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HomeMy WebLinkAbout028-1045-95-200 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and. Building Division INSPECTION REPORT Sanitary Permit No: 515043 0 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: City Village X Township Parcel Tax No: Weyer, Gregory & Jessica I Rush River, Town of 028 - 1045 -95 -200 CST BM Elev: Insp. BM Elev: BM Description: Sectionlrown /Range/Map No: % C f D , b VO 36.28.17.2868 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic /2 Bench / fin / / CU Dosing Alt. BM ' 6444 3 •, a �s Aeration Bldg. Sewer b 9Z, SZ Holding St/Ht Inlet TANK SETBA K INFORMATION St/Ht Outlet TANK TO P/L I ELL S ILDGA , , ri n , tak, ROAD Dt Inlet Septic , `b b , Dt Bottom c4 4 Dosing Header /Ma 6? 0 9 /oo Aeration Dist. Pipe t7/ /06- // Holding Bot. System Final / PUMP /SIPHON INFORMATIO Manufacturer r' Demand St Cover q �q � %ICyy GPM%Z Model Number 2 jV TDH Lift�,z t5� Friction Loss System Head TDH Ft Forcemain Length, Di Z Dist. to Well SOIL ABSORP ION SYSTEM 6UVn u/ BED /TRENCH Width Length No. Of Trenches PIT DIMENSI NS No. Of Pits Inside Dia. Liqui Depth DIMENSIONS /_ / ob SETBACK SYSTEM TO P/LE JBLDG IWELL LAKE /STREAM LEACHIN Manufacturer: INFORMATION C OR Type Of ystem: UNIT Model Number: � S l � DISTRI ON SYSTEM Heade anifo Distribution x Hole Size I x Holeng ngt V�o Air Intake SC (!O �7 e) ii Q • l ��p � � Length Dia V; L Length � Dia �� � Spacing :3 5 � SOIL COVER x Pressure Systems Only o un O At -Grade Systems Only Depth Over Ce I D O er Edges Topsoil h of / O � xx Seed /S ded xx Mulched awilo F Yes E] No Yes Ej No/ ` COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1:�/ C / j�A Inspection #2: Location: 2083 CTY RD YY Baldwin, WI 54002 (NE 1/4 SE 1/4 36 T28N R1 7W) NA Lot 2 /t� , / Parcel No: 36.28.47.2866 ( 1.) Alt BM Description 2.) Bldg sewer length = �1Ae, - amount of cover S - 7 Plan revision Required? Yes No Use other side for additional information. Date Insepctor's Signa re Cert. No. SBD -6710 (R.3/97) I 4 bzs County Safety and Buildings Division St. Croix pisconsin 201 W. Washington Ave., P.O. Box 7162 Sanitary Permit Number (to be filled in by Co.) Department of Commerce Madison, 6-31 7162 608 26 1 6 -35 to Plan I.D. Number State Sanitary Permit Applic on Trans ID 1 ( ,t {yo r 8Z In accord with Comm 83.21, Wis. Adm. Code, personal information you provide may be used for secondary purposes Privacy Law, s 15.04 Project Address (if different than ,� mai hh 'ng addr s) CEIVED 01 6 4 - AJ I. Application Information ase Print All Information U Property Owner's Name Pazce I Lot # Block # Mr. Greg Weyer Sint ISele� Z Property Owner's Mailing Address ST CROIX COUNTY Property Location 1691 Redhead Ave. PLANNING & ZONING OFFICE City, State Zip Code Phone Number N E ' / <, SE '/<, Section _36 r � Baldwin, WI 54002 715/760 T 28 N R 17 w II. Type of Building (check all that apply) X 1 or 2 Family Dwelling — Number of Bedrooms Four Subdivision Name CSM Number ❑Public /Commercial — Describe Use ' °"`~ $ 8,3 2 2- Z_ ❑ State Owned — Describe Use —1�—X �� D�r� � City_ Village XTownship of Rush River III. Type of Permit: (Check only one box on line A. Complete line B if applicable) i O Z9 r Q�V — A. X New System Replacement System Treatment/Holding Tank Replacement Only Other Modification to Existing System B Permit Renewal Permit Revision Change of Plumber Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Owner 2( e IV. Type of POWTS System: Check all that apply) d ' _Non — Pressurized In- Ground Mound > 24 in. of suitable soil X Mound < 24 in. of suitable soil _ At -Grade Single Pass Sand Filter _ Constructed Wetland Pressurized In- Ground — Holding Tank Peat Filter _ Aerobic Treatment Unit Recirculating Sand Filter Recirculating Synthetic Media Filter Leaching Chamber Drip Line _ Gravel -less Pipe ❑ Other (explain V. Dispersal/Treatment Area I nformation: a Design Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal Area Required (s Dispersal Area Proposed (s System Elevation 600 0.4 ,� 1500 sq.ft , 1 1650 sq.ft 99.5' VI. Tank Info Capacity in Total Numbe Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Concrete Constructed Glass New Existing Units Tanks Tanks u 6 ( AC o or Holding Tank 1200 1200 1 Wieser Concrete X Aerobic Treatment Unit 800 800 Combo X VII. Responsibility Statement- I, the undersigned, assume re onsi ility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plumper' ignature MP/MPRS Number Business Phone Number Kent Hoke G MP224199 715/962 -4155 Plumber's Address (Street, City, State, Zip C de) 200 Bremer Ave., Suite D , Colfax, WI 54730 VIIL Court /De artment Use Onl Approved tsapprs Sanitary Permit Fee (includes Groundwater Date Issue ing nt S G Issuignature o S s) Surcharge Fee) / Z G �p 3 Zoo I iven Reason r Denial lG J IX. Conditions of Approval/Reasons for Disapproval 3' f SYSTEM OWNER: t, Septic tank, effluent filter and dispersal cell must all be services / maintained as per management plan provided by plumber. 2. All semack requirements must be maintained as per q*AWble Code / **mica. Attach complete plans (to the County only) for the system on paper not less than 8112 x 11 inches in size I SITE PLAN NE,SE,36,28,17W cl Y Rush River township y St. Croix county - R✓ LEGEND 1 BM & 213M: 100.0' top of 1 '' /a" PVC pipe fo pits c/o clean -out aQQ Kok �;�e, > too'�M -- contour No Comm 83 problems Scale 1" — 40' except ?i w indicated 5 OJ 10 4 System Elev. 99.5' on contour 98.0' ra S c.. k (� Wets FI — qo i s6, 30 14-50 «_y u La c ir V ,O 1 a "0 1 i l G11Ltt�lLF page 6 of 8 project: WEYER 1 1 Safety and Buildings ov PO BOX 7162 commercemi. g MADISON WI 53707 -7162 Contact Through Relay i www.w w .c ommer isco n sin.go / Department of Commerce iscosin.gov Jim Doyle, Governor Richard J. Leinenkugel, Secretary March 10, 2009 CUST ID No. 224580 ATTN. POWTS Inspector LORETTA LARRABEE ZONING OFFICE L & L PERC TESTING ST CROIX COUNTY SPIA N2089 CTY RD Y 1101 CARMICHAEL RD MENOMONIE WI 54751 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 03/10/2011 Identification Numbers Transaction ID No. 1644082 SITE: Site ID No. 746195 Greg Weyer - Dwelling Please refer to both identification numbers, CTY YY above, in all correspondence with the agency. Town of Rush River, 54002 St Croix County NE1 /4, SE1 /4, S36, T28N, R17W FOR: Description: Mound Object Type: POWTS Component Manual Regulated Object ID No.: 1218699 Maintenance required; 600 GPD Flow rate; 18 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.01 101) The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. This system is to be constructed and located in accordance with the enclosed approved plans and with the component manual(s) referenced above. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. J No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, Co� stats. A P DE A A copy of the approved plans, specifications and this letter shall be on -site during construction and open to 0�V1S T inspection by authorized representatives of the Department, which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of construction /installation/operation. S EE C O RRt 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. LORETTA LARRABEE Page 2 3/10/2009 1raa Fee Required $ 250.00 Fee Received $ 250.00 Balance Du e $ 0.00 el YPlanR g Private Sewag rr , Integrated Services WiSMART code: 7633 (608)266-2889, M - F, 0600 - 1430 Hrs pete.pagel@wisconsin.gov cc: Leroy G Jansky, POWTS Wastewater Specialist, (715) 726-2544, Friday, 7:00 A.M. To 3:30 P.M. Private On -Site Wastewater Treatment System (POWTS) Mound and Pressure Distribution Component Design New Residential application Index and Title Sheet r ��'� 20 C 09 Project Name: WEYER Owner: Greg Weyer 1691 Redhead Ave. Baldwin, WI 54002 Location: Cty YY Legal Description: NE,SE,36,28,N /R17W Township /County: Rush River township, St. Croix county Contents: Page 1: index and title Page 2: general information & lateral diagram Page 3: mound drawings Page 4: dose tank Page 5: pump information Page 6: site plan Page 7: management plan Page 8: contingency plan Attachment: soil test to state plan Designer's name and license no.: Loretta Larrabee license# I& � ' Address: N2089 Cty Rd. Y •''••••••,'lQ�,r LOREWA A. �! Menomonie, WI 54751 * E Phone: 715/664 -8184 tees NOMOMIE �,Q'= �T Cell: 715/308 -1668 - p o :',z: ,F c .c� w, S. 1 E-mail: lanlperetestinagwwt.net ` /QNAL�'����� �fp� Designer's Signature: Date: 3/4/09 spoNo CF I the undersigned submitted these plans under my authority Mound component manual for POWTS Version 2.0 SBD- 10691 -P (N.01 /01), and Pressure Distribution component manual — Version 2.0 SBD - 10706 -P (N.01 /01) page 1 of 8 I� I ���;i' +11!!' � �� hf4'�tl; ,'�. �t�At ?ft�'..� : � . 4 •,� @t •. �I�1C� "'�' GENERAL INFORMATION New Site Four bedroom home, 600gal DWF end fed system w/2 laterals 4% slope system area dispersal cell design loading rate 1.0 0.4 soil application rate linear rate 6.00 18" limiting soil factor orifice sq /ft. 10.50 1200/800 Wieser tank with Orenco FT0822 -14BA filter effluent quality #1 LATERAL LAYOUT DIAGRAM (not to scale) End Fed System Number of laterals 2 orifice dia. 5/32in. (0.156) Lateral dia. 1 1 /2 " orifice spacing (X) 42in. (3.5') Lateral length (P) 98.0 ft. orifice per lateral 29 Lateral spacing (S) 3.5 ft. lateral discharge rate 15.66gpm Manifold dia. I 1 /2 in total system rate 31.32gpm Forcemain dia. 2.0 in * *see page 7 of 8 Mis. Construction for turn-up detail turn-up end on laterals at manifold for access of lateral at both ends for servicing _Valve box Pressure plug finish grade X P first orifice next to fitting X manif S 3 0' (36 ") Orifices located on bottom of lateral I Last orifice next to fitting Force main 2" dia. project: WEYER page 2 of 8 PLAN VIEW OF MOUND (not to scale) J= 8.0' D= 1.50' (18 ") K= 10.5' required bed 600sq.ft A= 6.0' E= 1.74' (20 7/8 ") B= 100.0' proposed bed 600sq.ft. I= 10.5' F= 0.83' (10 ") L= 121.0' required basel area 1500sq.ft. W= 24.5' G= 0.50' ( 6 ") proposed basel area 1650sq.ft. H= 1.00' (12 ") observation pipe @ 20ft. Observation pipe I w p 5 O 24.5 ~♦ 6�, IF 10.5' 100' 10.5' L 121' Mound Cross Section View (not to scale) Finished grade elev. 101.3' 1 Lateral invert elev. 100.5' Dispersal cell elev. 99.5' - - - -- 4 dispersal cell +2 -- -- - - - - -- - - -- - -- ---- - -- -4- 4aterals -- - -- - -- - -- - - - - -- - - -- - Aggregate bed 6" - -- - -- - - E l - -- - -- - - - -- - - - - -- - - - -- A 3 - - -- - - - -- - -- - -- - -- - E -- -- -- -- -- D - -- - - -- -- - -- - - -- - -- - -- -- - tilled layer tilled layer contour 4% site slope elev. 98.0' Numeral Key 1 topsoil cap 2 subsoil cap 1.5 ft. min. 3 ASTM C33 sand 4" min.dia. observation pipe IF 4 synthetic cover over cell with 1 /4 " slots, 6" min. height 5 aggregate 2 closet flange —p. L- O.Sft. min. infiltrative surface project: WEYER page 3 of 8 COMBINATION SEPTIC TANK / PUMP CHAMBER (No scale) .Approved Locking Manhole Cover Approved Cain, With Warning Label Attached _ Warning Label Weatherproof Approved Junction Box Vent Cap —� 12" Minimum Final Grade 4" Minimum , '18" Minimum Quick Disconnect i 1/4" Weep Baffle -- , _ Hole , Approved Joint " + tv /4!'S�9tc(0 PiCee t A Extending 3' Alarm + Onto Solid Soi 64 B On Approved Joint w /�" 5cJ 1go 14pe 1.5 CIEV C Extending 3' Off (1'' Onto Solid So D Conc. Block 3 of Bedding Under tank— Note. , Pow and., A] arm Are On Separate _Ci rcui is 20 07 o g aEi� Tank Manufacturer: W`icr �„�,�} Tank Size-Septic/Pump: 1 z001 S o o LP Gal 1 ons d s s Alarm Manufacturer: S s L-_ Model Number: S_S� Capacities: A inches or o0 3 Switch Type: h �,�i � } B _� 4 2 Gal l ons Pump Manufac hard1Pn / 2 inches or y Gallons f + C - 5 inches or i i i. Zo Gal i ons Model Number: Minimum Discharge Kate 32 + D 1 �_ i nche " -or Z a, 6 Gal ons _ Total....._ 3t, nches or Soo_ey Gallons Vertical Difference Between Pump Off and Distribution Pipe: q, 00Fdet nol Wh 22., 2q Minimum Required Supply Pressure:.: o 1.1 .............. 4 5 5 Feet Feet of Force Main x 2 Friction Factor/l00 Feet: + �r o` 2 Inch Diameter Force Main Total-Dynamic Head:... s $ Feet project: WEYER page 4 of 8 n ° Effluent SE -40H Series 4/10 HP Submersible Effluent Pump- High Head, 3/4" Solids FLOW - LITERS /MINUTE 0 50 100 150 200 250 35 10.0 30 Construction 25 8.0 Motor Housing Epoxy Coated Cast Iron tA Impeller Material Polycarbonate L 20 6.o W Impeller Type Closed Vane W 1s °a Volute ABS 4.0 = Power Cord SJTW -A 10 Nitrile With Carbon Mechanical Shaft Seat 2.0 and Ceramic Faces 5 Fasteners Stainless Steel Shaft Stainless Steel 0 0.0 0 10 20 30 40 50 60 70 Bearings Upper - Sleeve Lower -Ball Bearing FLOW - GALLONS /MINUTE 11.65 C n�r X 5.65 �� �/ '�. *`• 9.30 1.5" DISCHARGE O 9.00 3.91 SCREEN TO PASS 3 /4" SOLIDS Specifications RUNNING 73 MRIJIM12 .. DISCHARGE SIZE AMPS/WATTS .. SE 40H 509332 4/10 115 1.5" FNPT 13.0/1000 70.0 64.0 55.0 41.0 32.0 13.8 20' 24.0 509341 4/10 230 1.5" FNPT 6.5/1000 70.0 64.0 55.0 41.0 32.0 13.8. 20' 24.0 SE-40H-AF 509351 4/10 115 1.5" FNPT 13.0/1000 70.0 64.0 55.0 41.0 32.0 13.8 20' 24.0 509361 4/10 230 1.5" FNPT 6.5/1000 70.0 64.0 55.0 41.0 32.0 13.8 20' 24.0 } - - Effluent . SE -40H Series 4/10 HP Submersible Effluent Pump - High Head, 3/4" Solids FLOW - LITERS /MINUTE 0 50 100 150 200 250 35 10.0 30- Construction 25 8.0 Motor Housing Epoxy Coated Cast Iron tiii pe le :M saa #, ; f� !year 'a a, LL 20 6.0 ~ Impeller Type Closed Vane LU o � . 15 Q 1/011ite % " Ai$$ 4.0 = Power Cord SJTW -A 10 1 itr'IIE with CD11 Mechanical Shaft Seal' :and Ceranio Fades 2.0 5 Fasteners Stainless Steel Shaft Stainless Sfel 0.0 Beari Fower pper - Sleeve 0 10 20 30 40 50 so 7o g Ball Bearing FLOW - GALLONS /MINUTE 11.65 l \ A \ 7I /1 1, M 11 1 1 J 3 's 5.65 9.30 1.5" DISCHARGE O 9.00 3.91 SCREEN TO PASS 3 /a" SOLIDS Specifications PERFORMANCE (GP !! - 4 0H O 509361 . . 509332 4/10 115 1.5" FNPT 13.011000 70.0 64.0 55.0 41.0 32.0 13.8 20' 24.0 1 '4110 230 i:5 FNPT 6 «51000 7Q:0 .60 ° 55:0 41.(3 32:0 1:8 ` 20' ,' S 40H AF' 509351 4/10 115 1.5" FNPT 13.0/1000 70.0 64.0 55.0 41.0 32.0 13.8 20' 24.0 ' 4/10 230 1.5" FNPT 6.511000 70.0 64.0 55.0 41.0 ,!, 32.0 13.8 20; 24.0' Mound System Maintenance and Operation Specifications Service Provider's Name: H & H Plumbing LLC Phone: 715/962 -4155 POWTS Regulator's Name: St. Croix County Zoning Phone: 715/386 -4680 System Flow and Load Parameters Design Flow — Peak 600gpd Maximum Influent Particles Size 1 /8in Estimated Flow — Average 400gpd Maximum BOD5 220mg/L Septic tank Capacity 1200gals Maximum TSS 150mg/L Soil absorption component Size 600bed Maximum FOG 30mg/L Type of Wastewater Domestic Maximum Fecal Coliform >10E4 cfu/100mL 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 monthly Pressure System --------- - - - - -- Laterals should be flushed and pressure tested every 1.5years Mound -------------------- - - - - -- Inspect for ponding and seepage once every 3 years Other---------------------- - - - - -- Initially filter should be checked yearly to determine service schedule Miscellaneous Construction and Materials Standards I . Observation pipes, 4 "min. dia. are slotted and materials conform to Table Comm 84.30 -1, have a watertight cap and secured with water closet or 3/8" dia. bar as shown in 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 6. Lateral Turn-up to finish at grade or above, enclosed in a 6 -8" diameter lawn sprinkler valve box or similar product. (lateral turn-up consists of a long sweep 90 or two 45degree bends same diameter as lateral) 7. Lateral Turn-up on end of distribution laterals after the last orifice. project: WEYER page 7 of 8 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 component manuals 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 manholes 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" 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, Stats. 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 filter shall be cleaned as necessary to ensure proper operation. The filter cartridge should not be removed unless provisions are made to retain solids in the tank that may slip off the filer when removed from its enclosure. If the filter is equipped with an alarm, the filter shall be serviced if the alarm is activated continuously. The septic tank shall have its contents removed when the volume of sludge and scum in the tank exceeds 1/3 the liquid volume of the tank. If the contents of the tank are not removed at the time of a triennial assessment, maintenance personal shall advise the owner of when the next service needs to be done to maintain less than maximum scum and sludge accumulation in the tank. 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. Pump Tank Servicing East of system area, is side yard, enabling drive ability to pump tank for servicing. Mound and Pressure Distribution System No trees or shrubs should be planted on the mound. Plantings maybe 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 surface within the mound and snow compaction in the winter will promote frost penetration. Cold weather installations dictate that the mound be heavily mulched as protection from freezing. 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 at least once every 18months. When a pressure test is performed is should be compared to the initial test when the system was installed to determine if orifice clogging has occurred, if clogging has occurred orifice cleaning is required to maintain equal distribution within the 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" considered impending failure requiring additional, more frequent monitoring. Contingency Plan If the septic tank or any of its components become defective the tank or components shall be repaired or replaced to keep the system in proper operating condition. If the dosing tank or its components become defective the defective components(s) shall be immediately repaired or replaced with a component of same or equal performance. If the mound fails to accept wastewater or discharges wastewater to the ground surface, it will be repaired or replaced. Increasing basal area if toe leakage or by removing biologically clogged absorption and dispersal media and related piping and replacing components as deemed necessary to bring the system into proper operating condition. See page 7 of this plan for the name and telephone number of your local POWTS regulator and service provider. project: WEYER page 8 of 8 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 component manuals 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 manholes 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" 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, Stats. 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 filter shall be cleaned as necessary to ensure proper operation. The filter cartridge should not be removed unless provisions are made to retain solids in the tank that may slip off the filer when removed from its enclosure. If the filter is equipped with an alarm, the filter shall be serviced if the alarm is activated continuously. The septic tank shall have its contents removed when the volume of sludge and scum in the tank exceeds 1/3 the liquid volume of the tank. If the contents of the tank are not removed at the time of a triennial assessment, maintenance personal shall advise the owner of when the next service needs to be done to maintain less than maximum scum and sludge accumulation in the tank. 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. Pump Tank Servicing East of system area, is side yard, enabling drive ability to pump tank for servicing. Mound and Pressure Distribution System No trees or shrubs should be planted on the mound. Plantings maybe 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 surface within the mound and snow compaction in the winter will promote frost penetration. Cold weather installations dictate that the mound be heavily mulched as protection from freezing. 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 at least once every 18months. When a pressure test is performed is should be compared to the initial test when the system was installed to determine if orifice clogging has occurred, if clogging has occurred orifice cleaning is required to maintain equal distribution within the 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" considered impending failure requiring additional, more frequent monitoring. Contineency Plan If the septic tank or any of its components become defective the tank or components shall be repaired or replaced to keep the system in proper operating condition. If the dosing tank or its components become defective the defective components(s) shall be immediately repaired or replaced with a component of same or equal performance. If the mound fails to accept wastewater or discharges wastewater to the ground surface, it will be repaired or replaced. Increasing basal area if toe leakage or by removing biologically clogged absorption and dispersal media and related piping and replacing components as deemed necessary to bring the system into proper operating condition. See page 7 of this plan for the name and telephone number of your local POWTS regulator and service provider. project: WEYER page 8 of 8 Wisconsin Department of Commerce SOIL EVALUATION REPORT Page of 3 Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. e , Attach complete site plan on paper not less than 8112 x 11 inches in size. Plan mu include, but not limited to: vertical and horizontal reference point (BM), direction and rcel I.D. 0 2 , r /0 percent slope, scale or dimensions, north arrow, and location and distance to neare road. Please print ail information. Review by Y�Z Pe rsonal information you provide may be used for sec l�c`y�, s. 15. (1) (m)). d Property Owner Prope Location �� /� C �-2 `3 2 Govt. L t,�F 1/4Sr-1/4 S, T�9 N R 17 E (o W Property Owner's Mailing Address Lot # Block # Subd. Namp6FtgMj# 1X out tY P-etid i n City State Zip Code Ph ne N er Ity ❑ Village o Roa �, � �.1.) L . bra c - 7 t u `t — C, t-� If �?�Z L2IVew Construction Use: esidential / Number of bedrooms _� Code derived design flow rate GPD ❑ Replacement ❑ Public or commercial - Describe: L w al Parent material r c O U � / / Y Flood Plain elevation if applicable AJ & I ft. General comments c n and recommendations: us ` ,s�(A S LX ^J'�- C��(J� 2F- �c�� 2 0 � Ce I ✓"l �( G� S 5f"�u, E�e�, 0 Boring # El Boring � Q p Ground surface elev. ft. Depth to limiting factor �� in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 f L 3 .S k L' I Jc � •� C5 + �J t� [51 Boring # Ej Boring it Ground surface elev. ft. Depth to limiting factor �_ 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 / * Effluent #1 = BOD > 30 < 220 mg /L and TSS >30 < 150 mg /L * Effluent #2 = BOD < 30 mg /L and TSS < 30 mg /L CS me (Please Print) r gnature CST Number \ l r `' cam/ Address D valuation Conducted Telephone Number Property Owner Parcel ID # Page of ffl Boring # ❑ l.C�`� �Boring � 0 Ground surface elev. ft. Depth to limiting factor &— in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft in. Munsell Qu. Sz. Cord. Color Gr. Sz. Sh. *Eff#1 *Eff#2 �I CS i 6 ,3 3 b k wi-Ci zv, 1 , 6 75 V ,� F-1 Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil A lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDlfl? in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 Boring Boring # Ground surface elev. ft. Depth to limiting factor in. El Pit Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 *Effluent #1 = BOD > 30:5 220 mg /L and TSS >30 < 150 mg /L *Effluent #2 - - BOD < 30 mg /L and TSS < _ 30 mglL The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608 - 266 -3151 or TTY 608 - 264 -8777. SBD -8330 (R.07 /00) 3 Property Owner - 4�L�— Parcel ID# Page cD of [Y] Boring # � Boring L_ Pit Ground surface elev. �(� • �o ft. Depth to limiting factor in. Soil Application Rate Horizon 1 Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Qu. Sz. Cont. Color Gr. S Sh. *Eff#1 *Eff#2 a a� . C i cS t t b -C 75Y 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 GPD /fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 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 GPD /fF 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. SBD -8330 (R.07 /00) +o VV �I �rp P os�� _ PC) 'Y r C/ qq 0 V T4 sF tv pvc Proms 3 90 83 d 4 9b ��,r�? SI or c ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer Mailing Address _ /& ) y as 2 �,ld��'e-, �Z 5 Property Address �- !� o� . Y 13 7- (Verification required from Planning & Zoning Department for new construction.) City /State ac- IIAS l)s Parcel Identification Number -OHO 0? S� - - , / b q - - o0 LEGAL DESCRIPTION D Z $'- /d 4(5 - `i 5 - w Property Location Al 6 - '/ , 5& % , Sec. 3i�. , T N R_/7 W, Town of Subdivision , Lot # a Certified Survey Map # S 5 Volume o? 3 Page # 5576- Warranty Deed # 1 � Volume , Page # Spec house 0 yes )(no Lot lines identifiable k yes 0 no SYSTEM MAINTENANCE AND OWNER CERTIFICATION Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed, by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. Owner maintenance responsibilities e - ar specified m §Comm. 83.52(1) and m Chapter 12 St. Croix County Sanitary Ordinance. The property owner agrees to submit to St. Croix County Planning & Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on -site wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. I /we, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Planning & Zoning Department within 30 days of the three year expiration date. I/we certify that all statements on this form are true to the best of my /our knowledge. I /we am/are the owner(s) of the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. Number of bedrooms .A �1� 3 s SIGNATURE OF APPLICANT(S) r DATE ** *Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Department. * ** Include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if reference is made in the warranty deed. (REV. 08/05) State Bar of Wisconsin Form 2 -2003 8 8 5 3 9 4 1 WARRANTY DEED 8$5894 Document Number Document Name KATHLEEN H. WALSH REGISTER OF DEEDS ST. CROIX CO., WI RECEIVED FOR RECORD THIS DEED, made between Charles L. Weyer and Barbara A. Weyer, husband 12/29/2008 11:45AIM an wife WARRANTY DEED EXEMPT t ( "Grantor," whether one or more), and Gregory Weyer and Jessi Weyer, husband REC FEE: 11.00 and wife, holding as survivorship marital property TRANS FEE: 157.50 PAGES: 1 ( "Grantee," whether one or more). Grantor for a valuable consideration, conveys and warrants to Grantee the following described real estate, together with the rents, profits, fixtures and other appurtenant Recording Area interests, in St. Croix County, State of Wisconsin ( "Property ") (if more Name and Return Address space is needed, please attach addendum): Thomas A. McCormack Part of the Northeast Quarter of the Southeast Quarter (NE 1/4 of SE 1/4), and PO Box 2120 the Northwest Quarter of the Southeast Quarter (NW 1/4 of SE 1/4) , Section Baldwin WI 54002 Thirty -six (36), Township Twenty -eight (28) North, Range Seventeen (17) West, Town of Rush River, St. Croix County, Wisconsin, more particularly described as follows: 028- 1045 -95 -000, 028 - 1046 - 10-000 Lot Two (2) of Certified Survey Map No. 5576 recorded October 23, 2008 In Parcel Identification Number (PIN) Volume 23 of Certified Survey Maps, Page 5576, as Document No. 883222, office This is not homestead ro e of the Register of Deeds for St. Croix County, Wisconsin. P p '' his) (is not) Exceptions to warranties: Easements and restrictions of record. Dated Charle L. We e r - � Y (SEAL) C ___ _ (SEA L) -- * Ba ara A. a er AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF WISC ) - — ) ss. authenticated on ST. CROIX COUNTY ) Personally came before me on �,( y _,,, _ , _ the above -named Charles L. Weyer and Ba r_bara_ A. Weyer TITLE: MEMBER STATE BAR OF WISCONSIN (1f not, to me known to be the persons) �vhti ecuted thtioregoing y § �_ e � 8 he stime authorised b Wis. Stat. 706.06 instrument and ac owled ed t THIS INSTRUMENT DRAFTED BY: Thom A. McCormack Notary Public, State of WISCONSIN.4 Z _ Hatd W I 54002 My commission ►s ernnanent e -- — ) (Signatures may be authenticated or acknowledged. Both are not necessary.) NOTE: THIS IS A STANDARD FORM. ANY MODIFICATION TO THIS FORM SHOULD BE CLEARLY IDENTIFIED. WARRANTY DEED 02003 STATE BAR OF WISCONSIN FORM NO. 2-2003 *Type name below signatures, INFO -PRO TM Legal Forma • (80053.2021 • irdoproformo.00m l I 111111 `'11 11111111111111111111 11111111 * 8 8 2 2 2 3 888222 KATHLEEN H. WALSH REGISTER OF DEEDS ST. CROIX CO., WI RECEIVED FOR RECORD CERTIFIED SURVEY MAP NO. 5576 10/23/2008 03 :OOPM Located in the Northeast Quarter of the Southeast Quarter, CERTIFIED SURVEY MAP and the Northwest Quarlcr of the Southcast Quartcr, VOL 23 PAGE: 5576 Section 36, Township 28 North, Range 17 West, REC FEE: 15.00 Town of Rush River, St. Croix County, Wisconsin COPY FEE: 4.00 Owner: PAGES: 3 Charles L. & Barbara A. Weyer Route 2 #46 US Highway 63 SEE DETAIL Baldwin, Wisconsin 54002 -5508 f / ON PAGE 2 — 7 \ Magnetic nail survey monument at the E114 Comer Section 36, T28N, R17W o — o - - - - - -- US -- -- _____ __ _ T °� 1100 ° 14'45 "E 1322.44 HIGHWAY 63 _-'_— — — — — — — N00 ° 03 '21 "E - N00't4.45 "E 033.33 °r,�W \ 2634.69 \ i I /: �` ♦������� ��� rbedwiretenoe • t• ♦ T— m d d�ewe LOT 1 1► i I a o 6 INCLUDING R.O.W. W Rail Road Spike at the h v 2 m SE Comer Section 36, �. o m \ 22.532 acres m .. W Z I �; — new mounds tem 981,494 square feet m cc T28N R17W - North line NE 114 EXCLUDING R.O.W. ^ M m ( 20 . 287 acres Scale in Feet w I SE 114 Section 36, 2 T28N, R17W 883,700 square feet W o o zoo aoo m . I I _ x -- / x -- x -- x x barbed wire fence x u I x 7QW 0 14'45' 20.81 I 1 inch = 400 feet I N89 I ' x > I I��33.txw �0 1 -W 151.00 I I ` NO0 °14'45 "E 700.00 PERMANENT LIMITED I The east line of the SE 114 of Section 36 728N, R17W, bears EASEMENT. Q o LOT 2 o to N00 °14'45�E as referenced to the TRANSPORTATION PROJECT I R INCLUDING R.O.W. 2 St. Croix County Coordinate PLAT No: 8070-00.22 - 4.01 I I 20.627 acres 2 goo p System NAD 8 . AMENDMENT NO2 tt I I — West line NE 114 898,512 square feet a N oC Z . I ^JCUMENT NC. 8 &5250, I SE 114 Section 36, EXCLUDING R.O.W. �- "' .p I ` T28N, R 17W' 20.050 acres � o W N Filed in Transportation Project i 873,378 square feet N NOTES Y Plat Vol. 1, Page 20 N I 3� r CERTIFIED SURVEY MAP NO 5576 Located in. the Northeast Quarter of the Southeast Quarter, and the Northwest Quarter of the Southeast Quarter, Section 36, Township 28 North, Range 17 West, Town of Rush River, St. Cro*, County, Wisconsin Owner: 'Q �CN ,,,oi o+ ; ��� \•••......• Charles L. & Barbara A. Weyer � + + ++ Route 2 #46 US Highway 63 - Baldwin, Wisconsin 54002 -5508 ' 291 .` � O U E o 0 00Q S F3v 00 0 , �aeaava• ®° PERMANENT LIMITED EASEMENT. WARRANTY DEED The east line of the SE1 14 of TRANSPORTATION PROJECT DOCUMENT No. 513324 Section 36 T28N, R17W, bears N00 °74 45�E as referenced to the PLAT No: 8070-00 -22 - 4.01 N!12 of SE%s of Section 36 St. Croix Coun Coordinate AMENDMENT NO: 2 System NAD 83. DOCUMENT No. 865250, Filed in Transportation Project Plat Vol. 1, Page 20 DETAIL no scale and drawing is exaggerated for clarity � --..-------------------------------------- I Magnetic nail survey monument at the E114 Comer Section 36, T26N, R1 7W \ �+ HIGHWAY 63 � I " N00 "14'45'6 289.00 — US ion , S00 2327'W 181.13 aS In8 I o M gER T1 of VOLUME 229 2 1 9 PAGE 38 NV I $ .� N oo °14'45 "E 1033.33 1 _ I G VM 50 — — — — — i Do I 1 2 N 00 - 14'45 "E 108.32 r — — — — — -0 I I — O I- - - - - -- — / / — — — — — — — — — — I N oo ° 800 i a LOT I I _ Q X33 I � w Legend i 9LSS aped £Z '1 t£ 'ON 9O.0 BOO ' - 4 0 ARP W 9 2y4 uo �oroH ol!w ,iq paE¢njp Luau r4sw siyl £ Jo OF 96Dd lou•laurapuog@o plegGglur :11ew -3 ELOSS eloseww 'e►pueos IBLb ££b -L59 -^Jegwnu xed 99 xo8 'O'd 4ZY£-££b-1S9 :�agwnu soyjo WON anuany HjeZO 094 42 ':gul `6uiAgAinG jjL-wpuLj loo/ e 1 slewtoop pue laa) qi aie saoue ;s►p luawaned ul las /►eN - - solouao paquosep se JaXJew danms punoj selouao oo•ee n palou esmueLfto ssalun yas `•ll gt •l, uetp ssel ou ( I Z ,lo luawnuow edid uon 6uol L.pui og Aq ja awes a !suI au, we sa ou v, �`I r +ilr� CERTIFIED SURVEY MAP NO 5576 Located in the Northeast Quarter of the Southeast Quarter, and the Northwest Quarter of the Southeast Quarter, Section 36, Township 28 North, Range 17 West, Town of Rush River, St. Croix County, Wisconsin SURVEYOR'S CERTIFICATE 1, Joel T. Anez, Registered Wisconsin Land Surveyor, hereby certify that by the direction of Charles L. and Barbara A. Weyer, I have surveyed, divided and mapped part of the SE1 /4 of Section 36, T28N, R1 7W, Town of Rush River, St. Croix County, Wisconsin, described as follows: WARRANTY DEED DOCUMENT No. 513324 N%2 of SE% of Section 36-28-17 And is more particularly described as follows: The Northeast Quarter of the Southeast Quarter and the Northwest Quarter of the Southeast Quarter of Section 36, Township 28 North, Range 17 West, Rush River Township, St. Croix County, Wisconsin described as follows: Beginning at the northeast comer of said Northeast Quarter of the Southeast Quarter, thence South 89 degrees 42 minutes 50 seconds West, bearings are based on the St. Croix County Coordinate System, the north line of said Northeast Quarter of the Southeast Quarter and along north line of the y Northwest � along s Quarter of the Southeast ast Quarter, a distance of 2626.54 feet to the northwest comer of said Northwest Quarter of the Southeast Quarter, thence South 00 deg rees 18 minutes 07 9 seconds West along the west line of said Northwest Quarter of the Southeast t east Quart r e , a distance of 1315.98 feet to the southwest comer of said Northwest Quarter of the Southeast Quarter, thence North 89 degrees 51 minutes 17 seconds East, along the south line of said Northwest Quarter of the Southeast Quarter and along the south line of the Northeast Quarter of the Southeast Quarter, a distance of 2627.78 feet to the southeast comer of said Northeast Quarter of the Southeast Quarter, thence North 00 degrees 14 minutes 45 seconds East, along the east line of said Northeast Quarter of the Southeast Quarter, a distance of 1322.44 feet to the point of beginning. 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