Loading...
HomeMy WebLinkAbout020-1331-30-000Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Safety and Building Division 'y INSPECTION REPORT GENEF'.AL INFORMATION (ATTACH TO PERMIT) 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 Hoffman, Brett Hudson Townshi CST BM Elev: Insp. BM Elev: BM Description: TANK INFORMATION TYPE MANUFACTURER CAPACITY Septic w e.2 aun ICoS~ Dosing Cie t.t. Aeration Holding TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Septic ~ ~D/ ~ ~ } ~ .___~. Dosing t` tt -. ~8 i Aeration Holding PUMP/SIPHON INFORMATION ELEVATION DATA County: St~ro' Sanitary Perm' °~ 399583 0 ate Plan I No: 3~8R 9 'tF2s~NS. / ~ . Parcel Tax No: 020-1331-30-000 STATION BS HI FS ELEV. Benchmark a ~• V~ ni, p~.L.7 ~' ~r~ Alt. BM , $5 Q~.,~j~ Bldg. Sewer ', q3 3g, SUHt Inlet J St/Ht Outlet Dt Inlet Dt Bottom ~ ~- ~ q S r Header/Man. 1 ~ , 9q.RZ Dist. Pipe $~•m) t ~~•~Z Bot. System s`.4 , 1`l•Iq Final Grade 5~ ~ fir/ St Cover v Ca, ~ ZS ~..- BEDITRENCH DIMENSIONS Width J [~` S Length ~ / No. Of irrneher ~~ ~ ~ S PIT DIMENSIONS No. Pits Inside ia. Liquid Depth SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEAC G ufacturer: INFORMATION CH MB Type Of System: ~ ~~ 1 ` ~~ " a _~- NIT umber: DISTRIBUTION SYSTEM Header/Manifold 'r Distribution ~ 1( x Hole Size J, x Hole Spacing Vent to Air Intake ~/ J/ ~ Z Pies q ( y i g ~ `•0 S t 'V l/ 2 ~_ Length ,7 Dia pac n Length Dia - SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil ^Yes ^ No ®Yes ^ No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / ~ / ~~ Inspection #2: '~7'~7-~ Location: Waldroff Farm Road Hudson, WI 54016 (SW 1/4 NW 1/4 23 T29N R19W) NA of Parcel No: 23.29.19.1737 3 1.) Alt BM Description = e ` a•.~r A U,~r,..,,0 . ~ p 3 2.) Bldg sewer length = 3 ~, a ~'^~ (J~'~ -amount of cover = ~ 4Z M, , t b) A'-l°v EFf FJC-Tim . 3.) Contour = qg •5 $ ~ ~ S `olti~ot:~ a* H!~ _ (~-~ / ''o ~~ ~ar evisio ui~red? ^Yes ^ No _ I ~~ Use other side for additional information. ~ ~ 1~ Date Insepctor's Signature Cert. No. SBD-6710 (R.3/97) SOIL ABSORPTION SYSTEM "~ ~'2-S tt~M-dQ..oFF FA2~ ~. 3 ' ; Sanitary Permit Application Safety & Buildings Division In accord with Comm 83.21, Wis. Adm. Code 201 W. Washington Ave. ~ PO Box 7302 isc i See reverse side for instructions for completing this applicatii~„ ons n Department of Commerce Personal information you provide may be used for secondary purposes [Privacy Law, s. 15.04(1)(m)] Madison, WI 53707-7302 (Submit completed form to county if not state owned.) Attach complete plans (to the county copy only) for the system, on paper not less than 8-1/2 x 11 inches in size. County; ~ . ~t~--cam. State Sanitary Permit Number ^ Check if revision to previous application 3 ag s State lan I. D. Number 3~ g9R I. Application Information -Please Print all Inform ton Location: Property Owner N e ion o cat Property L // ff ~~ 2 .J f~ 1 /4 N ~°Y /4, S 3 T- ~,N, (or) Property Owner's Mailing Address Lot Number Bloc Number o ~~ ~ 3 City, State ' Zip Code Phone Number - - ' Subdivision Name or CSM Number 1~-t~Z .S G7 /~ S YES (7/.5 ) ~ ~ ~ 1~ - ~ II. Type of Building: (check one) ,. ~ ~a , 1 or 2 Famil Dwellin of Bedrooms :~ 0 ~ ~'' ~ ~ ' - No ^ City ^ Village y g . ~ %` own of ~;f ^ Public/Commercial (describe use):_ 1'""'" "" ~C~ 1 ~ ~F~ ^ State-Owned ~`'~+~- ,tM. . ~ ~ ~ _y ~, . Barest Ro a , r ~~~~ " ~ ST ~ umb r - , .. CAOIx J.: azc .,~ ~ ""© III. Ty ' • (Check only one box on line A. Check box , Z j ~ A 1. New D Replacement 3. ^ Replacement of c~F,,'j~, - 6. Addition to ~° '~a ` `~ \ System System Tank Only ) -,..".,_.._.-.-' Existing System B) Permit Number ~ ~ ;, Date Issued D A Sanitary Permit was previously issued IV. Type of POWT System: (Check all that apply) ^ Non-pressurized In-ground Mound ^ Sand Filter ^ Constructed Wetland ^ Pressurized In-ground o mg Tank ^ Single Pass ^ Drip Line ^ At-grade ^ Aerobic Treatment Unit ^ Recirculating ^ Other: V. Dispersal/Treatment Area Information: ~ ~ ~ 1. Design Flow (gpd) 2. Dispersal Area 3. Dispersal Area 4. Soil Applic tion 5. Percolation Rate 6. System Elevation 7. Final Grade ~~D Required ` , Pro d ~ at@ (Gals./day/sq. ft.) D (Min./inch) `- ~ ~ Elevation ~/f ~ S • , ~ ~, VII. Tank Capacity in Total # of Manufacturer Prefab Site Steel Fiber- Plastic Information Gallons Gallons Tanks . Con- Con- glass New Existing Crete strutted Tanks Tanks (.~ i ~ y- // ~SU ~-. ~j.J~~ ~~ ~ ^ ^ ^ ^ VIII. Responsibility Statement I, the undersigned, assume responsibility for installation of the POWTS show on the attached plans. Plumber's Name (print) Plum Signa re (no stamp PRS No. Business Phone Number Plumb/Br's Address (St~ree/t, City, /State, ZipCod~) „ ~(~ !v' / ! -.,~'~~s'-'e'er ~ / CJ .- (.~-~~ .~ ~J ~ IX. County/Department Use Only Approved ^ Disapproved ^ Owner Given Initial Adverse Sanitary Permit Fee (Includes oundwater Surcharge Fee) ?-~ _ ~ ~ Date Is ued ~ ~ Iss ' Age t Signature (No stamps) Determination ~S ~/p ~ q O~ ~ X. Conditions of A proval /Reasons for Disapproval: o ~ a C ` ~- c~rliy 1 `~ ~ra~r~~~rs c~~d~av~a-r~ -~/ ~ ~.~c~ n4 ~c~e a~ ~ ~Sf"~ ~~ ~'O~ ~5 ~ SBD-6398 (R. 07/00) ,{ ~ w isconsin Department of Commerce Safety and Buildings 4003 N KINNEY COULEE RD LA CROSSE WI 54601-1831 TDD #: (608) 264-8777 www. commerce.state.wi. us Tommy G. Thompson, Governor Brenda J. Blanchard, Secretary September 30, 2000 CUST ID No.267341 ARTHUR L WEGERER WEGERER SOIL TESTING & DESIGN 421 N MAIN ST PO BOX 74 RIVER FALLS WI 54022 ATTN.• POWTS INSPECTOR ZONING OFFICE ST CROIX COUNTY SPIA 1101 CARMICHAEL RD HUDSON WI 54016 RE: CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 09/30/2002 SITE: Site ID: 161427, Richard La Casse St. Croix County, Town of Hudson SW1/4, NW1/4, S23, T29N, R19W Subdivision: Evergreen Estates -lot 13 FOR: Description: Three Bedroom Mound System -Revision Object Type: POWT System Regulated Object ID No.: 428881 Transaction ID No 7899 Site ID No. 161A~"-;-;---. numbers, ', o" .. ~`~~ ?~~~ ~- "~ ~o ;~, ,\ s r c ~ COUNry ~•.~ IONlNG ~ ~ ~ OFF~CF f. ~ ,~ • The submittal described above has been reviewed for conformance with applicable mistrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The approved changes will become an addendum to the plans previously approved. All other portions of the installation shall conform to the original approval. The following conditions shall be met during construction or installation and prior to occupancy or use: • This system is to be constructed and located in accordance with the .enclosed approved plans and with the "Mound Component Manual for Septic Tank Effluent for Private Onsite Wastewater Systems" SBD-10572-P (R.6/99) and the "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems" SBD-10573-P (R.6/99). • In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approved plans. In addition, the owner must insure that the operation, maintenance and monitoring duties as described in section VIII of the mound component manual are complied with. A copy of this information must be given to the owner upon completion of the project. • An effluent filter is required. Maintenance information must be given to the owner of the tank explaining that periodic cleaning of the filter is required. Access to the filter for cleaning must be provided per Comm 84 product approval conditions. • A Sanitary Permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.135 and 145.19, Wis. Stats. • Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stats. A copy of the approved plans, specifications and this letter shall be on-site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of construction/installation/operation. ARTHUR L WEGERER Page 2 9/30/00 Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. Sincerely, Gerard M. Swim POWTS Plan Reviewer -Integrated Services (608)-789-7892, Mon. -Fri. 7:15 AM to 4:00 PM j swim@commerce. state.wi.us DATE RECEIVED 09/19/2000 FEE REQUIRED $ 60.00 FEE RECEIVED $ 60.00 BALANCE DUE $ 0.00 WSMART code: 7633 ~3 TITLE SHEET MOUND SYSTEM FOR A 3 BEDROOr1 RESIDENCE Page ~ of ~ This plan has been prepared in accordance with the Mound Component I4anual SBD-10572-P and the Pressure Distribution Manual SBD-10573-P C 2. ~14q~ Ctz.6L24~ LOCATED IN THE Sw 1 /4 OF THE NW 1 /4 OF SECTION 23 , T. ~ N, R 19 W, TOWiJ OF w~S pY`1 ST. CI?.~l~x COUNTY, WISCONSIN. -.- l`oT .-_t3. OF E V ~Z:G-ZL'-L'J`1 ~~~T'~'S - -- INDEX - PAGE 1 of 7 TITLE SHEET PAGE 2 Of 7 SYSTEPI riAI~TAGEMENT PLAN PAGE 3 of 7 PLOT PLAN PAGE 4 of 7 PLAN VIEW-CROSS SECTION PAGE 5 of 7 DISTRIBUTION PIPE LAYOUT PAGE 6 of 7 PUI~7PING CHAtYBER CROSS SECTION PAGE 7 of 7 PUMP PERFO:RI.IANCE CURVE PREPARED FOR . RECE-V,~D ~.1 cat=~-,n _ L,~ ~.~ss~-- _ ,~ r P 1 g 2 p p0 1_'~ ~-V~S3 E - CV BTU-r~1 ~~~ -- - --1~'rv~s~w; w,- - SvQL6__ B~QGS DIU: PREPARED BY k1EGEE~ER SL7I L .TEST 2 fVG AND . . - DES Z G~V SERVICE P.O. Box 74 421 N.ifain St. River Falls, tdI 54022 Phone 715-425-0165 Fax 715-425-6864 .. ui~y `r~s _nc~-_ Zs ~ - 2~v t S t0 ~ or -~~v c ~t~ -- - C~Mt,~E4tCE PAR~MfNj OF t) 1LDtNOS. ET pt~tglON Of ENGE JOB N0. GG RESP SEE 00-2~3 q- ~ 6-ou PLOT PLAN Scale 1 "= SO ' •.~,_., ~ w'P~.OR~~ Ff^~.wt \Z-A ~~..~~ 2a,ara ~3~-07' S V C~C,E,~"i~ x ~1L L:.O C~)p)v Page 3 of ~ 3 BDR,~^-~ ~M~ . ~ ~,`~b~ o C ~I YP U C ~S~ ~~ Z~~DV C F,t~t_ 0 7 o W OT COH1n~tr d1Z O ~S'tiRl3 ~q~ 6i Y11~t S R~t~ _ a.3 !h ~' cn~ ~~ z ~-- _ _ - N ~lV~ ` ~ t'1.g8s ~ ~ ~~~ __ q8s ~N r r r~ '«!~ N • ~ -!Zo j ez.Qg 6 n ~'~°"vZ ~ q8 S' 'flvti~ of e 1~~: ~~~~9. o' NOTES : ~ z.~~t. z.3• 1. Elevations shown are existing ground elevations unless otherwise noted. 2. Install 4" observation pipes with approved caps. ( Z required). 3. Septic tank to be tooo lbso gallon capacity manufactured by ~'L ~O hJ ~~Jy 1~\ ti'r.~. ~ , ! ~vr w `Z1~13~L. ~~F'r~U~uT ~ LT~l2 4 . $ench mark ~ ~L~i . l00.O~ ~N 1 `~ ~ Roti l~f P~ L.o'r' CO~~h1~z ~. Divert surface water around system to prevent ponding at the uphill side. Mound System Management Plan Page ~- of Pursuant to Comm 83.54, Wis. Adm. Code Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Stats. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code. The operating condition of the septic tank and outlet filter shall be assessed at least once every 3 years by inspection. The outlet filter shall be cleaned as necessary to ensure proper operation. The filter cartridge should not be removed unless provisions are made to retain solids in the tank that may slough off the filter when removed from its enclosure. If the filter is equipped with an alarm, the filter shall be serviced if the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an impending continuous alarm. The septic tank shall have its contents removed when the volume of sludge and scum in the tank exceeds 1/3 the liquid volume of the tank. If the contents of the tank are not removed at the time of a triennial assessment, maintenance personnel shall advise the owner of when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank. The addition of biological or chemical additives to enhance septic tank performance is generally not required. However, if such products are used they shall be approved for septic tank use by the Department of Commerce, Safety and Buildings Division. Puma Tank The pump (dosing) tank shall be inspected at least once every 3 years. All switches, alarms, and pumps shall be tested to verify proper operation. If an effluent filter is installed within the tank it shall be inspected and serviced as necessary. Mound and Pressure Distribution Svstem No trees or shrubs should be planted on the mound. Plantings may be made around the mound's perimeter, and the mound shall be seeded and mulched as necessary to prevent erosion and to provide some protection from frost penetration. Traffic (other than for vegetative maintenance) on the mound is not recommended since soil compaction may hinder aeration of the infiltrative surface within the mound and snow compaction in the winter will promote frost penetration. Cold weather installations (October-February) dictate that the mound be heavily mulched for frost protection. Influent quality into the mound system may not exceed 220 mg/L GODS, 150 mg/L TSS, and 30 mg/L FOG. Influent flow may not exceed maximum design flow specified in the permit for this installation. The pressure distribution system is provided with a flushing point at the end of each lateral, and it is recommended that each lateral be flushed of accumulated solids at least once every 18 months. When a pressure test is performed it should be compared to the initial test when the system was installed to determine if orifice clogging has occurred and if orifice cleaning is required to maintain equal distribution within the dispersal cell. Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the owner, and any levels above 4 inches considered as an impending hydraulic failure requiring additional, more frequent mdnitoring. General This system steal! be operated in accordance with Comm 82-84 Wis. Adm. Code, and shall maintained in accordance with its' component manual [SBD-10572-P (R. 6/99)] and local or state rules pertaining to system maintenance and maintenance reporting. No one should ever enter a septic or pump tank since dangerous gases may be present that could cause death. Septic and pump tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the tanks are no longer used as POWTS components. Septic or pump tank manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 8-inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into a tank or component. Continaency Plan = If the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep the system in proper operating condition. If the dosing tank, pump, pump controls, alarm or related wiring becomes defective the defective component shall be immediately repaired or replaced with a component of the same or equal performance. If the mound component fails to accept wastewater or begins to discharge wastewater to the ground surface, it will be repaired or replaced in its' present location by increasing basal area if toe leakage occurs or by removing biologically clogged adsorption and dispersal media, and related piping, and replacing said components as deemed necessary to bring the system into proper operating condition. 7 uestions on the operation or maintenance of this system should be directed to the County Zoning office at11,S_3g(,_~~,80 or to the licensed plumber who installed the system. PLOT PLAN • Page 3 of 7 • ~ Scale 1 "= SO ' ~ •~-'v+1i ~ ~ • ~c~:i..l.~C ~'PCA Z3 ~ •Q7 S V C3G~YL~P x w~LL Lo e~p~ 3 BDR.~ ~'0 wl ~, roc ~Y~U C ~i ~ t ~S~ O~ ZL~PV ~ F-~- N ~ r r 0 7 o wOT Co„~,C~rt-LT ~r2 ~ ts'n~~z~3 ~-9.~ 6i Ih ~' ~_ N ~ ~~1$ ~ ll~~ `,~ N ~~ _-__ e~,Q85 N . ~'~z."~ e't..Qg 6 n ~`~1ovvZ ~.q8 _S, '$~~ of e.l~tL NOTES : ~'1 ~-`~~' ~3' 1. Elevations shown are existing ground elevations unless otherwise noted. 2. Install 4" observation pipes with approved caps. ( Z required). 3. Septic tank to be looo~bSO gallon capacity manufactured by _'h't ~O hl ~`RsR-f~ 1>> ~, , ! ~v~ w ~Zl~'f.32Z. ~~r~LU~r Fa ~-I~rz 4. $ench mark • ~t~i .100.0 ~N 1`'~[ZaN l~lP~ L.o7' cOrzhJ~z 5. Divert surface water around system to prevent ponding at the uphill side. Paoe .~; Of 7 Approved Synthetic Covering AST~1 C33 Medium. Sand ~ _ _ Topsail 3 ,1 t ~ -~ istributian Fipe D G Elev. ~ a , O ~~ b C ~Lz% Slope • Distribution Cell of Farce Main Flowed Z" to 2''z" Aggregate From Pump Layer • 0 0. SOFt . • E b.S~ Ft. CROSS SECTION OF A ihOUND SYSTEM F O~ ~ Ft. . G o. S Ft. A y-S Ft. H l~0 Ft. Linear Loading Rate= y-S GPD/LN FT B lo~_ Ft. Design Loading Rate= o.2.GPD/SQ FT j 1.~; Ft. J ~, Ft . • K -7 Ft. L ll Ft. W Z$, S Ft . .. ~ ~ I • ,} -Observation Pipe fi ~ K _- -_------ --------- ------j ~ ~~c~s W -~---T__ - ---_--- -------------- ~ Force Main \ ~-- ~Oistribution ~--- Cell of %" t %" • x o 22 f Pipe a;gregate Observation• Pipe • (Anchor securely) PLAN VIET~T OF A MOUND SYSTEt4 Distribution Pipe Layout Place the holes at the bottom of the distribution pipes . at equal spacing. Reaove all burrs from the pipe and holes. Extend the end of each lateral up with the use of long turn or 4~ ° fitting to a point within six '~ inches of the final grade. Te.~inate the ends of the laterals with a vaIv~,: tlueaded cap or . threaded plug. Provide aces from final grade for the valve; threaded cap or threaded plug. " ~~L`~:..ss s~~ ~ ~s ~. ~ c~ ~ ~,~s s saz-n ~ tv PVC F~JC PVC Latera(~ ~. Manifold ~ Laterl x x ~ x x x2 x2 x x ~ x~ x L3tera( Length - LatEral Length - P !~- l..prN V \~ -- o- _ P h f,~L11 Ft1 ~ PoRCE ~+~~ a- -- ~~~ P ~ °~ Ft . 5 3 Ft. X ~Inchps Pace S of 7 ~C.G~s st,X - -o ---0 Hole Diameter ~~$ Inch~~ ~-~"~ Lateral ~ 1 1 «f InchEes) Manifold ~_ Inches Force Main " ~ Inches ~ of holes/pipe Z S ~ - w Invert Elevation of.Laterais ~tqS Ft. ~-.~sv~ou P IaE W /F~'I.(Z.~16I~ Gt'P A~-uT~IKE -i _ •' bii y1fUC ~ ~ . . 6".nw. i - I I 18~KINl. IWLET Approved joint w/ PVC pipe Ncn'E , :`, ::, .~ -- BgFTrtES Zf-BIR.. ~tl~`Q LLCY.~SfY ~ S_ O ~ CDUCRETE DLDCK-- ~- RISCiL EXIT PERMI1fED O~ILy iF TAWK MAUUFACTURIFR HAS SUGH APPROVAL~3"ApPQa.Fp 66D~tN4 sEPrlc a' ~ SPECIFIGaTlO>`IS 005E TAUK MA-IUFACTURER:~'~~Z~N per IJUMtiER OF DOSES: '7iY b TAAJK SIZC : 1000 ~ 6S0 GALLOAJS DOSE VOLUME Z pER OAy AL1.RM MAUUFACTUR.CR: S•5-~-~-~~ S ~Y'I S 1N000aIUG 6ACKF~ow: L 3~ (iAttON: MODEL 1JUM6ER: 10~ H(-il CAPACITIES: A-~ IUCHCSOR 32 " ~ _ SWITCH TyPC: ~1-~~J(2._J Z ' GALLOlJS ` f ~ ` $. I-JCHES OR ~ G~ILlOA15 PUMP MAIJUFACTURfR: GoU~-4S C= •g wCHES OR `3 b CALLOUS MODEL IJUMBER: 38$S' wE~US~ 0= INCHES OR ~' S 3 GALLOlJS SWITCH TYPE: ~C=~z-~1' 1JOTE: PU/1P A~1D ALARM RC TO bLy" b MlIJIMUM DISCHARGE RATE L~ l • O ~pM INSTALLED OAI SEPARATE CIRCUITS VERTICAL DIFFERENCE DETWCEU PUMP OFF AUD..DISTRI6UTIOiJ PIPE., l3 , SFEET f K1IJIMUM I.IETWORK SUPPLY PRESSURE 6- ZS F f ~lS , ~ ~ ~ ~ ~ ~ LET FEET OF FORCE MAIN X 3'y.bF~o F~,FRICTIOU FACTOR.. ~' ~ 7 FEET TOTAL Oy1JAMIC HEAD = z~' ~~ FEET ._ As per manufacturer ~~•C~ gal/in. Liquid depth 3 $i' . Combination Sept,3c~_Tank and PLfMP CHAMBER CRO55 SECTION AA1t) SPECIFICATIONS ~ PAGE ~ .OF ~. . _. ~ , f - WEATHER PROOF . -v>=uT cAr . • ~uucrlou eox . ti C.I. VE1JT PIPL ~ APPROVEp LOCKII~IG ~ lO' FROM ODOR, MAJJHOLE COVER wig :iiNDOW OR FRESH ~ wARN1>3G LAgEC-,, ~ . cor,,putr ~ I - I • ~ `I~ HU.1.~ ~, ~ 11~ _ PROVIDE I --- AiRTIGHT SEAL I ~ I ( ~ I I i v ~ ~ ~ I Approved I III joint w/ ALARM PVC pipe ~~ II I I .I ~ Ou •i I PUMP ~~~ OFF -. A a c D ., • Overload protection must be provided in starter unit. • Shaft: threaded, 400 series stainless steel. • Bearings: bail bearings upper. and lower. • Power cord: 20 foot standard length (optional lengths available). Single phase: •'/3 and''/2 HP -16/3 SJTO with 115 V or 230 V three prong plug. • 3/4-1'/2 HP -14/3 STO with bare leads. Three phase: •'/z-1'/z HP -14/4 STO with bare leads. On CSA listed models - 20 foot length SJTW and STW are standard. 3885 APPLICATIONS Specifically designed for the following uses: • Homes • Farms • Trailer courts • Motels • Schools • Hospitals • Industry ` • Effluent systems SPECIFICATIONS Pump ,~ • Solids handling capabilities: 3/4" maximum. • Discharge size: 2"NPT. • Capacities: up to 128 GPM. • Total heads: up to 123 feet TDH. • Mechanical seal: silicon carbide-rotary seat/silicon carbide-stationary seat, 300 series stainless steel metal parts, BUNA-N elastomers. • Temperature: 104°F (40°C) continuous 140°F (60°C) intermittent. • Fasteners: 300 series stainless steel. • Capable of running dry without damage to components. Motor Single phase: • '/~ HP,115 V, 200 V, 230 60 Hz, 1750 RPM; %z HP, 115 V, 60 Hz, 3500 RPM; '/z HP -1'/z HP, 230 V, 60 Hz, 3500 RPM. • Built-in overload with automatic reset. • Class B insulation. Three~phase: • %2 HP -1'/x HP 200/230/ 460 V, 60 Hz, 3500 RPM • Class B insulation. m 1995 Goulds Pumps, Inc. FEATURES ^ Impeller: Cast iron, semi- open, non-clog with pump- out vanes for mechanical seal protection. Balanced for METERS FEET so 25 80 --- , W E1 1 70 ___. so 50 a 30 10 0 0 _L 0 t~--~ i` Z o;- ~ MODEL 5 GPM s Fr can be operated continuously without damage. ^ Bearings: Upper and lower heavy duty bail bearing construction. ^ Power Cable: Severe duty rated, oil and water resistant. Epoxy seal on motor end provides secondary moisture barrier in case of outer jacket damage and to prevent oil wicking. ^ 0-ring: Assures positive sealing against contaminants and oil leakage. AGENCY LISTINGS SP Canadian Standards Association ~~ Underwriters Laboratories SERIES: 3885 SIZE: %' SOLIDS RPM: VARIOUS 10 20 30 40 50 60 70 80 90 100 110 120 130GPM 10 11 ~~v'+~~ P~-FOa-~i~cE C~~.~C uouias ~~~~~1"~1~~~ smooth operation. Silicon bronze impeller available as an option. ^ Casing: Cast iron volute type fior maximum efficiency. 2" NPT discharge adaptable for slide rail systems. ^ Mechanical Seal: SILICON CARBIDE VS. SILICON CARBIDE sealing faces. Stainless steel metal parts, BUNA-N elastomers. ^ Shaft: Corrosion-resistant stainless steel. Threaded design. Locknut on three phase models to guard against component damage on accidental reverse rotation. ^ Motor: Fully submerged in high-grade turbine oil for lubrication and efficient heat transfer. ^ Designed for Continuous Operation: Pump ratings are within the motor manufacturer's recommended working limits, CAPACITY 30 m3/h Effective May, 1995 83885 20 0 Q W V' a 15 Z } 0 J Q p 10 1 ~ ~,b.~ 1 ,~ a~' ~ . 0 Wisconsin Department of Industry, Labor and Human Relations Division of Safety end 8ulldings SOIL AND SITE EVALUATION in accordance with s. ILHR 83.09, Wis. Attach complete site plan on paper not less than 131/2 x 11 Inches to size. Plan must Include, but not limited to: vertical and horizontal reference point (BM), direction and percent slope, scale or dimensions, north arrow, and location and distance b nearest road. Page / ~ 3 ST GiPorX I.D. # pE.VD/~ APPLICANT INFORMATION -Please print all Information. awed by Date Personal information you provide maybe used torsecondary purposes (Privacy Lew, s. 15.04 (1) (m)). ~~/~~~ Property Owner Property Location `` q! ~(f~~/~Q(~ G'~Nv Cp/t~ Govt. Lot SGT 1/4/vW 1/4,S Z3 T 2 ~ ,N,R ~ / E (or W~ Property Owner's Mailing Address F S Lot # Block# Subd. Name or CSM# 33 z Mi N"'ESOTk Sr h~~ ~ G- . i3 gvER~~PEC~v ESTf1-T~ S City State Zip Code Phone Number Nearest Road /y~,j1., /2 .S`T ~i4V L J'"(INd ~ S/O ~ ~ (ol Z) 2Z2- SS$S ^ _Giu 0 Village To~ eLN~ /~EG"GLy l2~ . . L'~ New Construction Use: Residential !Number of bedrooms ~ - ~ Addition to existing building ^ Replacement ^ Public or commercial -Describe: ySv - Code derived dally flow ~ ~ ~ gpd Recommended design loading rate ~ bed, gpd/tt2 ' 2j trench, gpd/ft2 Absorption area required S~~bed, ft2 ~~ trench, ft2 Maximum design loading rate ~ bed, gpd/fl2 / trench, gpd/ft~ Recommended infiltration surface elevation(s) $EE P~ ' 3 ft (as referred to site plan benchmark Additional design/site con etions 5i•rE /Q~C~?v~~~s 7/c°E,vt~ T-yp ~' rl~,.~, f~ sy~'T, Parent material _ SG-S 8 " P/~/% r ~ .S~T-T',!'~" ~Q~I~fS • Flood plain elevation, if applicable ~~~ ft S Suitable for system U ~onvenaonai I ~ nnound I In-Ground Pressur I ~ AT-Grad System,i~n,FiN/ Hdding Tank = Unsuitable for system ^ S U l~ 5 ^ U ^ S ^ S U ^ S 1~7 ^ S 0111 I1CQrDiDTln41 neonoT ~ 1 _ . _ ~. ~ ~ _ A--~_ `~- A I ....a.. ~E Boring # ~,.,;. Ground elev. ~8..~tt. Depth to limiting factor ~[_in. /~ Boring # ~~. Ground elev. S~•S o ft. Depth to limiting Horizon Depth Dominant Color Mottles Texture Structure w~c.. - Consistence v - - -- Boundary - Roots - • - - - GPD/tt2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed ,Trench L /3~ /0 3/ 3 ----- SiL 2,w, S!„tt ~+-r fiP C s ' . ~ - ~ /OY c 2~- ScL- /7~S~i~ Li -- -~ . Z ~ - 3 /o ~ ' -~-~^ , Remarks: ( o-~ z io Y~ v/Z- - Sim / fSl,~ie ~ ~.~ ~ S' /~' . z. ' -3 Z a2- /0 2 3 ,Si L /fSl~ ,lr, ~i2 e ,~ -- , z ; . 3 b ~-.~ ' ~, . v In. Remarks: ST Name (Please Print) Signature -~,,, ~ Telephone No. 'Ro 6 E R 1- ?.{ t_ (3121 o~T' T ~) awl 7/.~' 3 gG" ~/ ~.S Address Date CST Number sates ~av~ /3, ~~~ csr-~ L y~z Private Sewage Consultants 655 O'Nail Rd. Hudson, Wis. 54016 t PROPERTY OWNER SOIL DESCFiiPTION REPORT PARCEL I.D.N ~ f l3 ~ ~U E" 12 ~1.QQ-~`- ~'S T' f T'~ S Boring # 3 Ground elev. ~~tt. Depth to limiting factor ~in. l Boring # .~ ~ r, Ground elev. tt. Depth to limiting factor In. Page z of 3' Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots 2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed ,Trench L , ~--• , Remarks: Remarks: Horizon Depth Dominant Color Mottles Texture Structure Consistence Bounda Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. ry Bed ,Trench Boring # ~._. .~ Ground elev. n. Depth to IimiNng factor in. Boring # :. Ground elev. tt. Depth to limiting factor Remarks: ln. Remarks: SBDW-8330 (R. 08/95) r ~ F ~~ tu~c-S T __ ~ e T < ~~C~ ~ _Z c ~ ~ ~ ~~ a ~ 0 y ` ~ ~ ~, .. ~ `s` o Z \~ ~ .c~ 1°, y -~~ .N o~ ., ~ ~ ,~ I Q~ J _ ~ a ~ a ~ ~ N r `~ c ~~ 1 ~ ~ ~` y ~ G ~ ~' ~ ` ~ r ~~ W ~ c.. ~ W ~ .. ~ moo. ~ r -1 w Oft - 24 ` O1 l Oi OOA To l eo a nee Too 1 651 770 2480 P . O 1 ~v . . " ~ t_AE;AS,;E CUSTOM HOMES PiaGE 81 / 81 ' j .1 SL!'7 IC 'i'AiJK MAINTi?N NC GItI?I3 • ' • MeN i ,r._ AiVn UWJJI;It,S(11P Cl?K'i;'1[~ICA~'1'IOiY 1rOItM OwncNDuycr Maiiinr Address Q ----,._,,,_ . _ ~~ ~ Properly Address ~ --mow (Vcrificalion requi+cd fiuur 1'ranuiog nel,arlfiient far new conaauotluu)~.,. Cit /Slat - y e ~ ~ ~ --.-` i --~,__` 1'jlf'CC~ IrrCI111IiC1irfU11 Ntunhcr Cltll~,j.~ ~ _ ~yy~ j'ropeny Locaiiou ~_ /~ ~J_ '/., ,Sec. Z 3 ~ 'I' 2 Z tJ-It L~W 'I' ~ -- .... ~ w -- tt u f Subdivlalou ~ .r.~, Ccrtlitlctl Sttrv~ey r,Zs,li y . ~, Vuluntc; I'ngc f! ~ ~~AI'1'Rilty UCCd {{ ~~~" ~, Vctluutc ~ i' 11 ngo Spx boost q ycs.!'riio l.ctt lints it{atlifiablc i~ y~ o tt~ lugrroltet iue t3ud ntaiolenauce of your septic sysfen, Cr,,,l,t result In its prcnfatwa faihuc to batrrUe waalc r. 1'toper t1ltLtturauee eonslsta of ptultpltrs out tha septic tank every thtte ycou e-r rnuaec, if IICClletl I,y R IICCnfCII llrt111pGf. What you rut lino the cystept cw at[ocl the tirnetlat ~rf Iho acp(ic trek os . t,cahncut stage lu Nta waata dipwsal cystour, ~~ rroperty owner stets to :ulrurlt ro SI. Crolxlurdng 1)epartmenl a certiRcatlou form, clgrted 1,}• the ottmer atul by t rtraakr ptumbcr, journetyntrrt prutnbw, t Galt is red plat uhcr or t licensed pumper vet ifyhtg Ih at (I) ibe ou-.Ito Mtstt:• traterdigtosd tyattutt is rrt rropcr ol,onliug carrdlliutt antUor (2) Rrlcr inspccliun and pwnpiug (if ucr:ctsary), ILc .optic tank !c leas Iru n 1/3 tirll of aludjo. 1/wo, Ure ttorle.Ktlrgtted hcvo read rho above regnifcnients and agree to urslnfa6t fhc ptivtic sewage dltgra:d system Mth II-e alaodards set fonh, betata, as set by the Derubnertt of L+~nuoerec and Ibe Ikpathuenl of Nodtrt! ltcicntrcet, State of W;t;onattt. Ct:rtlfkation ctating that youc scrtles;rratenc ha; beco ntainiaiucd nnist he cuury,lclcd tnd tchuued to the St, Croiz Caunly Zontnj Ofrleevrrlhia 30 ayr of !)rs Wroe year ea~piraUon data. AIURl3 APrI,ICAN'I' ~~ a11~ . bATi. gLYN~~.~ # ~ i 1 (wej ce:rtlfy that alt atateatcnts nn 14is lure, o,o r,nc to the hest of ary (our) knuwkdga. 1 (we) sat (RCe) the owner(.) of property datcrrbcd shove. by virtue of a waernuly deed recr,rdcd iu ttcgistcr of 1lecds 01[icc. S[GNATU 1- L CAN ` ~,~L """ Any rnfornntlon that ft mit-represu~led u,wy result fu tl,c cauNary pcrr,til hclntt revoked by /he Zp~ i ~)t arUrunt. (P •a~s~• " Include wlllt tltts rtppllcatlotr: a tlarrrirerl wa,tarrty decd tiwtt Ilre IteQialcr of 1)ectls olYiee a copy nt 1Lo certiried aevcy crap !f reforests la rrrada ru rho w.tinttty deem voi-1645PAGE359 ~ , STATE BAR OF WISCONSIN FORM 2 - 1999 Document Number WARRANTY DEED This Deed, made between haCasae Custom Homes . Inc. a Wisconsin Corporation Grantor, and Hrett Hoffman, a Single Person Grantee. Grantor, for a valuable consideration, conveys and warrants to Grantee the following described real estate in St. Croix County, S ' consin: (if more space is needed, please attach addendum): Lot 1 vergreen Estates in the town of Hudson, St. oix County, Wisconsin Exceptions to warranties: Protective Covenants Dated this 18th day of Mav , 2001 ^ 646345 I;A'THLE:EN H. WALSH FEGISTEk OF DEEDS ST. CRDIX CD., WI RECEIVED FOR kECORD DS-24-EDOI e:ao an IIRkRfltITY DEED EXElIpT q CERT COGY FEE: COPY FEE: TRRNSFER FEE: 149.70 RECOkDTNS FEE: 10.00 F~AOES: 1 Recording Area Name and Return Address Brett W. Hoffman 1409 Shasta Drive Hudson, WI 54016 020-1331-30-000 Parcel Identification Number (PIN) This is not homestead property. (is) (is not) e sto Homes, I c. ' ~.~ . uz io l~ ~ Richard W. LaCasse ~~C-'-- AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF WISCONSIN ) ss. St. Croix County. ) authenticated this day of Personally came before me this }8th day of Mav 20~_ the above named LaCasse Custom Homes, Inc. ~~" a Wisconsin Cozporation by " 'chard W. LaCasse. President Pres. TITLE: MEMBER STATE BAR OF WISCONSIN (If not, to~jne known to be the person who executed authorized by § 706.06, Wis. Stats.) if{tcf~regoi ~ s~ru i I acknowledged the same. ~~11~~ ~ THIS INSTRUMENT WAS DRAFTED BY ~ Marlene K. LiLtn Richard W LaCasse Notary Public, State of Wisconsin Hudson WI My Commission is permanent. (If not, state expiration date: (Signatures may be authenticated or acknowledged. Both aze March 19 , 2005 .) not necessary.) h Names of persons signing in any capacity must be typed or printed below their signature. • STATE BAR OF WISCONSIN WARRANTY DEED FORM No. 2-1999 aCasse Homes Realty 573 County Road A, Hudson WI 54016-7007 Phone: (7l5) 38t-5405 Fax: (715) 381-6541 )segue Howard T4229396.ZFX ProEUaG wNh ZpFOrm" try RE FamlNet LLC 18025 Fdleen MAe RoaO, CIIMOn 7awmhp, Mzlwgen 49035, (900) 393-6905 ~""' "' t ^~ i~w~~+ AwU TFE SEl;4 O;` THE NW~4 OF SECTION 23, T29N, RI9W, TOV LINTY, WISCONSIN. - • ~ ~~ia~em M wlal, w M~tr~dy~ntltrkt IeN 1.I.1 W s i~ Wt ~ wMr. ~a r !w r 1uiM a11M m a w N+eN ~tl eLt t4 t~liW~ we11 ~, a 4lul~il ~ Nip pllrittill~ M ynM dt1 t1. ~ . ~t M~~'~ Wl:'~M~ 1 a/ iR lip lc ltlwt IIM. tl~ aaWa~ a stc w it et s<t wie +ealiis a s~a.i., ~ ~ ~ • wlnt pb 1s q., k ~ .itxiw at srxl~ iss.n It ~, 31{.~ll, ~irpyL lhtrq~, aM IMi1 M ~aeplb y tl1 MNet~wt t[ ~ ~ wt ketl a~ tat t!l w at NISk Illiw W Riwtl 1~l aLit'iN My tll ~~ ~FRI1ElER. ~RYEY ~ ~ . ~~ ~ 0~ .101 I!'~..1Q, .~. ~ ~ S~!~L ~iaeT~lo~il p°i -«s sln a 711[ awVS ""'-y~~r-~-• s4.l2 ----'---snes• ~z'tisr Z.~• _ oEac~TCO _ / ~ F. r .. -- i• l.giellEa '. ws -~ :1 •pq.lia• . ~ -_ . . -. LtYt' T . ,.,- ~ r~ •~. :.~ ~. . • \\. ~ , • ~ Ioa,aM as ft, ~ • .. ~ ~~_ S~ :.ass ~ .¢ ~~~ 14.171 »o:.,r. is L.4T 11 ~ - ,.. - + ~ • K :.14 wets a ~ L~ 8 « ss.et as P7. ' ~ / s.so ACIILt ~y~ ~+ 1/S.tM a0.FD ,. ~ `~ p~ LV! IV ® t 1.01 AtaEf ~ _ ._ .-. att• ti0 'M .{71 f0. lT. N 'E SIa.7/' iaS. ~{ 11.17 A[.l 7~'~~ -aE-astc tJtlEN1EI77--~ :`J~ . - t/6.Bti 1QFT.) lb t1E aulorct 1/C9s E?Crir?cc,)n Y'"•'°~r ! r ~ ~ "- ~ Q_ N,aOt !O. fT. _• I ~ o ~w01~G lAaEtrlLlR Ila0.. 141.0 { /*~ 9 iio~,7rKsac.~) so.od w s to.to' lt.tt allcs ~•u~• ~V .00' {7Wi2' ~ K.OQ' tE.~ 11G saa• st•otrc __ __ tsaa-.r ss-cl !fs•G4'i~'E t~sar~ ~•~~~ E i4~.t3 94. t ~' l sisT- ~-rresr vs uNt oa s[trar p i UNPLATTED LANDS ~ -