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Home My WebLink About030-2070-10-000 Wisconsin Depadment of Cornffwce PRIVATE SEWAGE SYSTEM C Safety PM s Division Cr INSPECTION REPORT t. GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary Permit No.: Personal information you provice may be used for secondary purpose- (Privacy Law. x.15.04 (1)(m)]. 395101 Permit Holder's Name: ❑ City Vi tbbe ❑ Town of: State Plan 10 No.: Dru ffner, Mark St. Joseph Township CST BM Elev.; Inso. 8M E ev i BM Description: n Parce Tax No.: n 3- :to q - 3.1 D_ G5� A4 • V,"A �c� 30- 2070 -10 -000 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic T 1 W , e,l' 12-CD Benchmar �µ{ (, 5 d 0!5 Zz 0 1 3. :?Lz a: k 1l. BM Aeration Bldg. Sewer 3•qo off. gp' Holding - g' Ht In1 4 80 TANK SETBACK INFORMATION 4 CSt� Ht Ou et S• 30 TANKTO P/L WELL BLO ventto Air Intake ROAD Dt Inlet Septic r s ieJ' p i 9 NA Dt Bottom / --- NA Header / Man. 1 � 3 Aeration - - NA BistrRipe fi` t 9.9s. . ZS-r - 77 Holding __ Bot.Syste 19-10 4 Z Z a PUMP/ SIPHON INFORMATION Final Grade I I ; �, 9 8 .3 5 - Manufactu r Demand t over I OZ.4O' Model Numbe GPM TOH Lift riction System DH Ft Forcemaiti Length Fi Dist. Towel( SOIL ABSORPTION SYSTE I ) /4 BED /TRENCH Widh Length / N .O Trenches PIT No.Of Pits Inside Dia. Liquid Deptt - D IMENSIONS Q3•i e•. DIMEN ION SYSTEM TO P / L BLDG WELL LAKE/STREAM LEACHING Man act SETBACK INFORMATION S e O tem: - 1 � / 5-0 / ,� l - r � OR N T R Mo Number: � DISTRIBUTION SYSTEM Header / ani Di ribution Pipes x Hole Size x Hole Spacing Vent To Air Intak Length Di,. T ngth Dia. pacing 3 o SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only t� Depth Over Depth Over xx Oepth Of xx Seeded /Sodded xx Mulched r Bed /Trench Center Bed /Trench Edges Topsoil ❑ Yes C3 No ❑ Yes ❑ No COMMENTS: (Include code discrepancies, persons presen lMobction #1: Io/ Ind all Inspection #2: - J - Location: 1288 7th Street, Hudson, WI 54016 (NW 1/4 NE 114 36 T30N R20W) - 36 E 1.) Alt BM Description = %,w S T -cam �� o1 ' 3 2.) Bldg sewer length = > amount of cover = ` I!4A. �t �, 7 I1 �/ O�' Ql yvl L�7r'4• pb%. Ian feVlSlOn r ulred? Yes eq ❑ fZNo Use other side for additional information. `�f'/ l� SBO -6710 ( R o (C R.3/9 ` e{� _ A t D e t sP �Of Z Se r eb Cert Nc :+) � . s �acY S 1 Safety and Buildings Division County t 201 W. Washington Ave., P.O. Box 7162 isconsin Madison, WI 53707 - 7162 Site Address Department of commerce S 7 Sanitary Permit Number Salutary Permit Apphc ? � / 3�s In accord with Comm 83.21, Wis. Adm. Code, personal ' o you proviHF?,! ❑ Check if Revision may be used for secondary purposes Privacy 1 I. Application Information - Please Print All Informatl REC�NE State Plan I.D. Number Property Owner's ame t`L O ,� 2fl ni Parcel Numbe r ( , O . a C !��- X 1)30- a 07 - D - Property Owns Mailing Addr Z G�F1GE Property Location ^ pPi /(, W i4 NE; S T�3 ON, R 0 City, State Zip Code �� Lot Number Block Number g Subdivision Name CSM Number H. Type of Building (check all that apply) �Z ✓ ^ S / � / a ❑City A 2 Family Dwelling - Number of Bedrooms � ti18u� �(o w5 • ❑Village ❑ Public /Commercial - Describe Use _ ownship V ❑State Owned /'� /a Nearest Road III. Type of Permit: (Check only one box on line A (numbering scheme for internal use). Complete line B if applicable) A , \ For County use itew 2 Replacement System 3 C1 Replacement of 6 ❑ Addition to System Tank Only Existing stem B. ❑ Check if Sanitary Permit Previously Issued Permit Number Date Issued IV. Type of Permit: (Check all that apply)(m mbering scheme is for internal use) 44 KNon - Pressurized In -Ground 21❑ Mound 47 ❑ Sand Filter 50 ❑ Constructed Welland 22 ❑ Pressurized In- Ground 41 ❑ Holding Tank 48 ❑ Single Pass 51 ❑ Drip Line 45 ❑ At -Grade 46 ❑ Aerobic Treatment Unit 49 Q Recirculating 30 ❑ Oth V. Dispersal/Treatment Area Information: — Design Flow (gpd) Dispersal Area Dispersal Area Soil Application Percolation Rate System Elevation Final Grade Required Proposed Rate(Gals./Days/Sq.Ft.) (Min./Inch) T - evation I t Manu VI. Tank Info Capacity in Total Number acm r Prefab Site Steel Fiber Plastic Gallons Gallons of Tanks Concrete Constructed Glass New Existing Tanks Tanks Septic or Holding Tank f AJLA- � Dosing Chamber VII. Responsibility Statement- I, the undersigned, assume responsibility for ' tion of the POWTS shown on the attached plans. Pl ber's 14ame (Print) Plumbe ' MP RS Number Business Phone Number !� o� oho ;�,5` l?i Plumber's Address (Street, City, State Zip Code) VIII. Count /De artment Use Onl Approved ❑ Disapproved Sanitary Permit Fee (includes Groundwater Date Issued Issu Agent Signature (No Stamps) Surcharge Fee) ❑ Owner Given Initial Adverse I Determination IX. Conditions of Approval/Reasons for Disapproval 6k il u)&, ` as pe.." coik i t �s C tnticu`Yl. - � a.S ire C61A& Wk4A �6v1S Attach plete plans (to the County (!y) for a sy on paper not less tthan 81/2 :11 i h size SBD --6398 (R. 05101) i I I 0 I r- 7 5 h A-G 7` U lu = r <7 3 >o o� L 3 0-j �3' t3 e \ TQ y 1 i - D y 1 I /ago 76"k- � gy3, 6 < <, ,4 �-u� B/u = ref 0 � q3, >o' , are _ d TJ Or \ 13' x Bra 10 35- s N � o .'sy g .3D Sy. ya l JILT 7 Gr , Wisconsin Department of Commerce SOIL EVALUATION REPORT Page _ of 3 Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code County $t. Croix Attach complete site plan on paper not less tha�rrX8 jo inches In size. Plan must include, but not limited to: vertical and horizo ahreference point (BM) direction and Parcel I.D. 030 percent slope, scale or dimensions, north ow, and location and distance to nearest road. 4� Please pri all information. Re 'wed by Date Personal information you provide may be u ad for secondary purposes (Privacy Law, s. 75.04 (t) (m)). t Property Owner Property Location 1 Mark Druffner Govt. Lot NW 1/4 N19/4 S 36 T 30 N R 20 # (or) W Property Owner's Mailing Address.' Lot # Block # Subd. Name or CSM# 1288 27th. ST. City State Zip Code Phone Number ❑ City ❑ Village Mown Nearest Road Hudson, WI 54016 ( 715) 543 =5453 27 f New Construction Use: ® Residential / Number of bedrooms 4 Code derived design o a GPD [ Replacement El Public or commercial - Describe: — Parent material at: l�� } Flood Plain elevation i licable ft. t General comments and recommendations: I f t , �' ^ 5T CfiO+�` T r ` COU trenches s taR ING @ el. 92.90 spa tiw to cod 00 e 5. be a tc � Pa � qz' of 1= F-11 Boring # Boring ® pit Ground surface elev. 97.90 ft. Depth to limiting factor - in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /fit in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 1 0 -10 10 2 none 2msbk mfr CrW 2c .5 .8 2 10 -21 10yr4/4 none sic 2msbk mfr gy 1c .4 .6 3 21-461 10yr4/4 none sil 2msbk .5 . mfr cFw 1-F 4 46 -58 10yr4/4 c2d 7.5 5/6 sil .0 2 5 58 -10 7.5yr4/6 none is 0sq mvfr 2, v (ao gr, t Boring # Boring 97 100 F - 2 1 ® 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 /fit in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 1 0 -12 10 2 2 none mfr cs 1M 2 12 -26 75. 4 none mfr qw 1 3 26-100 7. 5rY4 /I none HIS Os Effluent #1 = BOD > 30 220 mg/L and TSS >30 < 150 mg /L Vuent #2 = BOD < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) Signature . CST Number Gary L. S teel 02298 Address Date Evdluafion onducted Telephone Number 1554 200th. Ave., New Richmond, WI. 54017 6 -20 -2001 715 - 246 -6200 Property Owner Mar Druffner Parcel ID # Page 2 of - 3 Boring # El Boring 8400 ® . pit Ground surface elev. 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 -16 10 2 2 npne T. 2msbk mfr cs 2c 1 .5 8 2 16-29 7.5yr4/4 none sl 1csbk mfr 3 29-100 7.5yr4/60 none ms Osq ml �Z q 2• Boring # F1 Boring 94.30 100 in. [ Q Pit Ground surface elev. ft. Depth to limiting factor Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. `Eff#1 `Eff#2 1- 0 -10 10 2 2 none T. 2msbk mfr qw 2c .5 .8 2 10 -24 10yr4/4 none sicl 1m .4 .6 3 24 -46 10yr4/4 none sil 1f .5 .8 4 46 -58 10yr4/4 c2d 7.5 5/6 sil 5 58 -10 7.5 4/6 none Ms 0 g MI na lid . F] Boring ❑ Boring # Ground surface elev. ft. Depth to limiting factor in. El Pit I Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. '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 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 (R.6 100) r STEEL'S SOIL SERVICE Gary L. Steel 1554 200th Ave. CSTM2298 Mark S36 - Ter New Richmond, WI 54017 Nw - NE' S36 T30N -R20w 715 246 -6200 MPRSW -3254 4 4 ( ) town of St. Joseph "N .✓� " -40' P .= top of 1" pvc pipe @ el. 100.00' t. = top of 1' pvc pipe @ e . 93 70' l /-L" 1 I Gary L. Steel 6 -20 -2001 i } r - 4 Private Onsite Wastewater Treatment System Management Plan Septic Tank And Gravity In- Ground Soil Absorption Component Pursuant to Comm 83.54 Wis. Adm. Code each Private Onsite Wastewater Treatment System (POWTS) shall include information and procedures for maintaining the system within the parameters of Comm 83 and 84, and the conditions of approval by the department, agent, or governmental unit. The approved plans and permits for system are on file at the county zoning or health department. This management plan complies with Comm 83.54, Wis. Adm. Code, and the In- Ground Soil Absorption Component Manual for Private Onsite Wastewater Treatment Systems SBD- 10567-P (R.6/99). Table 1: System Design Specifications Sanitary Permit Number SI I Number of Bedrooms Design Flow - Peak (gpd) lv Estimated Flow - Average (gpd) D'fl Septic Tank Capacity (gal) _ Soil Absorption Component Size (ft') `� Z " C Type of Wastewater Domes 'c Table 2: Soil Absorption Component - Limits of Reliable Operation Septic Tank Component Soil Absorption Component Design Flow - Peak (gpd) 2 - S 6 Maximum Influent Particle Size (in) 1/8 Maximum BOD (mg /L) 220 Maximum TSS (mg /L) 150 Table 3: Maintenance Schedule Septic Tank Inspect and /or service once every 3 years Outlet Filter Inspect once a year and clean at least once every 3 years Soil Absorption Component Inspect once every 3 years I Septic Tank The septic tank shall be maintained by 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 (Servicing Septic or Holding Tanks, Pumping Chambers, Grease Interceptors, Seepage Beds, Seepage Pits, Seepage Trenches, Privies, or Portable Restrooms). The operating condition of the septi and outlet filter shall be assessed at least once every 3 years by inspection. The utlet filte Shall be cleaned as necessary to ensu e made to pro er o on. The filter cartridge show d not be removed unless provisions ar retain solids in the tank that may slough off the filter when removed from its enclosure. If the ' Management Plan for a Septic Tank and Soil Absorption Component 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 scum and sludge 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 an 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. 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 the tank. No one should enter a septic or other treatment or holding tank for any reason without being in full compliance with OSHA standards for entering a confined space. The atmosphere within the septic or other treatment of holding tank may contain lethal gases, and rescue of a person from the interior of the tank may be difficult or impossible. Tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the tank is no longer used as a POWTS component. Soil Absorption Component The soil absorption component serving this structure is designed to accept domestic wastewater from a residential facility. The limits of operation of this component are shown in Table 2. The longevity of a soil absorption component depends greatly on proper and timely maintenance, and system use within or below the limits of reliable operation. Good water conservation practices by all occupants and the installation of water conserving plumbing fixtures are key factors in extending the useful life of this component. The soil absorption component's operation must be assessed by inspection at least once every three years. The inspection shall include recording the levels of ponding, if any, in the observation pipes, and a visual inspection for any evidence of surface seepage or discharge from the component. On steeply sloping sites, areas of erosion should be identified and reported to the owner for repair. The surface discharge of domestic wastewater or sewage from the system is prohibited and considered a human health hazard. Traffic around or over the soil absorption component should be avoided particularly during winter months. The compaction or removal of snow cover over the component may lead to hydraulic failure by freezing. This type of failure is usually temporary, but is difficult or impossible to repair until weather conditions improve. In general, soil compaction over this component will reduce diffusion of oxygen into the soil and dispersal cell, which may lead to more intense, and earlier, organic clogging of the soil. 2 Management Plan for a Septic Tank and Soil Absorption Component ted trees and shrubs directly over or within ten feet of the Plantings of deep-rooted component should be avoided since root intrusion into the component may obstruct wastewater flow. A N "e-- SA c7 5) _y�go ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer I o r K- Drry 4X�-"e r Mailing Address Property Address t4 U JSo W I (p (verification required from Planning Department for new co ) City /State Parcel Identification Number /� 3 b - o� O '? 6 LEGAL DESCRIPTION Location W N� '/4, Sec. T j cy • �N -R., .W, Town of property %, � Subdivision Lot # Certified Survey Map # , Volume . Page # Warranty Deed # 15 �� , Volume Page # Spec house O yes g no Lot lines identifiable eky es d' 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 mastorpinmber, joumeymanplumber, restricted plumber 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 of the thrye year exp• . on dat SIGNATURE OF APPLICAN DATE OWNER CERTIFICATION y ) g ( ) the owners) of I (we) certify that all statements on thus form are true to the best of m (our knowled I we am (are) the property described above y virtue o a warranty deed recorded in Register of Deeds Office. 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 l STATE BAR OF WISCONSIN FORM 2.- 1982 WARRANTY DF -LD L)nCuMLNT No V OL E� G 1 Richard W. Lindahl _ l in; 1 8:00 A rk R _DrUf fn °r- and _Mary E. Delar.ey husband and wife -- -- o : C UA: .r PF'.'�FR P N JEO � R 7�� rHiS ..aAC- - NAME, St. Croix_ ___ — ._ co 1111, g 1 /_ 43912070 - 10 030- 207.0 -20 -100 ; RARCE , GENT FCAT'ON NOABER - 030 - 2070 -35 See Attached Exhibit "A" $ NFER FEE i (his __.--- - - - - -- homestead property. of record, if any. Exception to warranties: Easements, restrictions and rights -of -way Dated this ( y p M� day of ,.Tune A D. ,, (SEAL) X- (SEAL) • Richard W. Lind (SEAL) (SEAL) — AUTHENTICATION ACKNOWLEDGMENT and W Lindahl State of Wisconsin, Signature(s) —�Cb ss County. ', 98 Personally came before me this day' of authenticated this � — day of June 19_ y' tq ,the above named ._ 'na land HILL -: MEMBER STATE BAR OF WISCONSIN (If not, to me known to be the person who executed the forgoing authonzed by §706.06, Wis. ~tats.) instrument and acknowledge the same. THIS INSTRUMENT WAS DRAFTED BY - -- Att urniay Kris ina--- gland - -- — — — _ n _p jjdcn WT 54016 Notary Public, Cou:.ty, Wis. tSignatuies may be authenticated or acknowledged. Both are not Nty commission is perma,ent. (If not, state e xpiration date: necessary.) - ^:ama: of Ixrwns ,igmng m any wpaoty should he .yped or primed below -1 >ignatures. W,,sc~ tejy 9 Co.. inC. STATE BAR OF WISCONSIN mma,*ee. We WARRANTY UFFD Form No. 2 - 1982 t I L Exhibit " A " Attached hereto All that part of the NW % of the NE' /. of Section 36, Township 30 North, Range 20 West, St. Joseph Township, St r•oix Co Wisconsin, described as follows, to -wit: Commencing at the Northwest corner of said NW % of the NE % of Section 36- 30 -20; thence East 1,247.3 feet along the North line of said NW '/& of NE % to the center of the Town Road; thence S23 VW for 545 feet along the centerline of the Town Road; thence S14 for 39.6 feet along the centerline of the Town Road to this point of beginning of this parcel; thence continuing S14 for 85.4 feet along the centerline of the Town Road t: fence S1 for 200 feet along the centerline of the Town Road thence S6 for 145.5 feet along the centerline of the Town Road; thence S88 for 712.74 feet; thence N1 °38'E for 463.8 feet; thence S88 for 696.6 feet to the point of beginning. Lot 2 of Certified Survey Map recorded in Vol. 6, Page 1590, Doc. No. 405866 in the Office of the Register of Deeds for St. Croix County, Wisconsin. A parcel of land located in part of the SW % of the NE % of Section 36, Township 30 North, Range 20 West, Town of St. Joseph, St. Croix County, Wisconsin; described as follows: Commencing at the E comer of said Section 36; thence S89 0 04'24 "W along the South line of the SE % of the NE %; 1302.37 feet thc,.. -e N00 0 07'10 "E along the East line of said SW ' / 4 of the NE ' / 4, 959.77 feet to the point of beginning of this description; thence continuing N00 0 07'10 "E along said East line, 362.76 feet to the NE comer of said SW % of the NE %; thence S89 0 07'55 "W along the North line of said SW % of the NE %; 693.16 feet; thence S00 0 52'05 "E 66.00 feet; thence N89 0 07'55 "E 112.02 feet; thence S00 296.75 feet; thence N89 0 07'55 "E 580.00 feet to the point of beginning. Subject to Town Road right of way 66 feet in width, the centerline of which right of way crosses the North line of the above described parcel 181.88 feet We-!erly of the NE comer of said parcel, and which crosses the South line of said parcel 74.15 feet Westerly of the SE comer of said parcel. AND All that part of the SW % of the NE' /. of Section 36, Township 30 North, Range 20 West, lying Easterly of the centerline of said Town Road; following the existing centerline of said Town Road and extending same to the South line of said SW % of the NE % at a point 20 feet more or less westerly of the SE corner of said SW % of the NE %. Subject to existing Town Road right of Way 33 feet in V idth Easterly of said centerline. AND Part of the NW % of the NE % of Section 36, Township 30 North, Range 20 West, Town of St. Joseph, St. Croix County Wisconsin, lying Southerly of Lot 2 of a Certified Survey Map filed October 7, 1985 in Vol. 6 of Certified Survey Maps, Page 1590, Doc. No. 405866, in the Office of the St. Croix County Register of Deeds, being a parcel of land described as follows: Commencing at the E % comer of said Section 36; thence S89 along the South line of the SE % of the NE %, 1302.37 feet; thence N00 0 07'10 "E along the East line of said SW % of the NE' /l, 1322.53 feet to the NE comer of said SW % of the NE %; thence S89 °07'55"W along the North line of said SW % of the NE '/4, 693.16 feet to the point of beginning of this described; thence N89 0 07'55 "E along the North line of said SW % of NE %, being also the South line of said NW % of NE A 66 feet more or less to a point SW55'21 "E, 21.5 feet of the SE comer of said Lot 2 of said CSM in Vo!. 6, Page 1590; thence N21 21.5 feet to the SE comer of said Lot 2; thence S87 along the South line of said Lot 2, along an existing fenceline, 66 feet more or less to a point N00 of the point of beginning of this description; thence S00 °52'05 "E, 20 feet more or less, to the point of beginning. Wisconsin Department of Commerce E SYSTEM Count y PRIVATE SEWA r Safety and RiAdings Oivision • INSPECTION REPORT St. Croix OENE"L INFORMATION (ATTACH TO PERMIT) Sanitary Permit No.: Personal information you provice may be used for secondary purposes (Privacy Law, s.15.04 (1)(m)). Permit Holder's Name: ❑ City C] Village rl Town of: State Plan ID No.: p. BM Elev.: BM Description: Parcel Tax No.: TANK INFORMATION ELEVATION DATA - ad tall 6�' TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark Dosing Alt - RM Aeration Bldg. Sewer Holding St /Ht Inlet TANK SETBACK INFORMATION St/ Ht Outlet TANKTO P/L WELL BLDG. Ventto ROAD Dt Inlet Air Intake Septic NA Dt Bottom Dosing NA Header /Man. Aeration NA Dist. Pipe Holding Bot. System PUMP/ SIPHON INFORMATION Final Grade Manufacturer Demand Model Number GPM TDH I Lift Friction System TDH Ft ti Forcemain Length Dia. Dist.ToWell SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. Of Trenches PIT No. Of Pits Inside Dia. Liquid Depth DIM ENSIONS DIMENSION SYSTEM TO P / L BLDG WELL LAKE / STREAM LEACHING Manufacturer: SETBACK ' INFORMATION Type Of CHAMBER Mod Number: System: OR UNIT DISTRIBUTION SYSTEM Header/Manifold Distribution Pipe(s) x Hole Size x Hole Spacing Vent To Air Intake Length Dia. 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 ❑ No ❑ Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) Inspection #1: / / Inspection #2: Location: 1288 27th Street, Hudson, WI 54016 (NE 1/4 NE 1/4 36 T30N R20W) - 363020611E -Lot 2 1.) Alt BM Description= 2.) Bldg sewer length= - amount of cover = Plan revision required? ❑ Yes ❑ No Use other side for additional information. SBD -6710 (R.3(97) Date Inspectors Signature Cert. No. Safety & Buildings Division Sanitary Permit Application 201 W Washington Ave. y iseonsiin In accord with Comm 83.2 1, Wis. Adm. Code PO Box 7302 Department of commerce Personal information ou provide may be used for seconda Madison, WI 53707 -7302 Y P Y y purposes [Privacy Law, s. 15.04(1)(m)] (Submit completed form to county if not Attach complete plans to the county copy only) for the system on paper not less than 8 -1/2 x I I inches in size. state owned, County –1 State Sanitary Permit Number ❑ Check if revision to previous application State Plan 1. D. Number S / t r �8 I. Application Information - Please Print all Information —, Location: Property Owner Name Property Location ,- is I/4 �/t= 1/4, S T u ,N R'�`�' or W Property Owner's Mailing Addr s UQt Number Block Number City, State I Zip Code ipneNumber _ r,', Subdivision Name or CSM Number LCCvc S L C �/ t ; _ v l S q� II Type of Building: (check one) 11 City ❑ 1 or 2 Family Dwelling -No. of Bedrooms: ❑ village ❑ Public/Commercial (describe use): He f,, S ), Town of ❑ State -owned - III Type of Permit: (Check only one box on line A. Check box on line B if applicable) Nearest Roac A) I.lew System 2. ❑ Replacement 3. 10 Replacement of 4. ❑ Addition to Parcel Tax Number(s) �r System Tank Only Existing System (� j' ) .- G I — B) Permit Number Dattr7s3ntd ❑ A Sanity Permit was reviousl issued 3 L N . Type of POWT System: (Check all that apply) K I ao )REN on-pressurized In- ground ❑ Mound ❑ Sand Filter ❑ Constructed Wetland ❑ ressurized In- ground r ❑ holding Tank ❑ Single Pass ❑ Drip Line ❑ At -grade \ G3 Aero i� Trey lent Unit Recirculating ❑ Other: 1 1 � ,c C V Dis ersaUTreatment Area Information: 1. Design Flow (gpd) 2. DispersalArea 3. Dispersal Area 4. Soil Application S. Percolation Rate 6. System Elevation 7. Final Grade Required Proposed Rate (Gals. /day /sq. ft.) (Min. /inch) Elevation 9 i Iii• as i..a . "l S.v� *7 VI Tank Capacity in Total it of Manufacturer Prefab Site Steel Fiber- Plastic Information Gallons Gallons Tanks Con- Con- glass New Existing crete structed Tanks Tanks QQ 00 0 -- ❑ ❑ ❑ ❑ ❑ VII Responsibility Statement I the undersi ned assume re onsibilit for installation of the POW TS shown on the attached tans. Plumber's Name (print) Plumber's Signstupf,(no statttps): MP/MPRS No. Business Phone Number Plumber's Address (Street, City, State, Zip Cod ) I I - �C,` , -1676 xk�v VIII County/Depart ent Use Only ❑ Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued Issuing Agent Signature (No stamps) Approved O Owner Given Initial Adverse Surcha Fee) Determinations, UCH _ �X�. Conditions of ApgXov /R easQns for Disapproval: Safety and Buildings 401 PILOT CT STE C WAUKESHA WI 53188 -2439 TDD #: (608) 264 -8777 visconsin www•commerce.state.wi.us /SB Department of Commerce Tommy G. Thompson, Governor Brenda J. Blanchard, Secretary October 30, 2000 CUST ID No.834177 ATTN: POWTS INSPECTOR JAMES W BOUMEESTER ZONING OFFICE BOUMEESTER & SONS EXCAVATING INC ST CROIX COUNTY SPIA 1070 HIGHWAY 35N 1101 CARMICHAEL RD HUDSON WI 54016 HUDSON WI 54016 RE: CONDITIONAL APPROVAL Identification Numbers PLAN APPROVAL EXPIRES: 10/30/2002 Transaction ID No. 444768 Site ID No. 200964 SITE: Please refer to both identification numbers, Site ID: 200964, MARK & MOLLY DRUFFNER above, in all correspondence with the agency. ST CROIX County, Town of SAINT JOSEPH; 1288 27TH ST, HUDSON 54016 NW1 /4, NEIA, S36, T30N, R20W FOR: Description: NON- PRESSURIZED IN- GROUND Object Type: POWT System Regulated Object ID No.: 768058 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: • This system is to be constructed and located in accordance with the enclosed approved plans and with the "Conventional Component Manual for Septic Tank Effluent for Private Onsite Waste Treatment Systems" SBD- 10567 -P (R.6/99). • In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approved plans. In addition, the owner must insure that the operation, maintenance and monitoring duties as described in section VIII of conventional component manual are complied with. A copy of this information must be given to the owner upon completion of the project. • Maintenance information must be given to the owner of the tank explaining that periodic cleaning of the filter is required. Access to the filter for cleaning must be provided per Comm 84 product approval conditions. • 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. • 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. Stats. D F SJ 0 .� JAMES W BOUMEESTER Page 2 10/30/00 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. All permits required by the state or the local municipality shall be obtained prior to commencement of construction /installation/operation. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. Sincerely, DATE RECEIVED 10/13/2000 r FEE REQUIRED $ 175.00 FEE RECEIVED $ 110.00 JULIA A LEWIS - OSBORNE , POWTS REVIEWER 2 BALANCE DUE $ 65.00 Integrated Services (262) 548 -8638, FAX: (262) 548 -8614 Make checks payable to COMMERCE. WiSMART code::7�� i ACCESSORY STRUCTURE SYSTEM WORKSHEET INDEX AND TITLE SH Project: Druffner accessory structure restroom Owner: Mark & Molly Druffner Address: 1288 27th Street Hudson, WI 54016 Legal Description: NW1 /4NE1/4, Sec.36, T.30N., R. 20W. Township: St. Joseph County: St. Croix Subdivision Name Lot No. Parcel ID Number: 030 - 2070 -10 -000 Plan Transaction Num R ec elvel) Index and title sheet Page 1 System calculations Page 2 p ►V• Site plan Page 3 sc►�51y System Cross section Page 4 Management Plan Page 5 Attached soil evaluation report Designer: Jim Boumeester License # : 222904 Signature: Phone # : 715)386-9020 Date: September 29, 2000 Notice: Tampering with this file by unauthorized persons is prohibited. Deliberate modification will result in disciplinary action under s. 145.10, Wis. Stats. SBD- 10462 -E (R.05198) Page 1 of 5 y� Of k RFS,00 �'�s �0F � Vc", . y WORKSHEET JOB DESCRIPTION: Accessory structure restroom. Conventional septic system design for Druffner family use of existing accessory structure. This facility will be used as a private school room for the home schooling use of the 4 Druffner children only. The facility will not be open to the public, will not contain cooking, dining or cleaning facilities. The facility will contain one restroom with lavatory and toilet for the convenience of Mr. &Mrs. Druffner and the children. ABSORPTION AREA SIZING UTILIZING HIGH CAPACITY INFILTRATOR CHAMBERS: 1. Existing grade elevation 100.06 1 at B -2 2. Depth to limiting factor 106" (elev. = 91.23') 3. System Elev.= 91.23 + 3.77'= 95.00' at chamber /soil interface. Infiltrative capacity of soil at system elev. = 0.7 gpd/sq.ft. 4. Absorption area required: 80.0 NA Wastewater flow per pupil from Comm 83.43(6) Table A- 83.43 -1= 400GPD/25 students = 16 GPD /student. (4 students + 2 teachersx 16GPD) = 96 GPD. 96gpd/�gpd/sq. ft. = WO sq. ft. of absorption area required 4 7 164 Proposal: Install Infiltrator hig capacity sidewinder chambers at 17.14 sq.ft per unit. (80.0/17.14 sq.ft per unit) = 4.67 units 1 trench using 7 chambers = I I9.98sq.ft. (131.25 actual) Trench length (B) 43.75' Trench width (A) 3.0' SEPTIC TANK CAPACITY: (4 students + 2 teachers x 16GPD) = 96 GPD (96 GPDx1.5) = 144 GPD/ 75GPD /person =1.92 person equivalency (96 GPD) + (11.61 x 1.92x3) + (46.77x1.92) = 252.67gal. minimum tank capacity Tank Manufacturer & Capacity: 800 gal. Weeks Concrete rv(v.W 0/7&/ L�Drk�'vncr 12 Z79 • So�'�G�6serdo-t�ar, W4 Syo�G ,j GJ / /I Ey , S Lc. S£ O rwell 0 re sidati ce �riJC L .• Tol eye' eoncm -e ap.•on. E /c r. = 99.92: ,Z��SE1�tef gs 30' o c Asrm 303v • 8 y sewer Pposed Pao g "t I �a�K. a6c /,g i gp ou/Ecf Yl Slope fAr�K9,4 lter lnS . ed�s per' S v% artQ. Code. $ 2 Propo - so:/ absorp•E,'o" cel( �ol : W# Wif cc 44 3 X 43.7S '"Jill ?,Tn�;l� by accessory struc.�C �� ca�oa ay 5,dtw;nder�'�+ 6 us. f elu sfin7 well. 36 /t /l,oro�o. /:no gre4*r SyStcm areA. f�e 3ofs N 5 Y s{ e, -,•,. Gross Sc c on cc •T u > CI- CA I n { r; � o r.� h p o E -2 4= 2sta-�, L; v►�� +�✓L� for q c to ^ � r .4 CA F A � y `3 r� pn� Conventional System Management Plan Pursuant to Comm 83.54, Wis. Adm. Code General The conventional septic system shall be operated in accordance with Comm 82 -84 Wis. Adm. Code, and shall be maintained in accordance with component manual SBD- 10567 -P (8.6/99). All local and/or state rules pertaining to system maintenance and maintenance reporting shall be complied with. Septic Tank The operating condition of the septic tank and outlet filter shall be assessed at least once every two years by inspection. The septic tank contents shall be removed when the sludge and scum in the tank exceed 1/3 the liquid volume of the tank. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code, by an individual certified to service septic tanks under s. 281.48, Stats. If the contents of the tank are not removed at the time of a biannual assessment, maintenance personnel shall advise th owner of when service will be needed to maintain less than 1/3 scum and sludge accumulation in the tank. The utlet filt s hall be cleaned as necessary to ensure proper operatio The filter cartridge should not be removed unless provisions are mad' a to retain solids in the tank that may slough 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. Septic tank manholes 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 the tank. No individual should ever enter the septic tank as dangerous gases may be present that could cause death. Septic tank abandonment shall be in accordance with Comm83.33, Wis. Adm. Code when the tank is no longer used as a POWTS component. The addition of biological or chemical additives to enhance septic tank performance is generally not required. If such products are used they shall be approved for septic tank use by the Department of Commerce, Safety and Buildings Division. Soil Absorption Cell Trees or shrubs should not be planted directly on the soil absorption system. The area above and around the system should be seeded and mulched as necessary to prevent erosion and provide some degree of frost protection. Traffic (other than for vegetative maintenance) over the system is not recommended. Soil compaction may hinder aeration of the infiltrative surface within the system and will promote frost penetration during cold weather months. Cold weather installations (October - February) dictate that the system be heavily mulched for frost protection. Influent quality into the system may not exceed 220mg/L BOD5, 150 MG/L TSS, and 30 mg/L FOG. Influent flow may not exceed maximum design flow specified in the permit for the installation. Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the owner. Levels above 4 inches indicate an impending hydraulic failure requiring additional, more frequent monitoring. Contineency 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. Excessive ponding within the dispersal cell will be eliminated by removing biologically clogged adsorption and dispersal media and replacing said components as deemed necessary or by installing a new soil absorption cell to bring the system into proper operating condition. Questions on the operation or maintenance of the system should be directed to your county zoning or health inspector. Pg. 5 9f 5 1316 Wisconsin Department of Commerce SOIL EVALUATION REPORT p age 1_of 3 - in accordance with Comm 85, Wis. Adm. Code Division of Safety and Buildings A.C.E. Sal & Site Evaluations County Attach complete site plan on paper not less than 8Y2 x 11 inches in size. Plan must St. Croix include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. percent slope, scale or dimensions, north arrow, and location and distance to nearest road. 030-2070-10 -000, ID #36 30 20.611E Please print all information. Reviewed B Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Property Owner Property Location Mark R. & Molly E. Druffner - Govt Lot NW 1/4 NE 1/4 S 36 T 30 N R 20 W i _. ____ _ -_ -- _ - -- - - - -- -- - - - -- - - - -- - -- -- - - -- Subd Name or CSM# Property Owner's Mailing Address Lot # Block # 1 . 128827th St. - - - -- - - -- -- - - -- - - - - - - -- -- Y _ - - - -- City State Zip Code Phone Number City _:I Village V Town serest Road Hudson WI , 54016 i 715- 386 -3250 St.Jose h I 27Th Street Use: Residential/ Number of bedrooms Code derived design flow rate GPD ✓J New Construction .� - - - -- - - - - -- - - - -- _J Replacement ✓J Public or commercial -Describe: Accesses s r estroo m - -- Parent material Glacial outwash -_ _ Flood plain elevation, if applicable General comments and recommendations: Accessory building to be converted into educational facility for home schooling of property owners children. Restroom to be added for convienience. FT] Boring # 16 Boring > 109 in. Soil Application Rate Pit Ground Surface elev. _ 100.08 _ ft. Depth to limiting factor -- Horizon Depth Dominant Color Redox Description Texture Structure I Consistence Boundary Roots GPDIft� i i 1 0 -12 !, 10 r3/2 i none sl 2fsbk ds as 2fm ,lc 0.5 0 -- Y - T--- 2 12 29 ~ - - -_ -- -- - -_ - - none ±- fsl 2msbk -� ash ±- svv - - 1 2fm,lc 0.5 0.9 -_. 10y44/4 - - - - - - - -- - - - -- - 3 29 -33 7.5 r4/4 none 9 • lmsbk ds sw 4 if 0.7 1.2 � i yIs & r - - -. -_- t -- -- - - - -- -- - - - -- 4 33 -92 7.5y none s Osg - -di t 9s - -- 0. 7 1.2 � Os -- dl 5 92 -109 10yr6/4 none - - - 0.7 1.2 _ r -- - s - H#3 contains 25% gravel and cobbles. Boring # Boring fm Pd Ground Surface elev. __ 100.06 _ _ ft. Depth to limiting factor _ -- � 1_ 6 rr In. Soil Application R to Horizon Depth Dominant Color Redox Description Boundary Roots Texture Structure Consistence 1 0-11 10yr3 /3 none sl I 2fsbk ds as 2fm,lc 0.5 0.9 2msbk 2 11-23 10y none fsl I dsh sw 2fm 0.5 o.4 - - . - ----------- - -- - - - - - - - - -� - - - - -- - -- - - - -- - + { -- 3 1 23-28 7.5yr4/4 n Is & gr. lmsbk ds I sw lfm 0.7 1.2 4 28 -84 7.5 yr4/6 none s Osg dl gs 0.7 1.2 5 84 -106 10yr6 /4 none s Osg dl - - 0.7 t.t H #3 contains 15 %gravel and cobbles. Effluent #1 = BOD 5 > 30 < 220 mg/L and TS >30 < ' E t #2 - BOD < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) ignature: CST Number J K. Thom on 3602 �-- Telephone Number Address A.C.E. Soil &Site Evaluations Date Evaluation Conducted Osceola, WI 54020 9/27/00 715- 248 -7767 • property Owner Mark R. & Molly E. Druffner Parcel ID # _03 Page F 3 Boring # ;=j Boring Pit Ground Surface elev. .__.. _100 13 _._ ._ ft. Depth to limning factor > 110" in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots E - GPD1ft E 1 013 10yr3 /2 none i sl 2fsbk ds as 2fm,1C 0.5 0.9 t �- - 2 13-29 10 44/4 I none fsl 2msbk I dsh sw 12fm,1c 1 0.5 0.9 - - � 7.5 r4 4 t - -_ - - - - -- 3 29 - 34 y -- / - -- none Is & gr. lmsbk - - its sw 1f 0.7 1.2 - -- -- - - - -- - - - fi- -- - - -- -, -- �. - -- - -- + - - -- -- 4 34 -89 %, 7.5yr4/6 none s Osg dl gs - 0.7 1.2 5 89-110 1 0yr 6 / none -. s - Osg al- - - - - 0.7 1.2 - -, i H#3 contains 25% gravel and cobbles. F Boring # 1/ Boring " _f Pd Ground Surface elev. 99.47 ft. Depth to limiting factor 96 in. Sal Application Rate Horizon Depth Dominant Color Redox Description Texture i Structure Consistence Boundary Roots i 'Eff#1 "Eff#2 1 0 -10 10yr3 /2 none sl 2fsbk ds as 2fm,lc 0.5 ! 0.9 - j on - - - -- + 0.5 0.9 - -{--- -f- - -- ± - - -- msbk -- - dsh - -- sw , 2fm � ---- t - - - -- - 2 1 -2 21 1 none 2 3 21 -31 1 7.5yr4/4 none Is & gr.'i lmsbk ds sw if j 0.7 1.2 4 31 -96 7.5yr4/6 none s Osg dl gs 1 0.7 1.2 { -_ - - -- I � � I I I i 16 Boring Bonin # �� ' 5 g th to limiting factor > ❑ pd Ground Surface elev. ...99.86. ft. Dep ng 96 m• Sal Application Rate Horizon Depth Dominant Color Redox Description Texture Structure I Consistence Boundary Roots __ *_ -- GPD/ft�__ -_ Eff#1 Eff#2 1 0 10 - - - - 10 Y - -- - - - - -- - Y -- -- - - -- - -- + - -- - - -- 2fm,lc 0.5 0.9 r3/2 none sl 2fsbk its as 2 10 -25 10y44/4 none fs1 i 2msbk i dsh sw 2fm,1c 0.5 0.9 - - - - - -- - - -- 3 25 -33 !� 7.5yr4/4 none i Is & gr. - lmsbk its I sw if 0.7 1.2 i 7.5yr4/6 none g dl gs - 0.7 1.2 s Os 4 33 -96 ` - H #3 contains 15% gravel and cobbles. 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. ' ■ Obse'r P 3a,�3 am Z7 6o�;nq /A.-oCsoh, of /. S y0/G 0 ,j w0//76w, 36, - r,,. OP p� � ��: � •• alp i �d . Jostp� .Croix (o�LZt. O rwell 0 r•e sidarr c¢ C1riJ�w�Y s k.K el ev = /oa . cv. $S 0 t ■ � ^s ■ iE Yto Sloop ti ro kc 1, :S Sit m argA. d $2 406E : wt(:t/ S " i" accessory Struc.b.rc Crv+r► P�7ci5 ;'n10 we iF ff /IP�oP. /;nesreder �l1aY, l am' �'ro/n Syste/n a rea . 1316 Wisconsin Department of Commerce SOIL EVALUATION REPORT p age of 3 Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code AC.E. Sal & Site Evaluations County Attach complete site plan on paper not less than 8'% x 11 inches in size. Plan must _ St. Croix include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. percent slope, scale or dimemsions, north arrow, and location and distance to nearest road. 030 - 2070 -10 -000, ID #36.30.20.611E -_ - - - - - - -- - - -- - -- Please print all information. Reviewed B Date Personal information you provide may be used for OCldary p os¢sriP h icy Law, S. 15.04 (1) (m)). Property Owner Property Location Mark R. &Moll E. Druffner ! G ovt. Lo N W 1/4 NE 1/4 S 36 T 30 N R 20 W Mar y p Property Owner's Mailing Address �{ E1v�J �' of # Block SulxJ. Name or CSM# 128 7th St. I — City St9 ' 110 C h�e tAun�gei, I City _, ] Village t� Town Nearest Road Hudson 1 4016 S7 CC ll 3 UU 50 ` St.Jose h 27Th Street j FteS /�l(H 1 _ Code derived design flow rate GPD 01 New Construction Use Replacement t+ Pubfic,8rrrt cial -ls . Accessory structure restroom Parent material Glacial outwash \'`� t � \ � Flood plain elevation, if applicable na General comments and recommend property Accessory building to be converted into educational facility for home schooling of prop owners children. Restroom to be added for convienience. a Boring # - Boring > 109" in. Soil r Pit Ground Surface elev. 100.08 ft. Depth to limiting facts Appli cation Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft' 1 0 -12 10yr3 /2 none sl 2fsbk ds as 2fm,lc 0.5 0.9 2 12 -29 10y none fsl 2msbk dsh sw 2fm,lc 0.5 0.9 3 29 -33 7.5yr4/4 none Is & gr. imsbk ds i sw if 0.7 1.2 4 33 -92 7.5yr4/6 none s Osg dl gs - 0.7 1.2 5 92 -109 , 10yr6 /4 none s Osg _dl - - 0.7 1.2 H #3 contains 25% gravel and cobbles. (x,.96 �� • 9 Boring Boring fyfj Pit Ground Surface elev. 1 00.06 ft. Depth to limiting factor > 106" in. Soil Application Rate Texture Structure Consistence Boundary Roots GPD /ft Redox Description e Horizon Depth Dominant Color P 1 0 -11 10yr3/3 none sl 2fsbk ds as 2fm,lc 0.5 0.9 2 11 -23 10y44/4 no fsl 2msbk dsh sw 2fm 0.5 — 3 23 -28 7.5yr4/4 none Is & gr. imsbk ds sw ifm 0.7 1.2 4 #_8-.:&4 7.5yr4/6 none s Osg dl as 1.2 5 10yr6 /4 none s Osg dl - - 0.7 H #3 contains 15% gravel and cobbles. * Effluent #1 = BOD ? 30 < 220 mg/L and TS >30 < 150 * E t #2:= BOD <_30 mg/L and TSS < _�0 mg/L CST Name (Please Print) l9 nature: CST Number James K. Thom a - 3602 Address A.C.E. Soil & Site Evaluations Date Evaluation Conducted Telephone Number Osceola, WI 54020 9/27/00 715- 248 -7767 Property owner Mark R. & Molly E. Druffner Parcel ID # 030-2070-10-000, 1D# Page 2- of 3 F3 ] Boring # j Boring elev. 100.13 Pit Ground Su Depth to limiting factor >110" in. Surface ft. Sol Application Rate Horizon Depth Dominant Color 1 Redox Description Texture Structure Consistence Boundary Roots ---G?D/W Eff#1 *Efl#2 1 0-13 10yr312 none sl 2fsbk ds as 2fm 1C 0.5 0.9 ----- -- 1- 2 13-29 10y44/4 I none fsI 2msbk dsh sw j 2fm,lc 0.5 0.9 3 29-34 7.5yr4/4 none Is & gr. lmsbk ds sw if 0.7 1.2 4 34-89 7.5yr4/6 none s Osg dl gs 1.2 5 89-110 10yr6/4 none s Osg dl 0.7 1.2 H#3 contains 25% gravel and cobbles. Bo 4 ] Boring # Id ring Depth to limiting factor 96" in. F �Ij Pit Ground Surface elev. ___ 99.47 -- ft. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots ;PDA2- *Eff#1 *Efl#2 1 0-10 10yr3/2 none sl 2fsbk ds as 2fm,lc 0.5 0-9 2 10-221 10y44/4 none 2msbk dsh sw 2fm 0.5 0.9 ...... . .. . 0 .5 3 21-31 7.5yr4/4 none Is & gr. lmsbk ds sw if 0.7 1.2 4 31-96 7.5yr4/6 none s Osg dl gs 0.7 1.2 Boring # 16 Boring Depth to limiting factor >96" in. Pit Ground Surface elev. -9 8 0 - - - Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots --GFWV- Efl#1 *Eff#2 1 0-10 10yr3/2 none sl 2fsbk ds as 2frn,1c 0.5 0.9 2 10-25 10y44/4 none fsI 2msbk dsh sw 2fm,lc 0.5 0.9 3 25-33 7.5yr4/4 none Is & or. 1msbk ds sw if 0.7 1.2 4 33-96 7.5yr4/6 none s Osg dl gs 01 - - - - 1.2 H#3 contains 15% gravel and cobbles. Effluent #1 = BOD ? 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BOD <_30 mg/L and TSS < 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. • ■ moo; � Obs cwa�' 12M 27' Sb . � Sotl see'✓ well O residence 9? P4 Z � e� e tIC.� Wlar • tIttom OFS,d n�q. �S ego/ S a � ■ B3 � B y 4r ■ y ■ Vl 0 51 o,o tl«• KYA 82 S Sit,^ circA. /1of,� : Wd-E�. suvic.c 16v acce ssgwy strut 6ac C�cr++� P�7ci S EIn� we ll. " 'G �l�si f (j� � � ►'1 S y s te„, a yea . )av{ /y6 -rd a ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer Mailing Address 122 Property Address (Verification required from Planning Department for new construction) City/State iLd:5 % 1 L Parcel Identification Numbe } - U 7 ~ LUG" DMC trMON Property Location /LA , %,, Le y,, Sec. T—E�, R Town of s Subdivision , Lot # CertHfied Survey Map # Volume �r , Page # 1 ' 5- TO n: Warranty Deed # I7 Volume 1332 , Page # L ( zl Spec house O yes .p no Lot lines identifiable O yes O no HARMANCE bVroper use and maintemmeof your septic system could result in its premature failure to handle wastes. Proper mainteamm coasiste of pumping out the septic teak every three yeah or sooner, if needed by a licensed pumper. What you put into the system eaa affect the inaction 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 master, plumber, o plumber, restrictedphumber or a licensed pumper verifying that (1) the on -site wastewatwdisposal system in ' PROM ►fig cantditi ►and/or (2) tlftor inspection and pumping (if necessary), the septic tank is tea dm ,44, of . `` Uwe, the n+!d ig•±eal have road !hc abcv ,?� agree is maiutaiin the private sewage disposal staodatde L . set forth. herein, as set by the Department and the Department of Natural Resources, State of Wlsooasin. Card n stating that your septic system has been msinUdne4 must be completed and returned to the St. Croix County Zoning Office witwo 30 . days of the iration date. SIONA O CANT DATE I (we) certify that all statements on.. s see true to the best of m ,,�.. p y (our) knowledge I (we) am (a s) the owner($) of the property y virtue of a. W4U& ty 4eed recorded in Register of Deeds Office. x n SIt3NATURB OF AP DATE •o *sow Any information that is mis- My imilt in the rani it being revoked b the •ass *a . _ . a � _ �} �Y !� i y Zug �+utmant. • Include with this ap a ste t �'- PM deed from the Register of Deeds office a copy catltkd survey map if reference is made in the warren} 2 �i� /5 AA-,f STEVE MUENICH ULBRICHT & ASSOCIATES PUMPING LLC — Private Wastewater Contractors — Hudson 105 East Chippewa Street Main Office 715-386-8277 Cadott, Wisconsin 54727 715-456-1440 Owners M4rF- �+-v.''.AhtK Name Date S- I f .d oe/ Time �epb•1 Address / ' S ?a n, .� CS/-dC f-O 9L/ Service Call: Routine Emergency ❑ Qa ,p Operator L At' ,,.,/e4 Comments p,s /2 r AA kF�r� i Al /oaAz/jo -e So,IO900%14 t7.�wCA co 7it -may.S�>C� , 7 ive✓C Azl/Z� %/?'r p eau !O/tl�t'f�<�4 — Septic System Conditions — S.T. Size /e o 0 - /d a o Amt. Removed Il o a Gals. Pump Chamber Size (f�( Amt. Removed /►/ A- Gals. Depth Scum S.T. 3i1 Depth Scum P.C. Depth Sludge S.T. 3 '1 Depth Scum P.C. Trenches or Drainfield, inches of effluent — Costs — • Pumping J y l • Digging up Covers • Adding Manholes, New Covers, Locks, Repairs, etc. • Extra Travel Service Labor • Taxes, if applicable 111 Ilti: Total Due /ys°° Pd. In Full ❑On Account �, ^ s/,krs BAR nr WISCONSIN FORM z-1wo n000wcmr NO, VOL ` .33? ; -l?9 ]UN 1 7 1998 A � ^."`~ aoq_�Ty-g_�-Ielp_�l�_. husband and wife __ '___ ------ --------------------- ---------------------- �-------'----------------------- THIS SPACE *,'E"'Eo~oonFcno:.^o°'^ NAME AND ,Er^"~~:aReI-IS the following described real estate /n St. Croix coumy, ouo.,fw/^"m/n V//9 / PARCEL IOENTIFICXT`�_N NUMBER � � � 030-2070-35 See Attached Exhibit "&" N ER v � � � o* homestead property .m �"°°°` Exception w"*,mm,""` Easements, restrictions and rights-of-way of record, if any. Dated this day oi June AD_ �w^ 98 asxu (ss^u . ' (SEAL) . . � AUTHENTICATION ACKNOWLEDGMENT � state of Wisconsin, Signa � ------ c""m' / authenticated this 10 JUne 1998 Personally camt*bre me this day of . 19____. the above name . /nu MEMBER STATE BAR opWISCONSIN (it not, _-_-___---_�____--__ -----' m./x^rizruo/or000^.Wis. swu) .uma known u}m the person -who executed the fonw^`«n Instrument and acknowledge `he^anu THIS INSTRUMENT VJ^s DRAFTED av --.--A tnrnev Kris, ina og iand nwurymw.^. C()U.'rw's .S.u^"wre, may he "u'hnmu=,"a ^, "'ko"°Ieugeq. u"/h are not uy wmm"amu is p,"m^n"u vr *^. r=n ,,p.""to° u^n .}v > "'"°"ry/ � /^"I.u `r u°�.".'o1x1o°`".-�^=" ^nn*x^,Wm��^ w��" Dal* CC, � v^xmNnmm - �""x^z '°u Vll^°-°w^ �b VOL Exhibit "A" Attached hereto All that part of the NW % of the NE'/. of Section 36, Township 30 North, Range 20 West, St. Joseph Township, St. Croix County, Wisconsin, described as follows, to-wit: Commencing at the Northwest comer of said NW' /. of the NE'/. of Section 36- 30-20; thence East 1,247.3 feet along the North line of said NW '/. of NE % to the center of the Town Road; thence S23 TW for 545 feet along the centerline of the Town Road; thence S14 for 39.6 feet along the centerline of the Town Road to the point of beginning of this parcel; thence continuing S14 for 85.4 feet alc%Og the centerline of the Town Road; t:ience S1°45'E for 200 feet along the centerline of the Town Road; thence S6 for 145.5 feet along the centerline of the Town Road; thence S88 for 712.74 feet; thence N1°38'E for 463.8 feet; th once S88 °19'E for 696.6 feet to the point of beginning. Lot 2 f Ce rtified Survey Map recorded in Vol. 6 , P age 1590 Doc. No. 405868 in the Office of the Register of Deeds for St. Croix County, Wisconsin. A parcel of land located in part of the SW'/. of the NE'/. of Section 36, Township 30 North, Range 20 West, Town of St. Joseph, St. Croix County, Wisconsin; described as follows- Commencing at the E Y. comer of said Section 36; thence S89 0 04'24 "W along the South line of the SE'/. of the NE'/.; 1302.37 feet; thence N00 0 07'10 "E along the East line of said SW % of the NE ' /., 959.77 feet to the point of beginning of this description; thence continuing N00 0 07'10 "E along said Fast line, 362.76 feet to the NE comer of said SW'/. of the NE %; thence S89 along the North line of said SW'/. of the NE' /.; 693.16 feet; thence S00 °52'05 "E 66.00 feet; thence N89 0 07'55 "E 112.02 feet; thence S00 296.75 feet; thence N89 "E 580.00 feet to the point of beginning. Subject to Town Ro id right of way 66 feet in width, the centerline of which right of way crosses the North line of the above described parcel 181.88 feet Westerly of the NE comer of said parcel, and which crosses the South line of said parcel 74.15 feet Westerly of the SE comer of said parcel. AND All that part of the SW % of the NE'/. of Section 36, Tcwnship 30 North, Range 20 West, tying Easterly of the centerline of said Town Road; following the existing centerline of said Town Road and extending same to the South line of said SW % of the NE %. at a point 20 feet more or less westerly of the SE corner of said SW % of the NE'/.. Subject to existing Town Road right of Way 33 feet in K;dth Easterly of said centerline. AND Part of the NW % of the NE'/. of Section 36, Township 30 North, Range 20 West, Town of St. Joseph, St. Croix County, Wisconsin, lying Southerly of Lot 2 of a Certified Survey Map filed October 7, 1985 in Vol. 6 of Certified Survey Maps, Page 1590, Doc. No. 405886, in the Office of the St. Croix County Register of Deeds, being a parcel of land described as follows: Commencing at the E'/. comer of said Section 38; thence S89 along the South line of the SE'/. of the NE'/., 1302.37 feet; thence N00 along the East line of said SW'/. of the NE'/., 1322.53 feet to the NE comer of said SW'/. of the NE Y4; thence S89 along the North line of said SW % of the NE %, 693.16 feet to the point of beginning of this described; thence N89°07'55 "E along the North line of said SW'/. of NE %, being also the South line of said NW'/. of NE 'A, 66 feet more or less to a point S01 0 55'21 "E, 21.5 feet of the SE comer of said Lot 2 of said CSM in Vol. 6, Page 1590; thence N21 I "W, 21.5 feet to the SE comer of said Lot 2; thence S87 along the South line of said Lot 2, along an existing fenceline, 66 feet more or less to P point N00°52'05"W of the point of beginning of this description; thence S00 0 52'05 "E, 20 feet more or less, to the poii it of beginning. .r � __ 4'`> ;.�,_3' 1 _ '�. _ .. - a. �: fi.._".'.tK .'�r .3 • `trr Yom: • Q pt. V ,y c7�Jt I; CERTIFIED SURVEY MAP LOCATED IN PART OF THE NW 1/4 OF THE NE 1/4 OF SECTION 36, T30N, R20W, TOWN OF ST. JOSEPH, ST. CROIX COUNTY, WISCONSIN. OWNER LEGEND ROGER F. SCHLIEPER • 3/4" IRON PIPE FOUND. 3137 RIDGEWOOD ROAD ST. PAUL, MN. 55112 O 1" x 24" IRON PIPE WEIGHING 1.68 LBS /LIN. FT. SET. S 8 AREAS �► INCLUDING R/W EXCLUDING R/W FILED Lot 1 365,648 sq. ft. 363,267 sq. ft OCT Y 1985 8.394s Acres 8.339 Acres JAM O' OONNILL Lot 2 394,435 sq. ft. 392,238 sq. ft. Rpy of pmt 9.055 Acres 9.005 Acres M Oak OaMb,� �! M►Mowi SCALE IN FEET 1 =300' 300 200 100 0 300 unplatted lands - owned - by - other s r NORTH LINE OF THE NE 1/4 _ N 1/4 CORNER N 8 9 0 11 1 26 11 E 1240.26' r- 1247.3' L SECTION 36 1204.19' 533.6 ° NE CORNER CO. MON. 5g9.75, 722i�9'S6° SECT 36 c S89 11 W / 6 �� CO. MON. co o - ° N !0 LOT 1 azo m C1 a v am w N88 I ca I : APPROVED °'_ j w 631 49' j °.' m m -n C CD * "' 322.09' 309.40' i ~ '�" m N N88 ° 21' 29 "W I I ��fi p2 1985 o I N + In w O IH 1 N ►+ - to ° ST. CROIX COUNTY co "' -' N O c m °_ COMPRQ►iEN31VE PARKS PIANPMNO a -+ CD N -%1-1 3 romm comjwm o m Cr co rn = w i ° ; + a N88 ° 31' 48 "E 1 66 1 n = CD .. �. 709.78' (r 712.74') Irn w - 67 .50' 340.26'°_' 1 S08 °52'57 "E ►- 66.56 LOT 2 y 373.54' 0 373.4' o TO BE DEEDED TO AN ° w cn S88 0 31 1 48 "W ADJOINING OWNER .I.-Of small tract -- m ' 4 " ALLEN! C. 667.62' r - 667.6' $Ts S87 °53' 49"W 1 ' NYM E AGN K . ***NOTE: unplatted lands owned by others S 9.14QT ------- - - - - -- �� True 40 corner computed from Ito Y government protraction of the section lies S31 0 45 1 45 "W, 8.34 '4 this instrument drafted by Douglas Zahler job no. 85 - 54 �\ Vol. 6 Page 1590 / f r I 069T a2sd 9 •TOA Z gdaso -4S Jo uMOy Pqq Jo XaeTO 6T ° pP '� STg udasor •qS go uMoy aq Aq P a I du uaaq spu dew AanxnS paTjT - 4ja0 siu'4 - 4Pu - 4 AST - 4zaa Aga. aq op 'I HdSSOf 'IS aO NMOI SHy aO SlvoialluaD �S � u bpgAN • O uaTTV P , l ins cyly �'� -a t� •sinn 'NosanH t LOVVS Olt MEWHAN WA W ,.. � •, ; �., ern � ,' �g''i •aures buTddpw pup buTAaAxns UT xTOZO •qs go Aqunoo aqq Jo aOUPUTP - UOTsTATpgns pupZ aqq pup sagngpqs I pasTAOU uTSUOOSTM V£ zagdpgD go SUOTsTAOad quazzno ago ggTM paTTdwoo ATTnj anpg I gpgq !pagTzOsap pup paAanzns Azppunoq zoTzaqxa aq'4 Jo UOTgP 4uasazdaz goazzoo p sT dpw AaAZns paTJT�zaO sTg4 4pgy •pzoOaa 90 squaw9spa zag4O TTp pup dPw sTg4 uo Umogs sp sasodznd ppo-d uMoy zoj quawaspa up oq goaCgns sT Taozpd pagTzosap anogv •BUTUUTbaq go 4UTod aqq off. 4aag T8 '9„£T,£Oo00N a0uaq4 : - 4aag Z9'L99 'M „6t,£SOL2S aouag4 :YaaS 9L•£9Z 'S„TZ,SSOTOS a0uag4 :-.aaJ t S•£LE: 'M „8V,T£O88S aOuag4 :gaag 95 'auTTza4uaO pips buOTe 'S„LS,ZSO80S aOuaq - 4. :ppoH uMOy aq4 90 auTTza4uaO aqq 04 4aa3 8L 'HAV ,T£O88N a0uag4 !4aa,g 68'Z9t 'M „ZT,OZ aou9g4 !4aaJ Ot 'M „6Z,TZ a3uag4 :49a3 L8'09V 'M,, LV.SZ O TOS aouag4 :4aag SL•69S 'M„9Z,TT aouag4 o4aa9 �T•ZL 'auTTzaquao paps buoTp 'M„9S,6S aouat?4 !PPOE uMoy ag} Jo auTla@gUao agq 04 gaaj 9Z'OtZT 'V /T SN PTps 90 auTT t14zou 9q4 buoTp 'S „9Z,TT aOuag4 !UOT4dTzOSap STgq JO buTUUTbaq JO 4UTod age. buTaq OSTp aGUaOO pips °9£ uoT�OaS p jo zaUJOO b/T N age. qe buTOUaWWOD :sMOTTO; sp pagTxosap zag4zng :uTSUOOSTpi 'AqunoD xTOZO •4S 'gdasor •qs go umoy 'b10lli 'NO £y 1 9£ uOTgOaS go V/T SN 044 go �/T MN aqq go gzpd uT pa4POOT pueT 90 Taozpd v :SmOTTOJ sp pagTzosap sT paddpui PUP paAaAans TaOZpd pupT aqq go Azppunoq zOTxagxa aqq gPgq !dpW AaAinS paTgTgzaD sTgq Aq paquasazdaz sT goTgM Taozpd pupT atTq paddpiu pup 'pagTZOSap 'paAanzns anpq I 'zadOTTgOS zabog go UOTgoazTp aqq Aq gpgq AJT4zao Agazaq 'zoAanznS pupZ uTsuoosTM paz94sT50z 'uabpgAN •O uaTTV 'I 3yVDIaIIHHD S,xOAUAUnS