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HomeMy WebLinkAbout026-1167-29-000 Wisconsin DepartMent,of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: Or 463065 0 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: City Village X Township Parcel Tax No: Environmental Holdin Cor an LLC Richmond Townshi CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range /Map No: J66 b� \ L -� 27.30.18. TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. 4 - /ca -71 9 Li Septic ff ,, I Benchmark -i IN ..74 /Dt, Dosing Alt. BM - 7 L) Z:I q `� L_ '1 -ce `I1 .)4 Aeration / n � Bldg. Sewer Holding St/Ht Inlet zi.yl TANK SETBACK INFORMATION St/Ht Outlet TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic ' -7 Ji /JA 5 ' 'Cl i _ Dt Bottom Dosing 7 Header /Man. O?4 O4 1's � Aeration Dist. Pipe 1�.r7 `N - o Holding Bot. System c? 3 . S3 7 Z PUMP /SIPHON INFORMATION Final Grade 5--7 `TS o* Manufacturer bbmand St Cover G GPM Model Number � • I � � TDH Lift Friction Loss N System Head TDH Forcemain Leng , • Dia. . Dist. to Well SOIL ABSORPTION SYSTEM BED/TRENCH Width / Length i No Of Trenches PIT DIMENSIONS No. Of Pit` Inside Dia. i Liquidepth DIMENSIONS SETBACK SYSTEM TO P/L BLDG WELL LAKE /STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR Type Of Syst0 J ' 5 i /J A � UNIT Model Number: \ DISTRIBUTION SYSTEM � Header /Manifol Distribution A �l x Hole Size x Hole Spacing Ven to Air Intake 1 � r r P () D I " S -- m - 5 /I Length J t' Dia Length I Dia ` / pacing �✓ 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 I t L' I Bed/Trench Edges Topsoil 1 4' Yes [] No <ees No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / d / [ / 64 inspection #2: � 1a && — Location: 1373 129th St. New Richmond, WI 54017 (N 1 NE 1/4 27 T30N R18W) Lundys Preserve Lot 29 Parcel No: 27.30.18. 1.) Alt BM Description = "e f tti C . ',. S ��ILS CC 2.) Bldg sewer length= 7_ 6 w - amount of cover = % Plan revision Required? [M Yes No Jb Use other side for additional information. SBD -6710 (R.3/97) Date Insepctor' ignature Cart. No. 'i I Safety and Buildings Division County N vi rsconsif MR 201 W. Washington Ave., P.O. Box 7162 r n Madison, WI 53707 — 7162 Sanitary Pe t umber (to be filled i y Co.) Department of Commerce / OS 2 - --- _ J Sanitary Permit A ion ° ° S tate Plan LD. Number In accord with Comm 83.2 1, Wis. Adm. Code, pers ation you provide l o s may be used for secondary purposes Privacy Law, s 5.04(1 bi{r� r i 1 2004 Project Address (if differ mailing address) 1. Application Information — Please Print All Information � 3 q Ve4l t�.L :; i G� �,a. �"G�i l 12— l �T Property Owner's Name in V q t�1Gq 0. Parcel # Lot # Block # z I,u vtd S `�'res 'v>✓ Lo 9 A-1 4, A s LL 'oZ9 Property Owner ailing Address P roperty Loca r +tt_ S �% y, Section X7 City, State Zi C LL o tt de �� / Phone Numb f� 5 Tv �� (16 3 / 1 " GM 0 (circl TN; R� E4,W J II. Type of Building (check all that apply) I/Ku� /L�� � or 2 Family Dwelling — Number of Bedrooms p " 6 Subdivision Name CSM Number El Public /Commercial — Describe Use IA ss �t( ❑ State Owned — Describe Use fh(Vttl r > f ❑City_❑t a Vge �Uownship of III. Type of Permit: (Check only one box on line A. Complete line B if pplica �' ew S stem y _ ❑Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of ❑ Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Plumber Owner IV. Type of POWTS System: (C heck all that apply) ❑ Non — Pressurized In- Ground Mound > 24 in. of suitable soil ound < 24 in. of suitable soil ❑ At -Grade ❑ Single Pass Sand Filter ❑ Constructed Wetland ❑ Pressurized In- Ground ❑ Holding Tank ❑ Peat Filter ❑ Aerobic Treatment Unit ❑ Recirculating Sand Filter ❑ Recirculating Synthetic Media Filter Y g Yn Leaching Chamber ❑Drip Line ❑Gravel -less Pipe 11 Other (explain) 0 V. Dispersal/Treatment Area Information: 6 Design Flow (gpd) Dew oil Application (gpdsf) Dispersal Area Re ' ed (so Dispersal ea Proposed (sf) System Elevation CA J (go© / ors' � �A S 1 06 1581' r '� VI. Tank Info Cipacity in Total Number f Manufacturer Prefab Site Steel tber Plastic Gallons Gallons of Units Concrete Constructed Glass New Existing Tanks Tanks Septic or Holding Tank 1 e Aerobic Treatment Unit Dosing Chamber ^ V _ p ` its VII. Responsibility Statement- I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) L flu ber'S Signature MP/IvlPRS Number Business Phone Number k 1 ?� Plumber's Address (StreV City, State, Zip Code) 'o'er VIII oun /De artment a Onl / Sanitary Permit F (includes Groundwater Date Issued ssuin A ent Approved ❑ Disapproved ld g g gnatu Stamps) Surcharge Fee) 0 El Owner Given Reason for Denial L;/ 3 �D � ZJ Q IX. Conditions of ApprovallR� easops for Disapproval YS7� Vll�A� toll� 1 Septic tank, effluent filter and Y dispersal cell must all be serviced / maintained �2e��rrcC. 3 as per man r v' d b lum i� 01�vnd Stye WtGc l ecC c� cY 2' setback requirements must be maintained �`�� 6 vyi L as per applicable code /ordinances. %096 xz,up—f cm Attach complete plans h County only) for-the system on pape not l ` than 1/ f x.11 in es in size p ?�5 SBD -6398 (R. 01 /03) � l ��••+.+ LJJVUV RUVGRJ rLUI'IDl1YU� 11VU rRUL U4 9 jo 9 abed m cc 0 0 u tl st rn r-- m _ �$ g ro zo c rn $; o v r .A O a � 0 c nu ' $ A -v y N r m to r CA o ❑ r r r' r r mm i r r / r r Z r r d lip, r T f rr 7 0 Q a > b z ram b� � 0 3 s / � N rn W ours Maid Safety and Buildings 4003 N KINNEY COULEE RD commerce.wi.gov LA CROSSE WI 54601 -1831 TDD #: (608) 264 -8777 isconsin www.commerce.wi.gov /sb/ Department of Commerce www.wisconsin.gov Jim Doyle, Governor Cory L. Nettles, Secretary September 13 2004 P , CUST ID No.225094 ATTN: POWTS Inspector MICHAEL P ROGERS ZONING OFFICE ROGERS PLUMBING ST CROIX COUNTY SPIA E4457 HWY 12 1101 CARMICHAEL RD MENOMONIE WI 54751 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 09/13/2006 Identification Numbers Transaction ID No. 1058110 SITE: Site ID No. 689220 Lundy Preserve Please refer to both identification numbers, 140TH Ave above, in all correspondence with the agency. Town of Richmond St Croix C unty N1 /2, /4, S27, T3 ON, R18W Lot: 2 , FOR: Description: Four Bedroom Mound System Object Type: POWTS Component Manual Regulated Object ID No.: 979323 Maintenance required; 600 GPD Flow rate; 28 in Soil minimum depth to limiting factor from original grade; System: Mound Component Manual - Version 2.0, SBD- 10691 -P (N.01 /01), Pressure Distribution Component Manual -Version 2.0, SBD- 10706 -P (N.01 /01); Biofilter The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes Wisconsin and 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. Condih No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, APPRI stats. DEP RTMENT 0 The following conditions shall be met during construction or installation and prior to occupancy or use: r N OF FT General Approval Requirements: SEE CORRES • This system is to be constructed and located in accordance with the enclosed approved plans and with the "Mound Component Manual for Private Onsite Wastewater Systems VERSION 2.0" SBD - 10691 -P (N.O1 /01) and the "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems VERSION 2.0" SBD - 10706 -P (N.01 /01). • 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. • Comm 82.30(4)(c) Wis. Adm. Code. The manifold diameter is reduce to 1.5 inches s as to provide for a pressurized per secon . • The changes made to this plan on 9/13/04 by this reviewer were acknowledged and approved by the system designer. T �e ose �o the system is to equal five times the void volume of the distribution laterals. A switch float setting of 5.2 inches will provide the minimum dose. MICHAEL P ROGERS Page 2 9/13/2004 • 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 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. Stat • 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 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. • 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 cbratz@commerce.state.wi.us cc: Leroy G Jansky, Wastewater Specialist, (715) 726 -2544 F p Mound System Cover Page Pg I of 6 4! . ° 0Q 0 Project Name: Lundy Lot 29 Mound Owner's Name Environmental Holdings, LLP Owners Address 706 19th St S. Hudson, WI 54016 715- 377 -2010 Legal Description N • '/Z NW '/. Sec 27 7 1 T 30 N, R 18 W • Township Richmond County Saint Croix • Subdivision Lundy's Preserve Lot# 29 ParcelID# tbd Table of Contents pg- 1 Cover page 2 Mound Sizing Calculations 3 Pressure Distribution Layout and Dynamics 4 Dose Tank 5 Management and Contingency Plan ��ly 6 Plot Map / Calculations ED cA GS total # of pages: 6 ol Designer Name: e z MP /License #: �GIJUL �y Date: 8/25/04 Ph. #: Signature: Mound System System Design Methods Used per 7&und Component Manual For Private Onsite Wastewater Treatment Systems' (Version 2.0) SBD- 10691 -P (N.01/01) per' Pressure Distribution Component manual for Private Onsite Wastewater Treatment Systems' (Version 2.0) SBD- 10706 -P (N 01/01) Spreadsheet provided by: 3bAdvisement N12486 220th St, Boyceville, WI 54725 Ph: 715-64349= email: 3bae3badvisement.com l Mound System P"s2or 6 Mound Sizing Calculations Project Name: Lundy Lot 29 Mound Site Conditions Design of Ent' trim ill Project Type i or 2 Family Dwelling C depth at upslope edg (D): 8.0 in. (0 - 7 �) % Slope: 7% Cell depth at downslope e e (E): 12.7 in. # of Bedrooms: 4 Distribution cell depth (F): 9.5 in. Depth to limiting factor: 28 in. Cover thickness over edge (G): 6 in. Absorbtion rate of fill material: 1 gal/ft2 /day / Cover thickness over center (H): 12 in, Absorbtion rate of in -situ soil: 0.4 gal* /day✓ End slope width (K). 8 ft. Effluent quality Eff #i Fill length (L): 125.0 ft. Max BOD effluent value: 220 mg /l Upslope width (J): 4 ft, Max TSS effluent value: 150 mg /l Downslope width (Toe) (1): 9.0 ft. Fill Width (W): 19.4 ft. Design of the Distribution Cell Basal Area System Design Flow: 600.0 gal /day Basal area required: 1500 ft Distribution cell width (A) 5.50 ft Basal area available: 1581 ft Distribution cell length (B): 109.0 ft Area of Distribution Cell. Observation Pipes Contour Elevation of Mound: 92.00 Location from end of cell (2): 18 ft System Elevation of Mound: Final Grade of Mound: ft Mound Ilan View Observation Pipes Z--sl W K Distribution Cell A B � I 1�-K Tilled ArealFill Material Mound rosy Section Final Grade Observation Pipe Synthetic Fabric H G Distribution Cell System Elevation a a • 1 Cover Material Lateral ��. 3 Fill Material Invert Tilled Area Slope �Forcemain System Contour Notes: Fill material to consist of ASTM 033 Sand Distributlon cell Owregate to Comply with Comm 84-30(6)(1) Synthetic Fabric covering on Cd per COMM S4.30(6)(g) DlsMbution coil to have minimum 6" aWregge below fateml and 7 abbe. Z0 3!)Vd ONI `JNIHWfI SN390a L983SEZ 90 :60 b00Z/EI /60 Mound System Page s of e Pressure Distribution Calculations Project Name: Lundy Lot 29 Mound Lateral Layout Lateral /Manifold Design Lateral elevation: 93.2 ft Lateral diameter: In Rows of Laterals: Z • Lateral spacing (S): 3.5 ft Manifold type: End . Lateral to cell edge: 1.0023 ft Orifice diameter. 0.12.5 rr In. Lateral discharge rate: 15.65 gpm # of Laterals: 2 System discharge rate: 31.31 gpm Distal Pressure: 5 ft Manifold diameter: r T Lateral Length: 108 ft Manifold length: 3.5 ft Orifice Spacing/Distribution Forcemain Friction Loss Orifice spacing N: 3 Inches Forcemain length: Orifices per lateral: 100 ft 38 Forcemain diameter: 2 V In. Avg, it /Orifice: 7.$g ft Friction loss in forcemain: 2.098 ft Lateral Side View Manifold Lateral Lateral Length Lateral Plan View Laterd Length Turn"W w /b44 valve or cleamut pkrg �, o S o Orifices an bottom PVC laterals and f0rcor4n to comply with later equally spac $recilications per Gomm 84.3 2 U[ 1i e Forcemain connection via tee o cross to manifold at any poiint Clean Out Detail Observation Pipes Final Grade Clean -out plug or ball value Water tight cap Lawn or plug Sprinkler Box lot ' r Note: Clq� Ca. Long S�nre ®p 90 6' Minimum ma be used in or two 45 dace of 3/8" bsr Leterotl 3 /8" Bar E0 39bd ONI `9NISWII SN39ON L9809EZ 50 :60 b00Z/ET /60 M System Page 4 of 6 Septic, Pump and Dose Tank Project: Lundy Lot 29 Mound Tank Information Dosage Volume Pump tank manufacturer: Wieser Concrete Forcemain drains back to tank? Q Yes O No Pump tank size /model: �W 1250/750 -MR Lateral void volume: 4" gal Pump tank gal /inch: 16.12 Dosage to absorbtion Cell: qiF .783 gal Actual Pump Tank Volume: 758 gal Forcemain volume: „ 3 W4 gal Tank bottom elevation (inside): g2 ft Total dosage: f , ,5 - 4" gal Septic tank size /model: W1250/750 -MR Pump and Filter Total Dynamic Head Pump Manufacturer: ZoeJleF Are laterals highest point? y Pump Model: 152 if not, enter highest elevation: 0 ft Effluent Filter: Zabel A100 System head (distal x 1.3) 6.50 ft Vertical Lift ( "D" to lateral) 10.17 ft C Note: Access opening of sufficient size to be provided to allow removal of filter. Opening to terminate at or above grade. F rictio n loss in forcemain: 2.10 ft Pressure loss from filter: �ft Total dynamic head (TDH): 18.76 ft I Pump Tank Diagram Dose Tank Levels � Watertight Locking Cover In. Gal 4 Inch With Warning Label WEjlecl. A Reserve .z.5 � 2 436: 7 Minimum B Pump off to Alarm 2.0 32.2 Alternate C Total Dosage 54 9g 6 Outlet 12.0 193.4 Location D Effluent depth for pump 16.28 and NEC 300 Total Capacity: (� $ 47.0 758.0 IForcemain Weep Hole p` W or Anti- w W PUMP PERFORMANCE CURVE Siphon B MODEL 15111521153 Device so G 14 45 153 D a :i5 L 10 30 a 0 8 25 6 20 '- Pump must be capable of: 31.3 GPM 15 and head pressure of: 18.8 Feet 4 10 z 5 0 10 20 30 40 50 60 70 811 90 100 GALLONS LITERS 0 40 80 120 160 200 240 280 320 360 FLOW PER MINUTE 014508A 1 Mound System Management Plan pursuant to comet 83.54 W. A. C. page 5 of 6 Owner's Responsibility: The component owner is responsible for the operation and maintenance of the component. The county, department or POWTS service contractor may make periodic inspections of the components, checking for surface discharge, treated effluent levels, etc. The owner or owner's agent is required to submit necessary maintenance reports to the appropriate jurisdiction and /or the department. Septic Tank: Septic tank(s) are to be inspected routinely and maintained by department approved individuals when necessary in accordance with their approvals. The use of chemical /biological "treatments" is not required or recommended. If such additives are used, make sure they are approved by Department of Commerce, Safety and Buildings Div.. Effluent filters are to be removed & cleaned as necessary, with provisions to keep solids from passing the septic during removal. No more than 1/3 of the usable tank volume may be occupied by sludge /scum. 3 year inspection: If tank has greater than 1/3 volume sludge, tank contents must be emptied and disposed of in accordance with NR 113 Wisconsin Administrative Code by an approved individual. If the inspector does not recommend pumping of the septic tank, then the owner must be notified of when pumping should be done as to not exceed 1/3 sludge volume. Septic tank should be routinely inspected to be watertight and of good repair. Pump /Dose Tank If an effluent filter has been installed in the pump /dose tank, it must be removed & cleaned as necessary, with provisions to keep solids from passing to the mound component during removal. The pump, float switches and alarms must be inspected at least every three years for proper operation. Pump /dose tank should be routinely inspected to be watertight and of good repair. Mound and Lateral System The mound system component must remain free of ponded surface water prior to pump operation. If 4 inches or more water level is detected in the observation pipes, the owner must be notified of possible problems /failure. The designed daily flow capabilities of the component should never be exceeded. Trees and any other deep rooted vegetation should never be planted, or allowed to grow anywhere on the component. Activities OTHER than mowing /maintenance (i.e. excessive walking, pets, vehicles, etc...) could compress the component and reduce it's absorbtion capabilities and /or possibly cause it to freeze in winter conditions. Lateral distribution pipes should be flushed out/tested every 18 months using the cleanout points at each end of the component to remove scum that may clog orifices. Performance Monitoring: Performance monitoring must be done at least once every three years following the installation or at the time of a problem, complaint, or failure. Contingency Plan: If the septic tank, pump tank or any of their components therein (including floats, alarms, pumps, etc) become defective, the defective tank or component must be replaced immediately to ensure that the system can operate as designed. If the mound component cannot accept wastewater or ponds wastewater to the surface, the component must be repaired or replaced in it's current location by either: extending basal toe to provide added absorbtion area; or by removing the clogged bacterial mat,aggregate cell, and distribution piping within the mound and replacing said components in order to return system to proper working order as required. Property Line m° CO co v m� � �W i In 0� Z mOb ' d o OD Cq E I o � m o O �LL W d CL leg m y awl cn CO o 0 CO Q a c� 8 E n W 1 � �g PaWVOf 6 b0 �Jdd ONI gNIswn7d sN39oN L9809EZ 90:60 b00Z /EL /60 RECEIVED JUN 0 1 2004 Lundy's Preserve Comments: ST. CROIX COUNTY ZONING OFFICE The soils in this subdivision are quite variable and differ across the 80 acres. Some consist of a clean outwash sand, other consist of glacial tills. In certain areas, the medium sands have a very deep red color unlike I have seen in all of St. Croix county. The color does not indicate high ground water because the color is so consistent. If you go through the red sands then the sands turn off white/yellow but not those of a sand stone. In talking with Pam Quinn from zoning, she commented that there could be a different chemical reaction with a sands. I believe this is the case for the sands have a consistent size, and no mottles were found above or below the sands. Sometimes bands were present, but were very slight, i and were mentioned to have the systems sized a little bigger in order to accommodate for any inconsistencies in the soil. Also it is worth mentioning that the intersections of lots 6,7,8, and 9 have a extremely poor soil present not suitable for a mound system. The surveyor and I discussed this condition, and the resulting tests were spaced as far away from this area as possible. All the soils tests were done to the best of my ability and I hold no liability for anomalies and other oddities that can be found on this site. Shaun Bird CSTM #226900 5/28/04 r 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 i include, but not limited to: vertical and hori4ref e d Parcel I.D. percent slop e, scale or dimensions, north do t 17 arest ro d. Please print on. II R "ew y Date Personal information you rovide may be used pose (OW.cyllaw. ZY�9 (1) (m ). ! d 1/ Property Owner PrR qty Lo tion i f t� 6tQyE Lot 1!4 /4 S.2 T N R E (o W Property Owner's ailing Address j Lot # Block # Name or CSM# S / , .5. city State Zip Code Phone Number 0 city ❑village wn Nearest R / ,c y0 New Construction Use. Residential I Number of bedrooms Code derived design flow rate 00 GPD ❑ Replacement /A Public orr commercia�be: Parent material JAL f n Cam- Flood Plain elevation if applicable �` ft• General comment and recommendations: sy ><� 2 r2ivcv � 3 1 ❑ ring F/ � # Pit Ground surface elevt ft" Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Clu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 •Eff#2 i3 3 I s ,6k F- _ Bori ring r �— �s a # Pit Ground surface elev.& ' tt. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Clu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 o/ 1 3 /� a mac r r , 6 2 Y e L - 3 "1�7 y S S ►� 5c-/ Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < ' Effluent #2 = BOD < 30 mg/L and TSS <_ 30 mg1L CST Number CST Name (Please Print) i re Bird Plumbing, Inc. Shaun Bird 226900 Date Evaluation Conducted Telephone Number Address 715- 246 -4516 1008 192nd Ave, New Richmond, WI 54 a Zy Property Owner Parcel ID # n Page of Boring # Boring F, � Pit Ground surface elev. ` r ft. Depth to limiting fad cal Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots *E GPD/k inn. Munseli Qu. Sz. Cont. Color Gr. Sz. Sh. // 7- - -5 7 4 W .3 - 0 a 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 Boring ng # Ground surface elev. ft. Depth to limiting factor in. a ❑ Pit Soil Application 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 Effluent #1 = BOD_ > 30 < 220 mgll. and TSS >30 1150 mgA- ' 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. SBa8330 (RAU) r s , Soil Test Plot : a Project Name Environmental Holding L.L.P. Bi Address 706 19th St. S. Hudson Wi 54016 STM #226900 Lot 29 Subdivision Lundy's Preserve Date 5/24/04 N 1/2 NE 1/4S 27 T 30 N/R 1 8 W Township Richmond [ Boring Q Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 100 ft. Top of Steel Fence Post System Elevation 93.1 *HRpSame as Benchmark Alternate Benchmark Top of Survey Iron C 96.0' 269' Property Line 110' B.M. 10 Alt. B.M. 20' B -1 60' B -3 75' B -2 71 Slope 92' 90' Please note:Soil test was done to satisfy 231' county zoning y requirement. Soil Scale is 1" = 40' Property test may not be unless otherwise suitable for owners desired building noted location. RECEIVED — — ] ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT r_ r 4 2004 AND OWNERSHIP CERTIFICATION FORM ZON OFF !CI Owner/Buyer � °', =�"�� LL Mailing Address 5 r'1 `f L S /�� CAS 0 ✓L W 1 5401 Property Address 13 / -L4 (Verification required from Planning Department for new construction.) City /State Parcel Identification Number t,)- 6 -/074 - /0 ' 0 U LEGAL DESCRIPTION nn Property Location /J 1 /4 t 1 / 4 , Sec. a� , T -30 N R /a W, Town of Subdivision �V 1/tU +� /S/�Q -Gt/ 1/� , Lot #. Certified Survey Map # Volume , Page # Warranty Deed # W1 510 , Volume P V 0 , Page # S8 Spec house yes no Lot lines identifiable yes o SYSTEM MAINTENANCE Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. Owner maintenance responsibilities are specified in § Comm 83.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance. The property owner agrees to submit to St. Croix County Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on -site wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. Uwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septi ystem has been maintained must be completed and returned to the St. Croix County Zoning Department within 30 days of th ee year expiration date. 0 SI N ` OF APPLICANT DATE OWNER CERTIFICATION I/we certify that all s ents on this form are true to the best of my /our knowledge. I/we am/are the owner(s) of the property de ed ov tue of a warranty deed recorded in Register of Deeds Office S16WAtURE OF APPLICANT DATE * * * * ** Any information that is misrepresented may result in the sanitary permit being revoked by the Zoning Department. * * * * ** Include with this application a stamped warranty deed from the Register of Deeds Office and a copy of the certified survey map if reference is made in the warranty deed. ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer �': '� , / .. Address 1 C-1 �� S � � � ✓l S`1' �1 So Mailing Property Address 3 � u ('Verification required from planning Department / r new construction.) // s e 74� #-- /O - rr o V City /State Parcel Identification Number o7 _ _�?O -- bOO U07(o LEGAL DESCRIPTION r" " A� /., Property Location � � r/4 ,Sec. 3�? , T � d N R f& 'VV, Town of Subdivision ��V�CJ �s !�&�Y ��- Lot # ° Certified Survey Map # 0.%j A. Volume _. , Page # Warranty Deed # '7 W1 50 5 , Volume P V o , Page # 68 Spec house yes no Lot lines identifiable yes �6 SYSTEM MAINTENANCE Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. Owner maintenance responsibilities are specified in § Comm 83.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance. The property owner agrees to submit to St Croix County Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on -site wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. I/we, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State s Wisconsin. Certification stating that your scpti ystem has been maintained mus b t e com leted Dep p and returned to th Pr+ d within 30 days of ee a St. De year expiration date. Croix County Zoning SI N ' OF APPLICANT OWNER CERTMCATI N DATE r/we certify that all c Property d o ats oq this form are true to the best of my /our knowledge. T/we am/are the o v a of a warranty ners) of the ty deed recorded in Rcgjster of heeds Office S ItE OF APPLICANT Pi /1(0/ d sy�wrrs Any information that is BATE misrepresented may result in the sanitary Permit being revoked by the Zonin De t. Include with this application a s g partment mFerence is Made in the tamped warrant deed from the Register of Deeds Office and a co warranty deed. PY of the certified surve map if E0 39dd DNI `9NIawn Sd39Od L980SEZ 6T :ET b00Z /TZ /60 STATE BAR OF U F9RM I` 2000 76 756F3 Document Number WARRANTY DEED ,� KATHLEEN H. WALSH REGISTER OF HEEDS Thus Deed, made between John Schommer and Barbara STS CROIX Co., MI Schommer,__husband and wife RECEIVED FOR RECORD Grantor, 07/01/2084 01:15pit and Environmental Holding Company LLC WARRANTY DEED REC FEE: 11.00 Grantee. TRANS FEE: 2314.20 Grantor, for a valuable consideration, conveys to Grantee the following COPY FEE: CC FEE: described real estate in St. Croix County, State of PAGES: 1 Wisconsin (the "Property") (if more space is needed, please attach addendum): Lots 1 through 33, inclusive, Lundy's Preserve, Town of Richmond. Recording Area Name and Return Address Title One.Premier Group 706 19th Street South Hudson, Wisconsin 54016 o 26- 1078 -10 -000 026- 1078 -30 -000 Parcel Identification Number (PIN) Together with all appurtenant rights, title and interests. This is not homestead property. (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, and Restrictions of Record Dated this 30th dav of June 2004 GZ�L *Jo Schommor * Barbara Schommer * AUTHENTICATION ACKNOWLEDGMENT STATE OF WISCONSIN ) Signature(s) tg PVe ) ss. St. Croix County. ) authenticated this day of x Personally came before me this 3 0,x_ day of r June 4 the above named r PAlh1 7 200 * and TITLE: MEMBER STATE BAR OF B r Sch ommer (If not, h OF �V4S�: to me known to be the person s who executed authorized by §706.06, Wis. Stets.) the fbreg2q aqd ack"Weed the same. THIS INSTRUMENT WAS DRAFTED BY *Ka Pal Micheal H. Forecki t Attorney Notary Public, State of Wisconsin Eau Claire, Wisconsin My Commission is permanent. (If not, state expiration date: ( Signatw= may be authenticated or acknowled ed Both are not necess December 12 2QQ4 . 'Karnes of persons signing in any capacity must be typed or printed below their signature. WARRANTY DEED STATE BAR OF WISCONSIN FORM No. 1-2000 ttorney Michael H Forecki 3452 Oakwood Hills Pkwy Ste 1, Eau Claire WI 54701 -7928 Phone. (715) 833 -3029 Fax: (715) 835 -4112 Michael H. 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