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HomeMy WebLinkAbout026-1163-01-000 r Wisconsifl Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division Y x INSPECTION REPORT Sanitary Permit No: 463263 0 GENERAL IINFORMATION (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: ,,,�,,,1l� Oeverin Homes Richmond Township 0 " I � -67 `0Vv CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range /Map No: /60 CST 25.30.18.1 1 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER � CAPACITY STATION BS HI FS ELEV. Septic �^�. �,,� Z ` Benchmark Dosing A lt. L1 %L 00 Goof 75 Aere4iml Bldg. Sewer Holding - St/Ht Inlet St/Ht Outlet TANK SETBACK INFORMATION TANK TO WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic i Z Z3 71 / Dt Bottom // r Dosing ' /Z-3' Z 3 i �Z ' �d e r Header /Man. 3 Aeration Dist. Pipe Z Holding Bot. System Final Grade T PUMP /SIPHON INFORMATION L•� /C►� Manufacturer // ' 9 / / Demand St Cover jJ z. b I l�,`c.- GPM T 75 Model Number p E 74 15 � b ✓�T' u' 1� �' � / ''�' Z . TDH Lift j Frictio Loss ll System Head TD�13 L Forcemain Length Dia. ,j Dist. to Well / TCJ L Z SOIL ABSORPTION SYSTEM BED /TRENCH Width j Length No. ( 0 Trenc s PIT DIMENSIONS No. Of Pits Insi q ia. Liquid Depth DIMENSIONS 1 6 SETBACK SYSTEM TO P/L JBLDG WELL LAKE /STREAM LEACHING Manufacturer: INFORMATION Type Of System / CHAMBER OR _ G�f 1� Model Number: DISTRIBUTION SYSTEM �� 7 /V Header /Manifold Distribution f �� x Hole Size r j I x Hole Spacing j Vqmlito Air Intake Pipe(s) , Z \ 5 Z �.•-r. Length Dia Length Dia Spacing 3 h v SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only Depth Over i Depth Over xx Depth of xx Seeded /Sodded xx Mulched Bed/Trench Center Bed/Trench Edges \ Topsoil (� ` yeS No es No COMMENTS: (Include code discrepencies persons present, etc.) Inspection #1: / / Inspection #2: Location: 1402 131st Avenue New Richmond, WI 54017 (SW 114 SW 1/4 25 T30N R1 8W) Hollow Pond Lot 1 Parcel No: 25.30.18. 1.) Alt BM Description = ' C �s 4-- Lc Lt) GJ 2.) Bldg sewer length = 9O - amount of cover = 7 '4 Z r� Plan revision Required? j Yes XINO Use other side for additional information. —_- .. --- -_ -._- _ -- 111 Date Insepctor's S' nature Cart. No. SBD -6710 (R.3/97) 4- ► Pb 11 StO P z,,,.,d PLOT PLAN PROJECT Ken Oeverina ADDRESS 838 Summei P es Circle Hudson Wi 54016 SW 114 SW 1 /4S 25 /T 30 N/R 18 W TOWN and COUNTY ST. CROIX SYSTEM ELEVATION 102.3' 1 3 1. BEDROOM CONVENTIONAL AT -GRADE )00( CONVE ONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 gallons LIFT ANK SIZE DOSE TANK SIZE 630 HOLDING TANK SIZE LOAD RATE .5 ABSORPTION AREA 900 # of chambers none BENCHMARK V.R.P. Top of Survey Iron ASSUME ELEVATION 100' Filter Zabel A -100 ❑BOREHOLE O WELL *H. R. P. Same as Benchmark RECEIVED AUG 3 1 2006 ST. CROIX COUNTY Property Line B.M. * /Alt. B.M. Tank is to be properly bedded and provided with lockdown covers with B -4 320' Property Line approved warning labels 5% Slope Area 15' below system is to remain Huffcutt undisturbed Combo Tank B -3 B -1 Well is to meet all 103' setbacks found in Comm. 83 Grading is to be done to divert run -off away from 102.3' system B-2 Pro 3 Bedroom House Scale = 1/4" = 10' 131 st. Ave Safety and Buildings Did ' oun ' 201 W. Washington Ave., P.O. 7 ) Irsconsin Madison, - 7 rmit umb be filled in by Co.) (608) ) 266 -3156-315 1 Department of Commerce Sanitary Permit Applic Plan I.D. Number GE1V Stat In accord with Comm 83.2 1, Wis. Adm. Code, personal i format provide may be used for secondary purposes Privacy La s 15.04(1)(m) r l op6 eject Address (if different than mailing address) V y� I. Application Information — Please Print All Information (Y C I I 2 — Property own er' Name P S� arc 1 # Lot # Block # I Property Owner's Mailing Address 0 "( =Pho Prope Locatio � h h, Section City, State Zip Code 4Name Lo T Nr W II. ype of Building (check all that apply) Subdivisio CSM P tuber 2 Family Dwelling - Number of Bedrooms ❑ Public /Commercial - Describe Use ❑ State Owned - Describe Use ❑City_❑nship of III. Typ f Permit: (Check only one box on line A. Complete line B if applicable) 02&- of • /2- Sl ' yttem ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System B. ❑ Permit Renewal it Revision ❑ Change of ❑ Permit Transfer to New List Previous Permit Nu ber and Date Issued Before Expiration Plumber Owner 7/ _ �l /ZtA IV. Type of POWTS System: Check all that apply) 0 � ❑ Non - Pressurized In- Ground ❑ Mound > 24 in. of suitable s ❑ Mound < 24 in. of suitable soil -Grade ❑ Single Pass Sand Filter ❑ Constructed Wetland ❑ Pressurized In- Ground ❑ Holding Tank ❑ Peat Filter ❑ Aerobic Treatment Unit ❑ Recirculating Sand Filter ❑ Recirculating Synthetic Media Filter ❑ Leaching Chamber ❑ Drip Line ❑ Gravel -less Pipe ❑ Other (explain) V. Dis e- Agreatment Area Information: e ign Flow (gpd) Design pplication Rate(gpdsf) Dis ersal Area Required (sf) Dis salsal A rea N posed (sf) System Elevation J" -L7 07 VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Units Concrete Constructed Glass New Existing Tanks Tanks Septic or Holding Tank Aerobic Treattnent Unit Dosing Chamber 3 VII. Responsibility Statement- I, the undersigned, assume responsibility for installation o he POWTS shown on the attached plans. Ptumbe 's Name (Print) Plum be 's Signature MP/MPRS tuber Business Phone Number Plumber's Address (Street, City, State p Code) VIII. Coun /Depart ent Use Onl Sanitary Permit F e cludes Groundwl to ate Issued Issuing Age ignature o ps) El Approved ❑ Disapproved Surcharge Fee) T� _ JD ❑Owner Given Reason for Denial , IX. Conditions of Approval/Reasons for Disapproval - SYSTEM OWNER: ltr�t 1 Septic tank, effluent filter and f dispersal cell must all be serviced/ intained as per management plan provided by plumber. r� 2. All setback requirements must be maintained as per applicable code /ordinances. Attach complete plans (to the County only) for the system on paper not less than 81/2 x 11 inches in size SBD -6398 (R. 01/03) PLOT PLAN ROJECT Ken Oeverina ADDRESS 638 Summer Pines Circle Hudson Wi 54016 SW 1 /4'SW 1 /4S 25 /T 30 N/R 18 W TOWN Richmond COUNTY ST. CROIX SYSTEM ELEVATION 102.3' 3 BEDROOM 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 BENCHMARK V.R.P. Top of Survey Iron ASSUME ELEVATION 100' Filter Zabel A -100 ❑ BOREHOLE O WELL *H.R.P. Same as Benchmark Property Line B.M. * /Alt. Tank is to be properly bedded and provided with lockdown covers with 320' Property Line approved warning labels 101' Area 15' below system is to remain 5% Slope undisturbed 102.3' B_ Well is to meet all 103' setbacks found in Comm. 83 P Huffcutt Combo Tank -2 o di g is to be d ne to Be om diOer run -off aw y from H use syste Scale 1/4 = 10 131 st. Ave AL C i i Safety and Buildings ` 4003 N KINNEY COULEE RD commercemi.gov LA CROSSE WI 54601 -1831 TDD #: (608) 264 -8777 sco n s i n www.commerce.wi.gov /sb/ www.wisconsin.gov Department of Commerce Jim Doyle, Governor Mary P. Burke, Secretary June 07, 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 PLAN APPROVAL EXPIRES: 06/07/2008 Identification Numbers Transaction ID No. 1277747 SITE: Site ID No. 713851 Ken Overing Please refer to both identification numbers, Town of Richmond above, in all corres ondence with the a en St Croix County SW1 /4, SWl /4, S25, T30N, R18W Lot: 1, Subdivision: Hollow Pond FOR: Description: Three Bedroom At -Grade System Object Type: POWTS Component Manual Regulated Object ID No.: 1079332 Maintenance required; 450 GPD Flow rate; 40 in Soil minimum depth to limiting factor from original grade; System: At -grade Component Manual, SBD- 10570 -P (R.6/99), Pressure Distribution Component Manual, SBD - 10573 -P (R.6/99) 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, Cony stats. The following conditions shall be met during construction or installation and prior to occupancy or use: APPI Reminders DEPaRTMEM N OF Slk G ? • This system is to be constructed and located in accordance with the enclosed approved plans and with the SEE CORF component manuals listed above. • Per manual cited above, limited activities are allowed in the area 15 feet down slope of the component area. Soil compaction, excavation, vehicular traffic and other similar activities that impact the treatment and dispersal are prohibited. • The well must be a minimum of 25 feet from any POWTS tank, and a minimum of 50 feet from the absorption area. chs. NR 811 & 812c • A Sanitary Permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.135 and 145.19, Wis. Stats. • Inspection of the POWTS installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of See. 145.20(2)(d), Wis. Stat i SHAUN R BIRD Page 2 6/7/2006 • Comm 83.22(7) A copy of the approved plans, specifications and this letter shall be on -site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. Owner Responsibilities: • Comm 83.52 Responsibilities. The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s. Comm 83.54(1). • Comm 2 83.52 A POWTS that is not maintained in accordance with the approved management plan or as () PP g P required under s. Comm 83.54(4) shall be considered a human health hazard. • Comm 83.55 The owner is responsible for submitting a maintenance verification report acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. All permits required by the state or the local municipality shall be obtained prior to commencement of construction /installation/operation. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide.a copy of this letter to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 Charles L Bratz POWTS Reviewer II , Integrated Services WiSMART code: 7633 (608)789-7893, 7:45 am - 4:30 pm Monday - Friday charlie.bratz @wisconsin.gov cc: Leroy G Jansky, Wastewater Specialist, (715) 726 -2544. Mq y 3 Cover Page sAFS� 0Zoos S Shaun Bird Bird Plumbing Inc. 1008 192nd Ave New Richmond Wi 54017 715 246 - 4516 Date: 5/25/06 Owner:Ken Overing Location:SW1 /4 SW1 /4 S 25T30 N,R18W Lot 1 Hollow Pond 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 ?�Olqallx 4. Pipe Cross Section /Pipe Layout r 5. Pump Chamber Cross Section OF rjEr cor$u Rcs 6. Pump Curve s 7 -8. Maintance and Contigency plan ESP�N�ENCE r� 9 -11. Soil test Shaun Bird Signature License nu #r 226900 PLOT PLAN PROJECT Ken Oeverina ADDRESS 838 Summer Pines Circle Hudson Wi 54016 SW 1/4 SW 1 /4S 25 /T 30 N/R 18 W TOWN Richmond COUNTY ST. CROIX SYSTEM ELEVATION 102.3' 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 BENCHMARK V.R.P. Top of Survey Iron ASSUME ELEVATION 100' Filter Zabel A -100 ❑ BOREHOLE O WELL *H.R.P. Same as Benchmark Property Line B.M. * /Alt. B.M. Tank is to be properly bedded and provided with lockdown covers with 320' Property Line approved warning labels 101' Area 15' below system is to remain 5% Slope undisturbed 102.3' B -3 B -1 Well is to meet all ❑ 0 103' setbacks found in Comm. 83 Huffcutt Combo Tank B-2 Pro 3 Grading is to be done to Bedroom divert run -off away from House system Scale ,= 1/4" = 10' 131 st. Ave • >- ; $ > M ?� • �T U��- u 4s t -_r A- 2:5 1 Afe�%r�a symTiinc. Fabric Distribution Lateral ,,,, Saii Cover Wei . • - r2 --. 2 �fbv,lED LMEA 2:5' A 0 coon of iiiscansisz At -grate Dot W'th a Plan Vies* and Cross Se Site Sfugle �,bsargtian Area on a Sloping, p age Of Qistribvtion pipe aetAil for Lateral Jfetwork Arse sf "TURK - UP ��li�n�OtiT� • _ - PVC Forte Pa in PVC nistribution Pipe . P * Last Mole Shoul Be Next To to "•up P Ft.. Mile Di arnete r L3 __ �4 ach Lateral Diameter 21 — Inch(es) X inches y inches Force Main Diameter Z inches of Holes /Pipe / J Lateral Ft. Invert Elevation Of 11 --��- Signed: License Number: Bate: CTIC3;�fi AND SPECIt ICATIOKS S£pTZC .�K £ P�3Nis CAMBER Cr2flSS SE ,. 141:M. A�DVE GRADE � Ji�A€CTifll� BOX ApPR4V� t� E13T PIPE 1� #I3�IW OR � #r� Tii Co DU IT MANHOLE COQ Eft y FROM DOER . I w/ PADLOCK & WAMING i.R$E:. t fry 4 MIfI GRADE � �.w�s � a I #LE —�-- GHQ t i�iAT£R TIGHT SEALS SEAL. �I�I P£ Lm 3` OOM S LIQ SOIL APPROVO C. . r PIP£ 3 = FF OM SID. OFF ELEv - � _ DD SOIL PUMP BEDDIN �i�TI3F.R 'MANY, CONCRETE PAO 3 i� � �pRO VED �CJ y'�.)�t�►o SPyr'iFICATILfN5 - Dosrs PER i1AY - _ 9 _ EP TIC ! DOSE S �flSE w mf- I N�gBC GAL i iv riANUrACTi3RER = v o . CAL. : 3b ���L. rAlrK ST. ZFS -- SEPTIC` £? CAS - - gDiCE�ES DOSE - CXpACjTZES= A : INCHE ' ALA F,p�C,3RER,- S GAL- 3�fKSER - S C = . � INCHE ITCH T - / . G ^ l L Sw TiJR = 11 15.23 WAC KODEL I 1d1R PUMP PER SWITCH TYPE �i � � s�T3lP £ A�R�€ i�tIRZidG A' FEET c�! C- rL PIPE • • C�- �- FEET F3ISCSARGE € TI(K3 REQUIRE pump OFF Ar[B _ _ - FEET $ETEEN Sc3RE - • £R ;C'TI�3 FACTOR • FEET d ERTICAL DIFFER '�'�� DYE C pRK St3PP1.Y PRE =I.TI I€� • £T' HE j M7� rop.0 ZN X TOTAL , 6 ; DIAKETL r rii^' JA": �,, � I��tI�RL L IC €NS z. Nt3i ER= _ r SIG�tED= _ i1�8 Sent By: HP LaserJet 3100; 1 715 552 BB27 ; May -5 -06 2:bbPM; Page 21:3 9EH SERIES SUMP /EFFLUENT PUMP e.11s p a Specifications INt Ca 11 wnc FRAWNkluw011A rant 11111011 w Lou K K 11 wns ft.1101 MOO= r it IF 2r W IN Mal 0 12 1181 9" 509330 ULCSA WC 115 3+4 13.0 1000 14 V 55 41 32 131 20' 24 4.11 :11.64x&94 ON-W 509340 W= sra 230 314 &5 1000 70 64 55 41 32 13.9 20` 24 S AI x 11.64 x 1L94 SR U PS 509350 Ut4MA d "0 115 314 130 1000 70 61 55 41 32 139 2C 27 8.11 111,64x9.94 SQ"W cc VW Ul4SA 4P0 230 V 65 1000 7D E4 55 41 32 118 20' 27 9.11 x iI 64 x UA Ca�tlOUS OutYRikd—"L� 6i7ntMh4t�a4rDU�sarot7kOc0�M�grstb4Yai bn04s11uYxeNnwitAie tlrop>5�h�►xlnpstor�esepimps.• FLOW- LITERS /HOUR Construction 0 1000 2000 3000 Motor Housing $foxy Coated Cast Iron Impeller Material Pol Carbonate 30 to Im ller Type Closed Vane _. -... . Volute __._.. _ _!DS cup 7.s 4 Power Cord SJTW -A 1 20 Mechanical Shaft Seal Nitrile with carbon and s ceramic faces A Fasteners Stainless Steel = 10 = Shaft. Stainless Steel 2.5 Bearings : Upper Sleeve and Lower i Ball Bearings 0 20 40 60 80 FLOW GALLONS /yINUTE _PU PERFORMANCE CURVE Little Giant Pump Co . 115V 60M = PO Box 12818 - Uidsko C%M Ott 73157 Phoae: 405'147.2511. Fax: 405428.1558 Email: cusiomenervkm@btdogbot.com www.LittleGiantftmp 4 Fam W5235 -07103 'S MANUAL & MANAGEMENT PLAN POINTS OWMER gySTEM SPECIFICATK}t+I Q N4 E: rrr> = OR noK _ septic Tank Cate' Manus 0 NA owne<' IZ ,�✓ i �uftidwer Q NA Perrt>it- pier Maier —I o NA DESIGN PAM— NA Effluent 0 NA Hww of B�n�s Pump Tank Capacity 0 NA ufac turer Numwof Comrwda�l Units � - aYd rump Tar, Mar+ flow ( aver) d - pilmo i pesvn flow (pea " �"� �� a Ptttnp Mode Pr ens Unit - 0 Peat FrW Sa APPS -mn P-* Mordt�lY average' r aYel EsOW trtAcretttlE�ua Q y30 mglL p Mectranikatt Aeration O Wetrand Fats,., Ora & Grease (FOG) C3 Other Demand (BODO :02o ��' ❑ Disinfec Bioctie oxygen Sornde ) Monthly average.. D ispersal domas II In- ground (pnessur� L UD11 round p Mound p E QY and (BODE S3Q mg1L race ❑Other_ B ioctrem ) a and Fecal Offen Solids {T� 53o cf boot Tota1$usPeR 1 5 10 4 Cful id for d--85W O es 000f0= (�prflOtflG mea V u0m Y inch6amete Matlinum Effluent Pa i t cle Sme .. ,tatues 0'P Aor Service Frequency t ,,l gGHEDULE rCs) (MaxFmurn 3 yrs -) service Event ❑ rnonttss At least once every on "� (y3 of tank volume inspect cor>doon of tanks) ) ytynen combined sludge and scum e4u�' r(s) (M murn 3 yrs Pump out contents of tank(s) p months At least once every E(s) inspect dispel cell(s) At least once every f3 months s) p NA p months C(eaniuent titer least once e p very s) p NA Inspect pump• pump contxo(s 8� al arm Mon At least once every L1 year(s) p NA test II rstonths 00-r At Wwais and pressure At least once every Q mont fl ypar(s) II NA oe ieas� VIM every aver one of the foIIo4 *V ricenses or .mXTEMANCE tNSTFtu noms carts shah be made by an ind'cvidual csrz rs P OW TS Mainiamer, SeP I pecriions of tanks and dispersal prurnber Res'Erleted sewer, POVN'rs pe �� any wig or broken Messer 'lumber. Master pn Of the tank(s) back up ns must Induce a v inspem a and SOUL and � effluent level Senitav Opelawr Tank inspecdo ure -the volume of combined studs Of efiusnt on the _ daniware. y wW cracks or leaks. The dist�r ceu(s) shall be visr�Y lr"R � ochec or po rdw of effluent on tare ground surface Pot of effluent on the 9*�nd n of the tam roguiat°n'sua in the obser+� p� and to chec �d�n and re4�uss me Immedrate or more of the r.Ln volume, the ground surface may indicate a fairing of in accon#an°B'^ ' NR tnuiation of sludge and scum in any tank equal i and disposed ch- When the comb shalt be removed by a Septage Servidng OPeM entire ft �mintstrative Code- - retreat�t comb vents: and anY 113 Wiscansln ressudzed PoWrS components, re 17Y t wed POD Maintainer. The king of e{f(ueni filtP.r'S. P event. of '12 months or less shalt be for fetion of any I� other ma Rance or Mw*0mg at 9nwva� authority whin 10 � of Come A service report SW -be prided to the Iota[ regu�tO'� the �� � p�� products or ether . START UP AMC) OPERATION pOWTS check Mr atrnent tank {s} for P Ctcentratwns are new consEnxdon. Prior to use of the s andfor damage the dispersal cell {s) - If high chemicals that MY impede the tr�� a~ hY a septage servicing operator prior to use domed ha�re the oontems of the tank( ) re • � ^ Page �_... -- - five su rface- ei n fiiitra • not occctr vMeri sorb condrfions are frozen at m is System start up shall � above normal Wghwater levels. When en i? r result in the During P0M1°r'Or ages t #� � t e cr cei�s) in one large dose, overloaa� the od6 {s} tan may ,arrlt be drsed tank removed by a �erast r to the dirt T��id this srtuartiorf have the contents of the puart¢ Mdutp or surface die of e_uen fm the effluent pump -or cantac! a Plutr or POYYfS I�fatrtiairrer th $ ppe=aiing the putnP to restore normal levels within the pump ta�- atsw dlspet'sa� its_ Do not dime or P21k OYK- or derll "e W1* of wm" D not dmre or pack o fiats or at -grade soli absor pfion area - y in 15 feet down stops � anY a r b m3= and prolong ft ffe UV � �m the ,��,,�e�rafes sfraam may improve 'th pe Reduction or eluzlinaf of tine �olbOng butts condoms; cottan Svrabs; deg detest 50M. draper; of the POINTS- artbbTOfiCs;'t Y P� r � getable QeeGng 8 herbcc� des; meat d � diatrt (strop P. p pest ) " "des= wry napkins; tampons Watef softener brine. scraps med OQ � 3duc€s: NMMFXT of service the following steps shalf tw taken to Insure that the Me pOWrS falls and is Pence" i�ken out end safely abandoned � compliance � ch_ Comm 83.33,1P�rsoo'risin Admlre�tative Coder system is properly ds shall be disconnec and the abandoned Pipe openh�gs sealed- AII plping W tanks and P of by a SOP Servicing Operator. - rh o oontents of air tanks and P stiaU be removed and properly d "I d n --md and the ",Ad spebe AfWr pumping, au tanks and pft Shaft be excavated and removed or ttselr oav ers , g SW vvltfr wfl ravel or another inert sofrd material . CONMGENCY PLAN the forlovring measures have been, or rratst be taken, to Provide a code if the POINTS fats and cannot be fePb0Wn0nt arrepay compfrant anent system evaluated and may be vtilbmd for the location of a reP4'oement sod 0 A suitable ea h� been and should not replaceme replaceme ar t ea should be protected from disturrbance an d com p ac tion setbacks from exssbng and Proposed strudur�e, lot fines and wells_ Failure to . required d ult in the need for a new soil and site evaluation to establish a suitable be protect the replacement area win res tvitir the rules in effect at that time. replacem rea ent a Replacement systems must comply advances In POWTS D A su itable re racement ales not avaTable due to setback and/or ce failed POD g . P as a last resort to rep techn�ogy a holding tank tray be mstalred failure of the POWTS a soit.arid The site has not been, evatuafi®d to identify a suiitable rePracernient area Upon t area is available a / site ev aluation must be P� W locate a suitable rePlacernent area tf no repl✓ao holes tank may be '&MWed as a Uds t res ort to replace the failed POV1tlac � of the bierTtat at n Systems may be reconstructed in Pace following � Mound and atVrade soil ab_'%X O _ s of such systems must comply with the rules in effect at that time_ ie lrrfitrative surfaoeL, Reca"n c<WARNlr+ (>> CC3filTAtN LET14AL fiAS SES ANDIOR INSUI=IriClENT OXYtsE7%E. gi p77C, PU1VfP ARID OTHER ZRFATMEhlT TANKS MAY ClaCuAKS;EANCES. DEATH MAY DO NOT ENTER A SEOMIC, PUMP OR OTHER TREA A T Be E IFFICULT OR IMPOSSI RESULT_ RESCUE OF A PERSON FROM THE INTER! O O AANK firt�4Y ADDMONAL COMAWXT*S POWTS INSTAL LIEM ppWrS NWN EName Naarne czl_ . ph Zone Phone S,EFTAGE SERVONG OPERATOR PUMP LOCAL REGULATORY A€J FHORITY A9enc3' Y % x_ 9 N2me � Phone 7r ,� - Z� - s� � - Prr�R rs . G -� Mks dOCUMMAU'as "i� by fire of she t sdce. 3ta and Waush= cowty zoning OW Sar?�ation l:tis Qoc rt me minimum ne4 of aL Cw n 83_Zk - 4 6Ht)(~ and 83 (2) & C3). YYrsm sia Admit20%rtiva Code Use of do�truKrt � M0t) gumvitee du performacuoe of the POWTS. Wisconsin Department of Corn rce So P RT Page of Division of Safety and Buildings a an ' h C m 85, WiFI Attach complete site plan onp Lr� ( T d471!!ee�r not less than 11 inc es ins 5 my �� include, but not limited to: verh I reference poi (BM), ireP I.D. percent slope, scale or dimensions, north arro�tion a d distance D Z6 l l b3 - D / - ST. 11' R viewed b Please print all information. ZO y Date at t((/ Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Z / 1 Property Owner Property Location Govt. Lot �,L) 1 /4 1 /4 S 7 3 0 N R E (or ddress Lot # Block # Subd. me or CSM# Property Owner's Maili 3 3 5 Q. �. v1h- yw {/1( City State Zip Code on umber El ❑ tllage T Nearest Road New Construction Use. esidential / Number of bedrooms Code derived design flow rate ,1� - GPD ❑ Replacement ❑ c or commercial - Describe: -- - - - -- - Parent material Flood Plain elevation if applicable ft General comments and recommendations: '2, O ❑ In F �# Pit Ground surface elev. 07 '` - 1 ft. Depth to limiting factor Soil Appl ication 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 oe �. l l0 3 ors. i ® Boring # , -� / Boring / 7 -U Pit Ground surface elev. Q L I ft. Depth to limiting factor 0 //2 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 �/Z- w . r .s Effluent #1 = BOD > 30 < 220 mg1L and TS >30 :150 'Effluent #2 = BOD < 30 rrrg/L and TSS < 30 rrgfL CST Name (Please Print) Si CST Number Bird Plumbing, Inc. Shaun Bird 226900 Address Date Evaluation Conducted Telephone Number I d 1008 192nd Ave, New Richmond, WI 54017 �,� s- _ b 715- 246 -4516 • Property Owner Parcel ID # Page Z - of Boring _ ❑ Boring I # pit Ground surface elev. 1 1 ` 'Yt. Depth to limiting factor /1 /0 in. Sail A (ate Horizon Depth Dominant Color Redox Description Texture Structure Consistencei Boundary Roots I GP in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. ^ 'Eff#1 'Eff#2 Qom) Boring # ❑ Boring Pit Ground surface elev.ft. Depth to limiting factor __F___ in. Sal 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 '042 E] Boring E Boring # ❑ Ground surface elev. ft. Depth to limiting factor in- Pit Soil ApoicationRate Horizon Depth Dominant Color Redox Description. Texture Structure Consistence. Boundary Roots GPDM in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. 'Eff#i 'Eff#2 ` Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < - 150 mg/L ' Effluent #2 = BOD, 130 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. sao•e330 tR.M) Soil Test Plot Pla Project Ken Oevering S B' d Address 838 Summer Pines Circle Hudson Wi 54016 TM #226900 Lot 1 Subdivision Hollow Pond Date 10/25/05 S W 1/4 S W 1/4S 25 T 30 N /R W Township Richmond Boring Q Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 100 ft. Top of Survey Iron System Elevation 102.3' *HRpSame as Benchmark Alternate Benchmark Top of 1/2" pipe @ 100.4' B.M. * /A1t.B.M. 206 Property Line Scale = 1/4" = 10' unless otherwise noted 100' 5% Slope B -3 70' B -1 0' 101' 50' B -2 103' 320' property line 131 st. Ave r a LOT 2 C ERTIFIED SURVE Y -..w 4-t - J� PAGIE 3 900 * s C> l �■ CON CNJ r ; LOr . ; °.` O. = tan. a l w 0 LLJ f i 251 434.4:r 2 5'wW 4 r • County l g Bui vision 62 n L� Sanincy Petsait Nutnber (to be f,Ucd in by Co.� WI 537 Is eoosin 3151 S „� P>� LD. Number D artment of Commerce 2004 —_�-- S Pernlit APP I� pw; ectAddress OftSfta�t�"'nnaStddm) 3= ,,d with Comm 83.21. Wts, Adm. Ptivacy , 815. OFFI N Nry may W USW for smn taty PUP° St Print AU 1p{"Moon I Fo Z Av � L ApPV�oa �formatIon — Pkase pstt:el I.ot odt i PtoP�y °ee � ' 3 p� o )Asa* r S Sv� - T 44 rv-zip rode pbooe Numbs City. State r ` I C? k7 T -30N s,rb� N of Bvuaing (check an that spp1T) 1 i ar 2 why vwWhms— K "'woe` or H�oo•� Qry : y '� Totvnft of n r�mmercisi - Desuibe Use :rate Ow _ gibe Use ilaable) only one hoz oa litse A. Complae line B tit app t> ioriesdon w 13w�8 Prom !3L Type o[ Permit: {Abed[ T•�t/Ao1" Tsnik R� t�o17 A. New System RePlaoeme+u S�sostn i3se Psavioas pmt Number tad Date Iwed • permit Traosfa to Naw permit Revision � of owner B, permit Rene Plumber Before BxPiralon Check alt that a 1 ' At -Grade S �� Of im I is Mound < 24 bL of suitablo Soil .e.. - pressu� 1a- Ground Mound 2 Z4 in of suitable soil pwt Filter Aaoblc Trestm pmt Floldiny Tsalc '� (( Construetod Wedand p In LAW Gavel- Pi OTC /) Meda Filter Sy:oua V ses� Arai Iuformstlon% � -7 gegoitod (sf) • Dispetd Arm Deafa Flow s D Soil Appliaaiva Z C �� silo e 0,0 am ty In r Q / Number Maoatacwter Co�+coed YI. TU* info Gallons of Units I � -I NOW F.tisdae •rants Se�db ar NoldioE Tact Do.fot tibmbs a o[ the 1*OR'•» O6 the Business p Number in for Number yII statecnwt z. the otabet' plums s L� aIZ- Plurabefs Address (Std , State. Zap Date issued A� ffi R'io Se° t Use O Sanwry peemlt Fee (�� � °1iA owtxx QvVn w:essm UL l;ondltiona SYSTEM OWNER: euf ivAU2�1dx¢ A.. kA 1 Septic tank, effluent filter and 4V dispersal cell must all be serviced / maintained a as per management plan provided by plumber. (oUA"^ 2. All setback requirements must be maintained as per applicable code /ordinances. for #yon 00 PsP� l�tbm =tflsttioclwi , Attseh Pbo (totheCoust�odl) �7 � S ku a PLOT PLAN PROJECT Oeverino Homes L.L.C. DDRESS 838 Summer Pines Circle Hudson Wi 54016 SW 1/4 SW 1 /4S 25 /T 3 /R 18 W TOWN Richmond COUNTY ST. CROIX MPRS Shaun Bird 226900 DATE 12/17/04 BEDROOM 3 CONVENTIONAL XXXX IN-GROU PRESSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .2 ABSORPTION AREA 2363 # of chambers IL BENCHMARK V.R.P. Top of Iron Pipe �-- S vvk ASSUME ELEVATION 10 ' Filter Zabel A -1� ❑BOREHOLE O WELL H. R. P. Same as Benchmark B.M. * SYSTEM ELEVATION 100.0/ .6/99.2/98.8 90' PA e 13 4 -3' X 119' Cells with >3' Sp Well is t a all Vents setbacks r uir by WDNR 4% lans Designed U ng Slope nv ntional Po s 140' n l Version f. 0 • ote: Soil conJitions 177 ` e field verified°to • determine if a ingr6und ystem is suitable! B -3 B -2 1t.B.M. 20' S o�- CO 3- Pro 3 - 3 Bedroom �,,,,�; C►+ House Vent 140th St. 4tanrlard Rindiffiiaer e r' rf% w.; y 41 ty ST. CROIX COUNTY f Z WISCONSIN r-' •w•e' _ ....' ZONING DEPARTMENT ST. CROIX COUNTY GOVERNMENT CENTER 1101 Carmichael Road Hudson, WI 54016 -7710 Phone: (715) 386 -4680 Fax (715) 386 -4686 Me o to F From: Pam Quinn Date: 7/21/2004 Re: On -Site Soil Report Verification for Lot 12 Hollow Pond Subdivision (SW '/< SW % Sec 25 Town of Richmond) On July 9, 2004 a site visit was conducted to evaluate soil conditions reported for Lot 12, 13 & 15 within this new subdivision. After making observations in test pits and subsequent review of all soil reports submitted for lots in Hollow Pond, it appears that the recommendations for installation of pressurized conventional (in- ground) systems may not be feasible. The weather was sunny, temperature in the 70's, with good light conditions for color determination and no precipitation for >24 hours. A sanitary permit was issued for this lot and excavation for the foundation had exposed soils that caused concern for installation of a conventional system. Test pits on lot 12 had been excavated at the approximate locations of B2 & B3 on the original soil report. At B3, the soil profile was similar to that reported, but redoximorphic features (iron deposits and high chroma concentrations) were observed at the irregular boundary between a sandy loam horizon and fine sands below, at approx. 60 inches. The fine sand horizon from 60 — 88" appears to be weathered sandstone, with extensive iron deposits throughout (2.5 YR 7/8) in a matrix of 10 YR 8/2. Bands of 7/5 YR 4/6 sandy loam were observed starting 6" below the textural change. A test pit near B2 showed massive sandy loam transitioning to fine sands at < 48 ", again with redox features along the textural change and much higher concentration of iron staining in the fine sands. Redox features at less than 48" would limit installation of a pressurized in- ground system to less than 12 inches below grade. This would place the system on Lot 12 in silty clay loam soils with an application rate of 0.2 gpd/ft Recommendations for "pressurized conventional systems" would require a minimum of 2250 ft for a 3- bedroom house, 3000 ft for a 4- bedroom system. Due to Dept. of Commerce code changes, effective as of 2/1/04, massive sandy loams now have a soil application rate of 0.2 gpd/ft On many lots these soils were encountered in a third horizon at depths of less than 24 inches from the surface. Pressurized pipe, not a dosed system using leaching chambers, would be needed to achieve even distribution of wastewater throughout 1 these soils. Costs for design and installation of an in- ground pressurized system should be compared to a traditional mound system, the latter having the option of being reconstructed if a failure occurs. The existing tested areas for all lots within Hollow Pond are not large enough for installation of a 3,000 square foot system and another equal area for replacement. Additional soil evaluations will be required and the replacement areas will have to be preserved from any construction activity for sites proposing to use this POWTS option. Mound systems for lots in Hollow Pond would require designs with lower loading rates where soils exhibit platy structure in the upper horizons and/or have <0.3 soil application rates within 12 inches of the surface. These long, narrow systems would, however, fit within the existing tested areas provided on the original soil reports. Sanitary permit applications for conventional POWTS will not be approved for these lots based upon this on -site determination unless the following items are included: 1. Additional soil test pits have been evaluated to provide both primary and future replacement areas. 2. Documentation that redox features are >36" below any proposed system elevation. 3. The soil application rate used for sizing the system extends a minimum of 6 inches below the proposed system elevation. For example, if the system is 18 inches deep and a massive sandy loam begins at 19 ", a soil application rate of 0.2 gpolfe would be required for sizing the system. Cc: Greg Peterson, Subdivision Developer Oevering Builders, owner Leroy Jansky, Regional Wastewater Specialist Tom Nelson, CST #227387 Property Owner Peterson Parcel ID # Page 2 of 3 Boring a � # 0 pit Ground surface elev. 103.60 ft. Depth to limiting factor >88 in. Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDM in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *E-M 1 0 -11 10yr2 /1 - sil 2msbk mfr aw 2f .5 .7 2 11 -18 7.5 4/4 - sicl imsbk mfr cw if .2 .3 3 18 -25 7.5yr4/6 - scl Imsbk mfr cw _ .2 .3 4 25-88 7.5yr4/6 - sl mfi - - .5 ,2 F-1 Boring # Boring pit Ground surface elev. ft. Depth to limiting factor in. Rate SON APPlication Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fP in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eif#2 F-1 Boring # Boring Pit Ground surface elev. ft. Depth to limiting factor in. Shc ication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/tF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Etf#2 ' Effluent #1 = BOD, > 30 < 220 mg1L 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- 9330Test (R.07)00) I w HOLLOW POND LOT N LOT CORNER B 13 1 M 17► T O W N 153, R 177' N O A D SCALE 1' = 40' 13'x. TOP OF IRON PIPE 1 00' 496 8M2 OP OF CONDUIT 103.75' B 2 B3 SLO 100.60' B2 101.55' B2 B3 103.60' 90' 100' 102' 104' THOMAS NELSON r� 977427 R ECEIVED PRELIMINARY PLA' pC T 2 8 (A cc 2003 Located in port of the Southwest 114 of ST. CRO North, Range 18 West, Town of jx COUNTY Neat 1/4 c omer ZONING OFFICE (Farm hhed w � i�T 2 CE TI; S R , p -iMOND -I MAP '✓l_UME 1 ! __. P -_ 39G NB '55'25 "IE 1315.51' I ?Qs' -,205 JO? 265' LA � I (. •8 ,;� -. 019. £oasment) NET BUILDABLE AREAS: - I Hm...1017.0' LOT 1 65,603 sq, ft. QI LOT V ' `- • .� 1.51 acres C-1 TI -� i LOT1 LOT2 LOT4 z 1 ,� 6W Sq. ft. 65, 603 s ft. \ r 82, 379 sq. ft , • .78,, 540 sq. ft ( LOT 2 58,134 aq. n. L B.O. =1021.0' s^� 1.33 acres 5 - 1.51 Q�eses 1 51 oc�es �' 1. B9 acres �9. 53,087 sq. ft. �. \ 1.80 acres 1.22 acres 1 0. = 1021.0 LOT 3 ' t� 97, 25; LOT 4 78,540 sq. ft. i 1.80 acres _ 2 23 LOT 5 97.252 sq, ft. ) ` - , - - ?OS' c ?4 ` \ l • 2.23 acres i�jd•, 4 LOT 6 8 1.88 acres A *M w - � ✓Ob; • rptg�.. Vii; LOT 7 128,028 eq. n. N a - 5' 2.94 acres r -?l5' - -2?0' 90,388 s ft. i r p �12 ;y LtlT 8 2.07 acmes !'tJP J LOT 9 89,4 sq, n. k 5 2,05 acres Q I ... a. ..•., . . „,. ` LOT 10 81,268 sq, n. 1.87 acres l 9� LOT 11 91,632 sq. ft. LIANU4E -1T I I� I -,,• Aa i - 2.10 acres 1 I II i�- ..._.�_ �..(sEE v : Ei \ LOT 12 77,189 s ft. �I LOT t/ ° R , - -- LOT B ; t.77 acres a `� 91 6 LOT In w „x,102,,#62 sq. h. '�.. 76,853 sq. ft, Q 0 1 ,31 sq, ft. 81,266 s ft LOT ` `235 acres LOT 13 1,77 acme �' v1 2 10, acres q 89, 416 sq. ft. f. 87 acres B. 0. =1033. D' LOT 14 93.544 sq i1. o 2. 05 acres 2.15 acres 1 i be Removed LOT tS 62,292 sq. ft. I QI W ' GRAIN 1.43 acres I -J , LOT 18 85,401 sq. n. Z� I^ aAkv / oaer On 1.50 acres In p 1 15'.. - Ja?' t?J' _ 75 4g7' HN�'10JLG LOT 12 _, LOT 1.3 c A' l LOT 14 Nwt 0 T 77,189 sq. ft. 76, 893 sq. ft. cAi� _ . 1.7 s 1.77 acres L t 13� 138 sq. ft acre ' acres x;65, d �`,� I.BA• =103,3 D' �� 1.� r; _ :.tan 4- 4.8.0 1 i I I VE - y _- - - -- - - - - 4/ - - -- -- --- ---- - - -- - - - - - -- - --- -- 589'43'24 "W' -,,- 10 7H AVFAt -- 1322.24 AP PROVING Al RITY TO WN OF RICH -� .�� - --- - ti. - • ', - -- - £ .: nr -- Sff9VJ14'W ?841141- -- TO LLo ST. CROIX COUNTY Southwest Comer Section 25 -JO -18 PL PLATTED AREA IS ZONED: AC -RES ZO (round 7/b'rebor) J`JPLATTELr - L aNDS - ` - - - - - - CURRENT USE: AC -RES ADJOINING LANDS ZONED: AG -RES CURRENT USE: AC -RES ,AREAS: TOTAL AREA OF LAND TO BE PLATTED: 1,543.552 SO. FT. own ACRES I hereby oe direct mwpen MINIMUM LOT SIZE REQUIRED: 85,340 S0. FT., 1.$0 ACRES NOTE: The parcels shown on this mop are subject to State. County and Township knowledge or AVERAGE LOT SIZE: 87,553 SO. FT„ 2,01 ACRES laws, rules and regulations (is. wetlands, minimum lot size, access to parcel, the laws of THIS ADDITION WILL CONTAIN 16 LOTS eta). Before purchasing or developing any parcel, contact the St. Croix County PROPOSED TOTAL LENGTH OF TOWN ROAD: 731 L.F. Zoning Office and the spproprtote Town Board for advice. R.O.W. DEDICATED TO THE PUBLIC: 142,705 S0. FT,, .128 ACRES TY DODGE, R _ I Maint enance and Contingency Plan for a Septic System Maintenance Plan 1. Septic Tank is to be pumped once every 3 years. lar filter is being installed in 2. Effluent filter is to be cleaned once a year. Please note: a la r g order to extend the maintenance interval of the filter; ia the inspections pipes at the ends of 3. Once every 3 years, cells are to be inspected v the cells. rees to limit greases, garbage, and water conditioner discharge into the system. a 4. owner g 5. The owner agrees to save this plan. 6. Do not plant trees nor park nor drive over system. 7. Watershed is to be diverted away from system. per Comm. 83 8. Discharge into system is not exceed those required as p Contingency Plan ' n #1. If stem fails, determine cause of failure, use ernate sr� and install new option Y sted replacement area. t a lower elevation, by removing chambers, removing biomat, OFinstall install system a a ew system. Optlo n#3. No adequate area is suitable for replacement area, and system elevation can nont be lowered. Install holding tank as last resort. 3. Replace any other failing components as needed. Plumber: Shaun Bird 715 -246 -45 St. Croix County Zoning 715 - 386 -4680 Pumper Tom Mondor 715- 246 - Shaun Bird #226900 RECEIVED `Wisconsin Department of Commerce SOIL EVA LUATION REPORT P age 1 of 3 Division of Safety and Buildings FEB 0 9. 04 in accordance wlttM o 85,1 1 Vis. Adm. Code Attach complete site plan on paper t iesa'ia�65 WWk& in s' e. Plan must County St. Croix include, but not limited to: vertical a horizoAWMtJfb&WFpblat (BM), 4irection and Parma I.D. percent slope, scale or dimensions, no arrow, anovIsTaInce to nearest road. Please print all information R 'awed by Date / Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). . 10 Property Owner Property Location Greg eterson SW SW 25 30 18 g Govt. Lot 1/4 1/4 S T N R E (or) W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# 1611 Hwy 10 1 Hollow Pond City State Zip Code Phone Number ity ®Mllage ■ Town Nearest Road Spring Lake Park i MN 1 55432 1 ( 7¢3- 7804996 140th Street Richmond E] New Construction tion Use[] Residential / Number of bedrooms 3 to 4 Code derived design flow rate 450 to 600 GPD ® Replacement ® Public or commercial - Describe: Parent material Loess over glacial till Flood Plain elevation if applicable AA General ft. Genl coat ese are massive soils with the need fore tremel careful installation t stem being used by the d recommend 'o s- stalling contrac r. My recommendation w to consider pressurized s st here the effluent can n n 4 - &4- _ ( � be dosed over the entire tstn urion area. Not requlr u dad. This site is sui le for a below grade conventional system. ( (1 ��--�yy 1 Boring # L] Boring � ❑ Pit 100.60 ft. Depth to limiting factor >88 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 1 0 -11 10yr2 /1 - sil 2msbk mfr aw 2f .5 .8 2 11 -17 7.5 4/4 - sicl lmsbk mfr cw if 2 .3 3 17 -25 7.5yr4/6 scl lmsbk mfr cw - .2 .3 4 25 -88 7.5yr4/6 sl Om mfi _ _ ,5 2 2 Boring # Borng 101.55 >88 El Pit Ground surface elev. ft. Depth to limiting factor in. Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDM in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0 -9 10yr2 /1 sil 2msbk mfr aw 2f .5 2 9 -19 7.5yr4/6 - scl imsbk mfr cw if .2 .3 3 19 -88 .5yr4/6 A Om mfi - - .5 * Effluent #1 = BOD > 30 220 mg/L and TSS >30 150 mg/L * Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) Signature CST Number Thomas C Nelson _ 227387 Address Date Evaluation Conducted Telephone Number 1432 120th Street, New Richmond, Wl 7/3/03 715- 246 -2454 I _ _ FROM :OEVERING HOMES LLC FAX N0. :7155311282 Dec. 15 2004 09:22P11 P1 C;pUNTY ST CROEK . • SBPTiC T O . �.�CATIQN F lop L L�r f" �F �wtte�l9 v ' 00� r H 449 t for sew caa�i0� Proper't'y Addt'� (Verifu�p � . Parccl xda�ti$�°Q Nuat� cctristz / N P� -- u -•-- Tower of / see• -= T Lot # -f Page # s Sub&VWOA �� Volume j Cord ed SurVeY b"P # y , Valuase Page 1� le �yn Ono WsrrsO►tY D� # I,ot liaes idos►ti��' (' Ito �� $per 1S011s q eosld t t is tsa sati+%� aThss ys�► p+l if Sa l bl It io d by amp w oo stw eato�s P� Qf saprotoe U& e` s ' sbl s o b Ill zo eaa s ThA ° y 0wIof s lie dP sar rY)• st *a grow so go b o n to St. CA d snd Pte" S �aww " s n. 9 maisvI "usosymu�P s ea iesPs� tivax t u c a l is in Few IPP00" xy►ve o� � abevo � s sl s4 sue. a� ° .oebr msn Mo g ul msCa im come b st mraa. ,,ysse� w� DTs sstt"s tbst yo Oyu * �p�taoa �• . �» �LiChNr of � es�s) SIONI�► will tot of toy v by VUW of r ti •bcd sba e. the be= waked by 60 VT OF may asulc is tbo wimy ...ss•. Asy W00060°�t is *a RIOW of D°ede °� a WMWAY been w�W desd ftom if rsE�e'� as ip�pdt witb� appueatlo0: s call of as oertited1ey trrP ess :za 4 0 st aaa T'd FROM :OEVERING HOMES LLC FAX NO. :7155311282 Dec. 14 2004 10:14PM P12 .._ --- - -- -------------------- - - -- ----- - - - - -- - - - -- �. - -• - •� ' I la F N ♦ r7 Mrw•.�w�wr� y I I 1 • FROM :OEVERING HOMES LLC FAX NO. :7155311292 Dec. 14 2004 10:14PM P11 r , a� NWA i -- ---- - - - - -- 0 y • E r .._............. I r � y C y C N r r - ------------ -- - - - - -- - - --- pu r =I a ti U 2685 P 179 STATE BAR OF WISCONSIN FORM 1 — 1998 KATHLEEN H. WAL5H WARRANTY DEED REGISTER OF DEEDS ST. CROIX CO., WI Document Number RECEIVED FOR RECORD This Deed, made between Silver Lake Land. LLC, a Corporation 10/29/2004 08:25AN Grantor, and Kenneth J. Oevering,.#._. ­­Grantee. WARRANTY DEED Grantor, for a valuable consideration conveys to Grantee the following EXEMPT i described real estate in St. Croix County State of Wisconsin (the "Property'): REC FEE: 11.00 TRAITS FEE: 1272.90 0 COPY FEE: nn_} CC FEE .�IWp�pcarn� ��U PAGES: i Recordino Area Name and Return Address . j.,N TO: urnet Title ?li Fmnce Ave. S. 026 1073 50 001 Parcel Identification Number (PIN) This is not _ homestead property. (Is) (is not) Lots 1 through 11, Hollow Pond Addition, Town of Richmond, St. Croix County, Wisconsin. Together with all appurtenant rights, title and interests. Grantor warrants that the title to the Properties good, Indefeasible in simple fee and free and clear of encumbrances except Dated this , - -)(I day of October 2004 (SEAL) (SEAL) Gregory J. Peterson, Presides Silver Lake Land, LLC (SEAL) (SEAL) AUTHENTICATION ACKNOWLEDGMENT Signature(s) State of Wisconsin, } ss. authenticated tni d NA St. Croix county STATE O F WISCONSIN S CO N S t N Oc Personally came before me this day of _ tober, 2004 the above named Gregory J Peterson as President of Silver Lake Land * LL n' to me known to be TITLE: MEMBER STATE BAR OF WISCONSIN the person who executed the fgregoing instrument (if not, and arks wledge a same. authorized by §706.06, Wis. Stats) THIS INSTRUMENT WAS DRAFTED BY Coldweil Banker Burnet Notary Public, State 6f Wisconsin 1301 Coulee Road Hudson, WI 54016 My commission is permanent. (if not, state expiration date: 3 -66215 g a b Q (Signatures may be authenticated or acknowledged. gI b ) Both are not necessary.) * Names of Persons signing in anX ca c must be ed or printed below their si nature. I Located do part of the Southwest 114 of the Southwest 114 of Section 2A Townsho 3o North. Range 18 West. 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