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040-1320-00-006
Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. CROIX Safety and Building Division INSPECTION REPORT Sanitary Permit No GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No 597482 : Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)] 2791 098 Permit Holder's Name: City Village Township Parcel Tax No TODD & KRISTEN GILLINGHAM TOWN OF TROY 040-1320-00-006 CST BM Elev: Insp. BM Elev: BM Description: Section/Town/Range/Map No: (UO• %fv"'' P "Pe- 24.28.20.2153 TANK INFORMATION ELEVATION DATA r TYPE MANUFACTURER ~ CAPACITY STATION BS H`I' FS ELEV. Septic Benchmark yd fo3 ~I 1G~'-O[3 LIJIV6 X ~j~30 Io(XJ +GD YUt tb~ t v b Alt. BM Bldg. Sewer j Y 83 din t Ht Inlet at. 7- a C~2 1Z7. St/Ht Outlet TANK SETBACK INFORMATION 70 TANK TO P/L WELL BLDG. Vent to Atr Intake ROAD Septic Dt Bottom Dosing Header/Man. n ~ THI tio n Dist. Pipe '7 ` "1 in 7L-4- 71 / Bot. System PUMP/SIPHON INFORMATION Final Grade ~..:l r_ Manufacturer Demand St cover Id• 7(~• GPM Model Number _ TDH Lift y Friction Loss System Head TDH Ft li~-Ip wO&AA oaf dd S~cl! a~ Cb.~( Forcemain LDia. „ Dist to Well SOIL ABSORPTION SYSTEM _ BED/TRENCH Width Length No. Of Trenches PIT DIMENSIONS No Of Pits Inside Dia. A.Auid Depth DIMENSIONS SETBACK SYSTEM TO 1 P/L / BLDG WELL LAKE/STREAM LEACHING Manufacturep INFORMATION Type Of System • CHAMBER OR ~ ° UNIT f~d`l Number: DISTRIBUTION SYSTEM HeaderjManifold Distribution Ix Hole Size x Hole Spacing Vent to Air Intake Pipe(s) - Length ZO Dia --"--,]Length, - '4 Dia 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 s No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: 11 Inspection #2: Location: 282 CROIX RIDGE DR G,1 ~wla G~~ r r 1.) Alt BM Description = ~LT1~ GV' 2. Bldg sewer length = 1 - amount of cover Plan revision Required? ❑ Yes ] No e J 'L Use other side for additional information. Date -~rt~Sigpa ure Cert. No 9D-6710 (R.3197) r rwy RG%PG _ County Safety and Buildings Division 72017 201 W.. Washingttlh Ave., P.O. Box 7162 Sanitary Permit Number (to be filled in by Co.) V~``~ Madis A17 07-7162 ST. CROIX COUNTY % = UNITY DEVELOPME EH 5 7 is Appil t,CF4 9JQBCJM Ctat: Tr-ne«ction NT.-nber unitary Yermi /0 98 In accordance with SPS 383.21(2), Wis. Adm. Code, submission of this form to the appropriate Pau.,..- brit ~ 7- is required prior to obtaining a sanitary permit. Note: Application forms for state-owned POWTS are submitted to roject Address (if different than mailing address) the Department of Safety and Professional Servies. Personal information you provide may be used for secondary ,2J v2, b 2d R t Q p e purposes in accordance with the Privacy Law, s. 15.04(1 (m , Stats. O 1. Application Information - Please Print All Information ~u r~5 d n~ Property. Owner's Name Parcel # OD_b kRI.51C^1 OVIQ _ 3;Z6 - 00 -00 Property Owner's Mailing Address Property Location n 733 n'./c C~ Govt. Lot City, State Zip Code Phone Number AJV,. , 2y _ Section ;S Q W_/ yQ _(ctrcle one II. Type of Building (check all that apply) Lot # V E ui 1 or 2 Family Dwelling - Number of Bedrooms Subdivision Name 99 / S~ a~ Block # d E- R / ❑ Public/Commercial - Describe Use Q JZL ❑ City of n CSM Number ❑ Village of L-1 Ztaie Owned-Describe Use / /6 X j'i'own of III. Type of Permit: (Check only one box on line A. Complete line B if applicable) &.Q-- xg' A. New S stem y ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only Other Modification to Existing System (explain) t B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of Plumber ❑ Permit Transfer to New List 111vious Permit Number and Oate Issul / Before Expiration Owner 44 IV. Type of POWTS System/Component/Device: (Check all that apply) Q ❑ Non-Pressurized In-Ground ❑ Pressurized In-Ground ❑ At-Grade ❑ Mound > 24 in. of suitable soil Mound < 24 in. of suitable soil ❑ Holding Tank ❑ Other Dispersal Component (explain) ❑ Pretreatment Device (explain) / V. Dis ersal/Treat ent Area Information: t 1/0 1 Design Flow (gpd) Design Soil Application Rat (gpdst) Dispersal Area Requir - (st Dispersal Area Propos (s ystem Elevatio 60o 60 OPT (0 6 d /6 O VI. Tank Info Capacity in Total # of Manufacturer- I t Gallons Gallons Units a o o a u U u m ~ Y p ~ New Tanks Existing Tanks t-11 P. Septic or Holding Tank (`LOO IZDO W'/e J1,4 12, /Zo0 6 Dosing Chamber Roo aop I I I I + VII. Responsibility Statement- T, the undersigned, assume responsibili for installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plumb ' Signa a MP/MPRS Number Business Phone Number / ,Vaj4J 71L, 1'731 U 3 Plumber's Address (Street, City, State, Zip Code) _5 jgt VIII un epartment Use Only Approved ove Permit Fee Date •sued Issuing a t Signatur i~ 01 > n Pn R-Sr'n for ial $ 7W 9 14 / IX. Condi{teasons for Disapproval . _ ttink 6ikKnt i&4 ' . 3 . 4-r r*Z t ispemin cell must all be stw%tca s! Ejnjt o t • _ as per,.7onagement plan pro Tided by plumber. 2. '1St nac*r, M Mtx;t,be i:'tt#int8.ir.E*! an per oppAwMe cock / crdinanre,3. A r -1• 1.. ..1.. a f^- tht nd "••i`.^ 1 I!= C_ -1. 1 7.. lh..« Q 11 chv 1 12 M: SBD-6398 (R. 11/11) S Plot Plan for Cove Ridge Town of Troy, & Croix Coway wasconsin Lot 6 LegQl lcriptionE of jw , E 5• T2YN 7t2Av~i 938.8Q4iT ~O ~Dl BENCH mac: , VD- Z~.457/vR gDVeu_ V 649 c ex! FDF=CEO►+~ ~B~4 - S LEA Art= `L`soft ft Pjt_ a # J ~ t I ~ ~f. r: of DIVISION OF INDUSTRY SERVICES 2331 SAN LUIS PL STE 150 7 A'~ • j GREEN BAY VVI 54304-5211 t~v Contact Through Relay « http://dsps.wi.gov/programs/industry-services vrmv.wisconsin.gcv J~A C 1 Scott Walker, Governor ~ssror Dave Ross, Secretary October 20, 2010 APPROV CUST ID No. 224832 ATTN: POP✓TS Inspector OF `CAF" :IFE sSIONAL MARY JO HZ")PPERT ZONING OFFICE H:OLLISTERS SOIL TESTING & DESIGN ST CROIX COUNTY SPIA 28497 KING ARTHURS 1 101 CARMICHAEL RD DANBURY WI 54830 HUDSON WI 54016-7708 CONDITIONAL, APPROVAL r`t L PLAN APPROVAL EXPIRES: 10/20/2018 Identification Numbers Transaction ID No. 2791098 SITE. Site ID No, 830197 Todd & Kristen Gillingham Please refer to both identification numbers; 282 Cov(~Ridge Dr above, in all correspondence with the agency. Town of Troy St Croix County NT 1/4, NE1/4, S24, T28N, R20W FOR: Description: Mound &steni N Bedrooms -New Construction) Object Type: POWTS Component Manual Regulated Object ID No.: 1630496 Maintenance required: 600 GPD Flow rate. IS 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 10 1.01(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: • Preserve dispersal area prior and during construction to avoid disturbance, compaction and use of the site. • With new construction; it is recommended not to activate the pump in the dose tank until the tanks are pumped prior to homeowner occupancy. • Wastewater generated from contractors cleaning of equipment and tools arrd,or left over construction products shall not be discharged into the drains discharging to the private onsite wastewater treatment system (POWTS). Waste generated shall be properly disposed of on-site or off site. • Any tail grasses, leaves and shrubs shall be cut short and removed prior to tilling the surface for installation to f prevent matting under the dispersal area. All loose organic material to be removed from around area. • Divert surface water from POWTS Area. 40 • Prior to construction of the dispersal area, check the moisture content of the soil to a depth of 8 inches. Smearina and compactioi of wet soil will result in reducing the infiltration capacity of the soil. Proper soil , moisture _content _can_bedetermined _b- rv_11 n2 a soil sanol_e_between the hands. _I_f_it rolls into a l,'4- inch \vire. t. 4L \;ARY JU 1?L PPER7 Pate 2 10/2-0 =2016 the site is too wet to prepare. If it crumbles. site r oration can rroceed. if the site is too wet to prenare_ do n0 proceed until it dries. • All piping shall conform to SPS Table 384.30-3 and SPS Table 384.30-5 • Insulate building sewer beyond 30 feet per SPS 382.30 (11)(c) • Well setbacks to meet chs. NR 811 & 812 • Tank Installation to follow all manufacture's recommendations. • Verify property line(s) prior to installation- • Pump Floats to be set and verified per approved plan. Any changes may result in pump resizing to meet TDH and GPM Specifications. • Areas that are occupied with rocl~ h ?zi-neni:s, tre'o r001s, stumps and bollldei"s reduce the =Unt Of So71 available for proper treatment. If no other site is available, trees in the basal area of the mound must be cut off at -2-ound level. A larger till area is necessar-V v"t"ett ar1V „t tae above conditions are encountered. to provide sufncient infiltrative area. 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 POW'I'S described in this approval 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. 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. A.11 permits required by the state or the local municipality shall be obtained prior to commencement of construction/in stall ation/operation. In granting this approval the Division of Industry Services reserves the right to require charges 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 This Amount Will Be Invoiced. When You Receive That Invoice, Tim Vander Leest Please Include a Copy With Your Private Sewage Plan Reviewer , Division of Industry Services Payment Submittal. (920)492-2214, Monday - Friday 6 am To 3:30 pm WiSN/IART code: 7633 tml. vanderleest,-,z/wiscon-s i n. Lov a A,LARY" JO H-UPPERT Past 2 10/202016 r F the site is too wet to xepare If it crumbles site precaration can proceed If the site is too wet to preoare. do not _ proceed until it dries. • All piping shall conform to SPS Table 354.30-3 and SPS Table 384.30-5 Insulate building sewer beyond 30 feet per SPS 382.30 (11)(c) • Well setbacks to meet chs. NR 811 L 812 • 'Wank Installation to follow all manufacture's recommendations. • Verify property line(s) prior to installation. • Pump Floats to be set and verified per approved clan inv chanties may result in pump resizing to meet TDH and GPM Specifications. • Areas that are occupied with rock fragments, tree roots, stumps and boulders reduce the amount of soil available for proper treatment. If no other site is available, trees in the basal area of the mound must be cut of- at ground level. A larger fill area is necessary when any, of the above conditions are encountered. to provide su icient infiltrative area. Q~°rer 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 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. 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 Industry Services reserves the right to require changes or additions should conditions arise malting 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 S 250.00 This Amount Will Be Invoiced. When You Receive That Invoice, Tim Vander Leest Please Include a Copy With Your Private Sewage Plan Reviewer, Division of Industry Services Payment Submittal. (920)492-2214 , Monday - Friday 6 am To 3:30 pm WiSMART code: 7633 tim.vanderleest,,-Dwisconsiii.Qov r M OC r; 7 2016 MOUND AND PRESSURE DISTRIBUTION COMPONENT D&6WTRY Residential Application SERVICES INDEX AND TITLE PAGE SLY Project Name: TODD 8, KRISTEN GILLINGHAM YAND ~V vv„c, s "a,,,a. (Saric~ -ERVICES Owner's Address: 733 Hunters Circle StvyiCES Hudson, WI 54016 C-~yl Legal Description.- NE1/4 of the NE1/4, Sec. 24, T28N, R20W Township: Troy County: St. Croix Subdivision Name: Cove Ridge Lot Number: 6 Block Number: NA Parcel I.D. Number: 040 -1320 - 00 - 006 Plan Transaction No.: ```~o~liiiti1411,€Ffpt/flJf Paqe 1 Index and title Page 2 Data entry ®0~ Page 3 Mound drawings Page 4 Lateral and dose tank VARY JO = Page 5 System maintenance specifications HUPPERT = Page 6 Management and contingency plan 0 181*9 rage r ruinN C,i.ii v2 ai iu SNCGi,iwiiv1 is ' RIVER FALLS' o Page 8 Plot plan r W l ICA rttcf, Designer. Mary Jo Huppert License Number: 1859 - 007 Date: 10/10/16 Phone Number: 715 - 821 - 1440 Signature: Designed Pursuant to the Mound Component Manual for POWTS Version 2.0 SDB-10691-P (N. 01101), 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) Version !.U (K. U3/2U12) Page 1 of 8 r Mound and Pressure Distribution Component Design Design Worksheet Site Information (R or C) - R' Residential or Commercial Design Note- Sand till (D) cala_dations assume a 400.00 ° Estimated Wastewater Flow (gpd) Table 383 44 3 in situ soil treatment for fecal coliform of 36 inches- 1 5C' Peakina Factor (e.g. 1.5 = 150%1, 600.00 Design Flow (gpd) 4 00 Site cinna 10/ 102.00 Contour Line Elevation (ft) r o vv ` ucLru I tv un Iuu Q riac►vi ,u ii 0.60; In-situ Soil Application Rate (gpd/ft2) Distribution Cell Information 60.00 Dispersal Cell Length Along Contour (ft) = 10.00 Cell Width (ft) ! 1 nnS i icnareai r_gii nAzinn i nnriinn p:4tp (nnriifi2i +1 y Influent Wastewater Quality (1 or 2) Are the laterals the highest point iirr a ~c uiau ivaa~iu~ i ~ 1 Pressure Disribution Information network? Enter Y or N (C or E) a Center or End Manifold 3.33 Lateral Spacing (ft) If N above. enter the elevation (ft) _ _3' Number of Laterals of the highest point. ~ 0.156 i Orifice Diameter (in) 3.507 Estimated Orifice Spacing (ft) = 11.76 ft2/orifice dill Forromain rli~mofor "in) 150.00i Forcemain Length (ft) Does the forcemain drain back? Y - T- 88.00 run-tN 1 ai in E IGVauGfl (iy Enter Y or N 4.bbl System Head (tt) x 1.3 1 24.411 Forcemain DrainbacK (gal) 15-09 Vertical Lift (ft) 1 55 971 5x Void Volume (gal) 2.47] Friction Loss (ft) 80.44 Minimum Dose Volume (gal) 0.00 In-line Filter Loss (ft) 27.46 System Demand (com) 22.11 Total Dynamic Head (ft) Lateral Diameter Selection Manifold Diameter Selection i ..1:.. i ...3:..110. ..a...:.... 1 .1:.. 4 ..1:.. f L...:.... / iii. uic. vNuvi is I %,i wn,c. ~ 111. uia. v uvi iS %.i ivn.c ~ 0.75 _ . 125 x x.-.. . 1.25 x x 2.00 1.50 x _ m r.. 3.00 2.000 x 3.00 x Gallonsfinch Calculator (optional) Treatment Tank Information Total Tank Capacity (gal) 7 ''lnrl (w) j `nntin Tnn1L f`nran..:i.i lnni\ 1 ninl lA lnrLinr. i i... .:ii ilnni4!in\ c.aiv.vv va+Nuv r us rra vuruvnr \yur! ..'v _ . vam r rvr rur ry uyurv vvi✓u ~n r! Wieser u Manufacturer u gal/in (enter result in cell B49) Dose Tank Information Effluent Filter Information 800.00< Dose Tank Capacity (gal) PolyLok W Filter Manufacturer 22.24. Dose Tank Volume (gal/in) 122 Filter Model Number Manufacturer Project: TODD & KRISTEN GILLINGHAM Page 2 of 8 Mound Plan and Cross Section Views T 1/10 B : J Observation Pipe - K 1 1 J LJ 4 4~ r S A rr ~ 4 v1 ~ 1 4~ W ..C...:::f' : J - B • L Mound Component Dimensions A 10.00 ft E [it in H 1.00 ft K M28.23 ft B 60.00 ft F in z 10.81 ft L ft D 18.00 in G J 7.42 ft W ft 0006 (ft`) Dispersal Cell Area 1248.581 (ft`) Basal Area Available 10.00 (gpdfft) Linear Loading Rate 6.00 (ft) 1/10 B Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area Finished Grade 105.27 (ft) o1i'll g! i !I;! Fil IH rrr.;rrrrrr 2 „rrrrrrrr,. G ~ .~iiiiiiriuririir rirrrrrrrrirrrr+. 104.00 (ft) Lateral I F : Dispersal Cell 103.50 (ft) - Invert Elevation = D = 1 J 5 r.. l.- v~. 102.00 (ft) Contour Elevation 4.0 % Site Slope Geotextile Fabric Cover Shading Key c I - Dispersal Cell See lateral details on 0 Topsoil Cap c 1.5 ft Page 4 for number, size, rrrr..rr Subsoil Cap c 1 tat and spacing of laterals. l-~-- 3 Laterals are equally 121 J ASTM 1-33J Sand _ ? 1~ 1 1 L •,1 C J~.J4\.GU I/VIII 111E ® Tilled Layer c H 0.5 ft Typal Lateral distribution cell's © r Aggregate o _ centerline in the A~ distribution cell (AxB). FrUJUU. T ODE) & KRIS i EN GiLLINGHAf i Faye 3 ui 8 i End Connection Lateral Layout Diagram Center the laterals over the Ae. B dimension •=Turn-up of ball valve orclaanout pl ug R PAIllat-als are i-0en[ic a1 Hoot es drilled on the bottom or the Leter al equally spaced S Laterals .&rorcemain Sch 40 PVC per SPS Table 354.30-5 S main cclnnection via tee or cross to mandold at any point. t , Number of Laterals 3 Orifice Diameter 0.156 in Lateral Diameter 1.25 in Orifice Spacing (X) 3.66 ft Lateral Length (P) 58.56 ft Orifices per Lateral 17 Lateral Spacing (S) 3.33 ft Orifice Density 11.76 ft2/orifice Laierai Fiow Rate to.-i3tgpm Manifold Length i5.67'Tt System Flow Rate 27.46 gpm Manifold Diameter 1.25 in Total Dynamic Head 22.11 ft Forcemain Velocity 2.80 ft/sec Dose Tank Information Locking cover with warning iahf-l anti inekinn dp_uirtp anti sealed watertight Electrical as per NEC 300 SPS 316.300 WAC 4 in_ min. Disconnect Tank component is properly vented E- Alternate outlet i location i i i Ln For--ma:- Weiser Manufacturer 2 in. lyd- idCIL 800.00 Gaiiui s Volume 22.24 gal/inch A i t l Weep hole or anti- nimension Inches gallons _ R ~cl i i I sinhondevine A 19.45 432.67 T 8 t 2.nOt 4.481 C t11 i i _ Pump, off eleva5on (ft, C 3.62 80.44 i 88.91 i t_1 1 ~1 4~ 7L1 f ~ I Total 35.97 800=- 0 D It i i v~tr~C iallK eit;vduon iii) 3t' Bedding under tank. 88.00 Alarm Manuafacturer SJE Rhombus Note: Switches Alarm Model Number `Tank Alert AB containing mercury may not be used in Pump Manufacturer Gouid this system. r;_iiiiPi i'Jlt-uit3! Ni_ii'Slt-ir?i PF n i o ff..... It A..e.i 1"l..l:... i •~7 w~ nu ia 7)71-141 t nr.r trtvot. r~cnrct l ~r .wlyrlit tt, l t.t. 1 t l(1 t vt t Project: TODD & KRIS T CN GiLUNGHAM Page 4 of 8 Mound System Management Plan Pursuant to SPS 383.54, Wis. Adm. Code General This system shall be operated in accordance with SPS 382-84 Wis. Adm. Code, and shall maintained in accordance with its' component manuals [SBD-10691-P (N.01/01), SSWMP Publication 9.6 (01/81), and Pressure Distribution Component Manual Ver. 2.0 SBD-10706-P (N. liI in-iii and inrai nr safe ri_iiec nertaininn fn cvciPm mainipnanep anti mainfi?nance rennrfinn- 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 SPS 383.33, 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 T ,he fruu,Ei kuvan nyi tan, anon be ,napoi:rcd ad icoaL owciy' 3 ycaib nil avri"iica, aia 66, our . _ operation. If an effluent filter is installed within the tank it shall be inspected and serviced as necessary. Mound and Pressure Distribution System No trees or shrubs should be planted on the mound. Plantings may be made around the mound's perimeter, and the mound shall be seeded and mulched as necessary to prevent erosion and to provide some protection from frost penetration. Traffic (other than for vege.,Av( maintenance) on the mound is not recommended since soil compaction may hinder aeration of the infiltrative surface within the mound and snow compaction in the winter will promote frost penetration. Cold weather installations (October-February) dictate that the mound be heaviic muiched as protection trom freezing. Influent quality into the mound system may not exceed 220 mg/L BOD5, 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 cel! : 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. Contin-gencv 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 'vviu i a component of the same or equal per'loimance. If the mound component fails to accept wastewater or begins to discharge wastewater to the ground surface, it will be repaired or replaced in its' present location by increasing basal area if toe leakage occurs or by removing biologically clogged 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. Pretreatment Units The information and schedule of mananagement and maintenance for pretreatment devices such as aerobic treatment units or disinfection i lnim arP aftarhPri ae CPnarAtP rinri tniPnm anti ara rnngiriarP ri narf of fha nvarAii mananPmenT ninn Tnr Thic CVSTPm ` I Wastewater u - METERS FEET 40 . --MODELS: PE31, PE41, PE51 PE51 HP_ .33-40-50 35 10 2 GPM i-J 30 PE41 1 FT Q x 25 PE31 Q z 20 J _ 15 O E 10 5 a 0 10 20 30 40 50 60 70 GPM 80 r- N 0 5 10 15 m3/h CAPACITY PERFORMANCE RATINGS PE31 PE41 PE51 Total Head Total Head Total Head (feet of water) GPM (feet of water) GPM (feet of water) GPM 5 52 8 61 10 67 10 42 10 57 15 59 15 29 15 46 20 50 20 16 20 33 25 39 25 0 25 16 30 26 35 8 PA6F..3 1 a Plot Plan for Cove Ridge Page a of8 Town of Troy, Sit Croix COMMY, N'rsconsin f Lot 6 I"= 50 ft Legal Des ►n NP.* aF -m NEh s£c•A 2 ft contomrs T2,201, Backkoe pit 938.8O41T CO ~2 eENOi YAWL. \ TOP OF i i/4" \5 ~IM pw iL o°„AsTM I ~Il~ ` FROM SEr'TIC TANK bZbbS lBZ, o Fofz~EMl~~ o~./ Lidlac~A Sys ~ ) a 945.7 q~1 F, X { i i ` f LvY t ~`J \ ~..J °oo 99'6Z19*_89 L--_- ),OO:OS e£°00 N o °YJ Z L'8$,Z N1 .9L p° s! \ \ ~i ti : tia °iZ ~o N oo / ao \ S ti co ~ZJ / \ I0 3 ..pp 61 a°fo v( WI>r LL (If 'v X00°8l If) LL: C4 Cl) 00 s ys ; W) M j o csD a o i It V; t- Cl V- lo) o af)(0 cr; 6, CM 00 0~ b£ A gyp.; •3 O ►o i I N, s °is~, os ` to ° I v 19 6*1 •zs'~ J 4 3 AN 1, j o) W Z N 3 ~ 1 Z - A 'Q 0 +~n av 04 ^ A ~t,l W NSF 9~ ° ti 00 ti ,~•ssz \ M 119Z .00°00 N h \ I W ~ I j • ~EcEIVE ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT SEP 0 ) 2017 AND OWNFRSIIIP CERTIFICATION FORM ;OMMUNIND .OZNTY Owner/Buyer Todd Gillingham OpMEn►r Mailing Addres 733 Hunters Circle, Hudson Wi 54016 4(282 Croix Ridge drive Property Address Vlt-< (Verification required from Planning & Zoning Departm t for new construction.) City /State Hudson, Wl Pat-cc] Identification Number 040-1320-00-006 LEGAL DESCRIPTION Property Location NE ,,4 NE ,,4 , See. 24 I. 28 N R 20 W, Town of Troy Subdivision PIat:11-008-Cove Ridge 040/06 LOTS 1-13 Lot # 6 Certified Survey Man # Plat Doc#830969 , Volume 11 Page # 008 Warranty Deed # 955634 (before 2007)Volume Page # Spec house ❑yes[ZIno Lot lines identifiable I]yesE]no SYSTEM MAINTENANCE AND OWNER CERTIFICATION Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed, by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. 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 wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. 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. 1/we certify that all statements o this form are true to the best of my/our knowledge. Uwe am/are the owner(s) of the property described above, by virtue of varranty deed recorded in Register ol•Deeds Office. Nu ~oms 4 oi~ l~OJOl ! 'NATURF, OF APPLICANT ' DATE ***Any 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 reference is made in the warranty deed. (REV. 01/12) ECEl Wisconsin Department of Commerce SOIL EVAL TIO REPORT Page l of 3 Division of Safety and Buildings 4 in accordfnce with' 8~rrg il~, dm. e J County ST. CROIX Attach rmm~lata vita nlan en narwr not IP.C¢ than $ 1/2 x; i i size. ruts{ .............t r._.. , , _ - include, but not limited to: vertical and horizontal reference point ( lb Fend Parcel I.D. N/0 / M t. percent slope, scale or dimensions, north arrow, a an o neare$t road. Please print all information. Revie by Dat Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 ( / (v Property Owner Property Location 2Y -2f2,0. 2/5-3 1:10 BOMAR HEIGHTS, LLC (Buyer: Bruce Lenzen Homes) Govt. Lot NE 114 N 1/4 S 24 T 28 N 20 E (or) W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# 6810 Brookhill Drive 6 - (Pending) City §10 AP 13fd@ PI1@n@ NuFnb@F Uhl OV1118Q@ ~ Town N@af@§i Rfldit Salt Lake City, UT 84121 ( ) South Cove Road New Construction Use[D Residential / Number of bedrooms 4 Code derived design flow rate 600 GPD Replacement © Public or commercial - Describe: Parent material till Flood Plain elevation if applicable UA ft. General comments Mound System 1.50 ft. sand fill 0.61oadin rate and recommendations: (If pre-treatment system -.50 ft. sand fill) 171 Bori ng # u Boring a pit Ground surface elev. 943.65 ft. Depth to limiting factor 18 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. 'Efr#1 -Eff#2 1 0-4 10YR2/1 - I 3fgr&sbk mvfr cs 3vf-co 0.6 0.8 2 4-7 10YR2/2 - sl 2f-ma&sbk mfr ci 2vf-co 0.6 1.0 j 9=12 7.5yRj/j §I Ahk flip E§ Nkt) 0:0 1:0 4 12-18 7.5YR4/4 - scl 2fabk mfi cb 2vf-m 0.4 0.6 5 18-22 - lsbr B Boring # 942.56 >35 l~ El Pit Ground surface elev. ft. 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 1 0-4 10YR2/1 - 1 3fgr mvfr ci 3vf-co 0.6 0.8 2 4-14 10YR2/2 - sl 2fa&sbk mfr ci 2vf-co 0.6 1.0 3 14-23 7.5YR3/3 - sl 2fsbk mfr cs 2vf-co 0.6 1.0 4 23-35 7.5YR4/4 - sl lmsbk mfr - 2vf-co 0.6 1.0 #®flf3n§; j NE 4 have >igffle 8f: Effluent #1 = BODr, > 30:5 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BODS < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) !Sinnature CST Number Ma Jo Hollister t l l~G t 5C 224832 Address Date Evaluation Conducted Telephone Number n_11_ {L ri cAn11~ nc /'11 c\ A-14 1'7'7¢ L wyrs /J oyUm avenue, tuver Cans, Y vi J'4VLG UJ - UL - UJ 1 ^"^!T^^ ^^`I BOMAR HEIGHTS, LLC (Lot 6) Parcel ID # (Pending) Page 2 of 3 Property Owner C Boring # Boring 944.27 F>20 Q pit Ground surface elev. ft. Depth to limiting factor i n. Soil ADjAication Rate Horizon Depth Dominant Color Redox Description Texture Stricture Consistence Boundary Roots GPD/fft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 *Eff#2 1 0-4 10YR2/1 1 3fgr mvfr as 3v-f-co 0.6 0.8 2 4-12 10YR2/2 - sl 2fa&sbk mfr ci 2vf-co 0.6 1.0 3 12-20 7.5YR3/3 sl 2fa&sbk mfr 2vf=co 0.6 i.u Boring E Boring # o pit Ground surface elev. ft. Depth to limiting factor in. r-Eff#1 l ication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#2 ®f1Fifl~ @erin~ Pit 6ff3Ufld §UF#flf@ 01f3ti. #i. B@pfH f8 Ilffltllng Me8f in. on Rate Soil nQPD1fF Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Ef'Eff#2 Effluent #1 = BODS > 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BODS < 30 mg/1- and TSS < 30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. SBD-8330 rest (R.071W) ' Plot Plan for Cove Ridge Page 3 0 3 Town of Troy, ,St. CTOLV County, Wisconsin ChEVIS~~ : o s- ) Lot 16> I" = 50 ft. Legal Description , ~ yv o1= -r► . J. sec• pi. 2 ft. contours -rzgN P.,zo~ Q = Backhoe pit C 938.8041 T C / RB-7C 1:939. ~o BENCH MARK: TOP OF 1 1/4" IRON PIPE F / BENCH MARC 40d IN~ _cOIRE ELM OEI: 944.34699 1: 940 36892' :942.56306' B-3B .65090' BENCH MAA4~r -94,5.7 40d SPIKE IN V 14" ELM---- VA 4775' 0,444.2701 T ~l1 F, ti x S LE:1 "=5 I I I t =w )LUS1 ER's: z:)UiL TESTING Mary Jo Hollister W9875 6901h Avenue River Falls, WI 54022 (715) 426 - 1775 FAX: (715) 426 - 4827 15 May 2006 \~J TO: St. Croix County Zoning ~ C"A ~j ATTN: Ryan Yarrington Zoning Technician RE: Cove Ridge Subdivision Enclosed are the revisions after your review of the soil evaluation reports. Ogden Engineering and I have confirmed the borings and elevations. Please accept the designated area for Lot 4. A boring from Lot 5 has been included on the soil report for Lot 4. See attach code intrepretation from Wiscosnin Construction Codes Report, February 2004. All the borings conducted were very similar for those lots. Lot 11 has enough system area within the 3 borings. Please let me know of your approval so that originals may be sent out. Thank you for your time and attention to this issue. Sincerely, MaryJo Hollister CST 224832 Cc: Ogden Engineering BLH Development Corporation Leroy Janksy, Dept. of Commerce, Wastewater Specialist i a Update on statewide enforcement of UDC by Laurence J. Swaziek„ S&B UDC Program Manager, 608-267-7701, Iswaziek@commerce.state.wi.us A new Wisconsin law requires the state's resolution to decline UDC enforcement. Munici- Uniform Dwelling Code be enforced in all palities of over 2500 have been required to municipalities. This includes the necessity to have enforce the UDC. new construction inspected for compliance with Now the smaller municipalities will also the UDC, the statewide building code for one- and come under the UDC system to assure the two-family dwellings built since June 1, 1980. proper construction of one- and two-family The change was effective December 18, 2003. residences. However, it will take three to six months to get Those municipalities which previously chose to the enforcement system into place. not enforce the UDC now have three options: Previous to the new legislation, municipalities 1. Adopt an ordinance to begin local enforce- with a population of 2500 or less could choose by ment of the UDC. This may include contracting with another municipality or a private party to do Where required, S&B plans to begin the work: contracted enforcement for new homes 2. Delegate enforcement to their county, if the by September 1, 2004. continued on page 3 System area for a POWTS can be extended beyond borings POWTS code changed Feb. 1 by Duane Steiner, Wastewater Specialist, by Rortkan Kaminski, POWTS Program Manager, 608-235-0608, dsteiner@commerce.state.wi.us 715-3455334, rkaminski@commerce.state.wi.us Can someone go beyond the soil borings with After multi-year effort, the first com- their Private Onsite Wastewater Treatment System prehensive revision in 20 years to Comm 83, design and installation? Yes. Private On 'te Wastewater treatment Systems The POWTS Code, Comm 83, states that three Code, was it plemented July 1, 2000. borings, at a minimum, are utilized to define Once the ndustry began to actually use the system area. Based on the soil borings, contours, code, a num er of "`issues" were brought to the slopes, soil profile similarities and/or dissim- attention of the Safety and Buildings Division A, ilarities, the Certified Soil Tester establishes a staff, inclu ng inconsistencies in code language, * suitable area, which must be identified on the soil requests f clarifications, and requests to address report. topics n covered in the code. By drawing a line around this suitable area on A c e council representing interests of parties the site, report, the CST indicates where a dispersal fr,, the private and public sectors was formed cell may be located. If the CST feels comfortable continued on page 6 continued on page F..-°' Wisconsin Cbristruction Codes Repo' °r 11~ Watch for the S&B plumbing credential The Wisconsin Enrolled renewal letters that are scheduled to be Commercial Building mailed during the middle two weeks of Code has been updated. February, 2004. See page 9. 1 Wisconsin Construction Codes Report, Safety and Buildings Division, Wisconsin Department of Commerce February 2004 SBD 10741-P O~Lz k014 W_ Ktru Plot Plan for Cove Ridge Page 3 of 3 Town of Troy, St. Croix County, Wisconsin Lot / 1 50 ft. Legal Description : E /y W- -rtw' i~E Yy, 5 j 2 ft. contours ~zg~l~vzoW Q = Backhoe pit I: 938.80417' ~O i ~ ZRR R8 77C I:939.8 BENCH / T [RON OP PI SARK: Q 000, TOP OF 1 1/4 ~ 1 j BENCH MARK-- \ 40df,ELM IRE IN ELM I: 940.36892' II: 944.34699' 942.56306' B-3B :9 3.65090' BENCH MARK: 0 945.7 40d SPIKE IN IN y 14" ELWL\ 7946.24775' 944.27017' j SCALE:1 "=5 I I ~ I I Parcel 040-1320-00-006 04/09/2008 08:41 AM PAGE 1 OF 1 Alt. Parcel 24.28.20.2153 040 - TOWN OF TROY Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 07/31/2006 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner O - BLH DEVELOPMENT CORPORATION INC BLH DEVELOPMENT CORPORATION INC 502 2ND ST STE 204 HUDSON WI 54016 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description ' 282 CROIX RIDGE DR SC 2611 HUDSON SP 1700 WITC Legal Description: Acres: 2.057 Plat: 11-008-COVE RIDGE 040/06 LOTS 1-13 SEC 24 T28N R20W PT NE NE; BEING COVE Block/Condo Bldg: LOT 06 RIDGE ('06) LOT 6 (2.057AC) Tract(s): (Sec-Twn-Rng 401/4 1601/4) 24-28N-20W NE NE Notes: Parcel History: Date Doc # Vol/Page Type 07/31/2006 830969 11/008 PLAT 05/02/2006 824187 WD 12/07/2005 813723 2940/194 QC 08/02/2005 802065 20/5033 CSM more... 2008 SUMMARY Bill Fair Market Value: Assessed with: 0 Valuations: Last Changed: 08/24/2007 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 2.057 273,000 0 273,000 NO Totals for 2008: General Property 2.057 273,000 0 273,000 Woodland 0.000 0 0 Totals for 2007: General Property 2.057 273,000 0 273,000 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00