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HomeMy WebLinkAbout020-1115-70-000Wisconsin 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)]. Permit Holder's Name: City Village X Township Seibel, John Hudson, Town of CST BM Elev: Insp. BM Elev: BM Description: TANK IN FORMATION TYPE MANUFACTURER CAPACITY Septic Dosing Aeration Holding TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Septic Dosing Aeration Holding PUMP/SIPHON INFORMATION Manufacturer Demand GPM Model Number TDH Lift Friction Loss System Head TDH Ft Forcemain Length Dia. Dist. to well SOIL ABSORPTION SYSTEM ELEVATION DATA County: St. Croix Sanitary Permit No: 515266 0 State Plan ID No: Parcel Tax No: 020-1115-70-000 SectionlTown/Range/Map No: 19.29.19.475 STATION BS HI FS ELEV. Benchmark Alt. BM Bldg. Sewer St/Ht Inlet St/Ht Outlet Dt Inlet Dt Bottom Header/Man. Dist. Pipe Bot. System Final Grade St Cover BEDITRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR Type Of System: UNIT Model Number: DISTRIBUTION SYSTEM Header/Manifold Distribution x Hole Size x Hole Spacing Vent to Air Intake Pipe(s) Length Dia Length Dia Spacing SOIL COVER x Pressure Systems Onlv xx Mound Or At-Grade Svstems Onlv Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center Bedlfrench Edges Topsoil ~ Yes ~ No 0 Yes ^ No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / / Inspection #2: / / Location: 352 Willow Lane Hudson, WI 54016 (NW 1/4 NE 1/4 19 T29N R19W) Willow River Estates Lot 7 Parcel No: 19.29.19.475 1.) Alt BM Description = 2.) Bldg sewer length = - amount of cover = Plan revision Required? Yes ^ No Use other side for additional information. Date Insepctor's Signature Cert. No. SBD-6710 (R.3/97) dP.Q.~I~~~,, , comrr>ter+ce.Md.gov Safety and Buildings Division c~ ' t62 2Ol w. Wasltiagbogt Ave., 1 ~( m; ,~ i ~ ~+~/~~~ ~~ ~ Madison, WI 5376 Sanitary Permit Ntunber (to be filled in by Co.) lspaslaeetyto! Coa~erce tt'' ` ~ .. 5/ S Z (o . ~ ~.,,.` Sanitary Permit A~pplicatioa .: , to TranSactioe Number ~~, submission of this form to t!re govetnmerital~ Code Wis Adm 21(2) x wnh s Comm 83 I d , . , . . . atx . n accor unit is required prior to obtaining a sanitary permit Note: ApplicaY -ow POWTS are Project Address (if different than mailing address) ~ submitted to the Department of Commerce. Personal i used or secondary.. qu, es in accardat>ce with the Priv Law s. 15. i m~ taLt. / , / ~ ~' ~ Z W ! ~`dtw~ ~. A lisation Informatige -. _ Plr~t Ail Ia. property Owner's Naeroe ~ l ~,~ ~ 2 Pawd # . ~ 07~ -. ///S• 70.. E repem~ Owner's biaitatg A g~ . CG & ZCNING G~~ NIN n5' Location ~ T 7S C - ! Li0yv~' pLAN Govt Lot , { City, State Zrp Code Phone Nuen6er ~i ,~ y., ~- ~/s Section (circle o e of Bui ing (check aR that apphy) EI T ~ # . yp 1 or 2 Family Dwelling -Number of Bedrooms ~ Subdivision Name Bleslc # ~ ib U ;C i l D P bli escr e. se otrunerc a - u c ^ City of s !State (awned -Describe Use CSM Number ~ f ®'f rl owrr ;I4. Type off Permit: (Check on one box online A. Complete line B if applicable) ` A' f ^ New System ®Replacemetrt System ^ Treatment/Holding Tank Replacement only ^ Other Modification to Existing System (explain) 3. ~ Permit Renewal ^ Permit Revision ^ Change of Plumber ^ Permit Transfer to New List Previous Permit Nutntier and Date Issued I Before Expiration Owner i IV. T of P®WTS 5 aeat/Device: Chectic all that ~ r ~ ~ loon-Pressurized Itt-Ground d Pressuri&ad IthErotutd E} At-Crrade ^ Mounq.? $4 in. of suitable soil ^ Mamd < 24 in. of suitable soil '~" Cam- 5 Holding Tank ^ Other I?ispersal Comportent.(explain) ^ Pretreatment Device (explain) ! i'~~.~ t~lL1C1~@tme®E,Aire' Lfoiii~atie6~ --- - ----------- -- -- - -- - Design Flow (gpd) Design Solt Appl~ation Rdsf) Dispersal Area Required ( Dispersal Area Proposed (sf) System Elevation v , !%a. Tan9c Info ` Capacity in Total # of Manufacturer Gallons Gallons Units ~ ~ $ X j New Teaks Existin Taaka ~ c ffi ~ ~ "' R ~ g ~ U y ~ . v. rn R. O. i Searle or Holding Tank i ilusing Chemtxv Vlar. ltrspansibility Sbtemeat- I, the uadereigaed, assume nvpoasibii&y !br insfallatiea of tLe POWT3 sl~atwa oa the attached pleas. i plumber's Name (Print) Plumber's 5' MP/MPRS Ntunber Business Phone Ntunber i o ~ ddress (Street City, State, Zip Cow) A , I plum s ( {^ , `// /~ {a ' V31I. man /Dc rtmeat Use bn __ -- _ pp.o~ed ~ P ~ ~5 S ~ ~ Z7 ~~ Issuing ignattue ^ err Reason ~ IX. Coedit' wsons far Disapproval / e ~~/ '' ~~Sd O/1 ' ~ ~ ~ ~+[ Dtrf pd ( tank,.efflutitt filter and ~ , i ells I cell must all be services / mat taln r persa n eel - ~ ~ t G _ _ t _ ~ ~ as per management plan provided by plumber. ,.~, ,_ t ~ O t '~`~""~ ~ 2. AH ~fback t'equiCementa must. be rnaintainad Attach b eoe~pleee plies for the systeas and wbsit to the Comty Daly ere paper oat k!f alas a t2 = >is seescs m me S33D-6398 (R. 02/09) Valid ttrrtt 02/1 l Conventional POWTS Index & Tilte Sheet Project Name: Seidel 3 bedroom Replacement Conventional POWTS Owners Name: Justin Seidel Owner's adress: 352 Willow Lane, Hudson, WI 54020 Site address: Same Project Location: Subdivision: Lot 7, Plat of Willow River Estates Legal Description: NWVaNEVa, Sec. 19, T.29N., R. 19W., Town of Hudson, St. Croix Co., WI. Parcel ID #: 020-1115-70-000 Page 1 Index and Title Sheet Page 2 Site Plan Page 3 Dispersal Cell Sizing Calcualtions Page 4 System Cross Section Page 5 System Management Plan Page 6 Filter Specifications Page 7 Treatment &/or Filter Tank Cross Section Page 8 Parcel map Page 9 Septic Tank Maintenance Agreement Page 10 Certification for Utilization of existing septic tank Page 11 Waranty Deed Attachments: Soil Evaluaiton Report Mater Plumber Restricted Service: Gary Zappa, Dept. of Comm. Credential #222373 Signature: Date: Q j'/,2j//o Page 1 Of 11 Design pursuant to In-Ground Soil Absorption Component Manual for POWTS, version 2.0 SBD-10705-P (N.O1101) SOI/ Q/~ /rl,R,~s~O.~ ~'/i~Cj Sc.Q./~~ ~us~.:~ Se: d~ / ~ro~O. 35"2 cJ; //o~ LanL f,~e~dso~, cJ/. Sf~4/G pu1i~//If~ Scc i9T..z9~, ,5~. CroiX G, u~/ ~Oc.!• ~l OZ,O-N/.S 9~-CYO ~;nq 0.33 ages PrppOStL'~~~3~~ CLlI, 7ftret ~~ ~~~`pj~-fi1t,IlCfa . S frS~ hr1 lira po se~1 rn~;YEYtLW i u, -'~a , 3~p,F~-~ ~o.,K~ Nyylc~' ; ,C-S15 er{7u~rwE ~,' i E a~• a ~ ou~lt~. ~~ ~ o ofv ~ t3rr~j ~. t trees , ' b~ ~ ' ~rcil~eie ~o~+^ E~• = 96Cf~2 ~ ~ ~ E.fiStu'~ Lkyvcll. E~cr:of ~ , ~a0~m of'dty cJG1I =g~,,SO~~ ~ an.~- E Q ConcrcftSc~Ab'c ~ ~ Exis 3 ~(eksr dMet .~ '7 r';~r ~ CXi-lfsit SiQ~C ~'~K ~ `wry wcll ~, i~'cma;•> ,i~~/Qu ~ ~,erri"t~ /o~ei /WG~ /asr+~~• ~,~e~ f!c, wrT.s. i ~oryc EX,~, we/l.J y ~~ ~ 3 ~ ~' / f oa° ,~'~ : f1. E. Co~irerof~Ca~ccEC S;le~ f}s3umtdtlG!' ~ i~ Q?' dccK i 9 J•^°'y~ 0 R--Exs~~ wwi COPY ~ , _ r ~~ ~Joi~ Qt/et ~iAQ~rOn ~`/ %~3 Sca./~• r. z ~Ps~~ ~-ust~:r~ S ei do ~ ~ro~0. 3S.Z cJ: //o KJ ~ SAD/G o f1/GtG~sdllr ~ . dot 7, GcJ.%/Ou7 ~i'/lr ~sts~l. n~~I/Jf~ Scc ~9T. a9n, iQ. /9cJ, >.~. a~'Nu dso~ hoc,/. ~[ oZO-i/l.s 7~-cYn bc: nJ o. 33 a e gas Proposcd a4~,~./ ct1l. ~~c c C~ ficnc.{is.s ~ ~/ T.+i~%trn.~ "QwzX-y~, G/t~: ~o bc''Y~ Sa: F~~a po s l.~ rn~;'/EYLt.tyY' i w - 4B ~ 3tp~'c ~m.~K~- N~y~cK ,~~-515 e~{/utrE EXis~' Dry ~vcl/. E/e.~; of 60~ ~ Fd`Y ~cll =84SO'r E„/Sfin~ COo-Cl~t~t_SC/Ab~e ~~., ~ ~l ~ L ~'X'f63 Q9•D~~Irb 8 ~K=- y r, r.9n , fa.rc.1~ Ex~~ 3 b~ ~ 9ara~t• ~tsid/~ ; r, ,~ - ~pfYG ~iJK ~ ~.- V ~,ry we.l/ /y y~crrran i/7~0 /QU ~ EX~, WC(/ ~ .~~,~ /~~_, /w~ /any ~ ~~ :v~s~ u%:t/ bt ned,i-c a~ ~i ~ 4e v.3 P G cJ. 7rS, ~ - ~ D~ t~ii'9 ukll P9 . ion ~~ ~' A I Wisconsin Department of Com ~"`---`~~-- SOIL EVALUATION REPORT Division of Safety and Buildings `""~~~°~°_-- ~n arrnrtanca with C:nmm R.ri Wis Adm Cnde 2212 Page 1 of 3 A.C.E. Soil & Site Evaluations County Attach complete site plan on paper not less than 8'/: x 11 inches in size. Plan must St. Croix include, but not limited to: vertical and horizontal reference point (BM), direction and percent slope, scale or dimemsions, north arrow, and location and distance to nearest road. ' Parcel I. 020- 115-70-000 Please rin all i fio a Revi d By Date Personal information you pro a may ~es (Pri y t.aw, s. 15.04 (t) (m)). / Property Owner Property Location Justin Seidel Govt. Lot NW /4 NE g 9 T 29 N R 19 W Property Owner's Mailing Addr ss Lot # Block # Subd. Na or CSM# 352 Willow Lane ST, CR(~IX CQUNTY 7 Willow River Estates City SE~t@Nffi ~ City _J Village ~ Town Nearest Road Hudson ~ WI 54016 Hudson Willow Lane J New Construction Use: yj Residential / Number of bedrooms 3 Code derived design flow rate 450 GPD /J' Replacement ~ Public or commercial -Describe: Parent material Glacial Outwash Flood plain elevation, if applicable Na General comments and recommendations: Site suitable for conventional POWTS dispersal cell with 0.7 gpd/sq.ft./day loading rate. Recommended system elevation to be 94.50'. Boring # J Boring ~ ~~ 80~~ ~ t~ Pit Ground Surface elev. 98.53 ft in. . Dept limiting factor Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP DIft~ in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 1 0-14 10yr3/6 none sl/Is fill na na as 1fmc na na 2 14-18 10yr3/3 none sl 2fsbk mfr gs 2fm,1 c 0.6 1.0 3 18-42 7.5yr4/4 none gr Is Osg ml cw 1fm 0.6 1.0 4 42-63 7.5yr4/6 none 1 Is Osg ml cw - 0.7 1.6 5 63-108 10yr4/4 none q ~ s Osg ml gs - 0.7 1.6 6 10 180 10yr4/6 none rt s Osg ml - - 0.7 1.6 H#3 cont ~ gh clay content -loading rate adjusted to effect reduced permeability of horizon due to high clay content. Soil observation pit excavated to 108". Observation depth extended with hand shovel to 130" and with auger to a depth of 180". Boring # _..~ Boring Pit Ground Surface elev. 99.97 ft. Depth to limiting factor >106" in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP DIftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. "Eff#1 *Eff#2 1 0-10 10yr3/2 none I 2fgr mvfr gs 2fmc 0.6 0.8 2 10-28 10yr4/4 none gr sl 2fsbk mfr gs 2fm,1c 0.6 1.0 3 28-42 10yr4/6 none s Osg ml cw 1fmc 0.7 1.6 4 42-63 10yr4/4 none / gr s Osg ml cw 1vf,f 0.7 1.6 5 63-106 10yr5/6 none 5 t~ Osg ml - - 0.7 1.6 V~ ~ orizo s #2, 3 ~ 4 co tain approx. 35°k gravel, cobbles and stones. `Effluent #1 = BODS> 30 <_ 22 mg/L and TSS 30 < 150 mg/L 'Effluent #2 = BODS < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) ignature• CST Number James K. Thompson ,,,,,~ _ S----- 3602 Address A.C.E. Soil & Site Evalu ns ~ ~ Date Evaluation Conducted Telephone Number 340 Paulson Lake La e, Osceola, WI 54020 5/14/2010 715-248-7767 Property Owner ]UStlrt Seidel Parcel ID # 020-1115-70-000 Page 2 of 3 Boring # Boring Pit Ground Surface elev. 99.66 ft. Depth to limiting factor > 105" in• Soit Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots P in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-10 10yr3/2 none I 2fgr mvfr gs 2fmc 0.6 0.8 2 10-30 10yr4/4 none gr sl 2fsbk mfr gs 2fm,1c 0.6 1.0 3 30-56 7.5yr4/6 none gr Is Osg ml cw 1fmc 0.6 1.0 4 56-65 10yr4l4 none gr Is Osg ml cw 1vf,f 0.7 1.6 5 65-105 10yr5/6 none G, ~ Osg ml - - 0.7 1.6 tl t:~ Horizons #2, 3 & 4 contain approx. 35% gravel, cobbl s an stones. H#3 contains high clay content -loading rate adjusted to reflect reduced permeability of horizon due to high clay content. ^ Boring # -~ Boring _f Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 ^ Boring # J Boring ~ Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 * Effluent #1 = BODS> 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BODS < 30 mglL 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 need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. SBD-8330 (R.09/00) A.C.E. Soil & Site EvalWtionS ~ So.%e/Q/ka.~,U,-,fir"~ ~ so;/ eda/uLC~'a.,Exriiaq c/„ ' ~us~'~ S ei d~ / Pro/o. 3S2 r,~,J; //ouJ ~anL Q ,y~udsan, t.J/. Ss~O/G fat 7, ~•Y/out ,(~/ve~ Est~Ec ~4c1lf/AE1f,~' Scc i9T. a9~, ,SE. CroiX Co; u~l ~Oc/. ~ozD-///S-~o-~ 6,c:nq 0.33 ae./'es ~4lt. 4_/U o 7e~ofUr~rJt4 EXi~t/i.~4 ,(ky~cll. E/~%~at bot~6o~r+OoFdry wel/SBG'.s~~t fem., >r ~ f Larks 1. ~ ~^e~s 44,A..,~,~._~,..~ gi ~ r ,~~ ^99,/x• i ~ 1' //rr J~C `fie i ~~ ~ /\ / ,i ' _~ ,tom •~ Peck Exrs~~f ' 3 bed• ? ~arauJ~ Exnsfn~ weu~ ~ 3~ ~ ,a ~ ~~ ~~ ~~ -~ - ! o0.O .~'~~ : f1.E. co~nero{'C~accfe r~nJ uklL (~~.3a{3 DISPERSAL CELL SIZING CALCULATIONS 1. (3 bedrooms)(100 gallons estimated flowxl.5 design factor) = 450.00 Gad desspn flow 2. Infiltrative capacity of native soil = 0.7 gpd/sq.ft. 3. Absorption area required: 642.$6 sa.ft. 4. Absorption area as proposed: b77:40sq.ft. (33 chambers total) Infihrator "Quick 4"=2Q.00 sq.ft. EISA per chamber, Infiltrator "Quick 4" ~d car (pair) = 5.80 sq.ft, EISA 642:86 sq:ft = (3 pair endeapsK~:80) = 625:45 sq:ft: 625.4b sq.ft/20.00 = 31.28 chambers required Number of trenches: 3tirt1l chambers per trench Trench Width: Trench Length: Trench Spacing: Total system w/5' trench spacing, 2.83' 40.00' 8.00' on center 21.00'x46.4(?' Pg. 3 of 1 t U u ~. A ti i i ,_,_~- ~1~ ~~~~ ~ ~ N ~I C r_ rr1 Z D ~, n 0 z ~, d ~, ~, ~ na Scn/e < '= ~. c, n _ ~ ~~ ~.~ofl1 Conventional Septic System Management Plan Pursuant to Comm 83.54, Wis. Adm. Code General The conventional septic system shall be operated in accordance with Comm 82-84 Wis. Adm. Code, and shall be maintained in accordance with component manual SBD-10705-P (N.O1/O1). All local and/or state rules pertaining to system maintenance and maintenance reporting shall be complied with. Septic Tank Septic tank servicing mechanics comply with Comm. 83.54(1)(e). Septic tank to be located within 150' of service pad, with bottom of tank to be <_ 15' below service pad elevation. The operating condition of the septic tank and outlet filter shall be assessed at least once every two years by inspection. The septic tank contents shall be removed when the sludge and scum in the tank exceed 1/3 the liquid volume of the tank. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code, by an individual certified to service septic tanks under s. 281.48, Stats. If the contents of the tank are not removed at the time of a biannual assessment, maintenance personnel shall advise the owner of when service will be needed to maintain less than 1/3 scum and sludge accumulation in the tank. 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. Septic tank manholes 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 the tank. No individual should ever enter the septic tank as dangerous gases may be present that could cause death. Septic tank abandonment shall be in accordance with Comm83.33, Wis. Adm. Code when the tank is no longer used as a POWTS component. The addition of biological or chemical additives to enhance septic tank performance is generally not required. If such products are used they shall be approved for septic tank use by the Department of Commerce, Safety and Buildings Division. Soil Absorption Cell Trees or shrubs should not be planted directly on the soil absorption system. The area above and around the system should be seeded and mulched as necessary to prevent erosion and provide some degree of frost protection. Traffic (other than for vegetative maintenance) over the system is to be avoided. Soil compaction may hinder aeration of the infiltrative surface within and above the system and will promote frost penetration during cold weather months. Cold weather installations (October-March) dictate that the system be heavily mulched for frost protection. Influent quality into the system may not exceed 220mg/L BODS, 150 MG/L TSS, and 30 mg/L FOG. Influent flow may not exceed maximum design flow specified in the permit for the installation. Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the owner. Levels above 4 inches indicate an impending hydraulic failure requiring additional, more frequent monitoring. Contin~ency 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. Excessive ponding within the dispersal cell will be eliminated by installing a new soil absorption cell to bring the system into proper operating condition. Questions on the operation or maintenance of the system should be directed to the installing plumber, Gary Zappa at (715) 386-2850 or the St Croix County Zoning Department at (715) 386-4680. Pg.S of 11 EFFLUENT FILTERS "The PL-525 has 525 linear feet of 1/16" slots. It has an automatic shut off ball. When the filter is removed for cleaning, the ball will float up and temporarily shut off the system so the effluent won't leave the tank. No other filter on the market can make that claim!" "The PL-122 has over 122 linear feet of 1/16" slots. Rated for 1500 gallons per day, and can be manifolded together with other PL- 122's to double or triple the GPD. It has an automatic shut off ball that stops flow when the filter cartridge is removed for cleaning. Comes complete with it's own housing, no gluing of tee or pipe and no extra parts to buy. Order # Model # Description PK-525 PL-525 Effluent Filter System PK-122 PL-122 Effluent Filter System 6-10 ~c Alarm accessibility I .(_______~ Accepts PVC ~, exrmsion handle szs rnear tact 0l 1/16" w IOtratlon slots Rated for over -~ 70,000 GPO Accepts 4" & 6" SCIiD. 40 Pipe `` ~-r;-. ~_ \ ~1:3L~.,,,~ \.../ 1-f.,t \ _`` { -w Gas deflector .-~ Automatic shut-oH ball when filter Is removed I~_~ Accepts t/2" PVC Handle Alarm Switch ~. 122 Linear ft. _e of 1/t6 inch Filter Slots Fiher Housing ,~ with 3"& 4" % Pipe Adapter r ... tt~ ~; •3~~~ Gas Deflector Automatic Shut-OH Ball When -,d, Fiher is °-3- Removed From Tank List Price 203.50 62.50 ~ ~-F 1 I (~~. ~~' ~~e~.srn-~ ~8d~~ 2 3z - 2~25~ TW-Series Septic Tanks (not to scale) ,SEPTIC TANK UD OPENINGS L. TW-375 Pump Tank (not to scale) - ,Crt n 4; °ya ~i ~. Lj INLET SEPTIC TANK LID OPENING Imo- 2a 0'--'( ~~ LENGTHNJID 7H i~__-_- 59.6 __._ PROFILE VIEW Table 1: TW-Series Septic Tank Nominal Soecifications INLET ELEVATION DETERMINED BY DRILLING HOLE OPTION MARKINGS / HOLE OPTION A = 42' __ HOLE OPTION B = 42 75" -~;;, I I I Iii o ____ 50.6 iy " i INLET END VIEW ~g 6~~~ # Z~g~`~ ~~/a ~~r HeIgM P~~- Tank Model Total Volume Length Width TW-900 1,055 gal. [3,994 L] 110.4 in. [2,804 mm] 66.0 in. [ 1,676 mm] 50.6 in, [ 1,285 mm] TW-1050 1,212 gal. [4,588 L] 123.7 in. [3,142 mm] 66.0 in. [ 1,676 mm] 50.6 in. [ 1,285 mm] TW-1250 1,448 gal. [5,481 L] 143.7 in. [3,650 mmj 66.0 in. [ 1,676 mm] 50.6 in. [ 1,285 mm] TW-1500 1,762 gal. [6,669 L] 170.4 in. [4,328 mmj 66.0 in. [ 1,676 mm] 50.6 in. [ 1,285 mm] Table 2: Working Volume Based Upon 39.75 inch Liquid Level .. _ ~. ° ;~~iume, Liquid Level and Freeboard vary based on elevation or outlet vvhlch varies by code. Tank Model Working Volume' Liquid Level' Freeboard' TW-900 915 gal. [3,465 L] 39.75 in. [ 1,010 mm] 10.1 in. [256 mm] TW-1050 1,052 gal, [3,981 L] 39.75 in. [1,010 mm] 10.1 in. [256 mm] TW-1250 1,254 gal. [4,745 L] 39.75 in. [1,010 mm] 10.1 in. [256 mm] TW-1500 1,523 gal. [5,765 L] 39.75 in, [1,010 mm] 10.1 in. [256 mm] Table 3: Working Volume Based Upon 40 inch Liquid Level (Florida Specification) Tank Model Working Volume' Liquid Level` Freeboard' TW-900 920 gal. [3,484 L] 40 in. [1,016 mm] 9.8 in. [249 mm] TW-1050 1,057 gal. [4,003 L] 40 in. [1,016 mm] 9.8 in. [249 mm] TW-1250 1,261 gal. [4,772 L] 40 in. [ 1,016 mm] 9.8 in. [249 mm] TW-1500 1,532 gal, [5,798 Lj 40 in. (1,016 mm] 9.8 in. [249 mm] 3247 56~' Street ~'c,€iLl ~iblrc, ~Xt~ 347f . ~ • . SYSTEMS I N C 6 Business Park Roaa • P O Bc,: 'Gc Old Saybrook. G 06,'~ 860-577-7006 • FAX 8u0- -%,-; "_ www.infiltratorsystems.com For technical assistance, installation instructions or customer service, call Infiltrator Systems at 1-800-221-4436. Twc„ ~oaisi-~ HEIGHT 52 3' ~5.7 0~ ll ---- VARIES BY MODEL--------------- PLAN VIEW ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM OwnerBuyer Mailing Address ~S'~ ~~nw L,c,,,tic /~uc~ro ~ ~ ~S'~~~6 Property Address ~S (Verification required from Planning Department for new construction) City/State ~~~, Parcel Identification. Number o 2d • //15 - 7d ~ ~'"~ LEGAL DESCRIPTION Property Location. ~,~, '/,, _~_ '/4, Sec. ~~, T v~N-RAW, Town of _~~~~~ Subdivision ~~__~ ~ ~~~? ~nnar~s ,Lot # _ Certified Survey Map # Volume ,Page # Warranty Deed # Volume ~ ,Page # Spec house ^ yes '$I no Lot lines identifiable 1~1 yes ^ no SYSTEM MAIl~tTENANCE Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. The property owner agrees to submit to Sf. Croix Zoning Department a certification form, signed by the owner and by a masterplumber, journeymanplumber, restrictedplumber or a licensedpumperverifying that (1) the on-site wastewaterdisposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. Uwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Ce*^rnerce :.:.d the Department of Na*.ural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 days of the three year expiration date. e `-~/D ~ '`.~_ SIGNATURE OF APP ICANT ©~/ / DATE OWNER CERTIFICATION I (we) certify that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owner(s) of the property described ab ve, by virtue of a warranty deed recorded in Register of Deeds Office. r~.-~ ~ ` ~ ~ %~ ~ZII ~ SIGNATURE OF PPLICANT DATE ****** Any information that is mis-represented may result in the sanitary permit being revoked by the Zoning Department. ****** ** Include with this application: a stamped warranty deed from the Register of Deeds office a copy of the certified survey map if reference is made in the warranty deed l~p~// ST. CROIX COUNTY ZONING OFFICE CERTIFICATION STATEMENT FOR UTILIZATION OF EXISTING SEPTIC TANK(S) ~~ This is to certify that I have inspected the existing septic and/or dose tank presently serving the following residence: (Street address)~s-~, ~~~, ~„~ located at: ~~ '/4, -~ '/4, Section ~~, Town~N, Range~_W, Town of moo,.,, , St. Croix County Wisconsin. Upon inspection, I certify that I have found the tank(s), to the best of my knowledge, will conform. to the requirements of Comm. 84.25, and it (they) appear(s) to be functioning properly. Most recent date of inspection or service o,~/~Y/~~ Did flow back occur from absorption system? (if no, skip next line.) Approximate volume or length of time: Tank Capacity: Construction: Prefab Concrete ~/ Steel Yes No_~ gallons minutes Other Manufacturer (if known); APT ~G~vw,./ Age of Tank (if known): ti~T ,~~,,,, Permit number (if known) ,,,ems ,~,,,,,,,,,,, GA~~ ~.~-~~~ (Lic u er Signature) (Print Name) (Title) (License Number) MP/MPRS ~-/~,/.o (Date) Form to be completed by licensed plumber (Dept of Commerce Chapter 5 and s. 145.06, Wisconsin Statutes) or licensed disposer (NR 113 Wisconsin Administrative Code) Rev. 9/2008 ~~. ~a ~~ ~~_r_ 3~''. ~' 1 Point of baq,nn,n~Jut9£ 1 }a•t s, and 1629: to a+ W o{ NE, corny of Su t9-19d9 Unpla}}ed Land ~~~ - - - ,~ a oa wsl zr w Jaa o0 f ti a ~o. oo saoo -~--~-1_,_ ~ S I ao.oo ~ i rr ~~:'~ e. k`~~x , 4 ~' ~ . h ..WILLOW RIVER. ESTATES. , LOCATED IN THE ~ N.E. I/4 OF SECTION 19, T29N, R19W TOWN OF HUDSON, ST GROIX COUNTY, WISCONSIN i q : ~~t ~ I + ~ ~ OwrN'+ Le + frco+.- a 3 {ca+ of YL ~~ it ° a. 1 ~ ~ G on}y r 5} o:r~ t~ n'h o ° x ~ i At ownar aM by }f fhar acctad +h•!a A 0, i d d dad mapp d, d ded¢a+ed adtscnud ted on 1~+ ti~o L' ola+fsd I +to b s ate ~ ` h ~~C ~~ '- +hrs IafW ~a ce fF tha++h pia+:en raprsuan Ala 6 ~b v and A y qu rod by s?Jbl0 ar a. ~ ~ ~ ~ 5 ~ 4 L,rn ~ ~ 296.12 t be s bm }t d +o ,•hs f Il " q +c~ approval ar obyac+,on: a° 4' ., ` a nh : Diro<+or Plo on,nq Drnsmn Dap + } of p•a.vrca Da valopmsn+ ^I +~ ~ n' '1~~ r;,~ ~ S+o+c Board of ktc7+h; Li+y Lounc,l , G+y of Hudson} and Town 9oard of Ta wr of Nudeon, II ~ xl Wr+na a. + p h ,~ ha hand and s•aI a+,,ard owns.. +b,+ /7'°day of Na:n,.,b.r, r9•L d r ' ~ ~' ~h y ~ ~~ Wr}nasscs r rouo a w w too ' aoaa S~ JCOh .n faaf -_--. ~:- - ~. Ih : wet z w seo.co z_~iaf -U. Sh Tan pn}• a n ~ '_ ~_ _ WILLOW LANE of ,` ~ _~..~_x---_--- ~~ <.:.>~ ~- ~ ~ - n pua..y r:+vson o t~~ - -- _ - ~ _ _~ ° - ~ ~~ traonal, v y coma baf +h . 17 day ~f N c b , 1961 }ha ubove na. a `\ a \ `o ad d. Sharman pnfar o ' M x n R d.ayhf n +a rna known ie •__ . ~ _ - ' zr. ~ or'ztw ssa.Jo y ~~ ~~ Kx ba. +ha Praa.na wh= cvau,ad +ha fo.ayo:ng rns+ru »ta n+ and ack - a0 ~ ~ o`,~ , '.ep, now?a4ytd th< aama. C • rto.go ~ J`t.. Iy --. lnplAfi'+nd Land CO ( ~~e [1~\~ `\"~0, No+O ry p bliC, 5+[ro~r Counry~ ~V,J. -- _. ._ - -- q0 ~ o. .a b ~~ ~. R My comrn.aion axp:rny -_..... `p \ 0 Dist 5 9T +-\ ` O R Iv+` of ~ ;, `\ \D A salt' d, ~{hat tha p!a+nf W;llo Rr var £s+z} ~h +ha Town of Hudson, qn \~ti J. Sharma F + son and Manes Avd yRa+ on <ry, ha PProsad by 7 1 + 7Nr, J+ cat was n~o tly~M o _ ~, qa Cr+yCouna L" ~ ~~ 1 iY'- d•a++ a by damxs P, of 3 .A +~4 ~ ~~ I harab t;fi +hat fine fo.e Y ~``-~-~" __ C-rcSC N 5 - No <-712, ~l v'~r ~~ Y y 90 9 caPY a so1v+. adcptad by ~ Y'z ~ ~~e ~ \ +H• Gi+y Causal o+ 4udacn W a at q non+np hold on Jl[. '/o, /96l .Nov is, ,961 y!~ Iri, rod'u` ~ rr :~ ° ~ _ ~, rat} ~ o :. `, °. see i~ ~/ G+y C ar$vY~~ hbdS+ nca l nq}hs and ~'h o t y, A ~° to a~ Q ~," - Rua/u+wn: ~ . ~ ll ~v m;d+hs m s d fa }h< I Ah" ~ q4 OP "A¢sclw.d,that tha plgf of Wrl7ow Rrvar Es~a+nc m +he 7awr, of Hodson q¢ans+ 0.01 >`oo+. ~ , r ~ t>\. ie} Y` ~ ~ J. Sherman icfarson and Marna Acdrey pa+anonr own•rsi.Dt gppro vad _ roa. oa % o, . r9 C~, 01~, / '~~ oy fhn Town dcard teg'rr~ ~ ,rvs >:: t ~ ,~• a , ~Q'~. / rose en m n __ _ __ _ ' Ind.ca}ar 1~dram roe ppe 30~lany, v ~ ~ a r ~ tI 0 T hanby car+:fy +haf +he raraq g ra a copy f asolu+ on adop}<d 3.87 "pcr ff ~U. ~ s ~~ Ah- nplpfftd +ha Town Board of fhcT wn o{ Hudson a} a nt + 9 r)cld on~i,rl4 •196L~ ° Indreafas! dram-ironprpa 30~lony, Unpla}}d N~" a9t~,as X ~ Lo«d 1.13"par ff, ~ n e It' ; ~~ / :i~. Land o\~ 's ~ L' Town [lark ~_ ___- t °p 6 ,~ y ~I gs°, v / S+a+a of W cons nj s e. Percela}Ion and sad }as+hales ~ ~ ~ Lave±y f J} G shown th ur' Ir q x a: ~ / '~" $ Barnq +h d y lac+.ad quahf,ad nd ac}Inq +raow,ar of J+Gqu Go- - percala+ion,.rLrm/ bor;nq i - ~ un+y j d h 6t' ea ++y +hctn daaea +b ¢eords n my off- ~ li - a iha ore no unPe d -Foxy nvaidsp i urn + of Ail ,e}s shaven hereon }a be Served by / i----------_ ?cc... !t -,y9Gl al{ac+;nq }ha lands rnclud d n +ha plq} {aW; qaw prrvq#e wa+tr and se ways sys}amr. a~~ '~~~ ~ ~ P, rar Ea}a+as. ! a ~.i , Unplgf}ad Land. - £, I ~ _ -~~Fti~1v~~-z A,k ~l.%r ~ Surva yarn Affrdavr+: ~~ Leta+ion Map Caun+y Traasurar 5+a+a f W sc nsr n~ s Sac t 9-29-19 t ' Ccvn+y f 3+< cu / S{a}a of W~ nsin} ' Govn+~ f S+ C e. I Jama R. G hb, s y , da haraby ar},:ft' +hc+ 7 nova svr.a yad d v,dad and mappad ~ `"' y Wr)law n Es+a+u Iota+ad 'n iha K£ guar+.. of Sac+on ,9,729 N, kl9 W, Town of _ ~ st B mp +h av. ya4c+ad q a'r f;ad and oc+:ny } as r r o+fba Town f Nvdeon, Sf C ao Coun+y Wiaeona n, fu•rho d.:ara•d as follows, bagnnnq a+ a pant unt _ ft fw.ugw Hudson 1 do haraby car+rfy that rn Doe ordanu ~ raoerds ro rot' off- ihe+w 8929 fiaa+ Soo+h and 2e297 fact Wa.a+af+ha .N £. sacfioo corner of sod q vaq sera 'c~ +h°a am n° a^Pmd +axu or npard aptc e; assassrgen+y as f - sacYon 19-29-/q~ +hsn.a s I'13'f q dis }onto op LS3. bS fay+; thane S ETZ7'E a du+an ca M" ~~ 4 4ldlA , i9c1 affac+rnq iha 'ands rna(vdgd n +ha plaf of Wi Hew a' '. U:, . ~ rar F,}o}a.. ~, i r a} LIDO fu+; +hanca S 2'33 W a d!s+anc of 76840 fay};thane J 89'JJ'E a du- ~i" R' ;,' 1 +anu of 100.00+aa+; +hanca SJS'OOE a dblanca f /9t.o0 fat} }o +ha nor}h Mina ' of C.T H jway "A ; +hanca N 60'NF along Ja d hryhway a di++anca of !9010 fssf ~ ~ :-a-c'a° f~' ' ~ Iw~_ 1 +hanca N SY 04f elan~y9 7r.a+ er•ek Road a d j+anca of 16170 fay+; +hanca NJB'LI'W a Tcwn 7raeaursr ' dAfanca of J23.IJ -faaf; {hanca N!'!J'W a d;a {Data of K770 fu+, +tianu rVdT27 W adu+dnuof 340,00 fa} +o pmn+of b• inn mq.7 car}:ft' +haf I made Juch survay, ta+careaofa. r Ian a ion g d din aqd plat 4t' fho dira<+roa of J. Sharman pe+wton Ind Manse Audrty Patar- liro}s .f City son, omnara of Jard )and; }hq+' such ply} iJ a corractraorasan+a+roa of all t.}ar;or bt- ei Nvdsen E<AYl~aedranM acs 4,'An badaea bia- 'y''v °~ n:"s+o n., C'--';.ro ~n~ax to l.ca islt~ undaria af~Fha fond survayed and rho subdivirion +haaaf mdda; +ho+ I hava fullyy coq- ~~0a SG&EQW dFfX1N 215.6, d-'o e•.1M7t tll W 111:&Aw. plrid wi}h the provrsrenr of Chop+ar tk of fho Wr'sconaln S+a+u}aa and iha svbdirrs;on ~.1 GsVK qa ~~,~ raqula+ions of the Tewn of Nvdaon in avrvay nq, Mapp%ng and dividing +ht Jama. 9de lairt~ 1 \, l - ~ ,~ 11ML9~1twK agp~erbai~4V I4.iL_. ~,~;~( , 26798: wwa~v+~~u.ab.redt w~ -~ acKtea~a,ra """'' s~lnaa R. 6.ubb, Jurvayar YlV3S1fl'$~1~` C(C 7 1¢t 7ga1W0~ CaPar~rd 4rra G.aq~y ~. 3ubaaribad and sworn d•obafox era }hra2Mday of Novt/~6 /9i1. I1.GfEttC'~ 1 ~. A Ilgswk M4lM~f@...M ~~ t.{asrn~ i, GsGo t N+ Wb' -j~~~cw 1 r-~ bYl 4..~,rrt• y or o Arq rrc~ Pr. nca G~Wit. Armansn coprrysuon .'~ ::g .. U 2719P '199 STATE BAR OF WISCONSIN FORM 2- 2000 WARRANTY DEED THIS DEED, made between Michael K. Kenney and Debbie R. Kenney, husband and wife, Grantor, and Justin Seidel, a single person, and Kimberly A. Tritt, a single person, as joint tenants, Grantee. Grantor, for a valuable consideration, conveys and warrants to Grantee the following described real estate in St. Croix County, State of Wisconsin: Lot Seven (7), Willow River Estates in Township of Hudson, St. Croix County, Wisconsin. Exceptions to warranties: Easements, restrictions and rights-of--way of record, if any. Dated this 10th day of December, 2004. ~8~ 1 3s tl KATHLEEN H. 1iALSH REGISTER OF DEEDS ST. CROIX CO., MI RECEIVED FOR RECORD 12/21/2004 02:40PM MARRAT9TY DEED EXEl~T t REC FEE: 11.80 TRANS FEE: 680.70 COPY FEE: CC FEE: PAGES: 1 Recording Area Name and Re m d ss{lETURN T0: Ed~'tta al i METRO IEGAL SERVICES, INC. jb0 S "" . - it t 15 330 SOUTH ZNU AVENUE, SUITE 150 ud n, 15 MINNEAPOLIS, MN 55401-2217 453 66 020-1115-70-000 Parcel Identification Number (PIN) This is not homestead property; . M1fetro Legal Services EDIRET 453766 A 42,iJ064 «D 33531, * Michael K. Keene * Debbie R. Keene * AUTHENTICATIQAThe(~ 8~(O ,1C Signature(s) 1. t?lry~P~V'b ,,~q~(~ _s \N\S~~ authenticated this 10th day of Deceml~~~4 TITLE: MEMBER STATE BAR OF WISCONSIN (If not, authorized by § 706.06, Wis. Stats.) ACKNOWLEDGMENT STATE OF WISCONSIN ) ST. CROIX COUNTY. ) ss. Personally came before me this December 10, 2004 the above named Michael K. Kenney and Debbie R. Kenney, husband and wife to me known to be the person(s) who executedZllg foregoi:}g instrtunent and acknowledged the same. THIS INSTRUMENT WAS DRAFTED BY Peterson, Fram & Bergman -Steven H. Bruns 50 East Fifth Street, St. Paul, MN 55101 (Signatures maybe authenticated or acknowledged. Both are not necessary.) *Names of persons signing in any capacity must be typed or printed below their signature *Cheri Brown Notary Public, State of Wisconsin My commission is permanent. (If not, state expiration date: 3/11/2007 ) WARRANTY DEED STATE BAR OF WISCONSIN FORM No.2-2000