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HomeMy WebLinkAbout032-2145-20-000 ,sconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix afety and Building Division . INSPECTION REPORT Sanitary Permit No: 430082 0 GENERAL INFORMATION„ (ATTACH TO PERMIT) State Plan ID No: Personal information you prmide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. 0 M Permit Holder's Name: City Village X Township Parcel Tax No: Kolstad, Chad Somerset Township CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range /Map No: �- 0 �� ht #/ C4 �� ,,4 13.30.19. 126 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark /�(� 0 Q o Dosing h Alt. BM C / / '71 . Aeration \ ' ' Bldg. Sewe w�a -) 3 -- Holding St/Ht Inlet 0 /4711 KI TANK SETBACK INFORMATION St/Ht Outlet TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic > 7 , ' 04-f Dt Bottom 11 0 Dosing CPA, y a ,,, Tf y%- y X1 Header/Ma C �� 0E S / Aeration Dist. Pipe T , h • 3 00 l p 2 I Holding Bot. System GM N 7 Final Grade t PUMP /SIPHON INFORMATION Manufacturer I— Demand St Cover GPM YYS2 -f 7 •73 fl V7 Model Number M CI` 6 �f� d 2 � 2- 106.6 TDH Lift . Z Frictioyi Loss System H d TDH t u[ �r Forcemain Leib / Dia. Dist. to ;j eT / /J ycf SOIL ABSORPTION SYSTEM /`1 BED/TRENCH Width 1 Length No. Of Trenched d PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS / / 3 / f.e— SETBACK SYSTEM TO P/L JBLDG WELL LAKE /STREAM L C G Manufacturer: INFORMATION T— CHA I R OR Type OT ! stem: 1 / 6 Model Number: DISTRIBUTION SYS M GC A l 7 7 wbn_ c9tvf Header /Manifold Distribution x Hole Si e x Hole Spacing Vent torAir Intak IP'pe(s) Length Dia Length Dia I Spacing ' r SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded /Sodded c ftw Bed/Trench Center / �„v Bed/Trench Edges Topsoil - 7 � Yes � J , No i �;� Yes [� No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1 — : / / / // o 3 Inspection #2: Location: 857 156th Ave New Richmond, WI 54017 (W 1/2 NE 1/4 13 T30N R19W) Nathan Hills Lot 2 FQ0, v � f ((j Parcel No: 13.30.19. 1.) Alt BM Description = __10f of Q4t, W4. f ` 1 N 2.) Bldg sewer length = /� C /_ ,W AAa - amount of cover =' 1_ 1(! � — lcs�Q�jadR �Y�et. �5 ' dE IAC Plan revision Required? F_ ] Yes 5edo j Use other side for additional information. SBD -6710 (R.3/97) Date Insepctor's Signature Cert. No. Sanitary Permit Application Safety & Buildings Division In accord with Comm 83.2 1, Wis. Adm. Code 201 W. Washington Ave. `�SCOnS,; See reverse side for instructions for completing this application PO Box 7302 Per information you provide may be used for secondary pu oses Madison, WI 53707 -7302 Department of Commerce � [Privacy Law, s. 15.04(l)(m)] (Submit completed form to county if not state owned.) Attach complete plans (to the county copy only) for the system, on paper not less than 8 -1/2 x 11 inches in size. County State Sanitary Permit Number St. Croix 00 Application State Plan 659376 I. Application Information - Plea de Print all ma,tion Location: Property Owner Name Property Location Chad & Gail KOlstad JUN 0 6 2003 Wl 124 NEI /a,s13T30��i31�€lw Property Owner's Mailing Address Lot Number Block Number ST. C;ROIX i_;OUI'v'T`r 506 Hunter Hill Road ZONI oFFicE= 02 - - - - -- City, IStat Zip Code Phone Number Subdivision Name or CSM Number n WI 54016 ( 715 ) 531 - 0921 Nathan:bl& Hil]S II. Type of Building: (check one) ❑ City C�c 1 or 2 Family Dwelling -No. of Bedrooms: 3 _Ar — ❑Village ❑ Public/Commercial (describe use):_ ,, j U Town of Somerset ❑ State -Owned W . 6e / / X� /'3 � (lYt C h_'hf � 10 aff4ij 0 &I / /1 ��(j 0 Nearest Road l2ucat�v � 94"L • . ��(,� Gtf!liy�ta � � III. Type of Permit: (Check only one box on line A. ChetA box on Rne B if applicable) A) 1. ]p New 2. 0 Replacement 3. 0 Replacement of 4. 5. 6. ❑Addition to System System Tank Only Existing System B) Permit Number Date Issued ❑ A Sanitary Permit was previously issued IV. Type of POWT System: (Check all that apply) ❑ Non - pressurized In- ground ❑ Mound ❑ Sand Filter ❑ Constructed Wetland ❑ Pressurized In- ground ❑ Holding Tank ❑ Single Pass ❑ Drip Line t - ade r ,$. ❑Aerobic Treatment Unit ❑Recirculating ❑Other: V. DispersaVrreatment Area Information: 1. Design Flow (gpd) 2. Dispersal Area 3. Dispersal Area 4. Soil Application 5. Percolation Rate 6. System Elevation 7. Final Grade Required Proposed Rate (GalsJday /sq. ft.) (Min. /inch) Elevation 450 1125 1130 .4 r/ - - - -- 100.5 101.79 VII. Tank Capacity in Total # of Manufacturer Prefab Site Steel Fiber- Plastic Information Gallons s Tanks I,(/ Con- Con- glass New Existing 2 crete strutted Tanks Tanks — 1,00 j9 Ile r Coo isr ❑ ❑ ❑ ❑ soo ® ❑ ❑ ❑ ❑ VIII. Responsibility Statement I, the undersigned, assume responsibility r installation of e POWTS shown on the attached plans. Plumber's Name (print) PI es Signatu W o. Business Phone Number Lynn Kolstad ` y 5171 (920) 863 -2921 +L Plumber's Address (Street, City, State, Zip Code) 14633 S. Maribel Rd. Maribel, WI 54227 IX. County/Department Use Only ❑,Disapproved t Permit Fee (Include oundwater Date Issued suing ent Signatur stamps) Approved ❑ Owner Given Initial Adverse urcharge Fee) w /_ Determination ���, 19 1 (p �3 X. Conditions of Approval /Reasons for Disapproval: � Ou t�Ca ut� ttit 46 LtP/! c sf✓s p n � , j o, �Lr n- w /fte d r H l�f��..2 o IF' of sa. / 1200 �""` ,kr; sa 1 CV 6 Ole � 3 6Je*5 u, 3 Ytti � rfa z �?,dzr �trte c�. XIT SBD -6398 (R. 07/00) At -Grade Plan View Name: Chad & Gail Kolstad County: St. Croix County Legal Description: W1 /2 NE1/4 S13, T30N, R19W �, I Scale: 1" = 50' I `� b 4 �31ObO3 � \ 1 bed . 20 o G 3 � hamc ��k Page 9 of 9 t Safety and Buildings 2331 SAN LUIS PL STE 150 GREEN BAY WI 54304 i�c�nsin TDD #: (6 tat .wi.us sb www. commerce. state.wi. us /sb Department of Commerce www.wisconsin.gov Jim Doyle, Governor Cory L. Nettles, Secretary May 20, 2003 CUST ID No.5171 ATTN: POWTS Inspector ZONING OFFICE LYNN R KOLSTAD ST CROIX COUNTY SPIA 14633 S MARIBEL RD 1101 CARMICHAEL RD MARIBEL WI 54227 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 05/20/2005 Identification Numbers Transaction ID No. 871976 SITE: Site ID No. 659376 Chad Kolstad Please refer to both identification numbers, 156TH Ave I above, in all 'correspondence with the agency. Town of Somerset St Croix County W1 /2, NE1 /4, S13, T30N, R19W FOR: Object Type: POWT System Regulated Object ID No.: 904216 The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes Con dll and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in AP 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: DEPARTMENT pWPN of W1 This lan action is subject to designer comments on Provide the omeowners wt a user's manual on the operation and maintenance of this POWTS system. #1. Locate the well per Comm 83.43, Table 83.43 -1. SE ' CORRE • Access to the filter for cleaning must be provided per ss. Comm 84.25 (7) and (8),Wis. Adm. Code product approval conditions. Maintenance informatio must be given to the owner of the tank explaining that periodic cl eaning of the filter is rSOuued. L — 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. 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. j LYNN R KOLSTAD Page 2 5/20/03 Sincerely, Fee Required $ 175.00 Fee Received $ 175.00 J C Balance Due $ 0.00 Wesley C 46be Plumbing Plan Reviewer, Integrated Services WiSMART code: 7633 (920)492 -5613 , M -r 7:00 - 16:30, F 7:00 - 11:00 wgrube @commerce.state.wi.us cc: Maribel Heating & Plumbing Inc Leroy G Jansky, Wastewater Specialist, (715) 726 -2544 ECENVI D MAY 19 2003 WETY SI.DGS, DIV. .RESIDENTIAL AT -GRADE DESIGN Pressurized - Sloping Site INDEX AND TITLE SHEET Project Chad & Gail Kolstad Mound Owner Chad & Gail Kolstad Address 506 Hunter Hill Road Hudson, WI 54016 Legal Description W1/2, NE1 /4, S13, T30N, R19W Township Somerset County St. Croix Subdivision Name Nathanal Hills Lot No. 2 Parcel ID Number 13.30.19.1264 ionally Plan Transaction Number OVED OF COMMERCE Index sheet Page 1 TYAN ILDING Calculations Page 2 _ At -grade drawings Page 3 Laterals and dose tank Page 4 SPONDENCE Specifications Page 5 Management & contingency plan Page 6 Pump Curve Page 7 Filter Diagram Page 8 Mound Plan View Page 9 Designer LynrylKolstad License Number 5171 SignatureYA4ti Phone Number 920/863 -2921 Date 0512/03 Designed pursuant to: At -grade Component Manual for POWTS SBD- 10570 -P (R.6/99), and SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST - SAS (01/81) Version 3.0 (R. 03/01) Page 1 of 9 I - PRESSURIZED AT -GRADE DESIGN At -grade Design Worksheet - Sloping Site Flows and Site Data Entry. (r or c) r Residential or commercial? 300.0 Estimated wastewater flow (gpd) 450.0 Design wastewater flow (gpd) 4.60 % Site slope 100.00 Contour elev. below lateral (ft) 36.00 Depth to limiting factor (in) 0.40 In -situ soil application rate (gpd /ft "2) Distribution Cell Information (1 or 2) 1 Influent wastewater quality 4.50 Linear loading rate gpd /ft 10.00 Effe absorpti width (ft) 10.00 M x. effective width permitted (ft) 113.00 Aggregate length (ft) Pressure Distribution Data Entry (c or e) c Center or end lateral connection 2 Number of laterals 0.125 Orifice diameter (in) e.g. 0.188 Not afinal 1.50 Estimated orifice spacing (ft) calculation 2.00 Forcemain diameter (in) 3.21 Forcemain flow velocity (ft/sec) 140.00 Forcemain length (ft) y or n y Does forcemain drain back? 85.00 Pump tank elevation (ft) y or n y Are laterals at highest point? 02 NA 6.5 System head (ft) x 1.3 22.8 Forcemain drainback (gal) 14.50 Vertical lift (ft) 50.5 5x Lateral void volume (gal) 2.95 Friction loss (ft) 73.3 Minimum dose volume (gal) 23.95 Total dynamic head (ft) 31.4 System demand (gpm) Lateral Diameter Selection Gallons /Inch Calculator (optional) Pipe diameter Design options Design choice 800 1 Total Tank Capacity (gal) Designer 1 in x I 42 Total Working Liquid Depth (in) must select 1.25 in x 19.0 Gal /in (enter result in cell G46) one lateral 1.5 in x x ��� � diameter 2 in x Treatment Tank Information 3 in x 1000 Septic tank capacity (gal) Weeks Concrete I Manufacturer Effluent Filter Information Dose Tank Information S Zabel I Filter manufacturer 800.0 Dose tank capacity (gal) A100 Filter model number 19.0 Dose tank volume (gal /in) �o, a(% b Weeks Concrete Manufacturer Project: Chad & Gail Kolstad Mound Transaction Number: Page 2 of 9 , AT -GRADE PLAN VIEW 1/6 B Observation pipes (2 typical) A 10.00 ft y 3.00 ft /6 B 18.83 C 12.00 ft W C p 0 E 2.00 ft L 123.00 ft B W 22.00 ft A x B 1125.00 ft ^2 L Cap Typical obs. pipe. = Total aggregate cell A x B Slotted in the lower e and anchored s = Plowed area L x W securely. 6" AT -GRADE CROSS SECTION Svnthetic fabric cover 101.79 ft Finished grade elevation Lateral invert elev. ft 100.50 0 .�- Observation pipe at aggregate toe E 4.6 % Slope Surface contour ✓ 100.00 ft C A and system p _1 elevation T ® = 12 in. topsoil and subsoil Plowed layer over aggregate and tapered to toes. below L x W = 6 in. aggregate below pipe(s), and 2 in. above pipe. Project: Chad & Gail Kolstad Mound Transaction Number: Page 3 of 9 PRESSURE DISTRIBUTION AND DOSE TANK Lateral Diagram - Center Connection I P If X—}I +812 I 02 +1 Laterals & force main of PVC Sch 40 Last hole drilled next to end cap (per COMM Table 84.30 -5) Holes drilled on the bottom of the lateral, • = Turn- upwi'ball valve orcleanoutplug equally spaced Lateral Specifications 0.125 Orifice diameter (in) Center Lateral connection point X 1.47 9( Orifices spacing (ft) 2 Number laterals P 38 Orifices/lateral P 55.3 Lateral length (ft) 15.7 Lat. discharge rate (gpm) 1.50 Lateral diameter In 2.00 Forcemain diameter (in) 31.4 Sys. discharge rate (gpm) 140.00 Forcemain Length (ft) 23.95 TDH (ft) Typical Pump Chamber Layout YP P Approved manhole cover with Weather -proof /�/ warning label and locking device junction box —� 4 disconnect Final grade Tank component is Alternate properly vented �� outlet / location 18" min. Electrical as per NEC 300 and /c Approved outlet joint Comm 16.28 WAC Tank full = Inches Gallons A Provide 1/4" C A 23.1 439.4 Alarm on weep hole or c B 2. antisiphon 0 38.0 g C 5.0 94.6 Pump on device. E C o D 12.0 228.0 86. 00 ft Totals 42.11 800.0 Pump off D 3" Bedding under tank ~- 85.00 ft �ii Fy Pump manufacturer SJ Electro Inc Alarm manufacturer � ME40 Series Pump model number 1 1 HW Alarm model number Project: Chad & Gail Kolstad Mound Transaction Number: Page 4 of 9 At -grade System Maintenance and Operation Specifications Service Provider's Name J Maribel Heating & Pl umbing, Inc. Phone 920/863 -2921 POWTS Regulator's Name St. Croix County Zoning Department Phone 715/386 -4680 System Flow and Load Parameters Design Flow - Peak 450 gpd Maximum Influent Particle Size 1/8 in Estimated Flow -Average 300 gpd Maximum BOD5 220 mg /L Septic Tank Capacity 1000 gal Maximum TSS 150 mg /L Soil Absorption Component Size 1125.0 ft Maximum FOG 30 mg /L Type of Wastewaterl Domestic Maximum Fecal Coliform >10E4 cfu /100 mL Service Frequency Septic and Pump Tank Inspect and /or service once every 3 years Effluent Filter Inspect and clean at least once every 3 years Pump and Controls Test once every 3 years Alarm Should test month) Pressure System Laterals should be flushed and pressure tested every 1.5 years Mound Inspect for onding and seepage once every 3 years Other Miscellaneous Construction and Materials Standards 1. Observation pipes are slotted and materials conform to Table Comm 84.30 -1, have a watertight cap, and are secured in as shown in the at -grade component manual. 2. Dispersal cell aggregate conforms to Comm 84.30 (6)(i), Wis. Adm. Code. 3. All gravity and pressure piping materials conform to the requirements in Comm 84, Wis. Adm. Code. 4. Tillage of the basal area is accomplished with a mold board or chisel plow. 5. The at -grade structure and other disturbed areas will be seeded and mulched to prevent soil erosion and help reduce frost penetration. 6. Areas within 15 feet of the downslope toe will be protected from compaction. 7. All other construction details are as per the at -grade component manual SBD- 10570 -P (R. 6/99). Lateral Turn -up Detail Finished •............•. ................ Grade 6 -8" Diameter Lawn Threaded Cleanout Sprinkler Valve Box Plug or Ball Valve Distribution Lateral `�. Long Sweep 90 or Two 45 Degree Bends Same Diameter as Lateral Project: Chad & Gail Kolstad Mound Transaction Number: Page 5 of 9 At -grade System Management Plan Pursuant to Comm 83.54, Wis. Adm. Code • General This system shall be operated in accordance with Comm 82 -84 Wis. Adm. Code, and shall maintained in accordance with its' component manuals [SBD- 10570 -P (R. 06199) and SSWMP Pub. 9.6 (01181)] and local or state rules pertaining to system maintenance and maintenance reporting. No one should ewer 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. r wa tightness and soundness. Access openings covers should be inspected fo at g Septic or pump tank manhole risers, access users and cove pec 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. Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Slats. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code. The operating condition of the septic tank and outlet filter shall be assessed at least once every 3 years by inspection. The outlet filter shall be cleaned as necessary to ensure proper operation. The filter cartridge should not be removed unless provisions are made to retain solids in the tank that may slough off the filter when removed from its enclosure. If the fitter is equipped with an alarm, the finer 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. Pump 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. At -orade and Pressure Distribution System No trees or shrubs should be planted on the at- grade. Plantings may be made around the at- grade's perimeter, and the at -grade 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 at -grade is not recommended since sal compaction may hinder aeration of the infiltrative surface within the mound and snow compaction in the winter will promote frost penetration. Colt weather installations (October - February) dictate that the at -grade be heavily mulched as protection from freezing. Influent quality into the at -grade system may not exceed 220 mg/L BOD5, 150 mg/L TSS, and 30 mg/L FOG for septic tank effluent or 30 mg/L BOD5 30 mg/L m FOG, and 10 cfu/100 mL for highly treated effluent. Influent flow may not exceed maximum design flow 9/ TSS, 10 9� speed in the permit for this installation. The pressure distribution system is provided with a flushing pant 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 9 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. Contingency 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(s) shall be immediately repaired or replaced with a component of the same or equal performance. If the at -grade 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 renovating the biologically clogged absorption and dispersal media, installing new piping, and replacing other components as deemed necessary to bring the system into proper operating condition. See Page 5 of this plan for the name and telephone number of your local POWTS regulator and service provider. Project: Chad & Gail Kolstad Mound Transaction Number: Page 6 of 9 M E40 Series MYM 4/10 HP Effluent and Drain Water Pumps Performance Curve MODEL ME40 EFFLUENT PUMP CAPACITY LITERS PER MINUTE 0 50 .100 150 200 250 300 350 40 12 35 10 tpo 30 W 8 E H 25 Z H 20 6 a 15 Q ~ 4 F�- F- 10 2 5 0 0 0 10 20 30 40 50 60 70 80 90 100 CAPACITY GALLONS PER MINUTE 1101 Myers Parkway, Ashland, Ohio 44805 -1923 419/289 -1144 FAX 419/289 -6658 Telex 98 -7443 Zabel' A100 -8 Series Effluent Filter Product Specification �I ` •,. 9.6440" -- — _ *LI r..0 .i. • Residential and light commercial - applications up to 2400 GPD • 50 -90% reduction in TSS within 6 months of installation 0 -" ' 4.0 - ' 1 5.82" — - • 20.45% reduction in BODs within a' ° 0 3525' 5.54' 18.5' _ 1 6 months of installation • Disc dam plates reduce turbulence ....... and promote sloughing fire= 9.64 1 4A100 -8x18 —_� • Case, central support and handle t � constructed of PVC L At00-8x18 • Lid and filter discs constructed of polyethylene • Outlet hub accepts 3" or 4" SCH c 40 4" SDR35 and 6" i e see < - -- 9.944' —� P P ( -- graphic below) • 4" reducer built into case • Filter support may be achieved by r extending a 4" support pipe from the reducer to the bottom of the tank. .Al O-8x26 325' ' — 4.645' — A100 -8x26 Outlet Hub options 4' sch 40 or 6' sch 40 r s 3 "Sch 40 .,D,P 35 w, outlet pipe + t + auu tpp' `44V�.ekip�tc• Accepts 4" Sch 40 + A100 -8x32 100 8X32 1 Specifications: A100 -8X18 8 1, 18-5"'-.' 1/16" 1200 492 in 1,356 inz 76 �. A100 -8x26 8" 25:5" r ' 1/16" 1800 738 inz 2,034 in' A100 -802 8" 32.5" 1/16" 2400 984 inz 2,712 in ...'Calculations are for the 1/16" area only. PAGE 8 At -Grade Plan View + Name: - Chad & Gail Kolstad County: St. Croix County Legal Description: WI/2, NE1 /4 S13 T30N, R19W Scale: 1" = 50' b 13i (trio 3 bo')+Y3M(s 00 6 3 0 2.,' 3 bed. ,Zoo G h omc � cnk �� n�C Page 9 of 9 •r ' Wisconsin Department of Commerce 1§ LT REPORT Page of _ vC Division of Safety and Buildings in acco nce with Comm 85, Wse Attach complete site plan on paper not less than 1 1/2 x A*ei in$Q54 mus County include, but not limited to: vertical and horizontal r Aerenoe point (BM), direction and Parcel I.D. percent slope, scale or dimensions, north arrow, nd kx �alioQ #"9 to. neare road. ! 3 r .3 0 f 1 1 4 6 Please print all !n attt ;l;' (FFiCI -_ by Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). / J D Property Owner Property Loca7on o— � 1 h a- A - ab ;� 67,fa-j Govt. Lot � � 1� 114 S T V N R E (or Property Owner's Mailing Address � f / � Lot Block # I Sub � � � CSM# l•' ( b �� v 1 Tl f 111 V, I l CAy� State Zip Code Phone Number ( ❑ City ❑ Village (Town Nearest Road u 1 s an ,pro l6 c 9 /S) sa y e t" E 14 Ct v � New Construction Use: ❑ Residential / Number of bedrooms Code derived design flow rate GPD ❑ Replacement ❑ Public or commercial - Describe: Parent material Flood Plain elevation if applicable I Gar ka ai uu nntents N o and recommendations: �t , , // 5 � t Q � c��e o✓ 4 L I 1"nes a Boring # ® Boring l o < e�e- sys i s rn,� KrjL -Q rte ❑ Pit Ground surface elev. _ ft. Depth to limiting factor 30 in. Soil Applicaltion 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 r a - 7"E 3 S J ,. a J - %- 't 4 Ll 6 Boring # Boring ❑ 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/ff In. Munsell Qu. Sz. Cont. Color Gr. z. Sh. •Eff #1 'Eff#2 0 s ya Y 3 G L3- ' Effluent #1 = BOD > 30 220 mg/L and TSS >30 < 150 ' Effluent #2 = BOD < 30 nxyL and TSS < 30 mg/L CST Name (Please PSig CST Number d 3 L ex o ) 6/7 / Adder Date Evaluation Conducted Telephone Number o Aab h3 -aqQ ,S-Ya Prope Owner CC i, 1 Parcel ID # �.J 3o, b q, t c) Page of F3-1 Boring # C] Boring 0 2 .// Pit Ground surface'slev. - ft. Depth to limiting factor 3 1F In. SoU ication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDfif In. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. 'Eff#1 'Eff#2 0 j ?� 3 S s� rn Boring # ❑ Boring ❑ Pit Ground surface eiev. ft. Depth to limiting factor in. !'Efffa l E ication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff In. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. 1 • ff#2 ❑ Boring # ❑ Boring ❑ 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/f? In. Munsell Qu. Sz. Cant Color Gr. Sz. Sh. 'Eff#1 •Eff #2 Effluent #1 = BOD > 30:5 220 mg/L and TSS >30 < 150 mg/L • Effluent #2 = BOD < 30 mg/L and TSS 5 30 mgk 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 (Rd00) L SOIL TEST PLOT PLAN a 4 f • nn 1 ~� r OWNER �rl d Cra \ � A 'Ac �1 N PARCEL# I �, 30 [ C f , I r) 6 z ( CST �v� �> SCALE 1 "= SCE Oa o c c�, a I Wisconsin Department of Commerce SOIL EVALUATION REPORT Division of Safety and BLiklings Page � — of _ in accordance with Comm 85, Wis. Adm, Code S Attach complete site plan on paper not less than 8 112 x 11 Inches In size. Plan must County include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I D r / a Zj percent slope, scale or dimensions, north anew, and location and distance to nearest road. 1 I C� Please print all Information. Ravi ed by Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Property Owner Property Location t �� CC� Govt Lot 1/4 S 3 T 3 C N R E (o 1 Property Owner's Mailing Address J ` Lot Block # Sub Na a City f� Ubt `fV 11l�' G? Val - 1h State Zip Code Phone Number ❑City ❑ Village [ZTown Nearest Road J4L �e� lc� `yol6 (� /f ) S3/ -���2 / �Z M er e 6 t4 C( New Construction Use: [3 Residential / Number of bedrooms Code derived design flow rate S GPD ❑ Replacement ❑ Public or commercial - Describe: Parent material Flood Plain elevation If applicabie G2r',caai tXXilil'IentS and recommendations: Boring # ® Boring / p in. E] Pit Ground surface elev. V ft. Depth to limiting factor 3, eP I � 9 Soil capon Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont Color G . Sz Sh. 'Eff #1 Eff#2 a- `�r�" 3 s r L L _ I a Boric # Q Boring i g ❑ Pit Ground surface elev. ft. Depth to limiting factor �7 � in. _— — Soil Appication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/W in. Munsell Qu. Sz. Cont Color Gr. z. Sh. •Eff#1 Efi#2 1 I n 3 3 s ' J -q 3G � -A Id 7SV7/Q a s� t i Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 ' Effluent #2 = BOD < 30 mg/L and TSS < 30 mgL CST Name (Please Prin Sig CST Number L o [ sia t 6J71 Address Date Evaluation Conducted Telephone i phone Number J i !`'(� 1.:) -7 Property Owner ,_ (� 6 l , �� /y/ Boring # [I Boring Parcel ID # oring / Page o f , 3 -� Pit Ground surface elev. 7 Q� (2 _ _ ft, Depth to limiting factor _ 3 6 In. Horizon Dominant Color Redox Description Texture Or. Consistence Bounds r. Sz. Sh. Roots Soil icatlor Race In. Munsell Qu. Sz. Cont Color ry Depth D GPDJfF 75 3 'Eff#i 'Effrt2 � 02 _ s rn v c c Li cc i , Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Horizon Depth Dominant Color RedO Descrf tlon Soil Icabon Race P Texture Structure Consistence Boundary Roots in. Munsell Qu. Sz. Cont Color GPD/ff Gr. Sz. Sh. 'Eff#1 'Eff#2 F-1 Boring # ❑ Boring I ❑ Pit Ground surface elev. ft• Depth to limiting factor in. Horizon Depth Dominant Color Redox Soii ication Race i Description Texture Structure Consistence Boundary Roots in. Munsell Qu. Sz. Cont Color GPD/ft' Gr. 3z. Sh. 'Eff #1 'Effu2 Effluent #1 = EtOD > 30 < 220 mcyL and rSS >30 < 150 MgIL • Effluent #2 = GOD < 30 mg/L and TSS < 30 nxyt, The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services ur need material in an alternate format, please contact the department at 608 - 266 -3151 or TTY 608 - 264 -8777. ssL)-9330 (ud(X) • SOIL TEST PLOTPLAN 0WNER N PARCEL# f y CST SCALE 1 "= 6 i C. 1 ' Oo o �3 � N - 912.9 6 0 - - 40 /- 930 ) 9.6 92 n 949.8 ' °� U 9�� J - X 0 9 X40 �O 0� 9 �O 3 i 1.3 AC .w.�. 3 S • ��; . • s9 • F F 915.4 0 • / , i 909.5 x 9i0 ) 954.3 ,r 950 �dN " 9 / 931.4 x x i 1fi ' x 5 9,335 i Y 960 - \ \ \� 0 960--- - _ r OD 1 0.3 T �.. � x 91?3! � a � N ✓ x_ � \ �� �' � 905 w i ( X962 6 \\ \ �\ \ 51.' — -�' � -��• �\ y x � =---� % - . (s�tr{ pi " .� i 4 Y - \� ^^ • , �,�- a (.y 960• 51.3` 952. x :I�IN j SE ON a-- ��--- --CRtr. \ ry er a , 4� _. I # , F NO AIUNtE�lU1A' oU n �k Tom\ 952.7 ''�` ✓. •r step t + t � / A ��� �s3.1 x _ 9695 9 - G y� 1 967.3 N 60 954.8 �� / !O�' ` �• \ �- a 962.8 9865 °l i 2 \ I / F. 7`, \.\ 970.5 959.5 x '9 987.6 © ' H of 8. / 1 1 7 960.1 c) `_'959.5 962.8 < 961 � x \� / � 19311 3n i� j /� �17 972.6 (� H.W.L. . 910.0 /.� _971.6 x 966.2 •i i 'r , �-- 0 �,, x 967. UA ST t l \ \\ tl ` - ! \ T TEII �R •,� �, . .� ` 983 \ � , � \ Wisctl�nsIn Department of Commerce SOIL EVALUATION REPORT Page --I—of Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code County Attach complete site plan on paper not less than B 1/2 x 11 inches in size. Plan must ✓ ' ! 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. 03 Z — Z Y 5 --2 0 Please print all Information. ewe by Date Personal Information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). GCC Z Property Owner Property Location Govt. 2, Lot i t O 1/4 S j T N R E (or W Property Owne ails Adcylroes [ Lot # Block # Subd. Name or CSM# U . City State Zip Code Phone Number (J City ❑ Village Town Nearest Road + R; ms d 1 �? c ) S G New Construction UseResidenttal / Number of bedrooms Code derived design flow rate _ GPD ❑ eplacoment /❑ Publi or commercial - Describe: Parent material u Flood Plain elevation if applicabl '�~ ft. General comments and reoommendations: JA ca C Boring # �❑ Boring V-�N�� / © /�-'. Pit Ground surface elev. ft. Depth to limiting factor 13 v �; / I Soi piication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary GPD/ tz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 'Eff#2 ° T 1A, /-s// 3 ® Boring # ❑ Boring I A Pit Ground surface elev. ft. Depth to limiting factor / 3 0 - In. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft In. Munsell Qu. Sz. , C J ont. Color Gr. Sz. Sh. "Eff#1 'Eff#2 •3/2 S e L5 3 so Effluent #1 = BOD > 13 0 mg/1 and TSS 1 g/L " Effluent #2 = 800 < 30 mgt and TSS < 30 mg/L CST Name (Pie se Print) _. e T Number Address Date Evaluation Conducted Telephone Number .s E 11 5 SOD -8330 (R07 100) L • M . of Property Owner Parcel ID # �� 8orrrtp # .p ❑�t Boring 00, pa p of ---- - va --Pit Ground surface elev. W3h Depth to limi ' or S� � Yact �" �� Soil Nerk0n Depth Dominent Color Rvdox Description Texture Structure ConsEstenca Bou Rye In. wry Roots t'sPp/Qf ARtataeN Qu. Sz. Cont. Color Gr. Sz. Sh. • Eff#1 'EM#2 �- - Borng # ❑ ❑ Pit Ground sudwe elev. ft. Depth to Ilmiting factor _ in. Nari=on Depth 13orttinertt Soil lee8or+ Rata Redox Description Texture Structure Consistence Y Roots C3PDVM In. Mun"ll Qu. Sz. Cont. Color Gr. Sz. Sh. . fit 'EffAZ c_ a ga # ❑ BWng {_ _ I ❑ N Ground trtutace elev. ft. Depth to limiting factor in. �^ Do+ *I" Redox Desatiptlon Texture Structure Consistence 8ourx{ery Roots Rate h Munsmil flu. S7- Cont. Color Gr. Sz. Sh. 'EfMII 'EfHf2 ' tBRuattt tit ■ 80D s 30S 220 mWL and TSS >30 S 130 mg& ' Effluent 92 = 800 S 30 nv& and TSS = 30 m k . The Depament of Commerce is an equal opportunity service provider and employer. if you need assistance to accass services or need Material in an alternate format, please contact the department at 608 266 - 3131 or TTY 608 264.8777. taao.ursar.spol, Soil Test Plot Plan Project Name Brian Boardman Sha d Address 824 East 11th St. New Richmond Wi 54017 # 26900 Lot 2 Subdivision Nathan Hills Date 5/13/01 W 1/2 NE 1/4S 13 T 30 N /13 W Township Somerset n Boring Q Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 100 ft. Top of Nail in Cherry Tree System Elevation 93.0/90.8 *HRPSame as Benchmark Alt. BM Top of Nail in Oak Tree @ 102.7' Pro Town Road Soil Test was done to fullfill zoning requirement, test may not be suitable for desired builind location 125' 100' 99' 90' 4 B -3 0, Alt 98' M. 97' B -2 a� a 11% _ t Slope a ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM OwnerBuyer G d ti` /o� S) 1h d Mailing Address So 6 H % n �' N; I I R o c, I � f v n W 2 -5`106 Property Address 9S /5-6't (Verification required from Planning Department for new construction) City /State � e w P T C i�l 0 Parcel Identification Number 3 ' 3 0 , Q 0 d3Z —660 LEGAL DESCRIPTION �1 Property Location i " } N�t %s, Sec. �� . 'f 6 N R W, Town of Su 2 err e- Subdivision I" Y�� n r "� S Lot # Certified Survey Map # . Volume . .Page # Warranty Deed # 1, � S Volume 1 0 . Page # 1 Y Spec house ❑ yes 9d Lot lines identifiable B yes ❑ no SYSTEM MAINTENANCE Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance a licensed r. What you p ut into the system ' tank eve three ears or sooner, if needed b L pumpe y p consists of pumping out the septic every y Y 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 mastor plumber, journeyman plumber, restricted plumber or a li cense d pum verifying that (1) the on-site wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. Uwe, 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 systm has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 da o the three y do date. � U' 3 SIGNATURE OF APPLICANT DATE OWNER CERTIFICATION I (we) certify statements on this fomr are true to the best of my (our) knowledge. I (we) am (are) the owners) of th perty des a v e of a warranty deed recorded in Register of Deeds Office. Tj b 14 103 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 y (oi .1789PRGE187 STATE BAR OF WISCONSIN FORM 2 - 1998 665062 KATHLEEN! H. WALSH WARRANTY DEED F? i.," T-R OF DEEDS Document Number a`. CROTX CO., V. This Deed, made between Nathaniel Stephen Enterprises, LLC, a :1ECEI'JED FOR RECORD Wisconsin Limited Liability Company, " , - - -2001 3:30 PM WARRAHTY DEED p Grantor, and Chad M. Kolstad and Gail L. Kolatad, husband and wife, EXEMPT .,tit; COPY =EE: COPY FEE: T,RAHS, FEE: 224.70 RECOEDING FEE: 11.00 ?AGES: 1 Grantee. Grantor, for a valuable consideration, conveys and warrants to Grantee the following described real estate in St. Croix County, State of Wisconsin: Recording Area Name and Return Address Lot 2, Plat of Nathan Hills in the Town of Somerset. F'G' yu�' � SUS 5q;4 032 - 2145 -20 Parcel Identification Number (PIN) This is not homestead property. (is) (is not) Exceptions to warranties: municipal and zoning ordinances and easements of record. Dated this 12th day of December 2001 NATHANIEL ENTERPRISES, LL —. 4Y -- ) i . By: Brian K. Boardman, Member AUTHENTICATION ACKNOWLEDGMENT STATE OF WISCONSIN ) ) ss. Signature(s) ST. CROIX County. ) Personally came before me this 12th day of authenticated this _ day of December 2001 the above named Brian K. Boardman, as Member of Nathaniel Stephen Enterprises, LLC r:� +: `• — e TITLE: MEMBER STATE BAR OF WISCONSIN to me known to be the person(s) wha,�tecyted the re (If not, instrument and acknowledge the sariir:.r ti 4 authorized by § 706.06, Wis. Stats.) /j,, rra /t THIS INSTRUMENT WAS DRAFTED BY �.'/K Judith A. Remington, Remington Law Offices P.O. Box 177, New Richmond, WI 54017 Notary Public, State of Wisconsin (Signatures may be authenticated or acknowledged. Both are not My Commission is permanent. (TFo , state explratlOn ate: necessary.) ) +Names of persons signing in any capacity should be typed or printed below their signatures WARRANTY DECD STATE BAR OF WISCONSIN FORM No. 2.1993 INFORMATION PROFESSIONALS COMPANY FOND DU LAC, W1 e00. 655.2021 o / _ i(ED) �' _Tl ' - 384 .96'- _ `a \` • - ��- - -- ---� S8154'36 "E O O= a - 7 . 624, 80 D wN ROAD r / • - i' '91.54' -� S81' 5 4'36" 57 -87'— Ul 10. gU1L ,DING. SE�ACI gg4'44'S1 "W N �O��. / 115.52 6 ' _ ?2 06 N� m 9 °! s9 ' V . cn�w \F °�. .E >s ^��• ' (t1 � Z ('� N N uu Ct LOT 3 292,299 SO. F7 6.71 ACRES F.F.E. 947.1 y y ,fi g. Z V O O \ p O V 4 -� w z W rri L O T 2 0 ^ 6? 9 k A 0 310,61J SO. FT. °D 91 ACRES o *I\b 7.13 ° � r F. F. E. 8.5 "? m� O T 1 364 SO. FT. 32 ACRES i E. 915.7 ss. . 2 N4 %NF 9 112 300.03' 375.04' 14 CORNER S89 "20'1 5 "W 1330.31' +3 -30 -19 +LUMINUM �j, 1� S89'20'15 "W 5384.60' OVERALL EAST —WEST 1/4 LINE VONUMENT) Iv UN P D LANDS St. Croix r..,ounty Reg-,tor of C r t