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HomeMy WebLinkAbout038-1239-05-000 09 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: $t. Cf01X Safety and Building Division INSPECTION REPORT Sanitary Permit No: 572819 0 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: Personal information you provide may be used for secondary purposes[Privacy Law,s.15.04(1)(m)]. Permit Holder's Name: City Village X Township Parcel Tax No: Nasset, Bladley &Joan Star Prairie, Town of 038-1239-05-000 CST BM Elev: Insp.BM Elev: BM Descriptio ; section/Town/Range/Map No: / �, ADM /o?o� 2//�1/C 17.31.18.1266 TANK INFORMATION ELEVATION DATA , $ / o2•�I /O/• 4 TYpE MANUFACTURER �r�S CAPACITY STATION B 'v�� I` % FS ELEV. Septic r. , Benchmark © .g d-v ���• Dosing �,M�p � Alt.BM ` C Po 5L5 `• � Aeration Bldg.Sewer It,7-71 Q/. e4j r ding St/Ht Inlet �Z yL qp„ 2'T St/Ht Outlet TANK SETBACK INFORMATION TANK TO P/ WELL BLDG. ent t A' Intake ROAD Dt Inlet we3� � , Septic Dt Bottom 87 ,C 3s A)4- 35 1 ? Dosing 3Jl. jv14' ,3s' !�� ` — Head< Aeration Dist.Pie 17 f Holding Bot.System��Z, \ Final Grade �� S 1 le 02. PUMP/SIPHON INFORMATION Manufacturer Demand St Cover 3•5 �,Z l GPM - Model Number �t 3,� ' • I 97• J r :For DH Lift �� Friction�os� System Head�� TDH I' 2 t h�y� D at ti S' cemain Lengths Dia.Z Dist.to well / �V SOIL ABSORPTION SYSTEM BEDITRENCH Width / Length No.Of Trenches PIT DIMENSIONS Inside Di`_ Liquid Depth DIMENSIONS 6 • Zq '_ SETBACK SYSTEM TO P/L BLDG / WELL LAKE/STREAM Manufacturer: INFORMATION Type Of 1 Model Number: DISTRIBUTION SYSTEM _ Ct�d x Hole Size x Hole Spacing Vent o Air Intake Heade anifol fipe(s)istribution �3, 1 0 r / 0 Q Length I L Dia ength G3' �ia Spacingf SOIL COVER x Pressure Systems Only xx Mound Or t-Grade Systems Only ,a Mulched Depth Over Depth Over 11,, xx Depth xx Seeded/Sodded Bed/Trench Center Bed/Trench Edges ` �� �.. r Yes No Yes No COMMENTS: (Include code discrepencies,persons present,etc.) Inspection#1:—p// ) /_Tj Inspection# : G/ r✓t f•' Location: 912 218th Ave.SO ERSET WI 54025(NW 1/4 NW 1/4 17 T31 R1 gquaw LLaakr/e"Es'tafe§'Lot 5 Parcel No: 17.31.18.1266/_,�� 1. Alt BM Description � ��� 2.)Bldg sewer length= 7� Lc 0�' .�/A► �' ��rsvn v - -amount of cover 7 — Plan revision Required? Yes No ' I q Use other side for additional information. Date Insepctor s 5 natur V Cart.No. SBD-6710(R.3/97) Nv� tjwllq So -r3 i w P- I ow 8 - sLOAQ qlz Aug a W I ,S CCZ5 Car y 77.32'I Z ci tl C6 1 7b-F LF Soli, i�1'�Icopv r COMW Ileilsi'-evict Z ir ty pmt,WI &M-7162 c/ ST. CROIX COUNTY MMUNITY ©EVEL®PME �3.C8�1-flI� s�T Swiitaxy Permit App 5 7�' 1a MVftSPs�2.C.Wh-As�.Ca of�ssiocmm0a�pVco � � mabsaYP�'- ��� p�� eolto pCif ,mss} s 15 m Snots. T ia ��e L satiea— pared# pr pmyowasr-sNMC �i � a� " < .,r I ' 03S "Z3`( . U C 0 paperty owners>a 0 soft rip Code V.I. (�a8 AR T VV 'SAyUZS T3—rA=P_ @ 1L Type ofBs�g( ButiulagPlY) � �j� ^�"✓ Ld#� K.Lw2Fam*D —NuberofBe mum Biodc* 0 PubfidCam —Desedw U39 ' Q city f C nAlbsaba' Q VMW of Q pwBed—D OQ^Taxa of S'rt r �P` HL Type efP+araait: ( J we bmz an VneA. COMPIlleft eB#fib) Q0GWMu 1W S140°1(-was '} B. Q Pdsmt$mewl ❑iIits►isiaa ❑ QPTra �I�w lit fitviom beoed B�ora F�atian own" ItT T of P0'i+VTS an that ❑ Q P bi-C#ooad Q A >24 is of a wH ❑Motmd<24 io afsa i+k MR rl i ❑HaTank QObert ) V. et at Amb1farmstion: � AseaPmpas�(SO VL Tank We GAUM thaw eerTa�cs T�mtia�Taeics l �n t t. T 1 /T� if SqWc r To& ROO VILR b Y 'a�smc�for. afoseP(fLVTSshownaB>9m 1QmeeNmnber/-� Numbers Nammt�) pu�a'3,&asss(St>rCM CbY= zw oxk) E�� GoaB Use - D�o © ravav[teasoasfae Disappravni ' DL 7' J 1.Septic tank,efFluent�ilter and dispersal cell must e serviced I b maintained / � Z( �'� . as per management plan provided by plumber. 5 f 2.All setback requirements must be maintained ---- ghssiera>be ams�ttsuece.ets w� ' ,.. ,' TGY lr h fs� l t' �Yv� r� 4r � '1L p j yt6?t41 sBn-�399(R".I><XI) JEFFERY V FOX Page 2 10/2/2014 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 S 250.00 This Amount Will Be Invoiced. When You Receive That Invoice, Patricia L Shandorf Please Include a Copy With Your POWTS Plan Reviewer,Integrated Services Payment Submittal. (715)634-7810, Fax: (715)634-5150,M-F 8:00 a.m.-4:45 p.m. WiSMART'code:7633' 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 addressed in a"300"series. For future reference,the Wisconsin Commercial Building Code will be addressed by SPS Chapters 360-366. I 9eTNFh DIVISION OF INDUSTRY SERVICES 10541N RANCH ROAD HAYWARD WI 54843 3 ' Contact Through Relay hftp://dsps.wi.gov/programs/industry-services 9� r w www.wisconsin.gov A ° 'ssION�tis� Scott Walker,Governor Dave Ross,Secretary October 02,2014 CUST ID No. 223242 ATTN.•POWTS Inspector JEFFERY V FOX ZONING OFFICE JEFF FOX CONTRACTING& SEPTIC INC ST CROIX COUNTY SPIA PO BOX 565 1101 CARMICHAEL RD DRESSER WI 54009 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 10/02/2016 Identification Numbers Transaction ID No.2457851 SITE: Site ID No. 806196 Brad Nasset Please refer to both identification numbers, 215TH St above,in all correspondence with theagency. Town of Star Prairie St Croix County NW1/4,NW1/4, S17,T3 IN,RI 8W FOR: Description:Mound,4 bedroom residence Object Type:POWTS Component Manual Regulated Object ID No.: 1503554 Li r Maintenance required; 600 GPD Flow rate; 26 in Soil minimum depth to limiting factor from original grade; System(sAP f 3 Rt Mound Component Manual-Ver.2.0, SBD-10691-P(N.01 101,R. 10/12),Pressure Distribution Component M .� OF � , Ver.2.0, SBD-10706-P(N.01/01,R. 10/12), SSWMP Pub. 9.6; Effluent Filter PFROFESS!N The submittal described above has been reviewed for conformance with applicable Wisconsin Administrativt)W4g�ION OF 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. r� The owner,as defined in chapter 101.01(10),Wisconsin Statutes, is responsible for compliance with all code requirements. SEE CORRE No person may engage in or work at plumbing in the state unless licensed to do so by the Department p r s.145.06, 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. 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. • 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 MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Project Name: Brad NRSSQ-71� Owner's Name: °l 1 Z -rt4 Owner's Address: CJv.-QS6-C VU S,i025 Legal Description: NW1/4 NW1/4 S17 T31NIR18W Township: Star Prairie County: St. Croix Subdivision Name: Squaw Lake Estates Lot Number: 5 Block Number: Parcel I.D. Number: 038-1239-05000 Plan Transaction No.: ViC 4`Pyr Page 1 Index and title ES Page 2 Data entry Page 3 Mound drawings Page 4 Lateral and dose tank ICON Page 5 System maintenance specifications N E Page 6 Management and contingency plan Page 7 Pump curve and specifications Page 8 plot plan Page 9 soil test 5 �� I Designer: Jeff Fox License Number: MPRS 223242 Date: 09/03/14 Phone Number: 715 755 2461 Signatu Designed Pursuant to the Mound Component Manual for POWTS Version 2.0 SBD-10691-P(N. 01/01, R. 11/12), and both SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST-SAS(01/81)and Pressure Distribution Component Manual Ver,2.0 SBD-10706-P(N. 01/01, R. 10/12) Version 7.0(R. 11/12) Page 1 of 9 Mound and Pressure Distribution Component Design Design Worksheet Site Information (R or C) R Residential or Commercial Design Note: Sand fill(D)calculations assume a 400.00 Estimated Wastewater Flow(gpd) Table 383-44-3 in-situ soil treatment for 1.50 Peaking Factor(e.g. 1.5= 150%) fecal coliform of-36 inches. 600.00 Design Flow(gpd) 4.00 Site Slope(%) 98.13 Contour Line Elevation (ft) 26.00 Depth to Limiting Factor(in) 0.60 In-situ Soil Application Rate(gpd/ft2) Distribution Cell Information 65.00 Dispersal Cell Length Along Contour(ft) = 9.24 Cell Width (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 Y Pressure Disribution Information network? Enter Y or N (C or E) a Center or End Manifold 3.08 Lateral Spacing (ft) If N above, enter the elevation (ft) 3 Number of Laterals of the highest point. 0.156 Orifice Diameter(in) 3.00 Estimated Orifice Spacing(ft) = 9.10 2/orifice 2.00 Forcemain Diameter(in) 75.00 Forcemain Length (ft) Does the forcemain drain back? Y 85.00 Pump Tank Elevation(ft) Enter Y or N GCS 7� 4.55 System Head(ft)x 1.3 12.23 Forcemain Drainback(gal) I 1 J 13.56 Vertical Lift(ft) 87.28 5x Void Volume(gal) 3 1.99 Friction Loss(ft) 99.52 Minimum Dose Volume(gal) -7` 0.00 In-line Filter Loss(ft) 35.54 System Demand(gpm) / 20.09 Total Dynamic Head (ft) Lateral Diameter Selection Manifold Diameter Selection in. dia. options choice in. dia. options choice I 0.75 1.25 1.00 1.50 x x 1.25 2.00 x 1 1.50 x x 3.00 2.00 x 3.00 x Gallons/Inch Calculator(optional) Treatment Tank Information Total Tank Capacity(gal) 1200.00 Septic Tank Capacity(gal) Total Working Liquid Depth (in) ieser Manufacturer gal/in (enter result in cell B49) Dose Tank Information Effluent Filter Information 800.001 Dose Tank Capacity(gal) Ilifetime lFilter Manufacturer 20-281 Dose Tank Volume(gal/in) 01/08/14 IFilter Model Number Wieser IManufacturer Project: Brad Page 2 of 9 Mound Plan and Cross Section Views 1/j, 10,E J Observation Pipe :© �. . B . . . . . . . . . ' I L Mound Component Dimensions A 9.24 E 14.44 in H 1.00 ft K 8.43 ft B 65.00 ft F 9.50 in I 8.50 ft L 81.86 ft D 10.00 in G 0.50 ft J 5.69 ft W 23.44 ft 600.60(ft2) Dispersal Cell Area Em(ft2) Basal Area Available 9.23(gpd/ft) Linear Loading Rate (ft) 1/10 B Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area Finished Grade 100.76(ft) --► ..,,1, ,". I G H 2 F 99.46(ft) Lateral Dispersal Cell 98.96(ft) — Invert Dispersal Cell Elevation E : D , 9 .13(ft)Contour Elevation rvd-tr �� q 4.0% Site Slope Geotextile Fabric Cover Shading Key 4 in. �— Dispersal Cell See lateral details on 1 Topsoil Cap dia• 1.5 ft ti.,,, — Page 4 for number, size, slotte a �` ," 1 and spacing of laterals. Subsoil Cap d © ASTM C33 Sand obse �— ` r .�, r.„ 1 Laterals are equally "` F spaced from the Tilled Layer rvati 0.5 ft T pica)Lateral , ® X r . ' distribution cell's © 0 Aggregate on " ; sF centerline in the pipe Imo-A_"=N distribution cell(AxB). Project: Brad Page 3 of 9 End Connection Lateral Layout Diagram Center the laterals over the A&B dimension 40-Turn-up wfball valve or aleanoutplug P —� FForce dentical IF X—�l Holes drilled on the bottom of the lateral equally spaced Laterals&forcemain Sch 40 PVC per SP Table 384.30b g nnection via tee o r cross to manifold at any point. Number of Laterals 3 Orifice Diameter 0.16 in Lateral Diameter 1.50 in Orifice Spacing (X) 3.02 ft Lateral Length (P) 63.42 ft Orifices per Lateral 22 Lateral Spacing (S) 3.08 ft Orifice Density 9.10 ft2iforifice Lateral Flow Rate 11.85 gpm Manifold Length 6.16 System Flow Rate 35.54 gpm Manifold Diameter 1.50 in Total Dynamic Head 20.09 ft Forcemain Velocity 3.63 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 nne �Jte outlet Tank component is prope ven a on Forcemain diameter Wieser Manufacturer 2 in. Capacityl 800.00 Gallons Volume 20.28 gal/inch Weep hole or anti- Dimension Inches Gallons siphon device A 21.64 438.87 B 2.00 40.56 Pump off elevation ft C 4.91 99.52 85.91 D 10.901 221.05 Total 1 39.451 800.00 Dose tank elevation(ft) 3" Bedding under tank. 85.00 Alarm Manuafacturer JRhombus Note: Switches Alarm Model Number JJ Pluger containing mercury may not be used in Pump Manufacturer JZoeller this system. Pump Model Number BN152 Pump Must Deliver I 35.54 gpm at F___2_0_059 ft TDH Project: Brad Page 4 of 9 Mound System Maintenance and Operation Specifications Service Provider's Name Jeff Fox Phone 715 755 2461 POWTS Regulator's Name St. Croix Cty� Phone 715 3864680 System Flow and Load Parameters Design Flow-Peak 600 gpd Maximum Influent Particle Size 1/8 in Estimated Flow-Average 400 gpd Maximum BOD5 220 mg/L Septic Tank Capacity 1200 gal Maximum TSS 150 mg/L Soil Absorption Component Size 600.6 ft2 Maximum FOG 30 mg/L Type of Wastewater Domestic Maximum Fecal Coliform >10E4 cfu/100 mL Service Frequency Septic and Pump Tank Inspect and/or service once every 3 years Effluent Filter Should inspect and clean at least once every 3 years Pump and Controls Test once every 3 years Alarm Should test monthly Pressure System Laterals should be flushed and pressure tested every 1.5 years Mound Inspect for ponding and seepage once every 3 years Other Miscellaneous Construction and Materials Standards 1. Observation pipes are slotted and materials conform to Table SPS 384.30-1, have a watertight cap, and are secured in as shown in the mound component manual. 2. Dispersal cell aggregate conforms to SPS 384.30(6)(i), Wis.Adm. Code. 3. All gravity and pressure piping materials conform to the requirements in SPS 384, Wis.Adm. Code. 4. Tillage of the basal area is accomplished with a mold board or chisel plow. 5. The 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 ....,.......s•. ■........s....■i Grade 6-8"Diameter Lawn Threaded Cleanout Sprinkler Valve Box Plug or Ball Valve Distribution • Lateral "�'► Long Sweep 90 or Two 45 Degree Bends Same Diameter as Lateral Project: Brad Page 5 of 9 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[SBD-10691-P(N.01/01,R.11/12),SSWMP Publication 9.6(01/81),and Pressure Distribution Component Manual Ver.2.0 SBD-10706-P(N.01/01,R.10/12)]and local or state rules pertaining to system maintenance and maintenance reporting. No one should ever enter a septic or pump tank since dangerous gases may be present that could cause death. 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,Slats. 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 fitter 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 of 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 Department of Commerce. Pump Tank The pump(dosing)tank shall be inspected at least once every 3 years. All switches,alarms,and pumps shall be tested to verify proper operation. If an effluent filter is installed within the tank it shall be inspected and serviced as necessary. 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 BOD.,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 18 months. When a pressure test is performed it should be compared to the initial test when the system was installed to determine if orifice clogging has occurred and if orifice cleaning is required to maintain equal distribution within the dispersal cell. Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the owner,and any levels above 6 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 5 of this plan for the name and telephone number of your local POWTS regulator and service provider. Pretreatment Units The information and schedule of mananagement and maintenance for pretreatment devices such as aerobic treatment units or disinfection units are attached as separate documents and are considered part of the overall management plan for this system. Tank Mangy wt,1 Manufactuurer ZOQA. K Tank Model Number IZXI 8W V1Y 1-P Pun p Model Number Kt-3 15-Z Total Tank Capacity ZOOO Alarm Manufacturer I N1 W'S Max.Bury Depth Alarm Model Number- J13 FLV6&"K- Switch Type I AM Filter Manufacturer L: 1 ij\C— Total Dynamic Head(TDW-Feat Filler Model Number I Elevation Head Distal Pressure Network Loss :Sd�c- Minimum Pump Performance Required Forte Main Loss 2 .Sy GPM @ 1201 9• Ft TDH Total Outlet Manhole Min.4"Above tirade With Looking Devices Inlet Manhole Manhole Min.4"Above Grade <6"Below Grade Sealed Watertight Securely Mounted Device -- weather proof`„, Junction Box •• ,,.,, •• •� "' Finished Grade •• •• ••• •,-,>,,, .. .,� Depth of Vey Min. 12"Cover Disconnect Ft Above Grade With Vent Cap Mesas >e talc < tss't>ts< < -9 -9 < < scssscct°st>cs as Outlet Outlet i'llteT ^� a�___-- >` -- Inlet Baffle 2. 2. >i A s; �i Switch Sdt W and Reserve Capacity ;4 y.,a <> Tank Volume= GPI >< weep ` Hole ;s Dimension Inches Volume Gal. .14 B . reserve)A Z f.�`I 36 r 87 >` < t < *,> (alarm) B 20-S Off Elevation _ C (dose) C .ri 1 Z �< -r. < Bottom ;t> D D Elevation "N Total W FL < t star tss'RStstssats0stss>tas>t>sss>cssstssssststsssaasstse sat t c : : t s s s s s s + t s s + e s R s � t e c s eat a a a s a s s a s s a a s a a a a s a s s a a s s a s > > a s a > a a a a s a a a a s a a s a s > s s a > a a s s a GENERAL INSTALLATION: The septic/dose tank is bedded and back filled in accordance with the man's product approval specifications. Maximum depth of bury as specified by the mangy may not be exceeded without prior approval. Manhole covers exposed to grade have an effective locking device(padlock) instal led. Piping at the inlet and outlet is of approved material, connected to the tank with vvatcrfi&fittings,and laid on stable soil to prevent settling or sagging. The force main is sleeved with V Sch.40 PVC to bridge the tank excavation and the sleeve is sealed watertight. Electrical service complies with NEC 300 and Comm 1628 WAC. 02/05I:J Page of a : { TOML t ! g' a. PUW iMnRWOM, CURVE �' MOOCLS /152/153 ist 152 153 L ' red 77 { � �� a . n � , Q: .��,;,�; ,ai • _ so � m , 40 L a „a y'deW UM 240 Tin -N�--Tmi SP 31M film Wo- bwd ^x- ■!e• t.' v !y a =�a r_ W ,j uvllq p- 193 W \—ZENCT zig-TH kv-L i crr 27,37'1 2- fvo-F,i;r- ATM- b Ism w I HM -7 7W tF 2' PVC P�rG Sc 1260 Wisconsin Department of Co me SOIL EVALUATION REPORT Page 1 of 3 Division of Safety and Buildings k'` - Tom Schmitt B m Vii()" 1iL"a�nm 85,Wis.Adm.Code County Attach complete site plan o paper not less than 8'%x 11 inches in s e. Plan must St.Croix include,but not limited to:v itical angttiori;ontal reference point(B direction and Parcel I.D. 3 p_ a3 soda percent slope,scale or dim sions,Ndrtl(am*, and lance to nearest road. a t Pie se pr rpt\al(infonmaa�'on. r Rpe ' B _ Date Personal information you p ' e may W If@r(.,se a �utpbses(P Law,s.15.04(1)(m)). .� Property Owner Property Location Grand Properties, LP Govt.Lot NW 1/4 NW 19 S 17 T 31 NR 18 W Property Owner's Mailing Address Lot# Block# Subd.Name or CSM# 712 Rivard Streeet, Suite 300 5 Squaw Lake Estates City State Zip Code Phone Number .,.J City J Village !M Town Nearest Road Somerset WI 54025 715-247-5900 Star Prairie I 218Th Ave. J9 New Construction Use: A Residential/Number of bedrooms 3 Code derived design flow rate 450 GPD j Replacement Public or commercial-Describe: Parent material Glacial Till Flood plain elevation,if applicable na General comments and recommendations: Area is suitable for a mound system. System elevation is 99.0'based off of contour line established at 98.13'. Slope is 4%. Depth to limiting factor is 26'. Boring# j Boring 16 Pit Ground Surface elev. 98.28 ft. Depth to limiting factor 28 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF *Eff#1 *Eff#2 1 0-8 10yr3/4 none sil 2mgr mfr as 2f .6 .8 2 8-14 10yr5/3 none sil 2fsbk mfr gW 1f .6 .8 3 14-28 7.5yr4/4 none sil 3msbk mfr gW -- 6 8 4 28-38 7.5yr4/6 c2d 1 /218 Sid 3msbk mfr gW — .4 .6 mad 7.5�/6 5 38-60 10yr4/6 7.5yr5/2 Sid 1 msbk mfr — .2 .3 Boring# '#h Boring le Pit Ground Surface elev. 98.53 ft. Depth to limiting factor 26 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF *Eff#1 *Eff#2 1 0-9 10yr3/3 none sil 2mgr mvfr as 2f .6 .8 2 9-17 10yr5/3 none sill 2fsbk mfr cW 1f .6 .8 3 17-26 7.5yr4/6 none ad 3msbk mfr gW 1f .4 .6 4 26-37 5yr4/4 c27.5.5 /2/6 Sid 3msbk mfi cW — .4 .6 5 37-59 10yr5/4 m�5� 2/6 Sid 1 msbk mfr — — .2 .3 *Effluent#1 =BOD?30<220 mg/L and TSS>30<150 mg/L *Effluent#2=BOD <30 mg/L and TSS<-�0 mg/L CST Nam(Please Print) Signature: CST Number Thomas J.Schmitt 227429 Address Tom Schmitt Date Evaluation Conducted Telephone Number 1595 72nd St.,New Richmond,WI 54017 —oZ _ 715-247-2941 I Property Owner Grand Properties, LP Parcel ID# Page 2 of 3 • 3 Boling# _„]Boring JO Pit Ground Surface elev. 97.13 ft. Depth to limiting factor 29 in. Sal Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDff *Eff#1 *Eff#2 1 0-9 10yr3/3 none I 2mgr mvfr as 2f .6 .8 I 2 9-16 10yr5/4 none I 2fsbk mfr gw 1f .6 .8 3 16-29 7.5yr5/4 none scl 2msbk mfr gw — .4 .6 4 2944 7.5yr4/4 025 Syr5/6 scl 2msbk mfr cw — .4 .6 5 44-61 7.5yr4/6 mad 5yr5/8 5yr5/2 sicl 1 msbk mfr — — .2 .3 I Boring# :j Boring _J 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 *Eff#1 *Eff#2 I I I F-I Boring# Boring Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots "Eff#1 *Eff#2 *Effluent#1=BOD?30<220 mg/-and TSS>30<150 mgA- *Effluent#2=BOD5<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. IL } Page 3 of 3 • bonducted by: Conducted For. Ref No. lJolo Schmitt Soil and Site Evaluations Name: Grand Pmpertim LP. Thomas J Schtmtt,CST 227429 Address: 712 Rivard St. Suite100 1595 72nd St. City,State,Zip: Somerset,WI.54025 New Richmond,WI. 54017 Phone: 715-247-2941 Subd.Name: Squaw Lake Estates Lot No.: 5- Legal Ir ion: /N! 1/4 Nt✓1/4 S17 T31N R18W Township of Star Prairie, St.Croix County Bench Mark EL I00.W Top of 2"pvc pipe Alternate Bench Mark El./0%!9'To of 2*pvc Pipe Slope=—Y19- Contour Line E� ./.3 Contour Litre Length Scale in=40' 17 6 �I 1 311 a f� �Op ?C r Pf�pQ5 eo� �e This WO report was done to futM a zoning n gdmT ant. No permanent iot rnatice►^$were in at the tints the test was conducted Tto area in which it was done may or may not be suitable far your use.or in the kxmgon shown. .c.'ru uc.r ca z .... ` QN t . L.B.0.=993.4' 991.7' r�• w.L.= JL 588',36'02"E S88.36'02"E 393.98' 560.42' 'w �rz?= LOTS _� 990.5 rya,; 0 1 v Co 40 _ C.V. a' `^ 78,102 sq. ft. n Linage o�0 1.79 acres r Co LOT2 "� _�" Drs rnen c, C-)L.B.O.=980.3 124,079 sq. ft. 3r °, z _ • 0 o N `�` t� 3d• 2.85 acres w o 0l0 L.B.O.=954.6' '\ n 14a.a° 4115 ;cts rn K-) V F w � f ' 1 6"E 484.35 6` •N 250.88 , 991.0' I ; c0 •, 00 CO ' a?� _ H.W L.= j LOTS 967.8'. r �•`119,946 sq. ft. ; 995.2 2.75 acres---* `• V ;` L.B.0.=978.1' e 1 0 U .HW.L,=�� f r LOT 4 ?a �' 976.1' 104,613 sq. ft. 7 51 V)i uj 2.40 acres r ��? 4�1,ps, E r'/ ,� 'f w • p W t /�l M a4! t• °z cr rn LOT 5 I C-4 F, j 108,067 sq. ,ft/�l� Jll � l.%r p h`D .� ...,.. 0 2.48 acres l _ ' C V Z" L.B.O.=982 I '�'��. �� •�. =��� � ��, � it �.`�,�/,.�� f ' H W L. •t(.,!980.4' �' f jL �� ' •• �`t� ��� fV X11 f 136�3 ____ C2---- ''/i'•.,, 3 r v 1 w .. ....... AL 20'21" ? -- --'' C33 S6933,s2 'N85'43'57"E _� I 4 245.9 ,� N� ?8) 30.94 .�` c� rn g•20'2�1g3.26 �`-.,� .49 •�• z CO to 00 0 39� 66' Join t 230 81 w 287 49, C3� N85 ' �43 Orr"vewaY J- �3' � IC;�+'`• EosemenI � - s S85.43'S7"N 6,68,• __C38 - '� 88.89'-- _ =LO t'? N N - LC?T 4f 4 H WL.=• '-•--. LOT 39 _ ... ........... ft, 86,290 sq. ft °o .0' LOT 4l? `1�'k` ,q�• 98 a' ( •'96,712 sq. ft --------3 w 1.98 acres z I � g ,' ( 2.22 acres 78,111 sq. ft. ,V (• F ` L.B.O.=985.2 5pN 1.79 acres R 4 N M ik �' �,�-4� Q 96 ,•� L.B.0.=985.2 o o z r z �'i� !f N.W.L.- �, r 982.0' ST.CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer r Mailing Address ��Z Z C M Vi t Z5 Property Address (Verification required from Planning&Zoning Departme t r ew construction.) City/State Parcel Identification Number LEGAL DESCRIPTION Property Location t4%V 1/a, '/4, Sec. T _ R W,Town of S`TINI& f P-lr- Subdivision Plat: :SQQNu;_LLI;C_E�-TMEN .Lot#�. Certified Survey Map# . Volume , Page# Warranty Deed# 9 l 7&`7 o (before 2007)Volume ,Page# Spec house--yesno Lot lines identifiable=yes=no SYSTEM MAINTENANCE AND OWNER CERTIFICATION Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner,if needed,by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. Owner maintenance responsibilities are specified in§Comm.83.52(1)and in Chapter 12-St.Croix County Sanitary Ordinance. The property owner agrees to submit to St.Croix County Planning&Zoning Department a certification form,signed by the owner and by a master plumber,journeyman plumber,restricted plumber or a licensed pumper verifying that(1)the on-site wastewater disposal system is in proper operating condition and/or(2)after inspection and pumping(if necessary),the septic tank is less than 113 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 Planning& Zoning Department within 30 days of the three year expiration date. Uwe certify that all statements on this form are true to the best of my/our knowledge. I/we amtam the owner(s)of the property described above,by virtue of a warranty deed recorded in Register of Deeds Office. Number of bedrooms 19/IZlIY WNATLat OF AP LICANT(S) DATE ***Any information that is misrepresented may result in the sanitary permit being revoked by the Planning&Zoning Department.*** Include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if reference is made in the warranty deed. J 997640 BETH PABST REGISTER OF DEEDS State Bar of Wisconsin Form 1-2003 ST. CROIX CO., WI WARRANTY DEED RECEIVED FOR RECORD 06/24/2014 10:20 AM Document Number DocumentName EXEMPT # NA REC FEE: 30.00 TRANS FEE: 108.00 THIS DEED,made between Citywide Development Inc..a corporation under the PAGES: 1 laws of Minnesota ("Grantor,"whether one or more), **The above recording information and Bradley D.Nasset and Joan L.Nasset,husband and wife as survivorship marital verifies that this document has 22gerty_ been electronically recorded &returned to the submitter ("Grantee,"whether one or more). Grantor,for a valuable consideration,conveys to Grantee the following described real Recording Area estate,together with the rents,profits,fixtures and other appurtenant interests, in St.Croix County,State of Wisconsin("Property")(if more space is Name and Return Address needed,please attach addendum): Burnet Title 5151 Edina Industrial Blvd,#500 Edina,MN 55439 Lot 5,Plat of Squaw Lake Estates,in the Town of Star Prairie,St.Croix County,Wisconsin Attn: Post Closing 14-06723 038-1239-05-000 Parcel Identification Number(PIN) Thi is not. homestead property. (is)(is not) Grantor warrants that the title to the Property is good,indefeasible in fee simple and free and clear of encumbrances except: None KATHLEEN A SAND + NOTARY'l1BUC.MINNESOTA Dated MY COMMISSION EXPIRES 1131116 t AL) (SEAL) *By:Andrew Peter Kociscak,Director Citywide Development Inc. (SEAL) (SEAL) * * AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF�r authenticated on ss. COUNTY ) * Personally came before me on �/ �! / , TITLE:MEMBER STATE BAR OF WISCONSIN the above-named Andrew Peter Kociscak,Director of Citywide (If not, Development,Inc.,a corporation under the laws of Minnesota authorized by Wis.Stat. §706.06) to me known to be the person(s)who executed the foregoing instrument and acknowledged the same. * THIS INSTRUMENT DRAFTED BY: Burnet Title-Scott Tranby,5151 Edina Industrial Blvd, Notary Public,State of #500,Edina,MN 55439/ 14-06723 My Commission(is permanent)(expires: 1 �G ) (Signatures may be authenticated or acknowledged. Both are not necessary.) NOTE:THIS IS A STANDARD FORM. ANY MODIFICATIONS TO THIS FORM SHOULD BE CLEARLY IDENTIFIED. WARRANTY DEED 0 2003 STATE BAR OF WISCONSIN FORM NO.1-2003 '9Y3r 4WCkRM sWg44@ Page 1 of 1 SNO VA'A79 (00),,o-1 �{���-SSL (SIL) NOI-Mel1�9 3131dV 9 d2"ISNOI ION - :'A98 Cf owils IM d-IO��SO 0 2w SNV-w 537NVNIdw v 53QY1-wlo-I -9nd PIOI LO%Z V'31d15'M9Q3d TV MO-W=l 15(" A321 SNO /�—I _ IlY901'8'S3ION'53ZIS'SWISN34d rl/V/6 31V4 / I1 '59'91A'c IgS IW 8 ° EEO D � 0 aoo aoo 0 0 �p o ®®®® ®®®® 0 8 n4� -a' w d ,na/aw+ r5, c 4 c�roerers rur-r, gw_ra� u»crs carers K VI AT SERVICES, LLG DATE: 9/k/IA 6ULDER&OwNEa Musr vrzElFV ALL NA��^ET DIMENSIONS,SIZES, NOTES,&LOCATIONS. 2637 IOTt1 AVE. �� rev - LOCAAL��INANCES.STATE, LAWSS&A;UE 05(,EOLA, WI 54020 f�E�IDENGE REV.: - NOT Ca4SIDERFD CaAUTE CaroTRWTI(N U' (715) 755-3343 SCALE:- I/a"= r-d' (U.NO.) FUTURE P)ASEMENT PLAN e n 9 � H b t III � III � III 3" III lro lro Y •Ppl M/+%aY PMIlRY PC PN1fRY �Ryc IF � F I-` I , rD IF boo I am III � Z r r y 3' ��{ DATE: 9/4/14 GUILDER&OWWR MUST VREIFY ALL -� AT SERVICES, LLC NA53ET PIMENSI",SIZES,NOTES,&LOOATIGNS. 2637 IOTI1 AVE. Rev: - �o ATL FCOMSES ORVI�NaZs.sT�AE 056EOLA, WI 5..4&20 REeIDENGE REV. _ Nor ccNsipmp WoPLETE 6"TIR WTION �' (715) 755-3383 56ALE:- 114"= Y-d' (U.NO.) FLOOR PLAN