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HomeMy WebLinkAbout020-1376-66-000 Wisconsin Department ofCcvmercedo e• PRIVATE SEWAGE SYSTEM 1COe0ty St. Croix Safety and Building Dh.ision • Sanitary Permit No INSPECTION REPORT 420305 Q 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)I Permit Holder's Name. City Village X Township Parcel Tax No: Premiere Development Hudson Township 020-1376-66-000 CST BM Elev ( Insp.8M Elev: BM Desuiption: b )l0 .v it70.0 ' .-Q V 6tuac h% ,,,J. te•v. = csr(6wZ,e„S)$tt. ( )y• a9• 1.a3�7 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION r, BS HI FS ELEV. c(6...S;r,.4.6..4 J Septic Ben mark L)C-�s I.2-Ve Da,- T•( 'h h S .(t 2-(L1,oS.(•2) 100.0 f Dosing W&644-! J Alt.BM NM Aeration v Bldg.Sewer (1) C ) Holding St/Ht Inlet ($( 9 2Sr TANK SETBACK INFORMATION St/Ht Outlet ( \ /2.15 70 r TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet `//1/j J 2 •/.7 pp Septic Li, / ^ (Dz/ ,s1 Dt Bottom / �` ((2"�� Dosing .3 t ( (( 1 Z`f n r Header/Man. J( ñ4?) - '///� /00•6 2 i.) Aeration D �pD Holding Bot.System ( n _� Final Grade (5Crei2-e- t PUMP/SIPHON INFORMATION ( < s.(,� o Manufacturer Demand , St Cover O�1/C/ J �cA le Ll•.lifZ GPM s._..el., (ati......e. Model Number !t" i 8 ^ak'hkdr I�. ) 12.31'— g. / LV1 p Lift Friction Los System Head TDH , Ft ��I �k 1p.`�`� 2- 13•61 Forcemain Length I Dia. r' Dist to Well / )t(0 2 ( > Ito SOIL : •RPTION SYSTEM( D 1c L 3. idth/ Length No.Of Tren PIT DIMENSIONS No.Of Pits Inside Dia. Liquid Depth DI ( .01 ) 3— SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufturer INFORMATION CHAMBER OR D 10 D �S(/� Type Of System 40/ > r > 1 ( UNIT Model Number / I or DISTRIBUTION SYSTEM Header/Manifold u Distnbution Hole Size S cing Vent to Air Intake ee(s Lengthk� Dia LenPipPgtrr) Dia Spacing iS 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 Bed/Trench Center Bed/Trench Edges Topsoil �7/� ■ Yes ■ No ■ Yes Y No COMMENTS: (Include code discrepencies,persons present,etc.) Inspection#1: 1 i / !/0/ nT- nspection#2:_r i_ Location: 926 Fraser Lane Hudson,WI 54016(NW 1/4 SW 1/4 14 T29 ce o: .2 . o, „P 6t.aa�t.,� ►,....t SYs(� • s 4.- 1.)Alt BM Description = < 2.)Bldg sewer length = )Sr' //���[y} 14. •- Z b•10 r (4) g+w 7) amount of cover= $-y.I.R-Q -4-top rr� ,a7- 4t, . /,N. -- a4 S: 5.t5 bHr 9'l�1 s �•�` Imo• = S �. t'1- = `l1 I 4 Plan revision Requir ? n Yes k No --�ts.,'1 f• 14 12- _`l9.5'o Use other side four id information. // �- 740. 2� SBD-6710(R.3/9,7f ( ct`.�ata�� )/ _ _ In is ignalure 4 7-( Cert.No. � r _.) . A- qzb FLA-Sell_ L filu€ 5 i ev0 Sanitary Permit ApplicCiafflii_icvl Safety&Buildings Division UsconsIn In accord with Comm 83.21,Wis.Adm. Code 201 W.Washington Ave. See reverse side for instructions for completing this application PO Box 7302 Personal information you provide may be used for secondary purposes Madison,WI 53707-7302 Department of Commerce (Submit completed form to county if not (Privacy Law,s. 15.04 Ixm y�G)] //.-'j .0L state owned.) Attach complete plans(to the county copy onl for the system,on paper not less than 8-1/2 x II inches in size. County C KO)\, State Sanitary PPer^mi Number Check if revision to previous application Stale Plan I.D.Number I.Application Information-Please Printt` all Information / Location: 7 PropertyProperty Location Owner Name 1 1\ 1 `1 e o� `TK t rlN i c K D_U 1 I V li JT\.Q t t I (sr h. /1 4S'J 14,S t / T f,N,R!/E(or)W Property Owners Mailing Address (J.1( 1 Lot Number Block Number • 'a3 LAui4l St (oce - City State Zip Code Phone Number Subdivision Name or CSM Number f'(4b3uti, L'I S`/1I L ( NA) 51..1“t Gl.AS S II.Type of Building: (check one) tJ ❑City ❑ 1 or 2 Family Dwelling-No.of Bedrooms: I RECEIVED ❑village ❑Public/Commercial(describe use):_ 114 Town of ❑State-Owned 1 A ' N 4 9.S V 03� 31 x Ir Z.So' ,t-.e.,J.an ( ]O cwe.�a�a)/(�nsrrQ 91 J` 1 ���� Nearest Rosd�rn. .4.e. tpi'Je ( ) 'I r kb2r4o' A-.r...Q s., 60 cL tars ? - ' - . . Parcel Tax Number(s) III.T pe of Permit: (Check only one box on line A. Che A) I. 1S7 New 2. 0 Replacement 3. ❑Replacement of 4. 5. 6. 0 Addition to System System Tank Only Existing System B) Permit Number . ,0 /� Qate Issued; IRA Sanitary Permit was previously issued c7l V 36s. vs ar.,s+J i Ion_ IV.Type of POWT System:(Check all that apply) -'t14 eQ it`I O ff 4 [ ar. I �" [Mon-pressurized In-ground 0 Mound 0 Sand Filter 0 Constructed Wetland Ya2a#.te's'� ❑Pressurized In-ground 0 Holding Tank 0 Single Pass 0 Drip Line Cr..%l� ❑At-grade 0 Aerobic Treatment Unit 0 Recirculating 0 Other: V.Dispersal/Treatment Area Information: I.Design Flow(gpd) 2.Dispersal Dispersal Area ✓4.Soil Application 5.Percolation Rate sternE evation 7.Final Grade Required roposed Rate(Gal /day/sq.ft.) (Min/inch) 3- 97.s 6 Tv'�i.osi Lo0 S5S ISQ( 41 - :). - lg .so/ -sw.st., VII.Tank Capacity in Total #of Manufacturer Prefab 'e _S�iber- Plastic Information Gallons Gallons Tanks Con- Con- glass New Existing crete structed Tanks Tanks t 3-kl/l 1 c I • — 1ac,0 ( 0 0 0 0 Pur+•D I d( ) ( In)-' El ❑ ❑ ❑ VIII.Respo sibility Statement I,the undersigned,assume responsibility for in lati n of the POWTS shown on the attached plans. Plumbers Name rint) Plu s to o stamps): MP/MPRS No. Business Phone Number TO," Doug.fs��. Da) 9a•J ']1S -7Lb-01l7 Plumbers Address(Street,City,State,Zip Code 1 �7U w 3S 1 - k.,DAii IA; SYU c, IX.County/Department Die Only 0 ner Disapproved Sanitary Permit (Includes Groundwater Date Issued Issugt Agent Sistamps) i�Approved ❑Owner Given Initial Adverse Surcharge )J,�"'� i(1 r3io Z O`/e Determination X.Conditions ofnApproov-al/Reasons� forr4isapprov �'r Siff - '4"S too 55,22 a 4SU6 Z rat 4 i-te.•1 . _n t- y—� I_ CSIA- 'k �U M9 d • -at k t Sf a cot s I �" an6htiK��i c �/ firer 1ne� L E� • FAl jFit — � �xP� A � (e .t , }�.Lu. Ll�• uor .. V tS . b LP L I t 70 t- / '/a.`) uikl S cl e. ub nda rs 7 /. .ec. _ •-....11 .2.Yli 1-.F.3.1)._ _____........... ...._._AMM E . . .. _ ;in. AvLl.Q7.2.e er. .. /611 a L 1 inn 5.-wR-{>1 . �Rbs-4": L./ ense ,yU . _..--.- ---. _ _.. _ ._' /.O7- _. " . _ . way 111 Q� ! i • - 4e N (.l, br l+y Iry= .d 133 i �l ' • ... ( Tor of r6L►.n6�'1ON go), ip Od Ct,U 800 51.,l I. (.) rfut.,_ 1 ' Rhr CJ, w1A•/u6r9-,r: . <- S 1 ai < I v"\./' • ufi 9 - ' Pwiz 5 a -- -1. -ems"'` _`i _ ._ _... '= ip (Le. 1 S/\14' u) $$$$'- ii Lim - g C x 01 (N Win °'14 '� CDC C IIIIIIIIIII Q I d. ,. i, , , g , t , F ..,:, , , . pil a) .f; ( W Vl " N W�' > ; roN = E x 0 co U .tiV i"i i"� u. 42 0 N // 11 CA cr) 1 a • • • • .. • , • fJ ti . - / I"lot / '/a..J unkL .5 i cf a i i ncl e rs ee_ P1. - -y^..111h Pi) N__--.- ---. ._.. _..__A/4M_ L . .. _ an 01.1.mE.e3 lea^. .. l 6.0a i-inn Sw- -c ..rcbslic. _. -___License -##"" ,.?? _,QyU- .5 - - _____ t kit Li 7 Z Q.T /� I 1 I ____Q� I a- 11C ,,, : 3 .50 At 98 Sb 41, 1, i •V ! o i - GN <l, bk. Irv- .() Q3 • j T �} 1 I01r 0i rot.1 Ov' 1 ON - I `1 0 6pArJR )-1U'r... 80o51.,t l.L( - i" ` Rhr U, wiA-I(A r, )1,,; v LIv , i b 4) g„�0�. ijmi... 1 w d a, ,)w{a () s 0 L o c ai co ro 2 > c A C g. `— rl . F 41L / / u)/II,,nAA� II Ex �j _a • • a n E , c c� N 1. towE E v c ,c x 0) ri y W _ cH T.oT °� lliJll:' 3 ( • a 'a RI o i d . I o ai .= in 72 = b pp { i \ 2 s -0 ai a- "o ii 0 •--- N t C U Erj-C) 8 ( I ,V V ���I`I`.1! i 1 , lL W o u E x /�L L \ \ -0 t >. a . c °) rn t cri Y C1 • • • • - 1 ' ,, 4L f° � -NU &Ye"' . —({k�� all• _ rt.. C(anr%ti.w_. , 1588 • Wisconsin.Departmentof.Commerce SOIL EVALUATION REPOR� page 1 of 4 Division of Safety and Buildings in accordance with Carron 85,Wfis.Adm.Code AC.E.Soil&Site Evaluations Attach complete site plan on paper not less than 8%x 11 inches in sae. Plan must County St.Croix include,but not limited to:vertical and horizontal reference point(BM),direction and Parcel I.D. percent slope,scale or dimemsions,north arrow,and location and distance to nearest road. 020-1376-66-000 Please print all information. /� s_ j 1 i ./ • Dale Personal information formation you provide may be used for secondary purWses(Prirec Law.s.15.04(1)(m)). e. .` lI/131e Z • Property Owner Property Location Jim Milleon -Premier Developmen RECEIVED Govt.Lot N 1/4 SW 114 S 14 T 29 NR 19 W Property Owner's Mailing Address oi# Block# Subd.Name or GSM" 823 Laurel St. � ?n6� 66 Sweet Grass City State N krl6ef J City J Village se Town Nearest Road Hudson WI 4016 . . Hudson 926 Fraser Lane ✓e New Construction Use: g R roams 4 Code derived design flow rate 600 GPD J Replacement J Public or commercial-Describe: Parent material Glacial drift Flood plain elevation,if applicable na General comments and recommendations: Install four trenches,two at 98.50'&two at 99_50'using 39 leaching chambers. Dosing req'd to reach system area. Insulate over end of trenches at driveway. i Boring tit Boring # J Pit Ground Surface derv. 100.26 ft. Depth to limiting factor 71" in. Soil Appication Rate Horizon Depth Dominant Cola Redox Desaiption Texture Structure Consistence Boundary Roots GPDIII' 'Eff#1 I 'Eff#2 1 0-6 10yr3/3 none Is lmsbk mvfr cs 21,1m 0.7 1.2 2 10yr4/3 none Is 1msbk mvfr gs 1fm 0,Z______1.2 3 61-71 10yr3/3 none Is lmsbk mvfr cw - 0.7 1.2 4 71-107 10yr2/1 none sl 2msbk mvfr - - 0.5 0.9 21. flat H#2 contains approo. 15%scattered gravel&cobbles. d Baring 2 Boring# J Pit Ground Surface elev. 101.28 ft. Depth to limiting factor 71" in. Soo Application Rate Horizon Depth Dormant Color Redox Description Texture Structure Consistence Boundary Roots GPDHP 'Ent I 'Effif2 1 0-10 10yr3/3 none sl 2msbk mvfr cs 2f,1m 0.5 0.9 2 10-56 10yr4/4 none Isis lmsbk/0 sg mvfr gs 1fm 0 7 1 2_ �{/y 3 56-72 10yr3/2 none sl lmsbk mvfr cw - 0.4 0.6 6*�tf{�- 4 72-90 . 10yr414 none sl lmsbk mvfr cw - 0.4 0.6 �, 5 90-102 10yr5/4 none sil lmsbk mvfr aw - 0.2 0.3 IC 6 102-111 7.5yr4/6 none gr Is 0 sg ml - - 0.7 1.2 H#2 consists of an u mbdur'e aT1\rnsbk Is&Osg s with apprao. 10%scattered gravel&cobbles. Effluent#1 =BOD 30<220 mglL and TSS 30<150 mpg. #2=BOD5<30 mgrL and TSS<�0 mg/1_ CST Nana(Please Print) Sigure: �j/� CST Number James K.Thompson �J`y `7�s� 3602 Address AC.E.Soil&Site Evaluations f Date Evaluation Conducted Telephone Number 340 Paulson lake Zane,Osceola WI 9/27/02 715-248-7767 ProQerty Owner Jim Milleon - Premier Parcel ID# 020-1376-66-000 Page 2 cf 4 3 BOAng* d "999.63 ft. Depth to limiting factor >105' in. � Pit Ground Surface elev. Sod Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDIIN •Eff#1 •Eff#2 1 0-9 10yr3/3 none Is 2msbk mvfr cs 2f,1m 0.7 1.2 2 9-19 10yr4/3 none Is lmsbk mvfr gs 1fm 0.7 1.2 3 19-36 10yr3/2 none sl lmsbk mfr aw I 0.4 0.6 -r .1 4 36-56 10yr4/4 none sl �2i sbk mfr cw - 0.4 0.6 5 56-78 10yr5/4 none sl/s 2msbk/0 sg mfr ai - 0.5 0.9 6 78-105 10yr4/6 none s 0 sg ml - - 0.7 1.2 Ft#5 consists of an usnsorted mixture of 10yr414 2msbk sl&10yr4/6 0 sg s. A sil inclusion was observed at 58"-72"X 36"wide al south end of sod pit. rn2d 7.5yr5/8 redox.concentrations observed within sit at interface with sand. 4 Boring# e 13orng J Pit Ground Surface elev. 103.48 ft. Depth to limiting factor 69" in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPO/ft' •Eff#1 'Efr#2 1 0-20 10yr3/2 none s1 2msbk mvfr cs 2f,1m 0.5 0.9 I -a 2 20-28 10yr3/3 none Is lmsbk mvfr gs 1fm 0.7 1.2 S 3 28-69 10yr4/3 none Is lmsbk mvfr cw 0.4 0.6 I 4 69 85 10yr3/2 none sl 2msbk mvfr cw - 0.5 0.9 v • A% 5 85-99 7.5yr4/6 none sl 2msbk mvfr aw - 0.5 0.9 41,"311i3'4 ° 6 99-108 7.5yr4/6 none gr is o sg ml - - 0.7 1.2 l-I#3 contains apprmc 10%scattered gravel&cobbles. 5 Ong# le Boring J Pit Ground Surface elev. 101.42 ft. Depth to limiting factor >92" in. Sail Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots . GPDHt' •Eff#1 •Eff#2 1 0-8 10yr3/3 none Is 1msbk mvfr cs 2f,1m 0.7 1.2 2 8-26 10yr4/3 none Is lmsbk mvfr gs 1fm 0.7 1.2 3 26-67 10yr4/4 none sl 2msbk mfr cw - 0.5 0.9 4 67-92 10yr5/6 none s&gr 0 sat ml - - 0.7 1.2 .54 IrC'ffilliPik. Ft#4 contains approoc 15%scattered gravel&cobbles. •Effluent#1 =BOD 5>30<220 mg/L and TSS>30<150 ngrL •Effluent#2=BO05<30 ng&L and TSS<�0 ngll. 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. Property Owner Jim Milleon - Premier Parcel ID# 020-1376-66-000 Page 3 of 4 6 Boring# d Boring J Pit Ground Surface elev. 100.15 ft. Depth to limiting factor >93" in. Sol Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft' 'Eff#1 •Eff#2 1 0-7 10yr3/3 none Is 2msbk mvfr cs 2f,1m 0.7 1.2 2 7-22 10yr4/3 none Is lmsbk mvfr gs 1fm 0.7 1.2 3 22-38 10yr3/2 none sl lmsbk mfr aw 1f 0.4 0.6 z 1^ q 4 38-66 , 10yr4/4 none sl Cyisbk mfr cw - 0.4 0.6 5 66-80 10yr5/4 none sl l 2msbk mfr ai - 0.5 0.9 6 80-93 10yr4/6 none Is 0 sg ml - - 0.7 1.2 Boring# --I Bonrg J Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Stricture Consistence Boundary Roots , GPO/ft' •Eff#1 'Eff#2 Boring# —I Bonng J Pit Ground Surface elev. ft. Depth to limiting factor in. soi Application Rale Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots . GPD/ft' •Eff#1 'Eff#2 'Effluent#1=BOD 5>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. Pet 4' /5-63 I cs II 50// Obscrva,-6"cv7 ,o.-6 aco.O r ♦ E4✓46'on a r , /Ica on 0444.n•ed eke.CwWe t3f z ?o.ss wq;llco" p.ap. c ,Cc t 64 6,...,ac,�G/ ra rs tY . - 61 c Stc. if!Tn. o{,4J So' F gt • 6S 14to/aU-rncrL ql 5y5f-,1,, • Aiu • sb lad : 100. 0.�}}- \ O $3 TOP 0k Iot,0atiokI #( EX%S4/n, 46.a rum, 0 0 a re S d•,Icc `\ Vie rst • r 94.5-3, • V e 3or3 • Pump Chamber Calculations I. Force Main: Diameter 2" Length 130' Flow rate 30.00 gal./min. Friction loss 2.67' (130'X2.05f1100ft.)= 1.95 ft. 2. Total dynamic head: Min. supply pressure 0.00' Vertical lift 14.00' friction loss 2.67' Total dynamic head - 16.67' 3. Pump selection: Manufacturer: Zoeller Model number: 98 Minimum discharge rate required: 30.00 gym Pump will discharge 40.0 gpm @ 16.67'TDH 4. Dose chamber: Manufacturer&capacity: Weeks concrete 800 pump chamber liquid depth: 42.0"(a. I9.05 gal./inch(800.10 gal.actual) Sizing: A)One day holding capacity: 21.00"= 400.05 gal. B)Alarm setting: 2.00"= 38.10 gal. C)Dose volume+flow back: 7.00"= 133.35 gal. (400ga1./4 doses per day)+(.164X 130')= 121.32 gal. min. D)Reserve storage: 12.00"=228.60 gal. TOTAL 47.0" = 800.10 gal. Dose Tank Information Locking cover with warning label and locking device and sealed watertight Electrical as per NEC 300 and ► I Comm 16.28 WAC 1 4 in.min. Disconnect Tank component is Probed),vented �� Mills'�■ �— Alternate outlet pktcalion ' Fcrarr an diameter Weeks concrete Manufacturer �— ■netts. 2 in. Capacity 800.00 Gallons III 19.05 galfinch A Weep hole or anti- Dimension Inches Gallons B : siphon device A 21.49 409.39 B 2.00 38.10 C • Pump off elevation IN) C 6.50 123.91 ■ 87.50 D 12.00 228.60 D Total 41.99 800.00 Dose k elevation(tt) 3" Bedding unser tank. 86.50 Alarm Manuafacturer LevelArm Alarm Model Number DLV .d1 Pump Manufacturer 'Q Pump Model Num.e ta 8 — 'i\-t,► A-t1 C_,u-g-t f es HEAD/CAPACITY CURVE HEAD CAPACITY CURVE pk.- EFFLUENT MODELS 7G - -,w. ,6,. I. 16 165. 186. ---,ae. 1e9. 191 IN MODEL 42 48 MI 96 137.139 41 4 N61 4163 41.5 4185 4,:6 4l. 4169 Q I I n I. GL OK LIRS VL on Gll L1K fJil LIPS GL l)11! 4L. IIIR GL- L1RS LIRS f!L LIMS Gl LOIS CAL - CAL L1115 GL. LOIS 1361�111� •5 U 1 Rt 34 1n 77 233 7* 357 N 311 ,11 61 22 731 !4 220 140 10 930 4! 170 N- 40 la n a N M in el 131 » }le {. 3N a 35x N 3» nl ]0 xM tN 140 510 a 1» 15 45t 6 IS 57 1{ 72 45 170 N 342 » »6 a at 40 nt 231 56 220 134 136 511 49 170 36_in 20 2! a 3{ IM N 757 7 299 59 n3 nt 5e 220 1» 131 NS a 1» M 1 0 RAIN 40 ]ae 0 M M 132 70 »5 57 tle _ 22022! NI 220 122110 125 4354 45 1» 1711 114 N la ex 2M 55 »{ a 322 5e 7» Il{ 1» 45L 45 170 71 » 45 170 44 172 - 204 70 7a 56 220 104 IW 413 45 170 ,'�„I 30 15 74 207e 33 57 IN Si 12 5e 220 71 97 3045 170 N I] !) 1N ax 111 5e 21 71 a nt 45 IA 34 110 70 1,1e»N e7 9 M 57 1e7 51 M »\ N 170 3 2 400 ■,.,,■I p 3743 M 45 II0 » 3. 129 45 170 31 170 M 193 45 170 30- ,00 MN 1e a 17 N 40 151 t6 ''�111 1m 3700 4 ,5 30 119 » to 7{ MA »- 10 M 60 1M Met filmniiiilliipl tu• nv 131 26- a Loa,YLL[ :2- MC§Ii11119111111/ , subjected to �_ 70 iIi �1,�, ♦ CAUTION Model 185/4185 should not be object a `\\\\II\I\\\■U■■■■■■ less than 30 feet TDH. 1{— 63\ ` I NOTE:For Head Capacity on Model 112, Industrial 1� , column-explosion proof pump, see FM0219. k 16- ` !' COMM 12_ .., 171.10140NI 1, 1�b�161 _ 2 =1111'1!11h, 11111111111\ILL IN 111111 4- 42 -SIN I 2- 1° at?‘ `` 4161 .50 0 U.S. 6ANL16 10 20 • 40 SO 60 70 90 60 100 110 120 130 140 ISO 160 U7216 00 40 20 320 400 400 500 NO 0 13•et'TQf+_FLOW Pit O i1L it W HEAD CAPACITY CURVE ' SEWAGE MODELS 74- 1 7 1 1 1 7 t I I I 1 , A i. 216 .001E i4 3i D7 1i ti i1 r 7M I NM .i: y ON w N61 NM ND 75 • n ens t 0l 003 (K Lm ON on a or a Oa 0* Lin 1 a OR a Elf[ a Oa a La a On 22- - 15 i M1 4i 404 1D W 1D 4M n7 510 4D 4N 1i D1 1N 5D .- __ 4i 7y ie ans. 70 - 0 30` D i7 D DI 64 D7 i 33I 101 : D aY 1D S 124 1Y -_ -_ n4 ! Ile 5 44 275 M D 1D * NI M Ia n 301 43 L ID III 10I an 1N 447 WI e16 1M M 2°-65 D e1 ,0 a II D to a Se In v 125 IS OP II 344 IM 40 ID li 1411 SD IS 14 D 110 5 19 II 74 IS 70_ M DI 134 515 154 563 304, 43 163 54 717 i 5i VI no 44e 6D 19-� 40 133 no D 46 103 14 364 415 431 55 54 q7 - i m ■ 331 b 14a 13 44 50 ID 16- IC 11 3 U V 50 — Lm Y11( it nr 213 213 79 it D ' N Sr5v Lt to-45 12-40 J 35 § 10 10 _ to CAUTION 1 Model 293/4293 293.1111 : 11111\11111116: should not be subjected to less than 4293 ° 25 15 feet TDH. 19242 274270 \ 6-20 ``` a096044 5 10 2"767'268 2- 5 264 4292.292 2e4. 294. 295 4284 4294 429j 0—I---41 U.S. GALLONS 10 20 30 40 50 60 70 90 50 100 110 120 130 140 150 160 170 190 190 200 210 220 230 LITERS 0 90 160 240 320 400 480 560 640 720 800 880 rLOw PER lNNO7E Cl Copyright 1999 Zoeller Co.All rights reserved. 5 `y 2(y ASEet._. LJ .J Safety It Buildings Division 7 Sanitary Permit Application 201 W.WashingtonOx Ave `I sconsinPO 707 702 In accord with Comm 83.21,Wis.Adm. Code 02 Department bf Commeroi Personal information you provide may be used for secondary purposes Madison, 5370y if not (Submit completed form to county if not [Privacy Law,s. 15.04(lXm)j g-ey-0L 10190LS stateowned.) Attach complete plans(to the county copy only)for the system,on paper not less than 8-1/2 x I I inches in size. County State Snipry Permit Number 0 Check if revision to previous application State Plan I.D.Number �- C,acrx 'tiO OS I.Application Information-Please Print all Information Location: Property Ow Name Property Location R-4 r'N cst-t DP\) t I &1 IV?kit (ITS` 1)1 1 I l le O KV u4S1.8 1/4,S11 TO9,N,_RILC for)W PAY Owners Mailing Address Number Block Number 8a3 cpuiu,) 5 Q(G4 o�ti City,State Zip Code rr�err % _E:` �1 D P Nu Q �,. _,, 'vision Name or CSM Number kIl,bsoI 1,.J'is ( �11Ol y" J%a ,, ,. Swcz� 6Ki)35 II Type of Building: (check one) �l v c.pi s a.. ❑city • I or 2 Family Dwelling-No.of Bedrooms: r ` 4 5. ❑Village O Public/Contnrercial(describe use): m Town of , State-ownedo N tA US t -J III Type of Permit: (Check only one box on line A. Check box on line B if applicable) Nearest Road(SIZ (f1 A) I. . New System 12. ❑Replacement 13. 0 Replacement of 14. 0 Addition to Parcel Tax Numbers) System l Tank Only Existing System 0 ZO - i3 - (rG-pip (a 232. B) Permit Numbs Date Issued 0 A Sanit ary Permit was previously issued IV.Type of POWT System: (Check all that apply) - I3J. F.-ttA (g Iles O Non-pressurized In-ground 0 Mound 0 Sand Filter 0 Constructed Wetland ❑Pressurized In- 0 4 age Holding Tank 0 Single Pass 0 Drip Line ❑At grade j r nbt et Aerobic'currnent UgitC o- rcu ❑Other. VDispersaliTreatment Area Information: (5 `f/~v.K�attty I.Design Flow(laid) 2.DispersslArea 3.Dispersal Area 4.Soil Application 5.Percolation Rate /b.System Elevation 7.Fatal Grade Required Proposed Rate(Galsiday/sq^R) (Min/inch) VI Tank Capacity in Total #of Manufacturer Prefab Site Steel Fiber- Plastic Information Gallons Gallons Tanks Con- Con- glass New Existing crete strutted Tanks Tanks wit ; (, I - 1a[.( I t %)itL l ❑ ❑ ❑ ❑ ❑ VII Responsibility Statement ,r .. . I.the undersigned, responsibility fori , 1'" s : ,•,.;-' aned,assumeu -.j_,i,, .••• s WFSvrrs shown on the attached plans. err diumbst N (print) Plat MP/MPRS No. Bu_�. f - �M ol,,r,,td1 , IA/ . . ! mats'} 6'�1 -1 15"y3r�t; 4udU Plumbers Address(Street.City,Stale,SState,Zip Code) I :,i -.;r!; VIII County/Department Use Only • 0 Disapproved • r : l,. tPee(Includes Groundwater Date Issued ' g (No ) (A Approved ❑Owner Given Initial Adverse ""'�Ir « : „ii--1 , 2c02r . . • Detemrination . 2 �- C d1U�omu�of�Ap royal /e/as• for Disa .. .i 0 n ` : ; Fr� K 1 7f _ /er1- - r�'.a3111• `�°. . t'` ,YAaDO -� lr.W•1_.• a & t _.w 14 1 Al * *yr w.•.. at2 I A I a. - v:j (U / I /V 1. I I /` i ui�u_ .... . .. v • 7 h "ICA : (f\N I1V tt°P1 MET .._..77.-01 OUM.e..e. et ... . uC a lion S C a-bs's — c.e. se .. . (..1A yvY --- ____ -.... --2P LO. • A _ . . . _.. - _ .. \- . U . L • i - TT uS 11,,1 Pvc s> P Pc Of*.loo.0 i L W�AIvoFlt4. \j go'� 8424. 1 4 (10.10 3 -Ta0,,c)4s owl? 3x8I 5 LI) 0 1 •vc r -!il' 3. 3r) i _ 1 V 3 I I I i i i ^ 1[ a)U I iti . co 7 ------, ----bamboo _1 __1;00ji 1�! III!I IN1 11111111111111 =�✓ T � E _ 1 ;, Illgrilort 5 g -@ C N X Doi ifi -Cr i1 - iif - a w � - 1II ;IIIII1 I � a) y � Hit cn __lc c y Z fill �1IIII � 6 U Od Zr) It . Ih 11I111111 M V- -0 co g � 2 irnt cl) L 0 1 ) -p � T rnt N 0 = h "v,,v,vv,,vvvvvvvll .l 0 • • O • fn in . _ fJ d , 6 / hot /'/, p and /.d e id i nd e rs V . - h vv-k i_ (S\N m tio41 AAii - in. . vume.e.3 er. LuP"v ./ten S IC c(L OS. _ .dense L.Uyv.,_ .1L ,) N. 1 °GI\ • - 'PLOT A7 \-\ , U . b • ____________ T 1, r/.1 Pvc S sue' 1 a(,o gal Id.:( 9, "/AI0() Fc)fi*,, ji 411P . L p� fp • 8, •8: w S, --N.\°^,-.) 3 -TT J45 CIAO 3x 81. 5 ( -20.‹.1. Mok)(4 �P vc P" pe flI\I 9 g. Y1 r2n.i ?{K up).) — › U zo 1111011110 ro 0 c‘i co �, o [. — 11' !I1If_1ili II il I '- ' —i �j ' I"f i�i —'�/ -0 E .c " cn I I 1I Ii ✓`,cede - m E m O 5 x vi cii w _ � eddjee -o o co E ^ � ccv pC hall E E co L x a) M 1111 __ _. opt il 42) cn -0 2._,'. iit1I1Iffl1h1 I : t; t N Z ill- P'III01 D 0aE c11.1 y .- n s- Zsa Q as c.� (V►.XN,: \ LL tiflt L >x N °,�° I O in co °14.4 .-7_ d • • • • wrxonsfn Department of Commerce SOIL AND SITE EVALUATION Division of Safety and Buildings Page of Bureau of Integrated Services in accordance with Comm 83.09, Wis. Adm. Code Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must County include,but not limited to: vertical and horizontal reference point(BM),direction and Si .C ro t ,,L percent slope,scale or dimensions,north arrow,and location and distance to nearest road. Parcel I.D. # APPLICANT INFORMATION - Please print iii •1114 , ,, wed by Date Personal information you provide may be used for secorwa i rplp" ,cy Law,s.15.04(1)(m)) _ 4 t13r 21IDZ Property Owner �� l� .-n Property Location )1,C kh�I fir' ', . . Govt�Lot „j 1/4 ..f i 1/4,S /G/ T?y ,N,R E(orc Property Owner's Mai ing Address .-' ' 1 Lot# Block# Subd.Name or CSM# 135- A l . - -V 1 ' l.n Suvee-k GICt S City State Zip Code ` - Phone Number Q City ❑ Village © Town Nearest Road 1--Ht1don I kOi i T-16)( •.I'(115 - -) / /4 5c, I 1=ic< 7�,- 1.4 ® New Construction Use: ®Residential/Number of bedroorya'"‘• -`y Addition to existing building ❑ Replacement ❑Public or commercial-Describe: Code derived daily flow bC-") gpd Recommended design loading rate, 7 bed,gpd/ft2 • trench,gpd/ft2 Absorption area required 8 S-) bed,ft2 )So trench,ft2 Maximum design loading rate • bed,gpd/ft2 trench,gpd/ft2 Recommended infiltration surface elevation(s) ' 's O ft(as referred to site plan benchmark) Additional design/site considerations d#G iL- Q 3. 3 B Parent material G u-4 c r c' In Flood plain elevation,if applicable , f4 ft S = Suitable for system Conventional Mound In-Ground Pressure AT-Grade System in Fill Holding Tank U = Unsuitable for system K{S ❑ U Os ❑ u ® s El u l's ❑ u ❑s ®u ❑ s IP u SOIL DESCRIPTION REPORT Boring# Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu. Sz.Cont.Color Gr.Sz.Sh. Bed , Trench , ...I I b4cO 10y(3l(o — ES Imsg mCr c5 I ./C • - ' '8 17 Z ccO-a), chyr31Z l £ma1 - m-Cr CS • S r Ground 3 %..IZ5 10 yry kP _ m5 OS� �rn I � . . $ elev. I CO•`ieft. • Depth to / • limiting fdr ql,- y • l&Cin. V"Si p • Remarks: Boring# I o-57 iby r 314, t_S 1 m5s rmffr cs i v c. . • 8 2Z 59-:, 16yr 3I2 S;l 2n-c:bk m ir s _ . 5 c ,T- a � 1 /( 1L(�co m5 v 'S m ( �� . "7 _ • g -} Ground elev. /() AM. Depth to • limning • Min. Remarks: CST Name (Please Print) �°'ture Telephone No. 1q-c(��_ -KC- I'l.tion.o ( v �. �c 7/s-- 2v7-4lGo a- Address Date CST Number Z.//I g-a % S1. Sor J/ 7i-- Gt.,/ _t—Ya z- --y-c�o z.0 3 3 6 OrSOIL DESCRIPTION REPORT PROPERTY OWNER S ki Page Zof3 PARCEL I.D.# Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu.Sz.Cont.Color Gr. Sz. Sh. Bed .Trench 6-e3 164(314, L5 1 fl 5c m-Cr c S 1,/ - -1 . 8 •1- fig( ip 31L — s;I Zrnaibk m-Er cj • : • (p .s Ground elev. 3 31-fZ7 /Uyr `1 I .c — r».5 an rn l c-3 - . -r : g .} 9 .(00 ft. Depth to • limiting N3.2/ -I9.2 factor Z7 in. • Remarks: Boring# fa .. 1 o �I I�yr3Iso LS 1_rnsj mFr cs Xi . 1 : • 5 •7 ` 1g yi /O T Z — a l 2 rrcthk_ rn Cr c s — •5 . 4. .r 3 ay Ix 0yr`i ti, _ ill Ds5 MI cS — •"1 : .8 ./ Ground elev. 99.Oott. Depth to 3 / �' limiting factor /Z in. Remarks: Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu.Sz.Cont.Color Gr.Sz.Sh. Bed , Trench Boring # i 0 -59. )1)yr3l(o L5 . 1MS • (Yl-Cr 6 At-r .1 ' . 8 .1 },S a sy �p, t'Uyr AIL 1 7m�6 ,m-Cr c S — .S : . •T 8/-ia4. IOyrLI M5 • CDScl raI c j Ground elev. • 98.3� ft. • Depth to • - limiting factor /Z6 in. Remarks: Boring # • Ground ' elev. ft. _ • Depth to limiting . factor in. Remarks: SBD-8330(R.9/98) • PAGE 3 OF 3 NAME U`-"- LOTH V O LEGAL DESCRIPTIONrn.' ''/.,u'/,S iK Tza,N,R I9 E(or)10 SCALE: 1"= /CO* BM I ELEVATION /vU •0 BM I DESCRIPTION topo if (r pp. ktL�GI,.� BM 2 ELEVATION fl. / BM 2 DESCRIPTION(.p♦L IC pc.i;p..1.41,_r y nor v SYSTEM ELEVATION 6((,.5 U 14 + — ALTERNATE ELEVATION CUP:50 CONTOUR ELEVATION V/A W' 5'4 Pt' •a' • 63 • iss • an.i Fr°Z'._ SIGNATURE DATE • • Private Onsite Wastewater Treatment System Management Plan • Septic Tank And Gravity In-Ground Soil Absorption Component Pursuant to Comm 83.54 Wis. Adm. Code each Private Onsite Wastewater Treatment System (POWTS) shall include information and procedures for maintaining the system within the parameters of Comm 83 and 84, and the conditions of approval by the department, agent, or governmental unit. The approved plans and permits for system are on file at the county zoning or health department. This management plan complies with Comm 83.54, Wis. Adm. Code, and the In-Ground Soil Absorption Component Manual for Private Onsite Wastewater Treatment Systems SBD- 10567-P (R.6/99). Table 1: System Design Specifications Sanitary Permit Number 1 30 Number of Bedrooms Design Flow - Peak (gpd) loQtj Estimated Flow -Average (gpd) y o U Septic Tank Capacity (gal) Soil Absorption Component Size (ft2) (2co 1-) Type of Wastewater mestic Table 2: Soil Absorption Component - Limits of Reliable Operation Septic Tank Component Soil Absorption Component Design Flow - Peak (gpd) *4q44 �-4 tzEo 12I 3 t 6.1 Pa.. by, Maximum Influent Particle Size (in) I a 1/8 Maximum BOD5 (mg/L) 220 Maximum TSS (mg/L) i Sd 150 Table 3: Maintenance Schedule Septic Tank Inspect and/or service once every 3 years Outlet Filter Inspect once a year and clean at least once every 3 years Soil Absorption Component Inspect once every 3 years 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 (Servicing Septic or Holding Tanks, Pumping Chambers, Grease Interceptors, Seepage Beds, Seepage Pits, Seepage Trenches, Privies, or Portable Restrooms). The operating condition of the se. ' _..,i : d outlet filter shall be assessed at least once every 3 years by inspection. Th- outl- - hall be cleaned as necessary to ensure proper operation. The filter cartridge should not be removed-unless provisions-are made to— r?ta i`n a o tank that may slough off the filter when removed from its enclosure. If the Management Plan for a Septic Tank and Soil Absorption Component • 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 scum and sludge 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 an 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. 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 the tank. No one should enter a septic or other treatment or holding tank for any reason without being in full compliance with OSHA standards for entering a confined space. The atmosphere within the septic or other treatment of holding tank may contain lethal gases, and rescue of a person from the interior of the tank may be difficult or impossible. Tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the tank is no longer used as a POWTS component. Soil Absorption Component The soil absorption component serving this structure is designed to accept domestic wastewater from a residential facility. The limits of operation of this component are shown in Table 2. The longevity of a soil absorption component depends greatly on proper and timely maintenance, and system use within or below the limits of reliable operation. Good water conservation practices by all occupants and the installation of water conserving plumbing fixtures are key factors in extending the useful life of this component. The soil absorption component's operation must be assessed by inspection at least once every three years. The inspection shall include recording the levels of ponding, if any, in the observation pipes, and a visual inspection for any evidence of surface seepage or discharge from the component. On steeply sloping sites, areas of erosion should be identified and reported to the owner for repair. The surface discharge of domestic wastewater or sewage from the system is prohibited and considered a human health hazard. Traffic around or over the soil absorption component should be avoided particularly during winter months. The compaction or removal of snow cover over the component may lead to hydraulic failure by freezing. This type of failure is usually temporary, but is difficult or impossible to repair until weather conditions improve. In general, soil compaction over this component will reduce diffusion of oxygen into the soil and dispersal cell, which may lead to more intense, and earlier, organic clogging of the soil. 2 Management Plan for a Septic Tank and Soil Absorption Component Plantings of deep-rooted trees and shrubs directly over or within ten feet of the component should be avoided since root intrusion Into the component may obstruct wastewater flow. When system fails, we will replace with another system at owner' s expense. Alternate area must be left undisturbed. St Croix County Zoning Office 386-9680 Boumeester 8 Sons Excavating 386-9020 Tri-County Sanitation 386-2130 3 ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT . AND OWNERSHIP CERTIFICATION FORM 1 Owner/Buyer PP-MN. CQ.R QQV tl Dy riNR Lu ( (1‘H. r111Q0r ' I N YT77 l J Mailing Addz_-- C . ' I= ,(.._PIA• S�_ T Property Address L, r� P- e (_,Dr.) E (Verification required from Planning Department for new construction) -I) City/State Rhk.lsc' �,1 1 ) c: Parcel Identification Number C)D 0- 137 1- `c G 0 d LEGAL DESCRIPTION ``1 Q t 1 Property Location NW y,,5 U , a , Sec. 1 T . T � I N-RI 1 W, Town of !-\kD S d N . Subdivision k=i1 SW e et v g,p ff , Lot # (P(Q . Certified Survey Map Itr � , Volume �— , Page # ! . .� Warranty Deed # (.o c) 9 1 �, '11 , - , Volume / 5 3`) , Page # el . ` Spec house 0 yes,la no Lot lines identifiable ®,yes 0 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 Zoning Department a certification form, signed by the owner and by a muter plumber,journeyman plumber,restricted plumber or a licensed pumper verifying that(I)the on-site wastewater disposal system is in proper operating condition and/or(2)after inspection and pumping(if necessary),the septic tank is less than 1/3 full of sludge. I/we, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth,herein,as set by the Department of Commerce and the 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 Office within 30 days of three year e iration date. ``� CSI-V 14 2- NATURE OF APPLICANT DATE OWNER CERTIFICATION I(we)certify that all statements on this form are true to the best of my (our) knowledge. I (we) am (are)the owner(s)of p described above, by virtue of a warranty deed recorded in Register of Deeds Office. the � �//d2_ ATURE OF APPLICANT DATE Any information that is mis-represented may result in the sanitary permit being revoked by the Zoning Department. " Include with thls application: a stamped warranty deed from the Register of Deeds office a copy of the certified survey map if reference is made in the warranty deed • ' U ._ 1944P 001 STATE BAR OF WISCONSIN FORM 2 - 1998 tS 6 6 4 1 2 WARRANTY DEED KATHLEEN H. WALSH REGISTER OF DEEDS Document Number ST. CROIX CO. , MI RECEIVED FOR RECORD This Deed, made between RICHARD 0. STOUT and JANET P. STOUT, 08-09-2002 8:30 MI husband and wife, WARRANTY DEED , Grantor, EXEIPT I and PREMIERE DEVELOPMENT, INC_ - REC FEE: 11.00 TRANS FEE: 179.70 COPY FEE: CERT COPY FEE: , Grantee. PAGES: 1 Grantor,for a valuable consideration,conveys and warrants to Grantee the following described real estate in St- Cra'X County. State of Wisconsin: Recording A,oa Lo • • Plat of Syeet Grass Farm, Town of Name and Return Address Hu.son, St.Croix County, Wisconsin. �) MtiY055a ( c, �V1US EDINA REALTY 3 `Pb "ry"i ioJ d/o Metro Legal Services 020-1376-66-000 Parcel Identification Number(PIN) This is nOthomestead property. (is) (Is not) Exceptions to warranties: easements, restrictions, rights-of-way and covenants of record. MATCH LINE `SEE SHEET 31 'OF -5 M.Z►,aesoN AL'0� qC•OOE OO OQf M.O/C L.00N �.w 00'OOa 00'OOL N £Z ZLI ,Z4gti.Z(1N q $.s7 --.. . 156It' II '------Zj i .3 _i gi ;I 11 ; - ti r6 i- it C) W d il i Si co 4 • ler 1p ;_ Z q I ! C ax O) I; 7+ loz OZl ° • . . . . . . . . . . _ _ — _ — —I — — -L'� • — � r -4— - - N — — . ./__ Ao•Oos i / CY IBL .I.VOSL i.LlA1'.LOS _ — — — _ — ` ,so es co • [� r� I - - - - - - t I . 1 — • gy'OIE uNj - I- - - - I- I I. .Z • t — — — — 1 I I I . . . • . . ' .1. I Z III z 14Ia I ' g I I I I IIo (�I a - I I C . r � f�l I 4 PO INIz 23 0Am i —.1 I2ill " 1I , c00 R I4I I co4: " I I Ihi c / 1 {I 1 / .y I �I I v I $I I I I ? • I I I I I I I I I