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Home My WebLink About020-1095-40-000 (2)Wsconsin Department of Commerce PRIVATE SEWAGE SYSTEM U-]Ly. .St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: GENERAL INFORMATION (ATTACH TO PERMIT) 61 %$67 State Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(ni Permit Holders Name: City Village Township Parcel Tax No: DOUGLAS & KRISTEN BARLOW I TOWN OF HUDSON 020-1095-40-000 CST BM Elev: Insp. BM Elev: BM Description %�- Grua- 4 u TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY Septic ;s�;k user /aoo 1 Aeration Holding TANK SETBACK INFORMATION TANKTO P/L WELL BLDG. Ventto Airintake ROAD Septic Dosing Aeration Holding PUMP/SIPHON INFORMATION Manufacturer Demand GPM Model Number TDH Lift Friction Lo S stem JTDH Ft Forcemain Length Dia. Dist. to Well SOIL ABSORPTION SYSTEM Z`fLZ Hot—i 0,,.'.k STATION BS HI FS ELEV. Benchmark .09 pz Tt /6 �11 Alt. BM If F Bldg. Sewer SUHt Inlet SUM Outlet Of Inlet Of Bottom Header/Man. 7,q N 06.6 Dist. Pipe Bot. System .z 87 S`l Final Grade q St Cover q . 1 s.o qJ,o BED/TRENCH DIMENSIONS Width v Length 1�7 b� C� No, Of Trenches Z PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth SETBACK INFORMATION SYSTEM TO P/L IBLDG WELL LAKE/STREAM LEACHING CHAMBER OR UNIT Manuta Type Of Sys erp`O ✓�4' 56� 7hni > 7 5-1 QgLNum r: I ? Header/Manifold Distribution Pipes) z Hole Size x Hole Spacing Vent to Air Intake Length Dia Length Dia Spacing SOIL COVER x Pressure Svstems Only xx Mound Or At -Grade Svstems Only Depth Over \N Depth Over xx Depth of xx Seeded/Sodded zz Mulched Bed/Trench Center I Bed/Trench Edges Topsoil Q Yes 0 No '_�'_� Yes No COMMENTS: (Include code discrepencies, persons present, etc.) Location: 651 OLD HWY 35 S /f ��"" 1.) Alt BM Description = fr % r A� �p lnt-r 2.) Bldg sewer length = ` y - amount of cover = Plan revision Required? L] Yes AI -No Use other side for additional information. / LV SBO-6710 (R.3/97) Date Inspection #1: Inspection #2: I I / 9 / 'z D �lh}' ?-te% lo' ,\ eko" c.c� - l O 3 S Insepctors Signature Can. No. ST. CROIX COUNTY ZONING OFFICE CERTIFICATION STATEMENT FOR UTILIZATION OF EXISTING SEPTIC TANK(S) This is to certify that I have inspected the existing septic and/or dose tank presently serving the following residence: (Street address) 651 Old Hwy 35 located at: SW �j4 NE /,, Section 33 , Town 29 N, Range 19 W, Town of Hudson , 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 SPS. 384.25, and it (they) appear(s) to be functioning properly, Most recent date of inspection or service L/ — q " Z 0 Z J Did flow back occur from absorption system? Yes_ No_ (if no, skip next line.) Approximate volume or length of time: gallons minutes Tank Capacity: loon Construction: Prefab Concrete x Steel Other Manufacturer (if known): Wieser Concrete Age of Tank (if known): 14 years Permit number (if known) 499153 John Schmitt censed Plumber Signature) (Print Name) MPRS (Title) L/-T-zeoZ� (Date) 223760 (License Number) MP/MPRS Form to be completed by licensed plumber (Dept of Safety and Professional Services Chapter 305 and s, 145.06, Wisconsin Statutes) or licensed disposer (NR 1 13 Wisconsin Administrative Code) Rev. 2/2012 1414,( ea- ,SA/v -aGao —n-70 C aa„,r 9' nCC�E V � D county Indus Services Division ST.CROIX =Pt 1400 E Washingtgn Ave P�.Box 71 2 Sanitary Permit Number (to be filled in by Co.) MAR 31 2020 Madison, WI 5 -7 • ! t2�/ Z tO�I SaIll,ft pplicaoon State fransection Number In accordance with SPS 383.21(2), Wis. Aim. Code, submission of this form to the appropriate governmental unit a �+ is required prior to obtaining a sanitary permit. Note: Application forms for state-owned POWTS are submitted to the Department of Safely and Professional Services. Personal infomtatim you provide may be used for secondary Project Address (if different than mailing address) purposesin accordance with the Privacy Law, s. 15.04 1)(m), Stats. 651 OLD HWY 35 1. Application Information - Please Print All Information Property Owner's Name Parcel # 13, 29.19. ?WA DOUGLAS & KRISTEN BARLOW r c 020-1095-40-M Property Owner's Mailing Address Property location 651 OLD HWY 35 Govt. Lot SW V. NE'/.. Section 33 City, State Zip Code Phone Number HUDSON. WI 54022 cycle one) T 29N R19Eor 4T1 It. Type of Buliding (check all that apply) Lot # Subdivision Name ® 1 or 2 Family Dwelling- Number of Bedrooms NA Block # ❑ Public/Commercial - Describe Use ❑ City of ❑ State Owned - Describe Use ❑ Village of CSM Numbs ® Town of HUDSON Ill. Tpe of Permit: (ClarsJrmilly one box on line A. Complete line B if • licable A. ❑ New System ® lacement System ❑ Treatment(Holding Tank Replacement Only ❑Other Modification to Existing System S (explain) ) B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of ❑ Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Plumber Owner 4"153. 9/5*006 of POWTS S stern/Com nent/Device: Check all that apply) on -Pressurized In -Ground ❑ Pressurized In -Ground ❑ At -Grade ❑ Mound> 24 in. of suitable soil ❑ Mound <24 in. of suitable soil ❑ Holding Tank ❑ Ocher Dispersal Component (explain) ❑ Pretreatment Device(explai V. Dispersallf7frestment Area Information: :-- Design Flow (gpd) Design Soil Application Dispersal Area Required (sf) TOsperse Area Proposed (sf) Sysum Elevation450 Rate(gpdsf) 900 00 87.90' OS V1. Tank Info Capacity in Gallons Total # of Manufacturer Y a k ,_m T, u New Tanks Existing Tanks Gallons Units c U 281 in � u ir, � ii k7 a Septic or Holding Tank 1000 1 Wieser Concrete VII. Responsibility Statement- 1, the undersigned, assume espoosibility for installation of the PORTS shown on the attached plans. Plumber's Name (Print) Plu S MP/MPRS Number Business Phone Number John Schmitt DAy� 223760 715-760-0496 Plumber's Address (Street. City. State. Zip Code) 586 Valley View Trail. Somerset, W154025 VIII. County/Department Use Only Approved ❑ Disapproved Permit Fee_ I urd 1 g Age tit Signalv�y�' �� Owner Given Reason for Denial $ �S �— 7' �0 .,/W`aKJ o"� I iiCon YSTt 1proval/Reasons for Disapproval NTe PtJ.�+�i?R 1. Septic tank, effluent filter and y� `� (dal dispersal cell must be serviced / maintained (ibiLl� U as per management plan provided by plumber. / I�� s��/:-_ _ �� r �{) Ptam,- S m'e a 2. All setback requirements must be maintained D as per applicable COICIFAMIPR9W plan for the system and sybmit to the( ou- me on page of less Mans in all inches in sin SBD-6398 (R03/14) `Tyv �r SYSTEM PLOT PLAN Barlow 3 Bedroom Septic System Project Address: 651 Old Hwy 35 BM1 Symbol:. 100.00• BM Description: Top of Filter manhole BM2 Symbol: A BM Elevation: 92.45' BMDescription: Top ofdrain field observation pipeclosesttos. lank Slope Gradient of Tested Area: (0%) Well Symbol (if applicable) Notes: Notes CO pal Design Flow: 450 GPD Attach design Bow calculations for commercial plans: Pipe Materials! ASTM Standard Tables 384.30-3 & 384.30-5 4•' SCH 40 PVC pipe ASTM- D2665 42034 PVC pipe ASTM-D3034 Property Line Tt - TxU' InNtrator Quick 4 trenches i sb� T2 - 3k52• Infiltrator Quick 4 trenches v T3 - 3k120' EZ Flow trenches EI =87.90' O T4 - 3'xl20' FS Flow trenches EI.=87.90' Therels a second septic system on the East side of the house covered by State Sanitary Permit 499153 Existing 1000 gallon septic tank wfZabel A-100 Efguentfilter, 3 Bedroom House Dnveway / ProoeM Line s 1 .r 90 120 ,illy ee' >Alt' Shed j I Shed ]I ■ B3 c B7 ■ 1 T T4 Ytn I_ T3 ■ 82 �COpY CONVENTIONAL COMPONENT DESIGN Reside itia'' ApplicaticI) INDEX AND TITLE PAGE Project Name: Barlow 4 Bedroom Replacement Septic System Owners Name: Douglas & Kristen Barlow Owner's Address 651 old High Way 35 S Hudson, WI 54025 Legal Description: SW1/4, NEl/4, S33, T29N, R19W Township Hudson County: St. Croix Subdivision Name: NA Lot Number: NA Parcel I.D. Number 020-1095-40-000 Plan Transaction No. Page 1 Page 2 Page 3 Page 4 Page 5 Page 6 Page 7 Page 8 Page 9 Page 30 Page 11 Page 12 Attachment 1 Block Number Index and title Plot Plan 1:100 Plot Plan Septic Tank Specifications Effluent Filter Information Valve information System Sizing & Cross Section EZ Flow Information Management and contingency plan Septic Tank Maintenance Agreement Existing Tank Certification Warranty Deed Soil Evaluation Report Designer: John Schmitt Licnese Number: MPRS 223760 Date: 3/31/2020 Phone Number: 715-760-0486 Signature: Z�I uGI/Lo In -Ground Soil Absorption Component Manual Version 2.0 SBD-10705-P (N. 01/01) Paae 1 SYSTEM PLOT PLAN Barlow 3 Bedroom Septic System Project Address: 651 Old Hwy 35 BM1 Symbol: - 100,00, BM Description: Top of Filter manhole BM2 Symbol: A BM Elevation: 92.45' BM Description: Top of drain field observation pipe closest to s. tank Slope Gradient of Tested Area: (0%) Well Symbol (if applicable) Notes: Notes Design Flow: 450 GPD Attach design flow calculations for commercial plans: Pipe Materials ! ASTM Standard Tables 364.30-3 & 384.30-5 4' SCH 40 PVC pipe ASTM- D2665 4- 3034 PVC pipe ASTM-D3034 Property Line .. ✓L�'� }. T1 - 3'x52' Infiltrator Quick 4 trenches T2 - 3'x52' Infiltrator Quick 4 trenches T3 - Xx120' EZ Flow trenches EI.=87.90' T4 - 3k120' EZ Flow trenches EI.=07 90' Thereis a second septic system on the East side of the house covered by State Sanitary Permd 499153 Dnwway Exisbng 1000 gallon septic tank w/Zabal A-100 3 Bedroom House M r 1 60 90 121 WrOVIAMP"I'l 0 Existingwall BMt;' VaIV0 Line '100' 987 94 -.aT ShM I I Strad 1 I ■ B3 061 ■ I T4 Tr, T3 ■ B2 SYSTEM PLOT PLAN Barlow 3 Bedroom Septic System Project Address: 651 Old Hwy 35 BM Symbol. A 100.o0 BM Description'. Top of Filter manhole BM2 Symbol: Q BM Elevation: 62.45' SM Descrption: Tap of drain field observation pipe U a a. tank Slope Gradient of Tested Ares. (ox) Wall Symbol (it applicable) Design Flow. 450 GPD Attach design flow calculations for commercial plans. Pipe Materials! ASTM Standard Tables 384.30-3 & 384.30-5 4' SCH 40 PVC pipe ASTM- D2665 4. 3034 PVC pipe I ASTM-D3034 Scale: 1" = 100' 0 100 150 200 VIIIIIIZA 25' Page 3 u 0 InA" k1*121 UT N 4" CAST -A -SEAL INLET - — - OUTLET M _ N e M A I MI L PUMP PAD TANKS ARE MANUFACTURED TO MEET OR EXCEED ASTM C-1227 REQUIREMENTS WLP1000— MR TANK SPECIFICATIONS DIMENSIONS: WALL:- 2 1/2" BOTTOM: SEPTIC 3" COVER: 4" MANHOLE: 24" I.D. PRECAST CONCRETE RISER HEIGHT: FLAT COVER 53 1/4" O.D. LENGTH: 104" O.D. WIDTH: 86" O.D. BELOW INLET: 42" O.D. LIQUID LEVEL: 36" WEIGHT: 6,790 LBS. INLET AND OUTLET: 4" CAST -A -SEAL BOOT OR EQUAL GASKET, CAST -A -SEAL BOOT OR EQUAL INLET AND OUTLET BAFFLE AND FILTER: WISCONSIN, SEE DETAIL #10 (OTHER STATES SEE CHART) LIQUID CAPACITY: 27.83 GALAN HOLDING TANK: OUTLET HOLE PLUGGED ACTUAL CAPACITY: 1,085 GALLONS LOADING DESIGN: 8' 0" UNSATURATED SOIL TANK CAN BE USED AS: SEPTIC/ HOLDING/ PUMP OR SIPHON COVER: MIX DESIGN /8 (NO FIBER) TANK: MIX DESIGN #10 (STRUCTURAL FIBER) CUSTOMIZED TANKS: FOR CUSTOM TANKS CONTACT WIESER CONCRETE DRAWINGS SUBMITTED FOR APPROVAL APPROVED BY: APPROVAL DATE: PRODUCRS NEEDED BY: W r N W U LD O't rc co z co Vo a U) � N M �_o I ': : 00 � ao �OF 1 } Home About Site Map F Order Info F Videos & Literature F contact F Drip Systems Treatment Controls Products Downloads Design Guidance r- The Bull Run Valve'" is designed to split flows to septic fields or systems. In addition to the advantages of longer life and easier installation it is the most public health safe alternating device available for wastewater disposal applications. The use has absolutely no contact with wastewater due to the valve's leak -proof and external operating characteristics. The change over from one drainage field to another can be accomplished in less than a minute by simply turning the valve without digging or contact with wastewater. F C ITEM DESCRIPTION BRV4 BULL RUN VALVE 4" BRVBULK BULL RUN VALVE B KEY ONLY BRVCIRISER BULL RUN VALVE RISER W/ CAST COVER BRVKEY28 BULL RUN VALVE KEY 28" BRVKEY36 BULL RUN VALVE KEY 36" BRVKEY48 BULL RUN VALVE KEY 48" d I n t 71, RISER TIRE e OUrPORT k= AMEN CAP VALVE DIRECTION Mau 1_jU614d181a1 .rA':I•7-. A The Bull Run Valve is available in 4" sch 40 pvc and is suitable wherever septic disposal systems are used - in commercial, industrial, and residential applications. OPERATING THE VALVE The direction control handle should be rotated periodically to direct effluent to one or the other of two septic fields. After removing the screw cap at the top of the riser tube, the valve handle can be turned with the valve key furnished. BULL RUN VALVE Complete Valve Kit Contains 1. Bull Run Valve body 2. 28" Valve Key 3. Riser Cap Adapter 4. Watertight Access Cap BRVCIRISER - 4" ADJUSTABLE TO 28" HIGH Page 6 IN -GROUND GRAVITY DISPERSAL AREA Uniform Elevation Trenches with EZ1203HP Bundles 3-ft Trench (down -sizing credit) Geotextile Cover SOIL COVER 12 min.bench depth (typal) System Elevation = 87.90 ft. (typical) min. 12' (typical) Septic Tank(s) Manufacturer: Wieser Concrete Septic Tank(s) Volume(s): 1250 gal gal gal gal Effluent Filter Manufacturer. Zabel Effluent Filter Model #: A-100 TYPICAL TRENCH CROSS SECTION VIEW (No Scale) Provide minimum 3 ft separation between trenches. TYPICAL TRENCH (Show location of inlet / outlet pipe connection on plan view.) PLAN VIEW 4e 0 OMern�M pqe shall be instaW (No Scale) al,unalon baMeen Dxo unit. Perforated Lateral Observation Pipe (typical) (typical) - — — — — — — — — L— — — — — — — — — — — — — — — - OL -— — — —— r— B = 120 ft (typical) INSTALL PER TRENCH: 12 10-ft bundles @ 50 ff EISA/unit = 600 ft2 + 0 5-ft bundles @ 25 f EISA/unit = 0 ft' OBSERVATION PIPE DETAIL (No scale) Saew-Type or — Shp Cap poose) 4'0 PVC Pipe - Top of pipe to terminal _ at or a bove hnlaMd grade - (4)11 1/j %6' SIW � apart Andtonng Devas 10 ft (typical) A = 3.0 ft (typical) EZ1203H Bundle (typical) (mfd by Infiltrator Systems, Inc.) Install pursuant to manufacturer's Instructions. = Proposed EISA per trench = 600 ft2 Required Infiltration Area = x 2 trenches = Proposed Total EISA = — Finished Grade (mulched & seeded) Topsoil Cover (min. t foot) InfmiaM1on Sudety 900 ft2 Distribution Method: 1200 ft2 branched manifold m W O n 4 Installation Instructions for EZflow Systems in Wisconsin �EZ O1•!JV ............................................................................................ •fey 1GNFILTRATOR Wisconsin Department of Commerce, Safety and Buildings 5. The Absorption area (SF) necessary for a given site shall Division, has reviewed the specifications and/or plans for this be sized based on maximum daily sewage flow (GPD) and product and determined it to be in compliance with chapters the Permeability for the site. If certain criteria is met, the Comm 82 through 84, Wisconsin Admin. Code, and Chapters : EISA sizing can be used in Wisconsin, resulting in a 40% 145 and 160, Wisconsin Statutes. All sites must meet the 5AC smaller drainfield. & Sal Conditions & Locations & Isolation distances as noted in local regulations. : 6. Place EZflow bundle(s) in the EZflow configuration ap- proved by system design permit specified for the particu- The approved products are 1203H (3-12" bundles with pipe in lar site. The top or center -most bundles containing pipe center bundle in 5' or 10' lengths) and 1203HP (3-12' bundles are joined end to end with an internal pipe coupler. Any with pipe in each bundle in 5' or 10' lengths. additional aggregate only bundles that may be required, should be butted against the other aggregate -only bun - A single pipe bundle contains a four inch perforated pipe sur- dles and do not require any type of connection. rounded by EPS aggregate and is held together with poly- ehtylene netting. A single aggregate bundle contains aggregate 7. The top of each GEO cylinder contains a filter fabric pre - only and is held together with polyethylene netting. manufactured in between the netting and aggregate. The fabric is inserted to prevent sal intrusion. The installer Materials and Equipment Needed shall make sure the the GEO is positioned upward and is • EZflow Bundles in contact with the fabric contained in the adjacent cylin- • ll Geotextile Fabric der before backfilling. • Maw Intemal Pipe Couplers • Pipe for Header and Inlet 8. The Mow Drainfield Systems should be installed in a • Backhoe/Excavator level trench in all directions (both across and along the trench bottom) and should follow the contour of the ground Installation Instructions surface elevation (uniform depth), with all continuous The instructions for installation of EZflow products are given adjoining 10-foot cylindrical bundles placed end to end, below. This product must be installed in accordance with state with central bundle distribution pipe interconnected, rules defined in chapters Comm 82 through 84, Wisconsin Ad- without any dams, stepdowns or other water stops. ministrative Code, and Chapters 145 and 160, Wisconsin Stat- utes, as well as the local health department's current design 9. The trench top shall be graded such that water will not manual. pond. Backfill should be seeded or sodded immediately after completion to reduce erosion. 1. After the local health department has determined sizing, configuration, and layout for the EZflow systems, stake 10. EZflow EPS bundles are flexible and can fit in curved or mark with paint the location of trenches and lines. Be trenches as may be necessary to avoid trees, boulders, or careful to set correct tank, invert pipe, header line or dis- other obstacles. Mullion box and trench bottom elevations before instal- lation of pipe bundles. 11. EPS aggregate is lighter than water, therefore, it might be expected that natural buoyancy forces would tend to 2. Remove plastic Mow shipping bags prior to placing cause EZflow assemblies to float out of ground when bundles in the trench(es). Remove any plastic bags in the ponding occurs. Field experience has shown, however, trench before system is covered. that this is not a problem when systems have a minimum of 6' of soil cover as recommended by manufacturer. 3. This product must have geotextile fabric that meets re- quirements of s. Comm 84.30 (6) (g), Wis. Adm. Code, installed directly on top of the product and extending down along the sides of the product to a pant at least six inches from the bottom of product. 4. When installed in a trench, the trench should be dug to a width of 36 inches. This not only saves labor in excava- tion, but also provides better load -bearing capacity after backfilling is complete. 1203H-GEO Geolexble r Material Palle 8 PAGE 4OF4 In -ground Gravity Management Plan IMPORTANT: The owner of this in -ground gravity system shall be responsible for its perpetual operation and maintenance pursuant to requirements of SPS 382-384, Wisc. Admin. Code. Pursuant to SPS 383.52 (2), Wisc. Admin. Code, this system shall be considered a human health hazard if not maintained in accordance with this approved management plan. Furthermore, all inspection and maintenance activities shall be performed by a registered POWTS Maintainer in accordance with SPS 383.52 (3), Wisc. Admin. Code. Maximum Dispersal Area Operating Limits: Design Flow = 450 gpd; BODE 5 220 mgL-'; TSS 5150 mgL-'; FOG 5 30 mgL" Inspection Checklist INSPECT EVERY 3 YEARS o type of use o age of system o nuisance factors (i.e. odors, user complaints, etc.) o mechanical malfunction (i.e., pumps, valves, switches, floats, etc.) o material fatigue (i.e., leaks, breaks, corrosion, etc.) o solids volume in anaerobic treatment tank(s) and any distribution appurtenance(s) (i.e., distribution / drop boxes) o neglect or improper use (i.e., exceeding design capacities, prohibited activities, etc.) o extent of ponding in distribution cell prior to dosing o dosing irregularities - if applicable (i.e., pump re -cycling, float switch settings, etc.) o electrical components - if applicable (i.e., wiring, connections, switches, controls, timers, alarms, etc.) o distribution lateral or lateral orifice plugging (measure lateral distal pressure — compare to design specification) o surface discharge of effluent or sewage back-up into structure served Maintenance Checklist MAINTAIN EVERY 3 YEARS (or when necessary) o Septic and dose tank(s) shall be pumped by a certified septage servicing operator licensed under s. 281.48 Wis. Stats. when the volume of solids in the tank(s) exceeds one-third (1/3) the liquid volume of the tank(s) or as required by local ordinance. Disposal of contents shall be pursuant to NR 113. Wisc. Admin. Code. o Effluent filter(s) shall be inspected every 3 years and shall be cleaned when necessary to remove any accumulated solids according to manufacturer's specifications. A servicing period will always be greater than 12 months. System maintenance reports shall be submitted to the proper local government unit in accordance with SPS 383.55 Wisc. Admin. Code. Report any component failure or malfunction to: Name of individual or company: Schmitt & Sons Excavating, Inc. Phone: 715-760-0486 Local government unit: St. Croix County Community Developement Phone: 715-386-4680 Local govemment unit address: 1101 Carmichael Road, Hudson ZIP: 54016 Any defective part of this system shall be repaired, replaced, or removed pursuant to SPS 383.51 (1), Wisc. Admin. Code. Repair or replacement of failed or malfunctioning components shall comply with SPS 383, Wisc. Admin. Code. No product for chemical or physical restoration of the POWTS may be used unless approved by the department in accordance with SPS 384, Wisc. Admin. Code. Contingency Plan In the event that any failed treatment component of this POWTS cannot be repaired, it shall be replaced pursuant to a plan submitted to the appropriate agency for review and approval. A failed in -ground dispersal component may be abandoned and replaced by a code -complying dispersal component in a pre -determined area of suitable soils. System Abandonment If use of this POWTS is discontinued, it shall be abandoned in accordance with SPS 383.33, Wisc. Admin. Code. Page 9 ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer Douglas & Krisdn Barlow Mailing Address 651 Old Hwy 35 S, Hudson, WI 54016 Property Address 651 Old Hwy 35 S (Verificauon required from Planning & Zoning Department for new construction.) City/State Hudson, Wl Parcel Identification Number 020-1095-40-000 LEGAL DESCRIPTION Property Location SW, 14 , NE ,,, . sec, _ 33 . T 29 N R 19 W, Town of Subdivision Plat: NA Certified Survey Map # Warranty Deed # Spec house ❑yesdw Hudson Volume . Page # (before 2007)Volume . . Page Lot Imes identifiable Oyes❑no SYSTEM MAINTENANCE AND OWNER CERTIFICATION Lot # NA 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 lank every three years or sooner. if needed. by a licensed pumper. What you put into the system can affect the function ol'the septic tank as a treatment stage in the uaste disposal system. Owner maintenance responsibilities are specified in sSPS. 383 >_( I ) and in Chapter 12 - St. Croix County Sanitary Ordinance The property owner agrees to submit to St. Croix County Planning & Zoning Department a certification form. signed by the owner and by a master plumber. journey -man plumber, restricted plumber or a licensed pumper s crifying that 11) the on -site waslewater disposal system is in proper operating condmon and or (2) after inspection and pumping Uf necessary). the septic lank is leas than 13 full of sludge. 14c. the undersigned haw read the abotc requirements and agree to maintain the pris ate sewage disposal system with the standards set firth, herein, as set by the Department of Safety And Prolcssional Scntces and the Department of Natural Resources. Stale of Wisconsin. Cenification stating that your septic system has been maintained must be completed and returned to the St. Croix County Planning & Zoning Department a shin 30 days of the three year expiration date. I we cerul'y that all statements on this form are true to the best otnmy our knowledge. 1 we am'are the owners) orthe property described ahote. by virtue ofa warranty deed recorded in Regislcr of Deeds Office. N ut o ins 3 �A:1_,_ � �aat, 2� ,t�;,20P o ATURE OF APPL A ) DATE information that is misrepresented may resell in the sanitary permit being revoked by the Planning & Zoning Department. *** Include with this application a res orded w.tn:mh deed from the Regisler of Deeds Office and a copy of the certified sun-ey map if reference is made in the warrants deed. (REV. 04/12) Page 10 t C5T-202_0-Oq8-Oq8 - e Department SOIL EVALUATION REPbRT ik j -2o2s S P Safety and it, accordance with Comm 85 W.s Adma Code ��3�, 6��. Page 1 of 4 = Professional Services Schmitt Saod Testing. Inc Attach complete site plan on paper not less than 87, x 11 inches in size Plan must County St. Croix include but not limited to vertical and horizontal reference point IBM). direction and percent slope scale of dimensions, north arrow and localion and distance to nearest road Parcel I D ozo• 1095-40-000 Please print all information. Personal mrormatron you prc,we may be used lc: seaxdary Iwrroses Prrvaa Laws 15 u I m'; w etl�y Data / .L Property Owner Property Location Barlow, Douglas & Kristen Gout rot SW114 NE1/4. 533. T29N. R19W Property Owner's Mailing Address Lot # Block 4 Subd Name or CSM# 651 Old Hwy 35 S NA 5 56 Acres city State Zip Code Phone Number CM Vii age Town Nearest Road Hudson WI 54016 715-381.2708 Hudson Old Hwy 35 New Construction Use Residential i Number of bedrooms 3 Code derived design flow rate 450 GPD Replacement Public of commercial - Describe Parent material Outwash( Burkhardt-Saftre Complex) Flood plain elevation ,f appecaole NA If General comments Replacement area Is suitat4e for a rrn.er'irrai sys=•- :;,,^ ; 0 P qr•1 �T• ra•e o.-s- ci= �a'e= =le, a+ �^r for reNatemen! area a and recommendations. 87 gC• Area has no slope .wLka44- a �Z �x 1 Boring # Boring 92.10 _- Pd Ground surface elev h Depth to limiting factor 96+ in jSal Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GoDIIV in Munsell Ou Sz Cont Color Gr Sz Sh •E", -Efr#2 1 0-6 10YR313 none sl 2mgr mvfr as 2m,2f 0.6 1.0 2 6-14 7.5YR5/6 none I5 Osg mvfr gw lvf 0.7 1.6 3 14-22 7.5YR5/6 none grsl 2msbk mvfr gW ----•- 0.6 1.0 4 22-41 7.5YR6/4 none grfs Osg ml ow ••---• 0.5 1.0 5 41-96 10YR6/4 none fs Osg ml --- ------ 0.5 1.0 5a� b - 87. �t ; 5e�. 5 Z Boring # Boring Lj ,-Z,' Pit Ground surface'elev. 91.20 It Depth to limiting facto, 96+ In SoilApplication Rate, Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft' in Munsell Qu Sz Cont Color Gr Sz Sh '0141 'Eftt2 1 0-12 10YR3/3 none $l 2mgr mvfr as 2m,2f 0.6 1.0 2 12-35 10YR3/4 none sl 2msbk mfr qw lvf 0.6 1.0 3 3542- 10YR4/6 none sl 2msbk mfr gw lvf 0.6 1.0 4 42-84 10YR6/4 none fs Osg ml Cs •----- 0.5 1.0 5 84-96 10YR5,6 nonee grfs Osg ml ---- ----•- 0.5 1.0 ..JJ 3 t•W . Effluent #t = BOD_,> 30 < 220 mi and TSS >30 < 150 mg:L ' Effluent #2 = 8O05 < 30 mi and TSS 1.30 mg,L CST Name (Please Print) Signature ! - a CST Number Thomas_ J. Schmitt -� �- s �> 227429 Address Schmitt Soil Testing Inc Date Evaluation Conducted Telephone Number 1595 72nd St New Richmond '41 54017 3124/2020 715-760-1978 .riill .-k - •. Property Owner Barlow, Douglas &Kristen_ _ parcel ID # _020-1095 40 000 - _ _— _ Page 2 . of _ 4 . a Boring # Boring Pit Ground surface slev. 91_60- h Depth to limiting factor 94+ in. Soil Application Rah Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots G_P_D_ /f l In. Mansell Qu. Sz, Cont Color Gr. Sz. Sh. _ _ 10#1 _ -Eff#2 1 0-17 10YR3/3 none grsl 2fsbk mvfr as 2m,2f 0.6 1.0 2 17-27 10YR4/3 none grsl 2msbk mfr gw lvf 0.6 1.0 3 27-39 10YR5/6 none gdfs lcsbk mfr gw Ivf 0.5 1.0 4 39-94 10YR6/4 none f5 Osg ml --- ------ 0.5 1.0 Boring # Boring factor pit Ground surface elev. fl Depth to limting in ---- - -- - -- - Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDM' in. Mansell Qu. Sz. Cont. Color Gr. Sz. Sh _ 'Ensi _'EIfa2 Ong # Boring Pit Ground surface elev.. -- - - � h. Depth to limiting factor m Soil Application Rele Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP_D_!h' in Mansell Car. Sz. Cont. Color Gr. Si. Sh _ _ -Efle1 I -Effe2 Effluent 01 = SOD,> 30 < 220 mg/L and TSS >30 < 150 mg1L ' Effluent #2 = SOD, -E 30 mgtL and TSS < 30 mglL The Department of Commerce is an equal opportunip ser%ice pros ider mud employer. 11'� ou nerd a"ieaance al uccess een ice. or need material in an altemele lbrmal. please contact file depannlent in 609-266.3151 or I I Y 6118-264-8777. 5a0-ycrvx Ir r... Srhmdt Sol TesLnq. Inc ComaCledln+ uaxfnex FnaltlDDel1.1 051 OW Hwy :35 Hadxm W1Moir, Pit) [901095AfP(KlO NW IIA NF. IIA 531 129N R 19W T.,11ep Ut hheHrm -" RM i I00 0 Tap 91 semhn tank mmPhate .,R, Cvntludetl by ibmnas J. abnnll / BM 2 93 d5 Twig dmmhaid atKervalinn pipe desesl la saldic lank Spur lank OMIel Ft Ml 80' OLD I-M/V 35 CST 21 4" 3-:a-:0.10 f i jf U+ 1 1 1 1 r 0! 1 1 1 j43 / I XISIING SEPTIC TANK eM 1. ; 1 ': xlZ6 JRAIN FIELD 1 1 1 1 13 '\ 9r 100' SOUIH PROPERTY LINE St Croix County, WI Legend InlorSiaps US HlOmeays Slate Hi Jhways County Hghatlye L.1 Road, Rash: Roads Ramp. 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