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Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix i Safety and Building Division INSPECTION REPORT Sanitary Permit No: 479413 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: Haas, Vern & Carol Springfield, Town of CST BM Elev: Insp. BM Elev: 8M Description: Section/Town/Range/Map No: /M t 21.29.15. TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION 3 BS J HI FS ELLEEV. Septic Benchmark 1( '1 :jt211G V - ~ .1, • 5 ~a~ r r5 /~O Dosing Alt. BM M Aprnfign Bldg. Sewer ii7 79,15 C_ 71~ Holding St/Ht Inlet ri ~7•V'5 St/Ht Outlet TANK SETBACK INFORMATION TANK 4TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic 31 -j / J Dt Bottom ,q • Dosin3) t Zi J Header/Man. L 1•! g 7L~P 16 Aeration a Dist. Pipe x.55 t61• Holding Bot. Systems Z 1/ 7.~ Final Grade 11.47 /aZ , IS 61,- Manufacturer INFORMATION Manufacturer I 1 Demand St Cover c9 15 a Z6 Q.l1 QP. GPM G P. 144,(- 6s Model Number /AJ 1 11 L4 XAJ • -J ~ CowJ 0,-.) f- TDH Lift Friction oss System Head TDH At VI k5. l; 1 T Z_5 Forcemain LenIthh Dia. Z Dist. to Well ✓`t / SOIL ABSORP(lTION SYSTEM BEDITRENCH Width I Length No. Of enche PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS / Ct ti- V SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer. INFORMATION CHAMBER OR Type OMoo tem: ! > UNIT Model Number: Z7 DISTRIBUTION SYSTEM a(' Header/Manifold I ) Distribution 44) x Hole Size N/11 x Hole Spacing Vent to Air Intake j Pi e s Length 3 Dia Z L ngth g5 Dia 1 Spacing l SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over 1 Depth Over xx Depth of xx Seeded/So ded xx Mulch Bed/Trench Center 73 Bed/Trench Edges Topsoil 1 es No es No r~~j l COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: Cl 6's V Inspection #2: Parcel No: 21.29.15. Location: 824 292nd Street Wilson, WI 54027 (SW 1/4 SW 1/4 21 T29N R1 5W) NA Lot 3 G n` 7S.c~/ a V 1.) Alt BM Description = ff~ 14t, 1 a~-- r (l k 2.) Bldg sewer length - amount of cover 11 5 Plan revision Required? Yes No Use other side for additional information. I_ 1 L~ _ - Date Insepctor's Si ture Cert. No. SBD-6710 (R.3/97) Safety and Buildings Division county Sr C ro 1 Visconsin 201 W. Washington Ave., P.O. Box 7162 Madison, WI 707 - 7162 Sanitary Permit Number to be filled in by Co.) De artment of Commerce (608 51 Sanitary Permit. NJ) State Plan LD. Number R e in accord with Comm 83.21, Wis. Adm. Code, oral tt O?b Waiting address). may be wad for secondary purposes Pei acy Law, sls.t)4(lXm) Project (rfdi8eratt than f K mot' filp4A 1. Application Information - Please Print All Inform n : t ltd osQJid-C . 66' ONXIty s Name CROIX CO Parcel # Block p Ownq /a 4- C*4 ZONING OFFICE 3 .y Owner's Mailing Address c~ Pfterty Locate 2 p tr11~ HL 5re>z 0 Section _ City tate Zip Code Phase Number • W~ 5 0Z IBS- 70.1 - :S TA N; ~E'Z) H. Type of Building (check all that apply) V ~O /~'lR,riri ~1 or 2 Family Dwelling - Number of 13edrooau Subdivision Name CSM Number ❑ Public/Commercial - Describe Use V., I al 1,4q3 -ry -J ❑ State - Use ❑eity ❑V me Iownship of Owned Describe W. Type of Permit: (Check only one box on line A. Complete line B if applicable) d 3 54-1 d elty- A fa New System ❑ Replacament System ❑ TmatmmUHolding Tank Replacemaot Only ❑ Other tion to Existing System B. ❑ Permit Renewal ❑ Penult Revision ❑ amp of ❑ Permit Thresfer to New List Previous Permit Number and Date Issued Before Expiration Plumber owner lV. of POWTS ten: Check all that a 1 ❑ Non -Pmmuized bt-Grand ❑ Mound?: 24 im of suitable soil AtMouod < 24 in. of suitable soil ❑ At-(tirade ❑ Single Pau Sand Filter ❑ awtnm.- Conttructed Wetland ❑ Pmsudzed In-Ground ❑ Holding Tank ❑ Peat Filter ❑ Aerobic Treatment Unit ❑ Recirculating Sand Filter ❑ ` Recirculating Synthetic Media Filter ❑ Laching Chamber QPrip Line vel-leu Pipe ❑ Other (eVlain) V. Ms rsal/ISreatment Area Information: Design Flow (gpd) Des a So' AMlicati spersaI Area RN ' (sf) Dispersal Area Pro Of) Sstem Elevation *rpo s~: 3 I! rs~ /Sob I DD• 4 ihv~f VI. Tank Info Capacity Mn Total Number Mauufaeturw Brffib Site Steel Fiber Plastic Gallons Gallons of Units Concrete Constructed Glass New axwing Tanks Tanks septic 06"DwingIrm Aerobic Treatment Unk /O Dosing Chamber VII. Responsibility Statement- 1, the ands ass nslbW for installation of.the PoWT3 shown on the attached plaus. Pl (Print) PI s 3 MPWRS Number Business Phone Number o , W 1394 4 2 171P ZSS- Plumber's Address (Street, City, State, Zip / 9 70 r Csz J il? V V Conn /De rtment Use c Approved ❑ Disapproved Sanitary Permit fee (includes Groundwater D Issued wing Agent ignature ~bps) S ❑ Owner Given Reason for Denial unrlmrge Fee) LX. Conditions of ApprovaMessons for Disapproval S YSTEep~c Septic tank, effluent filter and dispersal cell must all be serviced / maintained Ay~ r , • S as per management plan provided by plumber. G2ti 7 aX 2. All setback requirements must be maintained as per applicable code/ordinances. a~ na , Atbch complete plau (to the cowry oaty) f s paper 1/3 s SBD-6398 (R. 01/03) JUL.-12-2005 07:48 PM P.03 HAAS SITE PLAN SW-SW-21•20-13W 292ND STREET SPRINGFIELD TOWNSHIP ST.CROIX COUNTY, WI PARCEL DESCRIBED AS 3.0 AC, (95.2) I (98,2) 01 #2 90'X 8.0' DISTRIBUTION CELL f #1 I I WITHIN A MOUND COMPONENT 1 SYSTEM ELEVATION • 100.45' 4 ~ I °a D O PLACE UPSLOPE EDGE OF CELL ' ALONG THE 98.2' CONTOUR 00 0° O 0° I #z \.I O O 1 70'- 2" SCH 40 PVC FORCEMAIN $ (must draln back to pump tank) 8 ° ° o] O I7 ° I o 0 ° N ° a HUFFCUTT MODEL 100000 ° SEPTIC/PUMP TANK W E I Q (wlapproved outlet flbr) 1 S , -20'. 4" ASTM PVC SCALE 8UILDt Q SEWER LINE rr--r--T--~---T---r -T---I I 0 15 30 a 1 (UNLESS BHOANNOTHER ~i i i i •i r L__I W WILLIAM J. BER I I PROPOSED 3-BR _ I I WISCONSIN CERTIFIED SOIL TESTER ; BUILDING SITE DESIGNER OF ENGINEERING SYSTEMS (L__ L _ L__ L__ L_ L__ CUSTOMER ID 227818 I I 1 1 I 1 I I FBUIL1T G SEWER MUST Ca1M1PLY-1 1 WITH COMM 82.35 WAC (11)(C) I I 1 t LOCATION OF WELL MUST COMPLY i 1 WITH WDNR CHS. NR 811 & 812 r- - ~ I 1 IS BENCHMARK ELEVATION =100.0' 1 - (#1) top Of PVC pipe 5" above grade I ! A LOCATION OF SOIL BORING(S) j fl I 0 LOCATION OF SOIL PIT(S) I , I * NO APPARENT COMM 83.43 SETBACKS I (9) DESCRIBED LOCATION OF LOT LINE i ! I (V LOCATION OF RIGHT-OF-WAY I I1I I ® CENTERLINE OF DESCRIBED ROAD I 1 PAGE 3OF9 Safety and Buildings 4003 N KINNEY COULEE RD COrI'1f11eIrCe.Wl.gOv LA CROSSE WI 54601-1831 TDD (608) 264-8777 isconsin www.commerce.wi.gov/sb/ Department of Commerce www.wisco isconsinsin.go .gov Jim Doyle, Governor Mary P. Burke, Secretary I July 19, 2005 CUST ID No.227819 ATTN POWTS Inspector WILLIAM J BERGH ZONING OFFICE GEO TECH ST CROIX COUNTY SPIA 2667 113TH ST 1101 CARMICHAEL RD CHIPPEWA FALLS WI 54729-6575 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 07/19/2007 Identification Numbers Transaction ID No. 1149968 SITE: Site ID No. 700639 Vern & Carol Haas Please refer to both identification numbers, 292nd Street & 80th Avenue above, in all correspondence with the agency. Town of Springfield i St Croix County SWl/4, SWI/4, S21, T29N, R15W FOR: Description: Proposed Three Bedroom Mound System Object Type: POWTS Component Manual Regulated Object ID No.: 1025345 Maintenance required; 450 GPD Flow rate; 9 in Soil minimum depth to limiting factor from original grade System(s): Ezflow Mound Component Manual, (N.6/03), Pressure Distribution Component Manual - Version 2.0, SBD-10706-P (N.01/01); Biofilter 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. No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s. 145.06, stats. The following conditions shall be met during construction or installation and prior to occupancy or use: • This system is to be constructed and located in accordance with the enclosed approved plans and with the EZ FLOW Mound Component Manual (June 6, 2003). The pressure network is to be constructed and located in accordance with the approved plans and with the "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems Version 2.0" SBD-10706-P (N.01 /01). • The distribution pipe being inserted into the 4 corrugated pipe located in the EZflow product shall have one out of every five orifices installed at the 6 o'clock position. The remaining four orifices shall be installed at the 12 o'clock position. The laterals shall drain fully after every dose. • The lateral turn-up ends shall extend out past the exterior end of the cells at both ends. The observation pipes shall also be located in between where bundle(s) come together. These requirements must be followed so that the aggregate bundles will not be damaged during the installation process. • A sanitary permit must be obtained from the county where this project is located in accordance with the requirements of See. 145.135 and 145.19, Wis. Stats. • Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stats. • The area within 15 feet horizontally below the system shall remain undisturbed. Vehicular traffic or soil compaction in this area is prohibited. Conditionally ST ROVED WILLIAM J BERGH Page 2 7/19/2005 • A state approved effluent filter is required. Maintenance information must be given to the owner of the tank explaining that periodic cleaning of the filter is required. Access to the filter for cleaning must be provided per Comm 84 product approval conditions. • Comm 83.22(7) - 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. Owner Responsibilities: • The current owner, and each subsequent owner, shall receive a copy of this letter including instructions relating to proper use and maintenance of the system. Owners shall receive a copy of the appropriate operation and maintenance manual and/or owner's manual for the POWTS described in this approval. • Comm 83.52(1)(a) - The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s. Comm 83.54(1). • Comm 83.52(2) - A POWTS that is not maintained in accordance with the approved management plan or as required under s. Comm 83.54(4) shall be considered a human health hazard. 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. • The owner is responsible for submitting a maintenance verification report acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101. 12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 Gerard M. Swim POWTS Plan Reviewer - Integrated Services (608)-789-7892, Mon. - Fri. 7:30 am to 4:15 pm W iSMART code: 7633 jswim@commerce.state.wi.us cc: Glen N Pelke, Glen Pelke Plumbing (Plans Mailed To) Leroy G Jansky, Wastewater Specialist, (715) 726-2544 Cover Sheet VERN & CAROL HAAS 33 Franc Street - Roberts, WI 54023 MOUND COMPONENT Reference Component Manuals Pressure Distribution Component Manual SBD-10706-P (N.01101) - version 2.0 Ring Industrial Group - EZflow Mound Component Manual Job Location: 292ND STREET SW A SW, Sec. 21 T 29 N, R 15 W Village: SPRINGFIELD County: ST.CROIX Designer's name and license William J. Bergh License No. 1577-007) 1 the undersigned state t at these plans were ned and submitted under authority. Designer's signature: Designer's address: 266711 th reet Chippe a Ils, W154729 Designer's phone number: 715-723-5555 voice '`•~.••~~C'~NSj.,~,, 715-723-7535 fax % R 715-577-6838 cellular WILLIAM A. ECE(VEp soiltestin-gOcharter.netemail = = BERGH ' JUN 2 '~•.°~c`~.• ~ `c>2: 1 2005 Contents +5, • F,g`•' SAFE Page 1- cover sheet & BUILDINGS Page 2- system calculations Page 3- site plan Page 4- cross section of EZflow mound component Page 5- plan view of EZflow mound component & distribution lateral schematics Page 6- septic & pump chamber schematics Page 7- pump curve Page 8- maintenancelmanagement & contingency plan Page 9- maintenance/management & contingency plan 1of 9 OF FET 4411b 6u 'j'"" page ~i CO(~iZ SPO NGE JUL-12-2005 07:47 PM P.02 SYSTEM CALCULATIONS USING HUFFCUTT COMBINATION TANK residential dwelling with total of 3 bdrm calculated at 450 gpd design wastewater flow LLR (linear loading rate) SO3 - gal/daylft DLR (design/soil loading rate) el gal/sgfVday 150010 effective basal area depth to limiting factor 9 inches system area cross slope -B% percent forcemain length 70 feet using 2 Inch - SCH 40 PVC manifold and/or header length 3.0 feet using 2 inch - SCH 40 PVC forcemain volume 11.4 gallons length of each lateral 45.000 feet using 1 1/2 Inch - SCH 40 PVC total number of laterals 4 Invert elevation 100.95' (bottom of lateral). orifice diameter 0.1876.3/18 tenths/inches 100.45' system elevation distance between orifices 30 inches or 2.50 feet total orifices per lateral 18 total orifices all laterals 72 lateral volume (each lateral) 4.14 gallons 11.88 lateral discharge rate system discharge rate 47.5 gallons calculated at 325 distal pressure x 1.3 ft. vertical lift 15.0 feet friction loss in the forcemain 3.2 feet calculated at 47.5 gal/min discharge rate TDH (total dynamic head) 21.4 feet minimum pump discharge 47.5 gpm at 21.4 TDH (total dynamic head) pump manufacturer ZOELLER model number 140 estimated total dose volume 94.2 gallons 93.1 actual dose (total-forcemain) pump tank model .600 actual tank size 627 gallons septic tank model 1000 actual tank size 1029 gallons manufacturer of tank(s) Huffcutt pump float on/off measurement 7.0 inches alarm float from bottom of tank 19.0 inches Page 2 of 9 JUL-12-2005 07:48 PM P.03 _ HAAS SITE PLAN SW-SW-21.29.15W 292ND STREET SPRINGFIELD TOWNSHIP ST.CROIX COUNTY, WI PARCEL DESCRIBED AS 3.0 AC. I (98 i) #1 #2 ! I 90'X 8.0' DISTRIBUTION CELL WITHIN A MOUND COMPONENT 1 SYSTEM ELEVATION i 100.45' 4 I ° o° o° ,o PLACE UPSLOPE EDGE OF CELL ' 0 ALONG THE 98.2' CONTOUR O I 0 O0 #2 I, .I p0 70' - 2" SCH 40 PVC FORCEMAIN 0 o; (must draln back to pump tank) I a° o, O 000 1 00 0 00 N °0 a HUFFCUTT MODEL 10001800 SEPTIC/PUMP TANK w E I Q (w1approved outlet flltar) 1 It ~ 1 I S -20'- V' ASTM PVC 1 SCALE BUILDI G SEWER LINE rr--r_-T...-I---T---r I- L_. 1.-.. 1- L-.. L-_ L__ L-- I i 0 15 30 I (UNLESS 8HOWN OTHERWISE, r WILLIAM J, BERGH PROPOSED 3411 WISCONSIN CERTIFIED SOIL TESTER ; I BUILDING SITE DESIGNER OF ENGINEERING SYSTEMS I• L-- L-_ L-- CUSTOMER ID 227818 BUILDING SEWER MUST COMPLY L----- L-- L-- L-- L__ I WITH COMM 82,35 WAC (11)(C) r f I I I LOCATION OF WELL MUST COMPLY I 1 L WITH WONR CHS. NR 811 & 812 i BENCHMARK ELEVATION =100.0' i f - I - (#1) top of pvc pipe 5' above grade I 1 G LOCATION OF SOIL BORING(S) I .3 LOCATION OF SOIL PIT(S) t I * NO APPARENT COMM 83.43 SETBACKS I I DESCRIBED LOCATION OF LOT LINE j I ® LOCATION OF RIGHT-OF-WAY I I A CENTERLINE OF DESCRI8ED ROAD L__-.j PAGE 3OF9 EZFLOW MOUND COMPONENT CROSS SECTION (typical) 4" OBSERVATION PIPE >12" SOIL TO PROMOTE SUITABLE PLANT GROWTH DISTRIBUTION CELL SYNTHETIC MATERIAL DISTRIBUTION LATERAL(S) INVERT ELEVATION = 100.95' >12• UNDISTURBED 1 6'I 71 6-1 SOIL & VEGITATION CAP • 12" ©0, vs 27" 30.6,. ELEVATION = 98.20' /AS TM C-33 6" material PLOWEDITILLED AREA 6.0' 13.5' -1.8' 30.4' EZ1203H (10' length size - 30 sq. ft per product) 16 EZ1203H (5' length size -15 sq. ft per product) 2 CUBIC YARDS OF SAND (minimum -200 SYSTEM AREA SLOPE ^-6% SYSTEM AREA LONGITUDINAL (long axis) SLOPE NA ALL MATERIAL & PIPING SPECIFICATIONS AS PER THE EZflow MOUND & PRESSURE DISTRIBUTION COMPONENT MANUALS DRAWING NOT TO SCALE PAGE 4 OF 9 PLAN VIEW OF EZflow MOUND COMPONENT (typical) * All piping & material specifications per the EZflow Mound & Pressure Component Manuals 10'11 -15,0' UNIT DISTRIBUTION CEL40 FOIKEMAINIMANIPOUa - r _ ( I l~ _ DISTRIBUTION 3.0' ' LATERAL(S) 6.0, I---1 1.51 30.4' OBSERVATION PIPE($) i 15,3' isr Table 3 •EZflow j! Wound Manual! -13.2' 90.00' 13.2 Distribution laterals terminate at the end of the distribution cell ® Access box covering threaded plug at the end of each distribution lateral EFFECTIVE BASAL AREA DISTRIBUTION CELL -1, E20ow COMPONENTS DISTRIBUTION LATERAL (typical) * All discharge orifices are located per the EZflow Mound Component Manual ~6. final grade final grade <6. threaded cap 1112" DISTRIBUTION LATERAL threaded cap access box access box 2" FORCEMAIN/MANIFOLD ~---43,75' 30" 30" 15" X12 X ~-x 87,50' last orifice(s) are located 15" from end of cell Discharge orifice diameter 3/16" = 0.1875 X12 spacing 1511 Number of orifices per lateral 18 X spacing 3011 Total number of orifices (all laterals) 72 ORIFICES MUST BE LOCATED IN A (4 UP -1 DOWN) SEQUENCE (DRAWING 19 NOT TO SCALE) PAGE 5 OF 9 Z0 'd w t ib:A2 CAA7-r~i-1r11 JUL-12-2005 07;48 PM P.04 COMBINATION SEPTIC TANK/PUMP CHAMBER X-SECTION (DRAWING NOT TO SCALE) FINAL GRADE MANHOLE RISER & COVER (slope ground surface away from {per COMM 84.25 (7) & (8)) manhole(s) for proper drainage) j i ELECTRICAL & ALARM SUPPLY (electric & alarm wiring must be SUILOING SEWER InsraUed an asoarms dreuits) {per comm 82.30 (t 1)) ELECTRICAL JUNCTION BOX r„pctsum ' MANHOLE MANHOLE MANHOLE 18" in, t: BOTTOM OF INLET pnved elsvetbn) - Drooerry eedae 3" ~ wMn not usa L (wastewater level) INLET /////ii/~ij//s✓~i~/ /i..~//~i..y! ~./r%/// /•///ii'i' ! / . C ALARM FLOAT ; ON FLOAT 4" INLET PIPE • ' FILTERED 8 (tea orbaffe) APPROVED EFFLUENT FILTER " EFFLUENT OFF FLOAT REQUIRED ON OUTLET elev = MINIMUM OF 3" OF SUITABLE BEDDING BENEATH TANK PUMPPAO EFFLUENT FILTER ZABEL A•100 OR EQUIVALENT COMPONENT Tank Manufacturer HUFFCUTT DWF (daily wastewater flow) 450 GPD Septic/Pump tank model 10001600 Number of daily doses -4.8 (DWF / actual dose volume) Alarm manufacturer S.J. ELECTRO Alarm model number NW 101 Forcemain volume 11.4 Type of float switch MERCURY** Actual dose volume (gallons) 93.11 (total dose volume • volume of ftmmain) Effluent pump manufacturer ZOELLER PUMP TANK CAPACITIES Effluent pump model number 140 Reserve above alarm 21 Inches = 313.53 gallons Alarm float above on float 2 inches = 29.86 gallons (C) Minimum pump discharge rate (GPM) 47.5 On/Off float measurement 7 Inches = 104.51 gallons (8) Off above bottom of tank 12 inches = 179.16gailons (A) Vertical llft (pump off to distribution lateral) 15.0' system head (distal pressure X 1.3 feet) 3.25 PUMP CHAMBER DIMENSIONS Friction loss in the forcemain -•3.2 Length 49.0" Width 70,01' Total dynamic head (TDH) 21.4 Liquid depth 42.0" Gallons per Inch 14.93 X 3J Zb It PAGE 6 OF 9 • TOTAL DYNAMIC HEAD/FLOW = • w PUMP PERFORMANCE CURVE PER MINUTE MODEL 14014140 EFFLUENT AND DEWATERING ss MODEL 140/4140 3 i/8 V 5/,6 16 So Feet Meters Gal. Liters _ 4 ,/w 5 1.5 86 326 _ 14 45 10 3.1 80 303 _ 15 4.6 73 276 40 20 6.1 66 250 _ 12 25 7.6 59 223 35 140,4140 30 9.1 49 185 112 _ 11 ,12 VT a ~ 10 35 10.7 38 144 30 40 12.2 28 106 45 13.7 17 64 o 8 25 Shut-off Head: 50ft.(15.2m) ~ 5 20 0109405 7i ,z ,.;/a? fff 4 - 4 s03 10 - N I Ssc,s2aa 2 5 1 0 10 20 30 40 50 60 70 80 90 6 • • GALLONS LITERS 0 8D 160 240 320 ' FLOW PER NUTE~ 01o940A q-). ,CONSULT FACTORY FOR SPECIAL APPLICATIONS 48!/16 3 [9/32 • Electrical alternators, for duplex systems, are available and supplied with an alarm. • Mechanical alternators, for duplex systems, are available with or without- alarms. • Control alarm systems are available for 1 phase pumps used in simplex system. See FM0732. • Variable level control switches are available for controlling single phase systems. • Double piggyback variable level float switches are available for variable level long cycle controls. • Sealed Qwik-Box available for outdoor installations. See FM1420. } • Refer to FMO806 for applications above 130°F (54°C). ' 5/31 _1 sx,sxas 140 Series - 43 lbs. 414€3 Series - 53 lbs. SELECTION GUIDE 14014140 MODELS Control Selection 1. For automatic use single piggyback variable level float switch or double piggyback variable level float switch. Refer to FM0477. Model Model Volts-Ph Mode Amps Simplex Duplex 2, See FM1228 for correct model of simplex control panel. N140 N4140 115 1 Non 12.0 1 or 2 3 3. See FMO712 for correct model of duplex control panel. E140 E4140 230 1 Non 6.0 1 or 2 3 a caunorl BN140 BN4140 115 1 Non 12.0 * All insta fat€on of controls, protection devices and whing shcuid be done by a qualified BE140 BE4140 230 1 Non 6.Q licensed electriciatl. 1111 esectticst and safety codes should be followed including the rnost recent Notional Electric Code (NEC; and the Occupational Safety and Health Act (OSHA). *Single piggyback switch included. RESERVE POWERED DESIGN For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump. NAIL TO: P.O. BOX 16347 r Louisville, KY 40256-0347 Mawlactwers of.. SHIP v 3649 Cane Run Road Lo ® Louisisvdle, KY 40211-1961 p!/4L/TYPUMPS PUMP !O- (~2) 7 AX(502) 73624 PUMP http://www.zoeJler. cam © Copyright 2002 Zoeller Co. All rights reserved. POWTS OWNER'S MANUAL MANAGEMENT PLAN PERMIT NUMBER: STr ~/~tt)-c Owner: VER & CAROL HAAS POWTS Maintainer: Geo Tech Soil & Site Evaluation - Chippewa Falls, WI 715-723-5555 Local Regulatory Authority: St. Croix County Zoning Department - Hudson, WI 715.386.4680 POWTS Installer: _773ZZ J`//J.Z {~1O~'1ZO1u1~ Mendevi, WI 716 986 6999 Septage Servicing Operator Z 3 d S/y DESIGN PARAMETERS Influent/Effluent quality (values typical for domestic (non-commercial wastewater and septic tank effluent) Fats, Oil and greases (FOG) <30 mg/L, Biochemical Oxygen Demand (BOD) <220 mg/L, Total Suspended Solids (TSS) <150 mg/L. Soil loading rate (SLR) = 0.4 SYSTEM SPECIFICATIONS The components of this septic system are intended to serve a 450GPD (three-bedroom residence. The components include: a Huffcutt model 10001600 septic/pump tank with approved outlet filter and a ZOELLER effluent pump, alarm & controls and an 900 x 6.0' distribution cell within a mound POWTS component. All components must comply with WI Adm. Code COMM 84 and be installed per manufacturers specifications and approval letters. DESIGN CRITERIA o SBD -10572-P (R.6/99) "Mound Component Manual" o SBD -10691-P (N.01/01) "Mound Component Manual" Version 2.0 ✓ EZFLOW MOUND COMPONENT MANUAL o SBD -10570-P (R.6/99) "At-Grade Component Manual Using Pressure Distribution" o SBD -10567-P (R.6199) "in Ground Absorption Component Manual' o SBD -10705-P (N.01101) "In Ground soil Absorption Component Manual" Version 2.0 o SBD -10573-P (R.6/99) "Pressure Distribution Component Manual" ✓ SBD -10706-P (N.01/01) "Pressure Distribution Component Manual" Version 2.0 MAINTENANCE & MANAGEMENT Inspect the condition of the treatment tank(s) and dispersal cell(s) a minimum of every three years. The septic tank contents must be removed in accordance with Chapter NR 113, WI Adm. Code when the combined sludge and scum equals one-third (1/3) the tank volume. The effluent filter(s), effluent pump, controls & alarm and distribution lateral(s) should be inspected annually to ensure maximum performance. Lateral inspection/maintenance should include flushing of the laterals and pressure testing, START UP For new construction prior to use of the POWTS check treatment tank(s) for presence of painting products or other chemicals that may impede the treatment process and/or damage the dispersal cell(s). If high concentrations are detected have the contents of the tank(s) removed by a septage-servicing operator prior to use. OPERATION The property owner is responsible for the operation and maintenance of the POWTS and submission of required reports. The quantity and quality of wastewater will affect the performance and longevity of your POWTS. The installation of water-saving appliances and fixtures along with prompt repair of leaks reduces the wastewater volume. Also, the brine or waste from water softeners, iron removal units, and other clear water treatment devices and foundation drains should be discharged to the ground surface whenever possible. Note: this does not include laundry waste, showers, dishwater, etc. The system is designed to handle domestic strength wastewater, however the disposal of food based greases and oils, vegetable/fruit peels and seeds, bones, and food solids such as those produced be a garbage disposal should be minimized. Toilet tissue is the only paper that should be discharged into the system. Other non-biodegradable items such as baby wipes, tampons, sanitary napkins, condoms, cigarette butts, dental floss, and cotton swabs should not enter the system. Chemicals such as petroleum products, paint, disinfectants, pesticides, antibiotics (medications), solvents, etc., should not be flushed into the system as they can seriously damage your POWTS and contaminate your drinking water supply. Maintain regular steady flow by spreading the laundry washing throughout the week. Avoid vehicle traffic over all system components. Compaction of snow over the unit may cause it to freeze up. o Valves Valves should be operated in the following manner ✓ Alarms Alarms should be tested on a regular basis by the homeowner. If an alarm sounds, contact an individual licensed to serve POWTS. There is normally a one day reserve capacity under regular operating conditions, however water should be conserved until any problems with the system are corrected to prevent back-up of sewage into the dwelling or surface discharge. Page 8 of 9 i INSPECTIONS Inspections shall be made by a pdrson carrying one of the following licenses or certifications: Master Plumber, Master Plumber Restricted Sewer, POWTS Maintainer or Septage Servicing Operator (per the attached Maintenance Schedule) ✓ Septic Tank Component Tank inspections must include a visual inspection of the tank to identify any missing or broken hardware, identify any cracks of leaks, measure the volume of combined sludge and scum and to check for any backup or surface discharge of effluent. Access openings used for service of assessment shall be sealed and/or locked upon completion of service. Any defects shall be promptly corrected. Exposed openings greater than 8 inches in diameter shall be secured with an effective locking device to prevent accidental of unauthorized entry into the tank. nP~ d o d- The outlet(e uent i ter(s) shall be inspected and cleaned to remove any accumulated solids according to manufacturer's specifications. Provisions are to be made to retain solids in the tank during cleaning. Filter cleaning may be necessary at more frequent intervals than stated in the maintenance schedule to keep the system operating properly. ✓ Pump Chamber/Treatment Tank(s) Component The inspection must include a test of all electrical equipment such as pumps, alarms and floats. A visual check must me made for leaks, backups, surfacing, missing or broken security devices and other hardware and the condition of the filter. Any service needs or repairs shall be promptly taken care of. ✓ Mound, At-Grade, In-Ground Pressure The inspection shall include recording the levels of ponding, if any in the observation tubes and a visual inspection for any evidence of surface seepage or discharge. Any discharge to the ground must be promptly reported to the regulatory authority. Ponding greater than 75% of the height of the component may indicate overloading or impending hydraulic failure necessitating more frequent monitoring. Additionally, due to the excessive slopes, the toe of the component must be inspected a minimum of once annually for seepage. Refer to the 'reports' section of this agreement for filing requirements. REPORTS Reports for maintenance, inspection, and monitoring shall be submitted in accordance with COMM 83.55 Wisconsin Administrative Code. ABANDONMENT When the POWTS fails and/or is permanently taken out of service the following steps shall be taken to ensure that the system is properly and safely abandoned in compliance with Ch. COMM 83.33, Wisconsin Administrative Code. - All piping to tanks and pits shall be disconnected and the abandoned pipe opening sealed. - The contents of all tanks and pits shall be removed and properly disposed of be a Septage Servicing Operator. - After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil, gravel or other inert solid material. CONTINGENCY PLAN If the POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide a code compliant replacement system. o A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system. The replacement area should be protected from disturbance and compaction and should not be infringed upon by required setbacks from existing and proposed structure(s), lot lines and wells. Failure to protect the replacement area will result in the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rules in effect at that time. o A suitable replacement area is not available due to setback and/or soil limitations. Barring advances in POWTS technology a holding tank may be installed as a last resort to replace the failed POWTS. o The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluation must be performed to locate a suitable replacement area. If no replacement area is available a holding tank may be installed as a last resort to replace the failed POWTS. ✓ Mound and At-Grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time. WARNING SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASES AND10R INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OF OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. Page 9 of 9 SAFETY AND BUILDINGS DIVISION Page 1 of 3 Pam Quinn From: Swim, Jerry oswim@commerce.state.wi.us] Sent: Tuesday, August 09, 2005 11:04 AM To: Pam Quinn Subject: Twila Severson & Pat Hubbard Hi Pam - Attached is a copy of the approval letter for the Severson/Hubbard plan. I found the file and it contains a faxed copy of the same of the same soil test you faxed me today; the date on the first fax was 7/18/05. The fax you sent today, has updated subdivision info on it. The note regarding 4' drop from BM 1 and BM 2 and old B4 is gone also. I put today's fax in with the plan and refiled it. Would you like to receive all the emailed approval letters, instead of the secretary? I can look into changing for you if you'd like to keep a closer eye on your approvals. Thanks for your help in this plan, Pam. Give us a call anytime! Jerry Safety and E 4003 N KINNEY COU LACROSSE WI 546 Too (608) 2 www.commercem wwwmisco Jim Doyle, G Mary P. Burke, St July 19, 2005 CUST ID No.227819 ATTIC' POWTS Inspector WILLIAM J BERGH ZONING OFFICE GEO TECH ST CROIX COUNTY SPIA 2667 113TH ST 1101 CARMICHAEL RD CHIPPEWA FALLS WI 54729-6575 HUDSON WI 54016 Identification Numbers Transaction ID No. 1149968 Site ID No. 700639 Please refer to both identification numbers, above, in all correspondence with the agency. CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 07/19/2007 SITE: Vern & Carol Haas 292nd Street & 80th Avenue 8/9/2005 SAFETY AND BUILDINGS DIVISION Page 2 of 3 Town of Springfield St Croix County SW1/4, SW1/4, S21, T29N, R15W FOR: Description: Proposed Three Bedroom Mound System Object Type: POWTS Component Manual Regulated Object ID No.: 1025345 Maintenance required; 450 GPD Flow rate; 9 in Soil minimum depth to limiting factor from original grade System(s): Ezflow Mound Component Manual, (N.6/03), Pressure Distribution Component Manual - Version 2.0, SBD-10706-P (N.01/01); Biofilter 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. No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, stats. The following conditions shall be met during construction or installation and prior to occupancy or use: * This system is to be constructed and located in accordance with the enclosed approved plans and with the EZ FLOW Mound Component Manual (June 6, 2003). The pressure network is to be constructed and located in accordance with the approved plans and with the "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems Version 2.0" SBD-10706-P (N.01101). * The distribution pipe being inserted into the 4" corrugated pipe located in the EZflow product shall have one out of every five orifices installed at the 6 o'clock position. The remaining four orifices shall be installed at the 12 o'clock position. The laterals shall drain fully after every dose. * The lateral turn-up ends shall extend out past the exterior end of the cells at both ends. The observation pipes shall also be located in between where bundle(s) come together. These requirements must be followed so that the aggregate bundles will not be damaged during the installation process. * A sanitary permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.135 and 145.19, Wis. Stats. * Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stats. * The area within 15 feet horizontally below the system shall remain undisturbed. Vehicular traffic or soil compaction in this area is prohibited. * A state approved effluent filter is required. Maintenance information must be given to the owner of the tank explaining that periodic cleaning of the filter is required. Access to the filter for cleaning must be provided per Comm 84 product approval conditions. * Comm 83 22(7) - 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. Owner Responsibilities: * The current owner, and each subsequent owner, shall receive a copy of this letter including instructions relating to proper use and maintenance of the system. Owners shall receive a copy of the appropriate operation and maintenance manual and/or owner's manual for the POWTS described in this approval. * Comm 83.52(1)(a) - The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s. Comm 83.54(1). • Comm 83.52(2) - A POWTS that is not maintained in accordance with the approved management plan or as required under s. Comm 83.54(4) shall be considered a human health hazard. 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. * The owner is responsible for submitting a maintenance verification report acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. 8/9/2005 SAFETY AND BUILDINGS DIVISION Page 3 of 3 The above left addressee shall provide a copy of this letter to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 Gerard M Swim POWTS Plan Reviewer, Integrated Services (608)789-7892, Mon - Fri, 7:15 am - 4:00 pm WiSMART code: 7633 jswim@commerce.state.wi.us cc: Glen N Pelke, Glen Pelke Plumbing (Plans Mailed To) Leroy G Jansky, Wastewater Specialist, (715) 726-2544 8/9/2005 I Feb 15 05 11:54a owner 7154264827 P-1 y 4 Safety and Buildings Division CominerCeml.9ov 13 East Spruce Street Chippewa Falls WI 54729 RECEIVED isconsin Deparbnent of Commerce Jim Doyle, Governor r Cory L. Nettles, Secretary ST. CNO!X COONT'~ .ZONING OFFICE January 06, 2005 CUST ID No. 224832 A77N. Inspector MARY 10 HOLLISTER ZONING OFFICE HOLLISTERS SOIL TESTING ST CROIX COUNTY SPIA W9875 690TH AVE 1101 CARMICHAEL RD RIVER FALLS WI 54022-4011 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 01/06/2007 Identification Numbers Transaction ID No. 1087527 SITE: Twila Severson and Patricia Hubbard Site ID No. 692966 Town of Springfield, St Croix County Please refer to both identification numbers, SW 1/4, SW 1/4, S21, T29N, RI 5W LOT 3 above, in all corres ondencewrith the a en I FOR: Description: INTERPRETIVE DETERMINATION Object Type: Soil Saturation Determination Regulated Object ID No.: 995115 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 161.01(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: 1. Approval is hereby granted pursuant to s. Comm 85.60(2), Wis.. Adm. Code, to estimate the depth to seasonal soil saturation based on an interpretive determination process. Approval of the interpretive determination negates the requirement in s. Comm 85.30(2)(b), Wis. Adm. Code to designate the ground surface as the higest level of soil saturation when redoximorphic features are less than 4 inches below the bottom of the A horizon. 2. The estimated highest level of prolonged soil saturation approved under this determination is 9 inches below grade. At least 27 inches of sand lift on top of 9 inches of unsaturated, in-situ soil is required for adequate treatment and dispersal. 3. The basal soil application rate for the mound shall not be greater than 0.3 gpd/sf, and the linear loading rate not more than 5.0 gpd/ft. 4. Landscaping up slope.of the mound shall be incorporated into the POWTS design to prevent surface water from concentrating along the up slope edge of the mound and to divert surface water drainage away from the system. 5. This approval shall remain valid unless the site is altered in such a way that the depth to soil saturation would change or if saturated conditions are observed for seven consecutive days at depths less than 3 feet below the infiltrative surface of the POWTS distribution component. 6. This approval in no way relinquishes the use of color patterns to estimate the depth to high groundwater on any other parcels or portions of parcels. -7. A copy of this approval letter and attachments must accompany the mound system design for this site for purposes of plan approval and sanitary permit issuance. If the Interpretive Determination Report was accompanied with a plan and an expiration date is shown on this letter, the expiration date only applies to the plans for the design, not to the decision on the Interpretive Determination Report. ST CROTX C NCB 4 Qg$BMBNT RECI:IVIF ~ SEPTIC TANK AND 9 OWNERSF~[P CERTMCATION FOPIM i 1 2005 ryes- ~y9 /7y-3 s /9 S ROIX COUNTY per/Buycr ZONING OFFICE 3 3 ~2fi s~~a'T" o ~h 6iL'TS (.V Zvfaiiu~'Address ~Rcr$ N~ S~/LS Property Addreas (Verification rcgaircd from pianaiug Department for new consauation)_ paree! Identification Number city/State moo J nt<S X0 1 S+ illb Sec. T Z9 N"RfZ-FI' Town of PTop aty . A, f A. Lot # -3 i Subdivision page # ~'%~3 t% Certified Survey Map # Z9y 6 Page # U 7Z ' r-009/ :Z Volume A yVarranty Deed # I Lot lines identifiable )@ Y06 CJ W Spec house Q yes 0 no uilura to hodle Wtes• ProPct mawt~~ rismax could result ua its pmmxw,re Whit you put iaio :tha system S Y sts tic; usais d u~sasatana c you Tt~n 6 yeah or eo°na+ if neededby a licenses goslrtso out.tho svptio tmk as as t tmcat fut:ca PAP to ~,b,oait stage iu the wsW15% disposal syst b on Of tba scptlt: Uk ~ b the owe pd by a can affect tha a cartllicatiou form, s18J~ by d by a + tx ZotwsB '[kP~cnt the on-silo Q,aatnwatafcdl~~ T ilc pr*pem' owner 61;m" ccad ttuibu art hccascd pumlxr WifYiat tip(l) ~c tank is less than 1/3 full of sludge. tuasoe~p~ to 'S t. tiro' plumbor, resai pl is in rpo a op=tta8 oa azd/or (2) aRu tnspovdm and p`~Pi4g (S necessatY)+ tb►° i`'p azil system With tha Sunda & P er intaiu the privato sewage disp0 cation read the abova tyquimmouta and agru to ma Rcaourca+ Sesu of Crvix p✓ ~ within 3t? I/we, the uu dC of CA>m=teC and tbo Depstm °f Nate sec forth hec0ip. as set by the, Dep leted and rcturaod to the St County Zo g s , 111 that your septic system has been maintained must be comp udn days f the t>Srx year lion dato. (5-5 DATE ~A-'~~ OP Al'pLYCANr awlcdgc. I (wc) am (arc} th. ownra(s) of N I (WO) cGrtify.elut all atateuLents on tkus form are t:uc to tk~t but o stRyof Deed Office. above. by virtue of a xn=ty decd cecordcd in Rag' 3 I S the propcm' descn~ted DA'C~ F APPLICANT SIOt1A : woked by the Zoniq Depar=Cllr. r • Any infOnnstion that is atic•cepresontod may result itt the sanitary Pem►'t bring [G n deed from the Kagstor of NO& off'►cc deed, sumqx& •±~Iaciade r~th this appllcxtioa: x cop ed carvoY mp if ccformoc is Ada in the wuraatY of th, 1 r 11:54a owner 7154264627 p.2 A copy of the approved plans, specifications and this letter shall be on-site during constl'uction and open to inspection by authorized representatives ofthe Department, which may include local inspectors. If p)tu] index shei:ts were submitted io lieu of additional ftlli plansets. a copy of this approval l tter and index sheet shall be attached to plans that correspond with the copy on file with the Department. All permits required by the state or the local municlpalih' shall be obtained prior to cominenconlent of c{)nstruct'oii,izisl'ailat!on ~opcratioi,. 'r. ranting this approval the flivision of Sarmy c:. F?u06ir?`s r ser-,,[:s 01 1:T1'tli :e'l .CC:1.37c;Ci al' aUCllli ':S :ihOlllLl w!)i;i(ltillll3 arlsc )]]al•.1tl cn _ ' _t il-!eni n[:c:: )or c::!'Lre. •i' •iS ::'r Sig!: r= ; i :?'~tlt i :r; ? n: -.5: r •1]. FI t:'i C. _ -StC'!7~-1' ilt' c,i i•.!tit'\: ;tZr ~Cj it;- tic - . ,i a : tit t.:. Alex Blackburn From: Kevin Grabau Sent: Tuesday, February 01, 2005 8:11 AM To: Pam Quinn; Alex Blackburn Subject: FW: Hollister/Hubbard site -----Original Message----- From: Jansky, Leroy [mailto:ljansky@commerce.state.wi.us) Sent: Tuesday, February 01, 2005 7:10 AM To: Kevin Grabau Subject: RE: Hollister/Hubbard site This is actually a pretty good site compared to some I've been on. The site is technically an A+0 since the entire site doesn't have the 411+ across the entire site. I was pretty sure that the A+0 pits were down slope of the area for a mound. She did another pit at my request to the south (I believe) that was were my boring was done. Can't put my finger on that file at this moment to look at her 8330. Anyway this is an A+0 site and needed an interpretative report that is approved. The next step is for the design to fit the reported conditions. I'm out today for training so I will not be able to search for the full file until Wed. -----Original Message----- From: Kevin Grabau To: Leroy Jansky (E-mail) Sent: 1/31/2005 3:17 PM Subject: Hollister/Hubbard site Hey Leroy, Need an interpretation of one of your reports. It is for the owner: Hubbard, dated December 15, 2004. The plan trans 1087527. CST: Hollister You list A+2 conditions, but then talk about designing the mound to certain specifications. Are you giving the blessing to this site? It was a situation where Mary Jo was breaking up the A horizon. She has pit #1: Exactly A+4, pit #2 has A+O, pit #3: A+6, and pit #4:A+0. We need to know how to proceed with this one, for lot creation,etc. Your site report does not mention anything about interpretive determination, or further analysis. Thanks Leroy, Kevin Grabau St. Croix County Zoning Department 1101 Carmichael Rd Hudson, WI 54016 715.386.4680 keving@co.saint-croix.wi.us Zoning Department Web Page < http://www.co.saint-croix.wi.us/Departments/Zoning/default.htm <http://www.co.saint-croix.wi.us/Departments/Zoning/default.htm> > 1 SAFETY AND BUILDINGS DIVISION commerce.wi.gov Integrated Services Bureau 13 East Spruce Street Chinoewa F WI 85,4729 isconsin INSPECTION REPORT RECEMM (71 726-2544 Department of Commerce Date of Inspection: December 15, 2004 Plumber Name and A ressAN 1 0 Z005 Project Name: Hubbard Use: Residential ST.CRO~X000N7r Legal Description: r ZONING OFFICE Site Number: 692966 Subdivision: CSM Iuvi' e j Or`~ n~ Certified Soil Tester Name and Address: Municipality: Town of Springfield Mary Jo Hollister, CST 224832 County: St. Croix W9875 690th Ave River Falls WI 54022-4011 Plan Transaction Number: 1087527 Sanitary Permit Number: NA Owner Name and Address: Twila Severson & Patricia Hubbard Wastewater Flow: 450 gpd 808292 nd Street Persons Present: MJ Hollister Woodville W! 54028 An onsite soils verification was conducted at the above referenced site as per district policy for all sites with less than four inches of unsaturated soil below the bottom of the A horizon. The intent of this investigation is to confirm initial observations by the certified soil tester (CST) relating to the presence or absence of redoximorphic features in the A horizon and/or subsoil. In-situ soil texture, structure, and consistence factors were also reviewed as they relate to wastewater application rates. Other site conditions such as percent and direction of slope, landscape position, land surface contour length, and surface water hydrology may also be noted and their effects. are factors considered in the recommendations and conclusions portion of this report. A typical soil profile at could be described as follows: 00-03" 10YR 3/3 I, 2mgr, mfr, as. 03-08" 10YR 3/3 I, 2msbk, mfr, as. 08-10" 10YR 3/3 and 4/4 1, 2msbk, mfr, cw. 10-16" 10YR 4/4 sl, 2msbk, mfr, w/f2f 10YR 4/6 rmfs. If a mound system is designed to overcome limitations of a high level of seasonal soil saturation and slow permeability, the linear loading rate should not exceed 5.0 gpd/ft and the basal wastewater application rated should not exceed 0.3 gpd/ft2. The additional basal area will partially compensate for the gentle land slope and prevent wastewater leakage at the mound toe. At least 26 inches of sand lift is recommended when applying septic tank effluent to the distribution cell of the mound to ensure proper treatment. The longest portion of the mound must be orientated along the contour. The mound shall be constructed to divert surface water around the mound structure as much as possible. If there are any questions regarding this report, please contact me Leroy G. nsky, W tewater ecialist cc: © County ❑ Plumber Ljansky@commerce.state .wi. s E-mail © CST ❑ Owner 715/726-2544 Voice 7151726-2549 Fax ❑ Other SAFETY AND BUILDINGS DIVISION commerce.wi.gov Integrated Services Bureau 13 East Spruce Street Chin-wa Falk mer wi.ggo%sb INSPECTION REPORT isconsin RECEM c7, 726:2544 Department of Commerce Date of Inspection: December 15, 2004 Plumber Name and A res> AN 1 0 2005 Project Name: Hubbard Use: Residential ST.CROIX000NTY Legal Description: ZONING OFFICE Site Number: 692966 Subdivision: CSM Certified Soil Tester Name and Address: Municipality: Town of Springfield Mary Jo Hollister, CST 224832 County: St. Croix W9875 690' Ave River Falls WI 54022-4011 Plan Transaction Number: 1087527 Sanitary Permit Number: NA Owner Name and Address: Twila Severson & Patricia Hubbard Wastewater Flow: 450 gpd 808292 nd Street Persons Present: MJ Hollister Woodville WI 54028 An onsite soils verification was conducted at the above referenced site as per district policy for all sites with less than four inches of unsaturated soil below the bottom of the A horizon. The intent of this investigation is to confirm initial observations -by the certified soil tester (CST) relating to the presence or absence of redoximorphic features in the A horizon and/or subsoil. In-situ soil texture, structure, and consistence factors were also reviewed as they relate to wastewater application rates. Other site conditions such as percent and direction of slope, landscape position, land surface contour length, and surface water hydrology may also be noted and their effects are factors considered in the recommendations and conclusions portion of this report. A typical soil profile at could be described as follows: 00-03" 10YR 3/31, 2mgr, mfr, as. 03-08" 10YR 3/31, 2msbk, mfr, as. 08-10" 10YR 3/3 and 4/41, 2msbk, mfr, cw. 10-16" 10YR 4/4 sl, 2msbk, mfr, w/f2f 10YR 4/6 rmfs. If a mound system is designed to overcome limitations of a high level of seasonal soil saturation and slow permeability, the linear to ould not exceed 5.0 gpd/ft and the basal wastewater application rated should not exceed 0.3 gpd/ftz. The additional bass are wl pa rally compensate for the gentle land slope and pre t wastewater ea ag at the mound toe. At least 2l inches of sand limos recommended when applying septic tank effluent to the distribution cell of the mound to ensure proper treatment. The longest portion of the mound must be orientated along the contour. The mound shall be constructed to divert surface water.around the mound structure as much as possible. If there are any questions regarding this report, please contact me. Leroy G. nsky, W tewater ecialist cc: E County ❑ Plumber L1"anskY@commerce.state.wi. s E-mail © CST ❑ Owner .715/726-2544 Voice 715/726-2549 Fax ❑ Other RECEIVED Wisconsin Departmen of Commerce SOIL EVALUATION REPORT Page 1 of 3 Division of Safety and uildir!1A N 0 6 u 4 j ance with Comm 85, Wis. Adm. Code County ST. CROIX Attach complete ' plan 8112 11 inches in size. Plan must include, but not limit to: al point (BM), direction and Parcel I.D. percent slope, scale g rf lion and distance to nearest road. O 3 y- P/ease print all information. Date j6 Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Property Owner Property Location TWILA SEVERSON & PATRICIA HUBBARD Govt. Lot SW 1/4 SW 1/4 S 21 T 29 N R 15 E0 El Property Owner's Mailing Address L Block # Subd. Name or CSW 7 g 808 292nd Street ' d d .1' q3& City State Zip Code Phone Number OCity [:]Vllage • own Nearest Road Woodville, WI 54028 ( 715) 772 - 4262 Spv:agfield 80th Avenue E] New Construction UselD Residential / Number of bedrooms 3 Code derived design flaw rate 450 GPD Replacement Public or commercial - Describe: Parent material till Flood Plain elevation if applicable ETA ft. General comments Mound System - 0.4 loading rate - 2.5 ft. sand fill and recommendations: Additional boring required per Leroy Jansky, State Wastewater Specialist to extend area for system (See Interpretive Determination Report) (Amery series) 1❑ Boring # ❑ Boring Q Pit Ground surface elev. 99.54 ft. Depth to limiting factor 14 in. Sal Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots PD/fF in. Munseell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Efr#2 1 0-3 10YR3/3 - 1 3fgr mvfr as 3vf-co 0.6 0.8 2 3-10 - 1 2fabk mvfr as 2vf-co 0.6 0.8 3 10-14 10YR4/3 - sl 2fabk mvfr as 2vf-m 0.6 1.0 4 14-20 7.5YR3/4 f2f7.SYR4/4 sl If--mabk mfr as lvf-f 0.4 0.7 5 20-25 7.5YR3/4 c2d 7.5YR4/6 sl Om mfi lvf-f 0.2 0.6 (Some gr in all horizons; few cobbles.) 2 Boring # Boring 98.11 10 El Pit Ground surface elev. ft. Depth to limiting factor in. $oil Application Rate Horizon Depth Dormant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Efr#1 *002 1 0-3 10YR3/3 - 1 3fgr mvfr as 3vf-co 0.6 0.8 2 3-10 10YR3/3 - 1 2fabk mvfr as 2vfco 0.6 0.8 _370:15T 10YR4/3 flf 10YR4/6 sl 2fabk mvfr as 2vf-f 0.6 1.0 4 15-20 7.5YR3/4 f2f 7.5YR4/4 sl l f-mabk mfr as lvf-f 0.4 0.7 5 20-23 7.5YR3/4 c2d7.5YR4/6 sl Om mfi lvf-f 0.2 0.6 * Effluent #1 = BOD > 30:5 220 mgA_ and TSS >30:5 150 mg/_ * Effluent #2 = BOD < 30 mg/_ and TSS < 30 mg/L CST Name (Please Print) nature CST Number Mary Jo Hollister Lr, 224832 Address Date Evaluation Conducted Telephone Number W9875 690th Avenue, River Falls, WI 54022 11 - 18 - 04 & 12 - 17 - 04 (715) 426 - 1775 r ~ Pro perty Owner Severson/Hubbard Parcel ID # (Pending) Page 2 of 3 Boring 3 Boring # 0 Pit Ground surface elev. 98.32 ft. Depth to limiting factor 9 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Ef1#1 *Eff#2 1 0-3 IOYR3/3 I 3fgr mvfr as 3vf-co 0.6 0.8 2 3-9 10YR3/3 I 2fabk mvfr as 2vf-co 0.6 0.8 3 9-15 1OYR4/3 sl ' 2fabk mvfr as 2vf-m 0.6 1.0 4 15-20 7.5YR3/4 f2f7.5YR4/4 sl If--mabk mfr lvf-f 0.4 0.7 (Some gr in all horizons) F 4 ] Boring # R Boring 98.52 12 Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDHf in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eif#2 1 0_3 IOYR3/3 I 3fgr mvfr as 3vf-co 0.6 0.8 L' 2 3-12 I 2fabk mvfr as 2vf-co 0.6 0.8 3 12-15 l OYR4/3 f2f 7.5YR4/4 sl 2fabk mvfr 2vf-m 0.6 1.0 F-1 Boring # S Boring Pit Ground surface elev. ft. Depth to limiting factor in. Soft Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Mu nsefl Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 * Effluent #1 = BOD, > 30:5 220 mg/L and TSS >30 < 150 rrg/L * Effluent #2 = BODS < 30 mg/- 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 M 608-264-8777. S1113-833MM OL07M) 4 VL4r PLAN PA M 5-- a OYM~ S~v~soN i! ~ hmaL- QCA - o o Pr C.s ,4 o+E T E 7e1e S . 2- 24N AM - D i 'Towwm SM cqo - of Le f paiasrA o-- ~S N ti1J. qFW GONNA W 5EVACK ?RDPos*A 3 Acw-s Q= IfAA0 BORIJAJ U C - ~.NORZ11 pRO tV l.w~.~, VAAIJ Oro ~ w s F ~ c oq - ►w ~ J ~A14 4e Womm r'' l W FORM NO. 985•A ` ri~.drLllcr P.1.tz..l.t.e..1.. Stock No. 26273 CERTIFIED SURVEY MAP NO. VOLUME PAGE PART OF THE SOUTHWEST QUARTER OF THE SOUTHWEST QUARTER, SECTION 21, TOWNSHIP 29 NORTH, RANGE 15 WEST, TOWN OF SPRINGFIELD, ST.CROIX COUNTY,WISCONSIN West 114 Section n 21-29-15 Found Alum. Mon, Base Fd V Iron Pipe _ Z o ' UNPLATTED LANDS .471, S00'16'47'V o _o I w W from COMPuted position ' N Iv w rn . rn 40 Line (s88.47'21 "E) (13.2.53') , v N89'27'37"E 1312.66' 26.28' I NW / SW 1286.38' 445.98' --i I NE: SW SF SW 5W / SW N89'27'37"E 866.68' Z N89'27'37"E 419.70' o o N SOII tests O N N N 201,497 s ft. w N wlw OUTLOT 1 4.63 acres W LOT 3 w 1 ~ _ 867.81' 416.36' building 00 S89'27'37"W o w. 589'36'47"W 444.93' ~l setback line v Note: Outlot 1 is optional/additional land N 28.57' Z to be included with the sale of Lot 3 cLn LO_T_ 1 I I IN LOT 3 R m CSM #703 103,762 sq.ft. L N I ! 2.38 acres 0° 32.08' incl. r-o-w ° (:594.45') 394.32' 30 ,358 sq- ft. Z septic tank N8936'27"E 426.40' 97 0 ~ p 0 well (S89'24.20"W) I 16 5I 2.23 acres 1 0 0 0 vent ° ° not incl. r-o-w P D house LOT 2 i o I 'R 1 1,235,631 sq.ft. o X& A, 28.37 acres tz * anAwr * incl. r-o-w l l'° t c s-sea~ I m IZ 15: j GLOM000 arr' 1,168,610 s q. If t. h I 1 v Its ~1 ,COQ' 26.83 acres N ~d SURv~ not incl. r=o-w I c I %q o 1 Z' v I South 1/4 v - lv' 33.00' building back line , Section 21-29-15 ° 589'35'59"W 1274.43' Fd Survey Mark Nail sE/sE - I - - - - ---------1 1313.10'--Ij - - - rn 80th Ave_ NE NE ~g9'35'59"W v / P.O.B.- - - - - - - - r S89'35'59"W 1313.10, Southwest cornerUNPLATTED LANDS Section 21-29-15 2626.20' S89 35' 59"W Found Aluminum Mon, OWNERS/PREPARED FOR: PREPARED BY: Twila Severson and Trish Hubbard Joel A. Brandt 808 292th Street JB SURVEYING LLC Woodville, WI 54028 Glenwood City, WI- Note: Each parcel on this map is subject to State ahd County laws, rules and regulations (i.e. wetlands, minimum lot size, access to parcel, etc.). Before purchasing or developing any parcel, contact the St. Croix County Zoning Office for advice. Note: Outtot 1 is to be used for agricultural and recreational use only. No building development is allowed unless resubmitted for approval as a "tot". LEGEND Government Corner (as noted) SCALE: 1" = 250' o.......... Set 3/4" Iron rebar weighing North is referenced to the 1.502 lbs./lineal ft. South line of the Southwest ...,.......Found 1" Iron Pipe p' 250' 500' Quarter of Section 21-29-15, which bears S89°35'59"W o.- ........Found 3/4" Iron rebar (St. Croix County Grid System) ( ) Recorded data Page 1 of 2 • aI!~ p1946wadS }o unno I 9ZOt~5IM `all!ApooM `jS puZ6Z 908 `uosaanaS el!M_L - JauMO :oo Iw/ isileloads 6uiuoZ uangNoe18 Xaly `AlajaouiS •aogo ino }oetuoo of aa.il 19,91 aseald `sweouoo jo suoilsenb Aue aney nog( 1I •Bulleew OZd ay; o; .loud sAep g uey; ja;el ou pe:nlwgns eq;snw suoisiAON •elgel!ene uoi;ewiop aqj uo apew uoisioap a pue OZd ay; Aq paeay aq Aew dew ay; `paAlaoaa si uoiloafgo ue .tl •6ull9aw OZd txau ayt of joiad ;uaw:pedaa 6uluoZ au} of patt!wgns si uoi}oafgo uallpm a sselun elgeeajbe paaaplsuoo aq Minn siyl •passa.ippe we swat! anoge ayt li;un epua6e OZd ay; uo palnpauos oq ;ou Il!M WSO pesodoid aul •ao!go s,.ioAananS ~4unoO xiojo •tS aql woa} sluawwoo 6uiniaoaa aq Aew no k •u61sap pue uol;eulwaa;aa anl;aadjatul ue peau ll!nn;sel IloS -Z -suoi;eool Aennaniap mogS Y~lm . Ov 4 :apew aaann s;uawwoo buimollol ayl -dew anoge ay; pannalAal as}}!wwo0 nnalAaa leoiugoal i4unoO xioaO -;S ay; 900z 'z ijenagaj up :Lpuejq -ally aeaa ~Z •oaS plellBuijdS p umol - dew AananS peijiiuaO 9000NWSO uosJanaS :321 £ 60t,5 IM `/4!O pooMualE £ pal oi}sn~l 996 `BUTAgAanS S£ ;puej8 laof 90OZ '•b tienjgaj 9991,-98£ (9 LL) xe3 r089V-98E (9 LL) OLLL-9LOj7S IM `uospnH peon Iee4olwae0 LoLL d31N30 1N3WNa3AOJ AlNnoo XIOuO '1S - r r r M r ~ r 33IAAO `JAIIMOZ wages NISNOOSIM AJLNnoo Xiomo 1S T i0cle VAN Mary,o Hollister NIY W 5P875 69ot6 Avenue River ra11s, W) 5+022 ZEN\NG (715)+26 1775J--:+26-+327 Interpretative Determination Report 2+ November 200+ Property Owners: TWILA 5'E-VE.R50N AND PATRICIA HUF-)F-)AKD Location: SW of the `jW Section 21 , T2 9N, R 1 5W, Town of `jprimgfield, St. Croix County, Wisconsin INTRODUCTION: On 18 November 200+ a site and soil evaluation was completed on the property described above 6y this soil tester. The test was conducted 69 the recluest of the owners to sell a 3 acre parcel from the 37 acres that they own and have constructed a new home on it. The proposed 3 acre site is located north of the original farmstead site that was already sectioned off the original forty. (see Soil jurvey map.) Another test had been conducted a few months ago by another soil tester which initiated this report as it was determined then that there was no A++ conditions at the site. Apparently no paperwork was submitted. GEOLOGICAL HISTORY= As we know, this area in Wisconsin is an area of the Glaciated Region which occurred 35,000 to 50,000 years ago. This caused erosion, deposition, stream erosion and other processes. Wisconsin is divided into five natural regions which are related to land by the use of plants, animals and 69 man. Also the boundaries are determined 6y soil texture and d in the Western (Apland which structure in the underlying roclCS. St. Croix County is locate is underlain 69 Ordovician dolomites. (Martin, L. (1965)- The Physical Geology of Wisconsin. university of Wisconsin Press, Madison, Wisconsin.) This part of St. Croix i i Wisconsin Department of Commerce I L D Page 1 of 3 Division of Safety and Buildings ~V Wi . Adm. ' to accordance Comm 85, s Comity ST. CROIX e.((~Iaa~~ ust Attach complete site plan on paper not less than 8 112 x 1 inch e" include, but not limited to: vertical and horizontal referent point (BQ%ires(~ieSn T4%4 Parcel I.D. ending) percent slope, scale or dimensions, north arrow, and to ion a I%ceto nearest road. Please print all inform ZONING 0FF/ Y Personal information you provide maybe used for secondary purposes (Privacy L m)). Property Owner Property location ■ TWILA SEVERSON & PATRICIA HUBBARD Govt. Lot SW 114 SW 114 S 21 T 29 N R 15 E (or) W Property Owner's Mailing Address Lot # Block # Subd. Name or CSW A Wet S 4' ` 808 292nd Street City State Zip Code Phone Number ity [:]Village • Town Nearest Road Woodville, WI 54028 ( 715) 772 - 4262 80th Avenue Spp~ugfield E] New Construction UseE] Residential / Number of bedrooms 3 Code derived design flow rate 450 GPD ❑ Replacement Public or commercial - Describe: Parent material till Flood Plain elevation if applicable NA ft. General comments Mound System - 0.41oadin - 1. and recommendation: q , A+0 '7 5-/ 4 unlaw Itl QJ`~W"'°'A ry series)fih S FT-1 Boring # ❑ Boring 4 7 h l Q Pit Ground surface elev. 99.54 ft. Depth to limiting factor 14 in. Sal lication ate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fP in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 'Eff#2 {t 1 0-3 10YR3/3 - 1 3fgr mvfr as 3vf-co 0.6 0.8 flJ~ 2 3-10 1 1 2fabk m'r as 2vf-co 0.6 0.8 N 3 10-14 10YR4/3 - sl 2fabk mvfr as 2vf-m 0.6 1.0 4 14-20 7.5YR3/4 f2f 7.5YR4/4 sl l f-mabk mfr as l vf-f 0.4 0.7 5 20-25 7.5YR3/4 c2d 7.5YR4/6 sl Om mfi lvf-f 0.2 0.6 (Some gr in all horizons, few cobbles.) a Boring # Bo" 98.11 10 ■ pit Ground surface elev. ft. Depth to limiting factor in. Soil I'Ication Rate Horizon Depth Dominant Col Redox Description Texture Structure Consistence Boundary Roots GPD/rf in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 *Eff#2 1 0-3 10YR3/3 - 1 3fgr mvfr as 3vf-co 0.6 0.8 r 2 3-10 - 1 2fabk mvfr as 2vf-co 0.6 0.8 3 10-15 10YR4/3 flf10YR4/6 sl 2fabk mvfr as 2vf-f 0.6 1.0 4 15-20 7.5YR3/4 f2f7.5YR4/4 sl If--mabk mfr as lvf-f 0.4 0.7 5 20-23 7.5YR3/4 c2d7.5YR4/6 sl Om mfi lvf-f 0.2 0.6 ' Effluent #1 = BOD > 30:5 220 mg/L and TSS >30:5 150 mg1L ' E nt #2 = BOD < 30 mg/L and TSS < 30 mg/L CST Name (Please Ptird) nature CST Number Mary Jo Hollister 1~( WC3 224832 Address to Evaluation Conducted Telephone Number W9875 690th Avenue, River Falls, WI 54022 11-18-04 (715) 426 - 1775 Property Owner Severson/Hubbard Parcel ID # (Pending) Page 2 of 3 Boring 3 Boring # E] pit Ground surface elev. 9832 ft. Depth to limiting factor 9 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 1 0-3 10YR3/3 1 3fgr mvfr as 3vf-co 0.6 0.8 2 1 2fabk mvfr as 2vf-co 0.6 0.8 ~V 3 9-15 10YR4/3 A 2fabk mvfr as 2vf-m 0.6 1.0 4 15-20 7.5YR3/4 f2f 7.5YR4/4 sl If-mabk mfr lvf-f 0.4 0.7 (Some gr in all horizons) ❑ Boring # 0 Boring Pit Ground surface elev. ft. Depth to limiting factor in. Soil lication Rate 0 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 ❑ Boring # Boring Pit Ground surface elev. ft. Depth to limiting factor in. Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Murrell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 * Effluent #1 = BODS > 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BODS < 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. SBA-8330Test (R.07/00) I - - PLOf PLAN owe seveRsom tv ~ -o o ~~~e hotE - -ME THL - N ODUJD~ SSUIMED /00.00 tovimeir sM._ MCRoilcou OP OF TILLqtpffow IE. MWL.- `5 5 VO MY W/ DhAma q~~• OMM tb "1►LX 3 ,Ae.Rms ~LNOFCTtk -PROfetN l.wV-\'I, JyA* j #b2 DS v' ~ a13 s ~ w .w) ~ o SL9f.~' ~C 2 o- N 4e LorA"k 3 Xr r p1•i04E NO. Apr. l 9. 2W4 11; 58l'NI P2 FROM 1a ' WNAW • sow ao. faS• . ' '700 2.39 5#9* Na 26273 VOL'Ag PAGIC 4936 1 CERTIFIED,:-''SURVEY'" MAP INV. s°Bawc D VOLUME , P.AGE. „ 4. IM SURRr nAP a•~ l PART O>:'•rt•NE SOUTHWESTQUAR'fER~ 2' OF THE SOUTH1i00-GUART0, SEETION•21.'JOWNSHIP 20 NORT4, RANGE 15 WEST,' TOWN OF SPRfNG~IEkO; ST.~ROIX COUNTY,WISCONSIN' ` vest vi 1 found him Norc Dose , , . rd t• )r•on Pr 1 From ev"ted posltl l r v •l0 t.lne (lat'w'tl'E1 N~sr~rart; wise ze.sr _ D ~'s MW / sw - ` ±3oo.se' - - M~.e ,i: ...t . _ . - _ S< sw / sM ne9'ZTsrE' eee,ee' s Na§'0371 4,9.70' L- «t a sa. tetls R~ 201,417 sq.f t; vu7L ' 1 x.63 acres ' LOT J setboel tins I' Note=6uttoT 1 b'7ipt"IoriaUad0lNaAal land ' ` zesrl i , l to be Included with the sill of I.et 3 LOT I I r! or 3 a M - - I 762 ~ .I t03, CSM _!703 $4.1 t. u I 2.38 acres noir 1 Intl. r-o-W sE w ~ tw4.a5') , ~to.32• Nes~i'~7'E +29.40' 9T,35A sq. tt. o M 54000 WA ~r cssZtao•Mfj' 'I 2.23 acres G VV not ip(I, r-o-w 10r 2 1,235,631 s ,ft. ; 0 v~ 28.31 acres ~ l + twee . Intl. r-o-w. 1~• wvn, ...,,,69,614 sq, f.r. • ~ t ~ ~.atr ...not 1 !!„N~;~ ..South IN ne- "r--- 'Seaton 2t-29'15 - o n e a3.oo' L Fd, Survey Horn Nos i ~+t ~ .~ONJS's~"~M~. ~ 19sa.4J' ~ w,- " tPA satae,lH i3lif,to'- I 2np1AIM 14110 . ' Soutlwest .corYier'• ' SKtton ZI- 9-15 2626.20' g69'35'S9 w „.,...r ; OWNERVPREPARED FORT PREPARED Pi ..,.•JivfU bss~,~aMbsrand'Ttish ttulrbaro 'Jorl'A. draridt -10120h Street 18 SURV~IY{N6l.1,6 tJoodYille, Wt 54020 111enwood oty, WI Note: Each parcel1 on this neap is subject to State arn,~~ County laws, rules and requl Lions (I.e. ,retlands, fAlfllmwo lot %tze, et(tss to parcel etet. Belpre purchit" or. 402,1 ping any parcel, contact the 5t. Croix County 2onin4 uflca for advice. N Notes Outlot 1 k to be used loo, a ltvitural•and recreailonal use only:, No building tlevelape►Mt istt allowed unless retyg~(tkpd.CaC apprtoVat is s "lot`. L.:;tQevernete~f'CirMr (as twt:ol ' 250' o w :'Set 3fi.~•. Iron rtbii' ve~0ltinq SCALENI"• North is ral'ronced to ih. 13021as./iineal fr. South lige•or Ih* South-oal .--,Found 1' Iron Via. j Z d L£6LLZ8££9 'ON/9ti: H '1S/P: H 9002 6 A W(NOW) WOad CB AGPMMMT MADMWAN lr 4 f t SEPTIC TANK AND , X OWNERSFUP CERMCATION FORM i ja • h. 1 , 'i, f7 r C~ 7 3 3 f Zit s~rtaav' ~X ~ ~ ' , AZ , ~G "~"`/1-~ mt for naw capsauodon) N'-V, ` ~y eatioa raNired from pLaniaB AcP ea j ',,ls Parcel Identif r-ation 'llurnbcr G~/ rwi' ' S rS N.Rf.~-W. Town of b See' T i k o Mme' j. • Lot µ ^7 I volume +.'flxgcrveyMaP b Paga# q7 Cent p~*, 7 Voltucte f A~yDtfa~# D no Lot lines xdcntifitsbIo,0 yes C? yes no raot j. . f , 3' S0~ 1:i .t : wastss:'~P~ u to b=loc Y 11L4 3tetA It i~a its Pn~M t g ti1d a prat . ~Nha Y ` Y ~ ' ~ • ~ ~ ` ~~of yv~u sogtic'rys~°a'°° resa~ aeededbY a liees~edFu~aA~ , ; ' 0 1bq Npt3e tsaY cvczy►, tt+oee4 y of no ' the waste po"I system r y a `"rrr~ ;taa of tho sap de ti's s tcaattnent gap eetloa farm. bY' 901~ S' new tip to rt.~ ~ ~Y ' w oiM 1Y ~9 7 ~tot111t't0 Sf.'ClOt7C Z001k;i~e.~1~'~ taak~l ~'A X11C agcr jaspect~m ina4b~,raaic~Plumbc`arInd Tr'llwin (itnedcss•`l~"',rr~,ioptic 0 r 4~ n of (2) t g .y t, Si°osdiho `sbc vdVato rcquiraw sewa8e d ~ o- don e,t'iN, eats wd SW tomuidtdu ot Rwouroar; ~to 4~ ccct8od,baY° i"ati tbe:bova Natumt ZoB~~ R7 at d retwned to the St Croix Cotmty' r,# t!w tha'Dtparha,W of Cow=ereo and the Dql~l . L{. sot by , : , bcaa maiatalncd must be ~tnP r i~~~f ! o~~ ~P , cmhss s do mt _~C~S ,r~ t; a a on dato. O x; yew, DATE ~OF Al'pL'iC1~N'x' f ' ~o~rraortf)o ow104ge. I (we) t)4tbe,,s . • We best of my (our) 1m caul ~eb.►t;+!u ststexneets oa tk~is form are tzvc to tut ii gegidor of Deeds office. r S' .r. .c,. 'above, by ulnae of a craztity docd row 3 t,r asedbed' d r , ,1> g,Ay LICAN!' ~8 b the Za B D ~ ctm4)1G~` f / ; r y . 't rff~)Wr'C'rmkcd by k Ss that is atic mPr".*Qtadmay mwtt ~a the saaiWy p~_ . o/'~QEd~:OF+'~ •r r~' i • , S !~:u' Is s `r. .,.,.,t , traln'tea R~tcr Ilty ' + C~tI00" A nma~.a de,tu the Witt'L deed, L u ma dLbY AP• x o0 of tb'e oertiQad t~ttvoY', msp;' rv4e r . . c'~ r N4 ~ k5,,°~~,,.~vyl'~ 1, n ii~l/✓/yam/_ ~ t Uv L(f•i 1 1 l y , Y ,M 1 r I 81008 1 "7 U 2 8 4 6 P 4 7 2 KATHLEEN H. YALSH State Bar of Wisconsin Form 1 - 2003 REGISTER OF DEEDS WARRANTY DEED ST. CROIX CO., wI Document Number Document None THIS DEED, made between Twila R. Severson, a single RECEIVED FOR RECORD person and Patricia A. Hubbard, a single person as 07/19/2085 02:05PN joint tenants ("Grantor," whether one or more), WARRANTY DEED and Clarence V Haas and Carol J. Haas, husband and EXEMPT i wife as survivorship marital property ("Grantee," whether one or more). REC FEE: 11.00 TRANS FEE: 99.00 COPY FEE: Grantor, for a valuable consideration, conveys to Grantee the following CC FEE: described real estate, together with the rents, profits, fixtures and other PAGES: 1 appurtenant interests, in St. Croix County, State of Wisconsin ("Property") (if more space is needed, please attach addendum); Lot 3 of Certified Survey Map recorded in Volume 19 on page 4936 as Document No. 788139 being a part of the Southwest Quarter of the Southwest Quarter (SW's Recording Area of. SW d) , Section 21, Township 29 North, Range 15 Noma and Return Address West, Town of Springfield Title One Premier Group, Inc. 706 19th Street South Hudson, WI 54016 034-1048-20-000 Earl - r% Parcet Identification Number (PIN) This is not homestead property. (is) (is not) Grantor warrants that the title to the Property is good, indefeasible in fee simple and free and clear of eneumbcances except: Roadways, Easements, and Restrictions of record Dated , 2005 (SEAL) )CL (SEAL) *Twila R. everson *Patricia A. Hubbard (SEAL) (SEAL) * AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF WISCONSIN ) ss. authenticated on St. Croix COUNTY) Personally came before me on July, 18, 2005 , O;AR~ 4t the above-named Twila R. Severson and * Patricia A. Hubbard Patricia MEMBER STATE BAR . SC to me known to be the person(s) who executed the (If not, fo oing instrument and acknowledged-tbe same. authorized by Wis. Stat. § 70tS('j THIS INSTRUMENT DRAFTED BY: OF * Michael H. rorecki, Attorney Notary Public, State of Wisconsin tau Claire, wiseonain My Commission (is pemanent) (expires: L1174105 ) (Signatures may be authenticated or acknowledged. Both are not neceseary.) NOTE: THIS IS A STANDARD FORM. ANY MODIFICATIONS TO THIS FORM SHOULD BE CLEARLY IDENTIFIED. WARRANTY DEED STATE BAR OF WISCONSIN FORM No. 1-2003 *Type none below signatures. Attorney Miehul H Forecki 3452 OWcwood Hilly Phw, Ste 1, Hsu Clairs W1 54701.7928 PLoru: (713) 835.3029 Fax (115)1331112 T4469922.ZFX Title One Ptanier Group Produced Will ZipFormm by RE FormsNet, LLC 18025 Fifteen Mlle Road, Clinton Towrahlp, Michigan 19095, (a(q 383.8805 wom.6100 mtom 45 i t,¢ Ole S ) l.' l i of rD 00 N 0 4~ CO co' L d3 a G D GI ! •P ~ W uuu ~DOC1i L`3 Cl ti O D O im-urutj L.1 C7 wuuQQDD~. OODgnGQ.©GO C3p1 oaooogGGaa C) o a r • a❑na ~.r~v . • p0 %D r' n❑UG.~ p.DQ cy } , ~p dCnGw41'sA0 q X x`n v . ~ ppooaa. GgC~ C, C) a Li 5. f M O O d o C( O CQ` 0 00 [aQQdQ~'OgC3C7 . 26 0 WOa~ Z d 1.£szla8££9'ON/W l l '1S/W l l 500Z 6 Ow (NOW) 13 3 • FORM NO. 995-A t ~ o.,~~! ~!'!er 7 6 6 1 3 Stock No. 26273 VOL 19 PAGE 4936 REGISTER OF D EDS CERTIFIED SURVEY MAP NO. 82/24/20850 09E00AN VOLUME 19 PAGE 4936 CERTIFIED SURVEY MAP *REC FEE: 13.00 COPY FEE- 3.00 PART OF THE SOUTHWEST QUARTER PAGES: 2 OF THE SOUTHWEST QUARTER, SECTION 21, TOWNSHIP 29 NORTH, RANGE 15 WEST, TOWN OF SPRINGFIELD, ST.CROIX COUNTY,WISCONSIN West 114 Section 21-29-15 Found Alum. Mon. Base Fd V Iron Pipe r g UNPLATTED LANDS .47', S00'16'47-V r 3 s N C~ From computed position Y n u! v 40 Line (sflri•n..~. : ! • r.:,s') f N89-27.37-E 7312.66' 26.28' N!v / 5'.V 1286.36' 445.98' f `"N N89'27'37"E 866.68' Z N89'27'37"E 419.70 O N soli tests N 201,497 sq.ft. N N y C Io OUTLOT 1 4.63 acres w LOT 3 u ot. 0? 867.81' 416.36' hi,ildinq S89'27'37"W in 589'36'47"W 444.93' 1 I so:hack i,le Note Outlot 1 is optional/additional land 28.57 lm Z to be included with the sale of Lot 3 ? o ` OT 1 I ` IN LOT 3 ° m CSM 97 103,762 sq.ft. 4- u, t -,-YL I 1~ 2.38 acres V I 32.08 incl. r-o-w f0~' N. 4 f 0 A- 114-12' 24 septic tank N8936'27"E 426.40' 97.358 sq. ft. n2-23 ot acres C)C) a wello ^ ,9(' (ss9; 2:>°w) ; 165- N c°n vent O `ol"UD 1 nO incl. r-o-w vt co a house LOT 0 4 v ~~ti 1,235,631 sq.ft. i ( o .JO!'LA. 28.37 acres ~ w l ~b sa * ~ T s incl. r-o-w I rn I I z . a~wwooocrrv, Iti I Ir an 1,168,610 sq. ft. Cp ,o I ~-9~ pQ 26.83 acres o SUR~I Qy~ not incl. r-o-w I CD Z 4• Iz Lnn_ I ( South 114 ly 33.00' setback !in e: I Section 21-29-15 8 589'35'59"W 1274.43' Fd Survey Mark Nail L 1313.10' . f 80th Ave. 7. 589'39'59W z B.- - - - 1313.10'-~ 58935'59"W Southwest corner LJ PLATTED LANDS L Section 21-29-15 2626.20' S89-35'59"W Found Aluminum Mon. OWNERS/PREPARED FOR: PREPARED BY: Twita Severson and Trish Hubbard Joel A. Brandt 808 292th Street J8 SURVEYING LLC Woodville, WI 54028 Glenwood City, WI Note: Each parcel on this map is subject to State and County laws, rules and regulations (i.e. wetlands, minimum lot size, access to parcel, etc.). Before purchasing or developing any parcel, contact the St. Croix County Zoning Office for advice. N Note: Outlot 1 is to be used for agricultural and recreational use only. No building development is allowed unless resubmitted for approval as a "lot". LEGEND .........Government Corner (as noted) SCALE: 1" = 250' o-........ Set 3/4" Iron rebar weighing North is referenced to the 1.502 lbs./lineal ft. South line of the Southwest ...........Found 1" Iron Pipe Quarter of Section 21-29-15, 0' 250' 500' which bears S89°35'59"yi Found 3/4" Iron rebar (St. Croix County Grid System) Recorded data Page 1 of 2 Vol 19 Page 4936