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040-1322-07-000
VNsconsin Department of Commerce PRIVATE SEWAGE SYSTEM Safety and Building Division INSPECTION REPORT le 3 GENERAL INFORMATION (ATTACH TO PERMIT) Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)] Permit Holder's Name: City Village Township John & Michelle Stenz TOWN OF TF INFORMATION TYPE MANUFACTURER • s i CAPACITY Septic Z, Dosing Co ` SM Fi bl� 5L Holding TANK SETBACK INFORMATION TANK TO Pit- WELL BLDG, Vent Air Intake ROAD Septic 90 �7 3' 3D Dosing (61 // b 36 (J ^� JU Aeration Holding PUMP/SIPHON INFORMATION Manufacturer Deand Z mGPM Model Number "1- f 3 TDH Li FrictSon,Lo s System Heg,5 TD _{ .J Forcemain Length V�1 Dia, %N DLi-sit. tobW"ellll 2 p SOIL ABSORPTION SYSTEM TION DATA 1'...,y St. Croix Tax No 040-1322-07-000 I/TownMangelMap No: 19.28.19.2171 SIF0104 lialITLI!Z STATION BS HI Y4e•9 FS ELEV. Benchmark 6 ' �-r/ O_10 • 3 Alt. BM rof of zB 9�f.1 Bldg. Bewer 7.(0 91 SUHt Inlet S.'i5 �N5 SUHt Outlet DI Inlet Dt Bottom Header/Man. 3.)5 ►�1 Dist. Pipe 3.15 tvo.8 Bot. System Final Grade 5 .to St Cover F g , `r �5• �0yl4v,T-- 5.3 f8.7 VU l HS IS BED/TRENCH DIMENSIONS Width :i ? Lengpl 6 s q PIT DIMENSIONS o Of Pils Inside Dia. Liquid epth SETBACK SYSTEM TO L BLDG WELL LAKE! E LE HI�GMaINFORMATION H BEType UNImbec O/System\ ��� ��� UW I RIOUI IVIY OTj71 CM A" I Header/Manifold • • Distribution Pipe(s) x Hole Size 51-3 x Hole Spacing Vent to Air Intake Q L Length Dia' Length Dia Spacing ` - f V .i JVIL UV V CR x Pressure, Svstnms Only xx slrwmd nr At-nr=de Cvc.nme rinl•. ✓ — f%I. -..•1 %_ _ Depth Over I Depth Over xx Depth of xz Seeded/Sodded Mulched Bedrrrench Center Edges Z l� Topsoil >1 l� Yes _ No Yes No ixBed/Trench r COMMENTS: (Include code discrepancies, persons present, etc.) Inspection #1: /��/'tj() %�f Inspection #2: 5/ ZO` 7 • �0qV Location: 394 PEACEABLE HILL RD Lt�cu,s +6"L� ( � o ow 1.) Alt BM Description = FI )�r 63- tr 2 ) Bldg sewer length = 3 7z - amount of cover = /�/ // 04N U-7 Plan revision Requiredti ❑Yes No —Use other side for additional information.I J ✓ 1✓ "JI SBD-6710 IF 3197) _a Date I, 1 • ' Insepctor' igna re Cart. No. v — n "�n � f,P . i ' •`� I tsatety and bu(Idtnps Dtvislon 4 N -aV t q - 36y Sanitary Permit Number (to be filled it by Olt.) !g 201 W. Washington Ave., P.O. Box 7182 OCT 22 2ot4 T Madison, WI 53707-7162 0.a. s mti;�; Fc (a1 77Vv ull Com sAe e t Appl,. Stare Transaction Numbern accordance with 83.21(2). W is. Adm. Code, submissioV this form to the a� term) Lit /6 �f 6 Z37 —G r required prior to obtaining a sanitary permit Note: Application forms fCramt mail POWTS sabraMed to he Department of Safety and Professional Servies. Personal informetim you prwty 'or aeoond Project Address (if difkteot thm mailing address) wpons inaccordance with the Privacy Law, s.i5. i ro Stets. ��� ►fEl� �11�, . Application Information - Please Print All Information 'ropety Owner's Name iJU 4 m tc qLti,.0 STCton Parcel M o`t0-;-p7-4Doo 'roperty Owner's Muting Address 3 R Y -Pt- it ak jj( t-0 Ply Loosdoe " Go rt>� `1W'';W w SectioniG C�Jtyi state Zip Code Phone Number DU%/ eV O TT ;?pN: R rl one) IL Type of Building (check all that apply) Lot k 2 Family Dwelling- Number of Bedrooms -7 SubdM1ioioa Name ok cub IQ TR() 0U& -OOK Blorx ❑ Public)Commercial- Describe Use NCJS ` 1�— ❑ City Of ❑State Owned -Describe Use A ❑VOhtge of CSM Number 24 X 4Wrownof `i"2oy tall.T Cheek only one boa on line A. Complete line S if applicable) a A' ew System ❑ ReplatxtoeM Sysoen ❑ 7reannent/Holditmg Tank Replacement Only ❑ Other Modification to Existing System (explahm) B. ❑ Permit Renewal ❑ Permit Revision ❑ Chow of Plumber ❑Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration pwwr ❑ Non -Pressurized in -Ground ❑ Pressurized In -Ground`-❑ At -Grade • ❑ Mound > 24 in. of suitable i1 ) 'Mound < 24 In, of,uighk soil ❑ Holding Tank ❑,6Iher Dispersal Component (explain) ❑ Pretreatment Device (esplam) -- _ (OOP! .. r ....,, V L Tank Info Capscity, in Toms 4 of Gallons Galiorm Units Xo�j S'�5 tt u New Tacks ExiadnB Tm4:s U 'rA h VIL nsibf ' Statement- 1, the mule ned, a ore respomsibility f InstaUanon orthe POWTS shown on the anaehed as. Plumber's Name (Print 's ' / MP mber Business Pbone Number T�FI= - zZ3Z'iz 71679gr 21--SO Plumber's Address (Street, City, State, Zip Code) GGS _p z W/ ❑ Given Reoam, Delius! : Gsa • ad `I % I9 DL COVI*YE9 ttVReasoas for Disapproval � /� 2✓ 4 1. Septic tank, effluent filter and dispersal cell must be servit�d w...+ei—• I. as per management plan provided by plumber. 2.All setback requirements must be maintained for the syst. ad submit to the Ccaaty oily a paper not tea than B rn r l l isehes to sin SBD-6399 (P- 11/11) tl -Tfzit'�l C�t�,1zlLC� !� i�U� 1G i�iv�E 1�-t L1C Lori -7 TROY ©VCI), rnK ,y5 Alp id with 65' x 9.24' 2" Sch 40 PVC \// " '\ 1200/800 Wie er I( Septic/Pump ank with Lif/melter 3 4" Approved Pipe ® ANC i�MaK tc �a r' p� f P� � ,L _ 100 A Ai_- Ot K WAANeAf. Ti7¢ dF 4�i i'i/l! �ii'� �i. -ifJG Q SO& E�L)KttSL 5 Well to be 25'+ ftic tank SC�� 1 `1V pand 50'+ from tound C C� V October 29, 2019 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 2021-10-29 Plan Review: PWTS-101902374-C JEFF FOX PO Box 565 Dresser WI 54009 SITE: Troy Overlook Development LLC 394 Peaceable Hill Road St. Croix County Town of Troy NW Y..-SE'/.-S19—T28N—R19W FOR: OMSION OF ONMTRY SERVICES 10541 N RANCH RD NAYWARDWI 546438M cawara ThMugh R•4y MmJ/Arp4.wi.9�091 r4ftWu*y4wbe• www.WWCW& qov Tony Ewa - Dowrn•r Down CrNn - S•ormMy C OArDMONALLY APPROVED DEPT OF SAFETY AND PROFESSIONAL SERVICES DIVISION OF INDUSTRY SERVICES l PtA�Ck� SEE CO ESPONDENCE Description: Mound Component Manual —Ver. 2.0, SBD- 4 Bedroom Mound — 600 GPD — New 10691-P (N.01/01, R 10/12) Construction - 19" to limiting factor— Pressure Distribution Component Manual — Ver. Effluent Filter - Maintenance required 2.0, SBD-10706-P (N.01/01, R. 10/12) 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 any component manual(s) referenced above. 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: Reminders • The mound site shall be properly prepared prior to plowing. Any grasses longer than 6" shall be cut short and removed. To avoid matting, any leaves or loose organic matter shall be raked up and removed. Cut trees and shrubs flush to the ground and leave stumps. Avoid operating equipment on the mound site. If necessary, use only tracked equipment, during dry conditions, with minimal passes, to avoid compaction. A sanitary permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.19, Wis. Stats. 0 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. Stats. • 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 isrequired. • 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 The current owner, and each subsequent owner, shall receive a copy of this letter. Owners shall also receive a copy of the appropriate operation and maintenance manual(s) and be responsible for ensuring that POWTS is operated and maintained in accordance with this chapter and the approved management plan under s. SPS 383.54(1). 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 Industry Services 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 and the POWTS management plan to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Ce6�, g CeCe (Elizabeth) Rudnicki Wastewater Specialist/POWTS Plan Reviewer, Division of Industry Services (608)400-3186 elizabeth.rudnicki@wisconsin.gov MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Project Name: Troy Overlook Devi. LLC Owner's Name: Owner's Address: 394 Peaceable Hill Road Hudson Wi 54016 Legal Description: NW1/4 SE1/4 S19 T28N/R19W Township: Troy County: St. Croix Subdivision Name: Troy Overlook Lot Number: 7 Block Number: Parcel I.D. Number: 040-1322-07-000 Plan Transaction No CDIVDI77ONALLY APPROVED DEFT OF SAFETY AND PROFESSIONAL SERVICES DIVISION OF INDUSTRY SERVICES SEE CORRESPONDENCE 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 Page 7 Pump curve and specifications Designer: Jeff Fox License Number: MPRS 223242 Date: 10/15/19 Phone Number: 715-491-3458 Signature: Designed Pursuant to the Mound Component Manual for POWTS Version 2.0 SBD-10691-P (N. 01/01, R. 11/12), and both SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST-SAS (01181) and Pressure Distribution Component Manual Ver. 2.0 SBD-10706-P (N. 01/01, R. 10112) Version 7.0 (R. 11112) Pagel of 7 Mound and Pressure Distribution Component Design Design Worksheet (R or C) r Residential or Commercial Design Estimated Wastewater Flow (gpd) Peaking Factor (e.g. 1.5 = 150%) Design Flow (gpd) Site Slope (%) Contour Line Elevation (it) Depth to Limiting Factor (in) In -situ Soil Application Rate (gpd/ft2) 400.00 1.50 600.00 4.00 99.30 19.00 0.40 Distribution Cell Information 65.001 Dispersal Cell Length Along Contour (ft) _ 1.00 Dispersal Cell Design Loading Rate (gpd/ft2) 1 Influent Wastewater Quality (1 or 2) Pressure Disribution Information (C or E) a Center or End Manifold 3.08 Lateral Spacing (ft) 3 Number of Laterals 0.156 Orifice Diameter (in) 2.75 Estimated Orifice Spacing (ft) _ 2.00 Forcemain Diameter (in) 130.00 Forcemain Length (ft) 90.00 Pump Tank Elevation (ft) 4.55 System Head (ft) x 1.3 10.31 Vertical Lift (ft) 4.05 Friction Loss (it) 0.00 In -line Filter Loss (ft) 18.91 Total Dynamic Head (ft) Lateral Diameter Selection in. dia, options choice 0.75 1.00 1.25 1.50 x x 2.00 x 3.00 x Note: Send AN (0) calculations assume a Table 383-44-3 "u soil treatment for fecal co Worm of m 36 Inches. 9.24 Cell Width (ft) Are the laterals the highest point In the distribution network? Enter Y or N If N above, enter the elevation ft of the highest point. 8.34 ft2/orifice Does the forcemain drain back? 0 Enter Y or N 21.21 Forcemain Drainback (gal) 5x Void Volume (gal) Minimum Dose Volume (gal) System Demand (gpm) 87.37 108.57 38.77 Manifold Diameter Selection in. dia. options choice 1.25 1.50 x x 2.00 x 3.00 GallonsMch Calculator (optional) Treatment Tank Information Total Tank Capacity (gal) 1200.00 Septic Tank Capacity (gal) Total Working Liquid Depth (in) Wieser I Manufacturer gain (enter result in cell B49) Dose Tank Information Effluent Filter Information 800.001 Dose Tank Capacity (gal) lifetime JFlIter Manufacturer 22.201 Dose Tank Volume (gal/in) 8 Fitter Model Number Weiser Manufacturer Project: Troy Overlook Devi, LLC Page 2 of 7 Mound Plan and Cross Section Views 1l106 .. J ,:; tlon Pipe ..... Ls.l:•.•:• _ I A •iG:n�`.:..;...:.n.:::±+:'•:.:Si?:Y:FCr; •v'., ....- _:':'`:`:n :;it .:ii^.ai:'•t B �.............................................. .... ;. . I '.'IYJ.'....... '''''•'••.•.•,,••,',••'.'.'.'..'•.'.'.'.'.'.'.'.'.'.'••'••..'•.'.'.'.' : . ........................... a L Mound Component Dimensions Down,Al a toe extension made. A 9.24 ft E 21.44 in H 1.00 It K I 10.18 ft BI 65.00 ft F 9.50 in I 13.84 ft L 85.36 it DI 17.00 in G 0.50 ft J 7.25 ft W 30.33 ft 600.60 (ft') Dispersal Cell Area 1500.00 (fe) Basal Area Available 9.23 (gpd/ft) Linear Loading Rate 1 6.50 (ft) 1/10 B Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area Finished Grade 102.51 (ft) F 100.72 (ft)—* — Dispersal Cell Elevation Dispersal Cell G :I 101.22 (ft) Lateral Invert 99.30 (ft) Contour Elevation 4.0 % Site Slope Geotextile Fabric Cover Shading Key IL Dispersal Cell See lateral details on 1❑ _ Topsoil Cap c• 1.5 ft +.try -{I r. "' " : Pepe 4 for number, size, and spacing of laterals. 2❑ ..rrrrrr Subsoil Cap a°+•`?'.:':-ti�;r:"::':=.'•..,..•l � , Laterals are equally © ASTM C33 Sand ' v �° I .r �......... �........,..;:rr F spaced from the Tilled Layer Y © Aggregate c v 0. ft ?;TYPtigel;�?tara�, •. ; ti r; `-::%irS i''r distribution the the .:r+;•:.. o ;;a ,'•±4 centerline n ► A « cell distribution cell (AxB). Project: Troy Overlook Devi. LLC Page 3 of 7 End Connection Lateral Layout Diagram Calla the laterals over the A a B dlmenslon •. Turn•up r ban v&Wo or ol.s. out plug e P All Wads are ldantloal If—11 Holes billed onthobottomoF th.lateul Ir a4udly spaead S Laterals &norcemeln Sch 40 PVC per SPS Table 384.30-6 5 For.. main aonn.wl n via tee or oross to manaold at any polnt. Project: Number of Laterals Lateral Diameter Lateral Length (P) Lateral Spacing (S) Lateral Flow Rate System Flow Rate Total Dynamic Head Orifice Diameter Orifice Spacing (X) Orifices per Lateral Orifice Density Manifold Length Manifold Diameter Forcemain Velocity Dose Tank Information Electrical as per NEC 300 and SPS 316.300 WAC Tank component is property vented Weiser Capacityl 800.00 Volume 1 22.20 Manufacturer Gallons gal/inch Dimension Inches Gallons A 18.25 405.05 B 2.00 44.40 C 4.89 108.57 D 10.90 241.98 Total 36.04 800.00 A B #C tank Alarm Manuaaacturer I Rhombus Alarm Model Number JMJ Plugger Pump Manufacturer JZoeller Pump Model Number JBN 152 Pump Must Deliver 38.77 gpm at F77T51 it TDH Troy Overlook Devi. LLC Locking cover with warning label and locking device and sealed watertight 4 in. min. E— Alternate outlet location Forcemain diameter 2 in. Weep hole or anti- elphon device Pump off elevaem ft 80.91 iDe tank elevation ft 90.00 Note: Switches containing mercury may not be used in this system. Page 4 of 7 Mound System Maintenance and Operation Specifications Service Provider's Name _ Jeff Fox —� Phone 715-755-2461 POWTS Regulator's Name [ St. Croix County Zoning I Phone System Flow and Load Parameters Design Flow - Peak 600 gpd Maximum Influent Particle Size 1/8 in Estimated Flow - Average 400 gpd Maximum BOD5 220 mg/L Septic Tank Capacity 1200 gal Maximum TSS 150 mg/L Soil Absorption Component Size 600 ftZ Maximum FOG 30 mg/L Type of Wastewater Domestic Maximum Fecal Coliform >10E4 cful100 mL Septic and Pump Tank Effluent Filter Pump and Controls Alarm Pressure System Mound Other Service Frequency Inspect and/or service once every 3 years Should inspect and dean at least once every 3 years Test once every 3 years Should test month) Laterals should be flushed and pressure tested every 1.5 years Inspect for ponding and seepage once every 3 years Miscellaneous Construction and Materials Standards 1. Observation pipes are slotted and materials conform to Table SIPS 384.30-1, have a watertight cap, and are secured in as shown in the mound component manual. 2. Dispersal cell aggregate conforms to SPS 384.30 (6)(i), Wis. Adm. Code. 3. All gravity and pressure piping materials conform to the requirements in SIPS 384, 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. Finished ..... Grade 6-8" Diameter Lawn Sprinkler Valve Box Distribution L Lateral Lateral Turn -up Detail ............... Threaded Cleanout Plug or Ball Valve Long Sweep 90 or Two 45 Degree Bends Same Diameter as Lateral Project: Troy Overlook Devi. LLC Page 5 of 7 Mound System Management Plan Pursuant to BPS 383.54, Wis. Adm. Code General This system shall be operated in accordance with SPS 382-84 Wis. Adm. Code, and shall maintained In accordance with Its' component manuals [SBD-10691-P (N.01101, R. 11/12), SSWMP Publication 9.6 (01/81), and Pressure Distribution Component Manual Ver, 2.0 SBD- 10706-P (N. 01/01, R. 10/12)] 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 SPS 383.33, Wis, Adm. Code when the tanks are no longer used as POWTS components. Septic or pump tank manhole (sere, 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 a. 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 fitter cartridge should not be removed unless provisions are made to retain solids In the lank that may slough off the filter when removed from its enclosure. If the filter Is equipped with an alarm, the fitter shall be serviced if the alarm is activated continuously. Intermittent filter alarms may Indicate surge flows or an Impending continuous alarm. The septic tank shall have its contents removed when the volume of sludge and scum In the tank exceeds 1/3 the liquid volume of the lank. If the contents of the tank are not removed at the time of a triennial assessment, malmenance personnel shall advise the owner of when the next service needs to be performed to maintain less than maximum scum and sludge accumulaflon 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 forseptic tank use by the Department of Commerce. Puma Tank 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 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 BON, 150 mg/L TSS, and 30 mg/L FOG for septic tank effluent or 30 mg/L BODs, 30 mg/L TSS, 10 mg/L FOG, and 104 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 shell be reported to the owner, and any levels above 6 inches considered as an Impending hydraulic failure requiring additional, more frequent monitoring. Continency Plan lithe 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 mpaired 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 5 of this plan for the name and telephone number of your local POWTS regulator and service provider. Pretreatment Units The Informatlon and schedule of manenagement and maintenance for pretreatment devices such as aerobic treatment units at dlslnfecfion udle are attached as separate documents and are coneldered part of the overall management plan forthis system. FLOW PER MINUTE 014508 http://www.zoellerpumps.com/en-na/distributor/sitesearch?search=152 6/2/201 , 7R) q O �RLp(; k tD VE 1G r'M\E lo-v H C LDi -7 i (u)Y ©UE 14LWK ANIJq%1)14 _SIti `rR lc-IW r6 N if e)F- `796 `f � � `Z3 ZK2 041 �'1 V ;L1 PJJI_ �c SF� with 65' x 9.24' ,-ew I - =-;f 2" Sch 40 PVC 120 Sep01800 le er I( SeptiGPump ank with Lif/melter 4" Approved Pipe A BENGNMAKK TO of,3�i rC Ri> �L: IDU' � ALF 2902A.An ARIL 'TvP ar �ti Wl! �11'E �_ - "X) >1 5��fl, i5ntc►e`IL 5 Well to be 25'+ fptic tank and 50'+ from tound Oct. 8.2019 9:11AM v`�I�$C'DI18%I1 Oepadrrlenl of COmm61Te DMalon of Soletv and Bulldlnoe ---. No. 0 186 P, 3 a- A— . Al SOIL EVALUATION REPORT #1977 In aoaordena with Comm 85, Wis.Adm. Code 0-- Peg' _.L-911-.,. — Steele Soil service Adsch oompLela site pipe en paper not lees than 0%. % 11 Inches In size. Plan must Include, buf limiled (BM). dirallon and County 3l. Croix Persil I.D. 0 / 2 — 7—Q not to: vedbal and hodrontal reference Polnl poroent slope, scale or dimenes ma, north anew, and location and dlslance to nearest road, pleasaPrint Sit lnformalyon. Rev ea8y Da Paloonel lolameson you proms may taw, a 0,04 (1) (n)), Propany0wner BT�roperty Location Tom And Renee Palnode Govt. Lot me NWt 4, SE/1/4, 319, T28N, R19W Propady Owners Milling Address 1 2 2006 Loth Block 8ubd, Name or C8Ma 225 Cry Rd F 7 no Troy Overlook Csy 611 to YiAtODN0j"gD AMrber City [] Vlllaga 0 Town Nearest Road Hudson I V Tr Cty Rd F NewConalrudlon 1,114! Residential 1Number ofbedrooms 4 Code detiveddesign now role. 600 GPD H Reweamenl Publlo or oommaropl- Duoriba: no parent matedel Lhealone upionds Covered by gladal till Flood plate elovellon. If applicable na n Gsneral ammonto Mound design, system elevation 10 8 based on contour line elevation 100,OOR. Mlnlmudm �nchea and raoommendallons; of ASTM33 mound send. /0/, I/ZZ 17 ❑ Bodno 1 Bodrep N ® P6 Ground sudaoe elev. 100.00 ft. Depth to Inviting factor 19 In. Soil Application Rate Hodson Depth In. DominontColor Munsell Rodox Description Ou, ez. Cont. Color Texture Structure Gr. 8z. 8h. Confilglanu Boundery Roolt GPDM' 'EANt 'am 1 H 10yr3/1 none ell 2msbk mfr rs lvf .6 .8 2 8-19 7.5yr4/4 none sid 2msbk mfr a no .4 .6 3 19- 10yr7/4 none ia"ec umesbone na no ne .0 .0 7 8odrp N 8odnp J ® pit Grouts surfam elan. 100,00 A. Depth to Ilrnlling Factor 19 In. 6dt App6allon Rata Horizon Depth In. DominanlCdor Mumall Radox FMsalpllon Qu. oz. COAL -color TeAure shudum Or, Sz. SA. Congletem Boundary SOON 1 GPDIM -edat -ift 1 0.8 10yr3/1 none 311 2msbk mfr a 1vf .6 .8 2 8-19 7.6yr4/4 none Sid 2nlft mfr Cs ne .4 .6 3 19- IDY0/4 none :racturet Urnedone ne no no .0 .0 ' Effluent #1- HOD? 301220 aeplL and TSS 404160 mg/L 'BBfuentN2- BODe S30 nv/L and T88 <_30 mgn. CBTNsme(Pleats Print) CST Number Dm4of J. Steel G/F/ 248966 Address Altars SollSavlos Dale Evaluallon Conduoted Telephone Number $94 200111 St. Baldwin, WI 04002 10/3/2008 71&760-0347 seaemop.ousn 1. 8, 2019— 9:11 0186--- P 4 — Piopery'owner Tom And Renee Patrrode Parcel ID p perm to Page 2 of 3 3 Boring Of Boring Ph Oromd sudaw elev. 98,30 n. Depth to limiting factor 24 ✓In. Application Refs Horizm Depth In. Dominani Color Munsah Redox Desalpllon Qv. ez. Cont. Color Texture 8lructure far, U Bh. Consistence Boundary RootsPD1M •Crn2 1 019 10yr3/1 none s11 2mfbk mfr C9 2c FA .8 2 19-24 10yr4/4 none skd 2MSbk mfr 0w 1c .6 3 24- 10yr7/4 none 7attUra Urnef{One na na n0 . .0 ❑ Boring e ❑ Boring ❑ Pa Ground surfaceelev, n. Dspih 10 00111109 (dolor In, Soll p p p IloeUon Re Hedzon Depth In, Dominant Color Wood Redo> iijololpllon Do. 8z, Coni, Colof Texture Slruature or, Sz.9h. onslslenoe Boundary Roots GPOM •East •Rfis1 BadngA ❑ soma ❑ PII Oromd surface aiev. n. Depth to nmlling factor In, h Application-- Rate Hodson Depth In, Dominant Color— Munsell FWEdux Desodpilon Qu. Sz. Card. Color Te)dura Structure Or, sz. Sh. Consistence Boundary Roots F GPOM- 'lint I '6m2 • ElOueol xl = aODa> 90 <_ 220 mglL and TSS >30 <_l do mglt. ' Efnusnl e2 s BODe 130 mg& and TSS t30 mg/L 71re Department ofCommom IS On equal opportunity 9ervi0d provider and employer. Ifyou need aselersnae to sozea$ sorvlew or need material in an ellefnale formal, plesse oontael the department at 609-266-3151 or 7TY 608.264-8777, 3bl"Ma07om neete w srvtre Oct. 8.2019 9:11AM 0186--P. 5 STEEL'S SOIL SERVICE David J. Steel Tom & Renee PBtnode CST-POWTSM NWl/4,3131/4,8I9,T28N,1t19W Lio. #249956 Town of Troy, St Croix Co, Troy Overlook, Lot 7 994 200" St, Baldwin, W154002 Dirm 715-760-0347 Fox 715-684-3449 We soil evaluation was conducted to wtts4, a zoning Mqutranent, It May or may not be suitable for your use. The location of this test may or may not be as shown, as pormanent tot lines were not established at the time the soil teat was conducted. Legend It, —40' ♦ - Benchmark Hie. 100.00 ft Top of3/4" pvc pipe • - Alt Benchmark Me. 100.00 It Top of 3/4" pvc pipe ❑ -Borhw Boring 1310vattons Bl - 100.00 ft B2 - 100.00 It 83 - 08.30 ft 134 - 0.0011 i i' —7, N I. 3018 I � -iLLJ K Z o0 I J ~ � Lc) Ll � LQu U EI- an O a,U) of O 2 QI� ty O W O N O Z z O O L� O rn w v I CU 188.80, C3 EAST 2, T 8 'L7 ----PEACEABLE I 587729 S.F. BENCH MARK �`Sb \ EAST 00 00 1.35 Ac. `=1038.40' .00�0• G? ;' _79.71'� __ 1 1 / ` '1 0 10'- � / <1 '/22' DRIVEWAY ; p AND UTILITY t-J 1� EASEMENT i v (Col cn N EA / LOT &7 / 72859 S.F. 4, , -/ �� :,... 1.67 Ac. LOT 6 83044 S.F. 10I — li 1.91 Ac.cy -10L o I �/ / 1. 1 1 U, �'. I , I ! N 80.4 — — 10 L 08 E 370.97' o 106.35 - -j9'12 f - N 89 15 02 W 216.46 LT% �{ a 0o- -N 76'15'17" W 17.07'— ;f�22' J' L- 6 Sp• / 22' DRIVEWAY �. / AND UTILITY EASEMENT ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM OwnerBuyer John & Michelle Stenz Mailing PropertyAdd394 Peaceable Hill Rd. Hudson, WI 54016 City/State Hudson, Wl LEGAL DESCRIPTION from Planning & Zoning Department for new IN OCT 31 2019 Parcel Identification Number 040-1322-07-000 v Property Location NW 1/4 , SE ''A , Sec. 19 , T 28 N R 19 W, Town of Troy Subdivision Plat: Troy Overlook Lot#7 Certified Survey Map # Volume Page # Warranty Deed # (before 2007)Volume , Page # Spec house❑yes +no Lot lines identifiable (dyes[3no SYSTEM MAINTENANCE AND OWNER CERTIFICATION Improper use and maintensace of your septic system could result in its premature fiilure to handle waste. 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 are specified in §SPS. 383.52(1) and in 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, joumeynan 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. Uwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Safety And Professional Services 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 SL Cmix County Planning & Zoning Department wit/iin 30 days of the three year expiration date. I/we certify that all statements this form are True to We best of my/our knowledge. Ihve am/are die owner(a) of the property described above, by virtue of my deed recorded in Register of Deeds Office. Number of bedrooms 4 SIGNATURE OF APPLICANT(T L/��19 DATE "'My 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. 04111) v3sconsin Department of Commerce Division of Safety and Buildings SOIL EVALUATION REPORT in accordance with Comm 85, Wis. Adm. Code L� A I D #1977 v Page 1 of 3 Steel's Soil Service Attach complete site plan on paper not less than 8'/. x 11 inches in sae. Plan must County St. Croix include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. 0 / 32-2 —U %-0 percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Please print all information. Rev' ! By Dat 1 Personal information you provide may cy Law, s. 15.04 (1) (m)). 161 7 b Property Owner Property Location Tom And Renee Patnode I Govt. Lot na NWt 4, SE1/4, S19, T28N, R19W Property Owner's Mailing Address OCT 12 2006 Lot # Block # Subd. Name or CSM# 225 Cty Rd F 7 1 na Troy Overlook City St to Zi(itc0BODPiD67bM#M1ber City --,Village Town Nearest Road Hudson V r4016 , 7ja&aL-= Troy I City Rd F - New Construction Use: Residential / Number of bedrooms 4 Code derived design flow rate 600 GPD L_ Replacement a Public or commercial - Describe: na Parent material Limestone uplands covered by glacial till Flood plain elevation, if applicable na ft. General comments Mound design, system elevation 10 based on contour line elevation 100.00ft. Minimuilm'Inches and recommendations: of ASTM33 mound sand. /6/, J/Z ► % Boring # G Boring 0 pit Ground surface elev. 100.00 ft. Depth to limiting factor 19 in. Soil Application Rate Horizon Depth in. Dominant Color Munsell Redox Description Ou. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPDtft' -Ert#1 •Eff#2 1 0-8 10yr3/1 none sit 2msbk mfr cs lvf .6 .8 2 8-19 7.5yr4/4 none sict 2msbk mfr cs na .4 .6 3 19- 10yr7/4 none =racturec Limestone nor nor na .0 .0 Z Boring Boring # Pit Ground surface elev. 100.00 ft. Depth to limiting factor 19 in. Soil Application Rate Horizon Depth in. Dominant Color Munsell Redox Description Ou. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consisten Boundary Roots GPD/fl' 'Ert#f I 'Efl#2 1 0-8 10yr3/1 none sit 2msbk mfr cs lvf .6 .8 2 B-19 7.5yr4/4 none sicl 2msbk mfr a na .4 .6 3 19- 10yr7/4 none =racturec Limestone na na na .0 .0 Effluent #1 = BOD5> 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BOD5 < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) Sign re: CST Number David J. Steel 248956 Address Steel's Soil Service Date Evaluation Conducted Telephone Number 994200th St. Baldwin, WI 54002 10/3/2006 715-760-0347 seas»o(RWM) Property owner Tom And Renee Patnode parcel ID # pending Page 3 of 3 Boring # ❑ Boring Z Pit Ground surface elev. 98.30 ft. Depth to limiting factor 24 in. Soil Application Rate Horizon Depth in. Dominant Color Munsell Redox Description Cu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/fl' •Eff#1 -Efl#2 1 0-19 10yr3/1 none sil 2msbk Will, CS 2c .6 .8 2 19-24 10yr4/4 none Sid 2msbk mfr 9w lc .4 .6 3 24- 10yr7/4 none =racture( Limestone na na na .0 .0 ❑ Boring # Boring ] pit Ground surface elev. It. Depth to limiting factor in. Soil Application Rate Horizon Depth in. Dominant Color Munsell Redox Description Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPDIft' •Efl#1 •Ef#t2 ❑ Boring # — Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth in. Dominant Color Munsell Redox Description Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/fl' •Efl#1 •ER#2 • Effluent #1 = BODS> 30 < 220 mg/L and TSS >30 < 150 mg/L • Effluent #2 = BODS < 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. SRD 8330 (R 07/00) Steel's Soil Servos STEEL'S SOIL SERVICE 3 of 3 David J. Steel Tom & Renee Patnode 994 200th St. CST-POWTSM NWl/4,SE1/4,Sl9,T28N,R19W Baldwin, W154002 Lic. #248956 Town of Troy, St Croix Co. Direct 715-760-0347 Troy Overlook, Lot 7 Fax 715-684-3449 This soil evaluation was conducted to satisfy a zoning requirement, it may or may not be suitable for your use. The location of this test may or may not be as shown, as permanent lot lines were not established at the time the soil test was conducted. /,µ r :A 6 I Legend I" = 40' ♦ = Benchmark Ele. 100.00 ft Top of 3/4" pvc pipe • = Alt Benchmark Ele. 100.00 ft Top of 3/4" pvc pipe ❑ = Borings Boring Elevations B 1 = 100.00 It B2 = 100.00 ft B3 = 98.30 ft B4 = 0.00 ft N I 1 3 2 c:y al ' - r � _ . S ' _ ',y '-_--� � .. •'� pan — CCT TRUNK --HIGHWAY _ \ PER VOL ,off,• oil / co •%. W N 1'29'43" E 395.14' + to / N 1' 9'43" E 601 1 Z r 91' o m \ t o v - T70. 3�38.78 91.72'' r— — - — - — AAI , A, �� ��'• " V (� / �1 —� L M I \ \ LL T I I �p o ca \�\�\ \\� , \• y� 1\ . � \ IIIai y I �� Vrlr � i._�'� \ 1 1 �•8£Z \ \ VA.K\AXzi E /w°' N 01'18'34" E216 + ..` E'74.J1' v Iao p A m� Z I — — L4Z M "8£,602N I / I 0 1 I WOD pf I .K ern / /1`d\m`,\'.