HomeMy WebLinkAbout020-1171-10-001Wisconsin Department of Commerce
PRIVATE SEWAGE SYSTEM
county St. Croix
Safety and Building Division
INSPECTION REPORT
Sanitary Permit No
GENERAL INFORMATION
(ATTACH TO PERMIT)
631240
State Plan ID No
Personal information you provide may be used for secondary
purposes [Pnvacy Law s 15 04 (1)(m)I
Permit Holder's Name
Justin & Ashley Adducci
City Village Township
I TOWN OF HUDSON 1
Parcel Tax No.
020-1171-10-001
TANK INFORMA
TYPE
MANUFACTURER n •1 n
CAIYACITY
Septic
tit",
Dosing
Holtling
TANK SETBACK INFORMATION 1.APIid'5nrQ WA),. c
PUMP/SIPHON INFORMATION
umber
Ft
SOIL A
ELEVATION DATA
STATION
BS
HI
FS
ELEV
Benchmark
Alt BM
l
B d Sewer
�
y1
.65
SVHt Inlet JA
fI Lh
17
SVHt Outlet
q
D Inlet
Dt Bttom
Header/Man
�t
Dist Pipe
.03
r .a
s
Bot Syslemll•
3
�•
Final Grade
7 g'�
l
�`Y
/o3.gI
( _•—I /e 4 t^ i--7 7-1— 1-,
BED/TRENCH
DIMENSIONS
Width n
[,ISETBACK
Length
No Of T has
PIT DIMENSIONS
No Of PitsJR91de,
Liquid Depth
SYSTEM TO
P/L �j
BLDG
WELL
LAKE/STREAM
LEACHINGreINFORMATION CHAMBER ORTypp
UNIT
OfSystem
UIJ I Klt3U I IUIV JTJ I LM
Head er,'M a enfold
Distnbu io
x Hole Size
x Hole clog
Vent to Air Intake
1
Pipe(s)
Length Die
Length Spacing
SUIL GUVGK x Pressure Svstems Only xx Mound Or At-Grada Rvstams Onlv
Depth Over
BedlTrench
Center
/
i% H
r
Depth Over
Bed/Trench
Edges (�•I
xz
Tap
epih of
it
ee oddetl
es N
is Mulched
es No
COMMENTS: (Include code discrepancies, persons present, etc)
Location: 357 HIGHVIEW R,D.� �A
1 ) Alt BM Description =(-,�i r ✓ (AV{ ✓
2 ) Bldg sewer length = It 01
- amount of cover = 7q�"
Inspection #1 Inspection #2
No 01 � lirill4
Plan revision RequueV _ Yes ❑ No /
Use other side for additional information 1� _ _ __J
SBD-6710 (R 3197) Date s dor's Sig attire Cen No
5AIV -_?n_l_n 3 A
County
_�++r
/G s x
Safety and Buildings Division
201 W Washington Ave., P.O. Box 7162
St Croix
SanitaryPertnn Number (to be filled m by Co.)
�� �aN 2 8 Z021
Madison Wl 53707- 162
`� ;
RuNP
<031 Zyfl
Sanitary Petamit Application
State Transaction Number
In accordance with SPS 383.21(2), Wis Achim Code, submission of this form to a ovemmenml unit
v
Is required prior W obtaining a sanitary permit. Note. Application forms for stele -owned POWT rtted to
Project Address (if different than mailing address)
the Department of Safety and Professional Servies. Personal information you provide may be used for secondary
1 I d �a
ses in accordance with the Privacy Law, s. IS I (m), Stab
�-{ U e W K
357
I. Application Information - Please Print All Information
Property Owner's Name
Parcel s () O
Justin 8 Vley Adducci
020-1171-10,%0
Property Owner's Mailing Address
Property Location
f0
375 Highview Drive
�• r 0�0
Govt lot 4 A�
SE '/. NW y, Section 7
City, State
Zip Code
Phone Number
Hudson, WI
54916
(circle Oft)T 29 N; R 19 fgor W
II. Type of Building (check all that apply)
4
Lots
Subdivision Name
EkI or 2 Family Dwelling - Number of 1319droornS
�P"aAas)
BI
Edgewood Estates III
ElPublic/Commercial -Describe Use
❑ City of
••
❑State Owned - Desrnbe Use
Village of
CSM Number(;,Zj/Lf.El
® Townof Hudson
DaC'. o z3
Ill. Type of Permit: (Check only one boa on line A. Complete line B if applicable)
A
I (Jew System
❑ Replacement System
❑ Treatment/Holding Tank Replacement Only
❑ Other Modification to Existing System (explain)
B.
❑ Permit Renewal
❑ Permit Revision
❑ Change of Plumber
❑ Permit Transfer to New
List Previous Permit Number and Date Issued
Before Expiration
Owner
IV. T e of POWTS System/Component/Device:
ec
Chk all that apply)
F Non -Pressurized In -Ground ❑ Pressurized In -Ground ❑ AtGmde ❑ Mound> 24 in. of sintable sod ❑ Mound < 24 in. of suitable soil
,�fk
❑ Holding Tank ❑ Other DisperjComponmtplain) ❑ Pretreatment Device (explainV.
IN ersaVTreatment Area IDesign
Flow (gpd)
Design Soil pdsf)
Dispersal Area Required (sq
Dispersal Area Proposed (sf) System Elevation
600
.7858
900 94.25, 93.25, 92.25
V1. Tank Info
Total
k of
Manufacturer
Gallons
UnitsNew
Tag
Tags
PolyLock 525
;
v
d U
y y
h
W U
a
Septicor Bolding Tank
XX
125D
Wesier
x
Dosing Chamber
VII. Responsibility Statement- 1, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans.
Plumber's Name (Print)
Plumber's Sigma
MP/h1PRS Number
Business Phone Number
Tim DeYoung
664713
715-246-2660
Plumber's Address (Street, City, State, Zip Code)
321 Wisconsin Drive, New Richmond WI 54017
VIII. Court /De srtment ULRe�oo�ncnial
Approved ❑ Disa
Permit Fee
Date Issued
Issuin Agent Signature
❑ e
S
z L`
7 �Qj�
IX. Conditions Appro 3 ` I _ L 1) .=' _
L &AS OLAL
S pEMOWNER � �-7} l 1 2-
pS�y�y
filter W OaC f-` P•+
6P�/Z$
. S tic tank, effluent and t .)
must be serviced / maintained )
dispersal cell
as per management plan provided by plumber
All Setback equ FeMefitS,"
as per applicable codeiOrdlnan CBS r-" e.au, — �• '^ Ku" saumrr m Inc c.cuaryomy on paper not less hang in s 11 Inches to size
SBD-6398 (R. I I/11)
m ,r,2,Ay,ft Ls�
era
�ti
a
0A
V
0
fL•fb 2�1
N bz.�
)F �'i
7i0.4s vn °Iry
CONVENTIONAL COMPONENT DESIGN
Residential Application
INDEX AND TITLE PAGE
Project Name:
Justin and Ashley Adducci
Owner's Name.
Justin and Ashley Adducci
Owner's Address:
357 Highview drive
Hudson Wl 54016
Legal Description:
SE 1/4 NW 14 Sec 7 T29N R198W
Township.
Hudson
County:
St Croix
Subdivision Name:
Edgewood Estates Ill
Lot Number:
4
Parcel ID Number:
020-1171-10-000
Page 1
Index and title
Page 2
Plot Plan
Page 3
System Sizing & Cross -Section
Page 4
Filter Specs
Page 5
Maintenance Information
Page 6
Management Plan
Page 7
St. Croix Cty Septic Tank Maintenance Form
Page 6
Warranty Deed
Page 9
CSM or Plat
Attachments: Soil Test & House Plans
Designer/Plumber: Tim DeYoung License Number:
Date: 01/27/2021 Phone Number
664713
(715)246-2660
Signature
Designed pursuant to the In -Grow Soil Absorption Component Manual for POWTS Version 2.0 SBD-10705-P (N.01/01).
Page 1
jVICu, RcI
S w yy a
`1�-2y N
z
Yo'
` ya BJ
N
3s7
9J3" u-1 5`10 #to
SOIL ABSORPTION SYSTEM DETAIL 1 GRAVELLESS LEACHING UNIT Pag, L of 1
Project Name:
3 No. of Cells 6 Per Cell
3 ft Cell Width 18 Total No of 10
60 ft Cell Length 50 sq ft EISA Per Cell
3 ft Cell Spacing 900 sq ft Total EISA
Manufacturer Mt i , ...i.. ,
IMiftraWr
EZ1203H-5ft
5 0'
25.0
EZ1203H-10ft
10.0'
50.0
Gravelless Leaching Unit Manufacturer: INFILTRATOR
Grevelless Leaching Unit Model: EZ1203H-10FT.
12 in___� _
......................�.-
ON
-Observation Pipe with
approved cap or vent
Soil Backfill
.Geotextile Fabric
S ft Intiltrative Surface
7 �. Limiting Factor
/ Slotted and Anchored Vent/
Observation Pipe with Cap
...............................................
Plumber/Designer Signature:
Ucense #: 664713 Date; 1 /26/2021
paL� k aXII
Innowtlonsm Pre[est �ramaoe Zatrel
&Wastewater Products ggmson of roybM loci
PL-525 Filter
PL-525 Effluent Filter
The PL-525 Filter is rated for 10,000 GPD (gallons per day) making it one of the largest filters in its class. It has
525 linear feet of 1/16" filtration slots. Like the Polylok PL-122, the Polylok PL-525 has an automatic shut-off ball
installed with every filter. When the filter is removed for cleaning, the ball will float up and temporarily shut off
the system so the effluent won't leave the tank.
Features:
Rated for 10,000 GPD (gallons per day).
525 linear feet of 1/16" filtration.
Accepts 4" and 6" SCHD 40 pipe
Built in gas deflector.
• Automatic shut-off ball when filter is removed.
• Alarm accessibility.
• Accepts PVC extension handle.
PL-525 Installation:
Ideal for residential and commercial waste flows up to
10,000 gallons per day (GPD).
1 Locate the outlet of the septic tank.
2. Remove the tank cover and pump tank if necessary.
3. Glue the filter housing to the 4" or 6" outlet pipe. If
the filter is not centered under the access opening use a
Polylok Extend Br Lok or piece of pipe to center filter.
4. Insert the PL-525 filter into its housing.
5 Replace and secure the septic tank cover
PL-525 Maintenance:
The PL-525 Effluent Filters will operate efficiently for
several years under normal conditions before requiring
cleaning. It is recommended that the filter be cleaned
every time the tank is pumped, or at least every three
years. If the installed filter contains an optional alarm,
the owner will be notified by an alarm when the filter
needs servicing. Servicing should be done by a certified
septic tank pumper or installer.
1. Locate the outlet of the septic tank.
2 Remove tank cover and pump tank if necessary.
3. Do not use plumbing when filter is removed.
4. Pull PL-525 cartridge out of the housing.
5 Hose off filter over the septic tank. Make sure all
solids fall back into septic tank.
6. Insert the filter cartridge back into the housing making
sure the filter is properly aligned and completely inserted.
Replace and secure septic tank cover.
1/16" Filtrati
Accepts 4" & 6"
SCHD 40 pipe
rm Switch
-tional)
ccepts 1" PVC
:tension Handle
Rated for
10,000 GPD
525 Linear Ft
of 1/16"
Filtration Slots
Certified to
0 NSF/ANSI Standard 46
1
r Gas Deflector
f` Automatichut-0if Ball
Outdoor Smarii illerAlarm Exicnd & Lok"'
Polylok, Zabel & Best filters accept Easily installs
the SmartFiltera switch and alarm, into existing tanks
Polylok, Inc. 3 Fairfield Blvd. Wallingford, CT 06492 Toll Free: 877.765.9565 Fax: 203.284.8514 www.polylok.com
POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page 1 of 2
FILE INFORMATION
owner Justin & Ashley Adducci
Permit #
DESIGN PARAMETERS
Number of Bedrooms
4
❑ NA
Number of Public Facility Units
15t NA
Estimated flow (average)
400
gal/day
Design flow (peak), (Estimated x 1.5)
al/da
Soil Application Rate
,7 al/d /ft'
Standard Influent/Effluent Quality
Monthly average`
Fats, Oil & Grease (FOG)
530 mg/L
Biochemical Oxygen Demand (SOD,)
s220 mg/L
0 NA
Total Suspended Solids (TSS)
5150 mg/L
Pretreated Effluent Quality
Monthly average
Biochemical Oxygen Demand fBODbI
530 mg/L
Total Suspended Solids (TSS)
530 mg/L
❑ NA
Fecal Coliform (geometric mean)
510cfu/100ml
Maximum Effluent Particle Size
ya in dia.
❑ NA
Other:
❑ NA
`Values typical for domesuc wastewater and septic tank effluent.
MAINTENANCE SCHEDULE
SYSTEM SPECIFICATIONS
Septic Tank Capacity
1250
gal p NA
Septic Tank Manufacturer
Wieser
0 NA
Effluent Filter Manufacturer
❑ NA
Effluent Filter Model
525
❑ NA
Pump Tank Capacity
al NA
Pump Tank Manufacturer
NA
Pump Manufacturer
NA
Pump Model
)Ct NA
Pretreatment Unit
)dX NA
O Sand/Gravel Filter
❑ Peat Filter
❑ Mechanical Aeration
❑ Wetland
O Disinfection
❑ Other:
Dispersal Collis)
X® NA
❑ In -Ground (gravity)
❑ In -Ground (pressurized)
❑ At -Grade
❑ Mound
❑ Drpp Une
❑ Other:
Other:
❑ NA
Other:
❑ NA
Other.
❑ NA
Service Event
Service Frequency
Inspect condition of tankls)
At least once eve �':
3 earlsy6artsl
W ) (Maximum 3 years)
❑ NA
Pump out contents of tankls)
When combined sludge and scum equals one-third %) of tank volume
❑ NA
Inspect dispersal call(s)
At least once every:
13 l (Maximum 3 ears)
3 m year(g)
xQ yearis) y
❑ NA
Clean effluent filter
At least once eve
every:
11 month(s)
❑ year(s)
XF NA
Inspect pump, pump controls & alarm
At least once eve
every:
❑ month(s)
❑ year(s)
Xf NA
Flush laterals and pressure test
At least once every:
❑ month(s)
❑ year(s)
QXN A
Other.
At least once every:
❑ monthis)
❑ yearis)
)CI NA
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 tankls) 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 collie) shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding
of effluent an 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.
When the combined accumulation of sludge and scum in any tank equals one-third (Y) or more of the tank volume, the entire
contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113,
Wisconsin Administrative 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 <12 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.
START UP AND OPERATION Page Z of Z
'
For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or other chemicals
that may impede the treatment process and/or damage the dispersal call(s). If high concentrations are detected have the contents
of the tank(sl removed by a septage servicing operator prior to use.
System start up shall not occur when soil conditions are frozen at the infiltrative surface.
During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will be
discharged to the dispersal collie) in one large dose, overloading the call(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 controls 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 15 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; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat;
foundation drain (sump 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
property and safety 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 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.
❑ 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.
ng tank
p
❑ Mound and at -grade soil absorption systems may be reconstructed in place following removal of the biomat at the
infiltrative surface. Reconstructions of such systems must compy 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 OR 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
POWTS INSTALLER
Name Countryside Plumbing & Heating 771
Phone 715-246-2660
POWTS MAINTAINER
Name Paul Koehler
Phone 715-246-2660
SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY
Name Darrels Septic
Phone 715-426-1025
Name
ST. C ( ZOti!/�c l
Phone
—llS— 3SCo— ip D
This document was drafted in compliance with chapter Comm 83.2212)Ib)0)fd)&(f) and 83.540), (2) & (3), Wisconsin Administrative Code.
4" CAS
WLP1250-MR
TANK SPECIFICATIONS
n
DIMENSIONS:
w
WALL: 2 1 /2"
d
BOTTOM: 3"
4" CAST -A -SEAL COVER: 5"
MANHOLE: 24"I.D. PRECAST CONCRETE RISER
w
a
HEIGHT: 52 1 /2"
LENGTH: 10'-0 1/4"
WIDTH: 7'-0"
p
BELOW INLET: 41"
LIQUID LEVEL: 36"
o
WEIGHT: 8,810 LBS.
-I
INLET AND OUTLET:
3
4" CAST -A -SEAL BOOT OR EQUAL GASKET
m
a
w
as
INLET - - OUTLET
n
-----------
SIDE VFW
TANKS ARE MANUFACTURED TO MEET OR
INLET AND OUTLET BAFFLE AND FILTER:
WISCONSIN, SEE DETAIL #10
(OTHER STATES SEE CHART)
<
a
L
W
LIQUID CAPACITY: 34.81 GAL/IN
W
HOLDING TANK:
OUTLET HOLE PLUGGED
C
ACTUAL CAPACITY: 1,323 GALLONS00
C z
LOADING DESIGN: 8'-0" UNSATURATED SOIL
v a
TANK CAN BE USED AS:
�N
o
SEPTIC /HOLDING /PUMP OR SIPHONLu
COVER: MIX DESIGN #8 (NO FIBER)
00
�
TANK: MIX DESIGN #10 (STRUCTURAL FIBER)
CUSTOMIZED TANKS:
FOR CUSTOM TANKS CONTACT WIESER CONCRETE
J
I
Z
Lo
N
a
2
U
REVIEWED BY
REVIEW DATE
a.
F
a
w
cn
DRAWINGS SUBMITTED
FOR APPROVAL
APPROVED BY:
SHEET NC.
APPROVAL DATE:
PRODUCTS NEEDED BY:
of
ST. CROIX COUNTY
SEPTIC TANK MAINTENANCE AGREEMENT
AND
OWNERSHIP CERTIFICATION FORM
OwncrBuyer
Mailing Address 357 Hiahview Drive Hudson WI
Property Address
required from Planning
Department for new consuuwon.)
City/State Hudson Parcel Identification Numbcr 020-1171-10-001
LEGAL DESCRIPTION
Property Location S� %, PW / , Sec, 7 T 29 N R 19 W, Town of Hudson
Subdivision Plat: Lot # 3
Certified Survey Map # to 3 40 Z3 , Volume 27 Page # 6273
Warranty Deed # , ISM (before 2007)Volume �^Page #
Spec house Oyesl$ito
Lot lines identifiable $yes[]w
SYSTEM MAINTENANCE AND OWNER CERTIFICATION
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 veers or sooner, ifneeded, 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 ¢SPS 383 52(l) and in Chapter 12 - St. Croix County Sanitary Ordinance.
The property owner agrees to submit to St. Croix County Planning do Zoning Department a certification forth, signed by the
owner and by a master plumber, joumeyrnan plumber, restricted plumber or a licensed pumper verifying that (1) the on -site
wastewaler disposal system is in proper operating condition andror (2) after inspection and pumping (if necessan), the septic tank rs
less than 1/3 lull of sludge.
live, 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 Safety And Professional Services 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
Count)Planning & Zoning Department within 30 days of the three year expiration date.
I'wc ccrtif) that all statements on this form are true to the best of myiour knowledge. I/we am'are the owner(s) of the
property descn above, by virtue of a sa varranty deed recorded in Register of Dads Office
Num r of n rooms
SIGNA 1 URL OI• APPLIC'AN'f ') / 1 / j DATE
"'Any information that is misrepresented may result in the sanitary permit being resokad by the Planning S Zoning Department. "•
Include with this applrcaton a recorded warranty deed from the Register of Dads Office and a copy of the certified sun ev map if
reference is made in the warranty deed.
(RLN'.0a112)
Parcel #: 020-1171-10-000 02/2212008 11:25 AM
PAGE 1 OF 1
Att. Parcel #: 07.29.19.1066 020 - TOWN OF HUDSON
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 -Owner
0 - BJORNSTAD, DENNIS M & TERESA
DENNIS M & TERESA BJORNSTAD
1060 COTTONWOOD OR
HUDSON WI 54016
Districts: SC = School SP = Special
Property Address(es): = Primary
Type Dist # Description
' 357 EDGEWOOD OR
SC 2611 HUDSON
SP 1700 WITC
Legal Description: Acres: 1.430
Plat: 05-029-EDGEWOOD ESTATES III 020-86
SEC 7 T29N R19W LOTS 98,99100 & 101
Block/Condo Bldg: LOT 98
EDGEWOOD ESTATES III
Tract(s): (Sec-Twn-Rng 40114 160114)
07-29N-19W
Notes:
Parcel History:
Date Doc # VouPage Type
09/0412007 859863 WD
05103/1999 602368 1423/268 WD
07/23/1997 739/217
2008 SUMMARY Bill M
Fair Market Value:
Assessed with:
0
Valuations:
Last Changed: 1012512005
Description Class
Acres
Land
Improve
Total State Reason
RESIDENTIAL G1
1.430
55,900
0
55,900 NO
Totals for 2008:
General Property
1.430
55,900
0
55,900
Woodland
0,000
0
0
Totals for 2007:
General Property
1.430
55,900
0
55,900
Woodland
0.000
0
0
Lottery Credit: claim count:
0 Certification Date:
Batch #:
Specials:
User Special Code
Category
Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
%Wrt omm
K ff WLS
-- ----- ---
-------------
E
---------- ---- -----------
ROOF PLAN
LN
LN
----- --- ---
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REAR ELEVATION
Qu
44
F, F1
CST
ru w®
I
Ilit --------- -- ---- --- -- - ---------- --- -- ---- --- ----
--- ---- ---- -- -----
FRONT ELEVATION
BID SET -NOT FOR CONSTRUCTION17
I SS
6! �NG�f WSJ
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0i � •a,1n, NWI.
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,
M �w a �. M��Ienpaft k
Re
*J LODER LEVEL PLAN-yety
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Wisconsin Department of Commerce SOIL EVALUATION REPORT
Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code
FR,
nty
Attach complete site plan on paper not less than 8% x 11 inches in size. Plan must
include, but not limited to vertical and horizontal reference point (BM), direction and penxnt slope, scale or dimemsions, north avow, and location and dis!,Ar'
earesroad cePlease print all information. ia BY
Personal inronnaeon yw provide n I�u . 15 04
Page _ I of 3
A.C.E. Soil & Sde Evaluations
St. Croix
1171-10,000
Date A
a
Dennis & Tracy B'omstad I�.�} fl Govt. Lot '� SE 1/4 NW 11YS 7 T 29 N R 19 _ W
Property Owner's Mailing Address — � C r 1 �' L`��— Lot # ock # Subd. Name or CSM#
1060 Cottonwood Drive 98 - 101 / C i Edgewood Estates III
City St a zi um er _J City J Village a Town Nearest Road "y 5 7 ((l,kl eeJ
Hudson Hudson High vewp^ad
✓V New Construction Use K Residential / Number of bedrooms 4 Code derived design flow rate 600 _GPD
J Replacement J Public or commercial - Describe:
Parent material _Glacial Oulwash - Flood plain elevation, if applicable na
General comments
and recommendations: She suitable for conventional dispersal cell at2.7_gpd loading rate. Recommended installing 42 Q-4
chambers in 3 trenches at levations at 94.25', 93.25'. & 92.25'. a� 8. f d, z
Boring # I Boring
✓_J Pt Ground Surface elev. _ 9775 ft Depth to limiting factor ... >102" in Soll Application Rate
Horizon
Depth
Dominant Color
Redox Desrnption
Texture
Stmdure
Consslence
Boundary
Roots
GzPDfft
'Eff#1 'Eff#2
in.
Munsell
Du. Sz. Cont. Color
Gr. Sz. Sh.
1 0-4 1Dyr2/2
none sl 2fcr mvfr cs 2fm,1c'I
0.6
1.0
�ml
2 4-37 1Oyr3/4
none Is 0sig cs 2fmc
0.7
1.6
3 T55 7�7.5yr416
none s 0 sg ml gs tfm
0.7
1.6
4 55-80
�80-102
10yr4/6
none s 0 sg ml av
0.7
1.6
5
10yr5I4
none�g s 0 sg dl
0.7
1.6
H#4 contains 112" -- 3/4" bands of 7.5 /4 s. Horizon loading rate should not be affected by banding.
Boring # J Boring
>115"
16 Pt Ground Surface elev. 98.83 ft. Depth to limiting factor _in. Sod Appliatbn Rate
Horizon Depth
Dominant Color
Redox Description Texture
Structure
Consistence Boundary
Roots
GPD111'
-
in.
Mursdi
Qu Sz. Cont. Color
Gr. Sz. Sh.
'EfHt1 'EfW
1
0-6
10yr2/2
none
sl
2fcr mvfr
cs
2fm,1c
0.6 1.0
——_- -
t..
2 6-21 10yr3/4 none Is 0 sg
ml cs
2fmc 0.7 1.6
3
21-37
10yr3/4
none
sl
1msbk
mfr
cs
1fm
0.4 0.7
4
37 47
7.5yr4/6 none
Its
0 sg ml
1 cs
0.4
0.6
5 47-60 1 Oyr4/6
none �'j
r1 0 sg
dl
gs
0.7
1.6
6
60-115
1 Oyr5/4
none 101
1 s
0 sg dl
0.7
1.6
H#4 contains high clay content, resu akly cemented condition due to day bridging between sand grains. H#5 contains 1& - 3/4" bands of
10y 1641s. Banding should not reduce penniabillty of horizon.
Effluent #1 = BCD,> 30 <
and TSS/>30 < 150 mg/L
' Effluent #2 =
< 30 mg/L and TSS <30 mg/L
James K. Thompson 3602
Address A.C.E. Sal & She EvaluDate Evaluation Conducted Telephone Number
340 Paulson Lake Lane- Osceola. W 154020 829/2007 715-248-7767
Property Owner Dennis & Tracy Bjomstad Parcel ID # 020-1171-10-000 Page 2 of 3
Boring # Boring -
rJ/ Pa Ground Surface elev. 92.57 It. Depth to limiting factor >104" in. Sod Application Rate
Horizon
Depth
in.
Dominant Color
Munsell
I Redox Descdptbn
Qu Sz. Con[. Cdw
Texture
Stricture Consistence
Gr Sz. Sh.
Boundary
Rods
GPD&
'Eff#1 'Eff#2
1
0-3
1Oyr3/2
none sl
2fcr
mvfr
cs
`2fmc
2fm,1c
0.6
1.0
2 3-21
3 21-37
4 ', 37-57
5 57-721
6 72-104
10yr414 none
7.5yr4/6 none
10yr4/6 none
10yr5/4 none
10yr5/4 none
Is 0 sg ml
s 0 sg ml
s 0 sg ml
s 0 sg dl
s 0 sg dl
cs
cs
cs
gs
1fm
0.7 1.6
0.7 l 1.6
0.7 1.6
0.7 1.0
0.7 1.6
H#5 contains 12" - 3A bands of 7.5yr4/4 Is Horizon loading rate should not be affected by banding.
❑ Boring # Boring - --
J Pit Ground Surface elev _- ff. Depth to limiting factor n. So l Appl cation Rafe
Horizon
Depth
in.
Dom mmnt Color
Munsell
Redox Descdphon
Do. Sz. Cont. Color
Texture
SWcture
Gr. Sz. S .
Consistence
I
Boundary
Rods
_
'Etf#1 'Eff#2
❑ Boring# J Boring —_
Pit Ground Surface elev ft Depth to limiting tailor in Application Rate
Horizon
Depth Dominant Color
in. Munsell
Redox Descrl Texture SWcfum
Qu. Sz, Cont Color Gr. Sz. Sh.
Consistence
Boundary
Roots
'Eff#1 "Etf#2
" Effluent #1 = BODS> 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BOOS < 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 TTTY 608-264.8777.
SDD-8330 oLOWW) A.C.E. Sod a See Evakk*k
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Parcel #: 020-1171-10-000 02/22/2008 1125AM
PAGE 1 OF 1
Alt. Parcel #: 07.29.19.1066 020 - TOWN OF HUDSON
Current X ST. CROIX COUNTY, WISCONSIN
Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type
00 0
Tax Address:
Owner(s): 0 = Current Owner, C = Current Co -Owner
O - BJORNSTAD, DENNIS M & TERESA
DENNIS M & TERESA BJORNSTAD
1060 COTTONWOOD DR
HUDSON WI 54016
Districts: SC = School SP = Special
Property Address(es): ' = Primary
Type Dist # Description
' 357 EDGEWOOD DR
SC 2611 HUDSON
SP 1700 WITC
Legal Description: Acres: 1.430
Plat: 05-029-EDGEWOOD ESTATES III 020-86
SEC 7 T29N R19W LOTS 98,99 100 & 101
Block/Condo Bldg: LOT 98
EDGEWOOD ESTATES III
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
07-29N-19W
Notes:
Parcel History:
Date Doc # Vol/Page Type
09/04/2007 859863 WD
05/03/1999 602368 1423/268 WD
07/23/1997 739/217
2008 SUMMARY Bill #:
Fair Market Value:
Assessed with:
0
Valuations:
Last Changed: 10/25/2005
Description Class
Acres
Land
Improve
Total State Reason
RESIDENTIAL 31
1430
55,900
0
55,900 NO
Totals for 2008:
General Property
1 430
55,900
0
55,900
Woodland
0.000
0
0
Totals for 2007:
General Property
1 430
55,900
0
55,900
Woodland
0 000
0
0
Lottery Credit: Claim Count:
0
Certification Date:
Batch #:
Specials:
User Special Code
Category
Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 000
PRELIMINARY
r
FOR PERMIT
NORTH
\
SCALE:
-
/C_95.04'•
11NCH -40 FEET
p
9pt
VI'
\
4984'
0®0
E 3
k 8 C
•.1Q0o^D
--_
VERTICAL CONTROL DATUM. NAVD1988
^
$'
PROPERTY ADDRESS-
ROAD
OA
HUDSO ,WI5
HUOSOx, W154016
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ass►
�,
cl
J
i! •e
60_ 87
!
MINIMUM BUILDING SETBACKS.
G E.
FRONT 50 FEET
®
o c� v
9
/
SIDE 10 FOOT MINIMUM;
15 FOOT MINIMUM COMBINED
REAR 35 FEET
^
/
DIMENSIONS ARE SHOWN FROM
LOT LINE TO OUTSIDE WALLLOT
1�
3
L. 3 ACfl S—
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LEGEND
o
/ I
,J \ I
\ I I {
I / I
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• FOUND IRON PIPE PER PLAT OR AS NOTED
< Q
SO/L FESTAREAV I
I l
I
I .-
yvlj T
o H
M1
DOD BLING LI
OR ON BUILDING
0_ CC
s
NE EXT
EXTENSION
W
1�
I i /� /
.`i=
I /-
IW
TO.H. TOP OF HUB ELEVATION
E)
O
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/
/,
i'
l I I l I
l
T.O.P. TOP OF IRON PIPE ELEVATION
�F
_
360.99'_ —
Y V