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014-1016-40-000
Wisconsin r'epartment of Commerce PRIVATE SEWAGE SYSTEM Safety and Building Division y INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Personal information you provide may be used for secondary purposes IPrivacY Law, s.15.04 (1)(m)]. Permit Holder's Name: City Village X Township E ert, Dennis & Kath Forest, Town of CST BM Elev: Insp. BM Elev: BM Description: TANK INFORMATION n TYPE MANUFACTURER •~ CAPACITY Septic )j ~ / Dosing P 3 ~46 r'' / 1a Aeration ~~5~ ~,`~ Holding /~ S'~ Ia~buw~nAS /' r t ti r..._ n.,~ _ ~_ ,. ~~ TANK S ETBACK INFORMATI ON ""~~ I---" ` --- TANK TO P/L WELL L 5 Vent to Air Intake ROAD Septic ~ 6b / ~~ ~ 1 , `S„ <f Dosing y ~ / 7~ ~ I , `~• "J' Aeration Holding PUMP/SIPHON INFORMATION /y/ Manufacturer / '^J• ~ ~ f a ~ errand GPM Model Number ~ ~ ~ ~fi TDH Lift ~ /y Friction Loss ~r System Head TDH Ft Forcemain Length / ~~ Dia. i ~ Z Dist. to Well Z~ SOIL ABSORPTION SYSTEM county: St. Croix Sanitary Permit No: 515285 0 State Plan ID No: Parcel Tax No: 014-1016-40-000 Section/Town/RangeMlap No: 07.31.15.107 ELEVATION DATA ~ .97 Ia3.9Z ~rf'2E, STATION BS HI FS ELEV. Benchmark ~ ~ ~'~ ~~ ~.` 3 Alt. BM Bldg. Sewer C, ~7 ~! (o. 4 Z St/Ht Inlet 's' ~ ~ ~• ~, SUHt Outiet \~ Dt Inlet 1 Dt Bottom ~O• $~ •~q ~ 11 Header/Man. `3 .b Ll ~ ~~ ~ 5 ~` Dist. Pipe .3 ~ ~~ Bot. System .3 ,.~ ~ 3 I Final Grade Z • d ~S. 3 St Cover /. -' ~"G~.~ z•J ~~ ~C 1 Lor~ur S, ~' gL '~, S~ BEDITRENCH Width ~ Length i No. Of T nche 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 f ystem: y5~ ~~ ~~~ , 1/~_ ~//~ UNIT Model Number: rJ DISTRIBUTION SYSTEM ~;~ ~ d~ Header/Manifold i/ Length_~ Dia ~ Distribution /~ Pipe(s)C L/ Length J ~ Dia Z Spacing T x Hole Size J~ ~ r~ / x Hole Spacing ~ ~ Veq~to Air Intake IdJv 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 0 No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: ~ /~/ ~ fl Inspection #2: / / is ~/ Location: 2223 Hwy 63 ,D~e-e~r P'a-rk, WI 54007 (SW 1/4 SW 1/4 7 T31N R15W) 40 acres Lot c-.1h~t~'~3(~~ ~ ~ (~ (P~a1rcel No: 07.31.15.107 1.) Alt BM Description = r' 1~j C~J~~' ~ ~Q;,,~,g b/~. ~~ ~~ lJ'a+~.~l P" 1 ~ ~ ~~ 2.) Bldg sewer length = / ~'~ ~~~ Ova ~1 ~ ~~ 1 ~~ I -amount of cover = 1 aA-c.r, Plan revision Required? Yes No ~~ ~ / i Use other side for additional information. (~ Date Insepctor' Signatu ~ Cert. No. SBD-6710 (R.3/97) ~~J ~ ~~ l~ 3b I~ ~ - Safety and Build' D' n County ~ commerce.wi.gtrr ~-r . C , 201 W. Washington Ave., P.O 8at~~16~ ~~~~ ~ t ~ Madison, WI 5370'=31.2 ~.-.,, a' Sanitary Permu Number (to be filled in by Co J ~~ 5/52~s5 oeparanerK a Comn~we . State Transaction Number Sanitary Permit Application ntal I D ? ~ ~ I In accordance with s. Comm. 83.21(2), Wis. Adm. Code, submission tts o O arc Project Address (if different than mailing address) unit is required prior to obtaining a sanitary permit. Note: Appli lion f ' miffed to the Department of Commerce. Persona] information ou provide may be used for seco ry sub ~ ZZ,23 f~ 3 u oses in accordance with the Privac Law, s. 15. l m , Stet§. I. A Geation Information -Please Print All Inf / anon parcel # ~~Q p wner's Name - ~ ,~ ST. CROIX COUNTY ''- property Location ~ /~ '7 Property Ovine s fling Address ~ 2 ~ ~ ~ Gav°t. Loot Zip Code Phone Number ef/ 3/, W 'h, Section State ~ ~ ~~(eircle o~ ~ ~ _ T - N~ R E W k all-that a I Lot # Bulldiu chec NP Y Subdivision e eof g( II. ~ p 3 or 2 Family Dwelling - Number of Bedroo - Block # ^ Public/Commercial -Describe Use - ^ City of CSM Number ^ Village of~,~ ^ State Owned -Describe Use _~~- Town of rD ~ ~" -- ar 5 7 l~ CE-l III. Type of Permit: (Check only one box on line A. Complete line B if applicable) A ^ Other Modification to Existing System explain) ^ New System Re ement System ^ TreatmendHolding Tank Replacement Only List Previous Permit Number and Date Issued ^ Cha a of Plumber ^ Permit Transfer to New B. ^ Permit Renewal ^ Permit Revision ~ Owner Before Expiration ~ _ IV. T e of POWTS S stetdCom onentlDevice: Check all that a 1 ^ Non-Pressurized ln-Ground ^ Pressurized In-Ground ^ At-Grade and > 4 ~ f suitable soil ^ Mound < 24 in. of suitable soil s f ^ Pretreatment Device (explain) ^ Holding Tank ^ Other Dispersal Component (explain) _ ! V. Dis ersaUTrea ent Area Information: Dis ersal A~~ quired ~~ Dtspersa~Area Propo (sf) System E~ io~ Dest n Flow (gpd) Design Soil Application fl P ~/// r IV/v\ ~~~ t ~ O ~ Total # of Manufacturer d VI. Tank Info Capacity in Gallons Units ~ ~ U °~ .. h 't~ Gallons b New Tanks Existing Tanks ~ ~ ~ t j ~ ij ~ ~ r'~n ii. ~ A. Septic or Holding Tank Dosing Chamber ~ ~ (7 VII. Responsibility Statement- I, the nndersigned, ass responsibility for installation of the POWTS~ho~RS Number ched B s~rbess Phone Number pl is Name (Print) Plumb gnature ~ ~ / _ ~~~/,_,(/ ~- / ~~ ,,/w (7/tt7~) , ~j 7J (7 Plumbe/r's A~dd-r~ess Street, Ctty, ~e, Zip Cc ) v ~ ) III, Co~De artment Use Onl '~'n~C..IJ/ Permit Fee Da/t~e I ued ) x Issuin ent Signal Approved ^ ~ oved $ ` ~~ ~ V ~'~ / V Ow tven Rea for Denial ~ ~ ~~ ~ ~ i IX. Conditi~a~easons for Disapproval "I; Septic tartk,_e(~Uenfttltr and n• J~~ . dispersal cell must all {~ utv ~!i ~~ptal +~""~' as per rnanapement plan provided 4y'plu-nbef, ` 11L (/ _ _ 2, A11 stack t~gt~t`emtlMs must ba mainttlittet! ~ ~ ' ~l~ V t~ Dt}a.~~ Attach to complete p arts or t e system and submit o the County only on paper tees an a tn~ t t lathes i» ~ SBD-6398 (R. O1t07) Valid thru 01/09 ' PLOT PLAN _PROJECT Dennis Eaaert ADDRESS 2223 Hwv 63 Deer Park Wi 54009 SW 1/4 SW 1/4S 7 /T 31 N/R 15 W TOWN Forest COUNTY ST.CROIX ' SYSTEM ELEVATION 94.2' BEDROOM 3 CONVENTIONAL AT-GRADE CONVENTIONAL LIFT HOLDING TANK MOUND XXX SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE 630 HOLDING TANK SIZE L D RATE 1.0 ABSORPTION AREA 456 # of chambers none BENCHMARK V.R.P. Top o tank pad ASSUME ELEVATION 100° Filter BEST GF10-8 ^ BOREHOLE O WELL H.R.P. Same as Benchmark Highway 63 ~ _ ~~~~ 100' Scale = 1 /4" = 10' ~,' '~~ ` 400' Well Existing 3 -~ Bedroom House Property Line 1320' Tank is to be properly bedded and provided with lockdown covers with approved warning labels Old Tank is to be pumped and buried Area 15' Below system is to remain undisturbed Cleanout ST 93.2' = II B ~~~ ~~ Y 6 °~ Pole Shed Grading is to be done to divert run-off away frog'"'" stem Huffcutt Combo Tank 8% Slope 94' B 2 92 91' ` PLOT PLAN ,-PROJECT Dennis Eaaert ADDRESS 2223 Hwv 63 Deer Park Wi 54009 SW 1/4 SW 1/4S 7 /T 31 N/R 15 W TOWN Forest COUNTY ST.CROIX SYSTEM ELEVATION 94.2' 3 BEDROOM CONVENTIONAL AT-GRADE CONVENTIONAL LIFT HOLDING TANK MOUND XXX SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE 630 HOLDING TANK SIZE LOAD RATE 1.0 ABSORPTION AREA 456 # of chambers none BENCHMARK V.R.P. Top of Fuel tank pad ASSUME ELEVATION 100' Filter BEST GF10-8 ^ BOREHOLE O WELL * H. R. P. Same as Benchmark Highway 63 100' Well Tank is to be properly bedded and provided with lockdown covers with approved warning labels Old Tank is to be pumped and buried B.M.* Shed Area 15' Below system is to remain undisturbed Cleanout ST 93.2' \ - Scale = 1 /4" = 10' Existing 3 Bedroom House 400' Property Line 1320' Pole Shed Grading is to be done to divert run-off away from system Huffcutt Combo Tank B-3 94' B-1 ~ 3' p B-2 92 91' 8% Slope commerce.wi.gov isconsin Department of Commerce ATTN: POWTSInspector Jim Doyle, Governor Aaron Olver, Secretary June 24, 2010 CUST ID No. 226900 SHAUN R BIltD BIRD PLUMBING INC 1008 192ND AVE NEW RI('JI~VIOND WI Safety and Buildings i41 NW SARSTOW ST FL 4TH WAUKESHA WI 53188-3789 Contact Through Relay www.commerce.wi.gov/sb/ www.wisconsin.gov ZONING OFFICE ST CROIX COUNTY SPIA 1101 CARMICHAEL RD 54017 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 06!24/2012 SITE: Dennis Eggert 2223 Hwy 63 Town of Forest Transaction ID No. 1807081 Site ID No. 757626 Please refer to both identification numbers, above, in all correspondence with the St Croix County SWl/4, SWl/4, S7, T31N, R15W FOR: Description: Mound, 3 Bedroom Object Type: POWTS Component Manual Regulated Object ID No.: 1270309 Maintenance required; Replacement system; 450 GPD Flow rate; 30 in Soil minimum depth to limiting factor from original grade; System(s): Mound Component Manual -Version 2.0, SBD-10691-P (N.O1/O1), Pressure Distribution Component Manual -Version 2.0, SBD-10706-P (N.O1/O1); Ellluent Filter The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. This system is to be constructed and located in accordance with the enclosed approved plans and with any component manual(s) referenced above. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, slats. 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 Private Onsite Wastewater Systems VERSION 2.0" SBD-10691-P (N.O1/0'1) and the "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems VERSION 2.0" SBD-10706-P (N.O1/O1). In the event this soil absorption system or any of its component parts malfunctions so as to Great th • ~ the property owner must follow the contingency plan as described in the approved plans. In adch'' must comply with the operation, maintenance and monitoring duties as described in section component manual. A copy of this information must be given to the owner upon comp ~on of th~~i~T sqq All holding/treatment tanks are to comply with Comm. 84.25(7)(a). SFF C ORqq Maintenance information must be given to the owner of the tank explaining that periodic cleaning ofthe filter is required. Access to the filter for cleaning must be provided per Comm 84 product approval conditions. Numbers SHAUN R BIRD Page 2 6/24/2010 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. i9, 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. Owner Responsibilities: • Comm 83.52 Responsibilities. The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s. Comm 83.54(1). Comm 83.52(2) A POWTS that is not maintained in accordance with the approved management plan or as required under s. Comm 83.54(4) shall be considered a human health hazard. • Comm 83.55 The owner is responsible for submitting a maintenance verification report acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. 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. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state slats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence maybe made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter and the POWTS management plan to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. rely, Julia Lewis-Osborne POWTS Reviewer 2 ,Integrated Services (262) 397-6005, Fax: (608) 283-7481 julia.lewis@wisconsin. gov Fee Required $ 250.00 Fee Received $ 250.00 Balance Due $ 0.00 WiSMART code;-733 Notice: Starting July 1, 2009, no person or entity may engage or offer to engage in construction business in Wisconsin unless they hold a Building Contractor Registration, or equivalent, issued by the Safety and Buildings Division of the Wisconsin Department of Commerce. "Construction business" means a trade that installs, alters or repairs any building element, component, material or device that is regulated under the commercial building code, chs. Comm 60 to 66, the uniform dwelling code, chs. Comm 20 to 25, the electrical code, ch. Comm 16, the plumbing code, chs. Comm 81 to 87, or the public swimming pools and water attractions code, ch. Comm 90. The term does not include the delivery of building supplies or materials, or the manufacture of a building product not on the building site. For further information, go to our website: www.commerce.wi.gov/SB/SB-Building_ContractorProgram.html Cover Page RECEIVED ~uN - ~ Zoo Shaun Bird Bird Plumbing Inc. 1008 192nd Ave New Richmond Wi 54017 715-246-4516 Date: 05/ 30/10 Owner:Dennis Eggert Location:SW1/4 SW1/4 S 7 T31 N,R15 W 2223 Hwy 63 Forest System type: Mound System Manuals Used: Mound Component Manual Version 2.0 (01 /31) Pressure Distribution Manual Version 2.0 (01 /31) Page# 1. Cover Page 2. Mound Plot Plan 3. Mound Cross Section 4. Pipe Cross Section/Pipe Layout 5. Pump Chamber Cross Section 6. Pump Curve 7-8. Maintance and Contigency plan 9-12. Soil Shaun Birc Signature License rn SAFELY & BUILDIr~1~S ~,. -~. ,~, ~ ~`~~~ ~~~'~ Yq ~UrB;;M :' Npe~fFO~Gs S,o~N ~~~cF Mound System Cross Section and Plan View .~ .~ - - ` .. ~. ~... .. r. ~ ~...... ~....^ .. w .,...... ~. .. .,...n...i., ,~` ~ / "' . ,. r '~ 7 ~' i 'i 1 t T i A ~,; .'. ~ W ~ ~ ~: ~: ..~•~ ~Z. .~T `: i I f r ~. i ... .., r ~.- K B Dimensio_ n A B --IJ - E F H - I _ J K _ L 1N Z ~ "" "~ = To soil t ~ p =ASTM C-33 =Clean aggregate = 4 in. sch. 40 vc ,; .,,, Cap Material sand fill %Z to 2 %Z in. dia. 0 p observation pipe Geotextile Fabric ~3~~ Ft Contour Plowed Surface 1` Slope Direction "•~-,- GENERAL INSTALLATION: The mound area is staked out along the desi vegetation is mowed and raked off the site. The mound basal area (L x W) is plowed ith aomoldboard ogr chisel plow. Plowing may not proceed if the soil is wet enough at the plow depth to form a'/ inch soil wire when a sample is rolled between the palms of the hands. ASTM C-33 quality sand is placed immediate) after plowing, Sand is placed with a tracked machine keeping 12 or more inches of sand under the tracks or is placed overhead by a backhoe. Special care must be used when placing sand of less than one foot thickness to minimize compaction of the plowed surface. After the topsoil cap is placed, the entire moue is seeded and mulched to promote vegetative growth, limit erosion and protect from freezin . The observation pipes are slotted in the lower d inches and secured in place with rebar or a closet tlange.g ~ Oro71gl Page of Ft G' H ~D E Fee Pressure Lateral Layout Two Laterals -- End Manifold Manifold ~---- Threaded Cleanout Lateral Turn-up ---- Plug M I Farce Main X ---+ L Distribution Network S eciiieations Lateral Diameter Z In. Manifold Diameter Z.- In. Orifice Diameter In. X Orifice S acin In. L Lateral Len th Ft. M Manifold Len h Ft, Force Main Diameter in, Force Main Len th Ft. l~ ~~~~ 1J~ i Lang Sweep 90 Bend Pressure System Construction Laterals are constructed of Schedule 4U PVC pipe. Orifices are drilled perpendicular to the pipe with a sharp drill bit and face down. Lateral turn-ups terminate with a threaded cleanout plug and are enclosed in a 6-8 inch diameter lawn sprinkler valve box accessible from finished grade. 03/05 l~j Page of Septic~Dose Wank Cross Section And Pump performance Specifications Tank Manufacturer Tank Model Number t tl ~ O ~ Total Tank Capacity Od ~ Max. Bury Depth ~ Filter Manufactrirer ~ ~- ~ Filter Model Number != 0 Minimum Pump performance Required O GPM! @ ~'; Ft TDH Inlet Outlet Manhole 1VIin. 4"Above Grade With Locking De~iice. Inlet Manhole < 6" Below Grr~de Sealed W~atertisht Pump Manufacturer I ~-_~'" ' ~~ Pump Model Number - _~ Alarm Manufacturer GAP ~ ~ ---- ~ Alarm Model Number t- v - Switch Type -`--~~- Total D ynamie Head (TDH) --~ -Feet Elevation_Head ~ Distal Pressure ~-- Network Loss --~-- Force Main Loss Total ~ ~+ -- ------ Securely Mnuntad Manhole Min. 4" Above Grade With Locking Device Bottom Elevation ~_ Ft GENERAL Yl'VSTALLATION~ The septic/dose tank is bedded and back filled in accordance wit manufacturer's product approval specifications. Maximum depth of bury as speeihed by the manufacturer ma not be exceeded without prior approval. Manhole covers exposed to grade have an effective locking device adl c installed. Piping at the inlet and outlet is of approved material, connected to the tank with watertight fittin s k) laid on stable soil to prevent settling or sagging. The force main is sleeved with 4" Sch. 44 P'VC to brill a the t excavation and the sleeve is sealed watertight. Electrical service complies with N.EC 300 and C g ° and g ank 02/05 LJ omm 16.2Y. Page ~ of Sent By: HP ara68rJet 3100, 1 715 b5"C tftlC/ ~ 7nray-v-uv c.:~urmx ~ may.. .-, .. ~~ 9 E ~ ~iER1E'~a ,.,~-i Uh~iP/EF'F'LUENT PUMP ilABla ~' - ~ Na rfR 16N16 N~ IMI! •Bl~ ~A761WBR~g L~IB1f Ir/.Ct ~f i~ ti4tit7M 614.Mx1 46166614 Y tf ti' a Rl ~" BHt.pM 5 598349 ~ 1(~+ ~/~0 41'0 115 230 8N t3-0 1tL70 r 70 64 55 41 32 t3.B 2P ~ 9.fl~71b1z891 ~"~'~ 506360 INICBL 4N0 115 31 6,5 1000 3M 70 6a 55 h 32 13<8 2a 24 9.11 x 11.64x6.84 13.0 100p 70 Bd S5 41 3P 13.8 2!T 27 9.N ~ 11.64x6.714 Caalnutet OutYWttei-"UNM GltlntlMUlexxpxt ~ plNlpstaglt4cwdt 1 1. nuousdWyas 7a1p aslMyuerwtwl6dn?~itb6t lttOna te~lu-111K1 p Y111yE; ~. W tr. ~ A W I cu sU by 8lt f'lOW- GALLaNSiViNUT~ PUMP PERFL3fLMAAtCE CURVE _ USV bOHZ www.Littlec3tantP716mp.c>D621 Motor Houx;in~ Impeller Material 1 Imlreller 'lyre s W Power Cord _ Mcchaniwi Shag Sea! W ~8t3terLer$ ~_.__~._._ 5 s Sha1'.t ~..------__ Beariungs Coated Cast Irian Closed Vane ABS ~__..._...-.. _... , SJTW A ~~ _._._._.., Nitrite with carbon and Stainless Ste4!1 . ___ Stainiet~ Styx! _ Upper Sleeve and Lower Ball QeariLtg:~ Little Qri~tnt lump Ca Pt) Bax i]iLO~ vIx4M~a City, 06; 73L5T F6o>tr. ~IIS.l17.3SLL • Faa: 44!l.23R.Lii~ $-x..6: e~.x+xaer,.r.L~1a44.p..t,~x,m +~ rKxm 045285-..o~~oa FL~Y1- LITERS/HOUR iaoWCS p+~'NER'~ l~ANi~AL 8~ MANAGEN[~t~ P~.AN 8sptta 7e-alc CrAtcterlt FDOsr 11~~ ~ ~ ~~ ~ACial Uc~ts lr~Re~ed flow (ate) x ~..i5} :3t>it /'VpP~' Ft~Gs trellesr~etlElfkt~ ~ Dsetucnd Tatd a.d Eporeds ,SS} Pre~ea~ed Ett6lrlat ~Y met Par'ltde 57th 9srv~ee Ev~rret lnspeCt aa7ditlon of tank(s3 Pump out conbeer~ of tanit~s} inspecti dirp~d ~(s} Cleraet ~fus~t der P~~~ 1~ flush rsi~ and p oonLrot~ ~ afsrm e~ee;i teems J'L~ Sd24 mgt. Monthly Vie.. s~o mgn. dip myJl. ~1 t3` c#u/4 t?Qmi ~ Pun~p•Tank Pump Tieril~c MMn~ `' .ta'itmp IVtattw e Puma 11Aodenii __ L7 SelrrkllOr+!lcroi ~' O t+Aectar~ A fl D1sCcet~on a 1n-grcwnd t a ~t.~de3 p'~- of pp~~ ~~ ~ ~,. ~ E~TLS~ g t'~'~ ~ ~ ,,,~ T p III F_!0- g v~ ~v/~~~,y n r~- ~C~T'C[~,t ~7 NA e, i ~. C p~ D Paeyt PUOer D Weelland © Other. • II ~n-9~ iP~+-~l C] Otheu- 7( intfi disrnefiar + ~ vlKkur.eypl~rd for deneee~ G - ~ - ~~' SlrYtOe ~'rsqueaey At least anoe every ~i menthe 01 (Aila~dnttuse 3 yrs.) When cesaebine~l sludge and seaern ee~gceeeJs erne-~ ~K~ of ink vaturne At least once awry ,~ ~ ©marxths s) (Meeadmeiese 3 yes.) At lee3.3t arias every ©rree>rtffes s~ Rt lee~st once every D tri s} D hiA At leeist once awry is months sj Q 1tcA At least once every Q rnesreths D ywr(s) d t+lEl At iFSetst t~ruas every D olantfis t~ y~{s) to <1tA 3titE~iA~NClti lN1C'TitlNS one esf ttes 1iT iiasnsa: or } e~tteleties and dispsrsal ~~ sh~tti ties modes by an ir~diVtdicai carryle~ pone f,l~' P'funfbet: Msa~ese' Yturet~' Resdrlo0sd Bawler. POWC~ trespeedb~: Pt'yVYy'~ esP ~'Oprre~u Tsnfc inspsc must in~tcfe s visual ins~tJon of the ~nk{s! iov t~rrdly ae+Y ~' ~ lraedwsaet. k- ~ t,~aciai or ieillks, re~+'e ~ volume of oexnbined stud~a sled sesurrs end b c~es~eic tar srry Fsrorc up ar porir~ t~` i~tllJAtlt ort the gr~iund - -rns d~>~ oestl{i3 ~~ tw ~ eheok the e) Yleeent is+rots ~n tFee e~rreuwa8on pipes and ~ check irir eeeRy parydir~g of effluent ot7 t!'ls t~~ 'Y2is °~ sllltrent °° !~ 9 sW~OS rtWy kidlea0s s t+e~ ~ and mquiet~ the ienmee#eet6s s'+ of the loeasl rrgea[sJtary sud+o~- When ttre wmtl amen a~slud~ea and ecuri~ fn any tank egcmis oae~"t+trli (Y,~ cyr'rrulta tiftlie ink vowme, the ~q e{~ciaat~~~~t~s ~f Uce~,,,t,8.0~.k~~traU~+b~et~r+~r+o+red by a SePta~! n9 ~elsl~' ~ ~`P of to >tior~dae~lms wtlh ct+- ~ a ~.J~ *11~~~ ~i~Ali7Yatj~ I/VY~i- ~'ile tl~t~C+n~ art ellEues~t tbs. nl~' ar pr+eswri~ed PC1Vl1T'S cottyp~onent~s, preb'~a ~~ and ~Y crmalntanance or ntchimring ett irdiw+r~s ta}`~9? morrl~s or {~ ~tal! be ~ ~'N $ c~lfed ~~ M~ ~ ~ rem enrol ~e psnv~ed ~ tteec lacat reg~utatnry atltFioriiy wtd'yin f ~I rlay~s c~ tbmp of ar~- sctvive ~t '~'l•Att'Y" UP AND L~Pg.QAl`tOP1t for new cescee3truction, pr1~ ~ rrse a~ the P~3Vy'1 S drecdc•tr~tmertt tank(s3 tctr the pry ~l~nD Arndt or atfy~ ~ tlret,rr:a;. trrepsde the taneatm~t pry anci/ar aarrlsge the dispersal ree!((ex). tf h~tt oor>cen are • ~tC twee !ha oe~nnEec-rts of rtes tank{ea) remsyved by+a septage~ •s+en~dng aperea6cu prior to ~` sue. erect up shalt rmr accarwt~eri scx"1-conditions are frozen attire infCltratiVe stlrtdGS- fiil8tx~v8 nonnat ti~}f~swaUer levels_ Y~it~On P~ is;ei~ooed tEls esr '. Ota~ng v°1NOr °~ P ~~ tts8~ cell{s} in-one do-~s+e. avE!f{ddclit'~ ttt6' ittd tA~'t66Uit ifi 1l wasoeWamrwm be wed no ttse tatge p or• s+urfe~• die clE "t'o $void #fiis aciiuaE3or, have ttie corc!!ents old ~~ ~ nanu~ved by a ,. ~ ~` 'tom ~c ttie etriuert at conffi~t a ~ oP POVYTS ~ assiHetel ntanua~a l _ one t>etxi78J in ;fit: pumper, 0o not drive arperic viehidss r~r' ~autks and tC6pet~stf t~1S. DO not cft]vt: t'N' t~AEI', t!!`~IBiW~SL tft~tll'bUl the arena wt[htn t5 fioet dvwrt sbpa got ~ n7ol1t1d or at-grade stNl abs6rp~pn ~nea Itedtrcl~on or-otirrrtnation offhe deg ~mm fhe wastewatersi~eam may improve the ~tt~e ~ oft5e PoWrS= antit-b~,y~e ~; corrcioms; ~tton : ~~ ~'~' ~' fioeerida~ drab (s~P pump} water; ~ tea' de,~' ~; °~ - ~' SrKI peelings: ; $. h~ meat P~~: Pdcts; sarit~ary lYaptcirir tamporra;'aRd wabar~ ABANOOI~IIt'Eilft' YIIhPat the P01NTS labs erx{loris poem _- SY~n ~d ~M abandoned m ~p er~~ ~ ~ ~ 83.33 ~ Ps shall Ile taken fn Insure plptng to tanks and tstxmairt Admb=~Ve Cod that the T7,e eontenrs +of err tan P~ shop be Qisoonrlecteci al'td tfie ahandorted pipe ~nings wed ks oral piizs ahaU be riemoved and Ate- ~'1~9, ~ tartica and pRs shalt tie excavated ProDe`t5' d~b~ of tsy a Sepfage filed wkh sots gray,N vratroCher inert solid material ana removed or Itherr covers „Q,,, ~g aPlaratar and the ~+oaf ~e 'CONTINGEN'CY PI„gH tf the POW'?'S fouls and cannot be compfrantreP~caernentsystern; rSpe~rad irie 15ttowing +neasures h ova been, or must 6e ttliCer'l Ua Cl A satCabte ~nt'ansfa has Pt'ovide a caode ~ ~b`~Ysterrtl. The tapTat~me~ntna~ rsho dam rnaY be utili2ed for fhe loeBG'ort of a P~ t7y required setbacks firarrs exisLin p~Lectecl from disturtsanos ar-d went so7 Protacx the "~~errlent at8a ,~, result in then 9 anrt pruPosed strucxure~ tot th'res lalotakk~ arfd shc~ r1ID1 eed for a ner~, soi! and site'evatu3tio~rt by ttA9itfs_ ~'adune to D A s ~- Rapta~Et7t 6'ystert~s r°nust aom t es461tsh urlabre rep(a~m,~t au,~ is not available due LO sett7a ~ ~e rules in efl5act 3t that time. 3 sut4e6te r ~' ~°rO9Y a holdltrg t~ ~Y be rrlstaUerl as ~' an place if fimitatiorts_ ces i ~ S~ e+raluatior~~ ~n ~~ateci ~6o Fcter~ti€Y a s~ Est resort to re the faded POyy~ advan n PpVY]rS n7ttst ~ t~rrned to _ rtabte repfac~rnent area U ~r~~ ~ 'tom ~alfed as ~ cast reso 2 ~, ~tabf a reg3acemart# area,- If na far7ure of the PpW7'S g so7.ar~d the ~~~ ~ ~OrPtl'on A ace the >`aited PQWt"S_ $p~°B"ient area is available a ~'ititGatlv~e s~~g~ SYsterris may be rec~ons2rucied in Dace ~ . ~'~ARNIN ,t~•a. Runs of such systems .must wmpty with the Ong removal of the t~mat at SEPTlt;~ PU1MrP AND O rZrtes in etierx ~ ~, 6rrt~ VIER ~U~T ~~R.fl SEPTIC, P(lr~ ~ KS MAY CC?NTArN Li~{AL RESCUE-OFA pERSOitt' FR+DM THE 1 ~TnIrLNT T14r~(1{ UNDFR (IA~ES •p`NWOR INSUFF'1GIF1VTdXY ADDri7CJ,fyat NrERt©R C)~ '' CIRCUMSTANCE.s. D~j}t ~Y ~~-. ~DMMEiti(TS . A TANF~ MAY 8E DIFFJCiJLT OR !Ai[P.QS,gtBLl:„ p01AF;t'S tN'S7IU.~,ER - tYatrte ~' Div Phone _ ~ -~J POWTS MAiNTAfKER - Narn~ 3FPTAGE SERV1CINt~ ap Name .r-- ~tTQR PUMP - '~! [.oca[.. ~GU,{..QTORY.Q(I~FIaRRY Php~, '~~- ...... Agency- ~+Ln~u„ r.c~asi~ ~j!txra std atrLhe phflng ` D C.t ~? ruarar~tee ~ Perrormaace pr ~ ~'~Nt ~ ~ 8 ~~ YI/atrsl~a,-d Counts' Zon ~ ~ ~ f (7J & ftl. Wisrbrtsira q~ $ttd Sari ~ ThtS Qtl~p~ meets ~'fr"' rods Use of tl>ts t dt>~ cwt ~tuuv~t} PAID ' Wisconsin Departrnent of Com .SOIL EVALUATION REPORT Division of Safety and Buildings Page ~ of ire ac:w~aanc:e wnn wrnm oa, vns. ream. ~.uuc County ~~ (`! ~ ~aw~t~ere! Attach complete site plan on paper not less than 8 1/2 x 11 in Siir~ • ~ ` . include, but not limited to: vertical and horizontal refere po~~~~ri~l Parcel LD. , ~~ ~ ~ J percent slope, scale or dimensions, north arrow, and I lion to nearest roa D j Please print all inform lion. Re 'ewed b Date ~n q, Personal irdorrnaGon you provide may be used for secondary p rposes (~i~y 1°}w~.~SJD1t~1) (mp. v ~ (,{iy,-y~.~ ~ (~ D Property Owner GR01 ST Locati n ~ . ,~ ? ~ rv, ~ ~ ~; j NNING & Z F1C 1/4 ,~ X1/4 S ~ T ~ ~ N R ~S E (or~ Property Owners Mailing Address Lot # Block # Subd. Name or CSM# CAy State Zip C Phone Number ^ City ^ Village Town Nearest Road ~S~ ~r GPD ^ New Construction Use' Residential / Number of bedrooms 3 Code derived design flow rate Replacement (,~y~ublic or commeraal -Describe: ________ __-_-_-__~___.-_ ___ Parent material ~ .t!f:~LJ Flood Plain elevation if applicable ~ ~ ~ ft. General corrrrner>Ts and recorrrrrrendations: System Type ~ Dr.l ~'~/~ System Elevation J ^ Bonng Boring # Pit Ground surface elev. ~ ~ ft. Depth to limiting factor JU in. Soil lication Rate Horizon Depth Dominant Cdor Redox Description Texture Structure Consistence Boundary Roots GP D/fF in. Munsell Qu. Sz. Cont. Cdor Gr. Sz. Sh. 'Eff#1 •Eff#2 Z r'1J (7 _ S !!~ ~ c' Boring # ^ Boring © Pit Ground surface elev. ~• 3 ft. Depth to limiting factor ~ in. Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •Eff#2 Z ~~.. ~ PM ~ / ~/ 3 3a-rd ~,~ .~ s -,~- w~,~ - ~ - Effluent #1 = BOD > 30 < 220 mglL and TSS >30 < 150 'Effluent #2 = BOD < 30 mglL and T55 < 30 mg/L CST Narr>s (Please Print) Sig CST Number Bird Plumbing, Inc. Shaun Bird ~.f 226900 Address Date Evaluation Conducted Telephone Number 1008 192nd Ave, New Richmond, WI 54017 ~,, 3 ~ ,.- f ~ 715-246-4516 iX , ^. Property Owner Parcel ID # Page of ^ Boring ,~ Boring # ~, pit Ground surface elev. ~' ~ ft. Depth to limiting factor ~ ~ in• Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP DIIt? in. Munsell Qu. Sz. Cont. Cdor Gr. Sz. Sh. 'Eff#1 'Eff#2 3 -,6_S ~ r---- - /~ l ~ n~ ., oL Boring # ^ Boring ^ pit Ground surface elev. ft. Depth to limiting factor in. Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/fP in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 •Eff#2 ^ Ong # ^ Boring ^ Pit Ground surface elev. ft. Depth to limiting factor in. Soil ication Rate Horizon 'lepth Dominant Cdor Redox Descxiption. Texture Structure Consistence Boundary Roots GP D/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 •Eff#2 • Effluent #1 = BODS > 30 < 720 mglL 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. SBt}8330 (8.6/00) Property Owner Parcel ID # Pane _ __ of © ~~ # ^ Boring ~j ~. Pit Ground surface elev. ~ " ' ~ it. Depth to limiting farXor ~ ~ ~. Shc Rate Horizon DePlh i~ominant Got Redox t)escription Texture Structure Consistence t3ourrdary Roots Gp irr. Mur-seN Qu. Sz. Cont. Cdor Gr. Sz. Sh. 'Eff#1 •Et~ 2. _ ~ i ~ 3 ''6-.~ ,. ,,~ ..v U I~ng # ^ Boring ^ Pit Ground surface elev. ~ R. Depth to Nmitinsr factor in. Horizon Depth in. Darrrinant Color MunseN - Redox Description t1u. Sz. Col1t. Color 7exiure Shuchxe Gr. Sz. Sh. Consistence Boundary Roots ~~~ - Gp 'Eff#1 cation Rate D~ 'Eff#2 ~~ # [~ p~~ Ground surface elev. R. Depth to Ihdlir~ factor fir. Horizon 'leptlt Dominant Col Redox Descxiption. Texture Structure Consisterroe Boundary Roots SoN ication Rate GPD/ft° In. Munsell Qu. 5z Cont. Color Gr. Sz. 5h. 'Eff#1 •EfT#2 ' Effluent #1 = SOD6 ? 30 < 720 mgJL and TSS >3Q < 150 mglL ` ElRuent #2 = BODE < 3Q rrrgll. and TSS < 30 mglL The Department of Commerce is an equal opportunity service provider and employer. if you seed assistance to access services or need material is an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. Sar}i3J0 tR.6A001 Soil Test Plot Plan Project Name Dennis Eggert Sha ird Address 2223 Hwy 63 Deer Park Wi 54009 Lot ------ Subdivision 40 Acres p SW SW 7 31 15 ATM #226900 5/30/10 1/4 1/4S T N/R W Township Forest Boring ~ Well PL Property Line BM or VRP Assume Elevation 100 ft. County ST. CROIX Top of Fuel Tank slab System Elevation 94.2 *HRPSame as Benchmark Highway 63 100' Scale = 1 /4" = 10' 40 Acres Well Existing 3 ~ Bedroom House ST Pole Shed B.M.* Shed ~~ Property Line 1320' 400' B-3 p 9 4' ~ 9 3' B-1 ~ p B-2 9~ 91' 8% Slope . STe CROIX COUN'T'Y SFPTiC TANi~ 14~~1Ef ~TENANCE AGREEI4~ENT A1~TD OW'NIRRSi~P CFRTIFICATION FORM t3wnerlBuy~er ~-~ ~ M Aaare~ 2 Z ~ 3 ~ i Praperiy Address ~ Planning & zoning Deparmm~t for new oo~raction.) ~ c,~~ ~j f Parcel identification lumber ~/ ` ~~ `° ~ `~ d L City/State .G~ S[:RIPTION ~ ~- Location ~ ~4 ,~~ %4 ,Sec. ~~ , T ~N R~W, Town of / ~ Property ~.- Subdivision "- ~ Lot # _____.. CertiSed Suarvey Map # _ , Volume ,Page # ~- ~-- ~ Volume ~~.a Page # .'Wancanty' Deed # ' Spec hvase yes no Lot ~ ~ ~ S„~STEM M.~+-TNT~'~LAriCE AND OWNER CERT~CA_'TTON use and of yaaar septic sys zr~1t h 'W pan Ito . boa comsssta of p~map~ ont the tank as treatment stage is the waste disposal sysfiem. pwner . ~ system can affect the fanctiam of ~e Septic 12 - St. +C~COix County Sasa~Y 'bilities arc meted. iut $C•amQa. 83.SZ{i) and is G'hap~r 1"he owner' agrees tp Snbmit m St. Caoiuc Cataaaty Pl~umning ~ ~S °°°~t a ceafifi~ 1) ~' owner aadby a plumbao~ jautaacyma~P~ ~p or a licensed pint g f ,~ ~ , ~~ systcm is is prapea operatsn8 conchtaon and/or {2) after mspect;oa cad P ~ff aaccsser5'), ~ less t~as-1/3 full of stnd$e- Lwe, fEaa ~ ht~e sew the abovo roqu'md agreo'tio aot~N~ Resod, ~~~` ~ the of Coaaa>ecca cad Sae Deparma~t State of Wisconsin. standards set t~ laacein, as set by ~ Dep~taaa~ Chan stating that Yoac systems been znaiataiaed nmpst be completed ar~d re4aned'D~ ~s St. CSroia Covtrty T'~8 ~ ~8 ~ whim 34 days of the y~ ~ ~• Uwe certifythat all oa this form era true m the best of myleer Iano~-Ied8~e- I/we aua/are tine o~s+aGC{s) ofthe pmprsry describcd abm-e, by virdxe of a wanaatY dxd s+ecorded is Register of Deeds Office. Hinter of b ms SI TURE OF AI'PI,ICANT(S) DATE ~~~~:.+ .** ennod may resnYt in the sanitary pcxmit bring rcwolxd by the Planning ~;y ~ that is misrepe^es Ike with shin appficatioa a zecaoxded wasanty deed f~ t~ of Deeds Offitcx and a copy of the ocrtified ss~ z~ rice is aaadc is tins deed- . (REV. 08/~ ~ T.t'6 Ye4'TF RiCYSV [D fvR R4:..liDIN9 aaTA 11 _- w /.H ire T,Atif1T]Z l~n~of 1--1.$~A . .. ~ 4~.~~ t~ - re 1 Lorrc~ Egs~el: k: ark V'ioaet_- ~~$tr3'f~ ~~~~ 'K [~ ;. ~ ^I ..... .. .._- kss~a ~_ - ~~,greetx t-+FZS ~-,ts-• ~:+a'i'ft r_--. av .-. _ ~~J ~Y°T F -T223 ESIIl3,lia -Y• , -. •- ti S ~ .._ .__-.. - ... .. .. .._. _... ... . .. - ...... .... s - +3i - . F . __. 1:ransor. Ls~ntii~s_.~____.Eg9'e_rt...and--"K~it~ty ..~ _ ... ~ ~ '~e~pLf,,,...1~~.. ~~i~`•- s nd Eclgert, husEiaric3•••arir7•-~wf~~, as •joi'iit ~. -••tienants, ~ - ,~ ¢~ VET~tT2E3aS6~~2, SElcut the said Gr~nt3r, f'r a valuable evnsitirorat•ior .. S ~~ :_ `-..___..: _... __-- " St . LrL-O i it ~ wi~xcixri T° - convass to Grantee the following deacrioaxi rsa: a ..~:~: s ------ --- ....- r ~~ County, 3tata of ~7Visconain: 1 •~ Nt ~ The South one-half (8'~) cf the• south>aesC. quarter (SF7{) +sf Section -V Seven (7), Township Thirty-one (31) North. Range Fifteen (15) ~~ avast, a:tospt highutay and att,er easements of recor8. ~! This ~arraflty Deed is giapr: ifl satisfaction of that Land Contract r3ated February ZU, 1y~oi a,,u }ccrr~,? ?_^. !'hp st_ Croix County i Register of Deeds office on February 25, 1976, in Volume 534 of Records on Page 195 as Document No. 331fi~0. i ~~ j ~ ~ tf FEE '~ ~~ i' ~ 1 ~ is not This ..... ....................... homestead property. ' ii (is) (is not) Together with aI1 and singular the here3itamentn and appurtenances thereunto belonging; or r ij , an And...g .. ............. warrants that the title is good, tndefeaalble In fee simple and free and clear of cncumhrantca except ,, a ~ i~ 11 end will warrant and defend Ehe same. li ~~ Dated this --- -- -__.._~ ~.T.!d ......... . ..... daY of ,......... Aug.ust.. ..... ........., 18_..5.&. 1 /} ~,~ ~, "' L=rte fC.~ ~/ ~ . ` .~:i.:~._- -.._.....(SEAL) ~_..-- -._ -_._lC_Ci..kS:_,.._.. .~ (SEAL} 7t........'-.. ......._ ..~.~~~ ' --------Lorne Eggert--- ,.-----•° ............... • -.•- •- •-Violet Eggert ...._(SEAL) .. _-.. ... .. ... .(SEAL) ~~ !, .PaQTH$NTICATYOIS AfsS.NO W L»D(iMLNT ~I Signature(s) Of Lorne Eggert and STs1TE OF WISCONSIN it Violet S~gert sa. ______________________ __ ______._-.,._.__..___.____.__..__-_____.-- 1 tt ~~ g~ .......... _....... ............._.GOUnty. ..,.ii. s,.F•ino~ t1 t}i liaJ°.w.~ .__... ..... ,t,;. _.._______._ Tf~3ay of AUgus3t. _-- 19..__._ Ycrsonniiy c,uuv .,~ ...... ..... ...._ dax of ~,. ... ........... .........._._._.......... --.. ... 1 .. t~ . G. E. Norman TITLE: MEIISBER STATF, BAR OF r.ISCONSIN iI X qIl. - -X~ 'c X- d4X XxX3t.3Cx-3t xX X~~~~~R6C'~' lpft74@L KB/W~79XXXXXXXXX .. . ~~ ~ v to m~ kno~t-n to Fie tht• petsnn \\-he exectttec the !~ ~i fores;oing lnstrnlnrnt a,_d ackno\vleifgc the same. 7N18 /NSTNUA9EN-r WAS OP.:RFTED BY ~~ BAKKE ~ NOE2MAN & SCI3UMACHEFt , S . C : ' - ii ~ ..---•-------..._-----•• . ............•_..---.............-----.. _. _... 1"^,U Y.°r? raaR Drive ' .. : ...-...-aoia--R-ie.aR940Ftd~,---~h}~~~-544}.7......... .., Notnre Pubtie ~-,••.••e~• Cie. _.~.. ~ \;.- (-.,mn,ivcion is ncrm:.tl,~r..;H' rnt, ctlte exnirntim~ (Signatures may he nufhenticateti nr nci:nowir.: x;<n;. ..a, r• - - I~ A-@ nOi ri.CORe;try.) 1181,': i? .) 11 ~N41TCM JC pCiEV nA •1sn~n1C :: _, _ .A...'.i 1'.n •... - ~..~ n... .. .. .e . .. wAA:ri•:::r ..°e~r Sr lT:' 1t •lt 1rY H t" ~~•.1.\ '• - ~- It:a ~,1 1 .~ Ir.• . _. __ .. \~ 1•li~ ....ran 1r.••p~ tl',f.