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Wisconsin Department of Commerce PRIVAi'E SEWAGE SYSTEM County: St. Croix Safety and Building Diysion INSPECTION REPORT sanitary Permit No: `�C� 453321 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)i. Permit Holder's Name: City X Village Township Parcel Tax No: Sether, Lori Village of Wilson 1 q( CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range /Map No: l 0 ® j ° a 172) N \ C c �� /L 26.29.15. TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Jd � Benchmark' 8$ 7 t'7D D4e Dosing Alt. BM CA Aeration Bldg. Sewer Holding St /Ht Inlet ,1 ) Z1 1 7 I(p TANK SETBACK INFORMATION St/Ht Outlet '7.2 q IZ(; TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic � A is4 `i+' Dt Bottom O 6' f -9,:2 Dosing 7 40 /JA G , • Header /Man. I 4 . Aeration Dist. Pipe 3 bS • 3w .I � Holding Bot. System I PUMP /SIPHON INFORMATION Final Grade Z • I A Manufacturer Deman St Cove� r `� G w 'S zg ,9 GPM E- Model Number ` 0 or or TDH Lift Frictio Loss System Head TDH Ft Forcemain Length Dia. , t Dist. to Well PU Y Y e 1 /6% ,o� 24 C2 O SOIL ABSORPTION SYSTEM 'T n IZq . BEDITRENCH Width Length / No. Of Trenche PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS "75 ('3 ` �` N_-1_ °� SETBACK SYSTEM TO P/L ' B IWEL L LAKE /STREAM LEACHING Manufacturer: INFORMATION Ty t CHAMBER OR pe Of em: UNIT Model Number: DISTRIBUTION SYSTEM � Header /Manifold Distribution /J x Hole Size . I x Hole Spacing Vent to Air Intake t Pipe(s) C " 1 � Z 3 J T' Se P*�-r' �. Length Dia Z Length �Z Dia Spacing f �� �-wwk SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only Depth Over t Depth Over xx Depth of 1 xx SeededlSodde xx Mulched Bed/Trench Center t ` 7 Bed/Trench Edges Topsoil �, Yes _j No Yes 1t ] No f COMMENTS: (Include code discrepencies, persons present, etc.) InspectionC�_ Inspection #2: I Location: Unknown (NE 1/4 SW 1/4 26 T29N R15W) NA Lot Parcel No: 26.29.15. 1.) Alt BM Description = �— hock P� 2 • J 2.) Bldg sewer length = a amount of cover = 1 ; 54-. 3 D ' 3.) Contour = 41 Plan revision Required? _<] Yes KNo Use other side for additional information. �_ `_; Date Inse4e�s�Sign Cert. No. SBD -6710 (R.3/97) 05/07/2003 WED 07:21 FAX 1 715 132 4099 DUNN COUNTY DEVELOPMEN1 tv-1uul,UV. Safety and Buildings Division County 201 W. Washington Ave„ P.O. Box 7162 - 5 T. C R X I Madison, WI 53707 - 7162 lte Address v SS ze e eQ V �a W t '. Commerce I ' Sanitary permit Application PAID ' -3 ° 3 ez In accord with Comm 83.21, RJis. Adm. Code, personal information you p ma be used for secondary purposes Priya q Law x15.04 1 m 0 C heck if Revision I. Application Information - Please Print All hdarmatlo State Ptah I.D. Number 9& Property 0 w is Name Parcel Number nt2; Se�h� Lo Property Owner's Mailing Address PWP6M Loca Al S� , r ei�uix COON F 6`4, S rZ1 " N. P& E City, State Zip Code V Lot Number Block Number �. V el 1 V L ) Subdivision Name ' CSM Number y It t f .a aAAC eQ It. Type of 3fillding (cheek all that apply) S w« ocity or 2 Family Dwelling – Number ofpodrooms 0 Public/Cotmaetcial – Describe use ❑ State Owned X ' a nA1Z owag Nearest Road III. Type of Permit: (Check only one box online A (trwnbering scheme fns Internal use). Complete tine B if applicablo) A. ew 2 ❑ Replacement System 3 ❑ Replacement of 6 D Addition to For County Use stern i Tank Only Exisdn S m B. ❑ Check if Sanitary Permit Previously Issued. Permit Number Dam Issued IV. Type of Permit: (Check all tha r = nternal 9150 44 0 Noa - Pressurized In Ground Mound � Suld Filter 50 0 Consaumcd Wedand 22 0 Pressurized In-Ground 41 Hol 46 0 Single Pass 51 ❑ Drip line 45 ❑ At -Grade 46 ❑ Acrobic lhatment Unit 49 ❑ Recirculating 30 0 Other V. Dix ettsaMeatment Area Information: Design Flow (bpd) Dispersal Area Dispersal Area Soil Application Percolation Rate System Elevation Final Grade Required Proposed Rato(Gals. /Days /Sq,Ft,) (Min.Jlncb) Elevation VI. Tank Info Capacity in Total Number Manufaczater Prefab Site Steel J 'Fiber plastic `Gallons Gallons of Tatilcs ���_ /� C�Q,�a Concrete Constructed Glass Ncv Ht4tlnY TAWS Tattles Septic or Holding Tani[ 9p�0 Doane Chamhar O '0 VII. Responsibility Statement– I. the undersigned, assume responsibility for installation of the POWTS shown on the attached plans, PIName ff'ria0 � PI r' Si our MP/MP � Number Business Phone N Ep ::2�/4 2 6p 3 � Y P lumber's Address ( �eYcwi --/ ,-IV )� � r '`te36 Z' VIII. Caul /De artment Use O nly Approved 13 D isapproved Sanitary PemNt Pro (includes Groundwater Data Issued ZIsAgr. Signantre (No Stamps) Surcharge Fee) ❑ Owner GivenInitialAdve::se. ?� Ib2M Determination IR. Conditions of APprovaMasons for Disapproval 3) Lt:7(- 5 r ye e� f L SYSTEM OWNER. \-) � 1 Septic tank, effluent filter and�� dispersal cell must all be ` '�t£> . strutted f maintained l/ W as per management plan provided by plumber. 2. All setback requirements must be maintained f ) for the jy,tem on payer not leas than asn: inches in stse as per applicable code /ordinatip09: r r � A- 1 sa ,s r o r 9 s .-Y 1 �� COPY 6 f f J 5 � 6 ° �� q .� � J A L s ✓ f M � si �`� ' ' a.,..,, 4 � \\ f � _ � �'.� :"'I '• ` t r Safe and Buildings .i Safety commerce.wi. OV 4003 N KINNEY COULEE RD g LA CROSSE WI 54601 -1831 TDD #: (608) 264 -8777 ' ��O �' www.commerce.state.wi.us /sb Department of Commerce www.wisconsin.gov Jim Doyle, Governor Cory L. Nettles, Secretary May 18, 2004 CUST ID No. 222774 ATTN: POWTS Inspector HENRY F GROTE ZONING OFFICE CERTIFIED SOIL TESTING ST CROIX COUNTY SPIA E4366 353RD AVE 1101 CARMIC14AEL RD MENOMONIE WI 54751 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 05/18/2006 Ide Numbers Transaction ID No. 998666 SITE: Lori Sether Site ID No. 683587 Village of Wilson, St Croix County Please refer to both identrficatton ntunbsrs, .' NE 1/4, SW 1/4, S26, T29N, R 15 W above in all correspo with the a dnc. FOR: Object Type: POWTS Component Manual Regulated Object ID No.: 958321 Maintenance required; 450 GPD Flow rate System(s): Mound Component Manual - Version 2.0, SBD- 10691 -P (N.01 /O1) Pressure Distribution Component Manual - Version 2.0, SBD - 10706 -P (N.01 /01) 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, Wis. Stats. The following conditions shall be met during construction or installation and prior to occupancy or use: • This system is to be constructed and located in accordance with the approved plans and with the "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems Version 2.0" SBD - 10706 -P (N.01 /01). • This system is to be constructed and located in accordance with the approved plans, the "Mound Component Manual for Private Onsite Wastewater Systems Version 2" SBD - 10691- P(N.01 /01). • Pursuant to outlet filter product approval stipulations, maintenance information must be given to the owner of the POWTS explaining that periodic cleaning of the septic tank outlet filter is required. The access opening used to service the filter shall terminate at or above finished grade with a watertight cover. A copy of the approved plans, specifications and this letter shall be on -site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of construction /instal lation/operation. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. HENRY F GROTE Page 2 5/18/04 r 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 $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 Leroy G. sky, Wast water Spe ' ist Integrated Services Bureau WiSNfA0code: 7 34 (715)726 -2544 Voice 1jansky@commerce.state.wi.us cc: Leroy G. Jansky, Wastewater Specialist r 9 99 8 666 Lori Sether - Mound �� 'ea Construction Materials and Techniques v ' �O 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: Mound, SBD- 10691 -P (01 /01) Pressure Distribution, SBD- 10706 -P (01 /01) Location: NE 1 /4, SW 1 /4, Sec. 26, T 29 N, R 15 W P•O W.T.S. Village: Wilson Condit County: St. Croix AP PROVED Date: April 23, 2004 DEPARTMENT OF COMMERCE DIVI SON OF SAFETY AND BUILDINGS Owner: Lori Sether SEE CCjkRESP0jZENC Address: Johnson Street Wilson, WI 54027 Designer: Signature: 4 License: WI D — 99 -007 %� • ... Attachments: SBD -10577 - Plan Approval Application SBD -8330 — Soil Evaluation Report Page 1: cover 2: design criteria & calculations 3: plot plan 4: system cross section 5: plan view, lateral detail 6: pump tank exit detail 7: pump curve 8: system management page 1 of 8 L • Design Criteria. Residential Wastewater Contaminant Load: 30 mg/L < BOD < 220 mg/L Anticipated septic tank effluent 30 mg/L < TSS < 150mg/L Fecal Coliform > 10,000 cfu/100 mL Fats, oils, grease < 30 mg/L Bedrooms x 100 gal/bedroom/day x 1.5 4_sb gallons /day hydraulic load ' Design Calculations In situ designed loading rate z- 3 gallons /sq. ft. per day Depth to estimated high ground water in. Depth to bedrock in. Cross slope at system 4 �S� % �_ V_ Y Force main length ft. of in. Manifold/header length ° ft. of Z in. Drain -back 1 y gallons Lateral length @ Z ft. of O z in. Lateral elevation s�, ft. @ bottom of lateral Lateral hole size �� �° in. @ in. ( 4" ° ft.) Spacing \ C� holes /lateral g holes total Lateral volume gallons Total lateral discharge rate 25 °g gallons /minute @ ft. head Network pressure compensation losses Elevation difference �A ° ft. — n.. Friction loss Vd Z ft. @ �� gallons /minute Total dynamic head z4 o ft. Pump /siphon � 6 gpm @ ft. of head Z S Manufacturer a �7 Model # Dose volume g Z, 3 t' gallons Lift/siphon tank I � - Lo o-o 6 gallons Septic tank 1 gallons Effluent filter Measurement pump on and off 0 in. Height alarm from tank bottom 6. 0 in. Reserve capacity g gallons specs.calcs.res Page of a I y Qj QJ PA � y d s o N � s'o 9 / �c // v t 1 «� Pk 14.E i q <i it I I fj 1 z 6 y I .L 3 N o'YL� l 0.� a. w7�L TQJ1,. w.�, w.,� � � •w w �"s � � �e.G \4� �,...: f i� f' 11 l a Z P u C S cy1 4-0 � 30 . K : v G►v Or 1 RJr �� l .. 4-2,C)1` A � I a r - 1 „ _.'. - ,- .- > ,,..r ; ..�..,,,. ..ter•. ._ ._ F. � � n �•00.�4 �' I"'L /► I N x1T \�). TVA I L.. WEAT'AER Pa wF LocKIwG COVER JUNCTION QUICK 014CO14410--1 12� 4" °P P iet- 3 f ;'olm HoISTuR6ED \ SOIL_ 24w I.D. ° KAXLLQLF- vEnrT � I �wGtc nwawt� A 23yd'I Hat 4 .. nv` `MXET J'ONr.5 1`�` Ora WFLE Au. PIPE 4 q 3' owro 1 jko v "o gROUKc •3 e� L�}ao Ow 1 ptkp D �It CoA+GtEYF Lev. B4. oCK SEPTIC t _ SPECIFI'CAT10QS DOSE TAWKS MAWLIFACTUSLfg- QLVABER OF DOSCS: S PER DAts TAWK SIZE: GAL.LOAJS DOSE VOLUME �Z 1!�/ ALARM M/WUiACTUKGR: - GAL�OuS AODEL WUMpER: CAPACITIES A= 23'° IUCHCS OR 3�s�'g WLL ouS SWITCH Ty /[I w wwv 5 . 7 , IWCNE5 OR 3 GA LO 1..;5 PUMP h1AWUFACTURER: o wee C C ■ S IUCNE5 OR GALI.OWS S IkL�I= 3 0 MODEL QUMDER: 0 ■ 9 '� INCHES OR tAI " `1 �w �,Io ._......r GALLOuS 'd SWITCH TPE; `°'"�'"` WOTE: PUMP AWD ALARM ARE TO pC e MIIJIMUML DISCKAR" SQ t ATE�'1�_(,/M INSTALLED OW S o EPARATE CIRCUITS A TO V Q. tK ttitk k�ei �a... `•Q -S . VERTICAL DIFFEItfIJCE OETWECIJ ;w—+ AIJO OWTRIbUTIOM PIPE... ,4,c. FEET � , I + MiW IMUM WETWOftK SUPPLY PRELs;URE Z r 5 �1:�� �. .... ......�._ F C E T � o, 4-S' + z � FEET OF PORCC MAIM X l � �oFxFRICTIOU iACTOR. �•¢� FEET ZS/ —" TOTAL OtIWAMIC HEAD = FEET 10 ` WTERMAL. DIMEW61OWS 0I TAWK: LEIJ&TH "j ;WIDTH ;LIQUID DEPTH ' Engineering De tails Pump Characteristics Performance Data r Aww U'dt Spa" Avttm* Ale" SNEF30A1 � T � I Haspswor .30 FW toad Amp 1.0 Village 115 Hem b0 ionporstwo 12n AmWottt c, e,+�s uA o to tt NElIU Doop A u.L500w a •.,.. ..__1.....,.._r. .�....._._ ,._...�. hsd6tios 43as A ' DWWj4 She 1 -1/2' W" (3$1111W Total N*N feet 4 1 0 12 1 16 1 10 40 Solids HaA" 3/4 (1W 0'M M.Sj 1 . 44 36 2 1 23 1 12 0 LIM wool 3011s. Power Cerd 1 {/3, 1'1l SIN 24' sDimensional Data Materials of Construction ,so, M p {x rwaiaNl v,e. 4 '11A 2 �ee�IM1 Anrsbs HaNs SM1dou Stool r•va ,� In �a o,n ,n 1 ar tK warvuh tu"a L**dq CO NdKtk 01 Meter k"114 Cost ka wY n�+lryMn Cm Ud k •n S. On(OH Md osl,eeYs 1• Mk Stw nnar. is v Glue and sMir sPsdlsofae silboN M1kt Ntodleti<d Sal Foos: Calm /Cersseie �. Sian $oot Sw hir Aaslked Slid SKi.s� SNtobto wit kswN E * r rn GA Inn Skno (xn Lower Row IsN 1 �q _ zSO& 00eat flaps tk rye j` LOgs Eaghoaoi llslfws/leslk ( 1 ►,�,P°C.► ledo w Stobless S1oel — A 1999 H romaric' Pumps. Ashland, C)Wo a! R44i Rmved. I r,`jr HYDROMATIC Youw Aul honzk locd Oisnlburor- !910 loner Red Aslddm,l, 06 44105 W: 419.709.5042 Fix 419.211.1017 web She: mw.anldryue,o.tms ' SALES OFFIC9S IN All NUU0a CRIES AND COMES item w: W- 024360 1206 6M U �t 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 pump tank or compartment to allow a dose to be accumulated, a pump and controls, 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 tank is installed prior to sheet -rock and /or painting, pump the septic tank 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. Septic tank effluent must be less than or equal to the design criteria specified in page 2 of these plans. 10. If septic or pump 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 tank must be inspected every three years by a properly licensed person. 2. If necessary, the septic tank 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 tank is pumped, any solids in the bottom of the pump tank must be pumped, and the filter must be back - washed into the septic tank to remove accumulated material. System use may require more frequent filter cleaning. 4. Periodic observation pipe inspections should be made by the homeowner 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. If this system contains specific treatment components other than those mentioned here, maintenance requirements will accompany their specifications. 6. The pumping components for this system include an alarm which must be installed and remain on a separate circuit from the pump. If the alarm is 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. 7. Avoid compaction such as vehicle traffic within 15' down -slope of the adsorption system. 8. Avoid disturbing the system itself such that might encourage erosion or disturb the required seeding of the system. 9. Particularly avoid winter traffic such as sliding or snowmobiling which might compact snow and lead to increased frost depth. 10. Surface drainage must be diverted around the system; avoid landscape changes which might send surface run -off into the system area. 11. Warning: Do not enter septic, pump 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 for low effluent strength systems; 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 or conversion to a holding tank may be necessary. Page 8 of 8 / M s , _41i 3 VI s 9 .. t - tir J � w d f gym/ W JI Id r �� VI 4 � � J y► �. �- S L o l LLII J t f o s S.S. c ;- Spa � � � APR -12 -2004 19:11 FROM: 70:2330398 P.3 i est riot rla Project Name Brad Regner Sir' ird Address P.O. Box 37 r 1 1Nslson w 54027 CSTM 41226900 Lot Subdivision ---- Date 8/29102 NE 114 S W 28 29 16 1/4S T N/R W Villag of Wilson Boring (2) Well PL Property Line County $T. CROIX jgM ar VRP Assume Elevation loo !t. Tap of 1,5" Pipe System F-levation 104.5' *HRP as Benchmark Alt. BN Top of 1.5" Pipe @ 9$.4• AIL _M. 10 B.M. 14% 10' Sloe 101' 20% 103' 4S 105' B -1 80' 10 ' B-2 Pr43 100 Bedroom House 3 00' Johnson SL dnc:cn Pm nn uer VftconstWDepartment of Commerce SOIL EVALUATION REPORT Page of Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code County Attach complete site plan on paper not less than 8 1/2 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, and location and distance to nearest road. Please prim R 'ewed by Date PrKSOnaI kdw►netion You provide may be f p or sedicGW y law, .15.04 (l) (mp. Property Owner roperty Location C 1 Govt Lot r 1/4 &AM N R AE( Property Owner's Mailing Address Lot # I Block # Subd. Name Ari i O ST. UWIX COUNTY e State Zip ❑ City Village ❑ Town Nearest Road Ckiristruction U esidential / Number of bedrooms 3 Code derived design flow rate 4 GPD ❑ Replacement Public or commercial - Describe: Parent material J Flood Plain elevation if applicable General cornments and recornm dons: S�•- 2 `1�•va �i�r✓ /D ( ' y Boring # Boring F FTI Pit Ground surface elev /a✓ 1 01 ft. Depth to limiting factor in. 1. Sal Application Rate G Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPOM in. Munsed Qu. Sz. Cont. Color Gr. Sz. Sh. - Eff#1 'Eff#2 q- Z. 1.24 16Y., u/ Boring # Boring Pit Ground surface eley! a ft. Depth to limiting factor in. Sod Application Rate Horizon Depth Dominant Color Redox Description Texture Stricture Consistence Boundary Roots GPDM in. Munsed Qu. Sz. Cont. Color Gr. Sz. Sh. - Eff#1 'Eff#2 2 I- X lie S ---- Effluent #1 = BOD > 30 < 220 mg& and 5 150 mg/_ ' Effluent #2 = BOD < 30 mg/l. and TSS 130 mg/L 7 CST 2 (Please Signature Number Address Date Evaluation Conducted Telephone Number �' I v Property Owner Parcel ID # Page of BorbV ©# ° Boring C 1pit Ground surface elev. � O ft. Depth to limiting in. SoM Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDW In. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. •Eff#1 'Eff#2 g F -1 Boring ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil ication Rate Horizon Depth Dominant Color Redox Description Texture Stricture Consistence Boundary Roots GPD/fF In. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Eff #1 Eff#2 �, # ❑ �+ng ❑ Pit Ground surface elev. ft. Depth to Mmiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description. Texture Structure Consistence Boundary Roots GPD/ff in. Munsel Qu. Sz. Cont Color Gr. Sz. Sh. •Eff#1 •Etf#2 • Effluent #1 = BOD > 30 1220 mglL and TSS >30 < 150 mgA_ • Effluent #2 = BOD < 30 mglL and TSS < 30 mglL 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 P lease contact the department at 608 - 266 -3151 or TTY 608 -264 -8777. sB"w(RAM) I Soil Test Plot Plan Project Name Brad Regner Shaun B Address P.O. Box 37 Wilson Wi 54027 CSTKI #226900 Lot Subdivision -- - ---- Date 8/29 /02 NE 1/4 S W 1/4S 28 T 29 N/R 16 W Village of Wilson ❑ Boring Q Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 100 ft. Top of 1.5" Pipe System Elevation 104.5' *HRpSame as Benchmark Alt. BM Top of 1.5" Pipe @ 98.4' Alt .M. 10' * B M. 14% 101' 10' Slope 20' 103' a 0 45' 105' B -1 80' IF 10' 7 B -2 0' Pro 3 100' Bedroom House 50' 500' Johnson St. Wisconsin Department of commerce SOIL EVALUATION REPORT Page of Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code County !� . t Attach complete site plan on paper not less than 8 1/2 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, and location and distance to nearest road. Please print a Reviewed by Date Personal information you provide may be used secon� 4DL& -, s. 5.04 (1) (m)). P Owner P e Location T Lot k h 1 /45JIM S T A��R , E Property is Mailing Address L # Blo& # I SUM. Name cf 2 7 01 1 0 3 7 1 ST. CROIX COUNJY city r State S Tp } C � ode Phon �j City illage � Town e Road / J .J ✓ V06 / 7 o rl) - 303 New C4nstructlon us 'dential / Number of bedrooms Code derived design flow rate --) O GPD ❑ Replacement ❑ P is o� erclal - Describe: Parent material [./� _ �? Flood Plain elevation if applicable tL and amens: © Borin # Boring Boring ��,(} Pit Ground surface elev. ft Depth to limiting factory in. Sod Appl ication Rat Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDM In. Munsed Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 'EB#2 3Y -Z ® B.,j ng # ❑ Boring ,J. Pit Ground surface elev ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDM In. Munselt Qu. Sz. Cont. Color Gr. Sz. Sh. '01#1 'Eff#2 D- r3 /Z 2. C ,� ,6 ' l' 3V Effluent #1 = BOD > 30 1 220 nVL and TSS 50 mgll. • Effluent #2 = BOD < 30 mg& and TSS 1 30 mg/L _TZ me (Please Print) Si lure CST Number 2 Z_'_ 1 S;"—,; 2 2 110� "? ex� Adds �� Date Evaluation Conducte Telephone Number Property Owner Parcel ID # Page of Boring # ❑Boring pit Ground surface elev. ft. Depth to limiting factor � .�/ in. Sod �� Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots PD/ff: in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#2 ❑ Ong # ❑ Boring pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDM in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 I ❑ Boring # Boring a pit Ground surface elev. ft. Depth o limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description. Texture Structure Consistence Boundary Roots GPDlff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 ' Effluent #1 = BOD > 30 220 mglL and TSS >30 < 150 mglL ' Effluent #2 = BOD 130 mgA- and TSS < 30 mglL The Deparunent 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. 38"30(RAW) I Soil Test Plot Plan Project Name Brad Regner Shaun Bird Address P.O. Box 37 Wilson Wi 54027 CSTM 26900 Lot Subdivision ------- Date 12/18/02 NE 1/4 S W 1/4S 2 8 T 29 N /R W Village Wilson Boring Q Well PL Property Line County S T. CROIX BM or VRP Assume Elevation 100 ft. Top of l" Pipe System Elevation 98.9' *HRPSame as Benchmark Alt. BM Top of 2" Pipe @ 100.0' 98' A M11 0, B -3 55' 96' c M. 10' ,0 94' 40' B -1 90' 15% B -2 5' Slope 50' 1320' Property Line ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer 2 Q Mailing Address ' U'4 Jai/ S �' Property Address 141 /fo'/ LA4' S ©L? s 0 P (Verification required from Planning Department for new constructi on) City/State �✓� �S�''� �"�� ` S Parcel Identification Number LEGAL DESCRIPTION Properly Location /VC ' /s, �� ' /,, Sec. Z . T_f?�_N -R �� W, Town of �v•' �l o� -- Subdivision _. a - . Lot # Certified Survey Map # . Volume . Page # (�arranty Deed Volume 21 `f . Page # 3 Spec house ❑ yes ;R no Lot lines identifiable ® yes ❑ no SYSTEM MAINTENANCE Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a mastcrplumber, journeyman plumber, restrictedplumber or a licensed pumper verifying that (1) the on-site wastewaterdisposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. Uwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 days of the three year expiration date. o SIGNATURE OF APPLICANT DATE OWNER CERTIFICATION I (we) certify that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owner(s) of the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. L&S L SIGNATURE OF APPLICANT DATE « « « « «« Any information that is mis- represented may result in the sanitary permit being revoked by the Zoning Department. * * * * ** «• Include with this application: a stamped warranty deed from the Register of Deeds office a copy of the certified survey map if reference is made in the warranty deed DOCUMENT NO. STATE BAR OF WISCONSIN FORM 2 -1992 THIS SPACE RESERVFq FOR RECORDING DATA WARRANTY DEED ' k ,�5 VOL PA,'F 98 REGISTER OFFICE ~ ST. Cmix Cost ^, Gary D. Regner and Cheryl L. Regner, husband and wife Read f Re"d AUG 3 T 1994 11:30 A. _ M conveys and warrants to Bradley Regner a Lylah Regner. �1 husband and wife as survivorship marital property � _ �M9 to Of ouft } RETURNIO x' the following described real estate lit 3t. Croix County, }, State of Wisconsin: - b ' Tax 1 arai No: 191 - 1011 -95 ° The East One -Half (E 1/2) of the Southwest Quarter (SW 1/4) of Section Twenty -six (26), Township Twenty -nine (29) North, Range Fifteen (15) West, Village of Wilson, I St. Croix County, .Wisconsin, EXCEPT Lot One (1) of Certified Survey Map in Volume 4. page 939, Doc. No. 364160. r .. S. o • '� Sal' `�� IWA WMY40 M STATE OF NEBRASKA BURT COUNTY Personally came before me this This is homestead property. 22nd day of August 1994 Gary D. (IS! Omit Regner to me known tc be the pens °. who executed the foregoing instrull nt Exception toWarranties: and acknowledged the same. 22nd r't Dated this day of August ' 19 94 re .: (SEAL) (SEAL) A �# * • Gary D. Regner ( SEAL) SEAL) hesyl L. Regner •-•w AUTHENTICATION ACKNOWLEDGMENT s ' r rx Signature(s). STATE OF WISCONSIN Dunn County. authenticated this day of , 19 Personally came before me this day of Augus 19 {+ ' Gary D. Regner and Cheryl L. Reg en r, t I husband and wife TITLE. MEMBER STATE BAR OF WISCONSIN a ho executed t I fit not, to ma known to be the person j authorized by 9 706.176, Wis. Slats.) foregoing I trument and aekno the same. i Y r THIS INSTRUMENT WAS DRAFTED BY MUZA 6 MUZA r 'y 541 roadway - P.O. Box 408 Menomonie, WI 54151 Notary Public Dunn _ co u nty. Wis. 3 Mignatures may be authenticated or acknowledged. Both My Commission Is permanent. (If not, state expiration i" ' are not necessary.) 9 -17 f i g : date: I t r ' • Plumy rUDMK $62 NTF oon Nam" of persons el9n,n9 m any CapaOdy Should be typedor prml.d below their d9neturN. r ; STATE BAR OF WISCONSIN New Tax fOrmt P.Q Box 10208 Glean Bay, WI 54307 0208 f WAIIf ANTY DEED Form No. 2 — 1942 . 1 of w STATE BAR OF WISCONSIN FORM 3 — 1982 QUIT CLAIM DEED KATHLEEN H. WALSH DOCUMENT NO. ' VOL .5 15�5P u ST. CROIXOCO., W1 RECEIVED FOR RECORD Lylah Regner a /k /a Lylah Peterson 04 -24 -2000 3:30 Ph QUIT CLAIM DEED EXEMPT quitclaims to Bra ey Regner a a ra CERT COPT FEE: am COPY FEEL TRANSFER FEE: RECORDING FEE: 10.00 PAGES: 1 the following described real estate in St . C' County, State of Wisconsin: THIS SPACE RESERVED FOR RECORDING DATA The Northeast Quarter of the Southwest NAME AND RETURN ADDRESS Quarter (NEk of Swk) of Section Twenty -six IMCROIK VALLEY TMSERV10E%9= (26) , Township Twenty -nine •(29) North, Range F0 BOX 750 109 N. MAIN SL PA Fifteen (15) West, Village of Wilson, St. Croix RIVEN IX. VA 54022 County, Wisconsin. :J6 - a3sq THIS CONVEYANCE IS MADE PURSUANT TO A JUDGMENT OF DIVORCE RENDERED IN THE CIRCUIT COURT FOR DUNN COUNTY WISCONSIN ON 191 - 1011 -90 WISCONSIN, PARCEL IDENTIFICATION NUMBER MARCH 22, 2000, CASE NO. 99 -FA -129. Y � I J f r K 41- I This is not homestead property. (is) (is no t) r Dated this Z Z 'I-� day f !March y .xsc2.p9�. ' P� (SEAL) (SEAL) • . _ Lylah Regner (SEAL) (SEAL) AUTHENTICATION ACKNOWLEDGMENT Sign re(s) of Lylah Regner State of Wisconsin, ss. County. a thenti ed is day of March 0 Personally came before me this day of ~ 19 , the above named TITLE: MEMBER STATE BAR OF WISCONSIN (If not, authorized by §706.06, Wis. Stats.) to me known to be the person who executed the foregoing THIS INSTRUMENT WAS DRAFTED BY instrument and acknowledge the same. WARREN W. WOOD, LTD. New Richmond, W1 54017 blic, �' County, Wis. (Signatures may be authenticated or acknowledged. Both are not My commission is permanent. (If not, state expiration date: necessary.) 19 .) • Names of persons signing in any capacity should by typed or printed below their signatures. QUIT CLAIM DEED STATE BAR OF WISCONSIN Wisconsin LWSt B4rYt CO.. Inc. Form No. S - 1982 Ma „ r�M, "Vil, J 2 1 ,4 �, P. 3 4 �3 STATE BAR OF WISCONSIN FORM 1 - 2000 WARRANTY DEED 7 QD 9 8 8 6 ' Document Number KATHLEEN H. WALSH This Deed, made between Bradley Refiner, a /k /a Bradley REGISTER OF DEEDS D. Refiner, a single person ST. CROIX Co., WI RECEIVED FOR RECORD and Lori Sether Grantor, 02/14/2003 02:30PH EXEMPT # REC FEE: 13.00 Grantee. TRANS FEE: Igo-3o Grantor, for a valuable consideration, conveys to Grantee the following COPY FEE: described real estate in St. Croix County, State of CERT COPY FEE: Wisconsin (the "Property ") (if more space is needed, please attach addendum): PAGES: 2 See Attachment Recording Area Name and Return Address Title One Premier Group, Inc. 706 19th Street South Hudson, Wisconsin 54016 part of 191- 1011 -90 -000 Parcel Identification Number (PIN) Together with all appurtenant rights, title and interests. This is not homestead property. (is) (is not) Grantor warrants that the title to the Property is good, indefeasible in fee simple and free and clear of encumbrances except Roadways, Easements, and Restrictions of Record. Dated this 14th day of February 2003 * * ReqnWr * * AUTHENTICATION ACKNOWLEDGMENT I STATE OF WISCONSIN ) Signature(s) ) ss. St. Croix County. ) authenticated this day of Personally came before me this 14th day of February 2003 the above named Bradley Refiner TITLE: MEMBER STATE BAR OF WISCONSIN A V9 (If not, 0 % e known to be the person who executed authorized by §706.06, Wis. Stats.) th oregoin ent d a led a same. THIS INSTRUMENT WAS DRAFTED B * MERILEE J. BUNE Michael H. Forecki Attorney ary Public, State of Wisconsin Eau Claire Wisconsin �g� nt. ( Commission is perm eIf not, state expiration date: ( Signatures may be authenticated or acknowledged. Both are no !y *Names of persons signing in any capacity must be typed or printed b ture. WARRANTY DEED STATE BAR OF WISCONSIN FORM No. 1 -2000 ttorney Michael H Forecki 1830 Brackett Ave, Eau Claire WI 54701 -4627 Phone: (715) 835 -3029 Fax: (715) 835 -4112 Michael H. Forecki T7119560.ZFX Produced with ZipFormTm by RE Formshlet, LLC 18025 Fifteen Mile Road, Clinton Township, Michigan 48035, (800) 383 -9805 Jun. 8. 2004 1:27PM OTOLARYNGOLOGY l No.2046 P. 1 J 2143P 349 A parcel of land located in the Northeast Quarter of the Southwest Quarter (NE% of SW%), Section 26, Township 29 North, Range 15 West, Village of Wilson, described as follows: Commencing at . the S/s comer of Section 26, Township 29 North, Range 15 West;- thence N.00 °04'23 'W., along the North -South quarter section line 1321.10' to the southeast corner of the NE "/a of SW'/, said point also being the point of beginning; thence N:89 along the south line of said NE% of SVV , 1330.42' to the southwest comer of said NE% of SW /; thence N.00724'32 "W., along the west line of said NE% of SWY., 654.58'; thence S.8 9'57'25 "E., 1334.2!5 to a pint on the east line of said NE' /a of SW' /a; thence S.00 °04'23 "E., along said line, '04.5q' to the point of beginning. For Reference Only: Tax Key No part of 191 -1011- 90 -000 (Includes this parse, together with other pameD M Johnson St. Wilson, WI 54027 r i SAFETY WARNING - Risk of electric shock. This pump is SAFETY GUIDELINES supplied with a grounding conductor and /or grounding 1. Read all instructions and safety guidelines type attachment plug. To reduce the risk of electric thoroughly. Failure to follow the guidelines and the shock, be certain that it is connected to a properly instructions could result in serious bodily injury grounded grounding type receptacle. and /or property damage. 2. DO NOT USE TO PUMP FLAMMABLE OR Your 115V effluent pump is equipped with a 3 -prong EXPLOSIVE FLUIDS SUCH AS GASOLINE, electrical plug. The third prong is to ground the pump to FUEL OIL, KEROSENE, ETC. DO NOT USE IN prevent possible electrical shock hazard. Do not remove EXPLOSIVE ATMOSPHERES OR HAZARDOUS the third prong from the plug. A separate branch circuit is LOCATIONS AS C L A S S I F I E D BY NEC, recommended. Do not use an extension cord. ANSI /NFPA70. FAILURE TO FOLLOW THIS WARNING CAN RESULT IN PERSONAL INJURY When a pump is in a basin, etc. do not touch motor, pipes AND /OR PROPERTY DAMAGE. or water until unit is unplugged or shut off. If your installation has water or moisture present, do nottouch wet 3. During normal operation the pump is immersed in area until all power has been turned off. If shut -off box is water. Also, during rain storms, water may be not accessible, call the electriccompany to shutoff service present in the surrounding area of the pump. to the house, or call your local fire department for Caution must be used to prevent bodily injury I when working near the pump: instructions. Failure to follow this warning can resultin fatal electrical shock. a. The plug must be removed from the receptacle The flexible PVC jacketed cord assembly ounted to the prior to touching, or repairing the um Y P 9, 9 P 9 pump. pump must not be modified in any way, with the exception of shortening the cord to fit into a control panel. Any splice b. To minimize possible fatal electrical shock hazard, between the pump and the control panel must be made extreme care should be used when changing within a junction boxand mounted outside of the basin, and fuses. Do not stand in water while changing fuses comply with the National Electrical Code. Do not use the or insert your finger into the fuse socket. power cord for lifting the pump. 4. Do not run the pump in a dry basin. If the pump is The pump motor is equipped with an automatic resetting run in a dry basin, the surface temperature of the thermal projector and may restart unexpectedly. Projector pump will rise to a high level. This high level could tipping is an indication of motor overloading as a result of cause skin burns if the pump is touched and will operating the pump at low heads (low discharge restriction), cause serious damage to your pump. excessively high or low voltage, inadequate wiring, incorrect 5. Do not oil the motor. The pump housing is sealed. motor connections, or a defective motor or pump. A high grade dielectric oil devoid of water has i FLOW- LITERS /MINUTE been put into the motor housing at the factory. Use o ao ibo 2ao 320 of other oil could cause serious electric shock and /or permanent damage to the pump. eo 15.0 6. This pump's motor housing is filled with a dielectric lubricant at the factory for optimum 40 12.5 motor heat transfer and lifetime lubrication of the bearings. Use of any other lubricant could cause Li Z W 30 ,o. o w d and void the warranty. This lubricant is non - toxic; however, if it escapes the motor 7. housing, it should be removed from the surface a 20 5 A quickly by placing newspapers or other absorbent Q material on the water surface to soak it up, so = 5.0 = aquatic life is undisturbed. 10 2.5 7. In any installation where property damage and /or personal injury might result from an inoperative or 0 0 leaking pump due to power outages, discharge 0 20 ao 60 90 too line blockage, or any other reason, a backup FLOW- GALL ❑NS /MINUTE system(s) and /or alarm should be used. PUMP PERFORMANCE CURVE 115V 60HZ 3 INSTALLATION Pump must be installed in a suitable gas tight basin which REMOTE FLOAT SWITCH is at least 18" in diameter and 24" deep, and vented in LEVEL CONTROL accordance with local plumbing codes. The RFS series pumps are equipped with a remote float Pump features a 1/" female NPT discharge. NOTE: DO switch level control. This level control is sealed in a NOT OVERTIGHTEN DISCHARGE PIPE INTO PUMP polypropylene float cylinder. For automatic operation, the VOLUTE DISCHARGE. pump must be plugged or wired into a remote float switch. Pump can be installed with ABS, PVC, polyethylene or Pump will run continuously if plugged directly into an galvanized steel pipe. Proper adapters are required to electrical outlet. connect plastic pipe to pump. When the level rises in the basin, the cylinder floats up with Pump must be placed on a hard level surface. Never place the level. When the cylinder position is at an angle of about pump directly on clay, earth or gravel surfaces. 45 degrees, the switch activates and starts the pump motor. A check valve must be used in the discharge line to prevent As the level draws down, the cylinder floats down and back flow of liquid into the basin. The check valve should when it is again at an angle of about 45 degrees, the switch be a free flow valve that will easily pass solids. deactivates, and the pump motor stops. CAUTION: For best performance of check valves, when NOTE: BE CERTAIN PUMP IS SECURE IN BASIN AND handling solids install in a horizontal position or at angle of CYLINDER FLOATS UNOBSTRUCTED WITHOUT . no more than 45 °. Do not install check valve in a vertical TOUCHING THE BASIN WALLS OR PLUMBING. position as solids may settle in valve and prevent opening REMOTE FLOAT SWITCH on start-up. INSTALLATION When a check valve is used drill a 3/16" hole in the 1. The float switch consists of four parts: discharge pipe approximately 1" to 2" above the pump a) switch; discharge connection and below check valve to prevent air b) cord clamp; locking of the pump. c) clamp screw. WIRING d) cable tie NOTE: If screw is lost, use a #10 -16 X 1/2" long Check local electrical and building codes before tapping screw, longerscrews can crackthe cover. installation. The installation must be in accordance with 2 Attach cord clamp to pump cover as shown in the their regulations as well as the most recent National Electrical Code (NEC). switch instruction manual packaged with the switch. The clamp and pump handle must be To conform to the National Electrical Code all pumps must positioned as shown to allow free operation of be wired with 14 AWG or larger wire. For runs to 250 feet float. Be sure to locate pump and switch power 14 AWG wire is sufficient. For longer runs consult a cords away from switch float. qualified electrician or the factory. 3. A 2y" tether length is recommended. When a Pump should be connected or wired to its own circuit with tether length of 2y" is used, a minimum basin no other outlets or equipment in the circuit line. Fuses and diameter of 18" is recommended. The tether circuit breaker should be of ample capacity in the electrical length is measured as shown in illustration at right. circuit. See chart below. 4. After desired tether length is established hand tighten clamp screw. H.P. VOLTAGE FUSE OR CIRCUIT 5. TESTING: Without water in basin plug pump BREAKER AMPS power cord into switch in -line -plug. Plug switch 4/10 115 20 into outlet. Lift float and watch for pump to operate. 4/10 230 15 1 Do not run pump for more than 5 seconds. 4 I