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HomeMy WebLinkAbout032-2045-60-025 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division Sanitary Permit No: _ INSPECTION REPORT 579003 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: Oeverin Homes LLC, aka Oeverin Pro ertie Somerset, Town of 032-2045-60-025 CST BM Elev: Insp. BM Elev: BM Description: Section/Town/Range/Map No: lonb 1 ! CST (~.b 12.30.19.6576 TANK INFORMATION ELEVATION DATA TYPE MANUFACTVElR q ~V CAPACITY STATION BS HI FS ELEV. Septic Benchmark 11tOD .Z~ Dosing All. BM Bldg. Sewer 1q.1 Not - Holding Holding StAit Inlet TANK SETBACK I ORMATION C) ✓ lp TANK TO WELL BLDG. Vent to Aijintake g Septic ~ ~ ~ Dt Bottom Dosing Header/ an. Q Aeration Dist. Pipe 0. Holding S s I. ~o. PUMP/SIPHON INFORMATION Final Grade QCj, g Manufacturer Deman GPM Model Number 53 TDH Lift Friction Los System Head TD F 1. CA 1 1 i Forcemain Length Dia. Zl% Dist. to well SOIL ABSORPTION SYSTEM BEDITRENCH Width Length I No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia T uid De DIMENSIONS SETBACK SYSTEM TO P/ BLDG WELL /STR LEACHING Manufacturer: In~•C INFORMATION T ,,,e Of S s m: I 1 CHAMBER OR I % N J;L' UNIT Model Number: V Lk- DISTRIBUTION SYSTEM p~S k Z HeaderlM nifol Distribution Ix Hole Size x Hole Spacing Vent to Air Intake ~ Pipe(s) Length r is Length Dia Spacing 1/ I 5MAjA US& SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over 1 Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center L ! Bed/Trench Edges Topsoil ~ R/fles Fr-A] No "Yes ~ No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: Inspection #2: Location: 1605 85th Str et New(Riicchmond, WI 54017 (SE 114 SW 1/4 12 T30N R1 9W) NA Lot 1 Parcel No: 12.30.19.657B 1.) Alt BM Description i)~,VW -1 V1 \W1 I 2.) Bldg sewer length = 1 - amount of cover = t~ bh a', Y • C Plan revision Required? Yes VIN. ~h Use other side for additional information. SBD-6710 (R.3/97) Date Insepctor's Signature Cert. No. PLOT PLAN PROJECT Oeverina Homes ADDRESS 1433 Cernohous Ave Suite A New Richmond Wi 54017 SE 1/4 SW 1/4S 12 /T 30 N/R 19 W TOWN Somerset COUNTY ST. CROIX SYSTEM ELEVATION 91.5/91.4 4.5' below grade 6/24/15 3 DATE BEDROOM CONVENTIONAL IN-GROUND PRESSURE CONVENTIONAL LIFT XXX HOLDING TANK MOUND SEPTIC TANK SIZE 1000 gallons L FT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .5 7ABSORPTION AREA 933 # of chambers 46 BENCHMARK V.R.P. Top of 3/4" steel pipe ASSUME ELEVATION 100' Filter BEAR Filter ❑ BOREHOLE O WELL * H. R. P. Same as Benchmark Scale = 1/4'1 = 10 85th St. 1 Pro 3 v-) e Bedroom House 40' B-1 Huffcutt Combo Tank 50' 70' 8' 2-3' X 94' 5% Slope cells with >3' All piping shall be ASTM SDR 30/34, within spacing 6 , 10' of tank, piping shall be ASTM F891 B-3 6' B-2 61 00 Vents 74' CIC0 Mtye 152' B., * l~y"RrtEnr ii tnh~ l J V - C `C'84~1gs Division, -qJ ~ i a v 201 W. Washington Ave., , P,0. Box 7162 Smaan ?';rmir Numne: 4c, be tilled m b} Co p ` a ison, 07-7162 COUNTY EVELOPMENT 97(oV30 5 +9003 Sanitary Permit Application atcT-ansactiontiuA Y In accwdavc.with SPS 'Wis. Adm. Code; submission of this tom to the appropriate coverrmcntal unit i is required prior to ob arcing a sanmL7 per ut. 'Vote: Application ?bans for state-owned PCAVTS are submti d to P io eet Address i if dstiinu addre ss ~ Ute ores imcSate y and Professional acN Se vt s_ P rs ma information you provide may be used Ior Se on a purposes in ;3ordrdance with the e I Pmrivacy L av+ Slats. I Application Information Please Print kit I fo lion _ Property Ow 's Name r v - - - - Propeni Mailingss nrtpc } I. anon 1j3 Lot City, State it', Code PhoneNumbe; 111 ~ Section / 10_~? j~ / - Qc nr II. 4pe of Building (check at at app) '-ot H~ 777~~~ttt--- or 2 Famih' Dwelling - Number of Bedroo 1 Subdivision flame - - - 4lSthi4SC Blr - rL~ Public/Cotnmereial -llascribe Use - ~ J Sate 0wncd N umber t Describe Use Ir- 2015T116 J!bA CGW ►V 2J OI OZV(~ ,wn 1~3 M. Type Per "t (Check only one box o line a. ;om {etc ii e B if applied {e) A ew Syste Replacement System Tre le ,l n epja ement l'mi - Ir q:>dil7 ation~~t~~c LLnng 'Ilk, expiair R. Permit ReneHa ❑ Permit Revision. Chance of Plumber '-Permit r,rer a \etc ermtmXrate 1 .ucd - IrD Bcfore Expiration i i Own,-, 11 _ N~ /Component Device (Chest all that apptv) In- lion-Pressun2sd In x~ Fressu L d Ln-Ur~,and _ Grad L Mound 24 in of suitabi.. \ ioun + rf n itable ao _ o dins Tank i I tither Dispersai Comronert inapt iirl- - Yrv a ncn Dev i c i xplatn! - DispersaliTr atment Area loformati rc ^P Design FIC)" , ; Desig Soil APP lica n Ratan Ssf ~s ersal ?.red ne ed s1; U rsn, A:Ca t ruPosed ~sf) Stistem Ele%au n _ f VI. Tank Info y Capacity in ®z I Tu L s i Manuffcturcr - )a)lons j (-,ajjom Units -7 1- ~.):svrg !':;ar;•:. W V~ ! t / R 1 1 - _ -7 ;,pd r dC,71 v Tani: L osmL Ctiamb~. - VII. Responsibility State t- I, the undersigned, assu r6sponsihiiity for installation of the (),A"I'S shown on the attached plans. ng' er's Marne ;"Prin P;umher' _„a,ure 11 %44PKS um, bur Business Phone v bcr Plumber's .Address i,S eet, s. State, Lip (-Oclc) - - - - ~ VI11. County/De artment Use Only _ e mn ee Date issued u sE, pproved llt,appt w s i i y e: Giver R son i.:~en_a qj/•-- ApproyaLfR IX. CondSYSTEM OWNER:easons for Disapproval .h, + d1 E - ~~~l rk 817 Ye-qu,'oee ~t5 1. Septic tank, effluent filter and dispersal cell must be serviced /.main ine ~1 as per management plan provided by plumber. EY05~arl 2. All setback requirements must be maintained as per app%ic ab g Qr fia4lPdeBcspstem and submu to the County on)v nn pap ^ ,i 1 a 1-1 WlgevelW iJb ptzodt evaVa~bn h Vu/ ! vl~ s Sit LA,nd Use Pe vM Cover Page Shaun Bird Bird Plumbing Inc. 1432 120th St. New Richmond Wi 54017 715-246-4516 Date: 6/24/15 Owner: Oevering Homes Location: SE 1 /4 SW 1 /4 S 12 T30 N, R1 9W Lot 1 85th St. Somerset System type: In-ground absorbtion system(conventional) Manuals Used: In-ground absorbtion system (version 2.0) Pressure Distribution Manual (version 2.0) Page# 1. Cover Page 2. Plot Plan 3. Chamber Cross Section 4-6. Maintanance and Contingency Plan 7. Filter Specifications Sheet 8. Dose Tank Cross Section 9. Pump Curve 10.-12. Soil Test ; 0 Signature r License numper 226900 f PLOT PLAN PROJECT Oeverina Homes ADDRESS 1433 Cernohous Ave Suite A New Richmond Wi 54017 SE 1/4 SW 1/4S 12 /T 30 N/R 19 W TOWN Somerset COUNTY ST. CROIX SYSTEM ELEVATION 91.5/91.4 4.5' below grade DATE 6/24/15 BEDROOM 3 CONVENTIONAL IN-GROUND PRESSURE CONVENTIONAL LIFT XXX HOLDING TANK MOUND SEPTIC TANK SIZE 1000 gallons L FT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .5 ABSORPTION AREA 933 # of chambers 46 ,BENCHMARK V.R.P. Top of 3/4" steel pipe ASSUME ELEVATION 1001 Filter BEAR Filter ❑ BOREHOLE O WELL *H.R.P. Same as Benchmark Scale = 14" = 10, 85th S 7 Pro 3 Bedroom House 40' B-1 Huffcutt Combo Tank 50' 70' 8' 2-3' X 94' 5% Slope cells with >3' All piping shall be ASTM SDR 30/34, within spacing 6' 10' of tank, piping shall be ASTM F891 B-3 6' B-2 61' Vents 74' I 152' B * 160th Ave Cross Section of Infiltrator Quick 4 Leaching Chamber Typical cross section for 2 of 2 cells Quick 4 Standard Leaching Chamber with 20.0 ft2 of Area per Chamber 5.6ft^2 pair of end plates To be >1' above grade Finish grade elevation Typical Installation 96.0' Vent Grade Vent 3' 4" 3' X30/34 Septic Tank 5' Long 119 5' 5' Long 199 36" Grade at System Elevation Grade at System Elevation Spacing 5' 2-3' X 94' Cells Same on other end Observation tubeNent At end of cell A B 23 chambers per cell System elevations: A 91.5' B 91.4' ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Bayer C~~'v~'; t,:7L ----f~ Mailing Address r t`' Seefi Property Address 1 g5 (Verification required from Plannuig & Zoning .Department for new construction.) City/State _-_tw. A - 54bf - arcel Identification Number b,4 2 - E614 62~ LEGAL DESCRIPTION Property Locatioxt$_.- 1, Lo V4, Sec. 12- _a T30 N It 19 W, Town ol~ Subdivision .Lau # Certified Survey Map # - Volume Page # Warranty Deed # Volume Page # Spec house yes no Lot lines idetrtiflablq..DYC SYSTEM MAINTENANCE t no .AND OWNER CER.TIFICATI4N Improper use and maintenance of your se tic s maintenance consists ofpu main out the septic p Ystem could result in its rema g tank ever p tLl failure to handle wastes. Proper function of the septic tank three years or sooner, if needed, b responsibilities are specified in C as a treatment stage in the waste disposal s sterrnspvpumper- What you § omm. 83-52(l) y Y put into the system can affect the and in Chapter 11 - St. Croix Count Sanitary maintenance The y Ordinance. Property owner agrees to submit to St. Croix County Planning & Zoning Department a certification foram, si ne(l b 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 necessa th g Y the less than 1 /3 full of sludge, r3'), a septic tank: is T/we, the undersigned have read the above requirements and a ree in standards set torch, herein, n set by the Department of Co mmerce and 8 the Department n of the pr Natural private sewage Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the Si Croix al system with the Zoning Department within 30 clays of the three year expiration date. County planning &; T/we certify that all state7aama Property described above, by virtnty deed record form are true to the best of MY/our knowledge. I/we arn/are the owner(s) of the ed in Register of Deeds Office. Number of bedrooms----D lG_ NEAT O:F APPLICANT S DATE. ***Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Department. nclude with ties 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. 08/Os) POWTS OWNER'S MANUAL $ MANAGEMENT PLAN Page of FILE INFORMATION SYSTEM SPECIFICATIONS Owner t~2 J r n Tank Manufacturer ❑ NA Permit # Septic ❑ Dose ❑ Holding Volume: 1 (gal) DESIGN PARAMETERS Tank Manufacturer: 14 ~tC6&7_ ❑ NA Number of Bedrooms: ❑ NA Septic ❑ Dose ❑ Holding Volume: (gal) -30 Number of Public Facility Units: ~L4MA Vertical Distance Tank Bottom(s) to Service Pad: (ft) Estimated (average) Flow : (gal/day) Horizontal Distance Tank(s) to Service Pad: %O (ft) -~-7 Specific servicing mechanics must be provided if vertical is >15 feet or Design (peak) Flow = (estimated x 1.5): J v (gal/day) if horizontal is >150 feet. Specific Instructions to be provided on back. In Situ Soil Application Rate: s (galldaye) Effluent Filter Manufacturer: e ❑ NA Standard (Domestic) Influent/Effluent Monthly average Effluent Filter Model: l Fats, Oil & Grease (FOG) _530 mg/L Pump Manufacturer: k GCS Biochemical Oxygen Demand (BODs) s220 mg/L ❑ NA ❑ NA Total Suspended Solids (TSS) 5150 mg/L Pump Model: lu S~3 High Strength Influent/Effluent Monthly average Pretreatment Unit (FOG) >30 mg/L Manufacturer. (BOD5) >220 mg/L )<NA A (TSS) >150 mg/L ❑ Mechanical Aeration ❑ Peat Filter ❑ Disinfection ❑ Wetland Pretreated Effluent Monthly average ❑ Sand/Gravel Finer ❑ Other: (BOD5) 530 mg/L Soil Alp tion System (TSS) 5530 mg/LNA Fecal Coliform (geometric mean) 5_10' In-Ground (gravity) ❑ In-Ground (pressure) ❑ NA Maximum Effluent Particle Size Us in dia. ❑ NA ❑ rode [3 Mound ❑ Drip-Line ❑ Other: Other: NA Other: ❑ NA MAINTENANCE SCHEDULE Service Event Service Frequency Pump out contents of tank(s) hen combined sludge and scum equals one-third ('f6) of tank volume ❑ When the high water alarm is activated Inspect condition of tank(s) At least once every: month(s) (Maximum 3 years) ❑ NA Inspect dispersal cell(s) At least once every: / month(s) (Maximum 3 years) ❑ NA C ear(s) Clean effluent filter At least once every: ❑ onu(s) [I NA Inspect pump, pump controls & alarm At least once every: ❑ onth(s) ❑ NA ear(s) Flush laterals and pressure test At least once every:. ❑ month(s) NA ❑ year(s) Other: At least once every: ❑ month(s) LNA ❑ year(s) Other: MAINTENANCE INSTRUCTIONS Inspections of tanks and soil absorption systems shall be made by an individual carrying one of the following licenses or certifications: Master Plumber, Master Plumber Restricted Sewer, POWTS Inspector, POWTS Maintainer or Septage Servicing Operator (pumper). Tank inspections must include a visual inspection of the tank(s) to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of combined sludge and scum and a check for any back up or ponding of effluent on the ground surface. The soil absorption system shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a failing condition and requires the immediate notification of the local regulatory authority. When the combined accumulation of sludge and scum in any treatment tank equals one-third ('f3) or more of the tank volume, the entire contents of the tank shall be removed by a Septage Servicing Operator (pumper) and disposed of in accordance with chapter NR 113, Wisconsin Administrative Code: All other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment units. and any servicing at intervals of 5_12 months, shall be performed by a certified POWTS Maintainer. A service report shall be provided to the local regulatory authority within 30 days of completion of any service event. GMW-005 (02/05) Page of START UP AND OPERATION For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products, solvents or other chemicals or sediment that may impede the treatment process and/or damage the soil absorption system. If high concentrations are detected have the contents of the tank(s) removed by a Septage Servicing Operator (pumper) prior to use. Pump tanks may fill above normal highwater levels prior to startup or due to pump failures. Start up or restoration of power under these conditions is not recommended, as the excess wastewater will be: discharged to the soil absorption system in one large dose causing an overload that may result in the backup or surface discharge of effluent and damage to the system. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator (pumper) prior to restoring power to the pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls until normal effluent levels are restored within the pump tank. System start up shall not occur when soil conditions are frozen at the infiltrative surface. Do not drive or park vehicles over tanks or the soil absorption system. Do not drive or park over, or otherwise disturb or compact, the area within 15 feet down slope of any mound or at-grade soil absorption area. Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the treatment tanks and soil absorption system: acids, antibiotics, baby wipes, cigarette" butts, condoms, cotton swabs, degreasers, dental floss, diapers, disinfectants, fats, foundation drain (sump pump) discharge, fruit and vegetable peelings, gasoline, greases, herbicides, meat y napkins, solvents, tampons, and water softener brine discharge. scraps, medications, oils, painting products, pesticides, sanitar ABANDONMENT When the POWTS fails and/or is permanently taken out of service the following steps shall be taken to insure that the system is properly and safely abandoned in compliance with s. Comm 83.33, Wisconsin Administrative Code: • All piping to tanks, pits and other soil absorption systems shall be disconnected and the abandoned pipe openings sealed. • The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator (pumper). • After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil, gravel or another inert solid material. CONTINGENCY PLAN If the POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide a code compliant repla ement system: A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system. T e replacement area should be protected from disturbance and compaction and should not be infringed upon by required setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result in the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rules in effect at the time of their permit issuance. ❑ A suitable replacement area is not available due to setback and/or soil limitations. If the soil absorption system cannot be rehabilitated and barring advances in POWTS technology, a holding tank may be installed as a last resort. ❑ The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluation must be performed to locate a suitable replacement area. If no replacement area is available a holding tank may be installed as a last resort to replace the failed POWTS. ❑ Mound and at-grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time. WARNING TREATMENT TANKS, PUMP TANKS, AND HOLDING TANKS MAY CONTAIN POISONOUS GASSES OR LACK SUFFICIENT OXYGEN TO SUSTAIN LIFE. NEVER ENTER ANY TANK UNDER ANY CIRCUMSTANCE. DEATH MAY RESULT. ESCAPE OR RESCUE FROM THE INTERIOR OF A TANK MAY NOT BE POSSIBLE. ADDITIONAL INSTRUCTIONS: POWTS INSTALLER POWTS MAI TAINER . Nam 5 Name Q~ Phon t - S Phone ~J SEPTAGE SERVICING OPERATOR PUMPER LOCAL REGULATORY AUTHORITY Name L, ( Names Phone Phone ?I J This document was drafted by the staffs of the Green Lake, Marquette and Waushara County POWTS regulatory agencies in compliance with sections Comm 83.22(2)(b)(1)(d)&(f) and 83.54(1), (2) & (3), Wisconsin Administrative Code. f r kw Y li- r1~' ~ rt`j r y.. a 4 Mali, ~ a i Q Qa 11 r c w ~a I g U a al C\i i Septic-Dose Tank Cross Section And Pump Performance Specifications Tank Manufacturer Pump Manufacturer Tank Model Number 00 Pump Model Number - Total Tank Ca acit P y 3 O Alarm Manufacturer ' Max. Bury Depth Alarm Model Number V_~% Switch Type Filter Manufacturer toz! /A Total Dynamic Head (TDH) - Feet Filter Model Elevation Head Distal Pressure Network Loss _ Minimum Pump Performance Required Force Main Loss - - - I 2 GPM: @ Ft TDH - - Total Outlet Manhole Min. 4" Above Grade With Locking Device. Inlet Manhole Manhole Min. 4" Above Grade < 6" Below Grade Sealed Watertight Securely Mounted With Locking Device Weather-proof Junction Box t Finished Grade 00 ttr r ,...r Vent Min. 12" Disconnect Above Grade Means With Vent Cap Outlet Filter Inlet Baffle r... _ - inlet ; Switch Settings and Reserve Capacity '4 1~„ _Tank Volume = GPI Weep Dimension . Inches Volume Gal. B Note (reserve) A (alarm} B 2 Off Elevation C Ft (dose) C F 7, ' (dead) D Bottom _ 135 D Elevation Total ~Uj . . . . . . . . . . < . . . . ` > . ! f 1J J•>•>•la>~>•! J•i •1•I •)/•X •)•>•I•i•t>•>~i > ) i•> > t 1, t t t•/•.><•la/•I I l l•1 •,•t•/•a•1•,•I>1 GENERAL INSTALLATION: The septic/dose tank is bedded and back filled in accordance with the manufacturer's product approval specifications. Maximum depth of bury as specified by the manufacturer may not be exceeded without prior approval. Manhole covers exposed to grade have an effective locking device (padlock) installed. Piping at the inlet and outlet is of approved material, connected to the tank with watertight fittings, and laid on stable soil to prevent settling or sagging. The force main is sleeved with 4" Sch. 40 PVC to bridge the tank excavation and the sleeve is sealed watertight. Electrical service complies with NEC 300 and Comm 16.28. 02/05 L.1 Page of 25 j - -_a--- } I - ! - z \ ~C PI _S lu 2' JERQ T, h d 009897 Variable level float switches available. y Variable level long cycle systems available. i Available with special cord lengths of 15', 25', 35' and 50'. Alarm systems available. Duplex systems available. t- Single Seal Control Selection Listings Model Volts rPhase Mode Amps simplex Duplex CSA UL 1. Integral float operated mechanical switch, no external control r:quired. 2. Single piggyback variable level float switch or double piggyback variable level M53/55 & M57/59 115 t Auto -9.7- -1 - - Y Y N53!55 & N57/59 115 1 Non 9.7 2 3 or 4 & 5 Y Y _ float switch. Refer to FM0477. - BN53 115 i Auto 9.7 Y _-Y 3. Mechanical alternator "M-Pak" 10-0072 or 10-0075. - - - - - - BN57 115 1 Auto 9.7 _ N BE53i57 - T 230 _ 1 Auto ! 4.8 Y v 4. See FM0712 for correct model of Electrical Alternator. ~ _D53/55 & D57 59 230 1 ,Auto 4.8 1 Y Y 5. Variable level control switch 10-0225 used as a control activato with Electrical or4&5 Y Y Alternator (3) or (4) float system. Bas 5 & E57/59 230 i_ 1 Non 4.8 2 Single piggyback switch included. D CAUTION For information on additional Zoeller products refer to catalog on Piggyback Variable Level Float Switches, FM0477; Electrical Alternator, FM0486; Mechanical Alternator. FM0495; Sump/Sewage Basins, FM0487: and Single Phase Simplex Pump Control/Alarm Systems, FM0732. - - II, For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump. MAIL T0: P.O. BOA ;1. Lousville, KY 40250 Manufacturers of. . O F SHIP T0: 3649 Cane Run Road i, aaOO Louisville, KY 40211-1961 QV4L/TY PUMPS //NCE ~7d~ (502) 77~~ 31 - 1 (800) 928-PUMP http://www.zoelter.com (502) 774-3624 © Copyright 2002 Zoeller Co. All rights reserved. Exhibit A Legal Description Lot 1 of Certified Survey Map filed April 8, 2015, in Vol. 26 of C.S.M., pg 6100, as Doc. No. 1010262 located in the SE 1/4 of the SW 1/4 of Section 12, Township 30 North, Range 19 West, Town of Somerset, St. Croix County, Wisconsin. WARRANTY DEED STATE BAR OF WISCONSIN FORM No. 2-2000 St, Croix County 1011618 Page 3 of 3 o. A ~ I I TI I AJMM o sad s, ~ N r u ~ Ms me-IV *Y^ a - YIN i MO' r M ~ v~ NIP\ i i J ~ 4 M. ~ ~ n Sh.~~u~ndl , Doi (Al GVis~ Sifetyand rofessionalServices SOIL EVALUATION REPORT Page 1 of bivisioz,~'and Buildings in accordance with SPS 385, Wis. Adm. County Attach complete site plan on paper not less than 8 1/2 x 11 in include, but not limited to: vertical and horizontal reference poi , direction and Parcel I.D. percent slope, scale or dimensions, north arrow, and location and disttaOnc t r ~~s road. p _ py o- bub Pt ND)1J Is- Please print all information. A 1~\ Reviewed by Date Personal information you provide may be used for secondary purposes ( irasq~J~( 4'6@14 T y f7 ~OI j Property Owner ; OMM operty Location v X 'I- W4 Zd~ X / n Govt. Lot 1/4 ) 1/4 S T N R E (ore Property Owner's Mailing Address Lot # Block # Subd. Name ~6 6z~z City State Zip Code Phone Number ❑ ity ❑ Village ®Town NearesRoad ® New Construction User Residential / Number of bedrooms code derived design flow rate GPD ❑ Replacement ❑ Public or commercial - Describe: Parent material Flood Plain elevation if applicable ft. General comments and recommendations: d~i~S~o F/-1 Boring # tElI Boring / lay Pit Ground surface elev. L ft. Depth to limiting factor- in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft z in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. * ff#1 * ff#2 A/ Z Z;2 --3. _ y 9 1 - - 77 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 GPD/ft 2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. ff#1 * ff#2 -ZP A/ 9% * Efflue #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 g/L * Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L CST Name P ase MPt i ~ CST Number N , Address Date Evaluation Conducted Telephone Number 9 SBD-8330 (RI 1/11) Property Owner Parcel ID # Page of 17 Boring # Boring Pit Ground surface elev. ft. Depth to limiting factor ?hl~Z_ in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure onsistence Boundary Roots GPD/ft 2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. ff#1 * ff#2 1 / S , 'f 47 -1 7 a Q o 'v\` F-1 Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil :Application Rate Horizon Depth Dominant Color Redox Description Texture Structure onsistence oundary Roots GPD/ft 2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. ff#1 * ff#2 Boring F-1 Boring # Ground surface elev. ft. Depth to limiting factor in. ❑ Pit Soil A lication Rate Horizon Depth Dominant Color Redox Description Texture Structure onsistence oundary Roots GPD/ft 2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. * ff#1 * ff#2 * Effluent #1 = BOD 5 > 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BOD 5 < 30 mg/L and TSS < 30 mg/L The Dept. of Safety and Professional Services is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, contact the department at 608-266-3151 or TTY through Relay. SBD-MO (R11/11) _ 3 AC 3 1-w - , !"No monuments have bens . CERTIFIED SURVEY MAP Located in the Southeast Quarter of the Southwest Quarter, Section 12, Township 30 North, Range 19 West, Town of Somerset, St. Croix County, Wisco sib PREPARED FOR OWNER: lit 1 111111 i Michael Flandrick✓~~~♦~~$R~e~~~-7 1823 Winding Trail Road New Richmond, WI 54017 0 JOEL NOTE: Lots may be subject to future special assessments for Z'*" *2 any upgrades and improvements to the road. 14291 The parcel shown on this map is subject to State, County and Township laws, rules and regulations (i.e., wetlands, minimum lot size, access to parcel, etc.,). Before purchasing or developing the parcel, contact the St. Croix County Zoning ~401111Z11111 Office and Town of Somerset for advice. MATCH LINE SEE SHEET'` 2 Legend , , 0 Denotes set 15/16 inch outside diameter by o / 24 inch long iron pipe weighing 1.68 pounds per lineal foot. OR Denotes aluminum cap St. Croix County section comer monument. ~p QO Denotes probable wet land area per field observations and data published by the J~ eoO p/ Wisconsin DNR. ~CO ^ X Denotes soil boring location and B-2 corresponding report number. / /O K~ o Zr i See soils report dated Month Day, 2015 by A_ Reputable Soil Testing Company for additional information. Distances are in feet and decimals of a foot. c A -central angle of curve .1 n~ LOT 1 "NO I~ '1 R = radius of curve l~ ~V Including R.O.W. L = length a#curve Q~tO /i~ y J 229,469 sq. ft or 5.268 acres a 1 amp V 3 Excluding R.O.W. - ' CB =chord bearing , O , rn 182,217 sq. ft. or 4.183 acres 0 N-S 114 tine- {y East tine of SW1/4- O 33I' d Q ' r~,~, - M t. Norfh line rural electric tine ea ment-~ N 002232" rV 33# -South tine of SWIA 81.49' t M 5 89°19'40" W 479.37' } -33.00' M_T 160Th AVENUE i N `t7A 25 r S 1/4 comer Section 12, ~ rof160thAvenue -890-55-'-53"-E- T- R19W.--- M - o -l r - - 0' i I Scale in Feet LOT 5TONEWOODT LAID: V0~ z~ 0 25 50 100 Wetland locations shown hereon are highly probable T~ 1 inch = 100 feet however were not delineated by z' licensed personnel and other uio* 1o-4 I~nni:r~.n r.....:....:..L F,