HomeMy WebLinkAbout026-1163-06-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix
Safety and Building Division
INSPECTION REPORT Sanitary Permit No'
506217
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:
Clevering Homes LLC, c/o Kenneth J. Oeverin I Richmond, Town of 026- 1163 -06 -000
CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range /Map No:
(> w , , 1 25.30.18.1256
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER Nf CAPACITY STATION BS HI FS ELEV.
Septic t G J 2 / Benchmark
d, &OC 16�
( Alt. BM / $ 9`} • g
Dosing �p� q : 1,-w �AJ2�.
Bldg. Sewer
L 7
Holding SUHt Inlet 3� 9� Z
.`_
TANK SETBACK INFORMATION St/Ht Outlet '
TANK TO P/ WELL BLDG. Vent to Air Intake ROAD Dt Inlet -�
Septic A 1 A I J4 � Dt Bottom 1 ? � l 9
c jll1� T ""r J /
Dosing I A Header /Man. -7 /4V 9
Aeration y 7 T Dist. Pipe , - 7 Ie c1
Holding Bot. System J 4 , `o / e
Z • O �
PUMP/SIPHON INFORMATION Final Grade
Manufacturer Demand St Cove
�; GPM ; tqA. � D
Model Number Q 4X/ 2 - ,7
I b 4► ! 1P
7DH Lift Friction I,o System Head J TDH /t Ft
It ,( 1�.� 17 . I
Forcemain Length Dia j Dist. to Well y
SOIL ABSORPTION SYSTEM /V
BEDITRENCH Width ! Length / No. Of Trenc es PIT DIMENSIONS No. Of Pits inside Dia. Liquid Depth
DIMENSIONS
SETBACK SYSTEM TO P/L JBLDG - 71 WELL LAKE /STREAM LEACHING Manufacturer:
INFORMATION T e f S ste (`( CHAMBER OR
YP Q _ Y rTj , � l 1 ` r n Model Number:
DISTRIBUTION SYSTEM Sc J ll/ i �
Header /Manifold Distribution ' x Hole Size x Hole Spacing t V t to Air }/ Intake
Pipes) � 3/3 Z�{
Length 1 Dia Length_ Dia Spacing
SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only
Depth Over Depth Over xx Depth of xx Seeded /Sodded xx Mulc d
Bed/Trench Center Bed /Trench Edges Topsoil ' Yes No Yes No
COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: ! ! Inspection #2:_ /
Location: 1417 131st �l T New I j chmond, WI 54017 (SW 1/4 SW 1/4 25 T30N RI 8W) Hollow P d Lot 6 Parcel No: 25.30.18.1256
1.) Alt BM Description = 1
2.) Bldg sewer length = S14 X
amount of cover =
an revision Required? Yes )<No
lot 6*7
, )ther side for additional information. j 1____ _ _—
Date Insepctor's ignature Cert. No.
0 (R.3/97)
�ommeree, ,gp� Safety and Build' Division County J \ � ,14
201 W. Washington .O. Box 7162 T 7'°
scan Madison, 5 7 2 Sanitary Permit Number be -7 in by Co.)
Sanitary Permit Application State Transaction `umber
In accordance with s. Comm 83.21(2), Wis. Adm. Code, submission of this form to the approp gove tai -�
unit is required prior to obtaining a sanitary permit. Note: Application forms f wn WTS are Project Address (if different than mailing address)
submitted to the Department of Commerce. Personal information you pro 'de y be condary
purpos in accordance with the Privacy Law, s. 15.04 1 m , Stats. t/
I. App lication Information - Please Print All Information IVY f s7v
Property Owner's Name U , MAY 2 92 P :v — N
Property Owner's Mailing Address ' CRO c o , perty Location
,� w r� Y�.4'�� �I ��-Cl ► j VNr vt. Lot /g_<
S 19
Ci , S.�tatte�e Zip Code Phone Number y., s 1 y., Section
c crrele on
T N; R
,i V
II, ype of Building (check all that apply) o K cao Lot #
2 Family Dwelling - Number of Bedrooms
4464w 4_o Subdivision Name
ia64ro Block# PC-J
❑ Public/Commercial - Describe Us City of
0 State Owned - Describe Use CSM Number El Village of 4ryry,
-1 J ownof
16 -r
III. 'Type of Permit: (Check only one box on line A. Complete line B if applicable)
A. w System ❑ Replacement System ❑ TreatmentlHolding Tank Replacement Only ❑ Other Modification to Existing System (explain)
B. ❑permit Renewal C1 Permit Revision ❑ Change of Plumber ❑ Permit Transfer to New
List Previous Permit Number and Date Issued
Before Expiration Owner
IV. Type of POWTS S stem/Com onent'Device: (Check that apply) Q
O Non - Pressurized In -Ground ❑ Pressurized In -Ground At -Grade ❑ Mound > 24 in. of suitable soil ❑ Mound < 24 in, of suitable soil
❑ Holding Tank ❑ Other Dispersal Component (explain) ❑ Pretreatinent Device (explain)
V. Dis ersal/Treatment Area Information:
Desi j Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal Area Requited (sf) Di sa�Proposed,(sf? System Elevation /
VI. Tank Info Capacity in Total # of Manufacturer 8 c
Gallons Gallons Units e ° n
New Tanks Existing Tanks 9,3 N A to �
Septic or Holding Tank
Dosing Chamber x 63 J /
VII. Responsibility Statement -1, the undersigned, responsibility for installation of the POWTS shown on the attached plans.
Plum Name (Print) Plum ignature MPIMPRS Number Business Phone Number
7_7 6 �cv
Plumber's Address (Street, City, State, Zip Code)
VII Court !De artment Use Onl
A owed � Permit Fee Da 7 ed Issuing t Signature
FPr ven R or Denial $ Ob / 16 7
IX. Condlteasons for Disapproval Q / /1���
1. 30POC Wtk, SW rJ ✓f 4 dL a
dispemal tg must all t& / mai -- bled ` (_ „ D__ e� p t'� c ✓
as per rnansaWnent plan provided by plumber. ftt�" '� C^k-a`A cQ °t `-+`��
2. Alt se bwk requirements must be mahttained L 0
IN Fill _PP"ft
to comp e p lans ter the system and submit to the County only on paper not less than 8112 x t 1 inches to size
SBD -6398 (R. 01/07) Valid thru 01/09
PLOT PLAN
PROJECT Oeverina Homes LLC ADDRESS 888 Summer Pines Circle Hudson Wi 54016
SW 1/4 SW 1 /4S 2 5 /T 30 N/R 3
18 W TOWN Richmond COUNTY ST.CRO
SYSTEM ELEVATION 100.5' BEDROOM 3
CONVENTIONAL AT -GRADE )00( CONVENTIONAL LIFT HOLDING TANK
MOUND SEPTIC TANS 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 BEST GF10 -8
❑ BOREHOLE O WELL *H.R.P. Same as Benchmark
430' Property Line
Scale = 1 /4" = 10'
Well is to meet
all setbacks F
found in Comm.
Tank is to be properly 83
bedded and provided with
lockdown covers with
approved warning labels
Pro 3
Bedroom
House Area 15' below
Huffcutt Combo system is to
-Tank remain
B-2 undisturbed
7% Slope
2.3 Acre Parcel
Grading is to be done to B-3
131 st. Ave divert run -off away 99.5'
from system B-1 B.M.
528' Property Line 1 0.5'
Alt. B.M.
PLOT PLAN
� O
PROJEC everina Homes LLC ADDRESS 838 summer Pines Circle Hudson Wit 54016
SW 1/4 SW 114S 25 /T 30 N/R 18 W TOWN Richmond COUNTY ST. CROIX
SYSTEM ELEVATION 100.5' BEDROOM 3
CONVENTIONAL AT -GRADE X)(X CONVENTIONAL LIFT HOLDING TANK
MOUND SEPTIC TANK SIZE
1000 gallons LIFT TANK SIZE DOSE TANK SIZE 630
HOLDING TANK SIZE LOAD RATE .5 ABSORPTION AREA 900 # of chambers none
IL BENCHMARK V.R.P. Top of Survey Iron ASSUME ELEVATION 100° FiilteT BEST GF10 -8
i
❑ BOREHOLE O WELL - g,R.P. Same as Benchmark
430' Property Line
Scale = 1/4" = 10'
Well is to meet
all setbacks x.
found in Comm.
Tank is to be properly 83
bedded and provided with
lockdown covers with
approved warning labels
Pro 3
Bedroom
House Area 15' below
Huffcutt Combo system is to
Tank remain
B-2 undisturbed
7% Slope
2.3 Acre Parcel
131 st. Ave Grading is to be done to B - 3
divert run -off away 99.5'
from system B-1 B. M.
528' Property Line 100.5'
Alt. B.M.
Safety and Buildings
1
commerce.wi. OV 4003 N KINNEY COULEE RD
g LACROSSE WI 54601 -1831
TDD #: (608) 264 -8777
www.commerce.wi.gov/sb/
SCo n s 1 n www.wisconsin.gov
, t i c epartm of Commerce
Jim Doyle, Governor
Mary P. Burke, Secretary
May 23, 2007
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
' Numbers
PLAN AN APPROVAL EXPIRES: 05/23/2009 Identification ID o.
Transaction ID No. 1395257
SITE: Site ID No. 725355
Oevering Homes, LLC Please refer to both identification numbers,
131 st Avenue above, in all correspondence with the agency.
Town of Richmond
St Croix County
SW1/4, SW1/4, S25, T30N, R18W
Subdivision: Hollow Pond; lot 6
FOR:
Description: Three Bedroom At -grade System ! New construction
Object Type: POWTS Component Manual Regulated Object ID No.: 1131171
Maintenance required; 450 GPD Flow rate; 40 in Soil minimum depth to limiting factor from original grade; System(s):
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,
stats.
The following conditions shall be met during construction or installation and prior to occupancy or use:
• This system is to be constructed and located in accordance with the enclosed approved plans and with the
component manual(s) referenced above.
• A sanitary permit must be obtained from the county where this project is located in accordance with the
requirements of Sec. 145.135 and 145.19, Wis. Stats.
• Inspection of the private sewage system 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. Stats.
• The area within 15 feet horizontally down slope of the dispersal cell shall remain undisturbed. Vehicular traffic
or soil compaction in this area is prohibited.
• A state approved effluent filter is required. Maintenance information must be given to the owner of the tank
explaining that periodic cleaning of the filter is required. Access to the filter for cleaning must be provided
per Comm 84 product approval conditions.
• Comm 83.22(7) - A copy of the approved plans specifications and this letter shall be on -site during
construction and open to inspection by authorized representatives of the Department, which may include local
inspectors.
r i.
a� .
Condition all
yttt� '
SHAUN R BIRD Page 2 5/23/2007
Owner Responsibilities:
• The current owner, and each subsequent owner, shall receive a copy of this letter including instructions relating
to proper use and maintenance of the system. Owners shall receive a copy of the appropriate operation and
maintenance manual and/or owner's manual for the POWTS described in this approval.
• Comm 83.52(1)(a) - The owner of a POWTS shall be responsible for ensuring that the operation and
maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s.
Comm 83.54(1).
• Comm 83.52(2) - A POWTS that is not maintained in accordance with the approved management plan or as
required under s. Comm 83.54(4) shall be considered a human health hazard. In the event this soil absorption
system or any of its component parts malfunctions so as to create a health hazard, the property owner must
follow the contingency plan as described in the approved plans.
• The owner is responsible for submitting a maintenance verification report acceptable to the county for
maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized
in the POWTS.
In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should
conditions arise making them necessary for code compliance. As per state stats 101. 12(2), nothing in this review
shall relieve the designer of the 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
1 � �--� Balance Due $ 0.00
G erard M Swim
POWTS Plan Reviewer, Integrated Services
(608)789 -7892, Mon - Fri, 7:15 am - 4:00 pm WiSMART code: 7633
jerry.swim@wisconsin.gov
cc: Leroy G Jansky, POWTS Wastewater Specialist, (715) 726-2544, Friday, 7:00 A.M. To 3:30 P.M.
w ti O
G °0 J
Cover Page
w
Shaun Bird
Bird Plumbing Inc.
1008 192nd Ave
New Richmond Wi 54017
715- 246 -4516
Date: 515/07
Owner: Overing Homes LLC
Location:SW1 /4 SW1 /4 S 25 T30 N,R18W Richmond Lot 6 Hollow Pond 131st. Ave
System type: At -Grade
Manuals Used: At -Grade Component Manual version 1.0 SBD 10570 -P (R.6/99)
SSWMP Publication 9.6 Design of Pressure Distribution
Networks for ST -SAS (01 /81)
Page#
1. Cover Page
2. At -Grade Plot Plan
3. At -Grade Cross Section
4. Pipe Cross Section /Pipe Layout
5. Pump Chamber Cross Section
6. Pump Curve
7 -8. Maintance and Contigency plan
9 -11. Soil test
Shaun Bird
Signature
License number 2 IW900 �C r�cE
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amts SE+r Aacr� coda
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tai : pass sha •be die W4 the ahandoried a S S
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be
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evaded =d may be uiT¢ed for the awn Of n � � slat
beers
p A scs�e n� has area shoved be protected from r£ssfs��+� s and w� Fr+e to
sbswp - 3The ftom 02 sdng and proPosed.strucnss
a wM #uit in the need far a never soir and site w4Wusdca � � a suftble
' be ink � � � at S�'ticsse.
� wneM sy s4ems rnusi rarnp{Y �nriih the rules in effect � in g0wTS
D A s e n � i no t ra?table'dus to back andtor soil
� a � tanicrVaY be � as a Cast t�esort to replace POWTS a sdland _
/ idea r a sucrabie reptace t ate. i f no area
ft SW iabse a
to ioraTe a sure ,�e¢�nestt
taoicficg tarrlt May be "d as a Cast resort to t3eptac� ate fa2d'�' o€ Ste beornat at
be r�ecoaszrucxed lice f�
and atVrade soa �' such ,must comply with f� nsiea'n �stfiatt�
trtle kaballm
GASSES R oxY.
� � AND OTHM MWATM TANfC.�s MAY CQ E) ANY t om `
00 HOT MATH SAY
A tent's �3lKP F M Tfq TRF ERIOR O
�„� E3E,SCtIE A H �O� ' �� �R �iC A TANK MAYBE l3IFFK�li -"� OR APO- .
ADDMONAL C
pOWTS KAWTARN(ER
POYmnms 1NS 'ALi.ER Name a �,C v✓
tame S Pone
Ph=* j � E-
SFRt t�s U ATaR LOCAL REGULATORY Aft OM Y
1,111 1 101
SFPTAGE
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and Wkala= Cm*f Zwft znd S
# low a&od brl6c sss!£s aEibs firaen Lar#e• � the W 1 d=.=wd0dS wt
ma srsr3aea:n or ett Coeam 83Mjb}(SJ(dAM and s3 - M
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Wlswrwn DepartrnentofCommerce SOIL EVALUATION REPORT pa of
Division of Safety and suitdngs
in accordance with Comm 85, Wis. Adm. Code counlY
Attach complete site plan on paper not less than 8112 x 11 inches in size. Plan must
include, but not limited to: vertical and horizontal reference point (BM). direction and Para! I.D.
percent slope, scale or dimensions. north arrow, and location and distance to nearest road.
Please print all inforrnat fon. Reviewed by Date
Pensdnal Wftm sdon you pmride may be used for sewx1ary purposes (Privacy law, s. 15.04 (1) (m))•
Properly Qwrier Property Location )
Pl�P L. Govt Lot,,94) 11 SCd 114 S,4,5 t) N R t E(
owners MaWAddress Lot # Slodc # Subd Narge or CSM#
r
State Zip Code Phone " 0 c it y 0 w ge Town Nearest Road
Ito I t�L� ) ; G 131sx
New Construction Use�esidentlat !Number of bedrooms _ Code derived design flaw rats y- 9 3 GPD
Q Repwoement Q Public or owar erciai - Describe: _
Parent matecfai f=lood Plain elevation If applicable � � IL
Gerser� cerrsrer�
and
System Type System Elevation / yy .' F T1 o y
# Pit Ground surface elev. iL Depth to igniting factor 1 in.
Sal Application Rate
do t= . Depth Mff*w t Calm Redox Description Texture Structure Consistence Boundary Roots GPD
h M xud Q.U. SL Cont. Color Gr. Sz Sh.
2471
Z
12-24 c A
3. . A' A O� t.
F TI �# 0
. Pit Ground scxi>Mos eiev. &�ft- Depth to lffftV factor in
Snit Application Rate
Horbw Depth Dombunt Color Redox Description Texture &AN*" Consistence soundary Roots GPM
in. Mures Qu. Sz com Color Gr. Sz Sh. 'E!f#1 *M
-r 1 z. S c /
s 3a S L'
" s A l
-7
• Eftm t #1= SW > 30 < = uok and TSS >30 < 150 • EfAvent 92 - SOD 130 n1g/L and TSS <30 mglL
CST Alum tpbase fto CST Nurrfler
Bird Plumbing, Inc. Shaun Bird 226900
Address Date Evaluation Conducted . Telephone Number
1008 192nd Ave, New Richmond, WI 540( 7 715- 246 -4516
Y
Property owner Parcel 1D # Pap of
Bod # sori
Pit Ground surface e1w, ft Depth to limiting factor LSL_ xL Sri ltceiion RaAe
Horimn Depth Don*%antCda Redox Description Texture Sur zb" Consistence Boundary Roots
In. Munsell Qu. Sz. Cont Color Gr. Sz SK •Efi#t t `EM2
2 7• S s 1 inn 1 _ r✓1 • �i
s C Al 1,4 -
r
# ❑ �Buxing
❑ Pit Ground sr>rfaoe elev. ft Degsfu so limning fiackor in.
Sob Apploadon Rate
Hortm Depth Dorr*wntColor Redox Oescription Texture structure Consisrenoe Boundary Roots GOOM
in Mtrrseti Qu. Sz. Cont Color Gr. Sz. Sh. •EtT#4. :: #
g
s
i
T
F-I 0t� 130:ft
# u Pit Carvurxi surface elev. _ �_ ft Depth to lanrting ft= in.
Sot Rata
Hortim 'depth Dominant Color Pod= Description. Texture Struck" Cwsistence, Boundary Roots
kt. Mu ns" Ott. Si Cont Color Or. Sz Sh. 'EW
3
r
• Eflkwt #t, = BOD > 30: 220 mglL and TSS >30_< i50 rng& • Effluent #2 = SOD <30 mglL and TSS :S 30 ntgr<
'The Depa tmaat Commerce is an equal opportunity service provider and employer. If you need assistance to 'access selvitces or
need material in an alternate format, please contact the department at 608 -266 -3151 or TTY 608 -264 -8777.
z
F
R ' Test Plot Plan
50�. s �
Project Name Overing Homes LLC
Address 838 S Pines
fi Circle #226900
Hu son 5/5!07
Hollow Pond Date
Lot _6 _ gubdivision Township Richmond
S W 114 SW 114S 25 T 30_ N/R18 W
county ST. CROIX
[3 Boring . Well Top of Survey PL Property Line Iron
�
BM or VTtP Assume Elevation 100 It * H RpSame as Benchmark
System Elevation
100-5
nchmark
To of Fence Post @ 104.0, 430' Property Line
Alternate Be
Scale = 1 /4" = 10'
Scale is 1" = 40'
unless otherwise
noted
B -2
7% Slope
2.3'Acre Parcel B -3
� 99.5'
131 St. Ave B.M.
B -1
528` Property Line Alt. B.M.
Wisconsin Department of Commerce SOIL EVALUATION REPORT Page of
Division of Safety and Buildings
in accordance with Comm 85, Wis. Adm. Code
County
Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. pl mu include, but not limited to: vertical and horizontal reference point (BM), dir a I
percent slope, scale or dimensions, north arrow, and location and distan
Please print all information. Review by Date
Personal information you provide may be used for seconds (1) V —
Property Owner Property Loc ation /
el -I j . Lot5 4) 1/4C01/4 S� T3 (� N R [ E (or)
Prope Owner's Mair Address Lot # I BI # Subd Name or CSM#
City State Zip Code Phone umbe C3 City C3 Vi age Town Nearest Road
Ito I
New Construction Use>.Qesidential / Number of bedrooms _„�_ Code derived design flow rate GPD
❑ Replacement ❑ Public or commercial - Describe:
Parent material Flood Plain elevation if applicable
General comments
and recorrunendations:
System Type 1 �� �`2�� System Elevation �// f✓
a Boring # El Boring C ✓
pit Ground surface elev. ft. Depth to limiting factor / in.
Soil Application 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
i -�Z r7-
/ /' — S r ZZ — — o✓ / . vim. t
® Boring # Boring ✓
Pit Ground surface elev. ft. Depth to limiting factor -M in.
F - ' - � - — 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 1 ) L �� S C j'� t • (�
Z f 5- 3o S A/ PM 7/
, - -51 /rns • le x
Va _7 — S- r / _
Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 • Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L
CST Nam (Please Print) na CST Number
Bird Plumbing, Inc. Shaun Bird 226900
Address Date Evaluation Conducted Telephone Number
1008 192nd Ave, New Richmond, WI 540 17 -4 J��. -U 7 715- 246 -4516
' r
Property Owner _ Parcel ID # Page of
Boring # Boring
Pit Ground surface elev. ' ft. Depth to limiting factor = l in. Soil lication Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff
in. Munsell Qu. Sz. Cont. Colo Gr. Sz. Sh. 'Eff#1 'Eff#2
2- _L4
❑ Boring # ❑ Boring
❑ pit Ground surface elev. ft. Depth to limiting factor in.
Soil lication 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 I •Eff#2
I
I ❑ Boring
Boring # Ground surface elev. ft. Depth to limiting factor in.
❑ Pit Soil Application Rate
Horizon 'lepth Dominant Color Redox Description. Texture Structure Consistence Boundary Roots GPD/fF
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2
i
' Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BOD < 30 mg& 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 -9730 (RbNO)
Soil Test Plot Plan
Overin Homes LLC Sh r
' Project Name 9 �.
Address 838 Summer Pines Circle M #226900
Hudson Wi54016
Lot 6 Subdivision
Hollow Pond Date 5/5/07
S W 1/4 S W 1/4S 2 T 30 N /R W Township Richmond
P Line County
ST. CROIX
E] Boring Q well PL Property To of Survey Iron
BM or VRP Assume Elevation 100 ft. P
,' 100.5' *HRPSame as Benchmark
System Elevation
Alternate Benchmark To of ost @ 104.0'
Fence P 430' Property Line
Scale = 1/4" = 10'
Scale is 1" = 40'
unless otherwise
noted
k
B -2
7% Slope
2.3 Acre Parcel B-3
131 st. Ave p 99.5'
B -1 B.M. `
100.5'
528' Property Line Alt. B.M.
I
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OUNTY PLAT)
t 114. of the Southwest 114 of Section 25,
Town of Richmond, St Croix County, Wisconsin.
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LOT 14 I LOT 13 I LOT 12
OJft 96
1315.51'
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L. B. 0. = 1024.0' L -64
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ST. CROIX COUNTY
SEPTIC TANK MAR4TENANCE AGREEMENT
AND
OWNERSIM' MTIFICATION FORM
Ocvnear/Buyer �-J �` r
Mailing Address
-
1
Property
Are & Zoning Department for new construction )
('(/�catiion required from planning
City /State
Parcel Identification Number
LEGAL DESCRI' M0N
Property Location , iJ '/a , Sec. , T J (� N R W, Town of "
Lot #
Subdivision r
CerttSied Survey Map #
Volume Page'#
W arran ty Deed
.J Z� tS , Volume Page # —
no
# .
Spec house s no Lot lines identifiable
SYSTEM NCE AND OWNER CE CATION
improper use and maintenance of your septic system could result in its premature failure to handle '0sta- Proms
three years or sooner, if needed, by a licensed pmper What you put into
maintenance consists of pumping out the septic tank every Owner maintenance
the system can affect the function of the septic tank as a treatment stage in the waste drapes al s ystem
Comm. $352(1) and in Chapter
rn 12 - St. Croix County Sanitary Ordioasn,ce-
re5ponsibii ities are specified §
ne property owner Sgrees to submit to St. Croix County Planning & Zoning Department a cCrtificafmo form, signed by the
owner and by a mash plumber, 30urneyman plumber, restricted plumber or a licensed pumper verdying that ( �� -� tank is
wastewater disposal system is in proper operating condition and/or (2) after inspections and P (if necessary)
less than W full of sludge.
agree to maintain the private sewage disposal system with the
I/wc, the undersigned have read the above requirements and age of Kennel Resources, State Wisc
of onsin
standards set forth, herein, as set by the Department of Commerce and the Dc partment
Cartification stating that your septic system has been maintained must be completed and returned to toe St. Croix County planning &
�n,ng Depar=ent within 30 days of the three year expiration date -
Uwe certify that all statements on this form are true to the best of my /our knowledge. 1/we am/am the owner(s) of the r
desaibcd above, by virtue of a warranty deed recorded in Register of Deeds Office. �: - s ?s --D 7
pro
SIGNATURE APPLICANT(S) DATE
# * Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning DVartlneaah*"
L=Dx o with this application a recorded warrenty deed from ttce Register of Deeds Office and a copy of the certified survey map if
rdfatence is made its the wau'a?nty deed.
(REV. MOM)
. 11111111111111111111111111111111111111111111111111
* 8 5 0 6 2 6 1
State Bar of Wisconsin Form 1 -2003 85 0 626
WARRANTY DEED KATHLEEN H. WALSH
REGISTER OF DEEDS
ST. CROIX CO., WI
Document Number Document Name RECEIVED FOR RECORD
05/15/2007 01:OOPM
THIS DEED, made between Kenneth J. Oevering and Amparo K. Oevering, WARRANTY DEED
EXEMPT
husband and wife REC FEE: 11.00
( "Grantor," whether one or more),
and Oevering Homes LLC _ TRANS FEE: 216.90
PAGES: 1
( "Grantee," whether one or more).
Grantor, for a valuable consideration, conveys to Grantee the following described real Recording Area
estate, together with the rents, profits, fixtures and other appurtenant interests, in
St. Croix County, State of Wisconsin ("Property") (if more space is Name and Return Address
needed, please attach addendum):
Wisconsin Assured Title, LLC
1810 Crest View Drive, 41 B
Lot 4 Hollow Pond, Town of Richmond, St. Croix County, Hudson, WI 54016
Wisconsin
COYc - I lo3- C4- LX-c_"4 COb-f 03
AND Parcel Identification Number (PIN)
Lot 6 Hollow Pond, Town of Richmond, St. Croix County This is no t homestead property.
Wisconsin (is) (is not)
Grantor warrants that the title to the Property is good, indefeasible in fee simple and free and clear of encumbrances except:
Roadways, Easements, Restrictions, and Rights of Way of Record
Dated Ah� Z
' 'SEAL)
Kenne . Oevering " Amparo K. Oevering
(SEAL (SEAL)
*
AUTHENTICATION ACKNOWLEDGMENT
Signature(s) STATE OF W46CA In'r` '
authenticated on GJeu & -j- ) ss.
S4;-EI2 COUNTY )
* Personally came before me on j�pt, + , 7, 0 0 7
,
TITLE: MEMBER STATE BAR OF WISCONSIN the above -named Kenneth J. Oevering and Amparo K.
Oeve ring,
(If not, wn to to kn be person(s) who executed the fore fain
authorized by Wis. Stat. § 706.06) i rum tan rledged Msw
lam
DUANE F KLEIN
THIS INSTRUMENT DRAFTED BY:
Richard K.Y. Lau - Redmon Law Chartered Notary Public, State of Wiscons 1, 2010
2217 Vine St., Ste. 204 — Hudson, WI 54016 My Commission (is permanent) expires:
(Signatures may be authenticated or acknowledged. Both are not necessary.)
NOTE: THIS IS A STANDARD FORM. ANY MODIFICATIONS TO THIS FORM SHOULD BE CLEARLY IDENTIFIED.
WARRANTY DEED ® 2003 STATE BAR OF WISCONSIN FORM NO. 1-2003
• Type name below signatures.
1 of 1
FROM :OEVERING HOMES LLC FAX NO. : ?255311282 Dec. 14 2004 10:14PM P12
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FROM :OEVERING HOMES LLC FAX NO. :7155311282 Dec. 14 2004 10:14PM P11
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RECEIVED
Wisconsin Department of Commerce! L EVALUATION REPORT page 1 o f 3
Division of Safety and Buildings
in arc +�h;�omm 85; Wis. Adm. Code
E County St.. Croix
Attach complete site plan on paper bot less fli T k>es irrsfze. Plan must
include, but not limited to: vertical a re%erence 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. R by Date
Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04(l) (m)). p
Property Owner Property Location
Greg Peterson , Lot SW 114 SW 1/4 S 25 .T 30 N .R 18
Property Owners Mailing Address Lot # Block # Subd. Name or CSKV
1611 Hwy 10 6
city State Zp Code Phone Number ocity QVillage own Nearest Road
Spring Lake Park I MN 1 .55432 ( 7¢3 780 - 4996 140th Street
■:.New Constntction Use[D Residential /Number of bedrooms 3 to 4 code derived design flow rate 450 to 600 GPD
Replacement ® public or commercial - Describe:
Parent material Flood Plain elevation if applicable Xe ft.
General comments sl* 'th 1/2" lenses of Is 7.5yr4 /6,Irr1sl�jc
and recommendations: D . 2 X&a46 -&a46
- s site is suitable for a to t e moilnd
Fi� Boring # .[3 Boring
Pit Ground sut#aceeiev. 97.96 ft. Depth to limiting factor >48 in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Text Structure Consistence Boundary Roots GPDW
in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. 'Eff#1 'Eff#2
1 0 -10 10yr3 /3 - sil 2msbk mfr cs 2f .5 'R
2 10 -17 1 3/6 sic lmsbk mfr cs if • 3
3 17-48 7.5yr4 /4 - S* Om mft cs - 21 P 7,5
4 48 -84 7.5yr4/4 - scl Om mft - - 0 .0
2
F Boring # ��* y Boring 96.01 49
L:J pit Ground surface elev. ft. Depth to limiting factor '' in.
F sonApplication Rate
Horizon Depth _Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDHf
in. Munsell QU. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 1 '002
1 0- IOyr3 /3 sil 2msbk mfr cs 2f .5
2 12 -23 1 3/6 scl lmsbk. mfr cs I f .2 .3
3 9 7.5yr4/4 - Om mfi es .3 .5
4 49 -60 7.5yr4/4 c2d5yr5 /8 cl ]msbk mfr - - 2 3
' Effluent #1= BOD > 30 � - 220 mg/L and TSS >30:5 150 mg/L * Effluent #2 z BOD < 30 mg/L and TSS s 30 m g/L
CST Name (Please Print) - Signature CST Number
Thomas C Nelson - ^� - - T„� .� 227387
Address Date Evaluation Conducted Telephone Number
1432 120th .Street, New Richmond, WI 7/03/03 715 -246 -2454
ST. CROIX COUNTY
WISCONSIN
ZONING DEPARTMENT
ST. CROIX COUNTY GOVERNMENT CENTER
Natoli! 1101 Carmichael Road
Hudson, WI 54016 -7710
Phone: (715) 386 -4680 Fax (715) 386 -4686
Memo to "e
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
i
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 <03 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 gpd/f? would be required
for sizing the system.
Cc: Greg Peterson, Subdivision Developer
Oevering Builders, owner
Leroy Jansky, Regional Wastewater Specialist
Tom Nelson, CST #227387
I
'I
RECEIVEC
Wisconsin Department of Commerce O C I rSQW�,EVALUATION REPORT Page of
Division of Safety and Buildings
in accordance with ComnrieWimtdm • de County °
ST. CROIX COui� i Y
Attach complete site plan on paper n less thV*j�b6t &*s in size. Plan mu
'°�
include, but not limited to: vertical and ion and Parcel I.D.
percent slope, scale or dimensions, north arrow, and location and distance to nearegRtgel. 02(o ' 110 - 0 - MV(- ZS71
by
Please print all information. Re 'ewed Date IZIi�ID�
Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)).
Property Owner Property location
Govt. Lot ,{ 1 /4SJ 114 S r- S 3 0 N R E (o<
Property Owners Maili ddress Lot #_ Block # Subd. Npm or CSM#
3 '-f-Y* -t/\r F) ,_ L�
CRY State Zip Code Phon umber Q City Q iilage T Nearest Road
� -nt ( ) /
New Construction use. esidential / Number of bedrooms Code derived design flow rate yJ� GPD
❑ Replacement ❑ P 'c or commercial - Describe:
Parent materia Flood Plain elevation if applicable ft
General comments
and recommendations:
e
F_/1 Boring # [j Boring
-x Pit Ground surface elev. t ft. Depth to limiting factor in. Soil 8Wicadon Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPOM
in. Mursell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 'Eff#2
0 �I � /D 31z-
� ---- -, rr _
1 Z
®
Boring
Boring # ,
�IyCL Pit Ground surface elev. ft. Depth to limiting factor ��• M lication Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fP
in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Eff#1 `Eff#2
x'13 ® ✓ 3j ..._. -_ � 2 -•LQ ,r �-, �r e S 2 r � � �
2 --
13-3 Ln I d C I
Effluent #1 = BOO > 30 < 220 mg(L and TSS >30 150 ` Effluent #2 = BOD < 30 r1g/L and TSS < 30 mgJL
CST Name Pease P Sig a CST Number
Bird Plumbing, Inc. Shaun Bird 226900
Address Date Evaluation Conducted Telephone Number
1008 192nd Ave, New Richmond, WI 5401 �- _ ..._. 715- 246 -4516
Property Owner [ Parcel ID # Page of
[a] Boring# ❑ Boring U ✓ �
pit Ground surface elev. V ft. Depth to limiting factor in Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDNf
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. `Eff#1 `Eff#2
)Z fQ ✓g�2 ( 2 AI
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Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDlff
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❑ Pit Soil ication Rate .
Horizon Depth Dominant Color Redox Description. Texture Structure Consistence. Boundary Roots GPD/fF
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` Effluent #1 = BOD > 30 1220 mglL and TSS >30:E 150 mglL ' Effluent #2 = BOD < 30 mglL and TSS <_ 30 mgit
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Soil Test Plot Pla
Project Name Ken Oevering Sh Bi
Address 838 Summer Pines Circle
Hudson Wi 54016 TM #226900
Lot 6 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 104.4' *HRpSameasBenchmark
Alternate Benchmark Top of 1/2 pipe @ 100.4
Scale = 1/4" = 10'
unless otherwise
noted ?
1
1 2'
104' B -2
30'
7% Slope
5'
430'
property
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70' 0�
AD
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20'
IL 220'
528' property line 40'
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RICHMOND HILLS I
LOT 14 LOT 13 LOT 12
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