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HomeMy WebLinkAbout020-1479-06-000 U� 000 FIELD INSPECTION & SERVICE REPORT INSTALLATION AUTHORIZED SERVICE PROVIDER 11 Installation Address: ,67-5 OSe— Lti vc Name:ca-ZW.44, �... Owner Name: l.05 4o, Street: -6%Q Oq 4.V. C-q \fail Address: s73yasE r;dQ Mail Address: City' d Sfir State W/Zip S S��� city � /R State Zip 5Sr{D20 �2_ i Phone((P6 170-38�%ax— Phone or/go-aoLnvrFax e-mail S IX 19 e-mail aCIL.SD' �rI►+rt�'f/' L�, INSTALLATION INFORMATION Model No. Blower Brand and Serial No. Date of Installation Date of last pump-out Size f 4&M EQUIPMENT DETAILED COMMENTS OF SITE CONDITIONS- OPERATION YES NO MAINTENANCE PERFORMED OR REQUIRED Electrical Panel s Visual Alarm Operating Audio Alarm Operating (if resent I Blowers _ Air Inlet Filter Clean - Blower Hood Vents Clear Excessive Noise Excessive Vibration Treatment Unit (s): Unusual Odor System Vent Pum out Required: Primary Settling Zone Aerobic Treatment Zone EFFLUENT: LIMIT RESULT Estimated Daily Flow H Standard Units 6-9 S.U. Color Clear Temperature Dissolved Oxygen effluent 2 m /L Odor Slightly j Musty odor not se tic OWNER SIGNATURE TEC NICIAN SIG URE SERVICE DATE jr p~i ' A ' .00 :OE j c p 30) 0 3 C cn 3 x v, Z oUl 2 rn N • N Q CD a OD C N N W O x t0 v O N O. y O w0 O "S p n ? V O O c N c CD 3 0 0 (r O 7 N Go Ow O 0 l~ A m O. Q (D 7 _ CD c a o W O w CD F4~ ^Q o OD v z i:3 0 C, c to to 3 ° 6 O O O a rr 0) 0 0 Oro 3 v v j 0 m m 0 o O a 3 _ N 3 " S 0 > D m 0) y. 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O ~J 0 O' 0 w II D Cw 00) w 3 ~on"a n 'O LA a 3 3 w a ~ w N A 4.0 y O w C j S-3 N ,n~• c fD O w O_ j C `G CD 7 N O' O -Own O O C] 7 N Q w N CL O O n O N 6, O -I O U3 -w z a r(D 7 w D-I (D y N Ca U1 n (D F O O_ ID (D o -10 CD 0 'o (D 00 O ~o y 3 fpm R y o° CL o O N w 0 (0 F;: N 7 u O _a 0 o 7 O 0 O o C n ° O d O O =r 0 0 p N O (D a M = 3 N y twii N 7 CD n" O 'O N O v O O 7 U1 (D O N o W -OD C) CL Q' N N (D O w 0 N go < N O D C (~0 °A(~.Qo0 cx I. o1oi°'3(°3rD (D C= <D W Ch (D O 3 N W CD O y~. C w ~ 0 N~ 0 CL (0 W~ C H 0 ti (p' Q- (p N O C F 3 ° N A ti A ~ O O f$O~ N A O O ~7 "re CROIX COUNR A# 4..-k PLANNING & ZONING Jon & Julie Hokeness ' c/o Hokeness Construction, Inc. 1 907 Alex Lane Hudson, WI 54016 CodeAdministradon RE: Compliance deposit refund for Cottonwood South '07 Lot 6 715-386-4680 Section 36, Town of Hudson Land Information & ! Dear Jon & Julie: Planning 715-386-4674 00 I inspected site conditions at Lot 6 today to determine its compliance with requirements RealPropeyfT for erosion and sediment control. Thanks very much for doing such a good job making 715-386-T677 repairs to eroded areas - erosion blankets installed are providing protection of the soil while grass seed takes hold. This past few weeks of mild weather has allowed the grass Re cling to achieve the minimum 80% coverage for exposed soil and it should be in good shape 5-386-4675 for next spring. Your company made the $400 deposit on behalf of the lot owners, Mark and Beth Lisowski on 10/21/09. 1 can now authorize your $300 refund. ncerely, L7Pam Quinn, fning Specialist s } Cc: Mark & Beth Lisowski, lot 6 property owners I c;'4;.'.;: ST. CRO/X COUNTY GOVERNMENT CENTER 110 1 CARMICHAEL ROAD, HUDSON, W/ 54016 71-5386,4686 FAx PZ~CO.SA/IVTCRO/X. W/. US WWW.CO.SAINT-CROIX.WI.US STe CROIX AA4-,k PLANNING ZONING Julie Hokeness C/o Hokeness Construction, Inc. 907 Alex Lane Hudson, WI 54016 RE: Compliance deposit refund for Cottonwood South '07 Lot 6 Section 36, Town of Hudson Code Administration Dear Ms. Hokeness: 715-386-4680 Land Information & Per your request, I inspected site conditions at the above-reference lot today to Planning determine its compliance with requirements for erosion and sediment control. The Board 715-386-4674 of Adjustment Decision that approved the subdivision required compliance deposits for every lot developed per Condition #5: Real Props lPro-4677 "The plan shall be accompanied by a $100 nonrefundable staff review fee and a cash compliance deposit for the lot. The compliance deposit for the six lots under construction Re t-386f4675 shall be $1,100 each, and the compliance deposit for the remaining lots in the 7subdivision shall be $300 each. The cash compliance deposit will be held by the Zoning Administrator until construction is complete, permanent vegetation has been established, and the project is found to be in compliance with the conditions of this approval, at which time the deposit will be refunded in full. Upon completing construction on each lot, the applicant shall submit to the Zoning Administrator photos of the com lete and certification from the project engineer a the construction has been completed as approved to serve as proof of compliance." E Your company made the $400 deposit on behalf of the lot owners, Mark and Beth Lisowski on 10/21/09. You will be eligible to receive a $300 refund when the entire yard has permanent vegetation tha prove es a minimum 80% coverage of the expose soi . Photos taken April 7, 2010 show the yard had been graded, but no cover had been applied to exposed soil to prevent erosion. Now there is patchy cover (50% or less) of crabgrass that is not adequate to control erosion. Areas of concentrated runoff have washed sediment into the road ditch on either side of the driveway and partially filled the culvert pipe. The accumulated sediment must be removed from the ditch to prevent blocking flow of road runoff. You need to discuss with the owners whether they intend to install sod or grass seed and mulch yet this fall to establish adequate cover for erosion control. When we have received photos that document compliance with erosion and sediment control requirements for this lot, your deposit refund will be processed. incerel , i m Quinn, Zoni g Specialist Cc: Mark & Beth Lisowski, lot 6 property owners ST. CRO/X COUNTY GOVERNMENT CENTER 110 1 CARMICHAEL ROAD, HUDSON, Wl 54016 71x386-4686 FAx PZPCO.SA/NT-CROIX W/ US WWW.CO.SAINT-CROIX WI US County of St Croix Finance Department Check Number: Vendor Number: C® PY Vendor: Hokeness Construction Jon & Julie Hokeness 907 Alex Ln Hudson, WI 54016 Check Date: Approved: File Date: ! !o Total Check Amount: $ 300.00 Invoice Invoice Invoice Account Date Number Amount Description 11 Number IFAmount 11/11/2010 $300.00 Compliance Dep refund - Cottonwood S. Lot 6 100-26901 $300.00 Lisowski I Total Check $300.00 SAFETY AND BUILDINGS DIVISION Bureau commerce.wl.gov Integrated Services 13 East Spruce Street INSPECTION REPORT Chippewa Falls, e. 54729 i sco n s i n www.commerc~715) 726-2544 t6Department of Commerce Aaron Olver, Secretary Date of Inspection: April 21, 2010 Plumber Name and Address: Project Name: Lisowski/Bast William Schumaker, MP 227990 Use: Residential 1070 Scott Rd Legal Description: SW, SE, 36, 29, 19W Hudson, WI 54016 Site Number: 720623 Subdivision: Lot 6 Cotton Ridge South Certified Soil Tester Name and Address: Municipality: Town of Hudson Dave Steel, CST 248956 County: St. Croix Plan Transaction Number: 1343361 Sanitary Permit Number: 515180 Owner Name and Address: Mark Lisowski Wastewater Flow: 600 gpd 873 Yost Dr Persons Present: Owner, P. Quinn, Hudson, WI 54016 R. Yarrington This inspection was completed pursuant to s. 145.20 (3) (b) Wis. Stats., as part of the annual audit of the St. Croix County Private Onsite Wastewater Treatment System program. The following code discrepancies were noted at this site and require attention by the installing plumber. 1. The home on Lot 6 is occupied and is not connected to a functional private onsite wastewater treatment system (POWTS). Suitable provisions have not been make for the treatment and dispersal of wastewater from the dwelling on Lot 6 which is a violation of section Comm 82.10(2)(d), Wis. Adm. Code. 2. In order for the building on Lot 6 to remain occupied the POWTS described in plan transaction 1343361 shall be make fully operational. 3. Items not in compliance include: a. Plans shall be submitted and approved by the county for the exterior sanitary sump. The design and installation shall conform to s. Comm 82.30(10)(d), Wis. Adm. Code. b. Electrical service at the exterior sanitary sump shall comply with s. Comm 16.300 and NEC 300. Approved wiring methods shall be used. An LB fitting is not adequate to contain the wiring methods required to meet minimum code standards. c. The aerobic treatment unit is not functional. The air pump is not installed. d. The final dose tank is not operational. There is no power, pumps or control panel installed. e. The manhole riser at the final dose tank shall be at least 4 inches above finished grade. In addition, the electrical opening in the manhole riser ring was not sealed water tight when installed and this has allowed surface water to enter the tank. All tanks shall be pumped out by a licensed pumper to remove excess water and any deleterious materials that may have entered the tanks. f. Cleanouts along the private interceptor main sewer need to be finished. Their terminations shall be in accordance s. Comm 82.35(2)(d) and (5)(a), Wis. Adm. Code and the desires of the owner(s). 4. Until this system is approved for use the owner of Lot 6 will need to maintain the sanitary sump as a holding tank so as not to allow wastewater to flow to nonfunctional down stream components. 5. It is recommended that there be a method be utilized to remove and service the sewage pump in the exterior sanitary sump from outside of the tank. The present arrangement, although not a code violation, will present a major problem from a confined/hazardous space entry perspective for the owner. Page 2of2 April 21, 2010 Lot 6, Cotton Ridge South Please see that the above discrepancies are corrected by May 21, 2010. The plumber will need to contact either the county inspector or me for an inspection of the corrected installation. If you have any questions regarding this report, please contact me. Leroy G. Ja4ky, PS V, Wast ater Specialist leroy.jansky@wisconsin.gov E-mail 715/726-2544 Voice 715/726-2549 Fax cc: ®County 0 Plumber ❑ CST ® Owner ® Kernon Bast, Developer Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 515180 0 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: City Village X Township Parcel Tax No: Lisowski, Mark & Elizabeth Hudson, Town of 020-1479-06-000 CST BM Elev: Insp. BM Elev: BM Description: Section/Town/Range/Map No: 5 `2'~ 36.29.19.3027 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Benchmark 'Cat Dosing ►uV / `~(J Alt. BM eratio I~IUT 0 00 Bldg. Z- Holding SVHt Inlet 9s oo r s- SVH Outlet TANK SETBACK INFORMATION r S (v 9 TANK TO /L WELL B Vent ntake ROAD Dt Inlet V~~-S~ •5~ violet S 9 /Dl • s~S c Dt Bottom Z ~ vn~ D In ' 7D, gh Header/Man.( eration ^ f /7f Dist. Pipe / w. v ti Holding Bot. System ~ Final Grade PUMP/SIPHON INFORMATION OT %Nr'r~'r q p Manufacturer (i(_0 (NG4L GPM Demand ~ver ' i'xj~ L~ ~o ! 6• G Model Number 30 GjrrK TDH Lift Friction Los System Flea TDH J Ft 17, /u Forcemain Length Dim 3"I Dist. to Well 0 SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR Type Of System: UNIT Model Number: DISTRIBUTION SYSTEM Header/Manifold Distribution x Hole Size x Hole Spacing Vent to Air Intake Pipe(s) Length Dia Length Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil Ippp❑ Yes 0 No ❑ Yes E] No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1:~/ / Inspection #2: 3/027 Location: 873 Yost Rd. Hudson, WI 54016 (SW 1/4 SE 1/4 36 T29N R1 9W) Cottonwood So, t"h '07 LLot 6' A" Parce'l"Noo: 36.29-.1.9..L2~ 1.) Alt BM Description = ~~~U%1n ~+ltl'' JZCXV7~t~D>c ok pf!.~.Q bY~-~cU.r~. ~Y 2.) Bldg sewer length = .20 - amount of cover = 144(0;j Qt.IP,2 vi'WU C~~ Plan revision Required? Pets a FMM-]*No / q Use other side for additional information. / I Q l G SBD-6710 (R.3197) Date Insepctor's Signature Cert. No. Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: (ATTACH TO PERMIT) 506145 0 GENERAL INFORMATION State Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: City Village X Township Parcel Tax No: Bast, Kernon J. & Donalda J. S eer- Hudson, Town of Z 020-1479-28-000 CST BM Elev: Insp. BM Elev: BM De n ion: Section/Town/Range/Map No: G / - CS7- 36.29.19.3049 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Sew yt p i S Benchmark 7 10Y /0 e) Dosing o~~t DGO Alt. BM Aeration D Bldg. Sewer we"rg St/Ht Inlet TANK SETBACK INFORMATION St/Ht Outlet TANK T P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet n I ^ ^ L _ 9 Z 95 Sez/n (A 17C~Y~ Septic Dt Bottom Dosing Header/Man. Aeration Dist. Pipe A,'/ ~w Holding Bot. System lp S q. q 57.3 PUMP/SIPHON INFORMATION Final Grade y s /00, - Manufacturer ;K Co fina clo GPmNtand llfi ~J,7S /0 9 Model Number N e- e- /0 14 Z 9V TDH Lift 3~ Fricti n Loss System ad n)H Ft q' 3i5- 101, 2 ` Forcemain Length Dia. q Dist ~II . 3 Z CIE% %~t i LTA 7~ SOIL ABSORPTION SYSTEM 6 O /0 f ~p - S awt4IT BED/TRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Pits Inside Dia. Liquid Depth DIMENSIONS 3 I/as / SETBACK SYSTEM TO P/L BLDG WELL K TREAM LE G Manuf~c r INFORMATION OR C Type Of System: ~ 2-71 'V 'PBER /J) h A' A I~/ UNIT Model !Z V DISTRIBUTION SYSTEM 61S Head Manifold TDistrib t x HoleSize x Hole Spacing Vent t Air Intake 2 ipe) ~ L /Length Dia engDia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Centers f Bed/Trench Edges Topsoil 0 Yes M No 0 Yes ❑ No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / /0 /0:2X Inspection #2: Location: Settlement Dr. -Common Septic System lots 6 - 11 Hudson, WI 54016 (SE 1/4 SW 1/4 36 T29N R19W)/Cotto Parcel No: 36.29.19.3049 1.) Alt BM Description = `7J ~G2~' ~~1T1 ~~li(f 2.) Bldg sewer length = UUU Z' - amount of cover 417, i"y 0) 5-, _&,d/ -~4~ dlt~_ LDT & Plan revision Required? ❑ Yes No D D l0 Use other side for additional information. SBD-6710 (R.3/97) Date Insepctor's Signature Cert. No. 184. 41 , . ► 2124 no It weti t~ 4 ' wl4l yO. ~ t ~ ~ f •Y a•r•s.ei•■ltas.•s1.4+ta■resr.,, ara■r ow '~i7 //r ~ ~ 3....~ . sits F l7 VIELL /D s za 2.00 Acres f U(? )M't 871125 SO. FT. 200.74'` S, +aa.ns~~r►rs•aarwk+rww.tt+►y1{Mf+r.~. ~i~r~w►sa t•.rnq■ w. w./ni• ♦•wr♦i■~+.+A.~••a►•w i. ~ t"r ~ I ' ~ m pf G V, L-2 -2z J i ~ ~W 200.75' 212.59 No TH UNE OFTHE SE114 /U -~_I-vis-~~QQ~ I,US(3 ~ 4v D Z N D M m z 61 " 84„ c D 0 42„ M z v r m O n~ M M m rT-up 41" / ~+1 x 4" CAS \ \ . / 0 M m 3" 37 4„ I o, I D < < n I N m UP 39" m 1 r- p D i~ (A 4" CAS \ m D / N I \ / N v ~ C M m J0 N0 O O :O D C ODD M v 40" ~ v< o M DZ N - mDr I N m r- 0 m D t%1 mm~ D 0 r XM OX D Z G) M v_ C DO 0 --4 D Z O O.0 3 Z~ ?5 A -1 0 n D Z Z v --I M --l r m 0 =mom* N ~r m~ N D z~~ G7 Cn0 C) O~z D~zprT1C mD00~0 C --4 5Z > C)o iz~ xX - z v r-O v Fl i~ - ~n0 X00 SD N S=mOrN z s 2D N ~rZ 0 ~ZC ~U)C r °m -rn . CC N~ 0mm C) W r17, M Kz ZO S N r Z OD 1M nDm D D0N~4°~ G -40 z O M D 0 aD m~ D D r N U) << D N ~ N N I*I = v v D z o~k 0O Z D f~ m O ~o NmD I m r J r~r pc7- m o a m n U T` G7 N s C ONO Nvm Dr N s sm OD 01 < o o c Q N N58 0 z0 Z c mMm cam p ~A- O z ca (A OD r m m z o O <<'~ z My D D m0 v lc~ vD w °m 3 m C)C -n ao ~l O D v0 \ =rZ r0 Wrn0 m v m a H y E! m z A 0 Z D-tkv OJ O D -4 0 Z4 ;d > 0;0 O r z C m O --q OM OvC ~C7 En a) -0 0~ v N Z CD 0 Z z ~ p A~ O mr rn W 0 v z r C A H 0 N 0 ;0 z :L ITI Z r M \ = WLP750-MR WIESE~ COtICAETE DRAWN BY: SME ISCALE: 1 4"=1'-0" PRE-POUR: m REV. n ~ SEPTIC MANUAL W3716 US HWY 10 MAIDEN ROCK, WI 54750 DATE: JANUARY 2010 DATE:. POST-POUR: \ ° REVISED JAN. 2010 800-325-8456 FILE: WLP750-MR rAr-pt PUMP CHAIAbE,R CROSS SECTION AIUG SPCCIF'ICATIOUS vLUT cAP y" C.I. VENT PIPE WCATHERPROOr APPROVED LOCKIMr. 2S' FROM DOOR, JUNCTIOU BOX MANHOLE COVI=R WINDOW OR rRE7SH 12"MII.{. AIR IAITAKE GRADE I I w° MII,! I 7MIU. co~IDI~I~r IB"MIN. - - - IIllL1:T PROVIDE AIRTIGHT SEAL I I14 II * A ( !II I I I At,AKM a ~ II. I E 0 *APPROVED ( I ou JOINTS WITH I CL€,v - . FT APPROVED PIPE 3' ONTO PUMP r OFF D SOLID SOIL COUCRETIL BLOCK RISER EXIT PERMI-ITED WJILN IF TANK MAWUI=ACTUREIt HAS SLICFI APPROVAL, SEPTIC f SPEC-If pDSE TAI.IKS MAUUFACTUREK: DUMBER of oosE9: PER DAN t 't'AWK SIZE: GALLOWS DOSE VOLUME ALARM MAf.IUFAGTUFt£It= ~ Lr Yrvw IMCLUDIMG BACKFIA)W: GALLOWS MODEL 1 IAIS€R: ~ CAPACITIES.' A-...2~E IIJCHCS OR . -ZI1.0A1S SWITCH THPEI 101,2e, c 20.2t $ = ~IMCNES GR 3441 GALLOMS PL rAp MAMUFAC"f URER: n+-tGl/ if""~~~ C = ,j ILJCHES OR GALLOUS MODEL MUMAEA: 4) 5 d ..ZEUl - D = WCHES Olt GALtbf`i 5W17t1i TtIPI:: YC NOTE: PUMP AMD ALARM ARE TO DE. MIMIMUM DISCHARGE RATE ~GPM INSTALLED OW $EP&RATE CIRCUITS VERTICAL. DIIFFEREIQICE 6126TWEIZU PUMP OFF AuD DISTRIBUTIOIJ FIPC.. 12'!5 FECT + MIPJIMUM METWORK SUPPI_ti PRESSURE ' F=EET 4. _ G 3 . F€ET OF FORCE MAIM X lfF p rtFRICTIOU FACY+pR.. FEES` TOTAL. D9WAMIG HEAD "FEET IUTERLIAL DUAL .]SIOMRb OF TAlldK: LF.I.IGYH ,WIDTH -;LIQUID DEPTH .7 G.~ ~ - LICt:>L1SE DATE' Sep' 24, 2010 11:40AM No, 2884 P, 1 RGOULDS PUMIIMP Submersible Sewage Pump i WS.__B Series Prosurance available for rkSiderrtla) applications. APPLICATIONS component damage on • Built-1n overload with without damage when fully accidental reverse rotation. automatic reset. submerged. Specifically designed for the • w Fasteners: 300 series SIMW or STOW severe duty ■ Power Cable: Severe duty following uses: o;) and water resistant stainless steel. rated, oil and water resistant. • Homes power cords, E seal on motor end * Sewage systems w Capable of running dry . 'Is and HP models have pa + DewateringiEffluent without damage to NE ndA HP prong provides secondary moisture three •watertransfer barrier components. grounding plugs. dammn a case of outer jacket ■ Designed for continuous „ a damage and to ptevenfi oil !Q HP and larger units have wicking, Standard cord is 20'. SPECIFICATIONS operation when fully bare lead cord ends. stbmerged. Three hale (ii0 Hz): optional lengths are available. Pump: p 0 Motor Cover O-ring: • Solids handling capabilities: + Class 10 overload protection Assures positive sealing 2" maximum. MOTOR must be provided in against contaminants Size: 2" NPT. separately ordered starter and oil leakage, Discharge ■ Fully submerged in high unit. • Capacities: up to 185 GPM. gtade turbine oil for lubrication . STOW power cords all have • Total heads: up -to 38 feet and effldent heat transfer. All bare lead cord ends. AGENCY LISTINGS TDH, ratings,are within the working to ~ Temperature: limits of the motor. Bearings: Upper and lower r~ataul7rsa,d heavy duty ball bearing 0A22.2109". WWd$ 104°F (4011C) continuous insulation, syolimdiansmndr,rds 140°F (609C) intermittent, ■ Class B insu construction. Assa vdan single phase (60 Hz): ■ Designed far Continuous CM us pla*U08M • See order numbers on « All single phase models Operation: Pump ratings are eoft PUMPS is 1509001 RegWred, reverse side for specific HP, feature capacitor stark within the motor manulaCtUrer% voltage; phase and RPM 's motors for maximum recommended working limits, available, starting torque. Gn be operated continuously EEATURt S M61'FR9 ,per . I I,,., M„r....,_ ,s 30 . SERIES WS-13 { M impeller: Cast iron semi- I I i ` ! 21 SOLIDS 1 open, dynamically balanced, j 1 } PM 1750 non-dog with pump out vanes 40 i........,~,,.., ,,,....;.,.,,..,i_. mr,.,._..1...=.~' i _i.... ~.,....j I for mechanical seal protection. I ! SEE optional Silicon bronze impeller available, g so _ 1r Casing; Cast iron volute type fat maximum efficiency. W9051 Designed for easy installation on A10-20 guide rail, I wsa9B ■ MoChanical Seal: SILICON CARBIDE VS. SILICON CARBIDE sealing faces for superlor abrasive resistance, ! . , . ' stainless steel meal parts, BUNA-N elastOrners. 0 20 ,oo +zo 140 160 ago 2004pm 0 Shaft: Corrosion-resistant ° ,d a° 20 zs ao as 40 45 Wjh stainless steel, Threaded CAPAQTM design, Locknut on all models Goulds Pumps to guard against 0n2003 Pumps tlvo Na1ovwember,ber, 2003 www,peulds,cOm Effective N21 ITT Industries <4> 03996 / IdC~4 ~ t 1 , ~ dU'If 3~ ~ 'I \ \ ~ o i3 / (1 ~ \ \ \ ` ` I ao~ c~ s o - /1 1 I I~~ dOO4(0~3 I W 'X N 41 25 L60=1051.5 / x' on \1.80=1050A J I I I \ \ --1- Y 'x s s / ; u"Di . _~~\I \ \ 1 \ \ 1 ` VIP camsxgRiv~ \1.60=1050.0-'fr J / 1 1 Is ccl / 2\ 4' \ I ) l / 40P F - -.1661 MR N lad . i \\1.1110=1046.0 \ \ I _j aI \ B - xonaE \LBO_10450 9 t \ \ \Il \ \ \ I OUTLOTI-I~ \ ~I- iyousE - / LLJ z \ \ \ \ \ \ , / / / / / Z z zu) i WRTER C \ \ \ 1. / / i / / / / w m \ l I I J LIJ = p J U Q TAILS ON SHEET 3. U Co a > UNLESS OTHERWISE LLJ v IT RUNOFF FROM DISTURBED Seed LiJ Q N ND O SEPTIC AND STOCKPILE Mixture ml Areas of Use Species Pro, tins Seeding Rate ,DNS AS NEEDED. er V' O Z Kentucky Bluegrass D SHALL CONFORM 2Q L dry, wdl-dralned, 6 3 ~s/ 1000 sq ft N OF WISCONSIN DOT Y. or gravelly sods Hard Fescue 24 OR f- p 'ED, UNLESS PRIOR and high cut do fill slopes T~ Fescue 40 130 Ibs/aue Li l z = IF CONSTRUCTION Perennial Ryegrass 30 Y 'THE RATE JT SEED ING OF 5 SHALL BE Z O C CHBE~COMPLETED Q 'PLETED AT A RATE OF THE ° I NRTN 10 g m U )WN. SEE DETAIL SCALE 0 50 100 Y00 SHEET NO. w L i zzz. \ LN=1041.0 / r -LBO 1041.0' 20 26 75FT O.N.W.AI. SETBACK I ! £ ~ ; \ x' lei 24 of ( LBO 1038.0 k.~~~'/\ ieo?oZO gof 21 2i\ 23 x al r Le0=10420 - 1 M- POND 6 ~NWIy=1036.0 ~c \ I \ 1 \ \ \ \ k POND 1 ( NWL 10385 I ~ l NWL 1059.®~~ LOUTIN ~ ~ i - _ ~ • r = \ ,1---rte-= - - I - ME LWATION \ ' Ili I II ICI I i \I I ( i iz i LBO 11046.0. ° ' l \ I I, I I ~ ~ I I II I I ~ W ~ I ~a'~j LBO=1oas.s ~ l III I it I~ 1 llI 14 i o i' I►; , III, I fll ss~ I I WI , I C N - (L80=?16043 0 15 I I I I a ' 'SEPM a 1\ ( I~ I i I II Ij LBO=1043.0 I j I I v I -09n0T 2 _ \ IIII\ \ , / III - I Il 14 I i I I`F Lr L 1.110=1043.0 is I \ III LBO=1046.0 I l X. N \ \ _ _ \ I IJ ~w«~ 75FTO.N.W.M. \ J -POND 7 -yam -f - - I SETBACK l Irv \ \ J~ HWL=1099.0 LEGEND NOTES: _ 1. INSTALL EROSION MAT ON 4:1 SIDE SLOPES OR GREATER AS PER D EXISTING LOFT CONTOURS EROSION MAT TO BE VASDOT CLASS i TYPE B OR APPROVED EQUAL. NOTED. W / l EXISTING 2FT CONTOURS 2 AREAS OF THE TO BE SITE. ASDDIT ONAL SILT FENCE MAY BE REQUIRED AR ' AREAS. SEE DETAIL SHEET 3 FOR SILT FENCE INSTALLATION. V) APPROXIMATE HOUSE LOCATION 3. INSTALL SEDIMENT LOGS AT CULVERT INLETS AND ANY OTHER LOCAT N (ACTUAL HOUSE LOCATION MAY VARY) SEE DETAIL SHEET 3 FOR SEDIMENT LOG INSTALLATION. 0 CONSTRUCTION VEHICULAR 4. SEEDING AND MULCHING ARE REQUIRED ON ALL DISTURBED AREAS A o TRACKING PAD TO SECTION 627 MULCHING AND SECTION 630 SEEDING OF THE STATI STANDARD SPECIFICATIONS. SEED MIXTURE NUMBER 20 SHALL BE U. 4 75FT ORDINARY HIGH APPROVAL BY THE ENGINEER. TEMPORARY SEED SHOULD BE APPUEI Ln WATER MARK BUFFER EXTENDS PAST SEPTEMBER 1ST OF ANNUAL RYEGRASS AND OATS AT (V POUNDS PER 1000 S.F. OF AREA AND LEFT OVER WINTER. PERMAN o . - - - - - - - - - - - - - - - - - - - COMPLETED THE FOLLOWING SPRING. IF TEMPORARY SEEDING CANNO' i 100 YR HIGH WATER LINE BEFORE WINTER FREEZE UP THEN ALL DISTURBED AREAS WALL BE M r'! 120 POUNDS PER 1000 S.F. AND PERMANENT SEEDING SHALL BE Ca. FOLLOWING SPRING. DRAINAGE EASEMENT CL 5. INSTALL VEHICULAR TRACKING PADS AT DRIVEWAY LOCATIONS AS SH N LBO=)000(.X LOWEST BUILDING OPENING ELEVATION SHEET 3 FOR VEHICULAR TRACKING PAD INSTALLATION. i eommerce.wl.gov Safety and Buildings Division County 201 W. Washington Ave., P.O. Box 7162 Madison, WI 5370 6 by Co.) 'se n ' I ~ ~ ~ I ~ Sanitary Permit Number (to be filled in 0epartmertt Of Commerce 5/5 / S Sanitary Permit Application State Transaction umber In accordance with s. Comm. 83.21(2), Wis. Adm. Code, submission of this form to the appropriate governmental unit is required prior to obtaining a sanitary permit. Note; Application forms for state-owned POWTS are Project Address (if different than mailing address) submitted to the Department of Commerce. Personal information you provide may be used for secondary ~64- &1lw- L ur ses in accordance with the Privac Law s. 15.04 1 m Slats. ~ $ 73 A lication Information -'Please Print All Infor on tir-CEIVI ED Property Owner's Name Parcel # ~Ys22009 aao_ /~7 A- aG-aao Property Owner's Mailing Address Property Location NNING & ZONING OFFICE Govt. Lot - City, State Zip de Phone Number '50)-,, $ y,, Section 0 ctrcle one) 7-9 14 II. Type of Building (check all that apply) or W Lot # T_ N; R E or W Subdivision Name 1 or 2 Family Dwelling - Number of Bedroom 1sJ►~ Block # 4 d/tJ d 4 et s:1,4,yYA ❑Public/Commercial-Describe Use Vl~ ❑City of ❑ State Owned- Describe Use CSM Number ❑ Village of k ,Town of G Ill. Type Permit: (Check only one box on line A. Complete line B if applicable) A' New System ❑ Replacement System Treatment/1le ing Tank4bopiwswom .Only ❑ Other Modification to Existing System (explain) 00- B• 11 Permit Renewal El Permit Revision El Change of Plumber ❑ Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Owner IV. Type of POWTS System/Component/Device: Check all that a I ❑ Non-Pressurized in-Ground ❑ Pressurized In-Ground ❑ At-Grade ❑ Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil El Holding Tank ❑ Other Dispersal Component (explain) Pretreatment Device (explain) L7csd/y,S V. Dispersal/Treatment Area Information: Design Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal Area ReqT(sf)Dispersal Area Proposed (sf) System Elevation VI. Tank Info Capacity in Total Manufacturer Gallons Gallons v New Tanks Existing Tanks o r/Ot - ~p w" U fn v, w c7 a Septic or Holding Tank Dosing Chamber VII. Respongibility Statement- 1, the undersigned, assume responsibility for installation of the POWTS wn on the attached plans. Plumber's Name (Print) Plumber's Signature YYMPRS Number Business Phone Number .,,I /I a Aur Lc> moo? /S ~3 - 3l~ Plumber's Address (Street, City, State, Zip Code) VIII, Coun /De artment Use Only Approved Permit Fee Date I sued lssuin ent Signs re 9Reason for al $ Y~ 27 IX. Conditi~iHAliAl6Rpasons for Disapproval 3~ 1. Septic tank, eftluent filter and J .1 ~ C. , a dispersal cell must all be seivk:es / maintained r ~5 ~l t n- v as per management plan provided by plumber. r/1t L4- 1r 2. All setback requirements must be maintained I as per applicable code I ordinances. ` Attach to complete plans for the system and submit to the County only on paper not less than 8 in x 11 inches in size 7, q , th SBD-6398 (R.02/09) alid thru 02/11 t d.~i s~ ~^!Jj / P ~.ww a. fr mow. rltlre4t it, i~olxlljjjjplll~ U-- , i •t♦tir..sw.k / ii...~~ii E r ~sflHee 2.00 Act ~ 87J25 SQ. Ft. 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W ~ I .t'sc i ~ o ~ o N I I ~ a , 1 J 59 n, Document No. IIIII IIIII IIIII 11111 lilll 1!111 1111 llilll 1111 1111 * 9 0 5 9 5 8 1 POWTS AGREEMENT 905958 BETH PABST REGISTER OF DEEDS ST. CROIX CO., WI Owner name and address: RECEIVED FOR RECORD 10/26/2009 11:35AM Mark J. & Elizabeth A. Lisowski AGREEMENT 873 Yost Dr. EXEMPT I Hudson. WI 54016 REC FEE: 11.00 PAGES: 1 This indenture, made by "owner" and their successors in interest, own a POWTS (Private Onsite Wastewater Treatment System) requiring regular monitoring and maintenance in accordance with the manufacturers recommended Return to: J - procedures. These procedures must be performed by a manufacturer authorized Jim Thompson service provider licensed by the State of Wisconsin to perform these services. Results of these procedures shall be reported to the appropriate Governmental 340 Paulson Lake Lane Unit as required by code. Osceola, WI 54020 Location of PO WTS: Parcel ID#: 020-1479-06-000 Lot: 6 Block: 6a1 Subdivision/CSM: Plat of Cottonwood South being part of SWIA SE'/,, Section 36, T. 29 N., R. 19 W., Tn. Of Hudson. St. Croix County, Wisconsin. POWTS DESCRIPTION: Wieser Concrete Bio-tank with Boot systems H-600A pre-treatment unit, pre-treated effluent discharged to mound dispersal component constructed in compliance with Mound Component Manual, SBD-10691-P (N.01101). OWNERSHIP RIGHTS AND RESPONSIBILTY FOR POWTS: Property "owner" as described holds sole ownership rights. "Owner" is responsible for insuring inspection, operation and maintenance of POWTS. ce 12'q to, ( er si store) (Date) (Owner signature) (Date) Acknowledgement: T Mark J. Lisowski, known to me~ be the pens n ex cut' the foregoing instrument. cribed 'dc worn to beforeme this day of , 2009, a Q 4Z. -20 . , State of Wisconsin ` RY C 4tt `M}~Cotmrt ' Expires: October 23, 2011 r Instrument Drafted By: James K. Thomason 1 of 1 r POWTS SERVICE CONTRACT The proper operation and maintenance of the components listed below will significantly influence the performance and life expectancy of the POWTS (Private Onsite Wastewater Treatment System). This agreement authorizes A.C.E. Soil & Site Evaluations, L.L.C. personnel (Service Provider) or their representative access to the POWTS components during regular business hours to perform regular inspections and routine maintenance of those components. It is herby agreed by and between Owner and Service Provider that in consideration of the payments provided for herein, Service Provider will provide a manufacturer trained and State licensed inspector to perform periodic inspections of the POWTS components as set forth below. Service Provider will prepare a written inspection report after each inspection containing any recommendations for the operation, maintenance, and or repair of the POWTS deemed appropriate by the Service Provider. A copy of the report will be provided to Owner and the appropriate Governmental Unit. Service Provider will supply additional services, parts, or labor only after authorization by purchaser. This agreement does not assume any responsibilities or obligations that are normally the responsibilities and obligations of the Owner and does not cover any costs associated with operation, maintenance and or repair of the POWTS. In no event shall Service Provider be responsible for any special or consequential damages, including but not limited to, loss of time, injury to person or property, or incidental economic loss due to equipment failure for any reason whatsoever. This agreement will be automatically renewed each year unless amended or cancelled by either party with 30 days written notice. This agreement may be cancelled by Purchaser only if replaced by a service contract with another service provider authorized to inspect and maintain the specific POWTS components in question. Purchaser agrees to pay Service Provider the sum of $ 125.00 per inspection. Four (4) inspections will be provided over the first two-year period at six-month intervals. Payment for the first four inspections will be included in the cost of the POWTS design. One (1) inspection per year will be conducted thereafter with inspection fees billed at the time of inspection. Any additional fees for effluent quality testing (if needed) will be approved by POWTS owner prior to sample collection and submittal to lab. POWTS DESCRIPTION: Wieser Concrete tank with Hoot Systems "H-600A" pre-treatment unit, pre-treated effluent discharge to Mound dispersal component constructed in compliance with Mound Component Manual, SBD-10691-P (N.01/01). POWTS LOCATION: 873 Yost Dr., known as: Lot 6, Plat of Cotton Wood South, SW'/4 SE'/4, Sec. 36, T. 29 N., R. 19 W., Tn. of Hudson, St. Croix Co., WI, Parcel # 020-1479-06-000 Owner name and address: Mark J. & Elizabeth A. Lisowksi 62 Loughney Bay Hudson, WI 54016 ID12'~~09 (Own ~ ature) (Date) Service Provider: o Site Evaluations, L.L.C. James K. Th mpson 340 Paulson ake Road Osceola, W 54 S. ~ (S ice Provider signature (Date) Instrument Drafted By: James K. Thompson i Hoot Aerobic systems - Hoot Aerobic System Page 1 of 2 4uw[ a4Li[r~_ - OT S YS T E M S .2885 Highway 14:E, - Lake Charles, LA 70607 1-888-878-HOOT 337-474; Homeowners Manual Maintenance Items to Avoid Medication Warning Water Softener Info Troublesho, TO E-MAIL HOOT SYSTEM TREATMENT PROCES: HOOT Hoot Hoot BNR LA Hoot ~f Louisiana Hoot r r 4 . Commercial Help Me k - r Choose Page The efficient five-stage HOOT treatment system is designed with 1. Pretreatment tank where influent enters. 2. Aeration chamber where oxygen is pumped into the waste water. 3. Clarifier chamber where the clear, odorless effluent rises. 4. Chlorinator where the clear effluent passes through for disinfection. 5. Holding tank for disinfected* effluent ready for discharge. 6. Extremely quiet, efficient aerator and pump. 7. Unique solid-state HOOT Control Center monitors and controls the 8. Discharge Pump The HOOT Aerobic Treatment System is a complete five-stage, one p treatment system. This feature-packed aerobic treatment system opel municipal treatment plant. o The simple one-piece design of the Hoot System saves installatioi money. http://www.hootsystems.com/systems/hoot.html 10/27/2009 Ha •T Y www.hootsystems.com R Ins W1 A Hoot Don't Pollute LCe.,*,1.fie,d to Oncite Ready H -Series Gravity Treatment 5y r40 stem NSI Monitoring Green Choice Applications: :.,It, Single and Multi-Family _ - Dwellings, light commercial, { r - - _ r Churches, and other similar j Residential strength uses. _ Performance: 98% Reduction CBODs 1 \ 99% Reduction TSS 99% Conversion of Ammonia (NH3) i Fecal <1,000 w/o disinfection iF-.•,; 1 Range of Sizes: ri 500, 600, 750 & 1000 GPD High performance, low cost, energy efficient treatment system The H-Series Gravity Treatment System provides high performance at a price comparable to most entry level ATU's. Producing effluent of less than 3 mg/L on CBODs and 2 mg/L on TSS, it far exceeds the secondary standards of 25 mg/L on CBODs and 30 mg/L on TSS. With these results, many locations allow reductions in disposal areas between 25 and 40%. Because the H-Series completely transforms ammonia into nitrate, it is best suited for applications with rich organic soil content, surface plant growth and depth to groundwater to prevent nitrogen pollution of the water table. Simple installation, reliable performance, low cost of ownership This level of performance is enhanced by its simple installation, energy efficient performance and low cost long term maintenance and ownership. The systems components are assembled at controlled manufacturing facilities, rather than in the field, to ensure reliable performance with local support. Energy efficient, environmental protection Made of locally available and manufactured concrete, the H-Series features an energy efficient linear compressor that uses less power than an average light bulb. Its polyethylene clarifier hopper is made of recycled milk jugs. Choose Hoot, and you make a sensible, decision to protect the environment as you protect our most precious resource, our water. Drainfield and Vertical Separation Reductions With gravity flow discharge, the H-Series allows you to choose your disposal application from conventional lateral lines, leeching chambers, other alternative drainfield materials. In some areas direct discharge is an option as well. Reductions of vertical separations to groundwater and impermeable layers such as rock range from 1 to 2 feet. Make the green choice for wastewater treatment Your wastewater system is the most expensive and important appliance you will ever purchase. Don't settle for just any system. Protect your family and the environment with a Hoot H-Series System. Wieser Concrete Products Inc. 1-800-325-8456 www.wieserconcrete.com Hoot Aerobic systems - Hoot Aerobic System Page 2 of 2 o A long-life, state of the art computer manages the system. It operE for efficient, effective low cost operation. o The Hoot System computer monitors and verifies that every comp properly, without opening the system. It is much more than an idiot lig o Committed to the protection of the environment, we have made th preferred wastewater treatment system when there is no sewer conne poor soil conditions or there isn't enough space for a traditional syster o With our Warranty we stand behind the Hoot Aerobic Treatment S percent longer than the industry standard. We can do this because of design and manufacture. o Contact your local Hoot Aerobic Treatment System Area Represe more information. i Site design by CPU Grahics. Inc • Copywrite by Hoot Aerobic Systems, Inc. 2005 I http://www.hootsystems.com/systems/hoot.html 10/27/2009 1 VjQ111 i4rU * wfaifszam r. WWI T ST. CROIX COUNITY SEPTIC Ai'i ~~K NIFA 11N AVie W ffi f's~#€.,'Ernn'~'?tFT` aN;~ OWNERSHIP CERTIFICATION FORM Owne?t/H yer xviiallutg mess (,p 2- Lp Property Address ----~7 3 Ranning _ _ rr V.-~,a.i..u 4ctiia.cSL uidL tvn8 DMarh"Mt fnr.tM av-rnnois,rere:.+., t CitylState-2 ~ Parcel Identifil'afion Number Property Location 1> 01/4, 56114 , Soc. alp , T Z 9 N R M W. Town of -9'VJ60 e-%- Subdiv sion Go 14-6A.LJ 06C ~ So J Certified Survey Map # Volume , Page # Wft- Deed It $ ~~'711r Spec house yes no Lot lines identifiable yes no SYS'T'EM M,41tNU-MANCR A?' ; s1~TNTVV vvu- r-m. .sue. rise and maintenance of your septic systmn could rwilt in its premature failure to handle wastes. Proper Waintenance consb% of pur Ving out the septic tank every three yeah rr sooner; if needed, by a lice-Wed port r. What you put into the ¢ya!ent a aft ct the %Fiction of the septic tank as a tt'eatment stage in r nsilirl Rn~-e. } A r7r.s _ _ the avaste disposal sy m, .lt€ r ir?ftst€Tt~stune . ttk"s u.~ as3±~'c-3lr.ri :n n. . Aft Prey owl agrees to submit to St. Croix County Pie wring & Zoning Department a certification form, owner and by a tteaster plumber, journeyftM Plumber, restricted plumbr r or a licensed . veri srS Y w,•as'.ewater disposal system is in ,,roper /yamatr ' fY that (e j the on-site le=aq Own °a f•$ A41 ..r wF. j- lt'~"Y"' ~p~+n~ con~tion and/ r /71 n-R-- ft%spect:on 'G'tA -aw- r.ir"is (gf±~nsisnn...et f';,-. -s y war, nnaersrgned have read the abo* r smndatds 9d ft* as set b equrrerrr~ts and 71r re to marntartl the private sewage disposal with the in, the s5'a t, Y Tkpartnrcnt of Cormmerce arx Irene a ~ fteaticrn sr • p t of Natsnal RESOw-ems .;ra- that your septic system has been maintained of Wisconsin 90D tUtwt N et► le!3-d and re~*.r@~ _ .s$'`sFa~?t:# 232rf`e.'.d t.3 9# Pjrnr+r wnerda. 09~-~ u we cevaty rant all statements on this form am true to the be:;t c f my/our knowledge. Uwe arWare the owner(s) of the Property deunbed above, by virtue of a warranty deed reenrdeed in Re gic per of Deeda CMA-4. SIUNATURE OF APPz ICANTrSI w1 ■.AL atroaa is InrarEted may resuk in the sanitary E ernut being revoked by the Planning &ging Department, *s re~ isbr-Ade i !t Application dw- a rewrded warranty deed from the Regis`er r f I~eeris Office a,rd a fin` ~.f fry: r. : Ea « A • tl Slf~t<F9lfFSr t!+•. t I * 8 7 1 6 1 878716 STATE BAR OF WISCONSIN FORM 2- 2000 KATHLEEN H. WALSH REGISTER Of DEEDS Docuxnase Number WARRA IVTY DEED ST. CROIX CO., W1 RECEIVED FOR RECORD THIS DEED, made between Kernon J. Bast and Donalda 1. Speer- 07121/200B 03:00F" Bast, husband and wife, Grantor, and Mark J. Lisowsld and Elizabeth A. WAf1RANTY DEED Lisowski, husband and wife, Grantee. EMT I Grantor, for a valuable consideration, conveys and warrants to Crantee REC FEE: 11.00 the following described real estate in St. Croix County, Slate of Wisconsin: TRANS FEE: 353.70 Parcel l : PAGES: 1 Lot 6, Cottonwood South, St. Croix County, Wisconsin. AND Parcel 2: Recording Arum Together with an undivided 1/6+ interest in Ouflot 2, Cottonwood South, St. ' Title and Return Address:3,e Z-- ' Croix County, Wisconsin. Ed. (M 4W S. - Suite 115 \ Exceptions to warranties: Hudson. WI 16 1 Fasements, restrictions and rights-of-way of record, if any. $71705 'Metro Legal Services 020-14794)6-000 EDQ2ET 871705 A Parcel tdendrWation Number (PIN) 908251 1tD 48(1695 This is not homestead property. 1~1t~LIC, Da 9th day of July, 2008. > 1MMtAP~.1M! ~IQ{,tl11 r Keeton 1. Bast ' Donalde J. 5 d~st~" * s AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF WISCONSIN } ST. CROIX COUNTY. ) ss. authenticated this 9th day ofJuly, 2008 Personally came before me this July 9, 200$ the above named Kernon J. Bast and Donalds L Speer-Bast, husband and Wife to isle lmmm to be the person(s) who execxtted die TITLE: MEMBER STATE BAIL OF WISCONSIN fore inst un met and acknowkdgat ft saute. (If oat, authorized by § 706.06, Wis. Stets.) THIS INSTRualFxr wAS MAFrED av *Pamela A. Willman Notary Public, State of Wisconsin SO East Peterson, FiRlu Frain Stre eet t c. Par►aul, , MN 55 N 55 10 01 Hrum My commission is p~ennanent. (If not, state expiration date: , SttP 1!212011 ) (Signatures rray be aubaeticstod or wknowtedged. !loth m not necessary.) Pamela A. Willman Names of penam signing in any capscitymust be typed or primed bebw lttei<signdat Notary Public State of Wisconsin WARRANTY bBED S'L'ATE 9" o>: WWONStN FORM N0 -M tuft I~ 29.1 q. -M z~ CONTRACTORS/CONTACTS LIST (Lot (D - Cottonwood South) N JSID OCR 212~~g L.pt OwnerlFiM licant oN`NGpFF~~E G~00 S ~ Ceneral Contractor hgkeli Pff C rt G Excavating Contractor ~~PS Erosion Control Contractor `7 Sgt is System Contractor e- A" Well Contractor 7 Y SAMPLE PROJECT NARRATIVE (Lot -6- - Cottonwood South) Written Description and Request: The project site is located on Lot J(p within the Cottonwood South Subdivision located in Section 36, T29N, R19W, Town of Hudson, St. Croix County, Wisconsin. The project will include the construction of a single residential driveway and activities associated with the construction of a private single family residence. A private well and private septic (system or service line) will also be installed for this residence. The project will include the disturbance of more than 10,000 s.f. within the 1000 ft of the Ordinary High Water Mark (OHWM) of a navigable waterway/pond. This submittal is a requirement of a consolidated special exception permit that was granted in March of 2008 for all lots within the Cottonwood South Subdivision. A site plan has been developed for this lot and is included for review (see attached plan). The stormwater management plan for this lot was previously submitted, approved and implemented with the overall development of the Cottonwood South Subdivision. A copy of the Stormwater Management Plan and associated calculations should be on file with the St. Croix County Zoning Department and the Land & Water Conservation Department. No additional stormwater management is required for this lot to meet the county stormwater requirements or the performance standards described in NR 151. Stormwater ponds were constructed as part of the original development to treat runoff from individual homesites prior to discharging to existing waterways/ponds. Drainage easements have been established for all drainage ways and ponding areas necessary for stormwater management and their locations can be found on the plat of Cottonwood South. Approximate Construction Schedule: From: To: Month/Yr Month/Yr ~Cl ' C?!? -Initial Erosion Control Installation' + -Silt Fence & Tracking Pad e~ t ►oi cY~2vr~s -Initial Site Rough Grading/Building Exc vation sew w`I~ s 5odi ~v~~- l ~s . -Rough Grade Driveway _ ?Q -Construct House -Gravel Driveway -Continuous Maintenance of Erosion Control Devices P-02 d/d -Final Lot Grading -Final Erosion Control Installation -Erosion Mat (or Sod) & Seed/Mulch, as required j pz0lb -Remove temporary erosion control devices once a minimum of 70% vegetation has been established on the entire site r CHECKLIST (Lot _ci - Cottonwood South) Submit!Al Documents 12r Copy of Warranty Deed. Pf Copy of Sanitary and Building Permit (if issued). 13'-Project Narrative. Er'Contractor's List. G-'Site Plan_ 0" reconstruction Notice. 100 application fee. _ & $300 cash compliance deposit. - t Y e ; ~ Crrn~ LIT,t bt ®fas ,t 2"'Photographs of the site following the completion of construction. Site Plan - General Reouirements GY"Lot/Parcel dimensions, easements, and setbacks. 0~" Location of all existing and proposed structures. M' Location of all existing and proposed POWTS, wells, driveways, trees and other features. IT Location of navigable waters, OHWM, and highwater elevations associated with storm ponds. Site Plan - Erosion Control ►A It -e u O'Siit fence installed on the downslope side to intercept runoff from disturbed areas of the site J including the septic system and stockpiles of materials. Existing vegetative buffers may be -}used in lieu of silt fence depending upon site conditions. Nevices installed to protect existing trees. C~ Ditch checks/silt fence installed to protect road ditch and culvert as needed. e Vehicle tracking pad - driveway entrance. lid Proposed direction of surface flow upon final site grading. IT Winter Cessation plan/temporary seeding (if applicable). Site Parameters/Limitations *A separate permit(s) may be required by St. Croix County Planning and Zoning Department and/or the W1 DNR if construction on an individual lot includes any of the following: ❑ >1 Acre of total disturbed area on the site. ❑ >10,000 sq. ft. of disturbed area within 75' of the OHWM. ❑ >12% of the lot area consists of impervious surface (Additional stormwater analysis may be required to demonstrate that existing stormwater facilities are sufficient). ❑ Any activities that would require a deviation from the original stormwater management plan recorded for the overall development of Cottonwood South. L=3 i TA! 7te, 0; +►a►+•.•..a.ea♦►l.as..f.•i....y.r..Y ~IC~'C..Y/jnT 243.777 ~2.00 Acm C-4 87J25 SO. FT. Nod' 1 f4 200.74' / 200,74' fbft v7.rYJ re s 4 , 200.75' 212.56 N8 1H UNE OF THE SEil4 s Document No. 1 lull Il111 Iilll 11111 !1111 lull Ill! 111111 Ill! 1111 9 0 5 9 5 8 1 POWTS AGREEMENT 905958 BETH PABST REGISTER OF DEEDS ST. CROIX CO., WI Owner name and address: RECEIVED FOR RECORD 10/26/2009 11:35AM Mark J. & Elizabeth A. Lisowski AGREEMENT 873 Yost Dr. EXEMPT i Hudson, W154016 REC FEE: 11.00 PAGES: 1 This indenture, made by "owner" and their successors in interest, own a POWTS (Private Onsite Wastewater Treatment System) requiring regular monitoring and maintenance in accordance with the manufacturers recommended Return to: J j - procedures. These procedures must be performed by a manufacturer authorized service provider licensed by the State of Wisconsin to perform these services. Jim Thompson Results of these procedures shall be reported to the appropriate Governmental 340 Paulson Lake Lane Unit as required by code. Osceola, Wl 54020 Location of POWTS: Parcel IM: 020-1479-06-000 Lot: 6 Block: Na . Subdivision/CSM: Plat of Cottonwood South being part of: SW'/, SETA, Section 36, T. 29 N., R. 19 W., Tn. Of Hudson, St. Croix County Wisconsin. POWTS DESCRIPTION: Wieser Concrete Bio-tank with Hoot systems H-600A pre-treatment unit, pre-treated effluent discharged to mound dispersal component constructed in compliance with Mound Component Manual, SBD-10691-P (N.01/01). OWNERSHIP RIGHTS AND RESPONSIBILTY FOR POWTS: Property "owner" as described holds sole ownership rights. "Owner" is responsible for insuring inspection, operation and maintenance of POWTS. _ - ~7_ I&/Igto ( er si afore) (Date) (Owner signature) (Date) Acknowled eg ment: Mark J. Lisowski, known to me be the pers n ex cut' the foregoing instrument. cribed do worn to before me this day of , 2009. a Q. o 4 RY BL• , State of Wisconsin t~ Y MyfiCornm~i~tt.Expires: October 23, 2011 Instrument Drafted By: James K. Thomason 1 of 1 -T iv commerce.wo.g ~r~TM~ Saw and Buildings Davisior Coum~ I 201 W. Washington Ave., P,() [lox 71trl. t' F"O Madison. W1 33707_7162 r !i . ~1r! i co rt:rrent o! sin Sanitary Permit Number (to be Mod ire by Co) LS pQl• Permit Application ~ _ StateTrar~ssctionNumbcr Ire aacotdancc with s. Comm. 83.2 t(2), Wis. Adm. Cwe, subt•rtssion of this tbrm to the a E unit is required yriur to obtainin d sanitar ppruprrate govcrnit)emtal ~ flaw 34 c7c3 7 ZA 'o 8' Y permit. Note: Application forms lot state-owned POwIS are ~Pro'ec!Address(ifdifferentthanrtiuytgQdrtss) 1 ? sub:nirtecl to the Uepanment of t:omlrnsCC PClsallal inrornzattOn you piovide may he used for sece,mtlar} ~~u~r xtsrs rn~a~, u~,d~icr wirh tlrt Privac [ uw, s 1 S.U4 I) rn Stals ' A ►licatiort tntortnstiod _ Please Print ~ - + ! roi+crt;' UV.'llet "Y iVa!cu• ! 1'ropeny Ownt~ titaiiin~ Atklre l AP Property Location UNT 7~~ 9 C r ~LI~ C iiy, State J Govt- Lot `P ?.ip ode hone Nnnber Section (circleone 11. Type of building (check all that apply'} Lot p a~J AM) ttr2 Family Owelimg i r ut Btdronlt Subdrvieron Name 1 - Bttxk u L~ 1'u6t1G('nmmer,yrfl! • pnscritv. Ust r i ~ Crt•.• C4 State t)a•,rrS - Describe Use ❑ Village (it' r /O y i own of Type of Permit (Check only one bOx on line A. Comp ete fine 9 U applicable} tie„ System 0 Replacernent Spoem 'Treatment:iiuidur Tank Replacement Only R other MociiPicaur:n to i:r+surtyi Systw1! (explaui) ~~JJ It. ! OP ermit li-toial Q Permit Revision 0 Chan List Pros u,r',tb Permit Nt:m4er and Date issued I Change of Plumber D Permit Transfer to ?vew i Before Expiration Owner ~I.V Zy~le of P01VT'S SvsterurCons otte'11151vire: (Chick all tftnt Noti-Pieaaur' in-Ground `Prertswized le-Ground G At-CaWe Mound > 24 in, of suitallie soil _ c s,u;,ie 'sa+l Maand 24m. o: s 1.1 Holding Tank 0 Otlwr Dispersal Component (explain ~w ~ ~ ~ 3 14~~ ~ _ ) _ Preircatntent Device i_N~UiP se rsatrCreatment Area tatfor tnatian: Desttln Flaw lg;X0 Design Soil Appiieatiarn Rate(.anrisf) Dis rsaf A~e icr~utreJ ts t Dispel ail Are► Pro - posed ts`7 Sytkrn F."levarnon 1`t. TYnk lnt`o Capacity in _ Total k of Manufacturer -i1 ae, 71> Gallons (i3lioas ' t.!.ttts l✓~S; ,,.t (Ac~r~ v u T^ cam' i hlcw 7enks Cxistutg Tank $ P,i,• f w H es., 7-7Q6 sets or Holding Tank ~j ~1 1l. ktesnonstbility Slat: 1, tlt~underOlitied, assume res(ronsibllity too- installation of the POINT'S s ion •n the attACIlled plans. P rFnuniber's Name (Print) Piumber's Signature .9 mpn Number tDusiness Phone Nuniber T ~7 Feumt~ee's Address ( t;eet.City,State.ItpCutle) ~ - - e 1_11. Court /Re ttrratent Use ()n{Y - - --mot--~' _ ~ Approtitxi Disapproved ~'m+mrc Fee ' Date 1 ued Issuing nt SiYttatlr fs (toner Given Reason for Denial 2a b 7 l lX. Condf s A trov j(nS$IM~W R,.eaaons for Disapproval 3\ ~ ! A fb A(~J: cQ~o, Leo wac.~,ti-a-~ ~ l J ce.e... T ~ t. S ptic tank, efflu--)t filter and 4b V -C, dispersal cell must a.: I t as per management plan provided by plumber, p TU ~a2. Cee i 2. All setback requirements must be maw 4 ~ T UI,J (~j t:.s~! ~ _ . _.__ae flee 1 J itYt tl t > he syytrnn and Wbn,ir t0 tNe Count; sat ea r` of feat it a g in ti I 1 inCMr 614t L') ex SBD-6398 (R. 01/07) Valid thtu 01/09 i V SOIL EVALUATION REPORT #2020 Department of Commerce in accordance with Comm 85, Wis. Adm. cod Page 1 of 4 Division of Safety and Buildings Steel's Soil Service Attach complete site plan on paper not less than 8'/a x 11 inches in size. Plan must County St. Croix include, but not limited to: vertical and horizontal reference point (BM), direction and percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D. Pending Please print all information. n Reviewed By Date Personal information you provide may be used or seco ~ ~(~uk~Ey Law, 15.04 (1) (m)). 111Z61-6 7 Property Owner Pro erty Location Bast, Kernon 6 2006 Go . Lot na SE1/4, SW1/ , S36, T29N, R19W Property Owner's Mailing Address IN- Lot Block # Subd. Name or CSM# 948 Labarge Rd. O1X COUNT 6-7 8-9 na Cottonwood Ridge South City State Zip C de Phone Number City Village j 0 Town Nearest Road Hudson WI 540 715-386-7775 Hudson Cty Rd N New Construction Use: [x] Residential / Number of bedrooms 16 Code derived design flow rate 2400 GPD Replacement I I Public or commercial - Describe: na Parent material outwash plains and stream terraces Flood plain elevation, if applicable na ft. General comments Conventional system. System elevation to be determined by designer. and recommendations: F 1-1 Boring # Z Ground surface elev. 100.20 ft. Depth to limiting factor 110 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistent Boundary Roots GPD/ft- in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-13 10yr3/1 none sil 2msbk mfr cs lvf .6 .8 2 13-29 10yr4/4 none sicl 2msbk mfr cs na .4 .6 3 29-63 7.5yr4/4 none grcos osg mvfr cs na .7 1.6 4 63-110 7.5yr4/6 none ms osg ml na na .7 1.6 Boring # Ground surface elev. 100.00 ft.. Depth to limiting factor 110 in. Q Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-11 10yr3/1 none sil 2msbk mfr cs 1vf .6 .8 2 11-27 10yr4/4 none sicl 2msbk mfr gw na .4 .6 3 27-53 7.5yr4/4 none grcos osg mvfr cs na .7 1.6 4 53-110 7.5yr4/6 none ms osg ml na na .7 1.6 * Effluent #1 = BOD5> 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BOD5 <30 mg/L and TSS < 30 mg/L CST Name (Please Print) Signature: CST Number David J. Steel 248956 Address Steel's Soil Service Date Evaluation Conducted Telephone Number 994 200th St. Baldwin, WI 54002 10/13/2006 715-760-0347 SBD-8330 (R.07/00) Property Owner Bast, Kernon Parcel ID # Pending Page 2 of 4 Boring # U Ground surface elev. 99.80 ft. Depth to limiting factor 110 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. "Eff#1 "Eff#2 1 0-13 10yr3/1 none sil 2msbk mfr cs 1vf .6 .8 2 13-34 10yr4/4 none Sid 2msbk mfr cs na .4 .6 3 34-58 7.5yr4/4 none grcos osg mvfr gw na .7 1.6 4 58-110 7.5yr4/6 none ms osg ml na na .7 1.6 4 ] F Boring # C Ground surface elev. 99.30 ft. Depth to limiting factor 110 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ftZ in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 'Eff#2 1 0-11 10yr3/1 none sil 2msbk mfr cs ivf .6 .8 2 11-24 10yr4/4 none Sid 2msbk mfr cs na .4 .6 3 24-56 7.5yr4/4 none grcos osg mvfr gw na .7 1.6 4 56-110 7.5yr4/6 none ms osg ml na na .7 1.6 Fs~ Boring # ❑ Ground surface elev. 99.35 ft. Depth to limiting factor 110 in. ~ Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ftZ in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 *Eff#2 1 0-11 10yr3/1 none sil 2msbk mfr cs 1vf .6 .8 2 11-26 10yr4/4 none sicl 2msbk mfr cs na .4 .6 3 26-64 7.5yr4/4 none grcos osg mvfr gw na .7 1.6 4 64-110 7.5yr4/6 none ms osg ml na na .7 1.6 ~ rl 52 Z * Effluent #1 = BODS> 30 < 220 mg/L and TSS >30 < 150 mg/L " Effluent #2 = BODS < 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 (R.07/00) Steel's Soil Service II Property Owner Bast, Kernon Parcel ID # Pending Page 3 of 4 F6 ]Boring # H Ground surface elev. 99.30 ft. Depth to limiting factor 110 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-13 10yr3/1 none sil 2msbk mfr cs lvf .6 .8 2 13-28 10yr4/4 none sicl 2msbk mfr cs na .4 .6 3 28-65 7.5yr4/4 none grcos osg mvfr gw na .7 1.6 4 65-110 7.5yr4/6 none ms osg ml na na .7 1.6 / rl F7jBoring # El Ground surface elev. 100.00 ft. Depth to limiting factor 144 in. ~ Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ftZ in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#l *Eff#2 1 0-11 10yr3/1 none sil 2msbk mfr cs ivf .6 .8 2 11-28 10yr4/4 none sicl 2msbk mfr cs na .4 .6 3 28-71 7.5yr4/4 none grcos osg mvfr gw na .7 1.6 4 71-144 7.5yr4/6 none ms osg ml na na .7 1.6 - rr W Boring # 1XI Ground surface elev. 100.10 ft. Depth to limiting factor 144 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-13 10yr3/1 none sil 2msbk mfr cs ivf .6 .8 2 13-30 10yr4/4 none sicl 2msbk mfr cs na .4 .6 3 30-66 7.5yr4/4 none grcos osg mvfr gw na .7 1.6 4 66-144 7.5yr4/6 none ms osg ml na na .7 1.6 * Effluent #1 = BODS> 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BODS < 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 (8.07700) Steel's Soll Service STEEL'S SOIL SERVICE 3 of 3 David J. Steel Kennon Bast 994 200t" St. CST-POWTSM SE1/4,SW1/4,S36,T29N,R19W Baldwin, WI 54002 Lic. #248956 Town of Hudson, St Croix Co. Direct 715-760-0347 Cottonwood Ridge South, Lots 6-7-8-9 Fax 715-684-3449 This soil evaluation was conducted to satisfy a zoning requirement, it may or may not be suitable for your use. The location of this test may or may not be as shown, as permanent lot lines were not established at the time the soil test was conducted. /4 t2 - Legend N 1"=40' = Benchmark Ele. 100.00 ft V Top of 3/4 pvc pipe o = Alt Benchmark Ele. 100.05 ft - E9, 77~~ Top of 3/4" pvc pipe 11 =Borings / 7 ~ Boring Elevations A,~ BI = 100.20 ft TAA 2,' B2 = 100.00 ft B3 = 99.80 ft 1 3/ B4 = 99.30 ft B5= 99.35 ft T-gAA If B6= 99.30 ft B7= 100.00 ft B8= 100.10 ft Z'I3 ? n~ .Sor~ Cdr rw-zcl l/- l Z l3 3b~ ~3 C.B.A. 2:7 AC. 2.84 106 0 123840 Sq. ft C• . . = Z.8 AC. 2.64 cres LBO=1 0 14792 ft 23 C.B. . = 2.6 C. .20 Ac X 9 Sq. ft 1039.0 C B.A. 2.2 AC. 9 x 'OS 11.39' - X 211. 1040. 4.64 - - 330.00 1 53 \ t I I I 104, 2.49 res 2 2.69 r ft 117 C.B. . = 2. C• sq• ft LBO 1043. 11 t" `ul.B. . = 2.6 AC. 50 j L =1044.50 t IO p ~ ~ m I Ut o pp ~co , 46547' ` 1 ~ t D I I I:_ 1042.6 X 146 x 13 41.1 t 2.15 Acres 93760 sq ft 8 X , ' C.B.A. = 1.5 AC. )144.4 LBO=1044.50 ~ 043.3 -r---- ----X----------------------------- 1043.7 467.83' X / u 200.00 : W E 131ALsa 1044.8 X S1/4 CORNER 1044.4 SECTION36 I X \ J r 1045.3 x Document No. POWTS AGREEMENT Owner name and address: Kernon Bast 948 LaBar a Road Hudson, WI 54016 This indenture, made by "owner" and their successors in interest, own a POWTS (Private Onsite Wastewater Treatment System) requiring regular monitoring and maintenance in accordance with the manufacturers recommended Return to: procedures. These procedures must be performed by a manufacturer authorized Kennon Bast service provider licensed by the State of Wisconsin to perform these services. Results of these procedures shall be reported to the appropriate Governmental 948 LaBarge Road Unit as required by code. Hudson, WI 54016 Location of POWTS: Parcel ID#: Lots: 6, 7,8 , &9 Block: Na , Subdivision/CSM: Plat of Cottonwood South being part of. SE 1/4 SW 1/4 of Section 36, T. 29 N., R. 19 W., Tn. Of Hudson, St. Croix County, Wisconsin. POWTS DESCRIPTION: Wieser Concrete W2000 Bio tank with Bio-Microbics "Micro-fast 3.0" pre-treatment unit, pre-treated effluent discharged to conventional dispersal component constructed in compliance with In-Ground Component Manual, SBD-10705-P (N.01/01). OWNERSHIP RIGHTS AND RESPONSIBILTY FOR POWTS: perry "owner" as described holds sole ownership rights. "Owner" is responsible for insuring s ction, operation and maint ce of POWTS. (er signature) (Date) twner signature) (Date) Acknowled eg ment: These name , Kennon Bast, know to me to be he ergo executing the foregoing instrument. Subscribed and sworn t before me this da of 2007. OTARY PUBL C, State of isconsin My Commission Expires: 4c' Instrument Drafted By: James K. Thomason POWTS SERVICE CONTRACT The proper operation and maintenance of the components listed below will significantly influence the performance and life expectancy of the POWTS (Private Onsite Wastewater Treatment System). This agreement authorizes A.C.E. Soil & Site Evaluations, L.L.C. personnel (Service Provider) or their representative access to the POWTS components during regular business hours to perform regular inspections and routine maintenance of those components. It is herby agreed by and between Purchaser and Service Provider that in consideration of the payments provided for herein, Service Provider will provide a manufacturer trained and State licensed inspector to perform periodic inspections of the POWTS components as set forth below. Service Provider will prepare a written inspection report after each inspection containing any recommendations for the operation, maintenance, and or repair of the POWTS deemed appropriate by the Service Provider. A copy of the report will be provided to Purchaser and the appropriate Governmental Unit. Service Provider will supply additional services, parts, or labor only after authorization by purchaser. This agreement does not assume any responsibilities or obligations that are normally the responsibilities and obligations of the purchaser and does not cover any costs associated with operation, maintenance and or repair of the POWTS. In no event shall Service Provider be responsible for any special or consequential damages, including but not limited to, loss of time, injury to person or property, or incidental economic loss due to equipment failure for any reason whatsoever. This agreement shall remain in effect for a period of two (2) years from the date of POWTS installation, and will be automatically renewed each year thereafter unless amended or cancelled by either party with 30 days written notice. This agreement may be cancelled by Purchaser only if replaced by a service contract with another service provider authorized to inspect and maintain the specific POWTS components in question. Purchaser agrees to pay Service Provider the sum Of $ 85.00 per inspection. Four (4) inspections will be provided over the first two-year period at six-month intervals. Payment for the first four inspections will be included in the cost of the POWTS design. One (1) inspection per year will be conducted thereafter with inspection fees billed at the time of inspection. POWTS DESCRIPTION: Wieser Concrete W2000 Bio tank with Bio-Microbics "Micro-fast 3.0" pre-treatment unit, pre- treated effluent discharge to In-ground dispersal component constructed in compliance with In- Ground Component Manual, SBD-10705-P (N.01 /01). POWTS Location: Lots: 6 7 8 & 9 Plat of Cottonwood South, located in: SE '/4 SW '/4 of Sec. 36, T. 29 N., R. 19 W., Tn. of Hudson, St. Croix Co., WI, Parcel # Owner name and a ess: Kempwif%yli ge Road Hu , WI 54016 ( Cr signature) (Date) Service P viler: .C.E. SoiY& Site Evaluations, L.L.C. 0 Paulso ! Lake Road Osceola, W~I 0 j ice Provider signature) (Date) Instrument Drafted By: James K. Thompson 11/08/2006 10:59 FAX 715 233 0398 Certified Soll Testing a4(D E633 KATHLEEN H. NALSH Affidavit REGISTER OF DEEDS ST. CROIK CO., MI Per Comm 83.22 (2)(b)5.b RECEIVED FOR RECORD 12/14/2006 10:15AN Transaction # AFFIDAVIT EXERT # REC FEE: 11.00 TRANS FEE: COPY FEE: CC FEE: PAGES: 1 R,^EL Dav-11th _ 30. c~ Return, to: Henry Grote E. 4366 353rd Ave. Menomonie, WI 54751 Kernon Bast . hereby certify that 1 am responsible for maintenance to the septic (POWTS) system serving the four lots described as Lots 6, 7, 8, and 9, Cottonwood South Subdivision. Description of property: Lots 6, 7, 8, 9; Cottonwood South County: St. Croix Township: Hudson Property address: CTHW N Property Description: SE SW '/4, Sec. 36, T 29 N, R 19 W The proposed POWTS system operation and rnaintenance will be my responsibility. This includes the septic tank - pump tank systems on each lot, the common collection system, the aerobic treatment system, the cyst dose tank and pumps, and the dispersal system located by easement on lots 11 and 12. Signature: Title: owner Date: /tom/ 7 p~Ct~ Pamela A. Willman Subscribed and sworn before me this Notary Public 7 day of 6 La o o State of Wisconsin rtivw (/J , Notary Public 5.4- _ CA County, Wisconsin My commission expires This instrument drafted by Henry Grote 1of1 B 3 3 4 1 6 KATHLEEN H. WALSH REGISTER OF DEEDS ST. CROIX Co., W1 RECEIVED FOR RECORD STATE BAR OF WISCONSIN FORM 2- 2000 WARRANTY DEED 08/30/2006 01:00PN Document Number WARRANTY DEED THIS DEED, made between Michael E. Larson and Joann L. Larson, EXEWT # husband and wife, Grantor, and Kennon J. Bast and Donalda J. Speer-Bast, REC FEE: 13.00 husband and wife, Grantee. TRANS FEE: 2580.00 Grantor, for a valuable consideration, conveys and warrants to Grantee COPY FEE: CC FEE: the following described real estate in St. Croix County, State of Wisconsin: PAGES : 2 SEE ATTACHED EXHIBIT A Recording Area Name and Return Address: Edina Realty Title, Inc. 400 S. 2nd St. , -Suite 115 l;~ Exceptions to warranties: Hudson, WI 54016 U Easements, restrictions and rights-of-way of record, if any. 511203 040-1000-90-000 020-1109-60-000.. 020-1109-90-100 Parcel Identification Number (PIN) This is homestead property. Dated this 18th day of August, 2006. * Michael E. Larson * J L. Larson * * AUTHENTICATION ACKNOWLEDGMENT Signature(s) rhgrj B~Q~Vn STATE OF WISCONSIN ) . ~PUb1I%T. CROIX COUNTY. ) ss. authenticated this 18th day of August, 2006 State Of V V sCOns` personally came before me this August 18, 2006 the above named Michael E. Larson and Joann L. Larson, husband and * wife to me known to be the person(s) who executed the TITLE: MEMBER STATE BAR OF WISCONSIN foregoing . trtnnent and acknowledged the same. (If not, authorized by § 706.06, Wis. Stats.) THIS INSTRUMENT WAS DRAFTED BY *Cheri B wn Notary Public, State of Wisconsin Peterson, Frarn re Bergman -Steven Bruns My commission is permanent. (If not, state expiration date: 50 East Fifth h Street, St. Paul, MN 5510 01 3/11/2007 ) (Signatures may be authenticated or acknowledged. Both are not necessary.) *Names of'persons signing in any capacity must be typed or printed below their signature WARRANTY DEED STATE BAR OF WISCONSIN FORM No.2-2000 I of 2 EXHIBIT A A PARCEL OF LAND LOCATED IN PART OF THE NE OF THE SW % AND PART OF THE SE OF THE SW OF SECTION 36, T29N, R19W, TOWN OF HUDSON, AND IN PART OF THE NE 14 OF THE NW OF SECTION 1, T28N, R19W, TOWN OF TROY, ALL IN ST. CROIX COUNTY, WISCONSIN; INCLUDING LOT 1 OF CERTIFIED SURVEY MAP RECORDED IN VOLUME 6, PAGE 1642 AT THE ST. CROIX COUNTY REGISTER OF DEEDS OFFICE; MORE PARTICULARLY DESCRIBED AS FOLLOWS: BEGINNING AT THE S CORNER OF SAID SECTION 36 BEING THE N CORNER OF SAID SECTION 1; THENCE S00026'27"E, ALONG THE NORTH-SOUTH LINE OF SAID SECTION 1, 24.00 FEET; THENCE N45°1 8'02"W 34.02 FEET TO THE SOUTH LINE OF THE SW OF SAID SECTION 36; THENCE S89°50'23"W, ALONG SAID SOUTH LINE, 1268.60 FEET; THENCE N44°48'35"W 33.73 FEET TO THE WEST LINE OF THE E % OF THE SW %4 OF SAID SECTION 36; THENCE N00°32'26"E, ALONG SAID WEST LINE, 1480.62 FEET TO THE CENTERLINE OF COUNTY TRUNK HIGHWAY "N" AND A PONIT ON A 1999.00 FOOT RADIUS CURVE, CONCAVE SOUTHERLY, WHOSE CENTRAL ANGLE MEASURES 2°43'02", WHOSE CHORD BEARS S79°16'37"E AND MEASURES 94.79 FEET; THENCE EASTERLY, ALONG THE ARC OF SAID CENTERLINE AND SAID CURVE, 94.80 FEET TO THE POINT OF TANGENCY; THENCE S77°55'06"E, ALONG SAID CENTERLINE, 967.65 FEET; THENCE S76°47'47"E, ALONG SAID CENTERLINE, 280.04 FEET TO THE NORTH-SOUTH LINE OF SAID SECTION 36; THENCE SO0°27'05"W, ALONG LAST SAID LINE, 1216.78 FEET TO THE POINT OF BEGINNING. NOTE: Lot 1 of Certified Survey Map filed April 8, 1986 in Volume "6", page 1642, as Document No. 410755 is included in the above described lands. 2 of 2 t - _ . County commerce.W1. OV Saf'cty and Buildings Division ------~T~~_ V_- 2fil W. Washirigton AN e„ P,0. Box 7162 Yf~ ! t con sin Madison, Wl 53707-7162 San t}' Pe emit Number (to e fled to by Co.) Oeparttnent of Ce,mttseeoroer ~ .~JJ•- V -5ta.te Transaction Number ` Sanitary Permit Application j In accordance u tit s. Comm. 83.2i(2), Wis jnj lode subnvssiuri of this form to the appropriate; governmental 13o & 1._) unit is requited prior to obtai.nir g a sanitary permit Ncte: Application forn•is to state-owned PfJWTS are i Project Address (it'differenr thanmailing addreas) i submrticd to the Dcpar.mew o Commertu Pers n,ai inlorm4lion you piovitic m y be used for seconda;+y I dur>osrs ur a c i d311ce with the PPTVat law s. ! 5 0 t (n'i , S ~t<. _ 1. Ap licahon Information -Please Print Ate Information ~~7►e~'~~-~~^-- Pioper;y0),r.rr';Name - - Parcel# i Property!hvnea's Mailing Address _ APR 4 - - --1 Praperty LocaCiorr ~ G Y_ A Yc _ Govt. Lot fO ~ City, State Zip de '.S, L~ S e circle o on ne) iV; R E or ill. Type of Building (check all that apply} - Lot- _ II e 2 Family D.se;hng - Nu her of Redronms ubt?ivision Name ' - Block k i C it " v rJ ~av~ ❑ Publ;trCcmrne:cia' - D.^;cnlti Use y j ~ 12 City of j J Siatc• UArt d - Dcsc~ibe Us: CS~t\ a rb~ page of •-_~--_--._._---^--.--T---. 1 111. Type of Permit: (Check on)); one box ou line A. Comp to e fa plicable) i A. XNe.w System ❑ Replacement Sy, t m -1 ❑ Trealm t;r}loiciirg Tank Replacement 0,1Y Other Moditication to Existing System {explain) I B• + ❑ Permit Renewal - unit Revision C11 Change of' ?lum ber List Previous Permit Number and Date Issued ~ Permit "fransfer to New Betbie Expiration Own=r - 07- 1V, Z_ ype of POWD Svstem )onent( ce_(Check all that apply) Non-Pressurized In-tiround Pressurized In-Coound f] A.--i,tade ❑ Mound 24 in or ble I ~MoNn' < r^, ofsyual"e soyt/~/~ J~~ - ❑ }iotdim,' ai k ❑ ONrer Dispersal Component (a;<plainj-_.__._._._ ~Pr'e%reatmer,! Device (e. ain) ~c7G)r V. ills ersaVi'rcatmentArea Information. ites10 Floc i gpu) f3esign Soil Application R.ate(gpdst) 1. asperse; Area Required ('st) Dispersal Area Proposed (st) System Elrvat, c 2 41 C3 V1. Tank Info Capacity in - I 'I?xai ~ # of-' Manufacturer F - Gallons Gallors Units 2 c u "u New arks ExistvrgTanks 41 is I - - IT /~yj vn . iepr c or t-otdurg'fank 4~ Uu,rny r irambrr V11 Responsihility Statement- 1, the undersigned, assume responsibility for installation ofrbe POW rS s n on the attached plans. !,lumber's Nanoe (Pr:rU Plumber's iSignature 1P. PRS Number E~ Business Phone Number Pl,rnoer's Address (Street, City, State, Zip Code) ~4-- N'I1I. 6rtment Use-Only Permit tee pp Di 1 ued-- suing Agent Signal re e I rovei Disapproved u Owner Given Reason for Denial IN. Cjonaltions of .kpproval/Reasons,f`w D m t >,roval GC e-~c w d z O- tin ,!/ao~a D I Q!j?~Z__ . _ _ G•G~~ ~ ~i21-~~XXe_~1 c._~id_~_ ~~uo ~r+• to plete plants 11 1, svstern and submit to the County only on paper neat less than 8 3a x 1-in ties i sP a (N < S D-0,39S (R. 01!,107) Valid thru 01/0 ` / ,,(07ZE / a 74 LD73 6 -7 Safety and Buildings commerce.wi. 4003 N KINNEY COULEE RD gOV LA CROSSE WI 54601-1831 in TDD (608) 264-8777 www.commerce.wi.gov/sb/ i sc o n s i n www.wisconsin.gov Department of Commerce Jim Doyle, Governor Mary P. Burke, Secretary April 17, 2007 CUST ID No. 222774 ATTN.• POWTS Inspector HENRY F GROTE ZONING OFFICE CERTIFIED SOIL TESTING ST CROIX COUNTY SPIA E4366 353RD AVE 1101 CARMICHAEL RD MENOMONIE WI 54751 HUDSON WI 54016 CONDITIONAL APPROVAL Identification Numbers PLAN APPROVAL EXPIRES: 04/17/2009 Transaction ID No. 1386134 SITE: Site ID No. 720623 Cottonwood Ridge South Please refer to both identification numbers, County Road N above, in all correspondence with the agency. Town of Hudson, 54016 St Croix County SE1/4, SWIA, S36, T29N, R19W Lot: 6-7-8-9, Subdivision: Cottonwood Ridge South FOR: Description: Pressurized In-Ground / Commercial (4 houses) / ATU Object Type: POWTS Component Manual Regulated Object ID No.: 1108003 Revision; Maintenance required; 2,400 GPD Flow rate; 110 in Soil minimum depth to limiting factor from original grade; System: In-ground POWTS Component Manual, SBD-10705-P (N.01101), Pressure Distribution Component Manual - Version 2.0, SBD-10706-P (N.01101); Aerobic Treatment Unit, Biofilter The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, r. stats. CQ;1dt~ The following conditions shall be met during construction or installation and prior to occupancy or use: ~ Reminders p~taEt~t µ OF • This system is to be constructed and located in accordance with the enclosed approved plans and with the SEE GpRE component manuals listed above. • The Biomicrobics, FAST 0.75 units (one installed at each house) must be installed in accordance with the manufacture's printed instruction and system sizing criteria found in Comm 83, Wis. Adm. Code. If there is a conflict between the manufacturer's instructions and the plan approval, the plan approval and code requirements will take precedence. • A maintenance and monitoring contract for the Biomicrobics, FAST 0.75 unit is required for as long as the units are in service. • The observation pipes must be located at a junction point between two EZ-Flow products so as not to create separation of the bundles within a product. i HENRY F GROTE Page 2 4/17/2007 • The wells must be a minimum of 25 feet from any POWTS tank, and a minimum of 50 feet from the absorption area. chs. NR 811 & 812c • 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 POWTS 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. Stat • Comm 83.22U 7 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 Owner Responsibilities: • 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). • 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. • Comm 83.55 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. All permits required by the state or the local municipality shall be obtained prior to commencement of construction/installation/operation. In granting this approval the Division of 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. The above left addressee shall provide a copy of this letter to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Fee Required $ 75.00 Fee Received $ 75.00 Balance Due $ 0.00 Charles L Bratz POWTS Reviewer II, Integrated Services WiSMART°code: 7633 (608)789-7893, 7:45 am - 4:30 pm Monday - Friday charles.bratz@wisconsin.gov cc: Leroy G Jansky, POWTS Wastewater Specialist, (715) 726-2544, Friday, 7:00 A.M. To 3:30 P.M. r Cottonwood Ridge South Common In-ground System Revision to Transaction # 1343361, Site ID # 720623 Construction Materials and Techniques All materials must comply with Comm 84 and be installed in accordance with manufacturer's specifications. Construction methods must comply with the following Component Manuals: In-Ground, SBD-10705-P (01/01) Pressure Distribution, SBD-10706-P (01/01) Location: Lots 6, 7, 8, 9; Cottonwood Ridge South SE 1/4, SW'/4, Sec. 36, T 29 N, R 19W Town: Hudson County: St. Croix , Date: April 20, 2007 I Owner: Kernon Bast Address: 948 Labarge Road NS Hudson, WI 54016 /y~i HENRY F r, , Designer: Henry Gr - GROTE -1699 ENOMONIE; 5Z , Signature: WIS ~0~i IFS I GN~~ License: WI D- I9-O07 Attachments: SBD-10577 - Plan Approval Application SBD-8330 Affidavit of maintenance (copy) ° nn'~'rr,y Prior approval letter (copy) a V ED OF COMMERCE Page 1: cover 4ESP0 %"WS 2. overview 9: general system management 3: design criteria & calculations 10: system specific management DENCE 4: absorption area plot plan 11: general lot plot plan 5: system cross section 12: duplex dose pump check valve `detail 6: plan view, lateral detail 7: dose tank exit detail 8: dose pump curve page 1 of 12 Cottonwood Ridge South - Overview The revised plans differ from the original, approved plans in that the aerobic treatment units are decentralized onto each lot and incorporated into combination septic-ATU tanks. The in-ground trench system is shifted to the southern portion of the tested area due to changes in the subdivision final grading plan which will improve overall site surface drainage. Approximately three feet of landscape fill is proposed over the existing grade in the trench system area bringing final, filled grade to about 103 with about seven feet of backfill above the system synthetic aggregate. Final settled slope should be a nominal 2 percent to the southwest. In general the Cottonwood Ridge South Subdivision lots will have individual, on-lot septic systems. Four lots, lots 6, 7, 8, and 9, have soils which are poorly suited for on-lot systems. Each of these four lots will have on-lot, combination, septic-ATU tanks to produce highly treated effluent. Four bedroom homes are anticipated and designs will be limited to four bedrooms which will require the installation of Wieser 975/1425 SEPTIC/1310 tanks. Septic compartment outlets will be equipped with filters and filter alarms to ensure timely filter servicing. ATU units are Biomicrobics, FAST 0.75. Highly treated effluent will either flow by gravity or be transferred by small pumps to the system effluent collection line located in a thirty foot wide sanitary easement. Solids free effluent will flow downhill in the common effluent collection line to a pump tank located on lots 12 and 13. The common effluent collection line must be constructed with schedule 40 PVC and installed in accord with Comm 82.30(11)(e). In particular the trench bottom must be over-excavated a minimum of three inches and the elevation of the pipe established at the pipe invert with at least three inches of clean sand. Pipe backfill shall be in accord with Comm 82.30(l 1)(e)2.a for the initial twelve inches. Cleanouts with frost sleeves will be constructed at each lot line. The 1000 gallon dose tank is equipped with duplex pumps controlled by duplex controls. The duplex control alternates pumps to periodically send effluent to the in-ground trench system. At full designed flow of 2400 gallons the in-ground system will be dosed three hundred gallons eight times a day, approximately every three hours. The "conventional" in-ground trench system consists of six 3' x 105' trenches constructed with E-Z Flow synthetic aggregate. Equal distribution is assured by pressurized laterals with 1/8 inch diameter holes in the centers of each trench.' In-situ soils loading is a maximum of 1.6 gallons per day per square foot requiring at least 1600 square feet of adsorption area. System design is conservative at 1890 square feet giving an in- situ loading rate at full design flow of 1.27 gallons per day per square foot. System elevation is set to ensure system elevation about 2.0 feet below the sand horizon interface with heavier soil textures in the upper 24-34 inches of reported soil profiles. Page 2 of 12 Note that friction loss calculations include the first two segments of the center fed manifold due to significant friction losses in the 1.5 inch manifold; terminal segment manifold losses are covered by the 30% system loss calculation. Design Criteria YES Residential Wastewater Contaminant Load: 30 mg/L < BOD5 < 220 mg/L Anticipated septic tank effluent 30 mg/L < TSS < 150mg/L Fecal Coliform > 10,000 cfu/100 mL Ye& Treated Residential Wastewater Contaminant Load: 30 mg/L < BOD5 Septic tank + "highly-treated" effluent 30 mg/L < TSS Fecal Coliform < 10,000 cfu/ 100 mL Bedrooms x 100 gal/bedroom/day x 1.5 2.40-0 gallons/day hydraulic load Design Calculations In situ designed loading rate 1,2-- gallons/sq. ft. per day Depth to estimated high ground water X44 in. Depth to bedrock 1e+4 in. Cross slope at system 2(a> % System surge/dose tank ~eaS-, wt 0,.,o $(Z taws gallons ose tank filter S tiZ" ~r sir ~LL~~ A-7 77M of /S7 0?)se Force main length t 5 ft. of 2 in. 4 S~ ~"~17 0,J Manifold/header length ~-d ft. of 1 V-L in. 3.~e Drain-back X13 gallons Lateral length @ G'~ ft. of in. Lateral elevation qs.~ ft. @ bottom of lateral Lateral hole size q in. @ 16.0 in. ( 3• ft.) Spacing S/ holes/lateral holes--total Lateral volume s q , n~4- gallons Total lateral discharge rate 1 gallons/minute @ S ft. head Network pressure compensation losses k i 1 ft . Elevation difference o ft. Force main friction loss 2 ms' - ft. @ 8 6. gallons/minute 3. be < < er, Manifold, first segment friction loss 1 Z3 ft. @ 43.0 gallons/minute Manifold, second segment friction loss V ft. @ 2e gallons/minute (x2) e-'1'/` °v'') F11tP, ft. Total dynamic head ft. Dose pumps q0 gpm @ ft. of head, duplex pumps and controls Manufacturer C.9- o w o z gam- Model # w S k o N Dose volume o 613 gallons Measurement pump on and off l1~ n in. o Hei ht alarm from tank bottom in. Septic/ATU tanks 4-% ci' 142,E 5fP*nr- %ko gallons, on each lot Septic tank effluent filters (4~)-+ 0- a.`c ~ r o t m t4- a (N 1 with 1fil(ter alarms ATU ~~o►~~cr2ur~~cs t"1~ST n~~s' aac~h lo`~S 4- -,.UQ specs.calcs S l,r Page 3 of t Z T I I _ cw_ C l c 3S pr~rrl,C ~ - 1°to~ c,,.- I I Z" P vc- bCn w.Qn~S ~o~~ ~T ~`dto }ovc` w.~;~ ~ 11 1 ~ ` d~ ( I ~ M C\ e-~ . a~ Lv n ~o y~ fl ~4' (~uC ~p ~ yt0 1 d-►vev~ a~Q 1 QI 7 U (J a U ~ 0 0 ..c a T ^ a j p d -4 ID d -i 0 p S~i~✓/9 i In ` i VI V^ Q ✓ Q o ! ~ J Z ~ j I J J go ~1 7 r~ ~ > od ad ~ J Q LA d n `n J ~ d J i O O b• S' I Q Q 3 gr I 43 0 o z' S' 0 0 1 S' O o~el+uu.v o„1:0•. Wo,\~ -fro ~orco..., o~ ~~-c~. w~ ~ \ wt Q.v a\i ~ o+.~1f QN 4Q 4J 2 ~ G-: \ ~ " 1~ l7 L 6.~h 4'O ~ a. ~ W ~.-lS i l l l r~ ~J` S(~cQn Q'O I I I I I ~ ~,o, ~I 3,0 ( Vz, I M..4.w. 1 ( ( 1 ( 1 of 7,0' ar\-` Cp-,v, 3.nv G.~ `t' Qlr.^~-: `n al 04- Q-v S u~ WW1 Q al,o CAr C~ a Page + of 1 L PUMP CHAMBER CROSS SECTION Min. 2' Vent Pipe with cap 7 a 10' from door, window c~C2 ` w or fresh air intake vent Cap Weattur Proof T Jurwtton am Approved Iocking manhole coverw/warnin9labe I 12' MIN I Final 1 a / a Elev. w o3 I Grade I u a IJ T44* MIN 411 j I 1 18' MIN COndutt • .ll„\1\ ill \\~~a ~ ~u .4ea inlet Approved / S F1~` Provide vide Joint I I I I l \ / A Airtight Seal I I I Approved I Jo• s ~ ~ I I I Alarm ~Qro o.a l I c ~y~ ~ ~ I I { p I On i ELEV, ft Off ELEV, ft Concrete Block Elev. ~ 3' approved bedding material under tank 1ci liquid level 2~•g3 gallons/in. SPECIFICATIONS Note: Pump and alarm are on separate Number of Doses: 5? o Pe-r Day circuits as per Ws. Adm. Code Gallons Per Day of Doses: 3~.o Gallons Volume of Backflow: Gallons Tank Manufacturer: Total Dose Volume: 10~-Al Gallons Tank Size: L Gallons Alarm Manufacturer: S s `AQ_C_ Capacities: A \ -:ir,o inches or 4-~~.1 Gallons Model Number: B inches or Gallons C inches or 306.13 Gallons Pump Manufacturer: D q inches or zsro Gallons Model Number: Total........ = sq inches or\Gallons Minimum Discharge Rate: GPM Vertical Difference Between Pump Off and Distribution Pipe: :4,0 Ft. Minimum Required Supply Pressure. + s=o Ft i < Ft. of Force Main x 13,6% Friction Factor/100 Ft. +2'ns~ Ft.+ z.~q'Lw•- Total Dynamic Head = t s.`~- Ft. Internal Pump Tank Dimensions: Length ~g ' Width Depth to inlet ~-Z Bulletin CL2.1A _ July 8, 1983 ,i to For Homes - GOUL.DS • Farms • Trailer courts s Model 3885 • Motels (Supersedes Model 3870) • Schools • ~ • Hospitals Submersible EHluentPumP Effluent Pumps • Industry • Effluent Systems Pump Specifications anywhere effluent Solids Handliny Capabilily to or drainage must be Discharge Size 2 disposed of quickly, Sem.. i-T i-Open Impeller quietly and efficiently. 3 van,: Jet qii. UMIS USC back-off Philip Out ~8ni5 On DaCn5~1]e tol protectluf~ u! Casing volUfP Stainless Solids Handling ainless Steal Fasteners '7 `.7 ~ Series 306 5:8in1c» S~rci IJu :Or Dependable Capability to 3/4" re anic Mecchhanical Seal Ceraww spnny tlnu ""It.r Maximum Temperature 1/3, 1/2 H.P. 60 Hz Il 160,F Capable of Running Dry Single Phase 115, 230 Volt. w MOL11 dan),igo to cuwponenls Motor Specifications 1/2, 3/4, 1, 1 1/2H.P. 60 Hz Motor Fully Submerged in nign gr-,l l,,rD, n, o, or p)er Single Phase 230 Volt. Three on of D . Phase 208-230, 460 Volt. envirOflrnCil; Dy r,,gyua CdSI iron e: - & Bearings J Stainless Steel Shan Sou vs reSistiIf 1 i~,~,~,.~xr sl-.,ll Single Phase Units 90 All yin,ji„ ,,i.., D_i! 80 Three Phase units WE15H MODEL 3885 70 RPM 1750/3450 Power Cord w w WE10H ^lrn~~~ J:,,: u- 60 c WE07H S 50 gl,in~1 i~;l Single Phdsc um l5 a 40 WE05H u WE03M SJ1 C~ .v a „u . 0 30 mou~ls ti, , , 4 J Q Curti 0 20 WE03L" SPECIFICATIONS ARE J,DJECT'u 10 WITHOUT NOTICE r 0 :y 0 10 20 30 40 50 60 70 80 90 100 110 120 u GOU LDS PU M PS. I N C. GALLONS PER MINUTE L`~J ,ENFC A NF" U System Management Management of this system is critical. As a condition of approval of these plans this system management section must be reviewed with the owner, and the owner must be provided with a complete set of plans including this management section. If problems develop with the adsorption system or any other system components, the installing plumber or the St. Croix County Zoning Office, 715-386-4680, should be contacted for assistance. General Proper functioning of an on-site disposal system, "septic system," is significantly dependent on the volume of water which flows into the system and the level of contaminants in that volume. The lower the volume of water and the lower the level of contaminants, the better and longer the system will function. Typical system components include a septic tank or compartment to settle out solids and contain greases and oils, a filter on the outlet of the septic tank to retain small particles of the same density as water, a dose tank or compartment to allow a dose to be accumulated, a pump and controls or automatic siphon, and finally some type of soil adsorption cell to recycle the water in a manner to protect ground water quality and public health. 1. If the septic tanks are installed prior to sheet-rock and/or painting, pump the septic tanks before normal use begins to ensure adherence to contaminant load design criteria. 2. Install water-saving appliances whenever and wherever possible. 3. Repair even small water leaks as soon as possible. 4. Never pour grease or oil down any drain or stool. 5. Garbage disposals are not recommended; if you must have one, use it sparingly 6. No paper products other than tissue should go into the system. 7. No chemicals should go into the system. 8. Avoid surge flows of water; try to spread laundry throughout the week. 9. Aerobic tank effluent must be less than or equal to the design criteria specified in page 3 of these plans. 10. If septic, treatment or dose tanks are no longer used, they must be properly abandoned. 11. If construction timing and weather could create a frozen infiltration system, weather-proofing with plastic sheeting and heavy mulching may be required to maintain a functional system at start-up. Maintenance 1. The septic tanks must be inspected every three years by a properly licensed person. 2. If necessary, the septic tanks must be pumped to remove solids and scum; pumping is required if the combined scum and solids volume equals one third of the tank volume. 3. When the septic tanks are pumped, any solids in the bottom of the dose tanks and aerobic treatment tank must be pumped, and the filters must be back-washed into the septic tanks to remove accumulated material. System use may require more frequent filter cleaning; initial inspections of the septic compartment filters should be made every 6 months until a minimum time sequence is determined. 4. Periodic observation pipe inspections should be made by the owner to examine the state of the in-situ soil adsorption cell. Quarterly inspections are recommended; a licensed plumber should be notified if effluent is consistently ponded in the adsorption cell. 5. This system has an aerobic treatment tank which must be inspected every six months according to specifications and contract. 6. The aerobic treatment system has a blower which runs continuously; if blower operation has stopped a licensed plumber should be notified for service as soon as possible. 7. The pumping components for this system include alarms which must be installed and remain on separate circuits from the pumps. If alarms are activated, minimize water use and notify a licensed plumber for service as soon as possible. The system allows reserve capacity to accumulate some necessary flow until normal service can be restored; this volume is minimal, and no more than one or two days should pass before any necessary repairs can be made. 8. Avoid compaction such as vehicle traffic above or within 15' of the adsorption system. 9. Avoid disturbing the system itself such that might encourage erosion or disturb the required seeding of the system. 10. Particularly avoid winter traffic such as sliding or snowmobiling which might compact snow and lead to increased frost depth. 11. Surface drainage must be diverted around the system; avoid landscape changes which might send surface run-off into the system area. 12. Warning: Do not enter septic, dose or other treatment tanks; death may result because they may contain lethal gases or insufficient oxygen. Contingency Plan Wastewater monitoring of volume and quality is not a normal requirement; such monitoring may become necessary if problems develop. Any necessary monitoring shall be done in accord with the requirements of Comm 83.54 (2). Pumping and hauling of wastewater may be necessary while analysis and repairs are implemented. Additional testing, designing, and/or installation of additional treatment components may be necessary. Page 9 of 12 System Specific Maintenance The developer is responsible for all required maintenance. A properly licensed, experienced plumber should be under a maintenance contract. Treatment Systems 1 The aerobic treatment unit blowers should be periodically checked and the inlet screens cleaned approximately every six months or after any periods when debris such as leaves or mowed grass might have been air-borne in quantities. 2. The aerobic treatment units should never smell septic; if unusual odor occurs, notify the installing plumber or contractual maintainer. 3. Annual inspection is recommended of sludge depths in the septic (trash) compartments and in the treatment compartments. 4. Unusual noise from the blower units should be referred to the installing plumber. 5. Manufacturer's specifications for initial inspections every six months for two years must be followed; follow-up inspections required at yearly intervals. 6. The installing plumber must include the required initial six month inspections in the installation price according to NSF specifications. 7. Individual septic (trash) tank compartments with effluent filters are located on each of the four lots served by this system. The effluent filters have alarms to notify the homeowners if filter service is needed. If alarms are activated the homeowners need to notify the developer or contractual maintainer. 8. House locations and topography may require combination septic-pump tank installations (STEP systems) where the fl effluent is pumped up to the system effluent collection piping. The pump compartments in these cases will be equipped with alarms to indicate any problems with the pumping systems. If the alarms sound the homeowners need to notify the developer or contractual maintainer. 9. All alarm systems should be checked annually to ensure proper operating condition. Dispersal System 1. If any alarm sounds or indicates a problem, notify the installing plumber or contractual maintainer. 2. The dose alarm system should be checked at least annually to verify proper operating order. 3. The area above the dispersal cells should not be mowed after August 31 to allow. vegetative growth prior to cold weather. 4. Traffic of any kind is not permitted across the dispersal area; the perimeter of the area must be delineated with a decorative fence/barrier which must be maintained in a manner to prevent incursions by vehicles, "four-wheelers," snowmobiles or other equipment which might compact or damage the area. 5. Annual inspections of the dispersal system must be conducted; the surface above the dispersal cells should be of relatively uniform appearance with no unusually wet locations. Observation wells must be inspected to look for evidence of significant or prolonged ponding in the trench system.. 6. Manufacturer's supplied operation and maintenance manuals will be followed. Page 10 of 12 a i ~ IJ ~ \ d d s d s f I I 0 C s t ~C8 s ~ d 14- f S -h w- 134~3~ C. 43 r STF l csd ~ \14," PUL ScQ. ~ ~ ~