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Home My WebLink About032-2134-80-000 Wiscol� sin Deptment of Commerce PRIVATE SEWAGE SYSTEM County' St. Croix Safely i3nd Building Division INSPECTION REPORT Sanitary Permit No: 399632 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: LeVoir, Michael I Somerset Township 032 - 2134 -BO -000 CST BM Elev: Insp. BM Elev: BM Description: �� ,, TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark Dosing Alt. BM DM n S .e�a T We e C/ A Bldg. Sewer Holding UT t Inlet 1 9. 3 3 NK SETBACK INFORMATION r9ri Outlet 6 - TANK TO P/L E BLDG. Vent to Air Intake ROAD Dt Inlet A 1 o- Septic S r Dt Bottom i ©v �b a I Dosing d C� r s , Header /Man. "� /00 o Mrdd .,j 103 Aeration Dist. Pipe . L D 4 __ - - - -- -- 3 cv 3.5 r Holding i Bot. System t02. qS Final Grade PUMP /SIPHON IN FORMATION Manufacturer Demand S�er L S GZ Model Number b i g� 3- z� TDB Lift Friction System He TDH t rcemain Leng / Dia— 2 t , / Dist. to wel ,D3 ell _ I _ 5 o3 SOIL ABSORPTION SYSTEM BED/TRENCH Width- ` / Length -75 No. O f T ches PIT D ENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS '` (te I J SETBACK SYSTEM TO P/ EL LAKE/STREAM LEA ufacturer. INFORMATION Type System: Model Number. / DISTRIBUTION SYSTEM ro*"lUfcl % rT. . 3 = 2. Z Header /Manifold Distribution l r�gg ' S N � �8 r, x Hole Size x Hole Spacing Vent to Air Intake r/ Pipe(s) / /'7 S I G / \ l Length 3 Dia Z Length Dia 1� Spacing 3 / / SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only Over i Depth Over xx Depth of xx Seeded /Sodded T Mulched Bed ench Center Bed/Trench Edges Topsoil n Yes [W No O Yes (] No COMMENTS (Include code discrepencies, persons present, etc.) Inspection #1:-L?--/ 2 (// (1//� Inspection #2: ,,4/ Location: 2058 66th Street Somerset,, WI 54025 SW 1/4 NE 1/4 T31N R19W) Whitetail Trails Lo! -� Parcel No: 23.31.19. s 1. Alt BM Description = L"� S "tea a s -� /� *td d aA a j -g— 2.) Bldg sewer length = 3 6 - amount of cover = 71 /2 Plan revision Required? 10 Yes [ Use other side for additional information. ---- _L L� '��" Date Insepctol. Si ature Cart. No. SBD -6710 (R.3/97) I Safety and Buildings Division County 201 W. Washington Ave., P.O. Box 716 ' l v s consifn Madison, WI 53707 - 7162 Sitc Address Department of Commerce O aO 7 - Sanitary Permit Applieatio Sanitar Permit Number in accord with Comm 83.21, Wis. Adm. Code, personal info pn you v d Z may be used for secondary purposes Privacy Law, 5. ] m ) ❑Check if Revision � ( I. Application Information - Please Print All Information j O �,, State Plan I.D. Number ZS r Property is sme Parcel Number f /� E Prof Owner's Mailing Address t �y't. �,r., Property Location �'� G� / l� S4 & 'A, N, R City, State Zip Code /Mro e V110 ber Lot Number �� Block Number Subdiv' ' Name CSM Number S� II. Type of Building (check all that apply) ,, J ❑City 1 or 2 Family Dwelling - Number of Bedrooms at x LaA v,%-' []Village ❑ Public /Commercial - Describe Use JgTownship ❑ State Owned Nearest Road III. Type of Permit: (Check only one box on line A (numbering scheme for internal use). Complete line B if applicable) A. 1 ) New 2 ❑ Replacement System 3 ❑ Replacement of 6 ❑Addition to For County use System Tank Only Exis ' S stem B. ❑ Check if Sanitary Permit Previously Issued Permit Number Date Issued IV. Type of Permit: (Check all that apply)(numberingsdreme is for internal use) 44 ❑ Non - Pressurized In- Ground 219 Mound �t// 47 ❑ Sand Filter 50 ❑ Constructed Wetland 22 ❑ Pressurized In- Ground 41 ❑ Holding Tank 48 ❑ Single Pass 51 ❑ Drip Line 45 ❑ At -Grade 46 ❑ Aerobic Treatment Unit 49 ❑ Recirculating 30 ❑ Other 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.F't.) (Min./Inch) Elevation 1 . 5� O cc,, . Tank Info Capacity in Total Number NImufacturer / ' ' Prefab Site Steel Fiber Plastic Gallons Gallons of Tanks E .� ��C/ Concrete Constructed Glass New Existing Tanks Tanks Septic or Holding Tank _ _ I X/ Dosing Chamber t/ x VII. Respo ibility Statement- I, the undersigned, a responsibility for installation of the POWTS shown on the attached plans. Plum r' ame tint) Plumbe 's Si IMPRS Number ✓ Business Phone Number Plumber' Address (Street, City, S Zip Code s VIII ount /De artment Use Onl Approved ❑ Disapproved Sanitary Permit ee (includes Groundwater Date Issued Issuing Agent Signature o Stamps) Surcharge Fee) 11 Owner Given Initial Adverse �j & Determination IX. �Conditions of Approval/Reasons for Disapproval . �� • plod of l i, (�.e ""JG d'WI' " /4 ^"��,e�r Pi6..ar -tt • r �S 1 Q A 1 _ _ Wta < �GL• diZ•.�''iy►�'..] � I Wltii a i�-ti G�r,2Q �� -� �'(!•a.L l(-5 (lP�t- � 3 ' � � �) �Cr • ch n ete (to the C ,pape not less 81/2 x 11 in es to TSta�r:s -�oC •� ev onl for the em on paper r tl�q �e�-� !`t SBD -6398 (R. OS /Ol) w G` `�t'o.�`� u. „s �.�,��eks �.e crr,. wu.`f Sln. L• � .�/ � X18, t° � , ,� - SAC - � �'' S ®T � I M O err _may Safety and Buildings 4003 N KINNEY COULEE RD LA CROSSE WI 54601 -1831 TDD #: (608) 264 -8777 isconsin www•commercew i.usts www.wisconsin.gov Department of Commerce Scott McCallum, Governor Philip Edw. Albert, Acting Secretary November 28, 2001 CUST ID No.224263 A7TN.• POWTS Inspector KIM A O'CONNELL ZONING OFFICE K.O. CONSTRUCTION ST CROIX COUNTY SPIA 504 3RD AVE 1101 CARMICHAEL RD OSCEOLA WI 54020 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 11/28/2003 Identification Numbers Transaction ID No. 691254 SITE: Site ID No. 639130 Michael Le Voir - 205TH Avenue Please refer to both identification numbers, St. Croix County, Town of Somerset above, in all correspondence with the agency. SWIA, NE1 /4, S23, T3 IN, R19W FOR: Description: Three Bedroom Mound System Object Type: POWT System Regulated Object ID No.: 821641 The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. The following conditions shall be met during construction or installation and prior to occupancy or use: General Approval Requirements: • This system is to be constructed and located in accordance with the enclosed approved plans and with the "Mound Component Manual for Private Onsite Wastewater Systems VERSION 2.0" SBD- 10691 -P (N.01/01) and the "SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST -SAS (0/81) ". • 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. • 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/instal lation /operation. Owner Responsibilities: • A copy of this letter including instructions and information regarding proper use and maintenance of the system must be given to the owner and each subsequent owner upon completion of the project. • 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. I KIM A O'CONNELL Page 2 11/28/01 Owner Responsibilities Continued: • The activities relating to evaluation and monitoring mechanical POWTS components after the initial installation of the POWTS in accordance with an approved management plan shall be conducted by a person who holds a registration issued by the department as a registered POWTS maintainer. • The owner is responsible for submitting a maintenance verification report acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. 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 is n t a telephone number listed below, or at the address q th correspondence may be made o me t the ep , on this letterhead. The above left addressee shall provide a copy of this letter to the owner and any others - who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 erard M Swim POWTS Plan Reviewer, Integrated Services (608)789-7892, Mon - Fri, 7:15 am - 4:00 pm WiSMART code: 7633 jswim@commerce.state.wi.us ,d MOUND AND PRESS_ URE DISTRIBUTION COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Project dame: MICHAEL J L .EVOIR v ii, (C.i .3 Name: ie. iViluHf'iEL J (.EEV II �� ±p�S AriciirAss. 297-0 MEADOWBROOK AL COVE WOOD i � Ri pY wi rawnv Legal 4 iptio is i`v � ��- ��f'.23-T'�� • "•:- Pq."s� "v' " c i:.l,ip. SOMERSET coun t . ST CR01IX Subdivision Name: WHITETAIL T RAILS o,�� P . O �' W s Lot Number: 15 Ella ..k Number: Co clonally l✓a� uel i. D. Number: 0 -21 34.50 -000 n P � Q n v e D J0% I Transactio "fit;.: DEPARTMENT OF COMMERCE Plan Ti �pll UY AND BUILDINGS Page 1 Index and title 10, /W Page' Qata e• "•t I SEE CORRESPONDENCE Page 3 Mound dr arvA Egg Ram 4 Late:aal and do—c- tarn; Pa.ag v Sysi- i . i i aic ,,ena`�i specit iivi iv Page 6 Management and con!ingennv Nan Page I Pump curie and 3pec .ations Pane 8 PLOT PILAF a,�.� Design KIM A r- 7 r,.`(JNNF:LL License Num0er: 22420-3 Date:: 31004001 Phone Number: 715 -755 -5145 Sig natur Desi Purc;.wt I—, the. ,fin -�., Mound Comportment nepnual for P0 Version 2.0 SDB- 10691 - IN: 01/01", and 33`v`v`1,iP k- aaisi, 9.6 t7cstgsi u: Pressure E'iiS:rtirii,itic3rl N+rt`infvrkS for ST-SAS (01 /81 Version 3.0 (Oa/01l0-1, Page 1 of 8 I Mound and Pressure Distribution Component Design Design Worksheet Site information (r or e) R Residential or Commercial Design Note: Sand fill (D) calculations assume a 300,00 Estimated Wastewater Flow (gpd) Table 8344 -3 in -situ soil treatment for fecal 1.50 Peaking Factor (e ;g. 1.5 = I W%) coliform of <= 38 inches_ 450.00 Design Flow (gpd) 4.00 Site Slope ( %) 102.20 Contour Line Elevation (ft) 34,00 Depth to Limiting Factor (in) 0.40 In -situ Soil Application Rate (gpdM Distribution Cell Information ?5.001 Dispersal Cell Length Along Contour (ft) = 6.00 Cell Width (ft) 1.00 Dispersal Cell Design Loading Rate (gpdM 1 I Influent Wastewater Quality (1 or 2) Are the laterals the highest point in the distribution Y Pressure Disribution Information network? Enter Y or N (c or e) a Center or End Manifold 3.00 Lateral Spacing (ft) If N above enter the elevation ft 2 Number of Laterals of the highest point. 0.125 Cirifice Diameter (in) (e.g. 0.25) 3,00 Estimated Orifice Spacing (ft) = 9.00 ft 2,00 Forcemain diameter (in) 135.00 Forcemain Length (ft) Does the forcemain drain hack? [ Y 88.00 Pump Tank Elevation (ft) Enter Y or N 6.50 Systerin Head (ii) x 1.3 �2 v Fuiceinain Drainback (gall 14:53 Vertical Lift (ft) f 67.381 5x Void Volume (gal) 1.30 Friction Loss (ft)'-� 89.401 Minimum Dose Volume (gal) 22.34 Total Dynamic Head (ft) 20.601 System Demand (gpm) Lateral Diameter Selection Manifold Diameter Selection in. dia. options choice in. dia. options choice 0.75 1.25 x 1.00 1.50 1.25 x 2.00 X 1.50 x 3.00 2.00 x 300 x Gailonsfinch Calculator (optional) Treatment Tank Information 1000.00 Total Tank Capacity (gal) 1000.00 Se ptic Tank Capacity (0) 52.00 Total Working Liquid Depth (in) week Manufacturer 19.23 galAn (enter result in cell B$9) Dose Tank Information Effluent Filter Information 800.00 Dose Tank Capacity (gal) lZabel Filter Manufacturer 19.64 Close Tank Volume (galPrn) JAIOO Filter Model Number weeks Manufacturer I Project: M 1C L It. C L i i_EVOIR Pa e 2 of 8 ae nun d Plan V i e w 1/10 B Obsembon Pipe 0 K s 4 r W ( B. ... I L Mond Component Dimensions Down slope toe extension made. A 6.00 ft E 8.88 in H 1.00 ft K 7.24 ft B 75.00 ft F 9.50 in 1 9.00 ft L 89.47 ft D 6.00 in G 0.50 ft J 4.80 ft W 19.80 ft I 45u.uul(tt°) Dispersal Cell Area 112o.uu (ft) Basal Area Available 6.0 (gpd/ft) Linear Loading Rate 1 7.50 (ft) 1/10 B Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Ar Finished Grade 104.49 (ft) ---- H f; > F C�spersal c�i 103.20 (ft) Lateral 102.70 (ft) Invert Dispersal Cell Elevation E D ' e. 1 .20 (ft) Contour Elevation 4,U % S1[P Slo Geotextile Fabric Cover Shading Key $. pe rsal Cell See lateral details on Q Topsoil Cap 1.5 ft y> n> y — Page 4 for number, © Subsoil Cap c size, and spacing of Q ASTM C33 Sand :5 > Z. F laterals. Laterals are Tilled Layer c o 0.5 ft equally spaced from Aggregate o "< x ,r t the distribution cell's A centerline in the distribution cell ( AxB ). Project: MICHAEL J LEVCIR Page 3 of 8 End CCom nectinn I ateraul Layolltt Dianrarrm ...�.s�. .. _r._�. as eeWM owet the saoti # =Turn upv►�bali�raly� c» ala noutl�ug P Ail ratrtals at* klomAical l+E , C --?� Fiol es titilled an the b nttatn of flue lateral $ equably spa0ed F+om main oonwtion via toe at oravc to manifold K ," point. r stetals & fie Im►ain of P�dC scd► 40 fpet COMM Table $4.30 -51 Nulfiberol Laterals 2 Orifice Diarileter r 1J. 12 5 Ili Lateral Diameter 1.50 in ✓ Orifice Spacing (X) 3.06 ft Lateral Length (P) 73.44 ft ✓ Orifices per Lateral 25 Lateral Spacing (S) 3.00 ft Orifice Density 9.00 ft /orifice Lateral Flow Rate 10.30 gpm Manifold Length 3.00 ft System Flow Rate 20.60 gpm Manifold Diameter 2.00 in Total Dynamic Head 2.34 Forcemain Velocity 2.10 ft/sec Dose Tank Informat Locking cover with warning label and locking device and sealed watertight Electrical as per NEC 300 and ---� Comm 16.2B WAG E?ionned. 4 in. min. Tank component is properly vented iL— Alternate oL �tlet location Forcemain diameter weeks Manufacturer 2 in. Capacity 800.00 Gallons Volume 19.64 gal/inch A Weep hole or anti- Dimension Inches Gallons B siphon device A 25.93 509.20 C B 2.00 39.28 ump off elevation (ft) C 4.81 94.40 D 8.00 157.12 D Total 40.731 800.00 1 1 tank elev9tlOn (tt) 3" Bedding under tank, 88700 Alarm Manuafacturer ISA. ELECTO SYSTEMS Alarm Model Number HW 101 Pump Manufacturer I GOULDS Pump Model Number WE0311 Deliver n r �u Tr. t'I.ilrip Must lJCllitC1 .Sv g It at LL.,Yt it 1 D Project: MICHAEL J L EVOIR Page 4 of 8 r — • Mound System Maint and 012eratiun Spec ification s- ' Service Provider's Name KIM A OCONNELL Phone 7'15- 755 -3145 POWTS Regulator's Name ST CROIX COUNTY ZONING Phonel 71 0 System Flow and Load Parameters Design Flow - Peak r — 450 gpd MaximuFn influent PaiiiGie Size 1/8 in Estimated Flow- Average 300 gpd Maximum BOD5 220 mg/L Septic Tanis Capacity 1000 gal Maximum TSS 150 mg/L Soil Absorption Component Size 450 ft Maximum FOG 30 mg/L Type of Wastewater Domestic Maximum Fecal Coli €arm >10E4 cfu/100 mL Service Frequency Septic and Pump Tank Inspect and /or service once every 3 years Effluent Filter Should inspect and clean at least once every 3 years Pump and Controls Test once every 3 years Alarm Should test monthly Pressure System Laterals should be flushed and pressure tested every 1.5 years Mound Insoect for ponding and seepage once every 3 Other Miscellaneous Construction and Materials Standards 1- Observation pipes are slotted and materials conform to Table Gomm 84 -30 -1, have a watertight rap, and are Sec..' °°red in a sho:%n it the mound component manna! 2- Dispersal cell an_Clreoate conforrns to Comm 84.30 (6)fil, \ills. Adm. Code - 3 All nr lwAh, unrr4 r:l^ecc�o errs rrvnrs meta i�l� rnnnfn to the r—e eir ®mnritc in COMM 84 1111:c Ad z? f`oyte 4. Tillage of the basal area is accomplished w.Ath a mold board or chisel plotk S The mound stri jcttura and other dish rt-ed uraas v-All k e seeded and mulched to prevent soil e. vision and help reduce f penetration_ Lateral Tu n -up Detail Finished Grade 6-8" Diameter Lam Threaded Cleanout Sprinkler Valve Box Plug or Sall Valve Distribution Lateral Long Sweep 90 or Two 45 Deoree Bends Same Diameter as Lateral Project: MICHAEL i L EVOIR Page 5 of 8 N.4ound System Management Plan z w rit. to Comm 8164 Vffis -A Crode General i hl IS system sha V, be operated In a coordance Con az a= Wis. Adm. Code, and sh a 11 m is intained in accordance vilth Its component M o -1 _ . — M 4 . I Man;;-Ic MEMACOIT-1 -P and SSW P Publication 1 ,0 1 -and 1 --cal r stmte l e-alin-ling NO system.,m a i nter.. an C'3 and m int that could nnune dnvit h- N one sho Id ever m- a sar.*i or pu . p tank -innA, :fan? gerom g g ay be. pre n 0-ii and pump - inkaband sh U, Ua — L.. j .-O U a 11 donment, nall I- in accord nuevldhl 1 - - Omm 53 - - 33, Vvlis. Alm. G de ' ttsrik-z are no longer u5W az; POWTS, Gomponents- Septic or P' Limp tank MIM-We ril-4-IrS, MGF� rMA.Irs, and !should be ;nve-ded for meter tightriess and Amp 9 _ss orx-n:n s :. for And assn srriptnt shn11 be snnjnrl -wntpatinht iim-r the �-nmn & of An _pAn I inn �_��4nn j n in rinAmed ,inso.n-nd, defective, or subler to '..i must be re auce55 opvnings greater than 5-inuhu.,in diameter ishall.be ziecur�d by an effective locking device to Prevent accidental or unauthorized Pntry into a tank or component- Coptic Tank The seTlin t nk Fh 11 be. maintained by in i dim - al cieiti eO to seroice sq foinks under & 281-48, Stats. The n-c-neterits ofthe sepfic tank 31 a-- 5 1 Mn N.-H-1 _fi - - shaill be. disposed vi Fnaccordaance.v&h NRI 11 13, Wis. Admi. C_ode. Theoperatingcondition ofthazoptictankand. outlet fifter beassessodat least once every 3 years by inspection- n Th madeto- a; scifift;n the tanic that may sinimh off t e . filt h i n en if the f;%-;- e filter laill be e,\riciad ;.I the alarmm isaeberatE_d corm-nuously. irveranittent fit-er Warms may indicate surge %lows-or an impending continuous .,arm. I he septic tank shall have its contents removed when the Volume of sludge and scum in the tank exceeds I rS the liquid volume of the tonic. it thn rr mair-tenanne parsonneal -- -hitents- of the tank are- nc-A rero%��d at the firn nf a tri niAll A shalt! advise the- awmaer of wftmn the r*-.* --A muintion in t n tank- ce ne�_ t % o be p erfo"'med to maintain less than 1 m and maxim sim inp- addition 0 biologicat or chemicial additive-s to enhance-septic tank peaor mance is generally not However, if such products are Used they Shall be approved for septic tank Use by the Department or Commerce- ftnp nhni Tank Thn r irnn rdmz ing) tnnL 1% tie in pel tee l et}.. 1 '4+ once gv-emy 3 Y---rs- All s- A! rms, and n mr. shell t h y . 4 ested bo per _a I fi pro operation; 1 aneffilluunt Filter is 'IF ,it the to kitzhall be inzip--t- and xl.lced as Mound and Pressure Otstribution system Pin tr ornhriftshoul be _a _nth R nr*!. , H A An d p! rytedn--t amound- mnund'--e-d-minter ei the mound shall be sef-y'led ind mikhed as ne-c-essary art nre and to provide some protection from from-4 rnprefra-ti n Traffic (other than fh.. r o::ctot:n maimoriance) or, the mound is n recommended since sol compaction may hinder aeration of the iinflltrahv_-S�il lace livithin ti le mound and snaw compaction in the winter will promote trost penetration- Cold weather installations (C)Ctober-Februaryl dictate that the mound be heavily mulched as protnrfl-on frnivt frT f F Inffitm-f qua-R into nto the rr,-,fi ,n sy-_;te may riot em_-eed 2MmgA. BOED 1 ., 5D mg & TAS fin _:K) mg/� OG or *eFA;G tank e unt o r 0 ' 0 Highly uen' no, 3 rrigi(1- BOD6, 30 mgiL TS- 0 , I _ mL fur 1-1 nly treated e-fluent. in-I - ,ay inammur n dv zAgn TGV t sn� ' Ified in the nfxm for thLs. instalWicin- Th- pre-ssure di rftti systern is pi;�,-ridedd v h a flt*hing pr;nt at the en of each I eml, en it i re-norn-mended that emch W "_ 6 -& flu __ --ri -or, -at f4h o f AnnUM! it 1;nllris 0 1 _-4 n nn e� 1 P. mn-+"- V"Mn n-sure test Is peftr ad it s_hr�uld be mpored to the initial tAstwher. the F ie 5 ific-a lean OzitribLi.10 th 0 - � V , 04S a ll A I. , jp,*t mnineifoniGacl gm hias-occu_--Wandifun� cl ung M n v;dhin 1 y—em. eteF dis-Persal rnfl. Oityir inn Pi,�__ vOthin the di-sp I cell shall be checked for eff ,luent Ponding Invals shall be reported to the owner, arKl tiny levr-Js M.� l Anchrnn n morafrequent- on--oring C qnG,'j Plan It the sentic tonic or anv of Its comnonents become detective the tank or component shall be repaired or replaced to keen the system in nrom- c--ndiPl... n I P.- lfthedo5ingfnnle ni-Mn . +r oles 4k; becomendefecti thedef M or rupla,-Wwith a componeritt Of - tile same or equal perinnanco. It the mound component tails to accent wastewater or beams to c1tscharoa wastewater to the oround surtace, I Vail be repaired or renlaced in ii,_l l :nn 1 My 1 --sing basal a A Wnl�d C A -rsa �T M-n J ;c a Ijy c i og g . absorption a! Me �z "'.- U � � , . r -.. madia, and related piping, and rep- sa components as d nec ry t + the the sy-_dern into proper oper Mfj _ age. 6,fthis plan numb- your loca. PO _ 1 - - - vice pro'O.Ger. Prnicw-4• IkAl(-H F=I J! LEVOIR Pi r_ o R_ Curves Pumps wtmms FEET 90 T- -} 0 D E L 3 _ 7.- 'SIZE " Soligs we t — — 0H j 70 --i - --r-- --�_. W E 10H • � — i - - — ___,, -- -► �1 \, �. -i� r J 3 I t 0 10 20 00 +0 w w 7 0 w $0 ]CO t to t:U G ?M 0 CAPACITY e l y 1- -OULZti PUr,lPS METERS FEET I� _ �-�_ r�;00EL 3385 „p wE sr,H �- - - - ��t�_I'' - -'- SIZE 1 i4 SGIidS 100 7— 71 �..._ I eo — I F _ T ._ .�_... W 11 4 1,- -- _ _71 - — -,'- , 444 0 10 20 00 +0 $0 w 70 1i0 GPM 50 m'/h CAPACITY •I OWI0/ Pvmp4, InC. tart ' C:1�. of� yD /i'�f.9ao- �Jbc'on,r /t/ees�J,+� — �i�,+ /• a � ' We S E}'Ti e /� t1 �l��G�c� / �C ® l fB�e�.RjO / I /1a: -a � i I I x� C �yy8' 1 , � I -�ey. Wisconsin Department of Industry SOIL AND SITE EVALUATION REPORT Page 1 of 3 La k x and_j&rnan Relations ' Di Ision ciijhtety & Buildings in accord with ILHR 83.05, Wis. Adm. Code FPARC ELI.D.# OUNTY St. Croix Attach complete site plan on paper not less than 8 1/2 x nq �s in Plan must include, but not limited to vertical and horizontal reference point ict♦on a�rrd'9 /o lope, scale or Ba dimensioned, north arrow, and location and dista etq,n rest � ;, Penidin 9 APPLICANT INFORMATION- PLEASE P ]._ -,A IPf ION"""_ IE ED Y DATE t v( n5m (L IL 6j PROPERTY OWNER: PNI :P RTY LOCATION G 0 `OT SW 1/4 NE 1 / 4 ,S 23 T 31 N,R 19 IE (or) W F orest Oaks Condos, Inc PROPERTY OWNER':S MAILING ADDRESS �,.` ; IUNT BLOCK # I SUBD. NAME OR CSM # 11160 190th. Ave. N.W. FrrGF na Whitetail Trails CITY, STATE ZIP CODE NLMBER ITY EIVILLAGE ®TOWN NEAREST ROAD Eld River, M. 55330 ( ;'44.1- I� Somerset 205th. ave. [x] New Construction Use [ ) 9 Residential I Number of bedrooms 4 [ ] Addition to existing building I ] Replacement ] ] Public or commercial describe Code derived daily flow 600 gpd Recommended design loading rate .4 bed, gpd /ft .5 trench, gpd /ft Absorption area required 500 bed, ft 500 trench, ft Maximum design loading rate • 4 bed, gpd /ft2 - 5 trench, gpd /ft Recommended infiltration surface elevation(s) 103.20 ft (as referred to site plan benchmark) Additional design / site considerations system el. based on contour line El. 102.20' Parent material gi ac: al drift Flood plain elevation, if applicable na ft S = Suitable for system CONVENTIONAL MOUND IN- GROUND PRESSURE AT -GRADE SYSTEM IN FILL HOLDING TANK U= Unsuitable fors stem O S ®U E S ❑ U ❑ S ®U ❑ S ®U O S ®U O S ® U SOIL DESCRIPTION REPORT Depth Dominant Color Mottles Texture Structure Consistence Roots GPD /ft Boring # Horizon in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. N Bed T 1 0 -12 10yr3 /3 none 1 2msbk mfr 9W 2f .5 2 12 -36 10yr3 /3 none sl 2msbk mfr gW if .5 3 36 -84 7.5 r4/4 c2d 7.5 r5/6 sicl 2msbk mfr na na .4 Y Y 4 r G ou d elev. 1 Depth to limiting factor 36" Remarks: Boring # 1 0 -9 10yr3/3 none 1 2msbk mfr 9W 2f 1 .5 .6 2 2 9 -35 10yr4 /4 none sicl 2msbk mfr 9W if .4 tp 3 35 -66 7.5yr4/6 none is sOg mvfr 9W na .7 Z Ground elev. 4 66 -84 5yr4/4 c2d 7.5yr5/6 sl M na na na .3 5 1 Depth to limiting factor 66" Remarks: CST Name: -- Please Print Gary L. Steel Phone: 715- 246 -6200 Address: 1554 200th. ,New Richmond *154017 Signature Date: 4 -19 -2000 CST Number: mO2298 PROPERTYOWNER Forest Oaks Condos SOIL DESCRIPTION REPORT Page of PARCEL I.D. # pending Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Bmsidary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trends 3 1 —9 10 r3/3 none 1 2msbk mfr gw 2f .5 2 —34 7.5yr4/4 none s1 2msbk mfr 9w if .5 Ground 3 4 -38 10yr5 /4 c2d 7.5yr5/6 c1 M na gw na elev. it 1 •r at. 4 8 -57 10yr4 /4 none is Osg mvfr gw na .7 Depth to 5 7 -84 5yr4/4 c2d 7.5yr5/6 s1 M na na na .3 limiting factor Remarks: Boring # 13 Ground elev. ft. — Depth to -- limiting factor Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: Boring # 13 Ground elev. j ft. Depth to limiting factor Remarks: SBD- 8330(8.05/92) STEEL'S SOIL SERVICE Gary L. Steel Forest Oaks Condos, Inc. 1554 200th Ave. CSTM2298 SW4NE4 S23- T31N - New Richmond, WI 54017 M W -3254 town of Somerset (715) 246 -6200 lot #15- Whitetail Trails N 1 =40' BM.= top of 1" pvc pipe C el. 100.00 Alt. BM.= top of 1 pvc pipe C el. 99.50 kk Q1� 4 e1� (02-- z o • P� Gary L. Steel 4 -19 -2000 10 -05 -1995 7 :20PM FROM P•1 STEEL'S SOIL SERVIC Cary L. Steel Forest Oaks Cmu , Inc, 1554 200th Ave. CSTM2298 SWVWk S23 T31N - R19W New Richmond,'W) 54017 MPRSW -3254 town of Somerset ( 15) 246 -6200 lot #15- Whitetail Trails 1"=40 mil.= top of 1 pvc pipe el. 100.00 Alt. E14.= top of 1 1, pvc pipe e].. 99.50 , 'd Ift- h h a off- L w �w Io3' 2i�. Gary L. Steel 4-19 -2000 10/`0412001 15:45 7152473038 BELISLE EXCAVATING I PAGE 05 ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT OWNERSHIP CERTIFICATION FORM �O Owner/Buyer // t //c ��"t I ya >n \e y ZQ vo Mailing Address a q ?oQ �t /Cp�Jt� (�p40Spe}' MA) s 5 /Z_!S� Property Address 1 40 42 tl; i"A,-�5 (Verification required from Planning Department for new construction) City /State �j� "cS'�' ' 1'V T Parcel Identification Number LF D ESCRIPTION Property Location .�� '!•, 'A, See. -; , T N -R L? W, Town of Subdivision J �►. 4 l6 �� r , -1 - ' Lot # l Certlfled Survey Map # , Volume , Page # Warranty Decd # /��t5�� . Volume , Page #,_. Spec house ❑ yes 4 no Lot lines identifiablexyes [7 no MIEN MAINTENANCE Improper use and maintenanceof 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. TUe property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on -site wastewaterdisposal system is in proper operating condition and/or (2) cAer inspection and pumping (if necessary), the septic tank is less than 113 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 atating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning office within 30 days of the three year o pustion 44tc Z / � � 1 SIGNATURE OF APP CANT DATE OWNER CERTIFICATION 1 (we) certify that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owner(s) of the property described above, by virtue of a warranty dead recorded in Register of Deeds Office. � ;' z hfo A, 10 4)7-/ SIGNATURE APP1. CANT DATE 000066 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 trap if reference is made in the warranty deed II r 0 STATE BAR OF WISCONSIN FORM 2- 1999 6 ' 4 553 Document Number WARRANTY DEED KATHLEEN H. WALSH REGISTER OF DEEDS ST- r,OIX CO., WI This Deed, made between Forest Oaks Condos, Inc., a Minnesota RECEIVED Flit RECORD Corporation 01-11 -2001 9:30 AM Grantor, and Michael J. LeVoir, WARRANTY DEED EXEMPT N CERT COPY FEE: COPY FEE: TRANSFER FEE: 104.70 Grantee. RECORDING FEE: 10.00 PAGES I Grantor, for a valuable consideration, conveys to Grantee the following described real estate in St. Croix County, State of Wisconsin (if more space is needed, please attach addendum): Lot 15, White Tail Trails, St. Croix County, Wisconsin. Recording Area DAVID J. ESTREEN 304 LOCUST ST. lu"qeHUDSON, WI 54016 032 - 2134 -80 -000 Parcel Identification Number (PIN) This is not homestead property, Exceptions to warranties: Easements, restrictions and rights -of -way of record, if any, Of) (Is not) Dated this y ) J day o 2001 Forest Condos, r c. +Gerald Smith, Pr dent r AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF WISCONSIN ) ss, County ) authenticated this day of rsonal y came before me this of 2001 the above named * Forest Oa cs Condos, Inc., a Minnesota Corporation by Gerald Smith, its President TITLE: MEMBER STATE BAR OF WISCONSIN (If not, to me kn n to be the person(& who executed the foregoing authorized by § 706.06, Wis. Stats.) instru e t nd acknowl d d t same. THIS INSTRUMENT WAS DRAFTED BY Attorney Kristina Ogland Hudson, W 54016 Notary Pub )ic, State of Wisconsin (Signatures may be authenticated or acknowledged. Both are not necessary,) My Commis i' permaneZ (If not, state expiration date: Names of persons signing in any capacity must be typed or printed below their signature. ) g Information Professionals Company, Fond du Lao, WI WARRANTY DEED STATE BAR OF WISCONSIN e00- 65&2021 FORM No. 2.1999 O L AN" • 5 ( E SZE. - -CSS E,�,�.At '4 Qc A DE -E- :'NG -'0 CDN'<T T -E S CR -0*1JI,; j9z E A%) �F aPF R�,'R A'- '_' At. 31, • AR- ,R AL\, NoR7? LINE OF THE 5W '1 OF NE ME 1 1 4 • 56• 3t 4.13' 38& -1038.15' L= 6 LOT 13 LOT 1 2 LOT 11 140, 14J SO FT 1-; 50. FT U9.875 SO. FT .6 3. 22 A CRES 3 04 ACRES = 3. A CRES ISTER'S OFFICE A ST.CK,)LX CWMS. E = 491 :z AW 0 Z6 ............. ...... ............ -age N88'37'54'E 278 71' Deod's 588'45'03** ---- -- - -- -- ----- 45' C LOT 1 ------- - 224.55 - --------- - - 13C? 769 SO. FT 12' EAH-1c 3 00 A CRES 0! ............... ............................. .. '77 n L LOT 2 2 iv , r 0 7 . I135, 324 50. FT r 04 C-4 J I I A CRES 4:,4 p_ !4 j = N88'37 54'E OT 1 496.05' 136,919 FT 14 A LOT 2 3 IJO, 958 SO FT 0 5 301 ACRES m M .;.M UM pr E = 486 7 !- C N88*37*54'E 41204 'E 1 W 496m, -6 .92 3 20* Dr=.7c3e c--se—r. LOT 16 JOT 17 1,3' 0,30 50 F,' it? I A CRES IJO,958 SO FT J,:, WE 301 ACRES `'' $.�f ............. #ESr 21YAR7ER CORNER ... ........................................... . -�fcncw 2j-3l-1 'A'tirmu m �6 ,'FOUND ALLIA41 Tl,�'Y EASE-AE47 COUNTY MONUMEA(?; 2' - y ;- -SE ME',' :2' ------- ------ N88 412.04 -- - - --- -- ------------------- 49605 --- - - - - -- r .06i S88'38'39 S88'37 S88'38'39'W 1628. W EAST-WEST QUARTER UNE - - ---- - - - - -- - 2680.20' — - - - - - - S8838'39"W 5371.30' CURVE DATA CURVE RADIUS ARC CHC*O DELTA CHOM BE,%9t%%08 C4 Lc) 6 00 4 2389' 38 0. 90'5744' S•3'!6'11'f, C4 3 00' 528 67*1 4,4.87 9037'4 S43"16'11 0 z 3 _ '3,00' - '48 — IF�48 08 0676'44' .V " S84*36*41* 1 333 0' 1 205.361 2C2,'2' 35*20*03* S62*48'1 7 5' S34 6 6 0' , 66.4 11*27'31"