~CUt. $ ~~C.~ Cad / TANK INFORMATION TYPE MANUFACTURER CAPACITY Septic ~ sZ-its. /[2 OCR ~pCS Dosing Aeration Holding ~~rnc~ ~`;t~~ TANK SETBACK I TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Septic ~ ~-~~ ~ a •r ~ h ,~ / Z ~ Dosing '~~©, ,v a T :._ ~~ ~ (~ _ Aeration Holding PUMP/SIPHON INFORMATION Manufacturer ~~ Demand ~'~ ~ ~ GPM Model Number c,~o 3 I t L TDH Lift 9. Friction Loss System Head TDH Ft Forcemain Length ~ ~' Dia. ,. Dist. to Well NOT . ~ ) l.-. ELEVATIbN DATA STATION BS HI FS ELEV. Benchmark t/.7/ io y.~ I w~_vL Alt. BM Bldg. Sewer SUHt Inlet ~.~ . o gY. 4 +~ SUHt Outlet ~c.zS 9~.~f6" Dt Inlet Dt Bottom Header/Man. ~ ( ~` , ~ / Dist. Pipe g^ t c7G + ~ 1 Bot. System W E `~ o ,,{ ~'S_ ~,~ Final Grade ~/ y ~ ice. St Cover ~1 ~Z- S` ~^ S 1. b /0 3 7 J . ~'~~aSf ~ .~~ /00~9b ' nn -~C GO n rt`f /~ SOIL ABSORPTION SYS 1`E~IUL .-, ..s _ .P., __ ~1.1 ,...~...... ~, .. is ~ ~ / , .~ r .~ ... BED/TRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside 'a. Liquid Depth DIMENSIONS SETBACK SYSTEM TO P/ BLDG WELL LAKE/STREAM LEACHING Manufacturer: ~+('~ INFORMATION CHAMBER OR t' Wa-~- trj . o• ~ a Type Of System: 1 "t ~ d» ~ ~ ~ ~ ~{~ w~uT i / ~ ( tU UNIT . Modet Number: Co n v 2n h /' DISTRIBUTION SYSTEM ~~ /-fnrrzrzriG-- Header/Manifold Distribution x Hole Size x Hole Spacing Vent to Air Intakes ~ r k Length I Dia ~_ Pipe(s) Length Dia Spacing .~- /~ ~/ SOIL COVER x Pressure Systems Onlv xx Mound Or At-Grade Svstems Only Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center ...- / / ~ F.[ Bed/Trench Edges Topsoil Yes No Yes No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: ~ / ~ / cap-/ Inspection #2: / /_ Location: 1063 Daniel Drive Hudson, WI 54016 (SW 114 NE 1i4 11 T29N R19W) Mound View Estates Lot 3 Parcel No: 11.29.19.2691 1.) Alt BM Description = 4 F_ ~ r~va-,' ~ ~v i..1~ 3~ 2.) Bldg sewer length = ~(@' Q ~ as /J, C/, rh -amount of cover = ~'7 ~ Plan revision Required? Yes No ~ Use other side for addition I inf mation. SBD-6710 (R.3/97) ~ Dat~ ~~~ _Ins~ctor's Signature County: St. Croix Sanitary Permit No'. 453099 0 State Plan ID No: Parcel Tax No: 020-1433-03-000 Section/Town/Range/Map No: 11.29.19.2691 8.05 ' 3_ s . 8-..:P~~..; s •',F ; , y~~ ~~. Cert. No. ~, S't~ 0 /e V Safety and Buildings Division County ~ er~ ® 201 W. Washington Ave., P.O. Box 7162 l JC ,. ,~~O~~I~ Madison, WI 53707 - 7162 Sanitary Permit Number (to be filled in by Co.) De artment of Commerce (608)266-3151 ""°-• -a. Sanitary Permit Apphcati ~~~ ~.;~; State Plan LD. Number --~~-~ E Y s ') ,~ ' ,,° In accord with Comm 83.21, Wis. Adm. Code, personal informati you provide may be used for secondary purposes Privacy Law, s15. xm) Proje I Address (if rent mailing address) t`t 1. Application Information -Please Print All Information Property Owner's Name Pared # Lot # Bloc Property Owner's Mailing Address Propert do ~y33~~~• Zld~l! z.o3 5'//~ 5~. / ~ Section ~ '/c '~~ t~ City, State Zip Code Phone Number _ ~ '+ ~a W n j Q ~ f'(, p^ ~JS 3 0 7 QS ~~,Z ~ 3 ~-7~ (circle one) T ~ N; R~'~er W 11. Type of Building (check all that apply) 3 ~ J ~ , _ ,~ ~j / lyl or 2 Family Dwelling - Number of Bedroo J ~ Subdivision Name 6EAf~tber ~A- / L ~ ^ Public(Commercial -Describe Use (o , ~ / rW ~.t~d (/! et~ ES s ^ State Owned -Describe Use ^City_^Village ~wnsltip of~ 111. Type of Permit: (Check only one bog on line Complete line B if applicab ~ A. ew System ^ Replacement System ^ atmenUHolding Tank Rep cement Only Other odification to Existin B• ^ Permit Renewal ^ Permit Revision ^ Chan of ^ P t Transfer to New P t s Issued Before Expiration Plumber Own IV. T of POWT'S S stem: Check all that a I Non -Pressurized ln-Ground ^ Mound > 24 in. of suitable soil ^ 24 in. of suitable soil ^ At-Grade ^ Single Pass Sand Filter ^ Constnrcted Wetland ^ Pressurized In tmd ^ Holding Tank ^ Peat filter ^ Aerobic Treatment Unit ^ Recircu g..Sau Recirculating Synthetic Media Filter Ching Chamber ^ lhip Line vel-less Pipe ^ Other (explain Z ~ •E/' ~/'1 j'r"5 V. Dis rsal/Treatment Area In ormatIon: Z s w f ( ~ ~b - i udfrs o. 3~ Design Flow (gpd) Design Soil Application Rate(gpds tspers Requir s tspersal Area Proposed (sf) System Elevation ~s~ ~ a. ? ~s~ ~~.Z ~G G85~.~o s~'E A. 97s~~ _3_ VI. Tank Info Capacity in Total Number Manufac Prefab Site Steel Fiber Plastic Gallons Gallons of Units Concrete Constnrcted Glass Ncw Existing Tanks Tanks Septic or liu7dixg-~'eek~ ~ ~ ~y~ / / W {~ /!~ ~ ~/`/SL/~ C.L71t~ - / v .4crobic Treatment Unit - (,~,~ Dosing Chamber ~~ ~,. ~-y~ / v -M a~ Vll. Responsibility Statement- 1, the undersigned, ass esponsibility for installation of the PO shown on the attached plans. Plumber's Name (Print) PI 's Signature MP~Rt}Ntrmber ~~ Business Phone Number ' ,~ son ~ ~~C~ S- (~ d ~ 3~3 78 Plu mber's Address (Street, Ci ty, State, 'p Code) // ~f !,/~~~y~ O~ ~ ~ii~ ~~X~+-W/~ ~ s~(/C/~ Vll oun /De artment U e Onl Approved ^ Disapproved Sanitary Pemut Fee (includes Grotmdwater Surcharge Fee) ~ ~1r-71 ~a Da , issued y g Agent ignat (N s) V o(J ^ Owner Given Reason for Denial ~ ~ ~ 1?C. Conditions of ApprovaUReasons for Disap oval 3 G~ `-_d wry.. YL+t ~ • / 2 ~ `~~'n D ~-~2~~ G~ YSTEM OV' - _ S / ptic tank, effluent filter and ~ ~~T ... ~'O ~~ ~~ D~' ' v"~ ~ ~ ~ 0~~~~ Isot?rsa ce must all be serviced /maintained •'"' ~ ~ ~ ,~1.t y~+'~~h.f -~-- rum er ~~~ -as per management p4an provided by p b (ln- I2. All setba-cTc requiremen s mus a amtafrte>1--- d ~~,G!/f,c.,,~~ ~ ,~~d~ ac nar annlirahlP rodt?/ordinances Attach rnmpktc plans (to the County only) for sy tcmronlpa~not 81/2 x 1 fine c '~ c / _ "~ ^ ' _ ~~ '~~ SBD-6398 (R. 01/03) ~: -~ ^ Sc; i ~valua~ o~., P; ~ • Elt daf~e••~ • loeat~ed ~oro~0, Sfst~ ~ nr5~.• O~'i irta~-t' ,~.~~,rro..,~des6ro ye~I Propoxd ~tcStr C'.o+~cra~e 3-T,~iQ~. ~Dbd us.cd as S, T, r~ T ' ~ ~`~/ /0G3 Proposed u7e.il e pro p osc..d 3 d edraow+ Owa+l my 93 68 ~/~.~ ffrd. a~ bu;idnJ st~c• E • d.,.c .: 7'00 ~F Su.r /t y -~ , -1'terr~cr Elt~; _,_ - - A~ ~~. ,, \ 4~• i3' Scwtr; To be i~S ~.1 a~~ ~, 89 ~ ~ ~ Pro xd u~ cs•r' c.. w P 7sa - Q p p cl+o.w s~• ~ ~ of . C. < a .zs' ~ / - , ~ ~stor,K Wa~c,~ i - '~` ~ /_ ' ~, 2 "Sc~. ~o P, /. ~. f'arcc ~i,r. 83: /BJ. 3S' /00,78' iol, b~' v + = got, 68' ~' ^ ~ 6 z = goo. 88' ~enc.~, Yyta/l~: Tr off' SwJ~ey Mar~(ta- ,gssc,.,ncd efts:' _ /~.ad: pa,,,, : c/ 1~ ~ ~. • El c Ja,E, b.-~ • loca~-fed~oro~o, Sv`a~l'? ,~.~~ ,~a~c-~des,~d y~ - ~ ~ q~. ~ ~ ti~ Propoxd ~tescr C'.enc.~'~•f:e wLP i~/~~ -MAP Canb~~ra. S-r~/0~. Epb~us.cda5 s. T, w~ ga-6e,-~,4-its c Fflccs++f/ .~ ~ ~~ ~t e~~~• 93.68'l~.~ ord. a~ bcc;/d;n~ SifG• S, C 3 bui /a~iiJ ~ ~ A• T~J. 3 ~f . ~ 9~ i3' Stwcr; To be i~SW./~d - ~i ~6• o oFSw~ey 89• ~ ~ Pro xd w csrr c. • QP P hto.r,rir E~e~' s 48.98,, a~ P 7sv- clo~n tr / / of .C. ~ 8 .zS• SEor.~ Wow f -~~_ ,~ ~~ ~ / ~ rZ~n~i o-~ ar to ~ N, ~1. E. ~ ~ ~\ .~ ~ ~ , _ -o ~~~ ~, "Sc~. 9~0 P/, c, {arcc wta%a. ~3 . /e/. 3S' X00.78' ~~ ia. ~Y' ~~ ^ v ^ ~ 0 z= goo. 88" lien e,G, 1Ma.rJC : Tr o~ Sw Jay r-+ar~(cr. Assc,,,,acd ekr": _ /~.tb," ~OG3 Proposed Wtlf e Pro p osed 3 bedr'GOw+ ~wa+l~nq Wuksinich 3 bedroom Dose Conventional Pump Chamber Calculations Force Main Diameter 2" Length 250' Flow rate 40.00 gal. /min. Friction loss 8.25' (250')(3.30ft./100ft.) = 8.25 ft. 2. Total dynamic head: Min. supply pressure 0.00' Vertical lift 14.00' friction loss 8.25' Total dynamic head = 22.25' 3. Pump selection: Manufacturer: Goulds Model number: 3885 WE03M Pump will discharge approx. 40.0 gpm @ 22.25' TDH 4. Dose chamber: Manufacturer & capacity: Wieser WLP 750 - MR liquid depth: 37.50" (a, 20.28 gal./inch (760.50 goal. actual) Sizing: A) One day holding capacity: 17.00" = 344.76ga1. B) Alarm setting: 2,00" = 40.56 g_al. C) Dose volume + flow back: 6.50" = 131.82 gal. (450gal.)(20% Design flow) +(.164)(250') = 124.10 gal. Max. dose D) Reserve storage: 12.00" = 243.36 gal. TOTAL 37.5" = 760.50 gal. Project: Dose Tank Information Electrical as per NEC 300 and ~ Comm 16.28 WAC _ Tank component is properly vented Wieser Concrete Capacity 760.50 Volume 20.28 Manufacturer Gallons gal/inch A Dimension Inches Gallons A 17.00 344.80 B 2.00 40.56 C D Total b•~ /z.or7, 37.50 /3/.82 • 3G 760.50 3" Alarm Manuafacturer LevelArm Alarm Model Number DLV B C D Disconnect ing under tank. Pump Manufacturer Goulds Pump Model Number 3885 WE03M Pump Must Deliver ®. OC7 gpm at ,Z,2.,ZS ft TDH John & Dorothy Wuksinich 3 bedroom Dose Conventional Locking cover with warning Zabel and locking device and sealed watertight i 4 in. min. F- Alternate outlet location Forcemain diameter ~ 2 in. Weep hole or anti- siphon device Pump off elevation (ft} 84.42 D, ose tank elevation (ft) 83.25 h T ' ~ j ~ ~ f 1 ` ~ i ' c) - t i% 1 t . '~ - ~ }# A , C ~ ~ II 1 Y9i~ ~~ ~:;' 1 MFTEflS fEEi ,z~ 35 110 30 100 O ~ 90 w V Z5 - BO 4 Ta Z so >' 60 O ~ 50 t5 0 ~ 40 ~ la 30 r . ~, s 10 0 0 -_ .____~ MDDEL 3885 ~ . _._~ _= _.~. __I .+_~ ___ - ._- _ -+ ~_ __ __ _ _~_ _~_, - _. - -~~ i - - -.i_- ---!----~ 0 t0 20 30 4 50 50 ]0 80 9:) 100 :1C X20 130 140 U.$ CPM h ~ '!2y _ -- I F--~ - _ _- ~ - -~~ - ~9P H~ - y - -- - -'-- ~~_ _ - _ _ - - Pump Specifications '/3 through 1'/z HP Up to 130 GPM Maximum head to 123` Discharge size 2" NPT Solids:'i~' maximum Motor All motors feature ball bearing construction. Available in Single and Three Phase 115, 200, 230.. 460, and 575V. All single phase models have capacitor start motors. Materials of Construction Cast iron Stainless steel Features and Benefits •All models feature silicon carbide mechanica: seal faces for superior abrasive resistance and extra long life. • Cast iron semi-open non-clog impeller with pump-out vanes for mechanical seal protection. • Rugged cast iron volute type casing adaptable for slide rail systems. • Corrosion resistant threaded stainless steel shaft. • Motor is fully submerged in high quality oil fcr lubrication and efficient heat transfer. • Optional silicon bronze impeller available. • CSA listed models available. O Q w ~ V ~ 4 a Z ~ 3 O J O ~ 0 ~ f- -r- --~-- --~-- MODEL: 3872 za - ~--~-~- - - -- I 15 '- `--1"- ?- --~- I' __ _~_ -_.1-.. __ __.- _1__._ ~___.__ to - -- 5_ _ _~__~_ _--__ _ _____ __1 i Ji °o 'i~o-` zo 30 4o so so ]a-~-i.S.cfM Pump Specifications '/z H P Up to 75 GPM Maximum head to 18' Discharge size 2" NPT Solids: 2" maxirnum Motor All motors feature ball bearing construction. Single phase: 115V Materials of Construction Cast iron Thermoplastic Stainless steel CAPACITY Features and Benefits •Glass filled, thermoplastic vortex impeller with stainless steel insert and pump out vanes for mechanical seal protection. • Rugged glass-filled thermoplastic casing and base design provides superior strength and corrosion resistance. •Cast iron motor housing for efficient heat transfer, strength and durability. •Corrosion resistant threaded stainless steel shaft. • Available in automatic and manual models. •CSA listed models available. (~ Untlerwriiers Labora(ories I All Models are designed for continuous operation and feature stainless steel hardware. BioDiffuser Specifications r--moo 00 00 DO 00 ~ooi ~o _[ _ 34" - r ~ ' ~~~3~ tip!. Vin, f ~ ~ ~ ~ ~ r ~ ~ re r. ~ ~ Q Q ~ ~ " ;`; , r , .. p Y ~~~ . t ; f~f 4g4 c~ o Sao. Available Sizes 76" 00 00 °oo° OO 00 ~ OO ~ o t~ c [- C I ~' o Chamber Height Chamber Height End View ~ 4"Knockout Universal End Cap ... ~~ h r ~~ ~ r f 3 V ~ ~ ~ ~ ~ ~; 1{ 4 Length 76" ` ~ `76" ~ t ~ ~ ~ 76"x ' ;; i. n~ ~~ j 4 'y ,. 1 Wi th 34"` z ,. ~ X34" ~ $ ~ ~ ,; .. ~. ~ ~ 34" d ~~ ~:a ~ ~~': ,. ~ ~ ~~ ~.~ r 4r it' ~ ` 4 j yy{gg{ Y ! '2 ~7~E ~ ~ ' Height 11" 14" , K q ? 16" - d C § - ~: R tt" ~ ~ Invert ~ ~ 6.5 ~ . 9 ~ 3 Z ~ ~1t13 , ~ 3 ;~~ ~ ~~ Z 0 Q 'O^ U W 0 W 0 v ,I Y~ Z I- w 0 ,~ ~ W J I- W fi~tt.~.,, ,~ Lr--' .p~ n- \ ~ of Z ~ LUfrt, 'n U ~ ~J W Q ~ ~ ~~ ~ ~ ~Uwip ~ a O U~ ~ ~ D ~ j ~ aN ~~~ ~ O H ~ Y ~ F- J ~ W O ~ Z O- f-- U Q o I Q O O W Uw O p O O.O m W O I- ~ ...~ ~ ~ N Z F- o O °o ~ ~ ~ O N ~ Z = ~~ ~ o = - ~vo r O J J Q JJ Q ~ n~nn N L" -- W' p WQ W -U ~ ~ I I ~`° ~ vi ~ i av ~ ~ww 00 ~ Z3 ~ ~ ~ M w 0 0 - J -O Q ~ ~ o In a0 ca - O ~ ~ O 3 O ~ Q -~ ~O~~tf) O ~ ~ m Ww cn F- ~ ~ N ~ W ; ~ p O ~ ~Jy ~ l~ N ~ 1- ~ ~ ao O , M e ~~° W 7 ~_ ~ ~ Z J U J Z~ r W U ~~ ~ J 2~ Jt- o l- O~ W pZ~ U Q (n = ~ Nm = = O~ O o pm(n o w DOH O N O ( .7 - ]ZUZF WJ ~ Q OOQW W OWC'1W QdC~ Q~~ Q U U J Z Q ~ ZQ Q-U ?i~]U~2J~tZ1J~r Z Q i I O J J O Q ~ O Y Z Z C~ O Z ~ N Q _ J J ~ F- p F- U J Q J ~ F-- 002W W ~ J „Z~ o ~ a ~t Z 0 I ~, \ I I ( I I I ~ j1 I I I ~ I j ~ ~ / I I \~.~ ~~ I I -~ 1 I I I I 1 I . I I W I I W lJi I ; I j <L O m j . I I I ~__~` I I ~~ , I I• I I ~, ~ I 1 ~ ~ I . I I I I f I I I I I I I ~ ~_ ~~ ~ ~ ~ I I I I . ~ ~~ ~ i . ~-- .a i w II S\ O J Q U F w 5~ w~ ~_ J N U N o ,.6~ „95 0 U Z W J w Q H ~ ~ ~ Z Y 0 00 O ~° ~ ~m Q ~° oww a cn o ~ o I O ~ ~~ WNI~m (nQ d- M U ~b~ ~~ N N: 41- Jtn ~-Q W wwr w3U N~~J~~WZJIn S~F- N Gi o~0'-°30~ °Y ~ 22 = OmW )[ Qooaw~wow Q~c~ Z Z3mU~20oo~~ w ~ Q ~ J p Z J Q J N ZOO OSW 0. Q U / s ~ O ~ Q 1 \. \. ~~~ ~ ~~ ~ J J ~ Q ~~ li O tb „ti 8 w J z w O J ~ O W > ~' Z Q ~ U ~ ~ H O Z ~o~ Q ~ w~ o~QZ ~~ >Z aJU J o Q O j ~ O) N J W W O O~ O Z O ~ o In oo ~ i= > ~ Qw(n N JI-- p ~ d U W m~ Q N W a ~ p Q J z N ~ O U Z w 2 S N Y O Q J_ O O W Q Q w Q W 2~ ~(Ul7M- Q ~F-H ~ (nJ O a3~ o Zoa z Q3 a W ~ ~ ~ I- Z C3 O O Z J 2 J ~ F- z W U~ /~ ~ 11 l~ ~ t~ ~, '`• > ~ ~ V W N m Y Z zQ Q U D N W Y N Z Oa I- in U w „Z~ J Z ~--IN N w II W II - i S ~ 5 ~ ~ ~ „ J O 1 9ti „ ~ J O v 11 11 V) v N 11 11 ~ N 1/ 11 1 I 1 H W J ~ „~~ 0 - „l9 -~ ~ •- ;%' p P1f PAGE 3 OF .3 NAME: 6«~ LOT# 3 LEGAL DESCRIPTION~1 I/4tiEI/4,S~T_q N,R,~E(or~ SCALE: I"= y~ I 5 w V ~' ~-r ,, -~ ~d ~ ~y ti 25~ ~` ~ ~u ~_ ~b 6"~ ~z' ~ y, ~~ I ~, i r 6 - qa ~ r ~ i / ~ n „~- /a'S ( / SI ~ ~ !~- ~ ~ DA ~ /'U -vj L_ 1 ~ ` r ~ Z~ S /ir t ~~~ Wisconsin Department of Commerce ns,,:c:,n of C9rorv anrr Ftrr~as SOIL EVALUATION REPORT ~,\ ~~~~~/~~ ~~~-~~~c~~w~~, may.: Page I of `J " in accordance wdtr Comm a5, wrs. narrr. woe ~~ - , Cro l . Attach rarr~lete si6e plan on paper rat less tlrarr 8 1/2 x 11 inures b size. Plan must inducts. but not limited to: vertical and horizontal reference point (BAA), direction and Parcel I Z ~ ~y3 3 ~"' north arrow, and tocatbn and distance to nearest road. scale or dimensions e ercent sb Q , p , p Please prJnt al/ infbrmadon. by ~ D(a~t/e / / ` / ~ Personal inrormation you provide maybe used for secondary purpoaes (Privacy Law. s. 15.04 (t) (m)). " L Property Owner n M ~, ~ , x ~ i "` I Props Location Govt ~ot ~ ua NE ,ra s 11 T 29 N R ~ E (or~W~ ^c~rc KIC Property Owner's Mail'mg Address r s ~.~ ; . , ~.ot # ~ Block # Subd. Name or CSAA# ' S Zip Code P Number City ^ C' ^ Village [~ Town Nearest Road ~ 1 (~ )~ m r __ - ~/~ Qr~ la .. ... ~~_._.. [~ New Construction Use: C~ Residential I Number of bedrooms 3 -y Code derived design flow rate y~~ ~ ~ GPD ^ Replacement ^ Pubtic or r~mmerdal -Describe: ft ~ • - _ Fbod Pbin elevation iF applicable - _ _ Parent material a _~ ~1 --7 q General comments sys~ f~ e ~e V r < T• O " ~~/f.2C~ ~ ..Qo~f~ G~~ ~~G`'' ` a'~i.~a~ v-~-sl~~ Ion-~izc~ Wl ~D?-Z~ W~taiu- u~~ sLiorwK, of/y~ ~~/6~a~-~i-a~ c~rr- a~ie~l ~ ! , sys-~ ~a -~~ s J~~p ~y/~y~, ~. 02 .~~ .. oR ~~ i ~ 8z ~ ~~~~~ V -,. -7 '- i- i _~ n _ / .. _ ~ / i~~ ~_ 1 .. ~n A e ~/l w i ~ n .~~0/Y~-, ~ D/r7D~si1~~ a+~ `h ~' Boring # a Boring ., Pit Ground surface rev. ~~ 2 • ~ C tt. Depth to limiting factor _~__ in. Sol lion Rate Horizon Depth Dominarrt Color Redox Description Texture Structure Consistence Boundary Roots GPDffC~ in. MunseY t1u. Sz. ,Cont. Cobr Gr. Sz. Sh. 'Eff#1 'Etfi#2 I d-4 IQ 3 `-- Sl' I ~.rv~bK ~' ~ 5 ~ v~ . 5 .8 z 4_~ ~ - S ~ Zmsbk m-~r c S - . 5 - `~ L Boring # U Boring 2 ®pit Grornld surface elev. I U 2 - ~_ ft. Depth ~ tinutbrg factor ~ ~ ~ in. soy Rate Horizon Depth Dominant Cobr Redox Description Texture Structure Consistence Boundary Roots GPDlfP in. Munseti Qu. Sz. Cunt Cobr Gr. Sz. Sh. 'Eff#1 'Eff#2 ~ a-ii ~~ ~3 ~- 5-1 2 ~S ivy ,5 -~ 2 I I-2~ ICS `FIB{ - Si' cl mfr cS - . ~ • (a 3 2~-118 I(~ ~-FI '" ~5 - ~ . ~ I: 2 ' EtHuerrt #1 = BODS> 30 < 220 mg/L and TSS >30 < 150 mg/t ` trrwenc rFC = ovv5 ~ av mgrr_ mru ~ ~ _ ,~...~~,.. nature /-- CST Number CST Name (Please Print) 19 a ~, ~~ re~~.r,- ~--~~`' ~ 2 S 3 ~ 0 9' Address Date Evabatton Conducted Telephone Number j ~ ~ ~4~.S~X ~na.,z~~, ~`'~O ~ S /Z - ~ g•- a 2_ 7~-r~ ~~- `~p6~ y 2 0 y ~~~~`~ 6~ ,~-.~y=~s u.~-~~ ~~ s~~- ~~ ~~- ~ ~w~ t s P 1 ID # Page ~ of 3 property Owner _ ~ arce - --- 3 Bonng # [] Boring ~ I factor I in. aGrr ~ S h ^ Ground ~rface elev. ~ ,7C Pit ft• g rr Dept th Sod ication Ra Roots Bounda i t GPD!(t= Horizon Depth Dominant Color Redox Description Texture Strutxure ence Cons s ry 'Eff#1 'Eff#2 in MunseN Qu. Sz. Cont Color Gr. Sz. Sh. . rr 5 $ i j(~ ~ -- SCI 2 h~i-r ~`~ (v~ ' _ - 5 1 Z -I i ~ ~ c 2m5b ~,~~ c S , 3 1f~--I Ig tC)Y[' ~ - - m5 ~`~ . m i - - . 1 l - 2 ^ Bonng # ^ Boring Ground,surface elev. ft. De{~th m 9 iac~or in. Sod lion Ra ^ Pit _ Horizon Depth Dominant Color Redox Description Texture Stnu3ure Consistence Bourxiary Roots GPDIfP in. Munsed Qu. Sz. Cont Color Gr. Sz. Sh. 'Eti#1 'Eti#2 ^ ~rin9 ^ Borng # Ground surface elev. ft- ^ Pit Depth to limiting (actor ~ in. The Department of Commerce is an equal opportunity sernce Provider and employec. 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. ssassao rrt.mroo~ ' Effluent #1 =GODS > 30 <_ 220 mglL and TSS >30 <_ 150 rt~lL `Effluent #2 =BODE < 30 mgiL and TSS < 30 mglL Page ~ of 3 Property Owner _ ~~ Panel ID # - -- 3 ^ Boring ~ ~ F3o~g # Ground surface elev. ~ ~ ~ ~ ft. Depth to FinriGrrg factor ~ in• S~ tion F ® Pit 1 B nda Roots GPD/tf? Horizon Depth in. Dominant Cobr Mrtnsefl Redox Description Qu. sz. Cont. Cobr ~ (r'J ~ Z -I i I _. 3 1 i i ~ _ m Texture $irudure Consistence ou ry •F~#t •Etf#2 Gr. Sz Sh. 2 r~r- C`> (v~ 5 '$ Sit 5 ~- c I 2m5 -~.-~r- ~ 5 . - 5 ~ m ~ . -1 1- Z Borng # ^ Boring ^ ph _ Groundsurface elev. ft. Depth b 9 factor ~' ~ Rate Horzon Deptfi Dominant Color Redox De~ription Texture Structure Consistence Boundary Roots GPDIff' •Eff#1 •Eff#2 in. Mrmseft Qu. Sz Copt Cobr Gr. Sz. Sh. Boring Boring # Ground surface elev. __ ft- Depth to 1'rr(uGng factor in. ^ Pit Soi tier Rate Texture Structure Consistence Boundary Roots GPDIfP Horznon Depth Dominant Color Redox Description •Etf#1 •Etf#2 in. Mansell Qu. Sz Cont Color Gr. Sz Sh. • Effluent #1 =GODS > 30 <_ 220 mg1L and TSS >30 <_ 150 mgf L `Effluent #2 =BODE < 30 mglL and TSS <_ 30 mglL The Department of Commerce is an equal opportunity service provider and employer. [f you need assistance to access services or aced material in an altercate format, please contact the department at 608-266-3151 or TTY 608-264-8777. SBD-i33U (R.RN00) ` `, . PAGE ,3 OF 3 NAME: ~e ~ ~' LOT# ~ LEGAL DESCRIPTION:S~tI l/4ti~ 1/4,S~T ~',N,R,~E(or~ SCALE: 1 "= y~ ~ 1 ELEVATION: IDd ~ e BM 1 DESCRIPTION: ~~ o-~ ~9 rS~~~ ~ ~o d - + -~ BM 2 ELEVATION: ~lS. ~~ S e~ , l 1 1 r~ BM 2 DESCRIPTION:-1op a-~ iy Sec' ~c~~ SYSTEM ELEVATION: ~~~ $ ~ SYSTEM TYPE: C~or- d e n -~- ~ o na~-~ 5~~ V W~ ,~.~t5 ,, 0 ~c~ __ ~ ~~ ~~ r ~ o< ~r ~~ ~ C ~ ( 6~3 U r sa ~ r r I r 1 ~ ATE: L_ .r ~o stir ~,i z` ~CJ ~3 ~ -Z ~~ ~! 4 ~ ! ~ ~, y fI _.. ' • ~ ~~ PAGE ,3 OF 3 - - NAME: e a~ LOT# ,3 LEGAL DESCRIPTION:StiI l/4~E1/4,S~T~',N,R,1~E(or~ SCALE: 1"= yo ELEVATION: /Qd , ~ BM 1 DESCRIPTION:-ran ~-~ %y ~S~ce ~ ! a ~ - + BM 2 ELEVATION: 98. S~ Sec ~ ~ ~ ~ ~, ,~~ BM2DESCRIPTION:-~op c-~iy ~ed ~Qc~cQ ~', SYSTEM ELEVATION: y ~~ $ ~ x SYSTEM TYPE:_ Cor- u c ~ -~- ~ o ,~( S~ /57> ~ ~ ~/G~~ ph LoT (~,VE v' W~ ~,s ,o o ~~~ 1c~• ~~ r J ~ r ~, ~ ~ , ~, ~~ h 0 ~ 6~ o ~ - ~a t r 1 I ,~ ~ ATE: / ~~ -d3 ~-•,~ -Z _ C , I `, ~,~ . ~ ~ Z~'~ ~~Z ~~ _ r~ v, ~ ~ ~ ~•i L6~ I 7 :; z~ BMI o°~ ~ Conventional Septic System Management Plan 1 ~Li'~j Pursuant to Comm 83.54, Wis. Adm. Code '~'~ General The conventional septic system shall be operated in accordance with Comm 82-84 Wis. Adm. Code, and shall be maintained in accordance with component manual SBD-10567-P (R.6/99). All local and/or state rules pertaining to system maintenance and maintenance reporting shall be complied with. Septic Tank The operating condition of the septic tank and outlet filter shall be assessed at least once every two years by inspection. The septic tank contents shall be removed when the sludge and scum in the tank exceed 1/3 the liquid volume of the tank. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code, by an individual certified to service septic tanks under s. 281.48, Stats. If the contents of the tank are not removed at the time of a biannual assessment. maintenance personnel shall advise the owner of when service will be needed to maintain less than 1/3 scum and sludge accumulation in the tank. 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. Septic tank manholes 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 the tank. No individual should ever enter the septic tank as dangerous gases may be present that could cause death. Septic tank abandonment shall be in accordance with Comm83.33, Wis. Adm. Code when the tank is no longer used as a POWTS component. The addition of biological or chemical additives to enhance septic tank performance is generally not required. If such products are used they shall be approved for septic tank use by the Department of Commerce, Safety and Buildings Division. Soil Absorption Cell Trees or shrubs should not be planted directly on the soil absorption system. The area above and around the system should be seeded and mulched as necessary to prevent erosion and provide some degree of frost protection. Traffic (other than for vegetative maintenance) over the system is not recommended. Soil compaction may hinder aeration of the infiltrative surface within the system and will promote frost penetration during cold weather months. Cold weather installations (October- February) dictate that the system be heavily mulched for frost protection. Influent quality into the system may not exceed 220mg/L BODS, 150 MG/L TSS, and 30 mg/L FOG. Influent flow may not exceed maximum design flow specified in the permit for the installation. Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the owner. Levels above 4 inches indicate 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. Excessive ponding within the dispersal cell will be eliminated by removing biologically clogged adsorption and dispersal media and replacing said components as deemed necessary or by installing a new soil absorption cell to bring the system into proper operating condition. Questions on the operation or maintenance of the system should be directed to installing plumber, Dale Hudson at (715) 684- 3378, or the St. Croix County Zoning Department. ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer Mailing Address iZ U .~ ~ S%~!/e-'• ~ ~ •. (,tJi'Cd ri i4 i-? h . S'S3~ 7 Property Address /o ~.~ ~a n ,.~ l ~Y, J.~ (Verification required from Plarming Depar~iient for new construction.) City/State !~yzzso~•l , ~~~ Parcel Identification Number Oz0 - ,~~„ ~"~~--- /y33-o3-0 LEGAL DESCRIPTION • 2~q/ ~/ / Property Location-S~ '/a , /~C~ '/, ,Sec. /~ , T ~N R~W, Town of fi`~/S~ Subdivision /~ac~c,' /~;~ ~S~PS ,Lot # 3 Certified Survey Map # ~ ~ ,Volume l1 ~ ,Page # ~~' Warranty Deed # _~~0 3 ~3 ,Volume ~sZ- ,Page # ~ 7 Spec house ^ yes +[3'fio Lot lines identifiable ~s ^ no SYSTEM MAINTENANCE Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. The property owner agrees to submit to St. Croix County Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. Uwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Department within 30 days of the e year expira 'on date. ~' y/~/6~ NATURE OF APPLICANT DATE OWNER CERTIFICATION Uwe certify that all statements on this form are true to the best of my/our knowledge. Uwe am/are the owner(s) of the property described above, by virtue of w ty dee recorded in Register of Deeds Office. ~! ~ yl ~ l6~ SIGNATURE OF APPLICANT DATE ****** Any information that is misrepresented may result in the sanitary permit being revoked by the Zoning Department. ****** Include with this application a stamped warranty deed from the Register of Deeds Office and a copy of the certified survey map if reference is made in the warranty deed. • STATE BAR OF WIS ONSIN FORM 2 - 1999 Document Number I WARRANTY DEED This Deed, made between Richard L. Beer and Philippine U. Beer, husband and wife Grantor, and John F. Wuksinich and Dorothx,L. Wuksinich. husband and wife Grantee. Grantor, for a valuable consideration, conveys and warrants to Grantee the following described real estate in St. Croix County, State of Wisconsin (if more space is needed, please attach addendum): Lot 3, Mound View Estates. St. Croix County, Wisconsin. Recording Area Name and Return Address ATT1: "~:~ `Y AT LAW C'.©. SOX 359 HUDSOiV, WI 54016 02o--~~f33-03 Parcel Identification Number (PIN} This is not homestead property (is) (is not) Exceptions to warranties: Easements, restrictions and rights-of-way of record, if any. Dated this _~_ day of March , 2004 ~ ~ * * Richard L. Beer _ _ * * Philippine U~ AUTHENTICATION ACKNOWLEDGMENT Signature(s) Richard L. Beer and Philippine U. Beer, ___ , STATE OF husband and wife authenticated this r:7 day of March , 2004 * K_ristina Ogland _ __ ______ TITLE: MEMBER STATE BAR OF WISCONSIN (If not, authorized by § 706.06, Wis. Stats.) THIS INSTRUMENT WAS DRAFTED BY Attorney Kristina Ogland Hudson, WI 54016 75E~343 KATHLEEN H. YALSH REGISTER OF DEEDS ST. CROIR CO. , MI RECEIVED FOR RECORI> 03/11/2004 10:15A?! MARRAHTY DEED EJfEMNT ~ REC FEE: 11.00 TRANS PEE: 210.00 COPY FEE: CC FEE: PAGES: 1 County ss. Personally came before me this _ _ _ _ _ day of the above named to me known to be the persons} who executed the foregoing instrument and acknowledged the same. Notary Public, State of 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. SPATE BAR OF WISCONSIN WARRANTY DEED FORM No. 2 - 1999 Information Professionals Co., Fond du Lac, WI 500-655.2021 • ~~ -~ W f1/WIUJ • TEMPOf~ARY ' ~ CUL-DE~SAC .EASEMENT . ~, a~ LOT 5 s • ~ F~~ ~ . 3.51 ACRES . ~~o`, .~, ~ (152,714 SO. FT.) ' LOT 4 2.60 ACRES ~ ~.e.o. - . ~ • . (113,063 SO, FT,) ~ 91 r.a f/ ', \ \ L.8.0.=917.0 . \ ~ ~ ~~~ ~. ~ ~ ~-~ . ~ . 270.92' 1 ~ 1 ' . \ x'11 ~'E bS6.@2' 285.7p. 4T~ ~,1, ~ \ \ 1 •' 1 ' \ 1 . 1 ~ H.W.E. _ \ 915.0 / .., ~ \ ~ N ~ ~ I. ~ ~ ~e.o. - 917.0 ~ r I \ a I ~ ~ i LOT 9 ~ ` ~~~.~ \ Cc ,.~ Q 2.61 ACRES ~ ~ ~- ..,t,. ~ (113,770 SD. FT.) ~ -- ~ '~~ ~ ~ o ~ ~. ~~ •~ p I ~ I LOT 4 . Q 2.04 ACRES ~ H.W.E. - J ; (88,704 SC, FT,) / ~ .915.0 \ W ~s.o. - 917.0 ( ~ l ,. o '@8, ~ ~~ ,, '~ 2.40 ACRES > >'? ~` ~~ ~'` (104,397 SQ. FT,) s•??, r "F c y ~ ~ ' . L.B.O. = 917.0 4. T m ~ 08 . . S04°06 a6 ~ ~ ~ '~ 7~ EAST 169.94' ~ - . ~ ~~ c~ - ~ ®~~ ... ~ ~ .~~~~ ......... . , • ~, o ... ~ ~ • . Gyp of a~ o ~~ . `~ •. ~