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038-1217-30-300
/kf: � ® ■ � [ k J � � v: c — E � � z z \ a o 0 2 & [ § o S G ! # w 7 + � m 7 w CL ± j ■ T G \ CD c \ D \ to ) §: ¥ a § 08 . gc E'a © @ z ƒ 2 % /' e > CL . \ E � &' � / = w §(� � f / \. § E # M M 0 o 0) ! cn 0 § § ■ ■ ■ $ : o ® 2 \ \ \ , ° »� & / E 0 � \ � / j� � f � 0 \ \ . m . ƒ / ` f i / [ i / z { / P. � ■ 2 ) co CL / q § e cn - 7 z W 2 $ � \#2\ 0 rr § m e2z a �0E 0) a) aw k � %] % � K 0 CD § 69 0 § � / co � � 2 Parcel #: 038 - 1217 -30 -300 09/14/2006 09:07 AM PAGE 1 OF 1 Alt. Parcel M 18.31.18.1195C 038 - TOWN OF STAR PRAIRIE Current _X' ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 02/04/2004 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co -Owner RONALD E MARTIN O - MARTIN, RONALD E 2110 81ST ST SOMERSET WI 54025 Districts: SC = School SP = Special Property Address(es): ' = Primary Type Dist # Description * 2116 81 ST ST SC 5432 SOMERSET SP 1700 WITC Legal Description: Acres: 3.525 Plat: 4699 -CSM 18 -4699 038 -04 SEC 18 T31 N R1 8W SW SW FRL CSM 18 -4699 Block/Condo Bldg: LOT 27 LOT 27 (3.525 AC) Tract(s): (Sec- Twn -Rng 401/4 1601/4) 18-31N-18W SW SW Notes: Parcel History: 8- 18 -05- CALLED OGLAND LOT 27 SB CSM Date Doc # Vol /Page Type 18/4699.SMC 11/03/2005 811107 2921/435 WD 06/27/2005 798654 2830/307 LC 02/04/2004 753479 18/4699 CSM 02/04/2004 753478 2504/153 WD more 2006 SUMMARY Bill #: Fair Market Value: Assessed with: 0 Valuations: Last Changed: 10/05/2005 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 3.525 39,600 0 39,600 NO Totals for 2006: General Property 3.525 39,600 0 39,600 Woodland 0.000 0 0 Totals for 2005: General Property 3.525 39,600 0 39,600 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 0.00 753-•7'9 VOL PAGE 4699 KAT9EM H. L3A' -- REGISTER OF DEEDS ST. CROIX CO. MI f RECEIVED FOR kECORD N � n c 02/04/2064 03:00PH 0 O • CERTIFIED SURVEY MAP ® I I REC FEE: 13.00 COPY FEE: 3.00 Se � 9 m N PAGES: 2 In T v ^a � v v S S V O N^ 9 T V! -n a o z , iri GIN 0 - u' o o ° ' n -} c c m 0 -0 Q c 0.g -- N 8 m* o '' x x^N 2 m $a z "'. z �z o °° c S� -.� mo 4 � { b y g ^' o5. ri 9)b °_ = 0 1 cm < Z Z 5n S m m m �Op co D N n r O �Z �rj� 1 n m zip , p S S m rs �• n m 3Sv to z v m b� v R v 3c T, A o �� rra- o? Z z p m arZii �c> r� c �m� G� !7 o o N O O _ m 4 z z O) V �• D T m * m m m ` A N N a Z n f m _ E� m NOW21'49' W 2848.97'_ _ - - - _ _ _ _ _ E; �i 323.48' WEST UNE OF THE SW114 1323.48 0 5.; '3 � � co mm � o ca Q Sc"w� ° Sao o tci,a Zg $� cn mm�rr77 0w �n � �' ���/nniC� w �^' O I F ?z G�mooO 0m - m� A s m I Q vO O d a m�v 2C O G> GZi�O�mTon = i =1 z U) m� R���ia��s� ��i� izmZ Om oc D - � pFnnIy � ♦/ d O g z O o � m O Z v m> 9 � o C m� � V I m ER Q �' m V3 0 cn p c> z cn =m6� m m25 r 7 cnc -�.J O �� w p„ ` r- - - - - -- I � m z � � � Z'f o -' 1 o z Z I J ����` CS'�f T I� LOT � Z mZm I o Yn ' � o v m S o O m i -Z m F Z. I L, j a cn O m LOT 22 L�I99� ';5 m 1 f 0 I i f 1 ------ - - - - -- -/ \ ? 97S8p I j �' w 1 ICI Ix �� °_ ,y I I ^. d . i N , 2 a Z O I I • LOT 23 � 08. rl t� I N NO&07'06 "E 2 - - - - - - ' I r+ o I> Z I Y I /► I ' 6 0 J 1 \ Z 0 R7 Q Q m ' I '--' I I z gtN • g�F Q +C \ a m i" u r 1 LL \ ;'.Ni ... ...... .. . ; Z ♦` ` \\�•'�0 6i \ :� -1 -_oe ........................... 9 O I� CCC m \ Q� \ \�� \\ \ \ jL ' • - -- .h```id OZ /n r T O O \ \ O! \ \ 0 O z O w � co o o v , I N F °, 0' p I ZA 1 \ z G \ b BEARINGS ARE REFERENCED TO THE SHEET 1 OF 2 SHEETS 1 r � 8, ASSUME O TO BEAR N00°21'49W Vol 18 Page 4699 ` 1159 Wisconsin Department of Commerce SOIL EVALUATION REPORT p age 1 of 3 C" 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 parcel I.D _ percent slope, sale or dimensions, north arrow, and location and distance to nearest ro Cd , D �S 2 /� —� ^ 30 � Please print all information. U Revie V�IJV Date Personal information you provide may be used fmsecmdary purposes (Privacy law, s. 15,04, (1) (m)). Property Owner Property Location Stout, Richard Govt. Lot SW 1/4 SW 1/4 S 18 T 31 N R Property Owner's Mailing Address Lot# Block # I Subd. Name or C M# 1353 Awatukee Trail 24 1 t olling Oaks City State Zip Code Phone Number City Village ✓ Town Nee st Road Hudson I WI 1 540461 Star Prairie 81St St. C `�� ✓ New Construction Use: ✓ Residential / Number of bedrooms 3 Code derived design flow rate 450 GPD Replacement Public or commercial - Describe: Parent material Glacial Till Flood plain elevation, if applicable General comments and recommendations: Area is suitable for a mound system. System elevation is 99.02 based off contour line esablished at 97.52'. Slope is 25 %. ❑ Boring # Boring ✓ Pit Ground Surface elev. 97.79 ft. Depth to limiting factor 25 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Stricture Consistence Boundary Roots GPD/W in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-6 10yr3/3 none sl 2mgr mvfr cs 2f .5 .9 2 6 -21 10yr4/3 none sl 2fsbk mvfr gw 1f .5 .9 3 21 -25 10yr4/4 none sl 2msbk mfr cvv - - - -- .5 .9 4 25 -51 10yr4/4 0 jg 11 sl 2msbk mfr --- -- .5 .9 F 21 Boring # Boring u ✓ Pit Ground Surface elev. 98.45 ft. Depth to limiting factor 22 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 I *Eff#2 1 0-5 10yr3/3 none sl 2mgr mvfr cs 2f .5 .9 2 5 -22 10yr4/3 none sl 2fsbk mvfr gw 1f .5 .9 3 22 -29 10yr5/4 ' i0� sl 2fsbk mfr cw --- .5 .9 4 29-49 7.5yr4/4 10 /8 /1 sl 2msbk mfr - - -- - - - -- .5 .9 * Effluent #1 = BOO 5 > 30 < 220 mg/L 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 �z 227429 Address Tom Schmitt Date Evaluation Conducted Telephone Number 1595 72nd St., New Richmond, WI 54017 5/6/03 715 - 247 -2941 Pro Owner Stout Richard Page 2 of 3 F3 ] party Parcel ID # 9 Boring # Boring ✓ Pit Ground Surface elev. 90.82 ft. Depth to limiting factor 18 in. Sod 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 1 0-7 10yr3/3 none I 2mgr mfr cs 2f .5 .8 2 7 -18 10yr4/3 none I 2fsbk mfr cw 1f .5 .8 3 18 -25 10yr5/3 m2d 10yr6 /2 I p /g sit 2fsbk mfr cw .5 .8 4 25-48 7.5yr4/4 rr 1 d 10 5 6/2 scl 2msbk mfr -- - ---- . 4 .6 F-1 B 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. *Ef1#1 *Eff#2 ❑ Boring # Boring Pit Ground Surface elev. ft. Depth to limiting factor in. Sod 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 -j mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or i rs N C A_ Qr lcp " q S q l Corm,,- P, C,2,? .. -T w4-�) Se-ti.-i; h 135 /¢w a.T7 A- Try,` / y eS T ( a 5 -a-9 � s� shy S!8 T3liv ��BL.J , AVis m in Department of Commerce SOIL EVALUATION REPORT Page __I__ of � Division of Safety and Buildings �, I � 1 S T . S7 ' in accordance with Comm 85, Wis. Adm. Code County I Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. Y r n �.- percent slope, scale or dimensions, north arrow, and location and distance to nearest road. U 3 0 II © (- - tom'✓ Please print all infopop ton "`:.. evie d by Date Personal information you provide may be used for sp):prh(ar}i mrivecy't . 15.04 (1) (m)). / t7 Property Owner *' ^. perry Location �" v�r* •vl/t.c(.ro� �/; � � . Lot S L j 114 SrJ1l4 S T 3 N R E (or Property Owner's Mailing Address Block # Subd. Name or CSM# e- -r— J L' 1 2 2001 � , •� o c.� City State Zip Code one Nu bel- Y Ity El village D Town Nearest Road c�S w vi 5 ! S [4 New Construction Use: [�§ Residential / Num 61f s Code derived design flow rate 4 GPD ❑ Replacement ❑ Public or commercial - Parent material Flood Plain elevation if applicable 4 ft. General comments sysf t v✓, �� C v - 9y �� and recommendations: ('04-10ur elctl. 9y.00 Boring # Boring (,� pit Ground surface elev. 9/.�� ft. Depth to limiting factor 3 Q in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0 3 Z — 5,'1 V-( •.5 Z -S 2C S 3 Boring # Boring a [�4 Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 I a - 3/ — 51.1 , -Z 0 /d r / rrrob/ m-�/ cS G S • � * Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 mg /L * Effluent #2 = BOD < 30 mg /L and TSS < 30 mg /L CST Name (Please Print) Signature CST Number Address / / Date Evaluation Conducted Telephone Number t Property Owner clT Parcel ID # �G Z / Page of 3 a Boring # F1 Boring (� pit Ground surface elev. S 30 ft. Depth to limiting factor !? in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /fF in. Munsell Qu. Sz. Cont. Color / Gr. Sz. Sh. 'Eff#1 'Eff#2 e c • S tZ F] Boring # E] Boring .. - ❑ Pit Ground surface elev in. Soil Application Rate Horizon Depth Dominant G Wary Roots GPD /fF in. Munsell 'Eff#1 'Eff#2 rjlo Boring # Boring S El ❑ Gro �t � a4 �'� pit S� � a Soil Application Rate Horizon Depth Dominant Color j� S ry Roots GPD/fF dW in. Munsell T�-6 v' ` 'Eff#1 "Eff#2 r log a � L'�-� j o 6 y ' Effluent #1 = BOD > 30 < and TSS < 30 mg/L The Department of Commerce is, once to access services or need material in an alt _ _ _ 3 ► x o08- 264 -8777. SBV -8330 (RW /00) PAGE 3 OF NAME LEGAL DESCRIPTIONSc, j IW1., 1SS 1 1 ,N ,R 18"E (or Kffl SCALE: 1 "= BM I ELEVATION ZO O . - 0 BM I DESCRIPTION 'A / 6 YV1uPG- 4ie t BM 2 ELEVATION lDr)- s ern , BM 2 DESCRIPTION Nla i t )A 4 nS SYSTEM ELEVATION y ALTERNATE ELEVATION itY-A CONTOUR ELEVATION 9 "7 n O Y I Vs Q s � �U S ha t k � , c 0 a ° SIGNATURE /r t.a.., - .....o r it .. r vCfLANO V'� • l l l•— '1LAIW 11 M ' 7- %'26 i l �e C.S.M. IN \ tee3AOl,w. `s to .oR , J y 3 'hx 1 a.ta w v► fi a i — — — — — — — — — - •Y. , /�i� �VETLA11D u� ✓ r / i 28 \ 2 Yi EASE Ap1e0 Not. 134.0?4 00 Ff 114.6c VOL 14. Fc..:838 ♦�.� w ` -' :'� ' 1,� I - - — — - 2 �� �, 1 � ♦ �1 tta le � 1 4 $r ! 370.14' 1.66p �. / o" so pr ® asst 'a RASS ACRUS I 4 10 � • 00 rr ` 141, 4 ,. Lit" t 17 >8 1.440ACINKS w.4 ts AOltww M7bR 1 w3.@" Tg T *sy y ,ew.sM w R d".6" rt el {••, • 7•y �• ' a� r W ttw.3r 104.fT l _ t • MIA 1 1 4 p R l:er3str331>w3r r • b� z ts.1. + 20 21 t>.t- _ t M.470 W R lltl if tA70 Ap1Le 1.g0At�Ni ®Mao• so n e 8 6 f 34wi4 w R•' ! r !t • 1.403 ACRE Z � Jcrt. us e l I ® ® 't sl = — -f- I �'. t+ ww•A,Yr w t+.4 s.. OEDICAI ED TO Tim PIJBUC N or3rlr W 043.7r — ' 4 N 8"7 1 452.4x' �o. rwouwr L 21 M Ali ENUE �""�""� a - = - - - -- - - - /.�� D/ 7161A a 16 15 14 19 � 18 210M Av two A. ,e� A, a 21 .+ A" 20 3001, M .� a IOettAY a 25 27 26 25 30 s I 1 6 {� Ar Y J'' z 1640 AN w 32 1 � J 1304, A. • N M N N 4w 1a iwn M.. w Soe P4a Sp 1° $ i cons nIDepartment of Commerce ` � n � nivicinn of Ceafcfii �n�l R��nrli.,..� SOIL AND ,,,,,1— E"LUATION Page / of-3— in accordan Rh �Comm 83. 09' Wis. Adm. Code _<zA or jt1 SG�d• ft� 1,17 it less than 8 1/2 x 11 inct S$ in size. 'Pfarr must ` County may, TT o f d horizontal reference po�ht (BM), direction and �j I'G l,j� r # pJ " orth arrow, and location 8nd distance to nearest road. Parcel I.D. # Vo - Please print all information. ' viewed y Date sed for secondary purposes (Privacy Law, s, 15.04 (1) (m)): Property Owner Property Location Govt. Lot s 1/45 1/4,S T N,R 18- E (or)60 Property ? Owner's Mailing Address Lot # Block# Subd. Name or CSM# (J :fi r z wr') 0 City State Zip Code Phone Number City ❑ Village [a Town Nearest Road ® New Construction Use: ® Residential / Number of bedrooms — Addition to existing building ❑ Replacement ��"" ^^ ❑ Public or commercial - Describe: Code derived daily flow 6 6 gpd Recommended design loading rate . Z bed, gpd/ft • 3 trench, gpd1ft Absorption area required 30C bed, ft2 2 CIG trench, ft Maximum design loading rate gi bed, gpd/ft gpd/ft Recommended infiltration surface elevation(s) ? If. Y 0 ft (as referred to site plan benchmark) Additional design /site considerations • 5'0 Parent material 1 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 ❑ S 0 U I ® S ❑ U ❑ s [0 u I ❑ s ®u I ❑ s ® U ❑ s En u SOIL DESCRIPTION REPORT Horizon Depth Dominant Color Mottles Structure GPD /ft g Texture Consistence Boundary Roots a . n in. Munseli Qu. Sz. Cont. Color Gr. Sz. Sh. Bed ,Trench L —2 icy ( 4 % 1 Z �"VA f, T, w.,F Ground ? 2 O r-71 Lj Z- M A(? elev. Depth to limiting factor 24 in. Remarks: Boring # ` Z c,10 1 S :6 F( � Ground elev. Q "1�t'0 ft. Depth to limiting factor 2� in. Remarks: CST Name (Please Print) ZS1nature Telephone No. Q A S G 15 1 L I- y o oq Address Date CST Number a5 r SOIL DESCRIPTION REPORT PROPERTY OWNER Page of PARCEL 6D.# Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots 2 in. Munseil Qu. Sz. Cont. Color Gr. Sz. Sh. Bed ,Trench 1 - Z SA r wwg � � L+ Z 3 Z -zs o 13 \ I Ground -i o — C.5 u r S 6 elev. Y6 ZtJ ft. , Depth to limiting factor m in. Remarks: Boring # Ground elev. Q Depth to limiting factor ' / VIA— / in. Remarks: Horizon Depth Dominant Color PD/ft2 in. Munseil Qu. ; �Bei, Trench Boring # Ground elev. Depth to limiting factor ' Remarks: Boring # Ground elev. ft. Depth to limiting factor in. Remarks: SBD -8330 (R.9/98) / PROPERTCOWNER — SOIL DESCRIPTION REPORT � 7' Page Z of PARCEL I.D.# Boring # Horizon Depth Dominant Color Mottles Structure Boundary Roots 2 in. Munsell Qu. Sz. Cont. Color Texture Consistence B Gr. Sz. Sh. Bed ,Trench 3 S: Ground _ elev. 6 9i•ZU , Depth to limiting factor n. Remarks: Boring # Ground elev. ft. Depth to limiting factor in. Remarks: Horizon Depth Dominant Color Mottles Structure in. Munsell Qu. Sz. Cont. Color Texture Consistence Boundary Roots GPD /ftz Gr. Sz. Sh. Boring # Bed , Trench Ground elev. ft. Depth to limiting factor ' Remarks: Boring # Ground elev. ft. Depth to limiting factor in. Remarks: 8BD -8330 (R.9198) PAGE_�OF NAME S LOT# 2. LEGAL DESCRIPTIONIAJ 1 / 4-W /4,S /$T 31 ,N,RI $ E (or) SCALE: P= B ELEVATION M I EL ATION (d p • U BM 1 DESCRIPTION 1�,e • �'� g ".�ls� BM 2 ELEVATION 0 C) ' BM 2 DESCRIPTION SYSTEM ELEVATION U ALTERNATE ELEVATION x - � CONTOUR ELEVATION (/. y O �2 •ral BM L. cQ G SIGNATURE DATE — 1� C) ii �w ���• \\\ � '�. :* `- - ._ � � { f � , $> ✓f 4 �" f c I ��rt' 4. `� .r' .. 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V f ,�' ' .� '�' f � ' , 1'l'a' +'fj b', '' ?Itr',h r , A. _IC _ ".. rdrJ« _e r r� if `'S ♦`, o r v- �• v P /( '�• 1r,C ! \!' a�F,a b°s. \! ` '�,1! ! `t `O`4hq, Jd' j� � +� �s a � . , «•• r 't 6 ��b11`!!llO�,�+r`"'•_ + fi t . 4 ' S ° � • t 7 f . �1 +0 f a•t t l�� .� r •lip,, !� �` ,�! ! w ♦ q. ;,, a, ,` l d 4 t + I ;��1 � y, + / > o ♦ •� �'� l ty �v ti r �` .'�' .,w< �. �r . 4 � • � t r �, � � ,+ t• a ,!•• rr \t ` r r•R' _. - ♦`�!!Q�•`6� f �• ! ! r �iy � ` ♦ � ,� a'. � 4 f r i l ,� . !o A'I14 v a . l " f �t raw \s��?a- � r !� °? � %i� ",�� ♦!!ll�io���`�! \QO< <`v`y s'0r�!8": "" 'iti�i'�4e \�•��.. r' � I I �.� r tC ! �� . . �, 4 t f' +� - { IFpJ;. r; r1 . � , fi.:�.;.o ' �+ �Y.rFAe�.psrs ,.../�!'�, 4b f/YS/� r �'�" • w • � /,d+}et ,� i t.it•...t � ► /.>�+>�,�%�;*.i,`,�``�'fr,� �Ir X 4W a `.,�., �t,- _rJ, j '+ �y'�f,/y i 6 �0 F,�f '�� �•�,. ®'r �'�/�. a ! «\ J{ fd.! '�ir i x� /ri >r \ �y +a� �" ' it !gip ~P� OT, �+�.r,�. � s � � i •,.�p�j,o ` y idd O rt °�•r. . t $ e � ► � r" , a or •��� {� { , i ' f 'Ei:'�i«! \ \ f ' I ._- [s ,. ,• �.. L.!_ � lt9F°. r. .� � f d� r.+�. ,� A.9f �i4�! �..v�` �'.?�l£- -s- !!. �.L :« �fs :''�� Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: (ATTACH TO PERMIT) State 0 GENERAL INFORMATION State Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: City Village X Township Parcel Tax No: Grand Properties L.P. I Star Prairie Townshi CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range /Map No: 18.31.18. TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark Dosing Alt. BM Aeration Bldg. Sewer Holding St/Ht Inlet St/Ht Outlet TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic Dt Bottom Dosing Header /Man. Aeration Dist. Pipe Holding Bot. System PUMP /SIPHON INFORMATION Final Grade Manufacturer Demand St Cover GPM Model Number TDH Lift Friction Loss System Head TDH Ft Forcemain Length I Dia. Dist. to Well SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS SETBACK SYSTEM TO P/L BLDG WELL LAKE /STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR Type Of System: UNIT Model Number: DISTRIBUTION SYSTEM Header /Manifold Distribution x Hole Size x Hole Spacing Vent to Air Intake Pipe(s) Length Dia Length Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded /Sodded xx Mulched Bed/Trench Center Bedrrrench Edges Topsoil 0 Yes �� No [] Yes 'L No COMMENTS: (Include code discrepencies persons present, etc.) Inspection #1: / / Inspection #2: Location: 2116 81st St Unknown (SW 1/4 SW 1/4 18 T31N R18W) Rolling Oaks Lot 27 Parcel No: 18.31.18. 1.) Alt BM Description = 2.) Bldg sewer length = - amount of cover = 3.) Contour = Plan revision Required? ', ,; Yes P No Use other side for additional information. _ SBD -6710 (R.3/97) Date Insepctor•s Signature Cert. No. Safety and Buildings Division County ` 201 W. Washington Ave., P.O. Box 7162 ' ,5C0���� Madison, WI 53707 - 7162 Sanitary Permit Number (to be filled in by Co.) (608) 266 -3151 S 3 ?) Department of Commerce State Plan I.D. Number Sanitary ermit Applic rY P c P, _- w may be used fsecondary In accord with Comm or pur Code, poses P wady Law al infp� r �D - ,a or purriva4y , s to : Project Address (if different than mailing address) 1. Application Information -Please Print All Informati n JUL 1 J 20 4 ?_Ift, Property Owner's Name Parcel # o[ # �. 7 Wee" Property Owner's Mailing Ad ress ---m° °-° Property Location 7/a &VM42 i S-W— ' /., 5_W %, Section le City, State Zip Code Phone Number y a O circle o e) O� T Z N; R4E o� II. Type of Building (check all that apply) S wµ Subdivision Name h'1 S , �� �Q 9 A I or2 Family Dwelling- Numberof , edrooms r ' I ' ❑ Public/Commercial - Describe a lt�*�+ 0 3 ' r o L� r ` Q c 5� s Ciry ❑Village *Township of $T R /1 ❑ State Owned - Describe Use III. Type of Permit: (Check only one box on line A. Complete line B if applicable) we 7 5 Zvt A ' '$ New System ❑ Replacement System ❑ Treatment/Holding Tank Replacement my ❑ Other Modification to Eat ng S tern B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of ❑ Permit Transfer to New List Previous Permit Number and Date Issued Before Expirat'i'on Plumber Owner IV. T ype of POWTS System: Check all that apply) S ❑ Non - Pressurized In- Ground un ;2 . o ta it Mound < 24 in. of suitable soil ❑ At -Grade ❑ Single Pass Sand Filter ❑ Constructed Wetland ❑ Pressurized In- Ground ❑ Holding Tank Peat Filter ❑ Aerobic Treatment Unit ❑ Recirculating Sand Filter ❑ Recirculating Synthetic Media Filter ❑ Leaching Chamber ❑ Drip Line ❑ Gravel -less Pipe ❑ Other (explain) V. Dis ersal/Treatment Area Information: Design Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal Area Required (sf) Dispersal Area Proposed (sf) System Elevation VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Units , 4 - �_( a (Jp /� oncrete Constructed Glass New Existing ' I �"�'�` t t r l Tanks Tanks Septic or Holding Tank — t/ d� Aerobic Treatment Unit Dosing Chamber 0 VII. Responsibility Statement I , the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plu is ignature MP/MPRS Number Business Phone Number XA 3 r/ P lumber's Address (Street, City, State, ode) VITI. County /De artment 16se Onl pproved ❑Disapproved Sanitary Permit Fee fcludes Groundwater Date Issued I uing ent Signatur No Stamps) Surcharge Fee) ZO ❑ Owner Given Reason for Denial IX. Conditions of Approval /Reasons for Disapproval SYSTEM OWNER: 1 Septic tank, effluent filter and = ct�oLS I dispersal cell must all be serviced / maint as per management plan provided by plumber. 2. All setbac requirements c d ormust b es. m aintained as per appli Attach complete plans (to the County only) for the system on paper not less than 81/2 x 11 inches In size SBD -6398 (R. 01/03) OA Jl�'s C OL+ LcT .eT �� as yO' oo ��•Z'� 1 r' f i o \ \ ALT B - ti _ ®ey o IN _QROPOSr9 - - - iv\ �gvEW_A1! f Of�O _C��L..TrFR1K W Tit -------- -- - - -- -off_ _ ALT -;B�? l - — -- — =— - _ -r.--- �O—a -- - 7"oP Z" or {PVC � cot 7 0V Foe -- �.� ��eo r'E�eT�Es L. W T .s 4� S Safety and Buildings 4003 N KINNEY COULEE RD commerce.wi.gov LACROSSE WI 54601 -1831 ■ i TDD #: (608) 264 -8777 s co n s n www.commerce.state.wi.us /sb t epartment of Commerce www.wisconsin.gov Jim Doyle, Governor Cory L. Nettles, Secretary May 10, 2004 CUST ID No.223760 ATTN: POWTS Inspector JOHN F SCHMITT ZONING OFFICE SCHMITT & SONS EXCAVATING ST CROIX COUNTY SPIA 586 VALLEY VIEW TRAIL 1101 CARMICHAEL RD SOMERSET WI 54025 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 05/10/2006 Identification Numbers Transaction ID No. 993967 SITE: Site ID No. 682601 Mike Germain / Grand Properties Please refer to both identification numbers, 81 ST Street above, in all correspondence with the agency. Town of Star Prairie, 54026 St Croix County SW1 /4, SW1 /4, S18, T3 IN, R18W ` : 27,,Subdivision: taftg Oaks FOR: Description: Three Bedroom Mound System Object Type: POWTS Component Manual Regulated Object ID No.: 955323 Maintenance required; 450 GPD Flow rate; 18 in Soil minimum depth to limiting factor from original grade; System: Mound Component Manual - Version 2.0, SBD- 10691 -P (N.01 /01), Pressure Distribution Component Manual - Version 2.0, SBD - 10706 -P (N.01 /01); Biofilter The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, C�ndri'l�i stats. APPRO The following conditions shall be met during construction or installation and prior to occupancy or use: DEP RTMENT OF C General Approval Requirements: N OF EY • This system is to be constructed and located in accordance with the enclosed approved plans and with the SEE CORRESPC "Mound Component Manual for Private Onsite Wastewater Systems VERSION 2.0" SBD - 10691 -P (N.01 /O1) and the "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems VERSION 2.0" SBD - 10706 -P (N.01/01). • The manifold diameter must be reduced to 1.5 inches so that the velocity of the effluent is 2.0 ft/sec or more. • 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. • The well must be a minimum of 25 feet from any POWTS tank, and a minimum of 50 feet from the absorption area. chs. NR 811 & 812c • A Sanitary Permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.135 and 145.19, Wis. Stats. JOHN F SCHMITT Page 2 5110104 • 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 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/installation /operation. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 Charles L Bratz POWTS Reviewer II , 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 r SCITT & SONS EXCAVATING S86 Malley Kew Trail Somerset, 97 54025 715 - 549 -6651 (� MOUND SYSTEII� For. 6 -P A rJ O Pie n d r RT i 5.S Z. P. (MMitt' 6.6'e&m1 Addre 7/ Z v s -5 6i a - E /00 S'� .�,,es E ; t , 0 7 -5 - el Lega 5 29 % 3 AJ R Township: County: .5 C ,PO J X Cs Lam c C Page I Plot Plan Page 2 System Cross Section Page 3 Pipe Lateral Layout Page 4 Dosing Chamber Page S Pump Curve Page 6 Management Plan Attachment I Soil Evaluation Report Attachment 2 Mound Component Manual (Version 2.0) SRD 10691 -P(1V 01/01) Pressure Distribution Component Manual (Version 2.0) ra l� SRD 10706 -P(N 01/01) ,MMERCE By: MPRSW 02 7 NDENCE Date: % - / 9 - © L/ RECEIVED APR 2 6 2004 SAFETY & BLOGS 01% L c7 a 7 i ec p i 6 Le7 a y t pgjeT or a f l 1 -- t PRcPosen o QoS ��o S.T. _ W ELF Rc7 BMA _ __ H. 1N.E _- g - / _ - \' •�dG,� \ \ \ ' ALT B _ PROPC:.eO DRivEWAY CONY e at. Gill - - - .T _fObO.64L 7 A)K whit ` __ �+ $ , ; e��� zA e �L r� - ioo- __ . toa . _ _ _ PC X00 GAL Tt� � t�lpuev10 - 71.y Xa_g•�` _ - -- _. %o_P oF._��� PVC �L. = / 000a" 71D o, Z PVC -P!ar L. = /00.(oa HOL _- Cot\) ; out L ��•' = 103.��' i - -- 6 ��t11 GL'ScT � DoZ S __ 4v P R s gZa3 76 0- Page Cf Straw, Marsh Hay, Or Synthetic Covering ASTMC33 Distribution Pipe Medium Sand H G 6" Topsoil ... �_,�__ F SYS. ELEV. C5.0 L 3 E „ p b % Slope Bed Of ?"- 2 %2 Force Main Plowed Aggregate Layer (6 Below Pipe) 0 S Ft. Cross Section Of A Mound System Using E ,0 Ft. A Bed For The Absorption Area F D,79 Ft. G ©.5 Ft. A 1, v Ft. H �, D Ft. Signed: B St, © Ft. License umber: 22 0 K f0_2 Ft. Date: y- / c l "0 y L Z! Ll Ft. j 7 Ft. Alternate Position i iZ. Z Ft. of Force Main W Ft. —L Observation Pipe j 115 To 1/10 8 From End of Bed K A ��- - -- ---- .._-- _-- - - - - -- - - - - -- --- - - - - -- - - - --�I Force Main M Distribution Bed Of z - 2 % Pipe Aggregate I Observation Pipe Permanent Markers 1/5 To 1/10 B From End of Bed Plan View Of Mound Using A Bed For The Absorption Area Tum-up Wtth Cleanout Access Bqx Plug or Bag Valve PVC Force Main Distribution Calera! S �- PVC Manifold INWbution Lateral S PVC Manifold P x�X — I — X � X/2 Distributlon Lateral Layout P d3� Ft . s 3.0 Ft X 30.0 Inchpc s�FCO Hole Diameter /6 Inch Signed: P Lateral Inchtes: License um ber: a,? 76 O OND4NCF Manifold " t Inches Date: 'y'"�y —�7 Force Main " Z Inches # of holes /pipe_l Invert Elevation of Laterals /OS,S ai't. PAcrr UF .I�G PUMr� CHO+MtE.R CROSS SECT -aQM AMD SPEC+FICATIOuS VCWT CAP y "C.i, VENT rJPC wcATJJEK rft 00l APPROVED LOCKIMCP .ussXT10k1 601 MANNOL.E COVCR • r �' ► M+I►1 lulr�ll , � 1�' Mtrh t �ItiJUUw uK r Je►.6Jt � I AIK 1tiTAKE GRAAC } • + 1 Mt 1.1. t •� PROVIDE7 I JJULC T ___�_. AIRT�c:�+T SCAB. 1 APPM,0VL0 J0 �, t APPROVED ao +wY � I II W/c. =, P+'c W /c.z. Pop% I ! I LXTE WINO, 3' CKTCNOIN(o 3' I I ALARM ONTO low& WIL auYO 6o sal L a 7 rc G L��'"`CN I t t ou i � 1 I Ell. CV. �.._.. f _ - � rump --`, orf- COUCKE.TL DLDCK Ki6CK EXIT PCKMITTED GJJLt1 IF TAWK MAiJUFACTURCR HAS SUCH APIPPLOVAL 8Ep0ING BtfTJG } SI)CCIFiCATIOWS 0069 C. P, ' T� MAIiUFAtrU1t9R.- :.- r•• QU MbCi1 OF DGirrb. f e S PCR. o" TA,J<.JK LiZE :.._.._ 800 6AW.01J5 0059 VOLUME q I.m MAmurAcrusmit. SedP-0N %1 u�r✓►i4� 04CLUDIN4, GACKr60W: � , l!�� �At�oNt Ti " CAPACITIE :An n / q R / 4 L GAL MdD�L Jat�MDCR . ...L,L_ 1tiCHCS O y • "_ 1i5 SWITGN TyPC:.- Moecyk ISM ItiC11Et Oft ._, Sa t.0ui LtiMP mmuFAcruitCR: .. ZOt F I� C A y W046 OR 1�...� � GAL601l� M.00CL WumaftlL'_ _..__1rs D s /Z IMCil1ES Oft � Z 'GALLOWQ 6W1TC?f T NpC: N r CAL MOIL: PUMP AWO ALARM ARE TO OL r MINIMUM DISG►�ARCVE RATE OrM lNStA:LE:G pt! SEPhRATf< GiRCZJITJi 4CRTIC4I. OIffEREM(.E QILT'WCEIJ PUMP OFF A6J0,0I5TR1gUTfO&4 PtPC.. / F£E:Y t MiwjmUM SUPPI.tl PfLE$SLIItC .. . . . .. . . . . 3 •a` S F'CET FEET OF FORCC J"tAIJJ X F YQ#tFRte' 1 IOW FACToR.. / FEE t TOTAL 0�dWA.MIC. Rt:A4 _ LL FEET 1 M Of TAWKt L ;WICiTH..��._.iui Ll1O P"C JJ FrRAiAt. DIMLiJ6 a 4 Oir N .....,........ i T r 9ifi1�}4D: 1� LICEI3SE 1.UKbf.Ft: -o?,)-3/ I Page 5 of 6 TOTAL DYNAMIC HEAD/CAPACITY E H ' J E AD CAPACITY CURVE PER ti1,r DE EFFLUENT AND DEWATERING N DEL. 152/153 W I MODEL 152 153 50 Feet Meters Gal. 'Liters Go!. L'�ters 5 1.5 69 261 77 291 12 40 10 3.1 61 231 70 265 0 15 4.6 5 3 201 61 231 20 6.1 44 167 52 197 30 8 25 7.6 34 129 42 159 30 9.1 23 87 33 125 0 Q 20 35 10 7 -- -- 22 85 r- 42 4 Lock Valve: 38.0 Ft. (11.6m) 44.0 Ft. ( ?3.4m) 0 014509 0 20 40 60 80 100 GALLONS _ LITERS 80 160 240 320 E 0 ;; 27/32 4 5/ � FLOW PER MINUTE CONSULT FACTORY FOR SPECIAL APPLICATIONS 3 27/32 • Timed dosing panels available. ® 3 27/32 Electrical alternators, for duplex systems, are available and supplied with / an alarm. • Variable level control switches are available for controlling single phase I systems. Double piggyback variable level float switches are available for variable level long and short cycle controls. Sealed Qwik -Box available for outdoor installations. See FM1420. Over 130 °F, (54 special quotation required. I 1521153 Series 12 1/8 152!153 MODELS Control Selection Model Volts-Ph Mode Amps Simplex Duplex 5 1/8 115 1 Non 8.5 1 2 or 3 BN1 BN152 115 1 Auto 6.5 included 2 or 3 E152 230 1 Non 4.3 1 2 or 3 _ BE152 230 1 Auto 4.3 Included 2 or 3 N153 115 1 Non 10.5 1 2or3 8 5 N1 3 115 1 Auto 10.5 Included 2or3 SELECTION GUIDE I Ei53 230 1 Non 5.3 1 _ or 3 le level float I switch or double k variable BE153 230 1 Auto 5.3 Included 2 or 3 1. Single piggyback variable l float t pI99YbaC switch. Refer to Ftv10477. o CAUTION 2. See FM0712 for correct model of Electrical Alternator E•Pak. All installation of controls, protection devices and wiring should be done by a qualified 3. Variable level control switch 10.0225 used as a control activator, specify duplex (3) licensed electrician. All electrical and safety codes should be followed including the most 4 float system. recent National Electric Code (NEC) and the occupational Safety and Health Act (OSHA). or () y RESERVE POWERED DESIGN For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump. Uft TO: P.O. BOX 16347 Loulsvib, KY 402560347 Manufacturers of. r O t SHIP To: 3649 Cane Run Road r' • — ® LovisvWe, KY 40211 -1961 QrrauTY P Pa S iYCF ARF rso2i 9 •PUMP !O, AX(602 7°3624 http: / /www.zoelter.com © Copyright 2001 Zoeller Co. All rights reserved. POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page g of FILE INFORMATION SYSTEM SPECIFICATIONS Owner ftge C �� Septic Tank Capacity lt)t)o ga l ❑ NA Permit # Septic Tank Manufacturer VjfFK C, P ❑ NA DESIGN PARAMETERS Effluent Filter Manufacturer Z,C)Q E ❑ NA Number of Bedrooms 3 ❑ NA Effluent Filter Model ❑ NA Number of Public Facility Units B NA Pump Tank Capacity a l ❑ NA Estimated flow (average) 3 ©(� al /da Pump Tank Manufacturer GEMS C. P ❑ NA Design flow (peak), (Estimated x 1.5) 5 gal/day Pump Manufacturer ZCf; Ll E e ❑ NA Soil Application Rate , �� gal/day /ft2 Pump Model f S oZ ❑ NA Standard Influent /Effluent Quality Monthly average* Pretreatment Unit V NA Fats, Oil & Grease (FOG) 530 mg /L ❑ Sand /Gravel Filter ❑ Peat Filter Biochemical Oxygen Demand (BOD 5220 mg /L ❑ NA ❑ Mechanical Aeration ❑ Wetland Total Suspended Solids (TSS) 5150 mg /L ❑ Disinfection ❑ Other: Pretreated Effluent Quality Monthly average Dispersal Cell(s) ❑ NA Biochemical Oxygen Demand (BOD 530 mg /L ❑ In- Ground (gravity) O In- Ground (pressurized) Total Suspended Solids (TSS) 530 mg /L ❑ NA ❑ At -Grade IN Mound Fecal Coliform (geometric mean) 510' cfu /100m1 ❑ Drip -Line ❑ Other: Maximum Effluent Particle Size Y in dia. ❑ NA Other: ❑ NA Other: . ❑ NA Other: ❑ NA Values typical for domestic wastewater and septic tank effluent. Other: ❑ NA MAINTENANCE SCHEDULE Service Event Service Frequency ❑ month(s) (M Inspect condition of tank(s) At least once every: 3 ® earls) ximum 3 years) ❑ NA % Pump out contents of tank(s) When combined sludge and scum equals one -third (Y of tank volume ❑ NA • month(s) (Maximum 3 years) ❑ NA Inspect dispersal cell(s) At least once every: 3 ® year(s) • month(s) ❑ NA Clean effluent filter At least once every: ® year(s) ❑ month(s) ❑ NA Inspect pump, pump controls & alarm At least once every: ® year(s) ❑ month(s) ❑ NA Flush laterals and pressure test At least once every: It year(s) Other: ❑ month(s) ❑ NA At least once every: ❑ year(s) Other: =[]NA MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications: 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 chapter NR 113, Wisconsin Administrative Code. All other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, Pretreatment, units, and any servicing at intervals of 512 months, 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.. Page of START UP AND OPERATION For new construction, prior to use of the POWTS check treatrtlent tarik(s) for the presence of painting products or other chemicals that may impede the treatment process and /or damage the dispersal cell(s). If high concentrations are detected have the contents of the tank(s) removed by a septage servicing operator prior to use. System start up shall not occur when soil conditions are frozen at the infiltrative surface. During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will be discharged to the dispersal cell(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 to restoring power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls 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 wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat; foundation drain (sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting products; pesticides; sanitary napkins; tampons; and water softener brine. ABANDONMENT When the POWTS fails and /or is permanently taken out of service the following steps shall be taken to insure that the system is properly and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code: • All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. • The contents of all 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 fails 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. f 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 John Schmitt Name Owners choice Phone 549 -6651 Phone SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name Owners choice Name St. Croix Ct =Zo n Phone Phone 7 15 386-4680 This document was drafted in compliance with chapter Comm 83.22(2)(b)0)(d) &(f) and 83.54(1), (2) & (3), Wisconsin Administrative Code. 1159 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 an on a not less than 8% x 11 inches in size. Plan must County P a paper 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 Stout, Richard Govt. Lot SW 1/4 SW 19 S 18 T 31 N R 18 W Property Owner's Mailing Address Lot # Block # I Subd. Name or CSM# 1353 Awatukee Trail Rolling Oaks City State Zip Code Phone Number City _j Village V. Town Nearest Road Hudson I WI 54016 1 Star Prairie 1 81St St. New Construction Use: y Residential / Number of bedrooms 3 Code derived design flow rate 450 GPD j Replacement _ 1 Public or commercial - Describe: Parent material Glacial Till Flood plain elevation, if applicable na General comments and recommendations: Area is suitable for a mound system. System elevation is 105.02' based off contour line esablished at 103.52'. Slope is 6 %. Limiting factor is at 18 ". ❑ Boring # Boring r Pit Ground Surface elev. 103.55 ft. Depth to limiting factor 26 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ff 'Eff#1 'Eff#2 1 0 -7 1Oyr3/3 none sl 2fsbk mfr cw 2m,2f .5 .9 2 7 -26 1Oyr5/3 none sl 2msbk mfr gw 2m .5 .9 3 26 5yr4/6 c2 1 /6/2 sl Oma mfi — .3 .5 Boring # J Boring ✓J Pit Ground Surface elev. 103.55 ft. Depth to limiting factor 22 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Stricture Consistence Boundary Roots GPD/f? 'Eff#1 'Eff #2 1 0 -5 1Oyr3/3 none sl 2mgr mfr gw 2m,2f .5 .9 2 5-22 1Oyr4/3 none sl 2fsbk mfr gw 2f .5 .9 3 22 -39 7.5yr4/6 m2d Y� sl Drina mfi — .3 .5 10 /8 Effluent #1 = BOO y > 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BOD < mg/L and TSS <-.�0 mg/L CST Name (Please Print) Signature: CST Number Thomas J. Schmitt L 227429 Address Tom Schmitt Date Evaluation Conducted Telephone Number 15% 72nd St., New Richmond, WI 54017 1026/03 715 -247 -2941 � e 2 of 3 Property Owner Stout Richard Parcel ID # P 3 ] Boring # I Boring ✓' Pit Ground Surface elev. 101.42 ft. Depth to limiting factor 18 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots •Eff#1 'Eff#2 1 0 -8 10yr3/3 none sl 2fsbk mfr CS 2m,2f .5 .9 2 8 -18 10yr4/6 none sl 2msbk mfr gw 2m,2f .5 .9 3 18 -33 5yr4/6 c2d 100 gel sl Oma mfi — .3 .5 a Boring # Boring �) Pit Ground Surface elev. ft. Depth to limiting factor in. Sal Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GEDLIII 'Eff#1 'Eff#2 F—I Boring # t Boring �j Pit Ground Surface elev. ft. Depth to limiting factor in. Sal Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots •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 mgA- The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or --A ..... +a:..l :........1# —.. +o f ....e+ -1- nn. toM rh.. AP rtmP t at AnR- ')AA -Z 151 nr TTY h/1R- 7.F4.,R777. .,u VAL iop er o 2 Cc, 10-0 \ . �L. /00 .6d a Sx o T �&n oCA /Z �i FL. /03. .5"d ' to p � . Ga.J i�'►� �: f C �q, rd . S to wf � f�-✓ /1�. -O �/� �lo7ti eel .�� .�G l+ r•^�l /35 /�►wa,�c��e� T it�,'l 7 CS T a?d? j W.Z A .S'�OI r 1u� K S g ©© 6ALIDA) l'.C. Tank Anchoring: Per Comm 83.43(8)(g), Wis. Adm. Code, all tank(s) must be anchored whenever they are at risk for being installed in an area where they may be located in saturated conditions all /part of the year. Using soil as the anchor has become an acceptable alternative to concrete. • Flotation potential is the displacement of the tank calculated by its volume in cubic feet. Line A: Calculate cubic feet of tank. inches high, x 3. 14 , x -a r = "9 ubic inches. Divide this number by 1728 to equal /� D cubic feet. Line B: Convert the displacement to the weight of water. 16 D (from line A) cubic feet x 62.4 (weight of 1 cubic foot of water) x 1. j (safety factor) _ / 5iX / lbs. of lift potential. Line C: Calculate weight needed to counter buoyancy. 1S00t lbs. (Displacement weight from line B.) - C)Sq lbs. (weight of tank per manufacturer) = lbs. of soil needed to anchor tank: SJ ZO lbs. Line D: Weight of the soil media including safety factor needed over the tank to anchor the tank adequately. Tank cover radius 3.14 55 inches, divided by 144= 38S " square feet x 0.083 (1 inch in foot decimal) _ cubic feet (volume of 1 inch of space over the tank- cover). Line E: Calculated weight of I inch of space over entire cover. 3-A_ cubic feet of space ( from line D) x 100 lbs. /cubic foot of = 3aO Ibs.,'inch space above cover. Line F: Calculate inches of soil needed to counter buoyancy . 1 5 - 001 lbs. (from line C) divided by 3S.0 lbs. per inch of soil (from line E) = inches need over tank cover. Z17 NCKES O r CoU lv E Ed EIJ r r S LALcoAJ So /o Tank Anchoring: Per Comm 83.43(8)(g), Wis. Adm. Code, all tank(s) must be anchored whenever they are at risk for being installed in an area where they may be located in saturated conditions all /part of the year. Using soil as the anchor has become an acceptable alternative to concrete. • Flotation potential is the displacement of the tank calculated by its volume in cubic feet. Line A: Calculate cubic feet of tank. inches high, x 3. 14 , x-5- r 2 3a0 cubic inches. Divide this number by 1728 to equal /89 cubic feet. Line B: Convert the displacement to the weight of water. / (from line A) cubic feet x 62.4 (weight of 1 cubic foot of water) x /..i (safety factory _ / 7690 lbs. of lift potential. Line C: Calculate weight needed to counter buoyancy. 1 lbs. (Displacement weight from line B.) - f' tbs. (weight of tank per manufacturer) = lbs. of soil needed to anchor tank: IIZR / lbs. Line D: Weight of the soil media including safety factor needed over the tank to anchor the tank adequately. Tank cover radius 2 x 3.14 •�� 3- J inches, divided by 144 = 319S sgtuare feet x 0.083 (1 inch in foot decimal) = 3.a cubic feet (volume of 1 inch of space over the tank cover). Line E: Calculated weight of 1 inch of space over entire cover. 3 .a cubic feet of space ( from line D) x 100 lbs. /cubic foot of = 3RO tbs., inch st)ace above cover. Line F: Calculate inches of soil needed to counter buoyancy . 11ae1 lbs. (from line C) divided by,"QO lbs. per inch of soil (from line E) = inches need over tank cover. 3�.3 z�ucHcs of cou �EEo,�.G RECEIVED 1159 Wisconsin Department of Comm rce DEC 0 2 200%OIL EVALUATION REPORT P age 1 of 3 Division of Safety and Buildings ST. CFt�l� f�"d h County m 85, Wis. Adm. Code Tom Schmitt Attach complete site plan o ize. Plan must 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. 15.74 (1) (m)). Property Owner Property Location Stout, Richard Govt. Lot SW 19 SW 1/4 S 18 T 31 N R 18 W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# 1353 Awatukee Trail Rolling Oaks City State Zip Code Phone Number 1, City Village I+r" Town Nearest Road Hudson I WI 1 54016 1 Star Prairie 1 81St St. New Construction Use: in Residential / Number of bedrooms 3 Code derived design flow rate 450 GPD J Replacement Public or commercial - Describe: Parent material Glacial Till Flood plain elevation, if applicable na General comments and recommendations: Area is suitable for a mound system. System elevation is 105.02' based off contour line esablished at 103.52'. Slope is 6 %. Limiting factor is at 18 ". Boring # _{ Boring V1 Pit Ground Surface elev. 103.55 ft. 'Depth to limiting factor 26-- in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft *Eff#1 *Eff#2 1 0 -7 1Oyr3 /3 none sl 2fsbk mfr cw 2m,2f .5 .9 2 7 -26 10yr5/3 none sl 2msbk mfr gw 2m .5 .9 3 2641 5yr4/6 c2d 10vr6/2 sl Oma mfi ---- --- .3 .5 10 /6 a Boring # Boring Pit Ground Surface elev. 103.55 ft. Depth to limiting factor 22 Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ff *Eff#1 *Eff#2 1 0 -5 1Oyr3/3 none sl 2mgr mfr gw 2m,2f .5 .9 2 5 - 22 10yr4/3 none sl 2fsbk mfr gw 2f .5 .9 3 22 -39 7.5yr4/6 m2d l0 /2 sl Oma mfi - -- -- 3 .5 10 /8 T I I I * Effluent #1 = BOD ? 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BOD < 30 mg/L and TSS <J0 mg/L CST Name (Please Print) Signature: CST Number Thomas J. Schmitt �_ �__ 227429 Address Tom Schmitt Date Evaluation Conducted Telephone Number 1595 72nd St., New Richmond, Wl 54017 1026/03 715- 247 -2941 Property Owner Stout, Richard Parcel 10 # Page 2 of 3 3] F Boring # J Boring 1 Pit Ground Surface elev. 101.42 ft. Depth to limiting factor 18� Sal Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots *Eff#1 *Eff#2 1 0 -8 1Oyr3/3 none sl 2fsbk mfr cs 2m,2f .5 .9 2 8 -18 1Oyr4/6 none sl 2msbk mfr 9w 2m,2f .5 .9 3 18 -33 5yr4/6 c2d100yr6 /1 sl Oma mfi -- - - - -- .3 .5 F—I 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 QPD *Eff#1 *Eff#2 F-1 Boring # Boring P8 Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots *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 need material in an alternate format, please contact the department at 608 - 266 -3151 or TTY 608 - 264 -8777. dot ay ,x`4 041.4 o-3 o , ,/ �\ yk EC. /6a� �� \ ► 1� WI /0, 6d 0 5� 1 s� �rGk.J,1�y 1 C `1q rd S�►wf l ay.✓ /L► p -6Y; ?�vt RJ 1,5 x•� I #- I /35 /� j, ,' &, Ti ,� / 77 ' cs T /�- c�so•.. � W 1. �o /,l /S`�f.S� 7�?...�/ .Sid ,,of d,7 A// oLks 417—d 9y/ ScJ� s - 7d S1,8 731,'V e ASIA) � Sys r .. Twn � -�. P je ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer - 12 /-x" o2E/� 12 ✓ i�"� Ewadac Mailing Address /�_ 1 P4An 5.71 ti Cr g Property Address / L P (Verification required from Planning Department for new construction) _ 0 j J3 — /;C /2 — 30 —.Zola City/State Lld ' s_F (�� /` - Parcel Identification Number D38 /Ai '7 -,SD -ooa LEGAL DESCRIPTION Property Location _,5&L '' /4, 5&L %,, Sec. /9 T_3LN - R _ Zd W, Town of S blA /? t Subdiv Lot # _ i SuLi.tvt Certified Survey Map # , Volume Page # Y Warranty Deed # 7b 3 j� 7 8 , Volume g SO q , Page # 15'3 r Spec house ® 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 system 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 wastewater disposal 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. I/we, 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 septicisystem has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 davroT'the three veavcxpiraWf n date. SIGN JXW �OFV�PLIC DATE OWNER CERTIFICATION I (we) certify khat all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owner(s) of the,pmperty describc above, by virtue of a warranty deed recorded in Register of Deeds Office. SIGNAZJPE (?F. Af?LICANT DATE * * * * ;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 the certified survey map if reference is made in the warranty deed i i 04/22/2004 01:07 17152473622 j� C'• 1 - '; r :• PAGE 07 U 2 15 3 7 34 7S 577 OAR OF WISCONSIN FORM 2 - 396 LSH WARRANTY DEED Ir lITER OF DEEM 8C1X CO. I W1 RECCIM FOR RECORD ! 'his Dead, made between 02t@4/M4 0329W TRANS FEE,- 327,30 C Fat PAGES- 2 coraideriguon, czmv" and warmnu to Crimica the fb dL-5cf1bed real WPM In C rni5e -- County. state e( INtSCOT'sin: NVne end petuffl jko"q Lots 24 and 26, Flat Of 'Rolling O*ks 2, Town of Star Prairie, St. CrOix County, Grand Properties Wisconsin. 712 Rivard St. Somerset, WX 54025 Lot 24 has been amended to InvIud a glece of Lot 23 as described in attachel Vx ibit A . .... 4 Is dog c r and excluding a part of maid Lot 2 in at ached Exhibit A. 038-1217-30-200 N&M NFL M OP9 0 This ift 11 2-7 Exceptiorts to warrantits', olitaomants, ra triettane, rights-of-way and COV4 of racord. Dated this_ ZZ *w day of jan-11VIC F h n4 (SEALI Richard Q. Stout (SEAL) (PEAL} AUTHENTICATION ACKNOWLEDOMIENT State e. 4VIKOOaaia. St. Croix caurg5L ; autbenucated ItAs day a Ptmnazy eame baron me this 3,01yy 2044—. the above named i i — i TM L MEMBER ST BAR OF WISCONSI1,4 —to me known to be the PCM n ------- AKdo'Nbcuia 'I Ing autharmed by 5T06.D6. WuL State.) inswurient and ackri Tmis,wmwsN r W.4.9 DRA FTEP aV Janet P Stout 7353 kwatukee Tr_ Mirg 140 Nialf? State of W My cornmlSSio :, is (If not. jut tallorl sett: V t . (Slrtaturft may be iullrAhUtted at 3tknFMWi4id*d. Both am lint nacessary.) VATt BAR OR WIDWRIN wierown LIQui 9WA ft, WARItArl"" 0XIM FOAM N.. 9. 10151 M4ww" Wig. 1, 75347'9 VOL PAGE 4699 KATNLTM H. M7L LSH REGISTER OF DEEDS ST. CROIX CO. i MI !' RECEIVED FOR R ECORD n c 2 0 � S i I � 02/04/2004 03 :00PN C v • CERTIFIED SURVEY NAP I I REC FEE: 13.00 ' COPY FEE: 3.00 PAGES: 2 y 1 z � O o: - v' p" m0 r tn"O x rn H -1 �m� O _ = O O _v g $ c w g c') c 111 ON c,` ye$ C i N Q o D mOwl 8 T. a > z m �° ° NZ C 0 'A m?o Z c _ m a i! m { y g �o O a ry O z� 7o < O Z z G C ° s s7 ' 7C "n O m — � > O �c Z m � m v 111 08Z ~ 6 m m - n L") �� S =;z �o� -1p� A m C1 r Zz� 9 x N C m 22 0 cn _ lit `� �a � m Z v ° m s � ��7 m nY $O O z b, vm 8 cncn -I m n v S m r M 4 C s o Z 0 s m am Tm c LLIM Fn X _ x z 5 a7 P. o p N Z rn "� v �• n 9 v � � m N g m m m A z m T _ g n '� m x N00 °21'49 "W 2646.97'_ — — — y _ — _ _ _ J o r -4 323.48' WEST LINE OF TH SW1 /4 1 1323'48 d to mm N00 cn T a o m �W� 0 4 Zara = � mO�m:° zwm �mf�^D -,q��m 0 j O�v�{- zZ _ C mi0—n cq mr 5 wpm rtvn v v�mG �r*+� 0� -A I S2 a ovO � `Sv 9 C z�0-�m 0 j 2� C , O m x G��zw�g O �CO� N1 g� �z�7c m � 0� 1a7 6Nt °[�nGZi'C59 j p s i G d g� O y �o� c , z O r^xN ju5 O m � r --- -- - ----L I m O � ZZ 1 I� �_ ` S,l l I Lo� m Fn mOr I m _ mzl w r �A o v o� - ,41, L I I0 oA > i LOT 22 �c,J9y) z M2 8,3 8 I i A 0 ' I O -10 — @3 I O z - - - - "— � r ao rsr 37 O j I y O I d I cn LOT 23 108.21 ZA6'° - - - - - - NO2 °07'06 "E ► I C"' O j° °8� (59, v� 1 " �] ? I �-+ I I \N jy`gF O' w r / � -�� �`g pie T i � j i m m I O O C7 r \\ \S tn ! \\ \ `. W l4 �� �` ` T+ I d qz n \ �a c my OD O I r� BEARINGS ARE REFERENCED TO THE SHEET 1 OF 2 SHEETS ,� 1 r n GZ7 WEST LINE OF THE SW1 /4 OF SECTION 18, ASSUMED TO BEAR N00°21'49"W Vol 18 Page 4699