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042-1004-70-600 (2)
Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No (ATTACH TO PERMIT) 600305 GENERAL INFORMATION State Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)). 3037636 Permit Holder's Name: City Village Township Parcel Tax No: Roston Properties LLC (Richard Stout) TOWN OF WARREN 042-1004-70-600 CST BM Elev: Insp. BM klev: BM Description: h A J Section/Town/Range/Map No: ~VI~ /`,~J rvl 03.29.18.38A-70 3 TANK INFORMATION ELEVATION DATA TYPE MANUFACT/JRER CAPACITY STATION BS HI FS ELEV. Septic lM Benchmark g y Dosing Alt. BM ~~~a Asa 1, 3.5 gas •St AQraMern ' Bldg. Sewer .R ~ ~Q Z • r; 1 Holding St/Ht Inlet /6' to CM $ 3 St/Ht Outlet O TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent t Air Intake ROAD Dt Inlet i Septic `r_ y~ Dt Bottom J3 .7' Dosing / So 1 10 Header/Man. 6Z 7'" Aeration Dist. Pipe -A ,x J5 /67.01 V/ •7-5 7 16Z.•7(p Holding Bot. System 7'• ~ t / 8z, Z J ; • . PUMP/SIPHON INFORMATION Final Grade J Manufacturer v Qe D GPI~ 3.15 emand St Coyer L S y 7 Model Number 162-16 C7 1 TDH Liffft Friction Loss r System Head TD i. 3 . ZS Dim Dist. to Well Forcemain Yg/th0J ,l 1 - P SOIL ABSORPTION SYGTEM BED/TRENCH Width Length No. grenclej PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS /Ad e SETBACK SYSTEM' TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR Ty LV,M6 ( 1165 'Zt? P*J ^ UNIT Model Number: ` DISTRIBUTION SYSTEM Header/Manifold ID istribution / Hole Size (1-- x Hole Spacing/ Ve Air Inta Pips) ~ 2 /•S 3 V Z V Length Dia Length Dia pacing_ Ix 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 1 • 74o Bed/Trench Edges a Topsail Yes L No Yes l No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection 4,1: (0 Inspection #2: Location: 1186 121ST ST d0 1.) Alt BM Description = i'® 2.) Bldg sewer length = 5U /i ~b 1 a i,.~ - amount of cover = _ / J~ J L►1tie~ 'd" ~ 4 L e rt Q~.rx~ r Plan revision Required? Yes >eNo Use other side for additional information. {O ✓ - p - ` - ~I' - - Date Insepctor' Signatu Cert. No. SBD-6710 (R 3/97) ~ yrsRTAr~~~ - t ~ County I vz St. Croix Industry Services Division; c~(J j 7 - RECEIVED 1400 E Washington Ave ( by ) f + Sanitary Permit Number to be filled in b Co. P.O. Box 7162 DEC 0 9 Madison, WI 53707-7162 -2 it FsstrnnU~ 666 ~MIt Appllca ' State Transaction Number qP53ft3.,• 3037636 In accordance with 1( a War, tai unit is required prior to obtaining a sanitary permit. Note: Application forms for state-own i ed to the Department of Safety and Professional Services. Personal information you ro ondary Project Address (if different than mailing address) purposes in accordance with the privacy Law, s. 15.04(1)(m), Stats. t 186 121" Street 1. Application Information - Pleas All Information Property Owner's Name Parcel # Roscon Properties, LLC (Richard Stout)042-1004-70-600 Property Owner's Mailing Address Property Location 1353 Awatukee Trail Govt. Lot City, State Zip Code Phone Number NW ''/4, NW '/4, Section 3 Hudson , WI 54016 circle one) T29N R18Eor&) 11. Type of Building (check all that apply) Lot # Subdivision Name ® 1 or 2 Family Dwelling -Number of Bedrooms (~Z~ 1 ❑ Public/Commercial - Describe Use _ A Block # el? ❑ City of ❑ State Owned - Describe Used _ ❑ Village of / n //~/`i CSM Number /(V~1 f b d5al AJ-7 ®Town of Warren III. Type of Permit: (Check only one box on line A. Complete line B if a licable) A. ® New System ❑ Replacement System ❑ Treannent/Hotding Tank Replacement Only ❑ Other Modification to Existing System (explain) $ ❑ Permit Renewal ❑ Permit Revision ❑ Change of ❑ Permit Transfer to New List Previous Pennit Number and Date Issued Before Expiration Plumber Owner IV. Type of POWTS S stem/Com onent/Device: C t a ly) ❑ Non-Pressurized In-Ground ❑ Pressurized In-Gro nd ® At-Grade -Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil ❑ I folding Tank ❑ Other Dispersal Component (explain ❑ Pretreatment Device (explain) V. Dis ersal/Treatrr nt Area Information: Design Flow (gpd) Design Soil Applic n Dispersal Area Required f) Dispersal Area Pr osed (sf) System Elevation 450 Rate(gpd,fi 750 750 0.6 VVV Vl. Tank Info Capacity in Gallons Total # of 2 U .2 Manufacturer ~ ~ ~ ~ ~ ~ Gallons Units New banks Exist ing Tanks ~ p U v v ~ O P Septic or Holding Tank 1000 1000 ] teser Cot Crete ® ❑ ❑ ❑ ❑ Dosing Chamber 650 650 1 Wieser Concrete ® ❑ ❑ ❑ ❑ VII. Responsibility Statement- 1, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plumbs S nature 4 MP/MFRS Number Business Phone Number Z'f T ~'Z 223760 715-760-0486 John Schmitt Plumber's Address (Street, City, State, Zip Code) 616 150'x' Ave. Somerset. WI 54025 VII . Countv/Department Use Only Approved ve Permit Fee Date I stied issuing went Signatur ~~,,ven Reaso for Denial S (0, ///7 IX. Condi tot t~' J o.~ a o Disapproval e ~~Ct<~i~ ~J vim, t+SUerv:,, cell must all be s,~ ices as per marayemen'. plan p!o iiaed by alumbe:. 2. 'AD a. k rec, ems rnwAts.- m nt: I'VE-i n per vX11mbli cr!f I ;rdiii21ncn. ~b + Attach to complete plans for the system and a mit to the ( my only on paper not es than 8 1/2 ll intes in size SBD-6398 (R03/14) PLOT PLAN N Project Name: Roscon 3 Bedroom At-Grade Legal Description: NW114, NW1/4, S03, T29N, R18W P.I.D: M470-600 Subdivision Name: NA Lot SCALE: V=60' Township: Warren Parcel Size: County: St. Croix Contour Line Elevation: 102.10 Cell Dimensions: =440-AASSTM'D Lateral invert Elevation 102.60 At-Grade Dimensions: Slope 4.00 .00' To of survey iron ® BM1 Elevation: 100 D BM2 Elevation: ® Backhoe Pits: Septic Tank: E650 I llon Septic Tank Ewl EPoiyiok E525 f lue„t filter Dose Tank: lon Dose Tank I)~AIN+4Gc E,4_5EY71riUl !L i, ..'J C ~ r ~r \ ~ J "acr ~,tilri~ti ILI f \ 1 ~ZI ~C C ~ 'Page I-ry ser DIVISION OF INDUSTRY SERVICES a 'o, 3824 CREEKSIDE LN HOLMEN WI 54636-9466 Contact Through Relay P V http://dsps.wi.gov/programs/industry-services d www.wisconsin.gov A~~~~ssruNT~:`%/ Scott Walker, Governor Laura Guti6rrez, Secretary December 15, 2017 CUST ID No. 223760 ATTN: POWTS Inspector JOHN F SCHMITT ZONING OFFICE SCHMITT & SONS EXCAVATING ST CROIX COUNTY SPIA 616 150TH AVE 1101 CARMICHAEL RD SOMERSET WI 54025-6920 HUDSON WI 54016-7708 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 12/15/2019 SITE: Identification Numbers Roscon Properties, LLC Transaction ID No. 3037636 1186 121ST St Site ID No. 845247 Town of Warren Please refer to both identification numbers, St Croix County above, in all correspondence with the agency. NWI/4, NW1/4, S3, T29N, R18W Subdivision: CSM Vol. 20, Pg. 5026 - lot 5 FOR: Description: Three Bedroom At-grade System \ Sloping site Object Type: POWTS Component Manual Regulated Object ID No.: 1739568 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.01101, R. 10/12); Effluent Filter The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes -<1 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. a' ~r a No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.0 J~'0101" stats. The following conditions shall be met during construction or installation and prior to occupancy or use: Reininders • 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. • 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)(4), 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 b~ authorized representatives of the Department, which may include local inspectors. 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. Zrd ely, Fee Required $ 250.00 This Amount Will Be Invoiced. M Swim When You Receive That Invoice, POWTS Plan Reviewer, Division of Industry Services Please Include a Copy With Your (608)789-7892, Mon - Fri, 7:15 am - 4:00 pin Payment Submittal. jerry.swim@wisconsin.gov WiSMART code: 7633 cc: Edwin A Taylor, Wastewater Specialist, (715) 634-3484, Monday - Friday 8:00 am To 4:30 pm DESIGN RESIDENTIAL AT GRADE INDEX AND TITLE PAGE Project Name: Roscon 3 Bedroom At- Grade Owners Name: Richard Stout Owner's Address 1353 Awatukee Trail Huson,Wl 54016 Legal Description: NW1/4, NW1/4, S03, T29N, R18W ,t Township Warren t L y County: St. Croix Subdivision Name: NA Lot Number: 5 Block Number , Parcel I.D. Number 042-1004-70-600 - Plan Transaction No. Page 1 Index and title Page 2 Calculations Page 3 At-Grade Drawings Page 4 Lateral and dose tank Page 5 Specifications Page 6 Management and contingency plan Page 7 Septic and Dose tank specifications Page 8 Effluent filter information Page 9 & 10 Pump specifications and curve Page 11 Plot plan Page 12 Septic tank maintenance agreement Page 13 & 14 Warranty deed Page 15 CSM Attachment 1 Soil evaluation report Attachment 2 House Plans Designer: John Schmitt License Number: 223760 DE1927-7 Date: 11/8/2017 Phone Number; 715-760-0486 Signature: Z %7 __/L T Designed Pursuant to the At-Grade Component Manual for POWTS Version 2.0 SBD-10854-P (N. 03/07) and both SSWMP Publication 9.6 Design of pressure Distribution Networks for ST-SAS (10/81) and Pressure Distribution Component Manual Ver. 2.0 SBD- 10706-P (N. 01/01) Page 1 Version 7.0 ( 11/2012) PRESSURIZED AT-GRADE DESIGN At-grade Design Worksheet - Sloping Site Flows and Site Data Entry. (r or c) r'Residential or commercial? 300.0 Estimated wastewater flow (gpd) 450.0 Design wastewater flow (gpd) 4.00 % Site slope 102.10 Contour elev. below lateral (ft) 100.00 Depth to limiting factor (in) 0.60 In-situ soil application rate (gpdift^2) Distribution Cell Information (1 or 2) 1, Influent wastewater quality 4.50 Linear loading rate gpd/ft 7.50 Effective absorption width (ft) 7.50 Max. effective width permitted (ft) 100.00 Aggregate length (ft) Pressure Distribution Data Entry (c or } -------cc~ Center or end lateral connection F=2 Number of laterals 0.188 Orifice diameter (in) e.g. 0.25 r~o~ << S11>'~ 2.00. Estimated orifice spacing (ft) c~lculafion _ 2.00 Forcemain diameter (in) 3.37 Forcemain flow velocity (ft/sec) y Does forcemain drain back? 100.00; Forcemain length (ft) Y or n Are laterals at highest point? 89.00 Pump tank elevation (ft) y or n y NA 3.25 System head (ft) x 1.3 16.3 Forcemain drainback (gal) 12.52 Vertical lift (ft) 45.0 5x Lateral void volume (gal) 2.31 Friction loss (ft) 0.00 In-line Filter Loss (ft) 613Minimum dose volume (gal) 33.0 System demand (gpm) 18.08 Total dynamic head (ft) Ltal Diameter Selection Gallonslinch Calculator (,optional) Total Tank Capacity (gal) choice Total Working Liquid Depth (in) Design(;i- Gal/in (enter result in cell G46) must select. X anc I atc ral Treatment Tank Information X s in X 1000 Septic tank capacity (gal) Wieser Concrete Manufacturer Dose Tank Information Effluent Filter Information POLYLOK Filter manufacturer 650.0 Dose tank capacity (gal) Filter model number 17.0 Dose tank volume (gal/in) 525 Wieser Concrete ,Manufacturer Project: Roscon 3 Bedroom At-Grade Page 2 Transaction Number: AT-GRADE PLAN VIEW 40 D A 7.50 ft T pipes (2 typical) B 100.00 ft D 116 B :Obsobservation 0 1 /6 B 16.67 ft _1►-- C 9.5 ft 0 W C D 5.0 ft E 2.00 ft L 110.00 ft D B `,/V 19.50 ft A x B 750.00 ft^2 L 4~-- Cap Typical obs. pipe. = Total aggregate cell A x B Slotted in the lower 6", and anchored securely. =Plowed area L x W - 66" AT-GRADE CROSS SECTION Svnthetic fabric cover r 103.89 ft Finished grade elevation Lateral 102.60 ft r Observation pipe invert elev. at aggregate toe E 4 % Slope . Surface contour 102.10 ft C and system D T elevation f;, = 12 in. topsoil and subsoil Plowed layer over aggregate and tapered to toes. below L x W = 6 in. aggregate below pipe(s), and 2 in. above pipe. Project: Roscon 3 Bedroom At-Grade Page 3 Transaction Number: PRESSURE DISTRIBUTION AND DOSE TANK Lateral Diagram - Center Connection I` P 'I IE a(--a 1-,12 I sl241 Laterals & force main of PVC Sch 30 pnr SPS Tabl:: 3$4 30-5 Last hole drilled rye>a to end c.3p Holes drdled on the bottom of the lateral. • = Turn-up Mb.311 valvo or aleanoutptua t y~3:;?ly cp;cc d I Lateral Specifications 0.188 Orifice diameter (in) Center Lateral connection point X 2.00 Orifice spacing (ft) 2 Number laterals 25 Orifices/lateral P 49.00 Lateral length (ft) 16.5 Lat. discharge rate (gpm) 1.50 Lateral diameter (in) 2.00 Forcemain diameter (in) 33.0 Sys, discharge rate (gpm) 100.00 Forcemain Length (ft) 18.08 TDH (ft) Typical Pump Chamber Layout Approved manhole cover with warning label and locking device Weather-proof junction box 4° Final grade disconnect Alternate Tank component is outlet properly vented location 18" min. Electrical as per NEC 300 and Approved outlet SPS 316.300 WAC joint Tank full inches Gallons JA Provide 1/4" = weep hole or o A 19.6 333.7 Alarm on antisiphon a B 2.0 34.0 B device. Pump on E C 3.6 61.3 C 6) D' 13.0 221.0 90.08 ft Totals 38.2 650.0 pump off D 89.00 ft 3" Bedding under tank Alarm manufacturer Zoeller Pump manufacturer SJE Rhombus Alarm model number 152 Pump model number 1036378 Project: Roscon 3 Bedroom At-Grade Page 4 Transaction Number. At grade System Maintenance and Operation Specifications Service Provider's Name ;John Schmitt Phone 715-760-0486 POWTS Regulator's Name St. Croix County Phone.715-386-4680 SVstem 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 750.0 ft2 Maximum FOG 30 mg/L Maximum Fecal Coliform >10E4 cfu/100 mL Type of Wastewater Domestic Service Frequency Septic and Pump Tank Ins ect and/or service once eve 3 ears and clean at least once eve 3 ears Effluent Filter Ins ect Pump and Controls Test once eve 3 ears Alarm Should test month) Pressure System Laterals should be flushed and pressure tested eve 1.5 ears Mound Inspect for ponding and seepage once every 3 years Miscellaneous Construction and Materials Standards 1. Observation pipes are slotted and materials conform to Table SPS 384.30-1, have a watertight cap, and are secured in as shown in the at-grade component manual. 2. Dispersal cell aggregate conforms to SPS 384,30 (6)(i), Wis. Adm. Code. 3. All gravity and pressure piping materials conform to the requirements in SPS 384, 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. 6. Areas within 15 feet of the downslope toe will be protected from compaction. 7. All other construction details are as per the at-grade component manual SBD-10854-P (N. 03/07). Lateral Turn-up Detail Finished Grade Threaded Cleanout 6-8" Diameter Lawn Plug or Ball Valve Sprinkler Valve Box Distribution Lang Sweep 90 or Two 102.60 ft 45 Degree Bends Same Diameter as Lateral Project-. Roscon 3 Bedroom At-Grade Page 5 Transaction Number: At-grade System Management Plan Pursuant to SPS 383.54, Wis. Adm. Code General This system shall be operated in accordance with SPS 382-384 Wis. Adm. Code, and shall maintained in accordance with its' component manuals [SBD-10854-P (N. 03/07, R. 01112), SSWMP Pub. 9.6 (01/81), and Pressure Distribution Component Manual Ver. 2.0 SBD-10706 (N. 01/01, R. 10/12)] 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 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 o 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 at-grade 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 u to that- mound and snow compaction in the winter will promote frost penetration. Cold weather installations (October-February) d grade ate grade be heavily mulched as protection from freezing. Influent quality into the at-grade 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 101 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, an any levels above 4 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 absorption repaired or replaced in its' present location by increasing basal area if toe leakage occurs or by renovating the biologically clogged dispersal media, installing new piping, and replacing other 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. Page 6 Project: Roscon 3 Bedroom At-Grade Transaction Number: 95b8-5Z2-008 ° \ 84-099/oomda :q110 09L-V9 IM 'A008 N301bW Ol AMH sn 9LLCM z anaO 'A3v 4 00/00/00 31380000 ~t/(1NdW OI1d35 w 0 9/000WIM (V) a-,~=„~ 31dos doM,a NM31380000 13331M 8N-05 VOa D W w ~ H Q o' o co O o D V) r w J a o w w N m l/1 Q m Q c~,. W z = o t= a o [z l? F p ar w= J Z O co LLI o z CIO U F- CY o EL 0~ w D h H° o z (n om O ¢ zz iR mp 0 CY o CL ce in ° O w oQ L JU -~J U a f-- a p Ow Q QQ z a p~ N < a co tj m cn w w = N Z ? V) z © O m J I W O (n N O = (jj 0 Q LO U O= O ,oJ Q`Z U- to O O Q U~ t0 O_ (fj~ LL -NOCjd tO 0 ~F mWW N~ O N Z~ V) k- ~U JO) WQQ W N W D- Z U ~ c) z W 10 d ~F DV) o CL w c- 0c) _ ~w oozy m~1= zw U wUw OW w O~ M" J " O W O W Q W m O N O Z ..O~o =052 OU((f) OO~ Q O z L'i W OO 0. °-doOQWW°waJ ¢It0 a~~ U z C-) ~ ( J zimUm SJrSm F-- O Y ~Y U Z W W W = O Q OQ Q Q Z -j -i Z J h U~ J Q W I Q I w p U w Of n H > z d = w uj II I(~ i ~ N ~i Ir. I I ►i I I U ~ 1i 5 I I v ( > O W o l I J~ ~ W I I o I „g ~I v~ w I I w I I. F- I o d w m l j I „i s-~ w ail a l II. I I ~ I o 8 ~ Q M W O Li Q „fit' W ~~32i Q V) z „t8 sd „b8 Q A Page 7 A., I nt m+ rn 1 i i t Zabel ae^ri rtE A lliviion of POIllok l:zc. 13 ~ t"k l ~ I !v z" The Pt 525 Filter is rated for 10,000 GPD (gallons per day) making it one of the largest filters in its class. It has 525 linear feet of 1/16" filtration slots. Like the Polylok PL-122, the Polylok PL-525 has an automatic shut-off ball installed with every filter. When the filter is removed for cleaning, the ball will float up and temporarily shut off the system so the effluent won't leave the tank. Alarm Switch Rated for 10,000 GPD (gallons per day). Alarm mwl 10,000 G~'I? 525 linear feet of 1/16" filtration. Accepts 1" PVC 1 Accepts 4" and 6" SCHD 40 pipe. Extension Handle Built in gas deflector.' Automatic shut-off ball when filter is removed. gated for e 10,000 GPD Alarm accessibility. } :k Accepts PVC extension handle. 525 Linear Ft. Ideal for residential and commercial waste flows up to,- of 1/16" Filtration Slots 10,000 gallons per day (GPD). 1. Locate the outlet of the septic tank. .2. Remove the tank cover and pump tank if necessary. Accepts 4" & 6">3. Glue the filter housing to the 4" or 6" outlet pipe. If SCHD all pipe ; y the filter is not centered under the access opening use a Polylok Extend & Lok or piece of pipe to center filter. o~faze€r 4. Insert the PL-525 filter into its housing. 5. Replace and secure the septic tank cover. L lls The PL-525 Effluent Filters will operate efficiently for several years under normal conditions before requiring cleaning. It is recommended that the filter be cleaned every time the tank is pumped, or at least every three years. If the installed filter contains in optional alarm, the owner will be notified by an alarm when the filter` ~ Gas Deflector needs servicing. Servicing should be done by a certified p 1~ Automatic septic tank pumper or installer, a ,1 Shut-Off Ball 1. Locate the outlet of the septic tank. 2. Remove tank cover and pump tank if necessary. 3. Do not use plumbing when filter is removed. 4. Pull PL-525 cartridge out of the housing. ,-y 5. Hose off filter over the septic tank. Make sure all solids fall back into septic tank. ` 6. Insert the filter cartridge back into the housing making filters accept sum the filter is properly aligned and completely inserted. Polyloh , Zabel & Best pt Easily installs into existing tanks. the Smartfilter® switch and alarm. 7. Replace and secure septic tank cover. Polylok, Inc. 3 Fairfield Blvd. Wallingford, CT 06492 Toll Free: 877.765.9565 Fax: 203.284.85 14 www.poiylok.com Page 8 / p SECTION: 2.20.047 ~UQL/TV ~UiLlP9NCE f FM1919 0110 ~f f 1 p Supersedes edes Product information presented 1108 here reflects conditions at time of publication. Consult factory - - regarding discrepancies or MAIL TO: P.O. BOX 16347 • Louisville, KY 40256-0347 visit our Web site: inconsistencies. SHIP T0: 3649 Cane Run Road • Louisville, KY 40211-1961 www.zoeller.com (502) 778-2731.1(800) 928-PUMP • FAX (502) 774-3624 Durable cast iron construction 15111521153 EFFLUENT SERIES Model 151 comes standard with a glass-filled polypropylene base (For Pump Prefix Identification see News & mews 0052) Corrosion resistant powder coated epoxy finish ' 5 s iaf"n } a~ r ; Stainless steel lifting handle Assembled with stainless steel bolts FOR SEPTIC TANK -LOW PRESSURE PIPE (LPP) Non- impel!ogging engineered thermoplastic vortex AND ENHANCED FLOW STEP SYSTEMS impeller clogging O PY•* Model 151 -113 HP passes 1/2" spherical solids *`7"7f EFFLUENT SUBMERSIBLE Model 152 -.4 HP passes 3/d" spherical solids ~~~2~~ ~pT DISCHARGE Model 153 -112 HPpasses '/4' spherical solids Motor - 60 Hz, 3450 RPM, oil-filled, hermetically sealed, automatic reset thermal overload protected a 1 WOO. Carbon/Ceramic seals c us k~ Upper sleeve bearing and lower ball bearing running 1etd W ur staus uLna and Cerred ti) CsA in bath of oil StDdardGSR22.2No.108 " ' 20 ft. U L Listed power cord with molded 3-wire plug 1W NPT vertical discharge t~ x BN and BE standard models include a 20 ft, variable F115vN1521N153 & E1511E152/E153 nonautomatic BN1511BN1521BN153 & BE1511BE1521BE153 n ;H+ packaged with Piggyback Variable Level Float Switch level float switch Operates at temperatures t0 130'F (540C) In effluent 113..4 & 112 NP, iPh 115V or 230V applications " All models include a 1'/2' x 2" PVC adapter fitting p s Note: The sizing of effluent systems normally requires _a- variable level float(s) controls and properly sized basins to achieve required pumping cycles or dosing timers with nonautomatic pumps. PIT. POWDER ij COATED ~ l TOUGH" ' a s MAIL TO: P0. BOX 16347 Louisville, KY 40256-0347 r: SHIP TO: 3649 Cane Run Road s t x ~ ;c Louisville, KY 40211-1961 (502) 778-2731. 1(800) 928-PUMP T FAX (502) 774-3624 Manufacturers of... r ® QZ/,4Z/TY /'U/LIPS FIWZ-F 1,qY " Copyright 2010 Zoeller Co. All rights reserved. Page 9 TOTAL DYNAMIC HEAD/FLOW t" PUMP PERFORMANCE CURVE PER MINUTE LL MODEL 15111521153 EFFLUENT AND DEWATERING 50- 14 45_ 153 MODEL 151 152 153 12 40 Peet Meters Gal Liters Gal. Liters GaL Lters 0 35 4 5 1.5 50 189 69 261 77 291 1p 1 2 10 3.0 45 170 61 231 70 265 30 15 4.6 38 144 53 201 61 231 8 15120 6.1 29 110 44 167 25 62 197 25 7.6 16 61 34 129 42 159 t 30 0.1 - 23 87 33 125 6 2 _ - 22 85 35 1017 L41L 42 40 4 Shut-off Head: 30 n. (9.1m) 38 ft. (11.6m) L31 m) 10 0145088 2 5 Models 1521153 0 Model 151 10 20 30 40 50 60 70 BO 90 100 - 67!32 GALLONS f 67M L1TER5 0 40 60 12D 100 200 240 280 320 360 372 _ 458 372 _ 452 FLOW PER MINUTE 074508A a ~ 372 ~ ~ ~ 3z2 37,8 ~b • Timed dosing panels available 11rr NPT • Electrical alternators, for duplex systems, are available and j supplied with an alarm • Variable level control switches are available for controlling single phase systems • Double piggyback variable level float switches are available - I I for variable level long and short cycle controls I 12118 ~i " Sealed Qwik-Box available for outdoor installations - See FM1420 sire • Over 130°F (54°C) special quotation required - 41I55M SK2064 SK2444 15111521153 MODELS control selection Model Volts-Ph Mode Amps Simplex up) X 3 N151 115 1 Non 6.0 or 1 BN151 115 1 Auto 6.0 Included 2or3 E151 230 1 Non 3.2 1 "Easy assembly" BE151 230 1 to 3.2 Included 2or 3 (pump & adischarge pipe N152 115 1 Non 8.5 1 2 or 3 not inducted.} BN152 115 1 Auto 8.5 Included 2oor 3 r 3 E15 23b 1 Non 4. BE152 2 0 Auto 4.3 Included r3 N153 115 1 No 10.5 2or BN 553 115 1 Auto 10.5 Included 2or 3 E153 230 1 Non 5.3 1 DE153 230 1 Auto 5.3 Included 2or 3 1. Single piggyback variable level float switch or double piggyback variable level Reduces potential clogging by debris float switch. Refer to FM0477. Replaces rocks or bricks under the pump 2. See FM0712 for correct model of Electrical Alternator E-Pak. Made of durable, noncorrosive ABS 3. Variable level control switch 10-0743 used as a control activator, specify duplex PRaises pump 2' rovides the ability to raise e intake by adding sections of 1 %2" (3) or (4) float system. or 2° PVC piping a CAUTION Attaches securely to pump Accommodates sump, dewatering and effluent applications ~s I i?li c t rs k r ~Ip 1 ; ni I~ + ri i 1 a~ NOTE: Make sUfB float is flee from obstruction. 1'1 i rtltn, c~ 7 Gr:19° Id: l r s„, d r rt i~ t 1 All !cite ~I nnl For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump. c Copyright 2010 Zoeller Co. All rights reserved. Patie 10 PLOT PLAN N Project Name: Roscon 3 Bedroom At-Grade Legal Description: NW114, NW114, S03, T29N, R18W P.I.D: M042-1004-70-60000 Subdivision Name: NA Lot SCALE: V=s0' Township: Warren Parcel Size: County: St. Croix 40 -ASTM D2665 Contour Line Elevation: 102.10 Cell Dimensions: 4 inchCh Sch 40-ASTM D1785 Lateral invert Elevation 102.60 At-Grade Dimensions: 2 inch Sch 40 -ASTM D1785 1112 S Slope 4.00 ♦ BM1 Elevation: 100.00' To of survey iron -L BM2 Elevation: Backhoe Pits: Septic Tank: 1000 gallon Septic Tank w/ Polylok 525 effluent filter Dose Tank: 650 gallon Dose Tank 11)aklmikGE C:~t55~1~_Ni B ill _ VU ~ tii'Z'♦_r^`'~ ion 3y,,p c 4v~ , n~ \T 1 /b ~VELL (219 'Page ter c ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer Roscon (Properties LLC Mailing Addres 1353 Awatukee Trail 1186 121 st Street - Property Address (Verification required from Planning & Zoning Depar nt for new construction.) t~ City/State 1" udson, W1 Parcel Identification Number 042-• 1004-70-600 LEGAL DESCRIPTION NW V4, NW '/4, Sec. 03 , T 29 N R 18 W, Town of Warren Property Location Lot # 5 Subdivision Plat: Certified Survey Map # , Volume , Page # Warranty Deed # (before 2007)Volume , Page :k Spec house ❑yesQno Lot lines identifiable E lyesOno SYSTEM MAINTENANCE AND OWNER CERTII♦ ICATIO.N 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 duce years or sooner, if needed, by a licmised 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 days of the three year expiration date. I/we certify that all statements on th' form are true to the best of my/our knowledge. 1/we am/are the owner(s) of the property described above, by virtue of a war anty deed recorded in Register of Deeds Office. Number of bedrooms 3 SIGNATURE OF APPLICANT(S) DATE '11** Any information that is misrepresented may result in the sanitary permit being revolted 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. 04/12) ~~o aC it r- O ' b 3 Q C4 - 4 O oo b ! O 6 6 J k ~ S~,` I a > a F J LL 7 QW N J ~ Z " Q ((jI l - _ i~l L:l I, ~ 111 I LL -L LL~ C: as I ~ E } f ~II III ~ ~ ~ \ I (I I I I I a7 I+ v , I'a I `III I I L. ' _ I j I T-II II II j ! I J I ~ ~ J ~ i F11171, b f T1]I l.(I I I I Li I r i l~ o~ III - t J; ~~m - - - - ogo 'm q S p z E w _ _ _ _ _ J 11 e- ~ tao ~ j O t "O . 41I o O U oil , O` N W - ti ~ i{e} a us{, g sseY g{sE _ ~ - j - ~ ~ e ~ S 4 _ ~1 + : o, a. O J N Z W D-H ' ¢a I m I j - - - - - - - - - - - e ILL vl I SM ~I - - e I ~I , ~ I -nom _ I i s 4 ui~ ccl, gC - 11 L - - - I I - _ - _ O Nil 04 sfl i.q ~ oarc ~ oil 11 - t - <s I!I f w I w Ojo i : ( JF Z x3~~ ~ 3w _ II I I _ I ~ w a s I I - -I - Tom- I ~ 1 1 tl~ f 7 I T r. I L_ n a I I k I I Dom ~ ~ ~ - I 1 s I IL ~ a I I I I r_~ I I ~ I el ~ I~ ~ e I III II a b I I ~(IIII~: ~ I I I i - ~ s~ I I j y Y , II - .n r CU I Wisconsin Department of Commerce SOIL EVALUATION REPORT Page -L of 3 Division of Safety and Buildings ~i rdance with Comm 85, Wis. Adm. Cod County Attach complete site plan a of les n 8 1/2 x 11 inches in size. Plan must include, but not limit v Ian zontal reference point (BM), direction and percent slope, scale nsi , north arrow, and location and distance to near@yy~gl d Qy2_ ' 70_ ~j~ewe PPP Please print all information. y Date Personal information you provide maybe used for secondary purposes (Privacy Law, s. 15.04s"'~~II ('I)Q"1 L tf 3 !O / Property Owner Property Locatio OvH , ) T n N R E ( r) W 3 U r✓ Govt. Lot ~L/ 114,YIU / Z O S Property Owners Mailing Address / t # Block # Subd. Name M# { 1 I S Z c. City State Zip Code Phone Number City ❑ Villa e Z!FTown Nearest Road New Construction Use K Residential / Number of bedroom Code derived design flow rate JU GPD ❑ Replacement ❑ Pu lic or commercial - De Parent material Oi c.~J✓l 7f~n /Flood Plain elevation if applicable ff~ ft. General continents hAd40 l/h S ! ~t' /rat J ;'rvYJr~Z ~i7 and recommendations* System Type t D l T v~~ /f~G" ' System Elevation J ifi~J -Dwc Boring # Boring ~O __~i G' /l . L~ r ft. Depth to limiting factor m a Pit Ground surface elev. ~ 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 _ lr Boring # Boring pit Ground surface elev. r 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 ff ~C`` /014C 3l 5 1 %Z r Fr c_s o C - rs7 Y c t d k Fr rill 0 s ' Effluent #1 = BOD > 30 1220 mg/L and TSS >30 < 150 ' Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) CST Number Bird Plumbing, Inc. Shaun Bird 226900 Address Date Evaluation Conducted Telephone Number 1008 192nd Ave, New Richmond, WI 5401'`7 ~ r- / 7 715-246-4516 Property Owner _ Parcel ID # Page of Boring # ❑ Boring ~j ® pit Ground surface elev. Pa' I ft. Depth to limiting factor /l) 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 0-/0 o -3 Z 5/- 01r-t GS -ce 9 r Sl U 1F , 3 850 s~ 1~ 2 r 7,s, y / S 1 n h a Boring # ❑ Boring ❑ pit Ground surface elev. ft. Depth to limiting factor _ in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 Boring Boring # Ground surface elev. ft. Depth to limiting factor in. ❑ Pit Soil Application Rate Horizon ')epth Dominant Color Redox Description. Texture Structure Consistence Boundary Roots GPD/ff _ in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 Effluent #1 = BOD5 > 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BODS < 30 mg/- 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 (8.6/00) Property Owner Parcel ID # Page of 131 Boring # ❑ Boring JJ g pit Ground surface elev. l o ft. Depth to limiting factor M- 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 r 'S- U 1F 3 s-so 7 sr SI n h a F-1 Boring # ❑ Boring ❑ pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 Boring Boring # Ground surface elev. ft. Depth to limiting factor in. F-1 ❑ Pit Soil liation Rate Horizon ')epth Dominant Color Redox Description- Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 `Eff#2 Effluent #1 = BODS > 30:S 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BOD5 < 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 608-266-3151 or TTY 608-264-8777. SBD-8330 (8.6/00) Soil Test Plot Plan Projdct Name Roscon Properties LLC Shaun " d Address 1252 Awatukee Trail f Hudson Wi 54016 f, CS~"M #226900 Lot 5 Subdivision Date /24/13 N W 1/4 N W 1/4S 3 T29 N/R18 W Township Warren Boring Q Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 100 ft. Top of survey iron System Elevation TBD *HRPSame as Benchmark County Road E Scale is 1" = 40' unless otherwise noted 226' Property Line ~ Area of denser tills 30' B.M.* B-1 4% SLope 50' 85' B-2 101' 40' 102' 40' B-3 361' Property Line „ AL NW 1 i v E}, ~f4 ,{„.w,r rr»H ~ti..rM«,~.a wN.n.waev~t~ c.r'+.w.~%meA«rwF ~ .k... armor FQ°~ y+ yi",.. .~~w.....c.~•.•wn, +,ro.•.<a,.wmw>+ww' ,t+w~r,9w.n.w+. 7 d Ae. P: ~•ro d ~ P ~ ~d `ice ~ • ~C ~ „R ~ ~ ~ ~f"Ft ~'~6' Y „k.,y l 1 E 1 f cm 'r J7~' 5 { c r o Or ~AI 15 1 t~ (F 20r r W ~tr-* t~~'r~ 4 ✓ NOfE C t m~C A° } Ya.f.. R r ' K "2 . 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