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HomeMy WebLinkAbout026-1296-12-000 / 7 / \ (ƒ / / CD m § a m E . (D 7 k i \f ■ _&;r\ x£ z o o\ o o \ § [ \ \ CD / \ k \ 3 ° \ \ , � r ° \ E a a » < < ° \ = e C) / \ / } G ( 0 \ { \ °` \ / \/ E f c CD » 2 z> m% U? p§ E « > ® E o 3 \ 2_ / \ � - 2 5/ ; E \ § / \ 2 E ƒ CD R§ s F . ( .. ZA, V z « �, L / j § ) 0 0 $ 7 7 7 3 \ CD J \ D k \ § , K \\ CD � © (D " & rr 4 \ 3 z " C2 S = § § & \ \ 5 J Z ° ) ( \ . �. § X \ . ° [ 0 \ / / z / 0 - \ / z \ \ 0 \ �� % \ z & w ■ 1 > £ o CD CD \ $ $ 0 k \ \ § 4 ; CL � < CD CD § \ 0 ,}- c ]aF CL &[$ \ , E � / 0 E . G\ \ \ 3 0 ƒ 0 / 7 . ; \ < ' \ S , � \ ■ � \ \ w \ ƒ \ \ Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Z. County: St. Croix ,$afety and.8uilding Division INSPECTION REPORT Sanitary Permit No: 488230 0 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: -� ,n '� Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. { y' i" 7 = f r.Fr� A. Permit Holder's Name: City Village X Township Parcel Tax No: Country View Ridge LLC I Richmond, Town of c � - 1 z W, ! L +7 {�• 15?� CST BM Elev: Insp. BM Elev: BM Descri n: Section/rown /Range /Map No: O (fib 07.30.18. TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic i s enchma , /bU` 0 - Dosing t Alt. BM , �r ` • ^ ,� -.. � � � �t f z °- �.i ��! ;�,., a `'% (Z. � g2. Y r ✓ Aeration Bldg. Sewer Holding 90 -It Inle + , .; .' f 12 `� •Z� S i St/Ht Outlet TANK SETBACK INFORMATION I r TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic �� a �, ! t Botto �f � Dosing t r Header /Man. S .._.`` k t Aeration Dist. Pipe' -7 � 0 Y7 2. D Holding ot. System F1) /r7 70 'Cc O '�, t, L ? SOD U Final PUMP /SIPHON INFORMATION CA94t /tPQ�h� Manufacturer Demand St Cover GPM' 2 ' .� Model Number •� ' / i nn S ! 3 c TDH 101 Friction I ss Syste Head TDH Ft t r ; i ti r rti Forcemaln Length c Dia. Di � . to Well E - T- ..c .r. r SOIL ABSORPTION SYSTEM i .1. �A" H.2 7 BED/TRENCH Width Length No. Of Trenches PIT DI ENSIONS No. �pit5 Inside Dia. Liquid Depth DIMENSIONS SETBACK SYSTEM TO P/L ]BLDG WELL LAKE /STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR Type Of S tem: ^ Xs � r i� UNIT Mode'Ff+lumber. DISTRIBUTION SYSTEM Header /Manifold Distribution x Hole Sizef x Hole Spacing Van r Intake Pipes) 4 1 q it - Length - A Dia Length Dia Spacin O SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded /Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil t fp Yes N No ®Yes Q No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection 1: '';l' } r / ter '' Inspection #2: r Location: 1634 97th Street New Richmond, WI 54017 (NW 1/4 SE 1/4 7 T30N RT8W) Country View Ridge�ot 12 Parpe4 o: A7.A18. 1.) Alt BM Description - ��✓✓� dof d 2.) Bldg sewer length = 1 - amount of cover = r cr �• , - ,/ Plan revision Required? Yes 0 No Use other side for additional information. Ot� Date V lnsepctoesitignature Cart. No. SBD -6710 (R.3/97) I� t Safety and BuildipV Division County 1 �} l 2 E A AM - - .0. Box 7162 f /`1 (� Y� jo Vi 7162 Sanitary Permit Number (to be filled in by Co.) (608) 266 -3151' Z3� Department of Commerce Sanitary Permit App State Plan T.D. Number In accord with Comm 83.21, Wis. Adm. Code, personal forma aY ED 1 1 2-4c)2- 4( - '7m S ' maybe used for secondary purposes Privacy La , sl5.04(l)(m) oject Address (if different mailing ) 1 �'` �6 3/ 9 1. Application Information - Please Print All Information JUN Property Owner's Name ST. CROIX COUNTY Parcel It Lot# Block# Prope � Owner's Mailin Address Prop Loran I > %. Ste %, Section City, State Zip Code Phone Number / 1-E o rcl e e) �� `) �/ T� M W II. Type ofBuilding (check all that apply) S yp Subdivision Name CSM Numb r2 Family Dwelling - Number of Bedroom s ' / ❑Public/Commercial- Describe Use State Owned - Describe Use ❑City_❑vill wnship of Z - III. Type of Permit: (Check only one box online A. Complete line B if applicable) 02fo - 12%- 12- avD . / $" F3 A ' w System ❑ Replacement System ❑ Treatmenv'Holding Tank Replacement Only ❑ Other Modification to Existing System B. [I Permit Renewal El Permit Revision ❑ Change of ❑pe Transfer to New List Previous Permit Number and Date Issued Before Expiration Plumber Owner IV. Type of POWTS S stem: Check all that a 1) O - t ❑ Non Pressurized In- Ground [I Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil t -Grade ❑Single Pass Sand Filter ❑ Constructed Wetland [I Pressurized In- Ground El Bolding Tank ❑ Peat Filter El Aerobic Treatment Unit ❑ Recirculating San Filter ❑ Recirculating Synthetic Media Filter ❑ Leaching Chamber ❑ Drip Line ❑ Gravel -less Pipe El Other (explain) V. Dispersal/Treatment Area Information: Design Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal Area Required (sf) Dispersal Area Proposed (sf) yttem Elevation VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fber Plastic Gallons Gallons of Units Concrete Constructed Glass New Fxtsung Tanks Tanks Septic or Bolding Tank i� Aerobic Ihatmeai Unit Dosing Chamber x v V11- Responsibility Statement - L .. e unde ume responsibility for installation of the POWTS shown oa the attached plans Plummer' Name (Print) i Plum gastute MP/MPRS Number Business Phone N ber / cS.J -�✓' � ��J�` fi Plumber's Address (Street, City, State, de) r 1 ' VIII. Countyffievartment Use Onl Approved ❑Disapproved Sanitary Permit Fee (incl es Groundwater Date Issued Issu' g Agent Signs (No Stamps) Surcharge Fee) C�a O for Denial r i IX. Conditions al a a,— W \ tr SYSTEM OWNER: 3) OFFICE 1 Septic tank, effluent filter and / tso A U. dispersal cell must all be serviced / maintained as per management plan provided by plumber. ' I \� 0-4 2. All setback requirements must be maintained 't") as pet applicable code /ordinances. Attach complete plans (to the Couaiy only} for the sys em on papern 1ess� �� SBD- 6398 X 01/03) F PLOT PLAN /NVENTIONAL ountry View Ridae LLC ADDRESS P.O. Box 176 New Richmond Wi 54017 SE 1/4S 7 /T 30 N/R 18 W TOWN Richmond COUNTY ST. CROIX M ELEVATION 95.0 BEDROOM 3 AT -GRADE )00( CONVENTIONAL LIFT HOLDING TANK SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE 630 HOLDING TANK SIZE LOAD RATE .5 ABSORPTION AREA 900 # of chambers none hL BENCHMARK V.R.P. Top of Survey Iron ASSUME ELEVATION 100' Filter Zabel A -100 ❑ BOREHOLE WELL *H.R.P. Same as Benchmark I Scale = 10' = 1/4" Tank is to be properly bedded and provided with lockdown covers with approved warning labels Property Line 97th St. Huffcutt Combo tank Grading is to be done to divert run -off away B-2 Pro 3 -from system Bedroom House B -3 Area 15' below system is to remain Q(� undisturbed 10% Slope Well is to meet all Ep setbacks found in 95' g31 B- Comm. 83 s B. M. Q ProReM Line r 30 . ' Safety and Buildings 4003 N KINNEY COULEE RD commerce.wi.gov LA CROSSE WI 54601 - 1831 TDD #: (608) 264 -8777 sco n s n www.commerce.wi.gov /sb/ www.wisconsin.gov , t i c epartm of Commerce Jim Doyle, Governor Mary P. Burke, Secretary February 16, 2006 CUST ID No. 226900 ATTN. POWTS Inspector SHAUN R BIRD ZONING OFFICE BIRD PLUMBING, INC ST CROIX COUNTY SPIA 1008 192 ND AVE 1101 CARMICHAEL RD NEW RICHMOND WI 54017 HUDSON WI 54016 CONDITIONAL APPROVAL Identification Numbers PLAN APPROVAL EXPIRES: 02/16/2008 Transaction ED No. 1240241 SITE: , ' " Site ED No. 709656 Countryview Ridge, LLC Please refer to both identification numbers, 97th Street above, in all correspondence with the agenc Town of Richmond St Croix County NW1 /4, SE1 /4, S7, T30N, R18 Zoom Subdivision: Countryview Ridge FOR: Description: Proposed Three Be -grade System Object Type: POWTS Component Manual Regulated Object ID No.: 1062643 Maintenance required; 450 GPD Flow rate; 36 in Soil minimum depth to limiting factor from original grade System(s): At -grade Component Manual, SBD- 10570 -P (8.6/99), Pressure Distribution Component Manual, SBD- 10573 -P (R.6/99); 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: • This system is to be constructed and located in accordance with the enclosed approved plans and with the component manual(s) referenced above. • 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 POWTS 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. Stats. • The area within 15 feet horizontally below the system shall remain undisturbed. Vehicular traffic or soil compaction in this area is prohibited. • A state approved effluent filter is required. Maintenance information must be given to the owner of the tank explaining that periodic cleaning of the filter is required. Access to the filter for cleaning must be provided per Comm 84 product approval conditions. • 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 mgy include local inspectors. P.Q T.S. C(indit 1r j+ SHAUN R BIRD Page 2 2/16/2006 Owner Responsibilities: • The current owner, and each subsequent owner, shall receive a copy of this letter including instructions relating to proper use and maintenance of the system. Owners shall receive a copy of the appropriate operation and maintenance manual andlor owner's manual for the POWTS described in this approval. • Comm 83.52(1)(a) - 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. In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approved plans. • 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. 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 on gn e resp sibihty 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 &40G-� Fee Received $ 175.00 Balance Due $ 0.00 Gerard M. Swim POWTS Plan Reviewer - Integrated Services (608)- 789 -7892, Mon. - Fri. 7:30 am to 4:15 pm WiSMART code: 7633 jswirn@commerce.state.wi.us cc: Leroy G Jansky, Wastewater Specialist, (715) 726 -2544 b -� e e I r c :2 b r r DECEIVED FEB 13 2006 Cover Page SA FETY & BUILDIN Shaun Bird Bird Plumbing Inc. 1008 192nd Ave New Richmond Wi 54017 715- 246 -4516 Date: 2 /10/06 Owner:Country View Ridge LLC Location:NW1 /4 SE1 /4 S7 T30 N,R18W Lot 10 Country View Ridge Richmond System type: At -Grade Manuals Used: At -Grade Component Manual version 1.0 SBD 10570 -P (R.6/99) SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST -SAS (01/81) Page# 1. Cover Page 2. At -Grade Plot Plan 3. At -Grade Cross Section 4. Pipe Cross Section /Pipe Layout 5. Pump Chamber Cross Section 6. Pump Curve 7 -8. Maintance and Contigency plan 9 -11. Soil test Shaun Bird Signature _ LIFTARTMENT OF CO"IflERCE p{i'15 OtJ OF FETY AND BUILDINGS License numbe 26900 s CC)iZRES NDENCE I PLOT PLAN PROJECT Country View Ridae LLC ADDRESS P.O. Box 176 New Richmond Wi 54017 NW 1/4 SE 1/4S 7 /T 30 N/R 18 W TOWN Richmond COUNTY ST. CROIX SYSTEM ELEVATION 95.0 BEDROOM 3 CONVENTIONAL AT -GRADE XXX CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE 630 HOLDING TANK SIZE LOAD RATE .5 ABSORPTION AREA 900 # of chambers none IL BENCHMARK V.R.P. Top of Survey Iron ASSUME ELEVATION 100' Filter Zabel A -100 ❑ BOREHOLE O WELL * H . R. P . Same as Benchmark Scale = 10' = 1/4" Tank is to be properly bedded and provided with lockdown covers with approved warning labels Property Line 97th St. Huffcutt Combo tank Grading is to be done to divert run -off away 13 B-2 Pro 3 from system Bedroom House 'C B -3 Area 15' below system is to remain Q(� undisturbed 10% Slope Well is to meet all setbacks found in 95 93' B- 1 Comm. 83 B.M. Property Prop Line B ?5 ` PVG FOAE.E,MAttJ ...� > i �TU P #�. - Ul S" L n►r R-rt a t S �A$t�: QED a.`�ATt�rs WELL ir EA 5 i [ _ 1/6B ' 112- B L = f - E CELL of t z - Z/z ACsGtLF-GArTF- r - - Ft . S YMTt�EnC Fabric 1 Distribution Lateral i .STP,1 1 1r-b observation �� ti �. /W--- Soil C over Well 2 � J � 2. �bV1r�0 [ —2 S LbP� Pion View and Crass S of [iisc_o nsir: At -grade �3rxit with a Single Absorption Area an a Sloping Site j c Page Of Distribution Pipe Detail For Lateral lietwork T uRN - uP (CLERT PVC Pane Mai n €�1lC Distr- ib�rtion Pipe P Last Hole Should Be Next To TuRr�- �P p _ f Hole Diameter " .� Inch � 2— Inch {es} x inches Lateral Diameter i _ Force Main Diameter Inches Y inches �f Of Holes /Pipe f �� Invert Elevation Of Laterals ��__% Signed: License Number: Date: r^ ROSS SECi:-C'•'� SPEC`i ICATIt�hS SEPTIC TANK � Pump cilAtle..n C wEAtM£RPRWF APPROVED GRADE; NCT1014 BON Z � J t3 t r COi► ER VENT PZPE 3 k'I NDQ41 DR WITH CDNDU I T HANMDL_ s - �a` FROM Doop Wl FADLOCK � z RT i TR. INTAKE � rY. r ^ cf , WARNING LA TI rD GRADE ` y q Ia^ Ire - INL£'T GAS ` _. D TIGHT . E i�iAT£R TIGHT SEAL-5 � SEA£, z �� JOI 1 iIT H _ : ALM PIPE $ s ON 3 0lZTO SMID SOIL APPROVED C r = pi?£ 3= O FF Ogm SOLID FT - ` _ SOIL PUMP OFF EL,� - % _-- D ` t3XDDFR 'SANK ?Al) 3 == APpgL,YED BE73DIV'G C41wiCRETE �OS£S c£g DAY= �--- y �.� } DOSE �7 ' SC.0 ► ' GAL - T�IxK MAY GAL U ° _ T3O F LOWBACK = S£ jjj 'fE I Cy��i3I1 '1-- GAi SEPTIC / . Ul_ ___ INCHES = �c' -- TANK SIZES: 130SE GAL A r � jc r?p CAPACITZ _ CAL_ AI.A� �,�IUF�4C1�3RER = L- r INCHES - s.� ---� - MLDEL NUMBER .l' ✓GC �� ��. _� APE : C SyiITCH _�� � A G AL - Pump Mf NU- fl�CTt3R�= �� ;�^ C, --t-- -6.23 WAC MOI}EL Nili'iBFR : ,, L-` i2�i' AS I LHR Typr� SWITCH �� ,;? 49 �� � W'Rl M7 F££T �La. 7 REi}IR DISCHARGE gprTE �i / ----- P OFF #�� £=STKT �`�"s� —£EE�i p _ - `1` c LET JM VERTICAL. BIFFE tEIdCSt3P EPR£SS'J�E - RtZCTI()N FACTOR FEET + MINIMUM N£TWDAK IN x FTI F O TAI, DYN1 'sI M , �'_ ----- L / FEET FORM DIAMETER HG � 'fitT£KNAL DIgENSIONS of FUKP xAr1�c: IQ-61D i LICENSE Wna = '; -R I i.. ` SIGNE�3= _ i TOTAL DYINAM!C PLR M;N'jTE HEAD CA. N CuR EFFI IjENT AND DEWATERING 50 IVIODE 15 5) 3 7 53 MODEL i52 Liters I Gel. Liters 5 261 - 1 - 7 2 � 6C 6 1 I 231 i 7 1 75 40 752 j 4.6 i 53 201 61 j 231 o.t 4 4 167 52 30- 1 34 i 7[? 1 42 i 150 87 3 3 125 0 35 7 2 9 85 20 LO 12.2 4 voive: Fz. r 20 40 60 EO 700 GALLONS I LiTERS 40 2 0 0 80 i 60 3 27/32 1 5JB---I FLOW PER VlNUTE 3 27/32 CONSULT FACTORY FOR SPECIAL APPLICATIONS 717 Timed dosing panels available. I 7j _ Electrical alternators, for duplex systems, are available and supplied with an alarm. Variable level control switches are available for controlling single phase systems. Double piggyback variable level float switches are available for variable level long and short cycle controls. Sealed Qwik-Box available for outdoor installations. See R/1 • Over 130*F. (54T.) special quotation required. '!52!153 Series 151" 53 MODELS Control Selection Model Volts-Ph Mode Al N152 715 1 7-4 . Nor, 8-5 1 1 2or3 '75 1 E 1 1 230 1 1 Non 4.3 1 2 or 3 1 BE1521 230 1 1 Auto 4-3 1 In 2 o 3 1 N153 115 1 i Non I 10.5 i 1 2 or 3 S."I 531 115 1 ZZ 1- 0.5 Included 2 or 3 SELECTION GUIDE rE153 230 i Non 53 A - 2oc 3 1- S[rtqle piggyDack variable level float switch or double piggyback variable level float I t BE1531 .230 1 l AL10 5.3 include 2or3 sav ch. Refer to FfV10477. v CAUTION 2. See F1 for correct model of Electrical Alternator E-Pak. Ali installation of controls, protection devices and wiring should be done by a qualified 3- Variable level control switch 1 0 - 02.25 used as a control acty3mr, specify duplex (3) licensed electrician. All electrical and safety codes should be followed including the most recent National EfecWcCcide (NEC)and theOccupational Safetyand Health A- fOSKA). or t4) float system. RESERVE POWERED DESIGN IV the design of every Zoeller pump. For unusual conditions a reserve safe factor is engineered int o G r aft TO: P.0, BOX 53, lS'VjPe XY 40256-0347 SHY TO: 3649 Gana Run Rc3d Louisville, KY 40211-1961 (502) 77a-2731 - I t800,'926-):)Ut1,P ��y 511yrIc av http://*ww.zoej)er.com FAX (502) 774 -3624 Dc Copyright 2000 Zoeller Co. All rights reserved. NT PLAN page of POt1VTS t�4°�l1+tEE�'S MANiJAL & MANAGE SYSTEM SPE ' Septic Tank GaPadfy l� al ❑ NA Fit lNFOFtNtATtCtY ,�� l 0 CIA owner Septic Tank Manufac tureC C 3 Permit #_ Effluent Etter Manufacturer ❑ r4tn s ° NA DESIGN PARAI�> D NA Effluent Fftet Model , e jq mtbw of Bed "T' Pump.Tank Capa�r C7 al D NA Uns p Tank M 1i C3 NA Number of Comma it � � al/d flow (ave�9e) Manufacturer a s , ❑ NA Es$matEd lld Pump (Estimated x 3.5) / -°� c � . • : '�' �"� � C.-- ❑ NA Design flow (Peak ), al/da /ft� Pump Model Ra te P� a unent Unit sO MonL'�ty average' el Fitter 0 Peat Hider ❑ t QuaCrty ���'� ❑ Wetland irrfluer►tJEftl� 53{7 mgt ❑ Mechanical Aeration ❑ Qfher. Fats, Oct & Grease (FOG) 5220 m ❑ Disinfecfian Biochert1k i Oxygen -d Sold {TSS) (HODS) Manufacturer To tal Suspended Soli 5150 rn n- rsat Cett(s) . Monthly average"" Dispe round (gtavtty) ❑ In -ground (pressurized) pretreated Etttuent Qua Si0 mg1L 1:3 to g O Mound rode giachemical Oxygen Demand (SODS) 530 mgrs 'g ❑Other S Solids (TSS) ❑ Off ine Total 00form S1()` Cf /1 t]Oml on.00aunordao was w and Fecal CoGfarm (geometric mean} Varues tYPlca► for do n Y inch diameter seP- t=k elftuent Ma>dmum Effluent P artide Size values typtca[ for p � te4 WastaN2tet. M AINTENANCE SCHEDULE Service Frequency Service Event C7 rn onths ear(s) (Maximu 3 yr j At least once every ird y 3) of tank volume inspect con dition of tank(s) ua s on e - t h i rd ( When combined sludge and scum eQ aXimum 3 yrs -) Pump out contents of tank(s) p months years) rVl At least once every Inspect t ispersal cells) C3 months year(s) At least once every r (s) p HA Glean effluent filter p months controls & alarm 13 least once every � s} ❑ NA Inspect pump, pump 13 rnorlms press test At least once every a s [I NA Flush laterals and press At lea once every C] m onths ❑ ye r( ) o�r,er ❑ months 0 year(s) Cl NA At Least Once every otter_ rr one of the fallowing Licenses or rcegtNTE1dANCE INSTRUCTIONS _ inspe POWTS T+![aatfainer. Septage can d dispersal tnspectiCns of tanks and ce lrS shalt be made by an individu�al�s nspe an missing or broken c er �tfions: Master Plumber Maste must plu mber Restricted visual inspection of sludge tank(s) to U an y Y check for any bad( uP Servicing Operator. Tank inspe� ure the volume of combined sludge and scum and check the effluent levels hardware, �,� any tracks or leaks, rrteas The dispersal celi shall be visua inspe or portding of effluent on the ground surface- nding of effluent an the ground surface. T� i��tt'g of effluent authority- t and to check for any Fv in the observation pipes oondidun and requires the Immediate notification of the tarsi regulatory ground surface may indicate a failing equals one -third W or mote of Me tank volume NR k shall tie removed by a Septage Servicing Operator and disposed of in accordance with When the combined accumulation of sludge and arm in any tan eQ entire contents of the tan f meat components. and any yyl 113, risin Administrative Code. - retreat anical or pressurized P01r 'TS campone ed ,, in POWTS Maintainer- The servicing of effluent flters, g at i e,rent. ofhermaintenanae or MOnItorin at i n t erva ls of 12 mafl onty within Q days of COrn*Von of any service A SErvipe report s hall - be provided to the local reg ula t ory uth Prod or other DS check treatment tank {s} for the Presen of painting Pro START UP AN D OPERATION h ai ncentra are For new oot>struction. prior to use of the P O chemicals trtat may impede the treatment prOcess andlor damage the dispersal rator or p p ri or to use_ g f hi detecW have the contents of the tank(s) removed by a septage servicing Operi P a9e , Dt.,. -- il ondi`uons are frozen at the infii`trative Sur ce_ System start up snail not occur when s� �s restored tie excess pow outages Pump tank overir s may fill above normal h levels. When power During pow c>?il(s} in one large dose ra ding the cel;(s) and may result in the ,��tes hM�l be discttar+ged to the dispersal p or surface dcscharge of effluent avoid this sifz.rafir have the contents of the pump tank removed by a $ rtage Servicing operator prior '��ng power to the effluent pump o contact a p tank - r or POYi/TS Maintainer to rator assist in manually pperafing Me pump controls to restate normal fevers within die pump tank drive or vehicles Oyer #snits and dispersal cells_ Do not drive or park over, or otherwise disturb or compact, D o no U, e area within 15 feet dawn slope of any mound or at -grade soil absorption area_ th from the wastewater- S may improve ve the perfo and prolong the Gfe Reduction or eiiminativlz of the following . of the POWTS: antibiotics; �bab5`�!srlPeS cigarette butts condoms; cotton swabs; degreasers; dentsl floss: diapers disinfectants: fat: foundation draft (sulMP pump) water, fruit and vegetable pee d water often grea fine icides; meat scraps rnedx lions: oII; gainiing products; pestz 'des: san,tary napkins; tampons; and water s often er brine_ ABANE)Or*M taken otlt of service he folrativirTg steps shall 4.e taken to Insure that the When ffie POVM fails and/or is permane rrfl y system is property and safely abandoned in compliance with ch. Comm 83 -33, Ii-Ycsconsin Adn - drIM alive Code: r pit piping to tanks and pits shall be disconnected and tine abandoned pipe openings sealed- The contents of alt tanks and pits shall be removed and property disposed of by a Septdge Servicin g Operator After pumping, all tanks and pits shalt be excavated and removed or their covers removed and the .void space filled Yj�j soli, gravel or another inert solid material. CONTINGENCY PLAN if the POWTS fails and Cannot be repaired the f °st°```nng measures have been, or must be taken, to provide a erode compEant replacement system O A suitable replacement has been evaluated and may be u iEized for the rotation of a replacement soil replacement area should be protected` from disturbance and compaction and should not absorption system The be infringed upon try required setbacks from existir.�g and proposed structure, lot I and wells- Failure to protect the replacement area NVill result in the need for a new sail and site evaluation to establish a suitable replacement area- Replacement systems must comp €y with the n!Ies in effect at that time. 0 A suitable replacement area is not available due to setback and/or soil limitations- Barring advances in POWTS technology a holding tank. may be installed as a last resort to replace the failed POWTS_ elite has not been evaluated to identify a suitable repcaaernent area. Upon failure of the POWTS a soil and X �hofd&Fn q uation must be performed to locate a suitable replacement area_ f€ no repla area is available a ank may be installed as a last resort to replace the failed POWf$- nd at -grade Sor7 absorption systems may be reconstr eed in place following removal of the biomat at the rnfiItratirre surface. Reconsh udions Of suers systems must comply wit ifie riles in effect at that time_ <<WARNIN{>> SEPTIC, PUMP AND OTHER TRF�►TMENT TANKS MAY CONTAIN LETHAL. GASSES AN1310R INSUFFICIENT OXYGEN- RESULT_ , RESCUE OF A P O OTHER TREATMENT THE AtTERIOR O T A TANK UNDER AN y MAY B DIFFICULT IFFICUL OR IMPOSS 13LE. MAY ,& Dr oNAL COMMENTS POWTS INSTALLER POWF IVWNTAINER name (� , Lr j Name . c �'za� � ' ` _L` -� , ®� Z//-, Phone i ° ° �7 Phone l/ i �J SEPTAGE SERVICING OPERATOR PUMPER LOCAL REGULATORY AUTHORITY ( Name A9efiCy Phone C ?hone This aou,mem -as dratted by Vw st ift of the Green Lake, Marquette and Waushara County Zaning and Sanitation agendes_ This document meets tt:c miaimum requirements of ctL Comm 83- 22i2?{b}{t1(d}d {t} arw' 83.56{S}, {2} $ {3}, Wisconsin AdrnWst�+e Cc!rde. Use of ft document floes a t guarantee the pedorma:soe of the POVVTS- Gww (MI) Wisconsin Department of Commerce SOIL EVALUATION REPORT Page of Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code Count Attach complete site plan on paper not less than 8 1/2 x 11 inc es in tY Cr ot X include, but not limited to: vertical and horizontal reference poi t (BM), �gr�C� -y I.D. p slope, scale or dimensions, north arrow, and location nd distance to ne r t Please p rint all information P eview by Date CIA `r" r� Personal information you provide may be used for secondary purpos (Privacy La . 5.bj4 (�)QO �Q Property Owner (t p er,Lo (' / 1/4 54'1/4 S T N R/j E (o W Property Mailing Add Lot # Subd. Name or CSM# 7% L30 _V, / -) 6 �� "-� � is — city State Zip Code hone Number ❑C. ❑ dlage 70 Nearest RpadJo °u,J�rC�l) ls.J3 J / - 21( ) S New Construction Use: esidential /Number of bedrooms J Code derived design flow rate –XD GPD ❑ Replacement ❑ Public or mmeraal - D scribe: Parent material � � Flood Plain elevation if applicable lle I )I ft• General comments r and recommendations: � y So A✓ P�VC�% q 17 BodM # Boring q3-0 a / 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/fl= in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 o - I 3!L S/ /15 C 2 Z -1 s ---- -- c s- alAl ! ® Boring # ❑ Boring r� J � o j t Pit Ground surface elev. q5' o 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 o, D e - 3/ /.d Z IL -I 5 111 3 - T t vil y Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 1 ` Effluent #2 = BOD 1 30 mg/L and TSS < 30 mg/L CST Name (Please Print) lure CST Number Bird Plumbing, Inc. Shaun Bird 226900 Address Date Evaluation Conducted Telephone Number 1008 192nd Ave, New Richmond, WI 4017 J am- O?� — �'' 715 - 246 -4516 s IZ Property Owner _ Parcel ID # / Page of Boring 9 Boring # t P � Q ✓ ��n 3 i Ground surface elev. ft. Depth to limiting factor _ Sr.� in. � Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundar in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. i p 3 S / c� -z ��i --J C- s r m ,-►mot LA." `r 51 - m ' a ;L . (o F Sofing # O Boring ❑ pit Ground surface elev. ft. Depth to limiting factor on. 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 `EffiY2 ❑ Bori � # Ground surface elev. ft. Depth to limiting factor in. F ❑ Pit - Soil Application Rate Horizon Depth Dominant Col Redox Description- Texture Structure Consistence Boundary Roots GPD/PF in. Munsell Q u. Sz. Cont. Color Gr. Sz. Sh. `Eft#1 'Effff2 L I I Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 1150 mgA- ` Effluent #2 = BOD 130 mglL 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. SOD4330 (8.6(00) Soil Test Plot Pla Project Name Country View Ridge LLC Sh it Address P.O. Box 176 New Richmond Wi 54017 C M #226900 Lot 10 Subdivision Country View Ridge Date 5/20/05 NW 1/4 SE 1/4S 7 T 30 N /R W Township Richmond Boring Q Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 100% Top of Survey Iron/Nail System Elevation 95.0 *HRPSameasBenchmark 95' B -2 Scale is 1" = 40' unless otherwise 10% Slope noted B -3 285' Property Line 100' 50' B 25' -1 70' B.M. 70' 302' property line ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer u L _ Mailing Address o i l Property Ad (Verification required from Planning & Zoning Department for new construction.) City /State Parcel Identification Numb e _ l 12-%— I Z— COO PTI (• � / LEGAL DESCRION T O N Town o >� �,W, f/ u Property Location /U� /a �r '/a , Sec. , f Lot 4t / Subdivision Z�ce- Certified Survey Map # , Volume , Page* # /; Warranty Deed "l - 7 Z , Volume 2 .56 Page* Spec house (yes no Lot lines identifiable yes 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 systr� Owner maintenance responsibilities are specified in §Comm. 83.52(1) and in Chapter 12 - St. Croix County Sanitary The property owner agrees to submit to St. Croix County Planning & Zoning Department a certification ) f the or O by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying necessary) ( the Septic tank's wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping C ary)- p 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. Uwe certify that all statements on this form are true to the best of my /our knowledge. Uwe am/are the owner(s) of the prop described above, by virtue of a warranty deed recorded in Register of Deeds Office. 110106 SIGNATURE APPLICANTS) DATE * ** Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Deparuneni. * ** 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. 08105) U 2656P 061 774312 \� STATE BAR OF WISCONSIN FORM 1 - 1999 KATHLEEN H. WALSH Document Number WARRANTY DEED REGISTER OF DEEDS ST. CROIK CO., NI This Deed, made between Gerald A. Kieckhoefer, Jr. and David RECEIVED FOR RECORD J. Kieckhoefer Grantor, and Country View 09/14/2004 10:20AK Ridge, LLC Grantee. WARRANTY DEED Grantor, for a valuable consideration, conveys and warrants to Grantee EXW # the following described real estate in St. Croix County, State of Wisconsin (the "Property ") (if more space is needed, please attach addendum): REC FEE: 13.80 See attached Exhibit A TRANS FEE: 1410.60 COPY FEE: CC FEE: PAWS: 2 Recording Area Name and Return Address � �Q G 26- 1025 - 40-000 Together with all appurtenant rights, title and interests. 026 - 102430 -1100: 026 - 1024 -40- 000: 026 -1025 -30-0 Parcel Identification Number (PIN) This is not homestead property (is) Grantor warrants that the title to the Property is good, indefeasible in fee simple and free and clear of encumbrances except easements, restrictions and reservations, if any, of record. Dated this 2r"Ot— day of 2004 .. 4..6 Q, * Gerald A. Kie ckhoefer, Jr. * David J. Kirkhoe * * AUTHENTICATION ACKNOWLEDGMENT Signature(s) Gerald Kieckhoefer, Jr. and David J. STATE OF ) Kieckhoefer ) ss. County ) authenticated this da of 90 1Yw - 2004 Personally came before me this _ _ day of the above named * Kristin Ogland TITLE: MEMBER STATE BAR OF WISCONSIN (If not, to me known to be the person(s) who executed the foregoing • authorized by § 706.06, Wis. Stats.) instrument and acknowledged the same. THIS INSTRUMENT WAS DRAFTED BY Kristina Ogland, Estreen & Ogland 304 Locust Street, Hudson, WI 54016 Notary Public, State of My Commission is permanent. (If not, state expiration date: (Signatures may be authenticated or acknowledged. Both are not necessary.) ) • Names of persons signing in any capacity must be typed or printed below their signature. lnfonnation Professionals Co., Fond du lac, WI STATE BAR OF WISCONSIN 800.655 -2021 WARRANTY DEED FORM No. I - 1999 U 2656 P 062 Exhibit A Located in part of the SE Y, of the NE Y,, the NE % ' / / of the SE Y, and the SW Y- of the NE % of Sectio0 f the SE, the NW 7, Township 30 North a 18 of St. Croix, State of Wisconsin described as follbvvs:l g W est. Td" of Richmond, County Commencing at the East quarter corner of said Sect! n 7, this also being the Point of Beginning; Thence S00 ° 37'10 "E along the East fine of the SE'/ of said Se Thence ctio 7 S89 18 55`W on the northerly line of a Certi ad Survey Map recdistan n Vo Volume 3f Page 3752 a dista of 610.00 feet; Thence S00 "37'10 "E on the westerly line of said Certifted Survey Map 428.42 feet (Record 428.50 feet); Thence S89 °�18'52"W alo SE '/ of said Section 7 a distance of 1146,36 feet Thence N00° 3'53"W 1 e N of the N88 °57'22 "E 1048.00 feet; Thence N51 0 00'00 "E 25 .00 feet; Thence N88 0 22'35 "E 507. 0 feet to a point on the East line of the NE X of said Section* ; the NE % of said Section 7 a dl 'Thence the Point' o along $aid Eastline of stance of 248. 0 f terminating. eet to the Point of Beginning and there I � i all 82,781 sq.ft. 0 -\ S404946'&,, 4 I 1.900 acres 65.55' n N LBO = 984.00 ` 6 ! ryt�. ; S86'1$41 r S8'3.0"0 49.5E E ~ f E X30.0$ I ` 1 , LO 57, qp o N 8 .345 sq.ft. 100 1. 45 ocr 1 ,' �` s ,F �8 6' 1 29 7. CD S57'04'22 N89'52'41 "E 301.71' 1 N N 1 75.65 l � 80' radius temporary 130,69: cul —de —sac easement r: a 3.000 to be extinguished upon S`- , j N m� L60 road extension tQ �.j Qf tp Q v N 76,222 sq.ft. N Z 4 m 1.750 acres °' , , �F Parcel #: 026- 1296 -12 -000 06/20/2006 12:40 PM PAGE 1 OF 1 Alt. Parcel M 07.30.18.1543 026 - TOWN OF RICHMOND Current 1XI ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 11/29/2005 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co -Owner O - COUNTRY VIEW RIDGE LLC COUNTRY VIEW RIDGE LLC PO BOX 179 NEW RICHMOND WI 54017 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description * 1634 97TH ST SC 3962 NEW RICHMOND SP 8020 UPPER WILLOW REHAB DIST SP 1700 WITC Legal Description Acres: 1.845 Plat: 10/090- COUNTRY VIEW RIDGE LOTS 1 -27 026/05 SEC 7 T30N R18W PT NW SE COUNTRY VIEW Block/Condo Bldg: LOT 012 RIDGE LOT 12 (1.845AC) Tract(s): (Sec- Twn -Rng 40 1/4 160 1/4) 07- 30N -18W NW SE Notes: Parcel History: Date Doc # Vol /Page Type 11/29/2005 813158 10/090 PLAT 2006 SUMMARY Bill M Fair Market Value: Assessed with: 0 Valuations: Last Changed: 02/15/2006 Description Class Acres Land Improve Total State Reason Totals for 2006: General Property 0.000 0 0 0 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch M Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 i