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HomeMy WebLinkAbout034-1007-60-000 o■ o s o o CD » g I � 0 0 °- o Cl) 2° Z g co o $ % \ - ��� �� � Ul-4 \ # i R 2 » 6 ■ CL U) / ! S / g, C4 OR © $ > CL _ / 0 § \ \ § $ � 0 �- E Z T T o ` 00 o f Oro 2 z }� 7 f $ G) § co E > o � 0 7 [ ' � 3 ƒ CD � g § 3 CD -4 CO2 k § 9 E .. « CD CD a § ? \ ^ § F 7 � 7 I 2 7 § � 7 % $ � � @ ; ƒ � § � R \ � � � ■ o w < § 0 � \� �\ Owner: Novotny, Mike Computer #: 034 - 1007 -60 -000 Address: 1183290th St. Parcel #: 04.29.15.54A Glenwood City, WI 54013 Municipality: Springfield Township Address: 1183 290th St. Glenwood City, WI 54013 0811412002 3735 Jon Sonnentag This individual stated that the alleged violator is living out of a RV unit without a septic system. They believe that they might be dumping their waste into a hole on the property. 0812812002 Unknown, Unknown Jon Sonnentag On -site - took photos. It appears that the trailerhome is being used for temporary occupancy. 0910412002 Benson, Vicky Jon Sonnentag She left a message that Mr. Novotny did come in to renew his pole shed permit, but they were unaware of any other structure out there. It was there understanding that he wasn't going to build for another year. 0910412002 Benson, Vicky Jon Sonnentag Left a message for her to return my call. 0911112002 Novotny, Mike Rod Eslinger Mr. Novotny spoke with Rod. He will remove the trailer by Monday and get us something in writing. He may look at applying for a temporary occupancy permit, but it won't be until next spring. 0912512002 Unknown, Unknown Jon Sonnentag I was on -site and observed that the trailer was moved, but it still appears to be utilized for living quarters. The trailer is set up level, there is a generator attached, and he has 4 calves in a pen. 1010212002 Novotny, Mike Jon Sonnentag Mr. Novotny came in, but I wasn't around. He spoke with Judy and gave her an address of 1183 290th St. and a cell phone number of 715 - 377 -6965. He wouldn't really say where he was living. 1010812002 Novotny, Mike Jon Sonnentag Left a message for him to return my call. 11/08/2002 Novotny, Mike Jon Sonnentag Could not make a phone connection. 1111312002 Smith, Gale Jon Sonnentag I left a message for him to return my call. 11/13/2002 Novotny, Mike Jon Sonnentag He explained that he does not live in the RV unit on this property. However, he does use that property for his mailing address. He is a truck driver and is not usually around, but when he is in the area he will stay with his girlfriend (Deb ?) in Hudson or with his son Ben in Downing at 606 Wilson St. They help feed the calves that are currently on the property. He has Gale Smith looking into locating a suitable septic system. He wants to build a pole shed /shop and then his son from Rochester might move up and put a mobile home unit on the property. 1111412002 Smith, Gale Jon Sonnentag He said he will be getting out there to complete the soil test as soon as they get the corn off the field. He will then send plans down to the state, but he might run short of time because he will be heading down south on vacation. 0713112003 Novotny, Mike Jon Sonnentag Mike came in to determine what additional information we needed before the septic permit could be issued. We worked on a document that he signed explaining that he doesn't use the structure for temporary occupancy. Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety at 1 Buiidng Division Sanitary Permit No: INSPECTION REPORT 429994 0 GENERAL INFORMATIJIN (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: Novotny, Mike Springfield Townshi 034 - 1007 -60 -000 CST BM Elev: Insp. BM Elev: T Description: Section/Town /Range /Map No: CST BM Elev: Insp. BM Elev: 04.29.15.54A TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark Dosing Alt. BM Aeration Bldg. Sewer Holding St/Ht Inlet TANK SETBACK INFORMATION St/Ht Outlet 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 I F SOIL ABSORPTION SYSTEM BED /TRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS SETBACK SYSTEM TO P/L BLDG 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 SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only Depth Over fDepth Over xx Depth of xx Seeded /Sodded xx Mulched Bed/Trench Center Bed /Trench Edges Topsoil -1 Yes n No Yes No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / / Inspection #2: Location: 1183 290th St. Glenwood City, WI 54013 (NW 1/4 NW 1/4 4 T29N R1 5W) NA Lot 3 Parcel No: 04.29.15.54A 1.) Alt BM Description = 2.) Bldg sewer length = - amount of cover = 3.) Contour = Plan revision Required? Yes No } �I Use other side for additional information. SBD -6710 (R.3/97) Date Insepctor's Signature Cert. No. A Sanitary Permit Application Safety & Buildings Division In accord with Comm 83.21. Wis. Adm. Code 201 W. Washington Ave. See reverse side for instructions for completing this application PO Box 7302 1 4s COnSin . Personal information you provide may be used for secondary purposes Madison. WI 53707 -730^ Department of Commerce [Privacy Law, s. 15.04(1)(m)] (Submit completed form to county if r state owner Attach complete plans (to the count) copy only) for the system. on paper not less than 8 -1/2 x 1 I inches in size. County State Sanitary Permit N ber ❑ Check if revision to previous application State Plan 1. D. Number ST tx z999 8 229 - 3 =!^mss /d I. Application Information - Please Print all Informatio Location: Property Owner Name Property Location gel - Nailo 7` MAY 1 9 2003 N 4)1/4 /V41i 1/4, s T;ZY N. W Property Owner's Mailing Address Lot Number Block Number ST. CROIX COUNTY City, State , Z / ip Code Subdwieeerr br CSM Number I){ Type of Building: (c eck one) ❑ City CV- 3510 1 or 2 Family Dwelling —No. of Bedrooms e /o( rR o.1s 0Town Villag L3 Public /Commercial (describe use): of ❑ State -owned III Type of Permit: (Check only one box on line A. Check box on line B if applicable) Nearest Road O L s � A) 1. XNew System 1 2. ❑ Replacement 3. ❑ Replacement of 4. ❑ Addition to Parcel Tax Number(s) /,/ .Si(> System Tank Only Existing System �,� l ®O 9 ®Q — Ci e B) Permit Number Date Issued ❑ A Sanitary Permit was previously issued IV. Type of POWT System: (Check all that apply) G 2 T Scram Ste° • Non - pressurized In - g and r f(Mound ❑ Sand Filter ❑ Constructed Wetland • Pressurized In- grounC�,�., 11 '�) ❑ Holding Tank ❑ Single Pass ❑ Drip Line • At -grade , ❑ Aerobic Treatment Unit Recircull ing ❑ Other: is V,&e w %�� `t = I •O& x `` 9a.n� • Dispersal/Treatment Area Information: 1. Design Flow (gpd) 2. DispersalArea 3. Dispersal Area 4. Soil Application 5. Percolation Rate 6. System Elevation 7. Final Grade Required Proposed Rate (Gals. /day /sq. ft.) (Min. /inch) Elevation VI Tank Capacity in Total # of Manufacturer Prefab Site Steel Fiber- Plastic Information Gallons Gallons Tanks Con- Con- glass New Existing crete structed Tanks Tanks VII Responsibility Statement I, the undersigned, assume res on ibility for installation of the POWTS shown on the attached plans. Plumber's Name (print) Plumbe 's Signature (n ps)� MP V0. Business Phone Number Plumber's Address (Street, City, State, Zip Code) VIII County/Department Use Only ❑ Disapproved Sanitary Permit Fee (Includes Groundwater Date Issued Issu' g Agent Signature o stamps) KApproved ❑ Owner Given Initial Adverse Surcharge Fee) ? I ffi m, Determination J IX. Conditions of Approval /Reasons for Disappr /aril C'&) Qc.- ✓v+uo� 2� +n^au �7 f a� -� Ea-l.l �(�►�q �e.t, ; mss a...� ,�.,w� � .�l.t,�,�r � Pzc- cam. SBD -6398 (R. 07/00) I IN ■ /�'.�i ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■� ■ ■ ■■ ■fill ■NN ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■N ■ ■ ■ ■ ■ ■ ■�1�. MOE■ E ■■■■■ ■E■■NN ■NEE ■ ■■■ ■ EEE►�►�►'�N�N ■■■■■■■■■■■■■■■■■■■ ■M■■■■ .�■ ■1i■ W U ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■I /NOON■ ■r ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■■ ■NINE ■ ■I ■ ■ ■ ■ ■■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■If�L� ■SIN■ ■NONE ■■ iiiii�ii ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■!! ■�!!O ■ ■EEE■■ /J1.�! ■ ■!n ■ ■ ■ ■ ■ ■ ■ ■ ■ ■NEN■ ■NON■■■ �'J_ ■"E .. '!omEE ■ ■■■■■■ ■E■■ ■■■■■OE /n/% r!!mn ■■■■ ■NNN ■E■ENEENNE■■E■E i Safety and Buildings / 10541N RANCH ROAD HAYWARD WI 54843 TD #: (608) 264 -8777 erc *ihsconsin www www.comm .wis c ons .wisonsin.gov Department of Commerce Scott McCallum, Governor Philip Edw. Albert, Secretary December 30 2002 RECEIVED CUST ID No.222234 ATTN.- POWTS Inspector MAY 19 2003 ZONING OFFICE ST. CROIX COUNTY G ALE-W-SMITH ST CROIX COUNTY SPIA ZO NING OFFIC 3228 HWY 170 1101 CARMICHAEL RD GLENWOOD CITY WI 54013 HUDSON WI 54016 CONDITIONAL APPROVAL Identification Numbers PLAN APPROVAL EXPIRES: 12/30/2004 Transaction ID No. 822973 SITE: Site ID No. 654335 ichael Novotny Please refer to both identification numbers, M is el 29 0TH St above, in all correspondence with the agency. Town of Springfield, 54013 St Croix County NW 1/4, NW 1/4, S4, T29N, R15W FOR: New mound, 600 GPD Object Type: POWT System Regulated Object ID No.: 885776 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 �I 3 ;� chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. A The following conditions shall be met during construction or installation and prior to occupancy or use: p TI pl a n��f General Approval Conditions: • This system is to be constructed and located in accordance with the enclosed approved plans and with the ' "Mound Component Manual for Septic Tank Effluent for Private Onsite Wastewater Systems" SBD- 10691 -P SEE C ( N.01 /01) and the "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems" SBD- 10706 -P (N.01 101). • In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approved plans. In addition, the owner must insure that the operation, maintenance and monitoring duties as described in section VIII of the mound component manual are complied with. A copy of this information must be given to the owner upon completion of the project. Note • Complete the contingency plan portion of the owner's manual prior to providing the owner with his copy. • The proposed pump is near its limit with the proposed total dynamic head. If upon installation, the total dynamic head increases, the proposed pump must be reevaluated and may be inadequate. • The designer proposes to install a state approved effluent filter to achieve the requirement of wastewater particle size. Pursuant to outlet filter product approval stipulations, maintenance information must be given to the owner of the POWTS explaining that periodic cleaning of the effluent filter is required. The access opening used to service the filter shall terminate at or above finished grade with a watertight cover. Reminder • The orientation of the mound system must be such that the longest dimension is oriented along the surface contour per COMM 83.44(6)(a)2. • Limit activities in the area 15' beyond the down slope edge of the mound per Mound Component Manual. GALE W SMTI'H Page 2 12/30/02 • Surface water drainage shall be diverted away from the system area per Mound Component Manual. • Materials shall conform to the requirements of COMM 84. • Maintain well and waterline set backs per COMM 83.43(8)(i). Consult the Department of Natural Resources for well setbacks and exceptions to the setbacks. • Insulate building sewer per COMM 82.30(11)(c). A copy of the approved plans, specifications and this letter shall be on -site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of construction /installation/operation. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter to the owner and any others who are responsible for the installation, operation intenance of the POWTS. Sincerely, Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 J , Patricia L Shandorf POWTS Plan Reviewer, Integral ervices WtSMART code: 763,E (715) 634 -7810, Fax: (715) 634-5150, M -F 7:45 am - 4:30 pm pshandorf@commerce.state.wi.us cc: Leroy G Jansky , Wastewater Specialist, (715) 726 -2544 MOUND SYSTEM DESIGN Residential Application INDEX AND TITLE SHEET ( Ile, '15 - A( , O) - 30 O Project " Owner / L /l 6J L /V O I/ Q t!y Address �/ ,Q' ?I �heCl Gz' © d o/ Legal Description A/ //L), 57 Township S;D�7%N� �jL a / County Subdivision Name "'— Lot No. Parcel ID Number (,��1� - �QQ �Q ©�' :),W.T.S. �litionally Plan Transaction Number �'�s2 � �,•� IENTO mMERC Index and ti tle sheet Page 1 D INGS Mound calculations Page 2 Mound drawings Page 3 N Pres. dist. cs and cal laterals a Is Pa 9 e 4 TDH and pump tank drawing Page 5 Pump curve Page 6 ' z 7 c 7-3 Site plan Page 7 Soil test (a,b,& c of page 8) Page 8 Designe License Number '2- - )t- Signature s � `mil ,,�,�,- Phone No. ,17 /� - Date Notice: Tampering with this file by unauthorized persons is prohibited. Deliberate modification will result in disciplinary action under s. 145.10, Wis. Stats. Personal information you provide may be used for secondary purposes (Privacy Law, s.15.04 (1)(m)]. r Paged -r4f Straw, Morsh Hoy, Or Synthetic Covering Distribution Pipe Medium Sand G Topsoil F �J E � D b Slope Bed Of - - 2 z ( Force Main 1'tovred Aggregate From [lump l aycr Cross SeCtion Of A Mound Systern Using E / A Red For f he !',t, sorption Arc r, G A � i" t H Signed g F r. License Number: S Ft. J "3 rt [) dtC: K c 7 , IS F i✓ t . L /053 Fr. V F"t — pt�S�r�afion Pipe, of • ( Force Main W From Pu E3ed Of � z 2 Pipe Aggregate Observotion Pipe Flerrnonent Morkers Pion View Of Mound Using A tied For The Absorldlun Areo Page Of Perforated Pipe Detail P End View eF{ Fs PV4 PiNe e� Side of cell 1s t D Force Main PVC Inspection box IN / Holes located on bottom of force main are equally spaced Last hole should be next to - typical long sweep e11 with; valve or cap Distrihutation pipe layout Up R Inches Invert Elevation of Laterals Ft S l Inches X4 �I nche s Signed t Y Inches License: Hole Diameter � Inches Dates Lateral " /, Inches Manifold " J, Inches �f? GPM Discharge rate per lateral Force Main Inches # of holes/pipe b # of laterals r - Page S� 4- COMBINATION SEPTIC TANK /PUMP CHAMBER (No Scale) 4" CI Vent Pipe with Approved Locking Manhole Cover Approved Cap, +25' From Buildings W th Warning Label Attached Weatherproof Approved _ Junction Box Vent Cap - -� ` " 12" Minimum Final Grade -.s,, 6 Minimum 4" Minimum ' Quick 18" Minimum I Disconnect 1/4" Weep ' Hole Baffle:;' - .06 eL• ' • A j,4 7V R ' Alarm B On i C *APPROVED Off 17 JOINTS WITH APPROVED PIPE D 3' ONTO Conc. Block ' SOLID SOIL ' 3" of Beddinq Under Tank-/ Note: Pump and Alarm Are On Separate Circuits Number of Doses: ,� Per Day Gallons Per Day /i oDoses: - /13 Gallons ' kVolume of Backflow: ........ _� _ Gallons s Tank Manufacturer: 101' � e _ Total Dose Volume:........: l % Gallons Tank Size - Septic /Pump: G all ons Al arm Manufacturer: S ,3' ) � ect fR a Model Number: /0 / ff Gv Capacities: A' 3 inches or Gallons T + B nches or Gallons Ty Switch + C , inches or 1 Gallons Pump Manufac oy-/ d Model Number: 5 1'0 /-/ + D inches or C,�' Gallons Minimum Discharge Rate: a � �pM Total....._ inches o /7 ons Vertical Difference Between Pump Off and Distribution Pipe: L Feet Minimum Required Supply Pressure :....... ................... Feet ,'p Feet of Force Main x '2 ,o6 Friction Factor /100 Feet: + . Inch Diameter Force Main Total Dynamic Head: ... = Feet " i Internal Tank Dimensions: Length — Width F6 ; Liquid Depth Signature License Number _ ate VrcJ l DU"11" OUri - L Y IIAL 12 DUSTRiAI. RD, GOUIdS 4N, WI 54016 Submersible Effluent Pump '- MODEL C�7 3871 EPO4 EP05 APPLICATIONS • Fasteners: 300 series • Fully submerged in high ■ Moor Housing: Cast iron Specifically designed for the stainless steel, grade turbine oil for for efficient heal transfer, • Capable of running lubrication and efficient strength, and durability, fullowing uses without damage to heat transfer. • EIIluenl systems dry g a Motor Cover: Thermoplas components, tic cover with integral handle • Farms s Motor: Available for automatic and and float switch attachment • EPO4 Single h manual operation. Automatic • Heavy duty sump q phase: 0.4 HP. models include Mechanical points. • Water transfer 115 or 230 V, 60 Hz, 1550 Float Switch assembled and ■ Power Cable: Severe duty • Devvatenng RPM, built in overload with preset at the factory. rated oil and water resistant automatic resol. ■ Bearings: Upper and lower SPECIFICATIONS • EP05 Single phase: 0.5 HP. FEATURES heavy duty ball bearing 115 V, 60 I.Q. 1550 RPM, construction. Pump: EPO4 built in overload with r EPO4 Impeller: Thermo- , Solids handling ca,-ability automatic reset. plastic Semi -open design ' /,' maximum • Power cord: 10 foot v. ith pump out vanes for AGENCY LISTING • Capacities up to : 6 GPM standard longlh, 16/3 SJTO mechanical seal protection. SP Canadian Standards Assouaron • Total heads up to 21 leel with three prong grounding m EP05 Impeller: Thermo • Discharge size 1 . NPr plug. Optional 20 foot plastic enclosed design for (CSA listed model numbers • tvlechanical seal car bon- length, 16/3 SJTW will) improved performance, end in "F" or "AC" ) rotary /ceramic -st,r ooary three prong grounding plug BUNA N elastomers (standard on LP05) ■ Casing and Base: Rugged • Temperature Thermoplastic design provides 104 F (40'C) cort nuous s.iperior strength and 140 F (60 C) wlermitlent corrosion resistance. • Fasteners 300senes METERS FEET, stainless steel 1 0 I I I • Capable of running i dry withoul damage to 9 30' - c^ , r ^onenf - Pump: EPOS 8 I - 2.5 Fr • Solids handling capability: 0 25 — ' /,' maximum, a w • Capacities up to 60 GPM. _ 9 s 20 • Total heads up to 31 feet. • Discharge size V12' NPT. Z 5 • Mechanical seal carbon- 0 1S rotary/ceramic stationary, � 4 i rt I BUNA -N elastomers o t EP05 • Temperature 3 10 - -- -- _�.__._ _ .. ' _ _ _ _ I _ 1041 (40 ^C) continuous EPO4 140 - F (60 'C) inlermittent. 2 5- ' t 1 _ I _ _ 0 00 16 —J 20 30 - 40 50 GPM L 0 2 4 6 8 10 12 m/h CAPACITY q 1995 Goulds Pumps. VX. Effective May, 1995 83871 ■ ■mr'.'!1■■■■■■■■■■■■E NOMINEE ME�I ■ ■�!l►1 ■ ■ ■ ■ ■ ■ ■ ■ MEN ■ ■ ■ ■ ■M■ ■ ■■ ■ MEN MONE ■ ■ ■ ■ ■ ■ ■ ■ ■ ■■ ■NEE MEN ■ ■IBS■ ■ ■■■C'1% . ■■■■■■■■■■■■■■■■■■■■ S ■ ■ ■'! ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■■■■■■E�i� !� ■ ■ ■/■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■■■■■■■■m OEM ■ ■ ■■ ■■■■■■■■■■■■■■■■■■■■■■ ►1om■■■ ■■■ ■E■EE■E■E■■E ■ mom ■ ■ ■■ \�1�1 \� ■��■ ■■■■■ ■■■M■■■■■■■■■■ ■ mom � ��I�►l 0 ■■■■■■■■■■■■■■■■■■■■■■■! 7\ i■■ ■ E■ ■E■■ ■E■ ■E ■E ■E ■■■■O■■■ZMEMO ■■■■ ■■■■■■■■■■■■ ■■■■■■■■ MEN ■■■■■■■■■■■■■■■■■■■EME■N■ A /M ■■■■■■■■■■■■■■■■■■■ ■ MEN ■ ■.� ■ ■1/ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ MEN ■ ■ ■ ■ ■�!M , ��M■�A no ■■■■■■■■■■■ ■mEmO!Ew mummma onl�! ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ / / ■■EN . O■ ■ mom ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ %■ ■ \I,11Jl�. ■ ■ ■ ■■■■■■■■■■■■■■■■ ■ ■ ■ ■r■■■E ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■II■ ■ ■ E�r . �,E, ■■■■■■■■■■■■■■■■■■■■■ /I■■■■■ ■ ■ ■■ ■M■■■■■■■■■■ ■ ■ ■ ■ ■INEEMI■■■■■■ MEMO ■ ■■EEEEEE■■■■ ■ ■ !I ■ ■■ ■ ■ ■■ ■ ■ ■1'iM ■�1 ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■■ ■ISM ■ ■I ■ ■ ■ ■ ■ ■ ■■ ■■ iiiimmum ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■!!!!t! ■■■■■ qta FROPMEMEMEN mom ONE ■N : o"No . m NONE ■ ■ mom ■ mom ■■ ■■■ �Jll1 .�MMe ■ ■ ■ ■!M!'!!■■■■■■ MEN ■■■ENO ■ M!!!MloM ■■ MEMO ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■■ ■ ■■ ■ ■N■■■■■ ■■■ ■■■■■EE■■■■ ■ ■ ■ ■MMM . 11 POWTS 0WN1rK MANUAL 6� c�u�ivr�uc.. • •.•••• R ACE INFORMATION SYSTEM SPECIFICATIONS -tt O> ��h h L v0 f Septic Tank Capacity o "�� gal ❑ NA Permit # Septic Tank Manufacturer es ❑ NA DESIGN PARAMETERS Effluent Filter Manufacturer ❑ NA Number of Bedrooms 13 NA, Effluent Filter Model ❑ NA �D Number of Commercial Units ❑ NA Pump Tank Capacity i7� �; gal ❑ NA Estimated flow (average) gal/day Pump Tank Manufacturer ❑ NA Design flow (peak), (Estimated x 1.5) �, �� gal/day Pump Manufacturer ❑ NA Soil Application Rate gaUday /ft Pump Model ❑ NA influent/Effluent Quality Mon ly average* Pretreatment Unit ❑ NA O Sand /Gravel Filter ❑Peat Filter Fats, Oil ex Grease (FOG) S 30 mg/L ❑ Mechanical Aeration ❑ Wetland Biochemical Oxygen Demand (BODs) s220 mg/L p Disinfection ❑ Other: Total Suspended Solids ( TSS) 5150 mg/L Manufacturer Pretreated Effluent Quality ' ❑ NA Monthly average* * Dispersal Cell(s) Biochemical Oxygen Demand (BODs) s30 mg/L [3 In (gravity) ❑ In- ground (pressurized) ❑ At -grade .4 Mound Total Suspended Solids (TSS) 530 mg/L ❑Other: Fecal Colfform (geometric mean) 510 cfU /100m1 ❑ Drip -line r M __ ;iX _ iM _ um Effluent Particle Size -A Inch diameter * Values typical for domestic (non - commercial) wastewater and sepd unk effluent. * * Values typical for pretreated wastewater. MAINTENANCE SCHEDULE Service Event Service Frequency At least once every ❑ months Myear(s) (Maximum 3 yrs. ) Inspect condition of tank(s) Pump out contents of tank(s) When combined sludge and scum equals one -third (Ys) of Wnk volume At least once every / ❑months .(�'year(s) (Maximum 3 yrs. ) Inspect dispersal cell(s) Clean effluent filter At least once every ❑ months year(s) Inspect pu p ❑ months O� year(s) ❑ NA um um controls .alarm At least once every Flush laterals and pressure test At least once every ❑ months 0 year(s) ❑ NA Other: At least once every ❑ months ❑ year(s) ❑ NA Other: At least once every ❑ months ❑ year(s) ❑ NA MAINTENANCE INSTRUCTIONS inspections of tanks and dispersal cells shall be made by an Individual r; POWTS Maintainer; Septage Servicing Operator. Tank Inspecua Plum Master Plumber Restricted Sewer; POWTS Inspecto , must include a visual inspection of the tank(s) to Identify n any b k missing o� me of combined sludge and scum and to check for ponding of effluent the ground surfaceedThe dispersal volu y cell(s) shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding of effluent e oi the ground surface. The ponding of effluent on the ground surface may Indicate a failing condition and requires the immediate nodflcadon of the local regulatory authority. the entire When the combined accumulation of sludge and scum m In a n y tank equals l and disposed o In accordance ch. 1 13, Wisco� contents of the tank shall be removed by a S p a g e 8 Administrative Code. The servicing of effluent filters, mechanical or pressurized s hall be performed by a certified POWTS Ma n�tainer any ocher maintenance or monitoring at Intervals of 12 months or A service report shall be provided to the local regulatory authority within 10 days of completion of any service event. START UP AND OPERATION For new construction, Prior to use of the POWTS ch eck t treatm dispersal l(s)f o if high pr ncentratioru are detected have �the cone that may Impede the treatment process and/or damage P „r r►a rxr%ws) ram ovad by % ientape servicing operator pri to use. _ w • ' 1 t Pact Lof System start u A shall not occur whin soil conditions are frown at the InfSltrative surface. Y During power outages pump tanks may flit above normal highwater Levels. When power Is restored the excess wastewater will be discharged to the dispersal cell($) In one large dose, overloading the cell($) and may result In the backup or surface discharge on effluent. To avoid this situation have the contents of OR pump tank removed by a Sepuge Servktng Operator -prior to restoring power to the effluent pump or contact a Plumber or POWTS Malntatner to mist In manually operating the pump controls to restore ncrmal levels within the pump lank. Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise dlswrb or compact, the area within 15 feet down slope of any mound or at-grade soil absorption area. Reduction or ellndnadon of the following from the wastewater weam may improve the performance and prolong the lift of the POWTS: antibiotics; baby wipes; c1garettg butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat; foundation drain (sump pump) water; fruit and vegetable peelings; CzoAne; grease; herbicides; meat scraps; medications; oil; palndnR croducts: pesticides: sanitary napkins: tampons; and water softener brine. ASANDONEMENT When the POWTS fails and /or Is permanently taken out of service the following sups shall be taken to Insure that the system is properly and safely abandoned In compliance with ch. Comm 83.33, Wisconsin Administrative Codes • All piping to tanks and plu shall be disconnected and the abandoned pipe openings seakd. • The contents of all tanks and pits shall be removed and property disposed of by a Septage Servicing Operator. • After pumping, all tan ks and pits shall be excavated and removed or their covers removed and the void space fllled with soil, gravel or another Inert solid material. CONTINGENCY PLAN If the POWTS falls ;to cannot be repaired the following measures have been, or must be taken, to provide a code compliant replacement system: ❑ A sultabie replacement area has been evaluated and may be utillied 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 st ymm, lot (Ines and wells. Failure to protect the replacement area will result in the need for a new soil and site evaluation w ssublbh a suitable replacement area. Replacement systems must comply with the rules In effect at that time. • A suitable replacement area Is not avalliNe dire to setback and /.or soil limitations. Barring advances In POWTS technology a holding tank may be Installed as a lag resort to reptm the failed POWTS. • The site has not been evaluated to Identify a suftabk repbeemerit area. Upon failure of the POWTS a soil and site evaluation must be performed to locate a suitable replacement. area. If no replactnwrit area h 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 InfiluaUve surface. Re co ns tructions of such systems rm4t .c9Mply 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 OTHIX MATMENT TANK UNDER ANY CIRCUMSTANCES, DEATH MAY RESULT, RESCUE OF A PERSON FROM TKE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPMURl F. ADDITIONAL COMMENTS I POWTS INSTALLER POWTS MAINTAINER Name /,j ONS�` GAG /O Narne Phone _ 6 Phone SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name Agency Phone Wisconsin Department of Commerce SOIL EVALUATION REPORT Page of Division of Safety and Buildings in accordance with Comm 85, Ws. Adm. Code County Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must - include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Please print all in aap CEIVED R awed by Date Personal information you provide maybe used for *soon ry purposes (Privacy Law. s. 15.04 (1) )). Property Owner DEC 1 0 6r rty L tion Govt. Lot 1 /4 b!(,CA14 S T qN R WK) w Property Owner's Mailing Address Af lock # C or M# ST. C ZONING C ZONING OF IC City State Zip Code Phone ❑ City ❑ Village Town Nearest Road -�9d i � r New Construction Use: (o Residential/ Number of bedrooms . Code derived design flow rate a O GPD ❑ Replacement ❑ Public or / commercial - Describe: /-7 - -_ -- -__ __ -�-- — Parent material 4§z of /LL L / .t G Flood Plain elevation if applicable �- ft. General corrynerits arW reco mmendations: /� a �� d .s y s �`� �d� - 01 �,� 98- scy , ❑ Boring a Borin # ® Pit Ground surface elev. q 9, ft. Depth to limiting factor in. Sod Application Rate Horizon Depth Dominant Color Redox Description Texture Stricture Consistence Boundary Roots GPDM in. Munsed Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff #1 'Eff #2 -� s r Boring # ❑ Boring ® 5d Pit Ground surface elev. ft. Depth to limiting factor . Soil Appl ication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF in. Munsed Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 ; i G � 1 Effluent #1 = SOD > 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BOD < 30 mg& and TSS < 30 mg/L CST Name (Please Pmt) - - Si nature r CST Number GAL e, le S X� /tom vZ�-22 Address Date Evaluation Conducted Telephone Number i i Property Owner A / /7 // G lye VO * ,4/ ` d Parcel ID # 0 1�� �� G � , 'G�� Page ;2, of ❑ Boring / FY � # Pit Ground surface elev. Gr.� ft. Depth to limiting factor V * Z in. _—, Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Stricture Consistence Boundary Roots GPD/fP in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. 'Eff#1 •Eff#2 e j" ra YR 3 S 6 2 - _ a Boring# ❑ Boring [) pit Ground surface elev. ft. Depth to limiting factor in. Sal 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 Ong # ❑ Boring El 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 Effluent #1 = BOD > 30 220 mgr. and TSS >30 1150 mg/L ' Effluent #2 = BOD, 130 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. ssauw crL6W) - i - �l \1 4 E-T.- -- F 7 r-ty4e yy m P, r_42 -d /0,(- i I : I i - 'I i I I - : , I I LJ I 1 � I - - - -- 1 J ! I - - - - - -- ff __ ' I - - � I i I ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner /Ba9w Al G 1,4 e A %/ Mailing Address Property Address (Verification required from Planning Department for new construction) 25vQlly C� City /State Parcel Identification Number LEGAL DESCRIPTION Property Location . V,, .PV `,, Sec. , T. 2` N -R W, Town of S / `c Subdivision �^ . Lot # Certified Survey Map # . Volume f --? Page # Warranty Deed # L' 1- . Volume � - '7Z -, -- ,Page # Spec house ❑ yes k1 no Lot lines identifiable 0 yes ❑ no Ss NANCE Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system- -M property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a mas pl journeyman plumber, restricted plumber or a licensedpumper verifying that (1) the on -site wastewaterdisposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. Uwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin- Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 days of the time year expiration date. '- §jG OF Appubc DATE OWNER CERTIFICATION I (we) certify that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the' owner( of the proper described above, by virtue of a warranty deed recorded in Register of Deeds Office. R 1.2 l V l dr2 SICINATURE APPLICANT V DATE « « « « «« Any information that is mis- represented may result in the sanitary permit being revoked by the Zoning Department. «s Include with this application: a stamped warranty deed from the Register of Deeds office a copy of the certified survey map if reference is made in the warranty deed -,O-OOC Ll L Ish a 1­ JI 10 4_1 1 7%101 L 19.04 -e Av tv Viet, flol I 1 �♦ i r � i e I I I -- ! I ! -- - �_ - -- - - -E -- �- - -, - -- - -- - -- -- ! I � AL - - i - -- L- I- ! -' - -- - - - -- -- - - -- ,- -- - -- - - - -! -- - I_ I I r - I �- -4 � - -r-- I I I _ r I _ I i I viol- 1576PA�,,i �9 ( o 636924 KATHLEEN H. WALSH REGISTER OF DEEDS ocilment Number WARRANTY DEED ST. CROIX CO., WI RECEIVED FOR RECORD LeRoy A. Storley, conveys and warrants to Novotny, Inc., a 01 -17 -2001 9:30 AM Minnesota Corporation, the following described real estate in WARRANTY DEED St. Croix County, State of Wisconsin: EXEMPT a 17 CERT COPY FEE: COPY FEE: TRANSFER FEE: RECORDING FEE: 10.00 PAGES: 1 Recording Area Ngme and Return Address Thomas A. McCormack 1020 10" Avenue P.O. Box 2120 Baldwin, WI 54002 034 - 1007 -60 (Parcel Identification Number) Lot Three (3) of Certified Survey Maps, recorded in Volume 13 of Certified Survey Maps, on Page 3580, as Document No. 594359, being part of the fractional Northwest Quarter of the Northwest Quarter (frl. NW ' /4 of NW 1 /) and the Southwest Quarter of the Northwest Quarter (SW '/ of NW ' /4) of Section Four (4), Township Twenty -nine (29) North, Range Fifteen (15) West, Town of Springfield, St. Croix County, Wisconsin. This deed is given in fulfillment of a certain land contract between the above parties, dated January 5, 2000, and recorded January 11, 2000, in the office of the Register of Deeds for St. Croix County, in Volume 1483 of Records, at Page 350, as Document No. 616775. Exception to warranties: all easements and restrictions of record and except any liens or encumbrances created or suffered to be created by the acts and defaults of the grantees their heirs, successors, or assigns. This is not homestead property. Dated this S day 20011 *LeRoy torley AUTHENTICATION ACKNOWLEDGMENT Signature of LeRoy A. Storley STATE OF WISCONSIN ST. CROIX COUNTY Personally came before me this S day of ` 2000 the above named LeRoy A. Storley, authenticated this .S day of ✓e to me kno n to be the person(s) who executed the foregoing instrument and acknowledge the same. signature Thomas A. McCormack signature type or print name type or print name TITLE: MEMBER STATE BAR OF WISCONSIN Notary Public St. Croix County, Wisconsin . (If not, authorized by §706.06, Wis. Stats.) My commission is permanent. (If not, state expiration date: ) THIS INSTRUMENT WAS DRAFTED BY 'Names of persons signing in any capacity should be typed or Thomas A. McCormack printed below their signatures. Baldwin, WI 54002 .- 3'?l7 - 4 `i (40 5 l [ $ 3 0 2 qOT c tTY �G r N w oc 19 2 y Q cNHW�� 5 9 y 35 ���S��ao�s _ N CERTIFIED SURVEY MAP Leroy A. Storley l'c a /Ihe hiuclhural Northwest l 4 of the Northwest lid a d the Soulhwesl /. of the Northwe.s I 11-1 ol�ec ion 4, �t ; R. 75 own oj.Sj)ringflld, St. Croix Caunly, Wisconsin. OWtiE ?'d ADO. -SS- SCALE IN FEET /" +300 I. 990 H1 LCi'EST T -- 0 50100 300 600 BE RINGS ARE REFERENCED TO THE W T LINE OFTHE FRACTIONAL NW1 /4 ..4 NORTHWEST CORNER S T/ON 4, T. 29 N, R. 15 W, 4SSUMEO SECTION 4, 7729M, R. /5W AS N00'54'30 "W ? : CGUNTY SURVEYOR MGN/ ' � a o �6: n 6 SW CORNER LOT/ - - NB9 °5933 / E 1319.74 - o uN cs c r/ SAC Lori �0 33001, 286.74' -- 'I 00' LOT 3 CONTAINS 87 /, 62I SO FT OR 20.0/0 AC. ^� (849, 936 SO. FT OR 19.510 AC. EXCLUDING o ROAD RIGHT OF WAY( ° e Im m 2 N e I I n i 33.0' 1288.33'.._- 537. 86'- - •750.47' - - 3 • - N 89 "£ 132/.33' -- W ,33 T A PPFOX S. L /NE FgACT /OVAL NW / /_I. NW //0 l O 3 LO A frOX N. L �I � i 4 � F JI Q • c CONTA /NS 835, 195 S0. FT OR 19.173 AC. • �' Z 1 m_ m (814, 346 50. FT. OR 18.695 AC. EXCLUDING Z � n ROAD RIGHT OF WAY/ i x , i� /00' 33_0 -- 1289.85 - -- - l't•,• W - 536. /2 753.73 '- E -- S 89'59 X 33 W 1322.85- ` `ttµ mu Ur /h�� LEGEND - =`- �1� �N 22 6 INO/CATES /'X24" i o a LAU O /ROA' PIPE SET ? ; CE`• S o o (MIN WT / 13 LB /L.F) - m f W M RPHY o m `c x /NOICArES FOUND ' ten ° S 1713 t > x ( WEST 114 CORNER / " IRON PIPE iRI FALLS,:' Jk SECTION 4, r 29 N, R /5W WISC. Q` (COUNT r SUR MON./ ON./ INDICATES COUNTY • • ,.•' ,,� SURVEYOR MN OUMENT i —11- /SURVEY NAIL) 4 F� LAND S. Y�- INDICATES FENCE L/N E `l I ��� 1 /�����N��� 3evisad December 7, 1998 Th'1S INSTPUMEET OP4FTEO 8Y J EPA LD L L SHE / Uf Dated: C)ctober ..2. 1998 Vo1.13 Page 3580 July 31, 2003 RE: Intended Use of the existing RV unit Location: 1183 290` St. - Glenwood City, WI 54013 Computer #: 034 - 1007 -60 -000 Parcel #: 04291554A This letter is to inform St. Croix County that I do not currently use the RV unit in question for temporary occupancy. On occasion the RV is utilized during the weekend, but any waste generated will not be discharged onto the surface and will be disposed of properly. I understand that Section 17.70(3)(c)3 of the St. Croix County Zoning ordinance states that temporary occupancy is not allowed, unless a Land Use Permit is issued by the St. Croix County zoning office under the condition of connecting such unit to the use of a legal sanitary system. There are plans to eventually erect a residence on this property. I will be certain to stay in contact with the Town of Glenwood and the St. Croix County Zoning Department to insure that the proper approvals are obtained prior to any construction. If at any point a need arises to utilize the RV unit for temporary occupancy I will apply for a temporary occupancy permit with the St. Croix County Zoning Department prior to commencement. Until then the RV in question will be maintained in a suitable manner and not in violation of the St. Croix County Zoning Ordinance. Sincerely, Mike Novotny Wisconsin Department of Industry, SOIL AND SITE EVALUATION REPORT Page of 3 Labor dnd Human Relations . Division of Safety & Buildirgs in accord with ILHR 63.05, Wis. Adm. Code COUNTY Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must include, but not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or PARCEL I.D. # �� L' W G dimensioned, north arrow, and location and distance to nearest - APPLICANT INFORMATION PLEASE PRINT A � [off, IEWED BY DATE , PROPERTY OWNER: PR01' TY LOCATION 1 -E�A�( S�O�,Z `� ( ' J �� IJI�) tl4 1�1W 1 /4,S �/ T 2 9 ,N,R 1 S E (o@ PROPERTY OWNER'.S MAILING ADDRESS _._ �+ OT # LOCK # I SUBD. NAME OR CSM # I 3� ���`r�10 ----I T � - �eUo�►v� c r'1 �j CITY, STATE ZIP CODE PHONE NUMBER C C ILLAGE ®TOWN NEAREST AD WOUDVI A_Q- , rvl SCI U Zt'q fj1 1 I N 5 Ft Zol 0 `'M S_r (� New Construction Use M Residential / Num i '�eClrooms [ j AddifiQn to existing building Replacement (] Public or commercial t b o Code derived daily flow O gpd loading rate _ bed, gpdfit2 trench, gPd1ft Absorption area required S 0 tV3 bed, ft S QSQ french, ft KWmum design baling rate , S bed, gpd/ft - b trench, gpd/ft Recommended infiltration surface elevation(s) 9 9 - C) ft (as referred to site plan benchmark) Additional design/ site considerations W1oU tvZZ) vy /8 r is M l iv . 1 Z' o F s" F L L Parentmaterial Luk:�tS r l.o S ov Flood plain elevation, if applicable 'fV P4A ft S = Suitable for system CONVENTIONAL MOUND IN- GROUND PRESSURE 7AT- SYST IN FILL HOLDING TANK U= Unsuitable fors stem 0S 9U 0S O U ❑ S kru 0 U EM O S ICU ❑ S au SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD /ft in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Bed rends YA \o Z °t 6 t S c w Ground v3'A\ S�Q, elev. wiRrc t-y R 8 4 ft 60 1 o�-tt4 -813 fi `�s Depth to J C s S3Q> limiting factor �l Zh Remarks: Boring# z4.3bt tz- 3J L -' si 1 2 w, sbh M `F c k, _ • s 3 3 yY ti��- L�z�16 � Ground elev. ft. Depth to limiting factor 30 � Remarks: CST Name. — Please Print Arthur L. We erer Phone: 715- 425 -0165 e erer Soil Testing & Design Service —P.O. Box 74 River Falls,WI 54022' Signature: q g - Z 6S _ Date: ) G ) g CST Number: 04 �.� V �y �r M00576 PROPERTY OWNER �`TO \Z�`�f SOIL DESCRIP i iON REPORT Page ' Z of 3 PARCEL I.D.# ��al�►C, Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Bourxbry Roots GPDfft in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh, Bed Trench r I 3 0- to tiDL1 lz lz - sit Z + , s bk yq\3 eS 1 �j ,s •b z I - ZI Lo�iZ 3l s i Z `E� sbk Q. s� Cw _ • S Ground 3 zl -`� LO H tZ t f 3 elev. n O15.S yo_ S �0`� L 813 Depth to a g NS 0 F Z•S`tR 13U, sl SSg2� limitin factor L4 0 Lj Remarks: Boring # 13 Ground elev. ` ft. Depth to limiting i factor Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: SBD- 8330(R.05/92) r PLOT PLAN Pa 3 of 3 SCALE 1 "= 1 40 ' Q 0 - -4e $.3 � q S UT ! � 1. �y \\ • 2i z I •• �� Awe sM • �.1 , UT LW Ie S u n, 4g4 %Trr wl OF Q V) f C l OI dt�'t � i - �. �0 ON \ \ << H - �6�1, �ly�� D� � • PVC \?I1� ►.�/ L.�t`f?� PVC,,/ �vSE 'ro �E ►1T i� sr Z5 � �ZUr� �uv�� , w �� k � g13 -2.6s— C - Ld���� Lj ( 715 ) 425 - 0765 _ 14 00576 CST Signature Date Signed Telephone No. CST # i I Wisconsin De=nent of Industry SOIL AND SITE EVALUATION REPORT Page of 3 Labor and Human Relat Orr. . I)Kisiod of Safety & Buildings in accord with ILHR 63.05, Wis. Adm. Code COUNTY Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must include, but S� C�ZC) not limited to vertical and horizontal reference int B direction and % of sb scale or, PARCEL I.D. # \� �J-Z0J G Po (�� Pe. dimensioned, north arrow, and location and distance to nearest road. APPLICANT INFORMATION PLEASE PRINT ALL INFORMATION REVI B DA G A TE �a PROPERTY OWNER: PROPERTY LOCATION G%Qkg, 60T 1J IN 1/4 N W 1 /4,S L/ T 2 9 ,N,R \ S E (o@l PROPERTY OWNERS MAILING ADDRESS LOT # I BLOCK # SUED. NAIL OR CSM # `N\ I — 3 �\ O Sri'1 CITY, STATE ZIP CODE PHONE NUMBER ❑CITY ❑VILLAGE ®TOWN NEAREST ROAD SY0 (j ISI 698 -1 1 Za 0 nk Sr New Construction Use (JCS Residential / Number of bedrooms '-f [ ] AddiWn Add' ' to e xisting building (] Replacement (] Public or commercial describe Code derived dairy How b o gpd Recommended design loading rate ` _ bed, gp0 — trench, gpd4t Absorption area required S 0 C bed, 11 S 00 trench, ft Maximum design loading rate ' S bed, gpcW • b trench, gpoltt Recommended infiltration surface elevation(s) 9 8.0 It (as referred to site plan berx9tmaN Additional design/ site considerations M nn7 kJ/8'4 13Qb . M IN. Iz! OF S" F t_ t_ Parentmaterial �-uQ��S i Lo-i2:&s . overt stiyz� a Flood plain elevation, if applicable N A, ft S = Suitable for system CONVeM NJAL I MOUND IN GROUND PRESSURE I AT -GRADE SYSTEM IN FILL HOLDING TANK U= Unsuitable fors stem ❑ S 9U 0S ❑ U ❑ S O U ❑ S O U ❑ S U ❑ S ®•U SOIL DESCRIPTION REPORT Boring Horizon Depth Dominant Color wtties Texture Structure Consiswice Roots GPD /ft in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Bed Tmnch 1 °Z O- 9 l O `i R- 31 3 �s I Z `�$ �Dk `M U �lr 0 u S ` t I ry44 V • S Z °t — �p `1 R b l 3 — `� S Z e- Sb1z S 4*2 W - • S . l Ground 3 a -q 1p H,'�L S7Q, czbl - YAvj Off, •'� .� elev. 4 8 4 ft �} L t�= 10`1 tZ S !3 •S K 2 s /£i S Depth to C s S aQ> limiting factor Lt Zh Remarks: Boring# %1\ Z` '3bNt )A\3 h eS N\A Z 3J s � 1 2 � sbh ��h � _ •5 .(� 3 3o yy l�` -� �; -S`lR SlS S► 1 1eSbk Y - ,Z,3 Ground elev. a fL Depth to limiting factor I 30 Remarks: CST Name.— Please Print Art Phone: Arthur L. 715-425-0165 hu We erer ea%rer Soil Testing & Design Service -P.O. Box 74 River Falls,WI 54022 Signature: C IS -Zbs - 1 Date: `C - -4. 98 CST Number: l.� y rf00576 PROPERTY OWNER '—N St SOIL DESCRIPTION REPORT Page Z of 3 PARCEL I.D.# \ b 1NC, Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boird3y Roots GPD /ft In. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. Bed T rich 3 0-1.0 1•o`1(L � 1Z - sit Z`1'sb yel es Z 1 o -Z.1 � Ul VL 31 L — '31 Z F s byc & ` sly C►•.) . S Ground 3 ! -`L u W H R l3 — `FS 1 Z" C. s elev. I mo` _ s 1 ) `1 °i S S ft. � y o 0 �'1 R $ !3 -I .S `i lZ s `� '�s �>� e 6,► %A- Depth to Cq a g - 1 - S O P V 1 SS 6 2> limiting factor 04 : i i Remarks: Boring # I 7 • i 7 Ground i elev. i ft. Depth to f limiting factor Remarks: Boring # 7 E 3. i Ground elev. ft. i i Depth to limiting factor f Remarks: Boring # 13 I Ground elev. tt. Depth to limiting factor Remarks: SBD- 8330(R.05/92) P LOT P LAN Page 3 of 3 SCALE 1 "= 1 4K) ' �\ _ Q %ti �� oo rvoT eor- ►P�t-t.T oR D �� ��\ 4 �s\v \ 28 TH'ls f'f Mq . —1, q S - \ 5? ' S •2i `AT I QTrTOWI OF t3 V) f N KA- Lj)r of 0 . o' Gti \ \ 1�1GN, 3!y" Di A pv c \z W / LAT w L << N 4 Sol N n = J � IB s - k c - u / �L�j � �c,. -1 �_q ( 715 )--42, -0 1 69 14 00576 CST Signature Date Signed Telephone No. CST #