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HomeMy WebLinkAbout038-1190-20-000 eWlsconss Department ofCommerce PRIVATE SEWAGE SYSTEM Y Count Safety and Buildings Division INSPECTION REPORT St. Croix GENERAL INFORMATION (ATTACH TO PERMIT) SanitarXQefp��tlVo.: Personal information you provice may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)l. 3 / /44yy 66 Permit Holder's Name: ❑ City Vi llage Toyv f: State Plan ID No.: Haaland, Ron y Star 1' aineYiownship CST BM Elev.: Insp. BM Elev.: BM Description: Parcel TNo ,190 -20 - 000 1 vD . C T ►u- 2, StS TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic w�c� ODA) Benchmark 9) oS, /p J ofl • c'�. Dosing Alt. BM �• Im•92 Aeration Bldg. Sewer Holding St /Ht Inlet T SETBACK INFORMATION St/ Ht Outlet la •� �. �� TANK TO P/ L WELL BLDG. Air i ntake ROAD Dt Inlet ir Septic J r'p ` y t ` ' NA Dt Bottom Dosing NA Header/ Man. ' Zf �• 93 r Aeration NA Dist. Pipe 2 �P • 9L Holding Bot. System ''6 4 ,SZ PUMP / SIPHON INFORMATION Final Grade S•( g � S Manufacturer Demand St cover (eE Model Number GPM TDH Li L riction SY TDH Ft Forcemain Length Dia. H Dist. To Well SOIL ABSORPTION SYSTEM Lers BEA• TRENCH Width r Le th No t renches PIT No. Of Pits Inside Dia. Liquid Depth DI 3 (0 8 �� DIMENSION SYSTEM TO P / L BLDG WELL LAKE/STREAM LEACHING Manu ac rer _ n - SETBACK .CHAMBER � INFORMATION Type f M e Number: System: 30 �z w$ OR UNIT DISTRIBUTION SYSTEM`• Header f Id DistributionPipe(s) x Hole Siza leSpa ing Vent To Airintake Length Dia. Len Dia. Spacing Z• D SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over Depth Over xx Depth Of xx Seeded / Sodded xx Mulched Bed /Trench Center Bed / Trench Edges Topsoil ❑ Yes ❑ No ❑ Yes ❑ No COMMENTS (Include code discrepancies, persons present, etc.) Inspection #1: I'0/ lib /CO Inspection #2• -- Location: 1360 214th Avenue, S Pra ne, WI 54026 (NW 1/4 SE 1/4 13 T31N R18W) - 133118973 Northgate -Lot 24 1.) Alt BM Description 2.) Bldg sewer length = 2 3. o - amount of cover= > 18 S$+ e�otK 3) - tom a•r w-r of Sr✓M CT M,-ur - 16-V Pec.a- Plan revision required? ❑ Yes go Use other side for additional information. 02 - 0 T 0 1 ( Z SBD -6710 (R.3/97) Date Inspector's Signature Cert. No. ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: ...... _ m X { t # 3 i 3 { s � f � g € l i r E � i f $ }� e ll K L RL,:* v Q { i4 g R d .. �_, m.,.., �.,.... ...4..�..._.,�...2�m.�.....�c.. m......,.�;...._�.,�t SQ ..� ._ ?... m.»,..._.-. mi....... m.. ..ma,..�........F.......�..,.ms �.�. _,.�- �_.,.�,_��.,... -... � i _......� - a Z Sanitary Permit Application Safety & Buildings Divisi In accord with Comm 83.21. Wis. Adm. Code 201 W. Washington Ave. See reverse side for instructions for completing this application PO Box 7302 lV isconsin Personal information you provide may I5.04(1)(m)) be used for secondary purposes Madison. WI 53707 -7302 [Privacy Law, s. Department of Commerce (Submit completed form to county if not state owned.) Attach com lete plans (to the county copy only) for the s stem. on paper not less than 8 -1/2 x 11 inches in size. County State Sanitary ermit Number ertL� 7 fe lslo ,to previous application State Plan 1. D. Number '1 c t ! i I. Application Information - Please Print all In forma 'o` r Location: Property Owner Name 7 Property Location ( t f :a r n \ 1 � t V )o 0.01. \Gtv\� i " - - NVJI /4oSE1 /4,S \3T31,N.FA o W Property Owner's Mailing Address i? - f , _ , Lot r Number Block umber _1 C;f-1(� x City, State I Zip Code {t N'NG OFFi bet Subdivision Name or CSM Number C E b q 41(o (`t l - r d e I1 Type of Building: (check one) i 'j � ' ❑ City 3" 1 or 2 Family Dwelling - No. of Bedrooms: 3 _ ❑ Village ❑ Public/Commercial (describe use): c Town of ❑ State -owned o� P C i t" j III Type of -Permit: (Check only one box on line A. Check box on lire B if applicable) Nearest R d A) 1. I9 "New System 2.. ❑ Replacement 3. ❑ Replacement of 4. ❑ Addition to Parcel Tax Number(s) System Tank Only Existing S stem 03Q °� 0 - 2,6 —Q B) Permit Number 11 Date Issued A Sanitary Permit was previously issued Z fi a IV Type of POWT System: (Check all that apply) [ Non pressurized In ground ❑ Mound ❑ Sand Filter ❑ Constructed Wetland ❑ Pressurized In- ground ❑ Holding Tank ❑ Single Pass ❑ Drip Line ❑ At -grade ❑ Aerobic Treatment Unit O Recirculating ❑ Other: V Dispersal/Treatment Area Information: Z - / c ` 1. Design Flow (gpd) 2. DispersalArea 3. Dispersal Area 4. Soil Application 5. Percolation Rate 6. System Elevation 7. Final Grade Required 3 Proposed Rate (Gals. /day /sq. R) (Min. /inch) Elevation °4 b 0 (0 - 1 k i 7 0.2 a G. 5 a g, a VI Tank Capacity in Total # of Manufacturer Prefab Site Steel Fiber- Plastic Information Gallons Gallons Tanks Con- Con- glass New Existing crete strutted ti . Tanks Tanks ❑ ❑ ❑ ❑ ❑ VII Responsibility Statement I the und ersigned, assume responsibility for installation of e OWTS shown on the attached plans. Plumber's Name (print) Plu ignature (no s s): MP/l pf&No. Business Phone Number ��� e �skex\ 59c6 P M ' lumbees Address (Street, City, State, Zip' ode) *6 6 U e� ` �7� di�)e tix�Q. * ` i OY\C�) Qf 1 W k 5'416 S .VIII County/Departme se O ❑ Disapproved Sanitary Permit Fee (includes Groundwater Date Issued Issuing Agent Signature (No stamps) Approved ❑ Owner Given Initial Adverse Surcharge Fee) Determination 4 d. QO ! a / /Z-/ Z coal r IX. Conditions of Approval /Reasons for Disapproval: '! PP PP J 7Z C7 ✓ �Q Mat'vt �a.'s, td✓�SC'ruicoe4 -pPr ;IX �LCr4e- tc. -ee $ rtGdtKo -,eo a. ;oyti.6 , �(S re Vi , 3 O- WalS ✓ee'oe 4e Ve Gt ek, --ye w �I46Nbtv$. BB D -6398 (R. 07100) r . - T Ot �1 (y yrI `. t A vi top LU LU w �Cr ,�� . / SYSTEM.MANAGEHENT ' Pa e ... g Z of -? Management and maintenance of this system is critical to its proper operation and longevity. The system owner must be provided with a complete set of plans including the management section. GENERAL Proper functioning of any type of on -site waste disposal system is dependent on the amount of water entering the system and the quality of the water. The lower the volume of water and the lower the level of contaminants, the more efficient and longer lasting.the system will be. Typical system components include a septic tank to settle out and break down solids, an effluent filter at the septic tank outlet.to filter out small particles, a pump tank with an effluent pump and controls and an absorption cell to dispose of the water in a manner which will protect the groundwater and public health. RECOMMENDATIONS 1. Install water saving devices when and where possible. 2. Repair any water leaks as soon as possible. 3. Do not pour greases, oils, chemicals such as paint or paint thinners into the system. 4. If you have a garbage disposal, use it sparingly.. 5. Do not dispose of any paper products other than tissue into the system. 6. Try to avoid excessive flows of water in short periods of time Spreading clothes washing throughout the week is recommended. MAINTENANCE 1. The septic tank should be inspected by a licensed pumper every three years or less and pumped if necessary to remove solids and scum. 2. The effluent filter must be cleaned periodically to remove any accumulated particles. It should be washed back into the septic at 6 month intervals or as per the manufacturer's recommendation. 3. Periodic inspections at the observation pipes should be made by the owner to determine if any ponding is taking place in the absorption cell. Also check for any seepage to the ground surface. If consistent ponding or seepage is noted, a licensed plumber should be contacted. 4. This sytem.contains an alarm which must be installed on a separate circuit from the pump. If the alarm activates, minimize water use and contact a licensed plumber immediately. CONTINGENCIES Monitoring of the volume and effluent quality may become necessary if problems develop. Monitoring must be done as per the requirements of COMM 83.54(2). Pumping and disposal of wastewater by a licensed puiaper may be necessary while analysis and repairs are made. 1. Failed mound systems may require removal and disposal of the existirig sand fill and replacing it new sand or installing an aerobic pre- treatment unit to reduce or eliminate any clogging mat may be present. 2. In- ground soil absorption systems or at -grade systems may require the installation of an aerobic pre - treatment unit or replacement of the system. Additional site and soil evaluations may need to be done and additional plans may need to be, prepared and approved by the Safety and Buildings Division of the Department of Commerce. ! 3(a o Z I `l lE Sanitary Permit Application Safety & Buildings Division In accord with Comm 8311, Wis. Adm. Code 201 W. Washington Ave. 1 See reverse side for instructions for completing this application PO Box 7302 Madison, WI 53707 -7302 Personal information you provide may be used for secondary purposes Submit leted form to tort if not Deptrtment 6f taAmeree (Privacy Law, s. 15.04(t)(m)) ( comp mY state owned. Attach complete plans to the county copy only) for the system, on not less than 8 -1/2 x 1 I inches in size. State Sani Permit Number ❑ Check if revision to previous application State Plan Number I. Application Information - Please Print all Information Location: Property Owner Name Property Location J Ia>ti � N1,� 1145 ,r114 T 3 NIT Y it or w 7 C. y • . Lot Number Block Number Property Owners Mailing Address L�Cr:w t ro S �tr' t City, State Zip Code _ Ph%VVPnb,� Z�OQ ' \' + Subdivi NarneorCSMNumber 1,) "#'o 7 /.SST 7YUt�t'So t. COURTY 0 city II.�'ype of Bull ing: (check one) 'k Y �,,C ❑ yl� �®'' 1 or 2 Family Dwelling - No. of Bedrooms: �� \` ` " VTown of 5-70(6t Y ❑ Public/Commercial (describe use):_ ❑ State -Owned Nearest Road Parcel Tax Number(s) 6 III. T e of rmit: Check only one box on line A. Check box on line B if applicable) O S - 1 Iq0 -- 20 —60o 13.31. t8. 3 A) I - New 2. ❑ Replacement 3. ❑ Replacement of 4. 5. 6. ❑ Addition to System System Tank Only Existing System B) Permit Number Date Issued ❑ A Sanitary Permit was previously issued N Type of POWT System (Check all that apply) ❑ Sand Filter ❑ Constructed Wetland IV. In- ground ❑ Mound • Pre=6zed In -mound ❑ Holding Tank ❑Single Pass ❑Drip Line • At de ❑ Aerobic Treatment Unit ❑ Recirculating ❑ Other: V. Dis ersal/Treatment Area Information: 1. Design Flow (gpd) 2. Dispersal Area 3. Dispersal Area 4. Soil Application 5. Percolation Rate 6. System Elevation 7. Final Grade Required Proposed Rate (GalsJday /sq. ft.) (Min./inch) Elevation VII. Tank Capacity in Total # of Manufacturer Prefab Site Steel Fiber- Plastic Information Gallons Gallons Tanks Con - Con- glass New Existing crete strutted Tanks Tanks ❑ ❑ ❑ ❑ 1,500 .�'Pa 1 GJ I'S ❑ ❑ ❑ ❑ ❑ Zabel X- /OD VI11. Responsibility Statement I, the undersi ed, assume res nsibili for installation of the POWTS shown on the attached plans. Business Phone Number Plumbers Name (print) Plumbers Signature (no stamps): MP/MPRS No. D-Da)e F. -14a(46� zzo? Plumbers Address ( re City, State, Zip � Co d e) r,? IX. County/Department Use Only Date Issued Issuing Agent Signature (No stamps) Sanitary Pemiit Fee (Includes Groundwater �f A Initial Adverse Surge F X. Conditions of Ap roval !Reasons for Disapprov I: . ,� S vv, oe fie... 14. 04 . pp 1l 1l / Scale. �= K /l o n �YC?A /A✓I GY e 0. �''d 1 r% G S�• C ra,'.�C c+O• GVi�, - OF Co Z3 Chc z. a Assu..rud `I a ..- = l�.Q7 ■ bz ■ bq a v plot . 4 2000 ;. ST CRUlX G 1 GOUNTY I PraPasle� I ZONINGUFFtCE >> 3 bdrm o Q< e . DJ BOOTS PLBG & HTG Fax 715- 684 -3144 Aug 15 '00 12:50 P02 <a�' � P /Qf of /V, r��i ♦Eta ✓a-t:� G'4 c Wid TX, Sec. 13, T 4Si� Pra,'r; i - t , S�'- C �o,',�r Co. .GJ�', a . N o� c Za. r' a AeEs��• a v L fGSi�wL' s lob9ooSoO r L Q. o r z/V 9 , 0 e. per- , i i i p' Rdfr, /276 , BOLDTS PLBG & HTG Fax : 715- 684 -3144 Aug 15 '00 12:50 P01 x l Y i NSA= W. 11 9mving You For 40 Years" 620 Main WOW SWdwW, VW 84002 (715) 684 -3378 Rx (715) W441" Fax TranSMISSiOn TO: :� Company: �, C,�- >✓ e7ti . �v> > >v f Re: �vo�r�� .S Y � .�l Phone: _ FAX From: . �A1G Z&4 y� Including this page, there are pages in this transfer. MESSAGE: �r+ti �t- ��, �zsw.� S-"� p 1 of 3 sconsin Department of Commerce SOIL AND SITE EVALU TION soil &Sate Evaluations asion of Safety and Buildings in accord with Comm 83. 05, W is. Adm. Coe A .C . E. County not less than 8' /z tach complete site plan on P p BM direction and I.D.# dude, but not limited to: vertical and horizontal ref d , d ;tom to nearest road. Parcel 038- 1190 -2fl -000 11)# 13.31.18. scent slope, scale or dimemsions, north arrow, Date � �i'in formation. Reviewed By APPLICANT INFORMATION - r a purposed (pnvacy Law, s. 15.04 (1) (m)). ersonal information you provide may be j g W Govt Lot Property Location 31 N,R property Owner R �` ��h NW 1/4 SE 114 S 13 T Name or CSM# Ron Haaland Lot # Block # Subd. North Gate property Owner's Mailing Address ° A U P ��,QQ 24 708 Nearest Road Crosby Dr. [� y [] O um ber city Village ZTown {`-�T• 214Th Ave. City S Zip Co Star Prairie Hudson 4 r rooms--- 3 ❑Addition to existing building • [ New Construction Use: a describe 7 trench, gpdKF [] Replacement 0 bed, gpolftZ --�- -- 450 gpd Recommended design loading rate bed gpd/ 7 trench, gpd/W Code Derived daily flow Maximum design loading rate _ ---- bed, ft? 643 trench, ftz ft (as referred to site plan benchmark) Ab Mt ion area required 91.10 96.60'. Recommended infiltration surface elevation(s) riches using high capacity infiltrators• Additional design I site considerations Flood lain elevation, if a licable na ft Holding Tank System in Fill ❑ S ® U Parent material Glacial °utwash AT -Grade Mound In Ground Pressure ®S U D S ® u I S--Suitable Conventional Suitable for system S o u s❑ u U= Unsuitable for system ®S 0 SOIL DESCRIPTION REPORT GPDIfF Dominant Color Mottles Texture Structure Consisten Boundary Roots Bed Trench Depth Gr. Sz. . g Horizon Munsell Qu. Sz. Cont. Color Sh 0.5 Borin # in. dsh as I fin - 2fsbk 1 0 -10 10yr2/2 None sl mfr aw l f _ 0.5 1 None sil 2msbk 2 10 -18 10yr4/6 if - 0.7 Imsbk mvfr aw None icos 7 „ a- Ground 3 18 -29 7.5yr4/6 _ - elev Osg dl 9W s & cos None 0.7 99.60 ft 4 29 -81 10yr5 /4 Osg dl - - - 1 r Depth to 5 81 -162 � /4 None ' � m s & cos edium and coarse sand too numerous to differentiate as individual horizons• limiting Horizons #4 & 5 consist of many startlfied layers factor qL ° > 162" (° extracti of soil with 2" hand au er. Soil rofile Soil observa competed to 90" usp of soil �rt. Re obse rved by_ _ Remarks: - - - - -- -- - . entire depth of horizon. sl as 1 sil 2msbk _ 0.5 remained unlfarm through 2fsbk dsh None ', 0.5 1 0 -11 l Oyr2 /2 mfr aw 1 f 2 None 2 11 -28 10yr4/6 1f Ground 3 28 -36 7.Syr4 /6 _ 0.7 Imsbk mvfr aw None icos 0 7 _ - elev s &cos Osg dl gw 10 5/4 None _ 0.7 99.83 ft 4 3 dl - - None s iu cos Osg Depth to g 81 -168 loyr6 /4 of medium and coarse sand too numerous to differentiate as indlvidual horizons. limiting Horizons #4 & 5 consist of many startified layers factor >168" 31 �g.� 1 ° n of soil with 2" hand au er. Soil rofile Soil observation corn to 96" b of soil it. Remainin 72' observed b extractio Remarks: entire d of horizon. Telephone No. remained uniform thro 715 248 -1 e: �„f_ Ref# CST Name (Please Print) Signa CST Number James K. Thompson Date 3602 1276 Address A.C.E. Soil & Site Evaluations 8/5/00 340 Paulson Lake Lane, Osceola, W1 5402 .....cvvR�r i wN KEPORT 1276 Page 2 of 3 ,.......r... v ifi vszs -1190 -20-000 N13.31.18.1560 A.C.E. Soil &Site Evacuations Horizon Depth Dominant Color Mottles Texture Structure nsistence Boundary Roots GPD/ft' in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench 3 1 0 -11 1Oyr2/2 None A 2fsbk dsh as Ifin - 0.5 2 11 -24 10yr4/6 None sil 2msbk mfr aw if _ 0.5 Ground elev 3 24 -34 7.5yr4/6 None icos Imsbk mvfr aw if - 0.7 99.89 ft 4 3,48- 10yr5/4 None s & cos Osg dl gw Depth to limiting 5 90 -168 1 Oyr6 /4 None s & cos Osg dl - - - 0.7 factor Horizons #4 & 5 consist of many startified layers of tedium and coarse sand too numerous to differentiate as individual horizons. > 168" 8 8 Remarks: Soil observation competed to 96" by use of soil p it. Remaining 72" observed by extr action of soil with 2" hand auger. Soil profile remarne un orm ou ent= ) o onzon. 4 1 0 -10 1Oyr2/2 None sl 2fsbk dsh as Ifin - 0.5 2 10 -24 10yr4 /6 None sil 2msbk mfr aw I f - 0.5 Ground elev 3 24 -34 7.5yr4/6 None lcos Imsbk mvfr aw if - 0.7 100.04 ft 4 34 -86 IOyr5 /4 None s & cos Osg dl gw - - 0.7 Depth to limiting 5 86 -170 1Oyr6/4 None s & cos Osg dl - - - 0.7 factor Horizons #4 & 5 consist of many startified layers of medium and coarse sand too numerous to differentiate as individual horizons. >107" Remarks Soil observation competed to 98" by use of soil pit. Remaining 72" observed b extraction of soil with 2" hand auger. Soil profile remame un orm u entre en o orizon. S 1 0 -10 1Oyr2/2 None sl 2fsbk dsh as Ifin - O.5 2 10 -24 10yr4/6 None sil 2msbk mfr aw 1f - 0.5 Ground elev 3 24 -35 7.5yr4/6 None icos Imsbk mvfr aw If - 0.7 99.76 ft 4 35 -80 10yr5/4 None s & cos Osg dl gw - - 0.7 Depth to 5 80 - 165 10yr6/4 None s & cos Osg dl - - - 0.7 limiting factor Horizons #4 & 5 consist of many startified layers of medium and coarse sand too numerous to differentiate as individual horizons. > 165" Remarks: Soil observation competed to 93" by use of soil pit. Remaining 72" observed by extraction of soil with 2" hand auger. Soil profile remame un orm ou entire en o onzon. Ground elev Depth to limiting factor Remarks: '/ Sol �- p (ton NaQ /a.ld _.1� Y /0 2 1 1 , - � O�' %!O� ut qp ■.SDi� rY.l2�ior 1 . 6 O e, St- U-6 Co. c.J/ • /oca dp�of? __ 6. � r off' lof /3 c ri+t A TpA o �' lob S- fulfe. Assumed cI ot- 82 ■ ! •� o v ij cs "� v t a r ■ Pf 0 P p5ed F 3 bdrM Q. � �esid ■ Bs 81 D (� Rey #276 Private Onsite Wastewater Treatment System Management Plan Y 9 Septic Tank And Gravity In- Ground Soil Absorption Component Pursuant to Comm 83.54 Wis. Adm. Code each Private Onsite Wastewater Treatment System (POWTS) shall include information and procedures for maintaining the system within the parameters of Comm 83 and 84, and the conditions of approval by the department, agent, or governmental unit. The approved plans and permits for system are on file at the county zoning or health department. This management plan complies with Comm 83.54, Wis. Adm. Code, and the In- Ground Soil Absorption Component Manual for Private Onsite Wastewater Treatment Systems SBD- 10567 -P (R.6/99). Table 1: System Design Specifications Sanitary Permit Number +4 q © ( Number of Bedrooms Design Flow - Peak (gpd) 4570 Estimated Flow - Average (gpd) Septic Tank Capacity (gal) Soil Absorption Component Size (W) - +5 - 14 Type of Wastewater Domestic Table 2: Soil Absor tion Component - Limits of Reliable Operation p p Septic Tank Component Soil Absorption Component Design Flow - Peak (gpd) rn� S� -ST. S 2- - ` ^ I re�.c7 Maximum Influent Particle Size (in) 1/8 Maximum BOD (mg /L) 220 Maximum TSS (mg /L) 150 Table 3: Maintenance Schedule Septic Tank Inspect and /or service once every 3 years Outlet Filter Inspect once a year and clean at least once every 3 years Soil Absorption Component Inspect once every 3 years Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Stats. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code (Servicing Septic or Holding Tanks, Pumping Chambers, Grease Interceptors, Seepage Beds, Seepage Pits, Seepage Trenches, Privies, or Portable Restrooms). The operating condition of the septic tank and outlet filter shall be assessed at least once every 3 years by inspection. The outlet filter shall be cleaned as necessary to ensure proper operation. The filter cartridge should not be removed unless provisions are made to retain solids in the tank that may slough off the filter when removed from its enclosure. If the y Management Plan for a Septic Tank and Soil Absorption Component filter is equipped with an alarm, the filter shall be service mpending contin ous alp rm. usly. Intermittent filter alarms may indicate surge flows or an impending um and sludge in the tank septic tank shall have its contents removed when the volume is of the tank are not removed at the nten exceeds 1/3 the liquid volume of the tank. If the co time of an assessment, maid Scum and sludge accumulat on in the service maintenance personnel shall a needs to be performed to maintain less than maximum tank. Manhole risers, access risers and covers should be sent inspected be sealed watertight upon soundness. Access openings used for service and asses shal completion of service. Any opening deemed unsound, en shall be secured by the p be replaced. Exposed access openings greater than 8-inches an effective locking device to prevent accidental or unauthorized entry into the tank. No one should enter a septic or othe liance With OSHA holding standards for any reason without being in full comp n in septic or other entering a confined space. The atmosphere ethawgasesh a rescue of a treatment of holding tank may con be difficult or impossible. person from the interior of the tank may Tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the tank is no longer used as a POWTS component. S oil Absorption Compo The soil absorption component serving this structure ol i ofthi designed to component accept are shown was from a residential facility. The limits of operation Table 2. nt depends greatly on proper and timely The longevity of a soil absorption compone maintenance, and system use within or below the limits of reliable operation. Good water conservation practices by all occupants and the in of water conserving plumbing fixtures are key factors in extending the useful life of this component. The soil absorption components operation must be assessed by inspection at least once every levels of ponding, if eve three years. The inspection shall include recording toh Surface seepage or d any, in e the observation pipes, and a visual inspection for any evidece ed and from the component. On steeply sloping sites, areas of erosion f domestic uld be identif o sewage reported to the owner for repair. The surface discharge from the system is prohibited and considered a human health hazard. larl avoided Traffic around or over the soil absorption o f p snow cover the ompo e ' nt may lead during winter months. The compaction or removal to hydraulic failure by freezing. This type of failure is usually temporary, but is difficult m o r impossible to repair until weather conditions improve. In general, soil compaction oveead'to p en into the soil and dispersal cell, which may component will reduce diffusion of oxygen of the soil. more intense, and earlier, organic clogging 2 3 ST CROAK CO UNTY SEPTIC TAW MA OWNERSNll3 ��4ItM Owner/Buyer _ 4= Mailing Address `7 D Properly Address (Verification required from Planning Department for new c=structionj City/State 5 c? r Pir a , r i It 0.,' . Parcel Identification Number osg -t /9O - Z d - a00 LEGAL DESCRIPTION Property Location / t� l<, -Z- ;, Soc. /-.3 . T-?/ N -R /f W, Town of 4 r -i e, Subdivision /lo r - IA Sa / Lot # , Certified Survey Map # Volume Page # JC Warranty Deed # y Volume / 20 . Page # .5170 S house ❑ es & P� yes lines identifiable "Yes ❑ no SYSTEM-AiAIN'f NANCE Impmperuse and maW =anceofy=septicsystcmcouldresa tinits faffumto handle waste& Proper mamtenance consists of pawing out the septic tank every d= or if needed a J� by froeased What into the can a soct the _iimdion of thre Y I septic tank�ss. a stage in rind , TU PWPczW owner agrees to sabmitlo SL Q d'm Z=bg Department t .oettifim ioa form, signed by dw owner and by a - PI�Y�aplua�odpWmbcrai�odpcnuperr�► i�$: at( ij@ bcoaaitewastewaterdisposalsystem is is PwPcr *pealing condition and/or ( after inspection, and powpiag (;f ma &e septic.tauk is Iess .than 113 full of dodge. Y,,- dc amdezrkwd have read due above r aircaums and agree to maintain the private sewage disposal system with dre standards set folk h=in,'as set by Me Depamuent of C ===e and due Department of Nang Resources; State of Wis000sia.. Cerocatioa strong *d YOur artic gtcm has b= makftitiod mug be completed and ==mod to &c SL Croix County Zoning Office widda 30 ys of the Y= expiration date. - -- a'� SIGNATURE PP CANT 7 OF A DATE OWNER CERTIFICATION I (vm) certify that all Statements on this form are true to the best of my (our) knowledge. I (we) am (arc) the owner(s) of rtY deser bod above, by virtue of a warranty decd reoordod in Register of Deeds Of - 7 t;Wv tV SIGNAURRI OF APPI:I DATE Any infa=tion tbat is 4MS.s• Mis'npttiscatod may malt is the sanitary permit bring revoked by the Zoning DcpartmcuL �« Include with this application: a stamped warranty deed f-Orn the Register of Deeds ofTicc a Cop of the certified survey map if mfmnoe is made in the warranty deed STATE BAR OF WISCONSIN FORM I _ 1998 X2 ts4 D6cttmew Number WARRANTY DEED KATHLEEN H. WALSH REGISTER OF DEEDS This Deed, [Wade between f= Inwood En(ernrises Inc it Wisconsin ST. CROIX CO., WI torpor d2n (;rantor, and Ion E. liaaland and HonA.t RECEIVED FOR RECORD $rid wif ae sal lNa�I Ind t. t. a �ryivorOut) marital , Grantee. Grantor, fora valuable consideration, conveys to Grantee the following - 21 1040 AM described real estate in St. Croix County, State of Wisconsin (The "Property "); E1( "P DEED I CERT Corr FEE: COPY FEE: TRANSFER FEE: 71.70 RECO RDING FEE: 10.00 PAGES: Jt@c0Winy Area ame an etum Edina Realty Title 5, 400 South 2nd Street 4 Suite #115 Judson, W154016 txla -I t9o.2o Parcel Identification Number (pIN) Ilia la WA homestead propetty. (is sot) Lot 24 of the Plat of NorthGate, recorded in the Office of the Register of Deeds for St, Croix County, Wisconsin on May 20, 1994 in Volume 7 of Plats, at Page 46 as Document No. 603503. Together with all appurtenant rights, title and interests. Grantor warrants that the title to the Property is good, indefeasible in fee simple and free and clear of encumbrances except easanents, restrictions and reservations, if env, of record. Dated this ��—day of /� 2000• ORE W OD ELATE l ES NC. * By •Jame `E. Ruseh, its president s By: "M ry , use , s rota AUTHENTICATION ACKNOWLEDGMENT Signaturc(s) James E. Rusch, its president STATE OF WISCONSIN ) u. authenticated this LI. 63y of June, 2000 — St. Croix County ) Personally carne before the this I.SL. day of ,jugg 2000 the above named Mary R. Rush t� s. ,..a known to be the person(&) who executed the fore �• 1 k i< 1 instrument and acknowledge the same. TITLE: BERSTATE BAR QP'WISCONSIN author)zed by § 706.06, Wis. Stars.) THIS INSTRUMENT WAS DRAFTED B , Notary Public, State of Wisconai Lois A. Murray, Zilz, Estreen & Ogla ffpECCA J. PHAN "'& PC1manent. If not, stare expiration date: 304 Locust Street, Hudson, WI 54 16 NOTARY PO (Signarums may be authenticated or acknowledged. STAT OF WISCONSIN necessary.) a 'Mama of perao"s sign"S in any capacity should be typed or printed bai w their signatures WARaANrY Darin SrATE SA. or WISCONSIN FO li�l No. l • 199¢ INFMMATION PROFESSIONALS COMPANY FOND OU LAC, VW $00 -666 -2021 - wVisconsin Department of Industry SOIL AND SITE EVALUATION REPORT Page 1 of 3 Labor and Human Relations Division of Safety $ Buildings in accord with ILHR 83.05, Wis. Adm. Code COUNTY Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but St. Croix not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or PARCEL I.D. # dimensioned, north arrow, and location and distance to nearest road. 038 - 1055 -95 APPLICANT INFORMATION— PLEASE PRINT ALL INFORMATION R =� DATE n 8 1 9q PROPERTY OWNER PROPERTY LOCATION If Greenwood Enterprises, Inc. GOVT. LOT NW 1/4 SE 1 /4 13 T 31 ,N,R 18 k (or) W PROPERTY OWNER':S MAILING ADDRESS LOT # I BLOCK # SUBD. NAME OR CSM # 1416 Third St. 24 na NorthGate CITY, STATE ZIP CODE PHONE NUMBER [3CITY EJVILLAGEI�WOWN NEAREST ROAD Hudson, WI. 54016 (715) 386 -3674 1 Star Prairie I 214th Ave. k] New Construction Use [ Residential / Number of bedrooms 4 [ ] Addition to existing building I ] Replacement [ ] Public or commercial describe Code derived daily flow hnn gpd Recommended design loading rate bed, gpd /ft _ trench, gpd /ft Absorption area required 858 bed, ft 750 trench, ft Maximum design loading rate .7 bed, gpd /ft .8 trench, gpd /ft Recommended infiltration surface elevation(s) 95.15 ft (as referred to site plan benchmark) Additional design / site considerations na Parent material outwash Flood plain elevation, if applicable na It L S = Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE AT -GRADE SYSTEM IN FILL HOLDING TANK U= Unsuitable fors stem EiS ❑ U (RS ❑ U 0S ❑ U E] S ❑ U EI S ❑ U cis p U SOIL DESCRIPTION REPORT Depth Dominant Color Mottles Structure GPD /ft Boring # Horizon in. Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. Consistence Boundary Roots Bed JTW& . U 1 0 -12 10yr 2/2 none 1 lcsbk mfr gw if .41 .5 2 12 -22 none aic sbk mfr qW if .2 .3 Ground .2 .3 elev. 98.9 ft. Depth to limiting factor +84" Remarks: Boring # 2 11 -24 1 4 mfr .4 .5 3 24 -84 7.5 r 4/6 none cos 0SO ml na .7 .8 Ground , � 98.8 ft. Depth to limiting factor +84" ��• r �Rax ;� �Y ,NINGOFFIC Remarks: CST Name: -- Please Print Gary L. Steel Phone: 715 - 246 - Address: 1554 200th. Ave. Richmond W4 54017 Signature: Date: 10 -30 -98 CST Number: m02298 PROPERTYOWNER Greenwood Enterprise SOIL DESCRIPTION REPORT Page 2 of 3 ' � PARCEL I.D. # 038 - 1055 -95 r P f t Depth Dominant Colo Mottles Structure G D/ Boris # Horizon Texture Consistence Roots Boring nsell Qu. Sz. Cont. r. z. h. Y m. Mu Color G S S Bed Trerxh ,...3 ' 1 0 -12 10 212 non 1 gcsbk mfr Qw if 2 12 -28 10 r 4 4 none sicl 2csbk mfr gw if Ground 3 28 -84 7.5 r 4/6 none cos 0SQ ml na na .7 .8 elev. Depth to limiting factor +24 Remarks: Boring # 1 0 - 12 10 r 2/2 none 1 lcsbk mfr w if .4 .5 ...4... 2 12 -22 10 r 4/4 none sici lcsbk mfr QW if .2 .3 Ground 3 22 -32 10 r 5/4 none sil lcsbk mfr w na .2 .3 elev. 98.8 ft. 4 32 -8 r 4/6 none cos 0SCI ml na na .7 ; .8 Depth to - limiting fact Remarks: Boring # 1 0 -12 10 r 2/2 none 1 lcsbk mfr gw if .4 .5 5 2 12 -26 10 r 4/4 none sicl lcsbk mfr 9w if .2 .3 Ground 3 26 -30 10 r 5/4 none sil lcsbk mfr 9w na .2 .3 9ele ff 4 30 -84 7.5 r 4/6 none cos 0sq ml na na .7 .8 Depth to limiting factor +R4 Remarks: Boring # 1:3 Ground elev. j ft. Depth to limiting factor Remarks: SBD- 8330(8.05/92) STEEL'S SOIL SERVICE Gary L. Steel 1554 200th Ave. Greenwood Enterprises, Inc. New Richmond, WI 54017 MP SW 3254 Nw4 SE4 S13- T31N -R18W (715) 246 -6200 town of Star Prarie lot #24- NorthGatbs This soil evaluation was conducted to satisfy a zoning requirement, it may or may not be suitable for your use. The location of the test may or may not be as shown as permanent lot lines were not established at the time the test was conducted. N 1' 1 " =40' BM.= top of 2" pvc p ipe @ el. 100' Alt. BM.= top of 2 pvc p ipe C el. 97.40' 5, 4 p '2.15 V 2.3 P1 0 4 e Gary L. Steel 10 -30 -98 I` Z'CD .. Z I ' CD rn hi tr7 I� 1.p � N o. I — N .0 288.00' co ru 9:4 Z z n D i m o ° (U .o co 0 0 �' u. 7� —1 I ry cn " .A .p d ry ;,, tzi tr7 tri N 0 °52'34'E 1 300.00' I ° o '-' o y I I o o p 'V wNN (rD > ° v ° `a D j ,D co ' Ri ld - r N � � i o _ ;w o M V W N N C �t LA C %D ° , J o ►- �► O (� I .. I ro N 0 52 34'E 288.00' i O Co QQ O -- co rri , 00 co sill o I ► -" A �`� l Ls 0o O o °Q N 0.52'34'E 300.00' ° o t i o CD N � I q= 00 N.O O I p A cn O f 0• � U. �z En Z G7H .. N w 00 0, .. 'd.• � 8 A w o M ° (U I o N 0 ° 52'34'E 288.00' ,-'�,��`F •'D � c� O o v � Dt A I o z N 0 D 300.00' N 00 O N N ~' rU CD I co ° CD f m ru N J O co co r o I v, 1 100 --1 — f V O p 6' o �1 to• dR I 100' fU N 0 ° 52'34'E 288.00 m S6, F 1 rn 13(:) T" S t. U% m Z c t , c 31 c w N 0 ° 52'34'E 288.00' o o �'- S n O 4 ° o 0 Ca OD 123.00' o z z `" N 0 ° 52'34" till° ti� `0 o D 38.00' �� 1 �1. .� 80 g 8og I --I Z 69, /�F o , / Im CoS 0 ° 52'34'W 6 19.00' �� 6��'6- 9 1 0 S 0 °52'34W ° CD �- Ir- Oo cn . D 4 ro I � t j O I z r ;u t.) rU O tv d �. O r r N 100' : ^` ° p v ro (� 0 all M tz co O O (1 e Iv - O y Z D ro X87.99' S 0 °51'18'W 252.01' fTl x «4 c D Z CJ n CD o d --Irri S . 0 ° 51'18'W 309.99' fTl o a FJ CD oo D c 00 s 230.01' co g cj tTJ C: o n r F-- I ao w �1 < " O r <� o° o� p o , � C) d - a c. I T co CD Ln Tj b O Z I c' d -N crl� CD v —I 0 d ° 'b C D r i N 0 ° 24'57 "E 310.00' m ro ° c _ Ur ED Z cis _ � w °: N o 13 8 T" S t. °� °� o z W I ° 24' 5 7' E p rTl o� f U � E x 310.00' F ° b� ." O co U, -r' F—I o o z ° \ d o CD t0 r cn cn cn � rat 1 0 ,,, -�� CA .� (� 0 CN CD r: o m S 0 2 57' 66.� o° W 540.02 � 310.00' 230.02' ZEFERENCED TO TH E S 0`24'57 "W 606,02' '114 OF SECTION 13, UNPLATTED LANDS D TO 13EAR S 0 TT � — �D