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HomeMy WebLinkAbout022-1012-80-050 Department of Commwce PRIVATE SEWAGE SYSTEM County. St. Croix uilding Division ltd B INSPECTION REPORT Sanitary Permit No: 430562 0 ,ENERAL 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: Belli er, Lar Kinnickinnic Township 0 2 -Ipl 3- - '?o - OFD CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range /Map No: O �j�'h f yc Q.c, 05.28.18.7 7 TANK INF ORMATION EUVATION DATA Zd TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic .� Benchmark Dosing Alt. BM-5 rShi /03.x.. Aeration Bldg. Sewe Holding SVHt Inlet - 7. 7 - z- . TANK SETBACK INFORMATION 0_ ' St/Ht outlet TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic 3 3 ! / Dt Bottom ' , Dosing (� Header /Man. //1 / 3,3* Aeration Dist. Pipe S 3,toa / /• D v 3. &1 1 01,0 1 Holding Bot. System fiF ` N, 3 1100 a� a PUMP /SIPHON INFORMATION Final Grade ,-dM 2. 615 02• f Manufacturer Demand St Cover yJ GPM �•g'6 �vU• � s 1621f� Model Number .F to 6 1q-5'-**' TDH Lift • Friction Los System Head •2 H Ft &-n 417 0 , oO t Forcemain Length Dia /� Dist. to Well SOIL ABSORPTION SYSTEM 1 n o 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: t 14 p - UNIT Model Number: DISTRIBUTION SYSTEM Header /Manifold Distribution x Hole Size x Hole Spacing Vent to Air Intake t 1 1-engt h 0 e 3 1 `2 t 3 6 Length Dia 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 I ] Bed/Trench Edges l Topsoil _� g r ' Yes J No e3 No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: rr�y1l / /Inspection #2: 1) � / 01 0 Location: 545 Kreuzinger Road River Falls, WI 54022 (NE 1/4 SE 1/4 5 T28N R18W) NA L Z 7��lNri f��1^4 Parcel No: 05.28.18. 1.) Alt BM Description = 9^4-Aa Gn _iih UL✓ ./ 2.) Bldg sewer length - amount of cover Plan revision Required? Yes No ((�-� Use other side for additional informati n. lk � _ _ �1� —_ _ �l _ 1?D i Date Insepctor's Signature Cert. No. SBD -6710 (R.3/97) Safety and Buildings Division County I visconsin an 201 W. Washington Ave., P.O. Box 7082 Madison, WI 53707 - 7082 Sanitary Permit Number (to be filled in by Co.) Department of Commerce — Z/ REeEIVED Sanitary Permit Applic ti State Plan I.D. Number C/C[ In accord with Comm 83.2 1, Wis. Adm. Code, personal inf ation you provide `> / 7 Q may be used for secondary purposes Privacy Law, 15.04(W t�' �/ 1 o 2 00 3 Project Address (if different than mailing address) I. Application Information - Please Print All Information ST. CROIX COLJN Y 70NiNr OF- Property Owner's Name r Parcel # t # Block # , J Property Owner's M t ng Address roperty Location / /., 1546 Section City, State Zip Code Phone Number J _' 3 1 0 /6 „s _ t /� _C' ?6 E one) or Z J T N; E or W II. Type of Building (check all that apply) n �, - �6i2 1 or 2 Family Dwelling - Number of Bedroo .X/` Su ivision Na Numb ❑ Public/Commercial - Describe Use L / ❑ State Owned - Describe Use r ' �j � x - 7 �” on G�Q -� � j 9 D ❑City _ VillageXTownship of III. Type of Permit: (Check only one box on line A. Complete line B if applicable) A. New System ❑ Replacement System ys ep ys ❑ Treatment/Holding Tank Replacement Only ❑Other Modification to Existing System B • ❑permit Renewal ❑p Revision El Change of 11 Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Plumber Owner IV. Type of POWTS System: Check all that appl ❑ Non - Pressurized In -Ground 4 A40UPA _ i Mound < 24 in. of suitable soil ❑ A Grade El Single Pass Sand Filter ❑ Constructed Wetland ❑ Pressurized In- Ground ❑ Tank Peat Filter AbT rc reatment Unit Holding Ta ❑ Recirculating Sand Filter ❑ Recirculating Synthetic Media Filter ❑ Leaching Chamber ❑ Drip Line ❑ Gravel -less Pipe ❑ Other (explain) D V. Dispersal/Treat ent Area Information: Design Flow (gpd) Design S it Application te(gpdsf) Dispersal Area Required f) Dispersal ea Proposed (sf) System Elevation 1. S ' o SC> 0 VI. Tank Info zCapacity in Total Number M nufa rer Prefa Site Steel Fiber Plastic Gallons Gallons of Units � J� Concrete Constructed Glass New Existing / Tanks Tanks Septic or Holding Tank c Aerobic Treatment Unit c•GJ� Dosing Chamber VII. Responsibility Statement- I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Business Phone Number Plumb 'Name (P 'nt) Plumber' ignature MP/MPRS Number Plumber's Address (Street, Ci , State, ode) VII oun /De artment Use Onl Approved Disapproved Sanitary Permit Fee (includes undwa(er Dat Issue I uing Agent Si ature (No p a Surcharge Fee) �,-}., 3 � �U )� �+ O El Owner Given Reason for Denial 7f � 4 IX. Conditions of Approval/Reasons for Disapproval STEM OWNER: C!i //!/03) Qhe t_A_h 1 eptic tank, effluent filter and ` dispersal cell must all be serviced 1 maintained / ��L��y��i [ a �� 0'✓ as per management plan provided by plumber. 2. All setback requirements must be maintained as per Attach complete pleas (to the County only fort system on pape of less the /2 it 1I inches in size s � SBD -6398 (R. 08/02) PLOT PLAN .Page C, Scale 1 " =S0 ' . � 1 \3..'JT i i P �o u� i c- p►^�P -r�r a iz Cr _~ C 7 Q_ f C9 N o or-- y pvC I J 4 � f '1 t �jl �' ✓►iVl b : al - wl - a o"Ot s' ou �!z` PvC Play i — ? zs ' Fvjjwt NOTES: E. Elevations shown are existing ground elevations unless otherwise noted. 2. Install 4" observation pipes with approved caps. ( Z required) . 3. Septic tank to be17 lieu gallon capacity manufactured by 4. Bench mark + SLR P�pU�a 5. Divert surface water around system to prevent ponding at the uphill side. y Safety and Buildings 4003 N KINNEY COULEE RD LA CROSSE WI 54601 -1831 TDD #: (608) 264 -8777 isconsin www.commerce.state.wi.us /sb Department of Commerce www.wisconsin.gov Jim Doyle, Governor Cory L. N Secretary November 11, 2003 CUST ID No.220254 ATTN: POWTS Inspector ARTHUR L WEGERER ZONING OFFICE WEGERER SOIL TESTING & DESIGN SERVICE ST CROIX COUNTY SPIA PO BOX 74 1 101 CARMICHAEL RD RIVER FALLS WI 54022 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 11/11/2005 Identification Numbers Transaction ID No. 940962 SITE: Site ID No. 668289 Larry Bellinger Residence Please refer to both identification numbers, Kreuziger Rd & County Hwy N above, in all correspondence with the agency. Town of Kinnickinnic, 54022 St Croix County NEI /4, SEl /4, S5, T28N, R18W Lot: 2, FOR: Descript' n: Three Bedroom Mound System Object OW ys sect ID No.: 930494 The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes Conti and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in AP chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. The following conditions shall be met during construction or installation and prior to occupancy or use: DEPARTIIAEM ONO sq� General Approval Requirements: SEE CORRE • This system is to be constructed and located in accordance with the enclosed approved plans and with the "Mound Component Manual for Private Onsite Wastewater Systems VERSION 2.0" SBD- 10691 -P (N.01 /O1) and the "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems VERSION 2.0" SBD- 10706 -P (N.01 /01). • Per manual cited above, limited activities are allowed in the area 15 feet down slope of the component area. Soil compaction, excavation, vehicular traffic and other similar activities that impact the treatment and dispersal are prohibited. • The well 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 private sewage system installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stat • Comm 83.22(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. ARTHUR L WEGERER Page 2 11/11/03 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 $ 175.00 Fee Received $ 175.00 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 c bratz @commerce. state. wi. us cc: Leroy G Jansky, Wastewater Specialist, (715) 726 -2544 Y TITLE SHEET Page of MOUND SYSTEM FOR A 3 BEDROOM RESIDENCE This plan has been prepared in accordance with the Mound Component Manual SBD- 10691 -P and the Pressure Distribution Manual SBD- 10706 -P (N.01 101) ,(N.01 101) LOCATED IN THE NE, 1/4 OF THE S� 1/4 OF SECTION �'` , T ? �3 N, R I S W, TOWN OF t'C1IQ) ZCVz_l1JJtJ . �° ST - \ - ZJJl/ COUNTY, WISCONSIN. _ L� i Z oC= CS" IN V 0L _ k 15 �[ 6 l b INDEX PAGE 1 of 7 TITLE SHEET PAGE 2 Of 7 SYSTE 1 MA NAGEiJENT PLAil PAGE 3 of 7 PLOT PLAN PAGE 4 of 7 PLAN VIEW -CROSS SECTION PAGE 5 of 7 DISTRIBUTION PIPE LAYOUT PAGE 6 of 7 PUMPING CHAMBER CROSS SECTION PAGE 7 of 7 PUMP PERFOR14ANCE CURVE c PREPARED FOR RECE�VEQ L22� a� LJ►v6 -- NOV - 3 2003 SAFE1Y & BLOGS 131V f 'On��l y PREPARED BY OFC py"VERC E i•''lEGEFr<EF2 SO a: L . TEST S iVG 9A U � ANL . _ DES Z CCTV S�RV I CE SP ONpE P.O. Box 74 421 N.Hain St. River Falls, WI 54022 ®, *�owtcee, Phone 715 425 -0165 Fax 715 -425 -6864 $ 4 iE(itT, F'E'd 0.515 P t ELLS WORTH ® ��) ... r � ae S 1 G. d► • • JOB NO. D-3 Mound System Management Plan page of 7 Pursuant to Comm 83.54, Wis. Adm. Code Seotic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Slats. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code. The operating condition of the septic tank and outlet filter shall be assessed at least once even 3 years by inspection. The outlet filter shall be cleaned as necessary to ensure proper operation. The filter cartridge should not be removed unless provisions are made to retain solids in the tank that may slough off the filter when removed from its enclosure. If the filter is equipped with an alarm, the filter shall be serviced if the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an impending continuous alarm. The septic tank shall have its contents removed when the volume of sludge and scum in the tank exceeds 1/3 the liquid volume of the tank If the contents of the tank are not removed at the time of a triennial assessment, maintenance personnel shall advise the owner of when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank. The addition of biological or chemical additives to enhance septic tank performance is generally not required. . However, if such products are used they shall be approved for septic tank use by the Department of Commerce, Safety and Buildings Division. Pump Tank The pump (dosing) tank shall be inspected at least once every 3 years. All switches, alarms, and pumps shall be tested to verify proper operation. If an effluent filter is installed within the tank it shall be inspected and serviced as necessary. Mound and Pressure Distribution System No trees or shrubs should be planted on the mound. Plantings may be made around the mound's perimeter, and the mound shall be seeded and mulched as necessary to prevent erosion and to provide some protection from frost penetration. Traffic (other than for vegetative maintenance) on the mound is not recommended sinca soil compaction may hinder aeration of the infiltrative surface within the mound and snow compaction in the winter will promote frost penetration. Cold weather installations (October - February) dictate that the mound be heavily mulched for frost protection. Influent quality into the mound system may not exceed 220 mg /L BODS, 150 mg[L TSS, and 30 mg /L FOG. Influent flow may not exceed maximum design flow specified in the permit for this installation. The pressure distribution system is provided with a flushing point at the end of each lateral, and it is recommended that each lateral be flushed of accumulated solids at least once every 18 months. When a pressure test is performed it should be compared to the initial test when the system was installed to determine if orifice clogging has occurred and if orifice cleaning is required to maintain equal distribution within the dispersal cell. Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the owner, and any levels above 4 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring. General This system shall be operated in accordance with Comm 82 -84 Wis. Adm. Code, and shall maintained in accordance with its' component manual [5 _ ] and local or state rules pertaining to system maintenance and maintenance reporting. 1 v b O 1 - h No one should ever enter a septic or pump tank since dangerous gases may be present that could cause death. Septic and pump tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the tanks are no longer used as POWTS components. Septic or pump tank manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 8- inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into a tank or component. Continaencv Plan If the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep the system in proper operating condition. If the dosing tank, pump, pump controls, alarm or related wiring becomes defective the defective component shall be Immediately repaired or replaced with a component of the same or equal performance. If the e mound component fails to accept wastewater or begins to discharge wastewater to the ground surface, it will be repaired or replaced in its' present location by increasing basal area if toe leakage occurs or by removing biologically clogged adsorption and dispersal media, and related piping, and replacing said components as deemed necessary to bring the system into proper operating condition. Questions about the operation or maintenance of this system should be directed to: The County Zoning Office at Is- 3g6 -gb S — 1- \Y1 The. system installer at 1IS - Zb8 - 6 D S UT' p'[Z.1� The tank manufacturer at 1w IC�L1Z The effluent filter manufacturer at % IZ,I -- S`��Z Z,Its2 The pump manufacturer at t L L4 �) 6UUl.� S PLOT PLAN Scale 1 " =5 'Page 3 of - 1 w O i i i I Cr } y 7 S 2 b i N Zo or �4'oVc 3 I } I � , 1 0►.i r1Z` PVC PIPS i wL L 1t� E > Sv' Fv--w nn uUr- - - - - -- LUT LINE NOTES: I. Elevations shown are existing ground elevations unless otherwise noted. 2. Install 4" observation pipes with approved caps. ( Z required). 3. Septic tank to be \Z oO / �)uu gallon capacity manufactured by Cum e ) ("w�p ��u /goo 4. Bench mark �. Divert surface water around system to prevent ponding at the uphill side. L Paae Of Approved Synthetic Covering ASTM C33 Distribution Pipe Medium, Sand Topsoil :" _ _W _ a J y F Elev. COQ . �( 3 E " D I b % Slope Distribution Cell of Force Main Flowed Z" to 2 Aggregate From Pump Layer Ft. E 1 b`rr Ft. CROSS SECTION OF A MOUND SYSTEM F 0 Ft. G 0,5 Ft. A 6 Ft. H 1,k3 Ft. Linear Loading Rate= 6 iGPD /ILL'S FT B S F'• Design Loading Rate= 0 35. GPD /SQ FT j > > Ft. �a aa.Q_ j 3r = is 86 #- J c Ft. K 1O Ft. Position L 5 Ft. of Force Main W Z S Ft. L i I �y - Observation Pipe �� Distribuiio . n \-- Cell of %" z to 2 Pip e aggregate Observation - Pipe (Anchor securely) PLAN VIEW OF A MOUND SYSTEM r Distribution Pipe Layout pzQe S of I Place the holes at the bottom of the distribution pipes at equal spacin Remove all burrs from the pipe and "holes. Extend the end of each Iate -al up uith the use of long =rz or -, f' f r.;n; to a rout �itr>1? sL; inches of the fna.I grade. Te == e the ends of the laterals with a valve threaded cap or . threaded plug. Provide access from Enal grade for the valve; threaded cap or threaded p1uz Lat eri — Manitotd P �terf x x z zr Ixr x Lverat Length — Later! Length - P Gis ricuticn L'ne I C r P 3 S Ft. Hole Diameter 3 /! 6 Inch' _._. S 3 Ft. Lateral 1 D IY Inches) X 3S Inchps Manifold 1�1z Inches Force Main s • lof.holes /pipe �3 Invert Elevation of Laterals ft -R Ft. r - Combination Sept3c Tank and PUMP CHAMBER CROSS SECTION AND SPECIFICATIONS ' PAGE OF 7 VEUT CAP WEATHER PROOF JUIJCTIOU BOX . 'i C.I. VENT PIPE APPROVED LOCKING 110' FROM DOOR, P60,1HOLE COVER wl u.� :JINoow OR FRESH wA(itJIIJG LRgEL se1o>v P IPS a-r A�IUTAKE cor,cutr w /r�,•tcLT �, � � - tj Aim. ►- PROVIDE - I I/J LE: T - - -- �('AtRTIGHT SEAL ;., I \vim 8Al r�� I A r z>�8� r--t�� -- I I I ► Approve d ov / P ed i ifs joint oint w/ «/ A _ t`b�o ALARA PVC pipe PVC pipe I I I 6 � I I O U c I I c 1p.OB fT I CLEY . __J PUf�IP� pf D COQCKETE �t.a b " eI ocK u RISER EXIT PERMITTED CQLy AS SUCH APPROVAL IF TAWK MAIrUFACTURZR H 3 "ApPNr. N4 SEPTIC F SPEC.IFICATIOUS DOSE TAWKS MAW U FACT URER: �Z cajcz � A1UMgER OF DOSES: PER DAU TAWK SIZE: GALLOQS D05C VOLUME ALARM MA)JU FACT URGR: S S Q-� S - f zo-tS INCLUDlA1G DACKFLOW: GALLONS MODEL ►.!UMBER: lob RW CAPACITIES: A= 1a IWC14E5 OR 30 C' GALLO SWITCH TYPE: IIJCHES'OR 3 j 4LLOUS PUMP tALAUUFACTURCK: Q-0U � -L) S' C. S W CHES OR 8S GALLOUS MODEL NUMBER: —���� D= 3ti I�ICHES OR ZZ I GALLOAJS SWITCH TYPE: W1�TRC�1�� MOTE: PU x P AUD ALARM RC TO 5L MWIMUM DISCHARGE RATE 3` -3Z GFM IN5TALLED OU SEPARATE CIRCUITS VERTICAL DIFFEIRENCE DETWE[U PUMP OFF AUD- 015TRIBUTIOW PIPE.. FEET f mWIMUM NETWORK SUPPLY PRESSURE -ZS FEET f � FEET OF FORCE MAIN X ' F Y OFZ FRICTIOU FACTOR_. 0'3� FEET tJ TOTAL OyNAMIC HEAD = 14NS FEET As per nanufacturer t - n. \3 gal /in. Liquid depth 3 s Goulds _ I — � 1`�C / Ot / =� Submersible Effluent Pump 3871 EPO4 EP05 APPLICATIONS • Fasteners: 300 series • Fully submerged in high ■ Motor Housing: Cast iron Specifically designed for the stainless steel. grade turbine oil for for efficient heat transfer, following uses: • Capable of running lubrication and efficient strength, and durability. • Effluent systems dry without damage to heat transfer. ■ Motor Cover: Thermoplas- • Homes components. Available for automatic and tic cover with integral handle • Farms Motor: manual operation. Automatic and float switch attachment • Heavy duty sump • EPO4 Single phase: 0.4 HP, models include Mechanical points. • Water transfer 115 230 Float Switch assembled and ■ Power Cable: Severe duty • Dewatering RPM, , built in overload with automatic reset. preset at the factory. rated oil and water resistant. SPECIFICATIONS • EP05 Single phase: 0.5 HP, ■ Bearings: Upper and lower 115 V, 60 Hz, 1550 RPM, FEATURES heavy duty ball bearing Pump: EPO4 built in overload with ■ EPO4 Impeller: Thermo- construction. • Solids handling capability: automatic reset. 3 /a° maximum. • Power cord: 10 foot plastic Semi -open design AGENCY LISTING • Capacities: up to 55 GPM. standard length, 16/3 SJTO with pump out vanes for • Total heads: u to 24 feet. with three p rong mechanical seal protection. % Canadian Standards Association p p g grounding • Discharge size: 1 NPT. plug. Optional 20 foot ■ EP05 Impeller: Thermo- Mechanical seal: carbon- length, 16/3 SJTW with plastic enclosed design for (CSA listed model numbers rotary/ceramic - stationary, three prong grounding plug improved performance. end in 7" or "AC ".) BUNA -N elastomers. (standard on EP05). ■ Casing and Base: Rugged • Temperature: thermoplastic design provides 104 °F (40 °C) continuous superior strength and 140 °F (60 °C) intermittent. corrosion resistance. • Fasteners: 300 series METERS FEET stainless steel. 10 j I • Capable of running —� — dry without damage to 9 30 components. j i I R K Pump: EP05 $ -- - - - - - -- — • Solids handling capability: ° 25 3 /4 maximum. a 7 I I W - -- -- - - - -- — — , • Capacities: up to 60 GPM. 6 20 • Total heads: up to 31 feet. • Discharge size: 1'h" NPT. i Z 5 I I_ • Mechanical seal: carbon- ! 1 ° 1s rotary/ceramic-stationary, a 4 i I U. ys I BUNA -N elastomers. _ • Temperature: ° 3 1 104 °F (40 °C) continuous i l -�- 140 °F (60 °C) intermittent. 2 :>E? 3 — 5 l 3µa2 0 00 10 20 30 40 50 GPM 0 2 4 6 8 10 12 ml/h CAPACITY O 1995 Goulds Pumps, Inc. Effective May. 159c 1365 Wisconsin Department of Commerce SOIL EVALUATION REPORT P age 1 of 3 Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code Steel Soil Service unty Attach complete site plan on paper not less than 8'% x 11 inches in St. Croix include, but not limited to: vertical and horizontal reference point (B ), di EIV E Q percent slope, scale or dimensions, north arrow, and location and d nce to nearest road. P rcel I.D. ending Please print all information. 0 C j 3 0 2003 R vie d By Date Personal information you provide may be used for secondary purposes (Pri y law, s. 15.04 (1) (m)). { 6 Property Owner S jOFF E Lenertz, Fredrick 1/4 SE 1/4 S 5 T 28 N R 18 W Property Owner's Mailing Address L Block # Subd. Name or CSM# ' ,09 6 220 Livestock Exchange Building 2 na Vol. 17 Pg. 4616 7 'z 7 City State Zip Code Phone Number City J Village e Town Nearest Road J�, f Wj 1 MN 1 550075 Kinnickinnic I Cty Rd N 0 New Construction Use: y_j Residential / Number of bedrooms 4 Code derived design flow rate 600 GPD J Replacement J Public or commercial - Descdbe: Parent material Ground and end moraines, pitted glaical drift Flood plain elevation, if applicable na General comments and recommendations: Mound design, system elevation 100.53ft based on contour line elevation 99.20ft.minimum 16" of ASTM C33 sand. Boring # j Boring 1/J Pit Ground Surface elev. 99.50 ft. Depth to limiting factor 20 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff? in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0 -6 10y3/2 none sil 2msbk mfr cs 1f .5 .8 2 6 -20 10yr4/4 none sicl 2msbk mfr gW na .4 .6 3 20-43 5yr4/4 c2d 7.5yr5/6 scl 2msbk mfr gw na 4 6 4 43 -55 5yr4/4 c3d7.5yr5/6 scl om mfi na na .0 .0 Boring # Boring 16 Pit Ground Surface elev. 99.50 ft. Depth to limiting factor 20 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 -8 10y3/2 none sil 2msbk mfr cs 1f .5 .8 2 8 -20 10 r4/4 none sicl 2msbk mfr cs na .4 .6 3 20 -60 5yr4/4 c2d 7.5yr5/6 scl 2msbk mfi na na .4 .6 * Effluent #1 = BOD? 30 < 220 mg /L and TSS >30 < 150 mg /L * Effluent #2 = BOD < 30 mg /L and TSS < 30 mg/L CST Name (Pleas Print) Si natur CST Number David I Steel 248956 Address Steel Soil Service Date Evaluation Conducted Telephone Number 1564 CR GG, New Richmond, WI 17 10/24/2003 715 - 246 -5085 r— - Wisconsin D"a rtment of Commerce SOIL EVALUATION REPORT Page I of 3 Division of'Safety and Buildings In accordance with Comm 85, Wis. Adm. Code County Attach complete site plan on paper not less than 8 W x 1 =t,21 - � lnclude, but not limited to: vertical and horizontal referee and Parcel I.D. percent slope, scale or dimensions, north arrow, and loca ' and distance to nearest roadR Please print all informal n. tJ N -0 �� 200 I evi b at p Personal information you provide may be used for secondary (Privacy Law, x . 15.04 (1) Property Owner . (' [ 0 ^ ; i, �. Locati Govt. Lot 6j� 1/4:5,6 1/4 S S" T g N R E (or)6) Property Owner's Mailing Address Lot Block # Subd. Name or CSM# 7 Z l av e� oak nng City State Zip Code Phone Wmber ❑ City _ ❑ village ['Town Nearest Road -New Construction Use:] Residential / Number of bedrooms Code derived design flow rate 4 GPD [I Replacement ❑ Public or commercial - Describe: Parent material r� / Flood Plain elevation if applicable /� ft. General comments e �� U G / ° s-- O and recommendations: S�5>fil a Boring Boring # - [ ❑�7n° - ' L: Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon I Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 I 0 - IL lu r3(3 l 2.Q rn-jPr C 1 v4 S 8 Z- t2 -1 1 (6,cqlq 51 '6 DI r>Xz C 3 1- to CZP - 1.5 4 6 Sd ZmSbk rY,V'k [] In ❑ � Bori # ® pit Ground surface elev. �D ft. Depth to limiting factor I in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 •Eff#2 Vf 5 Z I -1 I © 4t' S�� -I Z>T2C\ by, m-�� C- J (1- C Z , 1 _S Zrn — M fl — (a ' Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 _< 150 mg/L ' Effluent #2 = BOD < 30 mg/L and TSS _< 30 mg/L CST Name (Please Print) i ature CST Number Sc - s3.3v y Address Date Evaluation Conducted Telephone Number 1 / D's>� � ► �s.� -E, �,U S s - I di Property Owner Leo e f 7 Z Parcel ID # Page � of 3 Boring # ❑ Boring ® Pit Gad surface elev. �'�� it Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft in. Mansell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 CJ= 34 3 — Si 2rrx�b mfr CS lv- 2 _ l 3 l Sid Z rnalnk 22 i c -S 3 ( ( L) 2 `7.5 C LL W S6 .I Z m yy- Ji — . `4 - �v i F-1 Boring # ❑ Boring ❑ pit Ground surface elev. it Depth to limiting factor in- Soil Application Rate Horizon Depth Dominant Color Redox Description Texture _ Structure Consistence Boundary Roots GPD/ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 •Eff#2 Boring # ❑ Boring Ground surface elev. ft Depth to limiting factor in. ❑ Pit 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 - 002 Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BOD < 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. ssD -8370 MUM) PAGE 3 OF NAME rl e e-+7 LOT# Z LEGAL DESCRIPTION tzC- S i4 ,S 12- ? ,N,R, / 9 E( orVd SCALE: I"= BM 1 ELEVATION lam- C) BM 1 DESCRIPTION *.;P o ',Ovc p BM 2 ELEVATION 9$ ed BM 2 DESCRIPTIO c-( - SYSTEM ELEVATION /0/• !S; a SYSTEM TYPE &0,2 n d CONTOUR ELEVATION ib-3 9� 0 SIGNA E DATE �I s• 4 t!'t77.j 77: 4L bbl td f62-13 l **� KUN HUMEt3 SNU 71 ST CRO COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Ow sr/Buy ^a Mai a$ Aid - r ;s S Y 7 &tL ig g—c' - E f' 4 43 .s' o v , � • ` Prod any A :u - ss , — -- (Variilc raft m aimd fiVM lianaing bepff a4 new coeutruction) _ Cit3 Suit— _ 14 n So �t r Pa=l Idatli Number 0 2-2- J0 Z iv GG o IN A !It' i'AumI Prop qty L it oo PLC %, S %., Sec. . T 2 N•R_ a—W. Town of _ _ ^� ti ► C i N n . < < Sub ivisiot r . _ C egg EA-12 C S O I.o1 ii w . Car lfkd f o r = cy Map i b � 4 6 , . volume W e rusty DO-1 4 N ?4� Vol. Ole Spc houtt L.: yea itc Lot tines it1amUfi")5 yes C3 no M3 E M46I WS u,N u!e end tea akno of you estate: systems o o tdd molt is itr pssmuwv failwe to baadk wastes. Pmp„r c. , acoucc coat .4 of pt+tw +:d out the a tie teak every thou y ear: or seom. if seeded by a Ikmcd putpet. Wbat you pA into system can .'[act the fu :lice of ds sepde teak se • tsestment step is the w!asts dispewi syaWW TLe ;* u;; arty 010110- WW ss wtbseit to &: Caoiu Zed DepettMM a CO Ieseioa form, sisoed by the owot: ; ad by a haler rlslumbrx ;; +tmeymeasp . areoigsdpi o0orcrs hoe■sedpmop -- vatAts *at (2) dwoa wastewataritlisp::: I system is in !euper a tx ' -a is& +cwdtt -a ao&w (2) after: impectioa wo pamepigg (if sscatsaty), the 4o0c urolc is lass thaw 1.13 tfiii !'k dudac. Ilwc tine wd;rr!i;; ned have m id the above rsqubt»seate mad agree to maisttsin the prim awap dispoul system with th• : ambrds set ! tit. hercit , ; s sot by rho Depubeent of C tamerce mod the Dgwurtau of Naltm! Rasourees. Sate of Wiseousia. C.. ':Rcattoe Kati ; that p'-4 7 i :ptic eyaeear_ hma bees unintoWW must be oaenpiseed mod tetucnod to tla St. Glnaix Ownty Zooiatl Oft, .. ichio 30 day% AlMldipc o eat tutpttm oa dow SIGH } ATUPJ 1 � UW DATE / I (W 1) o! rtify that Al s shussaos an dw form are true to tiffs beat of my (oar) baowletip. i (we) am (are) itte 4 r , terW O the t opany te Amd above, by vine of a wuTanty dood recorded is Regiew of Des& Mce. SIC; .A .4 A PLit`.l►1 W A43 DATE DATE • +•' My a ic nastion thr is mis•repreewttdmay result in fire sanitary pernpt being revoicadby the Zoning D - "nmr: •`• - -- '• t studs tit h Aie apptka tka a etataped weteegty dead from the Register or Deeds office a tapir of the cartifred survey amp if reftsatsce it medc in *a warranty deed TOO ' ._i WAFT : TO e0/ T l T T U 2433P 018 STATE BAR OF WISCONSIN FORM 1 —1998 KATHLEEN H. WALSH WARRANTY DEED REGISTER OF DEEDS ST. CROIX CO., MI Document Number RECEIVED FOR RECORD This Deed made between 10/09/2003 02:00PM Lenertz. Sr.. sinale , Grantor, and Larry G. Bellinaer and WARRANTY DEED Judith A. Belli aer. husband and wife . Grantee. EXEIPT tl Grantor, for a valuable consideration conveys to Grantee the following REC FEE: 11.00 described real estate in St. Croix _ County State of TRAMS FEE: 134.70 Wisconsin (the "Property'): COPY FEE: CC FEE: PAGES: 1 Recording Area T pK Address I ' par wp. WI 54022 022 1012 80 000 Paroal Identification Number (PIN) it This Is not homestead property. (IS) (is not) Lot 2, Certifled Survey Map filed In Val. 17, page 4616 as Document No. 740870, located in part of the NE % of the SE % of Sec 5, TWn 28 N, R 18 W, Town of Klnnlckinnic, St. Croix County, Wisconsin. Together with all appurtenant rights, title and interests. none Grantor warrants that the We to the Properties good, Indefeasible In simple fee and free and clear of encumbrances except Dated this a day of October. (SEAL) (SEAL) w , + d AG.LAMtz: ;�. (SEAL) (SEAL) AUTHENTICATION ACKNOWLEDGMENT Signature(s) State of Wisconsin, } u. authenticated Croix County cated this day of , Personally came before me this Sh day of Octobe [, = the above named Frederick G. Lenertz aka Frederick G. Lenertz. Sr.. a + single person to me known to be the person who TITLE: MEMBER STATE BAR OF WISCONSIN executed the br@goIng Instrument and acknowledge the (If not, same. NISNOOSIM d0 31v1S authorized by §706.06 Wis. Slats) I onend AUVION THIS INSTRUMENT WAS DRAFTED BY { Coldwell Banker Burnet NoterymPublic. Sthte of Wisconsin 1301 Coulee Road Hudson, WI 54016 My commission Is permanent (If not state expiration date: 3 -54449 (� I (Signatures may be authenticated or acknowledged.' ' t Both are not necessary.) N ames of sons a nln in a n ca must be or ranted below their si nature. STATE BAR OF WISCONSIN Wisconsin Legal Blank Co, Inc. WARRANTY DEED FORM No. 1 -1958 Milwaukee, Wis. ti f n ni c- 01 7.41ZIa70 VOL 77 PAGE 4616 KATIM19 H. MESA' - REGISTER OF DEEDS ST. CROIX CO.. WI I RECEIVED FOR RECORD s N i p ® 09/22/2003 03:45PM og I H I : I CERTIFIED SURVEY M AP 0 5� REC FEE: 15.00 a3 - om f- -o rogr g �mr� x A2p - 'r COPY FEE: 4.00 _o �z c i�8 Ma 9>$ !a 2 2t � y-44� 0 20Qcg 111 PAGES: 3 ° Z2 P2 L2 % prZp =1 C=Jxczo !C2 z m i I > m Z �1 2' Z 8 ° I c ° m m o - � �; Z / BEARINGS ARE REFERENCED 'R > ; m Z .,� w z5 - Y� n ° 9 . TO THE EAST -WEST 1/4 -+ g m °m 2 m m LINE OF SECTION 5, ASSUMED N X X B� TO BEAR S88'04'02'W o E o O� KIRID -------- JD n s� z 1 z WEST LINE OF THE NW CORNER OF THE NE1 /4 OF THE SE1 /4 NE1 /4 OF THE SE1 /4 m SO 1 5'11 "W 412.75 OF SECTION 5 88.06: 313.29 ; c 7 616' I W y IIN ' i 0`3 ca 1 4 < w co 12 0 D ' X11 0o c� to J \ /�,, .4 I � C rfi j: l01 `\ \ \o O N is • � o \ \ mil% �,,, ....... c� � ; I �S02 33'E 284.92' _ - U' N s -�, ♦ ; 66.25`' L Road C, Z m oz W c C►�� O�I� y N I Q� tWO y ` l ° O 1� �p (� °> r 4 I I N O Z r0 OD N t0 r N D I P -I Cli D N O �' I Iv D DD I � Z D {Ie Z� �� i & $ �gt� Z'R'n ' O m $ S00'3944M/ QQ g 9 Q Z p"o 4 O V4 � � � O � 381.10 I Z I tp i lUl I Z j pp CC au m I 0(n0 :11 IG� � NC l O . � I lol l Z 0 0� of .. �a (A > > l ��ii N ~ b I - 1 � I l (7 � Z I� r NI W l CD I r►vvvr> ° i 111 n W �' {1 to I c3lU�U In m o � N e = i V y D m ! m I I o i0° ' 1 L4 ID co M I I I of i n� C N l v S00.39'44"W" Z ' �+ l I O M tn A D l mi I I N zz t , f11 in I Q 378.90 L . .. _ O I I I l R �e Q � � I N WNQrt� r1 f�1 Rl J=• I Uuu N N> O N j Z O ,o �m :4 m� 40 a I C: : � 395.88 : n c w °• ns n I I NOO°39'44"E 436.05 n N w"PArkS CO WEST LINE OF THE EAST 200' I N . r l I OF THE NE1 /4 OF THE SE1 /4 N m m m S 2 2 2003 s I ODLJG° @[EL Oil ^� m If IW@L. &M 0 9 P@. �4� i O tlORnoordedwfthin30dayspf --------- - -- - -- pm0 approval date approval shag bo z null and void N mII t m p � crAl cjO D L11 6 0 m 1 m p —I �� Z V CO o 6I 33 81 _� ' N N � r x q '0 n c O C: m Nu to O 0 N�Rei C �' 209 m -� 0 rq °� o z� z v z 91 -� m hi p j .. O V1 °° °- Vol. 17 Page 4616 •