Loading...
HomeMy WebLinkAbout020-1353-10-000 iisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: ,ai- ATTACH TO PERMIT) 395289 GENE '.AL INFORMATION State Plan l oo: q Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. (t7 b f —1 ;014. bkir) Permit Holder's Name: City Village X Township Parcel Tax No: Ormson, Jon Hudson Township 020- 1353 -10 -000 ' CST BM Elev: Insp. BM Elev: BM Description: 100.0 10 .0 f _ tk i oat_ ,C--- Cs vuk,4+--- TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic r 'Benchmark W - C:� Se.. . 1 /&� 3. 103.0 1 vb , D , Dosing 1 _ ti Alt BM /03 0 F.6,6 cpi3O Aeration Bldg. Sewer Holding; t Inlet / .go 86 • (O0 1 t Outlet e G- TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic / Dt Bottom f s-T) (---) 2l to 81. Dosing LI , � L \ u t / Header /Man. i �. ST' 2- -S-- T 17r , Aeration C am ) to Dist. Pipe t "Z.,. }(,, 2. }t ( // 11 1 1 Holding Bot. System 3 • SZ / R �' Final Grade S CI PUMP /SIPHON INFORMATION t `� / Manufacturer ,", f�� Demand St Cover /] e�Ld� S t> GPM / e,Ya3k Model Number / �� O , CVO 8 0 -cr ioo.so Lo-o.. DH Lift ti Friction Loss Head / ITDH V??-1°- ,�g 2.1 1System 3. 2.5 1 V ? Z Ft - forcemain Length 1 Dia. r. Dist. to Well 0 0, 2 () SOIL ABSORPTI a'N YSTEM 12. (oO -1- 96 % ((o' `f' BED/TRENCH Width ILengt ® f II ( INS. Of Trenches 5 PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS l ! i p 1 _Ink SETBACK SYSTEM TO P/L BLDG WELL LAKE /STREAM LEACHING • anufacturer. INFORMATION CHAMB - • R 1 Type Of System: l* Y� (5 / 5-1 ` IT I Number; DISTRIBUTION SYSTEM, ld}ta-¢, G Header / w Distribution , x Hole Size Vent to Air Intake U Pipe(s) I i/ 3 /1 it Length 2. Dia �� Length '�� a ` • 0 Spacing iv /A(O , 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 X Y es 0 No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1acow —ch•-t-3 : ° /� 2 .3 / 0 t Inspection #2: / , 4 / �. Location: 640 Hillary Farm Road Hudson, WI 54016 (NW 1/4 SW 1/4 36 T29N R19W) Cwo / Parcel No 3 . .1 .2010 1.) Alt BM Description =1 � 0�""" ` • C "'� I� 2.) Bldg sewer length = Cv / 7 - amount of cover = r t) 3.) Contour = 1 -,gol od'�.10 i � 103.0 `�� �� �� w ';( ix "+. o., • ' _ t; a • gam Pl6n slon - equire �] Yes f No r t. 0 1 i Use other side for additional information. � _ 1a' Date Insepctor's Signature Cert. No. SBD -6710 (R.3/97) u 1 - 1'3 - � 4 ATV ■ 1Z`k 7.0 1fr 'k)' p Safety and Buildings Division Count �� / VI! 201 W. Washington Ave., P.O. Box 7162 s-->" , L1 sconsIn M��, WI 53707 - 7162 Site Address epartment of Commerce # 6fO /F/ eie FA-cwt lea • . Sanitary Permit Number Sanitary Permit Applicati 3C1 In accord with Canna 83.21. Wis. Adm. Code, personal information you provide 0 Check if Revision may be used for secondary purposes Privacy Law _ I. Application Information - Please Print All Information State Plan I.D. Number Property yr.. -- ,r's Nary Parcel Numbe� 1 'ND 3 4. 0 2 , 1 • 1 `f . �.D /6) h NS 6 arm Sod 0Q / 3 - » - 2 Property 49,2efrrl is Mailing Address Property Location �` p q s, 7' t/ S I. 3 , , t )-11 ,, ti; 4,14 s S 3 4 1 N, �7 4- W City, State Zip ode F; ber N ,., « Block Number A. l = vision Name CSM Number Sl ry( i)lW�C'� � ©�. � /� a hl.J6bd t cli r II. Type of Building (check all that apply) ✓ 2 St � , a � Oat; `i 1 or 2 Family Dwelling — Number of Bedrooms y / - 0 / age 0 Public /Co — Describe Use 1 el `f=D 1 o t 36 y► 0 State Owned t a J u Nearest Road i 1Q 10 X6o cps) .6u - 1.0 az ") S• fi t' III. Typ� , of Permit: (Check only one box on line A (numbering scheme for internal use). Comp ete line B if applicable) A ' 1 New 3 0 Replacement of 6 0 Addition to For County use System I 2"0 Replacement System l Tank Only Existing System I B. 0 Check if Sanitary Permit Previously Issued I Permit Number Date Issued IV. Type of Permit: (Check all that apply)(nu mbering scheme is for internal use) ie ao.W 1t--1 D O -fl 1 4 - 4 - 44 0 Non — Pressurized In- Ground 211Mound 47 0 Sand Filter 50 0 Constructed Wetland 22 0 Pressurized In- Ground 41 0 Holding Tank 48 0 Single Pass 51 0 Drip Line 45 0 At -Grade 46 0 Aerobic Treatment Unit 49 0 Recirculating 30 0 Other V. Dispersal /Treatment Area Information: Design Flow (gpd) Dispersal Area Dispersal Area Solt Application Percolation Rate System Elevation Final Grade �1 Required Proposed Rate(( Gala. / Days /Sq.Ft.) (Min./I ch) %7 Elevati 6O lt � 7 , '6,t VI. Tank Info Capacity in . Total ` Number Manufacturer Prefab Site Steel Fiber Plastic . Gallons Gallons of Tanks Concrete Constructed Glass New T Existing anks /dies* Sepdc or Holding Tank _ / a p f x' > cban "1,D l VIL Responsibility Statement- I, the undersigned, assume responsibility for t a o[ POW FS shown on the attached plans. Plumber's Name (Print) 1 RS N 1 • 1 Business Phone Number 1 AVnll'S I c Plumber's Address (Street, City. S to i Code) 91 2) 9 A)e ,s,er EA a01, s' /d x VIII. County/Department Use Only . Approved ❑ 0 Disapproved Sanitary Permit Fm (includes Groundwater Date Issued • Agent Signature (No Stamps) Surcharge 0 2C - - - -- • t r Determination 3 2S. , I + , 2to( I%. Conditions of Ap m r r n _ - � � (_ �� sapproval 4( Sys a° pi"- 9 lAtiwNti • et,�]�crt to- 4 , • _A , is Am 42.....A.AaAA ' iA--- ` . 1 ( . s �_, , g ..Y.� Goo • L. . COw1 +--- "Attack complete , (to the County only) for the system on paper not less then 81/2 x 11 inches le du SBD -6398 (R. 05 /01) _ r / PLOT PLAN Scale 1 " = Q ' page 3 of >1 '0 i ii-N, \(% , �u 0 \\ 1 'N'T ,?i,( \\ , Q o - `cog -� 1)1.-1Q ��O \ § /-■NNN\ '‘'QI\ >. \ i '/ �p ` \ \ . /..... 8 ; •,.-...„` o 1 0i / S A tis i \ v. 4 P V C J &i. N ,,-1_, �0 h16T °c Ord Pose -T N N vo ' OR � \s1v�t3 2Yp Ny. h/ TES P"► S A SS (4% go 31 Lo► Llkk: 1c1S,8 CV k a 1* z J B)'1 *-1 L c- - 1-L 3 \) q 4.v ' ezev.9.5.p • . -- -- "am 1 - EL. .0 __okl -lU1 _ IN) . -Z4` OM ._ Z.,, _ - "TL. T_2S'r - - NOTES: 1. Elevations shown are existing ground elevations unless otherwise noted. 2. Install 4" observation pipes with approved caps. ( 2 required). 3. Septic tank to be 12.%0 /BOO gallon capacity manufactured by k)l 2 COQ C2 -y w y -- L46Oo Z : t " Z • 4. Bench mark , S X0 5. Divert surface water around system to prevent ponding at the uphill side. r . ` r 7 " Safety and Buildings �/ /, .1 z ' /7. 4003 N KINNEY COULEE RD LA CROSSE WI 54601 -1831 ray TDD #: (608) 264 -8777 � , www.commercestate.wi.us /sb U sconsin t �".' s .- , www.wisconsin.gov Department of Commerce t * ` `^'� r , d*� : �S i_ Scott McCallum, Governor Brenda J. Blanchard, Secrete ry � ..,. , ® , :- Aug 20, 2001 f , ." ti % '� Kg, CUST ID No.691727 � z I �?+��: ' I WTS Inspector ARTHUR L WEGERER ZONING OFFICE WEGERER SOIL TESTING & DESIGN SERVICE ST CROIX COUNTY SPIA PO BOX 74 1 101 CARMICHAEL RD RIVER FALLS WI 54022 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 08/20/2003 Identificati tuber Transaction ID 448 SITE: Site ID No. 634 7 JON & LISA ORMSON Please refer to both numbers, COTTONWOOD TRAIL above, in all correspondence with the agency. TOWN OF HUDSON ST CROIX COUNTY NW1 /4, SW1 /4, S36, T29N, R19W FOR: DESCRIPTION: FOUR BEDROOM MOUND SYSTEM OBJECT TYPE: POWT SYSTEM REGULATED OBJECT ID NO.: 807940 The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The following conditions shall be met during construction or installation and prior to occupancy or use: • This system is to be constructed and located in accordance with the enclosed approved plans and with the "Mound Component Manual for Private Onsite Wastewater Systems VERSION 2.0" SBD- 10691 -P (N.01 /01) and the "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems VERSION 2.0" SBD - 10706 -P (N.01 /0I). • 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. In addition, the owner must insure that the operation, maintenance and monitoring duties as described in section VIII of the Mound manual, and section VI of the pressure distribution component manual are complied with. A copy of this letter including instructions and information relating to proper use and maintenance of the system must be given to the owner and each subsequent owner upon completion of the project. • The well must be a minimum of 25 feet from any POWTS tank, and a minimum of 50 feet from the absorption area. • Access to the filter for cleaning must be provided per Comm 84 product approval conditions. Maintenance intbrmation must be given to the owner of the tank explaining that periodic cleaning of the filter is required • Limited activities are allowed in the area 15 feet down slope of the component area. Soil compaction, excavation, vehicular traffic and other similar activities that impact the treatment and dispersal are prohibited. • Comm 83.52(3) The activities relating to evaluation and monitoring mechanical POWTS components after the initial installation of the POWTS in accordance with an approved management plan shall be conducted by a person who holds a registration issued by the department as a registered POWTS maintainer. ARTHUR L WEGERER Page 2 8/20/01 • Comm 83.52 Responsibilities. 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. Comm 83.54(1). In addition, 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. • Comm 83.52(2) A POWTS that is not maintained in accordance with the approved management plan or as required under s. Comm 83.54(4) shall be considered a human health hazard. • A Sanitary Permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.135 and 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)(d), Wis. Stats. 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/instal lation /operation. In granting this approval the Division of Safety & Buildings 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. Sincerely, FEE REQUIRED $ 175.00 6 7, FEE RECEIVED $ 175.00 C� �L' BALANCE DUE $ 0.00 Charles L Bratz POWTS Plan reviewer II- Integrated Services WiSMART code: 7633 (608) 789 -7893, Mon. -Fri. 7:45 AM to 4:30 PM cbratz @commerce.state.wi.us cc: JON ORMSON TITLE SHEET Page. of 7 MOUND SYSTEM FOR A y BEDROOM RESIDENCE This plan has been prepared in accordance with the Mound Component Manual SBD- 10691 -P and the Pressure Distribution Manual SBD- 10706 -P (N.01 /01) (N.01 /01)' LOCATED IN THE ? '- 1/4 OF THE SW 1/4 OF SECTION 36,T z-9 N,R 19 W, TOWN OF b..1 , �3T CL ��( COUNTY, WISCONSIN. LD1 10 OF C.4.)T1-pNW 001 INDEX PAGE 1 of 7 TITLE SHEET ' PAGE 2 Of 7 SYSTEM MANAGEMENT PLAN PAGE 3 of 7 PLOT PLAN PAGE 4 of 7 PLAN VIEW -CROSS SECTION PAGE 5 of 7 DISTRIBUTION PIPE LAYOUT PAGE 6 of 7 PUMPING CHAMBER CROSS SECTION PAGE 7 of 7 PUMP PERFORMANCE CURVE PREPARED FOR 4 s 9 1 T. PrPT RECEIVE SS09 AUG 1 0 2001 SAFETY & BLDGS DIV. PREPARED BY • 44 EFR SC3I L . TEST !VG AND. . DESIGNI SEFt • P.O. Box 74 421 N.Main St. Wo 9 ®em River Falls, WI 54022 'x' , cC N Phone 715- 425 -0165 °.�••• �. Fax 715 - 425 -6864 :•' "� t Pi4714(JA D915 P . 1! ErLLSW Condition ' A� .6 �. '4* 4 's APPROD DEPARTMENT OF COMMERCE $ .. $ ' $EE CORRESPON E JOB NO. '31-188 Mound System Management Plan Page 2. of 7 Pursuant to Comm 83.54, Wis. Adm. Code Septic Tank • The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Stets. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code. T1- • aerating condition of the septic tank and outlet filter shall be assessed at least once every 3 years by inspection. • - ou et 1 - shall be cleaned as necessary to ensure proper operation. The filter cartridge should not be removed unless provisions are made o r ain so i s in the tank that miry slough off titter 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 perforrnance is generally not required. However, if such products are used they shall be approved for septic tank use by the Department of Commerce, Safety and Buildings Division. Pumb 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. 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 vegetative 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 heavily mulched for frost protection. Influent quality into the mound system may not exceed 220 mg /L 8005, 150 mg/L TSS, and 30 mg/L FOG. Influent flow may not exceed maximum design flow specified in the permit for this installation. The pressure distribution system is provided with a flushing point at the end of each lateral, and it is recommended that each lateral be flushed of accumulated solids at least once every 18 months. When a pressure test is performed it should be compared to the initial test when the system was installed to determine if orifice clogging has occurred and if orifice cleaning is required to maintain equal distribution within the dispersal cell. Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the owner, and any levels above 4 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring. General This system shall be operated in accordance with Comm 82-84 Wis. Adm. Code, and shall maintained in accordance with its' component manual ] and local or state rules pertaining to system maintenance and maintenance reporting. SBD-\Db P to t> No one should ever enter a septic or pump tank since dangerous gases may be present that could cause death. Septic and pump tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the tanks are no longer used as POWTS components. Septic or pump tank manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of t replaced. P service. Any opening deemed unsound, defective, or subject to failure must be be secured by an effective locking device to prevent accidental or unauthorized entry in to a reater k or component. iameter shall -inches in 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 shall be immediately repaired or replaced with a component of the same or equal performance. 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 adsorption and dispersal media, and related piping, and replacing said components as deemed necessary to bring the system into proper operating condition. u Q estions about the operation or maintenance of this system should be directed to: The County Zoning Office at - 115_3R -6 _l 8o, S"r_CpplX The system installer at —) YS_ tL2S_ ctcjSa c The tank manufacturer at 00 • 32S- � 8" 6 w Les erc The effluent filter manufacturer at �Ot.— Z-Z], S71� Z Z, The pump manufacturer at - 6 a , a•v&P , -G ou LDS • PLOT PLAN Page -Sof -1 Scale 1"=40' • ., • 4.) '0 - \P \ 0 ■ \ -- ---- -.b.b.. /-, ■,, (46 19 4 4 0 ,- < • n, 14 1 4: <!.'■ 1. „ / C - )1.. 1)0 VQ6'1" e-OKPi ..._\ \ 'A , ),k ) -..... -...., -..... c9 , 14 \s'1■ 3C. . N -.,,„ i V - rtiis • _ Plizzoi / -,,, ss o . P 6. Lp 1 .,... xl. f ',......,..., 8 4 ) ( 4% ' LOT LWE. -. 1 etS v 11M14 _J tS \*--) co-IN-DAL CI 9. ' N OF C-ZI.L. _TtL- _ _t,IA-T _I-tftST SD i — F — - - I r - OM MilUlkA IftQl WT LT ZS' 17-717-03^1 Ter)Vr(.. -- —.- NOTES: 1. Elevations shown are existing ground elevations unless otherwise noted. 2. Install 4" observation pipes with approved caps. ( 2 required). 3. Septic tank to be l' capacity manufactured by `-. kJ F)- 00 Zr\ Ft L . 4. Bench mark:: S - " ,- 6 ----- 1)-\301\i t.? • — 5 . Divert surface water around system to prevent ponding at the uphill side. • .. Page Y Of 7 Approved Synthetic Covering - ASTii C33 - Distribution Pipe. Medium Sand - Topsoil ____ -- F Elev. ° I 5.0 b ° l. % Slope • Distribution Cell of • • Force Main Plowed Z" to 21/2" Aggregate From Pump Layer D 1.0 Ft • E \ - q Ft. CROSS SECTION OF A MOUND SYSTEM F cs;a Ft. . G 0-5 Ft. . A 10 Ft. - >•l \--0 Ft. Linear Loading Rate= t0.0 GPD /LN FT 8 60 Ft. Design Loading Rate= 0-4ZGPD /SQ FT 1 \4 Ft. • J 6 Ft. K NO Ft. P °1 e Position L BO Ft. of Force Main W 30 Ft. . I L I j I I - Observation Pipe I a n — -. I K w ,147-4/615- - -� _ __4:, � • Distribution • �� o �" Pipe C z t 2 2 .. • aggregate Observation Pipe • • • anchor securely) • .tom ,./ . • . - PLAN VIEW OF A MOUND SYSTEM _ 4 • • Distribution Pipe Layout Page S of `7 • • Place the holes at the bottom of the distribution pipes . at equal spacing. Remove all burrs from the pipe and holes. Extend the end of each lateral up with the use of long turn or 45° fitting to a point within six • inches of the final grade. Terminate the ends of the laterals with a valve,:threaded cap or . threaded plug. Provide access from final grade for the valve, threaded cap or threaded plug. n T`-VP L i; K•r..oss ._S��'�'Ct111�7 PVC • FuC t?„ /- Lateral Manifold Lateral • x 1 x 1 x J x lx/2x/21 x !xis x Lateral Length — Lateral Length P Distribution Line - o - - ti'uC FO C.E � " 1 H'rN • P 2$. • S Ft. Hole Diameter 3)1 Inch S y, HQ. Lateral 1 • Inchces) X 3 b Inches Manifold " Z Inches Force Main Inches !of holes /pipe 1.0 - Invert Elevation of . Laterals qS. S Ft. 1.()1..0.66= 6.60x6 39.60 6Pri1 • • Combination Sept.c: Tank and PUMP CHAMBER CROSS SECTION) AND SPECIFICATIONS . PAGE 6 OF ^ - VENT CAP WEATHER UTIO P8ROO • L - _, JLCIJ O ti C.I. VENT PIPE ■ /� APPROVED LOCKING 110' FROM DOOR.. • MA/JI4OLE COVER. kvilli :i1NDOW OR FRESH 1 7-• wA(ttJIUG Lt+�g sP vrJ P 1PE A1R INTAKE — X corJoutr •' -'J Ln u - - GYP , i I 1 • F1N1$i}© 6`+4w. . • _ 1• j ` ,. /i G r . E- au i I Iii, * I lei MILL . i . INLET ' PROVIDE I - — - ~ AIRTIGHT SEAL 1 I I � / I I CI NZ Approved/ tZrB�. r-t� -•e I ( Approved i joint w/ 'Pt— \b 00 II I joint w/ 1 i ( ALARM PVC pipe PVC pip - if . a 1 • • • I ► oN l I I • LLCV. RS •$3FT --- •- f I PUMP __J 1 ►OFF 0 • COLJCRETE MIMI - ,e)• $ s • (11 ( 1. - • DLOCK • ti: f , * RISER EXIT PERMITTED O►JLy IF TANK MANUFACTURER HAS SUCH APPROVAL 3" APPQotift BI=pOI >v>R SEPTIC F SPECIFICATIOIJS_ oosE W S TANKS MANUFACTURCR: Z C4}NC '`e'G NUMBER OF DOSES: S -Z • PER 0,+4 TANK SIZE • \ -7--9 - ) C 1 J 800 GALLONS DOSE VOLUME r ALARM MANUFACTURER: S- L - S �Rtsr�l g ILCLUDING 6 ACKfLOW: 1Z-5 • b GALLONS MODEL L1UMBER: y O 1 l"1-w CAPACITIES: A= 10 INCHES OR L4 11.0 GALLOIJS SWITCH TPE: '- `E -JJRi"( 8 = Z INCHES'OR LI- Z GfLLONS PUMP MANUFACTURER: G 0 U•-b S C s INCHES OR \ . r &ALLOIIS MODEL NUMBER: 3 811 ?OS D= 10 INCHES OR Z06 " GALLONS SWITCH TYPE: m eZ�'� NOTE: PUMP AIJO ALA TO el. 1 5 E. MIAItMUM DISCKARGE RATE (I 'l• bo GPM INSTALLED OM SEPARATE CIRCUITS VERTICAL DIFFERENCE DETWCEU PUMP OFF AUO.DISTRIBUTION PIPE.. a" 6 7 FEET + MIIJIMtUM NETWORK SUPPLY PRESSURE 3 - ?S FILET ( ZS.. ' ) T. + S.S IN FEET OF FORCE MA X ' Cl U F l o FLFRICT1oLi FACTOR_.` ` 1� ` __ FEET /- kU 3,"2b` TOTAL 13 1JAMIC HEAD = • / y• 7 `' As per manufacturer 2S , bO gal /in. Liquid depth 3 g'I , 1^'15' P FpRivi JCE C V . E 7 0, 7 1 s Goulds (r _ �, _ Submersible -- Effluent Pump MODEL 7 " - /_. -t1,, __ EP05 EPO4 • APPLICATIONS • Fasteners: 300 series • Full submerged in high 1 Housing: Cast iron Y 9 9 Specifically designed for the stainless steel. grade turbine oil for for efficient heat transfer, following uses: • Capable of running lubrication and efficient strength, and durability. •Effluent systems dry without damage to heat transfer. • Motor Cover: Thermoplas- • Homes components. tic cover with integral handle Available for automatic and •Farms Motor and float switch attachment • EPO4 Sin le hase: 0.4 HP, V manual operation. Automatic • Heavy duty sump 115 or 230 60 Hz, models include Mechanical Points. • Water transfer RPM, built in overload with Float Switch assembled and ■ Power Cable: Severe duty • Dewatering preset at the factory. rated oil and water resistant. automatic reset. • Bearings: Upper and lower SPECIFICATIONS • EPO5 Single phase: 0.5 HP, F EATURES h duty ball bearing 115 V, 60 Hz, 1550 RPM, . g Pump: EPO4 built in overload with Th construction. • EPO4 Impeller: Thermo- • Solids handling capability: automatic reset. plastic Semi -open design AGENCY LISTING /4' maximum. • Power cord: 10 foot with pump out vanes for r ) • Capacities: up to 55 GPM. standard length, 16/3 SJTO mechanical seal protection. SA Canadian Standards Association ptal heads: up to 24 feet. with three prong grounding Discharge size:1 /2" NPT. plug. Optional 20 foot • EPO5 Impeller Thermo- g plastic enclosed design for (CSA listed model numbers • Mechanical seal: carbon- length, 16/3 SJTW with end in "F" or "AC".) rotary/ceramic - stationary, three prong grounding plug improved performance. BUNA - elastomers. (standard on EP05). ■ Casing and Base: Rugged • Temperature: thermoplastic design provides 104 °F (40 °C) continuous superior strength and 140 °F (60 °C) intermittent. corrosion resistance. • Fasteners: 300 series METERS FEET stainless steel.. 10 - • Capable of running ; .' ;� dry without damage to 9 - 30 ! .d _ `' � components. 0la e• 1 s Pump: EPO5 '�- j .. , • • Solids handling capability: 24 t 25 ' ! Y4" maximum.: • up to 60 GFM. ~ � 6 - 20 ! Q� � � P''.;' • Total heads: up to 31 feet. § • Discharge size: 11/2" NP.T. Q z 5 - • Mechanical seal: carbon- } = rotary/ceramic- stationary, ° 15 4 - ! Ly'.SS ` I � _ � Epp- N BUNA - elastomers o • •Temperature: 1- 3 - 10 ).- 2104°F (40 °C) continuous 3g.6 l' ° (60°C) P rm ,='140 F 60 C intermittent _ ent. ( ) 2 _ . u 5 • a�..> _ 1 — ( ,../ e -,1,,: ' 0 - 00 M 10 20 30 40 50 PM , G 0 2 4 6 8 10 12 mv/h CAPACITY `` • ® 1995 Goulds Pumps, Inc. Effective May, 1995 RQC71 Wisconsin Osipartment Cof ommerce Division of Safety and of C gs SOIL AND SITE EVALUATIO Bureau of Integrated Services a • in accorda l s. L - L 09. Wis. Adm. Code Pa I of /. , ✓ • Attach complete site plan on paper not less than 8 112 x 11 ' '' fn slz taf�rnust \'* ': r" tyun include, but not limited to: vertical and horizontal !Mere (BM), d� i Percent slope, scale or dimensions, north arrow, and local d distance t ne�f1 road. �...i 4�'" Parcel I.D. # Q 1 APPLICANT INFORMATION - Please print a l , rmatleh x ae • by D , to Personal Information you provide may be used for secondary purpo rely 9�!� 1) (m)). -', l t, t t, , ffq Property Owner _-• —• 1 1 Cly 50 o ... i , 1 Pro• " i . �' Ajw 1/4 1 /4,S 36 T' C , N , R 1 J E (oft) Property Owners Mailing Address ` - r BiocI Su • Name Or CSM# l 5. ' ai et r. 1O 4 4, dad P ci 9 c-) City State Zip Coda Phone Number ❑ City 1�❑�' Village I. Town Nearest Road &I n L OII 1 � �G - (ss l - 1-1t Id Q1"1 I Co1flwaSoCI- +Y 0 3-t- tit New Construction Use: CI Residential / Number of bedrooms Fleplacement 1 Addition to existing building [] Public or commercial - Describe; Code derived daily flow LQLO gpd Recommended design loading rate • 7 bad, gpd/f1 • 8 trencch, gpd/ft Absorption area required `I bed, ft trench, ft2 Maximum design loading rate bed, gpd/ft trench, gpdNt Recommended intlitration °surface elevation(s) _ ela ft (as referred to site plan benchmark) Additional design /site considerations t £�• t f .. Parent materia l ket 10,1 C. Lr 1ni(.Sb Flood plain elevation, it applicable . '/4- ft S Suitable for System Conventional Moundd In- Ground Pressure AT -Grade System in Flit 'Holding Tank U . Unsuitable for system f: S DI; ❑ U ❑ S 11•17 ❑ S (-U ❑ s 00p ❑ S g SOIL DESCRIPTION REPORT • # H orizon Depth Dom inant Color Boring Pm Mottles e Structur Texture Consistence Roots GPD/ft2 in. Mansell Qu. Sz. Cont. Color Gr. Sz. Sh. ‘' 0 - L5 IMMIE5IM ini • 1 8 N! 16 ms around - IF 1 `1 IP rillMral -- a , Fy n � � 11.11 IIIIIIIIIIIIIIIIII � NMI Depth to 1 _ N 'FT t _ _ MIN in. NM OM MI 1111111111 Remarks: Boring # MI 6 -7- 1 1.- = ‘ Mini Z if, L � 2, -2 1D 'IN � gal �� r _ .,, 3 y4 10 r5/Li /L{ >k ! ±� ground Min elev. 111111111111.11 NO ft- 111111 Depth to limiting -- IIIIIIIIIIIIIIIIIIIII factor 2.5 in. Remarks: CST Name (Please Print) Signature Telephone No. Address Date CST Number © fS' C de St. ar ` S C rn rS� [ `-IUZS N - -/5- l� 2 W71;consin Department ofCommerce SOIL AND SITE EVALUATION Division of Safety and Buildings Page I of Bureau of Integrated Services in accordance 9S. fL .09, Wis. Adm. Code d. \ r / • / .,:6 . / Attach complete site plan on paper not less than 8 1/2 x 11 i e `�fn size a 1a1�)anust County include, but not limited to vertical and horizontal referenc �o'irit (BM), dfr' fprlil5���]] , - -� _ C�(�j t X q percent slope, scale or dimensions, north arrow, and locat .,elid distance to neaf'eh't road. - Parcel I.D. # s ,?g 1 _ , APPLICANT INFORMATION - Please print a =frJprmatr8fic, o ' ,I _ I` - . - Rev ed by Date Personal information you provide may be used for secondary purposes (Pi yac tt '(1) (m)). l L (,� U )/11 /,1 /91'q y� . , Property Owner \,, P 4bc ion / Q \c l o Y - 6 Sit \ ,..l % `, ,, ,.. .G V.t. 0 �w 1/4s i 1/4,S ? Tz ,N,R / E ( Property Owner's Mailing Address \ -„,_____L Block# Subd. Name or CSM# 1353 ANvfxkuke-e Tf - _ 10 CO --o n w 06 6 P kdB City State Zip Code Phone Number ❑ City ❑ Village [11. Town Nearest Road 14uc'\ SQ 1 W I 1 5iotto 1 (11 �j )54G- 191'51 4( K`hOr) I Col-inAwcsoci_ i-r, ro New Construction Use: 17 Residential / Number of bedrooms _ :" Addition to existing building ❑ Replacement ❑ Public or commercial - Describe: Code derived daily flow IOW gpd Recommended design loading rate • 7 bed, gpd /ft • c 8 / trench, gpd /ft Absorption area required 51 bed, ft `150 trench, ft Maximum design loading rate , 7 bed, gpd /ft • O trench, gpd /ft Recommended infiltration surface elevation(s) 9.5'7/10 ft (as referred to site plan benchmark) Additional design /site considerations ?y 4 (0 Parent material U.\aCiCal 3ri wash Flood plain elevation, if applicable ,v / , - ft S = Suitable for system Ir Conventional Mound In- Ground Pressure AT -Grade System in Fill Holding Tank U = Unsuitable for system ❑ S i al Kri ❑ U ❑ S D-5 ❑ S 11 ❑ S ID-0 ❑ s E0 SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Structure GPD/ft g Texture Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench l ► 3 -2 ib yr3J2 . - Ls In-11 m (C) I g , \"1 ' . 2 I1 y Le IU -- ins 03 �, c s — • '1 - g Ground 3 24-a) I0yr3'y V- `x '7.5 y r c L-lbe iI ilyl _ (n t r cs Nip .ivp ?'%5 Depth to limiting factor Zy in. Remarks: Boring # - 1 6 j6yr,3 /2- LS 1ms m4 C5 I C - . Z L 2725 to Y r L 1/ 4 C �� MS S m ( CS - i 3 Z5- Ioyr3 /kf 5:1E 1,51r yJ1D Si I bk 4 �( c3 - ;vp ;Np Ground elev. 9yGd ft. ; Depth to limiting factor 25 in. Remarks: CST Name (Please Print) Signature Telephone ROICUY 50 ha mnis er C7/51 2y 7 — yvv Y Address Date CST Number ' Ceder Sf• V 4 1 SOrr eree - i - , Ctll .5 Li 253309 cC yy SOIL DESCRIPTION REPORT 2 v PROPERTY OWNER d IcJCJ Page 2 - of 3 PARCEL LD.# Boring # Horizon D Dominant Color Mottles Structure G D /ft g Texture Consistence Boundary Roots P in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench 3 I 0 -10 tayr 3/2 LS { pi-6s ml cS . $ Z ip -z Ip yr 3/4 LS IMS5 l CS — 1 .8 Ground elev. 3 2, 3b I () 1r 313 r { K 1.5 y r Ito SI { mablL ,m-Pr cS — r\rp N{) 146 ft. Depth to limiting factor Zin. Remarks: Boring # Ground elev. ft. Depth to limiting factor in. Remarks: Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench Boring # ........................... ........................... ........................... .......................... ........................... Ground elev. ft. Depth to limiting factor in. Remarks: Boring # Ground elev. ft. Depth to limiting factor in. Remarks: SBD -8330 (R. 07/96) Fait 304.3 .7 G G f o Q . (vsvoCL. IQ ib 2 . t -.L__ . _. . , nat. l ;n1y 0A. 6ha.I, et- .l 00.O ilk i a,'( r..,(9" k (3vAZ, elev. ! Uas 0 -------- 3 Sysferae.It.u. gccei0 06,A.-1-e s P!eu 9Y . , .0 i.. LI.. , � \ ,e 5 i c \ r; � Cif 5 83 u A nte �\ et Q� �t:e a Z cm ■ . \ L ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION [CORM • Owner/Buyer / A I S Or Sp Malting Address d SS , , / Property Address ( LE ' 1I �Gi ` (Verification required from Planning � for new construction) • my/State Si ; `l eiTe to f `111 • Paneet Identification Number TEGAL DESCRIPTION Property Location NO %. S C 1/4, Sean. 3 T P9 . N -R 1 C j W, Town of 1Y L/ 613014 Subdivision ( B! t WOO d . Lo t # -16 . Certified Survey Map # , Volume • , Page # Warranty Deed ° � l , Volamc /5/ . P age# (9 . Spoo.bouse [] yes ano Lot limes identifiable El yes Cl. no oa , II apaame"odma� dea�°Aeofroaoc sysb� d tmitc Pmpetmaiaoe„amx . ,����� p� c ofthe 7 cc soa®cciiroededl t_oeasodpmmpc ran pat Hood esy�at - eepti�c as_a , eatagefatfetAssce tciztaiL ro z ragmes submit-to- St. Clok &zing Del admeat oetericarion ban, signed by !boom= and bya utaptvp�xoP�B'asmdtor ackTi�oeasodPaomQa�f, �g�t( �Qreoa�i�teiarasocwab ��an p (tf .tbaIslessdniaU3fagofdadge* tare midessignedhaveaead the above acquitemacts and+vx to maintain tic plate sewage disposal system w& die Scandals . sit fork * set by the D epartmcntofCbanneteemd theDcpardmentoniamalR State ofWisoonsin.- - $nSA your septic s g stcntbasteenn n in toaaodutbeeompldodaadretmmodtotheMerck/D ai nty ZoningO Cwidua30 days -of the tic rampication date. TORS of APPLICANT DATE ownEtteEttralicAmort tort) eafify that all statements on this fomt are true to the bat of my (ow) knowledge. I (arc) am (at+e) the owtacr(s) of the Propetty desoaibod abort. by *toe of a warranty deed recorded in Register of Dodds °face. ? /93 / TURN OF *APPTICAN: DATE s «sue Any infomtttion that is mis-tepiescotcd may Its is the wait uy Permit being revoked the uet- by Zoning D a��sa• " Include with this application: a stamped warranty deed Seem the Register of Dodds otrioc a copy of the certified survey map if tvfacnoe is made in the warranty decd PO STATE BAR OF WISCONSIN FORM 1 — 1982 62431 3 • WARRANTY DEED KATHLEEN H. WALSH .1516 REGISTER OF DEEDS DOCUMENT NO. Vr;; P AGE 526 ST. CROIX CO., WI RECEIVED FOR RECORD This Deed, made between 06-06 -2000 1:20 PM RICHARID 0_ STOAT and JANET P STOUT, YARRRNTY DEED husband and wife, EXEMPT M _ , Grantor, CERT COPT FEE: and _ION x 0RMCON anei LISA M. ORMSON, COPY FEE: husband TRANSFER FEE: 149.70 usband and wife, r RECORDIMG FEE: 10.00 PAGES: 1 , Grantee, Witnesseth, That the said Grantor, for a valuable consideration conveys to Grantee the following described real estate in St . Croix THIS SPACE RESERVED FOR RECORDING DATA County, State of Wisconsin: NAME AND RETURN ADDRESS e) 4,91- (MAS O Lot 10, Plat of Cottonwood Ridge, Town of a� Al ri' A �3 Hudson, St. Croix County, Wisconsin. S"T tom'` ?1 '1%0 56 020- 1353 -10 -000 PARCEL IDENTIFICATION NUMBER This _fig_ PQF homestead property. (is) (is not Together with all and singular the hereditaments and appurtenances thereunto belonging; And Richard 0. Sttntt and .TanPt P Stout warrants that the title is good, indefeasible in fee simple and free and clear of encumbrances except easements, restrictions, rights -of -way and covenants of record, and will warrant and defend the same. Dated this day of Ricpard q, stout (SEAL) - ) , ur _ (SEAL) RAtka (SEAL) (SEAL) AUTHENTICATION ACKNOWLEDGMENT State of Wisconsin, Signature(s) ss, St . CRoiX County authenticated this day of , 19_ Personally came before me this e6 - _ day of , p9'O the above named Richard 0. Stout and Janet P. Stout. TITLE: MEMBER STATE BAR OF WISCONSIN (If not,. NOTARY PUA authorized by §706.06, Wis. Stars.) to me known togItrloi PX@C}�efl the foregoing instrument • d ackratp.. l B � A V � S VV T �� ll1 � 1 � 1Yr THIS INSTRUMENT WAS DRAFTED BY J ^ Janet P. Stout . A 1353 Awatukee Tr. ' Hudsnn, Wi 54016 Notary 'ublic, _ ft County, Wis. (Signatures may be authenticated or acknowledged. Both are not My c.mmiss)on i permanent. (If not, state expiratto3t date: necessary.) /� !,'I'�j�) Nantes of persons signing in art capaaty should by typed or printed below their signatures. STATE BAR OF WISCONSIN Wisconsin Legal Blank Co., Inc. WARRANTY DEED Form No. 1 - 1982 Milwaukee, Wis. 1 ' • • I / i / // t o ) I/ 1 / : N 1 / / /0 I / __ _ __ ,1 , S'0kE3 „SS,00.00S __ __•__._ / •` i / I LA • / / . _ ._ J / / / // (1) I` of N r ,fi i 0 m w • / / /� N .-. / • / • ■ v- a OD a, // , -- - --_ --1 L % 09 • T 9 , 5� E _ $6-10 -_ -- °; I 4 i - S • - - 291.1O Zo 4 4/ � a _ 1 r• ; y r , o r - 19 5 . ° 0 O a,i 3 -+I • �, � ° 1 I ... Fi , o° • i 1 I I r •I II L 1 . • ii W i .c. , 6 fit J / ' I l v M to DO M // • , .., • :... § i I i iv \ / , 0 � „ f / �0 (Si 1` I I M \ , rb3 / // 1 / k / I g j J 4 _ . 1 i. i' • /• � , . / • i i o i i t .' / /' � � i w ll • -- -- -•'' - • r . • (/. N • - ------- / .. .• 1 1 • 33 3- - 4 3 1 i• ' I W / • ! \ 3� I'• I w �' 51 -i '• 1 .••I 1 I LL O • 3 ;t' i I I o 14%4 -43' 35',‘,1 , 1 .. 1 l i 1 Z I I / . \ I I . I i 1 a W ao 1 1• i 1 1 I JQ j1 11 n1 N i i i i i ?i C} i 1 1 1 it I I �1 • 1 1 1 1 I N � tnI j 1 NI• X oI 1 I I U o! I W I 1 O < Z m 1 tn• 1 u.) L i at W � 1 I W D � j 1' i 1 r W I1 5N .cis!! s N) 11)1 1 "� 000 oI I I CJ O n as. 1 O Z I I �y •a •11 1 I 1 w h co °' U N ap II N 1 I N of ZI l 1 I 1 :d • i i i' i '3 N I > ii ii i c_ 1 1 II 1 . ii i i - j 1 1I 1 ii i i I I I 1 .. 11 1 1 4. 11 ii ii — i' I 1 1 .,. • Page 1 of 1 Pam Quinn From: Pam Quinn Sent: Tuesday, August 07, 2007 12:19 PM To: 'Office' Subject: RE: Address I stopped over today and if the orange - painted corners indicate building exterior, everything should be fine. The fiber optic line marked on the ground is a good indicator of perimeter of work area. Please let all contractors know that they cannot park vehicles or heavy equipment within 15 feet below the mound or store lumber, etc. on the mound — that could compact soils or cause damage to the structure itself. Thanks! Pamela Quinn, Zoning Specialist (POWTS) St. Croix County Planning & Zoning Dept. 1101 Carmichael Road Hudson, WI parnq@co.saint-croix.wi.us From: Office [mailto:office @jghause.com] Sent: Tuesday, August 07, 2007 8:46 AM To: Pam Quinn Subject: Address Hey Pam I'm sorry I did get the address wrong its 640 hilary farm rd, hudson, WI. Sorry about that. Thank you, Kelly J.G. Hause Construction 8/7/2007 Page 1 of 2 Pam Quinn From: Pam Quinn Sent: Wednesday, April 25, 2007 8:21 AM To: 'Michael E Roberts' Subject: RE: Mond septic system setbacks Mike, just keep in mind that there should be no disturbance or compaction i.e. grading, filling, paving within 15 feet from the toe of the mound. Those soils are necessary for assimilation of filtered wastewater and if they are compacted there can be leakage from the base of the mound. Since the plot plan shows the mound and septic tank tucked in between the garage and lot lines, I'm sure it's going to be tricky to do any additional construction on that end of the house. Keep me posted! Pamela Quinn, Zoning Specialist (POWTS) St. Croix County Planning & Zoning Dept. 1101 Carmichael Road Hudson, WI pamq@co.saint-croix.wi.us From: Michael E Roberts [mailto:mer @niroinc.com] Sent: Wednesday, April 25, 2007 7:53 AM To: Pam Quinn Subject: Re: Mond septic system setbacks Pam, Thanks for your help. We are in the initial stages of determining an acceptable location for constructing a garage. Once we finalize on details, Pm sure we will need to pull the paperwork to verify its acceptable. Thanks, Mike E. Roberts "Pam Quinn" <PamQ @CO.Saint - Croix.WI.US> "Pam Quinn" To <mer @niroinc.com> <PamQ @CO.Saint- cc Croix.WI.US> SubjectMond septic system setbacks 04/24/2007 05:11 PM Dear Mike, The setbacks are measured from the interior distribution cell, with exception of distances required for well setbacks. Depending on the design for basal area, most systems can meet the minimum 10' from a building, 5' off a property line, etc. even when the final cover soil is closer. The observation pipes can be used to help determine the length of the distribution cell, but we'd have to check the permit to be certain of the dimensions. If you have a specific POWTS in mind, let me know and I can try to locate the paperwork. 4/25/2007 Page 2 of 2 Pamela Quinn, Zoning Specialist (POWTS) St. Croix County Planning & Zoning Dept. 1101 Carmichael Road Hudson, WI paynq @co.saint- croix.wi.us 4/25/2007