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030-2076-90-000
o �o' o s05 c o d r� m f I c tD r1 o m m a M n CD ° 4 ' m E Z oD cn rn w • O y w U) O N fD I O 3 r(Di C W Im O N O CD O CA 7 C 0 v N O C 0 cn z CD N Q 3 7 O- O �. S w O "S I C ) WI CD o wo S O N A 7 N O p v cn z Y m a cn � D m° < (D fl D N a cn N W a CD CD W o o 0 1 CL o 3 0 rn w ° c_ A o CD o o ° o l o cV0 y W w (o 00 a A I o 3 �+ N 0 0 0 NN gg v v v 0 Q v v v O fl' CAD . N - , 5 . (D 61 CD W O N A X A CD N C' lr d N 3 R 3 to O M M W 1 D D o D C O N O 0 3 Q I -b a m a (D ! • 7 N CD CD C CD (D c c CD CD w (D a N l a N N l N (a 0 Z � Cl) p Z m o N c cn Q a A Z 3 w ,n 3 , N cn - '1 N m o0 o moo 1 a` a� Z a C C = co N G o N N Z ? w A C CD Gl CD d CD E n CD O (1 n D) _ a 0 :E— 'md I o _ co a O Z CL o o °cn = Z C 0 0 0- CCD' o N M o o N 1 Q N � C D au ID Zam o I o� cnv 0 N CND n p' 7 �, O S 7c CD O D) CD w x — C1 CD x CD (D N co co O ti 0 O A O CD CD (� O o 0 ti CD a °o i 1 0 0 CL • AS BUILT SANITARY SYSTEM REPORT ';WNER r�'Cr tl � 1 r_,i�)f.� c �, n '.��,n �f4' , TOWNSHIP ` { �r_• � SEC..` L T 3�7N, R r r� W '.0. ADDRESS �� 1 _ , ST. CROIX COUNTY, WISCONSIN. LBDIVISION LOT LOT SIZE s A PLAN VIEW Distances & dimensions to meet requirements of H62.20 SHOW EVERYTHING WITHIN 100 FEET OF SYS • i IOU .. it •. ;.�,.t,c !, >�c' Zn ��1 APR M - • ION1�;N 79 O FFIC j ±U OPTIC TANK(S) STEEL MFGR. �� ,� n1ti12 ONCRETF NO. of rings on cover c, Depth DRY WELL TENCHES NO. of width _ length area '•D no. of lines ;j width °length 6 great . depth to top of pipe f -'GREGATE ERK RATE AREA REQUIRED , is (i _ AREA AS BUILT 'sclaimer: The inspection of this system by St. Croix County does not imply complete jmpliance with State Administrative Codes. There are other areas that it is not possible .= inspect at this point of construction. St. Croix County assumes no liability for °stem operation. However, if failure is noted the County will make every effort to Aermine cause of failure. ':EASES AND OILS SHOULD NOT BE DISPOSED THROUGH THIS SYSTEM. - ~ INSPECTOR - DATED PLUMBER ON JOB LICENSE NUMBER V - l�4 State a A County State Permit # PLB67 Permit" lication County Per # ` " ' for Private Domestic Sewage Systems County , *DENOTES STATE APPROVAL REQUIRED Date Approval Received from State if Required State Plan I.D. # A. OWNER OF PROPERTY Mailing Address: p afl N d a l�w �.ro f .i B. LOCATION: A� Y A/W '/4, Section T, ON, R" E (or) W Lot # // - f-City Subdivision Name, nearest road, lake or landmark Blk# �, Village Township t7o C. TYPE OF OCCUPANCY: mmercial *Industrial *Other (specify) *Variance Single family A Duplex No. of Bedrooms No. of Persons -Z_ D. TYPE OF APPLIANCES: Dishwasher __/ YES NO Food Waste Grinder_�YE-S_NO # of Bathrooms Automatic Washer V YES NO Other (specify) E. SEPTIC TANK CAPACITY �p�J Total gallons No. of tanks *Holding tank capacity Total gallons No. of tanks New Installation Addition Replacement — Prefab Concrete *Poured in Place Steel Other (specify) F. EFFLUENT DISPOSAL SYSTEM: Percolation Rate 1) L 2)_ — 3) _, Total Absorb Area sq. ft. New ✓ Addition Replacement *Fill System Seepage Trench: No. Lin. Feet Width Depth Tile Depth No. of Trenches Seepage Bed: Length Width Depth .— Tile Depth ;Z No. of Lines Seepage Pit: Inside dia eter squid Depth Tile Size Percent slope of land Q Distance from critical slope I, the undersigned, do hereby certify that the information I have reported is in accord with Section H62.20, Wisconsin Administrative Code, and that I have sized the effluent disposal system from the EH -115 prepared by the Certified Tester, NAME Q if' /C`l C.S.T. # .'f�- ����,� and other information obtained from (owner /builder). Plumber's Signature X MP /MPRSW# U Phone # ! ����, Plumber's Address 10 PLAN VIEW: Provide sketch below of system (include direction of slope and all distances in accord with H62.20, including well). CA V ( Ir ep c Do Not Write in Space Below FOR DEPARTMENT USE ONLY 00 p� �- C7 c� D at C l State �� ,7 u Fees Paid: Stat O f A p pl ica t i o n Y o pp Date PP �l.! � �` � C1 .-_ � Permit Issued /Roid=Ird (date) � to Issuing Agent Name Inspection Yes No Valid# Date Recd 1. county (wh'/e copy) 3. owner (green copy) DIVISION OF HEALTH, P.O. BOX 309, MADISON, WI 53701 state (pink copy) 4. plumber (canary copy) Revised Da te 6/1 /76 EH 115 WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES DIVISION OF HEALTH, BUREAU OF ENVIRONMENTAL HEALTH P.O. BOX 309 MADISON WISCONSIN 53701 REPORT ON SOIL BORINGS AND PERCOLATION TESTS LO CC�T ' /4� 4e 'on r �' , T N, R E (or) W, T ow n ship or Municipali of No. (� << - glop" I, •_ �l I I . r} CQGnty Subdivision Name % f Owner's Name: 1' � r Mailing Address: TYPE OF OCCUPANCY: Residence No. of Bedrooms - Other ZONIN c� OFFICE EFFLUENT DISPOSAL SYSTEM: NEW ADDITION REPLACE DATES OBSERVATIONS MADE: SOIL BORINGS WE 30 ' 11 6' PERC �$\ OC T 1 1976 SOIL MAP SHEET i F SOIL TYPE 1 �` PERCOLATION TESTS TEST DEPTH CHARACTER OF SOIL HOURS WATER IN TEST TIME DROP IN WATER LEVEL, INCHES RATE NUM- INCHES THICKNESS IN INCHES SINCE HOLE HOLE AFTER INTERVAL MIN /IN BER 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3 I 1 � ` ` ( �' G t3 K fo P _ = i � 1 �` ,�) 'rich / i� Z — - i ( ► t, j 4 1, ° ism 2 ° .Z SOIL BORING TESTS TEST TOTAL DEPTH DEPTH TO GROUNDWATER, INCHES CHARACTER OF SOIL WITH THICKNESS, INCHES NUMBER INCHES OBSERVED ESTIMATED HIGHEST (DEPTH TO BEDROCK IF OBSERVED) DitJ� t I ' b � -- - - -- - •-- - - - - -- . 4 0 " 61 h 0 - - -- - - - ;r - 1- - - s p r,. L9 si 3& , 0 B— SC' 4 s PLAN VIEW (Locate percolation tests,soil bore holes and suitable soil areas.) !bbC`N GL By �0►J +N�r�G �cQW � N •�- Mo f -1 Es Indicate on the plan the location and square feet of suitable areas. Indicate nu er o s uare eet of absorption area needed for building type and occupancy. 330 fag ?.�PE•�tloy ¢ I[� Q E D Indicate scale or distances. Give horizontal and vertical reference points. Indicate slope. At amm — - — + SF?E 4 • N r L-L .PV ca d tLo � t{ I E I = DE C E �- 4164hrlblJ z I, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and methods specified in the Wisconsin Administrative Code, and that the data recorded and location of test holes are correct to the best of my knowledge and belief. Name (print) �^ -'� / Certification No. Address Name of installer if known _ CST Signature � Y A —LOCAL AUTHORITY REPORT OF ITISPECTION-- EIDIVIDUAL SEWAGE DISPOSAL SYSTEM Sanitary Pernit -��- • • r i State Septic_' ' 1E _ T01•7IISHIP • t. c1t01 oun,ty Sr °TIC TA gallons. • Size /Q�'1J'� gallons. `"umber of Compartments Distance From: i1ell ft. 12% or greater s lopeo f t. Building` ft. Wetlands f. I1ighwater ft. DISPOSAL SYSTE:1 Tile Field or Seepage Pit(s) Distance From: i1ell ft. 12% or greater slope ft Building; _ ft. Wetlands FIELD High-water ✓"'ft. Total length of lines . T Z ft. Number of lines L- Length of each line ft. Distance between lines ft. Width of the trench ft. Total absorption area sq. ft. Depth of rock below tile 1Z, in. Dp-pth of rock over tile Z in.. Cover _.,over.rock,, 0400 Depth of tile below grade in. Slope of trench • �_,..— in per 100 ft. Depth to Bedrock r ft. Depth to ground water ft PITS --.� :Number of nits Outside di et ft. Depth below inlet ft. Gravel around pit: _ • yes o• Total absorption area t• , sq. ft. ".Square feet of seepage trench bottom area required Cquarn feet of seepage nit area required Inspected by: Title': • Approved Date 197, Rejected Date 197 i 9 r Y 0 , c��, T w o O C/) N N OZ O N W Q W ° C • C O Ql a D n (A N a O O c 3 C Z; W 0 1 N p v O 1 N Q j ? O A 7 CL O p • O O C <D 0 3 N O O �y O A P 0 � N m � b (n C ( 1 ) co c 3 m w c D rn a 0 cx � C nrcn � N z 0 0 b 0 !�1 D O 0 O Z N � c I c 4 v v v I N y N Ro _ a Q M v v, N � 3 W 1 d ( O1 (n !D W CL `v O N O D D o v O j CD 3 I C y W a fD � Z m 3 9 Q A G) 7 N 3 0 H I m C O CL C :r CA N (D ? 'O .p 0) I m D 3 ID a � CD I � � I 0 0 — � v c N — I N N N � I � A W 0 A N e R A I ti ti N O ' A O� Oe N i O A O �O O as CD O CL ti Parcel #: 030 - 2076 -80 -000 02/11/2005 08:20 AM PAGE 1 OF 1 Alt. Parcel M 26.30.20.652 030 - TOWN OF SAINT JOSEPH Current X' ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): " = Current Owner DAVID C & DEBORAH J ELERT " ELERT, DAVID C & DEBORAH J 1354 14TH ST HOULTON WI 54082 Districts: SC = School SP = Special Property Address es ' = Primary P p Y : ( ) Type Dist # Description SC 2611 SCH D OF HUDSON SP 1700 WITC I Legal Description: Acres: 0.000 Plat: 1910 - DRECHSLER HGHTS SEC 26 T30N R20W LOT 11 BLK 2 PLAT Block/Condo Bldg: 2 LOT 11 DRECHSLER HGHTS ASSESS WITH P653 Tract(s): (Sec- Twn -Rng 401/4 1601/4) 26- 30N -20W Notes: Parcel History: Date Doc # Vol /Page Type 12/03/1997 569334 1280/322 WD 07/23/1997 1178/100 WD 2004 SUMMARY Bill #: Fair Market Value: Assessed with: 0 Valuations: Last Changed: Description Class Acres Land Improve Total State Reason Totals for 2004: General Property 0.000 0 0 0 Woodland 0.000 0 0 Totals for 2003: General Property 0.000 0 0 0 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 Parcel #: 030 - 2076 -90 -000 02/11/2005 08:21 AM P A G E 1 O F 1 Alt. Parcel M 26.30.20.653 030 - TOWN OF SAINT JOSEPH Current X' ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): * = Current Owner DAVID C & DEBORAH J ELERT * ELERT, DAVID C & DEBORAH J 1354 14TH ST HOULTON WI 54082 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description * 1354 14TH ST SC 2611 SCH D OF HUDSON SP 1700 WITC Legal Description: Acres: 0.950 Plat: 1908 - DRECHSLER SEC 26 T30N R20W LOT 12 BLK 2 PLAT Block/Condo Bldg: 2 LOT 12 DRECHSLER HGHTS ASSESS WITH P652 Tract(s): (Sec- Twn -Rng 401/4 1601/4) 26- 30N -20W Notes: Parcel History: Date Doc # Vol /Page Type 12/03/1997 569334 1280/322 WD 07/2311997 1178/100 WD 2004 SUMMARY Bill M Fair Market Value: Assessed with: 6362 198,700 Valuations: Last Changed: 07/13/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 0.950 41,700 153,800 195,500 NO Totals for 2004: General Property 0.950 41,700 153,800 195,500 Woodland 0.000 0 0 Totals for 2003: General Property 0.950 23,000 118,900 141,900 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch M 128 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 r Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix ' Safety and Building Division INSPECTION REPORT Sanitary Permit No: 420753 0 ' GENERAL INFORMATION state Plan ID No: Personal information (AT - FACH TO PERMIT) tion you provide may be used for secondary purposes (Privacy Law, s.1 5.C4 (1)(m)J. Permit Holder's Name: City Village X Township Parcel Tax No: Elert, David I St J e h Township 030- 2076 -90 -000 CST BM Elev: 1 174 B IM Elev: BM Descri ption: Section/Town /Range/Map No: � rD C7 p VtJ t 26.30.20.653 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS hjl _ FS L . 6, .� '• Septic B mark verath J 9 1 9 11 0 Dosing � / J Alt. BM w Aeration Bldg. Sewer /S' 3 Holding St/Ht Inlet TANK SETBACK INFORMATION St/Ht Outlet 7-T-1 TANK TO P/L WELL BLDG. vent to Air Intake ROAD Dt Inlet �- s,aA, 0 G Septic �� , i }� Dt Bottom fy I -33 Dosing r Header /Man. Aeration Dist. Pi e r-y i' a 5 -25 X15 7 Holding Bot. System s � -St3 s•83 �s/2 PUMP /SIPHON INFORMATION Final Grade Manufacturer Demand S Cover GPM Model Number HFor Lift Fricpn�o System ead TDH Ft �� L gth , Dia. r . Dist. to \II SOIL ABSORPTION SYSTEM D - et � s - I ?_.f BEDITRENCH Width I Length No. Of Trenches PIT DIME S No. Of Pits Inside Dia. Liquid Depth DIMENSIONS ( /(/, O " SETBACK SYSTEM TO P/L 8 G WEL LAKE /STREAM ACHI Manufacturer: INFORMATION CHAMPPA OR Type Of System / Model Number: DISTRIBUTION SYSTEM o-' Header /Manifold Distribution I x Hole Size / / - x Hole Spa ing Vent to! nta /_ ! H Pipe(s) I� `` Length Dia Length Dia _ Spacing _ SOIL COVER j x Pressure Systems Only xx Mound Or At - Grade Systems Only U�(� Depth Over ,i- Depth Over xx Depth of xx Seeded /Sodded xx Mulched Bed/Trench Center I t S Y� Bed/Trench Edges Topsoil [r J Yes [ ] No ]Yes �i No t COMMENTS: (Include code discrepencies persons present, etc.) Inspection #1: /3 Inspection #2: / / 03 Location: 1354 14th St Houlton WI 54082 SE 114 SW 114 26 T30N R20W Dreschler Heights Lot 12 Parcel No: 26.30.20.653 � �� / f " 1.) Alt SM Description =� � � ItiQ JL(JL e P1 �-d /� (� /� ` O 2.) Bldg sewer length = Sic' J�20/ - amo tof o% .r I i vp f rQ'.jLyt J W ! ! jS a{ 1� q,I { •S Plan revisioriPequired? [ Yes '*j[ -Vo �` 1 / - - Use other side for additional Information. 103 � I — - ------ - - - - -- -- – �� - - ---� � � — -- -L- - -- ;' SBD -6710 (R.3/97) Date Insepctor's Sig lure Cart. No. Sa&c- and Buildings Division Cain w w 201 W. Washington Ave., P.O. Box 7082 irscons'in Madison, WI 53707 - 7082 Sanitary Permit Number (to be filled in by Co.) 608 261 -6546 Dep artment of Commerce '��,0 -- �J 3 Sanitary Permit Application State Plan I.D. Number In accord with Comm 83.21, Wis. Adm. Code, personal information you provide 3 52 may be used for secondary purposes Privacy Law, s 15.04(1)(m) Project Address (if different th&A mailing address) ) I. Application Information - Please Print All Information 7 C7 - Property Owner's Na l # Ca r Parcel # Lot # Block # cz Property Owner's Mailing Address Property Location / City, State Zip Code Phone Number � V4, Section 6 /( Q� T� R l _�, J ( -t IL Type of Building (check all that apply) � a "`� A or 2 Family Dwelling - Number of 8 Subdivision Name CSM Number , ❑ PubliclCommercial - Describe Use ❑ State Owned - Describe Use x 1ri , K6,0 M � O k . wr9i KTownship of HL Type of Permit: (Ch box on line A. Complete line B if _._, OdD ,0 JXO A ' ❑ New Sy Replacement System ❑ TreatmenNHolding Tank Replacement Only ❑ Other Modification to Existing System B• ❑ Permit Renewal ❑ Permit Revision ❑ Change of a Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Plumber Owner IV. ype of POWYS S stem: Check all that a pply) ❑ 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 ❑ Rccirculatiug Synthetic Media Filter ❑ Leaching Chamber ❑ Drip Line ❑ Gravel -less Pipe ❑ Other (explain) V. Dispersalffreatment Area Information: Design � ) Design Soil Applicatiop-ga DiS ral Area Reguir+ed (sf) Dispersal DD ed (st) System Elevation r VI. Tank Info Capacity in Total umber ( /O � -,C/J Manufacturer Prefab I Site Steel Fiber Plastic Galkats Ions of Units Concrete Constructed Glass New Existing Tanks Septic or Holding Tank � y � 7� Aerobic Treatment Una �^ � Dosing Chamber 7 - O VII. Responsibility Statement I, the undersigned, assume responsibility for Installation of the POWTS shown on the attached plans. Plumber's Nam (Print) PI 's Si PRS Number Business Phone Number Plumber's Address (Strom, Gity, S Zip VIII. County/Department Use Onl Approved ❑ Disapproved Sanitary Permit Fee (includes Groundwater Date Issued in Agent Signa (No Stamps) Surcharge Fee) ❑ Owner Given Reason for Denial IX. Conditions o� :oval/Reasons for Disapproval h eom as (tithe ( County only) for the system an paper not less than SMI x 11 Inches In stse ' l E Gt" ` �' ►1 9 dt/l4t'h �1LtrJ �'3-� a�Jo- molls - �plJ c►d (�^t� Cam- .�jU.t�,,Wl- �.��+.�, SBD -6398 (R. 08/02) 1 U r / PLOT PLAN ./ Scale . Page 3 of - 7 q 6 -� • �I ISM . ! I! -76 � 1 � ' ftx I B•3 � I � �3+� � Cp EN 1jG 81 Sew ) CA L a,N c � j ov t�^� DL i�.P►�`t� S P i NOTES: ' 1- Elevations shown are existing ground elevations unless 2 . Install 4" observation required). Otherwise noted. 3- Septic tank to be Pipes with approved caps. ( 2 ��5� T; j gallon capacity manufactured by W1 LSppp GftL w Nt�kj 1Sp 4- Bench mark 6f�v UE Fick, }}fir �P'TYt►�k DSO 6 OU E L Z . 5. Divert surface water around system to prevent o p nding at the uphill side. Safety and Buildings RECEIVE 44 003 N KINNEY COULEE RD F LA CROSSE WI 54601 -1831 TDD #: (608) 264 -8777 I \ Vhsconsin JA 0 2 ?00� www.commerce.state.wi.us/sb Department of Commerce www.wisconsin.gov ST. C`tiOIX COUNT Y Scott McCallum, Governor ZONING OFFICE Philip Edw. Albert, Secretary December 19, 2002 CUST ID No.267341 ATTN.• PO WTS Inspector ARTHUR L WEGERER ZONING OFFICE WEGERER SOIL TESTING & DESIGN SERVICE ST CROIX COUNTY SPIA PO BOX 74 1101 CARMICHAEL RD RIVER FALLS WI 54022 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 12/19/2004 Identificat Numbers Transaction ID No. 823531 SITE: Site ID No. 654370 David Elert Please refer to both identification numbers, 1354 14TH St above, in all correspondence with the a gency. Town of Saint Joseph, 54082 St Croix County SE1 /4, NW1 /4, S26, T30N, R20W FOR: Description: Four Bedroom Mound System Object Type: POWT System Regulated Object ID No.: 885958 The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. The following conditions shall be met during construction or installation and prior to occupancy or use: General Approval Requirements: • This system is to be constructed and located in accordance with the enclosed approved plans and with the "Mound Component Manual for Private Onsite Wastewater Systems VERSION 2.0" SBD- 10691 -P (N.01 /01) and the "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems VERSION 2.0" SBD- 10706 -P (N.01 /01). • Per manual cited above, limited activities are allowed in the area 15 feet down slope of the component area. Soil compaction, excavation, vehicular traffic and other similar activities that impact the treatment and dispersal are prohibited. Ftlonally • Access to the filter for cleaning must be provided per Comm 84 product approval conditions. Maintenance LOVED information must be given to the owner of the tank explaining that periodic cleaning of the filter is required 'OF'COMMERCE • The existing septic tank must be inspected for structural soundness, size and baffles and must be brought into conformance with the requirements of ch. Comm 83, Wis. Adm. Code. If it does not conform, a state approved m tank must be installed. SPONDENCE • The pump chosen for the design is at the limits of its capacity. If the total dynamic head is calculated to be higher, at the time of construction, a pump that meets or exceeds the system flow will need to be installed. • A Sanitary Permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.135 and 145.19, Wis. Stats. ARTHUR L WEGERER Page 2 12/19/02 • Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stat • Comm 83.22(7) A copy of the approved plans, specifications and this letter shall be on -site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. Owner Responsibilities: • Comm 83.52 Responsibilities. The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s. Comm 83.54(1). • Comm 83.52(2) A POWTS that is not maintained in accordance with the approved management plan or as required under s. Comm 83.54(4) shall be considered a human health hazard. • Comm 83.55 The owner is responsible for submitting a maintenance verification report acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. All permits required by the state or the local municipality shall be obtained prior to commencement of construct ion /installation/operation. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101. 12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 Charles L Bratz POWTS Reviewer II , Integrated Services WiSMART code: 7633 (608)789 -7893 , 7:45 am - 4:30 pm Monday - Friday cbratzVcommerce.state. wi.us cc: Leroy G Jansky, , Wastewater Specialist, (715) 726 -2544 I TITLE SIIEET Page 1 of 7 ROUND SYSTEM FOR A a BEDROOM RESIDENCE This plan has been prepared in accordance with the Mound Component Manual SBD- 10691 -P and the Pressure Distribution Manual SBD - 10706 -P (N.01 101) (N.01 101) LOCATED I'1 THE Sr 1/4 OF THE NW 1/4 OF SECTION Z6 , T 3p N, R ZO W, TOWN' OF ST. SO SL1�L� S7 0 - Z3 LX COUNTY, WISCONSIN. - . _C_DT - LZ Gr INDEX ax <�► PAGE 1 of 7 TITLE SHEET PAGE 2 Of 7 SYSTEM MANAGE24ENT PLAN �d) PAGE 3 of 7 PLOT PLAN.'�� PAGE 4 of 7 PLAN VIEW -CROSS SECTION, 00 PAGE 5 of 7 DISTRIBUTION PIPE LAYOUT PAGE 6 of 7 PUMPING CHAMBER CROSS SECTION PAGE 7 of 7 PUMP PERFORMANCE CURVE PREPARED FOR jv LAN , �JI SL4 pB PREPARED BY W FEE CEE=;tER SO I L. TEST I NG AND. DES I Gri SEF:ZV I CE P.O. Box 74 421 N.2Iain St. River Falls, WI 54022 Phone 715- 425 -0165 Fax 715- 425- 6864r��'' Fr7i!17!] , WEGC:i�rt 0.9iS P a -LS W ORTN Conti S p EPAR[MENI e � s ��� SAF V -Got JOB NO o -z69 -Mound System Management Plan Page Z of Pursuant to Comm 83.54, Wis. Adm. Code Septic Tan nk •The septic tank shall be maintained b.y an individual certified to service septic tanks under s. 281.48, Stats. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code. The o �er,ting condition of the septic tank and outlet filter shall be assessed at least once every 3 years by inspection. The outlet filte s hall be cleaned as necessary to ensure proper o eration. The filter cartridge should not be removed unless provisions are made to retain solids in the tank that may sro off the filter when removed from its enclosure. If the filter is equipped with an alarm, the filter shall be serviced if the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an impending continuous alarm. The septic tank shall have its contents removed when the volume of sludge and scum in the tank exceeds 1/3 the liquid volume of the tank If the contents of the tank are not removed at the time of a triennial assessment, maintenance personnel shall advise the owner of when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank. The addition of biological or chemical additives to enhance septic tank performance is generally not required. However, if such products are used they shall be approved for septic tank use by the Department of Commerce, Safety and Buildings Division. U PI MP Tank The pump (dosing) tank shall be inspected at least once every 3 years. All switches, alarms, and pumps shall be tested to verify proper operation. If an effluent filter is installed within the tank it shall be inspected and serviced as necessary. Mound and Pressure Distribution S tem No trees or shrubs should be planted on the mound. Plantings may be made around the mound's perimeter, and the mound shall be seeded and mulched as necessary to prevent erosion and to provide some protection from frost penetration. Traffic (other than for vegetative maintenance) on the mound is not recommended since soil compaction may hinder aeration of the infiltrative surface within the mound and snow compaction in the winter will promote frost penetration. Cold weather installations (October - February) dictate that the mound be heavily mulched for frost protection. Influent quality into the mound system may not exceed 220 mg /L BOD5, 150 mg /L TSS, and 30 mg /L FOG. Influent flow may not exceed maximum design flow specified in the permit for this installation. The pressure distribution system is provided with a flushing point at the end of each lateral, and it is recommended that each lateral be flushed of accumulated solids at least once every 18 months. When a pressure test is performed it should be compared to the initial test when the system was installed to determine if orifice clogging has occurred and if orifice cleaning is required to maintain equal distribution within the dispersal cell. Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the owner, and any levels above 4 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring. General This system shall be operated in accordance with Comm 82 -84 Wis. Adm. Code, and shall maintained in accordance with its' component manual E&BE) –t65 - e reporting. nd local or state rules pertaining to system maintenance and maintenance " 'tabgl = -P No one should ever enter a septic or pump tank since dangerous gases may be present that could cause death. Septic and Pump tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the tanks are no longer used as POWTS components. Septic or pump tank manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 8- inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into a tank or component. Continaencv Plan If the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep the system in proper operating condition. If the dosing tank, pump,. pump controls, alarm or related wiring becomes defective the defective component shall be immediately repaired or replaced with a component of the same or equal performance. If the mound component fails to accept wastewater or begins to discharge wastewater to the ground surface, it will be repaired or replaced in its' present location by increasing basal area if toe leakage occurs or by removing biologically clogged adsorption and dispersal media, and related piping, and replacing said components as deemed necessary to bring the system into proper operating condition. Questions about the operation or maintenance of this system should be directed to: The County Zoning Office at The system installer at 6 qqS UT61 The tank manufacturer at 800= .3Z.S S6 1 I��i? The effluent filter manufacturer at Z -LI S Zp�� TL — -- - -- The pump manu facturer at C. PLOT PLAN .Page 3 of -7 ./ Scale 1- LET L.r Kj& l`�t t s' .I F I� I �•3 � I � e� ti J ST.-- qS �Q p ��1S`n ►� 1 \3 0 Gq L CJ,J J tibP OF wTS1DL kkr`L_'fr, L GUT. l•���V 0� Vcr ccr L� NOTES: 1. Elevations shown are existing ground elevations unless otherwise noted. 2. Install 4" observation pipes with approved caps. ( 2 required). 3. Septic tank to be \ gallon capacity manufactured by W�MtEiz cZrve_ e Z-LS T: 1060 G6'vL wl1 'ISO Gf1t �y� (� l �fl o L� Fi L (S fv_ . 4. Bench marks : S gU£ W t QS tM 5. Divert surface water around system to prevent ponding at the uphill side. Page j OT - 1 Approved Covering AST -H C33 Distribution Pipe Medium Sand Topsa --� � = =,,,r ,_ j a = I °l a • �G p Slope Distribution Cell of Force Main Flowed 2" to 2 Ag'regate From Pump Lcyer D o S Ft. o --' F o. bS Ft, o•as CROSS SECTION OF A MOUND SYSTEM F o• 8 Ft. o =a G D -S Ft. O,S A Ft. F, o Linear Loading Rate =10 - E p Ft. Design Loadine Rate= p.ttiSGPD /SQ FT j 1 Z Ft, J (c Ft. K 8 Ft. L Ft. W F j � -Observation Pipe - - E 7 � K Ae-�- - B - -- --- - - - - -- -------- - - - - -- - - - -- _ —' ____ -- _ _ —------ - - - - -� Force in Distribution , „ Cell of to 2 Pipe aggregate Observation. Pipe EA=chor securely) PLATT VIEW OF A MOWN D SYSTEM Distribution Pipe Layout Page S of 7 - Place the holes at the bottom of the distribution pipes at equal spacing. Remove all burrs from the pipe and holes. Extend the end of each lateral up with the use of long turn or 4:5- fitting to a point within six inches of the $nal grade. Terminate the ends of the laterals with a valve :threade . threaded plug. Provide access from final grade for the valve, threaded can or threaded plug, T`[P1CTj L . �ZOSS 5 —�1pty I pvC. FVC �vC Lateral Manifold Lateral X x x x xfZ x!Z x x x x ' Lateral Lenoth — Lateral Length — p Distribution Line I • P —� � r�CC �Oy; — —o S PVC Pb n�rtN i o— P -2 ! Ft. Hole Diameter 3 11ko Inch S 43 Lateral 1 Inches) X 3 Inches Manifold " Z Inches Force Main " Z Inches i of holes /pipe 10 Invert Elevation of.Laterals CF2 -1 Ft. lv U•06= b•6 = 34 -6o G> >� PUMP CHAMBER CROSS SECTION AMD SPECIFICATIONS PAGE OF _J YEIJT CAP `I "C.Z VENT PIPE WEATHER PKOOr P-PPROVED LOCKING MANHOLE 10' FROM DOOR, JUJJCTIOIJ BOX COVER WITH WARNING LABEL WINDOW OR FRESH 12�M1U. I AIR IUJTAKE 4' MIJJ. COWDUIT �-- _ ___ _ I8'1�lIAl. --------- p - - - -- -- _ 11� IAILET PROVIDE _— _ � AIRT16H7 SEAL I III V I I I APPROVED JOI A I I APPROVED JOoJTS i I I I ALARM - I I I I ow -- � I I PUMP--,- OFF 0 ��. 8 q. S COW CRET DLOCK y RISER EXIT PEFLmrrrED OWLy IF TAWK MAUUFACTUREit HAS SUCH APPROVAL 3'•ApPRoVED Sr1�01 SPECIFICATIOUS DOSE TANKS MAIJUFACTURER \ -A- ) \ t� h i uVMBER OF DOSES: S PER OAy TANK SIZE: --1 SO GALLOWS DOSE VOLUME Z ALARM /1ML3FACTUR>rR: S ? O S''JS S IW CLUDIAIG OA CKFLOiJ: -1.1 - � C,ALLONS MODEL tiJUMBER : � O � �"lJJ _ - - -- CAPACITIES: A = -- Z-O - - - -1- - - .S - � - -- - - - - -- - -WCHES OR a2_ GA LLOIyS SWITCH TUPC: - D = � mcwtS OR L)) • � G{ LLOWS PUMP PIANUFACTURCR: (2)G U `.1Z5 C z _►IJCHES OR 1 Z ' 7 GALLONS MODEL IJUMBER: - L —POLf Dx- 9 MCHES 09 - S GALLOAIS SWITCH TYPE: WOTE: PUMP AIJD ALARM ARE O JSC a MINIMUM DISCHARGE RATE ��`�� GPM IN5TALLED OW 5EPARATE CIRCUITS �- �s ' VERTICAL DIFFER!<IJCE DETWCEU PUMP OFF AAIO_oISTRibuTtOU PIPE., __^ FEET + MIAII)AUM SUPPLY PPRE�5�5LURE . . . . . • . , . . , 3 -FE=ET '1 L "� FEET OF FORCE MAIN X F oFxFRtCTtoty FACTOR. � FEET TOTAL OtIUAMIC. HEAD FEET _ As per:manufacturer -Lo. gal /in. Liquid depth 3�1�� Goulds _oi Submersible --� Effluent Pump I EPO4 38- EP05 APPLICATIONS • Fasteners: 300 series • Fully submerged in high ■ Motor Housing: Cast iron Specifically designed for the stainless steel. grade turbine oil for for efficient heat transfer, following uses: • Capable of running lubrication and efficient strength, and durability. • Effluent systems dry without damage to heat transfer. ■ Motor Cover. Thermoplas- • Homes components. tic cover with integral handle Motor: Available for automatic and • Farms manual operation. Automatic and float switch attachment • Heavy duty sump • EPO4 Single phase: 0.4 HP, models include Mechanical points. • Water transfer 115 230 0 Float Switch assembled and ■ Power Cable: Severe duty • Dewatering RPM, , built in n overload with automatic reset. preset at the factory. rated oil and water resistant. SPECIFICATIONS • EP05 Single phase: RP M, , FEATURES ■Bearings: Upper and lower 115 V, 60 Hz, 1550 RP heavy duty ball bearing Pump: EPO4 built in overload with ■ EPO4 Impeller: Thermo- construction. • Solids handling capability: automatic reset. plastic Semi -open design /a maximum. • Power cord: 10 foot with pump out vanes for AGENCY LISTING -mo • Capacities: up to 55 GPM. standard length, 16/3 SJTO mechanical seal rotection. • Total heads: up to 24 feet. with three prong grounding p SP Canadian Standards Association • Discharge size: l' 2" N plug. Optional 20 foot peer: Thermo- . g / PT. ■ EP05 Imll Th P 9 p (CSA listed model numbers • Mechanical seal: carbon- length, 16/3 SJTW with plastic enclosed design for end in `P' or "AC ". rotary/ceramic - stationary, three prong grounding plug improved performance. ) BUNA -N elastomers. (standard on EP05). ■ Casing and Base: Rugged • Temperature: thermoplastic design provides 104 °F (40 °C) continuous superior strength and 140 °F (60 °C) intermittent. corrosion resistance. • Fasteners: 300 series METERS FEET stainless steel. 10 i I • Capable of running - dry without damage to y 30 i { oar. E P components. Pump: EP05 $ • Solids handling capability: 25 - -�-- 3 7 maximum. W x • Capacities: u to 60 GPM, � i P P • Total heads: up to 31 feet. S2 6 20 • I v Discharg size: l rz " NP g T• z 5 - • Mechanical seal: carbon - �N E rotary/ceramic - stationary, ° 15 r BUNA -N elastomers. 4 -POS— • Temperature: ° 3 10 I 104OF (40 °C) continuous _ ! o 140 OF (60 C) intermittent. 2 1 5 j 3q • bD �.� ° 0 20 30 40 50 GPM L L 0 2 4 6 8 1,0 12 ml/h CAPACITY 0 1995 Goulds Pumps, Inc. Effective May, 1995 1232 Wisconsin De0artment of Commerce SOIL EVALUATION REPORT P age 1 of 3 Division of Safety and Buildings in accordance with Comm Iv Steel Sal Service my Attach complete site plan on paper not less than 8% x 11 inches in size. Pla must St. Croat include, but not limited .to: - vertical - and. horizontal reference point (BM), dined and percent slope, scale or dimemsions, north arrow, and location and distance to earestdC 1 1' 030- 2076-90-000 I.D. LUJ tE Please print all information. R @d Date Personal information you provide may be used for secondary Purposes (Privacy Lair, S. 5.04 (i8m)) C R 0 I X C U (1 r � � 2 � 3 Property Owner Elert, Dave Govt. Lot SE 19 NW 1/4 S 26 T 30 N R 20 W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# 1354 14th St. 12 2 Dreschler Heights City // State Zip Code Phone Number City A Village Town Nearest Road #o 110 WI 54082 651 - 303 - 2589 St.Joseph 14 Th St. 5M New Construction Use: in Residential / Number of bedrooms 4 Code derived design flaw rate 600 GPD it Replacement Public or commercial - Describe: Parent material Sneam terraces Flood plain elevation, if applicable na General comments and recommendations: Moun design ,system elevation 97.1 Oft based on contour fine elevation 96.1 Oft - ----------------- -- - - -- a Boring # n" Boring id Pit Ground Surface elev. 96.20 ft. Depth to limiting factor 44 in. Sod Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/(t' •Eff#1 `Eff#2 1 0-4 10yr3/3 none sl 2msbk mfr cs 1f .5 .9 2 4-44 7.5yr4/4 none sl 2msbk mfr cs na .5 .9 3 44-63 1 Oyr6/2 c2d 7.5y 5/6 sicl om mfr cs na .0 .0 4 63 -96 7.5yr4/4 c2d 7.5yr5/6 sins lcsbk mvfr na na .4 .6 Z Boring # A Boring ts Pit Ground Surface elev. 96.00 ft. Depth to limiting factor in. Sod Apples Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/W - Eff#1 `002 1 0-6 1Oyr33/3 none sl 2msbk mfr cs 1f .5 .9 2 6 -45 7.5yr4/4 none sl 2msbk mfr cs na .5 .9 3 45-65 10yr6/2 c2d 7.5y 5/6 sicl om mfr cs na .0 .0 4 65=96 7.5yr414 c2d 7.5yr5/6 sins 1 csbk mvfr na na .4 .6 ' Effluent #1 = SOD ? 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 David J. Steel /^ 248956 Address Steel Soil Servi G Date Evaluation Conducted Telephone Number 1564 CR GG, N lc mooncl, Wl 54017 12/6/2002 715 - 246-5085 Property Owner Elert, Dave PardW iD # 030 - 2076 -90 -000 - fie 2 of 3 F 3 - { aring # Boxin I it Pit Ground Surface elev. 95.70 ft. Depth to limiting factor 47 in SW Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots SPD/ft *EfM *Eff#2 1 0-4 1Oyr3/3 none sl 2msbk mfr cs 1f .5 :9 2 4-47 7.5yr4/4 none SI 2msbk mfr es na .5 .9 3 47-55 7.5yr4/4 c2d 7.5y 5/6 sl 2msbk mfr cs na .5 .9 r 4 55 - 1Oyr6/2 c2d 7.5yr5/6 Sid om mfr gw na .0 .0 5 72 -96 7.5yr4/4 c2d 7.Syr5/6 sVls 1 csbk mvfr na na .4 .6 F-I Boring # Bing � Pft Ground Surface env. ft. Depth to limiting factor in. � Rate Horizon Depth Dominant Color Redox Description Texture Structure Cormtence Boundary Roots GPD/W *Eff#1 *Eff#2 F—I Boring # Boring ij PR Ground Surface elev. ft. Depth to limiting factor in, Sol Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft *Eff#1 *Eff#2 * 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 sen ice pro-v ider and emgloyw. If need assistance to access services or Page 3 of 3 STEEL'S SOIL SERVICE David J. Steel 1564 Cty Rd GG CST POWTSM David Elert New Richmond, WI 54017 Lic. # 248956 SEi /4,NW1 /4,S 26,T30,R20W (715) 246 -6200 Town of St.Joseph, St. Croix Co. (715) 246 -5085 Dreschler Heights, Lot 12 gend �= 40' ©= Benchmark El. 100.00Ft Top of outside water spiget Alt Benchmark E1.98.900Ft Up- of Retaining wall ❑ = Borings Boring Elevations B I =96.20Ft B3 = 95.70Ft B4 = 00.00Ft gyp+ i A' Ae �O 0t 3 BI 7q Zoe dwell Z- 3 7-414 r • ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP C'- RTIFICA T ION FORM Owner/Buyer Mailing Address _/3�� /� 7,* 5 �v�Li��✓ l.J. J Property Address 4 411 - 7a - ,l (Verification required from Planning Department for new construction) City /State /i."i Parcel Identification Number C3 , - ,076 90 - 000, 03D X76-95 -0a-'�P LEGAL DESCRIPTION Property Location J C '' /., M W '' /,, Sec. T 36 N -R - ZD W. Town of 5 i , JaszP �l Subdivision )m5c Ler kte4ckf5 Lot # / -�-��- w ec 13 Certified Survey Map # . Volume . Page # r-- Warranty Deed # �(o F> Volume ;�d , Page # Spec house dyes 0 no Lot lines identifiable 93 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, restrictedplumber or a licensed pumper verifying that (1) the on -site wastewaterdisposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. I/we, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State 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 days o thne& ye V a iratio date. 3 /g /O SIG ATURE 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 erty scribed bov by virtue of a warranty deed recorded in Register of Deeds Office. 3 /'& SIGNATURE OF APPLICANT DATE * * * * ** Any information that is mis- 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 STATE LIAR OF WISCONSIN FORM 2 - 1982 SC-9334 WARRANTY DEED ] DOCUMENT NO, 1Q� 17�� PACE _N rrvl R• - J - , &nson and Mar R• _Jphnson,,-husband -and_ REGISTER'S OFFICE w ife , - ST. CROIX CO. WI Rse'd for Record conveys and %.arrant:; to . -)avid Charle Elert and De borah Je DEC 0 3 1997 Elert, husband and wi 10:10 A M Register of Daade THIS SPACE RESERVED FOR RECORDING DATA _ NAME AND RETURN ADDRESS the following described real estate to St. Croix County, State of Wisconsin: 030 - 2076 -90 -000, 030 - 207 -95 -000 PARCEL IDENTIFICATION NUMBER Lots 11 and 12, W 1/2 of Lot 13, Block 11 Drechsler Heights in the Township of St. Joseph, St. Croix County, Wisconsin. $ 5Pj I$SFER .3 � This is homestead property. (is) xxxxx Exception to warranties: easements, restrictions and rights -of -way of record, if any. Da Yd I!; (SEAL) (SEAL) . Darryl R John o Marilu R Johns n (SFAL) (SEAL) AUTHENTICATION ACKNOWLEDGMENT Signature(s) State of Wisconsin, �x 4�— County authenticatedi this day of 119— Personally carna.15Ffore me s 4 1� day of �vgn�t= , 19 the above named Darryl R. Johnson and Marilu R. Jo hnson, husband and wife, TITLE: MEMBER STATE BAR OF WISCONSIN _ (If not, authorized by §706.06, Wis. Stats.) :rends Poplin to me ko n to be the person who executed the foregoing "f` Public instrument )d acknrv;edg r 5au THIS INSTRUMENT WAS DRAFTED BY Wisconsi Attorney Krici-i na Qgland GLl� Httcicnn 5d(11n N bhc, Count Wts. (Signatures may be authenticated or acknowledged. Both are not My col,Imisslom is permanent. (if not, state a trat n da necessary) • Nimes of prrmns slgntn., in any ,AP. wtY sh ncld by typed or printed below their ,igralu(Lsi SIAIE Iii OF WISCONStN ri&scensn Legal Bonk Co.. Inc. W:1RF 1NTY DE[U Form No. 2 — 1982 MIIwaJ,ee. V- WEG RER SAIL TESTING and D�ESIGl �•rv`SERVICE SOIL TESTING`- SEWER.SYSTEM DESIGN - MORTGAGE SURVEYS ATTN : n/6 DATE - - CC. i SUBJECT: �� 1,) t_�`7Zr THE FOLLOWING ITEMS ARE ENCLOSED 0. OFJ DESCRIPTION COPIES • S u t L � LS 5� ���012 - SENT TO YOU FOR THE FOLLOWING REASONS: v FOR YOUR USE FOR REVIEW AND COMMENT INFORMATION DESIRED ha) 66 LZY\i C S t ct�O r WEGERER SOIL TESTING AND i DESIGN SERVICE P.O.BOX 74 421 N.MAIN ST. RIVER FALLS,WI 54022 PHONE 715- 425 -0165 Wisconsin Departinent of Industry SOIL AND SITE EVALUATION REPORT Page \ of Labor AN Human Relations Divisian of safety & B uildngs in accord with ILHR 83.05, Wis. Adm. Code P ' COUNTY Attach complete site plan on paper not n 8 less tha1 f2 k 11 inches in e. Plan must include, but x not limited to vertical and horizontal referent girft(13M), direction and f slope, scale or PARCEL I.D. # emu a _%_zo7b- So `n Lur NZ - o DO st to road. \ t acd� �� - oa - u»b - -is dimensioned north arrow, and location a APPLICANT INFORMATION -PLEA JRIIINT ALL II�F631ATI6 R B D T r C f PROPERTY OWNER: I , n RbPERTY LOCATION - DflV l {sZ �R,�— _ �, ,... St_ 1/4 NW 1/4,S Z 6 T 3 0 ,N,R 2.0 E ( W PROPERTY OWNER':S MAILING ADDRESS `' j ;0ON! y T � BLOCK # SUBD. NAME OR CSM # S4 Lt4 `IT ST" 'ON'NGOFFICE , •ev�3 - `tJ C 1, t}i.G S CITY, STATE ZIP CODE MNU . ;= CITY []VILLAGE (MOWN NEAREST ROAD Lj (] New Construction Use [A Residential / Number of bedrooms [ J AddiiQn to e)assbng building n Replacement [ ] Public or commercial describe Code derived daily flow VsQ gpd Recommended n loading rate �- y bed polft e trench, gpd/ft \sop �q• h'C G►�fivtr Absorption area required - bed, � trench, 11: Ma)amum d gn loading rate ° " y bed, gpd/ft - trench, gpo1ft Q \S1ZLtau`rhU•. 1 t P� F� Recommended infiltration surface elevation(s) ft (as referred to site plan benchmark) Additional design / site considerations 9T G �Z S`-cS`i�- t w Z OR `poW ftVZ OS - 0Nr_j j ' LtsIQ G, Parent material S Pr"D4 ou'Nw r\-gt{ oUL 'Sc l L_L Flood plain elevation, if applicable 'ti- A ft S = Suitable for system CONVENTIONAL MOUND IN-GROUND RESSURE AT -GRADE SYSTEM IN FILL HOLDING TANK U = Unsuitable fors stem EIS tJ U ®S ❑ U ❑ S ®S ❑ U ❑ S O U ❑ S ® I SOIL DESCRIPTIO REPORT Depth Dominant Color Mottles Structure GPD /ft Boring # Horizon in Munsell p Sz, Cont Colo Te re Gr. Sz. Sh. Consistence Barxiary Roots reach ;,.4 <,, \AF � U - 1�Sek M Ufl-- Zuj •6 Ground J - n -33 R- 31 y — 1 csbk m wfi - elev. l -b ft. 33 - yy 1 • S `1(L �/y - ca w. Yn U'�►� C S — . Depth to S yq -3 S`ttz y/y sk[L 3/ s — limiting factor Remarks: Boring # _ 0 - 13 SYR z.s !Z Z►q sbk y) \A 2ui • 6 -'s �Sbl� vn v - 3 23 -�l 3 � • S `1 tz. �!! � ow v+� V'�' � Cg - • � — Ground C-L 5`t 31y elev. f X13 -LZ --)-S `1 �- YI prow 1 ti t S Owe w► '�t — rvP _ lt \ ft. Depth to limiting factor Remarks: TName. Please Print Arthur- L. We erer Phone. 715 -425 -0165 egerer Soil Testing & Design Service -P.0 - Box 74 River Falls,WI 54022' Signature: f Date: CST Number. i 1 PROPERTY OWNER 'ALT SOIL DESCRIPTION REPORT Page of , 3 PARCEL I.D. # S irt Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Tnanch -� o - - )•SCR 3!z - VS Z -`� .6 — Z 8 T` ._� s `1 FL V/ — 4S \U+ -6 Ground 'Jy -qz .S Yfz 's/ y - y — elev. »o. ft. 4 IlL�1 S `! R y/ c Z S I IL 31 y Ste] Ohm - Depth to limiting factor Z � f Remarks: Boring # 's j I Ground elev. ft. Depth to limiting ;'factor Remarks: Boring # , Ground elev. ft. Depth to limiting factor i Remarks: Boring # V(hw k '� T Ground elev. ft. Depth to limiting factor Remarks: SBD- 8330(8.05/92) I PLOT PLAN Pa 3 of 3 SCALE 1 "= y0 l V' l s " 1 fn �v / 5 f G a v C Q I Cl. I art t - �i. rflo.o' 01v �01'�orr o� Nv�sE sro��us. ©rte z - . r oi.o D iv eo OF C KJ c V,0. E . 7 4 715 ) 425 -0165 _ I400576 CST Signature Date Signed Telephone No. CST # Wisconsin Depe tment of Industry, SOIL AND SITE EVALUATION REPORT Page \ of- Labor and Human Relations Division of safety a Buildings in accord with ILHR 83.05, Wis. Adm. Code COUNTY e Attach complete site plan on paper not less than 8112 x 11 inches in size. Plan must include, but ST. t' x not limited to vertical and horizontal reference part (B", direction and % of slope, scale or PARCEL I.D. #f Laru o3p_ ao Bo wT x2 -(D Us _ z 076_9\1 dimensioned, north arrow, and location and distance to nearest road. X- _ oa - - LA31b - cis APPLICANT INFORMATION- PLEASE PRINT ALL INFORMATION PROPERTY OWNER PROPERTY LOCATION - t)PN I Z) E QV-* - r G=40T SIE 1/4 NW 1/4,S Z 6 T 3 0 ,NR Z.0 E( OR PROPERTY OWNER' MAILING ADDRESS �.OT BLOCK #� SUBD. NAME OR CSM #f ` S 4 l Ll `i +_ ST tz � � . nF t3 `tJ C L �4E�G S CITY, STATE ZIP CODE PHONE NUIN�ER []CITY �111LLAGE TOWN NEAREST ROAD ���h� ►J I 5 41J BZ (6lz) 43 N `7}t ST [ } New Construction Use 14 Residential / Number of bedrooms q [ ] Addit T to existing building n Replacement [ ] Public or commercial describe Code derived daly flow ks gpd Recommended design loading rate - bed, 9. trench, \C so-V NT-- 6czKoILA. Absorption area required - bed, fte trench, ft Maximum design loading rate ° y bed, gpd/ft trench, gpolft Q \S`Mt$u -W'Pj tP� F�2 Recommended infiltration surface elevation(s) �o�ret v�TS -- V . VO o . Pti ft (as referred to site plan benchmark) Additional design / site cor>,siderations FFr G E S`tShZ-t w/Z f'i$ %p'noU j ftjt,�- 05 - Is N \ S' x bp' Lu>v 6, Parent material S ftrj1W l ov'`w?d'W oUt_r 'S T1 t✓L Flood plain elevation, if applicable 1v A ft S = Suitable for system CONVENTIONAL MOUND "ROUND PRESSURE AT GRADE SYSTEM IN FILL HOLDING TANK U= Unsuitable for stem 11 S I� U ® S D U ❑ S ®U ®S [] U ❑ S ®U OS ® U SOIL DESCRIPTION REPORT Depth Dominant Color Mottles Structure GPD /ft Boring # Horizon in. Munsell Qu. Sz. Cont Color Texture Gr. Sz. Sh. Consistence Baxxiary Roots rem c) - 10 S`1fZ 31t s l Zwt M \ A C'L' - L vi -6 - Z to -z:1 -- ) -s 11Q 31Y Zt,-P, •� Ground 3 2 -33 - 1. S `1 R 31 y - S \ Csbk rn C - S •y - elev. 1 33 -yy 1. S `1 iL y /y 0-S Depth to S y4 -S S h tz Y S L I It- 31V S C_ - limiting factor Remarks: Boring # _ } 0 -13 - �.SyQ z.s s, ZwtS �viti �w 2u� •6 -- Z Z 13 z3 , .s ��.31y s► 1�sb>� vn v�- �S 1�� .y , 3 23 -4 3 -�• s ` R y/y - ��s owf wt v'��- C.g - . b Ground cz 5`itZ Sty elev. L] L13 -6o -).S `1 vl- Y/ k ( SCA 0M wt '� r•�P _ ft -'\ '\ ft Depth to limiting factor Remarks: CST.Name:- Please Print Arthur- L. :We arer ` Phone: 715 - 425 =0165 ergcrer Soil Testing & Design Service -P 0 r.Box 74 River Fa11s,WI 54022 _ ' -. Date: -CST Number. sgnat<ue / .� _ M00576' r PROPERTY OWNER )T SOIL DESCRIPTION REPORT Page of 3 PARCELIA# Ste? T>fy(Itz— I Depth Dominant Color Mottles Structure - GPD /ft In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Boring # Horizon Texture Consistence Bounday Roots Bed Trench �•S'-I Lt R y/y bk v� v'�►- c s i. 6 Ground Z. -� •S y2 - sl y elev. tibo, y R y/ c L S 'I IZ 31 y Depth to limiting factor kA Za Remarks: Boring # Ground elev. { ft. Depth to limiting Yactor Remarks: Boring # r i Ground elev. ft. Depth to limiting factor f Remarks: Boring # , Ground elev. ft. Depth to limiting factor Remarks: SBD- 8330(8.05/92) _ P 3 of. 3 PLOT PLAN g SCALE 1 "= y0 1 � wn� � �J B•1 4 So . ` i � ►�Zec3o I I are vf I - �g. \W,& otv �oY"1on ot= HovS� stb�ius. %N-1'R Z. - Lrz . \O 1 • b pN 0- MW (ER. oF CA►v CV-ITE _ . q8- L � (715 ) - 14 00576 CST Signature nature Date Signed Telephone No. CST # SAFETY AND BUILDINGS DIVISION 201 East Washington Avenue P.O. Box 7969 Madison, Wisconsin 53707 isconsin Department of Commerce Tommy G. Thompson, Governor William J. McCoshen, Secretary At -Grade System Onsite Verification Report Are the soil and landscape features accurately reported on the Soil and Site Evaluation Form -_yes no If no, provide a further description by including an onsite report, which may consist of a soil profile report., or provide a brief explanation below. If yes, what other type of Private Owned Waste Treatment System (POWTS) could be used? rnoynC, / _ Zo County Offi ial Signature Date I V i --22 Property Location -Dr- le- y �` � i k+6 1\ W 5 95 Z. Landowners Name SBD- 10513(N.11/96) Wisconsin Department of Industry SOIL AND SITE EVALUATION REPORT Page \ of -j- tabor and Human Relations ,n of Safety 8 Buildngs Div* - in accord with ILHR 83.05, WIS. Adm. Code FN Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must include, but �x not fimited to vertical and horizontal reference point (BM), direction and % of slope, scale or #f unu- dimensioned, north arrow, and location and distance to nearest road. 30 - Z-0 - )(6- b 9 oa u��b - - 5 APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION Y DATE. PROPERTY OWNER PROPERTY LOCATION l Z) E. l i�.T 601 4QT- S£ 1/4 N W 1/4,S Z 6 T 31,) .NR Z I) E( PROPERTY OWNER':S MAILING ADDRESS JOT BLOCK # SUED. NAME OR CSM i \. S 4 l LI 1 114 s r ` `.0��3 - � c 14t6 CITY, STATE ZIP CODE PHONE NUMBER ❑CITY (]VILLAGE (MOWN NEAREST ROAD �O�L ►tiI SLl oBZ (612) 3 - 11 8 ST- S It1 *TV ST. [ J New Construction Use Residential / Number of bedrooms q [) Addi n to existing buildutg K Replacement [] Public or commercial describe o y G r u Code derived daily flow o� gpd Recommended design loading rate - bed, gpolt� - trench, gpoW \ Soo 30,, Absorption area required - bed, trench, ft Maximum design loading rate ° y bed, gpd$ - trench, gpolft Recommended infiltration surface elevations) . pro • g it (as referred to site plan benchmark) Additional design / site considerations 9T 6 ��*rtE S` stt w /Z t a'soy- p'n(3h1 ftyz0S - la-i" \S'x S p' t_c1>v G, Parent material S boy OuAwhSW oUL 'Sc k )I L-t - Flood plain elevation, if applicable 'IV• P1- ft S = Suitable for system CONVENTIONAL MOUND "ROUND PRESSURE I AT -GRADE SYSTEM IN FILL HO-DM TANK U= Unsuitable fors stem ❑ S 10 U I RI S ❑ U 1 ❑ S ® U ®S ❑ U ID S ®U [IS ® U SOIL DESCRIPTION REPORT Depth Dominant Color Mottles Structure GPD /ft Boring # Horizon in. Munsell Qu, Sz. ConL Cola Texture Gr. Sz. Sh. Roots reixtt 0 - ►0 �•S�t(Z 31Z s 1 Zw�Sb4r w,v�►- ci.� z u� •6 - ! IM M Ground S `-R 31y — S 1 O sbk m v`ft- cS •y - elev. r_ 1 ou •`� ft. 33 44 -1-S `1 t - y /y Depth to l _ P S y 4 -S7 - 7 S `2 R � S LI iz 31 s e limiting factor �4 Remarks: Boring # _ 0 -13 -,.S z .s lZ s 1 Z+', sbk ', vJ�. mot... 2u•� • 6 Z �3 Z3 , S�tcL ply s I �sb� YA Vi . - 3 23 -�13 �S �1 y - \� ow, wt v'F►� CS - . to -- Ground Cz S,�Q 31Y - elev. y L13--Z I -S `1R- Y/ pr.•o \ ti l SCX 0M wt \ -1% ft. Depth to limiting factor _�3 4 Remarks: T Name: -Please Print Phone: Arthur L. We erer 715- 425 -0165 egerer Soil Testing & Design Service -P.O. Box 74 River Fa11s,WI 54022 Sgrk ture: Date: t_ - CST Number. L M00576 I —�4 b PROPERTY OWNER tr_NT SOIL DESCRIPTION REPORT Page o f ' 3 PARCEL I.D. S eL Boring # Horizon Depth Dominant Color Mottles Texture. Structure Consistence Boxclary Roots GPD /ft In. Munseli Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench - o - a 1• S �tz 3lz — -? w) V `Fh c S Zu .6 2. 8 3`f ? -S `t Iz y! y — ) 1 �-s blT y„ V `F C S 1 u � • 6 — Ground 'Jy -y2. S `12 �l U S �Sb1z Y►�'�t- C S �{ elev. oo , I ft. 4 �-lLq "� S ti R - y� ° Z s y 2 1 y S c J O m t^ — N P - Depth to limiting factor Remarks: • Boring # .13 I %Ground ' ..elev. ft.' Dep to �. limping � )'factor Remarks: Boring # Ground elev. ft. i Depth to limiting factor i Remarks: ; ,,Boring # •; F !:4 ;Ground elev. ft. Depth to limiting factor - 71 1 Remarks: e arks: SBD- 8330(8.05/92) PLOT . PLAN Pa 3 of 3 SCALE 1 "= y0 ' ` 4 ss t--L lrs 1 B•1 a' 4 / 1! s -z (7 15 ) 4 .S -n1 65 _ 1400576 CST Signature Date Signed Telephone No. CST # 5 � l ow c v � - � T 1 / -. 3 6 6 N 'C�r l WEGERER SOIL TESTING and DESIGN SERVICE, SOIL TESTING - SEWER SYSTEM DESIGN - MORTGAGE SURVEYS ATTN: wG DATE -'g CC: t .. . SUBJECT: I g THE FOLLOWING ITEMS ARE ENCLOSED�'u ^l�ti 0. OF DESCRIPT N' COPIES t SENT TO YOU FOR THE FOLLOWING REASONS: I/�OR YOUR -USE FOR REVIEW AND COMMENT INFORMATION DESIRED P LL 3e V E1 L F -Y 'sw LS A'f Ttf'LS S ITL ftm� WEGERER SOIL TESTING AND DESIGN SERVICE P.O.BOX 74 421 N.MAIN ST. RIVER FALLS,WI 54022 PHONE 715- 425 -0165 1 34c d v1 e� 0 3 ;� op.m C P rn • Z y o c ` w P N O- O 3 c� "� g 6 C A s b — a T v fp y Q W o0 N C4 N 9 a ° 0 2 N o c Z CA) ;wiz "M . 000 d4 'a 3 N fn N f�D a Q v v 0 w m m m to D o O > j CL I y N y I � C I � 7 N m a -� -1 y rn c A ? n g �!G� I m w We �wrn `uJ mo Z O p 0 I� m CD 1� p� I a 3 I °• � A 0 c r o F' cD U , I I I I �a I I � a 0 w ° I I � o 0 CD aro ti 69 f ~ Cz