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038-1201-40-000
Wisconsin Departmenlq f Gommerce PRIVATE SEWAGE SYSTEM County: S Croix Safety and Building Division . ' INSPECTION REPORT sanitary Permit No: 405091 0 GENERAL INFORMATION a (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 Holders X Township Perm Ho de s Name City Village To ns p Parcel Tax No: Grand Properties L.P. I Star Prairie Township 038- 1201 -40 -000 CST BM Elev: Insp. BM Elev: BM Description: TANK INFORMATION V ELEVAT DA TA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark Q �66 �� .2 t °Z•� co ro Dosing Alt. BM Aeration Bldg. Sewer r 9.9.E gz.29 Holding St/Ht Inlet y� TANK SETBACK INFORMATION St/Ht outlet D. TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet I Septic + �` Dt Bottom "5�- l Dosing Header /Man. l •! �g l �p I t'll / Aeration Dist. Pi ' !l -Z ti•a `68 5 Holding Bot. System V 2.25 Final Grade r l PUMP /SIPHON INFORMATION ,�,�, J Manufact r Demand St o Q JO. 3 Model Nu ber brilk *I r o• o leo• t ti j aa, o TDH Lift Friction Loss 1 System Head TDH Ft (oo .I0 Z. (0 9= Force ain Length Dist. to Well SOIL AB PTION SYSTEM cI) 3'x (V2 -SV 4 -ceM..1 ,(I) 3` x Ge. tys —Q-1 THE CI idth I Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIM � �2 1 SETBACK SYSTEM TO P/L BLDG WELL LAKE /STREAM LEACHING Manuf INFORMATION CHAMBER OR Type Of S stem: �tA +� t �' / _ UNIT Model : m % iPM�Mn DISTRIBUTION SYSTEM Header /Manifold Lt Distribution x Hole Size x Hole Spacing it Intake Pip s) length Dia Len is Spacing 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 f� No � i Yes No 1. L J COM E TS: (Include Wiscregen .I�j persons present, etc.) Inspection #1: 1 T. Inspection #2: Location: 2117 81st Street Somerset, WI 54025 (SW 114 SW 1/4 18 T31 N R18W) Rolling Oaks Lot Parcel No: 18.31.18.1068 1.) Alt BM Description = �, r",A- �� TT f / Gj /p3 - 7/02 6 3 2.) Bldg sewer length = Q r - amount of cover = > 24 f � L „( A . 3 - (t_Z5 5 Y 4., e. A1,9tY� ( (Bw� ►` !F tg.) Plan revision Required? Yes _ No Use other side for additional informa9ron. SBD -6710 (R.3/97) Date Insepctor's Signature Cert. No. �5;r�,r,.�u� ' 7 1 02m3 Z 1 4 5 P 5 6 6 KATHLEEN R OF DEEDDSS DRIVEWAY EASEMENT ST CROIX CO ., MI RECEIVED FOR RECORD 02/19/2003 09:36AH Document Number: EXDPT # REC FEE: 11.00 TRANS FEE: COPY FEE: CERT COPY FEE: Retum Address: KRISTINA OGLAND PAGES: i ESTREEN & OGLAND 304 Locust Hudson, WI 54016 Parcel I.D. Number: �$- 1 ao I — 50 -Oo0 M & G, Inc. conveys to Grand Properties, LP, an easement for access to Lot 18 ofthe Plat of Roiling Oaks to the town road over and across Lot 17 of said plat, described as follows: Beginning at the northwest corner of said Lot 17; thence along the westerly line of said Lot 17 S33 °44'23 "E a distance of 50.00 feet; thence N60 °5601 "E a distance of 66.22 feet; thence N33 °44'23 "W a distance of 50.00 feet; thence along the north line of said Lot 17 S60 "W a distance of 66.22 feet to the point of beginning. This easement shall run with the land and shall be binding upon and inure to the benefit of Grantor and Grantee herein, their heirs, successors and assigns. Dated this 2& ` day of September, 2002 M & G, Inc. a k1vt-z- Michael J. Ge in, President Subscribed and sworn to before me this 74p " day of September, 2002 ,> l6 y T r/ A' 0 C L4kN Notary Public F(E u v/ I My commission • s 1 This instrument drafted by: ' Attorney Kristina Ogland Estreen & Ogland 304 Locust Hudson, ; WI 54016 17ro — -- -- era -__.- - ------------- - - - - -- -- ' ,mot, �, - -- R op °- - -- ` - - -- - - - - -- ---- - - - - -- — - - -P -•� J K __ __P___.Ql✓1 _Tap . a "_1_'rt�. -�'�__ �t_� i�o U.__ __ . D - - -D/ _ . Z-011 _ S)! . - -- 7 - -- - - - p i. - P e.1 Fri /� L/ 44r3_ _s -%= s cic7t� �o.a - - - - � G_ .1.49 "Fy �J_ie-zv- ze__ b y0, C - - - 01'lE/1.5� ' Safety and Buildings Division County 5 n D ` N *isconsh� 201 W. Washington Ave., P.O. Box 7162 L-r - I Madison, WI 53707 - 7162 Site Address . _. _ _ 1 - 3' X15 T S T, Department of Commerce F • ,- SmAtary Permit Application = to J "may ermit Number In accord with Comm 83.21, Wis. Adm. Code, personal information y u prov... J Ch if Revision ma be used for ses Priva Law, s15. 04(1 �' a I. Application Information - Please Print All Information rate I.D. Number / CC; Property Owner's Name Parcel lqumber L COC - roperty Owner's Mailing Property Location SO,/T� Al t� Si 540 if : S T N, R City, State Zip Code Phone Number LOPNOfts, Block Number bdi ' ' n Nam CSM Number lE/1 & T o�5� .A S H. Type of Building (check all that apply) L City 1 or 2 Family Dwelling - Number of Bedrooms ovma e 8 ❑ Public/Commercial - Describe Use lyTownship C Nearest$oad 11 State Owned , 3 x lag ¢ 3'�r &2, �� a n III. Type of Permit: (Check only one box on line A (numbering scheme for ' use). Com to Iffie B if applicable) A ' �ON 2 ❑ Replacement System 1 3 ❑ Replacement of 1 6 ❑ Addition to For County use Tan Onl Existing stem B. Check if Sanitary Permit Previously Issued Permit Number Date Issued 0 5 - 0/ s o v IV:P a of Permit: (Check all that apply)(numbering scheme is for internal ) % /�� U5 7� L�/}C! <ir✓C� C/ �''t BLS 44 - Pressurized In- Ground 21❑ Mound 47 ❑ Sand Filter 50 ❑ Constructed Wedand W 22 ressor' n- to 41 ❑ Holding Tank 48 ❑ Single Pass 51 ❑ Drip Line l , 45 ❑ At -Grade 46 ❑ Aerobic Treatment Unit 49 ❑ Recirculating 30 ❑ Other V. Diswm rsal/Treatment Area Information: Design Flow (gpd) Dispersal Area Dispersal Area Soil Application Percolation Rate System Elevation Final Grade Required Proposed Rate(Gals./Days/Sq.FL) (Min./lnch) Elevation ✓ 11 -0 R3,7 ��`f -3 y5o G Y3 61�, S3, J . 7 A A26ftd61A ox " e )P-Vi VI. Tank Info Capacity in Total Number Manufacturer Prefab v % Site Steel Fiber Plastic Gallons Gallons of Tanks !� / Concrete Constructed Glass Now Tanks Tanks _,`� l� �`✓ Septic or Holding Tank Dosing Chamber VII. ResponsibuTity Statement- I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) plumvi Signature MP Nuii� Business Phone Number Phumbees Address (Street, City, State, Zip e) UAL L - j.— j 1� J QZ i VIII. our /De artmen Use Onl Sanitary Permit Fee (includes Groundwater Date Issued Issu' nt Signature )jpstamps) Approved ❑Disapproved Surcharge Fee ❑ Owner Given Initial Adverse . Lj (J ' OV Determination IQi:. Conditions of Approval/Reasons for Disapproval S y , , I tl) — OAd Pam vti S l ,je VSO` X24 ✓t U E .1�OLU7T Attach oomplde phw (w the County only) for the system on not lea than SM z U Inches In stse _ d rn -o�-�t d use -Z'� /4.�.�t ate...• �.e �--n ����- �c.�. I SBD -6398 (R. 1111e� I u o I c I I � I F-__T —. �`� - ►1 , L,r� -- •� I I v' U �� � _- !r!.91./ ��r__ % „ cam:: i/��E �L: " F�;.�v -- -- • - __ __ _ - -' - - --� . �_ _ ' E�Tl� L' -C2��, - opj-- . LET_SE,t�s�- Ru✓i ©�_ ,_ 14 OLile — - / L -- -_ JG9 -' 16. � 7 I I I I I I I P�Gcn�a. I I D -_ _ _ _ h ___ _ _ __ _ __ __ __ _ _ _ __ �_ _- _. = - -- � __ _ __ - -- - - __ _. __ _ _ _ _ _ _ __ 1136 Wisconsin Department of Commerce SOIL EVALUATION REPORT Page 1 of 3 Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code Tom Schmitt Attach complete site plan on paper not less than 8% x 11 inches in size. Plan must County St. Croix include, but not limited to: vertical and horizontal reference point (BM), direction and percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D. Please print all information. 9 4 'Y> 001v v we By Dat Personal information you provide may be used for secondary purposes (Pd 04 (1) (m)). Gt Zb Property Owner, operty Location Grand Properties, LP G" Lot SW 1/4 SW 19 S 18 T 31 N R 18 W Property Owner's Mailing Address L # Block # Subd. Name or CSM# 712 Rivard Streeet, Suite 300 ` 17 Rolling Oaks City State Z425 ode Phone Npmbef City Village se Town Nearest Road Somerset WI , 71 �247�5 Star Prairie 81St St ✓ New Construction Use: ✓ Residential / Number of bedrooms 3 Code derived design flow rate 450 GPD Replacement Public or commercial - Describe: Parent material Outwash Plain Flood plain elevation, if applicable na General comments and recommendations: Area is suitable for a conventional system with a 0.7 gpd /sgft rating. Possible system elevation range is 91.0' to 86.0'. This area has been cut. ❑ Boring # Boring 6e Pit Ground Surface elev. 93.53 ft. Depth to limiting factor >145 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft' in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0 -17 10yr4/3 none sl 2msbk mfr cs 1f .5 .9 2 17 -34 10yr4/4 none Is 1 msbk mvfr gw - - - -- 7 1.2 3 34 -145 10yr5/4 none Is Osg ml - - -- - - -- 7 1.2 D. 36 ❑ Boring # Boring ✓ Pit Ground Surface elev. 94.34 ft. Depth to limiting factor >146 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft' in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0 -22 10yr4/4 none sl 2msbk mfr cs 1f .5 .9 2 22-43 10yr4/6 none Is 1 msbk mvfr gw - - - - -- .7 1.2 3 43-146 10yr5/4 none Is Osg ml ---- .7 1.2 g .o . d G * Effluent #1 = BOD 30 < 220 mg /L and TSS >30 < 150 mg /L * Effluent #2 = BOD < 30 mg /L and TSS < mg /L CST Name (Please Print) Signature: CST Number Thomas J. Schmitt 227429 Address Tom Schmitt Date Evaluation Conducted Telephone Number 586 Valley View Trail, Somerset, WI 54025 8/20/02 715 -549 -6651 Property Owner Grand Properties, LP Parcel ID # D- ',v��j' y�~' ��� Page 2 of 3 3] Boring # Boring ✓ Pit Ground Surface elev. 94.70 ft. Depth to limiting factor > 143 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Stricture Consistence Boundary Roots GP D in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0 -10 1Oyr5/4 none Is Osg ml gw - - -- .7 1.2 2 10 -143 1Oyr5/6 none ms Osg ml - - -- - - - - -- .7 1.2 g 6 F-1 Borin Boring # Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 F-1 Boring # Boring Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 * Effluent #1 = BOD 5 > 30 < 220 mg /L and TSS >30 < 150 mg /L * Effluent #2 = BOD <_30 mg /L and TSS < 30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or —'I - — oIf—fa fn.,,,ot n].— t AnR- ')AA-11 G 1 — TTV fnQ- ')fA_R7'7'7 _ 0. c P o qv �l3 N j o rr ZIO r t v t/ b 7.4 vwtgtv i 3 TM ? d / l y G!r- , 7,-a , 1103 SOIL EVALUATION REPORT Page I of 3 Wisconsin Department of Commerce Tom Schmitt Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code County Attach a site plan on paper not less than 8 %x 11 inches in sae. Plan must . ; St. Croix include, but not limited to: verbal and horizontal raterence point (BM), direction and Parcel I.D. percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Please print all informadon. Reviewed By Date Personal Inforoabon yW pmvW may be used for mcondary pwPosea (Privacy La, s. 15.04 (1) (m))• Property Owner Property Location Grand Properties, LP Govt. Lot SW 1/4 SW 1/4 S 18 T 31 N R 18 W Property Owners Mailing Address Lot # Block # Subd. Name or CSM# 712 Rivard Streeet, Suite 300 17 Rotting Oaks City State Zip Code Phone Number 1 City _ Village ✓ Town Nearest Road Somerset WI I 54025 1 715 - 247 -5900 Star Prairie 1 81St St. Use: Code derived design flow rate 450 GPD el New Construction ✓Residential / Number of bedrooms 3 j Replacement _; Public or commercial - Describe: Parent material Pitted glacial drift Flood plain elevation, if applicable na General comments and recommendations: Area Is suitable for a mound system. System elevation is 98.49 based off of contour line established at 97.07'. Area is on a 20% slope. r Boring # .... Boring i/ Pit Ground Surface elev. 9$.28 ft. Depth to limiting factor 19 in. Soit Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roofs f ff#1 "Eff#2 In. Muraeli Cm Sz. Cont Color Gr. Sz. Sh. 1 0-6 10yr312 node sit 2mgr mfr Cs 2m,1f .5 .8 2 6-11 10yr5/3 none sit 2fsbk mfr gw 2m,lf .5 .9 3 11 -19 10yr4/4 none sl 2fsbk mfr gw 2f .5 _9 4 19-32 rn2 j Is 1 msbk mvfr cw 2f 7 1.2 5 32 -53 10yr5/4 m2 5�� .7 1.2 8 is Ogg ml Cw ----- 6 53-84 7.5yr4/4 m2A 7.5 r /6 sl Oma MA — ----- .3 .5 a Boring # Boring Pit Ground Surface elev. 97.62 it Depth to limiting factor 25 in. Sail Application Rate Horizon Depth Dorninant Color Redox Description Texture Structure Consistence Boundary Roots GPDHI' Ef #2 in. Mureell Qu. Sz. Cont. Color Gr. Sz. Sh. 1 0 -7 10yr3/1 none sit 2mgr mfr Cs 2m,2f .5 .8 2 7 -14 10yr5/3 none sl 2fsbk mfr gw 2m,2f 5 9 3 1425 7.5yr4/4 none sl 2msbk mfr gw 2f .5 .9 m2d�7.5,� /6 m k mfr 9w �-- .7 1.2 4 25-42 7.5yr4/4 1�r1 is sb 1 5 42 -75 10yr5/4 m if py0v/r26 /6 is 1 msbk mvfr - -- ---- .7 1.2 Effluent #1 = BOD? 30 < 220 mg/L. and TSS >30 < 150 m9A. ' Effluent #2 = BOD <30 mg/L and TSS <30 mg/L CST Name (Please Print) Signature: CST Number Thomas J. Schmitt vrµe�. --- 227429 Address Tom Schmitt Date Evaluation Conducted Telephone Number 4/19102 715 - 549 -6651 586 Valley View Trail, Somerset, W154025 • " Page 2 of 3 roes LP Parcel 1D # ty owner Grand Pro 93 , Depth to limiting factor 31 in. Soil Application Rate 3� Boring # Boring y Pit Ground Surface elev. J gyre C Boundary Roots •Eff#1 -002 Redox DesaiPtion Texture Horizon Depth , � Gr. 5z Sh. Qu. Sz. Cont. Color 2m,2f .5 . in. MWISM SO 2rrtgr mfr 1 0_7 10yr3/1 none _ none so 2fsbk mvfr gw 2m,2f .5 .8 2 7 -19 10yr5/3 1 f 5 9 sl 2msbk mfr 9w 3 19 -31 7.5yr4/6 none 5 .9 7.5yr4/4 m2d l Oyr6/ /2 5 516 sl 2msbk mfr gw 4 31-42 7 1.2 5 42-69 10yr5/4 �j 10%rj /6 is lmsbk mvfr _— Boring ft. Depth to limiting factor -- in. Soil Apd Rate a Boring # L Pit Ground Surface elev.._._..�— Redox Desa�fion Texture Shucture Consistence Boundary Roots "Eff #1 "Eff#2 Horizon Depth Dominant Cal Sz. Sh. in. Munsell Cnr. Sz Cunt Color Boring ft. Depth to fimiting factor in. Sol Application Rate a Boring # i Pit Gro und Surface elev. Redox Description __—_ -- Strtrc�ure Conststecrce Boundary Rocks "Eff#1 "EtT#2 Horizon Depth Dominant Texte Gr. Sz. Sh. M in. Qu. Sz. Cont. Color > < and TSS >30 < 150 mgA- " Effluent #2 = BOD < < _30 mg/L and TSS 30 mg/L Effluent #1 = SOD 30 _220 mg/L t The Department of Commerce is an equal opportunity service provideQ�demP�R ;� i� �i�assistance: ,4o acces cervices or d . i 1 qbj KR q h pve, } top_ to Ayr 71.2 ke' 1 / SYa t 7o jl� Q s syq �r/ 09/06/02 FRI 16:30 FAX 1 715 386 6560 ESTREENUGLAND 10 002 EASEMENT Document Number: Return Address: Parcel I.D. Number: M & G, Ine. conveys to Grand Properties, LP, an easement for a septic system drainfield, as well as an access easement for any and all maintenance and repair thereto, located on Lot 18, Rolling Oalcs, Town of Star Prairie, St. Croix County, Wisconsin, f gr the benefit of Lot 17, Rolling Oaks, Tgrrm o tar Prairie This easement shall run with the land and shall be binding upon and in to the benefit of Grantor and Grantee herein, their heirs, successors and assigns. Dated this 9M day of September, 2002 M & G, Inc. y By Micha 1 J. Germain, President Subsedbgd and sworn to before me this '1nn'1 CHERYL.WGOBS�•N I Safety and Buildings Division County 201 W. Washington Ave., P.O. Box 7162 ,S T. C,LO r ` Madi son, WI 53707 - 7162 ite Address Department of Commerce S z d 't__ o 1 S - o ? Sanitary Permit App Sanitary Permit Number Application f o.SO q � In accord with Comm 83.21, Wis. Adm. Code, personal info ou rovide ❑ Check if Revision may be used for secondary purposes Privacy Law, sl 1 I. Application Information - Please Print All Information e 9 J State 3 I.D. Number Property Owner's Name MAY 1 3 ? 00 Parcel Number 1g.31. 0( G P- lU p e2 / 6 S 1 KE u! / r eJ 0 - IZO (- q0 - am Property Owner's Mailing Address IX coury Ty Property Location p 7/ %uo $T, SU ITCH /00 ZONING OFFICE W A -5V A ;S I if T3/ N,R +/0 )E City, State Zip Code Phone Number Lot N ber Block Num ber S O N l r S t` T ' - 10d- S Subdivision Name CSM Number W/S(t)w51A) J 7�� -�Y7 �� /Ytt� pp 1C0I- &/A) DJ4 ks II. Type of Building (check all that apply) as par S 01% ❑City JE 1 or 2 Family Dwelling - Number of Bedrooms .3 ❑Villa ❑ Public /Comm cial - Desc se ❑ State Own 60411■^ It �� st Road _ �` x `�r t cA.QQ. "� " ."f L - 4 " ;f 1.5 % III. Type of Permit: (Check only one on line A (numbering scheme for internal use). omplete line B if applicable) A. County use 1 U New 2 ❑ Replacement System ❑ Replacement of 6 ❑ Addition to System Only Existing stem B. ❑ Check if Sanitary Permit Previously Issued I V t Number Date Issued • IV. Type of Permit: (Check all that apply)(numbe scheme is for intern e) 50 6 44 ❑ Non - Pressurized In- Ground 211R Mound 47 El ilter ❑ tructed Wet ,d aw 22 ❑ Pressurized In- Ground 41 ❑ Holding Tank 48 ❑ to Pass 5 45 ❑ At -Grade 46 ❑ Aerobic Treatment 49 ecirculatmg 30 er V. D' ersal/TYeatmeat Area Information: Design Flow (gpd) Dispersal Dispersal Soil cation Percolation to System Elevation Grade Required Propos q,501) Ra al s/SgTt.) (M' h) EI ation y� 0 9 ©a a G 41 so R �q, q 5 VI, Tank Info Capacity in Total Number Manufa er Pre Steel Fiber I Plastic Gallons Gallons of T Concre cted Glass New Existing Tanks Tanks X Septic or Holding Tank / a Q _ 10( W C le it / Dosing Chamber 00 S oo W C C K S VII. Responsibility Statement- I, the undersign , assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plum 's gnature MP/MPRS Number Business Phone Number sG/F,ll,17 1 441 4 # 1 a 2 3 76 0 - 6is( Plumber's Address (Street, City, State, Zip _ 616 � 1`f � �,no1 `��2SET �� .�cld 15 D T VIII. County /De artment Use Onl Sanitary Permit Fee (includes Groundwater Date Issued Issuing Agent Signature (No Stamps) Approved ❑Disapproved Surcharge Fee) ❑ Owner Given Initial Adverse §P Determination 3 ' IX. Conditions of Approval/Reasons for D' � a p p .. � pro � � al ��mt'"o..6R v� Wit✓ -G Attach complete plans (to the Count? ody) for the system on paper not less than It,, x 11 trachea In size SBD -6398 (R. 05101) I I i �a M 1 - -- _- - -- �ti5 _ _ ____ - _ __: - -- ___ -__ L B>� =f or- � •' we T. ?G' P - u R u WELL -- - - U cr -- ---- - - - -- - -- — - - -- - $oo CzR P. It JI -- - -- - G eOAM S MIKE -- — 7/ I�'r_VA�A Si • Ott i T,6 - SOIn " 1 aa3 �� IC �` '.:z �_ � � . «� 3 � � � ` ,�� ��, �.: .�. ,• �: . 4 [ Y Safety and Buildings 4003 N KINNEY COULEE RD LA CROSSE WI 54601 -1831 TD #: (608) 264 -8777 erce ,sc0n-s,n www. www.commw s i n.gov wisconin.gov Department of Commerce Scott McCallum, Governor Philip Edw. Albert, Secretary May 08, 2002 CUST ID No.223760 A7TN: POWTS Inspector JOHN F SCHMITT ZONING OFFICE SCHMITT & SONS EXCAVATING ST CROIX COUNTY SPIA 616 150TH AVE 1 101 CARMICHAEL RD SOMERSET WI 54025 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 05/08/2004 Identification Numbers Transaction ID No. 732525 SITE: Site ID No. 644378 Grand Properties / Mike Germain Please refer to both identification numbers, 2117 81 ST St L above, in all correspondence with the agency. Town of Star Prairie St Croix County SW1 /4, SWl /4, S18, T31N, R18W Lot: 17, Subdivision: Rolling Oaks FOR: Description: Three Bedroom Mound System Object Type: POWT System Regulated Object ID No.: 850626 The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. The following conditions shall be met during construction or installation and prior to occupancy or use: General Approval Requirements: • This system is to be constructed and located in accordance with the enclosed approved plans and with the "Mound Component Manual for Private Onsite Wastewater Systems VERSION 2.0" SBD- 10691 -P (N.01/01) and the "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems VERSION 2.0" SBD - 10706 -P (N.01 /01). • Per manual cited above, limited activities are allowed in the area 15 feet down slope of the component area. Soil compaction, excavation, vehicular traffic and other similar activities that impact the treatment and dispersal are prohibited. C01ldtle • The well must be a minimum of 25 feet from any PO WTS tank, and a minimum of 50 feet from the absorption APPRC area. chs. NR 811 & 812c OFI • A Sanitary Permit must be obtained from the county where this project is located in accordance with the OF �y requirements of See. 145.135 and 145.19, Wis. Stats. SEE CORRES • 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. Stat • 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. • The changes made to this plan on 5 /08/02 by this reviewer were acknowledged and approved by the system designer. JOHN F SCHMITT Page 2 5/8/02 Owner Responsibilities: • Comm 83.52 Responsibilities. 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. • Comm 83.55 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. All permits required by the state or the local municipality shall be obtained prior to commencement of construction /instal lation/operation. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, stricture, 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 Charles L Bratz POWTS Reviewer 11 , Integrated Services WiSMART code: 7633 (608)789 -7893 , 7:45 am - 4:30 pm Monday - Friday cbratz @commerce.state.wi.us cc: Leroy G Jansky , Wastewater Specialist, (715) 726 -2544 i f SCHAHTT & SONS EXCA VA TING 586 Valley View Trail Somerset, WI 54025 715- 549 -6651 For: (3,eAN (, � �d Peo ?arl6s OLtIAJ o ©l4 )CS DoT l7 Address: 71-� Oe) V,t2d ST, Su / % E /OD Legal. -S JA) /y - W l /�/ Sf c / 8 > 73 /,AJ - /2 IS VJ Township: -5'7 /4 , Pe4 t e- f e County: S% . C f C I X _Contents RECEIVED Page I Plot Plan MAY - 7 2,00Z Page 2 System Cross Section Page 3 Pipe Lateral Layout SAFETY & BLDGS DIV. Page 4 Dosing Chamber Page s Pump Curve Page 6 Management Plan Attachment I Soil Evaluation Report Attachment 2 ,S t4)e V 6 - y IN p P Mound Component Manual (version 2.0) SBD-1 0691 P(N. 01/01) Pressure Distribution Component Manual (version 2.0) SBD- 10746 -P(N 01/01) By: MPRS --2� 3 76 a �� Date: 1 1` - 9 4 a rya '� RCB ,N4o I �C 1C • 0 0 vc RLr, 0 PR o WELL —, - -- - -- /J ._ ... -_• _ .___- .._ - .- -_- - -_ I - u i o ! I ( -- — B 4 GkhN PE�e � -- 11'lj_KC -- �+2Yl�A /�✓ - .� C1fil' C!� /I�(�"T_, 71; d ._Wr _2 -- � In >� �� ter - 4- -/oas - - -- _ -- m toles �3 76 _ _ __ __ . '. Y. __ _. �� __ _ - - ___ _ _ _ __ _ _ - -- .r _;_ _._ __ _ . - -- -_ - _ / +,: - s �. __ _. __ __ __ __ _ _ _ _ __ _ _ _ _ _ -_ _ _ _ _ _ _ _ _ __ ___ __ __ __ __ _ _ _ __ __ _ _ _. j _ _ _ _ __ I Page Of Straw, Marsh Hoy, Or Synthetic Covering ASTMC33 Distribution Pipe Medium Send q o 6" Topsoil F SYS ELEV. 1 % Slope Bed Of I* 2 Force Main Plowed Aggregate Layer (6 Below Pipe) D IM Ft. .ba Ft. Cross Section Of A Mound System Using E F �_ Ft. A Bed For The Absorption Area G Ft. A '(O Ft. H J Ft. Signed: S S Ft. License Number: �37 K it. Ft. oZy L 97:96 Ft. Date: - — 3 ±21 Ft. 5 , Alternate Position 195 Ft. ° of W Ft. 1C Y Force Main - ObNivalian Wp� ' 115 To 1114 8 From End o1 Bed K A _ Force Main �'Dlstributiom L Pipe Ob>isrva #ion Pips ers 110'to 1140 B From End of Bed Plan View Of Mound Using A Bed For The Absorption Area Tum-up WO Clsanout uses "Plug or son V P1tC Force Mo1n taiwlbution Latsral PVC MW"d F V2 oNtriauWA U MI Layout p ,370 Ft. S 3.0 Ft. X I AChm. 1jole Dim"ter 3 b Inch Signed: Ietowa�l " 1a Inche3� a� � 3 � Mars 1 �'ol d 41 l �a triches Licetlse bier: � Fort• 141 " ...�..- inches Date: r ~0 of hopes /pipe I n Elevat ion of Laterals Ft. J POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page of { ILE INFORMATION SYSTEM SPECIFICATIONS F Owner 6 2,qA) T7 P,C,e rle Septic Tank Capacity DD al 13 NA Perrnit #. Septic Tank Manufacturer WfCtS D NA DESIGN PARAMETERS Effluent Filter Manufacturer Z/}(jr L 0 NA ent Filter Model A a NA Number of Bedrooms [3 NA Efflu Number of Comm8rdai Units Ig NA Pump Tank Capacity 800 R at 0 NA Estimated flow (average) allda Pump Tank Manufacturer C k' $ 13 NA Design flow (peak), (Estimated x 1.5) y.s© g al/day Pump Manufacturer �p L L E Q O NA Soil Application Rate Jr— aVda fle Pump Model > Y (� 0 NA Influent/Effluent Quality Monthly average' pretreatment Unit O NA ❑ Sand/Gravel Filter O Peat Filter Fats, Oil & Grease (FOG) 530 mg/L p Mechanical Aeration 0 Wetland Biochemical Oxygen Demand (BOD 5220 mg/L p Disinfection 0 Other. - Total Suspended Solids (TSS) 5150 m lL Manufacturer Pretreated Effluent Quality 1p NA Monthly average" Dispersal Cell(s) Biochemical Oxygen Demand (ROD 530 mg/L 0 In -ground (gravity) 0 in -ground (pressurized) Total Suspended Solids (TSS) 5 l7 At-grade ®. Mound 30 mg/L p Other. Fecal Coliform (geometric mean) 510 cfu/100ml 0 Dri ine Maximum Effluent Particle Size Y, Inch diameter Values typical for domestic (non- oommerda� wastewater and septic tank effluent. •+ Values typical for pretreated wastewater. MAINTENANCE SCHEDULE Service Event Service Frequency Inspect condition of tank(s) At least once every ❑ months ® year(s) (Maximum 3 yrs.) scum equals one -third (Y,) of tank volume Pump out contents of tank(s) When combined sludge and inspect dispersal cell(s) At least once every 3 0 months to year(s) (Maximum 3 yrs.) Clean effluent filter At least once every ❑ months 0 year(s) Inspect pump, pump controls &alarm At least once every ❑ months M year(s) O NA Flush laterals and pressure test At least once every ) 0 months [a year(s) ❑ NA other. At least once every ❑ months ❑ year(s) O NA other At least once every 0 months 0 year(s) O NA MAINTENANCE INSTRUCTIONS n licenses or Inspections of tanks and dispersal cells shall be made by an individual cartying one of the following cerfficadons: Master Plumber, Master Plumber Restricted Sewer, POWTS Inspector, POWTS Maintainer Septage Servicing Operator. Tank inspections must include a visual inspection of the tank(s) to identify any missing or broken hardware, Identify any cracks or leaks, measure the volume of combined sludge and scum and to check for any back up or ponding of effluent on the ground surface. The dispersal cell(s) shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a failing condition and requires the immediate notification of the local regulatory authority. When the combined accumulation of sludge and scum in any tank equals one -third (Y,) or more of the tank volume, the entire contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with ch. NR 113, Wisconsin Administrative Code. The servicing of effluent filters, mechanical or pressurized POWTS components, pretreatIment components; and any other maintenance or monitoring at intervals of 12 months or less shall be performed by a certified POWTS Maintainer. A service report shall be provided to the local regulatory authority within 10 days of completion of any service event. START UP AND OPERATION or other For new construction, prior to use of the POWTS check treatment tank(s) for the presence of pa inting products 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. System start up shall not occur when soil'conditions are frozen at the infiltrative.surface. Page- --_•_nf During power outages pump tanks may fill above normal highwater levels. When power is restored tPre excess wastewater will be discharged to the dispersal celt(s) in one Large dose, overloading the cell(s) and may result in the backup or surface discharge of effluent To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior .6 restoring power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump conbvls to restore normal levels within the pump tank Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area within 15 feet down slope of any mound or at -grade soil absorption area. Reduction or. elimination of the following from the wastewater stream may improve the performance and prolong the life of the POWTS: antibiotics; baby wow cigarette butts; condoms; Cotton swabs; degreasers; dental Boss; diapers, disinfectants; fate foundation drain (sump pump) water fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; off; painting products; pesticides; sanitary napkins; tampons; and water softener brine. ABANDONMMENT When the POWTS falls and/or Is permanently taken out of service the following steps shall the taken to insure that the system Is properly and safely abandoned In compliance with ch. Comm 83.33, Wisconsin Administrative Code: • All piping to tanks and pits shalt be disconnected and the abandoned pipe openings sealed. • The contents of aft tanks and pits shall be removed and properly disposed of by 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 another inert solid material. CONTINGENCY PLAN If the POWTS falls and cannot be repaired the following measures have been, or must be taken, to provide a code compliant replacement system: • 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, 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. • 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. tA 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 GASSES AND /OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLER POWTS MAINTAINER Name J N N SC H to i TT Name O t o N E S C 14 (9 (C � Phone 715- 66 �'( Phone SEPTAGE SERVICING OPERATOR PUMPER LOCAL REGULATORY AUTHORITY Name Ow N eie5 ©('� Agency . C/Z OIX CL) /UT ZOiU /N 6 Phone Phone This document was drafted by the staffs of the Green; take, Marquette and Waushara County Zoning and Sanitation agencies. This document meets the minimum requirements of ch. Comm 83.22(2)(bx1)(d)&(f) and 83.54(1), (2) & (3), Wisconsin Administrative Code. Use of this document does not guarantee the performance of the POWTS. G MW (2101) z 1103 Wisconsin Department of Commerce SOIL EVALUATION REPORT Page I of 3 Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code Tom Schmitt Attach complete site plan on paper not less than 8 %x 11 inches in size. Plan must County St. Croix include, but not limited to: vertical and horizontal reference point (BM), direction and percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D. Please print all information. Reviewed By Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Property Owner Property Location Grand Properties, LP Govt. Lot SW 1/4 SW 1/4 S 18 T 31 N R 18 W Property Owner's Mailing Address Lot # I Block # Subd. Name or CSM# 712 Ri vard Streeet, Suite 300 17 Rolling Oaks City State Zip Code Phone Number City Village ✓ Town Nearest Road Somerset WI 1 54025 1 715 - 247 -5900 Star Prairie I 81St St. ✓ New Construction Use: of Residential / Number of bedrooms 3 Code derived design flow rate 450 GPD Replacement Public or commercial - Describe: Parent material Pitted glacial drift Flood plain elevation, if applicable na General comments and recommendations: Area Is suitable for a mound system. System elevation is 98.49' based off of contour line established at 97.07'. Area is on a 20% slope. ❑ Boring # Boring ✓ Pit Ground Surface elev. 98.28 ft. Depth to limiting factor 19 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft' in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. "Ef1#1 "Eff#2 1 0 -6 10yr3/2 none sill 2mgr mfr cs 2m,1f .5 .8 2 6 -11 10yr5/3 none sl 2fsbk mfr gw 2m,1f .5 .9 3 11 -19 10yr4/4 none sl 2fsbk mfr gw 2f .5 .9 4 19 -32 7.5yr5 /6 m f 5 6 Is 1 msbk mvfr cw 2f .7 1.2 5 32 -53 10yr5 /4 m2d 5yr6/8 7.5yi6/2 Is Osg ml cw - - - -- 7 1.2 6 53 -84 7.5yr4/4 rr'10yr y2 sl Oma mvfi - - - - -- .3 .5 F21 Boring # Boring ✓ Pit Ground Surface elev. 97.62 ft. Depth to limiting factor 25 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft= in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. "Eff#1 *E 2 1 0 -7 10yr3/1 none sil 2mgr mfr cs 2m,2f .5 .8 2 7 -14 10yr5/3 none sl 2fsbk mfr gw 2m,2f .5 .9 3 14 -25 7.5yr4/4 none st 2msbk mfr gw 2f .5 .9 4 25-42 7.5yr4/4 '�,I py'j2 /6 Is 1 msbk mfr gw - - -- .7 1.2 5 42 - 10yr5/4 R ' j Diyrb /2 /6 Is 1 msbk mvfr - -- - - - -- .7 1.2 " Effluent #1 = BOD? 30 < 220 mg /L and TSS >30 < 150 mg/L ' Effluent #2 = BOD !i mg/L and TSS <30 mg/L CST Name (Please Print) Signature: _ CST Number Thomas J. Schmitt .� 2 27429 Address Tom Schmitt Date Evaluation Conducted Telephone Number 586 Valley View Trail, Somerset, WI 54025 4/19/02 715- 549 -6651 S Property Owner Grand Pr LP Parcel ID # Page 2 of 3 ❑ Boring # Boring ✓ Pit Ground Surface elev. 93.57 ft. Depth to limiting factor 31 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots QP in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 1 0 -7 10yr3/1 none sil 2mgr mfr Cs 2m,2f .5 .8 2 7 -19 10yr5/3 none sil 2fsbk mvfr gw 2m,2f .5 .8 3 19 -31 7.5yr4/6 none sI 2msbk mfr gw 1f .5 .9 4 31 -42 7.5yr4/4 m2d IOyr6/7.5yr5/6 sl 2msbk mfr gw - - - - -- .5 .9 _ 1 r6 /2 _ 5 42 -69 10yr5 /4 m2p 10yr6 /6 10 r6 /1 Is 1msbk mvfr - - -- - - -- 7 1.2 F-1 Boring # Boring Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP 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. Sal Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 * Effluent #1 = BOD? 30 < 220 mg/L and TSS >30 < 150 mg /L * Effluent #2 = BOD < 30 mg /L and TSS <30 mg /L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or -', —f—;.1 - on oIt—t. fnrmot n1-- the d- rf1Y1Pnt at !.(1R- , )4f -21 ,; 1 nr TTV AAQ.')AA -8777 y , O � 4 00 / / Su i ke 140 .5LJ �- S w S /B ? 71r- zeeil .I 183. 1 • ` ` �• 1 V� :\ / 1 I �� �.. HIGH WETLAND �P Y� 1 WETLAN 6 �sr.t-,�i .� y .ps'/.�!. BT g ^ KI►. 90.0 .\ 900.9 s �•� $1T, N �` ®'•. \, r _ 1 � e C_S. M. IN - e � Qb 'e \ 26 ` a t.oBTwcRBe t zo �• ' a 1.6.2 Aonas ,y Y 97.— S:.so" J h H WETLAND y N 25 2 ' \ 3 ACREB co ao N91.4Y vw_ .94' \ 134.97460 Pr � j • @ 116.06' VOL 14, PC. 3838� �, e t P. / D 3'20 $ — — — — \ 1k I SAT C N89e78 ?� r �.' e 11,E 1 7.324 Rast \ i' 'r a ^ �^ / a % es. 1.037 ACRES �. 8 89 E 375.44' \ N ow b S +�e68 84,374 80 FT 866.1 m 22 1 2.000 ACRES 00.936 BO FT 1Q 1.397 ACRES ",705 so Fr I Be •2•JP � / w e 16333 J e3•oe'•r E 333. 8 ' /� i — VF ' ' 9.9.5 P2 0 1 9 0 42' ts� 17 2.247 ACRes 30 h I ^ 16ACREa SO ?e• 2.417 ACME 97.007 W FT so Ft 12 �84"w 100,2" so FT 3 I 2.171 ACREB I ` (^ ; YI 6 7a• I I g I r e 61.663 Bo FT 1 H 9.OP r1 r1 ' I $ 1 a43.00'1TW 0.10.!7' IN.7T 0 \ e4 o0. Bo- e I \ \ 1 taco+. .40' 6ILL- I Z 960 0 O n 1.026 ACRES + b s e o FT b p ( I 1 f1• � ♦ g J 1 . tr 0. so FT b 0. BB73'1 B' E 312.2T 0 ^ IB zo 21 p 11 �� e [tt.0 (� O Ipv _ 1.479 ACREB 1.056 ACRES � �y\ d / U •O o b 4 M.41 t BO Ff 04300 s0 6 s4 ° u, A io rr I R I 3 r 1.,03 ACREB b w l Z R p $' 9223 L ® —: LC �8I — — 4,• — - Sao. -- ip - ,f77 - -Taos w wo -arlT W 7M tw N 673V16' W 643.7W 1 DEDICATED TD THE PUBLIC 9ENd11MRK 4 N 8" T.18 W 1 452.4 9' TOP OF r 81000 PwE " — #.TOO" - 9TV57 L 210TH AVENUE 11.9.30. DATY1.1 OF 1929 2 2151h W A 16 15 X211^ A „ 14 Al 13 h 18 m Q111 v 2101 Av 210th Av 210th Av 20700 Y Ih v Slh Av 21 r 1 20 � Tdb ZZ �,� 9� ' P/ 4• S �\ 2001h M Pj 19091 Av N 28 27 26 25 30� S 192970 Av T> 2911 Av L � 970 Ii 1 h AV 190th w AV _ ♦o . c n S iX 3 34 14 32 194th Ay 190th Av C6NW R M 1aB' 500 Sce Paae 59 100 i. , „ r 1103 Wisconsin Department of Commerce SOIL EVALUATION REPORT Page 1 of 3 Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code Tom Schmitt Attach complete site plan on paper not less than 8'% x 11 inches in size. Plan must County St. Croix include, but not limited to: vertical and horizontal reference point (BM), direction and percent slope, scale or dimemsions, north arrow, and location and distance to nearest road. Parcel I.D. Please print all information. iewed By Date Personal information you provide may be u r !ML (1) MY .� Property Owner perty Location Grand Properties, LP Lot SW 1/4 SW 1/4 S 18 T 31 N R 18 W Property Owner's Mailing Address # Bloc k # I Subd. Name or CSM# 712 Rivard Streeet, Suite 300 17 Rolling Oaks City State Zi Code k* WE City Village be Town Nearest Road Somerset WI 54025 7 - Star Prairie 81St St. ✓ New Construction Use: ✓ Residential / Number of bedrooms 3 Code derived design flow rate 450 GPD Replacement Public or commercial - Describe: Parent material Pitted glacial drift Flood plain elevation, if applicable na General comments and recommendations: Area Is suitable for a mound system. System elevation is 98.49' based off of contour line established at 97.0 7'. Area is on a 20% slope. ❑ Boring # Boring ✓ Pit Ground Surface elev. 98.28 ft. Depth to limiting factor min. 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 *Efi#2 1 0-6 1Oyr3/2 none sit 2mgr mfr cs 2m,1f .5 .8 2 6 -11 1Oyr5/3 none sl 2fsbk mfr gw 2m,1f .5 .9 3 11 -19 1Oyr4/4 none sl 2fsbk mfr gw 2f .5 .9 4 19-32 7.5yr5/6 m 10y 6/l Is 1msbk mvfr cw 2f .7 1.2 — 5 32 -53 1Oyr5/4 7 8 Is Osg ml cw - ---- .7 1.2 6 53-84 7.5yr4/4 10y5 /2 /6 sl Oma mvfi -- - - -- .3 .5 ❑ Boring # Boring ✓ Pit Ground Surface elev. 97.62 ft. Depth to limiting factor 25_.— in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Stricture Consistence Boundary Roots GPD/fl' in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-7 10yr3/1 none sit 2mgr mfr cs 2m,2f .5 .8 2 7 -14 1Oyr5/3 none sl 2fsbk mfr gw 2m,2f .5 .9 3 14 -25 7.5yr4/4 none sl 2msbk mfr gw 2f .5 .9 4 25-42 7.5yr4/4 m2d 7.5 r5/6 Is 1 msbk mfr gw - - -- .7 1.2 5 42 -75 10yr5/4 m j 2 / 6 Is 1 msbk mvfr ---- -- 7 1.2 — * Effluent #1 = BOD? 30 < 220 mg/- and TSS >30 < 150 mg /L * Effluent #2 = BOD < 30 mg/L and TSS < 30 mg /L CST Name (Please Print) Signature: CST Number Thomas J. Schmitt 227429 Address Tom Schmitt Date Evaluation Conducted Telephone Number 586 Valley View Trail, Somerset, WI 54025 4/19/02 715- 549 -6651 r Property Owner Grand Properties, LP Parcel ID # Page 2 of 3 ❑ Boring # Boring l ✓ Pit Ground Surface elev. 93.57 ft. Depth to limiting factor 31 Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Stricture Consistence Boundary Roots in. Munsell Qu. Sz. Cord. Color Gr. Sz. Sh. "Eff#1 *Eff#2 1 0 -7 10yr3/1 none sil 2mgr mfr CS 2m,2f .5 .8 2 7 -19 10yr5/3 none sil 2fsbk mvfr gw 2m,2f .5 .8 3 19 -31 7.5yr4/6 none sl 2msbk mfr gw 1f .5 .9 4 31-42 7.5 r4/4 m2d 10yr6/7.5yr5/6 sl 2msbk mfr gw - - - -- .5 .9 y 10 / 5 42-69 10yr5 /4 m2p I0yr6 /6 10 /1 Is 1 msbk mvfr - -- - - -- .7 1.2 ❑ Boring # Boring Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 Application Rate F Boring # Boring f S Pit Ground Surface elev. ft. Depth to limiting actor in. oil Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 * Effluent #1 = SOD 5 > 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BOD <30 mg/L and TSS <30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or nPAA motur+nl .n on oltArnotP fnrmot nlPOCA nnntort the Aort -t of A(1Q_')Af,_Z 1 S 1 `.r TTV Ann -')fA -9777 • 4 3r,+ d V y8 4L r t L W/i- 6)*I �,, fez Z2 , elf /o8; vl' 1 Air J , .���i,►y,� 7� 37 71.2 2 °��d S'� CST � Su ke 160 & /%l U ew ST CROIX COUNTY SEP TIC "TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner /Buyer �r► CAr -D _P. , D I , , -- Mailing Address'� A��.o >'f', `jv, r i' C 1 s� Property Address :T k I� (Verification required required from Planning Department for new construction) City /State `�`�V.e,, ,�.� Parccl Identification Number i LE GAL DESCRIPTION Properly Location V4, ' /�, Sec. Ia , T?,�A_N -Rj�_W, Town of SjAR RNjPI&; Subc lvlsian s�l�r� c A�. — - Lot* — Certified Survey 1Vfap # , Volume , Page # Warranty Deed # G 7 6 C 3 Q Volume AT 7 6 , Page # 3 *'7 Spec house 1h yes ❑ no Lot lines identifiable yes ❑ no SYSTEM MAINTENANCE Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the syster can affect the function of the septic tank as a treatment stage in the waste disposal system. The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a masterplumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on -site wastewaterdisposal system - is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. Uwc, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 days of the three year expiration date. SIGN TUBE OF APPLICANT DATE OWNER CERTIFICATION I (we) certify that all statements on this form are true to the best of my (our) knowledge. I (we) ant (are) the owner(s) of the property described above, by virtue of a warrant deed recorded in Register of Deeds Office. Y'r, �. I— - Y g e Ll SIGNATURE OF APPLICANT DATE « + «• «R Any information that is mis represented may result in the sanitary permit being revoked by the Zoning Department. " Include with this application: a stamped warranty deed from the Register of Deeds office a copy of (lie certified survey map if reference is made in the warranty deed - Wisconsin Department of Commerce S OIL AND S LUATION Division of Safety and Buildings ' Page of Bureau of IntjRrated Services in accordance G� . '83.09, Wis. Adm. Code 0 4 Attach complete site plan on paper not less than 8 1/2 x 11 inches i sm ' Plan rtiUs( County include, but not limited to: vertical and horizontal reference point ( , direction and cszz percent slope, scale or dimensions, north arrow, and location and stance tganearesuoad. Parcel f D. # APPLICANT INFORMATION - Please print all inforniatldn. Re ie by Date Personal infomlation you provide may be used for secondary purposes (Privacy Lov✓, s,15.04 (1)'(rn)): 2' Property Owner Property Location , \ A Govt Lot S,_ 1/4 Sw1 /4,S j T ' 3/ ,N,R / E (cre Property Owner's Mailing Address Lot # Block# Subd. Name or CSM# 0"'((' , (� City State Zip Code Phone Number ❑ City ❑ Village RI Tow Nearest Road w Sy01 (}1,6 )54q -6 - 4)k JTA New Construction Use: W Residential / Number of bedrooms 3 _ �/ Addition to existing building Replacement ❑ Public or commercial - Describe: Code derived daily flow _,20= gpd Recommended design loading rate I bed, gpd /ft gpd/ft Absorption area required / ZOO bed, ft �0 d y trench, ft Maximum design loading rate , d� bed, gpd/ft2 !�2 trench, gpd /ft Recommended infiltration surface elevation(s) 7 �5_ ft (as referred to site plan benchmark) Additional design /site considerations (° D nj e 6'av Parent material F ' ( Flood plain elevation, if applicable ft S = Suitable for system Conventional Mound In- Ground Pressure AT -Grade System in Fill Holding Tank U = Unsuitable for system El [� U [as ❑ U ❑ S 0 U ❑ S [� U ❑ S �U El �U SOIL DESCRIPTION REPORT MW Boring Horizon Depth Dominant Color Mottles Structure GPD/ft 9 Texture Consistence Boundary Roots .� in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench i 1 0 7 3 5 L G. Z Y. -\ (S 5 S' Ground 3 7 q - 1 O 3 - il A k Yw M cs ` G elev. 9 s0 ft. �- Depth to limiting factor Remarks: Boring # � I U —G 10 31 i L5 I YVNZI C C3 Ground elev. 1 7 L. Depth to limiting Victor 4 Rema rks: CST Name (Please Print) Si Telephone No. Address Date CST Number PROPERTY OWNER ( — C - ' SOIL DESCRIPTION REPORT Page i Z,_. of PARCEL I.D.# r Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots 2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed ,'french 3 C) -IFS �' r l0 12 Z SL ZrnAa - Z -2b to - 1 4 5 ' 1 Zm CS — •y ' Ground 3 '� U y o,3 1 14 5' 1 �. V� elev. 9 .3• �a ft, �_'" , Depth to limiting factor Remarks: Boring # Ground elev. ft. Depth to limiting factor in. Remarks: Horizon Depth Dominant Color Mottles Texture Consistence Boundary Structure Roots GPD /ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed , Trench Boring # Ground , elev. ft. ' Depth to limiting , factor in. Remarks: Boring # } w<„ Ground elev. I ft. Depth to limiting factor in. Remarks: SBD -8330 (R.9/98) PROPERTY OWNER — C'c�U� SOIL DESCRIPTION REPORT • Page �!•- of PARCEAL I.D.# Boring # Horizon Depth Dominant Color Mottles Structure in. Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. Consistence Boundary Roots Bed , Tren a 10 (0 It rA.FZ c5 r Z - Zb to Y4 � 5 , 1 Z.m W�i-� cs — Ground und 3 3 6 � tZ � 5 . t � k r^ Pa— elev ' V Depth to limiting factor m in. ! L Remarks: Boring # Ground elev. ft. Depth to limiting factor in. Remarks: Horizon Depth Dominant Color Mottles Structure GPD /ff in. Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. Consistence Boundary Roots Bed , Trei Boring # 7.: Ground , elev. ft. Depth to limiting ; factor in. Remarks: Boring # Ground elev. ft. Depth to limiting factor in. Remarks: SBD -8330 (R.9/98) t ' PAGE 3 OF__:�) NAME ly y LOT# 1 LEGAL DESCRIPTION Sw' /tiSc.' SI 8' T3 (,N,R (u E (or& (SCALE: F'= ! V U BM I ELEVATION (`� c) / BM I DESCRIPTION ,y ..' /,• r j 6 " v t , BM 2 ELEVATION � / BM 2 DESCRIPTION lip • / , • " 10 " ou (c i4ot" SYSTEM ELEVATION - 7 �� 1 ALTERNATE ELEVATION CONTOUR ELEVATION r �pn • � 3Z Ia SIGNATURE r � -- DATE I� �•, - -•�. ..�. ��..+ .nn .�, 404- 4-Out rncna40 Vr Yrxlv WjVV1 � � e t R 7 7 _STAT r. SA1� '! OF 4JSOOI A �ORM 11998 WARRANTY DEED li KATHLEBR R. wALSH RfiMIS'TER OF DEEDS Documanl Numbdr i; ST. CROIX Co., 0I This Deed, made .l...... • :..:. ......... F= az•aes.__.a... ........ ... _ ...... ..._.._:_:..•:.:._.:._. : .... ..... ...- ..._.i if RECEIVED FOR RECORD betw " 04 -22 -2002 2:00 Pig RICHARD • ,0.,�,.. Sx OT and .:JANI T P _ STOJJT husband and wife, ,I i ddARRABfflf DEED Grantor, l EXEi4PT a° and GRAND 1!R012PRTI.ES- 1 P ' r - -.r REC FEE.- ii.00 TRANS FEE,- 122.70 COPY FEE: CERT COPY Fa.- C,rantee. PAGESt 1 ji Grantor, for a valuable consideration, conveys and we;-ania to Grantee the following I' described real estate In St (_rni . - County, State of Wisconsin: !' 7. ( l i Racer tiny rUca i of Plat of Rolliltg Oaks, Town at _ .._ ._.. _ ._ . . . .. .... Star Prairie, St. Croix Couw y, Wisconsin. 1j Narno and Return Address i i t 'V" rev P,v ss= ka sre swo 100 II �I Il I� I ! I , 43 8, - 121'140 -_ Parcel Identification Nit lber (PIN) { ! I I! This i -q nnt iomestead property. (is) (is riot) it i t I� I( I I + it i l ! I I I li + it ) 1 I� I I Exceptions to warranties: easements, restrictions, rights—of—way and covenants of record. li I' y Dated this - -22,m(l,.., day of A pr i 1 2(1(12 j I. s -- • Il ' tx i 1 _ (S) AL) (SEAL) „ Ri O. Stout _ Jan P_ Stout _ (SEAL) SEAL. ' h ' AUTHENTICATION ACKNOWL.i'DGMENT ii 'I Signature(s) + -- � State of W isconsin, " SS. is f' County; • authenticated this _._.- .•...._ day of _ ^rsonaily came before me thi: 22nd day of i t -.fi j l 2!Q-Q2 _, the above named — B1.chard --�, f�„v arr3 ._Jane�_ li ' st rut.,.. TITLE: MEMBER STATE BAR OF WISCONSIN (U not, _.._ _ • nowrr to be the person I_ who executed the foregoing ;I I '°"•"""°'''• ii5sfriiment and .acknowledge the sa!:re. i �I authorized by §7DI"s.Q6, «lis. Stats.) 'Ch�.�N .f• I THIS INSTRUMENT WAS DRAFTED. BY Ftgtt3 ?f "'Niscanstn 7 ._ • . -.••• li II Stout .`'.' ' ...,.. .. w•. vw ••�xw,`�e!�1,J 1 3 53 Awatukes T r. '—`• _... J anet P . . ` ,� -+ _. I; Hudson, WI 5401�i Notary Pubhc, L, of W constn My : onanission permiuiortt. (.f not, state expiration date: I! (Signatures tray be authenticated or acknowledged. Sot' -re not necessary.) �1 •Names ul penWli NClling In any rapadty mart br typed Gt prirtcu W ax+lr Sign .,,, STATE r.AE )F .Y1SC0t% A,': Witoonsin Leger Milk Co., Inc. ii WARRANTY DIED FQI:M t .. - IS198 MUweuksc, H/s• is j • _— _ _ _.. __ __ _A __ -- 1403 .4 ,�' tw -- �, ---v I 1N.90 r 4a1•o6 1 as:.w• Tj 47 :� �• vwi[R t.urE • / wOLAND� �P \ .` WET ANO 6 / `� ar. 62r.o B r.L— - � q ✓ - 26 �P mwrACw99 -x b io C_S.M. 1N 1 Q \ ao \ , 1.N2ACM8 91.o9acaoFr J R w N e '• 3. ACRE N9r•K 134.974 60 Fr,', P 114.6 . oa'W p�s / A �� _a9w• VOL_ 14. PC. 3838A . t a`� 1 1 p $ ♦ , .37011, Y t1k ti� /Pe \ 'Ga 11_or O'C7 YA \ / 16 ' . \ YY 1.4 • 2-3 �' —% — O6 .1,�'� +y 1.937 ACRES 8 8.9'33'69' E 376.44' \ �S oa toq°n° ,s6 6do 1 gj • Y' ./ t, ,a 64.374 w n aa.oa 34 41• n 8 \ 4 .' 1.094 ACRES 10 9o.969 90 Fr 1.9" ACRE. • ".706 9O Fr I Q b91•24,/ /' .J� �p < J sl y. 41• cc 3 33.1 412 1B i7 646.6 'p u .8 i za47 Af` 9 I ! e 1 ,09 ACRE. 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