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HomeMy WebLinkAbout026-1147-02-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix SafeLv and Building vision INSPECTION REPORT Sanitary Permit No: 420370 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: Oeverin , Oranzo Richmond Township 026. 1147 -02 -000 CST 8M Elev: Insp. BM Elev: BM Description: TANK INFORMATION ELEV ION DAT A..yy 23 .0 9G. 7 TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. "Ary -f 160 Septic B nchmark Dosing Alt. BM b 3-b Aeration --/ BI w 0 . Holding _ SVHt Inlet , ?r 1� TANK SETBACK INFORMATION St/Ht Outlet TANK TO P/L WELL BLDG. ff 5M el Septic '/ (N -3 / D Dosing „ Header /Man. Aeration Dis t. Pipe ' C 2 7 1 �• Holding Bot. System 544-ht ad. Final Grade � Z� PUMP /SIPHON INFORMATION - 7 - g Manufacturer Demand St Cover , / GPM - / v» • 97 -0 Model Number s�- 96• TDH Lift Friction ss System Hepq TDH Ft Forcemain Length Dia. �� Dist. to Well i p�- Z--f d Z L ABSORPTION SYSTEM &t n•n � % E q4kRENCH Width j 01 ength No. Of Trenches PIT IMENSiON No. Of Pits Inside Dia. Liquid Depth D ENSI G)11 J G SETBACK SYSTEM TO < C P/L / BLDG� WELL LAKE /STREAM L r Manu facturer: INFORMATION CHA R Type Of System: /r/0 Model Number: DISTRIBUTIONS TEM Header /Manifold Dstribution ) x Hole Siz x Hole Spacing Vent Air Intake h Pipes) ' N /3?i Length Dia 7- Length 1 Dia Z Spacing SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only rm [PLe pth Over IDepth Over xx Depth of eeded /Sodded xx Mulched Bed rench Center *� xx S / Bed/Trench Edges Topsoil — Yes [] No G� i'IK Yes ] No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / 2 / 0 2-- Inspection Location: No: 1 4 r � o 2 Parcel 24.30.18.1060 477 1 0th S eet Nev Richmond, WI 54017 (NE 1/4 NW 1/4 24 T30N R18W) Richmond ead ws Lot i 1.) Alt BM Description 2. Bldg sewer length - amount of cover -A�� ja O! A ff v Plan revision Required? I Yes � No __F_ Use other side for additional information. �G'�±��!��!�C SBD -6710 (R.3/97) Date Insepctor's Si nature Cert. No. HE SO LID HEAD CAPACITY CURVE EFFLUENT MODELS ■ ■ ■ ■�m�mmm�mmmmmmmmmmmmmc�mm '� N■■\© ®mmm ®mmomomm ®m ®m ®mm ©m mmmmmm ®mm ®m ®m ®mmomm ®mm ■� ■ ■ ■■ mmommmmmm ®o ®mmo ®mmmmm® ' ■■ ■■■■ =mmmmmmmmmmmommmmo® ©mmm ■■■■■ ■�o�mmmmmmmmmmNmm ° mmm ° mm ©® V _ ■ ■ ■■�o ®mmmmmmmmmmmmmmmmmmmm ' ■► ■■ mmmmmmmmmmmmmmmmmmmmmm ■�,�■ m ®mmmmmmmmmmmmmmmmmmmm . \ ■ \\ \ ■1m ®mmmmmmmmmmmmmmmmmmmm ■N �C 1■ mmmmmmmmmmmmmmmmmmmmmm . ® ®mmmmmmmmmmmmmmmmmmmm \ \ \ \ ■� �■ �mmmmmmmmmmmmmmmmmmmmm ' ■►�h Iti mmmmmmmmmmmmmmmmmmmmmm mmm�m��m�m�m�mmm�m�® ., \. \ \�11 \1� \. ■ ■ ■■ ■ ��m�m�m�m�m�mmm0 mmm ®m ®mmom ®mmm ©�a ■ \ \ \�1 ■I \ \■■ ■ ■■ m ®s� ®m ®mmommomomm KIM ■ \\ 11 ► \` �■ ■■ \, mmm ®o ®mmommo ®a� ©� ■►� \�1111�■■ \\ ��� mmo ® ©mmmommmm ® ©m ■ 49\� 1�11� \■■► ■■■ mm © ®ommmomo ®mm ©m • Q.0 4 1 \. ■ ■ mmmmmmm ®ommmommm mmmmmmo ©m ©mmom ®m ■� \ \�11►� I� ■�■ \ ■ mmmmmommmmmmmmmm m � \, � � k160,10 � mmmmmmmmm ® ©v ©m ©m \ ■ ■■ \ \\ ■ mmmmmmmmmommmom® , ■ � 1 ■■ ■■■■ ■, mmmmmmmommmmmo® \� � 1� 1 \ \� \ ■ \�■ mmm Model 186/4185 should not be subj to less than 30 f TDH. explosion 1 19. SEWAGEAND m�mm�mmm�mmmmmm�m�mmmmmmmm DEWATERING mmmmm ® ®m® mm ®mmmmmm m mmm ®mm ®mmmmm •� ■ ■ ■Imm mmomm m� ®mmmmm mm ■m mm mommmmmmmm ®mm m mmmmm mmmmm mmmmmm ®m ®mmm m m mmmmmmmmmm ®m�m®m ®mmmm m■mmmmmmmmmmmomm� ®m mm mmmmmmmmmmmmmmmomm® • � � m m m m mmmmmm mmmmmmm® -� m ® . mmm ma�mmmmmm mm ®m�i ■ ■ ��• r subjected to less than 15 fe EASY DO'S & DON'T'S FOR INSTALLING A SUMP PUMP 1. DO read thoroughly all installation material provided with the pump. 2. DO inspect pump for any visible damage caused by shipping. Contact dealer if pump appears to be damaged. 3. DO clean all debris from the sump. Be sure that the pump will have a hard, flat surface beneath it. DO NOT install on sand, gravel or dirt. 4. DO be sure that the sump is large enough to allow proper clearance for the level control switch(es) to operate properly. 5. DO Always Disconnect Pump From Power Source Before Handling. DO always connect to a separately protected and properly grounded circuit. SSPMA DO NOT ever cut, splice, or damage power cord (Only splice in a watertight junction box). MEMBER DO NOT carry or lift pump by its power cord. DO NOT use an extension cord with a sump pump. SUMP 6. DO install a check valve and a union in the discharge line. ANDSEWAGE DO NOT use a discharge pipe smaller than the pump discharge. PUMP MFRS. ASSN. 7. DO NOT use a sump pump as a trench or excavation pump, or for pumping sewage, gasoline, or other hazardous liquids. YOUR ASSURANCE 8. DO test pump immediately after installation to be sure that the system is working properly. OF QUALITY 9. DO cover sump with an adequate sump cover. 10. DO review all applicable local and national codes and verify that the installation conforms to each of them. 11. DO consult manufacturer for clarifications or questions. 12. DO consider a Two Pump System with an alarm (Page 5) where an installation may become overloaded or primary pump failure would result in property damages. 13. DO consider a D.C. Backup System (See the Basement Sentry page 5) where a sump or dewatering pump is necessary for the prevention of property damages from flooding due to A.C. Power disruptions, mechanical or electrical problems or system overloading. Service Checklist ® A WARNING ELECTRICAL PRECAUTIONS- Before servicing a pump, always shut off the main power breaker and then unplug the pump - making sure you are not standing in water and wearing insulated protective sole shoes. Under flooded conditions, contact your local electric company or a qualified licensed electrician for disconnecting electrical service prior to pump removal. A WARNING Submersible pumps contain oils which becomes pressurized and hot under operating conditions - allow 2% hours after disconnecting before attempting service. CONDITION COMMON CAUSES A. Pump will not start or run. Check fuse, low voltage, overload open, open or incorrect wiring, open switch, impeller or seal bound mechanically, defective capacitor or relay when used, motor or wiring shorted. Float assembly held down. Switch defective, damaged, or out of adjustment. B. Motoroverheats and trips overload Incorrect voltage, negative head (discharge open lower than normal) impeller or seal bound mechanically, defective or blows fuse. capacitor or relay, motor shorted. C. Pump starts and stops too often. Float tight on rod, check valve stuck or none installed in long distance line, overload open, level switch(s) defective, sump pit too small. D. Pump will not shut off. Debris underfloat assembly, float or float rod bound by pit sides or other, switch defective, damaged or out of adjustment. E. Pump operates butdelivers little or Check strainer housing, discharge pipe, or if check valve is used vent hole must be clear. Discharge head ex- no water. ceeds pump capacity. Low or incorrect voltage. Incorrect motor rotation. Capacitor defective. Incoming water containing air or causing air to enter pumping chamber. F. Drop in head and/or capacity after Increased pipe friction, clogged line or check valve. Abrasive material and adverse chemicals could possibly a period of use. deteriorate impeller and pump housing. Check line. Remove base and inspect. If the above checklist does not uncover the problem, consult the factory - Do not attempt to service or otherwise disassemble pump. Service must be by Zoeller Authorized Service Stations. Limited Warranty Zoeller Pump Company warrants, to the purchaser and subsequent owner during the warranty warranty is in lieu of all other warranties expressed or implied; and we do not authorize any period, every new Zoeller Pump Company product to be free from defects in material and representative or other person to assume for us any other liability in connection with our products. workmanship under normal use and service, when property installed, used and maintained, for 1) Contact Zoeller Pump Company, 3649 Cane Run Road, Louisville, Kentucky 40211 -1961, Attention: Standard Warranty - a period of one year from date of installation or 18 months from date of Customer Service Department to obtain any needed repair or replacement of part(s) or additional manufacturer, whichever comes first OR 2) Optional Three (3) Year Warranty - a period of three information pertaining to our warranty. (3) years from date of installation or 42 months from date of manufacturer whichever comes first. Parts that fail, (within standard or three (3) year optional warranty) that inspections determine to ZOELLER PUMP COMPANY EXPRESSLY DISCLAIMS LIABILITY FOR SPECIAL, be defective in material or workmanship, will be repaired, replaced or remanufactured at Zoeller CONSEQUENTIAL OR INCIDENTAL DAMAGES OR BREACH OF EXPRESSED OR IMPLIED Pump Company's' option, provided however, that by so doing we will not be obligated to replace WARRANTY; AND ANY IMPLIED WARRANTY OF FITNESS FOR A PARTICULAR PURPOSE an entire assembly, the entire mechanism or the complete unit. No allowance will be made for AND OF MERCHANTABILITY SHALL BE LIMITED TO THE DURATION OF THE EXPRESSED shipping charges, damages, labor or other charges that may occur due to product failure, repair WARRANTY. or replacement. Some states do not allow limitations on the duration of an implied warranty, so the above limitation This warranty does not apply to any material that has been disassembled without priorapproval of may not apply to you. Some states do not allow the exclusion or limitation of incidental or Zoeller Pump Company, subjected to misuse, misapplication, neglect, alteration, accident or act consequential damages, so the above limitation or exclusion may not apply to you. of God; that has not been installed, operated or maintained in accordance with Zoeller Pump Company installation instructions; that has been exposed to but not limited to the following: sand, This warranty gives you specific legal rights and you may also have other rights which vary from gravel, cement, mud, tar, hydrocarbons or hydrocarbon derivatives (oil, gasoline, solvents, etc), state to state. wash towels or feminine sanitary products, etc. or other abrasive or corrosive substances. This © Copyright 2001 Zoeller Co. All rights reserved. 6 201 W. Washington Ave., P.O. Box 7162 NV 6consin Madison, WI 53707 - 7162 Site Address Department of Commerce I v T mit Sanitary Permit Application Sanitar Per + Number �Z. 0 3:fO In accord with Comm 83.21. Wis. Adm. Code, personal information you provide 0 Check if Revision may be used for secoalary Purposes Privacy Law, 315. 1 m L Application Information - Please Print All Information State Plan I.D. Number Propery owner's Nary REC E� Parcel Number Property Owner's Mailing Address AU G fir' Locsdon -� • �� W 3f A/A S G T M N. L ma State Zip Code Phoo NtWfdi Number Block Number Subdivision Name CSM Number Vol 6 of Building (check all that apply) .r, ?w s .� ( 1 OCity ar 2 Family Dwelling - Number of Bedrooms 'S / QVrbage 0 Public/Commercial - Describe Use oarn�tip ❑ Stage Owned t � " 7 0 9 � -6 i A - o K1 f t � - &--, cw[x III. Type of • (Check only one box on line A (numbering scheme for Internal use). Complete tine B if applicable) A 2 0 Replacement System 3 0 Replacement of 6 Addition to For Couurty use Tank Only stem B. 0 Check if Sanitary Permit Previously Issued Permit Number Date Issued Permit: Check an that a ly)(numbering scheme is for internal use) -)t A-- I� IV. Type of ( PP . 44 0 Non Pressurized In- Ground 210 Mound 47 0 Sand Filter 50 0 Constructed Wedand 22 0 Pressurized In.Ground 410 Holding Tank 48 0 Single Pass 510 Drip Line 46 0 Aerobic Treatment Unit 490 Recitcdating 30 0 Other t Area Information: Dew Flow (gpd) Dispersal Am Dispersal Area Soil Application Percolation Race System Elevation Final Grade Required Proposed Rate(Gals./Days/Sq.FL) (MinAnch) Elevation VI. Tank Info Capacity in Total Number Mamtfacturer Prefab Site Steef Fibber plastic Gallons Gallons of Tanks Concrete Constructed Glass New Existing Tanks Tanks Septic or Holding Tank tag Cbmb" a� VII, Responsibility Statement- L the undersigned, assume respomiibtlity for hastsdWan of the POWTS shown an the attached plans. Plumber's Naze (Print) Plumber's S' MP/I"RS Number Business Phone Number Z 6700 Phimimes Address (Street. City, State, zip �r lJ/ VIII. Coon me end se Approved ❑Disapproved Sanitary Permit Fee' (whides Groundwater Date Issued Issuing Agent Signature (No Stamps) ja Surcharge Fee) 0 owner Given Initial Adverse Determination 3z I%. onditions of ApprovaUReasons for Msfpproval S� C V l �.cali'eKs . , Ut Attach osmplete phms (to the c,,nq only) for the sptm ou paper mat less than 81/2 z 11 ruches hi she 39 8 SBD-6 (R 05/01 l PLOT PLAN ;ECT Oranzo Oe'verina ADDRE 8 SummerPines Circle Hudson Wi 54016 NE 1/4 NW 1 /4s 24 /T 30 N/R 18 TOWN Richmond COUNTY ST. CROIX MPRS Shaun Bird 226900 - DA CONVENTIONAL BEDROOM 3 CONVENTIONAL AT -GR ) =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 Steel Fence Post ASSUME ELEVATION 100' Filter Zabel A -100 DBOREHOLE O WELL - H. R. P. Same as Benchmark SYSTEM ELEVATION Alt.B.M. t S 6 B.M. 426' Property Line lo B -1 B -2 Well is to meet all setbacks found in Area 15' Below System is c Comm. 83 to remain undisturbed q�•b 99° B -3 4% Slope Huffcuff Combo Tank Tank is to be properly bedded and provided with lockdown covers with Grading is to be done to approved warning labels divert run -off away from system Pro 3 Bedroom House m Scale = 1 /4 91 = 1 O' Safety and Buildings 10541N RANCH ROAD • HAYWARD WI 54843 TDD #: (608) 264 -8777 Nvisc w ww.comm www.wisconsin.gov www.wis .wisconsonsin.gov n.gov Department of Commerce Scott McCallum, Governor Philip Edw. Albert, Secretary August 26, 2002 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 PLAN APPROVAL EXPIRES: 08/26/2004 Identification ED No. 776687 Transaction ID No. 7766687 SITE: Site ID No. 649126 Oranzo Oevering Please refer to both identification numbers, 140TH St above, in all correspondence with the agency. Town of Richmond St Croix County NE 1/4, NW1A, S24, T3 ON, R18W FOR: Description: At Grade 450 Gpd. Object Type: POWT System Regulated Object ID No.: 865866 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. The following conditions shall be met during construction or installation and prior to occupancy or use: Correspondence Notes: • This plan action is subject to designer notes / comments on the plan. • This system is to be constructed and located in accordance with the enclosed approved plans and with the "At Grade Component Manual, SBD- 10570 -P (R.6/99)" and SSWMP Publication 9.6, Design Of Pressurized Distribution Networks For Septic Tank- Soil Absorption Systems (01/81). I 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. All permits required by the state or the local municipality shall be obtained prior to commencement of construction /installation/operation. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions Q 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. v i • _ SHAUN R BIRD Page 2 8/26/02 Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 Thomas E Devereaux Plumbing / POWTS Reviewer II , Integrated Services WiSMART code: 7633' (715)634-3026, 7:45 am - 4:45 pm Mon. - Fri. tdevereaux@commerce,state.wi.us cc: Leroy G Jansky, , Wastewater Specialist, (715) 726 -2544 I i i r Cover Page Shaun Bird Bird Plumbing Inc. 1008 192nd Ave New Richmond Wi 54017 715- 246 -4516 Date: 8/2/02 Owner: Oranzo Oevering Location: Lot 2 Richmond Meadows 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 -9. Maintance and Contigency plan 4:�•s• 10 -12 Soil test itolw CE r S Shaun Bird il� SNT AND �ID�N� Signature o� License number 226900 GoR 8/2/02 PLOT PLAN PROJECT Oranzo Oeverina ADDRE S W8 SummerPines Circle Hudson Wi 54016 NE 1/4 NW 1 /4S 24 /T 30 N/R 18 � ' TOWN Richmond COUNTY ST. CROIX MPRS Shaun Bird 226900 DATE 8/2/02 BEDROOM 3 CONVENTIONAL AT -GR 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 BENCHMARK V.R.P. Top of Steel Fence Post ASSUME ELEVATION 100 Filter Zabel A -100 ❑ BOREHOLE O WELL - H. R. P. Same as Benchmark SYSTEM ELEVATION 94.5' Alt.B.M. B.M. 426' Property Line 250' B -1 B -2 94, Well is to meet all Area 15' Below System is setbacks found in o Comm. 83 to remain undisturbed ❑ C v .. B -3 4% Slope Huffcutt Combo Tank Tank is to be properly bedded and provided with lockdown covers with Grading is to be done to approved warning labels divert run -off away from system Pro 3 Bedroom '= House m Scale = 1/4" = 10' L > 5 B ' �� PVC Fbilt.E.MAiN -...� 5' r i �Tup w- UPS - F t wsrs%%;7A1TtatJ LATEtZAL ` STA$ILi��D 08�i =LYATtbrs WELL t _ a- >_ 5' 1 /6B 1 /6B 1/2 B R B , L _ � F�• C ELL. of %t - .& pt,GR�GAFE �� fabric t Distribu Lateral R P p 9,mi E b SY MTRE �� � �-- Soil Cover STPr8Iblr.b Observation---- --.,,_ .''� ' r2 . Well ro Pt,avVEv La OEX } 5' N 2 , . �. 5' l0 cj t_bP� Ad Cross Seotion of Wisconsin At -grade Unit with a Plana Vie Slo in Site Single o n Area on a p g StiC,tj0. TLA Wisconsin Department of Commerce SOIL EVALUATION REPORT Page of Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code Attach complete site plan on paper not less than 8112 x 11 inches in size. Plan must County include. but riot limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Please print all Intonnation. d� az 3s'� C) Re 'ewed by Date Personal kdomrabon you Provide may be used for secondary purposes (Pnvac�Low. s. 15.04 (1) (m))' o Property Owner Property Location A OV`/- , Govt. Lot �- 114 06 114 S pl L T N R E ( ) W Property ownees Mailing Address Lot # I Block # Subd. Name or Gty State Zip Code Phone Number 0 City Village Town Nearest R New C.ormtruction Use' esidendal Number of bedrooms „� _ Code derived design (tow rate GPO O Replacement O Public or at - Describe: RE ti. Parent material Flood Plain elevation if app cable 1L General and recommen--m. y1<-/, �1��� ,� !1G 0 5 2002 ST. UFco X court v ZONI �^ Q FTI B«i� # p erns Pit Ground surface elev. ft Depth tp CrrwUng factor in. Sod Application Rate Mail= t Depth Domkwrit Color Rados Description Texture Structure Consistence Boundary Roots GPDW in. Murnsed Qu. Sz. Cont Color Gr. Sz. Sh. 'Eff#1 'Etf#2 0-4 10kt,,-31c S vr~ r j, 3- # Q Boring /) Ground surface elev. v ft. to factor in. ® soring Pit - f Sod Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsed Qu. Sz. Cont. Color Gr. Sz. Sh. 'Etf#1 'Etf#2 J ,2 , ,mss --- --�- -, 6 t✓ ,� ✓ l / 6� s' l Al ,? 55 - • Effluent #1 = BOD > 30 1220 mg& and TSS >30 < 1 ' Effluent #2 = BOD < 30 ngA. and TSS 1 30 nxYL CST NaM (Please Print lure CST f4umber Address Date Evaluation Telephone Number 1 Property Owner Parcel ID # Page of Ong # ❑ Boring Pit Ground surface el, ,/I - - L— ft. Depth to limiting factor J in. Sol Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPM in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •E1f#1 I 'EN#2 Boring # ° Boring F] ❑ Pit Ground surface elev. ft. Depth to knifing factor in. Sob Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Murrell Qu. Sz. Cont Color Gr. Sz- Sh. *001 'Eff#2 ❑ Boring # ° Boring ❑ Pit Ground surface elev. R. Depth to lirtliting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description. Texture Structure Consistence Boundary Roots GPDAf in. Mtmsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 Effluent #1 = BOD > 30 < 220 mglL and TSS >30:< 150 mgA. ' Effluent #2 = BOD < 30 mg& 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. feD4370OL6W) Soil Test Plot Plan Project Name Oranzo Oevering Sha Address 838 Summer Pines Circle Hudson Wi 54016 ST-M #226900 Lot 2 Subdivision Richmond Meadows Date 8/2/02 NE 1/4 NW 1/4S 24 T 30 N /R W Township Richmond [] Boring 0 Well PL Property Line County ST. CROIX Ilk BM or VRP Assume Elevation 100 ft. Top of Steel Fence Post System Elevation 94.5 *HRpSame as Benchmark Alt. BM Top of Survey Iron @ 96.7' 2~ 3 Alt.B.M. B.M. 426' Property Line 250' B -1 B -2 94' j _0 13 B -3 9 4% Slope Pro 3 Bedroom House - o 0 CD r CD n � Scale = 1/4 1 0 ` Wisconsin Department of Commerce SOIL EVALUATION REPORT Pa e Division of Safety and Buildings g -A— of in accordance with Comm 85, Wis. Adm. Code Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must County include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Please print all information Reviewed by Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). P ert ly,Owner pp Property Location tV Itr YtCc�� f? 1 S G t� Govt. Lot 1/4kW114 Sze+ T 3o N R E(or)@ Property Owner's Mailing Address Lot # Block # , S uu bd. P , ame or CSM# .G 9 X (d(2 2 1'C(610civld hec'JOtiS City State Zip Code Phone Number ❑ Ci ❑ Village 0 Town Nearest oad Woe 6earLk i M in , I` 10 1 (CSI ) 0 iief I I {(ckA- ✓icy I NO S� New Construction Use: q Residential / Number of bedrooms Code derived design flow rate 7 GIRD ❑ Replacement ❑ Public or commercial - Describe: Parent material T / / Flood Plain elevation if applicable General comments SyS Z yn 2l-e , lO Z, z Q LE LEO) and recommendations: � n � r ,e APR 2 3 2002 ST. CROIX COUNTY F-/1 Boring # ❑ Boring Pit Ground surface elev. )(31 , 90 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. Cont. Color Gr. Sz. Sh. •Eff#1 'Eff#2 j -O r � � '�( ZtN► loK CS S 3 tMS (oK Boring # ❑ Boring pit Ground surface elev. lQI , ZO ft. Depth to limiting facto in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •Eff#2 I A 2 — St ( Zock�o �r CS 12-22 1 c f m fr 3 /6 5c (' Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 _< 150 mg/L " Effluent #2 = BOD < 30 mg /L and TSS < 30 mg/L C T Name (Please Print) ignature CST umber Address Date Evaluation Conducted Telephone Number 2<<3 So Sov"1Prs'Pf C-3( q 0 �S— c( -C1 -0 - T I S7 zu C(0og i SBD -8330 m11- 100) Property Owner &IP I In Parcel ID # Page �_ of ❑ 3 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/ft in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. 'Eff#1 'Eff#2 I ©13 -- I 0L 6K A AICr C I E LIN — I c l k c , 3 Z _ (o e z ❑ Boring F-1 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 1ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 `Eff#2 Boring Boring # Ground surface elev. ft. Depth to limiting factor in. F ❑ pit Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 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) PAGE 3 OF SAME LOT# Z LEGAL DESCRIPTION uw f tW X ,S 2 y T 3 ,N,R, i� E(or�I SCALE: 1"= yU BM 1 ELEVATION /0d • 0 BM 1 DESCRIPTION -/oe 6 1 / , ` I + BM 2 ELEVATION 0 BM 2 DESCRIPTION cy -f — Pc Z SYSTEM ELEVATION /ci Z . 2 0 ALTERNATE ELEVATION 616 CONTOUR ELEVATION /o/ Z 0 I ` G � 0 j3- Z\ SIGNATURE r DATE r ST CROIX COUNTY �,� /— So 3 .��r • SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM . r Owner/Buyer -Le, Mailing Address ntz,- Property Address (Verification required from Planning Department for new construction) City /State Parcel Identification Number L sAL DESCRIPTION Location V, '/ Sec. TnLN R, Town of Property Lot # Subdivision r _ Certified Survey Map # Volume Page # Warranty Deed # (9 � { `1 � _ . Volume 19(2- � Page # Spec houses ❑ no Lot lines identifiab e ❑ no SYSTEM MAIN'T'ENANCE use and maintenanceof your septic system could result is its premature f to handlew�stes- in the system consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. can affect the function of the septic tank as a treatment stage in the waste disposal system. Th property _ a certification form, signed by the owner and by a owner a to submit to St. Croix Zoning Department the on -situ system masterphnnber, jourwymanplumber, restrictedplumber or a hcensedpumper verj that tank is less than wastewat l udge Ih ism proper operating condition and/or (2) after inspection and pumping (if necemsaiy), the maintain the Private sewage disposal system with the standards ve, the undersigned have read the above requirements o irements and agree n Of Wisconsin. t',eriificatio set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State o Ogg within o stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning days of the three year expiration date. S c / ,2 ! D Z . DATE OF APPLICANT OWNER CERTIFICATION our knowl I we am (are) the owner(s) of I (we to the best of my ( ) certify that all statements on this form are true ) ( ) the property described above, by virtue of a warranty deed recorded in Register of Deeds Office- -- DATE SIGNATURE OF APPLICANT ent. « * * « ** * * * * ** A information that is mis- repr=ntedmiay result in the sanitary pest being revoked by the Zoning Departm «* Include with this application: a stamped warranty deed from the Register of Deeds office a copy of the certified survey crap if reference is made in the warranty deed l 12 I 13 U E�8 1 994 STATE BAR OF WISCONSIN FORM 2 - 1999 KATHLEEN H. WALSH WARRANTY DEED REGISTER OF DEEDS Document Number I I ST. CROIX Co., MI This Deed, made between Hillvale Development Limited Liability RECEIVED FOR RECORD Partnership, a Minnesota Limited Liability Partnership 06 -18 -2002 8:30 All WARRANTY DEED Grantor, and Oranzo John Oevering, and K J. Oeverin g EXEMPT it as joint tenants REC FEE: 11.00 TRANS FEE: 211.50 COPY FEE: CERT COPY FEE: Grantee. PAGES: 1 Grantor, for a valuable consideration, conveys to Grantee the following described real estate in St. Croix County, State of Wisconsin (if more space is needed, please attach addendum): Recording Area Name and Return Address Lots I, 2 and 3, Plat of Richmond Meadows in the Town of Richmond, St. Croix County, Wisconsin. A Ir 026 - 1070 -50- 000,026- 1070 -60 -0W, 026 - 1070 -80- 000,026- 1070 - 90-000 Parcel Identification Number (PIN) This is not homestead property. 04) (is not) Exceptions to warranties: Easements, restrictions and rights -of -way of record, if any. Dated this day of June 2002 Hillvale Development Limited Liability Partnership AUTHENTICATIO.1y ACKNOWLEDGMENT P r N Ip vA� u STATE OF WISCONSIN Signature(s) I ) ss. County ) it Rd0@t authenticated this day of D. � Personally came before me this day of June 2002 the above named Hillvale Development Limited Liability Partnership by bhp Of C TITLE: MEMBER STATE BARICF WISCONSIN it's (If not, to me known to be erson(s) who executed the foregoing instru d edged the same. authorized by 9 706.06, Wis. Stats.) �. THIS INSTRUMENT WAS DRAFTED BY + Attorney Kristina Ogland Notary P rc, State of Wisconsin H udson, I I M C miss'on is pe anent. (If not, state ex iration ate: (Signatures may be authenticated or acknowledged. Both are not necessary.) ) ' Names of persons signing in any capacity must be typed or printed below their sign ure. i tormwwn Proress&wls Cw pwy, Fond w Lee. vn 900855.2021 WARRANTY DEED STATE BAR OF WISCONSIN FORM No. 2.1999 CO oo 04 00 00 4i 0) � , 1 A N I I l ON 3d3 t � • 4s N .09 'sst .cg'si , I , w U I` 0 w D LL- C w 0 CL O w 0: 4� I 0 �o O� z �� N 4 W �i � C M � It � W O f � I� Q !A N J) pPpp 1� p � �� 2 � O f co o to N M C N LL. F w n^ aD N to N N n p LJ C W d � aQ � •3 LL' Y W j N m z > 0a i ° o i -° o o M.££,t0.00S - _C 14 - .99 x,00'££ ---------------- - - - - -- - -- � Y ZY L S Hl " �'' -- - i 9 66 EE < 0000M /' A Bt *8 • 'N 0£•1 W •03S */t MN 3Hl JO 3NIl 1S3M -- r