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F sconsin Department of Commerce PRIVATE SEWAGE SYSTEM County. St. Croix -.f.ty..d Building Division `�-� WA INSPECTION REPORT Sanitary Permit No: 430416 0 J 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: Kern, Jay & Denise I Somerset Township 032 - 1072 -50 -000 CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range /Map No: / c"', 4 s41 e 6r_t 26.31.19.3520 TANK INFORMATION ELEVATION DATA ` t A— TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark (.ta 2 �=-' , �3 $ , Z� /O S" • I, AP r✓U ry Dosing II . -� Alt. BM Aero ©n L y� Bldg. Sewer 5 - Z-; s �t I (ec c c, .Xn L Hddfrrg St/Ht Inlet Shy S. IT q7.( St/Ht Outlet e• 9 . 1 � TANK SETBACK INFORMATION t�ava� TANK TO P/L WELL BLDG. Vent to Air Intake ROAD J Dt Inlet rn sfc- L1s _ �c+•ryr c_ci7� Gfl� 1 �. Septic 7 ' r _ Dt Bottom Dosing + Header /Man. too Aerortirn Dist. Pipe 4 y.14 5 idG _ zp� H. J45 Svc, 8 Holding Bot. System t•1 Final Grade PUMP /SIPHON INFORMATION Manufacturer Demand St Cover GPM jv `� �`� �Jd `� Model Number --a" t TDH - FOeti Lossf3 i ad Ft 14'. 0. 8 LQ `1} .0 , D- \ N / 7+v �/ • . C rr 2 M .�iw p .� k I /1� t Forcemain �/ th - - -j� rR ' ° Dis . o Well — " - SOIL ABSORPTION SYSTEM 1b, 14o w .. S T% 46 4, o (, • --e nod c rc 1 R - e BED/TRENCH Wi o. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS -- SETBACK SYSTEM TO P/L BLDG_ IWELL LAKE /STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR Type Of System: i e UNIT Model Number: DISTRIBUTION SYSTEM Header /Manifold Distribution x Hole Size x Hole Spac[ _ Vent to Air Intake Pipe(s) ° 4 Length DiafT Length Dia F "" Spacing / • �` S SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only Depth Over Depth Over xx Depth of r eded /Sodded xx Mulched Bedlrrench Center J Bed/Trench Edges Topsoil Yes ] No [.] Yes " No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: 0 I / o Inspection #2: 9 I u to � µw' `k Location: 659 200th Avenue Somerset, WI 54025 (NW 1/4 NE 1/4 26 T31N R19W) NA Lot Parcel No: 26-31.19.352C 1. Alt BM Description = S.T rav,-� flaw% e1 �•�,,. � 5� h �. OtR.O A 2.) Bldg sewer length= �t �S�? -^ 3rr (If�`� - amount of cover = -- - - -- Plan revision Required? FL Yes Z No Jse other side for additional information. Date 3D -6710 (R.3/97) Insepctor's Signature Cert. No. �� •^ p')'oy�,_'' F ,_ Safety and Buildings Division County 201 W. Washin .5 lseons i X i�n Madison, W1 5REGME� anitary Permit Number (to be filled in by Co.) Department of Commerce ( )266 - 3151 3 d V I (p Sanitary Permit Appliea ian 12 2003 S tate Plan I.D. Number ) In accord with Comm 83.21, Wis. Adm. Code, personal infor tion you provide 1 2 � ! �SS' �f/VS • �4•/ may be used for secondary purposes Privacy Law, sl .04(10 CROIX COUNTY ZONING OFFICE ro }eft Address (if different Than mailing address) I. Application Information - Please Print All Information Property Owner's Na me Parcel # / Lot H Block # Property Owner's M ailing Address Property Location r 5�-C, City, State ,tW 'k, s� i4,Section a 4 tY Zip Code Phone Number 1 (circle II. T T JY N; R�V E o� Type of Building (check all that apply) A l or 2 Family Dwelling - Number of Bedrooms L�t � ,S Subdivision ivision N CSM, umber ❑ Public /Commercial - Describe Use _ T r X `J I rtt7t+'^A�1 A-- ��� ❑ State Owned - Describe Use ]City ❑Village GTownship of ��JnGrjY iT .S III. Type of Permit: (Check only one box on line A. Complete line B if applicable) A ' ❑New System Replacement System ❑ TreatmenuHolding Tank Replacement Only ❑ Other Modification to Existing System B. ❑ Permit Renewal ❑ Permit Revision � F� List Previous Permit Number and Date Issued ❑ Change of ❑ Permit Transfer to New I Before Expiration Plumber ! Owner 4` IV. Type of POWTS System: (Check all that apply) �� Non - Pressurized In- Ground tmd t suitable coil M ound < 24 in. of suitable soil D At- Grade ❑ Single Pass Sarni Filter ❑ Constructed Wetland ❑ Pressurized In- Ground ❑ Holding Tank L Peat Filter ❑ Aerobic Treatment Unit ❑ Recirculating Sand Filter � ❑ Recirculating Synthetic Media Filter ❑ Leaching C hamber ❑ Drip Line ❑ Gravel -less Pipe ❑ Other (explain) V. Dis rsal /Treatment Area Infor mation: Design Flow (gpd) Design So' A ca ate(gpdsf) Dispersal Area Required (sf) Dispersal Area Pro se d (sf) System Elevati ✓ VI. Tank Info Capa k in Total Number Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Units Concrete Constructed Glass E New Existing ' Tanks Tanks i Sepik or Holding Tank j l2� Aerobic Treatment Unii o.! i Dosing Chamber VII. Responsibility Statement- 1, the und ersigned, assur ' e responsib for allation of the POWTS shown on the attac plans. Plumber's Na me (Print) Plumber's Si gnature P" PRS Number Business Phone Number CA& A a'rs'e Plumbers Addre ss (Street, City, State, zip Code) VII . Count /Department Use Onl Approved ❑ Disapproved Sanitary Permit Fee (includes Groundwater D t(77LO ssued Issuing A ni Sign r o Stamps) Surcharge Fee) ern ❑ Own Given Reason for Denial f IX. Conditions of Approval/Reasons for Disapproval r _ 3) at Alga a f _ Alta co v • " t";% plete plans (to the County o ly) for the system on paper less than 81/2 x I1 in es 8121 S13D- -5398 R. 01/03) Gt%c�t� /��2gjo3 PLOT PLAN - Page 3 of - Scale — - Zoo T)4 � 11wREss LX \� T. `DSO G f� �._J) k:�_, ev- WJC , — - rb of IL �4�VC 6��oF L4 z P v F. 111- . F -by MA). fit- O\S.S -�5 -n, iy �Ww M q Pvc �1 sm a J Qj 0 •2..'� y�V C F. ►'1 . �31h � 0 l CV9 .b- o r.► OT SH- . "C_ w�L j y Esb tz-" (t... R'.,•: L Ir+1�1 /b :tLMA 1 N t `I `4 C yS'Of- y41'VC EE7.lf1N W \L iZUu/BUo Tw rZ.. NOTES: 1. Elevations shown are existing ground elevations unless otherwise noted. 2. Install 4" observation pipes with approved caps. ( Y required). 3. Septic tank to be N Z`Jb / gO Vgallon capacity manufactured byw�i�SQ'7 cotve • �02 ?� ,1S O GYn. t v 1Z B 6^fu-i P k 10 wlUUn� �10 SL 1000 G A 4. Bench mark S� ft$ou(. 5. Divert surface water around system to prevent ponding -n`_ the uph. —4 R=— RECEIVED SAFETY AND BUILDINGS DIVISION 4003 N KINNEY COULEE RD NOV 1 2 2003 LACROSSE WI 54601 -1831 Nvirsconsin WWW.COMMERCE.STATE.WLUS ST. CROIX COUNTY dim Doyle, Governor Department of Commerce ZONING OFFICE Cory L. Nettles, Secretary November 07, 2003 CUST ID No. 220254 ATTN: Inspector ARTHUR L WEGERER ZONING OFFICE WEGERER SOIL TESTING & DESIGN SERVICE ST CROIX COUNTY SPIA PO BOX 74 1101 CARNHCHAEL RD RIVER FALLS WI' 54022 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 11 /07 /2005cleficaton Numbers Transaction ID No. 941755 SITE: Jay Kern Residence Site ID No. 668 ... 659 200TH Ave Please refez to both *de ''On riumbers; Town of Somerset, St Croix County in correspondence w,Ith. e NW 114, NE 1/4, S26, T3 1N, RI 9W a en FOR: Object Type: POWTS 600 gpd Mound System Regulated Object ID No.: 930982 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: • Pursuant to outlet filter product approval stipulations, maintenance information must be given to the owner of the POWTS explaining that periodic cleaning of the septic tank outlet filter is required. The access opening used to service the filter shall terminate at or above finished grade with a watertight cover. • Comments made on the plans shall be implemented during construction of the system. 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 b the state or the local municipality shall be obtained prior to commencement of q Y P n' P 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 numberjisted 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. Sincer y, Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 Le G. Jansky, RPSS, Wastewater Specialist Integrated Services Bureau (715)726 -2544 OfficevT Ijansky@commerce.state.wi.us TITLE SHEET Page 1 of MOUND SYSTEM FOR A BEDROOM RESIDENCE wf3 - )lj po) ZSo 6Pr) This plan has been prepared in accordance with the Mound Component Manual SBD 10691 -P and the Pressure Distribution Manual SBD - 10706 -P (N.01101) (N.01 101) LOCATED IN THE ��V3 1/4 OF THE NEr 1/4 OF SECTION Z� , T 3 I N, R �9 U TO OF S( -- - S� 5-t--, C` 1X COUNTY, WISCONSIN. INDEX PAGE 1 of 7 TITLE SHEET PAGE 2 Of 7 SYSTEM MA NAGE1:4ENT PLAiv PAGE 3 of 7 PLOT PLAN PAGE 4 of 7 PLAN VIEW -CROSS SECTION PAGE 5 of 7 DISTRIBUTION PIPE LAYOUT PAGE 6 of 7 PUMPING CHAINBER CROSS SECTION PAGE 7 of 7 PUMP PERFORMANCE CURVE PREPARED FOR a �zt o Z S '9475 PREPARED BY RECEIVED 3rJaCCEF a: FR SO I L TEST 2 NG NOV O AND 2003 3�ES I c3 p4 Sa:RV I CE SAFETY & BIOG$, DIN. P.O. Box 74 421 N."ain St. River Falls, WI 54022 Phone 715- 425 -0165 c�•� ,�. -. �+�� Fax 715 - 425 -6864 6� l �8 FICA- a 6 .f ds.¢Y -v Ny • -F'F'A i�01r l i F 1 �prrw�iQ, � f-i.L .JNT4� DEPARTMENT Of COMMERCE D1V15ItT OF SAFETY AND B ItDiNGS JOB NO. O3 - ZL (� Mound System Management Plan p age Z of Pursuant to Comm 83.54, Wis. Adm. Code Septi The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Stats. The contents of the septic tank shall be disposed of i accordance with NR 113, Wis. Adm. Code. The o erating condition of the septic tank and Outlet filter shall be assessed at least once every 3 years by inspection. Th outlet filte s hall 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 ay s oug o the fi ter when removed from its enclosure. If the filter is equipped with an alarm, the filter shall be serviced if the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an impending continuous alaan. The septic tank shall have its contents removed when the volume of sludge and scum in the tank exceeds 1/3 the liquid volume of the tank If the contents of the tank are not removed at the time of a triennial assessment, maintenance personnel shall advise the owner of when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank. The addition of biological or chemical additives to enhance septic tank performance is generally not required. However, if such products are used they shall be approved for septic tank use by the Department of Commerce, Safety and Buildings Division. 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. Mound and Pressure Distribution System No trees or shrubs should be planted on the mound. Plantings may be made around the mound's perimeter, and the mound shall be seeded and mulched as necessary to prevent erosion and to provide some protection from frost penetration. Traffic (other than for vegetative maintenance) on the mound is not recommended since. soil compaction may hinder aeration of the infiltrative surface within the mound and snow compaction in the winter will promote frost penetration. Cold weather installations (October - February) dictate that the mound be heavily mulched for frost protection. Influent quality into the mound system may not exceed 220 mg /L 6005, 150 mg /L TSS, and 30 mg /L FOG. Influent flow may not exceed maximum design flow specified in the permit for this installation. The pressure distribution system is provided with a flushing point at the end of each lateral, and it is recommended that each lateral be flushed of accumulated solids at least once every 18 months. When a pressure test is performed it should be compared to the initial test when the system was installed to determine if orifice clogging has occurred and if orifice cleaning is required to maintain equal distribution within the dispersal cell. Observation pipes within the dispersal cell shall be checked for effluent pending. Ponding levels shall be reported to the owner, and any levels above 4 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring. General This system shall be operated in accordance with Comm 82 -84 Wis. Adm. Code, and shall maintained in accordance with its' component manual P (1� -g/g and local or state rules pertaining to system maintenance and maintenance reporting. — b No one should ever enter a septic or pump tank since dangerous gases may be present that could cause death. Septic and Pump tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the tanks are no longer used as POWTS components. Septic or pump tank manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 8- inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into a tank or component. Con" aencv Plan If the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep the system in proper operating condition. If the dosing tank, pump, pump controls, alarm or related wiring becomes defective the defective component shall be immediately repaired or replaced with a component of the same or equal performance. If the mound component fails to accept wastewater or begins to discharge wastewater to the ground surface, it will be repaired or replaced in its' present location by increasing basal area if toe leakage occurs or by removing biologically clogged adsorption and dispersal media, and related piping, and replacing said components as deemed necessary to bring the system into proper operating condition. Questions about the operation or maintenance of this system should be directed to: The County Zoning Office at The. system installer at Z�S — 3 8 -3 1 SCWIK}12LTR The tank manufacturer at �p(j',`.3:_ L ` The effluent filter manufacturer at The pump manufacturer at ( 031— i�U— L`$14 c�Dv�pS PLOT PLAN Page _�>o£ . � , Scale 1 "= ` 0 ' Y Zoo _Tl_ y fl)v 6sq zuo `fr+ -- ASE L IST. `1S0 G Pr t- '-.jt Q�& LL CojQ . z (� \S cn 10 Old 3 Z - i ) -U f21 S h yaw C �gG OF y z F wj\/ E�L _ qS . S � ww � ►� y `' P v c � +sro $ �ti Qj Y � � sN , 0 I r �z 4 ►�T - � � N�L•;�'71vG y � 4s'or y�Yvc Mr -- qZ` aov" S � NOTES: 1. Elevations shown are existing ground elevations unless otherwise noted. 2. Install 4" observation pipes with approved caps. ( Y required). 3. Septic tank to be \ ZVd /�O Vgallon capacity manufactured byW�t c*NQ* . �y` Q "13 O GNL R) NZ PogU - R Afu_j - - �vwr p rmk -% rAbQh_ 7 '10 �"C lo0o & A 4. Bench mark St�-pr8oyL 5. Divert surface water around system to prevent ponding at— the ��- 1— R_' -_,�_- r-- -- Page = Gr Approved synthetic Covering i SST_. H C33 sand Distribution Pipe _ _ 1 _ Topsoil � H G � 3 E , o WS lo e p ,S � Distr_bitioz Cell of Force Main Plow e d � l l Z n to 2- L��r��ate From Pump -Layer (undisturbed D 3-5 Ft. i Soil E o F �. Cross- section of a mound system using F p_8 Ft. 2 cells for the absorption area G o• S Ft. P_ � Ft � N - � Ft. B R Ft. 6 c \Z Ft. Linear Loading _3-2 T Design L ;ncr ate pD /L.'y FT _ F t. G � 3 F-- C 2xA +C.� -r) � T 1 W _L Ft . I A o T b 5 � K 4 bservatian C � p e!y) - _" — — o - Force W Main Distribution 1 n �n Pipe Cell of to- 2 s aggregate Plan view of a mound system usi� -s 2 cell . s for the absorption p area I . f Distribution Pipe Layout - 7 - S - Pa�,e 0— Place the holes at the bottom of the distribLtion pipes at'equal spacing. Remove all burrs from the pipe and 'holes. Extend the end of each lati=l up w th the use of Iohc t= or ;f' f=-L -z n - • r _ _ t0 a OL.L WI _ F tip sLx inches of the final arade. Te- -mina the ends of the later. Is with a valve,: threaded car or . threaded plug. Provide access from anal ode for the valve, threaded can or threaded FIus. — Lateri— Mandbid Laterf xa xr, z x z x = Lateral Lenath —t Lateral Lencth = Districuticn Line C-- C F . Ft. Note Diameter 3 f Inch S k Z Ft, Lateral R " ! 1 1 Z Inches) - X 3 3 S inches Manifold 2 Inches Force Main " Inches l of holes /pipe \ Invert Elevation of.Laterais S Ft. PUMP CHAMBER CRO55 SECTION AND SPECIFICATIONS ' PAGE 6 OF 7 VF AIT CAP y'C.I- VENT PIPE WEATHER PROOF PpPROVED LOCKING MANHOLE 7 JuuCTIOU Sox COVER WITH WARNING LABEL 10 ' FRO DOOM, ., OR FRESH I2�Miu. i AIR IN TAKE i GRADE I MI7 . CO►JDUIT �-- 18' MIIJ. IA1LrT PROVIDE I __ 1 4 T AIRTIGHT SEAL APPROVED JOINT A I I APPROVED 101 I I I i I I I ALARM 0 - I 1 1 I I I 1 � ON LLEV.�Z FT. _ -� PUMP , OFF - ti 0 tlLE�0 aZ -o COUCKETE &LOCK t - RISER EXIT PERMITTED ONLY IF TANK MWUFACTLIRER HAS SUCH APPROVAL FT'ADPRwr: 8b00 I � 5PEC. IFICATI0 AIS 005E W �i: 212 C \. 'r_/►!� MAIJUFACTURER. HUMBER OF DOSES: PER DAy TANK SIZE: GALLOQS DOSE VOLUME z AL1►Rl"f, - _M/WUFACTURCR: -- S S : f-Le- LO SCI S`'(l' S_ INCLUDING 6ALKFL01�1: 6 O - MODEL ►JUMBSR: CAPACITIES: A_ — CAPACITIES: GALLOWS SWITCH TYPE ; Z�'! IUCHES OR SS' GftLOLIS PUMP MANUFACTURCR: G�r`�D9 t• C=" IIICHES OR ' -4 dus MODEL NUMBER: D= .'ZS GAL I Z S -Z • S { u INCHES S OR .�_ LOAI SWITCH TUPE: �y�Z7 WOTE: PUMP A LARM ARE TO \ ^�' MIUIMUM DISCH/4RGE RATE Icy -�� GAM INSTALLED CIM SEPARATE CIRCUITS VEKTIChL DIFFERENCE OETWEEIIJ PUMP OFF ANO,OISTRIBUTION PIPE..1'6S FEET ♦ MINIMLIM . NETWORK SUPPLY PRESSURE � 3 Z- t� FEE7 rZ_S x 1, 3, - I' FEET OF FORCE MAIN X U- F / oo rxFRICTIOU FACTOR. 3 ' Ll d FEET TOTAL OyWAMIC HEAP "FEET As per:nanufacturer gal /in. Liquid depth 3 6 Goulds _oi -7 Submersible Effluent Pump 3871 EPO4 - EP05 APPLICATIONS • Fasteners: 300 series • Fully submerged in high ■ Motor Housing: Cast iron Specifically designed for the stainless steel. grade turbine oil for for efficient heat transfer, following uses: • Capable of running lubrication and efficient strength, and durability. • Effluent systems dry without damage to heat transfer. IN Motor Cover. Thermoplas- • Homes components. tic cover with integral handle Motor: Available far automatic and • Farms manual operation. Automatic and float switch attachment • Heavy duty sump • EPO4 Single phase: 0.4 HP, models include Mechanical points. • Water transfer 115 230 V, Hz, 155 Float Switch assembled and ■ Power Cable: Severe duty • Dewatering RPM, , built in overload with automatic reset. preset at the factory. rated oil and water resistant. and lower SPECIFICATIONS • EP05 Single phase: 0.5 HP, FEATURES heavy duty bail ■Bearings: Upper a 115 V, 60 Hz, 1550 RPM, construction. be Pump: EPO4 built in overload with ■ EPO4 Impeller: Thermo- • Solids handling capability: automatic reset. plastic Semi -open design /a maximum. • Power cord: 10 foot with pump out vanes for AGENCY LISTING • Capacities: up to 55 GPM. standard length, 16/3 SJTO mechanical seal protection. SA Canadian SiandardsAssociatioa ° Total heads: up to 24 feet. with three prong grounding / • Discharge size: 1 NPT. plug. Optional 20 foot ■ EP05 Impeller. Thermo- numbers (CSA listed model • Mechanical seal: carbon- length, 16/3 SJTW with plastic enclosed design for end in " to or "A de rotary/ceramic - stationary, three prong grounding plug improved performance. BUNA -N elastomers. (standard. on EP05). ■ Casing and Base: Rugged • Temperature: thermoplastic design provides 104 °F (40 °C) continuous superior strength and 140 °F (60 °C) intermittent, corrosion resistance. • Fasteners: 300 series METERS FEET stainless steel. 10 j ! ' • Capable of running dry without damage to 9 30 components. Pump: EP05 -- -_ -. -- -- -- _ ' " • Solids handling capability: 0 25 %" maximum. a Uj • Capacities: up to 60 GPM. 6 I ! • Total heads: up to 31 feet. 20 i ` • Discharge size: 1 NPT. a �— ! _ • Mechanical seal: carbon- 0 5 15 rotary/ceramic - stationary, _j 4 BUNA -N elastomers. i • Temperature: ° 3 10 104 °F (40 °C) continuous 140 °F (60 °C) intermittent. 2 ! 1 j 5 1 f yy 88 0 00 10 20 30 40 50 GPM 0 2 4 6 a 10 12 m-m CAPACITY ©1995 Goulds Pumps, Inc. Effective May. 1995 - Combination Sept;.c; Tank and PUMP CHAMBER CROSS SECTIOM AMD SPECIFICATIOMS ' PAGE G OF •VEUT CAP WEATHER PROOF JUUCTIOU BOX `t C.Z. VEUT PIPC APPROVED LOCKIMG 1 ' FROM - D - 0 - OR OOR. &WHOLE COVER ; •t :%I►JOOW OR FRESH ti'- 'RAt�3)sJG t"PtgES�, �sg�G10�J �tP� R ►fJTA,KE t S coratwtY _ wlrYttZnr. wr &frp � A 9 ' Ft na ts� G tzr�p � - - - - - -- IB'MIA1 - - - - - -- -- IML �" PROVIDE AtRTtGHT SEAL. BA�tC I I APProz�s8�� A I if! Approved joint �� 1 j oint w/ ALARA PVC pipe PVC p "I II a I ► CLCY. •�� FT. — T PUM -�� '-� I ,� OFF D COUCRETE �S1 S CLOCK ti . RISER EXIT PERMIT(EO O IJLy IF TAUK MAQU'FACTURZR HAS SUCH APPROVAL 3 "APFR�FD . BFDOtN4 SEPTIC f 5PEC 1FICATI0KJS DOSE TAWKS MAQU FACT URCR: DUMBER OF DOSES: L �•g . PER pA„ . TAMK SIZE: VLU) GALLOIJS DCSE VOLUME = ALARM MAUUFACTURER: S S ��Z`T�Z} �� �� S` IWCLUD)MG BAGKrLOW: MODEL ►.!UMBER 101 larW . CA;pp.ClTlES: A_ \� IA►CHCS DR WAD -3 CALLOUS SWITCH T:JPr6: yn���C°CJ� -� g= 1�lCMES'GR ��' b G�LLOr,�g PUMP PkAMUFACTURER: ��U� -� S C= y IUCHES OR "� GALL01J5 MODEL ).!UMBER: ���� S p= �ES1��.JVZ -�y L if1CHES oR GALLOiJS SWITCH TYPE: ) I�, '1ttTpr DOTE: PUMP AND ALARM ARE TO 5E MWIMU)"1 D15CKARGE RATE L }� CFtA INSTALLED OAS SEPARATE CIRCUITS VERTICAL DIFFEKEMCE DETWEEU PUMP OFF A1JO.. y'I �V C 1 PIPE g FEET Fwv + MWIMUM AtETWORK SUPPLY PRESSURE .. N FLET ,, �,,,,; ? nay`s /0, 1 U FEET OF FORCE MAIM X �• \ FT aFLFRICTIO►J FACTOR_. \3.�S FEET Y `' TOTAL OtJUAMIC HEAD =_ ` 3 FEET As per manufacturer 1 Z -ZY gal /in. Liquid depth 36 �' Gouldsc� °� I Submersible r r� Effluent Pump 3871 EPO4 EP05 APPLICATIONS • Fasteners: 300 series • Fully submerged in high ■ Motor Housing: Cast iron Specifically designed for the stainless steel. grade turbine oil for for efficient heat transfer, following uses: • Capable of running lubrication and efficient strength, and durability. • Effluent systems dry without damage to heat transfer. ■ Motor Cover: Thermoplas- • Homes components. tic cover with integral handle Motor: Available for automatic and • Farms manual operation. Automatic and float switch attachment • Heavy duty sump • EPO4 Single phase: 0.4 HP, models include Mechanical Dewatering RPM, , points. • Water transfer 115 230 V, Hz, 1550 Float Switch assembled and ■ Power Cable: Severe duty • built in ovv erload with automatic reset. preset at the factory. rated oil and water resistant. SPECIFICATIONS • EP05 Single phase: 0.5 HP, ■ Bearings: Upper and lower 115 V, 60 Hz, 1550 RPM, FEATURES heavy duty ball bearing Pump: EPO4 built in overload with ■ EPO4 Impeller: Thermo- construction. • Solids handling capability: automatic reset. 3 /4' maximum. • Power cord: 10 foot plastic Semi -open design AGENCY LISTING •Capacities: up to 55 GPM. standard length, 16/3 SJTO with pump out vanes for i • Total heads: up to 24 feet. with three prong grounding mechanical seal protection. SA CaaadianStandardsAssociation • Discharge size: 1' 12" NPT. plug. Optional 20 foot ■ EP05 Impeller: Thermo- plastic enclosed design for (CSA listed model numbers • Mechanical seal: carbon- length, 16/3 SJTW with ". d in "F" or "AC VVy /ceramic - stationary, three prong grounding plug improved performance. en ) BUNA -N elastomers. (standard on EP05). ■ Casing and Base: Rugged • Temperature: thermoplastic design provides 104 °F (40 °C) continuous superior strength and 140 °F (60 °C) intermittent. corrosion resistance. • Fasteners: 300 series METERS FEET stainless steel. 10 • Capable of running dry without damage to s 30. S components. i I � $ Pump: EP05 • Solids handling capability: c 25 3 / " maximum. a W -- • Capacities: up to 60 GPM. • Total heads: up to 31 feet. S2 6 20 • Discharge size: 1'R NPT. • 5 Mechanical seal: carbon- 0 15 ' rotary/ceramic- stationary, .j 4 i - _ BUNA -N elastom J ers. ' I EP_ • Temperature: 3 10 -- 104 °F (40 °C) continuous 140 °F (60°C) intermittent. 2 I — 5 I I I I 1 ! 0 10 20 30 40 50 GPM 0 2 4 6 8 10 12 CAPACITY ®1995 Goulds Pumps, Inc. Effective May. 1995 Wisconsin�Deparnt of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and duildi . i v ision INSPECTION REPORT Sanitary Permit No: 430416 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: Kern, Jay & Denise I Somerset Township 032 - 1072 -50 -000 CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range /Map No: 26.31.19.352C TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark Dosing Alt. BM Aeration Bldg. Sewer Holding St/Ht Inlet St/Ht Outlet TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic Dt Bottom Dosing Header /Man. Aeration Dist. Pipe Holding Bot. System Final Grade PUMP /SIPHON INFORMATION Manufacturer Demand St Cover GPM Model Number TDH Lift Friction Loss System Head TDH Ft Forcemain Length Dia. Dist. to Well SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. 7 uid Depth DIMENSIONS SETBACK SYSTEM TO P/L JBLDG WELL LAKE /STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR Type Of System: UNIT Model Number: DISTRIBUTION SYSTEM Header /Manifold Distribution x Hole Size x Hole Spacing Vent to Air Intake Pipe(s) Length Dia Length Dia Spacing _7 SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only Depth Over Depth Over xx Depth of eded /Sodded Mulched Bed/Trench Center Bed/Trench Edges Topsoil xx Se E Yes 7��N.T_ l?,d Yes COMMENTS: (Include code discrepencies persons present, etc.) Inspection #1: / / Inspection #2: ! / Location: 659 200th Avenue Somerset, WI 54025 (NW 1/4 NE 114 26 T31 R19W) NA Lot Parcel No: 26.31.19.352C 1.) Alt BM Description = 2.) Bldg sewer length = - amount of cover = Plan revision Required? n Yes [;] No I i i Use other side for additional information. SBD -6710 (R.3/97) Date Insepctor's Signature Cert. No. Wisconsin Department of Co mercRECEIVED S IL EVALUATION REPORT Division of Safety and Buildin s T Page of in accordance with omm 85, Wis. Adm. Code < ((]] Attach complete site plan o papeNniSt�less n`8 t7x 11 " ches in size. Plan must County include, but not limited to: rticalnd horizontal reference int (BM), direction and Parcel I. D. percent slope, scale or dim nsiort . (WW JIb'catio and distance to nearest road. ZUNING OFFICE j P ease print eviewe by Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). -7/ /1 2 Property Owner Property Location V J h-Lten) -Govt. Let- V 1/4 M[1/4 S Zz T , N R \ E or W i Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# Cih' State Zip Code one Number ❑ City [] Village ® Town Nearest Road Sor-1 t;�zS�T` w 1 I silo? s ( ❑ New Construction Use: ® Residential I Number of bedrooms -{ Code derived design flow rata S ) GPD 4 Q) Replacement ❑ Public or commercial - Describe: I t 6rJ FbiZ Parent material S I 1h P'(- Y! LL General comments Flood Plain elevation if applicable I`.111 ft and recommendations: �>� itif r X � ! Ll�► - �✓1pV I Z ��S � �£�- -} w 1 r� v M 6 OF Sfr ti-D F7 LL. f 1 3 c�T ►� 01=- • ��, o ' S ►JOTt Oav 6C Z) D Boring # ❑ Boring ® pit Ground surface elev. h 5 ft. Depth to limiting factor 3 S in. Soil Application Rate ' Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 3S -y - I' j `l (Z Yl Y Clk S' © vim tiv1 - 7 y i E Boring # ❑ Boring 140 1 ❑ pit Ground surface elev. � a -S ft. Depth to !inviting factor �t o in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft' in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 s� m-f>r cs z� 's .� �� t�� sib 3 s mom- �� v� s 3 i3 z-I lo`�l r� 31b — sL esbk w CS - , Z .3 zI -Uo 6 - S ca n� es - -S 19 ' Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BOD, < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) S! na a CST Number Arthur L. Wegerer 0 03 —ZbL 220254 Address W e g e r e r Soil Testing & Design Service Date Evaluation Conducted Telephone Number 421 N. Hain St. River r'alls, UI 54022 715 - 425 - 0165 Property Owner N Parcel ID # O -) S V Page Z of 3 1- 7�1 Boring # E] Boring � ® pit Ground surface elev. 1 ft. Depth to limiting factor 3 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •Eff#2 1 0- l0-1 R- 3 !z s i I ZrY, S b� \ f� e S - Z� . s . C6 b-1 IZ3l (� S �I L�Shh rn� as 3')_L1 '.Sy CA 1 `IQ S ly _ �►1`� i = S Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Sotl Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •Eff#2 K am3T ' �`PsSS (�!-, F1 V-" s y Lo o IZCyv w L� 2 S 1 t'N w ► L L- s �-<- ►� v T1'1 P \Z UP O sD h'1 �Ut� n vv t l L 2 ' 3� F-1 Boring # Boring Ground surface elev. ❑ ❑ Pit . ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft' In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 •Eff#2 • Effluent #1 = BOD, > 30 < 220 mg /L and TSS >30 < 150 mg /L ' Effluent #2 = BOD < 30 mg /L and TSS < 30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608-266-3151 or TTY 608 -264 -8777. SBD -3330 (R. WOO) PLOT PLAN Page 3 of 3 Scr \L - 1 6 �q Zuo TN- FlUC . - ISO 6 S ync - p g.3 .1 ro s - - -- -- �, yyywC c�. z L �l� J i D 0 L) 3� 121� 4s'o� o) S �IM - 2 WU •D' Dtv 3U'r) DF S ?1IFI�> S11,)3N6: i _ a vL t - 7) 5 ) + ? 0) ZZQ)Zs CST Signature Date Sijoe6 Telephone No. CST # Safety and Buildings Division County N 20 W. Washington Ave., P.O. Box 7162 ,�j'TCrr��')C N* 61consin Madison, WI 53707 - 7162 Sanitary Permit Number (to be filled in by Co.) De artment of Commerce (608) 266 - 3131 '/3 v Sanitary Permit Application State Pl 1.> �"mber In accord with Comm 83.21, Wis. Adm. Code, personal information you provide N MAY be used for secondary purposes Privacy Law, si5.04(1)(m) Project dress (if different than mailing address) I. Application Information - Please Print All Informati n RE & a 60 -1-4 Property Owner's Na me l Parcel # .� G3Z— Block aE SFa 3 0 2003 l Cd�s Property ner's M ailing Address Property Location ZO%^ N OFi 10E ' City, State Zip Code Phone Number 'A,Section �G T- N; R A-7 (cir or cle one) II. Type of Building (check all that apply) - Xi or 2 Family Dwell ing - N of Bedrooms ` 57 Subdivision Name CSM Number ` ❑ Public /Commercial - Describe Use , ` ❑ State Owned - Describe se X Y ❑City ❑'V'illageIownship of /' III. Type of Permit: (Check only one ltkx on line A. Complete line B li pplicable) 3'X l A. .. ; New System Replacement S em ❑ Treatment/Holdin ank Replacement Only ❑Other Modification to Existing System B. Q Permit Renewal [] Permit Revision ❑ Change of ❑ Permit Transfer to New Prev' e u lbvdnd . jkjjAed Before Expiration Plumber Owner IV. Type of POWTS System: (Check all that a ppik Non - Pressurized In- Ground ❑ Mound > 24 in. of suilble soif ❑ Mound < 24 in of suitable soil ❑ At- Grade ❑ Single Pass Sand Filter ❑ Constructed Wetland ❑ Pressurized In -Grown It ] arils (] Peat Filter C] Aerobic Treatment Unit 13 Recirculating Sand Filter ' ❑ Recircula Synthetic Media Filter J Leac bomber YDrip Line-, ❑ Gravel -less Pipe Other (explain) V. Dispersal/Treatment Area Information: S A. „f e 7” zj _ Design Flow (gpd) Design Soil Application Ra (gpdsf) tapers uired (sf) Dispersal Area Proposed (at) System Elevation VI. Tank Info Capacity in Total tuber Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons Units Concrete Constructed Glass T Tanks G Septic or Holding Tank Aerobic Treatment Unit Dosing Chamber ✓� BGl'1 l VII: Res nsiW Statement- 1, thi undjAigned, assume responsibility for at of the POWTS shown on the attached plans. Plumbe Na me (Print) Plu Z i S gna re P PPRSS umber Business Pho Number lJ�i �l �•GtJI'L �G( /xG LrI -1- / �l ✓ �.3a fi Plumber's Addre ss (Street, City, State, Zi ode)) , 1 ? .S m '7�' G� Ala VII ount /Ik arhnent Use Onl Approved 13 Disapproved Sanitary Permit Pee (includes Groundwater Date Osued wing Ag nt Signatur Stamps) Surcharge Fee) �7 crz) / (� ❑ Owner Given Re ason for Denial �f c? IX. Conditions of Approval/Reasons r Disapproval ( G� � TEM OWNER: p 1 Sep i t�h 0 dispersal cell must all be serviced / maintained as per management plan provided by plumber. 414 � 2. All setback requirements must be maintained /, s as per applicable code /ordinances �"D - 1`t ��° / VS \ - C , 3, c l 3- ( - G� ,do car uk.Q.O u&c �C ,�q � r �to� a uatp o 1 for the on page not less than 8U2 x 11 l to D�6398 (R. Ol /�3} G `5( i�d �l S�S n ✓� y W kA tN Q Zil -- � /00 o ti a 9 o MI y h 4 a 1 ka ," /Jt We u Ewa o z 9D 3 la G rr-e--Cke s � IZA 5 /s�T.��vGlasir� ��a� ,�edS U1 ° � 1 .ley al 1 NO U rage ui SEPTIC TANK & PUMP CHAMBER CROSS SECTION AND SPECIFICATIONS 4" CI VENT PIPE 12" MIN. ABOVE GRADE & WEATHERPROOF 25' FROM DOOR, WINDOW OR JUNCTION BOX APPROVED FRESH AIR INTAKE V WITH CONDUIT MANHOLE COVER W1 PADLOCK & FINISHED GRADE WARNING LABEL 4" CI RISER � y 4 r _-4" MIN. 18" IN. 6 MAX. l I L INLET I ' WATER TIGHT SEALS GAS- ' TIGHT i \/APPROVED A SEAL JOINTS WITH tPPROVED �— ALM APPROVED PIPE 'IPE 3' B ON 3' ONTO INTO SOLID � ' � SOLID SOIL ;OIL PUMP OFF ELEV . FT. _+_ I ' OFF '''' RISER EXIT D PERMITTED ONLY IF TANK MANUFACTURER HAS APPROVAL 3 APPROVED BEDDING UNDER TANK CONCRETE PAD SPECIFICATIONS SEPTIC / DOSE TANK MANUFACTURER NUMBER DOSES PER DAY: TANK SIZES SEPTIC 125 GAL. DOSE VOLUME INCLUDING DOSE t fed GAL. FLOWBACK: 157, 7.Z GAL. ALARM MANUFACTURER: ,CGUc / CAPACITIES: A = ZZ INCHES = �°Z GAL. MODEL NUMBER: ' PL v SWITCH TYPE: B = 2 INCHES GAL. PUMP MANUFACTURER: GaezIX -5 C = S INCHES = jG8 GAL. MODEL NUMBER: SWITCH TYPE: _hjep-e - D = INCHES REQUIRED DISCHARGE RATE 3,1 GPM PUMP & ALARM WIRING AS PER ILHR 16.23 WAC VERTICAL DIFFERENCE BETWEEN PUMP OFF AND DISTRIBUTION PIPE 12 FEET + MINIMUM NETWORK SUPPLY PRESSURE . . . . . . . . . . . . - 3� r FEET + ,23a FEET FORCEMAIN X L FT /100 FT. FRICTION FACTOR _ FEET TOTAL DYNAMIC HEAD FEET INTERNAL DIMENSIONS OF PUMP TANK: LENGTH ; WIDTH ; DIAMETER LIQUID E TH � — , a SIGNED: i1'� �- -- LICENSE NUMBER: Q DATE: _ yly 03 1/88 08/0212003 11:40 17154256BE4 WEGERER SOIL TESTING PAGE 09 Go ulds i-Y�s - 7 cF Submersible Effluent Pump EPO4 �= 387 EP05 AlaPI MONS • Fasteners: 300 series • Ful! subm tNess steel. y Q1 high ■ Moir Howirrp: Cast iron sta SpecikWly designed for the grade turbine oil for for efficient heat transfer, following uses: • Noble of running lubrication and Gwent strength, and duraWity. • Effluent dry wkhout da • Homes s components_ damage to heat transfer. ■ Motor Corer Thermoplas- • burns Motor. Arallabis for aufoesatic and tic cover with fntegraf handle ' Heavy duty sump ' EPO4 Suutt�gle base 0.4 HP, marwal operatlaa. Autametic 'and float oft atfaehment • Watertransfer 115 or V, so HZ, 1650' R include Maftaicai Points. • oe**dng RPM, built in overload with Float SwltCh assembled and ■ POW Cable; Severe duty automatic reset. Pf" d the factory. rated 08 and water resistant. SPENWATIONS • EP05 Single phase: o.5 HP, ■ l3eariaEa: Upper and lower lhrmp: EPO4 115 V. W H% 1550 RPM, FEATURES heavy duty ball bearing bulk in overload with construction. • Solids handling capability: automatic reset • EPO4 lmPeller. Thermo. '14 maximum. . Power cord: 10 foot A$* Semkp de sign AGENCY LISTING J) • Capacities: up to 55 GPM. standard length, l6/3 SJTO mac p ump out van protec , TOW Otal heads: up to 24 teat. With three Prong grounding 9 c=ft ednrrdeAu=Wu Discharge size: We NPT. ' plug. Options[ 20 foot ■ EM Imppeeller. Thermo- • MediankW seal: carbon- lenp,1613 SJTW with plastic enclond design for (CSA listed model numbers A stationary, three Prong grounding plug improved pedormdnce, end in T or'ACn,) BUNA -N e[astomem. (standard on EP05), ■ Caskq and Base: Rugged • 104 40 e: thermoplastic design provk* (60•C) Inter 140•F (� inter ften mittent %periorstrength and corrosion realshm. • Fasteners: 300 somas alarms FMT stainless stall. 10 • Capable of running � darltege dBrnaQC t0 p 30 I Pump: EP05 • Solids handling capabbky; 25 ; u 'Y rrra�dm rrt. W 7 ...t. � i • Capacities. up to 60 GPM. _ , Total heeds: up to 31 feet. `� s 20 ' Dfecherpe size 1W NPT, d 8 . Mecttat ew set carbon- ary Y ; s E 1c "on, BU" elastionrers. K 4 ! i 1�4 m. 3 10 (40 continuous , 140•F (8tt•L`) kdermittent. 2 s ` 1 • 0 0 10 0 2 4 E a 10 12 nwr CAPAWY . C low acuiae IPUnm I na. Wisoorin Department of Commerce SOIL EVALUATION REPORT Page A'D T)ivWo of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must County C 1 �� ) include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel LD, percent slope, scale or dimensions, north perew; ar d4ocatkmand.datala" nearest road. 0 3 2- _ l U / -7 .A — 9 —606 Please piintiall infidrMatlan.' } eview Date i Personal information you provide may be use for secondary purposes (Privacy Law, a 15.14 (1) (m)). iyl. �� 1 v 3 U3 Property Owner ) - ; ft ; ,y Property Location Fl �! ovt. Lot ,J/4 A S � T 3 l N Rj E (or W Property Owner's Mailing Address of # Block # Subd. Name or CSM# c� 4C9& city State Zip Code Phone Number ❑ City ❑ Village Town Nearest Road Q / - 3.s92 s�,�� c�c�o Af,� ❑ New Construction Us Residential I Number of bedroom L Code derived design flow rate GPD EZ( Replaoement ❑ Public r commercial - Describe: Parent material Flood Plain elevation if applicable A, ft. General comments and recommendations-_!5,'k' � 5 �Yc" 9� ; 0 _.k - 'n r C El V Boring # ❑ Boring �,gy� Pit Ground surface elevf ft. pepth 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. Sz. Sh. •Eff#1 •Eff#2 i Boring # Boring /� ® Z Pit Ground surface elev,/�ft. Depth to limiting factor in• Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDAf in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 •Eff#2 • Effluent #1 = BOO > 30 1 220 mg/L and TSS >30 < 150 mglL 'Effluent #2 = BOD < 30 mg/l and TSS < 30 mglL CST dame (Please Print) Signatu2V CST Number Bird Plumbing, Inc. Shaun Bird 226900 Address Date Evaluation Conducted Telephone Number 1008 192nd Ave, New Richmond, WI 54017 ��- 715 -246 -4516 i _ Property Owner _ Parcel ID # Page of © 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. Sz. Sh. •Eff#1 •Eff#2 I M F-1 Boring # C] 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 GPDM in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •Eff#2 Boring # El Boring C1 Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate. Horizon Depth Dominant Color Redox Description. Texture Structure Consistence Boundary Roots GPDM in. Munsell Qu. Sz. Cont. Color Gr, Sz. Sh. 'Eff#1 I •Eff#2 = < > < _ < < • Effluent 1 OD. > 30 220 and TSS 30 150 Effluent #2 BOD 30 and TSS 30 E uent # B _ mglL _ mglL s _ rn9� _ mg(L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or i need material in an alternate format, please contact the department at 608- 266 -3151 or TTY 608 -264 -8777. SOD-9330(RAW) l i Soil Test Plot P j un�B Project Name Jay Kern d Aildress 659 200th Ave Somerset Wi 54025 TM #226900 Lot - ---- Subdivision - ------ Da 6121/03 NW 1/4 NE 1/4S 26 T 31 N /R19 W Township Somerset [] Boring Q Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 100 ft. Bottom of shed siding System Elevation 96.2/96.1/96.0 *HRpSame as Benchmark Alt. BM Base of Shed @ 99.0' Failed drainfield 50' 15' 40 Scale is 1" = 40' a B _ 4 unless otherwise o B -4 has mottles present at 40" T noted 40' 0' Existin 5 30' bedroo 30' Well 50 , house 90' Shed Area of Soil not suitable for Septic Alt. system 30' .M. 0' B.M. Id 30' 1 20 , B -2 25 , 50' Tested area has 0% Slope 25' 45' B -3 15' 200th Ave B -1 ST CROIX COUNTY SEPTIC TANK MAINTEN&NCE AQREE<bEN AND OWNERSHIP MTIFICATION. FMM Owner/Buyer Meiling Address tQ Z Af P � as Addce _ - - - - – (Vaificatiaa w pined f mm P� Deptmnene fat new aotemuatfon) City/stste I AL6 aml Id4otifteAtiort NVMW 2�: UGAL nLscw= oh _ • 35�� C_ Property L4000A AW Y,, A, Sec. T �r N-R-ZY—'W', 'r0VM of Sumvisitm ,_,,,,_,,,,, Lot # �. Certi!' w Survey Map # Volume .�_._ ,._s PASO # w atirrtmty nod # 7'7 .�.,..�� , - ., Volume ....a; , Page # Spec. haute C2 Yee 4 no Lot lines ida dfi*l * YCS M no lrpgW Nee swd msbtauw,ea of y#ur opti b oonid rasnit in tts psemsjm Q Owe le hMWj*& wWtu. Frapar rbiitlemArca Consists of ptt aft art do up& tnk awry three years or awe, if Deeded by s awowd Fnaipar. Who you pals into 60 syitesn Celt 4ffbd dw 1WVAW of ttbr ieptw trek U a ftatment rthp its tale *"to diROW FOUM TkLr paopway %waC Wm to wbMit to St. 0mr, ZMM9 DqWMW a Cafteum &m aptd by taxi oww cad by a mum b i 1►tustibsot, Wftidwaphulbov or a UMM"d ptstnpec vsru�flrj One (1) aw ovate -*dUWx*K sal t}'itmn i9 in proper opmdog ammidon and/or (1) after hupctiou ad pumping (if nwftffi o p1 dA »ptic tank is teen dw 1 11Ai of rlWF. VWt, %be nodam4p +d am read the abom LegairaAaats and We to ttrslatria to p: M to sawap disposal sysum welts the need* set faith, burin, u stn by else Depls'L IM of OMMMM cad 9M Dcp ut tat of NAeuati Ruattroes, Bate of Sii tsaaasia CncttillCtltto1 . ststmg that yanr apt a system hue been ttuitkairtW mart be cornpl#W aad roMmed to the St, CION COMV Zt Or= 1 4 6 M 10 daysfB does year expt den. r of ATUM OF APPUCANr DATE QAMR 0RTIF"IMIN I (wo) oe# * that aA etstsmemts on this foe's &= true to tke best of ; (Wx) ksmwJr *G4 1 (Nn) ten (M) tbb erovnot(s) Of taro prop duarA" sbove w a of a tvstmwy deed rmordrd in Regisw of Duds Of o, ZEN A15nu OF APPLICANT DATE * * ** ** AAy i6mution beset is mis- reptaso ird may reeatt in tho ssaitary permit beit:g revoked by the Zastiati Depurtmettt "�'•' � *• Issctssde with thin appiieatten: a stamped warranty dtsd from tht Rejistar of 1)eeds offiat r copy of uses ctrl fled surrey mip if refemco is made in the wuraaty dead n Wcoj. €o& sz ' IFI£98£514 : TN XUA vcdA U 2420P 524 - 7-4.151Q lL STATE BAR OF WISCONSIN FORM 2 - 1999 KATHLEEN H WALSH WARRANTY DEED REGISTER OF DEEDS Document Number ST. CROIX CO., WI RECEIVED FOR RECORD This Deed, made between Judd L. Cates, a single person, and Shawn M. Svendsen and Randy Svendsen, wife and husband, _ 09126/2083 89:38AH r WARRANTY DEED EXEMPT N Grantor, and Jay Kern and De nise R Kern. REC FEE: 11.00 Husband and Wife TRANS FEE: 741.80 COPY FEE: CC FEE: PAGES: AGES: 1 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): Recording Area The E1 /2 of W1 /2 ofNWI /4 ofNEI /4 of Section 26, Township 31 N orth, Name and Return Address ` Range 19 West, St. Croix County, Wisconsin. LA++ TITLE, !me. C/ C TE 4 Together with a permanent easement for ingress and egress over the East 30 t. .. _ . ICt, e ; 0 feet of North 750 feet of the W 1 /2 of W 1/2 of Sri 1/4 of NE 1/4 of Section 0 `Tr 192 1 f;1Z NO. 26- 31 -19, St. Croix County, Wisconsin. U� 002 - 1 072 -50 -000 P/ _ d 2 Par en ► tcation Number (PIN) This is homestead property. (is) MOO Exceptions to warranties: Easements, restrictions and rights -of -way of record, if any. Dated this day of March , 2003 • Ju L. Cates Shaeq M. Svendse + + Randy Svendse AUTHENTICATION ACKNOWLEDGMENT Signature(s) J udd L. Cates, a single person, and Shawn M. STATE OF WISCONSIN ) Svendsen and Randy Svendsen, wife and husband, ) ss. County ) authenticated 4s day of March 2003 Personally came before me this day of the above named • Kristina Ogland — TITLE: MEMBER STATE BAR OF WISCONSIN (If not, to me known to be the person(s) who executed the foregoing authorized by § 706.06, W is. Stats.) instrument and acknowledged the same. THIS INSTRUMENT WAS DRAFTED BY + Attorney Kristina Ogland Notary Public, State of Wisconsin Hudson, W1 54016 My Commission is permanent. (If not, state expiration date: (Signatures may be authenticated or acknowledged. Both are not necessary.) , ) • Names of persons signing in any capacity must be typed or printed below their signature. Information Professionals company, Fora du Lac, VN WARRANTY DEED STATE BAR OF WISCONSIN 800655 -2021 FORM No. 2 - 1999 GENERAL ST. CROIX COUNTY, WISCONSIN OLD TXSCR01 LE.�IAII`— ���te OF:N COMPUTER NUMBER 0 umber 26.31.19.352C GT�1T� -ce OWNER NAM E: First JUDD L Last CATES CO -OWNER SVENDSEN SHAWN M Mailing Address 659 200TH AVE City SOMERSET State WI Zip 54025 - Type Vol Page Doc # Rec.Date Type Vol Page Doc # Rec.Date HISTORY WD 1730/ 45 658032 10/02/2001 961/343 07/23/1997 PROPERTY ADDRESS: Hse # 1/2 PD -- Street Name- Type SD Apartment Post Office 659 200TH AVE School District: 5432 - SCH D OF SOMERSET Special District: (1) 1700 - (2) - (3) - W ITC Plat Code: Last Changed on: 10/05/2001 Book Number: 1 SECTION 26 TOWN 31N RANGE 19W '/.160 '/.40 Map Number: 00 - Sales Area: Parcel Control 0 TAXABLE Number of Units: ZONING: Permit Number: Type: Bank Numbers: 174 -Prev, F5 -Next, F6- Legal, F7- Value, F8- History, F10 -Exit, F12 -More GENERAL ST. CROIX COUNTY, WISCONSIN OLD TXSCR01 REAL ESTATE TOWN OF BALDWIN COMPUTER NUMBER 002 - 072 -50 -000 Parcel Nu er 29.29.16.435A Claimed Date Re- certified 04 /2001 Relate Num r: OWNER NAME: First Last LUC ALDT AGRICULTURE CO -OWN INC Mailing Address 2606 CTY RD D City WOODVILLE State Zip 54028 - Type Vol Page Doc # Rec.D Typ Vol Page Doc # Rec.Date HISTORY ALC 1412/ 636 59993 03/23/199 C 14001403 596932 02/02/1998 PROPERTY ADDRESS: Hse # 1/2 PD -- Street N e- Type SD Apa ent Post Office School District: 231 - B DWIN- WOODVILLE AREA Special District: (1) 170 - (2) - (3) - WITC i Plat Code: Last Changed on: 05/25/1999 Book N ber: 1 SECTION 29 TOWN 29N RANGE 16W '/4160 1 /440 Map N mber: 00 - Sales Area: Parcel Control 0 TAXABLE Number of Units: ZONING: Permit Number: Type: Bank Numbers: F4 -Prev F5-Next, F6-Legal, F7-Value, F -H's F10 -Exit F12 -More t, g 8 i tory, , Il • t f '.TNPLAT T -31- • _1 N - R20 19 W �1 f m : POLK CO. See Page 112 For Additional Names. i 400 POLK/ST CROIX RD 500 600 700 800 I 1 S arence ^ ,0 3 David uyayR tr & FIrAw- < "Bork " 3 3 & � 00 Deeg Morten Pioneer Peterson Haa m 17 std 'Demul- 32 c x - 58 35 : IR 9 ^ r � 3z 41 4! o '� Farm Inc g FInc � Darlene 1 Gerald & 41 4o ittiow 45 35 2 > Iennifer t� _ ard � Lav- -' 167 Willi C W&M 20 to a U 00 a°o I i �? is n Haase tr c S 7 3�` 154 Mww P. t �-- 232nd 8 M 24 1 Chas & Tr $"t' 294 AVE ' a Cro Mary 117 11 t1 ^� it 10 ' 46 h & Bull 72 Susan 230th AVE 3 rr 40 r 21 x iralser ' 04Z WK � B JR CM Uj H E tl N bv C M-9.14 v 41 14 1 C &M 0 0 m ° Mary $ 40 s� 40 a tr Trhistr Fam4y 10 ebroct s _I ink uao braudt r` 1 e i 16 1 I E ° T ro A�orothy t1 ume N 40 R 40 ainn INE 4s 8 r a A Martin `-I-> -•r` 72 o s o J & a 20 K Davld & Gregory s ` so 40 3 Martin y , Gt 3 Sc�a Plourde I 35 1 i 6 °w 81 114 chard Elaine .: s edri. S0 it r AVE d Family LP Plourde Mildred j Trust i L 20 74 dtS 34 __ __ ._ 151 160 I 80 I I g ] �tr oara6 10 Walsh )Coact 3t < w x 4 R Sharon ¢ v Banner °n a L f h. O g Sehach el Trust A � ' Family 40 70 ki 10 Gam° 440 q1 50 Q I ro iv 216th zt t a DO°°s 0 1 Ps & Michael I y AVE " w ` 0 R 1 ax s 4 Germain y tr 3 20 2711 " ytr 3 1 Ng Luis & ' Ga d n h I 215th AVE 50 3 �I e urrry V ton M cones M & G 51 as Thomas a 79 T N O 16 rro 20- Man W Inc 150 & asY 20 LN aJeaa renaan Robert ° tr Cook David Richard & � letvin � w►rlyd- Martell 2 E m • c LE Carufel tr Sharon• 40 40 1 CW 7 9 etal 80 116 c_ m 85 G 80 tr ro t 1! 10 2� r M b V 3 3 210th AVE Walter & t tr eM $ a Ch G M b rt tr ejl Donald & Debra v� 141 Fra� Germain D� & , CarufelF T Louis Otto aadaai 160 Rivard H n Riv 40I Yruct S r 156 205th AVE 2 80 tr 1a tr oOF+ 55 s 2 , O a u z wiclCe N x &J 9 4 $ „� $ Damts n D ' rL y o R 4 44 Neuni nn 8; s s anasse0 ^ " _^ � Louis & 16 L r Maw i 19 Lorraine 23 c 14 U tr` Belisle tr && Lin & o th AVE o & I � oo � g .+ V u 1 a a6 i� of e "' m 4 z � TM 8 v Neumann 91 4! Cliff " us El Ear izabeth JUZky 40 1� 40 Partriership x x o ` ` tr 37 & rah James 2 T 6 Mart a Pm 1i Neumann 159 ���, Fsa e9er I'l Avg: 4 1 � 192nd C° L 40 ._.....� P Sampalr J - s Z 6 Nil, 80 aac Vir ginia 99 Dana At uada tr to 3 s s s iEaaine & Lawson Donald tr & Lisa &C 24 F n Martin- 7 17 Trust ti Martell ^ Gams M' B e -- _ _ (�1 �xn 40 101 49 ehl 49 40 40 C Bernard nn �_ ' a DM 0 "° �- # O Mauro i Louise w v Belisle �- Iva &K 11 40 0 ev p M 11 i / " e k rSamud ` C arol 13 tr I Kelley M!S 10 BBelisle I 4t k 40 0 10 AVF 65 _ �� u h •' t a i . k ",� " 1 j " V Z Q'iii 38 ST t s AVEd tl JKR ( a LL C 11 1 10 S 6 M Of Joseph maser f Q omerset 50 v argo 33 115 tr 41 tr .. ............ e I : / 1801h AVE 180th AVE ` SOMERSET'S' PAGE 62