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HomeMy WebLinkAbout032-1012-80-025 r - Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 463197 0 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: City Village X Township Parcel Tax No: Van Tassel, Mary I Somerset Townshi CST BM E�O D v Insp. B�Mev: BM Desc t Sectionlrown /Range /Map No: / �'V� fj � ( 51%44, -Prh4 1 05.31.19. TANK INFORMATION IfLEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. ��yy Septic / V U Benchmar 2 3.3y fo p (� 0 '`O Dosing Alt. BM Vl)a(!6 b Aeration Bldg. Sewer •S Q C) ,112 of Holding St/Ht Inlet O TANK SETBACK INFORMATION St/Ht Outlet I 6 / - s - G W) y 40 6 TANK TO P /LVQ WELL BLDG. Vent to Intake ROAD Dt Inlet .— Septic ' ( t Dt Bottom Dosing Header /Man. v Aeration Dist �.Y.3 97T' I f Holding Bot. System S - 7. gs 4 16 36 PUMP /SIPHON INFORMATION Final r e S • / Manufact Demand St C r O�t'� GPM . 1-3 Del Model Number Q TDH Lift Friction Lo I Sys ad TDH Ft Forcemain Dia. Dist. to Well SOIL ABSORPTION SYSTEM i 5'' (� G(,c�,� 0 •S l.t., BEDITRENCH Width Len th o. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS SETBACK SYSTEM TO P/L JBLDG WELL LAKE /STREAM LEACHING nufactu �^�-^II ''!! INFORMATION CHAMBER O �• C>3 F_ W Typ Of System: w 1 Model Number. 51 _. p « 'rO D BUTTON SYSTEM Headfol/I Distribution / x Hole Size x Hole Spacing Vent to Air Intake Pipe(s) 3 rr f /� i Dia Length_ Dia Spacing - too SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over H IDepth Over xx Depth of xx Seeded /Sodded xx Mulched r Bedfrrench Center / / Bed/Trench Edges Topsoil 1 Yes [] Nof Yes (J No COMMENTS: Include code discrepencies, persons present, etc.) Inspection #1:_[L/ 1 /D Inspection #2: / / Location elong Road Somerset, WI 54025 (NW 114 SW 1/4 5 T31 R1 9W) NA Lot 1 � / Parcel No: 05.31.19. 1.) Alt BM scription = �SJ 7w�'l'•�^'w`C�� y23(L / 'Zt9 z37 2.) Bldg sewer length (( - amount of cover =/ Plan revision Required? ' b ; Yes No i Use other side for additional information. V Date r Insepctor's � Ceq No. SBD -6710 (R.3/97) j / �, -AV � n � /C7�r�Q Safety and Buildings Division County m 201 W. Washington Ave., P.O. Box 7162 N isconsin Madison, WI 53707 — 7162 Sanitary Permit Number (to be filled in by Co.) Department of Commerce ( 266-3 1 3 Sanitary Permit Application to Plan I.D. Number In accord with Comm 83.21, Wis. Adm. Code, personal information you provide may be used for secondary purposes Privacy Law, Project Address ( than mailing address) L Application Information - Please Print All Information 2 3' Property Owner's Name P # Block # /vIAKY OW T�95S L ST. CR0JX '0 NT" ri �m' ZONING OFFICE Pro on 9'W RAYk ?t j* gT, Mir :W city, State Zip Code Phone Number K r A, Section r < [nIQR -7 YV l � 1 - ,31 ! `(t tole o II. Type of Building (check all that apply) a� T N. R E orr VV � pSt,�e Cs 1 or 2 Family Dwelling - Number of Bedrooms OVA v• � 3 Publ'ncJComrnettaal - Describe Use State Owned - Describe Use fit! Ciry_ Village Township of N r -Q� Ar Type of Permit: (Check only one box online A. Complete line B if applicable) A ew System Rephuxment System TreatrrreatlHol ' Tank, R ding eplaameat Only Other Modification to Existing System B • Permit Renewal Permit Revision Change of Permit Transfer to New Liu Previous Permit Number and Date Issued Before Expiration Plumber Owner IV. 12e of POWTS System: (Check all that a 1 Noa - Pressurized Ia Csmund Mound> 24 is of suitable soil Mound <24 in. of suitable soil At -Grade Single Pass Sand Filter Constructed Wetland Hd Peat Filler Aerobic Treatment Unit Recirculating Sand Fitter Recirculating Synthetic Media Filter Leaching Chamber p Line GraveI4ess Pipe Other (exp V. Dispersal/Treatment 0 b t S Design Flow (gpd) Des' i1 lication Ra te(gpdsf) Dispersal Area Required (st) 1. Dispersal Area System IIevatiou r Rio; ° pIr 45re VL Tank Info &padry m Total Number Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Units Concrete Constructed Glass New Existing Tanks Tanks ptic Se or Holding Tank I� � 1 r Aerobic Treatment Unit > ! 0 1 VII. Responsibility Statement- I, the undersigned, asstwe responsibility for'astailat' of the POWTS shown on the attached Plumber's Name (Print) umber' goatiue MP RS Business Phone Number J EFF Rn ZZZ324 I 715 - ZZq - 141 Plumber's Address (Street, City, state, zip cww VIII. Con /De t Use only rAppr ro Sanitary Permit Fee includes Groundwater Date Issued g t Signature o Stamps) Surcharge Fee) ner Given Reason for O UL Conditions of Approval/Reasous for Disapproval SYSTEM OWNER: 1 Septic tank, effluent filter and dispersal cell must all be serviced / maintained as per management plan provided by plumber. 2. All setback requirements must be maintained as per applicable code /ordinances. Attach complete plans (to the County only) for the system on paper not I= than SW x I I inches in sift M ARY 0 TAIL Nw'l 5"V' /9 5 5 T:SI N /,- i9 w `� /JO�TH P�1iZ1" sD rVt�KS�T 7 V 4 5P' L- 6T 1 90Z �'ftYMO�U/J sr soFne25 wl 5AoL5 <Z�47 U. J, rMMS Z Z3ZIZ SDfL WK 65 d � 6,N1, -9 1 7Z8) P '1" Pi�� �1 PE EL = A) 0 re All Ll mo ,, � - tor' ► �i P►� 1 Joao p 0 o low /OAIZY )(A►J ThSg - L ivt 5v v'�l 5 s -- r3 ) 0 e 1q W I-or 1 9t�Z Rft1�MQulJ 5 IV I 5g ©L5 U. A 1 Z Z3ZIZ m AIL W J115 Pit(, rl PE EL = loo ��r' P►rC PIPS 1 1 l GARM6 cdn 1271 4 W oconsinDeparhnentofComrmerce SOIL EVALUATION REPORT Page 1 of 4 Division of and Buildings in accordance with Comm 85, W is. Adm. Code Tom Schmitt Attach complete site plan on paper not less than 8% x 11 inches in size. Plan must County include, but not limited to: vertical and horizontal reference point (BM), direction and St. CrODC percent slope, scale or dimemsions, north arrow, and location and distance to nearest road. Parcel I.D. Please print all infonnaSon. ate Personal idfwnWon you provide may be used for secondary Wposes (Privacy Law, s. 15.04 (1) (m)). /( 9 O Property Owner Property Location Brown, J. Raymond Buyer: Van Tassel, Mary Govt. Lot NW 1/4 SW 1k1 S 5 T 31 NR 19 W Property Owner's Mailing Address Lot # Block # I Subd. Name or CSM# 2340 Delong Rd. 1 CSM Pending City State Zip Code Phone Number City jj Village N Town Nearest Road Osceola I WI 1 54020 715 -294 -2920 Somerset I Delong Road !6 New Construction Use: 11M Residential t Number of bedrooms 3 Code derived design flow rate 450 GPD Replacement Public or commercial - Describe: Parent material Outwash Plain Flood plain elevation, if applicable NA General comments and recommendations: ea is suitable for a conventional system with a 0.5 gpd/sgft rating. Possible system elevation for Area 1 is .80. Boring # f Boring Pit Ground Surface elev. 100.10 ft. h to limiting factor 100+ in. Dept g Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDM 'Eff#1 'Eff#2 1 0-5 1Oyr3/3 none sl 2mgr mvfr cs 21' .6 1.0 2 5 -15 1Oyr4/3 none sl 2csbk mvfr gw 1f .6 1.0 3 15 -31 1Oyr4/6 none sl 2msbk mvfr gW .6 1.0 4 31-42 1Oyr4/4 none Is 1msbk mvfr cs .7 1.6 5 42-69 10yr514 none grms Osg ml cs — .7 1.6 6 69 - 100 10yr5/6 none ffs mvfr — — .5 1.0 2] Boring # ]� Boring Pit Ground Surface elev. 100.80 ft. Depth to limiting factor 96+ in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP )ff 'Eff#1 'Eff#2 1 0 -7 1Oyr4/3 none sl 2fsbk mvfr cwf 2f .6 1.0 2 7 - 1Oyr5/3 none sl 2csbk mvfr gW 1f -6 1.0 3 20-35 7.5yr4/6 none grms Osg ml cs — 7 1.6 4 35 1 Oyr5 /4 none Is 1 msbk mfr cs — .7 1.6 5 84 -96 1Oyr6/4 none ms OS9 ml — .7 1.6 " Effluent #1 = BOD? 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BOD <30 mg/L and TSS <_0 mg/L CST Name (Please Print) Signature: CST Number Thomas J. Schmitt 227429 Address Tom Schmitt Date Evaluation Conducted Telephone Number 1595 72nd St., New Richmond, WI 54017 9/18104 715- 247 -2941 property Owner . Brown, 7. Raymond Buyer: Van Parcel ID # Page 2 of 4 ] F poring # Boring Pit Ground Surface elev. 100.70 ft. Depth to limiting factor 102+ in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots WON •Eff#1 'Eff#2 1 0 -5 10yr4/3 none sl 2fsbk mvfr cs 2f .6 1.0 2 5-15 1Oyr4 /4 none sl 2csbk mvfr gw 1f .6 1.0 3 15 -30 10yr4/6 none sl 2csbk mvfr gw 1f .6 1.0 4 30-46 7.5yr4/6 none cbcos Osg ml cs - .7 1.6 5 46-73 1Oyr5/4 none grcos Osg ml cs - .7 1.6 6 73-102 1Oyr5/6 none ms Osg ml - - .7 1.6 [ - 4 Boring # F.J Boring ol Pit Ground Surface elev. 98.65 ft. Depth to limiting factor 50 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roofs WON •Eff#1 •Eff#2 1 0 -7 1Oyr3/2 none sl 2fsbk mfr as 2f .6 1.0 2 7 -15 1Oyr3 /4 none sl lmpl mfr gw 1f .4 .7 3 15-40 1Oyr5/3 none I 2msbk mfr gw - .6 .8 4 40 -50 1Oyr4/4 none I 2msbk mfr gw - .6 .8 7 5 50 -84 7.5yr4/6 m . syr6ir6/ 6 6/8 sl 1 msbk m --- fr - .4 .7 F51 Boring # Boring Pit Ground Surface elev. 101.70 ft. Depth to limiting factor 100+ in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots •Eff#1 •Eff#2 1 0-9 1Oyr3/3 none sl 2fsbk mvfr as 2f .6 1.0 2 9 -19 10yr4/4 none sl 2msbk mvfr gw 1f .6 1.0 3 19-73 10yr5/4 none grcos Osg ml cs - . 7 1.6 4 73-100 1Oyr5/6 none ms Osg ml - - .7 1.6 Effluent #1 BOD ? 30 < 220 mg/L and TSS >30 < 150 mg/L • Effluent #2 = BOD 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. J i property Owner Broom, I Raymond Buyer: Van Parcel ID # Page 3 of 4 F 6 ] Ong # Pit Ground Surface elev. 99.85 ft. Depth to limiting factor 126+ in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots •Eff#1 •01#2 1 0-8 10yr3/3 none sl 2fsbk mvfr as 2f .6 1.0 2 8-24 10yr4/4 none si 2csbk mvfr gw 1f .6 1.0 3 24 -38 7.5yr4/6 none grvsi 2msbk mfr cw 1f .6 1.0 4 38 -54 7.5yr5/4 none grcos Osg ml Cs -- .7 1.6 5 54-64 10yr5/6 none ms Osg MI c e --- .7 1.6 6 64 -126 10yr5 /4 none cos Osg ml cs - .7 1.6 71 Boring # Boring J> Pit Ground Surface elev. 100.95 ft. Depth to limiting factor 104+ in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Stricture Consistence Boundary Roots •Eff#1 '01#2 1 0-6 10yr3/3 none sl 2fsbk mvfr as 2f .6 1.0 { 2 6 -19 1Oyr4 /4 none SO 2msbk mfr gw if .6 .8 i 3 19-36 1Oyr516 none sl 1msbk mfr cwr 1f .4 .7 4 36-48 10yr5/4 none grcos Osg ml cw - 7 1.6 I 5 48-69 10yr5/6 none ms Osg ml cwr - 7 1.6 6 69 -104 10yr6 /4 none fs Osg ml --- --- .5 1.0 F -8 I Boring # Boring Pit Ground Surface elev. 100.45 ft. Depth to limiting factor 104+ in. Sal Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPON 'Eff#1 'Eff#2 1 0-8 10yr3/4 none Is 2mgr mvfr as 2f .7 1.6 2 8-47 10yr5/4 none grcos Ogg mi cs 1f .7 1.6 3 47 -72 10yr6/4 none ms Osg ml cs - .7 1.6 4 72-84 10yr5/4 none cos Osg ml cs - .7 1.6 5 84 -104 1Oyr5/6 none nls Osg ml - - .7 1.6 • Effluent #1 = BOD ? 30 < 220 mg/L and TSS >30 < 150 mg& ' 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 aftemate format, please contact the department at 608- 266 -3151 or TTY 608-264-8777. i Page oof cI/ ' Conducted by: Conducted For: Schmitt Soil and Site Evaluations Name: Mary Van Tassel Thomas L Schmitt, CST 227429 Address: 902 Raymond St. 1595 72nd St. - City, State, Zip: Somerset, W1.54025 New Richmond, Wl. 54017 Phone: 715 -247 -2941 Subd.Name: CSM -_� Lot No.: 1 Legal Description: NWl/4 SWl /4 S5 T31N R19W Township of Somerset Bench Mark EL 100.00' Top of 1 1/2" pvc pipe Alternate Bench Mark EL /0 of 1 1//2" pvc pipe Scale 1" = 40' R�. 1 �� CERTIFIED SURVEY MAP LOCATED IN PART OF THE NW1 /4 OF THE SWI /4. SECTION 5 AND IN PART OF THE NEt /4 OF 1HE SE1 /4 OF SECTION 6. ALL IN 731N. R19w, TOWN OF SOMERSET, ST. CROIX COUNTY, VISCONSIN. SURVEYOR: PREPARED FOR: LOT AREA TABLE DOUGLAS J. ZAHLER MARY VAN TASSEL S at N LAND SURW*4CG INC. 712 S. 1ST STREET Lot # I Dacriptlon S4 FT. ACRES 2920 ENLOE STREET STILLWATM MN 58042 LOT 1 I INC MW 221&L408 5 .244 HUOSON„ WI 54016 (651) 351 -5522 LOT 1 M FRtD W 217 5.002 LOT 2 W 244,063 6 5 00S TING DRIV EWAY LOT 2 W 238.222 &423 ADJACENT NT O LOT 2 W Al 213.938 4. 11 PRESCRIPTION MNT SMALL llt ACI'S I J I SEE DETAIL "A' ! f DELONG ROAD f ! Ab \ I $67'37'2rE 277.63' �i { . •�'� ". � � �i� � Net _ � 1 DETAIL 'A' `� �• WADE ~0� Sa7'J7"26� 287.g0r 1 I EASEMENT SEE oo j 240.09. ..133 . DETAIL x v DETAIL 'C' ` OT i .^DRIVEWAY 6j vg i 1 g 1 jai RICO N _ I LOT . : I 44 50'1' z t DETAIL 'B' Sam LINE 9 N 0A NE 1/4—SE + 1/4. SEC 6 a 6,00 3 5885 ^ W 511.74 — � . 4 sn 9'W ,' tJNpL I.�NDS LEGEND gDUTM IINE FOUND ALIAMNUM COUNTY CURVE DATA Nsw SECTION CORNER MONUMENT / w 1/ TABLE C FOUND 1' OUTSIDE Number Ct Sw COL • DIAMETER IRON PIPE Rados Lanngth SMOW SEC. 5 Cantrd M& 146^37'59' ; DW�ETER RON PIPE Chord Bearing S14'S6'S3.5'E NDff TENS MAP MODIFES THE Chord Langth 114,95. P ROPERT Y O E BEY O N E T SET 1 OUTSIDE DIAMETER BY Are Langlh IS3,SS THAT NFRE CREATED PRIOR TO O 18' LONG IRON PM WEIGHING Tangent In S58WO(rw ANY LOCAL SUBDIVISION 1 -13 LBS. PER LINEAR FOOT Tangent Out S44 V53"E ORDINANCE. THIS MAP IS EXEMPT A SEPTIC VENT FROM TFNI ST. CROIX COMITY SCALE MI FEET 1� 150' ORDINANCE PER w„ ROADWAY SETBACK LINE SECTION 18 04(Ax3)._ NO (100' FROM RIGHT- OF -WAY) ADDITIONAL LOW ARE CREATM FENCE j 150 0 150 ING INSTRUMENT DRAM Brf: "LUAM KANE i JW Na 8465 -01 DATE 09/18/2004 SHEET 1 OF 2 SHEETS I l � i C - /, Y 1271 Wisconsin Department of Cornrrierce � � EVAL UATION REPORT Page 1 of 4 Division of Safety and Buildings( in accordance with m 85, W is. Adm. Code Tom Schmitt Attach complete site on paper not less Iiiarrr 4,004iches ' size. Plan mus County St Croix include, but not limited t . vertictil ontal refenernce point ), direction a' percent slope, scale ootidion distance to rnea Parcel I. D. Please P bon. By Dfe Personal information you provide may be used for secondary (Privacy Law, s. 15.04 (1) (m)). N" , 09 Property Owner Property Location t Brown, J. Raymond Buyer: Van Tassel, Mary Govt. Lot NW 1/4 SW 1f4 S 5 T 31 NR 19 W Property Owner's Mailing Address Lot # Block # Subd. Name or CSfiIF# 2340 Delong Rd. 1 CSM Pending City State Zip Code Phone Number City j Village A Town Nearest Road Osceola I WI 1 54020 1 715 - 2942920 Somerset I Delong Road 19 New Construction Use: !d Residential / Number of bedrooms 3 Code derived design flow rate 450 GPD ; j Replacement I Public or commercial - Describe: Parent material Outwaish Plain Flood plain elevation, if applicable NA General comments and recommendation l ea is suitable for a conventional system with a 0.5 gpd/sgft rating. Possible system elevation for Area 1 is � Boring # j Boring 41 Pit Ground Surface elev. 100.10 ft. Depth to limiting factor 100+ in. Sal Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft 'Eff #1 ff#2 1 0-5 1Oyr3/3 none sl 2mgr mvfr Cs 2f .6 1.0 2 5-15 1Oyr4/3 none sl 2csbk mvfr gw 1f .6 1.0 3 15-31 1Oyr4/6 none sl 2msbk mvfr gw — .6 1.0 4 3142 1Oyr4 /4 none Is lmsbk mvfr cs — .7 1.6 5 42-69 1Oyr5/4 none firms Osg ml cs — .7 1.6 6 69 -100 10yr5/6 none Ifs mvfr — — .5 1.0 Boring # I Boring #1 J" Pit Ground Surface elev. 100.80 ft. Doh to limiting factor 96+ in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Stricture Consistence Boundary Roots GPD/fF 'Eff#1 '002 1 0-7 1Oyr4/3 none sl 2fsbk mvfr Cw 2f .6 1.0 2 7 -20 1Oyr5/3 none sl 2csbk mvfr gw 1f .6 1.0 3 20-35 7.5yr4/6 none grms 0s9 ml Cs --- .7 1.6 4 35-84 1 Oyr5 /4 none Is 1 msbk mfr cs ---- .7 1.6 5 84 -96 10yr6/4 none ms Osa ml — — .7 1.6 ' Effluent #1 = BOD ? 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BOD SA mg/L and TSS <_0 mg/L CST Name (Piesese Print) Signature: CST Number Thomas J. Schmitt 227429 Address Tom Schmitt Date Evaluation Conducted Telephone Number 1595 72nd St., New Richmond, WI 54017 9118104 715- 247 -2941 Property Owner Brown, I Raymond Buyer: Van Parcel ID # Page 2 of 4 ].Boring # _j Boring Pit Ground Surface elev. 100.70 ft. Depth to limiting factor 102+ in. Sal Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots DAP *Eff#1 *Eff#2 1 0 -5 10yr4/3 none sl 2fsbk mvfr cs 2f .6 1.0 2 5-15 10yr4/4 none sl 2csbk mvfr gw if .6 1.0 3 15-30 10yr4/6 none sl 2csbk mvfr gw if .6 1.0 4 30-46 7.5yr416 none cbcos Osg ml cs - .7 1.6 5 46 10yr5/4 none grcos Osg 3 ml cs - 7 1.6 6 -102 10yr5/6 none ms Osg MI - - .7 1.6 I(. ao • odr . 3 s l �� ti 4 ] Boring # F Boring im Pit Ground Surface elev. 98.65 ft. Depth to limiting factor 50 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDIr *Eff#1 *Eff#2 1 0 -7 10yr32 none sl 2fsbk mfr as 2f .6 1.0 2 7 -15 1Oyr3 /4 none sl 1mPl mfr gw 1f .4 .7 3 15-40 10yr5/3 none I 2msbk mfr gw .6 .8 4 40 -50 10yr4/4 none I 2msbk mfr gw .6 .8 m2d 7.5yr6/8 5 50-84 7.5yr4/6 7 5yr6/6 sl 1 msbk mfr - - .4 .7 Boring # Boring Ig Pit Ground Surface elev. 101.70 ft. Depth to limiting factor 100+ in. Sal Appli Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots *Eff#1 *Eff#2 1 0 10yr3/3 none sl 2fsbk mvfr as 2f .6 1.0 2 9-19 10yr4/4 none sl 2msbk mvfr gw if .6 1.0 3 19-73 10yr5/4 none grcos Osg ml cs - .7 1.6 4 73 -100 10yr5/6 none ms Osg ml - - .7 1.6 ' Effluent #1 = BOD ? 30 < 720 mg& and TSS >30 < 150 mg/L ' Effluent #2 = BOD ^30 mgA. and TSS <30 mg/L The Depwtiaent 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. Property owner Brown, I Raymond Buyer: Van Parcel ID # Page 3 of 4 6]. Ong # Boring 16 Pit Ground Surface elev. 99.85 ft. Depth to limiting factor 126+ in. Sal Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots 'Eff#1 `Eff#2 1 0 -8 10yr3/3 none sl 2fsbk mvfr as 2f .6 1.0 2 8 -24 10yr4/4 none sl 2csbk mvfr gw if .6 1.0 3 24 -38 7.5yr4/6 none grvsl 2msbk mfr cw 1f .6 1.0 4 38 -54 7.5yr5/4 none grcos Osg ml cs - .7 1.6 5 54-64 1Oyr5/6 none ms Osg ml cs - .7 1.6 6 64 -126 10yr5/4 none cos Osg ml cs -- .7 1.6 F 7] Boring # Borin je Pit Ground Surface elev. 100.95 ft. Depth to limiting factor 104+ in. Sal Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots 'Eff #1 `Eff#2 1 0-6 10yr3/3 none sl 2fsbk mvfr as 2f .6 1.0 2 6-19 1Oyr4/4 none sil 2msbk mfr gw if .6 .8 3 19 -36 10yr5/6 none sl lmsbk mfr cw 1f .4 .7 4 36-48 10yr5/4 none grcos Osg ml cw .7 1.6 5 48-69 1Oyr5ro none ms Osg ml cw - .7 1.6 6 69-104 10yr6 /4 none fs Osg ml - - .5 1.0 ,tt �►/O F8 I Boring # Boring �! f' Pit Ground Surface elev. 100.45 ft. Depth to limiting factor 104+ in. Sal on Rate APPSt Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GM 'Eff #1 'Eff#2 1 0-8 10yr3/4 none Is 2mgr mvfr as 2f .7 1.6 2 8-47 1Oyr5/4 none grcos Osg ml cs 1f .7 1.6 3 47 -72 1Oyr6/4 none ms Osg ml cs - .7 1.6 4 72 -84 10yr5/4 none cos Osg ml cs - .7 1.6 5 84 -104 1 Oyr5/6 none f ms Osg ml - .7 1.6 �o •tN �f3• * 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. Page - Conducted by: Conducted For: � C.- 6 �an ^o+) #, Schmitt Soil and Site Evaluations Name: Mary Tassel Thomas I Schmitt, CST 227429 Address: 902 Raymond St. 1595 72nd St. City, State, Zip: Somerset, WI. 54025 New Richmond, WI. 54017 Phone: 715-247-2941 Subd.Name: CSM Lot No.: 1 Legal Description: NWI/4 SWIM S5 T31N R19W Township of Somerset Bench Mark El. 100.00' Top of 1 1/2" pvc pipe Alternate Bench Mark EL /0 of 1 1//2" pvc pipe Scale 1" = 40' �a ,a y o �y az sb ". CERTIFIED S URVEY MAP THE NWI /4 OF'"E SWI / ;. SECTION S AND IN LOCATED IN PART OF 4 OF SECTION 6. ALL IN T31N, R19W. PART TOM OF M1 . ST T. CROW C n WISOONSIN• pr"ARM Folb LOT ARVA TABLE AS J. � MARY VAN TA 59EL tat ion 9Q FT s x N LAUD S1lRVE'�+G me n 2 S. 1ST 31WMT STLLWAIM MN 56042 L OT 1 217 S. 2M VAAE VA 54016 (�5 '�—� LOT 2 INC RW 2 06.1' wt/4 COR. 6'4 EXan SEC 5 AND C T TO LOT 2 EW RW Io 2131939 WACW LAW BY RD E91BIF SEE DETAL -� �' ` y D UMG ROAD { � t t �r ( `f �q �� Se7'37'28'E 277.s3'_ Ell ' 1 DETALL SIM ; 24Q0W ' DETAIL _ I L 0T 1 Y diem {� N I L OT 2 i 3 L�� E ; i �, DETAIL SOM UK s �. I, pTTBD LANDS 1M g�► TJNP MJJIMN co� ittTr MaWjM Sam UK SEC" CQWW CUMM DATA � 1 t- TABLE • olAr� (� 64AC s 5 . �01PIPE Central At4e 146'JrW %W MAP MOpMS 7w ER t o OL41& BY Culsw Chord gow%g SUM 5&5 UNE BET4M M 11495' . o"M 811 am PARTY 1j' LONG IM PiPL VEX*" 15&W 7IMA SWRE CRFAIM PRIOR 1A 1.13 LB& PER LDFA F!OOT Tangent in s5sworw %= yAP is E wWT A SEPIC VENT Tangent Out Se6`fb63'E p011N7Y - FAM RIf91T --OF —WAY) FrM 1 W ST- PER M " ORDNVXM SCALE �1 FEE7 1' '� 150 SEC710N 10.06(AX31 N0 + i" l � ADDITIONAL- LOTS ApE CREATED. i i D TNLS wsI M*NT DWM y U SHEET 1 OF 2 SHEETS JOB N0. 0466 -01 r POWTS OWNER'S MANUAL & MANAGEMENT PLAN . Pa of /w FJLE. INFORMATION SYSTEM - SPECIFICATIONS Ovmer Septic Tank Ca �.� �lf{ � -55 EL P parity ga l ❑. NA Permit # t 1� 7 (q Septic Tank Manufacturer �C J ❑ NA DESIGN PARAMETERS Effluent Filter Manufacturer ZA$j�e ❑ NA Number of Bedrooms ❑ NA Effluent Filter Model - 100 ❑ NA Number of Public Facility -Units NA - Pump Tank Capacity gal 19 NA Esncnated flow (avera c3O0 gal/day Pump Tank Manufacturer U(NA .. Design flow (peak), (Estimated x 1.5) 50 gai /day Pump Manufacturer $a NA Soil, Application Rate gal/day/ft' Pump Model fYNA Standaed_lnfluent/Effluent Quality Monthly .average* Pretreatment Unit ANA Fats, Oil & Grease _(FOG) 530 mg /L ❑ Sand /Gravel Filter ❑ Peat Filter Biochemical Oxygen Demand (BOD5) 5220 mg /L ❑ NA ❑ Mechanical.Aeration ❑ Wetland Total Suspended Solids (.TSS) <150 mg /L ❑ Disinfection ❑ Other: Pretreated Effluent Qualiity. Monthly average Dispersal Cells) ❑ NA Biochemical Oxygen Demand (BODO 530 mg /L ,K In- Ground (gravity) ❑ In- Ground (pressurized) Total Suspended Solids (TSS) 530 mg/L ❑ NA ❑ At- Grade. ❑ Mound Fecal. Coliforrn (geometric mean) :510 cfu /100m1 ❑ Drip -Line ❑: Other: Maximum Effluent Particle Size Y in dia. ❑ NA Other. ❑ NA Other: Other: ❑ NA ❑ NA * Values typical for domestic wastewater and septic tank effluent. Other.: ❑ NA MAINTENANCE SCHEDULE Service Event Service Frequency Inspect condition of tank(s) At least once eve ❑ month(s) every: l5kyear(s) (Maximum 3 years) D-NA Pump out contents of tank(s) When combined sludge-and scum equals one -third (y) of tank volume ❑ NA Inspect dispersal cell(s) At least once every: ❑ month(s) (Maximum 3 ears) ❑ NA 13 [Yyear(s) y Clean effluent filter At least once every: ❑ month(s) ❑ NA year(s) Inspect pump_, pump controls & alarm At least once every: ❑ month(s) NA ❑ year(s) Flush laterals and pressure test At least . once every: ❑ month(s) NA ❑ year(s) Other. At least once every: ❑ month(s) NA ❑ year(s) .Other NA MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells shall be made by an individual carrying one. of the following licenses or certifications: Master Plumber; Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer; Septage Servicing Operator. Tank inspections must include a visual inspection of the tank(s) to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of combined sludge and scum and to check for any back up or ponding of effluent on the ground surface. The dispersal cells) shall be visually inspected to check the effluent levels in the observation pipes and to check for .any ponding of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a failing condition and requires the immediate notification of the local regulatory authority. When the combined accumulation of sludge and scum in any tank equals one -third (Y or more of the tank volume, the entire contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113, Wisconsin Administrative Code. All other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment units, and any servicing at intervals of 512 months, -shall be performed by a certified POWTS Maintainer. A service report shall. be provided to the .local regulatory authority within 10 days of completion of any service event. GMW (4101) of AND OPERATION . Page == new construction, prior to use of the POWTS check treatment tanks) for the presence -of painting .products or other chemicals that nw impede the treatment process . and /or-damage the dispersal cell(s). If high concentrations -are detected have th e . contents r of the tank(s) removed by a septage servicing operator prior to use. System start up shall not occur when. soil conditions are frozen at the infiltrative surface. During power outages Pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will be discharged to the dispersal cell(s) . in one large .dose, overloading the cell(s) and may result in - the backup or surface discharge of effluent.. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually. operating the pump controls to restore normal levels within the pump tank_ Do -not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area within 15 feet down slope of any mound or at -grade soil absorption area. Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the fife of the POWTS: antibiotics;. baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat; foundation drain (sump pump) water, fruit and vegetable peelings; gasoline; grease; herbicides; meat ..scraps; medications; oil; (sainting products; pesticides; sanitary napkins; tampons; and water softener brine. ABANDONMENT When the POWTS fails and/or is permanently taken out of service the following steps shall be taken to insure that the system is properly and safety abandoned in compliance with chapter Comm 83,33, Wisconsin .Administrative Code: • All piping to tanks and Pits shag be disconnected and the abandoned pipe openings sealed. • The contents of all tanks and pits shall be removed and property disposed of by a Septage Servicing Operator. • After pumping, all tanks and pits shall be excavated and removed or their drovers removed and the void space filled with soil, gravel or another inert solid material. CONTINGENCY PLAN ff. the POWTS fails and cannot be repaired the following measures have been, or. must be taken, to provide a code comp fiant replacement system - A suitable replacement area has been evaluated and may be utT¢ed for the location of a replacement soil absorption system. The - replacement area should be protected from disturbance and compaction and should not. be infringed upon by required setbacks from existing and proposed structure, lot .lines and wells. Failure to protect the replacement area will result in the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rotes in effect at that time. ❑ A suitable replacement area is not available due to setback and/or soil limitations. Barring advances in POWTS technology a holding tank may be. installed as a last resort to replace the failed POWTS. ❑ The site has not been. evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluation must be performed to locate a suitable replacement area. If no replacement area is available a holding tank may. be installed as a last resort to replace the failed POWTS. ❑ Mound and at -grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time. < <WARNING> > SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND /OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAYBE DIFFICULT OR IMPOSSIBLE ADDITIONAL COMMENTS POWTS INSTALLER POWTS MAINTAINER Name Phone S - Z . --51 Phone SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name \ Name Phone Phone - ' - (S - � This document was drafted in compliance with chapter Comm 83.22(2)(b)(1)(d) &(f) and 83_54(1). (2)'& (3), Wisconsin Administrative Code. 02/26x`2003 10:42 7152473038 SELI LE EXCAVAT =Pk3 I PAGE 01 �+ ST CROix couNTY SEPTIC TANK MAINTENANCE AGREEMENT AND O Y'NERSHIP CERTiFI�CATION FORM Owner /Buyer AMOCaM IkI l?y r Mailing Address 62 fl vtl) S L 907� t Propeny Address � 2 ' �C � u (Vex cation required from Planning D rittlerst for new construction) �P s City/State Parcel Ideatificatiant Numbe FOAL ESCRIPTI N Property Location � � '!., ��r %,, Sec. S , TJJ N - W, Town of lam. 4ZSC Subdivision , Lot # Ctrtified Survey Map volurne Q ,Page# Warra Deed # 0 . Volurre � q , Page # 3z.s' SPA house d yes ❑ no Lot lines identifiable ❑ yes ❑ no SYSTEM i Improper use and maintenanceof your septic systcrti 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 licsnsed pumper. What you put into the systetrt can affect the function of the soMic 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 masterplurn ber journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on - site wavewaterdispo3al system IS in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic rank is less than 1/3 fall 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 statttrg that your septic system has beErs maintained inust be comp days of the three year expiration Pate leted and returned to the St. Croix County Zoning office within 30 �— 101 / SiGNA ro A PPLICANT DATE 4WNE _ .�`R7('IFICATION 1 (we) certify that all statements on this fornl are true to the best of my (our) knowledge, I (we) am (are) the owner(s) of the property described above, by irtuc of a warranty deed recorded in Register of Deeds Office, v StGNA OF APPLICANT l Ld DATE An information that is mis- represented may result in the sanitary pe being revoked by the Zoning Department. • * *•�• •• Include with this application: a stamprd warranty deed from the Register of Deeds office a copy of the certified survey map if reference is made in the warranty deed 6r U 2690P 325 STATE BAR OF WISCONSIN FORM 1 —1998 WARRANTY DEED 779 1 31D Document Number KATHLEEN H. WALSH REGISTER OF DEEDS This Deed, made between a. Raymond Brown and Genevieve F. ST. CROIX CO., WI Brown, husband and wife , Grantor, and Ted Van Tassell and RECEIVED FOR RECORD Mary Van Tassell, husband and wife , Grantee. Grantor, for a valuable consideration conveys to Grantee the following 11/05/2004 11:30AK described real estate in St. Croix County State of Wisconsin (the "Property "): WARRANTY DEED EXEMPT # REG FEE: 11.00 TRANS FEE: 180.00 COPY FEE: CC FEE: PAGES: 1 Recording Area Name and Return Address er q ss b ��vYl r� 032 1012 80 000: 032 1013 10 0_00 Parcel Identification Number (PIN) This is not homestead property. (is) (is not) Lot 1 Certified Survey Map filed October 7, 2004 in Volume 19, Paste 4855 as Do u nt No. 776393, Located in of the NW % of the SW %, Section 5 and in part of the NE . of the SE % of Section 6 all m T31N, R19W, Town of Somerset, St. Croix County, Wisconsin. Together with all appurtenant rights, title and interests. Grantor warrants that the title to the Properties good, indefeasible in simple fee and free and clear of encumbrances except Dated this J day of November 2004 (SEAL) 9 (SEAL) Arl- ym n Brm n Genevieve F. Brown / (SEAL) (SEAL) AUTHENTICATION ACKNOWLEDGMENT Signature(s) State of Wisconsin, � E� I i p SS V,4AT71NA } ss. authenticated this N QlTAi� Y P UBLIC St. Croix County �,� STATE OF W I S CO N S N Personally came before me this � day of November 2004 the above named J. Raymond Brown and Genevieve F. Brown, husband and wife to me known to be the person who TITLE: MEMBER STATE BAR OF WISCONSIN executed the foregoing instrument and acknowledge the (If not, same. authorized by §706.06, Wis. Stats) ) ,4,,,, � THIS INSTRUMENT WAS DRAFTED BY ) r (r/ Coldwell Banker Burnet Notary Public, State # Wisconsin 1301 Coulee Road Hudson, WI 54016 My commission is permanent. (If not, state expiration date: 4 -52737 66 ) (Signatures may be authenticated or acknowledged. Both are not necessary.) Names of persons signing in any ca2 acity must be tytp2q or printed below their signature. VOL 19 PAGE 4855 KATHLEEN K. WALSH REGISTER OF DEEDS RECEIVED CERTIFIED SURVEY MAP 10/07/2004 09:30AM LOCATED IN PART OF THE NW1 /4 OF THE SWI /4. SECTION 5 AND IN CERTIFIED SURVEY NAP PART OF THE NE1 /4 OF THE SE1 /4 OF SECTION 6. ALL IN T31N, R19W, REC FEE: 13.00 TOWN OF SOMERSET. ST. CROIX COUNTY. WISCONSIN. COPY FEE: 3.00 PAGE5: 2 SURVEYOR: PREPARED FOR: DOUGLAS J. ZAHLER MARY VAN TASSEL LOT AREA TABLE S & N LAND SURVEYING. INC. 712 S. 1ST STREET Lot # Description SO. FT. ACRES 2920 ENLOE STREET STILLWATER. MN 55082 LOT 1 INC RW 228.408 5.244 HUDSON. WA 54018 (651) 351 -5522 LOT 1 EXC RW 217 882 5.002 Wl /4 COR LOT 2 INC RW .6 244.083 503 SEC. 5 EXIS TING DRIVE TY LOT 2 EXC RW 236,222 5.423 � ADDJJACCEN LANN D BY LOT 2 EXC SM do 213.939 4.911 RD ESMNT SEE DETAIL "A DELONG ROAD I I I -�I I 58737'28_E b ;. I °� ��4 \ 7.81 32' 33.00 DETAIL "A �� 66' WADE JOINT � '' " ate. -" -- -r _ DRIVEWAY w' S4737'28`E 287.90' 1 EASEMENT SEE m7. m 240.09' - ►133 DETAIL 'C"-� II ' �......A.� .R .................. t r 1 1 IQ DETAIL `C" I Z `OT '� I�-DRI VEW,�Y `\ o f r�i cr N Rn m , LOT 2 Og 501 A ' DETAIL 'B" 8 z �' SOUTH LINE I -S o z5y$ E 1/4—SE ` � '� f 31 $ `' S88'S — 27 W 511.74 26.00_ ^� S89'25'19'W ' x 148.44, N� $ LEGEND FOUND ALUMINUM COUNTY CURVE DATA - 1 /4- SECTION CORNER MONUMENT TABLE ' 1/4. SE 5 FOUND 1 OUTSIDE Number C1 SW • DIAMETER IRON PIPE Radius Length 60.00' SEC. 5 Central Angle 146'37'59" . FOUND 2' OUTSIDE Chord Bearing 51456'53.5 "E 1 �OTE THIS MAP MODIFIES THE DIAMETER IRON PIPE Chord Length 114.95 Len ' PROPERTY LINE BETWEEN TWO g PARCELS OWNED BY ONE PARTY SET 1" OUTSIDE DIAMETER BY Arc Length 153.55' THAT WERE CREATED PRIOR TO O 18` LONG IRON PIPE. WEIGHING Tangent In S58 "W ANY LOCAL SUBDIVISION 1.13 LBS. PER LINEAR FOOT Tangent Out 586 ORDINANCE. THIS MAP IS EXEMPT ® SEPTIC PENT FROM THE ST. CROIX COUNTY SCALE IN FEET 1" - 150' SUBDIVISION ORDINANCE PER ROADWAY SETBACK LINE ..................... . SECTION 18.05(A)(3). NO (100' FROM RIGHT —OF —WAY) 150 O 150 ADDITIONAL LO ARE CREATED. FENCE THIS INSTRUMENT DRAFTED BY: WILLIAM KANE JOB NO. 6455 -01 DATE: 09/16/2004 SHEET 1 OF 2 SHEETS Vol 19 Page 4855