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HomeMy WebLinkAbout020-1416-40-000W isconsin department of Commerce Safety and Building Division PRIVATE SEWAGE SYSTEM INSPECTION REPORT County: St. CI'OIX Sanitary Permit No: 499193 0 State Plan ID No: Parcel Tax No: 020-1416-40-000 Section/Town/Range/Map No: 20.29.19.2632 GENERAL INFORMATION (ATTACH TO PERMIT) Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)J. Permit Holder's Name: Gity Village X Township Mechelke, Steven Hudson, Town of CST BM Elev: ~J Insp. BM Elev: BM Description: _ (~ TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY Septic / / ~ ~Q ~(~ / ~~~ Dosing C~ ~1 ~ . ~~ Aeration Holding TANK SETBACK INFORMATIOy.-,rte TANK TO P/L V~ BLDG. Vent to Air Intake ROAD Septic , f ~ ! ~ ! O ~ f Dosing ~~ Aeration Holding PUMP/SIPHON INFORMATION (gyn. u Manufacturer Demand GPM Model Number TDH Lift Friction Loss ystem TDH Ft Forcemain Lengt Dia. Dist. to Weil SOIL ABSORPTION SYSTEM BED/TRENCH Width ! Lengl DIMENSIONS 3 SETBACK SYSTEM TO INFORMATION Typ Of System: i'~ Q1~4 IIIST.RIR11TInN SYSTEM STATION BS HI !~ FS ELEV Benchmar k / ~ l 0 y b~I~ 1 ~ ~~q ~ l k ~,~., ,, ' Alt. BM FN l~J//l~~ Z / V. _1 r ~~ ~~ Bldg. Sewer ~ Prb ~ / C _ 3b ' d .~ O p ~ ,O l J S t Inlet / / (0, SUHt Outlet ~G. 3 ~ Dt Inlet , /!~ .~ / Dt Bottom .~-- Header/Man. ~ r7~ /2 ~~ /' S; 3-~ `l Dist. Pipe (3, ~ ~ ~' / 1"t 3 k~ 1 . a b ~,3 ,Z`1 F, final Grade ~A b.~ St Cover ! ~- ~~'. ((~ 'C gl = 1 oi.'~S ~z ~~3 132;; tbJ~7S ~ ~ ~~ t`~- `~' ~'L' -- Z z~ Z3 No. Of Trenches ~P I5~ ~ Ire! ~~75 ~ ~ l/ S No. Of Pits Inside Dia. Liquid Depth ~ LEACHIN CHAMBER UNIT /~ l Header/ anifold l Distribution j~ n r ~ 1 Pi v t x Hote Size x Hole Spacing - Vent t it Intake l~l ~ dil I~-' pe(s) ~ 1, ~ 1 h ~ y -1 S in Di L ~ -I~ ~ r .. Dia Length- ~. g pac a ength 0 .. C(lll r(1VFR ., o.,...~...e c.,~~o.,,~ n..~.. ~~ Mn~~nrl (lr A4-rArarlca Svstemc only .~ Depth Over i Depth Over - xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center 1 ~ _ L Bed% ~ench Edges Topsoil Yes No Yes No COMMENTS: (include code discrepencies, persons pre~~nt, e c. Inspection #1:~/ X ~u i inspection #2: l 1 location: 434 Swift Circle Hudson, WI 54016 (NE 1/4 SW 1/4 20 T29N R19W) The GI of 38 ~~~ ~ Parcel No: 20.29 19.2632 o ~ Cry, IMG~ ~ ~ ~~~ tfLi-QJI~ 6-'~..c t 1.) Alt BM Description =~ ~ / 2.) Bldg sewer length = I ~~-.~ -.- ~ ~ ~Vrs)b~'e ~~ S S~ ~~^. ~SQ~- ~ ~ I;uZ~.o ~`-' -amount of cover = \ / ;h ~ . ~,,rin~ ,~ C~'f' ~ ~ 3 i tT u. _0 _ - i.~. t Plan revision Requaed[i al Yes VNo ~ ` f ~ ~ ~ U ~ r~' ~ ~~ ; ~~it-,-,.~.. l~ ~f Zvi sal Use other side fo ddi on information. _ -- Date \~i' ^ / ~/Insepctor's Signat/ure, - pr/ r/ Cert. ,N1o. ~j SBD-6710 (R.3/97) J[G t/v ~G( ~l.~it./~ ~K.~/~ .n~.. /d~' ~ '/„CG~ / . /C/ 'T'7 ~il-~ ~ aucsy aaso nurtatngn tltvtaion County `-' ~' ~~~ 201 W. Washington Ava., P.O. Box 7162 ~`~C~ C1 ~'I~ ~ ~ Q ~ ~ Mfadispn, W1 53707 - 7] trig SMitary Pcrmit Number (to br G!!ed in ny Co i Dt: art+nent of Commerce (608} 266-3151 ~9~ /93 Sanitary Permit Application s~~ plan l.D. Number ~`- ]n accord with Comm 83.21, Wis. Adm. Code, personal information you ptov' ~ { may be used for sxondnry purposes privacy Law; s i 5.04(1 xm} P _~ ddress (if di±Terent than marling address) ' _ h Application Informatiaa -Please Print Alt information ---- C ~3 ~ Sw, ~- c ~ ~ P ' ropCrty~g+,w,~nrer~ s Name Par¢oi It Lat+l I3;ock p ~/ ~/ / ~ G -Pr ~G~ Property Owner's Mailing Address ~Q~~--' Properry Location ~ ~ U S COUNTY // City, State 7,ip Cade Phanti umber w ~ ~/~, .7~i.; Section Z G ~ ~" - •.~ ra o t, ,rcle zit J ' / J'a ------_ _rr . _ ___- T ~~ N, ~ 7 E or II T f B ,, . ypo o ing (chsck •I! that A I PA Y) / b~na.[ ~ 5 u ~~ . __ or 2 Fainity Dwelling -Number of t3edrooma Subdivision Name PubiiclCommercial -- Describe Use ,__,_„~~ ~ ~~ ~ ~ ~J State Ounted - Descrbe Use .~,__ ~ ~.. ^CiIy~OVillage ~ownship of'~i~t fd /J III. Type of Perm#t: (Check only one box on lint: A. Complete line $ ff app!#cable) OzD _ ~r f/~ ~T _ a ~ 32 A ~" ~ ~~ _ ~..1 ~+v'ew System ~ Replacement Sysrom ^ 7reatrnettvHaldirtg, Tank Replacemenn Onty C' Other Modification W Existing System ~ B. List Previous Permit Number and Dato Issued I ~! Permit Renewal l~ Permit Rev[sion {~ Changc or ^ Permit 1'ransier to New ~ + `Before &xpirafion =Plumber gwner j r IV. Type of PQWTS System: (Check all that Appiy~ ~_ ~ ~' ~- ~~ Nan -Pressurized In-('Hound Q Mound y 24tH. of suitable soft ^ Mound <24 in. of suitable soil ^ At-Grade [] Single Yass Sand Filter ~~ i Constructed red ~] Pressurized ln-Ground ^ Holding Tank ~ Peat Filter ~ Aerobic Treatment Unit ^ kecirculating Sand Filter C~ j _ Recuculatin Synthetic Media Fitter caching Chamber ^ Dri Lino (~ C'irar'ol-les Pi ~ Cher a itain} ~ V. Als crsaVl'reatmentA~ea In orma oa: _ ~~ 2 ~_ ~r~e.T~~---~~ _ ~ la,~+~~d?~'~nA~ Destgn Fto w (gpdj f?esi n Soil A li te( ti R f d l AA } g pp ca on a s gp j tsperss rea Requimd (sf Dis;+ers rea Praposed (sE) System Etevat~an l A r ~j ~ / ~~h n ~ V Y ~ ~17 / A .2~ ~ ~/~ ~/f-`t7/ - .' VI. Tanklnfo Capacity in Tata1 Number Manufacturer Prefab Site Steel Fiber plastic ! ~ Gallons Gallons of Units Canerete Constructed Citass I New Existing _ Tasks f Tanks SVpt1C Oi }!Oklins TAnk ~~~~•~•. _W-._. ) ~~cs~- _ Acrobic'71na[enen[ Unit {I ~ + _ -_._.._.~~.._~- _...____.._._i Dosing Chuaba ~ ___._, VII. ResponaiDitit Stat+etnent• I, the undersigned, aaswnr rrsponsihility for last anon of the PQWTS shown en the attached plans. ~ - Plumber's Name {Print} Plumber's Signature tP PRS Number Business Pliant: Number i ~l~r/.ll.•a -_ ~o ~ 2 ~ 9r9~' tom' ~ 3fS~': ~'/.;~/ Plumber's Address (street, City, State, Zip Code) ~ iJ ~~~ ~_ I .~~wr~~~ ~~ ~ -.~ / Y~ ^^ ~ ~~ ~ . ....._,-.~. V71[. Coen /1}e artment ce dn L lv ~Appraved rJ' Disap ..~ Sanitary Permit Fee ncludea Graundwaixr t7ace Issued Issuing gent Signature No Stamps? Surcharge Fte} , 0 rason Denial ~~ - . D 3 ~ IX. Condition f p r t ~~ ~C~ ~~ ~~ SYSTEM OWNER: ~ 1 Septic tank. affhtar,t tutor ~.,a dispersal cell must all _be serviced /main irled as per management plan provided by plumber. 2. All setback requirements must be maintained as per applicable code/ordinances. (to the County only) for the system on paper not Ids SBD-E398 {R. 01!03) Cafi~.P % ' ~ i r-- ~Z G>G D'~. ~ Itiead~- 12' i~ Lefj -~~~-~L ~ P ~~ ~P -~ ~''Z^^ nnW~~iry a'r~ C~J~ Campy /~ c.~' .e• i ' = ' ~ ~ GG DO. 2' ~ ~~ lD~l, ~ ~~ ~ ~ , ~~ ~~~a~~~~ ~~~~~~~ Sys.,,,, ~,Q~,~. _ ~~. sv ~ ~~zs' 1 -- `°~- `~-B~~ . z 1099 Wisconsin Department of Commerce SOIL EVALUATION REPORT Page i ~ 3 Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code Steel Soil Service Attach complete site plan on paper not less than 8'/: x 11 inches in size. Plan must County St Croix include, but not limited to: vertical acrd horizontal reference point (BMj, direction and . percent slope, scale or dimemsions, north arrow, and location and distance to nearest road. Parcel I.D. ending Please print all infonr-alhon. ~ Personal information you provide maybe used for secondary purposes (Privacy Law, s. 15.04 {1) {m)). Reviewer G~~~-=- Date 3 G 3 Property Owner "~ f °> , ~ Property L ion ~ Sienna Corporation t y°"` ''~ + /Govt. Lot 1 NE 1/4 SW 1/4 S 20 T 29 N R 19 W Property Owner's Mailing Address Lot # `Block # Subd. Name or CS(VI# 4940 Viking Dr, Suite 608 ~ ~` ,~ ~, ~i 7 ~~i.~`$ na The Glen City State Zip Code P ne Number _~ City Village ~ Town Nearest Road ~GQr'h a MN 55435 q ,Z- &~3!.S-~~o(~ r Hudson Carmichael Rd. Y? New Construction Use: i/', Residential /Number of bedrooms 4 Code derived design flow rate 600 GPD !. R~rlacernent ~ Public or commercial -Describe: Parent material Pitted outwash Flood plain elevation, if applicable na General canments and rec~nmendations: System elevatio n 97.50ft, trenches spaced and depth to code 4.25ft below grade ~1.e~ /~ ~~~ ~ S /'Vvn ~ c^c " ~ ~ ~ ~ B 2- -f'd-Y ~ /-S~>"~~G~ L'~a~~L .SG>M. ~ .° ~.O ~ Boring # Boring ~` U ~~r ~~ ~ ~ tl+' Pit Ground Surface elev. 101.75 fl. Depth to limiting factor 112 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Corrs~tence Boundary Roots GPD/ft= *Eff#1 *Eff#2 1 0-9 10yr3/2 none sl 2msbk mfr cs 1f .5 .9 2 9 7.5yr4/6 none ms osg ml gw na .7 12 3 64- 12 7.5yr4/4 ~~ none cos osg mvfr na na .7 1.6 p p %~ q ~~~ ~~ 5~ ~~ SI ~~- Boring # Boring ~ Pit Ground Surface elev. 101.75 ft. ~h to limiting factor 96 in- Sod Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/itz *Eff#1 *Eff#2 1 0-24 10yr3/2 fill sl na na cs 1 f .0 .0 2 24-39 7.5yr4/4 none ms osg ml gw na .7 1.2 3 39-96 7.5yr4/6 none co osg mvfr na na .7 1.6 t~ /rj 3 " o~ c#~ Ct~~L1.4.r -Si%t~ve els : , a (~ ~ (~ ~ -f'4,e?c.:4~n.a-„~-f l.auze ~J - ~~ l ~'~~-~ -~ ter, - ~.q~i 'Effluent #1 = BOD ~ 30 < 220 mgfL and TSS >30 < 150 mg/L ' E luent #2 = BO s<SO mg/L and TSS < m 'ZOO CST Name (Please Print) Signature: CST Number David J. Steel ~ 248956 Address Steel Soil Service Date Evaluatiacr Conducted Telephone Number 1564 CR GG, New Richmond, W 15401 9/6/2002 715-246-5085 ~~ Property Owner Sienna Corporation Parcel ID # Pending Page 2 of 3 Q Boring # Boring 100 25 th to limitin De factor ft 112 Y Pit . Ground Surface elev. g p . in. Sod Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Cons~tence Boundary Roots GPD/it' "Eff#1 *Eff#2 1 0-12 10yr3/2 none sl 2msbk mfr cs 1f .5 .9 2 12-60 7.5yr4/6 none ms osg mt gw na ~ 1.2 3 60-112 7.5yr4/4 none cos osg mvfr na na ~ 1.6 !( ~i ~~ ~~ , Boring # Boring * Effluent #1 = BOD s' 30 < 220 mg/l and TSS >30 < 150 mg/L * Effluent #2 =GODS <30 mg/L and TSS <30 mglL The Department of Commerce is an equal opportunity service provider and employer. Tf you need assistance to access services or Rorina # _..' Boling _ Page 3 of 3 STEEL'S SOIL SERVICE David J. Steel 1564 Cty Rd GG CST-POWTSM Sienna Corporation New Richmond, WI 54017 Lic. # 248956 NE1/4,SW1/4,S 20,T29,R19W (715) 246-6200 Town of Hudson, St. Croix Co. (715) 246-5085 The Glen lot # 38 This soil evaluation was conducted to satisfy a zoning requirement, it may or may not be suitable for your use. The location of the test may or may not be as shown as permanent lot lines were not established at the time the soil test was conducted. 0~{S~ ~-~./~P~ 23~~' / ~.h,,~.SsF~ ~y P~~ ~ 27 ~ ~qeN~ ~~ ~~~-// ~ Qt~U7MQ/'~ ~~/OO,Q~~'F .r°~o~~~2~ ~vG~,~L o0,?~~~ s . ~ ~f ~3~~hM~Nk ~c. i TO~ o ~ ~2 ~`~v ` ~' jep.~' C1 = r3ar ~'n y5 r~a~r~9 l~ ~ ~ i~l~7~f f32= /a~,75Fr S S I` 0 S/oP e ~-~%9-~' y.6.ov a ~. ~~ -. ~/ _. ~ - .--'r' i :. - - - - - ~ - f ~! ~ , -. ~ \i 57:1' il• ,' - ~ ' .a - ,. - - .. _. , a' _ _ _ 11 a `pi! ~ .. t ~' , ~ ` ; 1 ~ 1 t a3./ •... ~ - N s ~I ~ ~J~ ~~ `' 11 ~! '\. ~ ,' ,ate"- ~k4- 1: -, , ~ , ~~ . - • - ~ - - 1 ". .. ~l,. i 1 ~ \ .-. -.. i <. ... \ 1 i 1 ~. ^-._.. .: " ~ \ 1/ .... / ,~ ~hr _ - 9 1 '1 `a 1:1 i t1 al , 1 4.1 - - ;, r r .. r b,~ a 77-~ 65 1 _ 1 , ___ _~ a... , . , - 4.a- _ _ _ ~. _._. ,. .. ' 1 ,,1,•' •. .. .. ~. \ ~ , , ..... \. .. ~ 3 'j :' _ ~~ as m M _ P , l _ r~ tt 1'' ~ ... r .- t .. .-1 ,i `__ _ .~ _. •~ 11,1;111 rt~'8~ - arr. :.. 144.' ~ a yJ'-' ~ :' 7 ~s ~~. " `I- .a1 ~ r -~ - 344. . ~ .\ ,, ..... ,, , i t ~.~ -, \a , ;, , ri ~~... _ i _ , .., ~ t; '73 , 671 _ ' ~~ -- 4 ~ \ .; _..• ..~ - ... .. :-: , 'i` \ ' ~ r ,' 1 1 1 ~\ r t? / ! / \\ C ! '. _,, =~ \ 1 ` ~ , ' ~. o- ~ , ,,. _. - ___ _ ..-, as ..~~ ~ ~.. __~- - . .- -. \,. a as - ~ ~.~~., t; i 1 .,. ~~ 1, i r'I Ir 1 y t~ a wr . ^.~„r!`/ \•\~~ i ~ s \`•- .t ~t ai-= ~ i 1,,1 rI! lt/ .` ; ~1tt , •.~ +1, _;.,~," n.. I' 1. ,1 ~ ~ , 'i 1 11.;1. L-----'-~ ! ) 1: \; ~ i ' -.. .. ~' ~.L 1 - ~Y 1 I ", ,' ~ 1 ~ w~ 1 1 \ ! 1 r~ ; '~ ` ~ = l t 1 ; i 1' I 1 , rl ,1 i 1 I ~ '! ~ ~\ `\ \ ~2~' If1 ~T ` ,` 1"•11\ , "~ r ~` ' Y /. b` -__ 1 - ~, /` to \ ------- !r ~. ~.~, ~ ,~ . - a .. \ a ` .'v ; ~`~''t..; R as ` 1 ~i:.` iG=.~=~_-~-----` / , - . I (~' . i ~ 1 ~~1 i :i 111 1 ,.1, tl~ l~yF~l/ .,. t - ... ~ _ 1 11: i N`1 ~ ~ __ .__~ ~~ rN 1 ~~ i 11 1 ifl ti ~~ W (~ ~ l ~ f " \ r'_ ~16~ ~ jai ~; ,~~__-- --- ,, _ . ;1 ~. N ~ i ~ X71 : ~ I ~ j`, t g , ', ; ~~~ SEPTIC TANK ~ I'L~MF' CN.~MB~:k Cfi~.~SS SECTIf1N AND ~:'~CIFiCATIQN5 ~+" CI `JE?JT PIPE I2" M7N. ABOVE GP,ADE 25' FROM DOOR, WiNDC~W OR FRESH AIR INTAKE FINISHED GRADE 4" :'I RISER --•~ 18" iN. 6" MAX. N LE T ~ ~ ~~~ r --,~-••g WATER TIG ~iT SEALS ',PPROVED 'IPE 3' 3NT0 SP31.0 ~13It PUMP OFF ELEV . FT. A _..i_. a ~,~.. C D WEATHERPROOF ~.7UNCTION BOX WITH CONDUIT T-"\ .~ f4 'r L GAS- 1 ; `R T?~GHT ~ SEAL f E ~ 3" APPFts~VED BEDDING UNDER TANK ~~ ~ \/AFPROVEQ JOINTS WITH ALM APPROVED PIPE ON 3' O~iTO SOLID SOIL OFF '~`~ RISER EXIT PERMITTED c?NLY IF TANK MANUFACTURER HAS APPROVAL CONCRETE: PAD SP:CCIFICAT.ONS SEPTIC I DOSE TANK MANUFACTURER: l~te.Se.,,~, '?'riPIK SIDES: SEPTIC ~,~, GAL. .~"...~ - OS E _ R p~_ GAL . A;;~RM MANUE'ACTL'RER: 1..~.~c~c~~3~ MODEL NUMBER: e~.V SWITCH TYPE: 'CY'~~Rc PUMP MANU~AC:TLIRER : Cs o~,J.~.S _~.. MODEL NUMBER : 'E.,~t~~4 SWITCH TYPE: 'C're..2c... i~EC~UiREn DISCHARGE RATE ~~ GPM NUMF3ER DOES FER DAY : DOSE VOLUME IT~CLUD{NG F LOWBAC K : ~S_,~„•_ GAL CAPACITIES: A = ~2` IracH:ES = ` A21• B = 2 INCHES = ~ a. GAL. C = $ INCHES = ~~ GAL. D = ~ INCHES = 1 ~~o CAI.. PJMP ~ ALARM WIRZ NG AS P::R I LHR 16.23 WA: '1iRTICAL DIFFERENCE BE;T7~,'E£N PUMP OFF AND DISTRIBUTION PIPE J~. E'EET + MiNIM'JM NETWORK SUPPLY PRESSURE . _ 2.5 FEET + (~,~ FEET FORCEMAIN X a.1oOFT/aO0 FT. FRICTIJN FACTOR ~ FEET TOTAL DYNAMIC HEAD = 13 •S7E'EE=' Ih:TERNAL DIMENSIONS OF PUMP TANK: LENGTH -- ; WTDTH__~_~_,; IJIAME7.'ER ~____. LIQUZD ~FP~~'-.~'! .~,, ~1 Gra i , P e, ~ ~ ,~ "IGNED: L:ICF•.Nci NUMBER: ~a ? 9 9 Ctl__ DATE: APPROVED MANHOLE CO`dER W / PAL LOC K ~ WARNING LABEL :_.....4" M.N. ~~as ~~GOULDS PUMPS Submersible Effluent Pump ~~ 3871 EPOS APPLICATIONS Specifically designed for the following uses: • Effluent systems • Homes • Farms • Heavy duty sump • Water transfer • Dewatering SPECIFICATIONS • Solids handling capability: 31a'"maximum. • Capacities: up to 60 GPM. • Total heads: up to 31 feet. • Discharge size: 1'/:" NPT. • Mechanical leaf: carbon- rotary/ceramic-stationary, SUVA-N elastomers. • Temperature: 104°F (40`C) continuous 140°F (60°q intermittent. • Fasteners: 300 series stainless steel. • Capable of running dry without damage to components. Motor: • EP04 Single phase: 0.4 HP, 115 or 230 V, 60 Hz, 1550 RPM, built in overload with automatic reset. • EP05 Single phase: 0.5 IiP, 115 U, 60 Hz, t 554 RPM, buih in overload with automatic reset. • Power cord: i 0 foot standard length,16/3 SJTOW with three prong grounding plug. Optional 20 foot iength,l fi/3 SJTW wish three prong grounding plug (standard on EP051. • Fully submerged in high grade turbine oil for lubrication and efficient heat transfer. Available for automatic and manual aperatsen. Auto• matic models include Mechanical fMat Switch assembled and preset at the factory. FEATURES ~ EP05 Impeller: Thermoplas- tic endosed design for improved performance. ^ Casing and Base: Rugged thermoplastic design provides superior strength and corrosion resistance. ^ Motor Housing: Cast iron for efficient heat transfer, strength, and durability. ^ Motor Cover: Thermoplastic cover with integral handle and float switch attachment paints. ^ Power Cable: Severe duty rated ail and water resistant. ^ Bearings: Upper and lower heavy duty ball bearing construRion. AGENCY L15T1NG ~• Csnadiaar standards Assodation (CSA listed model numbers end in "F" ar "C".) Goulds Pumps is i50 900r Registered. m 2000 Goulds Pumps Effective February. 2400 838y1 ^ EP04 Impeller: Thermoplas- tic Semi-open design with pump out vanes for mechanical sea{ protection. ITT Industries .Ynr~lsnr ~~~~~ rA- +.rrr +YYI•I~Y(Ar .Yr~r sr~Naa~o ch,~M~FR Qaick4 Standard Chamber , r1 ~ h sic*~c)rv vr~w Multipart End Cad ~ ~~ ~ ~ " ~'~ ~~ ~ 1 ~'~~ ~ .~ t '~ ~°' t: ~~ , 4 ' i. t _ .,. ' ~ _ ~. 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'' ~ YM YpGIN;:wm M.YY. w W lWk-L~' Y'ay:~trutYri r'+Ii~~'{,A!Y. Htl" ,J' S>•0 .AUO":n_ :h,,.W av 41idu end bctM ~l~ ~ r~' W v Wr+i drw ('W, rw Irv 1 ,'.,~a:•aIW'vnUi~:l,n"~'.~rMS a{N'M~rWckur,rM ar eeltlYtO ln~:i,rrtM Vygl,,1'+~ I'r+Wanu'r,r rNYM 4+. U I'.,+,. ~ , .. Y Y,1YMr+wtlaYl,lynU'dfa- ,'hr'.~%yv..l rySWS1 yMtr.MVv•1'rM nY RdM'MtY-A!NTnWr gryAr Of MYIW.+dIMf4'p'IY'tl'1 '~ r 1 'y QCt{•tielY e,NtlW~i'• . r1Yi ftlMUrtxw (il.'ll!Nrl~iN{. 1•MYr W N,,fy. rystfhrWl b p•Ndrn n 5..:.8 .K r74 x ... M1;ry ,,,!t.. ,Y:.!'-' ;f Un tS l`+,Jxl ::UtANC1~MaIOM~ 11•+( •wW el*Y PAW b InY .n'or'"YNt JI ,. Yll a I~q ~(Iliu9b'4 NYlrp'NN bf4t ~~~ t`/ 1,~' SYSTEMS 1NC _ ~~ ~~ yy/r ,f 0ldutl0lfi' 6 BvSli~ park FiOHti • ~'.U f~C'x 769 C~1d SA~/bt~k, C~T f,~Q ~:~ F3f3U'S77-7agG • ~~ 8fu•5%7.70(71 soor.xzi-~a~e 5.3NY.U ' 5.40' t ;K: 5,aG1 4!Sll tl„i1 +90;1 'Altb.stt^ fl:>frl~,iib; g,S19,AYii `.+. r , a.. ,~;~ ,~. !,.15~ A{!~r", ' .UIM15 UnlnNn~. r K i'? '1\nLM i. 1lNuwtw 61W^ra 1rN. r ~ , 'y 'it W.: fX`d DN+ 4,N'LM !: ~ v,tlltilAt :NY4CA n lr' : 'ddA{(01 ~U%,WlY~ifiAl:%<;t ~nfAN~80M. AO``Y~ ` a~ , t1YA.r~,m+4F yCM. Cu+cKCUt, Ouch'' „ `..LN+Yx'~tYY' yr :MiY1u"NQ lllpyyr lJ•,•'•11,r~.5•: Nrq, FrOi/ ~,..leriw, ,(}.-,3"..r, Ma{uC..:onla:r, (i0'lkkrf ,y.MveN VM'd . f4 hrna 1nt~1fMo/64StEM'r: k~C PYIrIh1Q i(( Li $~/~ ,r+iaret NN ~.n • .... ~~~ l.v .,1 .d'. ~ POWTS OWNER'S iVlANUAL & MANAGEMENT PLAN Rage ~„ of FILE INFORMATION Owner ~ ~ ~0 ~ Permit # ~ y 9 ~ `~3 DESI©N PARAMETERS Number of Bedrooms ^ NA Number of Public Facility Units ~7 NA Estimated flow (average- CfZ) ailda Design flow {peakt,,(Estimated x 1.5i .___ (~ ~ al/da Soil Application Rate z elide ,/ft Standard influent/Effluent auallty ~ ~ Monthly average" Fats, Oii & Grasse iFOG) ~ S30 mglL Biochemical Oxygen Oemand lBOpbi' <220 mg1E DNA Total Suspended Salida iTSSi 5150 mg/l Pretreated Effluent duality ~~ Monttsly average Biochemical Oxygen Remand (BOO%) 1 530 mglL Total Suspended Solids ITSSI ~ s30 mQ/l Q NA Facai Colifarm (geometric mean) 510° cfu/1Qt9m Maximum Effluent Particle Size __ Ys in die. ~~ C! NA OtnerM ^ NA °`fal~.~es typical for durnestic wastewater and septic tank effluent. MAINTEIIIANC>E SCHEDULE SYSTEM. BPiECIFICATfONS Septio Tank Capacity /~S t7 al DNA "septic Tank Manufacturer W ; +r.s~~ ^ NA Effluent Fitter Manufacturer '~~~~, ~ ^ NA Effluent Filter Modal ~ `f3D ©NA Pump Tank Capaoity ~' Q ~ dal ^ NA Pump Tank Manufacturer ~ ~~ 5,~, ~ !~ NA Pump Manufacturer ~, fl ~, ~ ~~ y Q NA Pump Model __._ ~Q T Pretreatment Unit ~l Sand(Gravel 1=filter ^ Peat Fistor q Mechanical Aeration ^ Wetland C] Disinfection D Other; _ ^ NA A Dispersal Cellts) in•Ground (gravity) CJ At-Grade i:Q L7rip-Line -_ . _~ Q NA ^ In-Ground Ipresaurized) ^ Mound (~ Othr?r: Other: ______ - - _ ' DNA Qthvn . . __"_ _ DNA ....._.. Other: ~ ._ ^ NA Service 'Event Serokse Frequency Ins act condition of tanklsi p At least once every; month(st ~„~ tlVlaximum 3 years? ^ NA Pump out cornehts of tank{si When comtairred sludge and scum equals one-third (Y,i of tank vofurne C7 NA ~ Inspect dispersal cents} At feast anew every; ~ ^ monthts} lMaxlmum 3 year~tl Q NA Clean effluent filter ~ . At least once 8very: C7 month(si ~ ' ~ ~ NA ~ Inspect pump, pump controls & alarm ~ At !east once every~~ yea-isjis) ^ NA and p st a ce ~ ear{g~ __ .~ .~ ~ NA Other: ~~~~'~' ~ ____ _^--- ^ monthls} At Isast once every, ^ NA Other: O NA MAINTENANCE iN5TRUCTION3 Inspections of tanks and disperse! cells shalt be made by an individual carrying one of the following licenses or certifications: Master Plumber; Master Plumber Restricted Sewer; F'OWT5 Inspector; POWTS Maintainer; Septage Servicir•,g Operator, Tank inspections must include a visual inspection of the tank(si to identify any missing or broken hardware, identify any cracks ar leaks, measure the volr~mo of combined sludge and scum and to check for any beck up or ponding of effluent on the ground surface. The dispersal cell(s) shall be visually inspected to chock the effluent levels in the observation pipes and to cheek for any ponding of effluent on the ground surface. The ponding of effluent pn the ground surface may indicate a failing condition and requires the imtnediata notification of the local regulatory authority. Wlien the combined accumulation of s;udye and scant in any tank equals one-third (Y3i or mwe of the tank volume, the entire contents of the tank shall be removed by a Septage Servicing Clperatgr and disposed of in accordance with chapter NR 113, Wisconsin Administrative Code. Alt other sHrvices, including but not limited to the servicin8 of effluent 'fitters, mechanical or pressurized components: pretrr~atment units, and any servicing at intervals of 512 months, shall be perforrtted by a certified POWTS Maintainer. R service report shall be provided to the {oval regulatory authority within 10 days of completion of any service event. A~~p Qr START UP ANQ OPERATION " For new construction. prior to use of the POW7S check treatment rankle) for the presence of painting products or other cherraicals that may impede the treatment process and/or damage the dispersal cell(si, if high concentrations ate detected have Che contents of the tankisl removed by a saptage servicing operator prior to uses. System start up sha#1 not occur when sail conditions are i`rozen at the•infiltt'atlve-surface: - During power outages pump tanks may fill above normal hfphvvater levels. When power is restored the access wastewater wiN tae discharged to the dispersal celftsl in one large dose, overloading the celltsi and may result in the backup or surf act' discharge of effluent. To avoid this situation have the contents Qf the pump tank retnaved by a Septage Servicing Operator pear to restor;rg power to the effluent pump or contact a Plumber oI Pt7WTS Maintainer to assist in cnanuafiy operating the pump contrcls to restore normal levels within the pump tank. C}o not drive or park vehicles over tanks and dispersal Cells. Do not drive or park over, or otherwise disturb ar compact, the area within t 5 feet down slaps of any mound or at-grade soil absorption -area. Reduction or elimination of the following from the wastewater etr0am may improve the performance and prolong the fife of the POWTS: antibiaties; iaaby wipes; cigarette butts; condoms; cottpn swabs; degreasers; dental floss; diapers; disinfertanis; fat: foundation drain (sumo ~`pumpi water; fruit and vegetable peelings; grssoiine; grease; herbicides; meat scraps; medications; ni#; painting products; pas*,icides; sanitary napkins; tampons; and wAtAr softener brine. ABANDONM1EiVT When the POWTS `ails and/or is permanently taken out of service the fallowing steps shall be taken to insure that the system a properly and safely abandoned in compliance with chapter Caml'n 83.33, Wisconsin Administrative Coda' • A!i pipsng to tanks and pits small be disconnected and the abandoned pipe openings sealed. • The contents of elf tanks and pits shad be rerr-overi and properly rlisposed of by a Septage 5erviciner Operator. • After pumping, aft tanks and pits shaft be excavated and removed or their covers removed and the void space filled w;th soil, ~ravef or another inert solid material. CONT4NQENCY PLAN ff the POWTS fails and cannot be repaired the fallowing measures have been, or must ba taken, to provide a code compliant replacement system: A rsuitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system. The replacement area should b® protected from disturbance and compaction and should not be infringed upon by required setbacks from existing and proposed'structure, lot lines and wails. Faffurs to protect the replacement area wilt result In the need for a new sAff and site evafuatlon to +sstabNsh 8 suitable replacement area, Replacement systems must comply with the rules in effect at that t1me. D k suitable replacement area is not available due to setback andtor sell limitations. Barring advances in POYVTS technology a holding tank may be installed as a 1$et resort to replace the failed FOWTS. \~Q The site as not en evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluetivn be performed to locate a suitable replacement area. It no replacement area is available a holding tank may b fella s a last resort to replace the faked POWTS. D Mound end at-grade sot{ absorption systems tray ke rsconetructed in place following removal of the biomat at the infiltrative surface. Recanstructians of such systems must comply with the rues in effect et that time. < <wARNiNO> > > SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CQN7AIN L~THAI GASSES AND/OR INSUFFICIENT OXYt3EN. DO NOT ENTER A SEPTIC. PUMP OR OTHER TREATMENT TANK UNpI~R ANY CIRCElMSTANCES. pEATH MAY RESItIT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DtRFICUp.T OR tMPQ8l61SLE. ADDITIONAL COMMENTS POWTS INSTALLER Name ' \` iA S c.~u ~ Phone "7 / S -- .~ $ -.,~ / c~. s/ Ptl!Vil'll'9 MAINTAINER Name Phone SEPTAGE SBRVICINC3 OPERATOR (PUMPER) LOCAL R64ULATORY AUTHORITY (yams Name i • ~t K //``stt-n~~'`t' ~~~af Prone lah4ner ~ ~• ~o• `t'6~ Th+s document was dratted in crmP!'ance with chapter Comm $3,a~(2ilbllt }ldf,iklfi end 83 54{t 1, i21 & f3). Wisconsin Admirnstrativs Cods. a~~ ,~~r LYJbb a I: 5L 7158625 ~9 GLEN JCiHNSQN ~~ .r..rw..r'Inc:r~ f-~.w~~~w~ two IYU. ./l:lJtsDJle.i ""~, ~~ Jt . ~riti0 i.i1- C~ V Lt A i SEPTiG TA~I~ Ml~~'EN,A-NCL AOgEEMENT ANA 01'~NgRSNit' t^~R'Z'1RICATiON FORM Mailing Adt~ Propaty AdciresA (vtxitfcatian PAGE 8Z City/State ~~ ~~• _- Parcel [denti.ficadvn Ntunber 0~,:~~.~,~.. ~~ ~ z 3 Propttty Lacatio~,,,~,'/~ , ~'~• , Seo, '~_~'~ ,~,N ~.,._W, Town of -,~,_ ~'~ Subdivision ~hfl Lot # ~. Vbltuxte ~ , ,~.. ,Page # - - - Ccrtiilcd S>atn+cy Map ~ _~,.... -.. Watmuory Dead # ~ 3 ~ ~ ~g' .___~._-_,a V olumo Page # Spec [sottte ~ Lot )fines idaat~lieblt: yot ao ~1l9"C~ MAINTRIVJ~i~~ ~V~~~~RT~~f'A'TI impt'opor usa and maiaoofnxncs of your t~.+dt: ^yxt~em oaul~d ntu[S In lts prtmatura ~f[mo to b rvrutae. Props »tenaaoe ootutats of ptun}rlag ovt the ttepdc tanJc t;vasy ti~rco y~ or aoonvt, if , by tt Nt~mod. pumper, What ~ro+s p~ imo t}k sy~socrr, cats atfict tbuo fun~iva 4f the septic tanlt tai a ueatme>st ~gc to the wash diepostl :yltCta. Chmet lAiiuteaanet retp~bilitist ara speei~ed {a ~Coamt. Sz.S2([) xn,'! in Cttepter [ 1 • St. G~vix Ctyuaty Sutittxy Ocdlnar~co, 't'Ae prvrp~erty Vwnmr s~t~p io submit to St, Croix County Ptsanit~ & R(~tlttlg Aapattrtsettt • ~:erdfloatian fbrrn, si~nnt by the vwaar sad by ~- tr+n^ter phambet. ~otunoycrat7~ plumtror, i~e^trietod plue~ar or ~ tloot-^ed pumper v+rtt'ying tl~li (l) lfse srn-stia watoawaLCr diapWaa2 :ystc7n fa irf proper operating ohr-ditiua and/or (2) ~' ia^F+ectit+u sad pua~pt~sg (ttttocostacyj, the aeptfc tarslc-ts lea than 1/3 ful3 of a[udgc, !/wC, sbe undcr^{ge~d have read tkbo ab~c requir+orracats and e~zee tc maiatnin the p2ivate revVxga d,{agosa! sytTem with the a4~arda ~t lonh,lSlS~Os13, az :a by tba Depazaawtt of Carm~xce arsd sba Depuamrat of Natluul Rawurcos, 9tata of Wu Cc~tiaa :dtisyg tbat y~oux septic tryseem bas boon meintairud mutt be cortsplated Rod rctnrsted to t~ 5t t~atx f.'ovstry Plamnfitla dt Zoning Departtrtortt wit3sin 30 daYr of tlso theem year expisttdcin Bata. ilwc~ certify that sll itatmaoa>% nn the form are ttuc to the brnct of sny/ate 1mo`s+led$e. 4'`~ ~atn tSe owr~er(a) of *he~ ptvperry deacribod above, by virtue of s wnrratiry cktd rt:t;otdtd in Raglatoc of Dntxyc ©Pffee, Number of bedroomis ~.._,_._ ..,~.. It3NATUR~ 0~` APPLICt1~M(S) SATE ••*Any tnfaruantlon that fa tszi.Yttrprestx~tod trey vault 1n the einitsry ptnttit being revoked by the Pfatming dC Y.quing Dtpafir+eat. "' lus:lude with thin syyticativn a tovotdod aa~rtnty deed fram the K~ister of t>~ OfSce tad a copy of the ccrtiSed surt'cy map i# tefarar~ u mods is the wtrr~'y deed. <;: 635 1 98 State Bar of Wisconsin Form 1-2003 WARRANTY DEED Document Number ~ Document Name THIS DEED, made between WEST LAKE BUILDERS INC. a Wisconsin corporation ("Grantor," whether one or more), and Steven J. Mechelke and Kelly M. Mechelke, husband and wife ("Grantee," whether one or more). Grantor, for a valuable consideration, conveys to Grantee the following described real estate, together with the rents, profits, fixtures and other appurtenant interests, in St. Croix County, State of Wisconsin ("Property") (if more space is needed, please attach addendum): Lot ,Block 5, Plat of The Glen in the Town of Hudson, St. Croix County, W ISCOr1Si KATHLEEN H. iIALSH REGISTER OF DEEDS ST. CROIX CO., NI RECEIVED FOR RECORD @9/25/2006 10:10AJY WARRANTY DEED EXE1tPT # REC FEE; 11.00 TRANS FEE: 377.70 COPY FEE: CC FEE: PAGES: 1 Recording Area Name and Return Address Rivu Valley Abstract ~ Tirlc, Inc. 1200 Hosford Street, Suite 201 Hudson, WI 54016 File q:2691293 020-1416-40-000 Parcel Identification Numbu (PiN) This is not homestead property. (is) (is not) Grantor warrants that the title to the Property is good, indefeasible in fee simple and free and clear of encumbrances except: Easements, restrictions and rights-of--way of record, if any. Dated ~(. /~ ~L~/17 ~L`~. ~°~ ~r/U, ---r INC., a Wisconsin Corporation * * l~ichard Grekoff, President y ~ (SEAL) (SEAL) s * AUTHENTICATION ACKNOWLEDGMENT Signature(s) authenticated op, STATE OF WISCONSIN * TITLE: MEMBER STATE BAR OF WISCONSIN (If not, authorized by Wis. Stat. § 706.06) THIS INSTRUMENT DRAFTED BY: STATE OF WISCONSIN ) ss. St. Croix COUNTY ) Personally came before me on the above-nRichard Grt West Lake t~ knoy~(i to be i trume and acl' s) who executed the foregoing the same. * ~I rl~l Attorney Doug Berg tary Public, State of Wisconsin J 3 /~ U 1200 Hosford Street Suite 201 Hudson WI 54016 / y Commission (is permanent) (expires: "? ) (Siguatura may lx autbeaHnted or acknowledged. Both Are not necessary.) NOTE: THIS IS A STANDARD FORM. ANY MODIFICATIONS TO THIS FORM SHOULD BE CLEARLY IDENTIFIED. WARRANTY DEED ®2003 STATE BAR OF WISCONSIN FORM NO. 1-2003 • Type name below signatures. tofl wNn sf:cTlaf R ~ THE GLEN " ~~ OUIID locoed n N4 NotlASOSI aorta of tM NorN"ost aertr, In qN NorMwN quota of tM NoMwN Ouerta, n 0w ~ ~i C PIPE FOUND Soulh4gt Ouata OT tM florih~t Water, ti 1fro SoYdnNil aefta M BN Natlwast aerla. N fhe NatAgtt aofla of p~An r tn. Soua~"4at quota. in tAe NorMwat aorta N Me swen.o.T Mquga.ta, to s» seuu~.osl aorta of tA. souM.~st o aaRaeM w the Sou0~"at data of 1M Southeori Ouerla.~ 19 ihst~TNOwn~el'W~ids~on~, st«ttr~~Gou~rity r ~~~n t b' NOIlt10 57EEL PIPE to VahHne 12, pogt 3302 aN in section 20, To.e ?9 Nor1A, R SIBS. PER FOOT, SET OT MW OUAA7 CD NG r € F"oo'r1",'DSE~ ~~~ ORAI1NiC OA&: OCTOBER f4M A0.CONOEp DATA ~ ~ F ~ NEVtsED: OEceMBF7t 67M, - ~Na }~!{ 0 50 100 ~TOTMD.~S~NAVD 29) i ¢ ~ ~ _ :17s• EAST qF ~ out amvE. SEE SHEET 4 ~~R~ stole t' . 50' 7e.4o 39 47687 AF. / SYO6~7 sF. t1.os5 AO.~/ // ~ \\ •' \ ,',~ \ ~/,//i/ {1.ifi3 A.C.) / ~'~ ~ \ 7 ~'~. ~ ~ / /,~,~ \ ` ` 461/7 S.i. -0~~~ /' / ,~ \ / / , t~ ~ f \ C\ / / 47703 SF. /' ~ 37 ~ n ~., i~ /' (Loss Ac.) / / ~ ,~ / 4az4o sF. / ,~ ~ ~., ' i' ,oo/ ~ (1.107 AC.) / ~ •, \`, .p / / per ,~ ,~ \ `7 \`. /~ i ~ ~'~~, ~',' BLOCK 5 .',~~ ~ `~ ~'~~'~~ \-~~ a`~/ ~~• / ~, / .\ \~ ~ r ~ ~'• ~ / AFT -~ - ,' / ~ , ~ .•. ,- , \ ay. x , \ / , 1.me Acj ,/ 1 \ ~. \ d+~ / •. ~ \ ~, ~'• ,L \ ~`\ •. \ ~. / ~ \\ ~ G ' I I ` 4 33 / / . ----------- 3EVA110NS ~'(~~ // / 1/ ~ ~ _ .. ~' ~I 1 '~ `~' `• sx \ ~'`6 /~ -'/~==;DNASUCE AND / ~ Sal t 1 ~ 30 'si ( \ 'x? \ / / uTa1n EASEMENT / / I I s35cs sF.n'I ) \\ ~" / / / / n {1.o4s Ac.) ~I I F /Nom/// /)/ / ~I 1 I 1 ~' \\• / 32 / / ;, , BLOCK 4 , ~ .\~ y 45915 S.F. / / $I I fl0 OIIELLINO 1 1 \\ PIP _. % (1.os. Ac.) i / 31 I I BELFUa BsEr.Ews.o~s I Soso I I j 1 29 \~ / // 54936 $-F. I 1 ~ o,`t i I 50370 S.F. ~ ~ vEIE ~na+s / / (1.zs1 Ac.) I 1 ses~sa'1y'E ~ 1 ( {1.+Sa Ac.) ea.ow es4.o o~ / I I r ~ _ ~7~? _ ~' 1 I 3 / / I I q'~') PONDMIO CASEMENT -_- / 1 1 ~/ / 6flsr 1 I ~~i eo.sr201.z7~\~ Bs.6r 1 I ~/ / ~^ ~ ~ . N89'54'15"W 270.16' _ b/ ~ M 't A. !/ // ~~ f} (N893Y'S9'W 2$0.00•) t 73,. `' 7~ ~ __ MEmS_ ~ ~-vl 2~ L / // ~6 ( - ELEVATION ~ 863.69 II _ 5~~ ~' .."~ °a // / ~~ ~ i ~-T TOPS-1_, ~ ~~ ~~ ~' I'I ELEVATON .867.99 / gn j / ~S~' ~ i ;/ gv I ( ~~ ~ 28 I g ssso7 sF. / -~ I- rOP s EL wP~E ----. / /// ~~ I 0 y~ I ~ No Dr,EUiNC ~ ElEVAAON - 873.19 ~ [~ O 1 ~ fLOdt CtEVAl10N$ •. / 168, •" 1 tIELOYf 871.0 '16'33"W 533.93' 3rG~~ , W Na3Y11Yw 552.16') "~I TOP SPpE---- ... I ''~ Nsss9^1s'w xo.sr ~ sw 2 (14~ AscF.)