HomeMy WebLinkAbout020-1049-90-400Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix
Safety and Building Division
INSPECTION REPORT Sanitary Permit No
GENERAL INFORMATION (ATTACH TO PERMIT) 641964
State Plan ID No
Personal information you provide may be used for secondary purposes [Privacy Law. s 15 04 (1)(mil
Permit Holder's Name: City Village Township Parcel Tax No:
Mike ld Betty Brueske TOWN OF HUDSON 020-1049-90-400
CST BM Elev: Insp. BM Elev. BfDescription: t Section/Town;Range/Map No.
Nl 20.29.19.192B-40
TANK INFORMATION ELEVATION DATA
TYPE
MANUFACT E
CAPACITY
Septic
-
Dosing
Appafion
Hol Ing
TANK SETBACK INFORMATION
TANK TO
P/L
WELL
BLDG.
Vent to Air Intake
ROAD
Septic
Dosing
Aeration
Holding
PUMP/SIPHON1NFORMATION
tmiTall
Ft
STATION
BS
HI
FS
ELEV.
Benchmark
�J
BM
Ot if
ftJa,
Bldg. Sewer
00.3
SUM Inlet
•
qcl
Jb
St/Ht Outlet
t Inlet
Dt otto
Header/Man.
Dist. Pipe
Bot. System
'it
rz
t3
ILI
2. p
v
Final Grade
T$
13
90 . 0
Cover
�
r
9
a
«
T
rr
qa
JVIL MOQwr\r 1 IVI`I 01 J I Ill
\1—
iq 7 1 /
BED/TRENCH
DIMENSIONS
Width n I Length
{l" /
r No. Cf Treryhes
i�
PI7 DIMENSIONS Na. Of Pits Inside Dia. Liquid Depth
SETBACK
SYSTEM TO
P/L
BLDG
WELL
LAKE/STREAM
LEACHING
ufa
rer
INFORMATION
CHAMBER OR
UNIT
t
Type Of System: r
v
,71t5
, +
T7fTL
M el
er
UI5TKI13UTION SYSTEM I
HeadedManifold
r1
istrb ion
x H
x Hole Spacing
Vent to Air Intake
/�
il-ength-W-Dia
jlp)ipe�s)
"I
Length Dia Spacing
SUIL GUVEK v Praeciwa Svetnme Ornh. vv Mnunrl nr
Depth Over t
Bed.tTrench Center r 3
Depth Over 1�
Bed/Trench Edges /
x epth of
Top it
xx Seede dded
xx Mulched
I?
Yesr_ No
j_.] Yes f_,. No
COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: Inspection #2:
Location: 795 MARTIN AVE --V C�1/T7 Q� lootli
1.) Alt BM Description=(1`kd! mil y,� O 11 O'^ 1 f 750• ��6M 11%,�n�11_ v
2.) Bldg sewer length = 4-1 Al `t t ` +• t lU j,�
- amount of cover = -f,46t•
Plan revision Required? [Yes I No U v /�/��}I�.j,,j�J
Use other side for additional information. ���JJJ �� �J o� _ _ (J( `''I _"'
SBD-6710 (R.3/97) Date m4epc1dr's-Sigrillature Cent. No.
JI\\V/e1Mlull WAN
v v
= Safety and Buildings Division
- -
/ Ctt-o (-
Sanitary Permit Number (to be 511ed in by Co.)
9 APR 6 2022 01 W. Washington Ave., P.O. Box 7162
` Madison, WI 53707-7162
St. Croix County
nt
! I
ommtutity Devetopm
State Transaction Number
Sanitary Permit Application
In accordance with SPS 38321(2), Wis. Adm. Code, submission of this form to tite approptive governmental unit
Project Address (if different than mailing address)
is required prior to obtaining a sanitary permit Note: Application forms for state-owned POWTS are submitted to
the Department of Safety and Professional Servies. Personal information you provide may be used for secondary
purposes in accordance with the Privacy Law, s. 15.04 1)(m), Slats.
� W-If�t—
���1fC!
I. Application Information- Please Print All Information
Property Owner's NameAAAK
Parcel #
E 1- i u SKE
DZQ 76- z o
Property Owner's Mailing Address
Property Location
-7Z ii2 EtcA ( R-1 X 0 A-w
Govt. Lot
y,, AJ4J y., Section ZO
City, Stater'
ZipCode
Phone Number
�0(circ
7//5-53/-333�
T N. RIEon'ED"
11. Type of Building (check all that apply) ��yj
Lot #
Subdivision Name
1 or 2 Family Dwelling - Number o Bedrooms
Block#
446
❑ City of
❑ Public/Commercial - Describe Use
❑ State Owned -Describe Use
❑ Village of
"Town Ait.�`lU.�
CSM Number0oG :
A f G A Q
t/ /C/ - 43 f
of
III. Type of Permit: (Check only one box on line A. Complete line B if applicable)
A.
New System
❑ Replacemert System
❑ Treatment/Holding Tank Replacement Only
❑ Other Modification to Existing System (explain)
B.
❑ Permit Renewal
❑ Permit Revision
❑ Change of Plumber
❑ Permit Transfer to New
List Previous Permit Number and Date Issued
Before Expiration
Owner
IV. T S stem/Com onent/Device: Check all that apply)
Non -Pressurized In -Ground ❑ Pressurized In -Ground ❑ At -Grade ❑ Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil
❑ Holding Tank ❑ Other Dispersal Component (explain) ❑ Pretreatment Device (e I
V. Dispersal/Treatment Area Information:
t
Desi�Flow (�d)
Design Soil Application Ra gpdsf)
Dispersal Required (sf)
Dispersal Area%P�pos
ti ent evanon
Ct
CC..��
7
.S 11
/ t
Z /
VI. Tank Info
Capacity in
Total
# of
Manufacturer
Gallons
Gallons
Units
� �y (
o
c
u
New Tanks
Existing Tanks
g25� T' [ t-""'
y 0
u
a°ri
mu g
Septic or Holding Talc
'L D.O
...�
_
w �2 Jl�l�
Dosing Chamber
9 0
v
c..-
%Q � C i�-(.F%f'C3
VIL Responsibility Statement- I, the undersigned, assume responsibility for installation of the PORTS shown on the attached plans.
Plumber' Nam? (Print)
Plumber's S' ature
MPRAPAS Number
Business Phone Number
'(! AJ eA,/
�-
zz
z13 YyW
Plumber's Address (Street, City, State, Zip Code)
15 t- ( '9
VIII. Coun /De artment Use Only
Approved
❑ -Disap ved
Permit Fee
Date Issued
Issuin Age n[ Sign r
❑
ven nforDenial
Ix. Conditions ffApprove pproval SYSTEM OWN ��-
3� �,�QQGP�wt
.
1. Septic tank, eMuemt Alter And 1 _
dispersal cell must be ggrviced 1 maintained
as per management plan provided by plumber.
2. All setback requirements must be maintained
-- r-• •-rr ••--,-•- -- r.wa ...mp,crc j,-- r-, we nn,- auu >uuuur to rue wuury oary on paper not IRS mama zee i tycaches in size
SBD-6398(R. 11/11)
cl
fir
if
M
Pg_of_Z
Private On -Site Wastewater Treatment System (POWTS)
Index and Title Sheet
11.
Owner's Name:
Site address: rr
Location: Lot , Block , Subdivision/CSM `1— Cc q L E�-
being part of the �'/a of the /" W'/, Section Z0, Town±aN, Range---W,
Tows of A j o AJ 57 -' CROIX. County, WI.
Parcel Identification # e ZD - /0 K�i - a Q ` �W-r O
Design: In accordance with Department of Safety & Professional Services (SPS) Wisconsin
Administrative Code ch. SPS 381 through 387 and 391. Design manual (choose one):
❑ Holding Tank Component Manual [VER 2.0, SBD-10855-P (N. 03/07, R. 1/12)]
Nth -ground Soil Absorption Component Manual [SBD-10705-P (N.01/01)]
Contents: Page 1: t(f ut
Page 2:
Page 3: `A"'y (Z
Page 4: F/L ftff R
Page5: ��4s tiGLGi�o,i
Page 6: Q L�LI C_ k T IA-1 F/G f ttA e,¢
Page 7: jPL A N
Page 8:
Page 9:
Attachments:
Plumber/Designer: &feeLzGj-0Al
Credential Number: z6 ;�21 Date: 7 ` Z
-r
b L
ro
120j"
TOP VIEW
SIDE VIEW
WLP1250-MR
TANK SPECIFICATIONS
DIMENSIONS;
WALL: 2 1 /2"
BOTTOM: SEPTIC 3"
COVER: 5"
MANHOLE: 24" I.D. PRECAST CONCRETE RISER
HEIGHT. 52 1/2" O.D.
LENGTH: 120 1/4" O.D.
WIDTH: 84" O.D.
BELOW INLET. 41" O.D.
LIQUID LEVEL- 36"
WEIGHT: 8.810 LBS.
INLET AND OUTLET:
4" CAST -A -SEAL BOOT OR EQUAL
GASKET, CAST -A -SEAL BOOT OR EQUAL
INLET AND OUTLET BAFFLE AND FILTER:
WISCONSIN, SEE DETAIL #10
(OTHER STATES SEE CHART)
LIQUID CAPACIT( 34.81 GAL/IN
HOLDING TANK:
OUTLET HOLE PLUGGED
ACTUAL CAPACITY: 1,253 GALLONS
LOADING DESIGN: 8' 0" UNSATURATED SOIL
MN TANKS:
WILL HAVE ONE VENT OVER OUTLET
AND WILL HAVE TWO VENTS IN,COVER OVER INLET
TANK CAN BE USED AS:
SEPTIC/ HOLDING/ PUMP OR SIPHON
4" OUTLET
n
7
CUSTOMIZED TANKS:
TANKS CAN BE CUSTOMIZED CONTACT WIESER CONCRETE
TANKS ARE MANUFACTURED TO MEET OR EXCEED ASTM C-1227 REQUIREMENTS
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Hsary-Duty outlet
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hltsrwa e..w aovtar wd raw do
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lhs a+l.t M dalAay..rls whkh
., bean adm,aa gnmgOr and abbalty -
mdragNad ..:i:.: :._.. Bottom Inlet
��+L'r'•' I.n.wee.Igm+nrl.wa.d.rc. ase..rr..lrst.rAsn. i,
AI=:.iit'%',i`.` d9tefwe7gYup
rgll.trlid4eaamph , .
SoatAs'wad atlgaa � �P•+aant.te..rk/nawlg
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Molded -In Hubs
v ._ 1hbMMMebr.pwld. aplrW uq.e
7M aD•n boaarnKA
kdat SId.1Jp.Adn addilwg dabaq
40—M.KW to sac y r.wlrMae
atlo. bibtwlalmtA4 back '`
down 6Aa the bnk �_
The mr h o we aVW
lichen tar rddiaaag
Inc
saptwt vM oes uwld.d-i.
hg. n. a»gaa ran rs,haar.
gaaKv0.r'"'0r ® Zabel•
w"d,.awp A UAA. d v.A1rw we
3 Fnirfleid ehrd. Wdlingrard. Connemkar 0e492
"77-795-OM Fax: 2QF2843514
MW In l» u qA
OM&W ulev®poiyiokcom
_
Web sit¢ r .Polyiak ,n
A Great Design
The Best GF10 fitter doesn't just trap solids. its
unique conical shape design allows urnrented
The GFT O Is brown for, its strength.
material to flow over the plates and fall back
The housing,"well as the outlet were
designed with durability In mind. To
Into the tank. The filter has a one-piece hous-
ing made of impact resistant PVC-
show Just how strong the filter is, we
placed a 420 pound concrete riser on
The GF10 filter plates era locked together with
top of the GF10 filter can and con, -
five nbe and two sections of %, SchedWs
netted it to a 4" Sch 46 pipe.
40 PVC pipe. This unique configuration pro-
vides even Weight distribution and maximum
Tofurtherimprove the strength of this
strength.
filter, our engineers redesigned the
handle, making it even sturdier than
The GF10 Is rated at 25DO GPD and fa available
the Original design.
in 1j8"., 1116" and Tj32" filtration levels_ The
smaller nitration levels are idW forlesidential
settings and the 1/32' filtration can be used
in most commercial applications including
C
WaSteWalartrBati'T19t1t SysterM, grBBse imps,
kennels or salons_
-dog t +:
BEST 1 D' FILTER
Ea
iiii 2ia::i'i" c5si:=?title
r
�— or 2— Family Dwelling In -ground Soil Absorption System (2-cell Conventional)
Daily Wastewater Flow (DWF) i = # of bedrooms x 150 gal/day/bedroom = , 7 gal/day
Design Loading Rate (DLR) or Soil Application Rate �01 gpd/ft2 (per SPS Table 383.44-1, 2, or �)
Required Distribution cell area = DWF t— gal/day + DLR UCH gpd/ftz ft'
l
# Chambers = Required Distribution cell area c�J� ft2 + ft2/ unit EISA = ? Chambers
Chamber Manufacturer and Model: 62- Lu L 41 us
�9
Actual Distribution cell area = Required cell area O 6O ft2 + 29Z ft2/ unit EISA End Cap Pair = 9.7diZft2
s'tiA
Cross -Section in -ground Soil Absorption System (2-cell):
4" Schedule 40 PVC
ff vent pipe with vent cap
12 inches minimum 12 inches minimum
°-k 3 inches Soil Cover
Trench 1 Sys-
tem Elevation Z inch Chamber Height
q ft �ft Trench 2 System
j� 01 ,.� Elevation
J ft ft
Trench Separation Leaching Chamber Width
ft to limiting factor
r
Plan View In -ground Soil Absorption System (2-cell): Trench 1
ft Modify
header/
A.
ft r design as
Leaching Chambers � �—� needed.
Trench 2
4 inch Header
ftwith end camps
Draw O for a Vent and for Observation Pipe above. They will be located ft from the end of the cell.
Vent pipes shall be Schedule 40 PVC and extend at least 12 Inches above finished grade.
Observation pipes that extend above finished grade must also be 4 Inch Schedule 40 PVC.
N
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Quick4 Plus Standard Chamber Side and End Views
48"
(EFFECTNE LENGTH)
12"
�IN
A` 1
34"—
Quick4 Plus All -in -One 12 Encap Front, Side and End Views
8"INJVERT 5.33- INVERT
Quick4 Plus All -in -One Periscope
Qull:tiul PLUS
12.7' INVERT QUICK4 PLUS
ALL411-ONE 12
ENDCAP
I . A&
Quick4 Plus Standard Chamber Specifications
6„ —s I�
—{
Size (W x L x H) .:........... 34" x 53" x 12" (86 cm x 1.35 cm x 31 cm).Invert Height',..,,,,,.,,....., 0,6", 5.3', 8.0', 12.7"
Effective Length........................................................ 48" (122 cm)
(1.5 cm, 8.4 cm, 18,5 cm, 22,6 cm) ' J
INFILTRATOR SYSTEMS, INC. STANDARD LIMITED WARRANTY
(a) The structural integrity of each chamber, end plate, wedge and other accessory manufactured by Infiltrator ( 'Units'), when installed and
operated in a laachfield of an onshe septic system In accordance with Infiltrator's Instructions, is warranted to the original purchaser ('Holder')
against detective materials and workmanship for one year from the date that the Septic permit Is Issued for the septic system containing the Units;
provided, however, that if a septic permit Is not required by applicable law, the warranty period will begin upon the date that installation of the
septic system commences. To exercise its warranty rights, Holder must notify Infiltrator In writing at Its Corporate Headquarters In Old Saybrook,
Connecticut within filleen (15) days of the alleged defeLt. Infiltrator will supply replacement Units for Units determined by Infiltrator to be covered
by this Limited Warranty. Infiltrator's liability specifically excludes the cost of removal and/or installation of the Units.
(b)THE LIMITED Willi
,.rANTY AND REMEDIES IN SUBPARAGRAPH (a) ARE EXCLUSIVE, THERE ARE NO OTHER WARRANTIES WITH RESPECT
TO THE UNITS: INCUJDING NO IMPLIED WARRANTIES OF MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE
(c) This Limited Warranty shall be void if any part of the chamber system is manufactured by anyone other than Infiltrator. The Limited Warranty
does not extend to incidental, consequential, special or indirect damages. Infiltralor shall not be liable for penalties or liquidated damages,
including loss of production and profits, labor and materials, overhead costs, or other tosses or expenses incurred by the Holder or any third party.
Specifically excluded from Limited Warranty coverage are damage to the Units due to ordinary wear and tear, alteration, accident, misuse, abuse
or neglect of the Units: the Units being subjected to vehicle traffic or other conditions which are not permitted by the installation instructions; failure
to maintain the minimum ground covers set forth in the Installation instructions; the placement of improper materials Into the system containing
the Units; failure of the Units or the septic system due to Improper siting or Improper sizing, excessive water usage, improper grease disposal,
or improper operation: or any other event not caused by Infiltrator. This Limited Warranty shall be void if the Holder falls W comply with all of the
terms set forth in INS Limited Warranty. Further, in no event shall Infiltrator be responsible for any loss or damage to the Holder. the Units, or any
third party resulting Irom'xiglallation of shipment, or from any product liability claims of Holder or any third party. For this Limited Wamanly to
apply, the Units must be installed in accordance with all site conditions required by state and local codes: all other applicable taws; and Infiltrator's
Installation instructions.
(d) No representative of Infiltrator has the authority to change or extend this Limited Warranty. No warranty applies to any parry other than the
original Holder. '
The above represents the Standard United Warranty offered by Infiltrator.' A limited number of states and counties have different warranty
requirements. Any purchaser of Units should contact Infiltrator's Corporate Headquarters In Old Saybrook, Connecticut, prior to such purchase.
to obtain a copy of the applicable warranty, and should carefully read that warranty prior to the purchase of Units.
y!r
INFILTRATOR®
systems inc.
6 Business Park Road a P.O. Box 768
Old Saybrook, CT 06475
860.677.7000 a FAX 860.677.7001
800.221.4436
www.infiltratorsystems.com
U.S. Patents: 4.759,661; 5.017.041; 6,156.468; 5,336,017; 5.401,116; 5.401,459, 5,511,903; 5,716,163; 5,588,778; 5,839,644
Canadian Patents: 1,329.959; 2,004,564 Other palenls pending.
Infiltrator. Equalizer. Quick4 and Oulck4 Plus are registered trademarks of Infiltrator Systems Inc. Infiltrator Is a registered trademark In France. Infiltrator Systems Inc.
is a registered trademark in Mexico. Contour Swivel Connection is a trademark of Infiltrator Systems Inc. 0 2009 Infiltrator Systems Inc. Printed in U.S.A.
PLUS0510101SI.2
IPA
in -ground Gra vity Management Plan 7
IMPORTANT. 11
The owner of i6 in -ground gravity system shall be responsible for its perpetual operation and malritanande pursuant to
requlrementsof SPS382-384, Wisc. Admin. Code. Pumwnt kPGPS 383.52 (2), Wisc. Admin. Code, this system shall
be considered -a hurRo health hazard if notmaintained in accordance with this approved managemed plan.
Furthermbre, all inspection and maintenance activillai shall be performed by a registered POWS Mallitalner in
accordance.with-SPS30.52 (3), Wisc. Admin. Code.
Maximum Dl ersalAreagneratiou Limb:
DesignFlown f000 gpd; BOWS 220mgC; TSS:5150mgL"; FOG S30moc
InsoectionChet.1ftt INSPECT EVERY 3 YEARS
0 type Of use
o age of system
o nuisance factors (i.e. odors, user complaints, etc.)
0 Mechanical malfunction (i.e., pumps, valves, switches, floats, 014C.)
o material fatigue (i.e., leaks, breaksi corrosion, eta)
• solids volurn I a in anaerobic treatment tank(s) and any distribution appudenance(s) (i.e;, distribution drop boxes)
• neglect or Improper use (Is., exceeding design capacities, prohibited itdivides, etc.)
• extent of ponding In distribution call prior to dosing
• dosing. irregularities - if applicable (i.e., pump rewcycling, float switch Setting$, etc.)
• elect" components - If . applicable icable (I.e., wiring, connections, switches, controls, tirners, alarms, etc.)
• dIstribution lateral or latefo odfice plugging (measure lateral distal pressure — compare to design specification)
• surface discharge of effluent or sawage- back-up into structure served
Maintenance.Checkllst MAINTAIN OffiRY 3 YEARS (c�F when necessary)
• Sapticand-do took( shall be pumped by a.cettified septagie'servicing operator licensed under s. 281.48 Wis.
Stats. when the volunWof solids :In the taniqu) exceeds one-third (113) the liquid volume of the tank(s) or
as required by1ocal ordnance. Disposal of pontents shall be pursuant to NR 113, Wisc. Admin. Code.
• Efflugatfiltoriel shall be Inspected 6Vsjy 3 y0ars and shall be cleaned when necessary to remove any
accumulated solids accordingrto manufacturees specifications. A servicing period will always be greater than 12
months.
System maintenance reports shall be submittet! to
SPS 383.55 V1114t. Admin. Code. Report anvvolniPc
unit In accordance with
Name of Individualor company. /J-- yep 7I- --Z7'5-1f44q'
Local gDVWnehtunit ..F. C.42-0 14 7::v a:v I --t#' .-Phone. 713;-3f6 416.9e)
Local 90469nt unit address. zip.
Any defectim part.of this sySterr*aill be rep 38 Vil alred,j0plated, Or remQ*pur6u9ff.to $Pt 3.61 (1),, sc. Admin.
Code. Repair or replacement of fbi)!ed *o' mallUnctioning,opmponents abaft comply with SPS'3133, Wsc. Admin. Code.
No product for chemical or physical restoration of the Pt: WtS may be used untess approved by the department in
a=rdance uft SPS 384, Wisc. Admin. Code.
ConiUrinengX.P'lap
In the event that any Wed - trbaftnent compone4afthiN70M cannotbe it shall be replaced pursuant to
a plan submittodto the appropriate agencyfor review and, approval. A failed in -ground dispersal component may be
abandoned and replaced by a code -complying disperse I component In a pre-determinso.,area of suitable soils.
61rt sm Abandonment
If usaof this POWTS is discontinued, it shall be obarxidned in accordance with SPS 383.33, Wisc. Admin. Code.
i.
�''Ile
AiV tlA- bY Cice Use OnlyOWNERS HIP/ADDRns r0RM reeoted12o27
^
Community Development Department will utilize this information to provide the property owner with
information regarding operation and maintenance of your new or replacement sanitary system! This
information will be provided as part of our ongoing efforts to protect public health, your well, groundwater,
surface water, property values, and county resources. Once approved, this completed form and educational
information will be sent to you by email.
OWNER113UYER INF6RMATION
Owner/Buyer PA�Vli 4 ;BE-'tfY ZkuE SKF
Mailing Address It-2 y Grae t4 f%KI AR, RoAb
City/State/Zip N Ub st-),Jy < <5 `t el 16
Phone Number (required)_ " 715 3 3-:�> 1
Email Address (required) ���_KE.brQe-SKe(-@9/ynii r Garr
Parcel Identification Number . b JO 1F9 `90 q00
(found on the property tax bill)
NEW SYSTEM: LEGAL DESCRIPTION
Property Location SE t/4 , " t/4 , Sec. 1_O , T Ni RA-W, Town of 14 uj�k 5 c) N(
subdivision Plat: Tblc L l E 1.1
Lot #.
Certified Survey Map # volume� Page *-AIWO
Warranty Deed # l XCC, 2 (before 2006)Volume . Page #
Number of bedrooms _4 Spec house 4 yes <no Lot lines identifiable )(yes 13 no
ONCE USE ONO
^
New Property Address
(Verifies 'on of n w address required from Community Devetopmen Depa ment for new construdfon.)
' 2 �.�
( a Init(als) (Dat
This form must be submitted with all Private Onsite Water Treatment System (POWTS) applications.
F
New System: Include with this form a recorded warranty deed from the Register of Deeds Office and a copy of the certified
survey map if reference is made in the warranty deed.
i
Community Development Department- Land Use Division
715-386-4680 St. Croix County Government Center 715-245-4250 Fax
cdclsccwi.gov 1101 Carmichael Road, tludson, Wl 54016 WWW.scCwzSj0V
1()ai9
tJ
i��'] ( E•(
Dlvfadan of SewY and In m mdam wkh Cararn 85, WF. Adrn Cads SW sod bmvk1 e
AfthoaAibai0mwppnctloriaralxItiWh=imsaePlaran* J�/�/�
b**.bulrntWedfxvntinimmmudidnw"PurAt{t3a�c- " .+�� 11 ' W'
percer[ etNr a dnslnuiorq hoot", am otxars snd 3aaretb rM6reet road. Pamd I.D. rr ! l ii � ' . ! (. -
PibfaH i ffiDab
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sienn. _ ►C�ch+2 r"+UU G 6 200
MO&ro .S T. , o
4W Wan Dr. Sude 808 ZON1c c 'l t Y
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s5dirA MN 55435 852435-2808
Rvs (a(eo>. / 43103
t Owfim
S'
1CCaftLot F IFt NW1P3 3 T 29 liR 19 W
L e!aaca Saari. Nero
1 J c c; v (W TO= Nwnw How � . l`7 L� 6)
"dam c.l:woa�eFtta.7y'S� 2t
Mw Cambuckm UM ! FAB daiYd / NmOw d bedrmns 4 Cade dww deslgr bar rah
600
GPD
}� RaplOWmft PtM or colrrrerCW - Die:
Parem waww Pkhd mdwaah
Pkwd pleb * Wm. M Wpkb
n.
GWWW ccrrrnsnts
and recarNAe dMW Sytttdn el WIM 81.5M trope M 8p ftd Md d" 10 ODde 3.50ft bWDW plede by--
V JO-4eA S,9b ack- 0. ay-t 4 k.1,
— 'g kg VZ
i 7 IBot�ps
105
0a�
1�J ]� Fst 3latnd Sutaco akrr.
85.00 tt paptfi io in3irg tumor kL
Sa gppb•d" Rek
Hart= Depth Dw*m t Color Ralnc
Tatars shwkye Cmuft ;6 tlandn/ Room
OPDW
-Emi
`EIR2
1 0 8 10yr3/3 11006
a 2mabk Mir Cs 2c
.5
.8
2 8-28 loom lwm
acid 2msbk n* ow I
,4
.8
&jW4 none
3 2P427-105
b 0" nNfr cs na
�
1.2
4 7.W4 none
COOS m ny& na ne
—
.7
1.6
,a 14-c-A
G"
Bart: Bm"
105
■ Pit Grw W surtece etev.
95.00 IL D4Ah to Nrnbt facby in,
Soi Apt zWm Rae
Nor'vm D40 Da mt Cula RE&m DwaW n
Tedre skit a Car aWm Omitbffy Root
`E}611GPOW
I 'Eff/4
1 G 8 SOyTJI3 none
ad 2rnobk P* C8 lc
.5
.8
2 6-16 5"9 none
Is m rrwfr gw 2f
.7
1.2
3 tt310.5 7.5yr4/4 none
cn CDs
� we j oag ffv* ne no
�
1.6
/149, dye ys, ja "�
0 r' ZA- syr'44. --A 4W4-.'�r..•.ra�
`f.Zr/tD2
0Eftwd#I-OW?30K220m81LandTSS>31)e138m &
'EfiiadrR-BOD �9 MOOLrrdTSSS,7Dmp11.
CST NWA i`PltMer PrM
CST Number
J. StYel �%
24
Add:sss Stoat Sail Servloe �^'�^-�
d*
Oft
Ddm Erekrdhn Coreduclad TSB NurMa
15154 CR Pieer wt 840I
8JI�fl2002 7154E 5085
Y
2L-AO (xli7iu;eitl0ii 1}i41If71J C r ii[! 17£r) 7 of
L�J i� Otaud Stelasotlw+. 9I1.70 IL Deplft to IiR�kg fer•Got 105 YI. '
Sd Awkdm Rd
Na¢nn DvM DwimiLbbr RedorDa oom To" S ldm Coai� Bomiq Rxb 0PDr
*EM °EfrMCi
1 0-16 lopes npns sid 2nlsbk ft* ce 2C .4 .6
2 16-20 5y014 rKMo b oeg nw(r cs If .7 1.2
3 105 7SyMJ4 n0ae ON 050 WAV ne na 1.6
�f S �� rn�G . �i'e e�• tys�� .�-�
PA Grand swhca aim 90.70 ft. Depth to Ym MV faclor 96 inf`ea o.e—I
2 14-32 5yn4/4 crone
3 32-BB 75yM/D none
r
am 2mabk mfr cs 2c .4 A
Is 0e9 rnvfr co 1f .7 1.2
ms 0ag rni na no 0 12
° Ef mril 01- SOD e 30 < 220 nWL and TSS >30 < 1 Go mg& • Ef lewd ail a BWS-S 30 ffOL and TSS < X mWt
The Dgw9wW of Comnvaoe man Nugoppmpmity a w 1ovid++d aw*yer. Ifyou med admaoe t0 000m awioce or
Pago 3 of 3
STEELS SOIL SERVICE
David L steel 1564 Cty Rd GG
CST-POWTSM Sienna Corporation New Riclmrond, W154017
Tic. # 248956 swtra,Nwlra,S 20,T29,R19w (715) za6-62o0
Town of jft dsan, St. Goat Co. (715) 246-5085
The Glen tat 0 4
This sail evalaatian wad eaadutted to satiety a zea is regobvmeA it day or ray mO be WNW for
yaw W.
pa rd
FA, la WO-
r� of"/>ra f7,pc
= Ali 8e%AP'HaAk FA-100rr
lr�m.� f4lf-
Rpr � r� fc'/e H► fiani
t 2f%
d /
1�2-= 4S•�ff
5Aft-
\
li3 = q O--fv r
ey' 9a.70,h"
+r•w�it
CU
91aPT-0
1081
Wisconsin Department of Commerce SOIL EVALUATION REPORT page t of 3
Division of Safety and Buildings in accordance with Comm 85. Wis. Adm. Code Steel Sal Service
Attach complete site on r not less than 8'% x 11 inches is size. Plan must County
pl plan Pape St. Croix
include, but not limited to: vertical and horizontal reference post (BM), direction and , ! , , r
percent slope, scale or dimensions, north arrow, and location and distance to neatest road. Parcel I.D. 0Z
Please print I in �i
���►(�� y Date
Personal mformawn you provide may be for SEGon SET pu (R'llkej�LdW, s. 15. (1) (m)). �` V 2'3 Q 3
Property Owner JLA
U Trtc,,y
y LocatiSienna wn _ rcl}�,26 2002ot SE 9 NW19 S T 29 N R 19 W
-94
Address Block # Subd. Name CSM#4940 Vilking Dr. Suite 608 ZCNIN� CCUNTY/na G(er4�7 y
City State ZiOFFICE �1 Vill
age i Town Nearest Road
%_V j , V141 MN 55435 952-835-2808 Hudson Gapl4it W"d. 7P5-
New Construction Use: 01 Residential / Number of bedrooms
4 Code derived design flow rate
600 GPD
Replacement Public or commercial -
Describe:
Parent material Pitted outwash
Flood plain elevation, if applicable
na
General comments
and recommendations: System elevation 91.50ft, trenches spaced and depth to code 3.50ft below grade DY--
W se�b a s�A ids- fr
—
o z E
Boring # Boring
105
Pit Ground Surface elev.
95.00 ft.
Depth to limiting factor in.
Soil Application Rate
Horizon Depth Dominant Color Redox Description
Texture
Structure Consistence Boundary Roots
GPD/tP
'Eff#1 I `Eff#2
1 0-8 10y13/3 none
sit
2msbk mfr cs 2c
.5 .8
2 8-28 10yr4/4 none
sicl
2msbk mfr gw 1 c
4 .6
3 28-421 5yr4/4 none
!S--
osg mvfr cs na
07 1.2
4 d2-105 7.5yr4/4 none
Cos
osg MW na na
.7 1.6
CA qs- kd,
D
42 C, t leA, p. '7 ,Sago —,4Ac 4? &,aS Is .
/
a+ iZ•a
Bofing # Y'• Boring
Pit Ground Surface elev.
95.00 ft.
Depth to landing factor 105 in.
Soil Application Rate
Horizon Depth Dominant Color Redox Description
Texture
Structure Consistence Boundary Roots
GPDtW
'Eff#1 'Eff#2
1 0-6 10yr3/3 none
scl
2msbk mfr as is
.5 .8
2 6-16 5yr4/4 none
is
osg mvfr gw 2f
.7 1.2
3 16-105 7.5yr4/4 none
( cos \
osg mvfr na na
C 1.6
t4u9l dA.J-A ys""-A ice -
& 0 s54r4e-p" -"46
u of saxes
crrruem si = tsvu ? au < [[u mgtL arm r tos >su < 1 W mg/L
' Effluent #2 = BOD5- W mg/L ano TS5 < X mg/L
:ST Name (Please Pri(d) /� Signature:
CST Number
David J. Steel �C�>
248956
kddress Steel Sal Service ��cc•• --✓✓
Date Evaluation Conducted Telephone Number
1564 CR GG, New Richmond, WI 54017
8/24/2002 715-246-5085
property owner Sienna Corporation Parcel ID # pending Page 2 of 3
3] Boring # Boring
90.70 ft.
Depth to
limiting factor
105
in.
Pit
Ground Surface elev.
Sod Application Rate
Horizon Depth Dominant Color
Redox Description
Texture
Structure
Consistence
Boundary
Roots
GPD/k'
'Eff#1 `Eff#2
1 0-16 10yr4/4
none
sicl
2msbk
mfr
cs
2c
.4 .6
2 16-29 5yr4/4
none
Is
osg
mvfr
cs
I
7 1.2
3 9-105 7.5yr4/4
cos
osg
mvfr
na
na
L7_-,I 1.6
none
qS° mty, , di o*
A4- y?. 2/ = 4/2
a Boring # ri Boring
90.70 ft.
Depth to
limiting factor
96
in.
e Pit
Ground Surface elev.
Sod Application Rate
Horizon Depth Dominant Color
Redox Description
Texture
Structure
Consistence
Boundary
Roots
GPD1H'
'Effi" 'Eff#2
1 0-14 1Oyr4/4
none
sicl
2msbk
mfr
cs
2c
4 .6
2 14-32 5yr4/4
none
Is
osg
mvfr
cs
I
7 1.2
3 32-96 7.5yr4/6
none
ms
osg
ml
na
na
C7 1.2
��
g�2'ti,��
4
❑ Baring # -j Boring
;Pit
ft.
Depth to
limiting factor
in.
Ground Surface elev.
Sod Application Rate
Horizon Depth Dominant Color
Redox Description
Texture
Structure
Consistence
Boundary
Roots
GPD/ft'
'Eff#1 'Eff#2
' Effluent #1 = BOD 5> 30 < 220 mg/L and TSS >30 < 150 mg/L • Effluent #2 - BOD5<30 mg/L and TSS <_N mg/L
The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access seryices or
I
Page 3 of 3
STEEL'S SOIL SERVICE
David J. Steel 1564 Cty Rd GG
CST-POWTSM Sienna Corporation New Richmond, WI 54017
Lic. # 248956 SW1/4,NW1/4,S 20,T29,R19W (715) 246-6200
� Town of Hudson, St. Croix Co. (715) 246-5085
r h,r
e Glen lot # 4
This soil evaluation was conducted to satisfy a zoning requirement, it may or may not be suitable for
your use.
r 1=n�j/hRrk 41C. /6U.6U�r
Op- re- ?,;ac
Top b6� yL«,,VC'
- 130 r i o II
(3or;ICE(foobu
rls
# I. 95aox-f
02_- 95'00-rF
a3= 9a.�of"r
Sys ---
CP
I-
L�°
I3 I 5
SY� \ '-P- crYr7VFF'
IL-
\ 96.70'P+ 92�%urr
4gy.zot+
87
Parcel #: 020-1049-90-400
02/26/2008 09:57 AM
PAGE 1 OF 1
Alt. Parcel #: 20.29.19.192B-40 020 -TOWN OF HUDSON
Current X ST. CROIX COUNTY, WISCONSIN
Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type
00 0
Tax Address:
Owner(s): O = Current Owner, C = Current Co -Owner
O - DARDINE, JAMES R & LISA J
JAMES R & LISA J DARDINE
508 CARRIAGE LN
HUDSON WI 54016
Districts: SC = School SP = Special
Property Address(es): = Primary
Type Dist # Description
795 MARTIN AVE
Sc 2611 HUDSON
SP 1700 WITC
Legal Description: Acres:
1.087
Plat: 4394-CSM 16-4394 020-02
SEC 20 T29N R19W PT SE NW EZ-U-1797/610
Block/Condo Bldg: LOT 04
BEING CSM 16/4394 LOT 4 1.087AC
Tract(s): (Sec-Twn-Rng 401/4 1601/4)
20-29N-19W SE NW
Notes:
Parcel History:
Date Doc # Vol/Page
Type
11/08/2007 863815
WD
06/21/2006 827914
WD
10/09/2002 693490 16/4394
CSM
2008 SUMMARY Bill M
Fair Market Value:
Assessed with:
0
Valuations:
Last Changed: 10/25/2005
Description Class
Acres
Land
Improve
Total State Reason
RESIDENTIAL G1
1.087
78,500
0
78,500 NO
Totals for 2008:
General Property
1.087
78,500
0
78,500
Woodland
0.000
0
0
Totals for 2007:
General Property
1.087
78,500
0
78,500
Woodland
0.000
0
0
Lottery Credit: Claim Count:
0
Certification Date:
Batch #:
Specials:
User Special Code
Category
Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
St. Croix County Planning and Zoning Wednesday, February 20,2008ar10:25:00AM
Detail Sanitary Information Page 1 of
Computer#:
030-1095-70-300
Sub/Plat: NA
Section:
32
Parcel #:
32.30.19.347E
Lot: 2
TN/RNG:
T30N R19W
Municipality:
St. Joseph, Town of
CSM: Vol. 06 Pg. 1736
1/4 1/4:
SE 1/4 NW 1/4
Owner:
Lyon, Duane 445 Old E East Hudson, WI 54016
State Permit:
119527 Issued:
06/27/1989 POWTS Dispersal:
Non -Pressurized In -ground
Permit: New
County Permit:
0 Installed:
08/1711989 POWTS Detail:
Bed - Seepage
Bedrooms: 2 WI Fund:
POWTS Pretreatment:
NA
Notes
Issuer/Inspector As Built
Not determined Yes
Tom Nelson Signed OH: No
Maintenance
Scheduled Pump
Date Pumped
6/27/2005
7/1/1994
7/1/1997
6/15/1998
6/15/2001
5/25/2006
5/25/2009
Plumber Other Reaulrements
Additional Notes Money Owed
Zappa, Gary
Mark Stahnke installed system, used 1000 gallon $0.00
Wieser tank and 18' x 25' bed - this system will be
undersized for >4 people.
Tom did not fill in the report or sign it, just took
down rod readings - calculated elevations from as -
built data
Notification
Notification
04/2012006
04/20/2006
04/20/2006
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Irc COUNW H0.641964
STATE ANITARY� PRMIT
7715 MKPN
VfPTWMSr .
PREVIOUS NO. ..
OWNER
PLUMBE
TOWN
SUBDIVISION
CHAPTER 145.135 (2)-MSCONSIN STATUTES
(a) The purpose of the sanitary permit is to allow installation
of the private sewage system described in the permit
(b) The approval of the sanitary permit is based on
regulations in force on the date of approval.
jc) The sanitary permit is valid and may be renewed for a
specified period.
(d) Changed regulations will not impair the validity of a
sanitary permit.
(e) Renewal of the sanitary permit will be based on
regulations in force at the time renewal is sought, and that
changed regulations may impede renewal.
(f) The sanitary permit is transferable.
History: 1977 c. 168; 1979 c. 34,221; 1981 c. 314
Note: If you wish to renew the permit, or transfer ownership of
the permit, please contact the county authority.
SUING OFFICER - DATE
C
SS RENEWED BEFORE THAT DATE
VIEW
VISIBLE FROM THE ROAD FRONTING THE LOT DURING CONSTRUCTION
SBD-06499 (R11/20)