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HomeMy WebLinkAbout032-2095-40-000 s'•-• PRIVATE SEWAGE SYSTEM St. Croix `alety end liai n.^r, GwGK+' INSPECTION REPORT Sanuar.=crn,IN GENERAL INFORMATION ;ATTACH TO PERMIT] R." m N. 600344 Slam •'ersonal mlc-rr*t:,, yur: , v,d..ari a" . . cal lug p:upnc IPnun<y Law , On ILIm'.1 Ycl.r`rl NOlde'c N'tol l G" Vliti t- Tl.w-hrp Ii. N. Michael & Kimberly Kreyer TOWN OF SOMERSET 032-2095-40-000 CST NM F rs Insp uM tie TIM De.m:oplvm /T Srd:ontTpmlHaneMhlnF No t6 ~ - C< 23.31.19.928 TANK INFORMATION ELEVATION DATA TYPF MAN01-AC ILkFH CAPACITY [i IN ON HS IIb FS ELEV Sepirc: Hrn<hmark /t1D d S/•L Dosing ov Alf. -N1 t 9 . ce yS •g C6 11600s~n P, 4-.p co~~ ,rl L-I KI'~"1 HATSev.r 13• 9/+9 Holding SUI It 11110 y I'/ p0 . 7 ! 7. I\ ll11 ol,t It TANK SETBACK INFORMATION Si \ FAINK 1NFI 1 HLDC .mke RMI: Ci nlel I p.q7 H:,ttc'n it 4 V 7 --TTgat Pipe -J.O =ina cl:+de PUMPISIPHON INFORMATION 3 ~ /O'/• Z Manafafluret Ctemalla S. iaver } ~C I I GPML u ~ti -IJ Model Wanner Zg~ - ~J 7.1g /ao • 3 I DH Lr~4 Fwlon I i System He TD/ TL Fbrwrn:vn I cr+IlP / U:a p n~cl m vvev r 4 99. -1 r 20 Z 1,477 SOIL ABSORPTION YSTEM NEUIrRENCH ':boor Icgl!r IN, fYTmnrn"s PIT DIMENSIONS Ile Cs>rta Invde C~ Ceoth DIMENSIONS 7 3 Tl~ SE78ACK SYS IT IV Ii) L' P/I BITtlt( Vh II. 1:1KRSTREAM LEACHING hinnallc:~l INFORMATION Typo 'N Syxmm b CHAMRFR OR .{r I d:~ /VO eY UNIT Model N., . ` ' V G '-J J n DISTRIBUTION SYSTEM 4/ c/- Hnaden0.la aS l Z I D15lrlnue0' x Hoe [ilzc r Hoe Sp ,ng Vw Ar ISh Prlxsf \ LIncID ✓ Iha~_ Ic•rgth__`_ C: 5pau-g SOIL COVER X Pressure Systems Only xx Mound Or APGrade Systems Only p uopc. o~r•r pppp r u~- o.<r rH,pu, ^I .,r sreoma:snndM r. rnwa~l HF,n wncr Cent. -q Hnml mr.:.h Fdgcs lo[sne 1_ vax vc r..e r: COMMENTS: (Inooft code dlscrepences. persous plescnl etc I nspecto'r M7 ,e aN Insp nn MI Location: 2029 601111 S 1 •Vl E Er- 11M/~) 1) nit HM Descnptitn = 2 Bldg sower length - yC Larks c n - amount of cove. - y 417- o n a)[JC Plan revision Required? VPs N,, 5 ZI 1 0 G KJ~ S Use Who, side lot ade.h oal ...forreanon - C:rc Inseepces Srgnatu Cort tw SRD 6710 :11 NW, y r?~ Safety and Buildings Llvlsicn 0 1 101 W. Washitgtoa Smum Ycmir Number (m be filled m by Co.) Madison, V01 53707-7162 , Sanitary Permit Application smrT nsamm In a: Ra` cc:. w'fip SYS iAi?i12~. his A.im Colic sOraissix.. of Na fgn.:u the *Kusla[ 4~wmwmoJ wp i. rcyuirod pnnr en ob:atpmq a smxary pawn Not Apppcaam flans la Blau-owed PJNTS are sobrn=d w Ynlrn Addres ;if diRaml thw r_i. vn rss) the Dcpstmart of Safe ad NjfmiixW 5a am Pa„nal iNarniaDa: ynu provide may 4 mW for s<[andan xaasa m r..cordancc w th me Pnvacry Ls. s. !5 u4,1 ) rc Suh 4 Applicauutilsiforwati(ja Please Prinl All lnfot ma~uoa '~1 L. 1 "7 rf hopery ;TADa's Nano ~yuQq Yycrd Property CYWM s Medm; Add= _ Property I=aum Gov/ lAx . 7,7 C4& Mori: Nmilies ~ f ~ 'A, Secooo c I ITT r of BaddlnL'"- yPe R (chat all that apply) 'Q l a 2 family Jw<llm•+, Number of Ledrown _ - f L - Subdmstoe Naar: ~ Ole QA r h r~/~_'- J/ J NN;ci 'awac:a1- Da.=nbc Use ❑ Ctry of, 1Suite rtwco-Ogcnbcus< CsVINWI3C [)VdUac of. III. Type of P<rmi[: iC3exlc Duly oD oz ou pac A. Complete lint R if appliubl<) j AA .gyp. syaum-TL Raplaesmml;rsreu.x eu 'I re:,ou<neI!,la:,o r~i Rgi.,.u only C Otier odd ww b Ems6sig syl1ezo (explim) T a. I U Yaum Renewwl -i pemn Rer.+mc Lf Cbyyc „CPlumbe Fit ::ansfa w New list Reviout PCnM Numaa and date Itaued f Dc1br ^xpv:Cioa C 1 r ti - I OwDet f~r 11 a/~ x fV.'fype of PORTS Svsmm/CompoaenoDrvice (Cp<ck aU Nal apply) Voo-IYe[mr;t-d Io.(-roucd L~ Rn r.~-c L.-:~rn;sd A:iinx Mowd >''i iu of minable soil U mound m of nilable coil I Hnld n,. •+mt - [rtSe- [is pawl C i i . me'•rxplaml _ ' presrrmnnm rlnioe (explain) V. Dis aLrr "ttvrr Ara la(ormauoo_, fbi,m Fl's. tpyd) Uexbo >oil .1ypl mnw 61) Dispcaal A- Required (so / Dnpaaal Aso Pr.ga,seC (xlt yueo F.ev - J /VL TaDls Ldo - - C [ >cam' n To a of Manuta~ma :alum _ Crallwm Units = L S d _ ew+Taolw FsWmr woks In. - - K3 IA.a - . OIL- • /.f ~ m „ X c T.tx - acaa - - `j✓ -f ifs I - - 1 V11. Rapoasibility Statement- S Lc nmdualgaeQ we rapauwbihn for itrxtWaboa of the POW t3 iboyrn a the aUe,chW planer. _ Plumbs c 4=C Tn , PI s Ssauau:< 1T'r5(PRS Numba R.W , Pbmsc N ba i,weasAdores:tsD<acrosrue.7i6c«t -i- -LJ-- , e rtnat Lse bill h Vin. 'tVP uatvrD -17 Yee .>ak Tsuin mbiiame rovd k s. leer :f MCoud mzlor Disapproval \ ea•11 Hurt r tet14}~1yk 6'~31G. 3 J ~S tilltsgetlleM plbn p•o sdM W yw~~ce.. 2. Mag%w* te. -en.s mua li : a.nt. of-1 G(~ - 81/Mf Wretow r M I'.dxe_ Ana[S b wmplee plain 1-.r We syasea• amd saosu n me omry aoi. -w qw oN tell rh.a a sc . l i ixan m w< _ _ SBD-6398(8 11!11) System PLO PLAN PRO.H-.CT Mic-iael K:-ever ADDRESS ?.O. Box 369 So-verse' Wi ri4025 N'W 114 SW 1;4S 23 ; 1' 31 NIR 19 iss TOICN Somerset COUNTY ST. CROIX SYSTEM FI.EVATION 99.7199.4.'99.1 4.5' below Oracle '16:'- 8 DATE 3. BEDROOM 3 CONVENTIONAL CONVENTIONAL LIFT XXX HOLDING TANK MOUND SEPTIC TANK SIZE 1000 aalons LIFF TANK SIZr63D DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE. .5 ABSORYIION AREA 916 ti of chambers 45 BEN( HNI.ARK N.R.P. 'Top of well ASSUME FAYN ATION 100- Filter LifeLme Fiitcr ❑ROREHOLF WELL s11.R.p. same asborchmark 4119 Proper.)' Line 00, 50 Scale 1s F = 40' 3-3 ~ X 62~ cells Frith pacin , unless otherwise - B I ,o' B 2 noted 1'• 104' Area of poorer soils Vc its IIE7 103 H-: ' .If.Slopc _0' ,t;• 90 E1~Pro 3 31 S' PropetlvLine ~~f d Redrnrnn llutfcutt Combo1'ank IB.IVl.x Housc R •11 1 36 PI, i 531' Property Line Vent To Wh S:. , 6•. Quick4 Standard Leaching Chamher of Cover with 20.0 n2 of Area All piping Shall he ASTM SDR 30'34, within 5.6ft^2lpair of cnd caps 10' of tank, nipmp viral! lx+ :\STM FS91 4, I-ont• l Gradc tR System Llc+ration 4 Cover Page Shaun Bird Bird Plumbing Inc. 1432 120th St. New Richmond Wi54017 715-246-4516 Date: 3/16/18 Owner: Micheal Kreyer Location: NW 114 SW 1i4 S 23 T31 N,R19W 2029 60th St. Somerset System type: In-ground absorbtion system (conventional) Manuals Used: In-ground absorbtion system (version 2.0) Pressure Distribution Manual (version 2.0) Pageir 1. Cover Page 2. Plot Plan 3. Chamber Cross Section 4-6. Maintanance and Contingency Plan 7. Filter Specifications Sheet 8. Dose Tank Cross Section 9. Purnp Curve Signature- - License number 11226900 System P1.01' PLAN PROJIic'l' Michaol Krever ADDRESS P.O. Box 369 Somerset Wi 54025 NW 114 SW 1r4s 23 /r 31 NIR 19 M' TOWN Somerset COLNIV ST. CROIX SYSTEM ELEVATION 99.7/99.4199.1 4.5' below grade 3116/18 3 DATE BEnnoml CONVENTIONAL CONVEN'I70NAL LIFT XXX IIULUIN(: TANK R10END SE;P'1lC TANK SIZIi 1000 gallons LIE'P TANK SIZE630 DOSE: TANK SIZE. HOLDING TANK SIZE LOAD RATE: .5 ABSORPTION AREA 916 N or chamhers 45 BENCULNIARK V.R.Y. Top of well ASSUME ELEVATION 100• Filter Lifetime Filter ❑BOREHOLE (D WELL *II.R.P. same as:)enchmark 409' Property Line 100' 50' Scale is I"= 40' 3-3' X62'ccllswith>3' cpacivg unless otherwise 15 B -I .u' B-, noted 104' Area of poorer soils Vents 103 B-3 . 5' 4'M. Slotx 90' 20' 90' Pro 3 118' Propeov Line Bcdrornr. Huffcutt Combo Tank B.M.* House Well PL 551' Property Line Vent T'o 60ih Si- ~6., Quick4 Standard Leaching Chatnbu of Covet' with 30.0 ft2 of Area All piping shall he ASTM SDR 30134, within 5.6ft^2/pair of end caps 10' of tank, piping shall be AS'I':`1 F891 4' Long 12" Grade at System Elevation 34 Cross Section of Quick 4 Standard Leaching Chamber Typical cross section for 2 of 3 cells - Quick 4 Standard Leaching Chamber with 20.0 112 of Area per Chamber 5.61*t^2 pair of end plates To be .1' above grade Finish grade elevation Typical Installation 104.2' Vent / Vent 0 Grade 4' A-I x/30/34 Septic Tank 5' 4' Long I " Gradc at Svslem LlevnUon 4 Gr.ide :a Sy tem Elevation 34 Spacing 5 3-3' X 62' Cells Observation tube/Vent Same on other end To be located on end of Cells %A B System elevations: C A 99.7' B-99.4' C-99.1' 18 chambers per cell POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page _of_ iFILE INFORMATION SYSTEM SPECIFICATIONS Owner it Septic Tank Capacity L 1 El NA ---~a= Sept); Tank Manufac-turer yr Lt k _ r ❑ NA SIGN PARAMETERS Effluent Filter Manufacturer, 0 NA Number of Bedrooms 0 NA Effluent Filter Model r U NA Number of Public Facility Units - ANA Pump rank Capacity 0 NA Estmated Mow (average) _ ag Uday Pump Tank Manufacturer ❑ NA Design flow (peak), (Estimated x 1.5y - X11 o NA cler Pump Manufacturer gaU -t - Soil Application Rate Pump Model I - Standard Influent/Effluent aUda/IfT P O NA venVEtRuent Quality Monthly average' Prelreatmenl Unit Fats, Oil & Grease (FOG) SW ri ❑ Sand/Gravel Fitter ❑ Peat Filter Biochemical Oxygen Demand (BOD5) 420 mg/L U NA 0 Mechanical Aeration 0 Wetland _ Total Suspended Soids (TSS < , 1 50 ^~9rL L Disinfection O Other Pretreated Efflutxlt Quality Monthly average D' sisal Cell(s) - - Biochemical 0 NA Oxygen Demand (BODs) 530 mglL Ground (gravity) ❑ In-Ground (pressvnzed) I otar Suspended Solids (TSS) :s3O ri NA 0 At-Grade ❑ Mound Fecal Coiform (geometric mean) <104 cfkUt00ml J' 11 Drip-Line p Other Maximum Effluent Particle Size - )k in dia_ 0 NA Otnec - Other - - O NA OtAer.- ❑ NA 'Values _ typical for domestic wastewater and septic tank efflrrenf Other C NA MAINTENANCE SCHEDULE T Service Event Service Frequency inspect condition of tank(s) At teest once Avery: ❑ mont (s) _ - z@ rear(s) (Maxfmtm3 years) ❑ NA Pump out contents of tank(s) Wlwn combined sludge and scum equals one-third (3S) of tank volume 0 NA Inspect dispersal cent(s) At !east once every: month(s) earls (Maximum 3 years) C3 NA lean effluent fixer ---Y-- ) - 11 NA At least once every Q month(s) inspect pump. Pump Controls & alarm At least once every: - month(s) - - year(s) ❑ Flush laterals and - - NA pressure test - t At least once every: El m (s) year(s) least once every ❑ month(s) - r - 0 tear(s)- - - NA NA MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells shall be mace by an individual carrying one of the following licenses or certifications: Master Plumber, Master Plumber Restricted Sewer: POWTS Inspector; POWTS Maintainer Septage Servicing Operator. Tank itspecbdns must include a visual inspection of the tank(s) to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of combined sludge and scum and to check for any back up or pending of effluent on the ground surface. The dispersal cell(s) shall be visually Inspected to check the effluent levels in the observation pipes and to check for any pending of effluent or the ground surface. The pending of effluent on the ground surface may indicate a failing oci bon and requires the immediate not)ficatior of the local -egulatory authority. When the combined accumulation of sludge and scum in any tank equals one-third or more of the tank volume, the entire contents of he tank shall be removed by a Septage Servicing Operator and diseased of in accordance with chapter NR 113, Wisconsin administrative Code. alt other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment units. and any servicing at intervals of 512 months. shall be performed by a certified POWTS Maintainer. 4 service report shah be provided to the local regulatory authorty within 10 days of completion of any service event Papa _ of START UP AND OPERATION or odsr chaffs" to For saw construction, Prior to use of the POWTS dsok treatment tank(s) for the Presmc• of painting prod' ucla Is may impede the treatment Process andbr damage the dispersal calls). If high concentradors are detected have is contents of the tank(s) removed by a septage servicing operator prior to use. System start up shell not oats when soil coruftons are frcaan at the infiltrative surface. During power outages; pump tanks may fill above normal highwaler levels. When power is nsatol the excess wastewaW will be r9sctsrged lo the dispersal cell(s) in one large does, overloadtrg the call(s) and may result in the backup or surface discharge of effluent. To avoid this situation have the contents of the pump tank removed by a Ssptaga Servicing Operalor pnor to testbdrhg power to the affluent Pump or corded a Plumber or POWTS Maintainer to swiss in man sly operating the pump controls to restore normal levels within to pump tank. Do not dive or park Vehicles over tanks and dispersal cols. Do not drive or park over, or cUsrv+ise disturb or compact, the area within 16 feet down slope of any mound or al-grade soil absorption arse. Reduction or elimination of the following tram the wastewater ahaam may improve Via performance and prolong the pe of the POWT$' andbrotic , baby wipes; cigarette butts; condoms; cotton swabs: degreasers; dental floss; diapers; dsiriedards; fek foundation drain (sump Puna) water; fruit and vegetable peelings; gasoline; grease; tsrbiddes; meet scraps, medications; od; Paining produdb; pesticides; sandmy napkins; tampons; and water soRaner brine. ABANDONMENT When the POWTS fads andAx is pernanamly taken out of service the following steps shall be taken to insure Met to system is propelty and 30d* abandoned m compliance with chapter Comm ta3.33. Wisconsin Administrative Code:. • All Piping to tanks and pits shall be disoonneded and the abandoned pipe openings sealed. • The cordeds of all tanks arid piss shall be removed and property disposed of by a Septage Servicing Operamr. • After pumping, all tanks mid pals shall be excavated and removed or their covens removed and the void space filed with soil, gravel or another inert solid material CONTINGENCY PLAN It We POWTS Pals and cannot be repaired the following measures have been, or mud be taken. to provide a code compfient replacorrrord system; -F"4utrable nhplecerrent area has been evakaded and may be utitaed for the location of a replacement and absorption systern. The replaoensrd aria should be prolecied from disturbance and compedion and *xxA not be inakgW Upon by reputied seIDarks from ardatkg and propoeW structure, lot Ikros and wept. Falure to proled to replacement area will result in the rated for a new soil and aite evaluation to establish a suitable replacement area. Replacement systems must comPlY with ire leas in enet at that time, El A suit" replscertsm area is nut avelabla due to setback andfor soil imitations. Barring advances in POWTS technology a holding tank may be irstalW as a last resort to replace the failed POWTS. ❑ The ads has not beers evaluated to Identify a euitable replecnrtrord area. Upon feik" of the POVVTS a act and site evaWafon rrwrt be parfamed to locate a suitable replaoensnt arse. If no replacement arse is evelaW a holding tank may be installed as a labs resort to replace the failed POWT'S ❑ Mound and in gracie sod absorption syseme may be recorstmcted in place folWMrg removal of the biomat al the kdlbative surface. Reconstructions of such systems must am" with the rules in etex at that time. «WARNINO» SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND/OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TAN* UNDER ANY CIRCUINSTANCFB. DEATH MAY RESULT. RESCUE Or A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE ADDITIONAL COMMENTS POVVTS INSTALLER POWTS MAINTAINER Hama - Name Phone , / / / Phonro _ F, _ ) " SBPTAGE SERVICINO OPERATO UMPER LOCAL REGULATORY AUTHORRY Fizel Phone ? ! J ` l This document was ds&W in own plamce with chapsr we 393.22(Z0x1)(d)6(fl and 3a3.WI), (2) 6 (3). Wisconsin Adnivumve Code. - I 1 1 i ' iivjn li•: ell, • T lk it i tT4n ~ V .~44N s7fr SePtic-Dose '~'ank Cross Section And Pump Performance Specifications rf I Marrufacttutu ~ Tank Pam Manufacturer Tank Model Number ti Pump Model Number 4 Total Tank Capacity r 7 - Alarm Manufacuner Max. Bury. Depth - j Alarm Model Number Switch Type I Filter Manufitcttuer _ Total Dynamic Head ('I'DH) - Feet Filter Model Number - Elevation Head rDistal Pressure _ Network I oss_ - Minimum Pump Ptafortnance Required Force Main Loss GPM, Q / Ft' DH i T•- - - Outlet Manhole lain. 4" Above Grade With I r - lam- - - I,ocking Device. Inlet Manhole J r Manhole Min. 4" Above Grade < 6" Below Cirade Sealed Watertight ` Securely Mounted With Locking Device - Weather-proof l Junction Box J - - - Finished Gradc _ t -i t Vent Min. 12" Disconnect Above Grade Means With Vent Cap Outlet Filter ~y Inlet ~4------ Inlet Baffle 4 !;!Witch Set~and Reserve Capacity I A Tank Volume - > GPI Weep Dirnension Inches Volume Gal. B Hole (reserve) (alarm) B 2 I Off Elevation C (dose) C Ft (dead) D / Bottom Z 1 D Elevation Fl GENERAL INSTALLATION: 7110 septidduse tank is bedded and back filled in accordance with the be exceeded manufacturer's witho product prior approval epecificatitats. Maximum depth of bury as spoaifwd by the manufacturer may not approval. Manhole covers exposed to grade have an effective locking device (padlock) installed. Piping at the inlet and outlet is of approved material, conneeted to the tank with watertight fittings, and laid on stable soil to prevent sealing or sagging The f muc main is sleeved with 4" Sch. 40 PVC to bridge the tank excavation and the sleeve is sealed watertight. Electrical service complies with NEC: 300 and Comm 16.28, 02/05 1 J Page of-..-- 280-SERIES 112 hp Submersible Effluent/Sump Pumps The Liberty 280-Series provides a cost effective "mid- Perfon'nance Curve: 280-Series range" pump for on-site waste water systems, liquid 40 12 waste transfer and commercial heavy-duty sump pump - applications that require higher head or more flow. 35 11 Designed around Liberty's unique "Uni-Body" casting, 30 - 9 the 280-Series will provide years of reliable performance. 1 25 8 All Models Feature. 20 6 m • Vortex We impeller permitting UP to 31" fly passage of solids t~ 1 5 • 416 stainless steel rotor shaft 10 3 • Pemranently lubrigfed upper and lower ball bearing 5 - 2 • Epoxy powder coat finish 0 _ 0 • All fasteners-corrosion-resistant stainless steei 0 5 10 15 z 25 30 35 40 45 50 55 60 65 70 • 1 Y." Discharge US. Gallons Per Minute • Stainless steel bottom screen - easily removable ;P - i - F.. • Maximum fluid 0 38 78 114 158 192 228 270 temperature: 140°F. Liters Per Minute 280-Series Cord Lengths _Model o' _ u Dimensional Data: dard Optiond. p eonal OPbo~ welghC 2s lbs. dard O _ final O tiortal O bony H 13" ~ - --L--. Maajor or Width: 10" (model 2A7) dard Optional _ Optional WA ua d oPtipnal - wA N/A - Minimum Sump Diameters: starxkrd on art models For opao" it nVtns. Model 281, 283...14" 5" s,dflx to modol number. Model 287 VMF...10" odel 280 with 35' cord, order 2803 Factory switch Model 281, 283 Model 287 Motor Specifications sett in 5 VMF Turn on bvel 13" 9.5" hp 60 Hz 3450 RPM Turn off level 7" 4.0" Oil filled, thermally protected (PSC) Permanent Split Capacitor The Model 283 features a fusty adjustable wide-angle float. Differential 8.0 amps (115V) adjustments can be made essay by tethering the float to the dis- 4.Oamps (208/2301 charge pipe or odor mounting poirg. Vertical float modes 267 is rat adjustable. Model 2W Model 281 Model283 Model 287 Manual, Wide angle Vide angle VMFSerles no switch float switch - float switch Vertical mag- with quick- with series nefic float for disconnect (piggy-back) smaller Pits - plug - will operate in a 10" diameter sump c us Certified sc. zoru,.w,,,y,r,mww"ns~oin mx.. Liberty Pumps • 7000 Apple Tree Arenue • Bergen, New York 14416 • Pane 800-543-2530 Far (585) 494-1839 www.llbertyptrmps.eom c Mydoub"I~jry mewt7 M riahm moo. L good nosh 7 ST. CROIX COUNTY SEPTIC TANK MARTrENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer) t Address ' ~ ' ~ ~ ~ Property Mdrm-? / (Veri&ution required from Planning & Zoning for new coostiucbm) City/State _ Parcel Identification Number LEGAL DESCRIPTION Property Loeabon , Sec. T _ _N R _W, Town of Subdivinon Lot # Certified Survey Map # Volume ` page # f Warranty Deed # i Volume , Page # Spor: house yes(7'm,,' Int lie ideutiBabtD 7) no SYSTEM MAMENANCE AND OWNER CERTIFICATION Improper use and rmmsetance of your septic system could result m its premature fsihae to handle waAd. Proper mandi oanee camust c of pumping out the septic tank every three years or sooner, v needed by a licensed pumper. What you put men the syssem can affect the fauctim of the septic tank as a treatment stage in the waste disposal system. Owner mamtmaoce responsibilities are specified in Kottmt 83.52(1) and in Chapter 12 - St (rout County Sanitary (hdm mcc. 71)e property owner agrees to submit to St Croix County Planning & Zoning Department a certification foam signed by the owner and by a maser: plumber, journeyman plumber, restricted plumber or a licensed. pumper verifying that (1) the on-abe wastewater disposal system is in proper operating condition and/or (2) after inspection and pimping (if necessary), the septic tank is Jess than 1/3 full of'shidge. Lwc, the undersigned have read the above requiremears and agree to asinmw the private sewage disposal system with the standards set forth. herein, as set by the Department of Commerce and the Department of Natural Rrwou rms, State of Wisconsin. Certification atatmg that Your septic system has been maintained must be completed and returned to the St Croix County Plauning & Zoning Deparanout within 30 days of the three year expuarion daft. Uwe certify that all statements on th~u form are true to the beat of my/ours: knowledge. Uwe amhtt: the owner(s) of the property deam'bed above, by virtue of a wa)ktatitty deed recorded in Register of Deeds Office. Nun berxof bedrooms A APPLICANT(S) DATE ***Any information that is miuepzptsrted may result in the sanity permit being revoked by the P1arrom & Zoning Department hicmde with this application a recorded warranty dad from the Register of Deeds Ctf ice and a copy of the certified survey top if reference is made in the warranty deed (REV. NAPS) N U ~ M Sri O t COO T r/. u•,ro a r/r u..n a fir' M[K iN Ip1 I } P L4-NO W IYYI M. YE-( IYII EM .r/1 P'.Y~ ells lMl AAII e = RYR: a IF n g3g w~--~ F E 11 ` ~ ~ UQ~- 4 t few x Tf P .ui F ~ b a e ~ a ~ ~ ~j a ~'~!(z a~ m All C_~ P~ n S Tn E J Q t Sir A9iv~p~cA y P~ ® 9~ _ h~~ k 1 fit y gq r Q fit 3 ~Z. PA atio r oE, .v~ i r~ P: m S b Oi4-E " ^ - r _ p • ' xfj YD[ L r_ ~ O I ~F _IM 110 j. 77 t J .M d 3 M pit c k k 0 W M vl ~ OF SECTION 23,T31N, R19W, TOWN OF SOMERSET, ST. CROIX COUNTY, WISCONSIN. v w F.acL parcel n1c..: m: .Lin -,ap Ipl a:1 in No Pc mA'j'-;:f' I; scat..' CCJnCy ann_ Tvnnnhip pla-1 laws, Hiles and regulaciae, li.e., discolot. 61xe dcccdn Lo parcel, ecc1. rcthasi eg or Thee. ' .C. Coup any parcel cen penta U!, Sc. The Croix Pinney oni nq OLLlcc and LOT f anyo° aP✓r. pr=a Ce Town BOd:d LC[ etlv:^p, of C-S. NI £a6rc Q, FG. Z7-3 the,% P q 588°5318"E 409.41' nern 1 W114 CO(MR Of sECrlON 23 on z3 0 m H m LOT 4 I C.S.M_ 00 a(R o 0 21!•E0) soJl V_=-A F_ : , r3 Pi C',^~Ci~EI. 1~ 0 . n V_QI_ 752, FG.231 S89.53*18°E 433.01' Z °I v i V i NAV53'10 W 4W.p;i 00 vQa m S e?. _ o LOT 3 7 of o .sos,a K~ so .6r. $ I 4 I N n n w I m rv [ I v _ 1 , I Stltl'63iX E 8-08 Z4 IJ: ~ 0 jN - 1 or 1 3 u Vf?I_1075~r uz cal p I k+j ~ ° wismnsinDeoanmentof Commerce SOIL EVALUATION REPORT Pa,e _o' Division of Salary and Buildmys in accordance weh Comm 85. Nhs Adm. Coco CwtiY ~ y _ Attach Compete site pan on paper rid less than B 112 x 11 inches in Sae Plan must - 1 - - - include. but not limited to. venal and honzontal relerence point (BMI, dimcUon and PXaM ID. 47 ~t =4175 & l/' d~ percent slope, scale orNmenslons, norlh arrow, and location and distance to nearest road. O✓L Please print all information. Reed by Date 9 Pm0N rn!Mmetan you orov met !w axed nrx sersndery o.,moees iprwxcy Le+. • is (Iii It l Wf prop" Owner Property Lowlbn r, - I . 1 i Govt Lot x/ 114 . , . )1;4 S/. T / N R I E (or W 1 ' Property Owner's Mailing Adorers ` Lo; 0 Block P SLDd Name CSAkf Cay State ' Zip Code Phone Number ❑ Coy ❑ Village Towri Neprest Roed (,T New Construction Use-Q Residential / Nirrsher of bedroorns Corte derived desg•i lbw rate i e__.-~ GPD ❑ Replacement ❑ Publi> or commercial - Descnbc Parent material Flood Plan elevation it applicable / --r- ft General continents _i 7/" - %;<t' '~r-<<. ~i ! / and reCOmrrrlloridmundatl0na. - l wstem Typc -r-1, 3• / System Elevabnn i 1 L 1 fl . i Boring a Boring ..Pit Ground stAaee elev.l' ft DBPtri to lmitlirig !actor m. cual icabori Rate a Horizon Depth Dominant Color Redox Desonpuai Texture SbucNre Consistence Boundary Roots GPD1W in. Munsell Qu Sz. Cont Color Gr Sz Sh. •E9a1 'EF92 ~a "I~ - - .C-• if 1 -7 d I .Z `4 a r0 Boning .y l a ~ Pit Ground surface elev.!/ L_..,'.= ft . Depth to broiling facto' C_ in Sp,l ~caoori Rate Horizon Depth Dominant Color Redox Description Texlure Structure Consistence Boundary Roots GPD!}I' in. Munset Ou. Sz. Cont. Color Gr. Sz Sh •ERat •Eaa2 / • r• i I 1 1 y e I-V • Ef luau a1 = BOO. > 30 < 220 rrig!L and ' > < 1501,04d ' Eftlueni 92 z BOD. < 30 rng'L and TSS < 30 nn L CST Name (Please Print) ali to CST Number Bird Plumbing, Inc. Shaun Bird 226900 r 4kLess ?z1v f 1.1111.1 an ConJuCled -~tcpMme Numhor 1432 120th St, New Richmond, WI 54017 715-246-4516 Li ~ p r7; W,"rxj pit GvwhKl sufece elev/n)/• / It Depth tG limiting fagot. ' Sol p;atien Rate Honzon Depth Donnnanl Color Redox Desonpeen Texture Structu a Consistence Boundary Rods GPDrtr v. Munseli Ou Sz CAN. Color Gr Sz Sh •EfWl *EfW2 it L/ S l ~ I i Boring a Bering o;t Ground swtacc elov. ti Depth to limiting factor m. _ Sol iUbm Ralp r+x Depth Dcmruvn Colon Redox Desglpeon Texture Structure Consistence Boundary Roots GPDMr in Mansell Ou. Sz Cont. Coon Gr Sz. Sh. •Ef?#l 'ERa2 i I Borings; 0 Donrg n.t Ground st0ace eie'- it Depth. to emtng twor . n. Sod Inalion Rate /IerlZOrt '*DM Dominant Colon Redox DeSnzpoon. ; Texture SlrLoure Cortsvenoe Boundary Roots GPO/fr n. Mansell Ou. Sz. cont. Colo, Gr. Sz. Sh. •Eflp1 'Eff#2 I I i F Muent p I = BOO, > 301 220 ny'L arx1 TSS >30 < I SC mg'L ' Efflutim N2 = BOD, < 30 mgt and TSS 130 nV& the )rpnnm cu aQ,ial ,rmr. i:. ,c rv i, _ pro. dcr x: d cmpiov cr If vau need assi slxrcc to acccss scr .ccs or n^~d '+i T. r u. r r:,:c Ir-r i'.c3s~. n! to t Jrdcpa-t m_n' st 6~ H :nn-ll T~I 1' 6C'%.?(yi_k777 Property Owner Pmcul ID 0 Page ol Boring # r❑» Lc.LJ 121. Pit Grountl Surface elev/1,,'+ _'7 k DeptF to IimGrg factor 1~. n. Sad -Cal. Rate ! Ho ,nn Npm Dominant Col Rader Desonptior Texture Structure Consislarce Boundary Roots GPD" in WP.Iwh Qr Sz Cont. Color Gr Sz. Sh 'Exa' 'Eap2 -57 Z b~-`l1 Lrj 1 6 Being a ❑ Boring ❑ Pit Ground sutace elev k. Depth to firruarg tada n Soil Application Houton Depth Dormant Color, Rocox Description Texture Slrucaure Consistence j Boundary Runs GPDAf _ m. Mumell Ou Sz. Cora Color Gr Sz. Sh ' •Eka1 'Etfa2 i i i I I D Bonny a ❑ Inn ❑ Pit Ground surface elev. k. D8Pth to IMM" faanr n. _ ;,oil lion Rate Horizon 'lepth Domloant Cd RWux Desoipaon. Texture Structure Co Istence Bwndary Root _ GPDff m. Mmsd7 Ou. Sz Cont. Color Gr. Sz_ Sh. 'E"! 'E=2 I I I I E1Mrera 01 = EMO, > 10 < 22t1 mgrL and TSS >30 < 150 mglL ' Elfsuem #2 = BOD, < 30 mryL and TSS <'M mgf- The Department of Commerce is an equal oppottonity 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 608-265-8779. ' vo-nurxam~ Soil Test Plot PlaA Project Name Michael Kreyer Shaun Bird Address P.O. Box 369 Somerset Wi 54025 CST M #220900 Lot 4 Subdivision Serenity Date 3/16/18 NW 1/4 SW 1/4S 73 T 31 N/R19 W Township Somerset F] Boring Q Well PL Property Line County ST. CROIX B W or VRP Assume Elevation 100 ft. Top of well System Elevation 99.71199.41199.1 •HRpSameasBenchmark Aj4 109' Property Line 100' 50' Scale is I"= 40' unless otherwise 25' 15' B-1 70' IF 13 noted -0 El -4 104' Area of poorer soils 103' 35' 4'G Slope ' 9() 318' Property Line B.M.* Well PL 551' Properly Line To 60th St. 'os4onsmnap,rtrrwr,.tI.,&-'; SOIL AND SITE EVALUATION REPORT Facer of tabor and t,1o^rar R,"t,jn,, Dro=wn or salnry a B,-kings in accord with IU-R 83 05, 'JJ s. Adrn. Code CGu ~T`/ Atlach compete site plan on paper not less thor. a 1.'2 r 11 rchez. rr size Plan must include. but St. Croix pAC~.E_ y not I m!ted to vent rc-l and hart rtal role n~ po.n• tBY~ dyer be n enr! of slope, scale Or d!monsronod rt er-ow and Ic "nnco d dsta r•ce o nearest r..z.C 3 7 7 r i -'1-O - , APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION R~ Z•11'R1 Pflp:r ',IT viC'FN'1'_C~ 'C'r Benjaminc Lick 3C'v",CT NW SW 23" 31 %;i 19 !KortW nFJac Nl r'r„'. H ..lit a 642 13th. Ave. N. 4 Ina Sereni,.y ~f k ' 7. try3~;-....~.._ -AaESTP,14- s St. Paul, MN. 55075 613 451-8806 N. Part Somerset 60th. St. I New Construction J, IX] Residerfa!'tvamM'ro'tc'c[~. 4 Additionioexstingt,uding ReDlaCement !'u`i )r ~U••.nrcrr,.,..tlQsc•i.1(~i _ Code tlenvetl daty llo'N 600 ~a7 Fccomme• lez ces n-. canine 'a:e .4 beet 9[x1112 ,5 trerch, 9Pdi12 Absorption area requwrec 1500 1200 r'E des r -c ~q ate .4 bed gpd'R2 .5 herkh, 9pd'B2 Pecvmmen nhlr bor e :~o;r_ 106.50 ' •:',rrretoste Dlanterchmar*l Ad6ttonal des!ur Ste . _ r ya :-1'1 s trenches spaced to code 3.25 below surface grade P»rent mille'I,tl pitted glacial drift `j plan E' lahpn i'epf~li,,.a le na r~! , cySlem Nv. y H A'I+ ur,.'orsstern xJ` ~l~ - GIBS -.I - ®S OL ❑S :2j ❑S~cl]f~' SOIL DESCRIPTION REPORT C!-- _ (;,'•1~zh'nCP. , 111Y23'y 100t° '.:J^I.Caior C,r. Bad T!rf,- 1 0-7 10yr4/3 none 1 2msbk mfr yw 2f .5 .6 1 2 7-21 10yr4/4 none sil lcfhk mfr yw 11 .2 .3 mend 3 21-84 7.5yr4/4 none sl 2csbk mfr na na 6 ' 1c _ b.sf, ~L I a'Dlr•. to 1 r rmg tsOry i ir:~!r l1 i 4.;. t3rnngi 1 0-12 ^10yr3/3 none v 1 2msbk mfr yw 2f 5 .6 li 4 5 2 12-26 10yr4/4 none sicl 2msbk mfr gw If 2 3 26-36 7.5yr4/4 none sl 2mgr mvfr gcr nd .5 .6 4 36-84 7.5yr4/4 none M Oay mvfr na na .7 .8 109.5 it opt' i :u Jm4 rQ +84" Remark. I t"1 ~it!17 _ 12-4-97 ';T Vu~b.r r, In+qg a PRCPERTY0WNER I1. Lick SOIL DESCRIPTION REPORT o!_ DCDI'7 "am +nt Cclc, ..I~ St_ ,r 'e GPO,..; Boring a Hcr,7on -~a;.t Te+.tt!n. G Ga rstence ii(ArrSry' Soots In b ,~n5e.' 0a °c Coil! Bee T'EnC` G-10 IOyr4/3 none sl 21 mfr gw 2f .5 .6 2 10-29 7.5yr4/4 None sil Icsbk mfr gw -1 .2 .3 Ground -3 29-84 7.5yr4/4 none lfs Osg trlvfr na j na .5 Ff Bled 1.08.4 i )ec!h to II _ 13r10r I +84" _ I Remark; Boring# 1 0-18 10yr4/3 none sl Icsbk mfr gw 2f .5 .6 4 2 18-36 10yr4/4 none sil imsbk mfr gw if 2 3 f 3 36-82 7.5yr4/4 none sl Icsbk mfr na na .5 Ground / !v i 106.2 It - - • I I D~pUt t0 - - ! { --1 . I M'Ing I---- - Remar~s. _ Boring p 1 '0-6 loyr4/3 none sl 21 mvfr gw 2t .5 .6 i 5 2 6-52 7.5yr4/4 nonce co s Osg T.1 gw na .7 .8 3 52-59 5yr4/4 none sl Icsbk Tfr gw rid .4 .5 5tound _ . elev. 4 59-80 7.5yr4/6 none fs Osg iir na na .5 .6 106.2 tt '~ptlth to m~6ng +80'. iemafk$ ncri.ng st i I 1 elev. J ' Depth to - ~rrna I I ;nrtarkn _ I F'. STEEL'S SOIL SERVICE Cary L. Steel 1554 200th Ave CSTM2298 Benjamine Lick New Richmond, WI 54017 MPRSW-3254 Nw'aS4; 523-731N-k19w (715) 246-6200 town of Scm irset 4 lot 94-Serenity N 1"=40' HM.= top of W lot corner survey stake el. :00' Alt. BM.= SE corner of garage cement slab cal. 11C.20' I -Tl 'bfy Ql' 1 ~t '5'?' T4 17 - \ ~ f ?-J 2 La- ! r3 a JI IOv c,aty L. Steel 1 2-~1-'17 SOIL AND SITE EVALUATION REPORT L, .n Ili clan Reia;lon S in Par i ? _ oi~a ,n n! s..rey r BulkMrx~s acr, 283 05. Wis. Adm. Code Z02 A!,act- complete site plan on pap,,r not less t P r ' I i-.-lice V, Wo, in rnust Include but r i7 JA not limited ;G vPrtlGd and l r¢!eten ♦jf~t di µ+Ci rdrl And "~r ope, scale or DA d~1•ensioned, Wort,, anew, aril location A9 -Ice to {rP2rec1 road °+p li 3 2 - 10`/x- yC9' or U APPLICANT INFORMATION-P-LFJ6~ T ALL INFORMATIO A- _ PROP;R-Y:ow%. l/ y" Lf.~!~""r• S/ll 0 4 '45 1 O' A 1 Y CI✓V~R l4gIJv, LFFtiS~~ F I ~~t~`iLyt -C rAl'E n~,~I'p _ v r r ❑c r A,- 0-M/14 ~ r RAaEsr Reno jx) New Const,uaion USe (Wj HCS den6al ; Number of ted•ccm; _ _ _ - ( l Addmen to exsbnq bui.dlrq J Replaxrlent I J Public or oommercia descntle - - Code derived daily flow gpd Re omm ridec des on loading rate bed gpd ftz_,/ trench gpa ft` Absorption area requred _ bed, ft2~C_ trench, H2 Maximum desigr loading rate bed, god rig french, gp02 Recommended ~rhltfation surface elevabonls Ii ias referred to site can benchmarki Additional design; site Considerations_ _~LQ„Q_ Q,S P Parent material nciddpiainMevaaOn.it appii,^,2ble $ = Suitable ldr System ?V;FN': Vn~ lti;lrO I 9t: ~1`1C. ~5.`3JRF q':i 9P 1- -s-Fr.1 it fir; ] -Y,.: U - Unswtab a la svslem fLl S r y(: S ❑ U Zs ❑ ll (y] S [ :i --IS ~ L' ❑ S U ;1 SOIL DESCRIPTION REPORT 3ori # Horzen Depth Dominant Co'or , Mott 05 St'. ct.ire GPD; ft` Cot;StenceE3Clllcla• Roo S, Bee irrrr- in. Munsell Ou. Sz. Cont Cola TI x, e Cr. ,;z Sn GrourO G, ✓ - 7 ft. Depth to in) ling J ice. f+✓ I. faalc Remarks _ Boring # - _ 2 'Ink 7-4 rii 1.11.J aclcr Hernarks: , F Nama--P'aas?°•int AdAru cs . ~ 31e - PJum?a' SOIL DESCRIPTION REPORT Fag PROPERTY OWNER PARCELI.D.t - - - S'ruc'ure SP'. + Bonng# Horizon) Depth DominantColorl Mottles Texturo Qmsisterxx,BourAnY'Roos 't'" Bed r Sz. TT+rr in. Munselt Ou.sz.Cont.Cbr sh Gfound F~ alz ~y,Jft. Depth to ~T . limiting - - - - fac:or Remarks: 30nng X- -4 Ground - eiev 1 - Depth to factor f Remarks BcrrD# a 41 lev t, 1 ~ - - -4/ Depth to ImitinG - - - - RemarkS: _j i arc-nd - _t---..-- r,tra t,clof Remarks:_ ~;Pn F! io..N.n-42i r C S/ ~ 1. l y i Z i - - _ - - - is