HomeMy WebLinkAbout030-1055-20-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Cr oix
Safety and Building 'Division
INSPECTION REPORT Sanitary Permit No:
499276 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:
Pope, Tom St. Joseph, Town of 030 - 1055 -20 -000
CST BM Elev: Insp. BM Elev: BM Description � - Section/Town /Range /Map No:
/ SD . 4 /6& a obll7iW, 23.30.19.198N
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic Benchmark
q � v M3 /aD . c.
lob 0
Dosing Alt. BM
- 11
Aeration — Bldg. Sewer
olding d U � S et sG
g3� ls
TANK ETBACK INFORMATION
n�J Y7-
TANK TO P/L WELL BLDG. Vent to Air Intak ROAD t Alet M
Septic Dt Bottom r -
r b
Dosing Header /Man.
Aeration Dist. Pipe
Holdin �i/ U 2 Bot. System
'
D
p^til ; Final Grade 3 6
PUMP /SIPHON INFORMATION
Manufacturer V Demand ECov y S
GPM
Model Number
TDH Lift Friction Loss m Head TDH Ft d 4 '° ' Y7_ f Y _ t
Forcemain Length Dia. Dist. to 7
S
SOIL ABS ORPT ON SYSTEM
BED /TRENCH Width Length f Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth
DIMENSIONS 7
SETBACK SYSTEM TO P/L BLDG WELL LAKE /STREAM LEACHING Manufacturer:
INFORMATION CHAMBER OR
Type Of S m: UNIT Model Number:
DISTRIBUTION SYSTEM
Header /Manifold IDistribution I x Hole Size x Hole Spacing Vent to Air Intake
Pipe(s)
L length Dia Sp
SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only
Depth Over Depth Over I XX Depth of I XX Seeded /Sodded xx Mulched
Bed/Trench Center Bed /Trench Edges Topsoil /� Yes No Yes 7:N]o
COMMENTS I �I{Ide code discrepencies, persons present, etc.) Inspection #1: / /_ / Inspection #2:
Location: 1 New Richmond, WI 54017 (Govt Lot 2 23 T30N R19W) metes & botods Lot Parcel No: 23.30.19.198N
v n �,��
nom/ C1�2 r, 2 _ _ , im - p r°�✓ G�v�Z�in ''�✓
1.) Alt BM Description = e'p' `" _ ' "" _ 1 '"
2.) Bldg sewer length = �', �1� �s +
amount of cover = � p C ,l s4A 11 " d
Plan revision Required? /Yes No
Use other side for additional information. _ - - -- -- -' - - --
Date '/ In pc ^Si-gnatu�rgg 111 / h
SBD -6710 (R.3/97) _ GD1 �V� 6�f/ 9_. I b
v� �e aWd to Ae- - s$_-tc
Safety and Buildings Division County
201 W. Washington Ave., P.O. Box 7162 St. Croix
Madison, WI 53707 — 7162 Sanitary Permit Number (to be filled in by Co.)
61consin
Department of Commerce (608) 266 -3151 (p
Sanitary Permit Applicati 133578 I.D. Number
In accord with Comm 83.21, Wis. Adm. Code, personal informal ou ide Project Address (if different than mailing address)
may be used for secondary purposes Privacy Law, sl (1x
I. Application Information — Please riot AL D Same , f /��L K J K v � Pal
Property Owner's Name Parcel #: Pending Lot # Block #
Thomas W. Pope & Freya Mansfre'
DEC 19 2006 030 - 1055 -20 -000 Na Na
Property Owner's Mailing Address COUNTY Property Location
ST. CROIX
1442 Ridge Run Road Gov't lot 2 ; Section -V-; T 30 N; R 19 W
City, State Zip Code Phone Number
New Richmond, WI 1 54017 (71 5) 246 -2682 < O
II. Type of Building (check all that apply)
X I or 2 Family Dwelling — Number of Bedrooms Subdivision Name CSM Number
❑ Public/Commercial — Describe Use
❑ State Owned — Describe Use ❑City ❑Village XTownship: St. Joseph
Ill. Type of Permit: (Check only one box on line A. Complete line B if applicable)
A. ❑ New System ❑ Replacement system X 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. TyN of POWTS System: Check all that appl
❑ Non — Pressurized In- Ground ❑ Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil ❑ At -Grade ❑ Single Pass Sand Filter ❑
Constructed Wetland ❑ Pressurized In- Ground ❑X Holding Tank ❑ Peat Filter ❑ Aerobic Treatment Unit ❑ Recirculating Sand Filter ❑
Recirculating Synthetic Media Filter ❑ Leaching Chamber ❑ Drip ' Lino ❑ Gravel -less Pipe ❑ Other (explain)
V. Dies rsaUTrestment Area Information: See inspection report for previously installed 2000 dispersal cell
Design Flow (gpd) / I Design Soil Application Rate (gpdsf) Dispersal Area Required (st) Dispersal Area Proposed (sf) System Elevation
450 gpd V/ Na Na Na Na
VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic
Gallons Gallons of Units Concrete Constructed Glass
New Existing
Tanks Tanks
Septic or Holding Tank 2,000 7 1 Wieser Concrete X
Aerobic Treatment Unit On A eh Q /1 f-h; i
Dosing Chamber S. C t l h — ,P 67-
VII. Responsibility Statement 1, the undersigned, asstune respo 'lity for stallatiou of the POWYS shown on the attached plans.
Plumber's Name (Print) Plumber's S' lure MP/MPRS Number Business Phone Number
James K. Thompson i MPRS #30021 (715) 248 -7767
Plumber's Address (Street, City, SqWTip Code)
340 Paulson Lake Lane, Osceola, WI 54020
VIIL Coon /De partment Use Onl
�pproved ❑ � P� Sanitary Permit Fee (includes Iss d Issuin t Signature
Groundwater Surcharge Fee) �d
❑ iven Reason for Denial 4 5Z 5 . 0 0
OL Conditions of Approval/Reasons for Disapproval \ CL
SYSTEM OWNER: 3 J A. J` J i�C�,E4 -e.r ot�Q.
1. Seplic tank, ef& sM4i1*r and
dil"6~1 must all be services I maintained
as per management plan provided by plumber. l /
2. AN askock requirements must be maintained
as per applicable code I ordinances.
Attacb complete plans (to the Coolly only) for the system on paper not less than 81/2 x 11 inches in size
SBD -6398 (R. 01/03)
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Safety and Buildings
" 4003 N KINNEY COULEE RD
+ C0111111 @rC @.WLgOV LA CROSSE WI 54601 -1831
: TDD #: (608) 264 -8777
i sco n s i n www.commerce.wi.gov /sb/
www.wisconsin.gov
Department of Commerce
Jim Doyle, Governor
Mary P. Burke, Secretary
October 19, 2006
CUST ID No. 30021 A7TN. POWTS Inspector
JAMES K THOMPSON ZONING OFFICE
A.C.E. SOIL AND SITE EVALUATIONS ST CROIX COUNTY SPIA
340 PAULSON LAKE LN 1101 CARMICHAEL RD
OSCEOLA WI 54020 HUDSON WI 54016
CONDITIONAL APPROVAL
PLAN APPROVAL EXPIRES: 10/19/2008 Identification Numbers
Transaction ID No. 1335787
SITE: Site ID No. 719689
Tom Pope & Freya Manfred Please refer to both identification numbers,
1442 Ridge Run Road above, in all correspondence with the agenc
Town of Saint Joseph
St Croix County
Government 2, S23, T3 ON, R19W
FOR:
Description: Holding Tank / Three Bedroom
Object Type: POWTS Component Manual Regulated Object ID No.: 1103546
Maintenance required; Replacement system; 450 GPD Flow rate;
System: Holding Tank Component Manual, SBD- 10571 -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.
p.,
No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, Ca n
stats.
The following conditions shall be met during construction or installation and prior to occupancy or use:
Reminders n N OF'
'' ^,+�
• This system is to be constructed and located in accordance with the enclosed approved plans and with the
"Holding Tank Component Manual for Private Onsite Wastewater Systems" SBD - 10571 -P (R.6/99). SEE COk i E
• A notarized Holding Tank Agreement between the local governmental unit/Municipality and the property owner
is required prior to the issuance of a sanitary permit. A Holding Tank Servicing Contract may also be required if
no other service provider for the holding tank has been identified.
• The existing septic tank must be inspected for structural soundness and must be brought into conformance with
the requirements of ch. Comm 83, Wis. Adm. Code. If it does not conform, a state approved tank must be
installed.
• A service drive or road is to be provided to the service access opening or pump out port. The minimum
measured distance required is 25 feet.
• The well must be a minimum of 25 feet from any POWTS tank. 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.
JAMES K THOMPSON Page 2 10/19/2006
• Inspection of the POWTS 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 $ 60.00
Fee Received $ 60.00
Balance Due $ 0.00
Charles L Bratz
POWTS Reviewer II , Integrated Services WiSMART code: 7633
(608)789 -7893 , 7:45 am - 4:30 pm Monday -Friday
charlie.bratz@wisconsin.gov
cc: Leroy G Jansky, Wastewater Specialist, (715) 726 -2544
I
r
CONCRETE HOLDING TANK DESIGN
Single Tank Option
INDEX AND TITLE SHEET
Project Tom Pope & Freya Manfred 3 bedroom residential Holding Tank
Owner Tom Pope & Freya Manfred
Address 1442 Ridge Run Road
' New Richmond, WI 54017
Site Address: 1442 Ridge Run Road
Legal Description Gov't. lot 2, Sec, 23, T.30N., R.19W.
Township St. Joseph County St. Croix
Subdivision Name Na Lot No. Na
Parcel ID Number 030 - 1055 -20 -000
Plan Transaction ID Number
RECEIVED Index and title sheet Page 1
Holding tank specifications Page 2 ,�,
OCT 1 s Z006 Site plan Page 3 ` .Y
Maintenance and contingency plan Page 4�
SAFETY & BUILDINGS Soil evaluation report Page 5 OF COMMERCE
cYAy �NGS
SPONDE CET_
Designer James K. hom son
Signature 5--- -- Phone No. (715) 248 -7767
License Number 30021 Date 09/20/06
Designed pursuant to:
Holding Tank Component Manual For POWTS
SBD- 10571 -P (R.6/99)
Version 4.0 (04103) Page 1 of 5
HOLDING TANK SPECIFICATIONS
3 Number of bedrooms
0.0 Non - residential estimated flow (gpd)
2000.0 Minimum holding tank volume required (gal)
2000.0 Propos h oldin tank capacity (gal)
Wieser Concrete Tank Manufacturer
W2000 -M Tank model number
LevelArm - + v .;Alarm manufacturer
DLV Alarm model number
Tank Dimensions and Data Tank Anchor Calculations
' X for round tank r 19830 Ibs Weight of tank and cover
47.0 Liquid depth below inlet invert (in) 1.50 Safety factor
4.0 Maximum de th of soil cover (ft) 26595 Ibs Weight of anchor required
66.0 Height (in) Outside 30.8 in Soil cover req. for anchor or
151.0 1 Length (in) Dimensions 6.6 yd' Concrete counter weight
86.0 lWidth (in) Only
HOLDING TANK CROSS SECTION
manhole cover with
locking device and finished vent cap
junction warning label grade
box —�
a =—� 1 24 in. y� 2" min.
Manhole and vent locations conduit vent p7 _—T—
may be reversed. �s" min.
service � 12.0 in _•—•— .— .— .— ._._._._._._ buildi inlet
�
blind plug alarm on Note. All tank joints, and
to seal joints between tank
outlet openings and piping are
Electrical as per 35.0 in. sealed watertight. All pipe
NEC 300 and vent materials comply
and Comm 16 with Comm 84.
3 in. bedding under tank. Tank is anchored as necessary to negate buoyancy.
Project: Tom Pope & Freya Manfred 3 bedroom residential Holding Tank
Transaction Number: Page 2 of 5
l
HOLDING TANK MANAGEMENT PLAN
This Private Onsite Wastewater Treatment System ( POWTS) has been designed, and is to be installed and
maintained according to Comm 83, Wis. Admin. Code, the Holding Tank Component Manual (SBD- 10571 -P
6/11/1999), and the St. Croix County Sanitary Ordinance.
1. This POWTS is designed to accommodate an estimated domestic wastewater flow of 400.0 gpd.
2. The owner of this POWTS is responsible for system operation and maintenance, including all provisions in
the attached Holding Tank Servicing Contract and Maintenance Agreements.
3. Each time the wastewater in the tank reaches 90% of the tank(s) capacity or a level of 12" below the inlet
(at which time the alarm will activate), the pumper listed in the current Servicing Contract must be called to
empty the tank's, contents and dispose of them in accordance with NR 113, Wis. Adm. Code.
4. At each service event, the service provider should visually inspect the condition of the tank, risers and
manhole cover(s) and verify that the alarm system functions and manhole locking devices are present.
Discrepancies are reported to the owner in a timely manner for corrective action. All corrective actions
shall comply with the county sanitary ordinance and Comm 83 and 84 Wis. Adm. Code.
5. All service events or inspections of this POWTS shall be reported to the county within 10 business days.
6. The owner may not remove any of the wastes from the holding tank(s), or cause such wastes to be
removed by any person not authorized to do so under Ch. 281, Wis. Statutes. The discharge of wastes
tank to the ground surface, including intentional discharges and discharges caused by neglect, constitutes
a failing POWTS and may result in issuance of correction orders or a citation by the county or state.
7. No one should enter a holding tank for any reason without being in full compliance with OSHA standards
for entering a confined space. The atmosphere within these tanks may contain lethal gases, and rescue
of a person from the interior of the tank may be difficult or impossible.
8. In the event that this POWTS fails and cannot be repaired, a code compliant replacement holding tank
may be installed in the same location (a new sanitary permit is required for such a replacement). Con-
nection to municipal services would also be considered at this time if they are deemed available to the
property.
9. If this POWTS is replaced, or its use discontinued, components no longer in use it shall be abandoned in
accordance with Comm 83.33 Wis. Adm. Code.
10. If there is a problem with, or question about this installation, the following persons should be contacted:
a. Installer ............................. James K. Thompson Phone: (715) 248 -7767
b. Service Provider .................. Tri -County Sanitation Phone: (715) 386 -2130
c. Co. Zoning or Health Dept. St. Croix County Zoning Dep't. Phone: (715) 386 -4680
11.
Project: Tom Pope & Freya Manfred 3 bedroom residential Holding Tank
Transaction Number: Page 4 of 5
1938
Wiscunsin Department of Commerce SOIL EVALUATION REPORT Page 1 of 3
Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code A.C.E. Soil & Site Evaluations
Attach cornDlete site plan on paper not less than 8'/: County x 11 inches in size. Plan must St CrolK
ocluoe, but not limited to: vertical and horizontal reference point (BM), direction and
percent slope, scale or dunemsions, north arrow, and location and distance to nearest road. Parcel I.D.
030 - 1055- 20-000
Please print all information.
Reviewed By Date
Po-krai ir.fumat" you provide may be used for secondary purposes (Privacy Low, s. 15.04 (1) (m))
Property Owner Property Location
Thur as W Pcpe & Fre ya Mansfred Govt. Lot 2 1/4 1/4 g 23 T 30 N R 19 W
Prof*rty Owners Mailing Address Lot # Block # Subd. Name or CSNW
1412 Ridge Run Road
City State Zip Code Phone Number _f City J Village J✓ Town Nearest Road
New Pichmonc WI 1 54017 1 (715) 246 - 2682 St.Joseph 1 1442 Ridge Run Road
J Ne,v Construction Jse: ✓I Residential / Number of bedrooms 3 Code derived design flow rate 450 GPD
Rapiacentent iI Public or commercial - Describe:
Parer;! materEl - Glacial till_ Flood plain elevation, if applicable na
General comments
and recommendations: Site unsuftasble for standard POWTS approval -requires variances to slope aspect/mound orientation and
soil disturbance prior to issuance of mound approval.
Boring # J Boring
✓ Pit Ground Surface elev. 98.97 ft. � r in. Soil
J Depth to limiting factor Application Rate
Norm Depth 1 Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft'
j n. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2
0 -8 1 Oyr32 none sl fill 2fsbk ds as 2vf,f 0.0 0.0
2 8 -17 7.5yr4/6 m1d 5yr4/6 sl fill 1thinpl dsh ai 1vf,f 0.0 0.0
3 17 -31 j 1Oyr32 m2p 7.5yr5/8 sil lfsbk dsh cs - 0.4 0.6
f2d 7.5yr5/8 &
4 31 -4C 1Oyr4/4 m2d 10yr6 /2 sil lfsbk mfr gW - 0.4 0.6
5 40 -4G 7.5yr4/6 c2d7.5yr5/8 scl 1msbk mfi cW - 0.2 0.3
6 49 -62 10yr5/4 i& 10yr6 /2 sil Om ds - - 0.0 0.2
I
C 2
Boring # J Boring
C ✓ Pit Ground Surface elev. 94.48 ft. Depth to limiting factor 23 in. Sal Application Rate
Hcczu, Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft
r. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff #1 'Eff#2
0-6 1 1Oyr32 none sil 2fsbk ds as 2f,1mc 0.6 0.8
2 6 -11 1Oyr4/3 none sil lthinpl ds cs 1fmc 0.4 0.6
3 11 -23 !, 1Oyr4/6 none sl lfsbk dsh cw if 0.4 0.7
4 23-43 ! 7.5yr4/6 f2f 7.5yr5/8 SVIS/s 1 msbk/Osg mfr /ml - - 0.4 0.7
i
Ef luent #1 = BOD 5 > 30 < 220 mg/L and T S >30<150 g/L ' Effluent #2 = BOD , 30 mg/L and TSS <-0 mg/L
CS- Name (Please Print) n / CST Number
Jam es K. Thompson C ,,_ �� <, 360 2
Adcress A.C.E Soil & Site Evaluations Date Evaluation Conducted Telephone Number
340 Paulson Lake Lane, Osceola, 7/142005 715 - 248 -7767
Property owner Thomas W. Po & Freya 030 - 1055 -20 -000 P 2 of 3
perty _ Pe Y Parcel ID # g
3] Boring # Boring VI Pit Ground Surface elev. 97.20 ft. Depth to limiting factor 27" in. Sal Application Rate
Horizon Deptn Dominant Color Redox Description Texture Structure Consistence Boundary Roots GFID
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff #1 'Eff#2
1 0-6 10yr3/2 none sit 2fsbk ds as 2f,1mc 0.6 0.8
2 6 -20 10yr4/3 none sil lfsbk ds cs 2fmc 0.6 0.8
3 20 -27 10yr4/6 none fsl lfsbk dsh cw lfmc 0.4 0.7
4 27 -34 7.5yr4/6 m1d Mg fsl Om mfi - 1fm 0.4 0.7
Manganese concentrations observed in H#4.
"J Boring
BBoring # '
Pit Ground Surface elev. 101.5+ ft. Depth to limiting factor 29" in, Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots Gyf
in. Munsell Qu. Sz, Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2
1 0 -2 1 Oyr3/3 none sil fill 2fsbk ds as 2vf,f 0.0 0.0
2 2 -17 7.5yr4/6 none scl fill 2fsbk dsh ai 1vf,f 0.0 0.0
17 -29 1Oyr313 none sit lfsbk ds cs 2fm,1c 0.4 0.6
4 29 -44 1 Oyr5 /4 f2d 7.5yr5/8 sil lfsbk ds gw 1fm 0.4 0.6
E 44-63 1Oyr4/4 c2d 7.5yr5/8 sicl 1msbk mfi - - 0.2 0.3
Site unsuitable for mound due to presence of fill material and insufficient area.
F—I Boring # � Boring
J Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate
Horton Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2
i
I
' Effluent #1 = BOD ? 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BOD < mg/L and TSS <-0 mg/L
'fhe Department of Commerce is an equal opportunity service provider and employer. 117 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.
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Wisconsin ofCanmerce EVALUATION REPORT Page 1 of 1 938 3
Division of Safely and Btddirgs (f with t35, Wis. Adm. Code A.C.E. Sol & Site Evaluations
A#-ch complete site plan paper not less than =x 1 j,T s in . Plan must County St Crobk
but not lunded to: vertical rx}�u� pant direction and
sI sc or dinem onss, riNtlS , and location and to nest road. Parcel I.D.
r 030- 1055 -20-000
Y
pd R Dale
Personal wd may be u �ay Law, s. 15.04 (1) (m)).
Property Owner Property location
Thomas W. Pope & Freya Mansfred Govt. Lot 2 19 19 S 23 T 30 N R 19 W
Property Owner's Ma0'irg Address lot # Block # Subd. Name or CSW
1442 Ridge Run Road
City State Zip Code Phone Number _j City J Vdlage 0 Town Nearest Road
New Richmond WI 1 54017 1 (715) 246 -2682 StJoseph 1 1442 Ridge Run Road
Use: Code derived
New Construction Use: R / Number of bedrooms 3 design flow rate 450 GPD
01 Replaciament Public or commercial - Describe:
'I Parent m Glacial tM Flood Plain elevation, if Vocable na
General comments
atd Site unsuftasble for standardTMUS approval -requires variances to slope aspecNmound orientation and
soil disturbance prior to issuance of mooneappreval. - i _/ . / �_
�# Borft
Pit Ground Surface elev. 88.97 ft. Der to limiting factor <8 " in. Sod Application Rate
Horizon Depth Dominant Color Redox DesaQtian Texture Stnrcture Consistence Boundary Roots GPDffI=
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. '0101 'Eff#2
1 0-8 10yt32 none sl fin 2fsbk ds as 2vf f 0.0 0.0
2 8-17 7.5yr4/6 m1d 5yr4/+6 sl fm 1thinpl dsh ai 1vf,f 0.0 0.0
3 17 -31 10yr32 m2p 7.5yr5/8 sil 11sbk dsh cs - 0.4 0.6
4 31 -40 10yr4 14 7 ' 5 8 & m 2d 1 /2
M lfsbk mfr gW - 0.4 0.6
5 40-49 7.5yr4/6 c2d 7.5yr5/8 scl 1 msbk mfi cW - 0.2 0.3
6 492 1 /4 m3p 7�.5 /8 & sil Om ds - - 0.0 0.2
Boriing rrr2d U0yr6/2
o f
t Pd Ground Surface elev. 94.48 ft. Depth to lmling factor 23" in. Sod Application Rate
Horizon Depth Dominant Color Redox DesaQtion Texture Structure Consistence Boundary Roots GPD/fF
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. '091 'Eff#2
1 0-6 10yr32 none sil 2fsbk ds as 2f,1mc 0.6 0.8
2 6-11 10yr4/3 none all lthinpl ds cs lfmc 0.4 0.6
3 1123 10yr4/6 none sl 1fsbk dsh cw if 0.4 0.7
4 23-43 7.5yr4/6 f2f 7.5yr5/8 sUlsfs 1 msbldit mfr /ml - - 0.4 0.7
' Effluent #1 = BOD y > 30 < 220 mg/L and T >30 < 150 4 & ' Efthient #2 = BOD <30 mg/L and TSS <-0 mglL
CST Name (Pima Prom) CST Number
James K. Thompson 2 3602
Address A.C.E. Sal & Site Evaluations Date Evaluation Conducted Telephone Number
340 Paulson lake Larne, Osceola, 0 54020 7/142005 715 - 248 -7767
• pity owner Thomas W. Pope & Freya parcel ID # 030 - 1055 - 20-000 Page 2 of 3
F3 ] Boring # IV 97.20 ft. Depth to limiting factor 27" hr.
A Pit Ground Surface elev. Sol Application Rate
Horizon Depth Dominant Color Redox Desaption Texture Stricture Consistence Boundary Roots GPDM
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2
1 0 1 Oyr3f2 none Sil 2fsbk ds as 21,1 me 0.6 0.8
2 6-20 1Oyr4/3 none sit lfsbk ds cs 2fmc 0.6 0.8
3 20-27 1Oyr4/r6 none fSl lfsbk dsh cw 1fmc 0.4 0.7
4 27 -34 7.5yr4/6 m1d Mg fsl Om mfi - 1fm 0.4 0.7
Manganese cancentratior s observed in H#4. Ekxft
o � # OM pit Ground Surface elev. 101.5+ ft. Depth to Smiting factor 29" in. Sod Apple Rate
Hcxtm Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDIfF
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2
1 0-2 10yr3/3 none sit fill 2fsbk ds as 2vf,f 0.0 0.0
2 2 -17 7.5yr416 none sd fiA 2fsbk dsh ai lvf f 0.0 0.0
3 1729 1Oyr3/3 none sit lfsbk ds cs 2fm,1c 0.4 0.6
4 29-44 1Oyr5/4 f2d 7.5yr5/8 Sti lfsbk ds gw lfm 0.4 0.6
5 44-63 1 Oyr4 /4 c2d 7.5yr5/8 Sid 1 msbk mfi - - 0.2 0.3
Site unsuitable for mound due to presence of fill material and insufficient area. F 9 # I Boring
Pk Ground Surface elev. 1L Depth to limiting factor in. Sod APPS Rate
Hor¢on Depth Dominant Color Redox Description Texture Stricture Consistence Boundary Roots
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2
'
Effluent #1 = HOD ? 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BOD a 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.
Jon Sonnetag
From: Rod Eslinger
Sent: Friday, August 04, 2000 11:10 AM
To: Jon Sonnetag; Kevin Grabau; Mary Jenkins
Subject: FW: TerraLift
- - - -- Original Message - - - --
From: Jansky, Leroy [mailto:ljansky @commerce.state.wi.us]
Sent: Friday, August 04, 2000 6:40 AM
To: Barron County; Eslinger, Rod; Farmer, Darryll; Helgeson, Mike;
Herrick, Cleo; Jain, Kenneth; Koehler, Jim; Peterson, Dan; Peterson,
Larry; Shambeau, Jay; Spanel, Gary; Tesky, CeCe
Subject: TerraLift
On August 3, 2000, TerraLift received product approval to use their
device
for physical restoration of hydraulically failed dispersal /distribution
components. There is no requirement for a state level sanitary permit
for
this type of work. However, you could issue a county sanitary permit if
your sanitary ordinance allows. The following conditions (stipulations)
apply to the use of TerraLift when physically restoring a
dispersal /distribution component. If you have any questions please
contact
me.
Conditions of TerraLift use:
1. The probe must be inserted no deeper that one foot below the
elevation
of the infiltrative surface of the distribution /dispersal cell.
2. The probe must be inserted outside of the distribution /dispersal
cell
and no closer than one and one -half feet from that edge of the
distribution /dispersal cell.
3. The elevation of the system's infiltrative surface must be above the
estimated highest groundwater elevation or bedrock by the distance
prescribed in Table Comm 83.44 -3, Wis. Adm. Code.
Leroy G. Jansky
Wastewater Specialist
13 East Spruce Street
Chippewa Falls, WI 54725
Ljansky @commerce.state.wi.us E -mail
(715) 726 -2549 Fax
(715) 726 -2544 Voice
i
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.� t�, b• , : - re et. F, c. ` � 8! $uw � Assumed elcu'. = /0O. �.' a
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A6ancicr,ed d ;spot sa/
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.Private On -Site Wastewater Treatment System (POWTS)
HOLDING TANK SERVICING CONTRACT
CONTRACT DATE
1 , 2 1W06
This contract is made between the
Holding Tank Owners(s) Name(s) and Pumper's Name
We acknowledge the install tion of a holding tank(s) on the following property: (Provide legal descriptions:)
/Al2 /oca td:-o Corm c .2 30 1 de%) T o,f 5E.•
5 E C-1V � CA, Q /. a S W 030 - io sS- M ate
------------------------------------------------------------
V. The owner agrees to file a copy, of this contract with the iocal governmental unit that has signed the puniping
agreement required in Ch. 83.54(3)(c), Wis. Adm. Code and Section VII of the Holding Tank Component Manual
with the County of _.& - ft/ r.
?. The owner agrees to have the holding tank(s) serviced by the pumper and guarantees to permit the pumper to have
access and to enter upon the property for the purpose of servicing the holding tank(s). The owner agrees to maintain
the access road or drive so that the pumper can service the holding tank(s) with the pumping equipment. The owner
further agrees to pay the pumper for all charges incurred in servicing the holding tank(s) as mutually agreed upon by
the owner and pumper.
3. The pumper agrees to submit to the local governmental unit which has signed the pumping agreement required by
s.Comm 83.55(1)(a), Wis. Adm. Code, and to the County, a report for the servicing of the holding tank(s) on a
semiannual basis. The pumper further agrees to include the following in the semiannual report:
a. The name and address of the person responsible for servicing the holding tank;
b. The name of the owner of the holding tank;
c. The location of the property on which the holding tank is installed;
d. The sanitary permit number issued for the holding tank;
e. The dates on which the holding tank was serviced;
f. The volumes in gallons of the contents pumped from the holding tank for each servicing;
g. The disposal sites to which the contents from the holding tank were delivered.
4. This agreement will remain in effect until the owner or pumper terminates this contract. In the event of a change in
this contract, the owner agrees to file a copy of any changes to this service contract or a copy of a new service contract
with the local governmental unit and the County named above within ten (10) business days from the date of change
to this service contract.
Owner(s)Name(s) (Print) Owner's Signature(s) Subscribed and sworn to me on this date:
Today's Date:
Pumper's Name (Print) Pumper' s i ature Notary ubli Si atur
_7)c \11
Pumper's Registration Number : C mmission Expiration:
Drafted b=, 5,!fe>-S e- ! Z fnn
030 -1655 v - R0-000
V 2g50 P 0 7 X458410
yy ((jj PP ? KATHLEEN H. WALSH
STATE AR � R IS ORSIN FORM2 - REGISTER OF DEEDS
Document Number WARRANTY DEED ST CROIX CO., WI
RECEIVED FOR RECORD
This Deed, madebetween Robert A. Luhman and Lois E. 11/05/2003 10:45AN
Luhman, husband and wife Grantor,
and Thomas W. Pope and Freya Manfred, WARRANTY DEED
Grantee. ':X> MGT i
Grantor, for a valuable consideration, conveys and warrants to Grantee REC FEE: 11.00
the following described real estate in St. Croix County, State of Wisconsin TRANS FEE: 1071.00
(if more space is needed, please attach addendum): COPY FEE:
CC FEE:
Part of Government Lot 2 of Section 23, Township 30 North, Range 19 PAGES: 1
West, St. Croix County, Wisconsin described as follows: Commencing at
the E 1 /ocorner of said Section 23; thence South 686.4 feet; thence West
1293.3 feet; thence North 180.0 feet to the place of beginning; thence
North 90.0 feet; thence N88 *10' W 368.0 feet more or less to the Ely shore
of Bass Lake; thence Sly on said Ely shore 90.0 feet more or less; thence
S88'10'E 368.0 feet more or less to the place of beginning Recording Area
Together With an easement for a 33 foot road in Section 23, T30N,
R19W, St. Croix County, Wisconsin, the West line of which is described Name act Return Address
as follows: Commencing in the center of the town road 1300 feet West of R- V A T
the SE corner of Section 23; thence North parallel with the East line of
said Section 23, 2392 feet to the end of the easement.
030-1055-20
P arcel Identification Number (PIN)
This is homestead property
(is) (is not)
Exceptions to warranties: Easements, restrictions and rights -of -way of record, N any.
Dated this day of October 2003
* * Robert A. unman
* * Lois E. Lohman
AUTHENTICATION ACKNOWLEDGMENT
Signature(s) STATE OF )
) ss.
County )
authenticated this day of
Persona y came before me thi day of
October , 2003 the above named
Robert A. Luhman and Lois E. Luhman, husband and wife
*
TITLE: MEMBER STATE BAR OF WISCONSIN
(If not, to me kno o ing
authorized by § 706.06, Wis. Stats.) ns ent thdNAMeTowit
PUBLIC - NINNESOfA
cam tssion Expires Jan. 31, 2005
THIS INSTRUMENT WAS DRAFTED BY _
Attorney Kristin Ogland * _
H udson, WI 54016 No 11c, tate of
My Commission is permanent. (If not, state expiration date:
(Signatures may be authenticated or acknowledged. Both are not necessary.) )
* Names of persons signing in any capacity must be typed or printed below their signature. Information Professionals Co.. Fond du Lac. WI
STATE BAR OF WISCONSIN 800-655 -2021
WARRANTY DEED FORM No. 2 -1999
_ 84 1 534 j(
' KATHLEEN H. MALSH
REGISTER OF DEEDS
ST. CROIX CO.. MI
RECEIVED FOR RECORD
Document Number Document Title
12/29/2006 10 : 30AM
St. Croix County HOLD T AGREEMENT
Holding Tank Agreement
REC FEE: 11.00
TRANS FEE:
tate Plan Transaction Number - /3317,07 COPY FEE:
CC FEE:
PAGES: 1
mas LA.) • ii . $ �e va /Yf'a-1rS1
Name — (Owner) Typed dr printed
being duly sworn , states, under oath, that:
1. He/she is the owner /part owner of the following parcel of land located in St.
Croix County, Wisconsin, recorded in Volume Z Page Ile? Document
Number 7y1589b Croix County Register of Deeds Office: Recordin Area
L
(gipp Y• A0 Name and Retum Address
A parcel of land located in the --- T rofttre _ 3: of Section 2 I W • R,pe d L�1 y4 /Plan t�itol
T om_ N - R / f W, Town of - , rxc - . - I Sao4 , St. Croix I fW-2 1 ,Puy, A41acl
County, Wisconsin, being duly described as follows (include lot no. and /ts.v�c�r>terf�l �� s,xor7
subdivision/CSM or detailed legal description): a Y,� Corn or Sae-A 3, 6"
s.e ,Idd/. IS. ysrf7Qaf'eQo..r Q.od .sf:CafY, A.,t9bfd 030 -/D SS- -LC.10
Agreement Date: ��� •/9 3 i �7, 90FE �•j�FE'�" B"� faXi Parcel Identification Number (PIN)
J. 0-0s46., er 360ice o °• a•
We acknowledge that application is being made for the Installation of (a) holding tank(s) on the above described property or that continued use of
the existing premises requires that a holding tank be installed on the property for the purpose of proper containment of sewage. Also, the property
cannot now be served by a municipal sewer, or any other type of private onsite wastewater treatment system as permitted under Ch. Comm 83,
Wis. Adm. Code, or Ch_ 145, Wis. Slats.
As an inducement to the county to issue a sanitary permit for the above - described property, we agree to do the following:
1. Owner agrees to conform to all applicable requirements of Ch. Comm 83, Wis. Adm. Code relating to holding tanks. If the owner fails to have
the holding tank property serviced in response to orders Issued by the governmental unit or the Department of Commerce to prevent or abate
a human health hazard as described in s. 254.59, Slats., the governmental unit (Town) may enter upon the property and service the tank or
cause to have the tank to be serviced and charge the owner by plating the charges on the tax bill as a special assessment for current
services rendered. The charges will be assessed as prescribed by s. 66.0703, Stats.
2. The owner agrees• pursuant to s. Comm 83.54 (2), and Comm 82.40(3)(e), Wis. Adm. Code, to have a water meter Installed in the structure.
The water meter shall be installed by a plumber authorized by the Department of Commerce to make such installations, with said installation
complying with State reciulations and manufacturers specifications. The owner agrees to be financially responsible for the ourchass.
installation, maintenance, and repair of the water muter, and agrees to allow the governmental unit or the Department of Commerce to enter
the above - described property on a regular basis to read and/or Inspect the water meter.
3. Owner agrees to pay all charges and costs incurred by the governmental unit or county for inspection, pumping, hauling, or otherwise
servicing and maintaining the holding tank in such a manner as to prevent or abate any human health hazard caused by the holding tank.
The governmental unit shall notify the owner of any costs which shall be paid by the owner within thirty (30) days from the date of notice. In
the event the owner does not pay the costs within thirty (30) days, the owner specifically agrees that all the costs and charges may be placed
on the tax roll as a special assessment for the abatement of a human health hazard, and the tax shall be collected as provided by law.
4. The owner, agrees to contract with a person who is licensed under Ch. NR 113, Wis. Adm. Code, to have the holding tank serviced and to
file a copy of the contract with the governmental unit. The owner further agrees to file a copy of any changes to the service contract, or a
copy of a new service contract, with the governmental unit within ten (10) business days from the date of change to the service contract.
5. The owner agrees to contract with a person licensed under Ch. NR 113, Wis. Adm. Code, who shall submit to the county on a semiannual
basis a report detailing the servicing of the holding tank. The governmental unit or county may enter upon the property to investigate the
condition of the holding tank when pumping reports and meter readings may indicate that the holding tank Is not being properly maintained.
6. This agreement will remain in effect only until the county office responsible for the regulation of private onsite wastewater treatment systems
certifies that the property is served by either a municipal sewer or a private onsite wastewater treatment system that complies with Ch. Comm
83, Wis. Adm. Code. In addition, this agreement may be cancelled by executing and recording said certification with reference to this
agreement in such manner which will permit the existence of the certification to be determined by reference to the property.
7. This agreement shall be binding upon the owner, the heirs of the owner, and assignees of the owner. The owner shall submit this agreement
to the register of deeds, and the agreement shall be recorded by the register of deeds in a manner which will permit the existence of the
agreement to be determined by reference to the property where the holding tank is installed.
Owner(s) Naniets) - - I w Print ! by ^r.ed and s,.,,m cc befc. co r^c en :,.s daw.
h ar�rG�s / X_X a' � t� y?Gzrr�C
Notaolpd Owner's Sign (s) otary Public y a+
/Gb vemmental Unit Offs 'al Name. Title - Please Print mission Expires _
Fyra tat(',`n��o✓� zon; ncr �lc.L.�:c i�,ti d ^ T/ ��.QJ ry�
Govemmen nit Official Sign re I Drafted by: i r.
Perso I info ion you provide may be used for secondary purposes (Privacy Law s. 15.04(1)(m)]
"THIS PAGE IS PART OF THIS LEGAL DOCUMENT- DO NOT REMOVE"
This information must be completed by submi ter. document title. name 6 return address. and EM ftf required). Other information such as am
granting clauses, leagal description, etc may be placed on this Mat page of the document or may be placed on add/tionai pages of the
document. Use of this cover page adds one page to your document and Klaconsin Statutes, 59.517.
1 oft
ST. CROIX COUNTY ZONING OFFICE
CERTIFICATION STATEMENT
FOR UTILIZATION OF AN EXISTING SEPTIC TANK
This is to certify that I have inspected the septic tank presently serving the
ma.s W • e e' /�; ya residence located at:
u ' . ',4,- Section ;?-3 , Town 30 N, Range /9 W, Town
of 5-6, T , St. Croix County Wisconsin. Upon
inspection, I certify that I have found the tank(s), to the best of my
knowledge, will conform to the requirements of Comm. 84.25, and it (they)
appear(s) to be functioning properly.
Most recent date of service lVI S/a4
Did flow back occur from absorption system? Yes Pe' No
(if no, skip next line.)
Approximate volume or length of time: gallons .20 minutes
Capacity: / 6 &e)
Construction: Prefab Concrete Steel Other
nu ac er (if known):
Age of Tan (if known):
censed Plumber Signature) (Print Name)
(Title) (License Number) NV4MPRS
—' bec - l '
(Date)
Form to be completed by licensed plumber (s. 145.06, Wisconsin Statutes)
or licensed disposer (NR 113 Wisconsin Administrative Code)
r
Parcel #: 030 - 1055 -20 -000 07/14/2005 05:15 PM
PAGE 1 OF 2
Alt. Parcel #: 23.30.19.198N 030 - TOWN OF SAINT JOSEPH
Current X ST. CROIX COUNTY, WISCONSIN
Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type
00 0
Tax Address: Owner(s): " = Current Owner
THOMAS W POPE M NFRED F EYA
MANFRED FREYA
1442 RIDGE RUN
NEW RICHMOND WI 54017
Districts: SC = School SP = Special Property Address(es): Primary
Type Dist # Description 1442 RIDGE RUN !—
SC 3962 NEW RICHMOND
SP 8040 BASS LAKE REHAB DIST
SP 1700 WITC : ( iMO -26 e)---
Legal Description: Acres: 0.000 Plat: N/A -NOT AVAILABLE
SEC 23 T30N R19W PRT GL 2 COM E 1/4 COR Block/Condo Bldg:
SEC 23, S 686.4 FT, W 1293.3 FT, N 180
FT TO A POB: N 90 FT, W 368 FT TO BASS Tract(s): (Sec- Twn -Rng 40 1/4 160 1/4)
LK, S 90FT. E 368 FT TO POB 23- 30N -19W
Notes: Parcel History:
Date Doc # Vol /Page Type
11/05/2003 745840 2450/407 WD
08/27/1998 585929 1352/116 QC
07/23/1997 1052/439 WD
07/23/1997 690/167
more
2005 SUMMARY Bill #: Fair Market Value: Assessed with:
0
Valuations: Last Changed: 07/08/2004
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 0.000 194,000 114,400 308,400 NO
Totals for 2005:
General Property 0.000 194,000 114,400 308,400
Woodland 0.000 0 0
Totals for 2004:
General Property 0.000 194,000 114,400 308,400
Woodland 0.000 0 0
Lottery Credit: Claim Count: 1 Certification Date: Batch #: 217
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
1
Si 2 3 a O C1
O A
7 1D
7 I
3
r
Z in Z ° w °w• se
S a m O w Q ►•�
y y p M
CD cn
CD
n
O 7 7 O --1 0 p Q
CL O — N Z O O
O y
II (A z N � ip a � •
W C
CD
CL
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p s i 3 0 C
r o �
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C 0 �y
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ti � � O F• A
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Parcel #: 030 - 1055 -20 -000 09/19/2006 11:11 AM
PAGE 1 OF 1
Alt. Parcel #: 23.30.19.198N 030 - TOWN OF SAINT JOSEPH
Current ! X' ST. CROIX COUNTY, WISCONSIN
Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type
00 0
Tax Address: Owner(s): O = Current Owner, C = Current Co
THOMAS W POPE C - MANFRE
TH
FREYA
MANFRED FREYA
1442 RIDGE RUN
NEW RICHMOND WI 54017
Districts: SC = School SP = Special Property Address(es): * = Primary
Type Dist # Description * 1442 RIDGE RUN
SC 3962 NEW RICHMOND
SP 8040 BASS LAKE REHAB DIST
SP 1700 WITC
Legal Description: Acres: 0.000 Plat: N/A -NOT AVAILABLE
SEC 23 T30N R19W PRT GL 2 COM E 1/4 COR Block/Condo Bldg:
SEC 23, S 686.4 FT, W 1293.3 FT, N 180
FT TO A POB: N 90 FT, W 368 FT TO BASS Tract(s): (Sec- Twn -Rng 40 1/4 160 1/4)
LK, S 90FT. E 368 FT TO POB 23- 30N -19W
Notes- � � � , -7 � j � Igg7 Parcel History:
Date Doc # Vol /Page Type
L 12 11141] 11/05/2003 745840 2450/407 WD
08/27/1998 585929 1352/116 QC
'k " 07/23/1997 1052/439 WD
h 07/23/1997 690/1
more
2006 SUMMARY Bill #: Fair Market Value: Asses`sadw-Ith:
0
Valuations Last Changed: 07/08/2004
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 0.000 194,000 114,400 308,400 NO
Totals for 2006:
General Property 0.000 194,000 114,400 308,400
Woodland 0.000 0 0
Totals for 2005:
General Property 0.000 194,000 114,400 308,400
Woodland 0.000 0 0
Lottery Credit Claim Count: 1 Certification Date: Batch #: 217
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00