HomeMy WebLinkAbout030-2141-00-001 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix
Safety and Building Division
INSPECTION REPORT Sanitary Permit No:
�, 515154 0
GtNERAL 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)]. ez
Permit Holder's Name: City Village X Township Parcel Tax No:
Grand Properties LP, C/o Mike Germain I St. Joseph, Town of 030 - 2141 -00 -001
CST BM Elev: Insp. SM El BM Description: Section/Town /Range /Map No:
(/�( r 36.30.19.2051
TANK INFORMATION ELEVATION DATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic Ste, •` / 4nO Benchmark q-
Alt. BM
�� P la fz sz ` 6&j Z .'7 I ib z
Aeration Bldg. Sewer 5. 75 IF
Holding SUHt Inlet J
TANK SETBACK INFORMATION St/Ht Outlet 7 7. 7
TANK TO � /L WELL BLDG. EVent ir Intake ROAD Dt Inlet
Septic / y 5 A)4— /� 7 Dt Bottom
Dosing D Header /Man. 7. 7 9.7
Aeration Dist. Pipe $ 6
1
Holding Bot. System
99
PUMP /SIPHON INFORMATION Final Grade
Manufacturer Demand St Cover
G PM Z• - 7 /aZ .
Model Number ��� •' �•
TDH Lift Friction Loss System H DH Ft 1_0LJ ! � t s
Forcemain Length Dist. to Well r
SOIL ABSORPTION SYSTEM
BED /TRENCH Width Length / o. Of T PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth
DIMENSIONS / A Z �f G ` `— \
SETBACK SYSTEM TO P/L IBLDG WELL LAKE /STREAM LEACHING Manufactur /�•�
INFORMATION CHAMBER OR �-s b��•
Type Of System: 2- 7 /► UNIT Model Number: ' 1 614 1 .k
DISTRIBUTION SYSTEM
Header /Manifold If Distribution x Hol Size x Hole Spacing Vent to Aih lnte
�,( Pipe(s) \ 2�,
1 1-ength - ML2 - 1 Dia Length Dia \ Spacing
SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only
Depth Over Depth Over xx Depth f xx Seeded /Sodded xx Mulched
Bed/Trench Center #o Bed/Trench Edges Topsoil 0
Yes No No
COMMENTS (Include code discrepencies, persons present, etc.) Inspection #1: 1 6 / Zg / P2 Inspection #2: / /
Location: 802 126th Avenue H dson, WI 54016 (SW 114 NW 1/4 36 T30N R1 W) Natalie 's Ridge Lot 1 Parcel No: 36.30.19.2051
� 40c" o v�
1.) Alt BM Description = t
2.) Bldg sewer length - amount of cover = / n t / •
Plan revision Required? 'es No
Use other side for additional information.
Date In pctor's S' ature Cert. No.
SBD -6710 (R.3/97)
�attntetQe.tati.gtanr Safety and Bufld' Division
• 201 W. W"Itingmn r n Ave., P.O. Bo an
ounty
Madison, WI 53707 -71b2 y , N (to ye )
Sanitary Permit Application tote Ttaroacti0n N'�er
in accordance With s. Comm, 03.21(2), Wis. submission of this form t
Co
Adm. de, o e
i the govemrnentsl N �
unit is Ired r to
trgtt prior obtaining a sanitary permit. Nate: Application forms for state -owned POtiVTS are
suhmilted to the DepartIn" of CommOrcc, Personal information you provide WAY " act pgpt -Sea secondary act Address (ifdilraent than mailing address)
purpos in accordance with the Privy Law s. I s. 1 m ft". ORCE V G � � Z � � 4v �
1. A Ileaden - information - Please Print All l / tion�
Property r' t Name
ro 2009 " 030 . 21/ ao - i
Property Owner's Meiling Address ����V `4 Pre" Loca ion /
ZONtN OFF1 Govt. Lot
Oily, State ,
Zip Code Pftie Number j l�f '!, �Gc/ V�, Section
� "
T oL ` N; R /�
11. Type of BuiWlatt (check all that apply) Lot # ❑ E JXW
13or Family Dwelling Number of Bedrooms pp��. SubdnryeiOttName
(0/r 9
Public/Commercial - Describe Use /t�l
Black ii
YYY City of
State Owned -- Describe Use CSM Number (❑ Village of
Z / � i b + Ce L Town of
Ill. Type of Perm[t: (Chat only one boat on litre A. Complete line Bit applicable)
A New System Repleaanratt Trealm m/Hokling Tank � Only Other Modifaxtbn m ExMir� Sya/em (explain)
B. Permit Permit Revision Change of Permit Transfer to List Previous l'amit Nambix and Date Issued
Renew sl Betbre Plumber New Owner
lion 1r;
IV. Tvpe of POW" 3 o neaIMeviee: Check all that apply)
Non- Pre+suriud In- Ground Pm amized In- (around At -Grade Mound i 7 in. of suftMe soil El Mound 1 24 in. of suitable 8031
Holding Tank 0 Other Dispersal Component (explain) [Irreueaanm Device (explain)
Y, Dlepersalffnatmeat Area Information;
Design Flow (gpd) 4 Design Soil Application gpdsf) Dispersal .Ate4 Required (so Dispersal Area (sf) System Elevation
V Tank info L'apaeiry in Total # of Monninchda Material
GOUaos Gallons Units
New Tanks Exists »g Tmdca � I I a � �
Sepdcor Holding Timk p!J!f ��'G SB a" !� CDif� eQt
Dosing awnbat
VII. Reg aeibill Statement -1, the anderslaaed, sesame Mpnddlft tar lIMMIllatfott of the POWTS MImm on tie Mbelod
Plumber's Name (Print) Plu 's Si Business Now Number
Plumber's Address (Street, City, State, Zip Code)
8T > s"-o
VIII. Carla /De parunent We on
proved _�� aappti ove T miffcc Date G Iaeui Si
n14�i;A n Ream" , O� Z D l
1?(. Condit®lif`i Yiif iBlReexons for Disapproval O
1. Se // // � r� •
Septic tank, effluent filter and 3 #1 OSd d
p 5
I ma intained
dispersal cell must all be se ai ed - � • ��
as per management plan provided by plumber. �D '
2. All setback feclUttrements must be maintained
as " k code / orb.
ANach ss eaapietr plw arc Musa nay satsstM ro ttie eeaaly saty ea wpsr asr ray a� a sn t A tactics to arse
SAD -6396 (R. 01 /07) Valid thrn 01/09
�✓�� cl-..v � /�►^r� � � � �-� � l �/ a. tea. /; ,mss' /2,'dg� S �,�G�'�� /!
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N,N EVALUATION REPORT #1620
+ Department of Commerce in accordance with Comm 85, Wis. Adm. Code Page 1 of 4
Division of Safety and Buildings Schmitt Soil Testing, Inc.
Attach complete site plan on paper not less than 8% x 11 inches in size. Plan must County f01�
include but not limited to: vertical and horizontal reference BM direction and
percent point
p ( )' slope, scale or dimensions, north arrow, and location and distance to nearest road. ParcelI.D.
a 2141 - o- �
Please print all information. Revie . By a e
Personal information you provide may be used for MEgM Rvacy Law, s. 15.04 (1) (m)). S L ,� Y ? ,' t
Property Owner Property Location
Grand Properties, LP Govt. Lot SW1 /4, NW1 /4, S36, T29N, R19W
Property Owner's Mailing Address 0 Lot # Block # Subd. Name or CSM#
712 Rivard St. 1 Natalie's Ridge
City State Zip APd;11Ndi >FICt City ❑ Village W Town Nearest Road
Somerset WI 1 54025 1 715- 247 -4449 1 1 80Th St.
❑ New Construction Use: ❑ Residential / Number of bedrooms 3 Code derived design flow rate 450 GPD
❑ Replacement ❑ Public or commercial - Describe fir _ ❑;,�,oh�� ��
Parent material Outwash Flood plain elevation, if applicable na ft.
General comments
and recommendations: Area is suitable for a conventional system with a 0.7 gpd /sgft rate. Possible systm elevation for Area I is,
Step trenches (high trench) 957 (low trench) 94.7'. Slope is 13%
Fi-I Boring # F Boring
Pit Ground surface elev. 99.49 ft. Depth to limiting factor 125+ in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft'
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
1 0 -7 10yr3 /3 none sil 2mgr mfr a 2vf .6 .8
2 7 -17 10yr4 /4 none sl 2msbk mfr gw 2vf .6 1.0
3 17 -52 10yr5 /6 none Is lcsbk mvfr cs - - - - -- .4 .7
4 52 -66 10yr4/4 none sil lmsbk mfr cs - - - - -- .4c .6
5 66 -125 10yr5/4 none grs Osg ml - - -- - - - - -- .7 1.6
Fi-I Boring # F Boring
Pit Ground surface elev. 100.19 ft. Depth to limiting factor 72 in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consisten Boundary Roots GPD/ft'
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
1 0 -12 10yr3/3 none sl 2mgr mfr gw 2vf .6 1.0
2 12 -17 10yr3/2 none sil 2msbk mfr gw lvf .6 .8
3 17 -39 10yr4 /4 none sil 2msbk mfr gw - - - - -- .6 .8
4 39 -72 10yr5/6 none Ifs lcsbk mfi gw - - - - -- .5 1.0
5 72 -80 10yr4/6 c2d 10yr6/2 sl Om mfi w - - - -- 2 6
10yr6 /6 g
6 80 -96 2.5y6/4 c2d 10yyr6g /3 sil lmsbk mfr a - - -- 4C 6
7 96 -145 7.5yr4/4 none grs Osg ml - - -- - - - - -- .7 1.6
* Effluent #1 = BOD 5> 30 < 220 mg /L and TSS >30 < 150 mg /L * Effluent #2 = BOD S30 mg /L and TSS < 30 mg /L
CST Name (Please Print) Signature: _ CST Number
Thomas J. Schmitt 227429
Address Schmitt Soil Testing, Inc. Date Evaluation Conducted Telephone Number
1595 72nd Street New Richmond, WI 54017 10/27/2009 715 - 247 -2941
SBD -8330 (tt07 /00)
Property Owner Grand Properties, LP Parcel ID # 030 - 2141 -00 -001 Page 2 of 4
`+ .7 Boring # El Boring
E pit Ground surface elev. 100.69 ft. Depth to limiting factor 96+ in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft=
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
1 0 -10 10yr4/4 none sl 2msbk mfr CS 2vf .6 1.0
2 10-42 10yr5 /6 none grcos Osg ml cs lvf .7 1.6
3 42 -72 10yr6/4 none s Osg ml cs - - - - -- .7 1.6
4 72 -96 10yr5 /4 none grs Osg ml - - -- - - - - -- .7 1.6
11
8] Boring # Boring
Pit Ground surface elev. 100.69 ft. Depth to limiting factor 100+ in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft'
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
1 0 -12 10yr3 /4 none SI 2msbk mfr a 2vf .6 1.0
2 12 -28 10yr4/4 none sl 2msbk mfr gw 1vf .6 1.0
3 28-40 2.5y6/3 c2d 10yr6/3 sil Osg mfr cs - - - - -- 6 8
10yr6/6
4 40-47 7.5yr4/6 none grsl Osg mfr cs - - - - -- .6 1.0
5 47 -76 10yr5/4 none grs Osg ml a - - - - -- .7 1.6
Meets 1 foot rule for features, Comm 85.30(3)2
7 76 - 100 10yr6 /4 none , s / Osg ml - - -- - - - - -- .7 1.6
Fi-1 Boring # Boring
Z Pit Ground surface elev. 7.23 ft. Depth to limiting factor 100+ in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft'
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. I *Ef 11 *Eff#2
1 0-4 10yr3/4 none sl 2msbk mfr cs 2vf .6 1.0
2 4 -25 10yr5/6 none sl 2fsbk mfr gw 1vf .6 1.0
3 25 -31 10yr4 /4 none grsl 2msbk mfr cs - - - - -- .6 1.0
4 31 - 36 7.5yr4/4 none s Osg ml a - - - - -- .7 1.6
5 36-48 7.5yr5/4 none grcos Osg ml CS - - - - -- .7 1.6
6 48 -80 10yr5/4 none grls Osg ml cs - - - - -- .7 1.6
7 80 -100 10yr5 /6 none s Osg ml - -- - - - - -- .7 1.6
*Effluent #1 = BOD 30 < 220 mg /L and TSS >30 < 150 mg /L * Effluent #2 = BOD < 30 mg /L and TSS <30 mg /L
The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or
need material in an alternate format, please contact the department at 608 -266 -3151 or TTY 608 -264 -8777.
SBD -8330 .07/00
� > Schmitt Soil Testing, Inc.
Page 3 of 3
Conducted by: Conducted For:
Schmitt Soil Testing, Inc Name: Grand Properties, LP
Thomas J. Schmitt, CST 227429 Address: 712 Rivard Street
1595 72nd St. City, State, Zip: Somerset, WI. 54025
New Richmond, WI. 54017
Phone: 715 - 247 -2941 Subd.Name: Natalies Ridge
Lot No.: 1
Legal Description: SWl/4 NWl /4 S36 T30N R19W
Township of: St. Joseph, St Coix County
■ Soil Boring
♦ Bench Mark El. 100.00' Top of concrete frost wall at patio door opening
A Alternate Bench Mark El. 104.89' Top of 2" pvc pipe
Slope = 13%
b Art'
Scale 1" = 40'
67 / \
--� �egCr bet� prt
S! �,� �'°``` � SOLI ke - -(�r 44, Za -,
F , 231'
A
f
as H . 2
— L.O =9 .2
940.8
.926.6
x x 4 x
zzz
Y
940.8 93 8
934. } .
{ 936.3 • j
a
3. A
3.000 A (2 6 AC.j
j
LB ._ 935.5
_ 937.6
z 939.7
i ) V
\ s'F
x L = 935.5
929.3 —
K
x L =933. —
a s:.
929.7 . .
m
— w 929.
� 38
x � -
y
x
A
r
isalrttaMlrae.wd.glootr Safety mid Bufklinip Diviaiar i^otnidy
201 W. Waahingbon Ave., P.O. Z 7
Le e �� Madison, W1 53707 -7)p ihry 1Patnh Number (ar be Plied io by Co.)
FRI
55/5
Sanitary Permit Application ft" T jjmbef
In accardance with a. Comm. 83,21( Wig. Adm. Curie, submission of ibis f asm t o the aplasp gov 7
unit is n geiited prior to obtaining a sardtwy permit. Note: Applies forms for g ill Pmjeat Add�+ess (ifdiffimnt dean suiilkg Wdmaa)
311111111110d 311111111110d ae
tted to the DOpatbnit of Comes= POraonal iaf � ® secondery
Pon in acooritlirrce vtidi the Privapy LAW, a. 15, l tp data, =Fr 12(. U, /a
I. A sth
s Iansatlen - Plta Print AR IWbrsmatian
Property owner's Name SjEP 2,4 200E Per° 0.30 - ZJ 60 -
Property Owner's Mailing Address 5 i nom ,,, ,uv • . Pmle Lacadoa
PLANNING & ZONING OFFICL
GOVIL Lot
c1dy S uft Zip Cado Plane Numba �� y., I fIA) '.4 C Saxian , ✓?
U. Type of BuLWi (ekeek all that apply) o K ad Lot #
T,70 N; R /? 13E A§i�
19 1 or 2 Family Dwelling - Number of p Sabdivisiot+Nato
❑ Publiemonanerc' - .Describe UN
ci ll "
❑ state Opned - Descr u � D CSId Number, Village of
7awn of
t
111. 'I'Fpe of Peridt: (Cbe k Golf one blur an kse A. COMM& tine B l(
A. NOW System ltepiaoerraxa U T g Tank Replecemont Only Otter Modifiadou to Existing Wjsftm (aPlem)
System
B. Pernik El Permit PAvisiou CMngO Pesmit T tatrifer so Ust P m°` Permit Number and issued
Renewal 8alime Plamber Owner 7 Cr 2 5 f Z O 5
lion / c7
IV. Tna of POWTS S t/DavLee: Ckwk Aftell S jft N,
Aim- Pressurl Feeseurized in- around Atdirnde U moundWA in, orsunaWe soil Mound <Zi in. of suilNrie sett
Holding Tank [] Other Dispersal Compost (expiaiii) PtlClltlalnlCtlt Dw sin)
V. erenIfI reattsseet Area Infor aation: e4 ,' e-
Design Flaw (gpd) Design Soil Apptica0w t) Required ( Dispersal Ana Ian System ���
'T� V G �s� EGG 77/ 41,
VI. Tame info Capseky in Taint d of Mst"iel
cltitlaas as ilatat Units
New Tanks 13�dsdng Tmdcs 0
Sepdoa iiutding 2knk / d d!� ! ` �+
bail Chamber �/ li S�lf. ,•`Q S �r C m.0 G r e �L
VII. Res slbft Stetess st-1, the aaddndgaud, meanie %r •s �e O° we attaei ed
M miller's Name (Print) Plumber's Signature Number Bohm PMtie Number
Plumber's Address (Street, City,'818K 7rp Coda)
jv7 d saw G� �lG 7 6
VIII Can nt Use rD
pproved Di Permit Fes Date isstdng igtelAiro
gwner t 75 • 4:5 /d 0
11X. Candlt�p���saas for Disfpp
1. Septic tank, effluent finer and 3 d�— Q 51 p All
dispersal cell must all be servMes / maintained J '
as per management plan provided by plumber.
2. AU setback tegttirements must be maintained / rC�� (�- Me •
Aglaeh b o I p e Mbar Ian Masyslaas ant sataslt ro tke Cpnnty satY tanlN net lass a ti2>< t t ieeirs he sloe
SBD -6398 (k. 01/07) Valid think 01/09
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1314
W sconsin Department of Commerce ` V T Page I of 3
Division Of Safety and Buildings in ac a B, Adm. Code Tom Schmitt
J County
Attach complete site plan on paper not less than 8% x 11 inche in size. Plan m «��,? ! St. Croix
include, but not limited to: vertical and horizontal reference poi (BM), nd
percent slope, scale or dimensions, north arrow, and location nd dicta i Parcel I.D.
r�
Please print all information. NING �FF�CE
evie y Date -]
Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)).' - �" �
Property Owner Property Location
Grand Properties, LP Govt. Lot SW 1/4 NW 1/4 S 36 T 30 NR 19 W
Property Owner's Mailing Address Lot # Block # Subd. Name or CSM#
712 Rivard Streeet, Suite 300 1 Natalie's Ridge
City State Zip Code Phone Number J City J Village N' Town Nearest Road
Somerset I WI 1 54025 715 247 - 5900 St.Joseph I 80Th St.
_f✓ New Construction Use: ✓e Residential / Number of bedrooms 3 Code derived design flow rate 450 GPD
J Replacement _ I Public or commercial - Describe:
Parent material Outwash Plain Flood plain elevation, if applicable na
General comments
and recommendations: Area is suitable for a conventional system a 0.6 d/ sqft rating. Possible system elevation for Area 1 is
high trench 94.0', low trench 92.0'. Slope is 7°o.� `
Boring �Q ` S
Boring # --� g - 46i K
�f Pit Ground Surface elev. 96.95 ft. Depth to limiting factor 111+ in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP /fF
*Eff#1 'Eff#2
1 0 -11 10yr3/4 none sl 2fsbk mfr as 2vf .6 1.0
2 11 -24 1Oyr3/3 none sil 2fsbk mfr gw 1vf .6 .8
3 24 -34 1Oyr4/3 none sl 2msbk mfr gw .6 1.0
4 34 -54 1Oyr5/6 none sl 2msbk mfr gw C_6 1.0
5 54 -95 10yr5/4 none Icos Osg ml cs -- .7 1.6
6 95 -111 10yr6/4 none ms Osg ml - ----- .7 1.6
Boring # Boring Q/-
_f✓ Pit Ground Surface elev. 96.25 ft. Depth to limiting factor 110+ in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft
*Eff#1 'Ef1#2
1 0 - 1Oyr4/3 none sl 2msbk mfr as 2vf .6 1.0
2 8 -22 1Oyr4/4 none sl 1mpl mfr gw 1vf .4 .6
3 22 -39 1Oyr4/6 none sl 2msbk mfr gw 1vf .6 1.0
4 39 -81 1Oyr5/4 none grcos Osg ml cs ---- .7 1.6
5 0 1Oyr5/6 none ms Osg ml - - 7 1.6
' Effluent #1 = BOD ? 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BOD <30 mg/L and TSS <-0 mg/L
CST Name (Please Print) Signature: CST Number
Thomas J. Schmitt 227429
Address Tom Schmitt Date Evaluation Conducted Telephone Number
1595 72nd St., New Richmond, Wl 54017 12/16/04 715- 247 -2941
Property Owner Grand Properties, LP Parcel ID # Page 2 of 3
f 37 Boring # I Boring
i/ Pit Ground Surface elev. 95.70 ft. Depth to limiting factor 114+ in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP
*Eff#1 *Eff#2
1 0 -13 1 Oyr32 none 1 1 mpl mfr as 2vf .4 .6
2 13 -27 1Oyr4/3 none sil 2fsbk mfr gw 1vf .6 .8
3 27 -37 1Oyr4/4 none scl 2fsbk mfr gw 1vf .4 .6
0 1/ 4 37 -47 1 Oyr4/6 none Is 1 msbk mvfr gw -- .7 1.6
5 47-63 10yr5/6 none sl 2msbk mfr cs ---- .6 .8
6 63 -92 1Oyr5/4 none grcos Osg ml cs --- .7 1.6
7 92 -114 1Oyr5/6 none ms Osg ml - 7 1.6
4] Boring # a Boring
ICI Pit Ground Surface elev. 98.501 ft. Depth to limiting factor 112+ in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP
'Eff#1 'Eff#2
1 0 -12 1Oyr3/3 none sl 2msbk mfr as 2vf .6 1.0
2 12 -23 1Oyr4/4 none grsl 2msbk mfr gw 1vf .6 1.0
3 23 -38 7.5yr5/6 none ms Osg ml cs -- .7 1.6
4 38 -65 1Oyr5/4 none grco Osg ml cs 7 1.6
5 6 - 12 1Oyr6/4 none ms Osg ml - - .7 1.6
I �!
F-1 Boring # Boring
_I 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
*Eif#1 *Eff#2
' Effluent #1 = BOD 5> 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BOD <30 mg /L and TSS <30 mg/L
The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or
need material in an Alternate format, please contact the department at 608 - 266 -3151 or TTY 608 - 264 -8777.
Page 3 of 3
Conducted by: Conducted For:
Schmitt Soil Testing, Inc. Name: Grand Properties, LP
Thous I Schmitt, CST 227429 Address: 712 Rivard Street
1595 72nd St. City, State, Zip: Somerset, WI. 54025
New Richmond, W1.54017
Phone: 715- 247 -2941 Subd.Name: Natalies Ridge
Lot No.:
Legal Description: -51 _1/4 1/4 S36 T30N R19W
Township of St. Joseph, St Coix County
Bench Mark El. 100.00' Top of 1 /2" rebar
Alternate Bench Mark El. 96, - Top of 1/2" rebar
Slope= 7g Contour Line El. /Vii
? q
Scale I"= 40'
t
OA � I
1 �S
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1/V
a�
P �o pes ��ad
This soil report was done to fulfill a zoning requirement. A preliminary plot map was used, no drainage easements or
driveway locations were established at the time this soil and site evaluation was conducted.
LINE TABLE
DRAINAGE
EASEMENT 'D'
/ DIRECAON DIST.
DI 51728'38 50.06'
NW D2 50919'30 "W 89.65'
I 38 D3 S76V2'35 0 W 24.77'
04 N5653'37"W 67.88'
4 I D5 N2176'53'W 11.119'
I D6 S8951 1 E 121.21' NORTH UK OF THE
D7 S0079'19 136.27' S1 /2 OF TH NW/4
I 34.72' 229.03 231.32 231
I DRAINAGE BEN(H yam TOP
"D
I I EASEMENT " �+ OF 1' IRON PIPE.
c � H.
00 ELEVATION 927.5
1 —� cn� H.W.E.-
o
927.2 v I
8.0.- 929.2 h
1
Q3
I I
I I
I LOT 1 LOT 2
1000 ACRES
TABLE RE
3.000 ACRES 130.682 SO. FT.
AINAGE z -� ; 130.698 SO. FT. m L6.0.- 935.5 LO'
►SEMMENT "E" F
^ I m '° 3.000
D/RECAOW DIST. + Fi 130.882
S895108 90.39' ail r
N15'40'53 "E 80.49'
N3273 07 "W 65.53' ( I CS L.B.0.- 935.5
N722425 "W 81.93' N 1
N7224 25 "W 9811'
N2778'18 'W 109.77' $ y fs\
S7341'13 "W 91.94' I
S00W 53 'W 25823' I m F
50079'19 "E 15746' I H.W.E.- 933.5
DRAINAGE
la I 'b I N
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II I W1
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> N19 N89'51'08'W 704.07'
d r
I DRAINAGE \
EASEMENT "N" I
I I
H.W.E.- 933.5
LOT 32 - N16 •�
FA 1000 ACRES
i I I 130.685 SO. FT.
C I I -B.0.- 935.5 ? 1a
I 1N BENCH MARK: TOP
100' --- OF 1" LRON Pff-
y i ELEVATION 928.3
LOT
3 4.w
i ( 34.58' 404,61 N18 3.000
rt S89 °88'39 "E 439.19' w 130.682
I 1 30 LB.o.-
z I
I � �
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LOT 1 C.S.M. IN 3 d
VOL. 19 PG. 4997 to
I ----------- - - - - -- g N S89- 51'08`1
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I
P � w
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P 19 I I
.3V��
WON
GRAND PROPERnES LP -'-!I FA' on
Riv St. Somerset, M 54025
J OSEPH. TOW OF ST.
PR ELIMINARY
f
SEPTIC TANK °LAMP Ch AF CROSS
WEATHERPROOF APPROVED
4 CI' VENT" 1,2 �1• 'p,80VE GRADE � JUNCTION BOX
25' FROM DOORt WINDOW OR WITH CONDUIT MANHOLE COVER
NTAKE WI PADLOCK £
FRESH AIR I
.�-- WARNING LABEL
FINISHED GRADE 411 CI RISER 4" MIN.
16" IN. 6 N Mme +�
' NLET
WATER TIGHT SEALS GAS -
�"'" TIGHTi PPROVED
A SEAL JOINTS WITH
__L-- ALM APPROVED PIPE
P PROV ED A ' ON 3' ONTO
IPE 3' SOLID SOIL
NTO SOLID C I ** RISER EXIT
OIL PUMP OFF ELEV . T. - - ~ OFF
F PERMITTED ONL`
D IF TANK
MANUFACTURER
HAS APPROVAL
all APPROVED. BEDDING UNDER TANK CONCRETE PAD
SPECIFICATIONS
SEPTIC / DOSE NUMBER DOSES PER DAY: _..._.
TANK MANUFACTURER:
TANK SIZES : SEPTIC DOSE V OLUM£ INCLUDING GAL.
1. - � GA L. F LpWBAC K : 1_,.._........_
DOSE GAL.
CAPACITIES: A = INCHES "- GAL
ALARM MANUFACTURER: �� B s r te ! INCHES s Y2 GAL
MODEL NUMBER: - -_- --
SWITCH TYPE: yri c r —
C _ $ INCHES =GAL
PUMP MANUFACTURER: o a * INCHES @AL
MODEL NUMBER: a D = „�,
SWITCH TYPE:
TLHR -I6.23' WP
RE
GE RATE GPM PUMP & ALARM WIRING AS PER
D D I SCHAR-
U IRE T
Q ,,� F
N PUMP GFF AND DISTRIBUTION PIPE • ' FEET
ETWEE •
VERTICAL DIFFERS SURE FEET
ES
ORK SUPPLY PR FACTOR
UM NETW FRI CTION + MINIM FT, FRI FEET
FTI1.00
II3 X
+� FEET FQRCEMA TOTAL DYNAMIC HEAD
DIAMETER
NAL DIMENSIONS OF PUMP TANK: LENGTH ...� WIDTH, 7�,&,/
INTER LIQUID
LICENSE NUMBER s7 �7Q'p� DATE
67
SIGNED:
K GOULDS PUMPS Submersible
Effluent PUMP
i
3871 EPO4
EP05
i
■ EP05 impeller: Thermoplas- ■Bearings: Upper and lower
APPLICATIONS • Fully submerged in high tic enclosed design for heavy duty ball bearing
grade turbine oil for roved construction.
Specifically designed for the lubrication and efficient imp Pe
following uses: heat transfer. ■Casing and Base: Rugged AGENCY LISTING
• Effluent systems thermoplastic design provides
• Homes Available for automatic and superior Strength and corrosion �, CmOSm Sta Ax6 Awodedw
• Farms manual operation. Auto- resistance. numbers end
matic models in M Motor Housing: Cast iron ( listed model
•Heavy duty sump
• Water transfer Mechanical Float Switch for effident heat transfer, in or or "Co.)
• Dewatering assembled and preset at the strength, and durability.
factory. ■ Motor Cover. Thermoplastic Goulds? "P if 'so 9W
SPECIFICATIONS FEATURES cover with integral handle and
• Solids handling capability: float switch attachment points.
■ EPO4 Impeller: Thermoplas- M power Cable: Severe duty
maximum.
•
Capacities: up to 60 GPM. tic Sem vanes f mechanical ated oil and water resistant.
• Total heads: up to 31 feet. pump out
• Discharge size: `h" NPT. seal protection.
• Mechanical seal: carbon -
rotary/ceramic- stationary
BUNA N elastomers.
•Temperature: ..__
104•F (M continuous
METERS FEET
140°F (60°C) intermittent. 10
.... _.....
• Fasteners: 300 serves
stainless steel. 9 30
1 ;
• .. Fr
Capable of running
i. .
4
S
dry without damage to s -
components. zs!_ +_. _... _.
Motor. =
u 6 zoo _
• EPO4 Single phase: 0.4 HP, — i. , _. ... __� _ ... _ . _
-
.._ _
11 S or 230 V, 60 Hz, 1550 " "
5 _..._ _ —'- ----
RPM, built in overload with �� ;
EP05 •-
automadc reset a a --
•
EPOS Single phase: 0.5 HP,
115 V, 60 H7,1550 RPM, ! .. _.._�..._ EPO4 -
built in overload with
2 . .....
automatic reset. .
5 ,. . l I_. __...
• Power cord: 10 foot
1 i
standard length. 16(3 _... as 1__._ . _.__._.... _. _ -.._.. _ ._ GPM
:,.._.._._..__..
SJTOW with three prong o o o..,,.,_....__. _._';o.. __.20 30
grounding plug. Optional 10
foot length, 16/3 SJTW with a 10 12
m °/h
three prong grounding plug o 2 a s
(standard on EP05) CAPACITY Goulds PU MPS
ITT Industries
®2000 Goulds Pumps <&
Effective February, 2000
83871
POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page of
FILE INFORMATION f aLA, SYSTEM SPECIFICATIONS
Owner ,'r F S� pis Tank Capacity QDQ al ❑ NA
Permit # Septic Tank Manufacturer ,'CSe ❑ NA
DESIGN PARAMETERS
Effluent Filter Manufacturer tP'A �. � C• / ❑ NA
Number of Bedrooms 3 ❑ NA Effluent Filter Model '.�,$� ❑ NA
Number of Public Facility Units ❑ NA Pump Tank Capacity gal ❑ NA
Estimated flow (average) jf al /da Pump Tank Manufacturer Se ❑ NA
Design flow (peak), (Estimated x 1.5) Pump Manufacturer �aG ❑ NA
�� gal /da
Soil Application Rate al /da /ftZ Pump Model El NA
Standard Influent /Effluent Quality Monthly average* Pretreatment Unit ❑ NA
Fats, Oil & Grease (FOG) 530 mg /L ❑ Sand /Gravel Filter ❑Peat Filter
Biochemical Oxygen Demand (BOD 5220 mg /L ❑ NA ❑ Mechanical Aeration ❑ Wetland
Total Suspended Solids (TSS) 5150 mg /L ❑ Disinfection ❑ Other:
Pretreated Effluent Quality Monthly average Dispersal Cell(s)
❑ NA
Biochemical Oxygen Demand (BOD 530 mg /L ❑ In- Ground (gravity) ❑ In- Ground (pressurized)
Total Suspended Solids (TSS) 530 mg /L ❑ NA ❑ At -Grade ❑ Mound
Fecal Coliform (geometric mean) 510 cfu /IOOMI ❑ Drip -Line ❑ Other:
Maximum Effluent Particle Size Y in dia. ❑ NA Other' ❑ NA
Other: ❑ NA Other: ❑ NA
* Values typical for domestic wastewater and septic tank effluent. Other: ❑ NA
MAINTENANCE SCHEDULE
Service Event Service Frequency
Inspect condition of tank(s)
At least once every: eaf( }(s) (Maximum 3 years) ❑ NA
Pump out contents of tank(s) When combined sludge and scum equals one -third %) of tank volume ❑ NA
❑
month(s) (Maximum 3 years) ❑ NA
Inspect dispersal cell(s) At least once every: .� year(s)
months) ❑ NA
Clean effluent filter At least once every: years)
❑ month(s) El NA
Inspect pump, pump controls &alarm At least once every: *-- ❑ years)
' ❑month(s) ❑ NA
Flush laterals and pressure test At least once every: ❑ years)
❑ month(s) ❑ NA
Other: At least once every: ❑ year(s)
Other: ❑ NA
MAINTENANCE INSTRUCTIONS
Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications:
Master Plumber; Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer; Septage Servicing Operator. Tank
inspections must include a visual inspection of the tank(s) to identify any missing or broken hardware, identify any cracks or leaks,
measure the volume of combined sludge and scum and to check for any back up or ponding of effluent on the ground surface.
The dispersal cell(s) shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding
of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a failing condition and requires the
immediate notification of the local regulatory authority.
tank volume, the entire
um in an tank equals one -third (Y or more of the
accumulation of sludge and scum Y .
When the combined c 9 NR 113,
or and disposed of in accordance with chapter
b a Se to a Servicing Operator P
removed p 9
c
contents of the tank shall be Y
Wisconsin Administrative Code.
All other services, including but not limited to the servicing of effluent filters, mechanical or pressurized gomponents, pretreatment
units, and any servicing at intervals of 512 months, shall be performed by a certified POWTS Maintainer.
A service report shall be provided to the local regulatory authority within 10 days of completion of any service event.
SEPTIC TANK & PUMP CHAMA R C SA IQN AND SPF +CATIONS
rr. ••
Page of
$TART UP AND OPERATION _ _.._ - .. _....- ..._ -- - ._ - -__ _.._...._.__..�:.._ _ -.- "� �-•
For new construction, prior to use of the POWTS check treatment tankisl for the presence of painting products ions are detected have the contents
or other che -
that may impede the treatment process and/or damuge the dispersal celi(s). If high concentrat
of the tank(s) removed by a septage servicing operator prior to use.
System start up shalt not occur when soil conditirns are frozen at the infiltrative surface. wastewater w)11 be
During power outages pump tanks may fill above normal highwater levels. When power is rest the excess
writ
discharged to the dispersal coils) in one large dose, overloading the ceilis) and may result a SheicbackOpossurfP store
effluent. To avoid this situation have the contents of the pump tank removed by a Sep g
power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to
restore normal levels within the pump tank.
the area
Do not drive or,park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact.
within 15 feet down slope of any mound or at -grade soil absorption area. the
Reduction or elimination of the following from the wastewater stream
ab , imp reasers; dental floss diapers; pe disinfectants; fat
POW antibiotics; baby wipes; cigarette butts; .condoms; cotton • meat scraps; medications; oil;
foundation drain (sump pump) water; fruit and vegetable peelings; g asoline; grease; herbicides '
painting products; pesticides; sanitary napkins; tampons; and water softener brine.
ABANDONMENT shall be taken to insure that the system is
When the POWTS fails and/or is permanently taken out of service the following steps
properly and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code:
• All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed.
• The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator.
• After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with
soil, gravel or another inert solid material.
CONTINGENCY PLAN
If the POWTS fails and cannot be repaired the following measures have been, or.must be taken, to Provide a code compasnt
replacement system:
d may be utilized for the location of a replace men so il absooptlor
❑ A suitable replacement area has been evaluated an
system. The replacement area should be p sed str cture Lot lines and wells. Failure to protect the replacement area wil
required setbacks from
existing .artd proposed stru ,
result in the need for a new soil and site evaluation to establish a suitable replacement area. Repl�ement systems m
comply with the rules in effect at that time.
13 A suitable replacement area is not available due t setback l� f o i l l POWTS $ Barring advances in POW
technology a holding tank may be installed as a last resort sit
tar
A ° s .
1 at at tr
V be El Mound and at -grade soil absorption sy nchs ems must comply r econstruc ted
in the iinleffect at that r em ov a l om
infiltrative surface. Reconstructions of s y.
< <WARNIN
G > >
S ANDIOR INSUFFICIENT OXYGEN. DO NC
gEisTlC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL (iASSE
NK UNDER ANY CIRCUMSTANCES. DEATH MAY
ENTER A SEPTIC, PUMP OR OTHER TREATMENT TA RESUL RESCUE O
PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR
ADDITIONAL COMMENTS
POWTS MAINTAINER
POINTS IN STA LER Name
Name Phone
`�1.: u ,� Q e Phone Phone
LOCAL REGULATORY AUTHORITY
SEPTAGE SERVICING OPERATOR (PUMPER) 26A,
Name G(o
Phone 3$l0 0 6
Phone ive Code•
dstrat
This document was drafted in compliance with chapter Comm 83.22121(b)111(d) &If) and 83.54111, (21 & (3), Wisconsin Adfor
3
ST CROIX COUNTY
SEPTIC TANK MAINTENANCE AGREEMENT
' AND
OWNERSHIP CERTIFICATION FORM
Owner/Buyer
Mailing Address 7/ 1 `t /'UA46 .ST, 1 sE 41 i
Property Address T�
(Verification required from Planning Department for new construction)
City/State 4 a d s o y Parcel Identification Number RL�
LEGAL DESCRIPTION
Property Location _51& i /4, i /4, Sec. 76 T -R_L�_W, Town of L T %r�s� E /
i
Subdivision "U L I S Rio &
, Lot # �.
Certified Survey Map # Volume . .Page # '
Warranty Deed # Volume I P11 , Page # 61Y -
Spec house ® yes 0 no Lot lines identifiable 0 yes 0 no
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.
The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a
masterplumber, journeymanplumber, restricted plumber or a licensed pumper verifying that (1) the on -site wastewaterdisposal system f
is is 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 of Wisconsin. Certification
stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 i
days of the three year expiration date.
SIGNATURE OF APPLICANT DATE
OWNER CERTIFICATION
I (we) certify that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owner(s) of
the property described above, by virtue of a warranty deed recorded in Register of Deeds Office.
i
e
7 a - I o-
SIGNATURE OF A&PLICANT DATE
e � i
* * * * ** Any information that is nts- represented 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
a copy of the certified survey map if reference is made in the warranty deed
f
t
�(�W� •Jbnu�lrv�C(\ rLU1 lO11Y1.i fI"1/Y IVU. •f1JJOOJltl P. 1JJ GvJrJJ lYJ•JJrv fG
ST. CROLX COUNTY
SEPTIC TANK MAINTENANCE AGREEMENT
AND
OWNERSHIP CERTIFICATION FORM
OwnerBuyer . L? r s`rn6 C) f�C 'C�I f,.�
Mailing Address `7 l 'Z IR - N"Ar(J
Property Address ` OZ. -- I ? +t% 4%)e ---- AkJ So✓1 516-1 c, _.
(Verification mph from Plannning & Zoning Deparment for new oonstraction.)
(
City /State Parcel identification Number
LEGAL DESCRIPTION
Property Location SI,� '/. , N k '/. , Sec. 3( T 3 0 N R / W, Town of :5� Vo
Subdivision �bV'cc .� i�d[c- . Lot #
Certified Survey Map # _ _ _ „ , Volume _ ,_. „•„ , Page #
Warranty Deed # , Volume 314 , Page # 3 zn z
Spoc house yes no Lot lines identifiable yes no
SYSTEM MAINTENANCE AND 2MER CERTIECATION
Improper use and maintenance of your septic syat.em could result in its premature faffin to hmmo 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 §Conan. 83.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance.
'I•he pruperty owiwr agtvwr to submit to St. Croix County planning & 7.onmg Department a certification form signed by the
owner and by a mraur phrmber, journeyman plumber, mstrictod plumber or a licensed pumper verifying that (1) the on -site
wastewater disposal system is in proper operating condition and/or (2) after inspootiou and pumping (if noeossary), then septic tank. is
lea than 113 full of sludge.
I/we, the undersigned have read the above requirenwats 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 Rosources, State of Wisconsin.
Certification stating that your septic system has bean maintained must be completed and teturned to the St. Croix C'outrty PLrming &
Zoning Department within 30 days of the three your expirstinn date.
i /we certify that all statements on this forni are true to the bot of my /our knowledge. Uwe ardare the owners) of the
Prop" described above, by virtue of a warranty deed recorded in Register of Dee& Office.
Number of bedrooms
SIGNA OF APPL,ICANT(S) DATE
' "Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning DepaMnenr.
Include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified surrey map if
reference is made in tyre warranty deed.
ST. CROIX COUNTY
SEPTIC TANK MAINTENANCE AGREEMENT
AND
OWNERSHIP CERTIFICATION FORM
Owner /Buyer �)D 2=L
Mailing Address /
Property Address l o�� 'f �`f — - 1 K c'o n
(Verification required from Planning & Zoning Department for new construction.)
City /State Parcel Identification Number
LEGAL DESCRIPTION / - ? I 4 — ,
Property Location t/a , '/a ,Sec. , T _�O N RLW, Town of
Subdivision i fia 2 1 0- , Lot # �.
r
Certified Survey Map # , Volume , Page #
4
Warranty Deed # , Volume �-�y , Page # '37
Spec house yes ?no
Lot lines identifiable yes no
SYSTEM MAINTENANCE AND OWNER CERTIFICATION
Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper
m
maintenance consists of pumping out the septic tank every three years or sooner, if needed, by a licensed pumper. What you p ut into
is 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 Planning & 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
Jess 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 of Wisconsin.
Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Planning &
Zoning Department within 30 days of the three year expiration date.
I /we certify that all statements on this form are true to the best of my /our knowledge. I /we am/are the owner(s) of the
property described above, by virtue of a warranty deed recorded in Register of Deeds Office.
Num er of bedrooms
_L0 6
SI ATURE OF APPLICANT(S) DATE
** *Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Department. * **
Include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if
reference is made in the warranty deed.
(REV. 08/05)
U 2 8 1 2 P 6 1 8 7964m4 u
• KATHLEEN H. WALSH
DOCUMENT No.
1. STATE BAR OF WISCONSIN FORM1 —1 998 REGISTER OF DEEDS
ST. CROIX CO., WI
!' WARRANTY DEED
i RECEIVED FOR RECORD
06/01/2005 11s40Aii
This,. Deed a� e._bet�rZa --- Ray.._ a__- Arctwr .L_.and-------- ------ ----- WARRANTY DEED
l�anax �_.,7. _.Rz osan. husband .and- _snzi£� ,�rasltoss- ------ -- EXEWT it
-- -- -- ----- ------ ----- ---- . - - --- REC FEE: 13.00
and Grand__ Pxoper_ t3ss-,__- I. -------------------------------------------------------- TRANS FEE% 5445.00
.......................................................... Gwan- tee-------------------------------------- COPY FEE:
°-... -.._.. ( CC FEE:
.....---- -_- ••-•-- ••-_-...... ••••••-------••••-•-•---._...-••----------- ----- •__••_- -•__•_-- -•- •__-.._.
f PAGES: 2
..._...... •-- ...- -•-- •-- ..... - -• •-• ..............•--•-••••-•----••--•---•--_•----- -- ......-•- _•- -•_........._....
the following described real estate in .. ........ ......... •...... County,
State of Wisconsin: To
See Attached Exhibit A
Tax Parcel No: - -S .... !���.:
0
oho • -�'� -�
1
Together with all appurtenant rights,title and interest.
Grantor warrants that the Title to the Property is good,
indefeasible in fee simple and free and clear of encumbrances
This ......... nP.t............ homestead property.
(ls) (is not)
Datedthis .............. .. .3.1- 9t ............ .......... day of ................ May ....... ........ ---- •------- -------- ---- - - - -- 1920ja5
................................... .................................. (SEAL) '`?��^ ..:1_� ?yir................(SEAL)
w .......................... ........................ • .............. RaY.��z.. B 1�. 4. I�FI..... ...............................
.......... .................................... (SEAL) v ............ (SEAL)
. .....................•--•.......... .._.._......................... * .'Ell i I1QX. @..aT —_. $rccwn.........................
AUTHENTICATION ACKNOWL13DGMIMNT
Signature (a) ....................................... - \.\A.... .. STATE OF WISCONSIN
.f faCe� �. $ fib Lt_
\\ } sa.
(� . S O -- 5� I:ra3.X ..............County.
authenticated this -------- day of_.>�Q a 'g1. C_'., 19 ------ Personally came before me tl a ..31st,.._. day of
6 O __ . May --- ---- - --- 1920A.5the above named
.. .............................•• .gam--•---- • ••----- ---- -- -- - - -- tt,Y._. .. �zahrl7t.. aztd ... El.eanara.-1
' _.Rzamn husband.. and ..waif$ .......................
TITLE: MEMBER STATE BAR OF WISCONSIN
(If not. ............................................................
authorised by $ 706.06. Win. Stets.) °° -- _ _ -...
...... °--•.. ._.
executed be e
to me own to t perao ....._... who executed the
foreg frame an e e same. I
/,••THIS INSTRUMENT WAS DRAFTED BY I
1.�r.A. ........ . . . ......
...... g.. A.._.. F... z: ir., tcs�on----- ----- -- -------- -•------ -..._ ... .........................
Erickson and Schuller LLC �•..... . " ' ' "• " " .. ""
t ............. Notary Publi .........County, Wis.
(Siunaturos may be authenticated or acknowledged. Both My Com lemon is permanent. (If not, state expiration
are not necessary.) date: I .. C.. . .... ..... ............................... 19 .........
U. 2812P 619
Exhibit A
A parcel of land located in the SW 1/4 of the NW 1/4, the SE 1/4 of the NW 1/4, the NW 1 4 of
the SW 1/4 and the NE 1/4 of the SW 1/4, all in Section 36, Township 30 North, Range 19 West,
Town of St. Joseph, St. Croix County, Wisconsin, described as follows: Commencing at the West
Quarter corner of said Section 36; thence along the west line of said NW 1/4 of the SW 1/4 South
00 degrees 47 minutes 44 seconds East a distance of 454.21 feet to the pow of beginning; thence
continuing along said wCst line South 00 deErees 47 minutes 44 seconds East a distance of 874.58
feet to the Southwest corner of said NW IXof the SW 1/4; thence along the south lime of said NW
1/4 of the SW 1/4 North 89 degrees 37 minutes 16 seconds East a distance of 100.74 feet to the
centerline of County Trunk Highway "A", being a 1041.74 foot radius curve, concave southeasterly,
with a central angle of 33 degrees 24 minutes 44 seconds, a chord that bears North 43 degrees 07
minutes 11 seconds East and measures 598.92 feet; thence northeasterly along the arc of said curve
and centerline a distance of 607.49 feet to the point of tangency; theme along said centerline North
59 degrees 49 minutes 33 seconds East a distance of 432.98 feet to the point of curvature of a
1145.92 foot radius curve, concave southeasterly, with a central angle of 14 degrees 16 minutes 46
seconds, a chord that bears North 66 degrees 57 minutes 56 seconds East and measures 284.85 feet;
thence northeasterly along the arc of said curve and centerline a distance of 28559 feet to the point
of targencr, thence along said centerline North 74 degrees 06 minutes 19 seconds East a distance of
408. 25 feet to the point of curvature of a 572958 foot radius curve, concave southerly, with a central
angle of 05 degrees 06 minutes 58 seconds, a chord that bears North 76 degrees 39 uunutes 48
seconds East and measures 511.44 feet; thence easterly along the arc of said cuuve andc;enterline a
distance of 511.61 feet to the point of tangency, thence along said centerline North 79 degrees 13
minutes 17 seconds East a distance of 461.97 feet to the point of curvature of a 881.47 foot radius
curve, concave northerly, with a central angle of 09 degrees 50 minutes 52 seconds, a chord that
bears North 74 degrees 17 minutes 51 seconds East and measures 151.31 feet; thence easterly along
the arc of said curve and centerline a distance of 151.50 feet to the east line of said NE 1/4 of the
SW 1/4; thence along last said line and the east line of said SE 1/4 of the NW 114 North 00 degrees
19 minutes 19 seconds West a distance of 152726 feet to the northeast corner of said SE 1/4 of the
NW 1/4• thence along the north line of said SE 1/4 of the NW 1/4 and the SW 1/4 of the NW 1/4
North 83 degrees 51 minutes 08 seconds West a distance of 2642.99 feet to the northwest corner of
said SW 1 /4 - of the NW 114; thence along the west line of said SW 1/4 of the NW 1/4 South 00
degrees 08 minutes 20 seconds West a distance of 912.35 feet; thence South 89 degrees 58 minutes
39 seconds East a distance of 439.19 feet; thence South 00 degrees 03 minutes 30 seconds West a
distance of 51531 feet; thence South 50 degrees 36 minutes 55 seconds West a distance of 560.70
feet to the point of beginning.
Abstract.
o.c. a/M
Wiscon Department of Commerce PRIVATE SEWAGE SYSTEM County:
Safety and Building Division
' INSPECTION REPORT Sanitary Permit
479351 0
(ATTACH TO PERMIT)
GENERAL INFORMATION State Plan No:
Personal information Ou provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)].
Permit Holde's Name: City Village X Township Parcel Tax No:
Grand Properties L.P. St. Joseph, Town of
CST BM Elev: Insp. BM Elev: 7 Description: Section/Town /Range /Map No:
36.3Q.19.
TANK INFORMATION ELEVATION DATA •`
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic Benchmark
Dosing Alt. BM
Aeration Bldg. Sewer
Holding St/Ht Inlet
St/Ht Outlet
TANK SETBACK INFORMATION
TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet
Septic t Botto
Dosing eade Man.
Aeration i . Pipe
Holding ot. Sys
f t
Final Grade
PUMP /SIPHON INFORMATION
Manufacturer a Demand =
1 GPM
Model Number r°
E ,
TDH Lift Friction Loss stem Head TDH Ft
f .
Forcemain Length Dia. Dist. to well
A�
SOIL ABSORPTION SYSTEM
BEDITRENCH Width Length No. Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth
DIMENSIONS I i
SETBACK SYSTEM TO J P t JBLDG IWELL LAKE /STREAM LEACHING Manufacture,
INFORMATION CHAMBER OR
Type Of System: UNIT Model Number.
DISTRIBUTION SYSTEM
Header /Manifold Distribution x Hole Size x Hole Spacing Vent to Air Intake
Pipe(s)
Length Dia I Length Dia Spacing
SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only
Depth Over Depth Over xx Depth of xx Seeded /Sodded xx Mulched
Bed/Trench Center Bed/Trench Edges Topsoil Yes U No L J Yes L No
COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / / Inspection #2:
Location: 802 126th Avenue Hudson, WI 54016 (SW 1/4 NW 1/4 36 T30N R1 9W) Natalie's Ridge Lot 1 Parcel No: 36.30.19.
1.) Alt BM Description =
2.) Bldg sewer length =
- amount of cover =
Plan revision Required? ] Yes 1 No
Use other side for additional information. _
Date Insepctor's Signature Cert. No.
SBD -6710 (R.3/97)
Safety and Buildings Division County
201 W. Washington Ave., P.O. Box 7162 X
Visconsin M adison,
(0) �CEIVED anitary Pertnit umba(tobefill�ICo.)
Departrl'tent of Commerce 60 266- Y
ST Plan I.D. Number
Sanitary Permit Applica on�� 2
In accord with Comm 83.21, Wis. Adm. Code, personal inform lion y td 8 2 005
may be used for secondary purposes Privacy Law, sl S (I Xm) Pr 'ect Address (if different than mailing address)
ST. $02
1. Application Information - Please Print All Information OFFICE
Property Owner's Name O Parcel # Lot # Block #
Property Owner's Mailing Address Property Location
Section
City, State Zip Code Phone Number
_
(circle one)
/ Q 7 S T � N; R_Zf E otg
II. Type of Building (check all that apply)
' $� Subdivision Name CSM Number �/ O
1 or 2 Family Dw °Iling - Number of Bedrooms f
❑ Public/Commercial - Describe Use Y7 l�l� `7? -
❑ State Owned - Describe Use . City_ ❑Village INTownship of
III. Type of Permit: (Check only one box on line A. Complete line B if applicable)
A ' 11 New System ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System
B. ❑Permit Renewal El Permit Revision ❑ Change of ❑Permit Transfer to New
List Previous Permit Number and Date Issued
Before Expiration Plumber Owner
IV. Type of POWTS System: Check all that apply)
s T
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 ❑ Holding Tank ❑ Peat Filter ❑ Aerobic Treatment Unit ❑ Recirculating Sand Filter ❑
Recirculating Synthetic Media Filter 8 Leaching C r El Drip Line ❑Gravel -less Pipe ❑
V. Dis ers2LfTreatment Area Information: 1 U
Design Flow (gpd) Design Soil Application Rate(gpdsf) / Dispersal Area Required (sf) Dispersal ea Propos System Elevation
yS0 v SO 7 7 . >/
LO
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 / 000 o
Aerobic Treatmcnt Unit tN
Dosing Chamber
VII. Responsibility Statement- I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans.
Plumber's Name (Print) Plum Signature M Business Phone Number
Plumber's Address (Street, City, State, Zip ode) "
L t IF feu)
VIII. unt y/ cpartment4Jse Onl
Approved El Disapproved Sanitary Permit Fee (includes Groundwater D 7 Issue suing A en igna e ( ps)
Surcharge Fee) �� g
❑ Owner Given Reason for Denial r
IX. Conditions of Approval /Reasons for Disapproval
, - SY&TEM OWNER:
1 ptic tank, effluent ilter and ��grL - ����
dispersal cell must all be serviced / maintained /�1 �jj� B3 ale-
as per management plan provided by plumber. U ✓ ' h , U "(
2. All setback requirements must be maintained �
as per applicable code /ordinances.
6W 46u-
Attach complete plans (to the County only) for the system on paper not less than 81R x 11 inch size
SBD -6398 (R. 01/03)
Pao. or
POWTS OWNER'S MANUAL & MANAGEMENT PLAN f'
4 FU INFORMATION SYSTEM SPECIFICATIONS
'
Owner Septic Tank Capacity 1000 al 13 NA
Grind Properties L.P.
Perrrsit 0 Septic Tank Manufacturer Week' s. C . P . D '
DESIGN PARAMETERS ' Effluent Fitter Manufacturer Zabel
Numb or of Badiooma 3
•
D NA Effluent Filter Modal A -100 CJ.NA•.
NA
Number of Public Facility Units . NA Pump Tank Capacity gal 0
Estimated flow (average) 300 gal/da
Pump Tank Manufacturer ■ NA
Design flow (P", (Estimated x 1.5) g al/da y
Pump Manufacturer ■ NA
Soli Application Rata 0 a. al /da /ft' Pump Model Y
Standard Influent/Effluent Quality Monthly average* Pretreatment Unit ■ NA
Fats, Oil & Grosse (FOG) S30 mg /L D Sand /Gravel Filter O Peat Filter
_ Wochem" Oxygen Demand (BODJ 5220 mg /L 0 NA 0 Mechanical Aeration ❑Wetland
Total Suspended Solids (TSS) 5150 mg/L 0 Disinfection 0 Other
Prgtreated Effluent Quality;;:..: Monthly average Dispersal Call(s) O NA
8tochemical Oxygen Demand (600.1 530 mg /L' 0 In- Ground (gravity) 'O In- Ground (pressurized)
¢ Total Suspended Solids (TSS) 530 mg /L E NA D At -Grade 0 Mound
Fecal Collform (geometric mean) 510 cfu/100m1 0 Drip - Line 0 Other:
Maximum Effluent Particle Sits Y. In dia. D N.A
Other: El NA
Other. D Other: DNA .
� w Other. DNA •
• Vatws typical for donw as
silc wteater and septic tank effluent.
Y.
t.
' MAINTENANCE SCHEDULE
Service Event Service Frequency
❑ month(s) (Maximum 3 years) D NA•
inspect condition of tank(s) At least once every: 3 earls!
Pump out contents of tux(s) When combined sludge and' scum equals one - third (Y of tank volume q NA.;
0 month(s)
{ At least once every: ® aerial (Maximum 3 years) 0. NA': {
S <. Inspect dispersal collie) 3
I � ❑ month(s) ❑:Nq: ;
Clean effluent filter i' At least once every: 1. I 1)1 ear(s)
❑ month(s) NA;
Inspect pump, pump-controls & alarm At least once every: ❑ ear(s)
' IJ month(s) * NA,'•
Flush laterals and pressure test At least once every: ❑ earls!
❑ month(s)
Other:. At least once ovary: ❑ year(s) Q•NA
Other: O NA= 4
MAINTENANCE INSTRUCTIONS `
I of tank; and dispersal Coils shall ba made by an individual carrying one of the following licenses or cetrtl #Icati a '
Master Plumber; Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer, Septago Servicing .Operat.. . -.
inspections must Include a; visual inspection of the tank(&) to Identify any missing or broken hardware, identify any..cracl�s or ' leaks
measure the volume of combined sludge and scum and to check for any back up or pending of effluent on the ground s e
The dispersal call(s) shall be visually Inspected to check the effluent lovels in the observation pipes and to chock .for any,.po�d
of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a faIling condition and requke�e
Imm ediate notification of the local regulatory authority.
M• .
When the combined accumulation sludge and scum in any .tank equals one -third (Y or more of the tank volume; the .;on,.,tite..
contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter. NR:.l t 1,3;
Wisconsin Administrativa Code.
All other services, including but not limited to the servicing of effluent filters; mechanical or pressurized components,, pretreatment
units,.and any servicing at intervals•of S12 months, shall be performed by a certified POWTS Maintainer. .: {
.:.t:
any service event.:
A service report shall be provided to the local regulatory authority within 10 days of completion of ,;;a;
Page of
START UP AND OPERATION
For n4W Cutructlon. prior to use of the POWTS check treatment tank(s) for the presence of painting products or other chonticals
on
that may irnpede the treatment process and/or damage the dispersal call(s). If high concentrations are detected have the contents
of the tank(s) ranZived by a "pugs servicing operator pr o use.
System start up "not occur whbn sot conditions are-frozen at the Infiltrative surface.
During power outages pump tanks may fill above normal hIghwater lbvels. When power is restored the excess wastewater will be .
discharged to the dispersal cells) in one large dose, overloading the cell(s) and may'result in the backup or surface discharge of
effluent. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring
power to the effluent pump or contact a Plumber or POWTS MaIntainer to assist in manually operating the pump consols to
restore normal levels within the pump tank.
Do not drive or park vehicles over tanks and dispersal cells. Do-not drive or park over, or otherwise disturb or compact, the area
within 16 feet down slope of any mound or at -grade soil absorption area.
Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the
POWTS: antibiotics; baby wipes; cIgarotta butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat;
foundation drain (stunp pump) water: fruit and vegetable peelings; gasoline, grease; herbicides; meat scraps; medications; oil;
painting products; pesticides; sanitary napkins; tampons; and water softener brine.
ABANDONMENT
When the POWTS fails and /or Is permanently taken out of service the following steps shall be taken to insure that the system is
properly and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code:
• All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed.
• The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator.
• After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space tilled with
soil, gravel or another inert solid material.
CONT)NGENCY PLAN
if the POWTS fails and cannot be repaired the following measures have been, or. must be taken, to provide a code compliant
replacement system:
■ A suitable replacement area has been. evaluated and may be utilized for the location of a replacement soil absorption
system. The replacement area should be protected from disturbance and compaction and should not be infringed upon by
required setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement. area will
result In the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must
comply with the rules In effect at that time.
17 A suitable replacement area Is not available due to'setback and /or soil limitations. Barring advances in POWTS'*�`
technology a holding tank may be installed as a last resort to replace the failed POWTS.
Th sit as no been evaluated to tify a s ale replace nt area. o fail e o the P S . it and site .'.•
a on t b perfor to ate sui ere laceme a ea. If ore c ent are i WS
a h g k'
y e Installed as I eso o replac failed P
Mound and at -grade soil absorption systems may be reconstructed in place following removal of the biomes at that:
Infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time.
«WARNING»
SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND /OR INSUFFICIENT OXYGEN. DO NOT
ENTER A SEPTIC, PUMP'dR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A
PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE.
ADDITIONAL COMMENTS
POWTS INSTALLER POWTS MAINTAINER
Name' Schmitt Name Owners choice
.�
Phone Phone
SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY
Nam
Name hoice e St . Croix Ct . Zonin
Phone
:: p hone 715 386 -4680 t
Wisconsin Administrative Code.
This document was drafted In compliance with chapter Comm 83.22(2)(b)(i)(d) &(f) and 83.54(1), (2) & (3),
79 J
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EASEMENT 'D°
DIRECnON DIST.
Of S177838 E 50.06
' I D2 S09V9'30 0 W 89.65'
NW 00 R• D3 S76172 "W 24.77'
.36 D4 N565337 "W 6788'
I
D5 N2176 . 53"W 11.E l9
N
� 06 58951 0 8 E 121.21
D7 S0079 - 19 "E 136.27'
I 229.03 D6 231.32
3 DRAINAGE BENCH MARK:
I
`` EASEMENT "D" ; OF 1" IRON PIF
I
J—, oo- - ° cry H.W.E. = t ELEVATION 927
927.2 v
I 6 6' 8.0.= 929.2 \ fiN
33' 33' I 1
der
I � � p3
I
LOT 1
LOT 2
I 3000 ACRE
LINE TABLE 3'000 ACRES 130.682 SO.
DRAINAGE Z �30 SO. FT.
m LB-0.- 935
EASEMENT °E" zI -� I
DIRECnOW DIST.
£1 S8951'08 0 E 90.39' �iI ;+►
£2 N15 40'53 "E 8Q49' \#
E3 N3273'07 "W 65.53' I (� �` LB.0.= 935.5
E4 N7224'25 "W 81.93'
£5 N722425 "W 98.11'
£6 N2",6'18"W 109.77' 1 O
E7 S7341 7 W 91.94' O
£8 S00V8'59 "W 25523' ( O F
£9 S0079'19 1 E 15746' I H.W.E.= 933.5 \
L DRAINAGE
o v
EASEMENT
I 233:86' E
r" w N s
i 19 1'os "w 7
N 9'S
� J
o DRAINAGE
I I EA N" _
I N I \ H.W.E.= 933.5
LOT 32
3.000 ACRES "30
130.685 SO. FT.
I I L.B.O.= 935.5 z
s ,00' i
Its
1-
— 11 34,51W