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CD OP y f�0 ( I 0 D I � fD (D Y I I O A C CL CD Z ai c N I < I O O • A I I � CD I CD to 69 69 O ti O O- O O. ?' 1 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 463207 0 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan to 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: LaGrander, Kurt I Pleasant Valley Township 024 - 1021 -50 -200 CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range /Map No: l�' 0 l00•0 _�64 / 17.28.17.1166 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI S ELEV. R .1 06 Septic / b a O Benchmark d. V Dosing ^ - Alt. BM r { 3 , 3aG- Aeration ` Bldg. Sir 3614 q� � b Holding S S — H, t ..�' �^.. TANK SETBACK INFORMATION SUHt Outlet TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic �D � 0 tZ— Dt--- `� Dosing Head r /Man. [ todo Aeration Holding Bot. System D. Final Grade PUMP /SIPHON INFORMATION ---.A Manufacturer Demand S GPM 2 3 Aox Model Number TDH Lift Loss System ,a Z TD H � Forcemain Leng Dia. Dist. to We I 3 L• SOIL ABSORPTION SYSTEM �-- ( ,S' f -: j-da — % F—IV �— B MENSIONS Width Length No. Of Tren hes P DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS SETBACK SYSTEM TO P/L BLDG IWELL LAKE /STREAM L CHI Manufacturer: INFORMATION Type f System: � �t Lt '/ CHA TOR Model Number: DISTRI TI SYSTEM i Heade anifolf _• Distribution j x Hole Size x Hole Spacing. Vent to Al n e Pipes) __73 - Length Dia �._ Length Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over Depth Over , xx Depth of xx Seeded /Sodded J xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil [] Yes 0 No Yes y � No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: ( I [ 1 r I / Inspection #2:11 ! Location: 354 170th Street Hammond, Wl 54015 (SE 1/4 NE 1/4 17 T28N R17W) NA 1 r� f�6e -Q reel N 17.28 7.11 QB 1.) Alt BM Description = S?' + C 4 T 9A— � Yi ! 14 ��� 2.) Bldg sewer length = / - amount of cover =� f ->g2:0j CIA 1&+4W &1fu, eg- Plan revision � � .... R Yes to Use other side for additional information. Date Insepctor's Signature Cart. No. SBD -6710 (R.3/97) lk i I x 4)25vq> osj P, U �Sef 7:T X " Ci</ / / Q'C}�i �(ls'lr+t, � ' r) IXPQ J,'Alk 70 COPY `yam .� �'"•`.� .___.»____.._.._ �..._._._.»__....w.... �.�...._,.._........_��,..�.... (�Z' /'� 44, i - 1 3 7/8 HEAD CAPACITY CURVE 6 1/4 ' MODEL 98 30 5/8 .;. 4 I 8 25 ® I 3 5/8. s 8 � � I O - - 4 / t3 4 3/16 i3 t0-- – 2 r 6— — 1 1/2 -11 1/2 NPT 0 ; U.S. GALLONS 10 20 '8 40 b0 80 70 80 LITERS so 240 0 FLC W PER MINUTE TOTAL OYNAMIC HEAWl.0W PEP MWUTe - tFFtUENTANDOeWMTERIHG CAPACITY 12 HEAD UNITSIMIN FEET METERS GALS LTRS 5 1.52 72 273 10 3.05 a, 231 is 4.57 45 170 4 3/16 20 e.10 1 25 95 L ock valve � 23• } I ' eK11o: CONSULT FACTORY FOR SPECIAL APPLICATIONS • Electrical alternators, for duplex systems, are available and Variable level float switches are available- for controlling single supplied with an alarm. and three phase systems. • Mechanical alternators, for duplex systems, are available with Double piggyback variable level float switches are available or without alarm switches. for variable level long cycle controls. SELECTION GUIDE 1. Integral nost operated 2 pole mechanical switch, no external control required. Standard all models - Weight 39 lbs - 1 /2 H.P. 2. Single piggyback variable level float switch or double piggyback variable level, 99 Series Control Selection float switch. Refer to FM0477. E98 Volts Ph Mode Amp simplex Duplex 3. Mechanical alternator 10.0072 or 10.0075. 115 1 Auto 9.4 1 or 1 b 7 — 4. See FM0712, for correct model of Electrical Alternator, E -Pak. 115 1 Non 9.4 2 or 2 6 8 3 or 4 8 S 5. Control switch 10 -0225 used as a control activator, specify duplex (3) or (4) 230 1 Auto 4.7 1 or 1 d 7 — float system. 8. Four (4) hole J -Pak, junction box, for watertight connection or wired-in 230 1 Non 4.7 2 or 2 d 8 3 or 4 & 5 simplex or duplex operation, 10 -0002. 7, Two (2) hole J -Pak, for watertight connection or spike. CAUTION Fatnlon t bnonwmNlonWZoenwploducunferbcalsbgonComb imWnSlaAer,FMOS14;PWybode All Installation of controls, protection devices and wiring should be done by a qualified Variable levelSwllchu, FM0477; Elec" Allemalor, FMO486 :MechankalAllemabr,FM049S;StxW licensed electrician. All electrical and safety codes should be followed Including the rnast Sewage Basins. FMO487; and Single Phase Simplex Pump Contml/Alagn Systems, FMO732. recent National Electric Code (NEC) and the occupational Safety and Health Act (OSHA). RESERVE POWERED DESIGN For unusual conditions a reserve safety factor is engineered into the design of bveq Zoeller pump. MAIL To: P.O. BOX 16347 Ltwille,KY40256.0347 •Manufadurersof.. SH)P T0: 3649 Can• Run Rood 1 _ v L tod"e. -1981 I �rrPuav�; ;vcE /939 PUMP 10. (502 ) 778.1731. 918 -PUMP FAX (501) 774.3614 P oe, 7 4 1 Sanitary Permit Application Safety & Buildings Division In accord with Comm 83.2 1, Wis. Adm. Code 201 W. Washington Ave. See reverse side for instructions for completing this application PO Box 7302 1 4sconsin Personal information you provide may be used for secondary purposes Madison, WI 53707 -7302 Department of Commerce bi td f t (Submit completed o county if not [Privacy Law, s. 15.04(1)(m)) state owned.) Attach complete plans (to the county copy only) for _tkCsystem, on paper not less than 8 -1/2 x 1 1 inches in size. County State Sani a Number heck if revision to previous a lication State Plan I. D. Number 7 D 77 isT. (" e i 'M Ai✓S. I 0 - 7 d-� I. Application Information - Please Print all Information Location: 35 1 ' Property Owner Nam�+e /' � roperty Location � �{ V � �"' I,t,& r(` 2 v ly O NOV N V 2�� s6 1/41j 1/4, S 1 ,N, RI°1E (or) Property Owner's Mailing Address Lot m r Block Number ��� to t�t�t �ZONINGOFFICE � 1 City, State *Zip Code Phone Number Sub ' . ion Name or CSM Number II. Type of B ilding: (check one) , _ /� ❑ City Ct7 01( 1 or 2 Family Dwelling - No. of Bedrooms : 0 ❑Village ❑Public /Commercial (describe use):_ Town of j� `R ❑ State - Owned 1 ( &v ` V (f� �� •� �x 5 ��� d (� w 1 �� Z Nearest Road t'7t oayvig- y "d QhQ.Cc aa P Parcel Tax Number(s) / a III. Type of P erffiit: (Check only one box on line A. Check box on 1' B if ap lica le) I A) 1. ew 2. ❑ Replacement 3. ❑ Replacement of 4. 6. ❑ Addition to S ystem System Tank Only Existing System Permit Number Date Issue B) A Sanitary Permit was previously issued Q�Q 3 f / Zod IV. Type of POWT System: (Check all that apply) ❑ Non - pressurized In- ground Moun .2( / 02. N?A' / t ' Q ❑ Sand Filter 11 Constructed Wetland 11 Pressurized In- ground Holding Tank 1`ri Sv'� ❑ Single Pass ❑ Drip Line ❑ At -grade ❑ Aer is Trea e t Unit ❑ irc at' g ❑ Other: V. Dispersal/Treatment Area Information: y /tie l/ td 1. Design Flow (gpd) 2. Dispersal Area 3. Disp rsal Area 1 4. Soil Apolication 5. Percolation Rate 6. System Elevation 7. Final Grade Requ Prop Rate (Gals. /day /sq. ft.) (Min. /inch) Elevation I � (�l) V C j11 X 19 /"-- Z /a3, ) VII. Tank ty i n Total # of Manufacturer Prefab Site Steel Fiber- Plastic Information Gallons Gallons Tanks Con- Con- glass New Existing / crete structed Tanks Tanks S kx Sno k d ®p I g ock 600 ❑ ❑ ❑ VIII. RespUnsibility Statement 1, the undersigned, assume responsibility fo 'nstallation of PQWT s own on the attached plans. Plumber's Name (print) I Plumb Plumb& Signature (n s s): MP/MPRS No. B iness Phone Number G �/ G �/►07a -tr � �.. � d�� � �' b Plumber's Address (Street, City, State t e) / XI h&a!r H IX. County/Department Us Only 61 F ❑ Disapproved Sanitary Permit Fee (Includes Groundwater Date ssued Z ignature o tamps) Approved ❑ Owner Given Initial Adverse Surcharge Fee) Determination "' l �O d 7 !� X �o�lproval /Reasons for Disappro�l: Septic tank, effluent filter and 4 dispersal cell must all be serviced / maintained ? /� cv �z - as per management plan provided by plumber. 2. All setback requirements must be maintained as per applicable code /ordinances. aGA�is 42. r o OA ' SBD -6398 (R. 07/00) Safety and Buildings • 4003 N KINNEY COULEE RD commercemi.gov LA CROSSE WI 54601 -1831 TDD #: (608) 264 -8777 isconsin www.wmmerisco govsb, Department of Commerce isconsin.gov Jim Doyle, Governor Cory L. Nettles, Secretary November 16, 2004 CUST ID No.220728 ATTN.• POWTS Inspector CLARENCE L GLOTFELTY ZONING OFFICE ENVIRO -TECH SYSTEMS & SERVICE ST CROIX COUNTY SPIA N4955 SUNNY HILL RD 1101 CARMICHAEL RD WEYERHAEUSER WI 54895 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 11/16/2006 Identification Numbers Transaction ID No. 1077028 SITE• Site ID No. 669893 Curt Legrander Please refer to both identification numbers, 170TH Street above, in all correspondence with the agency. Town of Pleasant Valley, 54015 St Croix County SE1 /4, NE 1/4, S17, T28N, RI 7W FOR: Description: Three Bedroom Mound System Object Type: POWTS Component Manual Regulated Object ID No.: 938176 Maintenance required; 450 GPD Flow rate; 24 in Soil minimum depth to limiting factor from original grade; System: EZ -Flow Mound Component Manual, (N.6/03); Biofilter The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, stats. Confi The following conditions shall be met during construction or installation and prior to occupancy or use: APPR Approval Requirements: DEPARTMENT • This system is to be constructed and located in accordance with the enclosed approved plans and with the EZ �TOFr FLOW Mound Component Manual (June 6, 2003). with the "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems Version 2.0" SBD- 10706 -P (N.01 /01). SEE CORRE • The observation pipes must be located at a junction point between two EZ -Flow products so as not to create separation of the bundles within a product. • 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 CLARENCE L GLOTFELTY Page 2 11/16/2004 • 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. 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 cbratz @commerce.state.wi.us cc: Leroy G Jansky, Wastewater Specialist, (715) 726 -2544 D AND PRESSURE DISTRIBUTION:COMPONENT DESIGN �-� Commercial Application INDEX AND TITLE PAGE Project Name: L.-r3 o, In ke,r 1 U I C N" Owner's Name: Cv't Owner's Address: �� ?� ,, U 0D- �Ir`: - 71 S - 7*, - —1gRB Legal Description: SI: Yq NCA ;LB `( Township: eA County; l x Subdivision Name: jig 324 Lot Number. Block Number. Parcel I.D. Number. I ul — 5 -- a l - Plan Transaction No.: ` 5 B y 3 S Page 1 Index and title Page 2 Data eptry Page 3 Mound drawings o Page 4 Lateral and dose tank Page 5 System maintenance specifications/ 'T r., P L Page 6 Management and contingency plan 74 017, 1 1 age 7 Pump .Curve dnd specific attions OV y a- 1A OF COMMERCE EY Gs G SP ONDENCE Designer. — License Number. Date:� Phone Number. Signature: 7 Version 4.0 (R. 04!03) Page 1 of $ r Mound and Pressure Distribution Component Design Site Information R Residential or Commercial Design Note: Sand fill (D) calculations assume a 300.00 Estimated Wastewater Flow (gpd) Table 93-44-3 In -alto soli treatment for fecal 1.50 Peaking Factor (e.g. 1.5 = 150%) coNform of <: 36 inches. 450.00 Design Flow (gpd) 5.00 Site Slope ( %) 101.20 Contour Line Elevation (ft) 24.00 Depth to Limiting Factor (in) 0.60 In -situ Soil Application Rate (gpd /ft�) Distribution Cell Information 75 Dispersal Cell Length Along Contour (ft) _ .90 Cell Width (ft) 1.00 Dispersal Cepl Design Loading Rate (gpd /ft 1 Influent Wastewater Quality (1 or 2) Are the laterals the highest point In the distribution Y Pressure Disribution Information network? c Center or End Manifold � ) Lateral Spacing (ft) If N above, enter the elevation (ft) 4 Number of Laterals of the highest point. 0.126 Orifice Diameter (in) (e.g. 0.25) 3 Orifice Spacing (ft) _ � ft 2 /orifice 2.00 Forcemain Diameter (in) 40.00 Forcemain Length (ft) Does the forcemain drain back? Y 95.00 Pump Tank Elevation (ft) 6.J0 System Head (ft) x 1.3 6.5 Forcemain Drainback (gal) 6,0 Vertical Lift (ft) ! 5x Void Volume (gal) 0... Friction Loss (ft) Minimum Dose Volume (gal) ,may Total Dynamic Head (ft) _off System Demand (gpm) Lateral Diameter Selection Manifold Diameter Selection in. dia. a tiorts I choice in. dia. ojitions I choice 0.75 125 x 1.00 x 1.50 x x 1.25 x 2.00 1.50 x x 3.00 2.00 x 3.00 x Gallons/inch Calculator .- Treatment Tank Information ( Total Tank Capacity (gal) &?00 Septic Tank Capacity (gal) `/D ` Total Working Liquid Depth (in) Manufacturer gauin (enter result in cell B49) I x �3 Dose Tank Information Fffluent Filter Information 4000 Dose Tank Capacity (gal) vK t Filter Manufacturer Dose Tank Volume (gal /in) ((CC> Filter Model Number N� /OG� /� Manufacturer Project: Curt LeGrander 3 bedroom residential mound Page 2 of jd� MOUND PLAN VIEW qbservation pipes (typical) r ` 1/6 B IE-- _ A= ft A� B = ft I J= W �-- . B I = ft I K - ft K 1/6B = �t _ ft typ. obs. pipe (anchored securely) I = down slope dimension = absorption cell (AxB) J = up slope dimension O = plowed area (LxW) K = end slope dimension s• T MOUND CROSS SECTION D in = in subsoil cap lateral topsoil G H E= in invert 4L:.1.. - -- 7 � F = in elev. - - - F G = 6.0 in ` T ASTM C33 H = 12.0 in - D Sand Fill F �v y Sys. � elev. 2 , Jft contour \/ slope D = upslope fill depth plowed layer E = downslope fill depth U.911z Absorption cell media will consist F = absorption cell depth of - c&rnPorr -n+x "7 /96MI G = subsoil + topsoil depth at cell wall centered across AxB media. The cell H = subsoil + topsoil depth at cell center media is covered with geotextile fabric Designer notes: eSIA o e I r• 7 ' Project: Transaction Number: Page,) of ci /' /c'F�j �, ,JG Q/ri / /G/ Yh �� 1� f%N•r /c �o�. / / Center Connection Lateral Layout Daigram Force main connection via tee of Oros$ to manifold at any point. Laterals are identical WL 1 P Ak- •- Turn -up vdbsll wlw or IE X- -+-rJ2 I d2 +1 Laterals k force main of PVC Sch 40 olissnoutplup per COW Table 84.30.6 Holes drilled on the bottom of the lateral. Number of Laterals Orifice Diameter in Lateral Diameter in Orifice Spacing (X) i rtc Lateral Length (P) ft Orifices per Lateral Lateral Spacing (S) 3.o ft Orifice Density ft /orifice MD Lateral Flow Rate gpm Manifold Length ft System Flow Rate o gpm Manifold Diameter in Total Dynamic Head > ft Forcemain Velocity r 0 -- 3 ft/sec SEPTIC TANK AND PUMP CHAMBER C ROSS SECTION AND SPECIFICATIONS Loolag Cover vM Weather Prod Junction 8". vameg libel. Accts Electrical "Per NEC 000 and opening. na ion a «. C ornin t6 :J conic l { Vera Plea mUM oaand at leak 4' E t? abow 9rade above *Wa ed grade. �� ^ a AA0011116 opening. not top Mawnto" Cover over T o l ana of cover. must extend to a pone no greater awl a• below aninneo grade. 7Y Mn. opening Disconnect f- Alternate "at it own, location l I Face Main olamtler I 27' MK A ace Minn Length opening ealtwa War Quilt" < to t li A aawr D tW Weep tale or and eprwn device. Pump oA Bev. �Twec Elw. �•t r sad and baeas rteoeeaary wilt aoeord4q to muedamaere apedleatldrts Note: AN p ipe and vent matenals comply with Comm 84. Anclter Carle • to negau 1 s Tank Manufacatrer. ' I r1C, Doses Qer Day: - x l e -,- ucl epti �1 y� Tank Sizes: Sc 1 +ma Gallons G86�I Bases: �5 b gallons Pump �_ Gallons Backtlow: _D- gallons Gallons Per Inch: jq J . 3 Total Dose Volume: 7 gallons Liquid Level: Required GPM: I Pump Manufacturer. ' Dimensio I Inches Gallons A 3 Pump Model: �l B Alarm Manufacturer. C - C 0 I Alarm Model: �`t W 1 1 Total i pp l7 1 � . SJ Vertical Difference between pump off and distribution pipe L3Si +-$" K Minimum Required Supply Pressure (0 for dosed conventional) 17 a Feet of force main x friction factor/ 100 I [p� Total Dynamic Head Mound System Maintenance and Operation Specificagons --- 0 - ` - Phone 1 Service Provider's ' P- Name c Av _ __�...._^ - --�- POWTS Regulator's Name St. C roix C ounter Zoning �_� Phone 715- 388 -4880 Syltern Flow al3SLLO§d Pi Design Flow - Peak 450 gpd Maximum Influent Particle Size 1/8 in Estimated Flow - Average 300 gpd Maximum BOD5 220 mg /L Septic Tank Capacity :{ w gal Maximum TSS 150 mg /L Soil Absorption Component Size 460 ft` Maximum FOG 30 mg /L P Type of Wastewater Domestic Maximum Fecal Coliforml >10E4 cfu /100 mL Service Freauencv Septic and Pump Tank In spect and /or service once every 3 ears Effluent Filter Should inspect and clean at least once every 3 years Pump and Controls Test once eve 3 years Alarm Should test monthl Pressure System Laterals should bL flushed and pressure tested every 1.5 years Mound Inspect for bondin and s eeps a o nce every ars - -.. - M iscellaneous Construction and Materials Standards 1. Observation pipes are slotted and materials conform to Table Comm 84.30 -1, have a watertight cap, and are secured in as shown in the mound component manual. 2. Dispersal cell aggregate conforms to Comm 84.30 (8)(i), Wis. Adm. Code. 3. All gravity and pressure piping materials conform to the requirements in Comm 84, Wis. Adm. Code. 4. Tillage of the basal area is accomplished with a mold board or chisel plow. 5. The mound structure and other disturbed areas will be seeded and mulched to prevent soil erosion and help reduce frost penetration. Lateral Turn -up Detail Finished •••'••••••••••• Grade \� Threaded Cleanout 6 -8" Diameter Lawn Sprinkler Valve Box Plug or Ball Valve Distribution Lateral -� Long Sweep 00 or Two - --- - -- 45 Degree Bends Same Diameter as Lateral Page 5 of Project: Curt LeGrander 3 bedroom residential mound 8 Mound System Management Plan Pursuant to Comm 83.54, Wis. Adm. Codef I This system shall be operated in accordance with Comm 82 -84 Wis. Adm. Code, and shall maintained in accordance with rte• component manuals ISBD •10691 -P (N.01i01) and SSWMP Publication 9.6 (01/81)] and local or state rules pertaining to system maintenance and maintenance reporting. • b use de ath. Na one should ever enter a septic or pump tanpt since dangerous gases may be presen t that could cause 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 nears, access risers and covers should be inspected for water tightness and soundness, Access openings used fcr service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to falluie must be replaced. Exposed access ope.,lings greater than 8- inches in diameter shall be secured by an sTlWIve locking device to prevent accidental or unauthorized entry into a tank or component. S The septic tank shall be maintained by an individual ceitified to service septic tanks under s 281.48, State. The contents of the septic tank shall be disposed of in accordance with Nit 113, Wis. Adm. Code. The operating condition of the septic tank and outlet finer shall be assessed at least on ;e every 3 years by inspection The outlet finer shall be cleaned as necessary to ensure proper operation. The finer cartridge should not be removed unless provisions are made to retain solids in the tank that may slough oft the finer when removed from its enclosure. If the finer Is equipped with an alarm, the litter shall be serviced if the alarm is activated continuously. Intermittent finer alarms may indicate surge flaws or an impending continuous alarm. Ths septic tank shall. nave its contents removed when the volume of sludge and scum in the tank exceeds 113 the liquid volume of the tank. If the contents of the tank are not removed at the time of a triennial assessment, maintenance personnel shelf 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 attditkon 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. eunw 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 finer Is installed within the tank it shall be Inspected and serviced as necessary. MA und and Pressure DIstrlbuUon System No trees or shrubs shoula 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 them for vegetative maintenance) on the mound is not recommended since soil compaction may hinder aeration of the infiltrative surface within the mound and snow compaction in the winter wlli promote frost penetration. Cold weather installations (October- February) dictate that the mound be heavily mulched as protection from freezing Influent quality into the mound system may not exceW 220 mg/L BOD5, 150 mgiL TSS, and 30 mg /L FOG for septlo tank effluent or 30 mg9- BUD„ 30 mg/L TSS, 10 mg/L FOG, and 10 cfw100 mL for highly treated effluent. 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 racommended that such lateral be flushed of accumulated solids at Nast 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 It 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 6 inches considered as an Impending hydraulic failure requiring additional, more frequent monitoring. i Contingency Plan if the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep the system in proper operating condition. If the dosing tank, pump, pump controls. alarm or related wiring becomes defective the defective component(s) shall be Immediately repaired or replaced with a component of the same or equal performance. if the mound component accept nt f ile to t wastewater or begins to discharge wastewater to the ground surface, it will be repaired or replaced in p its' present iocation by increasing basal area if toe leakage occurs or by removing biologically clogged absorption and dispersal media, and rate ted piping. and relxacirig said components as deemed necessary to bring the system into proper operating condition. See Page of this plan for the name and telephone number of your local POWTS regulator and service provider I Project: Curt LeGrandef 3 bedroom residential mound Page 6 of i I i I t 3 7/8 6 1/4 . ` HEAD "98" CAPACITY CURVE 30 MODEL. 4 5/8 a . 25 J 9 3 51 . t = � 8 0) I I O 0 15— 4 �` 4 3/16 � g o 10 ; 2 i 1 1/2 -11 i/2 NPT g— U.S. GALLONS 10 20 0 70 80 LITERS 80 240 0 FLC. W PER MINUTE TOTAL OVNAMIC NlAfXfLOWPl�7 MNiUT! 1IFFLUe.14001WATERINO CAPACITY 12 HEAD UNITS/MIN FEET METERS GALS LTRS 1 5 1.52 72 273 10 3.0s et 231 1s 4.57 45 170 4 3/16 20 6.10 25 95 !.� Doll Valve � 27 ' aK1,l0a ' CONSULT FACTORY FOR SPECIAL APPLICATIONS • Electrical alternators, for duplex systems, are available and Variable level float switches are available for controlling single supplied with an alarm. and three phase systems, • Mechanical alternators, for duplex systems, are available with Double piggyback variable level float switches are available or without alarm switches. for variable level long cycle controls. SELECTION GUIDE 1. Integral float operated 2 pole mechanical switch, no external control required. Stand:lyd all models - Wei 11t 39 tbs. - /s H.P. 2, Single piggyback variable level float switch or double piggyback variable level, 96 Series Control Selection float switch. Refer to FMO477. Model Volts Ph Mod@ Amps Sim lax Du lex 3. Mechanical alternator 10 -0072 or 10.0075. M95 115 1 Auto 9.4 1 or 1 b 7 — 4. See FM0712, for correct model of Electrical Alternator, E•Pak N98 115 1 Non 9.4 2 or 2 6 8 3 or 4 b 5 S. Control switch 10 -0225 used as a control activator, specify duplex (3) or (4) 098 230 1 Auto 4.7 1 or 1 d 7 _ float system. 6. Four (4) hole J -Pak, Junction box, for watertight connection or wired -in E98 230 1 Non 4.7 2 or 2 d 6 3 or 4 3 5 simplex or duplex operation, 10 - 0002. 7. Two (2) hole J•Pak. for watertight connection or splice. CAUTION Forinbmud*non&Mftbna1Zoar,w roductsmrwbn le"OnCombineOonStarter,FMOS14 :Piggyback All Installation of controls, protection devices and wiring should be done by a Qualified Variable Level Switches, FM0417; Electrical Akemalx,FUC486: MechanicalAllemabr, FM6495; Sumpl licensed electrician. All electrical and safety codes should be followed Including the most Sawage Basins, FM0487; end Single Phase Simpiex Pump ConboUAbnn Syslens, FMO732. recent Nallonal Electric Code (NEC) and the Occupational Safety and Health Act (OSHA). RESERVE POWERED DESIGN ' For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump. MAIL TO: P.O. BOX 16317 LIw1 W49 C ans Run R oad • ManlAada@r3 d.. O SHIP T0: 3619 ane Run R 1 � Louisvife, KY 40211.1961 Q irr Pes�PS .`,: eeF /9.9 ~ PUMP"O. (502)778-273I-I(800;928-PUMP FAX(501)774.3624 P &7 of q 11 A 4 (7 . cI J � � P v rp o o ). PV d'eW I kop Co (> W3 Pe n j ji e f- Site df iv 64 g< i v+>rn�r Q � C/) v� z n C v Z I1 r- m O z� m El $ ;u -1 c . ic O -n = m rn X m O X 2 CO) m . rnQ X O �► z > —� - n rn c z o �o z N '&O Z c m n z Z - bf G� rn to C r CO) a ' = v WO ;v c — m _ Z O rn CN r0 m 0 Q m m Z V1O >m< v ;a row. _ v O z 10 • O M P 0 -1 1111 1 8 1 1 .1 F. O 2. ■ ■■ e a e o aoo 0 z 0 n ;1, p uI - cr e z cr d e S x s L Q N c m .. Ut o 0 � W 43 "rob ps r 9 N 6 d Ck co O z r State of Wisconsin County Safety and Buildings Division NITA I CIF X Integrated Services Bureau Tra " ....i enewa Uniform Permit Number Personal information you provide may be used f seconds purposes (Priva s.15.04 (1 )(m)]. Permit Renewal Date Permit Trans to Original Permij Issuance Date State Plan ID Number 03 ( 200 `�- 7 Property Location � - T wn El Village El City of �l/4 1 — _ 1/4,S T ,R 17 E (or W (? Lot Number Block Number Subdivision Name Nearest Road, Lakr; or Landma PREVIOUS SANITARY PERMIT HOLDER - IF CHANGED: SANITARY PERMIT TRANSFERRED TO: Name (Please Print) Signature Name (Please Print) Phone Number Address Phone Number Street Address, City, State, Zip Code ( ) I, the undersigned, assume resp(jisibility for ir4allation of the private sewai e system that has been previously approved for this property. Plu Si ture Previous PI tuber Name „ (if changed) At �1100r' . I Z PlufteTlAddress Previous Plumber Address �, I 5 r) i a umber Phone Nunfer I MPIMPRSW Number Phone Number Issuing Agent Signature Date Approved SBD -6399 (R.04/96) Distribution: Original - County; Copy - Owner; Copy - Plumber IV r� S Safety and Buildings commerce.wi. OV 4003 N KINNEY COULEE RD g LA CROSSE WI 54601 -1831 TD #: (608) 264 -8777 i s co n s i n www•commer isco sin.go / Department of Commerce www.wisconsin.gov Jim Doyle, Governor Cory L. Nettles, Secretary November 16, 2004 CUST ID No.220728 ATTN: POWTS Inspector CLARENCE L GLOTFELTY ZONING OFFICE ENVIRO -TECH SYSTEMS & SERVICE ST CROIX COUNTY SPIA N4955 SUNNY HILL RD 1 101 CARMICHAEL RD WEYERHAEUSER WI 54895 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 11/16/2006 Identification Numbers Transaction ID No. 1077028 SITE: Site ID No. 669893 Curt Legrander Please refer to both identification 170TH Street numbers, above, in all Town of Pleasant Valley, 54015 correspondence with the agency. St Croix County SE1 /4, NE1 /4, S17, T28N, R17W FOR: Description: Three Bedroom Mound System Object Type: POWTS Component Manual Regulated Object ID No.: 938176 Maintenance required; 450 GPD Flow rate; 24 in Soil minimum depth to limiting factor from original grade; System: EZ -Flow Mound Component Manual, (N.6/03); Biofilter The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, stats. The following conditions shall be met during construction or installation and prior to occupancy or use: Approval Requirements: • This system is to be constructed and located in accordance with the enclosed approved plans and with the EZ FLOW Mound Component Manual (June 6, 2003). with the "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems Version 2.0" SBD- 10706 -P (N.01 /01). • The observation pipes must be located at a junction point between two EZ -Flow products so as not to create separation of the bundles within a product. CLAFENCE L GLOTFELTY Page 2 11/16/2004 • 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 ermit must be obtained from the county where this project is located in rY tY p J 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. 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. CLARENCE L GLOTFELTY Page 3 11/16/2004 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 cbratz@commerce.state.wi.us cc: Leroy G Jansky, Wastewater Specialist, (715) 726 -2544 MOUND AND PRESSURE DISTRIBUTION;COMPONENT DESIGN Commercial Application INDEX AND TITLE PAGE Project Name: L a L o vk.vl Owner's Name: C Lk - ' Lo. G r&vdt-r Owner's Address: J0, LU u `l Da-� 1 %S - Legal Description: SL Yq NC- I 0 TIBN `l Township: County; S-}- C t"OI x Subdivision Name: vim,[ leg J Lot Number. �_ Block Number. Parcel I.D. Number b ky — i D - 5n - a Plan Transaction No.: Page 1 Index and title Page 2 Data eptry Page 3 Mound drawings Page 4 Lateral and dose tank Dz r `� / . Page 5 System maintenance specifications/ NA L; 6 Management and contingency plan age 7 Pump curve dnd specifications t?(Q+ ?WA Designer. (2,1�Cg �.21&U - License Number. a� p7 Date: Y Phone Number Signature: s V Version 4.0 (R. 04/03) Page 1 of $ eA 1 Mound and pressure Distribution Component Design Site Information R Residential or Commercial Design Note: Sand rill (D) calculations assume a 300.00 Estimated Wastewater Flow (gpd) Table 83 -44-3 In -situ soil treatment for fecal 1.50 Peaking Factor (e.g. 1.5 = 150 %) cofiform of — 36 Inches. 450.00 Design Flow (gpd) 5.00 Site Slope ( %) 101.20 Contour Line Eleva (ft) A-4 pu -- 2 . Depth to Limiting Factor (in) 0.50 In -situ Soil Application Rate (gpd /ft istribution Cell Information qp � Z_f) , Dispersal Cell Length Along Contour (ft) _� �� .q0 Cell Width (ft) 1.00 Dispersal Cell Design Loading Rate (gpd /ft ) 1 Influent Wastewater Quality (1 or 2) Are the laterals the highest point in the distribution Y Pressure Disribution Information network? c Center or End Manifold Lateral Spacing (ft) If N above, enter the elevation (ft) 4 Number of Laterals of the highest point. 0.125 Orifice Diameter (in) (e.g. 0.25) j.(j Orifice Spacing (ft) _ � W /orifice 2.011 Forcemain Diameter (in) 40.00 Forcemain Length (ft) Does the forcemain drain back? Y 95.00 Pump Tank Elevation (ft) 6.4 System Head (ft) x 1.3 6.5 Forcemain Drainback (gal) 6,, Vertical Lift (ft) 5x Void Volume (gal) 0.9V Friction Loss (ft) Minimum Dose Volume (gal) i ; Total Dynamic Head (ft) �� System Demand (gpm) Lateral Diameter Selection Manifold Diameter S in. dia. o tions choice in. dia. o tions I choice 0.75 .25 x 1.00 x 1.5 x OX x 2.00 1 — .5 - 0 x 3.00 00 x 3.00 x Oallons /Inch Calculator Treatment Tank information &, F Total Tank Capacity (gal) /DOO Septic Tank Capacity (gal) VD'. ` Total Working Liquid Depth (in) Manufacturer Et I gat/in (enter result in cell 849) Dose Tank Information Effluent Filter Information P OO Dose Tank Capacity (gal) S I tn_1 l Filter Manufacturer Dose Tank Volume (gal /in) 00 Filter Model Number lavlw Manufacturer Project: Curt LeGrander 3 bedroom residential mound Page 2 of i MOUND PLAN VIEW gbservation pipes (typical) ^ 1/68 A = ft ., tt 4 I B ft W B I= ft �, K 1/613 = `t �--- L typ. obs. pipe (anchored securely) I = down slope dimension [ absorption cell (AxB) J = up slope dimension O plowed area (LxW) K = end slope dimension 6- MOUND CROSS SECTION subsoil cap D = a, in lateral topsoil G H E = in invert �. F - in f elev. - '`- F G = 6.0 in T ASTM C33 H = 12.0 in 0 Sand Fill E Sys. elev. /e ft contour --� slope D = upslope fill depth plowed layer E = downslope fill depth U2W Absorption cell media will consist F = absorption cell depth of Z�f ouu VrRnare. 6,brrtPott}s �rt:,�� G = subsoil + topsoil depth at cell wall centered across AxB media. The cell H = subsoil + topsoil depth at cell center media is covered with geotextile fabric. Desi ner notes: o i e r " ' / i Project: Transaction Number: Page3 if /h Ole— 1► . 6 Center Connection Lateral Layout Daigram Force main connection via tae or cross to manifold at any point Laterals are identical P S • Turn -up wdball valve or IE X--� xl2JI.W 2+ 1 Laterals & force main o« PVC Sch 40 oiesnoutplup per COMMA Table 84.30.5 Holes drilled on the bottom of the lateral. Number of Laterals Orifice Diameter in Lateral Diameter , in Orifice Spacing Z d r +e Lateral Length (P) ft Orifices per Lateral Lateral Spacing (S) 3x ft Orifice Density , 2 j fe /orifice jr*0 Lateral Flow Rate 6 1 gpm Manifold Length n ft System Flow Rate 30A. b gpm Manifold Diameter , in Total Dynamic Head ft Forcemain Velocity ft/sec SEPTIC TANK AND PUMP CHAMBER CROSS SECTION AND SPECIFICATIONS Lootong Cover rrdh WaMMr Pna>f Aawdron am. warrong ubei Electrloar ad Per NEC 900 ant Comm not top W cover. Comm 16.26 WAC Vert Pipe Wow : AS St grMM 4 _ �� `1 `• V err f" 1 r ¢a {� !� a P I Maamaan Cover over TORN a poet no gram ban 4r r Dalow 6rusbed grate. 2r Min. opening Duce naa 't E•� Adamate adlat 16' nwL location 1 , I Fares Main Oiamatr 23 Mtn pig am Main LWgM BLWdkq ! to 1/a' Norton GOV". wrvar �>� A_` wow h am as or i a s I i0® 0 Oat am beci i tole noordWV to mwfadnra apeodicabora Antler tun as naoaaary m ttagan r Nate: All p lpe and vent materials comply with Comm 84. s Tank Mernrfacturer ' IYIC,• Doses per Day: �c c3 v�.,c)• � � Tank Sizes: Septic � � Gallons GHQ# Roses: t ( J; ' , gallons Pump Gallons 1 Backflow: ' D - viions i Gallons Per Inch: � 3 Total Dose Volume: l L7 gallons i Liquid Level: tfn Required GPM: 3' � (+ t v\ c \iJ`x, i Pump Manufacture °[.cc.a.rM�,t Manufacturer, ' 1 ' Dimensio s 1 Inches Gallons 4- Pump Model: 7 - 3 1 B Alarm Manufacturer. C I ,' D I Alarm Model: A 1 Total Vertical Difference between pump off and distribution pipe �SU Le- tit Minimum Required Supply Pressure (0 for dosed conventional) _ • �, , —+ Feet of force main x ' 1100 r1/�friction factor D Total Dynamic Head I Mound aaystem Maintenance and Ogeration Specifications r Service Providers Name z1� / Phone ,e'S:3�' POWTS Regulators Name St. C roix C ounter Zonin _ Phone 715.3 -4 680 S ystem Flow and Load Parameters Design Flow - Peak 450 gpd Maximum Influent Particle Size its in Estimated Flow - Average 300 gpd Maximum BODS 220 mg /L Septic Tank Capacity { gal Maximum TSS 150 mg/L Soil Absorption Component Size 450 ft` Maximum FOG 30 mg /L Type of Wastewater L22T—est-123 Maximum Fecal Colifomn >10E4 cfu /100 mL Service Frequency Septic and Pump Tank Ins ct and /or service once eve 3 years Effluent Filter Should insp2ct and clean at least once eve 3 ears Pump and Controls Test once every 3 years Alarm Should test month) Pressure Systenil Laterals should b8 flushed and pressure tested eve 1.5 ears Mound - - - Insp -- ect for pondin and s ee a e o nce every 3 y ears - - )trlei' ____.._ --------- _.__.__----- ..____._..___.._.J Mi scellaneous Canstrruction and Materials Standards 1. Observation pipes are slotted and materials conform to Table Comm 84.30 -1, have a watertight cap, and are secured in as shown in toe mound component manual. 2. Dispersal cell aggregate conforms to Comm 84.30 (8)(i), Wis. Adm. Code. 3. All gravity and pressure piping materials conform to the requirements in Comm 84, Wis. Adm. Code. 4. Tillage of the basal area is accomplished with a mold board or chisel plow. 5. The mound structure and other disturbed areas will be seeded and mulched to prevent soil erosion and help reduce frost penetration. Lateral Turn -up Detail Finished rrrrrrrr�rrrrr rrr�rrrrrrrrrsr Grade q. =._.- Threaded Cleanout 6 -8" Diameter Lawn - -- Sprinkler Valve Box Plug or Bell Valve Distribution Lateral Long Sweep 90 or Two ��� C- - - -- 45 Degree Bands Same Diameter as Lateral project: Curt LeGrander 3 bedroom residential mound Page 5 of �j Mound System Management Plan , Pursuant to Comm 83.54, Wis. Adm. Code 910KO This system shall be operated in accordance with Comm 82 -84 Wis. Adm. Code, and shall maintained in accordance with its' component manuals (SSD. 10891 -P (N.01/01) and SSWMP Publication 9.6 (01 /et)) and local or state rules pertaining to system maintenance and maintenance repotting. No one should ever enter a septic or pump tanrt 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 Dump tank manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings used fcr 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 acceas openings greater then 13- inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into a tank or component. Se is Ta tl6 The septic tank shall be maintained by an Individual certified to service septic tanks under s 281.48, State. 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 lean once every 3 years by inspection The outlet fitter shall be cleaned as necessary to ensure proper operation. The fitter 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. 11 the filler Is equipped with an alarm, the titer small be serviced if the alarm is activated continuoualy. Intermittent filter alarms may Indicate surge flows or an impending continuous alarm. 1 h 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 addftion of biological or cherrrical 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. PUrnp.J'ank The pump (dosing) tank shall be inspected at least once every 3 years. All switches, alarms, and pumps shall be tested to verity proper operation If an effluent fitter is installed within tree tank it shall be inar ectad and serviced as necessary. Mound and Pressure Distribution Svs em No trees or shrubs should be planted on Ilia ntound. 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 sores protection from frost penetration. Traffic (other than for vegetative maintenance) on the mound is not recommended since soil compaction may hinder aeration of the infiltrative surface within the mound and snow compaction in the winter will promote frost penetration. Cold weather installetlone (October- February) dictate that the mound be heavily mulched as protection from freezing Influent qualify into the mound system may not exceed 220 mg/L BOD 150 mWL TSS, and 30 mg/L FOG for septic tank effluent or 30 mg,'I- BOD 30 mgrL TSS, 10 mg/L FOG, and 10'0000 mL for highly treated effluent. Influent now 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 6 inches considered as an Impending hydraulic; failure requiring additional, more frequent monitoring. Continaencv Plan It 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(s) shall be Immediately repaired or replaced with a component of the same or equal performance. It the mound component fails to accept wastftwater or begins to discharge wastewater to the ground surface, it will be repaired or replaced in its' present location my increasing basal area if toe leakage occurs or by removing biologically clogged absorption and dispersal media, and relsled piping and repincirip said components as deemed necessary to bring the system into proper operating condition. See Page 6 of this plan for the name and telephone number of your local POWTS regulator and service provider Projects Curt LeGrander 3 bedloom residential mound Page 6 of g ' Safety and Buildings C0111111t?fC @.WI. OV 4003 N KINNEY COULEE RD g LACROSSE WI 54601 -1831 TDD #: (608) 264 -8777 i ��O � �' � www.commerce.wi.gov /sb/ • Department of Commerce www.wisconsin.gov Jim Doyle, Governor Cory L. Nettles, Secretary October 28, 2004 CUST ID No. 220728 Fee Required $ 175.00 Fee Received $ 60.00 CLARENCE L GLOTFELTY Balance Due $ 115.00 ENVIRO-TECH SYSTEMS & SERVICE N4955 SUNNY HILL RD Make Checks Payable To WEYERHAEUSER WI 54895 Commerce. WiSMART code: 7633 REQUEST FOR ADDITIONAL INFORMATION SITE: Curt LeGrander 170TH St I dentific ation Numbers Town of Pleasant Valley, Transaction ID No. 1077028 St Croix County Site ID No. 669893 SE1/4, NEIA, S17, T28N, R17W Please refer to both identification numbers, above, FOR: in all correspondence with the agency. Description: Three Bedroom Mound System Object Type: POWTS Component Manual Regulated Object ID No.: 938176 Maintenance required; 450 GPD Fl mini a th to limiting factor from origina],gradeC��� System: EZ -Flow M omponent Manual, (N.6 3); Bio t� The submittal scribed above has been placed on HOLD and the review and approval i pending subject to receipt of the ADDITI NAL INFORMATION and/or revised plans requested by this letter. U on receipt of the additional information and/o ised plans, the plans will be reviewed for compliance to ap le Wisconsin Administrative Codes and Wisconsin Statu The following must be corrected/revised and accompany the resubmittal: • This design is considered a new 121a n and not a revision in that it is sign by you and not by the original designer. Please submit the required fees as listed in the right hand comer of this letter for complete review. • One copy of a completed Soil De Report (SBD -8330) signed by a certified soil tester (CST). (I did pull the other design that was submitted for this site and retrieved the soil test that was submitted for this site. I will include a copy with this plan.) • The EZ -Flow product has their own manual for the design of mounds when using their product. There are a number of construction and design considerations that are to be included with this plan assiocated with the EZ- Flow product. Please contact Mai;k Prevost in Eau Claire (715 -552 -1934) for a copy of their manual. • The use of the Sign Tech effluent filter requires that 0.5 feet of head loss be added to the total dynamic head. • The size of the mound appears to be undersized as based on the requirements of the mound manuals. Please see the corrections on the following pages. • The offsetting (D) is proposed tp beat six inches from the bottom of the taiii The pump pad, alongNiM the legs of the pump, may leave the impellers out of the liquid effluent before kee pump "off' settin i setting maybe adjusted, wit4 the inches coming from the reserve capacity ar CLARENCE L GLOTFELTY Page 2 10/28/2004 • The pressure distribution network shall be sleeved through the 4 -inch corrugated pipe located in the EZ -Flow product. One out of every five orifices in each distribution pipe shall be installed at the 6 o'clock position to allow for thorough drainage of the distribution pipe following each dose. The remaining four orifices shall be installed in the 12 o'clock position. All pipes must drain after dosing. • The observation pipes must be located at a junction point between two EZ -Flow products so as not to create separation of the bundles within a product, fq,? 3 • The capacity of the Huffcutt 1000/600 pump chamber is listed inthe Wis. Plumbing Product Register as 14.93 •` gallons per inch, with a liquid bevel of 40 inches. When using a crew program, enter the exact number of gallon and then the inches. It should then calculated the correct gallons /inch. For the Huffcutt tank that would be 597.2 gallons for the (600) number. • Comm 83.43(8)(a)3. Wis. Aden. Code. The manifold diameter is reduced to 1.5 inches so as to provide for a pressurized flow of 2 feet per second. Send your submittal into the address listed above, unless otherwise noted, and the department will review the resubmittal within 5 working days of receipt date. Please include a copy of this letter with your resubmittal. If you have any questions, after reading the above comments and related code sections cited, please call me at the telephone number below. If the above requested information and/or plans are not received within 30 business days of the date of this correspondence, this submittal will be returned denied. No fees will be refunded, and a new fee, application form, and submittal of plans /specifications will be required should you desire to continue with this project. The code in effect at the time of new submittal would apply. Sincerely, Charles L Bratz POWTS Reviewer If, Integrated Services (608)789 -7893 , 7:45 am - 4:30 pm Monday - Friday cbratz @commerce,state.wi.us Encl. 3 pages. I I Wisconsin Department of Commerce Count PRIVATE SEWAGE SYSTEM Crolx Safety and Building Division {INSPECTION REPORT Sanitary Pe o: 453030 0 GENERAL INFORMATION (ATTACH TO PERMIT) state Plan I o: 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: LeGrander, Curt I Pleasant Valley Township 024 - 1021 -50 -200 CST BM Elev: Insp. BM Elev: BM Description: j Section/Town /Range /Map No: 17.28.17.1168 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATIO BS HI FS ELEV. Septic Benchmark Dosing Alt. BM Aeration Bldg. wer Holding St/ Inlet i St/Ht Outlet TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROA Dt Inlet Septic Dt Bottom Dosing ader /Man. Aeration Dist. ipe Holding ot. S m 9 s Y Final Grade PUMP /SIPHON INFORMATION Manufacturer Oemand St Cover 'GPM Model Number TDH Lift Friction Loss System Head iTDH Ft Forcemain Length Dia. Dist. to Well SOIL ABSORPTION SYSTEM pth BED /TRENCH Width Length No. Of renches PIT DIMENSIONS No. Of Pits I ide Dia. Liquid De DIMENSIONS SETBACK SYSTEM TO P/L BLDG IWELL LAKE /STREAM LEACHING Manu turer: INFORMATION CHAMB OR Type Of System: T Model Nul,er : DISTRIBUTION SYSTEM Header /Manifold Distribution x Hole Size x Hole Spacing Vent to Air Intake Pipe(s) Length Dia Length Dia Spacing SOIL COVER x Pr sure Systems Only xx Mound Or At - Grade Systems Only Depth Over Dept Over xx Depth of xx Seeded /Sodded xx Mulched Bed/Trench Center Bed/ Trench Edges Topsoil � Yes No ': Yes No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / ! Inspection #2: / ! Location: 354 170th Street Hammond, WI 54015 (SE 1/4 NE 1/4 17 T28N R17 NA Lot ?�/� � P cc�el No: 17 8.17.1166 1.) Alt BM Description = /��� 2.) Bldg sewer length I - amount of cover = /rn�r Plan revision Req uired ? or Yes No Use other side additio in formation. ��, � J - SBD -6710 (R.3/97) Date Insepctor's Signature Cert. No. I Safety and Buildings Division County r 201 W. Washington Ave., P.O. Box 7082 �� G f isc onsin Madison, WI 53707 - 7082 Saniikry Permit Number (to be filled in by Co.) e 608 partment of Commerce ( ) 261 -6546 45 o 3 o tate Plan I.D. Number .— Sanitary Permit APO C ��/ In accord with Comm 83.21, Wis. Adm. Code, personal ra t��°GEEA V E � I J u / 3 Fps ' +) may be used for secondary purposes Privacy La 5.04(Ix m) rojec ddress (if different than mailing address) I. Application Information - Please Print All Information MAR 1 7 2004 �" 3S� /� 5 Property Owner's Name ST. C AUIX COU Y Parcel # Lot # Block # Cf„r et ��� �• ZONING OFF E .Sa - Zvo Property Owner's Mailing Addres _ Property Location � r .o JrZ' y., 1 6 /., Section Z City, Sta Zip Code /. Phone Nu r (� � yp e of Building N!. i - S 1 1 ��a ? /�S' T N; R circle II. T r 11Iot d \ LJ ,.,/ g (check all that app � wv� 611 or 2 Family Dwelling -Number o /Beedr000m Al .,/' Snbairisien idartre ❑ Public/Commercial - Describe Us v6w°"^i 10 p -�zo, 3 7 0 o 99 � ❑ State Owned - Describe Use x 1 r l ❑City ❑village ship of� lff f 1 -411 •• , o a / /c III. Type of Permit: (Check only one box on line . Complete linep if applicable) A ' New System ys ❑Replacement System TreatmenUI -I ing Tank Replacement Only ❑Other Modification to Existing B • ❑ Permit Renewal ❑ Permit Revision ❑ C ge ❑ Permit Transfer to New List Previ s P i N e Issu Before Expiration Plumb o Owner IV. Type of PO WTS System: Check all that appl ❑Non - Pressurized in -Ground El Mound >_ 24 in. of suitable so' \Mound < 24 in. of suitable soil ❑ At Grade Single P and Filter ❑ Constructed Wetland ❑Pressurized In Ground ❑ Holding nk t Flter ❑ Aerob ic Treatment Unit El Recirculat Sand Filter ❑ Recirculating Synthetic Media Filter El Leaching Chamber Dri❑ Gravel -less Pi ❑Other ex lain) V. Dis ersaVTreatnient Area Information: - Design Flow(gpd) Design Soil Application Rate(gpdsi) 7bispersa l Area glared (sf) Dispersal Area Proposed (sf) System Elevation VI. Tank Info Capacity in Total I fumber M facturer Prefab Site Steel Fiber Plastic Gallons Gallons of Units Concrete Constructed Glass New Existing Tanks Tanks Septic or Holding Tank Aerobic Treatment Unit I/ L Dosing Chamtxr _ C e l VII Responsibility St atement - 1, the underigned, assume responsibility for installation of a POWTS shown on the attached plans. Plumber's Name (Print) Plumb 's Signature MP/MPRS Num r Business Phone Number 0A 1!0G- Plumber's Address (Street, City, State, Zip C ) VIII.County /De artment Use Onl Approved ❑ Disapproved Sanitary Permit Fee (includes Groundwater Date Issued Issuing Agent Signature o Stamps) A Surcharge Fee) ❑ Owner Given Reas for Denial 3 /7 2CV IX. Conditions of ApprovaUReas s for Disapproval SYSTEM OWNER: 3) 1 Septic tank, eft filter and �o c,�i C¢ S� -}y atQ a dispersal cell mu all be serviced I mainthned n as per manage ent plan provided by plumber. i c Q o+� ? CSC 2. All setback req irements must be maintained — h wrut as per applicable code /ordinances Attach complete plans (to the County only) for the system an paper not less than 81/2 x 11 inches In size SBD -6398 (R. 08/02) of c 64 . r f�Q.,x.�, Marl• P P ,� ��sw„ed clef: = /�•�' ♦ Elu/Q led o, IL 43 ■ a / oZ . o Co n �p i.� L Proposed mau.ndn 19.K q w/ S X90'd,sptr34r cerr. ��'(yJ S c ProeoS�d GcJ,'eser eons. dis�ibc�f;on /Q� «srCs at / ?O' wLl�7 -5V �4ccmpckam6�� , '✓S!.Ld' y8•o�i�'CtS �e l /2 Jr Spaced aE,Z.s3.' g2 e4�(lutn4: IinZ• , /'.Sc.1,. q A, ,/. c. I building Se�' o• �( P ,I uJres�r p�nposed Cur�er�E2 /4W /�� nj 3 bedim,�, Sfr Ao ve / A- iOo e /uen t g au.;(/416. -- - - --- 2-X� s6'•n �ara9e Pro posed drioewoy d.c' CL C,OP 5/BG' t i I i ■ z7(o �j. 6 oa Nor c Safety and Buildings 4003 N KINNEY COULEE RD LACROSSE WI 54601 -1831 TDD #: (608) 264 -8777 iseonsin www.w www commerce.state. iscon s i n.gov isconin.gov Department of Commerce Jim Doyle, Governor Cory L. Nettles, Secretary January 09, 2004 CUST ID No.220853 ATTN: POWTS Inspuc[or ALE E HUDSON ZONING OFFICE BOLDT'S PLUMBING & HEATING, INC. ST CROIX COUNTY SPIA PO BOX 78 1101 CARMICHAEL RD BALDWIN WI 54002 HUDSON WI 54016 CONDITIONAL APPROVAL Identification Numbers PLAN APPROVAL EXPIRES: 01/09/2006 Transaction ID No. 958435 SITE: Site ID No. 669893 Curt Legrander Please refer to both identification numbers, 170TH St above, in all correspondence with the agency. Town of Pleasant Valley St Croix County SE1 /4, NEIA, S17, T28N, R17W FOR: Description: Three Bedroom Mound System Object Type: POWTS Component Manual Regulated Object ID No.: 938176 Maintenance required; 450 GPD Flow rate; 24 in Soil minimum depth to limiting factor from original grade; System(s): Mound Component Manual - Version 2.0, SBD- 10691 -P (N.01 /01), Pressure Distribution Component Manual - Version 2.0, SBD- 10706 -P (N.01/01); Biofilter The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. Cond[tlf) No person may engage in or work at plumbing in the state unless licensed to do by the department per s. 145.06, stats. APP LK The following conditions shall be met during construction or installation and prior to occupancy or use: M DEP RT ENT of General Approval Requirements: ! • This system is to be constructed and located in accordance with the enclosed approved plans and with the SEE CORRESF "Mound Component Manual for Private Onsite Wastewater Systems VERSION 2.0" SBD - 10691 -P (N.01/01) and the SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST (0 1/8 1) • P er 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. • Access to the filter for cleaning must be provided per Comm 84 product approval conditions. Maintenance information must be given to the owner of the tank explaining that periodic cleaning of the filter is required • 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 See. 145.135 and 145.19, Wis. Stats. DALE E HUDSON Page 2 1/9/04 • 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 See. 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. 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 11 , Integrated Services WiSMART code: 7633 (608)789 -7893 , 7:45 am - 4:30 pm Monday - Friday cbratz@commerce.state.wi.us cc: Leroy G ]ansky, Wastewater Specialist, (715) 726 -2544 I s 4 MOUND AND PRESSURE DISTRIBUTION COMPONE SII 41 C FI INDEX AND TITLE PAG E O& e �� a Project Name: Curt LeGrander 3 bedroom residential mound V� Owner's Name: Curt LeGrander ,/ Owner's Address: 577 Co. Hwy, J Roberts, WI 54023 Site Address: XXXX 170th Street Legal Description: SE1 /4NE1/4, Sec. 17, T.28N., R.17W. Township: Pleasant Valley County: St. Croix Subdivision Name: CSM Vol. 16, Pg. 4293 Lot Number: 1 Block Number: NA Parcel I.D. Number: 024 - 1021 -50 -200 Plan Transaction No.: Page 1 Index and title Page 2 Data entry Page 3 Mound drawings Page 4 Lateral and dose tank Page 5 System maintenance specifications Page 6 Management and contingency plan �. ; ERA Page 7 Pump curve and specifications { J -A e E Page 8 Site Plan Jt OIN Page 9 Soil Evaluation Report ONDEN Designer: Dale Hudson License Number: 220853 Date: 12/24/03 Phone Number: 715- 684 -3378 Signature � &l Designed Pursuant to the Mound Component Manual for POWTS Version 2.0 SDB- 10691 -P (N. 01/01), and SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST -SAS (01181) Version 3.0 (03/01/01) Page 1 of 9 Mound and Pressure Distribution Component Design Site Information R Residential or Commercial Design Note: Sand fill (D) calculations assume a 300.00 Estimated Wastewater Flow (gpd) Table 83 -443 in -situ soil treatment for fecal 1.50 Peaking Factor (e.g. 1.5 = 150 %) coliform of - 36 inches. 450.00 Design Flow (gpd) 5.00 Site Slope ( %) 101.20 Contour Line Elevation (ft) 24.00 Depth to Limiting Factor (in) 0.50 In -situ Soil Application Rate (gpd /ft Distribution Cell Information 90.00 Dispersal Cell Length Along Contour (ft) = 5.00 Cell Width (ft) 1.00 Dispersal Cell Design Loading Rate (gpd /ft 1 Influent Wastewater Quality (1 or 2) Are the laterals the highest point in the distribution Y Pressure Disribution Information network? c Center or End Manifold F_____ Lateral Spacing (ft) If N above, enter the elevation (ft) 4 Number of Laterals of the highest point. 0.125 Orifice Diameter (in) (e.g. 0.25) 2.50 Orifice Spacing (ft) = 6.25 ft /orifice 2.00 Forcemain Diameter (in) 40.00 Forcemain Length (ft) Does the forcemain drain back? Y 95.00 Pump Tank Elevation (ft) 6.50 System Head (ft) x 1.3 6.52 Forcemain Drainback (gal) 6.70 Vertical Lift (ft) 81.25 5x Void Volume (gal) 0.76 Friction Loss (ft) 87.77 Minimum Dose Volume (gal) 13.96 Total Dynamic Head (ft) 29.66 System Demand (gpm) Lateral Diameter Selection Manifold Diameter Selection in. dia. options choice in. dia. options I choice 0.75 1.25 x 1.00 x 1.50 x v 1.25 x 2.00 1.50 x U 3.00 2.00 x 3.00 x Gallons /inch Calculator Treatment Tank Information 760.50 Total Tank Capacity (gal) 1600.00 Septic Tank Capacity (gal) 37.50 Total Working Liquid Depth (in) Wieser Combination Manufacturer 1 20.28 gal /in (enter result in cell B49) Dose Tank Information Effluent Filter Information 760.50 Dose Tank Capacity (gal) Zabel Filter Manufacturer 20.28 Dose Tank Volume (gal /in) A100 Filter Model Number Wieser WLP750 -MR Manufacturer Project: Curt LeGrander 3 bedroom residential mound Page 2 of 9 Mound Plan View ............ ........................... J 1 /10 B Observation Pipe • .' A 0 ... W .. ... . ...................................... . . . . . . . . . . ... ... ..0 ......... .................. ........... .......... ........ ........... ....................... . ....... . . ..... ................................. ........... .............................. ..... ................................. .... .................................. . . a ............ 11 ............... 11 ... ........... .............................. .................. I ...................... ........... .............................. ......................................... .... .................. ........................................ .......... ... ...... 0 L Mound Component Dimensions A 5.00 ft E 15.00 in H 1.00 ft K 8.75 ft B 90.00 ft F 9.50 in 8.97 ft L 107.50 ft 12.00 0.50 5.98 19.95 DAin G Aft J Aft WAft 1 450.001 (ft2 ) Dispersal Cell Area 1 1257.351 (ft2 Basal Area Available 5.001 (gpd/ft) Linear Loading Rate 1 9.00 (ft) 1/10 B Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area Finished Grade 103.99 (ft) 7ZA G . . . . . . . . . . . . . . F ........... 102.70 (ft) Lateral Dispersal Cell ::-*-,-*-,-*. . . . . . . . . . . . . 102.20 (ft) Invert Dispersal Cell Elevation E D . . . . . . . ............. . ...... .... .............. ......... ............... ................. *--** .............. ............. ......... ......... ...... F4 ,� F4 101.20 (ft) Contour Elevation 5.0 % Site Slope Geotextile Fabric Cover Shading Key d T Dispersal Cell See lateral details on Topsoil cap o 1.5 ft Page 4 for number, F2] rrrrr Subsoil Cap E 0 /- *0 size, and spacing of .2 ASTIVI C33 Sand F laterals. Laterals are Tilled Layer a 0.5 ft Typical Lateral equally spaced from QS 0 Aggregate v 0 j the distribution cell's A centerline in the distribution cell (AxB). Project: Curt LeGrander 3 bedroom residential mound Page 3 of 9 t t Center Connection Lateral Layout Daigram Force main connection via tee or cross to manifold at any point. Laterals are identical I P � •= Turn -up wlball valve or IE X402 1 Laterals & force main of PVC Sch 40 clean out pl u g per COMM Table 84.30 -5 Holes drilled on the bottom of the lateral. Number of Laterals 4 Orifice Diameter 0.125 in Lateral Diameter 1.50 in Orifice Spacing (X) 2.53 ft Lateral Length (P) 44.28 ft Orifices per Lateral 18 Lateral Spacing (S) 2.50 ft Orifice Density 6.25 ft /0 rifice Lateral Flow Rate 7.41 Igpm Manifold Length 2.50 ft System Flow Rate 29.66 gpm Manifold Diameter 1.50 in Total Dynamic Head 13.96 ft Forcemain Velocity 3.03 ft/sec Dose Tank Information Locking cover with warning label and locking device and sealed watertight Electrical as per NEC 300 and Comm 16.28 WAC 4 in. min. Disconnect --�_ Tank component is properly vented Alternate out location Forcemain diameter Wieser Combination Manufacturer 2 in. Cap acityl 760.50 Gallons Volume 20.28 gal /inch A Weep hole or anti - Dimension Inches Gallons B siphon device A 19.00 385.28 C B 2.00 40.56 Pu off e levation (ft) C _ 4 .50 91.30 96.00 D 1 243.36 D Total 37.50 760.50 Dose tank elevation (ft) 3" Bedding un er tank. 95.00 Alarm Man uafactu rer ' LevelArm Alarm Model Number I DLV 1 ­__.__­­__­_­ --------- --- -_ _ - -------- - --------- Pump Manufacturer Goulds Pump Model Number 13885 WE05H Pump Must Deliver 29.66 gpm at 1 — 3 - 961 ft TDH Project: Curt LeGrander 3 bedroom residential mound Page 4 of 9 Mound System Maintenance and Operation Specifications Service Provider's Name _ Boldt's Plumbing - Dale Hudson Phone 715 - 684 -3378 POWTS Regulator's Name St. C roix County Zonin __ j Phone 715 - 386 -4 680 System Flow and Load Parameters Design Flow- Peak 450 gpd Maximum Influent Particle Size 1/8 in Estimated Flow - Average 300 gpd Maximum BODS 220 mg /L Septic Tank Capacity 1600 gal Maximum TSS 150 mg /L Soil Absorption Component Size 450 ft Maximum FOG 30 mg /L Type of Wastewaterl Domestic 1 Maximum Fecal Coliform >10E4 cfu /100 mL Service Frequency Septic and Pump Tank Inspect and /or service once every 3 years Effluent Filter Should inspect and clean at least once every 3 years Pump and Controls Test once every 3 years Alarm Should test month) Pressure System Laterals should be flushed and pressure tested every 1.5 years Mound _ _Inspect for ding and seepage once ev ery 3 y ears Other — .�� -- - - - - -- - - -_ - -- — — Miscellaneous Construction and Materials Standards 1. Observation pipes are slotted and materials conform to Table Comm 84.30 -1, have a watertight cap, and are secured in as shown in the mound component manual. 2. Dispersal cell aggregate conforms to Comm 84.30 (6)(i), Wis. Adm. Code. 3. All gravity and pressure piping materials conform to the requirements in Comm 84, Wis. Adm. Code. 4. Tillage of the basal area is accomplished with a mold board or chisel plow. 5. The mound structure and other disturbed areas will be seeded and mulched to prevent soil erosion and help reduce frost penetration. Lateral Turn -up Detail Finished • ............. 7 �_� Grade Threaded Cleanout 6 -8" Diameter Lawn - Sprinkler Valve Box Plug or Ball Valve .. Distribution Lateral � Long Sweep 90 or Two 45 Degree Bends Same Diameter as Lateral Project: Curt LeGrander 3 bedroom residential mound Page 5 of 9 Mound System Management Plan Pursuant to Comm 83.54, Wis. Adm. Code General This system shall be operated in accordance with Comm 82 -84 Wis. Adm. Code, and shall maintained in accordance with its' component manuals (SBD- 10691 -P (N.01/01) and SSWMP Publication 9.6 (01/81)) and local or state rules pertaining to system maintenance and maintenance reporting. 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. Septic 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 every 3 years by inspection. The outlet fitter shall be cleaned as necessary to ensure proper operation. The fitter cartridge should not be removed unless provisions are made to retain solids in the tank that may slough off the fitter when removed from its enclosure. If the fitter 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 113 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. 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 since soil compaction may hinder aeration of the infiltrative surface within the mound and snow compaction in the winter will promote frost penetration. Cold weather installations (October- February) dictate that the mound be heavily mulched as protection from freezing. Influent quality into the mound system may not exceed 220 mg/L BOD 150 mg /L TSS, and 30 mg /L FOG for septic tank effluent or 30 mg/L BOD 30 mg/L TSS, 10 mg/L FOG, and 10 cfu /100 mL for highly treated effluent. 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 6 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring. Contingency Plan If the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep the system in proper operating condition. If the dosing tank, pump, pump controls, alarm or related wiring becomes defective the defective component(s) shall be immediately repaired or replaced with a component of the same or equal performance. If the mound component fails to accept wastewater or begins to discharge wastewater to the ground surface, it will be repaired or replaced in its' present location by increasing basal area if toe leakage occurs or by removing biologically clogged absorption and dispersal media, and related piping, and replacing said components as deemed necessary to bring the system into proper operating condition. See Page 6 of this plan for the name and telephone number of your local POWTS regulator and service provider. Project: Curt LeGrander 3 bedroom residential mound Page 6 of 9 4 MO • • M OD EL • thr Submersible Effluent Pump Submersible Sewage Pump .... =. ail. •�: MODEL: 3885 L a C APACilY — Pump Specifications Features and Benefits Specifications Features and Benefits � — •a e silicon carbide UI` �cjr j, c'.S ro 5J1)e[I • Ca Motor f1�(Or _ L c v Ali "V. • h.i� Jf(1 .,,1., .I . .'o) ute I /pe casinq SIIIQ�e i)iILIS�: ' 1 J� • Lns' r:,a s roc „II Materials of ConstrUCllon _'J' - • �U 'OS, , 'cs �(l t !llie .�!�, iii i _I_ Lt,: '-I1St (foil •, - siat dlE» 5!L­ U`l The rill oplD0c . Mo101 s' ; ! i n high St���;l's sl'r'I ., r5s 5 en �s of Construction 6L Underwriters Laboratories LI /�1�1�7 /) ' 7oP of %'ic bay a o LflT ene ►Ylar A So,� ¢✓ �uQ�. �] 63 ■ r— i YZ'' SCI.. Ito A. ✓. e . 5c�. /e : � _' S,�p 4 4pe. 6 = /0.2,23' / eeP v /7yG Q io2.o'Ccnf.QL,4,r Proposed mowrda 19.45iWSo' q W/ S X Qo' d,sP crJIX/ e-e t/. ICII,.. e (y� S o ?o /a�e PioeoSed Gc�ieser eonC. i ' dt3�libu'E;on �wrCs 4L-6 / wLA R� -M� r 4ccmp �- hamb�r: / .� Spaced a ios, zo' gZ Q4l uc n4- On 'y A.d.C. buildirll Se•.�� -!: o• Proposed �tcscr Ilcxo' Cure f '46 - e w k P/'o 1 6Q Co , 6,�,�E; k,edroon•� ba be/ A_l e�{ /uent rl5;dtr1CC SfYCC� e.XiS�'n � Pro(+o d�;vt��ay ari ✓eu5 y 5 u.6 y8G' 64 ■ z76' = .see a 1746 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 A.C.E. Soil & Site Evaluations Attach complete site plan on paper not less than 834 County x 11 inches in size. Plan must St. Croix include, but not limited to: vertical and horizontal reference point (BM), direction and percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I. D. 024 - 1021 - 50-200 Please print all intonation. Reviewed By Date Personal information you provide may be used for swondary WNposes (Prwy Law, s. 15.04 (1) (m)). Property Owner Property Location Curt LaGrander Govt. Lot SE 1/4 NE 1/4 S 17 T 28 N R 17 W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# 577 Co. Hwy. J 1 CSM Vol. 16, Pg. 4293 City State Zip Code Phone Number City Village ✓ Town Nearest Road Roberts WI 1 54023 1 715 - 796 - 2488 Pleasant Valley 1 170Th Street ✓ New Construction Use: of Residential / Number of bedrooms 3 Code derived design flow rate 450 GPD Replacement Public or commercial - Describe: Parent material Glacial till Flood plain elevation, if applicable na General comments and recommendations: Install mound system at elev.102.20' at 12" above 101.20' contour. a Boring # Boring ✓ Pit Ground Surface elev. 101.95 ft. Depth to limiting factor 30" in. Sal Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/f? in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. I *Eff#1 *Eff#2 1 0 -9 10yr4/4 none sil 2fcr ds as 2f,lm 0.5 0.8 2 9-15 10yr5/4 none sil 2fsbk ds cs 2f 0.5 0.8 3 15-26 10yr416 none sl 2fsbk ds cs 2f 0.5 0.9 4 26 -30 10yr4/4 none sl 2msbk ds cw 1f 0.5 0.9 5 30 -36 10yr4/4 f2f 7.5yr5/8 sl 2msbk dsh cw if 0.5 0.9 6 36 -50 7.5yr4/4 f2d 7.5yr5/8 scl 2csbk mfi - if 0.4 0.6 F I i i I I ❑ Boring # Boring ✓ Pit Ground Surface elev. 100.14 ft. Depth to limiting factor 34" in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/W in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0 -9 10yr4/3 none sil 2fcr ds as 2f,1m 0.5 0.8 2 9-18 10yr514 none sil 2fsbk ds cs 2f 0.5 0.8 3 18 -34 10yr4/6 none sl 2fsbk ds cs 2f 0.5 0.9 4 34-46 10yr4/4 f2f 7.5yr5/8 sl 2msbk ds cw if 0.5 0.9 5 46 -58 7.5yr4/4 f2f 7.5yr5/8 sl 2csbk dsh - if 0.5 0.9 * Effluent #1 = BOD � 30 < 220 mg/L and SS >30 < 150 mg/ M #2 = BOD < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) nature: CST Number Sig James K. Thompson 3602 Address A.C.E. Soil & Site Evaluations Date Evaluation Conducted Telephone Number 340 Paulson Lake Lane, Osceola, WKA020 11/102003 715- 248 -7767 Property Owner Curt LaGrander parcel ID # 024 - 1021 -50 -200 Page 2 of 3 3] Boring # Boring ✓ Pit Ground Surface elev. 100.45 ft. Depth to limiting factor 24" in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots 1 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 1 0-8 10yr4/3 none sil 2fcr ds as 2f,1 m 0.5 0.8 2 8 -16 10yr5/4 none sil 2fsbk ds cs 2f 0.5 0.8 3 16 -24 10yr5/4 none sil 2fsbk ds cs 2f 0.5 0.8 4 24 -30 10yr5/4 f2d 7.5yr518 sil 2msbk ds cw if 0.5 0.8 5 30-36 7.5yr4/6 f2f 7.5yr5/8 sl 2msbk dsh cw if 0.5 0.9 6 36-49 7.5yr4/4 f2d 7.5yr5/8 scl 2csbk mfi - if 0.4 0.6 4] Boring # Boring ✓ Pit Ground Surface elev. Na ft. Depth to limiting factor 31" in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots QP in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 1 0 -9 10yr4/3 none sil 2fcr ds as 2f,1 m 0.5 0.8 2 9-19 10yr5 /4 none sit 2fsbk ds cs 2f 0.5 0.8 3 19 -31 10yr4/6 none sl 2fsbk ds cs 2f 0.5 0.9 4 31 -35 10yr4/4 f2f 7.5yr5/8 sl 2msbk ds cw if 0.5 0.9 5 35-62 7.5yr4/4 f2f 7.5yr5/8 sl 2csbk dsh - if 0.5 0.9 F-I Boring # 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 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 ' 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. i `� � Qa.nc4. lylar�l/: Tp of �B �rcbc,.r: A 50;/ ¢da /ua�on /Oo.o' ♦ E / 4/Q �i'or� 43 ■ B.M.: To,o of 1 ys "sa Scale: .�o A. ✓, c. - /y j o,pe. E/eo /02.23, N loll I?" / 0' Co 0 1�o Kr v� S /off �� 81 oS, 7S' �u v/ ♦ Z ■ �� /D /. ZO' Proeo SQ d 36ci(mm rc.s, 4meA 94•naa�c. hcc�, �r 170 S6rce� �xi s�rny dC1✓ 0. 5 u-6 64 ■ 276 l�. 3 oFj Zarrow,a 1746 Wisconsin DepartrnerltofCom SOIL EVALUATION REPORT page 1 of 3 3 Division of Safety and Buildings accordance with m 85, Wis. Adm. Code A.C.E. Sal & Site Evaluations Attach complete site plan paper County �es in ze. Plan must St. Crooc include, but not limited to: ant (B ), direction and percent slope, scale or dimemsions, tance to nearest road. Parcel I.D. 024 - 1021 - 50-200 Plea se print all information. Ma Date p Personal information you powie may be used for secondary p (Pnvawy Low, s. 15.04 (1) (m)), �0 Property Owner Property Location Curt LaGran Govt. Lot SE 114 NE 19 S 17 T 28 N R 17 W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# 577 Co. Hwy. J 1 CSM Vol. 16, Pg. 4293 City State Zip Code Phone Number J City J Village 1/ Town Nearest Road Roberts I WI 1 54023 715 -796 -2488 Pleasant Valley 1 170Th Street 01 New Construction Use: &JI Residential / Number of bedrooms 3 Code derived design flow rate 450 GPD _ I Replacement J Public or commercial - Describe: Parent material Glacial till Flood plain elevation, if applicable na General comments and recommendations: Install mound system at elev.102.20' at 12" above 101.20' contour. Boring # I Boring Pit Ground Surface elev. 101.95 ft. 30 in. Soil ✓� Depth to limiting facts " Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF # 1 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 I - Eff#2 1 0 -9 10yr4/4 none sil 2fcr ds as 2f,1m 0.5 0.8 2 9-15 10yr5/4 none sil 2fsbk ds cs 2f 0.5 0.8 3 15 -26 10yr416 none sl 2fsbk ds cs 2f 0.5 0.9 (� 4 26-30 10yr4/4 none sl 2msbk ds cw 1f 0.5 0.9 5 30-36 10yr4/4 f2 7.5yr sl 2msbk dsh cw if 0.5 0.9 6 36 -50 7.5yr4/4 12d 7.5yr5/8 scl 2csbk mfi - if 0.4 0.6 -- a Boring # J Boring 1/ Pit Ground Surface elev. 100.14 ft. Depth to limiting factor T 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 I 'Eff#2 1 0 -9 10yr4/3 none sil 2fcr ds as 2f,1m 0.5 0.8 ( 2 9-18 10yr5/4 none sil 2fsbk ds cs 2f 0.5 0.8 , 3 18-34 10yr4/6 none sl 2fsbk ds cs 2f 0.5 0.9 4 -46 10yr4 /4 f2f 7.5yr5/8 sl 2msbk ds cw if 0.5 0.9 5 46 -58 7.5yr4/4 f2f 7.5yr5/8 sl 2csbk dsh - if 0.5 0.9 -- T T Effluent #1 = BOD ? 30 < 220 mg/L a TSS >30 < 150 l- #2 = BOD < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) ignature: CST Number James K. Thompson 3602 Adder A.C.E. Soil & Site Evaluations ate Evaluation Conducted Telephone Number 340 Paulson Lake Lane, Osceo 154020 11/102003 715 - 248 -7767 Property owner Curt LaGrander Parcel ID # 024 - 1021 -50 -200 Page 2 of 3 F 3]Boring # J Boring V" Pit Grand Surface elev. 100.45 ft. Depth to limiting factor in. Soil Applicatim Rate Horizon Depth Dominant Color Redox Description Texture Stricture Consistence Boundary Roots GPDff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 1 0 -8 10yr4/3 none sit 2fcr ds as 2f,1 m 0.5 0.8 , 2 8 -16 10yr5/4 none sit 2fsbk ds cs 2f 0.5 0.8 3 16 -24 10yr5/4 none sit 2fsbk ds cs 2f 0.5 0.8 4 24-30 10yr5/4 f2d 7.5yr5/8 sit 2msbk ds cw if 0.5 0.8 - 5 30 -36 7.5yr4/6 f2f 7.5yr5/8 8 sl 2msbk dsh cw if 0.5 0.9 6 36-49 7.5yr4/4 f2d 7.5yr5/8 scl 2csbk mfi - if 0.4 0.6 - 4] Boring # J Boring 1/ Pit Ground Surface elev. Na ft. Depth to limiting factor 31" n. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots Dff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 1 0-9 10yr4/3 none sit 2fcr ds as 2f,1m 0.5 0.8 2 9-19 10yr5/4 none sit 2fsbk ds cs 2f 0.5 0.8 3 19 -31 10yr4/6 none sl 2fsbk ds a 2f 0.5 0.9 4 31 -35 10yr4/4 f2f 7.5yr5/8 sl 2msbk ds cw if 0.5 0.9 _ 5 35-62 7.5yr4/4 f2f 7.5yr5/8 sl 2csbk dsh - if 0.5 0.9 Boring F-I # Boring I Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 •Eff#2 • 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. Tp of 4 'i'c bar A, So, ¢da /ua� "vn oo.0 ♦ E /tt/CoEion �_�o /.o' /�.• B.M. • 7"vp of �yz "Sc,�,.�1oR ✓.�. /� Scale: /: "5l0'� I�d 7IlG d� 0� /c% 20' po r sej 3bt.droom res� den�c 9a,�je. hs� �rad 170 max; s� a c f r•e.,,� a 5 �.6 ■ z7(o �. 3 of 3 ST CROIX COUNTY SEPTIC TANK MAIMM. ° , CE AGREEMENT AND- - - OWNERSHIP CERTCFICATION FORM Owner/Buyer �' ,. �e ��C e 1� Mailing Address �� r 2foLe' t -- Property Address 3 tea sue, (Verification required from Planning Department for new construction) City/State _ _ rya, art. ��' Parcel Identification Number A2I- —10Z I 5L? ,Z, 017 LEGAL DESCRIPTION Property Location 5 4 1 - - %, A2 7 y,, Sec. 17, T -RNW Town of /P. 0 Subdivision Lot # Certified Survey Map # _ ��/'�'�� Volume Page # . Warranty Deed # 9 1 �D Volume I9D� . Page # J Spec douse ❑ yes Er no Lot lines identifiable 2' yes ❑. no SYSTEMWAR4ENANCE Iupsvperuseandmain c= weofyourscpdcsystcmoouldremtmitspre fai lurctohandlewastes.Pnopermaiaben we consists of pamrping out fire septie tank every three years or so=4 if neaded by it liecased pumper: What you pat into the system can affact -t e - fanction of the septic tactic ss. a trea t stage is a vrss6e system. Thim property owner agrees to uzbmirto St. Croix Toning Depattmcat t ccrtificatiaa foam, signed by tier owner and by a P 'joameymaap>nmbcr. r s6cictedphambcroe a H=sodpmmperrerifying diia(1) tiro on-nts disposal system is in proper ope=&&g condition and/or (2) after boa and pamping_(if accessary). the scptic tank-is less than 18 M of sludge. Ywe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set fadk beoein.'as set by the Dgwtincat of Commc= and the Dgmc neat of Natural R=ocn ctt; State of WisoonsuL. Ccrtacation statice the y*w scPdc zyurtfas been maiatainod most be eomplctod and rcwmod to the St. Croix County Zoning Office within 30 days fdw throe date. SIGMA O PLICANT DATE OV�NER. CER' MCATTON I (we) certify that all suki tents on this form am true to the best of my (our) knowledge. I (we) am (am) the owner(s) of the property described by virtue of a warranty deed recorded in Register of Deeds Office. TUBE O APPLICANT DATE s « « « «« Any information that is mis- represcated may result in the sanitary permit being revo by the Zoning Department " Include with this application: a stamped warranty dood from the Register of Deeds office a copy of the certified survey map if reference is made in the warranty decd 7 REC E IVED Imo- z�'-13% If 9 '2003 x couN March 3, 2003 ZONING OFFICE Kurt LaGrander 577 Cty. J Roberts, WI 54023 796 -2488 Rod Eslinger, On May 28, 2002, 1 purchased 35 acres from Donna and Donald Hauser. The parcel is located in the plat book at (Pleasant Valley, Rush River T.28 N. - R. 17W, section 17, corner of Cty. N and 170th street). This parcel was split off of the south end of their 80 acre farm, which they have owned since 1966. This parcel has been surveyed and perk tested and regisistered in my name. I am currently farming 10 acres of the 35 acres. I plan on raising organic vegtables and organic beef, I am seeking a organic certification at this time. I need to live on this land to care for my cattle and crops. In the future this farming operation shall provide up to 50% of my income, but I need to establish a resident at this location before I can proceed with my farming operation. I am writing to request the county's zoning commission's approval to build a single family resident and barn on this before mentioned parcel of land. Thank-Yo , Kurt LaGrander TE BAR OF WIIS ON FORM 2.1999 KAATH STATE H. WALSH WARRANTY DEED REGISTER OF DEEDS Document Number ST. CROIX CO., MI This Deed, made between Alan Hauser, Wayne Hauser, Sh aron RECEIVED FOR RECORD Achterhof, Don Hauser, a/k/a Donald P. Hauser, and Donna Hauser 06 -05 -2002 11:45 Ali a /k/a Donna M. Hauser, a one -fifth interest each, - -- EX P DEED Grantor, and Kurt G. LaGrander -- - REC FEE: 11.00 TRANS FEE: 397.50 -- _ — COPY FEE: CERT COPY FEE: - - -- - -- 1 Grantee. PAGES: Grantor, for a valuable consideration, conveys to Grantee the following described real estate in St. Croix __ County, State of Wisconsin (if more space is needed, please attach addendum): Part 1/4 ofNEI /4 of Sec. 17- 28 -17d a tIof Recording Area e tf d S ey Map filed May 14, 2002, ' ol. 16, a e Doc. No. 789 Name and Regt(NA OGLAND 698 St. roix County, Wisconsin. y293 ESTREEN & OGLAND 304 Locust Hudson, W164016 024 - 1021 -50 Parcel Identification Number (PIN) This is not homestead property. 00 (is nnt) Exceptions to warranties: Easements, restrictions and rights -of -way of record, if any. Dated this _ '�� day of May , 2002 • <(r' L IA A4 4 aron Ac er of • Alan Hauser « Don Hause a/Wa Donald P. Ha user • W ayne Hauser r Donna Hauser, a /k Donna M. Hauser AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF WISCONSIN ) _ ) ss. — — — - St. Croix _ County ) authenticated this day of Personally came before me this day of May 2002 the above named Alan Ijauser, Wayne Hauser, Sharon A chterhof, Don Ha user, -- - - - - -- - - . -- - -- .. - - -. , y - , "d onald P. Hauser, and Donna Hau a/Wa Donna M . — — - — -- v,S .••• "••'•.; H a r, a one -fi interest each, TITLE: MEMBER STATE BAR OF WISCONSI)k --- - - - — (if not, y f k :;.V known to be the person(s) who executed the foregoing authorized by § 706.06, Wis. Stats.) :� omen[ and acknowledged the same. .ter � �r'fn,.'• THIS INSTRUMENT WAS DRAFTED �, p Attorne Kristine Ogland Public, State of Wisconsin Hudson, WI 54016 Commission is permanent. (11'not, state expiration date: (Si natures may be authenticated or acknowledged. Both are not rite 5� • Names of persons signing in any capacity must be typed or printed below their signature. Ind —lion Prorassiwals company, F-d au sec. wi WARRANTY DEED STATE BAR OF WISCONSIN 800.655 -2021 FORM No. 2 -1999 lov �o - � `' 11ba� dL /`� • � � �,• ice (. ,S 7,� f �,S • a2 , C 67 8998 ` VOL 429.1 KATHLEEN H. WALSH REGISTER OF DEEDS S?. CROI CO., V I RRC91VED FOR REMO CERTIFIED SURVEY MAP 05 -14 -2002 4:30 PH Located in part of the Southeast Quarter of the Northeast Quarter of Section 17. CERTIFIED SURVEY HAP Township 28 North. Range 17 West. Town of Pleasant Volley, St. Croix County. WlsconsinREC FEE: 13.00 COPY FEE 3 90 Northeast Cod Prepared for and at the request of: SectAon 17-28 - OWNER: (Found arumhum Donald and Donna Hauser 1� _` ,�� `� County monument) m 394 170th St. ik- Hammond, WI 54015 Drafted by: MHL _ U N P L A T T E D r L A N D S_ m tit I S89 47 08 E 1324.97 333.78' 958.19' 3 00' 1291.97' _ T_ I 33' fENQE, rltRCAL I is a I IC IC I {Z {Z �cA� I� w Z 8 3 l I 8 1 O T 1 4 o �'• {n 1 z -s AREA: ° 0• 0 rn o� I � $ TAL •• "" to -i TO I� �+ 1525,515 SO. Fr wI � rn 35.02 ACRES C l N ( rn r'1 v AREA XACU G R. Q W.: { I 4 N 1, 4 7, 5,32 S . T• 34.15 ACRES 1> � al Z # NOTE: AREA 561.11H OF CE UAY B SESSED BY I OTHERS. CONTACT ATTORNE JOINING LAND OWNER I IO I p BEFORE REMOVING SHOWN FENCE. IIn + in round 1 -J/4` kw Pipe W97917V Set Aran P(w S89'47'08 "E FENCE rS 2,2' FENCE rS D.6' N JH A� 111VE nrraanr OF Aan i_ . l 3880.90' 1109. �'�$'�.$8' 183.27' { v 11 0 ON N89'47 0 W 1325.80' IO N89'47'08 5316.70' N4,rst r/ 4 Comer of East 11 4 Comes I = Section 17 - 28 - 17 East - libst 114 /lie Sechan 17 - 28 - 17 I I (Found 1' /ran P,jve) { (Found PK No#' _ UNPLATTEO_LANDS_ I� { NOTE: The parcel shown on this mop are subject to State, County and I M Township laws, rules and regulations (i.e. wotlands, minimum lot size, across to parcel, etc.). Before purchasing or developing any parcel, contact the St. Croix County Zoning Office and the appropriate Town Board for advice. \``\```ttttatuutuutrtuun ,q � i '3 .�p2 Section Corner Monument R. '•. �# fF of Record a � • Set 1' x 18` Iron Pipe weighing r CERTIFIED SURVEY MAP Located in part of the Southeast Quarter of the Northeast Quarter of Section 17, Township 28 North, Range 17 West, Town of Pleasant Valley, St. Croix County, Wisconsin. SURVEYOR'S CERTIFICATE: I, Ty R. Dodge, a Registered Wisconsin Land Surveyor, do hereby certify that by the direction of Donald and Donna Hauser, I have surveyed, divided and mapped a parcel of land locatcd in part of the Northeast Quarter of the Northeast Quarter of Section 17, Township 28 North, Range 17 West, Town of Pleasant Vallee St. Croix County, Wisconsin, described as follows: Commencing at the East Quarter corner of said Section 17; thence, on an assumed bearing along the east -west Quarter line of said Section 17, North 89 degrees 47 minutes 08 seconds West a distance of 1325.80 feet to the west line of the Southeast Quarter of the Northeast Quarter of said Section 17; thence, along last said west line, North 00 degrees 16 minutes 44 seconds West a distance of 1151.05 feet; thence South 89 degrees 47 minutes 08 seconds East a distance of 1324.97 feet to the east line of the Northeast Quarter of said Section 17; thence, along last said east line, South 00 degrees 19 minutes 10 seconds East a distance of 1151.05 feet to the point of beginning. Containing 1,525,515 square feet (35.02 acres). Subject to 170'' Street (A Town Road) along the most easterly line of the above described property. Also subject to all easements, restrictions, and covenants of record. I also certify that this map is a correct representation to scale of the exterior boundaries surveyed and described, that I have complied with the provisions of Chapter 236.34 of the Wisconsin State Statutes and the Subdivision Ordinance of the County of St. Croix and the Town of Pleasant Valley in surveying and mapping the same. 5 - 1'9 z ge—Registered Wisconsin Land Surveyor No. 2484 Date JEO Consulting Group, Inc. P.O. Box 325 New Richmond, WI 54017 `s. ".autin CONe.��w� * 7Y R. DODGE S 5.2484 CLEAR LAKE, P WI gN't SURV ni APPLICATION FOR TOWN BUILDING PERMIT Property owner: ro 'i– L - afro, h, C4 Y Contractor /Agent (if not owner:) ol Mailing address: S - 7 _T Mailing address: o s � yoa 3 36 (7O G �� J Daytime phone: ( �) �, ' Daytime phone: Property location: 1/4, 1/4, ec. ` R. -7 W., Town of I WB 0 W Computer #: - - - arcel #: CJ — '''';1 r+ ) 1110 4 �. Zoning District:. CRO:, , Cvui" Type of Town Building Permit Checictee ( Single- family residence ( ) Farm Building O Commercial Building O Accessory Building ( ) Industrial Building ( ) Seasonal Dwelling ( ) Remodeling Application Check List: The following is a list of submittal requirements for a town- building permit per Article 17.70 (3) (b) of the St. Croix County Zoning Ordinance. It is important to submit a complete application, as it will help town officials review the request efficiently. To ensure your application is complete check offthe box as you complete :s- -❑ A general written statement that specifically identifies what is being requested. ❑ A statement indicating whether or not a private water or sewage system is to be installed. ❑ Indicate the type of occupancy (single- family dwelling, personal storage, Ag. related, etc... ) ❑ SITE DEVELOPMENT PLAN SUBMITTED ON 8'% INCH BY 11 INCH PAPER A complete site plan showing at a minimum the location of the following: • Identify and label any slope 12% or greater, • Dimensions and area of lot, Location of any structures with distances measured from the lot lines and centerline of all abutting streets or highways, • Location of any existing or proposed on -site septic systems or private water supply systems within 100 feet of the construction, ■ Location of the ordinary high water mark (OHWM) of any abutting navigable waterways and show all setbacks from the OH WM. • Location and landward limit of all wetlands, specifications and dimensions for areas of proposed wetland alteration. • Existing and proposed topographic and drainage features and vegetative cover, • Location of floodplain and floodway limits on the property as determined from floodplain zoning maps used to delineate floodplain areas, • Location of existing or future access roads • And any other unique limiting condition of the property ❑ THE BUIDING SITE MUST BE STAKED. The Deputy Zoning Administrator will view the site to ensure compliance with the Permit, I agree to with raw this ap atio bstantive false or incorrect information has been included. Signature Date This review only verifies that the project complies with the applicable St. Croix County Land Use Ordinances. This is not an application for a Uniform Dwelling Permit or to install a private onsite wastewater treatment system. n' f(� °`TOWN USE ONLY Permit Issuance Date: / Permit # Expiration Date: / / 0 'l ➢ The application "materials will remain on f k ith the TOWN. 5��a WWY r ORIGINAL RECEIVE 1531 Wisconsin Department of Commerce SOIL EVALUATION REPC RT age t of 3 MAY Division of Safety and Buildings 3 0 2002 Certified Soil Testin in accordance with Comm 85, Wis. Adm. Code g Attach complete site plan on paper not less than 8% x 11 inches in size. Plan must ounttT. CROIX Croix include, but not limited to: vertical and horizontal reference point (BM), direction and percent slope, scale or dimensions, north arrow, and location and distance to nearest road. CSM Pending Please print all information. Reviewed By Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Property Owner Property Location LaGrander, Kurt Govt. Lot SE 1/4 NE 1/4 S 17 T 28 N R 17 W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# 1592 CTHW N CSM 678998, V 16, P 4293 City State Zip Code Phone Number City _ j Village e Town Nearest Road Hammond WI 1 54015 1 715 - 246 -7125 Pleasant Valley 1 170Th St. ✓ New Construction Use: f Residential / Number of bedrooms 3 Code derived design flow rate 450 GPD Replacement Public or commercial - Describe Parent material loess over till Flood plain elevation, if applicable NA General comments and recommendations: install 4' x 112.5' rock bed mound on 98,9 contour as upslope edge of rock w/ 05 sand fill for 3 br FT] Boring # Boring Pit Ground Surface elev. 96.4 ft. Depth to limiting factor 41 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 I "Eff#2 1 0 -11 10YR 3/3 - sil 2 f sbk mvfr cs 1f /m .5 .8 2 11 -32 10YR 4/4 - sit 3 f -m sbk mvfr gs 1m .5 .8 3 32 -41 1CYR 4/4 - sil 2 m sbk mvfr cs if .5 .8 4 41 -50 7.5YR 4/6 f2f 10YR 6/2 s 0 sg ml - - . 7 1.2 I ❑ Boring # _ Boring I Pit Ground Surface elev. 98.9 ft. Depth to limiting factor 37 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 1 1 0 -10 10YR 3/3 sil 2 f sbk mvfr cs 1f /m .5 .8 2 10 -28 10YR 4/4 - sil 3 f -m sbk mvfr gs 1 m 1 .5 .8 - - - - - -1 3 28 -37 10YR 4/4 - sil 2 m sbk mvfr cs if .5 .8 4 37 -48 10YR 4/6 f1f 7.5YR 4/6 s 0 sg ml - 7 1.2 i - * Effluent #1 - BOD 30 < 220 mg /L and TSS >30 < 150 mg /L " Effluent #2 = BOD < 30 mg /L and TSS < 30 mgL CST Name (Please Print) i ature: CST Number Henry F. Grote 222774 Address Certified Soil Testing Date Evaluation Con uc ed Telephone Number E. 4366 353rd Ave., Menomonie, WI 54751 5/24/2002 715- 233 -0398 Property Owner LaGrander, Kurt Parcel ID # CSM Pending Page 2 of 3 ❑ Boring # -a Boring j Pit Ground Surface elev. 98.9 ft. Depth to limiting factor 31 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots QPQ ' in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 `Eff#2 1 0 -10 10YR 3/3 - sil 2 f sbk mvfr cs 1f /m .5 .8 2 10 19 10YR 4/3 - sl 2 m sbk mvfr cw 1M .5 .9 3 19 -31 10YR 4/4 - sl 2 m sbk mvfr cs if .5 .9 4 31 -53 10YR 4/4 c2d 10YR 6/2 sl 0 m mvfr - - .3 .5 i i I I 47 Boring # r Boring ✓i Pit Ground Surface elev. 104.0 ft. Depth to limiting factor 31 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots _ in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 1 0 -10 10YR 3/3 - sil 2 f sbk mvfr Cs 1f /m .5 .8 2 10 -20 10YR 4/4 - sl 1 m sbk mvfr gs lm .4 .6 3 20 -31 10YR 4/6 - Is 1 m sbk mvfr Cs 1 m .7 1.2 4 31 -36 10YR 4/6 c2d 10YR 6/2 Is 1 m sbk mvfr Cs .7 1.2 5 36 -52 10YR 4/4 f2d 10YR 6/2 sl 0 m mfr - - .3 .5 I ❑Boring # 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 P ' in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 `Eff#2 i � I I i I � ' 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. 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