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HomeMy WebLinkAbout032-2175-70-000 . Croix Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM c°°"t' St Safety and Building Division Sanitary Permit No: INSPECTION REPORT 597384 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: 2893089 Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)] Permit Holder's Name: City Village Township Parcel Tax No: TIM & TRACI WAALEN TOWN OF SOMERSET 032-2125-70-000 CST BM Elev: Insp. BM Elev: BM Description: Section/Town/Range/Map No: 05.30.19.1125 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark Dosing Alt. BM Aeration Bldg. Sewer Holding SUHt Inlet St/Ht Outlet TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic Dt Bottom Dosing Header/Man. Aeration Dist. Pipe Holding Bot. System Final Grade PUMP/SIPHON INFORMATION Manufacturer Demand St Cover GPM Model Number TDH Lift Friction Loss System Head TDH Ft Forcemain Length Dia. Dist. to Well SOIL ABSORPTION SYSTEM BED/TRENCH 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 Ix Hole Size ix Hole Spacing Vent to Air Intake Pipe(s) Length Dia Length Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over 1xX Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil! Yes No, Yes No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1 Inspection #2: Location: 421 172ND AVE 1.) Alt BM Description = 2.) Bldg sewer length = - amount of cover = Plan revision Required? Yes F7 No for additional information. Use other side Date P or's Signature Cert. No Inse ct SBD-6710 (R.3/97) County Division St. Croix 5~~,A~ 0qSVEDBuildings 1 W. Washington Ave., P.O. Box 7162 Sanitary Permit Number (to be tilled in b% Co.) iA'N ukI4 0 I~n, WI 53707-7162 U, ~g 73'9 Sanitary -Ikq?mw tatz'Cransaction~jNumb fw( In accordance with SPS 383.21(2). Wis. Adm. Code. submission ofthis form to tire a pro P .ud / V is required prior to obtaining a sanitar}' permit. Note: Application forms for state ;d atted to Project Address (if different than mailing address) the Department of S Lfety and Professional Service.,,. Personal information } oil pc ov or secondary purposes in accordance with the Privacy Law, s 15.04(1)(m), Stats. Same YZ I f -72e, 1. Application Info rmatio lease Print All Information Property Owner's Name ( Parcel n Tim & Traci Waalen 032-2125-70-000 Property Owner's Mailing Address Property Location 05. 30, Govi. Lot 421 172°`1 Ave. City, State Zip Code _SW _ a. SW one) OS_ Phone ;Number (circle one) Somerset. WI 54025 T 10 N: R 19 E or W II. Type of Building (check all that apply) Lot F ❑ 1 or 2Fan1ilvDwelling-Number of Bedroonas SubdivisionName o. Bloch ~ C177 Plat of Chabre ❑ Public/Commercial - Describe I oG pyD Na ❑ Cityof ❑ State Owned Describe [sv ~ CS\I Number ❑ Village of 75 14 ! Na ❑ Town of Somerset O ~ III. Type of Permit: (Check only one box on line A. Complete line B if applicable) Zoo ae ❑ New System Replacement System ❑ TreatmentiHolding'fank Replacement Only ❑ Other Modification to Existing System (explain) List Previous Permit _ Numb°r and Date Issued w e B.❑ Permit Renewal Permit Revision ❑ Change of Plumber ❑ Permit Trans ter fir to New F. Before Expiration Ocl'ner IV. Type ofPOWTS System/Component/Device: (Check all that apply) ❑ Non-Pressurized In-Ground ❑ Pressurized In-Ground ❑ At-Grade ❑ Mound 24 in. of suitable soil ❑ Mound 24 in. ofsuitable soil ❑ Holding Tank- ❑ Other Dispersal Component (explain) ❑ Pretreatment Device (explain)_ ,J Lit V. Dispersal/Treatment Area Information: Existing Zabel A-100 effluent filter Design Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal Area Required (sf)Dispersal :krea Proposed (sf 7-le\atiorl 1.0 gpd/sq.f(. ASTMC-33sand t 12" above X50.0 Gpd 0.5 gpd/sq.ft. native soil 450.0 sq. ft.~ 450.0 Sq. FL ontour VI. Tank Info Capacity in Total o Manutacturer Gallons Gallons Units Neva I inks Existing Tanks I Septic or Holding Tank 0 1.000 1,000 1 Weeks Concrete ~X nosing chamber 0 800 800 1 Weeks Concrete X VII. Responsibility Statement- I, the undersigned, assume responsibility for installation of the Powrs shown on the attached plans. Plumber's Name (Print) Plumber's Signatur, MP MPRS Number Business Phone Number William Schumaker 227990 (715) 386-2131 Plumber's Address (Street, City, State. Zip Code) 1070 Scott Road, Hudson, WI 54016 VIII. unty/Department Use Only ypproved pp Permit Fee Date slued Issuing : fit Signature csa rove b G ~ 06 CP Z'/) -71 ic"n Reason li>rDemal IX. Conditiftm-s jft4oReasotis for Disapproval 1 ir tar•k EtAliCn, iiRer*'~itd PTja I AA' p ' ~ ~ W 1 JK•• `nlsper.{s+i cell must all be snt:ic?~s ' =c AXE, ''as per gwrdgement plan p!o 1i ed bk t, nbc . 2. sow* reCt.irsrtents mtrjt oe ra; rr.. it as pK t he radts 1 CMinlnoe:t. I .kttach to complete plans for the system and submit to the County only on paper not less than 8 1/2 s t I inches in size SBD-6398 (R. 11/11) • Sa'1 e✓clua~'~~Oit EX151ino tra.dr 4t(d✓. ~ip 1 T Cr c,Jaa lc r7 PrO p. 4W 171=`tif - 5oirtsfs~-~i SS~o2.f C~a brt, .,e It fl 0/,f EXi3~.n~~J, tJte S C~encrcEcSGL) stys'S/Sr.~Yy Stc OS 7.304. ~So sc , ~(;Ta. s. P~"^l0 .n~cr/~Icrcrerj~Coh / 74, 41 /n4,,kdVeC'ov4- . Elt✓-92.p' alp Fes- /od a/a~ iz o-tom a0 s S ~h*, f7~/aecc4..~/ Ls+~t~ ~Oc% a31-2125 rosTprig;n y EX.sz:' !d~lagap tJ ConU 6AC4 y3.ca4uar :b s~o-~aUU~ oh r n 5p~c~'an ,Sro ~cv~,r.., ~ •o/tea bal ~-/m ~cporEdvkd /e?. . Exs~:.,g wed/ 30~ v~ t'rs~ z'sGf. vC ESQ P.I.C. nccnaa;n Ex:s x ~ / / 3 ~tdra~m ty ~ t i__ ~ $araaG 1 ~ 1 ~ G/~md1! S~~ ~ 'dom. \ ~4,SG 1 ~ ~ 9G.o' _ P•P~ 99.5' _ L`ra.v~C"btd ~ ~'',ts•++:na.~to/ .Sa., d•fn be ~s~n.c✓cd ,,,y Ia aGd, Ste C v f sla-tpera on Je 'P•,4 &C q /'tp /actme„~PrO cce.alu.reJ. Index & Title Sheet Waalen 3 Bedroom Residential Replacement Mound POWTS Project Name: Waalen Residential Mound Owners Name: Tim & Tracie Waalen ` Owner's adress: 421 172nd Ave., Somerset, WI 54025 JAN 6 2017 I Site address: Same Project Location: Subdivision: Lot 17, Plat of Chabre Legal Description: SW 1/4 SW1/4, Sec. 05, T.30N., R. 19W., Town of Somerset, St. Croix Co., WI. Parcel ID 032-2125-70-00 Page 1 Index and Title Sheet Page 2 State Approved Mound Design Page 3 Septic Tank Maintenance Agreement Page 4 Warranty Deed Attachemnts: Soil Evaluation Report Mater Plumber Restricted Service: Bill Schumaker, Dep't. of Safety & Professional Services Credential 4227990 1 Signature: t.G~'-1-L~---•~~ z Date: Page 1 of 4 Design pursuant to In-Ground Soil Absorption Component Manual I'm POW I'S. version 2.0 S13D-10705-P (N.01/011R.10/12) ~9tie xTarE~T DIVISION OF INDUSTRY SERVICES 3824 CREEKSIDE LN 'T HOLMEN WI 54636-9466 m 3 I' Contact Through Relay P S+ http://dsps.wi.gov/programs/industry-services www.wisconsin.gov ~O ssrotiPN'Scott Walker, Governor Eric Esser, Acting Secretary January 31, 2017 CUST ID No. 227990 ATTN POWTS Inspector WILLIAM C SCHUMAKER ZONING OFFICE SCHUMAKER PLUMBING ST CROIX COUNTY SPIA 1070 SCOTT RD 1101 CARMICHAEL RD HUDSON WI 54016-7302 HUDSON WI 54016-7708 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 01/31/2019 Identification Numbers Transaction ID No. 2893089 SITE: Site ID No. 834769 Tim and Traci Waalen Please refer to both identification numbers, 421 172ND Ave above, in all correspondence with the agency. Town of Somerset St Croix County SWI/4, SW1/4, S5, T30N, R19W FOR: Description: Three Bedroom Mound System / Sloping Site / Dispersal Cell Re-construction Object Type: POWTS Component Manual Regulated Object ID No.: 1687606 Maintenance required; Replacement system; 450 GPD Flow rate; 24 in Soil minimum depth to limiting factor from original grade; System(s): Mound Component Manual - Ver. 2.0, SBD -10691-P (N.01/01, R. 10/12), 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 O10 ND requirements. AP No person may engage in or work at the state unless licensed to do sob the Department per s. 145.06 plumbing ~ in by p ~ OF stats. PROFESSIO `t€t The following conditions shall be met during construction or installation and prior to occupancy or use: OF IN Reminders • A sanitary permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.19, Wis. Stats. "'E C01,,p,1 • All contaminated POWTS materials and components shall be abandoned/removed per SPS 383.33, and NR 113, Wis. Adm. Codes. • Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stats. • A state approved effluent filter is required. Maintenance information must be given to the owner of the tank explaining that periodic cleaning of the filter is required. • The area within 15' downslope of the dispersal cell shall remain undisturbed. Vehicular traffic, excavation or soil compaction is prohibited in this area. • 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 WILLIAM C SCHUNCWER Page 2 1/31/2017 Owner Responsibilities • The current owner, and each subsequent owner, shall receive a copy of this letter including instructions relating to proper use and maintenance of the system. Owners shall receive a copy of the appropriate operation and maintenance manual and/or owner's manual for the POWTS described in this approval. • 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. SPS 383.54(1). • In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approved plans. • 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. 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 PO,WTS. Sincerely, Fee Required $ 250.00 Fee Received $ 250.00 Balance Due $ 0.00 erard M Swan POWTS Plan Reviewer, Division of Industry Services (608)789-7892, Mon - Fri, 7:15 am - 4:00 pm WiSMART code: 7633 jerry.swim@wisconsin.gov cc: Edwin A Taylor, Wastewater Specialist, (715) 634-3484, Monday - Friday 8:00 am To 4:30 pm WILLIAM C SCHITMAKER Page 2 1/31/2017 Owner Responsibilities • The current owner, and each subsequent owner, shall receive a copy of this letter including instructions relating to proper use and maintenance of the system. Owners shall receive a copy of the appropriate operation and maintenance manual and/or owner's manual for the POWTS described in this approval. • 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. SPS 383.54(1). • In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approved plans. • 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. 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. Sincerely, Fee Required $ 250.00 Fee Received $ 250.00 Balance Due $ 0.00 R erard M Swim POWTS Plan Reviewer, Division of Industry Services (608)789-7892, Mon - Fri, 7:15 am - 4:00 pm WiSMART code: 7633 jerry.swiTn@wisconsin.gov cc: Edwin A Taylor, Wastewater Specialist, (715) 634-3484, Monday - Friday 8:00 am To 4:30 pm r ' MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGNr Residential Application - INDEX AND TITLE PAGE Project Name: Waalen 3 bedroom mound Owner's Name: Tim & Traci Waalen Owner's Address: 421 172nd Ave., Somerset. WI 54025 Property Address: Same Legal Description: SW1/4SW1/4, Sec.05, T.30N., R.19W Township: Somerset PTIONACLY County: St. Croix 'ROVED Subdivision Name: Plat of Chabre SAFETY AND STRiaSERV~'" ' Lot Number: 17 Block Number: Parcel I.D. Number: 032-2125-70-000 Plan Transaction No.: QNDENCE Page 1 Index and title Page 2 Data entry Page 3 Mound drawings Page 4 Lateral and dose tank Page 5 System maintenance specifications Page 6 Management and contingency plan Page 7 Pump curve and specifications Page 8 Site Plan Page 9 Attached Dispersal Cell Replacement Proceedures Page 10 Attached Soil Evaluation Report Designer: Bill Schumaker License Number: 227990 Date: 12/16/16 Phone Number: (715) 386-3121 Signature: T Designed Pursuant to the Mound Component Manual for POWTS Version 2.0 SBD-10691-P (N. 01/01, R. 11/12), and both SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST-SAS (01/81) and Pressure Distribution Component Manual Ver. 2.0 SBD-10706-P (N. 01/01, R. 10/12) Version 7.0 (R. 111112) Page 1 of 10 Mound and Pressure Distribution Component Design =71gn Worksheet Site Inionnatioti ~rru _ Rj Residential or Commercial Design Note: Sand fill (D) calculations assume a 300.00 Estimated Wastewater Flow (gpd) Table 383-44-3 in-situ soil treatment for fecal coliform of 36 inches. 1.50 Peaking Factor (e.g. 1.5 = 150%) 450.00 Design Flow (gpd) _ 6.001 Site Slope 95.49 Contour Line Elevation (ft) 24.00 Depth to Limiting Factor (in) 0.5001 In-situ Soil Application Rate (gpd/ft) Distribution Cell Information 75.001 Dispersal Cell Length Along Contour (ft) = 6.00 Cell Width (ft) 1.00 Dispersal Cell Design Loading Rate (gpd/ft2 1 Influent Wastewater Quality (1 or 2) Are the laterals the highest pant in the distribution _Y Pressure Disribution Information network? Enter Y Qr ;°I. c` Center or End Manifold I 3.00 Lateral Spacing (ft) If N above, enter the elevation (ft) 4~ Number of Laterals of the highest point. 0.156 Orifice Diameter (in) 1.601 Estimated Orifice Spacing (ft) = 4.89 ft2/orifice 2.001 Forcemain Diameter (in) 160.00 Forcemain Length (ft) Does the forcemain drain back? € Y 82.211 Pump Tank Elevation (ft) Enter Y o; `J. 4.55 System Head (ft) x 1.3 26.10 Forcemain Drainback (gal) 13.78 Vertical Lift (ft) 67.30 5x Void Volume (gal) 7.84 Friction Loss (ft) 93.40 Minimum Dose Volume ((i:,fl) 0.00 In-line Filter Loss (ft) 49.54 System Demand (gpm) 26.17 Total Dynamic Head (ft) Lateral Diameter Selection Manifold Diameter Selection in. dia. options choice_ in. dia. options choice 0.75 1.25 1.00 1.50 x x 1.25 x 2.00 x 1.50 x x 3.00 2.00 x 1 3.00 x Gallonsilnch Calculator {<=pfik-j!i6i, Treatment Tank Information s808.45i Total Tank Capacity (gal) 1000.001 Septic Tank Capacity (gal) 37.00€ Total Working Liquid Depth (in) Weeks Concrete~Manufacturer 21.85 gal/in (enter result in cell B4.9 Dose Tank Information Effluent Filter Information 808.451 Dose Tank Capacity (gal) 32abel (existing)M____ Filter i'J3 ;ri .it wt rcr 21.8 1 Dose Tank volume (gal/in) A-100 Filter Model Number M..,.__ Weeks Concrete !Manufacturer Project: Waalen 3 bedroom mound Page 2 of 10 TOTAL DYNAMIC HEAD/FLOW LL PUMP PERFORMANCE CURVE PER MINUTE MODEL 140/4140 EFFLUENTAND DEWATERING 3118 $511e 55 4 518 1e MODEL 140/4140 Feet Meters Gal. Liters 32432 14 5 1.5 86 326 50 - 45- 10 3.0 80 303 + 15 4.6 73 276 0 12 40 20 6.1 66 250 25 7.5 59 223 1 V2.11 112 NPT - 1 35 140 4140 30 9.1 49 185 10 35 10.7 38 144 40 12.2 28 106 45 13.7 17 64 -26,17 1 Shut-off Head: 50 11,71 5.2m 25 010"o 1J s g 20 1213!32 15 4 10 4 5132 SK1524A 2 5 10 20 30 40 80 70 80 sp GALLONS LfTER:i 0 80 180 240 320 FLOW PER MI - 3118 8 vie y/9. s s~r`J'Yo wl:n: rn c~-n ~`~/~P JPLICATIONS 45!18 CONS ULT FACTORY FOR SPECIAL 3 29/37 • Electrical alternators, for duplex systems, are available and supplied with an + alarm. • Mechanical alternators, for duplex systems, are available with or without W-111/2WT alarms. • Control alarm systems are available for 1phasepumpsused in simplex system. See FM0732. • Variable level control switches are available for controlling single phase sys- tems. • Double piggyback variable level float switches are available for variable level long cycle controls. is is • Sealed Qwik-Box available for outdoor installations. See FM1420. • Refer to FMO806 for applications above 130°F (54°C). - 4572 .112. SELECTION GUIDE 14014140 MODELS Control Selection 1. For automatic use single piggyback variable level float switch or Model Model Volts-Ph Mode Am s Sim lex Du le double piggyback variable level float switch. Refer to FM0477. p s p 2. See FM1228 for correct model of simplex control panel. N140 N4140 115 1 Non 12.0 1 or 2 3 3. See FM0712 for correct model of duplex control panel. E140 E4140 230 1 Non 6.0 1 or 2 3 BN140 BN4140 115 1 Auto 12.0 0 CAUTION All installation of controls, protection devices and wiring should be done by a qualified BE140 BE4140 230 1 Auto 6.0 ' licensed electrician. All electrical and safety codes should be followed including the most recent National Electric Code (NEC) and the Occupational Safety and Health Act (OSHA). 'Single piggyback switch included. RESERVE POWERED DESIGN For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump. MAIL TO, P.O. BOX 16347 49 Manufacturers of.. ~~Ii~ ltr+W ® Louisvll~, 40256-0347 0 P T0: 3649 Cane Run Road Louisville, Ky 40211-1961 Q7e&J TY PUMPS SINCE 19,79 - ® (502)1 SH7762731 • i (1800) 928-PUMP www.zoeffercom PUMP !O_ FAX (501) 774,3624 © Copyright 2005 Zoeller Co. All rights reserved. 7 ",4'/o 5 ~ E}ri:5 fiT~y grctdr c It✓• 1-;Me 77- G'LJaa/e,7 flr•op. 1=~.fWe- 4f?,/ 17 5a 55 o2S' Lot r7,, ~/a of ckL 6rf, EXi.S~."a c.Ju•~s ee,~,'~s~w~ SwYysc~Yy, Scc• os T..~Orry nlcrca~~.Con//9u~y Trt, o~<SorrNrSc, K: T s. P~Id Ata„,(a/CC'®sK/ Elt~-9,2.p' F/po~PLun~d alarm SE. CnDiY o i„7r CsvM~OLa'~i pc/'r03Z-2/2~ 70~ EJrOSjorr ,naQS 6Lon, rV1,eeW,-YCaCla Y Err-ter' I,drJd 9a~ cJ Loner bc.'.~y 3.cn 4cias r'yS~n/~a~ oh tn3PtcE,'or~ Soo a ~1:n ~ /t& 6c1 ~`rfcrmf acLex' EX;s~'ng we// 3~~ t` . o ~D v l~ .2 " a. atie O r_ own r Y r 3 bedew," ka ( r i ,r L__ ; ~ara~C r ~ ~ \ ~%nt~ slgac 1 'df \ ~y' SSG d o may, Olt( Ire o- NII-v 955 C }c° 99.5' G`ra Ye C dtd tsw f:,7so~ .10+, d CP bt r`n~ s✓c e~ ~/yo/acGd, Sde /A-yOLne GY1 fA &r %T veto /ace.~~„eProe~e ele.J. piSa/o Site Preparation & Procedures for Reconstruction of Existing Mound Dispersal Cell 10l3 DESCRIPTION: Full & Traci Wallen residential property: The existing 3 bedroom mound system serving the Wallen residence has developed a clogging mat at the sand/gravel interface. Effluent surfaces at the top of the mound when applied to the system under pressure. Evaluation of the system has revealed that the clogging mat extends approximately 3" below the gravel into the sand fill The sand fill beneath this &pth is clean and dr< as is the sandirnath c sail interfacc PROPOSAL Remove the existing mound system and rebuild a new mound in approximately the same location as per owner preference. The existing 1,000 gallon Weeks Concrete septic tank containing a Zabel A- 100 effluent filter and existing 800 gallon Weeks Concrete pump chamber will be left in place with all existing plumbing. effluent filter. electrical connection and pump left in place. Mercury pump and alarm control floats will be removed. disposed of in compliance with regulations and replaced «ith code compliant mechanical control floats. Both septic tank and um chamber have been inspected and found to be structurally sound with fiberg ass a es in lace. CONSTRUCTION PROCEDURES: The existing pump will be disconnected for a 30 day period prior to system replacement, allowing the sand fill within and beneath the dispersal cell to adequately dry prior to commencement of dispersal cell replacement. Tanks will be pumped as needed during this period. The topsoil and cover soil will be removed from the surface of the system. All contaminated sand fill and aggregate will be removed from the existing system by use of a track mounted backhoe. An additional 3" of sand fill beneath contaminated laver will be removed, approximately 6" in total. Caution will be used when removing the sand fill to prevent the underlying native soil from being disturbed. The remaining sand fill will be evaluated to determine compliance with ASTM C-33 standards. Any- noncompliant sand fill will be removed and replaced with con liant aterial. The under_hi g soil will be re- ow7e using a steel shank mounted on backhoe arm. The backhoe will not travel on o system area - reaching as tam posse e across system area from eac end and then p remai r o new sys n area as per normal installation. The existing distribution network will be removed and replaced using new pipe to build a distribution network complying with this design. The dispersal cell will be rebuilt as per this design with cover soil replaced as per approved mound system component manual. Pg. 9 of 10 IS S NON-NAVIGABLE - ,f - WETLAND TOWN ROAD N er"x" a twer 9 9'44'W W 74&fr 122.W IWO& 18 H.W. _ 960.00 16 13=75 80 !R 3.W4 R9 1 9 I~q 1tt 17 a,, - sa9ao. a+ar r~r H.W.L. R TRANS 233 4lt9.?3!' 2314AV t77.a1 i" 16'131 1816.83' SOUTH LINE OF THE sw1 PROPOSED STATE TRUNK HIGHWAY 35-& 64 1.T. NOTES PER TRANS 233: Downer I hereby restrict all Lots and Blocks so that that no owner, possessor, r, licensee or other person may have any right of direct vehicular ass from or egress to any highway lying within the right-of-way of * trunk Hichwev 135 A 84'. A .q awn LAM r#hAtk^n min it axrvwccly ST. CROIX COUNTY SEPTIC TANK. MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer /0'v) Mailing Address - J n U Property Address- E (Verification required from Planning & Zoning Department for new construction.) City/State IL~A 7'S(' ( .,el Identification Number } - ~ 5 - G ' 00 G LEGAL DESCRIPTION Property Location, (A) 1/a '/4 , Sec. 0 , T 30 N R J W Town of /A S c. Subdivision Plat: 07 - 100 _ G NAERL 03r -00 ~7 ,Lot#C/. Certified Survey Map # , Volume , Page # Warranty Deed # r' 16 (before 2007)Volume , Page # Spec house Clyeswio Lot lines identifiablepyesono SYSTEM MAINTENANCE AND OWNER CERTIFICATION Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper n>a:-fenance consists of pumping out the septic tare 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. Owner 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 owner and by a master plumber,.journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site w3stewater disposal system is ir. proper operating; condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. I/we, 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 Safety And Professional Services and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Planning & Zoning Department within 30 days of the three year expiration date. I/we certify that all statements on thi form are true to the best of my/our knowledge. I/we am/are the owner(s) of the property described above, by virtue of a w r deed recorded in Register of Deeds Office. Number of bedrooms -L-Ld -2 SIGNATTIRE OI APPLICANT(S) DATE ***An;j information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Department. Include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if ~`I?I~~@1tc~ ~s made in tl~~ warranty deed, Fx. o4/12) Wisconsin Department of Commerce SOIL AND SITE EVALUATION F 3 ' Division of Safety and Buildings Page of Bureau of Integrated Services • in accordance with Ggrfi;It1, 83.05, Wis. Adm. Code Attach complete site plan on paper not less than 8 1/2 x 11 inches in §rie. Plan mAt County include, but not limited to: vertical and horizontal reference point (BA, direction add ! i percent slope, scale or dimensions, north arrow, and location and diIpance to nearest road.' Parcel IND. # L APPLICANT INFORMATION -Please print all information. Review b Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (t) *I.; 3 Z Property Owner Property Loc on Govt. Lot vC~J "A/4 5G~! 1/4,S S TN,R E (or) W Property Owner's Mailing Address tots _ . Blocktf Subd. Name or CSM# - ~v C i _ 1 A 10 ti- city State Zip Code Phone Number ❑ City ❑ Village Town Nearest Road New Construction Use: Residential / Number of bedrooms 3 L~_ Addition to existing building Replacement ❑ Public or commercial - Describe: Code derived daily flow 6 O 6 gpd Recommended design loading rate / bed, gpd/fF -6 trench, gpd/ft2 Absorption area required / ZCIO bed, ft2 e'o G a trench, ft2 Maxitr~um design loading rate __L5 bed, gpd/ft2 ' Co trench, gpd/ft2 Recommended infiltration surface elevation(s) ) _ft a rred to site plan benchmark) Additional design/site considerations Parent material 7~' I Flood plain elevation, if applicable 14" ft S = Suitable for system Conventional Mound In-Ground Pressure AT-Grade System in Fill Holding Tank U = Unsuitable for system ❑ S U 14S ❑ U ❑ S U ❑ S [i~ U ❑ S 132? U ❑ S E~PU SOIL DESCRIPTION REPORT Bonn # Horizon Depth Dominant Color Mottles Structure GPD/ft2 t^r W 9 Texture Consistence Boundary Roots in. Munsell Ou. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench c,udr 31 ,o& Ground 3 - It \aL 31 6 IM elev. v60o f t . Depth to limiting factor , Z = in. Remarks: Boring # I 0 r ' S S Ls .G LA-4i a 2 6 .S 4 L Ground elev. 7.3o ft. ; Depth to limiting IF-tor in. Remarks: CST Name (Please Print) Signatu~ Telephone No. Address Date CST Number Z > S Z:5 S 330 S PROPERTY OWNER SOIL DESCRIPTION REPORT Page -Zeof PARCEL I.D.# Boring # Horizon Depth Dominant Color Mottles Structure 2 hew' in. Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. Consistence Boundary Roots Bed Trench off[ C Z_ 1c) V_ 9 :5 Lw I j,14 elev. Ground 2 "3~ 1 0 L Z►~ _ CS Depth to limiting factor- L4Y in. I-[-[- Remarks: Boring # F:3 n: Ground elev. ft. ' Depth to limiting factor in. Remarks: Horizon Depth Dominant Color Mottles Texture structure Consistence Boundary Roots GPDoe in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench Boring # O Ground elev. ft. ' Depth to limiting factor 'n' Remarks: Boring # Ground elev. ft. Depth to limiting factor in. Remarks: SBD-8330 (R.9/98) PAGE OF FAME S fzsv h LOT# I:) LEGAI DESCRIPTIO'y ! 45w'/4 S S T N R lit F (ar) ~V~ r SCALE: 1 r Z BM i ELEVATION • C~) BM I DESCRIPTIONAk j ; „ Q~vblc Q (3.'Cch W f ~Iw BM 2 ELEVATION ((>C>• O C, BM 2 DESCRIPTION~,,',_S'ej, _4~1 q~ SYSTEM ELEVATION ~U A:- ALTERNATE ELEVATION ) K CONTOUR ELEVATION .Y • X. ,4 t N.w.f;.• pfS vV.(S SIGNATURE DATE G