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026-1163-15-000
J F ST. CROIX COUNTY WISCONSIN ZONING DEPARTMENT i No M W r '— mars ST. CROIX COUNTY GOVERNMENT CENTER raps Carmichael Road Hudson, WI 54016 -7710 Phone: (715) 386 -4680 Fax (715) 386 -4686 Memo 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/f?. 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 gpd1ft 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 u c 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 gpd/ft would be required for sizing the system. Cc: Greg Peterson, Subdivision Developer Oevering Builders, owner Leroy Jansky, Regional Wastewater Specialist Tom Nelson, CST #227387 t II Wisconsin Department of . nmerce PRIVA " SEWAGE SYSTEM County: St. Croix Safety and Building Division ,. t INSF�'EC.' di' REPORT sanitary Permit No: 463024 ;5pa1� 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 , Ken Richmond Township p - � - 15 _ occ) CST BM Elev: Insp. BM Elev: BM Description: 1 Section/Town /Range /Map No: / ► Pie.. em 1 C 5 25.30.18. TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic • Benchmark Dosing C Alt. BM 1 awr lc 3D �ro•9 n d�a 4 o •.� Z •� 141 AeFat � f � Bldg. Sewer Holding St/Ht Inlet TANK SETBACK INFORMATION St/Ht Outlet _N� TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic 33' 3 - ; Dt Bottom 1 F� J Dosing + n _ f Header /Man. `tom tT _33 : - 3 �� 3.6 r &o .14'+ Aeration Dist. Pipe 3.6 Ica Holding Bot. System y l z J PUMP /SIPHON INFORMATION Final Grade Manufacturer Demand St Cover Z-O J U, GPM , 3� /63 Model Number TDH Li `� Friction ss System Head T �' Ft f I - C.p Forcemain LenG& ` I Dia.�ii Dist. to Well Pi Pr SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS i ! n a,._ .� 1_� SETBACK SYSTEM TO / P/L BLDG WELL LAKE /STREAM LEACHING Manufacturer: INFORMATION ^ CHAMBER OR Type Of Sys ! is UNIT 77 Model Number: 6 DISTRIBUTION SYSTEM I v Header/ anifold Distribution I x Hole Size / f x Hole Spacing Ve to Air Intake Pipe(s) A i Length Dia Length `� Dia Spacing \ 5 /3 Z SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only Depth Over / Depth Over xx Depth of xx Seeded /Sodded xx Mulched Bed/Trench Center 2 I Bed(rrench Edges Topsoil / as No es ` ! No i COMMENTS (Include code discrepencies, persons present, etc.) Inspection #1: / / t; n Inspection #2: Location: 1416 130th Ave. New Richmond, WI 54017 (SW 114 SW 1/4 25 T30N R18W) Hollow Pond Lot 15 Parcel No: 25.30.18. 1.) Alt BM Description = i `-' 2. Bldg ewer length t 9 g - amount of cover " � Z,.,ca✓G�Jfcti 5� �- Plan revision Required? J Yes Use other side for additional information l a SBD -6710 (R.3197) Date lnsep or's Si ature Cart. No. i Safety and $uilaings IDMsion County �, 201 W. Washington Ave., P.O. Box 7162 / i N *tsconsi m n Madison, WI 53707 - 7162 Sanitary Permit Number (to be filled in by Co.) Department of Commerce (608) 266 -3151 41� 3 oZ Sanitary Permit Application State Plan 1.0. Number In accord with Comm 83.21, Wis. AdflL Code, personal information you provide /d (O `F 4 may be used for secondary purposes privacy Law, sI5.04(Ixm) Project Address (if diffeient than mailing address) I. Application Information - Please Print All Information /3U x )Ti) n ��r' Property Owner's Name l Parcel # Lot # Block # PropeRy Owner's Mailing Address F°PAY Locahwt City , State zip Code Phone Number � K �'• won c2 �_ G'V 1 ,5,fzo/ T ;O N. /Z (d r W CI Z IL Type of Building (check all that apply) A. ® ,� ( p mber Subdivision or 2 Family Dwelling - Number of Bedrooms bpr tSL vision Name Nu lidCommercial - Describe Use f State Owned - Describe Use )/�.- n x 1,- 0 (7 City_ Vdla"rns)up ° III. Type of Permit: (Check only one box on line A. Complete line B if applicable) P 4,3 - - 60t) A ew System Replacement System Treatment/Holdt Ttmk R °g eplatxrutert Only Other Modification to Bxistiag System B • Permit Renewal mil Revision CChwge of Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Own" IV. T of POWTS S : (Check all that apply) Non - Pressurized In- Ground Mound Z 24 in. of suitable soil Mound < 24 in. of suitable soil At -Grade Single Pass Sand Filter Constructed Wetland Pressurized !n- Ground Holding Tank Peat Filter Aerobic Treatment Unit Recirculating Sand Filter ReciraAaung Synthetic Media Filter Leaching Chamber Drip Line Gravel -less Pipe Other (explain) V. DispersaVilreatment Area Information: Design Plow (gpd) Design Soil Applicestioa RaWgpdsf) Dispersal Area Required (sf) Dispersal Area Proposed (sf) S ystem Hevation 7 c � ✓ [✓ V 9�� j VL Tank Info capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Units ' Concrete Constructed Glass New Tanks T Z . / S,* or Holding Tank Aerobic Treatment Unit Dosing mamba VII. Responsibility Statement I, the undersigned biHty for Installation of the POWIS sbown on the attached plam Plumber's (Print) Plumber's S' ---- 7 MPMRSNumj1eri Business Ph Number Z6,9, "o one 6 Plumber's Address (Strut, City, State. zip Code , VIIL Cou artment Use Onl veil Sanitary Permit Fee (includes Groundwater Issued L (No Sy") Surcharge Fee, o5 enon for Denial DL Conditions of ApprovaVReasons for Disapproval Zg SYSTEM OWNER: 1. japoe.WM6 dfliwk Mw Mil ppti I 1 i;.A mint M hL1 I d " aaMr+laMpMlIOaM/Mfl►p11MIIbM. t M �#rsll �iM nwlA M MMMMIMd �tN►il�Nllli�M�ot>�IlitrllrlOw. -- Attach complete plans (to the County only) for the system on paper not less than sill x 11 inches in size 1 }, •. , :t�ar+rnro Nara t� ant wwi1M.. . r !/�I�,Lfl�oadt� w Awn �a �' wwM�nv �4 ��� �• IIM�i1AN1�1MMwa dn��w �IerMM .S .wo�rliM1 Meo �� t1� +li Safety and Buildings commerce.wi. OV " ' 4003 N KINNEY COULEE RD LACROSSE Wl 54601 -1831 TDD #: (608) 264 -8777 iscons i n www.commer isco sin.go / Department of Commerce uwvw.wisconsin.gov Jim Doyle, Governor Cory L. Nettles, Secretary October 08, 2004 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: 10/08/2006 Identification Numbers Transaction ID No. 1066484 SITE: Site ID No. 690382 Ken Oevering Please refer to both identification numbers, 130th Avenue L above, in all correspondence with the agency. Town of Richmond St Croix County SWIA, SW1 /4, S25, T30N, R18W Lot: 15, Subdivision: Hollow Pond FOR: Description: Proposed Three Bedroom At -grade System Object Type: POWTS Component Manual Regulated Object ID No.: 984370 Maintenance required; 450 GPD Flow rate; 44 in Soil minimum depth to limiting factor from original grade Systems: At -grade Component Manual, SBD- 10570 -P (R.6/99), Pressure Distribution Component Manual, SBD- 10573- P (R.6/99), Pressure Distribution Component Manual - Version 2.0, SBD - 10706 -P (N.01/01); SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST -SAS (01/81); Biofilter The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in chapter 161.01(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 approved plans, and with publication SBD - 10570-P (R. 6/99) "At -grade Component Manual Using a Pressure Distribution System for Private Onsite . Wastewater Systems ". • The pressure network is to be constructed in accordance with publications SBD - 10573 -P(R. 6/99) "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems" and/or the sizing methods of publication " SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST -SAS (01/81) ". • 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 Sec. 145.20(2)(d), Wis. Stats. • The area within 15 feet horizontally below the system shall remain undisturbed. Vehicular traffic or soil compaction in this area is prohibited. • A state approved effluent filter is required. Maintenance information must be given to the owner of the tank explaining that periodic cleaning of the filter is required. Access to the filter for cleaning must be provided per Comm 84 product approval conditions. C ondition ally P. n e% r% 0%S jr s — SHAUN R BIRD Page 2 10/8/2004 • 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: • 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 he designer f the res responsibility for designing a safe building, or shall relieve t o p ty gn g g, component. p 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 Gerard M. Swim POWTS Plan Reviewer - Integrated Services (608)- 789 -7892, Mon. - Fri. 7:30 am to 4:15 pm jswim @commerce.state.wi.us WiSMART code: 7633 cc: Leroy G Jansky, Wastewater Specialist, (715) 726 -2544 SEC FIVFD 3 . SEP 2 82004 Cover Page Fty,& 8 was DIV. Shaun Bird Bird Plumbing Inc. 1008 192nd Ave New Richmond Wi 54017 715- 246 -4516 Date: 09/26/04 Owner:Ken Oevering Location:SW 1/4SW1/4 S25 T30 N,R18W Lot 15 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 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 g DEPARTMENT OF COMMERCE License numb 226900 DIVISION SAFETY AND BUNDINGS O S RR ( S " P0 D FENCE PLOT PLAN _r ' PROJECT Ken Oeverina ADDRESS 838 Summer Pines Circle Hudson Wi 54016 SW 114 SW 1 /4S 25 /T 30 N/R 18 W TOWN Richmond COUNTY ST. CROIX SYSTEM ELEVATION 99.5 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 OAD RATE .5 ABSORPTION AREA 900 # of chambers none BENCHMARK V.R.P. TO Of 1 " ASSUME ELEVATION 100' Filter Zabel A -100 ❑ BOREHOLE O WELL *H. R. P. Same as Benchmark Property Line Scale = 1 /4" 1 O� AIt.B.M�. •M _ 99 99.5' Grading is to be done to divert run -off away from system 4 Slope Area 15' below B system is to remain undisturbed Tank is to be properly bedded -2 ❑ and provided with lockdown covers with approved warning labels Huffcutt Combo Tank Well is to meet all setbacks found in Pro 3 Comm. 83 Bedroom House i 327' Property Line 130th Ave F L B ?:5 P FOALEMAi 11 .�� 2:51 2 i '"TUP w U PS�� T_ - - - 4_1 Yr A STABia.tZED 08tU NAT'" WELL jr 5 1/6 B I 1/6B 1/2 B A = I•t. 8 = R. ,� n L = ALZ2 FA CELL of ki elz A6GaE��rE �vea0,rl.b SYUTAE' L FabriC Distribution Lateral STAI IICMLb Observation - - —_,,• �. l2 „ �-- Soil Cover Well -- 2" s7LeWF LAYER > 5` A ��� 5� °lo SL OPE. Plan Vi and Cross Section of Wisconsin At -grade Unic with a Single Absorption Area on a Sloping Site SLGNaTu KE Page Of Distribution Pipe Detail For Lateral Oetaork AC r e sr TuRM -UP (C.0 ftk0Ur) i PVC Force Main PVC !?istribution Pipe P - --�" * Last bole Should Be Next To P9f Ft. TURN• �P __ }tole Diameter � Inch X inches Lateral Diameter Inch(es) � `f _ _ —"" Y Inches Force Main Diameter �' Inches �� �. of Moles /Pipe Invert Elevation Of Lateral Ft. Signed: License Number: Date: A p� SPECti ICATFOKs PIMP CROSS f: CT ` G TA . gEnTZC NX 5 vEATHER APFRQVED FE I Z•* pllN. OvE GRADS ,J NCTI3K L II HOLE COMER A B C OU i T MAPi ,� VENT FI WINDOW QR WZTK W/ FAD LOCK 6 £ROM D4flR. y G WARtiING LABE r ^ � �✓ FRE�Ir a IA ZI+tTEKE p �t e� 4 I , IV urn.. � INLET --�-- T IGHT � � � JflZ1�RS wI'� HATER TIGHT SEA A sFAi• APPRWED PI PE 3' ONTO N SaLic SOIL 1 = pppRpYEi3 C OFF P IU L)FT- pi3Np flFF ELEV SOIL 1+iG V i�DEg. T €K ED D'I c NCRETE PAD 3- APpROU ED B . r J � r gprCZF'ZCA TIDNc' �HBER 5 DOSES ?ER DAY = SEFTSC DOSE ER A DOSE v {y:.UME FL��, gpC GAL - - Na GAL' TANK ?4p�£A GAi. • f=P►L • S : A ` s ZI�ICS SEPTIC TAI1K SZ2ES DOSE .... S GApACITZE GAS" ALAti?1 "^�FAC -W1LER. -..� GAL. HS TYPE• n ` ! 3 ... -- — L. WILTCN _ MpNt1FA ..TuRFR -. I LHYt -L6.23 WAC �ttlom : - - ��''� jI,,:1 �G AS PER Pump KODEZ► ti TYPE= 3 G• PtSaiP £ AL ARM FEET SW-ITC s Off[ 4 �. pH . TP£ - • �_ j FEE? RERUZRF.D p ;SCHARGE RATE' • 4?ZS'FgZ - 'I l FEET £EM pu mp fla F ANB QH FACTOR • _ FEET $ETS`t PRESSURE - FR ;CTI ;C {BEAD ��TICAL DIF� ©RCE K SOPFLY a FT!IDD DyPfAl"I t-- + MINIMUM NE T ltic SU ABM X � T flT AL �_ DIAMETER �---- # � LENGTH M£ TANS < ID h . INTERNAL DIM'£NSIOI+IS �� r LIQ DATE LICENSE i+AIH$ . KIGKEB: - TOTAL DYNAWC HEAD /CAPACITY .► . P_R MiNUTE EFFLUENT AN DE1"IATERING � ^ HEAD CAPACITY CURVE 1 l ,;' MODEL 152/153 MOLEL l —, �- Feet I Meters Ga. L tars I Gal- Li.ers t _ W 77 I 1 W 50 5 J 5 I 69 I 261 10 I � 231 70 t :65 , 153 531 gyp; 61 231 1 i 15 4. 12 40 152 { 20 6.1 I 44 i5? 52 9. 25 ?.6 34 129 1 42 59 t = 30 30 9.1 1 :� 87 33 { L5 U 8 10 .? 22 �5 3 5 r r T42 20 � 4.0 � 12.2 -- � Q 11.6m) o i Lcck Votve 5.0 ' ^'`— 616508 r 4 10 1 O 100 0 20 40 60 E ; J GALLONS - 3 27/32 —jam— - -"I� -4 5/3'1 LITERS 0 80 160 240 320 FLOW PER MINUTE t `7, 32 ECIAL APPLICATIONS -j e CONSULT FA CTORY FOR SP 1 3 27, • Timed dosing panels available. • Electrical alternators, for duplex systems, are available and supplied wit are available for controlling single phase Variable level control I an alarm. I • switches - II systems. •Double piggybad variable level float switches are available for variable ^ r1 level long and short cycle controls. I l Sealed Qwik -Box available for outdoor installations. See FM1420. • Over 130 °F. (54 °C.) special quotation required. 1/s i iVJ153 8ertes ' I ' i U jy G can el A Sim 1 lax Ou le: I I J slctoa Model YolwPh Node 2 or 3 t ' ' N752 115 Non 1 ' e -5 8.5 Included 200 3 aN152 "I 1 Auto 1 2 or 3 Non 4.3 E162 1 4.3 Included 2 or 3 SELECTION GUIDE SE152 230 1 AuSo 10.5 1 2 or 3 Qi99y back variable level float N1 115 1 Non 2 or 3 back variable level float switch or double 1 Auto 10.5 Included 2 or 3 1. Single pi99Y BN153 115 1 Non 5 . 3 1 i E163 5.3 included 2 or 3 switch. Refer to FMO477. Alter E-Pak. SE153 2� 1 Auto 2. See FtA0712 for correct model of Electrical o c UTION 3. Variable level control switch 10 -0225 used as a control active or, specify duplex (3j should be done by A All installation of controls, protection devices dp sAould be tot owed Including the most or (4) float system. licensed oiectrlcisn. AO elsctrlsal and 5,1* recent National Ebotdc Code (NEC) and the occupational Safety and Health Act (OSHA)• RESERVE POWERED DESIGN I n of every Zoeller pump. For unusual conditions a reserve safety factor is engineered o B� 16�e de ManullidVem AM Louisville, KY 40256.0347 SHIP r 0: 3649 Cane Run Road 'Wry alas Sdc /939 Louisville, KY 40211-1961 �Q Q 6 (502) 778- 2731.1(30o) 928 -PUMP PUM/ M. Copyright (51)2) 774 -3624 http.1Avww.=°011et ® Copyright 2000 Zoeller Co. All rights reserved. I PLAN Page of 'S MANUAL MANAGEMENT — pOWTS OWNER SYSTEM SPECIFIC al 0 P1A S Tank CsPacity 0 tan FttF INFORMAnO . (t Septic Tank Manufactufer ❑ NA Permit - Effluent Filter INanufadur er p NA E gg Effluent Flter Model / Q NA DESIGN PARANi - d NA �.1- at Number of SedMO Pump Tank Capacity NIA Comm ercial Units Ud p TanK Manufacturer Number of Comm a 0 NA Estimated flaw (average) aVd . Pump Manufacturer / O (Estimated x 1 .5) pump Model Design flow (P� + , J <'""� al/d pretrea +ant Unit Sos'►PP�tiO Rate Monthly average` 0 Sa /Grgvel Filter O Peat Fltter t Quaffty S30 mgn- 0 Mechanical Aeration O Wetland Influent/Effluent ( FOG) [3 Other' Fats, Oil 4 Grease BODE :5220 mg/L 0 DjsInfeCtIOn Biochemical Oxygen Demand ( SS) 5150 m /L- Manufacturer Total Suspend Solids l real Cets) surized) WA Monthly average" 0 n�round (gravity) 0 In -ground (per Pretreated Effluent Cluardy ) S30 mg/L rade O Mound oxygen Demand (BO 5 �0 mg/L - C3 Other Bi pri ine Total Suspended Solids (TS n) s10 cfu /100MI man vrasttewat� and Fecal Conform (geometric mean) y typical for d erttest[c loon -oom� inch diameter sePW Y, uentt ,,, rater. Maximum Effluent Particle Size values values typical for pretreated CE SCHEDULE Service Frequency (s) (Maximum 3 yrs.) MAINTENAN p months Service Event At least once every of tank volume When combined sludge and scum equals one -third (�) Ins condition of tank(s) p month s ear(s) (Maximum 3 yrs.) Pump out contents of tank(s) At least once every r(s) persai oeli(s) At least once every O months ear inspect O NA Clean effluent filter At least once every 0 months on s YBaKs) O NA ,trots Insped pump, Pump co" jre t & alarm 0 m At least once every p months Y ea � ) s 0 NA Flush laterals and press' test � At least once every Cl months 0 Years) O NA Olow. At least once ever otw_ plumbe Licenses or �i,ENANCE INSTRUCTIONS an individual carrying one of the following maintainer. Septage cell be made by S I PO WTSan rriissIng or broken of tanks and dispersal ce Sewer, i?OWT to identify y back up tnspetdions Master r, Master Plumber Restricted on of the tank(S) n m and to check for any comy ItIl O p . inspe ctions must include a visual In a and scu che ck the effluent levels Sery idn9 Op�atior. Tank inspe Me asure the volume of combined a via of effluent on the any cracks or leaks, -rn dispersal cattle) shall be visually tnsPet� to e ponding hardware. Ioe" round surface. round surface- ulatorY authority. effluent or p)ng Of effluent on the g for any Ponding tank of eff ort the g and to c h e ck for requ the immediate no tank of the focal re9 in the obsetvatlon P n and or more of the volume. - NR ground surface may indicate a failing and scum in any tank equals one -third (K) sad o f in accordance with tank shall be removed by a Septage Servicing Operator and disposed When the combined accumulation of sludge and any entire contents of th retreatfinent components. 113, Wisconsin Administrative Code onents. P a certified POWTS Maintainer. an]CSI or pressurized POW TS temp rformad by event The servicing of effluent finals, meet» Intends of 12 months or IeSs shall be Pe of completion of any service other maintenance or monitoring i regulatory authority within 10 days 88M* report sha((�be provided the iota e9 p ro d u c t s or other A se ant tank(S) g P START UP AND OPERATION pOWTS check rearm for the preSence of painting ersat califs). if high conoentratiollS are For new oonstnic�n, Prior to use of the rocess anC/or damage the dispo tarot Prior use. chemicals that may impede the treatment p a septage servicing Pe - detected �Ve the contents of the tank(s) removed by � �. � •, - .. 1 z., � Page of,_,__ i t conditions are frozen at the infiltrative surface- is resto the e=m system start up shall not occur when above normal tiighwa when power the �ti(s) and 'may result in the Dufmg i ages Pump I ds oett(s) in one large dose. ov ontent O um tank removed by a wilt be discharged To avoid this situation have me a�rnoontad a P umber or POWTS Maintainer to dace d-�arge of etiint the effluent pump backup Selig operator priorld rti;stOd rO P ier S ng the pump r othe Q prlttpis to restore normal levels within the pump assist in manuaityb rails. Do not drive or park over, orwise disturb or compact, over tanks and dispersal - Do not drive or Panic vehides of arty or at -grade sail absorption area . rfalmanee and prolong the rife the area within 15 feet down slope ny rove the pe Reduction or•elunination of the toltowing from the wastewater stn3am may Improve dental floss; diapers: . y pe5: cigarPtte butts; condoms; cotton swabs; of the poWTS: andb� Vvatet, fruit and vegetable peet'ings gasoline; grt�se� herbicides; meal drsinfeC��: {�nda6on diWn (sump P+�p) n apkins; tampons: - and water softener Wine. s�Ps: �� of meting products; pesticides: sanitary p ABANOOWMENT taken out of service the following steps shy d t to insure that the andlor is permanent When the POWTS ttEdls ly franca with ch_ Comm 83.33. VV'isoorisin Administr Code and . abandoned in comp in s sealed - system pr be disconnected and the abandoned Pipe open g e servicing O rator. All piping to tanks and p shall disposed of by a SePtag 9 Pe The oontents of art tanks and pits shall be removed and property • After Pumping, ail tanks and pits Shan be e�ccavated and removed or their covey removed and the void space fiAed with soil, gravel or another inert solid material. CONTINGENCY PLAN aired the following measures have been, or must be taken, to Provide a code If the pOWTS falls and cannot be rep compliant replooement'ys n evaluated and may be utilized for the location of a r ctio and should not 0 A suitable replacemen�Yares. has b en area should be protected from disturbance and compa absorption system. uired setbac from existing and proposed structure, es tablish lot tines and welts. suititae b le be infringed upon by req ult in the need for a new soil and site Leval at that tirn tt a suitable protect the replacement area Vil res s y ste ms must comply with the rules in effect sYs A suitable replacement area s aitabie d a Est resort o p arm soil li � failed POWTS advances i not av In P01I1R replacement area. Replacement O be installed as technology a holding tank may a suitable replacement area. Upon failure of the POWTS a sod an The site has not been evaluated to identify site evaluation must be performed to locate- a suitable replacement area. If no replacement area is available a holding tank may be insWied as a last resort to replace the failed P in plat remov of the bl Mound and at -grade soil sbsorpbon systems may be reconstructed in piaceth ikules effect at that time. at at ns of such systems must comply with fie infiltrative surface. Reconstructio MAY CONTAIN LETHAL GASSES AND /OR INSUFFICIENT OXYGEN. SEPTIC, PUMP AND OTHER TRFATME� ANY CIRCUMSTANCES. DEATH MAY DO NOT ENTER A SEPTIC. PUMP OR OTHER TREATMENT TANK UNDER RESULT.. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITiONAL COMMENTS powrS MAINTAINER POYtiTS INSTALLER Name Name Ct It Phone Phone LOCAL REGULATORY AUTHORfTY SEPTAGE SERVICING OPERATOR PUMPER Agency t � ` Name Phone � Phone j ^— 2 This document meets of the Csen �. Marquette and Waushara County Zoning and Sanitatinn ass- This aomme t wa s chatted by the staffs t Code. Use of this cum doent does not me minimum requirements of di Comm 83.22W(b)( )(41 (0 and 83.54(l).(2) (3). Wsconsin Admintstra D Myy (1l01) guarantee the perrotmance of the POWTS. l Wisconsin Department of Commerce RreC� LUATION REPORT Page of Division of Safety and Buildings ® t in acc ' p� ince with Com; 5, Wis Adm. Code r County Y „� � , Attach complete site plan on paper no less than 8 1/2 Q 1¢ ir1� n size. Ian must include, but not limited to: vertical an onz I reference phi M), dir lion and Parcel I.D. percent slope, scale or dimensions, rth ar v �aRtft 8 n and distan to nearest road. IS 2-(V // 63 ' / ' tSaO Please print a <<d / WB�F y Revie by Date Personal information you provide may be used for secondary purpose w, s. 15.04 (1) (m)). f � d Property Owner ! Property Location �� /aeL Govt. Lot t /4� X1/4 &j� - N R/j E (o W Property Owner's Mailing Lot # Block # S or CS -' LG � l City State Zip Code Phone umber ❑ City ❑Village Nearest Roa Construction Use: esidential / Number of bedrooms Code derived design flow rate srz? GPD ❑ Replacement lic or commercial - Describe: __— Parent material l Flood Plain elevation if applicable �'�✓� ft. and recommendations: j��i� �l / "� � M Boring # O Boring � Rit Ground surface elev ft. Depth to limiting factor m. Soil 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 ' Z O r31� t - „j !� ® Bori # k Boring 4lI pit Ground surface elev. ft. Depth to limiting fact or 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 Effluent #1 = BOD > 30 < 220 mg(L and TSS >30 1 150 ` Effluent #2 = SOD < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) re CST Number Bird Plumbing, Inc. Shaun Bird 226900 Address Date Eval ation Con acted Telephone Number 1008 192nd Ave, New Richmond, WI 54017 -�_ - 715- 246 -4516 Property Owner _ Parcel ID # Page of F3_1 Boring # - ❑ ring � it Ground surface elevp ft. Depth to limiting factor � )n. 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. A 'Eff#1 •Eff#2 ej 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/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. - Eff#1 •Eff#2 F-1 Boring # ❑ Pit Boring ❑ Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description. Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 - Eff#2 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. 5668330 (8.6100) Soil Tegt Plan Project Name Ken Oevering Sh rd Address 838 Summer Pines Circle Hudson Wi 54016 TM #226900 Lot 15 Subdivision Hollow Pond Date 9/24/04 S W 1/4 S W 1/4S 25 T 30 N /R'8 W Township Richmond Boring Q Well PL Property Line County ST. CROIX i BM or VRP Assume Elevation 100 ft. To p of 1 /2" p p e System Elevation 99.5' *HRPSameasBenchmark Property Line Alt.B.M. B.M. * 99' 99.5' Scale = 1 /4 " = 1 ► 1/2" Pipe @ 99.1' t� B- ❑ 4% Slope ❑ B -3 B -2 ❑ 327' Property Line 13 0th Ave Safety and Buildings Division County r f 201 W. Washington Ave., RO. Box.7162 ' 0 ) FN Vi s consin M adison, WI 53707 - 7162 Sanitary Permit Number (to be filled in by Co.) (608) 266 -3151 2 De artment of Commerce Sanitary Permit Application sate Plan I.D. Dumber In accord with Comm 83.21, Wis. Adm. Code, personal information you provide Project Address (if different than ling address} may be used for secondary purposes Privacy Iaw, sl5.04(lxm) 2,, I. Application Inforimation - Please Print AU Information I � l � r � �e — Block o Property Owner's Name S E F 1 2004 P # a � ✓�.� _ � IYC.r J N i Y perry Pro Owner's Madang ""Z OFFICE ) '� Section 0� City, State T.np Code Phone Number ,5P � 7 10 N; I w IL of Building (check all that app 6 .1"ll Sa vision Name CSM or 2 Psmily Dwelling - Number of Bodroo Pu ideviumeccial - Dcsaibe Use t Village ownsltip of State owned - Describe Use q 1>)ST C III. Type of permit: (Check only one box on line A. mplete line B if applicable) A• Sy-tern Replacement System lding Tank Replacement Other Modification to Existing System . f Permit Trans o New Fist Previous Permit Number and Date Issued B Permit Renewal Permit Revision Before Expiration Plumber OWN IV. Toe of POWTS S m: (Check all that a 1 `' on - Pressati and - Mound >_ 24 is of suitable soil < 24 in. suitable soil At -Grade Single Pass Sand Filter Constructed Weiland Pressurized In- Ground Holding Tank Peat Iter Aerobic Treatment Unit Recirculating Sand Filter RecirculIft Synthetic Media Filter Drip Lane -less Other (ex lain V Di ersaVTzratment Area Infor w ation: OD SUS Design Plow (gpd) resign Soil Application f) Dispersal Area {sf) Elam' (sB SystElam' Tank Info ace m Total Number c oncre t e Mana Prefab Site S G tbcr antic P. l^' V I. I ons Gallons of Units Cte constructed GWss ✓ ` J New Existing Tanks Tanks S Kc or ltolQmg Tad xl A=cme Twstrmnt Unit hosing Cumber nsibnity for installation of the PO shown on the attacited V Responsibi Statement- I, the and Mp�PR Nu B Phone Ju ["ltifuflca f la.°") Fla Plumber's Address ( eLci + m• tiP ) VIII. Coun /De partment Use Onl Da Si We Sanitary Permit Fa (includes Grouadwatec ` pproved Dkffproved Surcharge Fee) ,H- '1 - 7l 4J Owner Given Reason for IIC. Conditions of Appr�o fo pprov���� SYSTEM OWNER :D 4, be I ax,' -" 1 Septic tank, a uent filter a ` Gii►2 d Ste'' ` 0 dispersal cell must all be iced maintained �nf as per management planf rovided b lumber. 2. s mus e maintained Ha4v �Zoc_k. as per a li I r 'n e /o S p 5 ttaa gomplete,piaos (to the Cou4h Y) [err the systew on papa' not left than x t ine gddl �v� vQS- ��a�►'e�^ PLOT PL PROJECT Ken Oeverino ADD 838 SummerPines Circle Hudson W 54016 SW 1/4 SW 1/4s 25 /T 30 N/R 1 W TOWN Richmond COUNTY ST. CROIX MPRS Shaun Bird 226900 DATE 8/31/04 BEDROOM 3 CONVENTIONAL )00C IN- GROUND P URE 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 chamb 76 ,BENCHMARK V.R.P. Top of Conduit ASSUME ELEVATION 100' Filter Za A -100 ❑ BOREHOLE O WELL H. R P. Same as Benchmark Well is to meet a SYSTEM ELEVATION 96.5/96.3/96.1/95.9 ' below tirade setbacks required b ( B. M. #2 is top 52► #1 WDNR of conduit @ Plans Designed Using ( 99.96' 10' Conventional Powts 327' Manual Version 2.0 ' Property Bedroom House 20' Line ST 0' -3 20, Vents 159 _ d 72' IQ liU (_ eVA L.UATtt_ - UUe /nJCT F-Cou f} 4-4' X 1 9' Cells with >3' Sp Icing 130 ro\j P1 0A - -1 D r I Vent 1 00 29' >6„ Standard Biodiffuser B - 1 of Cover Leaching Chamber /J0V with 3 1. 1 ft2 of Area 52' 6' Lon g 34 Grade at System Elevation Town Road be ( o c d arlu se,�6�c� -d i � dc.o =eo 1�0 c.o dos f i P :N/R OT PL PROJECT Ken Oeverina ADD 838 SummerPines Circle Hudson Wi 54016 1/4 SW SW 1 14S 25 /T 30 1 W TOWN Richmond COUNTY ST. CROIX MPRS Shaun Bird 226900 8/31/04 3 DATE BEDROOM CONVENTIONAL )= IN- GROUND P E URE 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 chamb s 76 BENCHMARK V.R.P. Top of Conduit ASSUME ELEVATION 100 Filter Zabel A -100 ❑ BORE LE O WELL * H R P Same as Benchmark Well is to me 11 SYSTEM ELEVATION 96.5/96.3/96.1/9 B 3.5' below q setbacks require B. M. #2 is top , WDNR of conduit C #1 Plans Designed Usin 99.96' 10' Conventional Powts 327' Manual Version 2.0 1 Property Line Bedroom House ' ST I 0 1 r -3 20, Vents 159 `� - ----a 7 2' 'p /N srr� i,c E✓� So L C6 n1D i - n 6 tIS - '1�U2rn�CT F- �ousE ��� ��, 0 r }�� p 4-4' 19' Cells with >3' Sp I cing 130 Vent /00 29' -pot B -1 >6" Standard Biodiffuser of Cover Leaching Chamber �0 with 31.1 ft2 of Area 6' Long 1 1 " �� 52' 34" Grade at System Elevation � pzs ' � o� �i h -� Town Road t -d dL0 :B0 b0 Lo des to cn CD 10 ta o 1 p 10 1 ''' , ' N 00 "05 "E a I cn I 327.01' N c� ccoo N w I• � o Q z A N O I , 1 I ' 1 i I� I A'� I� •°i y ?95 co �• Im -- i1Z I� i N. 100 N I = � ' •• OC OD � 1p T O r OD I N O v N "E V 4 y O A -- 142ND ST. o o •�.�.�.....• �, - - - - -- o ~-� 0 8 . — — .N to 1 r y _ : Q • �Ow Ly_ D I . "E 411,00' I - T, I r -- i� t"= 327,01' I 10 y 83.99' 101 I 6 6' o : 8 I g ,, 33.00' i WN�C �� 1 1 0 � � — � � 327.01' IZ � 1 I I� a 1> IM 00'05'55 "W 8 g 8 I rri Poo ....,.....,_ ' — I I l m I \ ' ST. CROIX COUNTY WISCONSIN ,,,,,,�►'• �� ZONING DEPARTMENT N M R our ST. CROIX COUNTY GOVERNMENT CENTER 1101 Carmichael Road Hudson, WI 54016 -7710 Phone: (715)386.4680 Fax (715)386 -4686 Fax To: Fam Pages: Phone: Date: Re: � 0 T /� /�OLL�C /, CC: 0 Urgent M For Review ❑ Please Comment ❑ Please Reply 0 Please Recycle P� A/ s�f� 6 ,fj kt� fi u-&� -5 PLOT PLAN PROJECT Ken Oeverina ADDRESS 838 SummerPines Circle Hudson Wi 54016 SW 1/4 SW 1/4S 25 /UND /R 18 W TOWN Richmond COUNTY ST. CROIX 8/31 /04 MPRS Shaun Bird 226900 DATE BEDROOM 3 CONVENTIONAL )00 IN -RESS URE 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 7 6 IL BENCHMARK V.R.P Top of Conduit ASSUME ELEVATION 100' Filter Zabel A -100 ❑ BOREHOLE O WELL *H.R.P. Same as Benchmark Well is to meet all SYSTEM ELEVATION 96.5/96.3/96.1/95.9 3.5' below grade setbacks required by B. M. #2 is top 52' M. #1 WDNR of conduit @ Vent Plans Designed Using 99.96' 10' Conventional Powts 7' Manual Version 2.0 >6„ Standard Biodiffuser Property of Cover Leaching Chamber Line with 3 1. 1 ft2 of Area 6' Long 11 " 3 4" Grade at System Elevation Vents -3 20' 4-4'X 119' Cells with >3' Spacing ', 1y 159 4-t;, C 72' r V"6 / 130 U G ri Vj s 2 ST 20' 29' - ---- 2 ( B -1 52' 2 cb' /o 7 �3 Town Road ST. CROIX COUNTY WISCONSIN ZONING DEPARTMENT f ST. CROIX COUNTY GOVERNMENT CENTER �\ w u. M .� ■ ■� 1101 Carmichael Road Hudson, WI 54016 -7710 Phone: (715) 386 -4680 Fax (715) 386 -4686 M e 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 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 gpd/ft would be required for sizing the system. Cc: Greg Peterson, Subdivision Developer Oevering Builders, owner Leroy Jansky, Regional Wastewater Specialist Tom Nelson, CST #227387 RECEIVE Wisconsin Department of Comme IL *' ALUATION REPORT p age 1 of 3 Division of Safety and Buildings , �Wr(@nge mm Iii, Wis. Adm. Code County St. Croix Attach complete site plan on pa r not less than 8 1/2 x 11 inches iiq size. Plan must include,. but not limited to: vertical nd h&Tzc0%U teeF�r�9Nj4nt (B ), direction and Parcel I.D. percent slope, scale or dimensio , no and di#tance to nearest road. Please print all infonnation. e ' wed 6 y Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). I p Property Owner Property Location ■ Greg Peterson Govt. Lot SW 1/4 SW 1/4 S 25 T 30 N R 18 Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# 1611 Hwy 10 15 Hollow Pond City State Zip Code Phone Number ity ® Village ■ Town Nearest Road Spring Lake Park i MN 1 55432 ( 7¢3 780 - 4996 140th Street E] New Construction UseE] Residential / Number of bedrooms 3 to 4 Code derived design flow rate 450 to 600 GPD 0 Replacement Public or commercial - Describe: Parent material Loess over glacial till Flood Plain elevation if applicable NA R General " cent These are massive soils stem bein W by r mendations: ntractor My recommendation would also be a ressurized s s her a effluent x' S` a&o.3 be os over e e s ution area. Not required, but reco end !o S + wK ! ( This site is suitable for a below de conventional system. „�,Nl 3� W Boring # n9 Q pit Ground surface elev. 100.00 ft. Depth to limiting factor >84 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/(F in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 1 0 -9 10yr3 /2 sil mfr aw 2f (O .8 S 2 9 -17 1 4/4 Cvi I sicl lmsbk mfr cw if .2 .3 ho d, 3 17 -24 IOyr4 /4 off- sicl 2msbk mfr cw if .4 • 4 24 -84 7.5yr4/4 sl Om mfi 5 .2 cfZ / Oo 2 Boring # Boring 98.60 >84 pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure ; Boundary Roots GPDM in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 'EW 1 0 -10 10yr3 /2 sil 2msbk aw 2f .5 .8 2 10 -24 1 4/4 - si 1 lmsbk cam' if .2 .3 3 24 7.5yr4/4 is Om cw .5 .7 4 47 -84 7.5yr4/4 sl Om - - . Z r * Effluent #1 = BOD > 30 220 mg/L and TSS >30 150 ' Effluent #2 = BOD 30 mg/L and TSS < 30 mg/L CST Name (Please Print) — _ Signature - —" `. CST Number r Thomas C Nelson 227387 Address Date Evaluation Conducted Telephone Number 1432 120th Street, New Richmond, WI 7/3/03 715- 246 -2454 i Peter Property Owner Pe Parcel ID # Page ? of 3 ❑ 3 Boring # Boring El ' Pit Ground surface elev. 99.50 ft Depth to limiting factor X88 in. Sal ication Rate Horizon Depth. Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Qu. Sz. Cont. Color Gr- Sz. Sh. •EW1 •Eff#2 1 0 -10 10yr3 /2 - sil 2msbk mfr aw 2f .5 .8 2 10 -26 I 4/4 - sicl Irnft mfr cw If .2 .3 3 26 -55 7.5yr4/4 _ 1 Dm mfr cw _ .5 .7 4 55-88 7.5yr4/4 - si Orn mfi - - .5 v F �� # s Boring pit Ground surface elev. ft. Depth to limiting factor in. Soil Applicabon Rate Horizon. Depth Dominant Color Redox Description Texture Stricture Consistence . Boundary. Roots . GPDM in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Efr#1 `Eff#2 Boring Boring # Ground surface elev. ft. Depth to limiting factor in. F-1 lapit 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 " 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- 2648777. SB13- 9330Teg (8.07/00) BM2 BMI THOMAS lIELS t - 52 22738? 2 B3 I° SL PE 327' BM'I TOP OF COWDZTIT 00' BMX TOP OF COW -DZTPT 9.96' B i 100.00' 192 98.60' 183 99.50' SCREE Y" = 40' I59 B2 � X W ; S OP 130' ol 32 n S E L O T 98' ' 'nV 100' o, W TO W F SO.AD w I B 0 Id IL 0 W IRO W ID LOT 15 AWBI sAMCMlIWD)WW t3V9FX e'0WW*WM AV%N1N71M✓dXI 79NIMS '3'N 0l A MHOW «91 d a s - oU/ dnoi0 ftInsuo0 GAW M0770H AK)9b OEM *XU V � � s O dOl MAEIMN173Md OW "1 o � Ua < <Zyl o+ x at wOF O j rc n e n ox � c a:� Z Zt � � ( 3 3 ^17 Oc" 0��� HA 3 2 K > S I C J - �' a ZZ O 32K 1, 0s Q > Sit ' iO w 5 g = e t 0 I ° n< 2 `r t oW Ia PLC g Z w �,,, \\ \ r L � ))) N� y V i O Z K N Z 2 le w a. o °, < ,i 1 3MU 1LL&K < Z N 11p��V J Ja° <y' V 4 t2 Q U) w K W < N p N r < O K - F w � _� h I I \ I RICHMOND �Ic�IC ilj h e y O l OI \ _JI JI4 I F EEo Ct 0 //�� I /?t I w, , I li. East e of the Sll�1 /f of the SW-114 c \ vI _' 9 0 "S00 555 "W 1166.06 1 N a k . 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OJ W V V O a¢ a a a zi cn ze dE Q E to gE &t' at ° YS < ° o ° ° a ° o • a a •o ° o D ° o ° o °o Z nw n♦ ioN No mn 2N 'n an g �"^ v �' n o �y �,_ Oq � o^ O n! ^� aN �^ �^ 72 1^ v� t �p r N h N m N YD W O ^_ N M l r!f m J : 6 '� r F � . u 0 z? z -< i (3 o m 9 o a ° 9 9° o a of�rcF s N 03 u a U s < a of ' iA . r ST CROM COUN SEPTIC -TANK PENANCE AGREEMENT` Dy$.SHIP CERTIFICATION FORM owner/Buyer Mailing Address b - D armaent for new construction) � PropertY Address d from Plannir►g eP (Verification require �1 parcel Identification Number City /State LEGA , 13 E SCRIPTION w, Town of 1/ L , Sec. property Locate° ; Lot Subdivision Page # Volume Certified Survey Map # d 2 . Deed # Volume Z j5 Page # � � Warranty es D no Lot lines idenrifiab y p hous es D no t S ''� 3 130 e-601T - Pel c wastes.Propermatat eaaaas w� a tNTFNA ICE 1 ' r What you p Sys tem S premature failure YS i� o your could result in its P a licensed pUmpe - p u t into the sys Improper use 8aa main f our septi s sep tic tank every wee years or sooner, if needed by stem. tng out the sep a in the waste disposal sy consists of pump tank as a treatment stag owner and by a can affect the fuaction.of the septic cation form, sired by oral system at a ccrtifi r verifying that (1) the ite wastewater disp °n -s s to submit to St. Croix Zoning Departure is less than 1!3 full of sludge. The proper owner agree lumber or a licensed pumps the septic task ourzx.Ymanplumber, restrictedp e and pumping (if necessary), masterplumber, j condition andlor (2) after inspe to main sal system with the standards is is proper operating taiu the private sewage dispo cation eats and ague itesources, State of Wisconsin - Certification d h ave read the above requires �ncnt of Natural so Croix County Zoning Office within 30 Uwe, the undersigns t of Commerce and the Dep e d to the set forth, herein, as set by the DeP� � must be completed and return stating that Your septic system has been main days of e a year piration date. th DATE ,aNA FtJRE OF UCANT g ICATI N our) laiowledge. I (we) am (arc) the o waer(s) of O WNS are true to the best of my I (we) certify that all statements oa Ibis form deed recorded in Register of Deeds Office. t 9; 0 F bed above, by virtue of a warranty 6 , DATE * * « « «« APLIC�`NT 1Cvoked by the Zoning P ** ormation that is mis nPreseu%d=Y result in the sanitary percnrt being De arrcncat. « « «* An inf d warranty deed from the Register of Deeds office ** Include with this application: a atatrtpe if reference is made in the warranty deed a copy of the certified survey map Maintenance and Contingency Plan for a Septic System Maintenance Plan 1. Septic Tank is to be pumped once every 3 years. 2. Effluent filter is to be cleaned once a year. Please note: a larger filter is being installed in order to extend the maintenance interval of the filter. 3. Once every 3 years, cells are to be inspected via the inspections pipes at the ends of the cells. 4. Owner agrees to limit greases, garbage, and water conditioner discharge into the system. 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. 8. Discharge into system is not exceed those required as per Comm. 83 C Plan Option #1. lfkystem fails, determine cause of failure, use alternate area and install new system in tested replacement area., a Option #2. Install system at a lower elevati n, by removing &fAmbers, reni6ving biomat, and install new system. Option#3. No adequate area is suitable for replacement area, and system elevation cannont be lowered. Install holding tank as last resort. 3. Replace any other failing components as needed. Plumber: Shaun Bird 715 - 246 -4516 St. Croix County Zoning 715 - 386 -4680 Pumper Tom Mondor 715- 246 -5148 Shaun Bird #226900 r ' U..2575 P 025 7Es29E36 tt STATE BAR OF WISCONSIN FORM 1 — 1898 KATHLEEN DEEDS WARRANTY DEED ST . CROI O XCO. , WI RECEIVED FOR RECORD Document Number This Deed made between liv Lake Land C , Grantor, and 05/ 18!2004 11:30Al1 S er . LL � Kenneth J. Oevering,,a married Person , G rantee. WARRANTY DEED Grantor, for a valuable consideration conveys to Grantee the following EXENR t real estate in St. Croi Count State of described x ___.. _ Y RfiC FEE: 11.06 Wisconsin (the "Property "): TRANS FEE: 438.66 COPY FEE: CC FEE: PAGES: 1 Recordin Area Name and Return Address Burnet Title 7550 France Ave. S. First Floor Edina, MN 55335 026 1073 50 001/ 026 1073 50 0001 Parcel Identification Number (PIN) This I$ noA homestead property. (is) (is not) Lots 12, 13, 15 and 16 Hollow Pond Addition, Town of New 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' ` day of ; j 2004 (SEAL) (SEAL) Silver Lake Lan LC By Gregory J. Peterson (SEAL) (SEAL) AUTHENTICATION ACKNOWLEDGMENT Signature(s) WEND)(- SWAT -ZI . _ State of Wisconsin, NOTARY PUBLIC I ss. S rA I E OF WIS CONSIN St. Croix County authenticated this day of pLA Personally came before me this T day of 1" Glaaafg, 2004 the above named Greaory J. Peterson. vice nresidtnt of Silver Lake Land LLC to me known to be the pers who executed TITLE: MEMBER STATE BAR OF WISCONSIN the fore in in rument and ac owledge the same. (if not, - =- --� authorized by §706.06, Wis. Stats) THIS INSTRUMENT WAS DRAFTED BY Notary Public, State of Wisconsin Coidwell Banker Burnet 1301 Coulee Road My commission is perma 7P (if not, state expiration date: Hudson, WI 54016 3 -66470 Q ) (Signatures may be authenticated or acknowledged. Both are not necessary.) Names of p rsons s!p in any capacity must be typed or p rinted below their signature. 1 ��dIINi�, UI �i aft N ITV OMJ 1bIN6 %I 161NIIRIIYV��'�' FROM :OEVERING HOMES LLC FAX NO. :7155311282 Aug. 30 2004 09:16PM P3 itttL `-mss � w r � r n � r f w w Z . r t r f i FRAM :OEVERING HOMES LLC FAX NO. :7155311282 Aug. 30 2004 09:16PM P2 p s i w i O all wr /um iW • W o 1 -a' I I 1