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HomeMy WebLinkAbout032-2181-16-000 Wisconsin Department of Commerce County: St. Croix PRIVATE SEWAGE SYSTEM Safety and Building Division INSPECTION REPORT Sanitary Permit No: (ATTACH TO PERMIT) 578957 GENERAL INFORMATION 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 Township Parcel Tax No: Brent & Gretchen Minikel TOWN OF SOMERSET 032-2181-16-000 CST BM Elev: Insp. BM Elev: BM Description: Ill Section/Town/Range/Map No: 100 2• 4 40 CST 60 01.31.19.1540 TANK INFORMATION 7~ ELEVATION DATA TYPE MANUFACTUR • "PACITY STATION BS HI FS ELEV. Septic Benchmark OC, Do Dpe]Rg Alt. BM J l Bldg. Sewer 1L to, 2 I ( St/ t Inlet 13.5 / Z .ZZ TANK SETBACK INFORMATION SUHtOutlet TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet i / ~2•y5 4- Septic ~ 50 I )IOU I 1 1 Dt Bottom . Dosin b" Heade an. 3.05 VZ . Dist. Pipe ~02. Hoitling Bot. System ! ~O n V PUMP/SIPHON INFORMATION Final Grade Manufacturer Demand Cover Model Number E US -0101- 5,0 v TDH Lift q Friction Loss System Hea, TDH~' 'Ft ri 61 -3 . ZS Forcemain Leng I Dia. Z18 IDist.toWell db 1 F SOIL ABSORPTION SYSTEM BEDITRENCH Width V Length t No. Of Tren e PIT DIMENS S No. Of Pits Inside Dia. Liquid Dep DIMENSIONS ILY~ vial SETBACK SYSTEM TO Phi) 1-1.6 BLDG WELL LA E/STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR Type Of S stem: I O\ - A ! UNIT Model Nu r: DIST N SYSTEM ' eo,%+ Header an' Distribution % ole Size tl x Hole Spacing Vent to A7--1 • ~f ILang pe(s I JI 3 Q /y~~ 1 Length (O Dia th 29 •14 Dia_ Spacing ✓ • LJ . U SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded/Sodded 'Mulched Bed/Trench Center I L Bed/Trench Edges Topsoil 0 ! Yes No he Yes 0 No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: VNItI Inspection#2: Location: 756 233RD AVE l u n k-4 PLot-V 4 d K ct O N d6 1 *es, reo°)^) 1.) Alt BM Description = ~-I L-WV. ~.w S 1 1 S 0-1-- O r i xvN1 A C f b~ 2.) Bldg sewer length = O 1 ('06, - amount of cover = 0 65 ~ ~2" on all N Plan revision Required? ® Yes No Use other side for additional informa ' n. SBD-6710 (R.3/97) Date Insepcto s Sign ture Cert. No. County kn aa~t 7*1 Industry Services Division J 1400 E Washington Ave ~ ~ Sanitary Permit Number (to be filled in by Co.) $ P.O. Box 7162 ~ p Madison, WI 53707-7162 S anitar~State Transaction Number In accordance with SPS 383.21(2), Wis. Adm. Code, submission of this form to the appropriate governmental unit 5 is required prior to obtaining a sanitary permit. Note: Application forms for state-owned POWTS are submitted to project Address (if different than mailing address) the Department of Safety and Professional Services. Personal information you provide may be used for secondary purposes in accordance with the Privacy Law, s. 15.04(1 (m), Slats. 1. Application Informatio - Please Print All In or tion ~J a Property Owner's Namc c e, Parcel # 5XV-1" 0 3a - a /8 / - /6 - 0 o a Property Owner's Mailing Address Property Location Govt. Lot ~r Zip Code Phone Number AJtK'/4, SE '/4, Section City, State (circle one) ,P: lax S' 017 7/S-a?yCo..9868 T 3IN/9' R4,q EorW II. Type of Building (check all that apply) L Lot # / Subdivision Name or 2 Family Dwelling - Number of Bedroomss Qk F1 Public/Commercial - Describe Use G+b Block # El City of El State Owned - Desciibe Use ` El Village of Number Town of 16 o nd( III. Ty a of Permit: (Check only one box on line A. Corn lete line B if applicable) d A. C2 New System ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only El Other Modification to Existing System (explain) ❑ Permit Renewal ❑ Permit Revision ❑ Change of ❑ Permit Transfer to New List Previous Permit Number and Date Issued B. Plumber Owner Before Expiration IV. Type of POWTS System/Component/Device: (Check all that apply) Q ❑ Non-Pressurized In-Ground ❑ Pressurized In-Ground ❑ At-Grade ❑ Mound > 24 in. of suitable soil Mound < 24 in. of suitable soil ❑ Holding Tank ❑ Other Dispersal Component (explain) ❑ Pretreatment Device (explain) V. Dispersal/Treat me Area Information: Design Flow ((gpd) Design Soil Applic on Dispersal/Area Require sDispersal Area Propos (sf) System Elevation J 600 Rat (gpdsO A o 600 16 600 VI. Tank Info Capacity in & c Gallons Total # of E N y Manufacturer w U 6 Gallons Units Ja /L L~ E o 1 - New Tanks Existing Tanks d ( ( J A- U i7, 'A "`2. 3 i" Septic or Holding Tank Roo Ia200 l ❑ ❑ ❑ ❑ Dosing Chamber QQ 00 VII. Responsibility Statement- I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's ame (Print) Plum 's Si nat ®/MPRS Number Business Phone Number 1.~7G~9/Qd o s 7,4-5- 760 - 0c, ' ;Condi s (Street, City, State, Zip Code) /,30 e artment Use Onl ❑ Diermit Fee Date ssued ssuAgent Sign r~. en Reason for Denial $ (0Z ✓ [ 6 Z / TOYtQ nk a Disapproval ~ '#a(e t Gow ~ dispersal cell must all ¢g services /maintained C ce~ w/ as per management plan provided by plumber. ~rC t A. 2. All iplkt, egibenjents must be Maintained r as per applicable Code / ordmanms. tw! i r L% f Z. A,' Attach to complete plans for the system and submit to a Coun only on paper not less tha 8 t@ x 11 i~ hgsize •TL Od : F afore _0 SBD-6398 (R03/14) t ,'S f~c~tltcQ , 1 dye - 1 = 1 66 o~cb rv r ~i ~ s JA / i ~y c b W 15J Ste` Q3 AU BRADY J UTGARD Page 2 5/14/2015 , is of a type conforming to the standards or specifications of chs. SPS 382 and 383 and this chapter and ch. 145, Stats. • Maintain well and waterline set backs per SPS 383.43(8)(1). Consult the Department of Natural Resources for well setbacks and other regulations and exceptions. A copy of the approved plans, specifications and this letter shall be on-site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of construction/installation/operation. In granting this approval the Division of Industry Services reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter and the POWTS management plan to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Fee Required $ 250.00 y~ Fee Received $ 250.00 t Balance Due $ 0.00 Patricia L Shandorf POWTS Plan Reviewer, Division of Industry Services WiSMART code: 7633 (715) 634-7810, Fax: (715) 634-5150, M - F 8:00 a.m. - 4:45 p.m. pat. shandorf@wisconsin.gov cc: Edwin A Taylor, Wastewater Specialist, (715) 634-3484, Monday - Friday 8:00 am To 4:30 pm DIVISION OF INDUSTRY SERVICES 3 9tiynxrarN 10541 N RANCH ROAD 5ti? ` rGn HAYWARD WI 54843 r/ Contact Through Relay 3 . O S P http://dsps.wi.gov/programs/industry-services v S www.wisconsin.gov G Scott Walker, Governor A~OF~ssror~y'~ Dave Ross, Secretary May 14, 2015 CUST ID No. 220357 ATTN: POWTS Inspector BRADY J UTGARD ZONING OFFICE UTGARD PLUMBING & HEATING ST CROIX COUNTY SPIA PO BOX 413 1101 CARMICHAEL RD AMERY WI 54001 HUDSON WI 54016 CONDITIONAL APPROVAL Identification Numbers PLAN APPROVAL EXPIRES: 05/14/2017 Transaction ID No. 2529809 Site ID No. 811547 SITE: Please refer to both identification numbers, Brent Min e above, in all correspondence with the a enc . 233RD A vve Town of Somerset St Croix County CONDITI FOR: gPPR Description: Mound, 4 bedroom residence DEPT OF $ Object Type: POWTS Component Manual Regulated Object ID No.: 1531147 Maintenance required; 600 GPD Flow rate; 21 in Soil minimum depth to limiting factor from original grade; O~$,ND Mound Component Manual - Ver. 2.0, SBD -10691-P (N.01/01, R. 10/12), Pressure Distribution Component 0an't Ver. 2.0, SBD-10706-P (N.01/01, R. 10/12), SSWMP Pub. 9.6; Effluent Filter The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. This system is to be construc d and located in accordance with the enclosed approved plans and with any component manual(s) referenced a SEE CORP, The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all co e requirements. No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, stats. The following conditions shall be met during construction or installation and prior to occupancy or use: Key Item(s) • In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approved plans. In addition, the owner must insure that the operation, maintenance and monitoring duties as described in section VIII of the mound component manual are complied with. A copy of this information must be given to the owner upon completion of the project. • The revised soil test with additional boring(s) on which this approval is based shall be recorded with the original soil test. 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 Page 2 5/14/2015 BRADY J UTGARD 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 ittions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing 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. Fee Required $ 250.00 Sincerely, Fee Received $ 250.00 Balance Due $ 0.00 Patricia L Shandorf WiSMART code: 7633 POWTS Plan Reviewer, Division of Industry Services (715) 634-7810, Fax: (715) 634-5150, M - F 8:00 a.m. - 4:45 p.m. pat.shandorf@wisconsin.gov cc: Edwin A Taylor, Wastewater Specialist, (715) 634-3484, Monday - Friday 8:00 am To 4:30 pm MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN INDEX AND TITLE PAGE Project Name: BRENT MINIKEL Owner's Name: BRENT MINIKEL Owner's Address: Legal Description: NW/SE/S1/T31/R19W Township: SOMERSET County: ST.CROIX 14ALLY Subdivision Name: WOODLAND MEADOWS ,VED FETY AND Lot Number: 16 Block Number: RVICES Parcel I.D. Number: 032-2181-16-000 )STRY SERVICES Plan Transaction No.: Page 1 Index and title VNJD) Page 2 Data entry Page 3 Mound drawings Page 4 Lateral and dose tank Page 5 System maintenance specifications - - Page 6 Management and contingency plan Page 7 Pump curve and specifications Page 8 PLOT PLAN Designer: BRADY UTGARD License Number: 220357 Date: 04/02/15 Phone Number: 715-760-0946 Signature: 9~~A- ) Designed Pursuant to the Mound Component Ma ual for POWTS Version 2.0 SDB-10691-P (N. 01101), and SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST-SAS (01/81) Version 3.11 (R. 06/01) Pagel of 8 Mound and Pressure Distribution Component Design site information R Residential or commercial Design Note: Sand fill (D) calculations assume a 400.00 Estimated Wastewater Flow (gpd) Table $3-44-3 in-situ soil treatment for fecal 1.50 Peaking Factor (e.g. 1.5 = 150%) coliform of 36 inches. 600.00 Design Flow (gpd) 2.00 Site Slope 100.05 Contour Line Elevation (ft) 21.00 Depth to Limiting Factor (in) 0.40 In-situ Soil Application Rate (gpd/ft2) Distribution Cell Information 60.00 Dispersal Cell Length Along Contour (ft) = 10.00 Cell Width (ft) 1.00 Dispersal Cell Design Loading Rate (gpd/ftz) 1 Influent Wastewater Quality (1 or 2) Are the laterals the highest point Pressure Disribution Information in the distribution y c Center or End Manifold network? 3.33 Lateral Spacing (ft) If N above, enter the elevation (ft) 6 Number of Laterals 0.188 Orifice Diameter (in) (e.g. 0.25) of the highest point. 3.00 Orifice Spacing (ft) = 10.00 ft2/orifice 2.00 Forcemain Diameter (in) 150.00 Forcemain Length (ft) Does the forcemain drain back? 94.00 Pump Tank Elevation (ft) 3.25 System Head (ft) x 1.3 24.47 Forcemain Drainback (gal) 7.05 Vertical Lift (ft) 35.80 5x Void Volume (gal) 4.80 Friction Loss (ft) 60.26 Minimum Dose Volume (gal) 15.10 Total Dynamic Head (ft) 39.32 System Demand (9Pm) Lateral Diameter Selection Mrchxoice in. dia. o tions choice 0.75 1.00 x X 1.25 x 1.50 x 2.00 x 3.00 x Gallons/inch Calculator Treatment Tank Information 1200.00 Se tic Tank 800.64 Total Tank Capacity (gal) P Capacity (gal) 36.00 Total Working Liquid Depth (in) WIESER Manufacturer 22.24 gal/in (enter result in cell B49) Dose Tank Information Effluent Filter Information 800.64 Dose Tank Capacity (gal) POLYLOK 22.24 Dose Tank Volume (gal/in) PL-525 Filter Manufacturer WIESER Manufacturer Filter Model Number Project: BRENT MINIKEL Page 2 of 8 mvunu vtvoo agGnon view Aggregate Dispersal Area Finished Grade 103.05 (ft) f}rf~r.rr 2 G Dispersal Cell 101.30 (ft) - 101.80 (ft) Lateral : . . . . . . Dispersal Cell Invert Elevation E D ® a 100.05 (ft) Contour Elevation 2.0 % Site Slope Key ~ a~ Geotextile Fabric Cover Shading ~j Topsoil Cap o .Q 115 ft Dispersal Cell See lateral details on c Page 4 for number, size, Subsoil Cap w o 5[] © ASTM C33 Sand 0 and spacing of laterals. F Laterals are equally ® C] Tilled Layer d 0.5 ft Typical Lateral spaced from the cell's n5 Aggregate v c Q I distribution A centerline in the in the distribution cell (AxB). Project: BRENT MINIKEL Page 3 of 8 Center Connection Lateral Layout Daigram Force main connection via tee or cross to manifold at ang point. Laterals are identical s L. P s = Turn-up wf ball valve or 51(-X }If x112 x112-4 Laterals & force main of PVC Bch 40 E JP cleanoutplug per COMM Table 84.30-5 Holes drilled on the bottom of the lateral. Number of Laterals 6 Orifice Diameter 0.188 in Lateral Diameter 1.00 in Orifice Spacing (X) 3.08 ft Lateral Length (P) 29.26 ft Orifices per Lateral 10 Lateral Spacing (S) 3.33 ft Orifice Density 10.00 fe/orifice Lateral Flow Rate 6.55 gpm Manifold Length 6.67 ft System Flow Rate 39.32 gpm Manifold Diameter 2.00 in Total Dynamic Head 15.10 ft Forcemain Velocity 4.02 ft/sec Dose Tank Information Locking cover with warning label and locking device and or- sealed watertight Electrical as per NEC 300 and - Comm 16.28 WAC 4 in. min. Disconnect Tank component is properly vented Alternate outlet location Forcemain diameter WIESER Manufacturer 2 in. Ca act _ 800.64 Gallons Volume 22.24 gal/inch A Weep hole or anti- Dimension Inches Gallons B siphon device A _ 22.29 495.74 C B 2.00 44.48 P~ ump off elevation (ft) C 2.71 60.26 94.75 D 9.00 200.16 D Total 36.00 800.64 m Dose tank elevation (ft) 3" Bedding under tank. 94.00 Alarm Manuafacturer LEVEL Alarm Model Number DLV Pump Manufacturer GOULDS Pump Model Number EP05 Pump Must Deliver 39.32 gpm at 15.10 ft TDH Project: BRENT MINIKEL Page 4 of 8 Mound System Maintenance and Operation Specifications Service Provider's Name UTGARD Phone 715-760-0946 POWTS Regulator's Name ST.CROIX 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 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 eve 3 ears Effluent Filter Should inspect and clean at least once eve 3 ears Pump and Controls Test once eve 3 ears Alarm Should test month) Pressure System Laterals should be flushed and pressure tested eve 1.5 ears Mound Inspect for ponding and seepage once every 3 years Miscellaneous Construction and Materials Standards 1. Observation pipes are slotted and materials conform to Table Comm 84.30-1, have a watertight cap, and are secured in as shown in the mound component manual. 2. Dispersal cell aggregate conforms to Comm 84.30 (6)(i), Wis. Adm. Code. 3. All gravity and pressure piping materials conform to the requirements in Comm 84, 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 M45 Grade 6-8" Diameter Lawn ♦ Plug Threaded Cleanout Sprinkler Valve Box or Ball Valve Distribution ......Lateral Sweep 90 or Two Degree Bends Same Diameter as Lateral Project: BRENT MINIKEL Page 5 of 8 Mound System Management Plan Pursuant to Comm 83.54, Wis. Adm. Code General This system shall be operated in accordance with Comm 82-84 Wis. Adm. Code, and shall maintained in accordance with its' component manuals [SBD-10691-P (N.01/01) and SSWMP Publication 9.6 (01/81)] 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 Comm 83.33, Wis. Adm. Code when the tanks are no longer used as POWTS components. Septic or pump tank manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 8-inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into a tank or component. Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Stats. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code. The operating condition of the septic tank and outlet filter shall be assessed at least once every 3 years by inspection. The outlet filter shall be cleaned as necessary to ensure proper operation. The filter cartridge should not be removed unless provisions are made to retain solids in the tank that may slough off the filter when removed from its enclosure. If the filter is equipped with an alarm, the filter shall be serviced if the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an impending continuous alarm. The septic tank shall have its contents removed when the volume of sludge and scum in the tank exceeds 1/3 the liquid volume of the tank. If the contents of the tank are not removed at the time of a triennial assessment, maintenance personnel shall advise the owner 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 a Pressure Distribution S m 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 BOD5, 150 mg/L TSS, and 30 mg/L FOG for septic tank effluent or 30 mg/L BODE, 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 specked 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. Project: BRENT MINIKEL Page 6 of 8 ` M 1161111 ll t PU i EP04,11,~Pa 5 Sedes AMICAIIONS !'f?S Impeller: Thenaop as. 0 I sd signed fDr k tk ttodOW design for karicip and lower peritxertarxl. beanlrg ` Efftulr►t systems ~ t+ttiott. Homes f11 • C41169 and kff ftjVd Farms th""Wk • Heavy der sump _ Pli'lli ~'"9~ amend cmasmn AGENttf tISTIMG • water transfer resistant!. C110404n srrnrifiel „ • Oewaterr ' # tam" ~ n9 F4 Moto Nouzirrq: Csst irof+ fact the ~ !'Kieft heat trarlll". 60" po" is ISO owl koft w. SFUIFICATIONi~ ory" Wen". tu10 dn►abiilty. "'r M MOta► COvtr. Then Solids Handling tapabilny: FEAtiJt t t VA* ara! rt.• nldarienrtm. ~ of • Capatrcies: up 60 ~ M x'04, fltla(swittlt *Wv rwloks • Total heads; up to 3 t f"j. tit a:: ~'+twer Cable: 5ere1 dr~h PM T. wed oil and water resist w. ` a +gt size' 1 yr' W Mecha+auit seal: tarbwl rotatYt MMIC.stationaly, IUNA•N Nastomers. r' ' temperature _ 7040F (4$'C? tontbluaus 140' f60T) intermittent • Fasteners: 300 series to st entess steel, • Capable of running 9 m... . dry without darna" 10 s exec. i (omponents a Matar z fP04 4s 3le pae: O.4 HP11501`2 0 V, 6 tot RPM, bu1t ~ +n over(obd Sv A > 5 JUIOmatK few C is • EPt? 5ingle Phase 0.51HP. ` i . 5 Y Of f 2 550 ° RPM built ur overfobd with 3 to ~~/O loos automatic reset. • Power -ord- 10 fool 1 rod S. standani length. 16/j S)TW with three prong t 91"U' ^9 plug. Optiorwi 10 a oo rQ~+'2•-,,4h 16/3 S1TW with 10 '.hree Prong z0 30 *111.3 grounding plug 5a Gorw Standard on EP05! 0 ~z B 10 CAPACITY t 1003 ri-Ids Pv-o rr Goulds rumps {hKtrvf lulr jp(13 V ~~II ~ ~~iJ4+~ ele7 : ~i (1 ~1~~~~11f1y/~j ITT Industrie-s t~ f ~ X t3- (-/ao, os- ~ ~ X 13-~ ~~=y8 c _ 1_66 r, i ~y pay l >ti o boa/oea n- FF a3 ~U~ ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer Mailing Address 0/ Property Address 75 3 (Verification required from Planning & Zoning Departm t fo ew construction.) City/State is Parcel Identification Number D 32 -006 LEGAL DESCRIPTION Property Location N Gil 1/4 , S F_ 1/4 , Sec., T _j_N R~W, Town of 5 Subdivision Plat: Auzd _ , Lot # . Certified Survey Map # , Volume , Page # Warranty Deed # 16~9 (before 2007)Volume , Page # Spec house ❑ yeskno Lot lines identifiable4yes ❑ 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 §SPS. 383.52(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 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 Safety And Professional Services 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. I/we certify that all statements on this orm are true to the best of my/our knowledge. I/we am/are the owner(s) of the property described above, by virtue of a wary ty deed recorded in Register of Deeds Office. Num of bed ooms SIGNATURE OF APPLICANT(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. (REV. 04/12) ¢r Zr- - 209.09'- 209.59'- C8 ` ' 9 / ~g 46 p2~ to a w ow o w 627.77' 7&6.5¢x__•_ i> ~g90 5 o ~ z - $ r- - S13.04'10"N, ¢5.78' / FW a - o a o c E 629.69' C7 NX3,0 _ ~272,,3~2 C6 O -j w w w z ? a -209.09*- -211 ^51 • _ 4 10"E 212 32' r o z w m cn ¢ c -C5- 33' q, D M N ~b O O QI h O C C0 O _ 0, . M CD O N O U 7 to -0 CL 0 C a: O1 c 0 C In U l ' M I M I m UL a J ? m a to cn C.) Zt rn° o ,n 'Q rn° N00 18'10"E M v r 3 o n o ro c0 n p 442.80' 90.04 "o D. ' 0 3 0 w m O "i a o ! I z 0- to E o> < z U \o+ 0 Nr m hlo o^ 2 a ~b a c -j (D 6 C) U3 3: ro W3 1 o O N N~.mz-.n D 3 En b C, m N II a " z N v~ aim\ `f'~ N 0I O p j O k N 16~y f`O 4" mUCv 90. 4' I h Qi ` N00'18'10 E 616'p •(v NO l~i\ I f o o -1069.93'- by 209.09' 206.66' 445.09' 66.02' DOCUMENT NO. STATE BAR OF WISCONSIN FORM 1-2003 !I IIIII~IIIiI~I~I~IIIIIIII~~I ~ll WARRANTY DEED Tx:4229810 1007171 THIS DEED, made between Gregory Schadt a single man("Grantor" whether BETH PABST one or more) conveys and warrants to Brent Minikel a hen inikel , REGISTER OF DEEDS husband and wife as survivorship mar- a ("Grantee , w ether one or ST. CROIX CO., WI more), the following described real estate in ST CROIX County, State of Wisconsin: 01/27/2015 3:04 PM EXEMPT#: NA L Q16,'aWlisconsin. t of Woodland Meadows in the Town of Somerset, St. Croix REC FEE: 30.00 CTRANS FEE: 85.50 PAGES: 1 RETURN TO St. Croix County Abstract & Title Co. Inc. 219 S. Knowles Avenue New Richmond, WI 54017 Tax Parcel No: 032-2181-16-000 This is not homestead property Exception to warranties: Municipal and zoning ordinances and agreements entered under them, recorded easements for the distribution of utility and municipal services, recorded building and use restrictions and covenants, and further except 2015 real estate taxes. Dated this 23rd day of January, 2015. Gregory cha AUTHENTICATION ACKNOWLEDGMENT Signatures authenticated this day of STATE OF WISCONSIN 20 COUNTY OF ST CROIX ss. TITLE: MEMBER STATE BAR OF WISCONSIN (If not Personally came before me this 23rd day of Jan ary,,2015, the authorized b 706.06, Wis. Stats.) above named Gregory Schadt, a single man to me known to be the y person(s) who executed the foregoing instrument and acknowledge the same. ,a•-+NIINip11~~~~ THIS INSTRUMENT WAS DRAFTED BY Robert L. Loberg / LobeM Law Office A-MA? CA a2 a 1521647 / alm Notary Public QZOaI G County, WiyAt' Q ` My Commission is permanent. (If not, state e pjra;ion die (Signatures may be authenticated or acknowledged. Both are 4t not necessary.) ) J/ZZ~~jJ(„ 'ary~'' Q a -Names of persons signing in any capacity should be typed or printed below their signatures. I WARRANTY DEED Form No. 1-2003 St. Croix County 1007171 Page 1 of 1 Wisconsin Department of Commerce F RCCEII)Vjbkj~ EV LUATION REPORT Division of Safety and Buildings Page 1 of 3 in accordance with cqr 85, ~ 1111'i is. Adm. Code St.Croix paper n less tl~aA 81/2 z '''I inches in size Plan must Attach complete site plan on li CountyLD• Pendin include, but not limited to: vertical and orizontal reference ~4 i rt (~M), air coon and Parcel percent slope, scale or dimensions, no h arrpyKdluba9oNdistan to nearest road.. Please prFl` i✓' NI G R i - Date Personal information you provide may be u#ed - / Property Owner (Privacy law, e. 15.04 (t) (m)). ~ ~ Property Location AHRH Properties LLC Govt. Lot NW 1/4 SE 1/4 S 1 Property Owner's Mailing Address T 31 N R 19 E (or) yy Lot # Block # S I 1 Name or CSM# 404 Screen Avenue 16 - Woodland Meadows City State Zip Code Phone Number New Richmond WI 54017 ( 715-222-0169 Village own Nearest Road CTH New Construction Use[] Residential /Number of bedrooms 3 Code derived design flow rate 450 Replacement Public or commercial - Describe: GPD Parent material over lacial till Flood Plain elevation if applicable General comments ft.- and recommendations: ite suitable f a r)Dund system v,; n. / IXHOC ` ~~WT' -~V~ Gcr[ lob " S ~cI12sy • to Boring `G •G 1 FTI Boring # Pit Ground surface elev. 100. ft. Depth to limiting factor 21-31 in. Horizon Depth Dominant Color Redox Desori on Soil Application Rate pb Texture Struoture Consistenoe Boundary Roots GPD/1P in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#2 1 0- 10yr3/1 2 mfr as 2f 2 6-12 1 413 sil 6 8 3 lm mfr cw if .4 .6 -21 1Oyr4/4 sic] 2msbk mfr cw if •4 .6 4 21-31 10yr4/4 f2f5yr5/8 sicl lmsbk mfr cw - .2 .3 5 31-38 7.5yr4/4 - fsl Om dvh - - .2 .5 F 2Boring # Boring *a'C " 99 22-39 Pit Ground surface elev. ft. Depth to limiting factor in. Solt ication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 `Eff#2 I 10yr3/1 sil 2 mfr 2 6-10 as 2f 6 .8 1 4/3 sil mfr cw if .4 .6 3 10-22 10yr4/4 sicl 2msbk Nn f•4 .6 4 22-29 10yr4/4 nf5yr5/s sic] lmsbk 2 3 5 29-34 7.5yr4/4 fsl Om 2 5 Effluent #1 = B OD > 30 < 220 mg/L and TSS >30 < 150 mg/L • Effluent #2 = BOD < 30 CST Name (Please Print) mglL and TSS < 30 mgrL Signature CST Number Thomas C. Nelson Add5b 227387 Date Evaluation Conducted Telephone Number 1432 120th Street, New Richmond, WI 11/17/04 715-246-2454 ' w Property Owner AHRH Properties LLC /66 Parcel ID # Pending 2 3 I Page of Boring # Boring pit Ground surface elev. 23-28 ft• Depth to limiting factor in. Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots Soil AGPD/1F Rate in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 `Eff#2 1 0- 10yr3/1 - sil 2ms mfr as 2f .6 .8 2 6-10 10 4/3 - sil Im 1 mfr cW if ,4 .6 3 10-23 10yr4/4 sicl 2msbk mfr cW if .4 .6 4 23-28 10yr4/4 flf5yr5/8 sicl lmsbk mfr cW - 2 .3 5 28-32 7.5yr4/4 - fsl Om dvh - - 2 5 a 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 GPDM in. Munseli Qu. Sz. Cant. Color Gr. Sz. Sh. *Efl#1 'Eff#2 ❑ Boring # Boring Pit Ground surface elev. ft. Depth to limiting factor in. Application Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots Sal GPD/fI2 Rate in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. `Eff#1 'Eff#2 * Effluent #1 = BOD5 > 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BODE 130 mg/l. and TSS < 30 rTU& The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. SBD-8330rem (R.07/00) f Scale 1801 Woodland, Meadows SM1 Top of conduit pipe 100.00' BM2 Top of conduit pipe 100.20' 91100.051 Lot 16 82 89.48' 83100.951 NOO a~ j r lot 0 Thomas Nelson al 227387