HomeMy WebLinkAbout020-1418-60-000Parcel #: 020-1418-60-000 osi27i2oo7 09:20 AM
PAGE 1 OF 1
Alt. Parcel #: 20.29.19.2654 020 -TOWN OF HUDSON
Current X ST. CROIX COUNTY, WISCONSIN
Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type
00 0
Tax Address: Owner(s): O =Current Owner, C =Current Co-Owner
O -MUTSCHLER, JEFFREY J &KELLI N
JEFFREY J & KELLI N MUTSCHLER
472 WREN LN
HUDSON WI 54016
Districts: SC =School SP =Special Property Address(es): ' =Primary
Type Dist # Description * 472 WREN LN
SC 2611 HUDSON
SP 1700 WITC
Legal Description: Acres: 1.010 Plat: 1983-GLEN, THE 02
SEC 20 T29N R19W SW NE LOT 60 BLK 6 THE Block/Condo Bldg: 6 LOT 60
GLEN
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
20-29N-19W SW NE
Notes: Parcel History:
Date Doc # Vol/Page Type
07/05/2007 855007 WD
08/03/2005 802135 2856/331 WD
12/21 /2001 666080 1797/613 W D
2007 SUMMARY Bill #: Fair Market Value: Assessed with:
0
Valuations: Last Changed: 06/05/2007
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 1.010 94,300 0 94,300 NO 05
Totals for 2007:
General Property 1.010 94,300 0 94,300
Woodland 0.000 0 0
Totals for 2006:
General Property 1.010 76,400 0 76,400
Woodland 0.000 0 0
Lottery Credit: Claim Count: 0 Certification Date: Batch #:
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM
Safety and Building Division
INSPECTION REPORT
GENERAL INFORMATION (ATTACH TO PERMIT)
Personal information you provide may be used for secondary purposes (Privacy Law, s.15.04 (1)(m)].
ermit Holder's Name: City Village X Township
glen Johnson Construction Hudson, Town of ~
ST M Elev: Insp. BM Elev: BM Description/ - /~
S V 8 ~ ~X~cl • ~ L • ~or
'ANK FORMATION ELEV TION DATA
TYPE MANUFACTURER CAPACITY
Septic / / /
, , l
Dosing ~ I ~ ~
` S,L~
Aeration ~
Holding
TANK SETBACK INFORMATION
TANK TO P/L WELL BLDG. Ve~Air Intake ROAD
Septic ~
0 ~ d~l
IN /
~' 7
Dosing / /Z
Aeration
Holding
PUMP/SIPHON INFORMATION
Manufacturer
Model Number
ction Loss
Forcemain
to
Demand
GPM
Ft
Cotlnty: I
St. Croix
Sanitary Permit No:
506228 0
State Plan ID No:
Parcel Tax No:
020-1418-60-000
cti ap No:
20.29.19.2654
STATION BS HI FS ELEV.
Benchmark
2.
/D ,
~'• t/ i
Alt. BM
,
Bldg. wer '_~
Ht Inlet
3
9~i•
Ht Outlet ~
,5-. ~• c
~
s
Dt Inlet
~ `
r
Dt Bottom
~ i
Header an. ~• q.
t ~ I n
d
Dist. Pipe S ( 6 1. om, [1 D
'
a
7
Bot. System
r--- ~ ~ -1 „
3
bl S
Fina~ I Grade ~ ~~ 0~ )7G 2. 3 C'~~ T
<
St Cow / .3 • ~o ~'
.~
ris
1 Ih ~~
rnid _ syr ~' r o
r
cnn ADCl1DDTilIAI CVCTGM ~ ~J 1 ') ~ tI/ .._~ Li.1 .e
BEDITRENCH Width Length o. Of Trenches ^ PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth
DIMENSIONS ~
~ ~v~ 1'
V /- ~
SETBACK SYSTEM TO P/L BLD WELL LAKE/STREAM LEACHING Man: /7-) j ~ r
CHAMBER /T}~ /j~E
INFORMATION Type f System: ~~ -/ /
(~ ~ ~~ 1 ~~ ~ '` Model Number:
/
r11CTDID11T1llAl CVCTGM
J
vead anifold _ Distribution .~ x Hole ize x Hole Spacing r In ake ¢ ~"
to A
i
nt
V
e
!' i/ //
~' Pipe(s) ~- ~ ~~
acin
S
h Di ~~ ~- ~~
//
/
~
7~~
vY~ JC~
/ Dia
Length g
p
a
Lengt
[+/'111 !1A\/CD
.-. ___ _ r.._._.__. ~_~-. .... 1111.......1 !l. A•!_r~Mn t•i~Tnmc 1lYll\/
vv~r v~~..
Depth Over ~ ~~ •~.a.i... .. ..)...~...~ ~...)
Depth Over ______.___
xx Depth of
xx Seeded/Sodded
xx Mulched
Bed/Trench Center ~ S
7 Bed/Trench Edges ~ Topsoil ~~. Yes ' ', No
` i Yes '-+ No
COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1:_~/cam /U / Inspection #2: / /
Location: 472 Wren Lane Hudson, WI 54016 (SW 1/4 NE 1/4 20 T29N R19W) The Glen of 60 ~ Parcel No: 20.29.1 2654
~/f~-p~ p ~.Qq... ~R.cQ/t~ ,~" v it ~l~t ;~ ~S
1.) Alt BM Description = ~ "/ ~ ~~'~" ~ ~ ~~ ~ ~ ~~A
2.) Bldg sewer length = ~ /~ ~ /t~N/~~~ `"'''7~ ~ r ~ ~-"'~
-amount of cover = ~ ' g t ~ ~ ~~ ~ 2 ~ ~~V K y~~,l ~-~e~~j ~ejC
iJ ~ ~ i
w
i
Plan revision Required? ' Yes No ~ ~~ GZ _ /f~ ~ I ~~ i
Use other side for additional information. ~yyl.~ ~~~,~~ ~ "~~/,~
SBD-6710 (R.3/97) Date ~ Inse ct~ Signat re ~/~~~%~l~/ ~~T"~ Ce . No ~
RECE-v~-,
_~
~ ~
`
Safety d B 'Idings Division
201 W. Was ingto~, 0 -7162
0
0
ounty
S / _ G~~
rS
CO/tSlfl Madi on, WI 537
7i 6
06 Sanitary Permit Number (to be filled in by CoJ
De artment of Commerce (6086- sl
~ ~D(o ~- ~
Sanitary Permit App Brace P,anLD. Number
In accord with Comm 83.21, Wis. Adm. Code, personal information you provide
may be used for secondary purposes Privacy Project Address (if different than mailing address)
I. Application Information -Please Print All Information ,_µ..
~~Z ~ Q~ ~~~
Property Owner's Name Parcel # Lot # Block #
Property Owner's Mailing Address Property cation
.~/ '/
~~'/
~~
City, State $ip Code Phone Number .,
., Section
~G~~S`O'~ e~
.3 Q 'G
/~"381-~~~Y ~`,,"~
T~N
R~E
e
II. Type of Building (check all that apply)
~ „ sL , ,
o
V
~
~v
1 or 2 Family Dwelling -Number of Bedrooms ~ / Subdivision Name CSM Number
~~/ -
^ Public/Commercial -Describe Use ~ ~e l
"~ -lJ
^ State Owned -Describe Use )
^City_^Village~Township of J/y
III. T ype of Permit: (Check only one box on line A. Complete line B if applicable) OZ D ~ - (~D - t?Ua 26S
A' New System ^ Replacement System ^ TreatmenUHolding Tank Replacement Only ^ Other Modification to Existing System
B• ^ Permit Renewal ^ Permit Revision ^ Change of ^ Permit Transfer to New List Previous Permit Number and Date Issued
Before Expiration Plumber Owner
IV. T e of POWTS S stem: Check all that a I
Non -Pressurized In-Ground ^ Mound ? 24 in. of suitable soil ^ Mound < 24 in. of suitable soil ^ At-Grade ^ Single Pass Sand Filter ^
Constnrcted Wetland ^ Pressurized In-Ground ^ Holding Tank ^ Peat Filter ^ Aerobic Treatment Unit ^ Recirculating Sand Filter ^
Recirculating Synthetic Media Filter Leaching Ch ber ^ Dr'p Line ^ vel-less Pi ^ Other (explai
V. ))is ersallTreatmentArca Information: S ~ S 4r'r.Qrr gl 8
Design Flow (gpd) Design Soil Application Rate( sfj Dispersai Area Required (sf) Dispersal Area Propo rem Elevation ~
VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic
Gallons Gallons of Units Concrete Constructed Glass
Now Existing
Tanks Tanks
Septic or Holding Tank /~~d
l , ee ~ ~
Aerobic Treatment Unit
Dosing Chamber {7'4 ~ s,
VII. Responsibility Statement- I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans.
Plumber's Name (Print) Plumber's Signature RS Number Business Phone Number
-'llr•~r ~oL`rr~r~ ~ 2 ~ ~ 9 ~ 7~s- 3 mac- ~~~
Plumber's Address (Street, City,
St
at
e, Zip Code)
,
~
y
,~ / J /'
G S d G~/ ~°f G-~l D.~ frJ l J~YDr~ Cp
VIII. un /De artment Use Onl
pproved ^ Disapproved Sanitary Permit Fee includes Groundwater
Surcharge Fce) ~ L / Jh~
~ Dat Issu
~ r 5" wing Agen ign/atfure ps)
^ Owner Given Reason for Denial
0 V ~ n ~ "~~~. ///t
r/`C~e
IX. Conditions of Approval/Reasons for Disapproval ~~E^~~~' /~~~'f~ J
FZ~ ""' "" "
~
SYSTEM OWNER D, L
1 Septic tank, effluent filter and
i~- P"
%
- ' ~ r7T
dispersal cell must all be serviced /maintained [iJJ
Pd
v~
~
~~~~~
v
--
as per management plan provided by plumber. -'"
G
2. All setback requirements must be maintained
,
fy
as per applicable code/ordinances. 7 Q.n, ~.-
Attach complete plans (to the County only) for the system on paper not less than al rl x l Pinches in size
~~
t3 3 ~
./"~
~o .
SBD-6398 (R. 01/03)
~ ~/~ Q ~ ~d ~ ~ ~~ ~ ~ ~ ,l! J / f~ O ~~y (/ ~~"` ~ ~~~n/ ~ 11,6// ~ ~l"- J6'~1.~~~~lJ'
r
~ ~ ` ~ ,. ~?yi 2 ~ f?9 iii 9f ? -S
bfl~~~
~~,,,.~
vii w; ~; ~
~~ ,~ ,~ ,
~~
_~
~~
9~,
1127
Wisconsin Department of Commerce SOIL EVALUATION REPORT page 1 of 3
Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Cade Steel Sal Service
County
Attach complete site plan on paper not less than 8%: x 11 inches in s¢e. Plan must St. Croix
include, but not limited to. vertical and horizontal reference point (BM), direction and
percent slope, scale or dimensions, north arrow, and location and distance to nearest mad. Parcel I.D.
pending
Please print ail information. Revi y Qate
Personal information you provide may be used for ~".~P"rivacy"C~v; s"tTa.lid~(~ (r~))_ ~ 6
Property Owner vProperty~ Location
Sienna Corporation Govt. Lot; SW 1/4 NE 1/4 S 20 T 29 N R 19 W
Property Owner's AAailing Address v ~~ ~ v ~~ :' l .tit # Block # Subd. Name or CSM#
4940 Vilking Dr. Suite 608 60 ~ na The Glen
~.T S
City ~~~ it U State Zip Code Phony NS}mber J Clty Village Tam Nearest Road
f MN 55435 - "'°~"`~ Hudson Dorwin Rd.
/? New Construction Use: iii Residential /Number of bedrooms 4 Code derived design flow rate 600 GPD
Replacement Public or commercial -Describe:
Parent material Pitted outWash Flood plain elevation, if applicable na
General comments
and recommendations: System elevation 95.95ft, trenches spaced and depth to cod e 3.50ft below grade
u~~~ s-~~ ~ 8 ~ ~ cam. ~~.~ ~ s .~ .mot,. ~
Boring # _ Boring
/
96
' Pit Ground Surface elev. 99.45 ft. Depth to limiting factor
in• Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ftZ
*Eff#1 'Eff#2
1 0-12 10yr3/3 none sil 2msbk mfr cs 2f .5 .8
2 1 22 Z 10yr4/4 none Is osg mvfr cs na .7 1.2
3 22-96 7.5yr4/6 none ms osg ml na na~ 12
Boring # Boring ~S
tiI' Pit Ground Surtace elev. 99.45 ft. Depth to limiting factor 96 in. Sof Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2
'Eff#1 *Eff#2
1 0-16 10yr3/3 none sil 2msbk mfr cs 1f .5 .8
2 16-36 10yr4/4 none Is osg mvfr cs na .7 1.2
3 <36-9 7.5yr4/6 none ms osg ml na na ~ 1.2
Z y., ~~ ~`'~-~~' coo-.~" ~ /f- ~ ~ (8 " ~/-) ~° ~ `~/~as
s;~o u
Y/ ~~ ~~~~ ~ ~L ~/
/~
~ ! /p ~~
errweni e: r = esvu ~ su < <zu mgi~ ana r ~s >su < ~ Su mgiL "Effluent iF2 = BODS < 30 mg/L and TSS < 3p mg/L
CST Name (Please Print) Signature: CST Number
David J. Steel 248956
Address Steel Soil Service Date Evaluation Conducted Tele'hone Number
1564 CR GG, New Richmond, WI 54017 9/13/2002 715-246-5085
,~
Property owner Sienna Corporetaon Parcel ID # pending
Boring # Boring
97
65
th to limitin
factor
De
ft
/; Pit Gro .
und Surface elev. g
p
.
Horizon Depth Dominant Color Redox Description Texture Structure Cons~tence
1 0-15 10yr3/3 none sil 2msbk mfr
2 15-37 10yr4/4 none sl osg mfr
3 7-96 7.5yr4/4 none fs osg ml
g ~,
~
,
Y
~
~
(o/9~h
Boring # -[ Boring - - ... .. ... _ .
Page 2 of 3
96 in. Sod Application Rate
undary Roots GPDfftz
"Eff#1 `Etf#2
gw 1 f .5 .8
gw na .5 .9
na na ~ 1.2
'Effluent #1 = BOD ~ 30 < 220 mg/L and TSS >30 < 150 mglL 'Effluent #2 = BODS < 30 mg/L and TSS < 30 mg/L
The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or
Borino # _ Boring _ _
Page 3 of 3
STEEL'S SOIL SERVICE
David J. Steel
CST-POWTSM
Lic. # 248956
Sienna Corporation
SWI/4,NE1/4,S 20,T24,R19W
Town of Hudson, St. Croix Co.
The Glen lot 60
1564 Cty Rd GG
New Richmond, WI 54017
(715) 246-6200
(715} 246-5085
This soil. evaluation was conducted to satisfy a zoilirig 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.. Legend
1" = 40'
~ =Benchmark-El. 100AOFt
Top of '/2"pvc pipe
• =Alt Benchmark 1.99.75Ft
Top of'h" pvc pipe ~.~
o =Borings
Boring Elevations N
B1 =99.45Ft
_ t
~f
of
h~'~
r ~
I _ ~~-- -
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4
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STANDARD CHAMBER
Quick4 Standard Chamber
SECTION VIEW
MultiPort End Cap
SIDE VIEW
Top vlEw
FRONT VIEW
~Quick4,Standard Chamber Nominal SpeCifigtions-'
Size(WxlxN} 34'x52'x12'
Effective length 48•
Invert Height g•
r,-
Nami~f Speci17ca1isna
Size(WxCxH) 34`x16'x12"
Invert Height 8' or 1.25'
INFILTRATOR SYSTEMS INC STANDARD LIMITED WARRANTY
WI rM slnctral rwegray a earls aarttMr, ero Gate. wedge and oM« aocess«y mvaiachrdl by ~iarat« l'~s"1. wMn tlsttisd and gl«ded
in a IeachreM a en Bette sopdc system h ax«mrce wUh trt6alor's 6t4vrcltort~t, k warawsi b r,o oritjrvt p+dm« C'Flolda~ ~d dated6e
m-.1«iais am Makm:schp for one veer tom tlro dale sat Me sepac perm a isslrad b the sgitle syslam mtteFdrg nn llt~s: PruNdaa. troriewM
that U a saplb pemdt s ml reytietl by apptceNs ~t are warar4y Period wi t>tgtr upur ato mle ngtl tytlrtWiorr d iM sepan syslan cerrtrrtatces
to etmrcise Its waearUy rtglrs.Fbldar met may tttR:xrr tt wdtg al its Corporate rteerxwrmc r O!1 snyerodc C«rraaar wMttl wear Itsl
Intlird«Se dB1aGi, ttwfaef Wa Sllrlpt). llris teI llrYls ddamirled by trYtel[r b M dtwrBd by ~ Ltrihd
~y «rdudBS MB cad d removal «rY« ttat~ton d a,e tttas.
Nl TttE LaMrEp WANttAN7y AND REAAEDIES aJ Sl1~ARAGRANt{ W ARE DU:LIKaNE. 71•IFpE AtiE ~ Ol7~ER WARRANTES yyffN RESPECT
ro rttE uNrrs, tNCUmxv~ No erw~o wARRANfES of atEft<'IiAHrnetrrv aR FrtNF~ rt>sx n rywrttxn.iw ruRPOSE.
IW This Lmied Warr:yUy spas M wid U any Pal d Ur dnnber system is marutcArred rH :+ryt~m core Nm tUilr.'Wr. Tlo I.irited WhrmrYy UoC,t
ml cen«td to txdderral. wnsdtuerUiet, sPerial «triect dams. ttwraar swat nd M tam tr ParraRiess « t9t+drted dmreAes. inctrtfrg Des d
lraArciion and proms, b6« and naterlak. ovatread coats. «oM« tosses «etgrertsse trasred by ate Hekta «ary Mkt
esct~ld tom tinted warr«Ny coverage are darrcga b tM Uris duo b arctrety war arts tmr, atteretioe, aoddaa, mislce, muse «rteanr,~ a
the Uris; tho (1ntS Mtn9 Stthieded b vetdda kalAe «dher cnrtdtiorc rMYrlr ere ml p«rNMd Ay ate tryctalham ttstlrnorc; laMie b rmiMetr ate
r ~+S a` ~ co~«s sd todh h me t~taimron tarudwez re t~troanted a trtnov«mat«teta teo ore eratem ovnatrg me trAS: tatt,re d
sec system Are b trtproP« sting «tltgap« settg eer~sive water sago, imPmPergrtem dlsposa6 «tnpep« eperdUorr «
any soar aw,M nd ~ ~,. twtat«. rn6 umaed t~ srgtt M vdd U ate Nam. ~ b cargry witlt N d tM ta„ta ad win in Mss t.ttered
Warrady.
Funtter, h m ev«tl shat t,wrator M reeponst>te br sty tae «rtnnge b tro Notch, ate l1Nla, «any Mtd OetM ~MinU tom tctldaUen «ehip•
wUh at ~i~ ~Y Balms a Flotder «any M'vd PaN Fu atkc pried WanaMy b aPp~. are Urns must 6e irclaled fi sd~adarno
reared ~ sw~ aM local ~; a+ont« appicable taws; and hwrattr4 ttslakWOn irdrr,diens.
Hokl~es«raliue d trwrabr has Ure titratorily b dvrtge «enl«td ais LYriaed wamrtly. tb werrady apples b «ry PatY ears Man a,e origf
Tlxr shove rW resetrs rte Starlonl Lhtlie[f Wdrady al«ati M tiM.N«• A in4ad nnd7ar a slags »d ounlsa Mrs daer«tl
neds. Ary purdctsar d lJryls irtaid c«rad tNwator's c«p«ae Fbod<Na1as t, Otl SayhrooR. Conracactrt. Ib« b suir ptadsme, b ~leln e
copy d nta apptrnt>te wanenly. and sh«w carauy read ttra wan«ay Prier b aw pudtarw: a lJris
U.S_ Pnlnnlc• a ~co r~r. c n,~ n... ~ .
. ~ ~ .
Q
.~ MS INC
ElJi7iORRLpll~drOltSifB N1~e11~rSOh~ord"
6 Eiusiness Park Road • P.O. E;ox 768
Old Saybrook, CT 06475
860-577-7000 • FAX 860-577-7001
800-221-4436
Canat~anPatenls:1.329.~J59:2.1x14.564 Olherpeterasperd'irg••o•a+~r.gxr.o.all:.~w:5.iiti.~C~3:5.588.778:5.1~.t344
Inidtrata, Equalizer and StieWincler are registered trademarks of htldtrator Systonls krc. Walrala is a rt>Qslett~tt kaderrtark in Frar>ce. 6tBgrakr rwskrrrc Irr
SEPTIC TANK E PUMP CHAM$~A CRQSa 0£CTI~3N P.ND SPECIFICATIONS
4" CI VENT PIPE 12" MIN. A$0~'~ G~A3~E
25' FROM DOOR, WINDOW OR
FRESH AIR INTAKE
FINISHED GRADE
4" GI RISC ~^
18" IN. 6" MAX.
I N L£ T ~ (~~ /~
/ ~,
WATER TIGHT SEALS
A
APPROVED ~ -~-
'IPE 3'
)NTO SOL I0 '~
TOIL
PUMP OFF ELEV . F'T.
I
4
WEATHERPROOF
JUNCTION BOX
WITH CONDUIT
..
• ~~
~~
~,
GAS- , 'ti
TIGHT ~ ~,
SEAL
r
~ '-
3" APPROVED BE~1~IN4 uNpE~ TANK
SPEG~F~CAT~0~1
SEPTIC / DOSE
TANK MANUFACTURER : ~ iQ,~~c..P~
TANK SIZES: SEPTIC 1~,5 Q GAL.
~`~ .DOSE ~bb~ GAL.
ALARM MANUFACTURER: ...~at~.~S,i"~
. .MODEL NUMBER: 'D i_V
SWITCH TYPE : ~'~-~.._.~::
PUMP MANUFACTURER : ~~
MODEL NUMBER : ` i~ d
SWITCH TYPE: Mn~e~C
REQUIRED DISCHARGE RATE y ~ GPM
APPROVED
MANHOLE COVER
W/ PADLOCK E
WARNING LABEL
4" MIN.
~r ~
VAPPROVED
JOINTS WITH
ALM APPROVED PIPE
ON SOLIDTSOIL
OFF '~~ RISER EXIT
PERMITTED ONLY
IF TANK
MANUFACTURER
HAS APPROVAL
CONCRETE PAD
AMBER DACES PER DAY: ? .
DC1S~ VOLUME INCLUDING ~~~ GAL.
F LOWBAC K
C,AP~C.~T~E~; A = ~ INCHES = EI~_GAL.
B 2 INCHES = 4 ~ GAL.
C = ~ INCHES - ~S GAL.
D = !~ INCHES = ~_GAL.
PUMP ~ AL~A~tM WIRING AS PER ILHR 1b.23' WAC
VERTICAL DIFFERENCE BETWEEN PUMP Q~'I" ANI~ I~ISTRI~UTION PIPE ~~ FEET
+ MINIMUM NETWORK SUPPLY PRESSURE , . ~ ', . 2.5 FEET
+ ~ D FEET FORCEMAIN X ~~bOFT/1QQ ~'~'. ~I~ICTTON FACTOR =FEET
T,QT~~ F'~NAMIC HEAD - FEET
INTERNAL DIMENSIONS OF PUMP TANK: LENGxH ~ ; WIDTH .~-~' DIAMETER
~xQUr~ ~' ~3 ~' " ~ ~~L pe.2 1 °
SIGNED: __ ~~~":~----.;_.,-. LICENSE NUMBDR ~ ~q t7 DATE:
~.
1/$8
•~GOULDS PUMPS
Submersible
Effluent Pump
~~
3871 EP05
APPLICATIONS • Fully submergpfJ !n hf ~h ~ EP451mpeller. Thermop(as- ^ Bearings: Upper and lower
Specifically designed for the 9-a~ turbine III tpr tic enclosed design for heavy duty bail bearing
following uses: lubrication an,~ e~iclent fmptoved performance. construction.
heat transfer
• Effluent systems ~ Casing and Base: Rugged
• Homes
• Farms
• Heavy duty sump
• Water transfer
• Dewatering
SPECIFICATIONS
• Solids handling capability:
'/+" maximum.
• Capadties: up to li0 GPM.
• Total heads:. up to 31 feet.
• Discharge size: l'/:" NPT.
• Mechanical seal: carbon-
rotarylceramic-staponary,
BUNA-N elastomers.
• Temperature:
104°F (40°C) continuous
140°F (b0°C} Intermittent.
• Fasteners: 300 series
stainless steel.
• Capable of running
dry without damage to
components.
Available for aultamatie and
manual operation; ~Au1tp-
maticmodels ittpl~4~e
Mechankal Float ~~~ch
assembled and {reset at ~a
factory.
FEATURE5
^ EP04 Impeller,l'hermoplas,
tic Semi-open design w~h "
pump out vanes for mgchanical
seal protection,
METERS FEfT ..._....:.. ,.,..-,,..-.
10 I
f
9 30
1
zs~ .,..,.....,.:,...., ..._.
.~
s i
5~ ,....:, ,~....
15 :..... ~ .}
4 I ;;
3 ~o ~.~,.....:,.P.,.___ ~~_.
I ..
........ _:.a._...........,~._.
z
s r_~.. , ...~........ t.
r ~...-._.... ~..
0 OQ .,. ...... ..~.'~p.
ernloplast~c design provides AGENCY LISTING
superior strapgth and corros'wn
i~s#ittance,
w Moto,~r HQUSing: Cast iron
1vr ~efff dent heat transfer,
sae~tti, and durability.
Motor Cower: Thermoplastic
cover Wit) i~f~tegral handle and
Heat svritth attachment points.
A Power Viable: Severe duty
rated a~i and water resistarrt.
~• canadian st» Assodatbn
(CSA listed model numbers end
in "F" or "C".)
Goidds Pumps is is0 Soot ~•
Motor:
• EP04 Singgle phase: 0.4 HP,
115 or Z30 V, 50 Hz,1 S50
RPM, built in overload with
automatic reset,
•EP05 Singgle phase: 0.5 HP,
115 V, 60 Hz, 1550 RPM,
bulb in overload with
automatic reset.
• Power cord: l0 foot
standard length,16/3
S1TOW with three prong
grounding plug. Optional 20
foot length,1G13 S11W with
three prong grounding plug
(standard on EP05}.
O 2000 Goulds Pumps
Effective February, 2000
83871
~p 30
.
40 50 GPM
~ ~w
Q 2 4 6 8 10 12 mrlh
CAPACnY
Goulds Pumps
ITT Industries
..-SGPM~_...: _
I ;
~~ _._ . -_
i
C_...-_.._ _._ _.__ _
~~~ can
~-~ (~~n
t~
p1UV
Name on File ~`~'~~ `~
Location L-r~# ~oG - ~~~12;-~
Schumaker Plumbing
1070 Scott Road
Hudson, WI 54016
Phone & Fax 715-386-3121
Checklist for septic permit (St. Croix County)
Soil Test
Copy of Recorded Deed
Septic Tank Maintenance Form
Copy of Blueprint
Check for sewer (Conventional)
Check for sewer (Mound)
Copy of Recorded Survey Map
Or
Subdivision Lot
$400.00
$550.00
Copy of Approx. Location on Lot
Notes:
~ ~~
~ ~~
~ ~S,~t RU1'1 • ~W-11.N' WKCK f'LUI'Its 1 fVU
rI-1n nu. . (1J,5tsbJlGl Sep. ~.t ee~u~ 1r~.JJru~i rt
ST. C:ROl.X CUUNTY
SEPTIC TANK MATNTL'NANCL AC3RE1aMENT
AI~'D
OWNf~RSHfP CERTIFICATIdN FORM
,.
OwnerBuyer , 1~ ~~. 'bh~S~ ~.~.°.,~~~C~hc~ ~'~ L.,
Mailing Address ~ ~X ~~~ ~-}.__ ,... t ~~~ S~ C't ~ ~o_,,, ~~
Property Address
~ 02-
(VeriTication required from Planting & 7aning Depamnent for new ooostruction. j
City/Stag ~uc~S~'1 ~~--i-- Parcel [dantification Numbtr OZO - I `F I g- (~o~ vw (! _2~5`~'
Property Location _~ '/. , ~'/, ,Sec. ~,, T ~N R ~ ~ W, 'town of , t-0~_
_.. _ (~ .._ ~ , I,ot # CDC .
Subdivision ~ I ~1Q ,
Ccrtiited Survey Map # _ _ ~ .~, __--- ,, Volwzte r---„T,~ Page
Warranty Deed # ~~ ~ ~ J , Voltuna ,`J~ .Page # 3 ~ ~
Spec house yt:s no
Lot lines identifiable yes no
SYSTEM M~-yNTENANCE AND Q,yV,~VER CIE~T,~~ATiON
improper use and maintenance of your septic system could result in its prrmaturo falhtre to hanctln wastes. Propel
maintenance consists of pumping out the septic tank every thrtx years or sooner, if needed, by a Hcensed pumper. What you put imo
the system can affect the function of the septic tank as a treatment stage in the waste disposal System Owner maintenance
reaponstbilities are speci~cd in ~Connn. 83.52(1) xnd in Chapter 12 - St. GYvix County Sanitary Ordinance.
'I'hc property uw~wr aprass to submit to St. Croix County I~laanitlg & 7e-rtu~ Aepartrttertt a c~.ertlfioation form, signe~rt by the
owner and by ~- mister plumber. jouravymsu plambc+r, restrictod plumber or s llCOnsed puatper vnrttying that (1) the on-sits
wxtttewatcr disposal systcnz is in proper operating condition and'or (2) aRer insgactiou sad pun'tpiag (if heeossary), the septic task is
leas than 1 /3 full of sludge.
i/wc, the undcrsigacd have read the above rcquircmeats and agree to maintain the private sewage disposal system with the
standards set forth, herein, as set by the Department of Commerce and the Daparmoent of Natural Rvaotucos, State of VlTtacoasia.
CertsSpitioa :rating thst your septic system has been maintained must be cott~leted and returned to the St. CYotx C.'atutty Plsrmina &
Zoning Dcparttzyant within 30 days of the three yoar expirAticm date.
1/we ecrti.fy that all statements ott this fornt are true tv the best of trey/our ltnowledge. L'we am/are the owner(s) of ~e
property described above, by vittu4 of a warranty deed recorded in Register of Dneda Office.
Numb r rooms
SIGMA Ol~ APPI.ICANT(S} ~ ~ nATE
"+Any information that is misreprescntod may result in the sanitary peztnit being revoked by the Planning dcL,oning Department. ""
include with this application a recorded wamittty decd &otn the legister of Uaeds Office and a copy of the certified sur'ey rrmp if
reference is made in tfic warranty deed.
t~v. os~as
Pt~WTS OWN~~"S MANUI~~. & M~INAGEMENT Pi.AN Page ~ of ~'
~Fi INFORMATION ~,~L - (r, ~
Qwner .
Permit ~ ~,6 2 Z ,
ura~it3N PARAMETERS
Number of Bedrooms ~ A Nq
Number of Public Facility Units, iVA
Estimated. fbw leverage} a ids
Design flow (peak}, (Estimated x 1.5} ~~ Q al/da
Solt Applicat~n Rate Q, '7 a-fda /ft
Standard inftuent/Effluent Quality Monthly ava~lspd"
Fats, Oil & tirease IFOG}`, 530 mg/L.
Biochemical Oxygen Demand (BOOB) 5220 mill. p NA
Total Suspended Solids (TSS) x'160 !~A/1-
Pretreated Effluent Quality Monthly~au~repe
Biochemical Oxygen Demand (80Dg) 5.30 mq/l.
Total Suspended Solids (TSS) Sr30 mgEl. ~ NA
Fecal Coliform (geometric means 5104 cf-~/1 Apml
Maximum Effluent Particle Size Ya in di~i. q NA
Other: q ryA
"Values typical for dorneatio wsetawater and septic tank effluQnt. ~
Slf$TF,NI SPECiFICAT10N8
Saptio Tank Capacity ,~ ~J al Q Nq
Sepiic Tank Manufacwrer ~ ~ ~~ O NA
lrtfiluent Filter Manufacturer ~ ' ~ ,~ O Nq
@~#~upnt. F'dier Model ~ ~Q' ~ O NA
Rump Tsnk Capacity- ~j'Cf' of Q NA
Rump Tank Manufacturer reS ~ y, DNA
Pump Manufacturer G~.~ j O NA
Pump Model ~ A
pretreatment Unit
~ &and/Gravel Filter
f~ ~!Ipchanicai Aeration
^ Peat Fllter
^ Wetland
a other: A
Qiaparsal CeU(sI ~
n-Ground {gravity)
A;-Grade
q Qrip-Une -~j O NA
In-Grottfid (pressor e
^ Mound
^ Other:
Oihl+~`` O NA
Qtlisri O NA
~~~ ^ NA
MAINTp-IANCE $CNEOULE
5ervke Event Sewice Frequency
inspect condk'~on of tsnkis) At ieaa4 once every; 3 e~sir s s (Maximum 3 years) O NA
.Pump out contents of tank{s) Where Gairlbined sludge and scum equals one-third iYa) of tank volume ^ NA
Uspeot dispersal cell(s) At lean once ovary; ~ ear ~{s} {Maxtrnum 3 years) ^ NA
Clean effluent filter
Ai 1sa3t Qnce evgry; O monthla}
~(. ~ ~ ear(c}
DNA
Inspect pump, :pump controls & alarm At least Qnce every: month(s)
o earl.) p NA
Flush laterals and pressure test At !atilt once every; month(sl
D earls) ~ NA
other:
At laatl~ once every: O month(s)
--- p earls} O NA I
Other.
O NA
MAINTENANCE INSTRUCTIONS
inspections of Lanka and dispersal cells shall be made py an individuAl cmrrying one of the following licenses or certifications:
Master Plumber; Master Plumber Restricted Sey~ror; ~WTB inspeator; RQWTS Maintainer, Septage Servicing. Operator.- Tank
inspections moat include a visual inspection of-the (ankle} to ideniify any missing or broken hardware, identify any cracks or leaks,
measure the volume of combined sludge and scum' et?d to check for any back up or ponding of effluent on the ground surface.
The disperse! ce[ils} 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 pocxiing of +aff~uerat on the ground surface may Mdicste a failing condition and requires the
immediate notffication of the local regulatory authority:
When the combined accumulation of sludge and slum in any lank equ~-is one-third (Ysl or more of the tank volume, the entire
contents of the tank shalt be removed by a Septage Servicinp OparatQr and disposed of in accordance with chapter NR 113,
Wisconsin Adminiatratiue Code.
Atl other sorvicos, including but not limited to file servia#ng o} offhlen~ filtacs, mechanical or pressurized oomponants, pretreatment
units, and any servicing at intervals of 57 2 months, shall be perfcnred by ti`Certif'ied POWTS Maintainer.
A service-report shalt be provided to the local regulatory authcrity vr+itlhln 1Q (lays of completion of any service event.
Page ~of v
START UP AND OPERATION
For new construction, prior to use of the POWTS aheRk traaxmant flank(s) fpr the presence of painting products w other chemicals
that may impede the treatment process and/or damage thg d~spptlaal oell4si. If high concentrations are detected have. the contents
of the tank(s) removed by a septaQe servicing o(~eretQr prior •to use.
System start up shall not occur when soil conditioRa.sre jroxen at the infiltrative surface.
During power outages pump tanks may fill above t~orrrta~ highYvater levels. When power is restored the excess wastewater will be
discharged to the dispersal celNsl in one large doa~; Overloading the oallta{ and may result in the backup or surface discharge of
effluent. To .avoid this situation have the contents of She pump tank remQV®d by a Septage Servicing Operator prior to restoring
power to the effluent pump' or contact a Plumber or PQWTS Maintainer to assist in manually operating the pump controls to
restore normal evels within the pump tank.
po not drive or park vehicles over tanks and dispersal oafs. Do npt drive tat park over, or otherwise disturb or compact, the area
within 15 feet down slope of any mound or at-grado soil absorption area.
Reduction or elimination of the following from the wastewater stream may_ improve the performance and prolong the life of the
POWTS: antibiotics; baby wipes; cigarette buttsi gUrdAmB; Dorton sv~rap~; degreasers; dental floss; diapers; disinfectants; fat;
foundation drain (sump pump) water; fruit and vegatafa~e p®elings ~as4liee; grease; herbicides; meat scraps;. medications; oil;
painting products; pesticides; sanitary napkins; tarrlpahs; ono water aofteher brine.
ABANDONMENT
When the POWTS Yaila and/or is permanently taken out Qf sarvioe tfia fa111~wing steps shall be taken to insure that the system is
property and safely abandoned in compliance with ohaiC~tef Comm 8.39, 5?lliaconsin Administrative Code:
• All piping. to tanks and pits shall be dis~cani}aa~ad and the apat~doti+td pipe openings sealed.
• The contents of all tanks and pits shall be rpmaveo and properly disposed of by a Septage Servicing Operator.
After pumping, all tanks and pits shalt be expauated ant! 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 thrf foUowin~ rneas4res have been, or.must be taken, to provide a code compliant
replacement system:
A suitable replacement area has been. ava'y„t~ted and may. ba tatilized for the location of a replacement soil. absorption
system. The replacement area should bd pwtec~i~d from di~fUrbenoe and compaction and should not be infringed upon by
requited setbacks from existing and propgslp~ etruatur~e, Iqt `lines and wells. Failure to protect the replacement area will
result"in the need for a new soli and situ eveluatiarl t4 establish I~ suitable replacement area. Replacement systems must
comply with the rules in effect at that tinde•
^ A suitable replacement area is not ava)lable due to setback alndJor soil limitations. Setting advances in POWTS
technology a holding tank may be insta~isd as'a last resort tq rr?place the failed POWTS.
~~ O T .site d site
e tank
^ :Mound and at-grade soil absorption ystQtnB may ~e fetronstructed in place following removal- of the,. biomat at the
infiltrative surface. Reconstructions of suoh gysfems must pomply with the rules in effect at that time.
< <WARNINf3> >
SEPTIC, PUMP AND OTHER TREATMENT TANKZ; [VIAY CONTAIN ~,fiTHQI, BASSES AND/OR INSUFFICIENT OXYGEN. DO NOT
ENTER A SEPTIC,'PUMP OR OTHER TREATMENfi 1`ANK UNp~R AA~Y CrIFiCUMSTANCE8. OEATH MAY RESULT. RESCUE OF A
PERSON FROM THE iNTERIOR'OF A TANK MAY 8~ piFFICUI.~' ~i3 IMPS&~s~•
ADDITIONAL COMMENTS
POWTB `INSTALLER'
Name ~~~`l~~u ~~ ~.~Ql^
Phone 7 l _ ~. _ ~~~
~.1C QL-ff1„AI~,/1 AllBd /~TA~ en, n
aCr1 M\7G ~GIYIV 11117 Vr"Gni~, V~1~11-yMrcn!
Name
Phone
This document was drafted in compliance with chapter Comm $3.27121
P4WTS MAINTAINER.
Name
Phone ~~
~1.1]GAL REGULATORY AUTHORITY
game Si C~i'X. ('~ ~ P~• ~ ~~^~
pnar,e~ 3~ . ~
4b}iii'~di&ifi and 83.54{1i, (2i & (3i, Wisconsin Administrative Code.
03/86/2806 08:10
Document No.
7153862979
GLEN JOFHJSON
STATE 6AR OF WISl~bN~~GFilOf 2P 1l)82 3
WARRANTY DEED
SIENNA CORPORATION, a Minnesota corporator, conveys enq warrants to
GLEN JOHNSON CONSTRUCTION, iNC, s Minnesota eorporetlon, the
following described real estate in St. Croix County, State of Wisconsin.
PAGE 02
+~mH~ x 33
~Bdril~~~X~COp~MZ
RBGEZVBD FDtt Rti:CORO
Oa/43/200g 10:00AI1
MARRY i t~ED
JiCC FSpSgs 11.00
C~OP~YSFBS: s X62.60
pC.AC~ITES: 1
11
NAME dt RETttfRN DDRE3
SCENIC TITLE ANO A9STRACT, INC.
2Z0 LOCtJ3T STttt?B'I', 3'IE. 1
tiIJIJSON, Wif 5~Ot6
PiLB A ~I'ff a`
~~~
Yax Psroel No:. n2o-, a, e-g9.ooo
Lot lock 6. Plat eT The BNn In ehs Town o1 Htxlaon,
St. Croix Country tlVNaonsM
This is not homestead property.
Exceptions to Wartsntles: Easements, reservatbns, and restrtctlons of tscord.
Dated this ' ,~) day of ~Siul~' 8005.
(SEAL) 81E~NN~A~CORF~QORATION. Minnesota corporation
L
(SEAL) Marshs A, Plarce
Arslstant Secretary
AUTHENTICATION
gtgnature(s)
ACKNOWLt:DGMENT
STATE OF MINNE50TA
Hennepin County
aUthantbated is day o 2
}ss.
)
Paroonslly came befb-e ma this $D day of
~Tilw~ .2006, the above named Marsha A.
[.ti:: M BER S AT bAR OF dNSI ~Isroa, the Asslttiant 3ecrstary Of Sienna Corporotbn, a
MMnesota oorporatbn, on behalf of the corporation, to me
(If not, known to be the person who~exaoutad the foregoing
authorl=ed by § TOt9. Wis. .) fns mart end acknowledge asma.
'This Instrument was draRed by: Catnel'ina hem i! , pubik
Sienna Corponagon
4940 Viking t?rNe, Suite 608 Notary Public of Mennapln County, Minnesota.
Edina, MN 55435 My Commission expires January a1, 2010
S~~ry may bA suthaMicated or acht+owledged. ®oth are not o~MAn! ~~
norM+-PtwuO-
1Mow~w~~a>tl.lM
Names of pereons signing In any capacity should bs typed or punted ow r signature.
Visit our website at: www.glenjohasonconstruction.rom
~~y;3
~:
GENERAL CaNTRACTOR
.715-386-2974
The Glen
Hudson Township _ - 1 ~ 54 . 55 ~ ~ ' .
____ ~, ~ p
~ 49 r ~ ~,~ ,:• ~I~
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h~ . ,, 88 - c ,'~ ~~ 80. ~ 60 ~~
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35 - ~~ ~ _ ,. ~ _ ~- _.
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-~----------------. - -- -. _. I~ _ .._.f= 18 s~~
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23 ~ 22 ~
--- ~
P.O. Box 809 Hudson, WI 54016