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HomeMy WebLinkAbout040-1303-00-062 b\§scensln Oepanmerl of Connncrce PRIVATE SEWAGE SYSTEM C_-ty. St. Croix Safely and Bui ding Division INSPECTION REPORT sam'ah per-.n NO. {ATTACH TO PERMIT) 606973 GENERAL INFORMATION slate Plan ID No Persu-u • fp-°.otc- you proode may li _see for secc•ldary purposes IPn vacy Laa, s u oa rt limit 111802338-C Pwmil Hcl_-w S Name Cey Vil age Tannsh p parcel T... No: Oevering Homes TOWN OF TROY 040-1303-00-062 CSt 13M Lle, nsa R10 F ev 610 newrptin- Scut--. 'oy n1Ra~geMap Nc. - "I 22.28.19.1797 TANK INFORMATION ELEVATION DATA TYPE LIANUFACTURIER CAPACITY STATION ~BSO 116H FS ELEV. Septic yy~ y. t Berchmark u a~ l Z D b yo" ~ ; ao Dosing `6 / b r / SO Alt HP.1 J ` /6/ L vK10 s; Bldg. Sewer' Hold rg _ SUHt Intel -7-7 95 3 TANK SETBACK INFORMATION SvHtOu:et Air ima-a RCA= D: Inlet TANK TO Pit W3 Septic DI Bcllom I / • 7 3 26 Dosing ~ Headed tan / z • ao • q Aeration Disc Pice z.~ 160 Ho cmg _ Bat. System 7-1 lad • Z . PUMP/SIPHON INFORMATION F ral Grade /a I /Lu P,danufaaurer 1--. 6 Demand StCover~' I ~J / • W 161,41 GPM Model Numbe- 141 . ~ TDH Lit4, traction Loss System Head 1 U~1~r `1 . ff to 11240 1 t Forcen-ain Lcnglh ! D aZ Of U sl to tie I - 1~ SOIL ABSORPTION SYSTEM '2 BEDlTRENCH WiV / I eng7F Nc. CI 1 ere, PIT DIMENSIONS NO. Of pCs I-S de Ca. Liguid Dep:ti DIMENSIONS is ,c e_ ~ SETBACK SYSTEM TO V I':L /B✓LDG V,,`ELL LAKF~STREAPA LEACHING taa-u'ar..urer INFORMATION CHAtrtBER OR S Tyoe O' - P5 Z-7 J A / UNIT fAcce V.mhef DISTRIBUTION SYSTEM Heade•!Var i-v: 14 Distri-wic- xHO:c Sze Ix Iole Spa nine '•Jnn Art I, ke 1tP.'tgfh 60 Dla- 2- _ ~nGI9 D 3 $pJGIeG__ _ I '/3 SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only ...v 1=p'n er x JCVnI cl xx $ucds~lScdeed nx `d utcYed Dept -7', Bcdl lren r ;:awe / r 1 1"i, I VQ Tc rsml t ~ NO ~~e4 ] No f COMMENTS: i nc ude code discfecencies. persons present, etc) Inspection p^ Inspection k2. Location: 215 tW,l T HI_L!,% Y IL, +iLt Ill ev, 1. 1 Alt 810 Description 2.j Bog sewe• Ienctn = amount o` cover = Jr G k 4,: A,,--, ~rOG.GS 6~ Jr 61h Crx•~~ ~~~III Plan revision Required= Yes XNO (7 ~i /Y ~Q S3~~S Use other side for additional information. L-~ • u - - - - Dalc• Inseptr.' ig,a:w Cerl No SBO 671C :14 nlaln' 1 Safety enc Buildings Division 1--) if / - t a 2U1 W. Vfasnin9lor Ave. I'. Bc% 7132 S=,vy PC no Ncioke no to 61EuI it by C'o''• ~ Madison, lydl E37'0 •1 1T51e I.LLWC9 L VU6Kt ~atukuv crmit App1ic13tio2 aL 18 0 Z 339 . - e- t he appr,.pn c vcromco tl r: m ,u.uy.ly uTrb 5FS:28,721,11 - ! 1 + '.dc, s.b,LUSin 1 u TV. WI TT. u icnnl}fd poor I?,-,.ntJ56 v 5.cslta.ti pin 1 1 me ALPb a': r f. m t swc wncd v.T are >ut•1 u A 1. : 1: i-.tt 'Adyr 'If dilfaent Iha w. u ai4trs^.I uc kl ?rtn a 1,Sr) m{ °ro[e sur,Y.v Swtct. man 1 n: ,mni'.-:c V. '.U nit, iJr c'a' tti used tot sr;k.. p L PLAppinlicarioon on lnfo Informarlno Ff Pluveasr' o Print All l l nfofotrJ C n - _ ~Ap 1 _ _an •(t 411L P.Op O`QJe~N,t'"y, Pr v~-I O n _.~'a3 o(tI 'tuperrv lmncr s Mmlmg 5 - a~ opc , l~ crr~. six, t Lip L Nir. PLOor Numb= s-.m Wool (l///type of Building (ch4 all tbat appl j ec 1 Y 2 FamiiT €Ja¢Ihns \'umbrx of lleortw L' _ _ L 61- Suhdi'sor , /ry~y J / ` - fL tYd 13:nJ:: l (mac 1•L 1.-_ 1.=".` rn~~ L) f'ablw':c'mstocial-IMCr.M ttie- _ V\,6J-je, . 1 I -;r, of Cs - L 1 tha@c o: ' 5 aL° [ Ma T)GCCr' ts' if/ate -Y lob -iTT.~nu Ill. 'I .pe of mit: (Cbeck rally one box Ov liner. Complete line B if appbeable) evsrcm~ ❑ R, Pba:r^rn r.?cm LI Tt a::unt 1 'ry, l c:i. <z a a : ntniai+ . Cri4u x odif a a t Eltira; System lmlain R. I, 1 ttni Rcnevzl J ?ermu . .nl:.e r I (.t Too ct ItmYC : I ' Lim i CC,unu r _uut.i:vn.+m mm Chic hsuec f.;U'il f1.vLfU W. vCN .1ct : zcir_tioa haver _ v°,W O✓t % froJv,V*wgtm.<ompnncut Dev ice (Check all that applt) ressu't.,.d In G :n.t ~Il r rl l: la .u- ~.4Hma~. 1j!:,:m .r f cm ~N v Itiur lint afa:dr sna ~hn:dsmz ,art ---~"C"I'Dt,~as..~ :-x➢Ina.l P. Di IT rea_t t Area Information- t t4l, ys S w yr.R Iks z. II 4pp1 auyrC.vttlgpi 1 h., r" al Ar.a iicaauc vtl x 0.: IYu '511 S. ste Elevauno LI a,y 6a 'L'fankInfo ~caF ardyu at n,:f e,utneuan 1 allows ni:-m I mitt c Ti Ivr.•:ani--. .`iueuK i aul~ / ~ ~ 1 ~ u c " _ y n F r/7'11! _ 1 i _ VD. Rc,-ponsibihry Statemen the u_n_drnigne s+i r responsibilio' for installnnuo of 1hr Miw TC shnwa on the amcbed pli oc }'I~yt:ie a:Pf' k 1 ~ Wirt U:~C':."..nmhc Ru ID+SS i'hC tc\m'~~~ / , ,!t. _ . I mstK:r' on cca iS-1, t:iry s to Li Cf~ otv Dcp_armrent tw tlnly ''amrt ime .,at, sual ) I I ru'? gent cigr.azm.. hnu,l S 6~D ! I~ Z rv / o LX t:noddClfS$E4Gt~r1'aSklEReasous for Disapproval /1r ~ . q ( O✓ 1 Seppotark a fTW) :1tc nl 3` ,J G 0vx '0 ~~-D~~~ ~ L Y:~prc' c I' ?ua Abe- is s IT, ~ tt_-: e< ~Ce- i~ Cam- r,.l ~Q,f t,t.r Y Asper tarayemen pl n iirel PIwnbe. i 2. AI rtetba k ect ira on ,s m ;l t.c c t i - - Sm:L u: a mp4R plain ter mr s>itaY and wDmn m the Cent. eoi~ ue yayer am Msa roan ri .9 x l I ixno m>¢e SBD-6398 (!R- 11.1:j System PLOT PLAN PRO.IECq Oeverino Homes y ADDRESS 1433 Cernohous Ave Suite A New Richmond Wi 54017 SE 1;4 SE 1!45 22 ;T 28 NIR 19 W TOWN Troy COUNTY ST.Ca01X SYSTEM ELEVATION 100.4' D A TF. 11!6!' 8 BEDROOM 4 CONVENTIONAL AT-GRADE CONVENTIONAL LIFT HOLDING TANK MOUND M SEPTIC TANK SIZE 1255 gallons LIFT TANK SIZE DOSE TANK SIZE 765 HOLDING TANK SIZE LOAD RATE '.0 ABSORPTION AREA 60C t of chambers none BENCHMARK V.R.P. Top W. survey :-on ASSUNIF; F:LEVA'rION loo' lifter I_ir.~°time Filer ❑BOREHOLE 11ELL +D.R.p. sameasooncnmark Wainut Hill Wav Scale = 1/4" = 10' Acre Lot Pro 4 Grading is to Bedroom be done to House divert run-off from awaATank Huffcutt CWell is to meet ali WDNR setbacProperty Linc f I Area 15' below system is to remain undisturbed Property Lines B.M.' 1 0 0' e8' 99' nr,,,.; - UPf1S ON OF INDUS-RY :?CRVICLS 23331 SAN LJIS PL GREEN RAY Wl 54304-5211 `0 S l'CoTact i hrough Relay \ P hllp-r:Asps.svi-gov:programsandushy-srrvmcs "AV W SNnc n.dov Scott Walker, Governor Laura Gutidrrez, Secretary November 8, 2018 CONDIIIONAI. APPROVAL PLAN APPROVAL EXPIRES Plan Reviee': PWl'S-I I IX023,38-C slLM N R DIRD 1432 120111 S7. VPW RICI Ih1OAL1 W l ;4017 SITE: Oevering I lomes - 215 Walnut Hill Way Saint (*Fors (moot Tovt'll of Troy . Mound l'unliument Manual A'cr. 20, SM-10691-1' IXJJ 1!01. 12 10;12) Prcaxve Distri`.n::ion Conlpuncra \I.nnu l Vs. 2S0, SBD-107(16-P(\.01!01,8 1012) Dewriplion: 400 GPU Maitamnce Require) The sul rutuJ dv,;ri x:d :!ho%'e has been reviewed for conlirrmancc ,vilh applicable Wisconsin Administrative (odes and Wisrooain slauues. the suhmittal has hxn (ONDI I IONALL)' APPItOVI(D. This s) stem is to he ara;vuo:cd and located in accordance with the ewloscd approved plans and with ;m) component manual(s) rolbrenccJ shove. The oo'nnr, as Jef i ncJ in chapter 10 LU I (I M. 14 iscvnsin tital rues, is responsible i i,r cunrpl i.iwe teilh all code requiremenl. No person may engago in or work at plumbing in the state unless licensed to du x, by I:ae Department per s.l •li.06, slats. the lolloa'ing conditions shall he ntet during construction or installation and prior to ucarpane) or use: • Preserve di%limal area prior and durinK construction to ovoid dkimbante, compaction and use of the site. • %Vith nevi' construction; it is recommended not to icli, atc the pump i1: the Jose tun'; witil the tanks are pumped prior to L•omeomwr oe(upxw). • \Vr lewaler generated from contractors cleaning of equipment acrd awls and'or left user construction nroJucts shall not 'oc discharged into the drain. diachargine to the pri\aw onsite ,sir;te,cater treamwin, s< wiii WOWTS). Waste :ener;nod ;hall he properly disposcd of on-Tile or rat'' site. • Any tall grasses, leaves and shrubs snail be out short and rcaimed prior to tillin" the surface :or installation to prevent maain!_ tmdcr the dispcrsai area. A11 Ioosc„rganie material it, l7e removed from mound arc:. • Divert surface water that V(Ak I t Arco. • Prior to construction of the dispersal area, cheek the moisture content of the soil to a depth of 8 inches. sl,warine;rod onnp;r,:Iin_ uf„el oil ,,ill ir. r:Jueiny Ihe. iCti.lr;r,i.m ;11),!k it'. of lane soi'. Proper ;oil u s:arc ionte-d run I , d.~t::pet ne t Lc -.sins a soil coon+le hops eon Ya.. l'ar'k. 1: it tuffs -11" :I I! I- :),-IT tsirc. the site is too wet to orenarc. If it crumhles, site nremmition canL,cce;l_If the site is loo weI in prcnprr ikt not nrocccd until it dries. • All piping shall con:i nt to SPS fable 394.30-3 and SPS'1 ahle 384.30-i • Insulate building sewer beyond 30 feet per SPS .382.31) (11 I(c) • N% ell setbacks to meet chs. NIL 911 s& 81? • Tmtk Installation to tbllo\s all ujnuf;!clure's recommendations. • SPS 383.540)(e) I lie management plan for a I'M IS shall specifically address the c. ,r\ icing mechanics of nt aerobic or anacrohic treatnxm tank or a holding lank where either oflhe. Rtllowing conditions exist: I. The bottom of [he lank is located mo-e Ihan I i li•el below We ele\ation "here the servicing pad i, located, 2. l he hotom of the tank is brat::;l .lore [limn I it_) feet horizontalh Iron[ v,a°re (n;:. -r\ icing. Pad is located. • Verify properly line(s) prior to instal Laion. • Puma I•Ioats to be set and verified ter improved elan. Any charwes mar result in puma rc•sizing to meet 'I Dill and GPM Specifications. • Vrca, than lure occupied % 11 ran I fl it . 1. . r.q•~ -.e. dd: -<rrc.t2 :he -n,~1 it 11 Jlal'l; , 1,,- n, a ,-u. i s faoh.c, I rr.'.lie haul urea ollhc mount int ri I'~ c.u pit ,,,.nJ --l \ 1.,: o it :or.t i, n: r+.,..in •..Lrt r n of the nbovc moll .lots ctr;: ;n.c unl •:c..L h 111-1\ Owner Responsibilities • 'fh;: correct owner, aa;t each suhsrqu::m onncr, sail receive a copy of this letter ird coding insuvctions relating k1, preprr use and main[cnance ol'Ih;• a; Gent. Unnars shall rxcive a copy ul the appropriate operaCon and nuintenanee manual anJor oss ner's manual for the 110 \k fS described in Ctrs approval SI'S 383.54( 11. • fn the event this soil absorption sy slum or;:ny of its conptoncol palls malfunctions so as to a•erne a health ha/ord. dw properly owner nn14 ii+Ilo\s Ihr a+nlingeocy phut as deserhed in the approval plans. rep, ollhe approved phut, spe::ilicationssnd tP.iS l.•:k•r shall be kin-site during conslruclion and open h, inipec:ion b\ authori/ed representalkes of the Oeparlment. which may include local inspectors. All permits required by the state or the local wunicipal.ty shall he ob:aawd prior to commencement of construction. instal lationloperation. In granting this approval the Division of Induslr, Socials rscrees Una right to r quire changes or additions should conditions arise nmking Ihun neccssar, lit code compliance. AN er %late stats 101.12(2), nolhing in Ihis review shift l re;ieve the designar of CIC rcsponsihi.iI, Iii eleai I I inq a: sale building structure. Or component. Inquiries concerning this correspondence may be made to Inv al the Ie!ephuae number lkied helow, or al the;uldres, kill this letterhead. I he abi)%c let: acdressee stint: provide a copy of this letter and the 110\1' I-S rn::enrol;arr. plar :o l:.te o„n;: and and others wito arc re,pomib:o or Cne installation. operation or maintunoncc ol'.hc P(M I Sincere//h''. Trot V;mdcr Leem I'l oalk. S;:w:ma Ilan Itev ic\rcr . Div kior of Indastrv Servrees I')^111.172-," I I . Man- I r:. r..nt_ - 1:.1,11 p.ni. iia Jr l: r.l Cover Page Shaun Bird Bird Plumbing Inc. 1432 120th St. New Richmond Wi 54017 715-246-4516 Date: 11/8/18 Owner:Oevering Homes Location: SE1/4 SE1/4 S22 T29N,R19W 215 Walnut Hill Way Troy Manuals Used: Mound Component Manual Version 2.0 (N.01/01, R. 10/12) Pressure Distribution Manual Version 2.0 (N.01/01 R. 10/12) Page# 1. Cover Page 2. Mound Plot Plan 3. Mound Cross Section 4. Pipe Cross Section/Pipe Layout 5. Pump Chamber Cross Section 6. Pump Curve 7. Filter Specificatio and cross section Shaun Bird Signature License num r 226900 Page 1 ofl, System PLOT PLAN wtO.IEU'r Oevorino Homes ADDIt1;SS 1433 Cernohous Avo Suito A New Richmond Wi 54017 SE 114 SE 1/45 22 rr 28 N/It 19 w TowN Troy COUNTY ST. CROIX SYSTEM ELEVATION 100.4' DATE 11/6/18 BEDROOM 4 CONVENTIONAL AT-GRADE. CONVENTIONAL LIFT IIOLDING TANK MOUND )pp( SF.P1'HJ TANK SIZE 1255 gallons LIF,I' 'TANK SIZE DOSE, TANK sin 765 ' HOLDING TANK SIZE. LOAD RVIE 1.0 ABSORPTION AREA 600 p of chambersnono BENCHMARK V.R.P. Top of survey iron ASSUME F.LEVA'1'ION 1110' Filter l.ilctimc Filter ❑ BOREHOLE O -II.R.P. sa:ne as benchmark Walnut Hill Way Scale = 1/4" = 101 1 Acre Lot Pro 4 Grading is to Bedroom be done to House divert run-off away from system Huffcutt Combo Tank Well is to meet all WDNR setbacks Property Line B-2 Area 15' below system B - 3 is to remain undisturbed 5 Slope Property Lines B.M.' B 1 1 00' 98' 99' Mound System Cross Section and Plan View Dimension Feet r t A J t 0 t 1 t _ _ 13 I F -T ` 5- - t I E!H I t 1J I t I Z 'p 3 _l - - - - - - - - - - - - - - - - - - - - - - - - - - - - - . K; - B--- -T I Z . I. - ~ S4c 5 % Topsoil r - AS'l NI ('-'3 Clean aggrcgale 4 in. sch. 40 pN c Cap vtaterial sand fill to 2 in dia " observation pipe Geotcxtilc G if Fabric - - 77 / F 101't / ll q Plotaed Surface l 2r e pt Contour dope L)irection ~s GENERAL INSTALLATION: The mound area is staked out along the design contour. Existing vegetation is mowed and raked off die site. The rnound nasal area (L x W) is plowed wilt a moldboard or chisel plow. Plowing stay not proceed if the soil is wet enough at the plow depth to form a inch soil wire when it sample is rolled bethvccn the palms of the hands. ASTM C-33 quality sand is placed immediately after plowing. Sand is placed with a tracked machine keeping 12 or more inches of sand under the tracks or is placed overhead by a backhoe. Special care must he used when placing sand of less than one foot thickness to minimize compaction of the plowed surface. After the topsoil cap is placed. the entire mound is seeded and mulched to promote vegetative growth, limit erosion and protect rrotn freezing. The observation pipes are slotted in the lower G inches and secured in place with rebar or a closet flange. 10 10? lhl Page _ of Perloralea Pipe Detail /Ennyiew (PU ta•a iea y PVC P.Dt ~pMce Ha/e$ LDLarea On *0110M. ~ •re Eoaeny ioecea -il'krn~~ i r~ K a PVC Forcr Maw .,sP~~~Dr Yl%8T MOIL NL%T rs CenMC~rot• PVC S MarulO'd do Pipe s~Ao Ortt•wt.an / NPt /~ex To Tcc~n. -urns Di:vinmfion Pipe loyoW p 5"Ft. R 3 Fj. X 3 0 inches y Inches Signed: Hole Diameter : /~3Inch License Number: Lateral Inch(es) Date: Manifold " Z Inches Force Main Z Inches l of holes/pipe Invert Elevation of Laterals l~ Ft. Foicz Plain = 50 Fcci Septic-Dose 'Wank Cross Section And Pump Performance Specifications Pura Manufacturer 't'ank Manufacturer HL Q- c4sl Tank Model Number 1 Pump Model Number D _ Total Tank Capacity ~s / Alarm Mufacturer UCr Max. Bury Depth Alarm- M _r T_--- Switch Type - r C- - > i ,Q (TDH) - Fce[ Filter Manufacturer Total Dynamic Head ~ - - . Filter Model Number I Elevation Head C7 _ _ Distal Prosaure / Network Loss _ ( --Minimum-pump ce Required / Force Main Loss _ L GPM l~ Ft TDH Tour) outlet Manhole Min. 4" Above Grade With Manhole Min. 4" Above Gradc Locking Devices. Inlet Manhole Securely Mounted With Locking Devi <6" Below Grade Sealed Watertight Weather-proof 1 Junction Box 4 . - - Finished Grade - - - - - - t~ - Vent Min. 12" Disconnect Above Grade Means With Vent Cap {;5 outlet Filter ~y Inlet Inlet Baffle TA 14 SW itch Settin ad Reserve CapaciWe p Tank Volume dole Dimension Inches volume Gal. (reserve) A X22' off Elevation C (alarm) B 2 Ft Bottom (dose) /oZ rte--. (dead) D D Elevation Ft Total GE'YERAL iNsTALLATION: The septiddose tank is bedded and back filled in a: cordance with the manufacturer's product approval specifications. Maximum depth of bury as specified by the manufacturer may not be exceeded without prior approval. Manhole covers exposed to grade have an effective locking device fi (adl and ted to material, main onnec ~ with 4" nk with 0 YVCrti t ridge the tank the installed. Piping at the inlet and outlet is of approved laid stable soil to prevent settling or sagging. ~ ice lies with NEC 300 and Comm t 6.2' excavation and the sleeve is sealed led watertight• Electrical service comp Page__ _ of 021051) 280=SERIES 112 hp Submersible Effluent/Sump Pumps The Liberty 280-Series provides a cost effective "mid- Performance Curve: 280-Series range" pump for on-site waste water systems, liquid 40 12 waste transfer and commercial heavy-duty sump pump applications that require higher head or more flow. 35 -7 11 Designed around Liberty's unique "Uri-Body" casting, 30 g the 280-Series will provide years of reliable performance. N 25 8 All Models Feature: U 20 •Vortex style Impeller permitting passage of solids ~ i g ~ up to Y." i i = 10 i - 3 • 416 stainless steel rotor shaft - - - • Permanently lubricated upper and lower ball bearing 5 2 • Epoxy powder coat finish 0 - - 1 0 • All fasteners-corrosion-resistant stainless steel 0 5 10 15 20 25 30 35 4 45 50 55 065 70 • 1'/:" Discharge U.S. Gallons Per Minute • Stainless steel bottom screen - easily removable r 1 { 0 38 76 114 156 192 228 270 • Maximum fluid temperature: 140' F. Liters s Per Minute 280-Series Cord Lengths Model 10' 25'(-2) 35'(-3) 50115L Dimensional Data: " -_Weight: 29 lbs. 280 Standard Optionai Optional Optional Height: 13" 287 Standard Optional Optional Optional Major Width: 10" (model 287) 283 Standard Optional _ Optional WA 287 _ Standard_ "O tional _WA_ WA Minimum Sump Diameters: Model 281, 283...14" 10' cord length standard on all models. For optional lengths. add '-2,-3 or S' suffix to model number. Model 287 VMF...TO- Example: far model 280 with 35' cord, order 280 3 Factory switch Modol 281, 283 Model 287 settin- s yMp Motor Specifications Turn on level 13" 4..0 5" hp 60 Hz 3450 RPM 1 Turin oft level 7" 4" Oil filled, thermally protected (PSC) Permanent Split Capacitor The Mudol 283 features a fully adjustable wide-angle float. Differential 8.0 amps (1151/) adjustments can be made easily by tethering the goat to the dis- 4.0 amps (20a/230V) charge pipe or other mounting point. vertical float model 287 is not Y adjustable. ti r_ ~ [p )o 1/;. Jul Model 280 Model 281 Model 283 i / Model 287 a- Manual, + Wideangle I^ f. r Wirleangle VMF-Series no switch float switch - _ float switch Vertical mag- netic float for with quick- i, with seriesC disconnect / (piggy-back) smallerpits- plug will operate in ' a 10" diameter sump c c us Certified :ovo~v:.u++na my w:,lvr.:: rrtxe. wenrt,wt~.•_ Liberty Pumps • 7000 Apple Tree Avenue • Bergen, New York 14416 • Phone 800-543-2550 Fax (585) 494-1839 www.libertypumps.com orfrlght a uberty l'umps' Inc. 2017 All rights rosavml. Ufr 2060 RWI7 s ~ ~'t~lill r_ - t f ~ O R rr 4 55 / I? a ~ U ~ ~ I/ N\l Nll j~! ~ A~! 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C'ROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION hURM 0wncr/Buyer tle Pr) Mailing Address 7jL Property Address lt_11,177 (Vertticah(rn reyttire from Planning K 'lontnKDrp uncut far new curl. ciionJ - City/Slate Parcel Identification Number O - LEGAL DESCRIPTION ~ Property Location SF- sm., ZZ: TZ N K(~( _ W,'1'own of Subdivision L-c% --ta-k T(1 - -11-_..__ - _ , Lot # Certified Survey Map # r - - -T - - Voltaire Page 9 Warranty Deed # 1 - Volume Page # Spec house ' rs uo f.ot lines rdratifiablo - - rre no SYSTEM MAINTENAiVC'E AND OW VER CERTIFICATION foq)roper use and maintemnce of your septic system could result j a its prernatmi: failure;[u handle wastes. Pmpm the systteem m --all atfcxa the consists h p timcumphing out )he sr:ptic lank every three years or soulwn. if needed, by a licensed punipet. What you put m[o the system of the septic tank as a esponsibililics arc lreatr»ent stage in flit. waste disposal system. [)wear rnaintciunce sprcifie<I in ¢Cmr m, k452(t) and in Chapn:r 12 St. Cniix County Srentary Ordinance. 11ty property owner agiees to submit to s). Croix (;oan[y planning 7(mbtg Department a eertiiit:ation f7urn,n signrd by rhr owner and by a master plumber, fourneyman plumber, iesti ictat plumt:or of a licensed pumper veri 'tying that (1) the n site wastewater disposal system is in proper operating condition and/or (2) after inspeotiun and puiitpink (ifneccssary), the septic tank is less than V3 full of sludge. Fwe, ystent sCandards set f,hth he rein, ass ed have sset by the Dethe abow. part umt or ( -ommetcr and the apiet- to Depu farm cif Nantural r lie nut es''Stuic of wiscanm the Certification stating that vour septic system hub heel maintained most be completed and rear ned to the St Croix County planing Nc i.onng Department within 39 days ul'the threr yrar expiration date. Ifwr, ceriitp chat all statements on this to t arc fn-,t to file best of ury:'our knowledge. Uwe aurfare the owner(s) of the property descrihed above, by `virn~te pf a wart m flee l recordr(i in itegalcr of l]ee(Is t )tfim Number of bedrooms ~S? 16NAT( . ( FAPPI..ICAYF(S)- - L>ATE -**Any information that is mistepresenred ruty result in the sanitary permit hcing revoked by [he Planning & "Lonny; Department. ILcInde, with this application a recorded waranly decd from the RG pislcr of Dreds Office, and a copy of the cutbtied survey inap if reference is made in tfw wan tansy deed. (RFV. oaros) I i I i I~ w e F7 n 4~yyy3 ( c + r z ! y1! ,o f D 1\ I 1 III Jr- I yS1 I ~ I~ ~ G]i~S L\ I G ti ! ",1.(7~ S JIB +e Iaj9tD~Qq;4,a i In i i tp~~ I I I II I j I~ I I' I N v g't~ F-IIl~f ~I ylsiy`t ° I~il S 3xl n;.~~ ~~flt `yiCF~ i I i x ~I.s Z Is3~ ~Yt~ sr[sf e'argl' I I i I i k IIIy I I Z ~I I I n 3 - 6 rah i I r-4 b lE~i ~:g I Sgt a`Os a d X11 to. y Gk1 a n "~I '4 i I I II L. ' i1 T ~ i' 11 ~II~, a l ~ 1 Y ~ a { f1 ~ i i Y ~1c i -1 L - L 1 i I F~ Y i p ~ p'p I. I ~tH3~ P P' P ~y a r F ] p t i a A ~ ~I s r jy qp : 'hE ~ECF •o or u i 5 I ~ RI' i i I i e 1 ' t O!h I 4 p e I All 1L , 3 2018 - w Wisconsin Department of Commerce $OIL EVALUATION REPORT Page of Division of Safety and Buildings in-aaddrdamcew§Comm 85. Ws. Adm. Code - - County Attach compete site pan on paper not less than 8 112 x 11 inches in size. Plan must ~ include, but not limited to' vertical and horizontal reference Point (BM). direction and Parcel I.D. Percent slope, scale or dimensions, north arrow, arc location and distance to nearest road. 6Y6-1363 - - Please print all information. Re by Date PMOrlai mrwmation yw pry.,de may ~ vaed nor •scaWary pwpoees (Privacy LaW . E. 15 Oa (l l imp Property Owner Property Location GOVT. Lot 114 Sf 1; S G T L N R cill E( W Property Owner's Mail' Address Lot k Block a Subd. or CShW r,, r -ct r^✓ C 62-1- 1 p C Code _ 'Phone Number S❑ City Q Village own Nearest Road CM J / ` J 1 c r 1 f Ll C~~ New Construction Use s:deneal I Number of bedrooms Code derived . ign flow rate 1lla _ GPD ! Replacement ublic or commercial - Describe Parent material _ Flood Plum elevation i!apVlieabo ILI 1 General comments end reoornmendations. Sys' ,P System cle•:abun_ ( t Borcig a r❑ Boring ] Q l pit Ground surface elev ` ! R Depth to limiting factor in Soil "llon Rate Horizon Depth Dominant Col Radek Description Texture Structure Consistence Boundary Roots GPD,MY in. Munseli Ou. Sz. Cont. Color Gr. Sz. Sh. •Effl+t •Effa2 ✓-lC J l~ T l T Boring Of ❑ Bonng 9^-r ET Pit Ground surface elev. / r R. Depth to limiting r factor in. SW hcation Rate Horizon Depth Dominant Cola Redox Description Texture Structure Consistence Boundary Roots GPD1it• in. Munseli ou. Sz. Cont. Color Gr. Sz. Sh. •EBpt 'E"2 9 X) • Effluent a1 = BOD. - 30 < 220 rntyL and TSS -30 < 150 myz4 • Effluent #2 _ BOD• < 30 mg /L and TSS < 30 mryl CST Name (Please Print) Sig e CST Number Bird Plumbing, Inc. Shaun Bird 226900 Addre55 Date F-aleat,n Conduc'od --Inphnre Number 14,32 120th St. New Richmond. WI 54017 715-246-4516 Parcel ID4 Page tar Properly O~er ❑ Boring ✓ Boring # GI Ground surface elev. l V ' R. Depth to hmitirg fauYa- I[~ Pit - - Soil watxxt Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Do Si. Conl. Cola Gr. Sz. Sh. -Elf#1 'Ef1#2 sr• /r ely P/A I - - i Boring # ❑ Boring - ❑ Pit Ground surface elev. _ It. Depth to limiting factor is Soil licalxxt Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD#f _ in. Munsell Ou Sz. Cont, Color Gr. Sz. Sh. 'Eff 11 'Eff#2 Boring Boring # Ground surface elev. R. Depth to limiting factor ❑ Pit Soil ice6on Rate fforizon 'bpth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDlfF n- Munsell Du Sz. Cont, Color Gr- Sz. Sh. 'EH#1 'EB#2 L. Effluent #1 = BOD, > 30 220 mg4. and TSS >30 < 150 nViL ' EfhueM #2 = BODR < 30 ngR and TSS < 30 n'91- 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 ttte department at 608-2663151 or TTY 608-264-8777. 1.11 t, W IR e:GI Property Owner Parcel ID it _ Page ur-. Boring # ❑ Boring 3711, pit Ground surface elev. a fl. Depth to limifing factor C7" _ 91 Sell APPlication Rate Horizon Depth Dominant Color, Real Description Texture Structhre Consistence Boundary Roots GPDMf it) Munseell J Ou. Sz Cont. Coex Gc Sz Sh ' 'EH#1 'E~ftj#2 r -37 o"/ I i Boring # ❑ Boring ❑ Pit Ground surface elev ft . Depth to limiting factor _ in Sol A lpliratior Rate Horizon Depth Domxlant Color Radox Description. Texture Structure Consistence Boundary Roots GPD,KF in. Morsel: Ou. Sz- Con, Color Gr Sz. Sh 'EM#2 1 1 Boring # Boring ❑ pit Ground surface elev. M. Ooplh to limiting factor in. Soil Application Rate Horizon -1epth Dominant Color Redox Description. Texture Structure Consistence Boundary Roots GPDMF in. Munsell Ou. Si Con, Color Gr Sz. Sh 'Ett#'. -Eff#2 ~ I I I i i ' Effluent #f = BOD, > 30 < 220 mgrL and TSS -30 < 150 mglL ' Effluent #2 = BOD, < 30 mglL and TSS < 30 rrxy2 The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access scrvices or need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. Sedt110 (R I Soil Test Plot Plani Project Name Oevering Homes ShaOr' ird Address 1433 Cernohous Ave Suite A New Richmond Wi 54017 C TIv #226900 Lot 62 Subdivision Walnut Hill Farm Daft 11/5/18 SE 1/4 SE 1/4S 22 T 28 N/R19 W Township Troy ❑ Boring Q Well PL Properly Line County ST. CROIX BNI or VRp Assume Elevation 100 ft. Top of survey iron System Elevation 100.4' •HRpSame as Benchmark Walnut Hill Way Scale = 1/4" = 10' 1 Acre Lot Property Line. B-2 B-3 5% Slope ❑ B. M.' Property Line B - 1 100' 98' 99' Wisconsin Department of Commerce SOIL EVALUATION REPORT Division of Safety and Buildings Page/ of__ in accordance with Comm a5, Ws . Adm- Code cx+nty, ST. G,e O/JL n Attach complete include. but notI EROSION CONTROL PLAN nnlst be Parcel 1D. ev7- I T- Percent N ti slope. V completed bclbre sanitary pernut i,SUance I- P~ vOua !r b R y Date Personal Informatron you Woe may De uscN for seoonEary pu'poees (Pmaq Law. t. 15.04 (1) (mlJ. 1 Its Property Owner /0 7~/ D v TODD Property Local 1 ODD S J E RS l-e70 7-- % A/" H.N. Govt. Lot /}I I o~ 5 f 114 S -4L- T 2,b N R E (or) w Property Ownefs Maisrlg Address Lot" Block" Suhd. Name or CSNW !Hots CA t}iLL t4Ue ~Z cvAcWor Kill CAY S,vU1L/2 State P Code Phone Nullbrr - PVOE fl T ; MN 55076, &5/ 199. 109 C] City ❑ V rage [ATOVm Nearest Road C ovER t ) TRoj' SO. &I Now Construction Use: 0 Residential / Number of bedrooms _ Code derived design flow rate _ 027 GPD ❑ Replacement ❑ Public or commercial - Descnbe: - _ N Parent material Flood Plain elevation if applicable ft- General comments and recommendations: 74-75TE17 50/•7--`d/4- j IJe sys~.y • Zfsi.u(~ .zo" s~,vo f1-// - ~ Za_~( - old Gmilq _j N FT] Baring" ❑ pit //Z ® Pit Ground slrYace elev. `T _ ft. Depth to lirtlilirg factor Rate HorLZDn Depth Dominant Color Redoz Description Texture StrudLre Consisterxx BouldaryRoots GPDIIF ~ in. ML^sell Qu. Sz Con! Color Gr. Sz Sh. •Eff"1 'Etf"2 / O.7 1-0 Yle 3 - S' Z 7 24shC /W-rx CS 13f- f .5 /z /0 1 3 - ^'-F (fs 5/ . 3 42, )o Sfsh IPmfk -s / f- cza~-1 s S/L s -5 Z /I„e / Z /o y,e 4;;,/ Z o Z oBoning B°'"'g" ® Pit Ground surface elm, n i .S. S. S Depth to limiting facto ^ Soil Application Rate rV~ Hermon Depth Dominant Color Redgx Description Texture Structure Consistence Boundary Roots GPDffF 1111 in. MLmsell Ou. Sz. Corn. Color Gr. Sz. Sh. -Eff"1 -Eff"2 / 0-7 DI J L 2~She .wL FR 5 3 -f- • 5 N z •1 /bl 3 C5 /f y N 3 a-lG /o - SQL 2 h ,1,~fR GS / s 8 S c~~Q hors slcL z~a ~•,ef ' 3 /o yle 2- s ye s/ EMuent !f 1 = BOD > 30 1220 nxft and TSS >30 < 150 mgA. ' EfMaerlt "2 = BOD < 30 TSS < 30 mg1L CST Name (Ploaso Print) Q L{ 1-13 R i G l.T- Sg G 3 7 Address Ulbricht & Assgciates Dale Evaluation Conducted TelePhone Number Private SEpj• 1/--io6 -z, 7t 5. 770 3yy2-_ 2812 10th Ave. Spring Valley, WI 541-67 t'in fob pP~'o k' . Z yo ~y0 • /o8s • so • ~ 0 yo • /D k(P /o ago d y0 • /(70'(0 • 2D • Ufi0 oyv•/o8G• ~D•~ oyo•/og6 70. 0011 r, 0 yo al,41-N v 7- h111 145~9iPM ToD~ r'rn;x ny CC,e /3JE e 5TEDT- GO f 6Z Z 3 Panxl ID _ - Pr-:;-• e, Bc nyr Urw nt _ - 133 /p S5.5 - Pir Cnnind stniax eIi ~ ~ ft Oepth b iimrli:xi tx!rx _ ~ id¢oDeptt ,»lA{plicrit0r t r f n . U:xnin;+nl Cn(or Redo Ur5mP4rr.: Tcxdae Strucu" C:am%ln . Boundary Roots GPDff in. MunSnH Qu, Sz. Cont. Color Gr. $z h Eft#1 TINY, 0 t'n t/OYl? --L - ~S17/C n. Fly f lrJ 3 F c~ 13 IS /0 y1f 4 3ff sit ~ h 1 Sic 11f~ 3 Boring # U Bonny ❑ Pit Ground stafacx etev.___ k Depth to timitiN factor Se7 Appliw~l Ra!: fiavon Depth Dominant Color Redox Description ! texture Stn1C(Ure COnsistence Boundary Roots GPDftf in. Munson Ou. Sz. cord. Color Gr. Sz. Sfi. 'Eff#t 'Eff!12 i ❑ (kmrg Bor ng # Or Pit Ground surface elev. fl. Depth to Nrni /aanr in. _ Sol Application Rate tkxtzon Depth DorMnarrt Color Red" ()esaiptian Texture ire Consistence i Str Roots GPD!(f Mtmselt Qu- Sz. Cont. Color G. t Sh. EF#1 Eff#" i~ _ .I i Bo Bor(n) # nny - II U Pit Gmumi swiamelev. N. Depth to FrriNng factor in. _ _ Soli IicaAion Rate ( ttrxi)on Depot Domtnant i:,nlM Redrm Destxi(Aion. Tm u.. Structure t%etnistenco BaaWaY Roots C iR. Munsell Qu. Sz Cont. Col Gr. Sz. Sh. 'E8#l 'E1t#2 _ j--' - F"i:,rx>i #f = BOU,> :YJ < 220 nkyl and TSS >30 c 150 rnWI ' Effluent 0 = BOO. < 30 nxft and TSS < 30 PYYL _-,I,, fhnunt ol-Commerec is an equal opportunity service provider and employer. ifyou need assistance to access services or :,rid material in an alternate format, please contact the department at 608-266.3151 or TTY 608-264-8777- PLOT PLAN WALNUT HILLS FARM. LOT # 6~ Z Pa. 3 of A = Contour elevation lines. • = Backhoe Soil pits. O = Benchmarks set, maRKED WITH FLAGGED lathes. 1/2" steel conduit pipes. Ulbricht & Associates SCAI, E: t " - 3 O Private Sewage Consultants 2812 10th Ave. Spring Valley. WI 54767 2 M Oplal7 1 N g' uAJ FoR~ GiN- o~ c oa-rov~ ~ 9 N~. ~ ~ 2-7 0 /0' Q a~ yo 91 A Afov, 1) SYST-.