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HomeMy WebLinkAbout038-1202-70-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: (ATTACH TO PERMIT) 589718 GENERAL INFORMATION State Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. 2725913 Permit Holder's Name: City Village Township Parcel Tax No: Shawn & Brianna Doyle TOWN OF STAR PRAIRIE 038-1202-70-000 CST BM Elev: Insp. BM Elev: BM Description: Section/Town/Range/Map No: i - 23.31.18.1079 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. . /1 Septic y r~ Benchmark e ~o~ ~ ~Np l05. ~ 0~ 1 Dosing Alt. BM Ga b.0 'g (0Oo ✓ Z•~ % p°rat~r I Bldg. Sewer Holding St/Ht Inlet I. C) I TANK SETBACK INFORMATION St/Ht Outlet TANK TO P/L WELL BLDG. Vent Air Intake ROAD Dt Inlet 1 Septic 1 9o , G Dt Bottom Z, Dosing t / I S Header/Man. 170 Aeration Dist. Pipe 3. 56 16 1. 9 Holding Bot. System , z rat'2 I PUMP/SIPHON INFORMATION Final Grade Z, 4 /d3a ' 02% 1~0 Manufacturer Demand St Cover Q 163-4, &OLA S GPM Model Number b~ 6-7 4f.ZrS / TDH Lij''~ FrictiolLoss 1 System 6067 Head TD7, ( .41 Forcemain Length / Dial tt Dist. to wen .0 96 SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. O111fCCnche PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS ~k e SETBACK SYSTEM TO U P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR Type 1-1 A 1 UNIT Model Number: V DISTRIBUTIO SYSTEM Header/Manifold Of Distribution t If Ix Hole Size Ix Hole Spacing V Air In Pipe(s) A IlLength_jj~_L Dia Len th T.7• (7 " Dia • y Spacing 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: $ r Inspection #2: Location: 1273 202ND AV it ejjA_ ) Alt BM Description CC Jam' `J 1. 2.) Bldg sewer length - I ~JQW - amount of cover = a,0 q a r~ A Plan revision Required? ❑ Yes o Use other side for additional information. VV VVV Date Insepctor's Signa re Cert. No. SBD-6710 (R.3/97) .,E4AR~ TO SSA N 2. lu -O2. County Safety and Bul dings Division 57 C_ LZ 5~tl 201 W. Washington Ave., P.O. Box 7162 Sanitary Permit Number (to be filled in by Co.) f< I MadisoRMl 1/ GD 5 7115 ~~~~v y3f,'PQN~K~ 1f~sz, 21041 ~J State Transaction Number Sanitary Permit Application 7Z S /3 in accordance with SPS 383.21(2), Wis. Adm. Code, submission of this form toUieCp$QPWQUNWntal unit is required prior to obtaining a sanitary permit. Note: Application forms@10hMAMWDE'EMI ►4to Project Address (if diffthe Department of Safety and Professional Servies. Personal information you provide may be used for secondary purposes in accordance with the Privacy Law, s. 15.04(1)(m), Stats. ^L Application Information lease Print All Informs «Property Owner's Name y. Q~ I Parcel # / a ~~j DCUQ Property Owner's Mailing Address Property Location 07 cf 7-3 ` r (J~`^ Govt. Lot City, State n Zip Code Phone Number J` 1/,_ Section circle one_~ 1(U-tT 1~ yjJ G~ T. N: R E or~L 11. Type of Building (check all that apply) Lo Subdivision Name 1 or 2 Family Dwelling -Number of Bedrooms ak c.A ut -,a ❑ Public/Commercial - Describe Use ❑ City of CSMNumber ❑ Village of ❑ State Owned -Describe Use kTown of S X~~- ti c~ L L a III. Type of Permit: (Check only one box on line A. Complete line B if applicable) A. New System ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System (explain) List Previous Permit Number and Date Issued B. El Permit Renewal ❑ Permit Revision ❑ Change of Plumber ~Transfer Before Expiration IV. Tv e of POWTS System/Component/Device: Check all that apply) O~ ❑ Non-Pressurized In-Ground ❑ Pressurized In-Ground k At-Grade ❑ Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil tgm ing Tank ❑ ther Dispersal Component (explain) ❑ Pretreatment Device (explain) ersal/Trea ent Area Information: Flow (gpd) Design Soil Application Ra (gpdsf) Dispersal Area Require (sf) Dispersal Area Propose System Elevation VI. Tank Info Capacity in Total # of Manufacturer Gallons Gallons Units L" F c`rc New Tanks Existing Tanks Itwk ) L o n U v, c~ J ~ Septic or Holding Tank Dosing Chamber © 6 2t2 VII. Responsibility Statement- I, the undersigned, ass me responsibility for installation of the PORTS s own on the attached plans. Plumber's N e (Print) Plum r' Signatur RS Number Business Phone Number 7,1 Plu is Addre treet, City, ate, Zip Code) ~>GY LPL .~~~~c> N 1. unty/De artment Use Only ermit Fee Date sued Issuing nt Signature Approved pprove ❑ er Giv eason for D nial $ 4f+ ~ IX. CondiSVSTWxN J&Reasons for Disapproval 3 /lam vba:wa 1. 'Septic tank, effluent flfter tai' r dlsper -.,mi cell must all be spi sic.?s ! nl4~in r.2 L44 as,per nagement plan pra /ided by plumber. 2. iJedl viii it must~* maintti4d a n. as par tppk 1" cadre 1 Qrdiwim, 4N Attach to complete plans for the system and sibmit to the~C/ounmy o paper not less han 8 112 x 11 inches in size SBD-6398 (R- 11/11) r 5-3 !f v~ P~s ~ r 'I 7~ F !r V.-7 - ti f i ! I r% n r DIVISION OF INDUSTRY SERVICES 10541 N RANCH RD HAYWARD WI 54843-6462 ~ Contact Through Relay http://dsps.wi.gov/programs/industry-services www.wisconsin.gov io* Scott Walker, Governor Dave Ross, Secretary June 17, 2016 CUST ID No. 220357 ATTN• POWTS Inspector BRADY J UTGARD ZONING OFFICE UTGARD PLUMBING & HEATING ST CROIX COUNTY SPIA PO BOX 413 1101 CARMIC,HAEL RD AMERY WI 54001 HUDSON WI 54016-7708 CONDITIONAL APPROVAL PLAN APPROVAL. EXPIRES: 06/17/2018 Identification Numbers Transaction ID No. 2725913 SITE: Site ID No. 825381 _ Shawn Doyle Please refer to both identification numbers, 1273 202ND Ave above, in all correspondence with the agency. Town of Star Prairie St Croix County SE1/4, SE1/4, S23, T31N, R18W FOR: Object Type: POWTS Component Manual Regulated Object ID No.: 1608037 Maintenance required; 450 GPD Flow rate; 100 in Soil minimum depth to limiting factor from original grade; System(s): At-grade Component Manual, Version 2.0, SBD-10854-P (N.03/07, R. 1/12), Pressure Distribution Component Manual - Ver. 2.0, SBD-10706-P (N.01/01, R. 10/12); Effluent 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, stats. The following conditions shall be met during construction or installation and prior to occupancy or use: Submit • The building sewer and distribution network piping shall be of material listed in Table 84.30-3 and 84.30-5, Wis. Adm. Code. Reminders • Pursuant to outlet filter product approval stipulations, maintenance information must be given to the owner of the POWTS explaining that periodic cleaning of the septic tank outlet filter is required. The access opening used to service the filter shall terminate at or above finished grade with a watertight cover. 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 con structi on/i nstallation/operati on. I BRADY J UTGARD Page 2 6/17/2016 In granting this approval the Division of Industry Services reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 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 may be 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. Since, Fee Required $ 250.00 Fee Received $ 250.00 Balance Due $ 0.00 Carl p ert Wastewater Specialist , Division of Industry Services WiSMART code: 7633 (715)634-5035, M-f 7AM - 12PM carl.lippert@wisconsin.gov cc: Edwin A Taylor, Wastewater Specialist, (715) 634-3484 , Monday - Friday 8:00 am To 4:30 pm Utgard Plumbing BRADY J UTGARD Paee 2 6!17/2016 In granting this approval the Division of Industry Services reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 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 may be made to me at the telephone number fisted 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. Sincerely, Fee Required $ 250.00 Fee Received $ 250.00 Balance Due $ 0.00 Carl p ert Wastewater Specialist , Division of Industr}, Services W]SNI RT code: 7633 (715)634-5035 , M-f 7AM - 12PM earl. lippert@wisconsm.gov cc: Edwin A Taylor, Wastewater Specialist, (715) 634-3484 , Monday - Friday 8:00 am To 4:30 pm Utaard Plumbing AT-GRADE AND PRESSURE DISTRIBUTION COMPONENT DESIGN INDEX AND TITLE PAGE Project Name: DOYLE ✓G ~ oj:`` Owner's Name: SHAWN DOYLE o .py °l6 Owner's Address: 1273 202 ND. AVE. NEW RICHMOND Wl. 54017 sk~ ~c 1273 202nd ave. new richmond wi. 54017 Legal Description: se/se/s23/t31/r18w Township: star prairie County: st. Croix CONDITIONALLY Subdivision Name: wolers estates APPROVED Lot Number: 12 BIQcFR Iut~e~AFETY AND PROFESSIONAL SERVICES LJ9ISION USTRY SERVICES Parcel I.D. Number: 38120270000 Plan Transaction No.: Pagel Index and title Page 2 Data entry SEE RESPONDENCE Page 3 At-grade drawings Page 4 Lateral and dose tank Page 5 System maintenance specifications Page 6 Management and contingency plan Page 7 Pump curve and specifications Designer: UTGARD License Number: 220357 Date: 06/13/ 6 Phone Number: 715-760-0946 Signature: De d Pursuant to the At-grade imponent Manual for POWTS SDB-10570-P (R. 06/99), and SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST - SAS (01/81) Version 3.11 (R.06/01) Page 1 of 7 At-grade and Pressure Distribution Component Design Site Information R Residential or Commercial Design 300.00 Estimated Wastewater Flow (gpd) 1.50 Peaking Factor (e.g. 1.5 = 150%) 450.00 Design Flow (gpd) 0.00 Site Slope 101.30 Contour Line Elevation (ft) 100.00 Depth to Limiting Factor (in) 0.50 In-situ Soil Application Rate (gpd/ftz) Distribution Cell Information 90.00 Dispersal Cell Length Along Contour (ft) 10.00 Cell Width (ft) 1 Influent Wastewater Quality (1 or 2) Are the laterals the highest point in the distribution Y Pressure Disribution Information network? c Center or End Manifold 5.00 Lateral Spacing (ft) If N above, enter the elevation (f', 4 Number of Laterals of the highest point. 0.125 Orifice Diameter (in) (e.g. 0.25) 2.00 Orifice Spacing (ft)= 1.99 Actual (ft) 2.00 Forcemain Diameter (in) 100.00 Forcemain Length (ft) Does the forcemain drain back? Y 89.00 Pump Tank Elevation (ft) 6.50 System Head (ft) x 1.3 16.31 Forcemain Drainback (gal) 12.13 Vertical Lift (ft) 35.78 5x Void Volume (gal) 2.87 Friction Loss (ft) 52.10 Minimum Dose Volume (gal) 21.50 Total Dynamic Head (ft) 37.07 System Demand (gpm) V Lateral Diameter Selection Manifold Diameter Selection in. dia. options choice in. dia. options choice 0.75 1.25 x x 1.00 x x 1.50 x 1.25 x 2.00 1.50 x 3.00 2.00 x 3.00 x Gallons/Inch Calculator Treatment Tank Information Total Tank Capacity (gal) 1000.00 Septic Tank Capacity (gal) Total Working Liquid Depth (in) weiser Manufacturer gal/in (enter result in cell B49) Dose Tank Information Effluent Filter Information 600.00 Dose Tank Capacity (gal) polylok Filter Manufacturer 16.67 Dose Tank Volume (gal/in) pl-525 Filter Model Number weiser Manufacturer Project: DOYLE Page 2 of 7 At-grade Plan View T 1//66 BObservation Pipes (2 typical) D FD O W A O B D L At-grade Component Dimensions A 10.00 ft D 5.00 ft 900.00 (ft) Dispersal Cell Area A x B B 90.00 ft W 20.00 ft 2000.00 (ft2) Total area (L x W) 1/6 B 15.00 ft L 100.00 ft 5.00 (gpd/ft) Linear Loading Rate At-grade Cross Section View Aggregate Dispersal Area Finished Grade 103.05 (ft) ik" Observation Pipe Lateral Invert (ft) Typical Lateral See Details 101.80 O O >1 X y A D 0.0 % Site Slope 101.30 (ft) Contour Elevation Shading Key 0 Topsoil Cap See lateral details on Page 4 for the number of Tilled Layer laterals, size, and spacing. Laterals are equally Aggregate spaced from the centerline of the distribution cell. Project: DOYLE Page 3 of 7 t ip s ° €t"s iff3"sa Lateral Layout ~~3~ya3f a E. ~t nl + a 3 6 _ I( I Y S 3 it t 1 3 uttl-lp vi dfiteal... r @e >(-y(° sIC -vr t L a : 1 3'cF sncra r. sin r_:(s C, .1 4;) cleanoutplurg per COMM Tattle 84.30-5 i uafft~eroi Latefais 4 Orifice Dlaineter L ^v - f- in ° tpral Diameter _1.00 in Orifice Spacing (X) } 11 .99 Lateral Length (P) ft Orifices per Lateral 22.5i Lateral Spacing 4S) 5.00 ft Orifice Density ft`iorir"ice Lateral Flow Rate i 9.27 gpm Manifold Length 5.00 €t System Plow Rate 37.07 gpm Manifold Diameter 1.25 in obi? Uyteamic Head 21. ft Forcemain Velocity 3.79 fUsec Dose Tank Information Locking cover with warning label and locking device and sealed watertight Electrical as per NEC 300 and ► Comm 16.28 WAC 4 in. min. If Disconnect j Tank component is properly vented E-- Alternate outlet location Forcemain diameter Weiser Manufacturer 2 in. Ca aci 600.00 Gallons - t Volume 16.57 gal/inch A Weep hole or anti- Dimension inches Gallons B siphon device A 22.87 381.20 C l3 2.00 33.34 Pump off elevation !fti C 3.13 52.10 i f 89.67 D 8.00 133.36 D Total 35.99 600.00 Dose tank elevation (ft) 4-1 ----3" Bedding un er tank. - --I r 39.0 1 Alarm Manuafacturer level Alarm Model Number d1v Pump Manufacturer goulds Pump Model Number ep05 Pump Must Deliver s7.07'gpm at 21.50 Pt TDH Project: DOYLE Page 4 of 7 i i At-grade System Maintenance and Operation Specifications Service Provider's Name utgard Phone 715-760-0946 POWTS Regulator's Name st. croix Phone 715-386-4680 System Flow and Load Parameters Design Flow - Peak 450 gpd Maximum Influent Particle Size 1/8 in Estimated Flow - Average 300 gpd Maximum BOD5 220 mg/L Septic Tank Capacity 1000 gal Maximum TSS 150 mg/L Soil Absorption Component Size 900 ftz Maximum FOG 30 mg/L Type of Wastewater Domestic Maximum Fecal Coliform >10E4 cfu/100 mL Service Frequency Septic and Pump Tank Inspect and/or service once eve 3 ears Effluent Filter Should inspect once a year and clean once eve 3 ears Pump and Controls Test once eve 3 ears Alarm Should test month) Pressure System Laterals should be flushed and pressure tested every 1.5 ears At-grade Inspect for ponding and seepage once every 3 years Miscellaneous Construction and Materials Standards 1. Observation pipes are slotted and materials conform to Table Comm 84.30-1, have a watertight cap, and are secured in as shown in the mound component manual. 2. Dispersal cell aggregate conforms to Comm 84.30 (6)(i), Wis. Adm. Code. 3. All gravity and pressure piping materials conform to the requirements in Comm 84, Wis. Adm. Code. 4. Tillage of the basal area is accomplished with a mold board or chisel plow. 5. The at-grade structure and other disturbed areas will be seeded and mulched to prevent soil erosion and help reduce frost penetration. Lateral Turn-up Detail Finished Grade \J4 6-8" Diameter Lawn Sprinkler . . . Plug or Ball Valve Valve Box Distribution Lateral 101.80 ft Long Sweep 90 or Two 45 Degree Bends Same Diameter as Lateral Project: DOYLE Page 5 of 7 At-grade System Management Plan Pursuant to Comm 83.54, Wis. Adm. Code General This system shall be operated in accordance with Comm 82-84 Wis. Adm. Code, and shall maintained in accordance with its' component manuals [SDB-10570-P (R. 06/99) and SSWMP Publication 9.6 (01/81)] 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. 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. Pump 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. At-grade and Pressure Distribution System No trees or shrubs should be planted on the at-grade. Plantings may be made around the at-grade'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 at-grade is not recommended since soil compaction may hinder aeration of the infiltrative surface within the at-grade and snow compaction in the winter will promote frost penetration. Cold weather installations (October-February) dictate that the mound be heavily mulched as protection from freezing. Influent quality into the mound system may not exceed 220 mg/L BODr, 150 mg/L TSS, and 30 mg/L FOG for septic tank effluent or 30 mg/L BOD5, 30 mg/L TSS, 10 mg/L FOG, and 104 cfu/100 mL for highly treated effluent. 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 6 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring. Contingency 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(s) shall be immediately repaired or replaced with a component of the same or equal performance. If the at-grade 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 absorption and dispersal media, and related piping, and replacing said components as deemed necessary to bring the system into proper operating condition. See Page 5 of this plan for the name and telephone number of your local POWTS regulator and service provider. Project: DOYLE Page 6 of 7 ~Z 100, ?f VOW ` 0 hY` r is s Ir 4 r. ' xb a d RSY eY➢r l.. - } s' . r.g:,, u :f € 1r stet Is' « 1w .4 n I 1_ r r w • r'f ay ~„a. t.~ ` c 6 37siF4 ' Yet' y a ~p1 ~ciiiti$p. 3I?H~"sC)£i?, ?lit' l~srrarjii*. a P. 1 Y a 1,50 i _ , a f r t €a3 ttt }~~O ~ "~w, 1 ..alt: J4:1 r i 4 mo T u ' f ; I-T, x d t~ o ~ lot OX-13 a~ l3v\- 248.00 248.00' 248.00' 327.35 I __66,,_ I - - - - - \ 0,~ r20' WIDE DRAINAGE EASEMENT 33' 1 I WEST LINE OF I. i THE SE 1/4 OF V) L O T ;p'yo9~ p THE SE 1/4 w .n a q p 33~ L:O T 22 16 g <I I o 76,866 50. FT. 8 L. O T 21 L O T 20 Z n 1.76 ACRES I 31 : 76,362 50. FT. w a w n' FF 76,270 S0. FT. w 76,179 S0. FT. ~ I n, 1 I` 1.75 ACRES 1.75 ACRES n 1.75 ACRES m Q of I i LOT AT S 8 0 133, 760 50. FT. 12 I I a 1° 1 , J. 07 ACRES 000, 8 ,oo' N I { - - - - - -r - - - L -'Z46-00- i - I ~ N Bp'3~ 21• S 89'28'15" W 811.17 ~ QO i ---TO-W-N- -R-OA-0 - - - - - - - i N 89.28'15' E 811.07' ' - - - - - i L O T - - - 1112' UtiGty Easement (Typicol) 1 I , i ' 9296754 I......I................. I........................I. 1...~. SsJ, 2.13 ACR, FFf.- 10t% 'w EAST LINE OFD ~6- N 33' THE SW 1/4 011I I F~ THE SE 1/4 33,. '33` gee . I M ry I Iw a I L:OT v LOT ff LOT W LOT V W s - 76, 306 S0. FT. w 76, 467 S0. FT. 76,215 S0. FT. I I i a 74,627 SO. FT. - $I o I 1.75 ACRES n 1.76 ACRESI F.F.E. ' 1.75 ACRES I 1,7) ACRES W < n - 1006.0 F.F.E. g • 1006.0 0 l o z n I M ~ I 0 A(90190190-If 06.18'- 0 L O T g a 18 100'-..: N A 776.18'- a10.00" o 1 3` z I 46~p' w o ai r o 82,786 SO. FT •n M I yrye\0o N o 1 t o o z o 0 1, 90 ACRES n I.H. W.L. '244.00' 241.54' S 174.04'W Wu ~e 1 1 wo N 89.36'51" E 485.54' N Z ~i5 Q W N -•x_70. 8 ~4 h 3 I o 9;~ 3' o r~ ,L g I 2 171.5 7' 33' 7768750. FT., ti' W o _ _ 33 2 1.78 ACRES N88 J5 £ 6- N 89.36'51 E 361.43' Q- F.F.E." 1006.0 20' WIDE DRAINAGE EASEMENT S 7606.76' 240 4AP LOT M N. e m S 8732'20' W 485.79' I I o^ 40.00•- , 70 ; \ \t 8 80,28J 50. FT _o _ - _ - - I 1.84 ACRES z L O T 15 S89'36'39'W 171 \ / ' LOT 8 20' WIDE DRAINAGE EASEMENT 77,538 50. FT. 98.35' 80,444 S0. FT. 1.78 ACRES \ N 1,85 ACRES 2 S89.36'51'W 381.00' ~p~0 \ o g +1 R-N89~'6 07 $ N 3 15y ay 1 y\~ ~20' WIDE DRAINAGE EASEMENT w o UNPLATTE y,~ \Qc s. - N OQ '1'v~ . J9, - - 89'36'51" E 396.43' I b Jam!//~ \~\sJ9\ Aso o , L--0-T- 5 ° i., LOT B s, g CERTIFIED SURVEY _MAP_. 8 74 469 S0. Fr \ e k VOLUME 12 PAGE- 3305 ST. CROIX COUNTY SEP 1'IC TANK MAINTENANCE AGREEMENT AND ;v iW'NT-R3HIP CERTIFICATION FOR-MI Owner/Buver _ Ali" ~V Do Property Address' 73 -A~ A O Ave_ NeAQ RiOn morij , ~ i S I.4011- t` v :,rificatlon required from Pkinning & Zoning Department for FiF \i consfnuc ion.'! 1 City/State /U- lei Parcel Identification Number '~=1 G - ~QCab LEGAL DESCRIPTION Property Location <5/ ;'4 , Sec. 3 3~^NR 1 i o~ n of Subdivision Plat- Lot # /6_~. Certified Sun ey IViap Volume , Page ; - -Warranty Deed # 1C~~~Q pZ~ (before 2007)Volume Page Spec house ^ ye no Lot lines ide :tilaa S I STEM MAINTENANCE AND OWNER CERTIFICATION improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper ,tcmunce consists of pumping out the septic tank every three years or sooner, if needed, by a licensed pumper. What you put into he system can affect the function of the septic tank: as a treatment stage in the waste disposal system. 0,%-ner maintenance responsibilities are specified in §SPS. 383.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance. The property owner agrees to submit to St. Croix County Planning & Zoning Department a certification form. signed by the ,J. vner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site astewater disposal svstem is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is es~ than 1j3 full of sludge. l/we, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the arcis set forth, herein, as set by the Department of Safety And Professional Services and the Department of Natural Resources, State of Wisconsin. Certification stating that voter septic system has been maintained must be completed and returned to the St- Croix t;t}unty Planning & Zoning Department within 30 days of the three year expiration date. L'we certify that all statements on this form are true to the best of my/our knowied* ge. L`we am/are the owner(s) of the. pri>pert}r described above, by virtue of a warranty dee corded in Register of Deeds 111ce. 'lumber of bedrooms SI 1; GNAT _'RE OF APPLICANTS ) llAT I- ***Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Departmeni * Include with this application a recorded warrant, deed from the Register of Deeds Office and a copy of the certified survey snap if reference is madt, eti ;h, k1 irrAnr} Jt,f,O +MseonsinDepartment ofCommerce SOIL EVALUATION REPORT Page of Division of Safety and Buildings In accordance with Comm 85, Wis. Adm. Code County r" Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel LID, p percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Please print all information. R ed by Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.05 (1) tm)), PropertyOwney- Property Location GC- Govt. LgL(V ESL-114, 1/4 T3 N R E (o Property rs Mailing Address-, , A Lot Block # Subd. Name or CSM# t,.-mil/ City tat Zip Code Phone Number g ❑ City ❑ lfllage Town Nearest Road I 5 Y6t ( , ~.5~ ~allc~ ew Construction Usel2leftsidential / Number of bedrooms Code derived design flow rate _ GPD El Replacement Pubtigrpry~~ommar~ ~ Describe; Parent materiai Flood Plain elevation if applicable N//f ft, General comments and recommendatlons,5y ,S ~G 01 ~ Boring # Bodnd' Pit Ground surface efev, Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPOM In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 `Eff#2 Lo v PL,, 5(- ri F,1 V. C rVA '.7 i 1071 Boring # Boring Pit Ground surface elev. 1 r' ft. Depth to iimiNng factor /0() in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ffF In. Munsell Qu. Sz. Cant. Color Gr. Sz. Sh. "EfT#1 `Eff#2 3 / S ` Effluent #1 . BOD > 30 t 220 mg/L and T S , < 150 g/L ' Effluent #2 = BOD _5 30 mglL and TSS E 30 mg/L CST Nar1H Please Print) r' ature, ,T Gj~ /f p Z2, Address Date Evaluation Conductea _ Telephone Number ` / Ayllel LQ Property Owner Parcel ID # Page of 7 Boring # ❑ Boring J U , Z Pit Ground surface elev. oft. Depth to limiting factor iJ in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 I t~- 9 10K S/ y- r-e 36 9 7, j r n ,.L 5 nI w I?/ 7 ❑ Boring # ❑ Boring ❑ pit Ground surface elev. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 -Eff#2 ❑ Boring # ❑ Boring - Pit Ground surface elev. Depth to limning factor in. Soll ication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD In, Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 1 Effluent #1 = BOD5 > 30 < 220 mg/L and TSS >30 < 150 mg/L " Effluent #2 = BOD6 30 mg/L and TSS 30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 648-266-3151 or TTY 608-264-8777. SBD•8330 (R.6/00) Soil Test Plot Pla Project Name Ronald Wohlers Sha ird Address 1282 200th Ave Tom'%f`i - N ew Richmond WI 54017 M #226900 Lot 12 Subdivision Wohlers Estates Date 8/16/00 SW/SE 1/4 SE 1/4S 23 T 31 N/R 18 W Township Star Praise Boring 0 Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 100 ft. Top of Survey Iron System Elevation 97.0 *HRPSame as Benchmark Alt. BM Top of 1 1/2" Pipe @ 100.8 Pro Town Road Tested area does not have enough slope to establish contours <1% B-2 Slope 20' B-3 80' 40' ,L- 0 30' -1 r o~ Q. 80' Alt. IL ft- . B.M. 190' Property Line 0 10