HomeMy WebLinkAbout040-1231-20-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix
Safety and Building Division
INSPECTION REPORT Sanitary Permit No: 420586 0
GENERAL INFORMATION • if (ATTACH TO PERMIT) St to Plan ID No:
Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. ?,R)6716— = TryMSq bN /O.
Permit Holder's Name: City Village X Township Parcel Tax No:
Blake Builders, Inc. I Troy Township 040 - 1231 -20 -000
CST BM Elev: Insp. BM Elev: I BM Description:
I to .0 LTO.3 C51 1'3w& #1 1 Z� ��•`
TANK INFORMATION ELEVATION DATA '
TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV.
Septic Benchmark
l2 SD • Zo 1
Dosing � c � Tit
Aeration Bldg. Sewer
Holding St/Ht Inlet
X3.10
St/Ht Outlet
TANK SETBACK INFORMATION
TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet
Septic ' �5 ' ` 1 DtAette"
Dosing , 1j I I Header /Man. o�LZ �JJp�t
Aeration Dist. Pipe
Holding Bot. System
O
Final
PU IPHON INFORMATION %.., "' u 12�+ )
Manufacturer Demand 4lrCover /
C f GPM D pC. 3
Model Number 1 ' tl
H Lift Friction Loss System Head TDH Ft
e s' 10,E 3. 3 . SM I -
Forcemain Length �1 Dia. /� Dist. to Well
SOIL ABSORPTION SYSTEM Cam(-
BEDITRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Di Liquid De
DIMENSIONS )['1 /(
SETBACK SYSTEM TO 710 P/L l BLDG WELL LAKE /STREAM LEACH Manufacturer:
INFORMATION CHA R O
Type Of System / 1 UNIT
Model Number:
DISTRIBUTION SYSTEM f� - PIL
Header /Manifold Distribution t x Hole Size x Hole Wing ent to Air Intake
Pipe(s) I 11 5 q
Length Dia 1 Length ��' ia_ Spacing /3Z • 0
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 j � Yes U No Ink Yes l l No
CEN (Include dis repencies, all n #1: /� Inspection #2: -
(') e s>�� i�.s pease►, r sent, etc.) Inspection
Location: 684 Buttercup court Hudson, WI 54016 (NE 1/4 SE 1/4 3 T28N R19W) Country wood ddn. I Lot 2 Parcel No: 03.28.19.1138
1.) Alt BM Description= S �D T Mw.. t84Qr�
2.) Bldg sewer length = 19
- amount of cover = 18 u '+' �• �' - 1 _ ,,ne,...b
3 Contour = 96. 3
Plan revision Required? L e
Ys No f'F_ 1 +
Use other side for additional information. y
SBD -6710 (R.3/97) Datt Insepctor's Signature Cert. No.
Sanitary Permit Application Safety & Buildings Division
In accord with Comm 83.2 1, Wis. Adm. Code 201 W. Washington Ave.
Madison, WI PO 7302
See / reverse side for instructions for completing this application Box Box 7302
145COnSin Personal information you provide may be used for secondary purposes M M d form to coon if not
Department of Commerce (Privacy Law, s. 15.04(1)(m)] (Submit comp tY
a _p — Z f f�0 3 7 state owned.)
Attach complete plans (to the county copy only) for the system, on paper not less than 8 -1/2 x 11 inches in size.
County State Sani Permit N ber Check if revision to previous application State Plan I. D. ICJ
( p
I. Application Information - Please Print all Information, Location:
7 P Owner Name perty cation
3 1/4�� 1/4, S VoP N, E ("a
erty Owner's Mailing Address Lot Number Block Numb
7��i• T �vr� ZOO �rc.�e.eie.�jo c� � �r
City, State Zip code Phone Number Su Name or CS Nu r
itJ 561 Z8 lZ) 833 A ;4 T �
H. Type of Building: (check one) 'V a D City
y g- A/ RECEIVED To wn e �P,D
1 or 2 Famil Dwelling No. of Bedrooms: ES/� �"Pown of
D Public/Commercial (describe use):_ S
D State -Owned ,,. /� O (, N
�'l�LtnZd i.� /G71LG .U4- 41 XIS-4, "-= 69' Nearest Road ,� —060
ST. CROIX COUNTY
a4 " Ls ' , 2 1 �l DY S ZONING OFFI Parcel ax Number(s) b - / S'
III. Type of Permit: (Check only one box on line A. Check box on line B 1 app
A) 1. New 2. Replacement 3. Replacement of 4. 5. 6. Addition to
System System Tank Only Existing System
B) P ermit Number ate Issue
D A Sanitary Permit was previously issued
IV. Type of POWT System: (Check all that apply)
• Non - pressurized In- ground ,Mound D Sand Filter D Constructed Wetland
• Pressurized In- ground D Holding Tank D Single Pass D Drip Line
• At -grade D Aerobic Treatment Unit D Recirculating D Other:
V. Dispersal/Treatment Area Information: V • 3
1. Design Flow (gpd) 2. Dispersal Area 3. Dispersal Area 4. Soil Application . Percolation Rate 6. System Elevation 7. Final Grade
Required �t}� Proposed 2to Rate (GalsJday/ q, ft.) (MinJinch) _ S Elevation
oo SOD � -7; - �� n 4 `� gS.o5- ID(,
L
VII. Tank Capacity in Total # of anu cturer Prefab Site Steel Fiber- Plastic
Information Gallons Gallons Tanks 0 & -AC ,B�07V,6 Con- Con- glass
New Existing y iC 7�-� crete structed
Tanks Tanks
sir L Zso /ZsS"o D ❑ ❑ ❑
.� D D D D - i
1400.1 7�
VIII. Responsibility Statement
1, the undersigned, assume responsibility for stallatio a POWTS shown on the attached plans.
ices ame rint um [gnat tamps : MP P o. Busmess one umber
TM
Plumber's Address (Street, ity, State, Zip de
S 61g'
IX. County/Department Use Only
_ Disapproved Sanitary Permit Fee (Includ undwater Date Issue suing t Signature (No stamps)
aA Pproved D Owner Given Initial Adverse Surcharge Fee)
Dete rmination /
X. Conditions of Approval /Reasons for Di proval:
m f�,rn,�/12cvm v►1
n'l�w 7; %, . v^`- �o� � ('�,.,,..,,,� Y3 , Z/3 �� FXe- 6 !0 0� L+ ST
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Safety and Buildings
4003 N KINNEY COULEE RD
LA CROSSE WI 54601 -1831
TDD #: (608) 264 -8777
iscons� www.w
n
w ww.commerce.state.wi.us/sb
i n.gov
isconin.gov
Department of Commerce
Scott McCallum, Governor
Philip Edw. Albert, Secretary
November 11, 2002
CUST ID No. 139462 ATTN: POWTS Inspector
TODD L SINZ ZONING OFFICE
T L SINZ PLUMBING INC ST CROIX COUNTY SPIA
E5609 708TH AVE 1101 CARMICHAEL RD
MENOMONIE WI 54751 -5520 HUDSON WI 54016
CONDITIONAL APPROVAL
Identification Numbers
PLAN APPROVAL EXPIRES: 11/11/2004
Transaction [D No. 806815
`� L'+* Site ID No. 653164
SITE:
p k E BU L i s Please refer to both identification numbers,
Buttercup Court t,D 1 /y` above, in all correspondence with the agency.
Town of Troy
St Croix County
NEl /4, SEI /4, S3, T28N, R19W
Subdivision: Country W ood- lot 2 fi r+' ��`� "T
FOR:
Description: Proposed Four Bedroom Mound System
Object Type: POWT System Regulated Object ID No.: 880470
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 Conditions:
• This system is to be constructed and located in accordance with the enclosed approved plans.
• A Sanitary Permit must be obtained from the county where this project is located in accordance with the
requirements of Sec. 145.135 and 145.19, Wis. Stats.
• Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with
the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stats.
• Pursuant to outlet filter product approval stipulations, maintenance information must be given to the owner
of the POWTS explaining that periodic cleaning of the septic tank outlet filter is required. The access
opening used to service the filter shall terminate at or above finished grade with a watertight cover.
• 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(1)(a) - The owner of a POWTS shall be responsible for ensuring that the operation and
maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s.
Comm 83.54(1).
Cop 0 . � l S.
to
�r�
Illy
TODD L S1NZ Page 2 11/11/02
Owner Responsibilities Continued:
• 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.
• The owner is responsible for submitting a maintenance verification report per Comm 83.55, that is acceptable to
the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the
component(s) utilized in the POWTS.
In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should
conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review
shall relieve the designer of the responsibility for designing a safe building, structure, or component.
Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address
on this letterhead.
The above left addressee shall provide a copy of this letter to the owner and any others who are responsible for the
installation, operation or maintenance of the POWTS.
Sincerely,
. Fee Required $ 175.00
Fee Received $ 175.00
Balance Due $ 0.00
Gerard M. Swim
POWTS Plan Reviewer - Integrated Services
(608)- 789 -7892, Mon. - Fri. 7:30 am to 4:15 pm WiSMART code: 7633
jswim@commerce.state.wi.us
cc: Leroy G Jansky , Wastewater Specialist, (715) 726 -2544
Henry F Grote , Certified Soil Testing
- - - -
V
c Fi
Brandon Schmidt - Mound < "I 1 ��
B
Transaction #
!O
Construction Materials and Techniques 4 SO
All materials must comply with Comm 84 and be installed in accordance with manufacturer'je*;
specifications. Construction methods must comply with the following Component Manuals:
Mound, SBD- 10691 -P (01/01)
Pressure Distribution, SBD - 10706 -P (01/01)
Location: Lot 2 (formerly Lot 71), Country Wood
NE 1/4, SE 1/4, Sec. 3, T 28 N, R 19 W
Town: Troy
County: St. Croix
Date: November 11, 2002
Owner: Brandon Schmidt
Address: 684 Butter Court
Hudson, 5401
Plumber: Tod i z
Signature:
License # M x9462
Attachments: 6748 -Plan Approval Application
SBD -8330
page 1: cover
2: design criteria & calculations
3: plot plan exu Y E
4: system cross section DEPARTMENT OF COMMERCE
5: plan view, lateral detail DIVISION F SAFETY AND BUILDINGS
6: pump tank exit detail
7: pump curve SEE CO ONDEMr,
8: system management
page 1 of 8
I
•
Design. Criteria
�wS Residential Wastewater Contaminant Load: 30 mg/L < BOD < 220 mg /L
Anticipated septic tank effluent 30 mg /L < TSS < 150mg/L
Fecal Coliform > 10,000 cfu/100 mL
Fats, oils, grease < 30 mg/L
Bedrooms x 100 gal/bedroom/day x 1.5 4 0- '. gallons /day hydraulic load
Design Calculations r
5 01 t5 0rbe %0 07y //n�
In esigned loading rate Z z gallons /sq. ft. per day J
Depth to estimated high ground water '• 1S in. c,
Depth to bedrock in.
Cross slope at system S� %
Force main length ft, of in.
Manifold/header length ft. of — in.
Drain -back gallons
Lateral length ft. of VI z in.
Lateral elevation `� �� SY ft. @ bottom of lateral
s
Lateral hole size �� �- in. @ 3 L o in. ( 3 • o ft.) Spacing
26 holes /lateral holes total
Lateral volume 14 • C) gallons
i
Total lateral discharge rate Z `g • 0 $ gallons /minute @ 3 ' S ft. head
Network pressure compensation losses � S7 ft.
Elevation difference ° ` Ig ft.
Friction loss 3 . 4 `� ft. @ 3 gallons /minute
Total dynamic head • 8 4 ft.
Pump /si'pkon 44 gpm @ Z o ft. of head
Manufacturer ° �`l°'`� Model # �� 2
Dose volume kc> Z y- gallons
Lift/sipkon tank `� w�w �� �� -.�w� — +S - O gallons
Septic tank gallons
Effluent filter Q. -o FT o 2.'L - 1 S A
Measurement pump on and off 19. CID in.
Height alarm from tank bottom A o in.
Reserve capacity 5 25 + gallons
specs.calcs.res
Page Z of
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SEPTIC t 5PCC FIGATI�S
DOSE
TA,.1._S MAQUFACTURCR: T 1 ` IJWIBER OF DOSES: �'Z- „PEk D ,k,-
TA►JK SIZE: 1 �sv ' \ GALLOUS DOSE VOLUME
ALARM M UF^CTUK9,st: S `� ° K ��s WCLUDIAJG 6ACKFLOW: � '� (,AL�.ONS
^00CL UUIhbEK: ° I �'} ``� CAPACITIES: A IWCACS OK S (,ALL0U5
SWITCH TyPi: ' 8 Z 3g
IuC>iE5 OR CAL LOUS
PUMP h1AUU FACT URCR: � 0IL 4 R'" 1
C p � iUCHES OR 107_ GALLOuS
MODEL IJUMDCR: Z DO INCHES OR 1 °1- � GAL LON:,
JWI -TCH TdPC: ~ IJOTE: PUh1G AUD ALARM ARC TO tL
MIUIMUt'\ DISCHAK" RATE �'�'� GPM INSTALLED OIJ 5EPARATC CIKCL ;'.S
VORTICAL DIFFCRCLJCC DCTWCCIJ PUMP OFF AUD DIJTRIbIJTIOIJ PIPE.. 13. FEET
+ ht+UIKUM ►JETWORK SUPPLY PRELSUIIE 3 'S FEET d�
+ » FEET OF FORCE MAIIJ X 1 GL4 F ' 3 0
IoorcFRlCTIO►J FACTOR FEET
— TOTAL DyJQAMIC HEAD FLc7Zi•
1. fig . ,
IIJTERU E
AL. DIMUblOAJt • 0I TA1JK: LE1JC,7H 4Ar ;WIDTH „ iLIQWD DEPTH
-'1
w
`O'AL DYNAMIC HEAb/CAPACITY
HEAD CAP TY CURVE PER MINUTE
EFFLUENT AND DEWATERING
LJ
MODEL 152 153 -
w w MODEEL� 152 153
LJ L
50- Feet Meters j Gal. Liters Gal. Liters
153 5 1.5 69 261 77 291
12 40 15 10 3.1 61 231 70 265
C { 15 4.6 53 201 61 231
a
= 20 6.1 44 1 52 1
30 I
a 8 25 7.6 34 122 1 42 1 159
- r-- -�
>- 30 9.1 2 8 7 _ 1 .25
a 35 1 -- -- 22 85
° 1 0 12.2 42
t -- — --�
T
4 Ik
Loci `'cave T36.0 F!. (1 . 6 m)i4a 0 F ('3,
q
10
ousoe
i 0
20 40 60 80 100
GALLONS
LITERS 1 6 1 (4 —
' 0 80 0 160 240 320 � I
z i 1 21/3G !--
FLOW PER MINUTE -
2? .?2
CONSULT FACTORY FOR SPECIAL APPLICATIONS
• Timed dosing panels available. \ `�
• Electrical alternators, for duplex systems, are available and supplied with 27152
e
an alarm.
• Variable level control switches are available for controlling single phase
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 °C.) special quotation required. - -
1521153 Series r _ -
_ 152A53 MODELS Control Selection
Model, Volts-Ph Mode Amps Simplex Du lex
N t52 115 1 Non 8.5 I 1 2 or3 �
BN 115 1 Auto 8.5 Included 2 or 3
E 152 230 1 Non 4.3 1 2 or 3 -_i _ _ sK2064
B E152! 2 30 1 Au 4 Included to 3 I r
c uded 2 0 3
N153 1 15 1 Non 10.5 1 2 or 3
BN153 115 1 Auto 10.5 Included 2 or 3
E t53230 1 3 Non 5.3 - t — 1- 2or SELECTION GUIDE
BE153' 230 t Auto 5.3 Included — 2 or 3 1. Single piggyback variable level float switch or double piggyback variable level float
switch. Refer to FM0477.
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
recent National Electric Code (NEC) and the Occupational Safety and Health Act (OSHA). or (4) float system.
K ��
W I U�
RESERVE POWERED ERED DES GN
For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump.
MAIL TO: P.O. 80X 16347
Louisville, KY 40256 -0347 Manufacturers of.
SHIP TO: 3649 Cane Run Road
Louisville, KY 40211 -1961 p
http: / /www.zoelleccom `f PUMP L O (502) 778 -2731. 1(800) 928 -PUMP yL V PUMPS SNCE 1g,7, N
FAX (502) 774 -3624
9 Copyright 2000 Zoeller Co. All rights reserved.
' P�
System T o
Sys m Mana ement
g
Management of this 'system I is critical. As a condition of approval of these plans this system management section must be
reviewed with the owner, and the owner must be provided with a complete set of plans including this management section. If problems
develop with the adsorption system or any other system components, the installing plumber, T.L. Sinz Plumbing, 715- 235 -2644, or the
St. Croix County Zoning Office, 715 -386 -4680, should be contacted for assistance.
General
Proper functioning of an on -site disposal system, "septic system," is significantly dependent on the volume of water which flows
into the system and the level of contaminants in that volume. The lower the volume of water and the lower the level of contaminants, the
better and longer the system will function. Typical system components include aseptic tank or compartmentto settle out solids and contain
greases and oils, a filter on the outlet of the septic tank to retain small particles of the same density as water, a pump tank or compartment
to allow a dose to be accumulated, a pump and controls, and finally some type of soil adsorption cell to recycle the water in a manner to
protect ground water quality and public health.
I . If the septic tank is installed prior to sheet -rock and/or painting, pump the septic tank before normal use begins to ensure adherence
to contaminant load design criteria.
2 Install water- saving appliances whenever and wherever possible.
3. Repair even small water leaks as soon as possible.
4. Never pour grease or oil down any drain or stool.
5. Garbage disposals are not recommended; if you must have one, use it sparingly.
6. No paper products other than tissue should go into the system.
7. No chemicals should go into the system.
8. Avoid surge flows of water; try to spread laundry throughout the week.
9. Septic tank effluent must be less than or equal to the design criteria specified in page 2 of these plans.
10. If septic or pump tanks are no longer used, they must be properly abandoned.
11. If construction timing and weather could create a frozen infiltration system, weather - proofing with plastic sheeting and heavy mulching
may be required to maintain a functional system at start -up.
Maintenance
1. The septic tank must be inspected every three years by a properly licensed person.
2. If necessary, the septic tank must be pumped to remove solids and scum; pumping is required if the combined scum and solids volume
equals one third of the tank volume.
3. When the septic tank is pumped, any solids in the bottom of the pump tank must be pumped, and the filter must be back - washed into
the septic tank to remove accumulated material.
4. Periodic observation pipe inspections should be made by the homeowner to examine the state of the in -situ soil adsorption cell.
Quarterly inspections are recommended; a licensed plumber should be notified if effluent is consistently ponded in the adsorption
cell.
5. If this system contains specific treatment components other than those mentioned here, maintenance requirements will accompany
their specifications.
6. The pumping components for this system include an alarm which must be installed and remain on a separate circuit from the pump.
If the alarm is activated, minimize water use and notify a licensed plumber for service as soon as possible. The system allows reserve
capacity to accumulate some necessary flow until normal service can be restored; this volume is minimal, and no more than one or
two days should pass before any necessary repairs can be made.
7. Avoid compaction such as vehicle traffic within 15' down -slope of the adsorption system.
8. Avoid disturbing the system itself such that might encourage erosion or disturb the required seeding of the system.
9. Particularly avoid winter traffic such as sliding or snowmobiling which might compact snow and lead to increased frost depth.
10. Surface drainage must be diverted around the system; avoid landscape changes which might send surface run -off into the system area.
11. Warning: Do not enter septic, pump or other treatment tanks; death may result because they may contain lethal gases or insufficient
oxygen.
Contingency Plan
Wastewater monitoring of volume and quality is not a normal requirement for low effluent strength systems; such monitoring
may become necessary if problems develop. Any necessary monitoring shall be done in accord with the requirements of Comm 83.54
(2). Pumping and hauling of wastewater may be necessary while analysis and repairs are implemented. Additional testing, designing,
and /or installation of additional treatment components or conversion to a holding tank may be necessary.
Page 8 of 8
i
Safety and Buildings
4003 N KINNEY COULEE RD
LACROSSE WI 54601 -1831
Nvisconsin = TDD #: (608) 264 -8777
www.wisconsin.gov
Department of Commerce
Scott McCallum, Governor
Philip Edw. Albert, Secretary
November 11, 2002
CUST ID No. 139462 ATTN.• POWTS Inspector
TODD L SINZ ZONING OFFICE
T L SINZ PLUMBING INC ST CROIX COUNTY SPIA
E5609 708TH AVE 1101 CARMICHAEL RD
MENOMONIE WI 54751 -5520 HUDSON WI 54016
17
CONDITIONAL APPROVAL �d �
PLAN APPROVAL EXPIRES: 11/11/2004 Identification Numbers
Tra action ID No. 806815
SITE p "7� J R E'vE Site No. 65316
�o "
Brandon Schmidt t,� Ple e refer to both identification numbers,
� U l L
B uttercup ourt NOV 2 bovA in all correspondence with the agency.
Town of Troy
St Croix County ST. Cf N COUNTY
NE1 /4, SETA, S3, T28N, R19W ZONING G OFFICE
Subdivision: Country Wood - lot 2
FOR:
Description: Proposed Four Bedroom Mound System
Object Type: POWT System Regulated Object ID No.: 880470
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 Conditions:
• This system is to be constructed and located in accordance with the enclosed approved plans.
• A Sanitary Permit must be obtained from the county where this project is located in accordance with the
requirements of Sec. 145.135 and 145.19, Wis. Stats.
• Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with
the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stats.
• Pursuant to outlet filter product approval stipulations, maintenance information must be given to the owner
of the POWTS explaining that periodic cleaning of the septic tank outlet filter is required. The access
opening used to service the filter shall terminate at or above finished grade with a watertight cover.
• 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(1)(a) - The owner of a POWTS shall be responsible for ensuring that the operation and
maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under S.
Comm 83.54(1).
TODD L SINZ Page 2 11/11 /02
Owner Responsibilities Continued:
• Comm 83.52(2) - A POWTS that is not maintained in accordance with the approved management pl an or as
required under s. Comm 83.54(4) shall be considered a human health hazard.
• The owner is responsible for submitting a maintenance verification report per Comm 83.55, that is acceptable
to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the
component(s) utilized in the POWTS.
In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions
should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this
review shall relieve the designer of the responsibility for designing a safe building, structure, or component.
Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address
on this letterhead.
The above left addressee shall provide a copy of this letter to the owner and any others who are responsible for the
installation, operation or maintenance of the POWTS.
Sincerely,
Fee Required $ 175.00
Fee Received $ 175.00
Balance Due $ 0.00
Gerard M. Swim
POWTS Plan Reviewer - Integrated Services
(608)- 789 -7892, Mon. - Fri. 7:30 am to 4:15 pm WiSMART code: 7633
jswim@commerce.state.wi.us
cc: Leroy G Jansky, , Wastewater Specialist, (715) 726 -2544
Henry F Grote, Certified Soil Testing
S anitary Permit Applicatio Safety & Buildings Division
S th Wi 201 W. Washington Ave.
In accord with Comm 83.2 1, Wis. Adm. Code PO Box 7302
See reverse side for instructions for completing this application Madison, WI 53707 -7302
Iviscons
Personal information you provide may be used for secondary purposes
Department of Commerce [Privacy Law, s. 15.04(l)(m)] (Submit completed form to county if not
state owned.)
Attach complete plans (to the coup copy only) for the system, on paper not less than 8 -1/2 x 11 inches in size.
County State Sanitary Permit Number UCheckifrevision g � n State Plan 1. D. Number
I. Application Information - Please Print all Information, Location:
Property Owner Name petty cation
p i n u
ZS W(°
1� . 6114 �C 1/4, S 3 T ,N,
Property Owner's Mailing Address Lot um r Block Number
11
Cl , State Zip Code V Phone Number Sub ivision Name or CSM Number
/ 1501 b ( S D - 7 )Zla_ MY T U)v afi
II. Type of Building: (check one) ❑ City
1 or 2 Family Dwelling - No. of Bedrooms: '� ❑ Village Z
Public/Commercial (describe use):_ # of
❑ State -Owned
Nearest Road
Parcel ax Number(s)
III. Type of Permit: (Check only one box on line A. Check box on line B if applicable)
A) I jq New 2. 0 Replacement 3. 0 Replacement of 4. 5. 6. Addition to
System system Tank Only Existing System
13 B) ennit um er ate Issue
A Sanitary Permit was previously issued
IV. Type of POWT System: (Check all that apply)
• Non - pressurized In -ground JO Mound ❑ Sand Filter ❑ Constructed Wetland
• Pressurized In- ground ❑ Holding Tank ❑ Single Pass ❑ Drip Line
• At -grade ❑ Aerobic Treatment Unit ❑ Recirculating ❑ Other:
V. Dispersal/Treatment Area Information:
1. Design Flow (gpd) 2. Dispersal Area -- 1 — Dispersal Area 4, Soil Application 5. Percolation Rau 6. System Elevation 7. Final Grade
Required Proposed Rau (GalsJday /sq. 8.) (Min./inch) Elevation
Soo a 7 a7 71Z, 71Z, . �8. o s /o /• a �f
VII. Tank Capacity in Total # of Manufacturer Prefab Site Steel Fiber- Plastic
Information Gallons Gallons Tanks Con- Con- glass
New Existing crete structed
Tanks Tanks
Rr ❑ E3 ❑ ❑
�t 7Sa p
VIII. Responsibility Statement
1, the undersigned, assume responsibility f ' stallatio OWTS shown on the attached plans.
Plum er ame (print) um s Signature o ps : MP/M
p o Business Phone umber
IOQfl �... �l��r�i4v
Plumber's Address (Street, City, State, ip a ys� '
IX. County/Department Use Only
Disapproved Sanitary Permit Fee (Includes Groundwater FDate Issued Issuing Agent Signature (No stamps)
0 Approved ❑ Owner Given Initial Adverse Surcharge Fee)
Deter mination
X. Conditions of Approval /Reasons for Disapproval:
A-- 'A. M A, /M\
Wisconsin Department of Commerce SOIL EVALUATION REPORT Page 1 of 3
Division of Safety and Buildings
in accordance with Comm 85, W' . m. Code
// _ y O - D Z 03 / y County St. Croix
Attach complete site plan on paper rdl2ss than 81/2 x 11 inches in size. Plan must
include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D.
percent slope, scale or dimensions, north arrow, and location and distance to nearest road. �� - /Z 3 / -- d - 066
viewed by Date
Please print all nfon�
Personal information you provide maybe used fors ndar purposes (Privacy Law, s. 15. ( 1 ) (m))-
Property Owner Pro Locatl
Brandon Schmidt Govt. of NE 1/4 SE 1/4 S 3 T 28 N R 19 E (or) W
Property Owner's Mailing Address Lot# Block # Subd. Name or CSM#
684 Buttercup Ct LIU A - Country Wood
City State Zip Code dmne Number ity []village • own Nearest Road
Hudson WI 1 54016 ( 612708 - 6833 cell Tower Road
a New Construction Use[:] Residential / Number of bedrooms 3 - 4 Code derived design flow rate 450 -600 GPD
Replacement Public or commercial - Describe:
Parent material Glacial till Flood Plain elevation if applicable NA ft.
General comments S ite suitable for a mound at 15 inch restriction
and recommendations:
spint @frontternet.net
B94.95 @176byl67r
Boring # ❑ Ing
a pit Ground surface elev. 99.05 ft. Depth to limiting factor 16 in.
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDR
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. - Efr#1 'Eff#2
1 0 -10 10yr3 /3 1 2msbk mfr gw if .5 .8
2 10 -16 1 4/4 scl 2msbk mfr gw 1 1f ,4 .6
3 7.5yr4/4 c2d5yr5/6 set lmsbk mfi - - 2 .3
a 2 Boring #� 96.35 15
El 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. 'Efr#1 'Eff#2
1 0 -10 10yr3/3 1 2msbk mfr gw 2f .5 .8
2 10 -15 10 3/6 scl 2msbk mfr gw if .4 .6
3 15 -36 7.5yr4/6 c2d5yr5/6 scl lmsbk mfi - - 2 .3
Effluent #1 = BOD > 30 220 mg1L and TSS >30 150 mg/L < 30 mg/L and TSS : < 30 mg&
CST Name (Please Print) Signet CST Number
Thomas C Nelson 227387
Address Date Evalua ' - Conduct Telephone Number
1432 120th Street New Richmond 6/26/02 715 - 246 - 2454
eropenY uwner parcel 10 # rage of
FTI — Boring
Boring # Q Pit Ground surface elev. 94.90 ft Depth to limiting factor 15 in.
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDV
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Ef1#1 - Efr#2
1 0 -10 10yr3 /3 - i 2msbk mfr gw 2f .5 .8
2 10 -15 1 l 3/6 - scl 2msbk mfr 9w If .4 .6
3 ' 15-38 10yr4/6 c2d5yr5 /6 scl lmsbk mfi - - 2 .3
Boring
❑ Boring # R pit Ground surface elev. _ 96.15 ft. Depth to limiting factor 15 in.
Sal — Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ffz
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 •Eft#2
1 0 -10 10yr3 /3 - 1 2msbk mfr gw 2f .5 .8
2 10- J-i- - 10vr3/6 scl 2msbk mfr 9w if .4 .6
3 15 -38 1 4/6 c2d5 5/6 scl Imsbk mfi _ - 2 .3
❑ Boring # Boring
Pit Ground surface elev. _^ fl. Depth to limiting factor in.
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. - Efr#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&
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.
M- 8330ren (R.07 100)
Brandon Schmidt
Lot 71 Country Wood
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POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page ! of "y
ME INFORMATION SYSTEM SPECIFICATIONS
owner BL e- t, Septic Tank Capacity ga l 0 NA
Permit a Septic Tank Manufacturer VG/fjJ -- E3 NA
DESIGN PARAMETERS �O Effluent Filter Manufacturer I p—v�'d NA
Number of Bedrooms ❑ NA Effluent Filter Model ❑ NA
Number of Public Facility Units A Pump Tank Capacity D a l ❑ NA
Estimated flow (average) gal/day Pump Tank Manufacturer Be-,) ❑ NA
Design flow (peak), (Estimated x 1.5) OU g al/day Pump Manufacturer ❑ NA
Soil Application Rate 1' /TAI b — g al/da y/ft? Pump Model � 5� 7i ❑ NA
Standard Influent/Effluent Quality Monthly average` Pretreatment Unit M-NA
Fats, Oil & Grease 1 530 mg /L ❑ Sand /Gravel Filter ❑ Peat Filter
Biochemical Oxygen Demand (BOD 5220 mg /L ❑ NA ❑ Mechanical Aeration ❑ Wetiand
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) ❑ In -Gro d (pressurized)
Total Suspended Solids (TSS) 530 mg /L A ❑ At -Grade - ound
Fecal Coliform (geometric mean) 510` c 100ml ❑ 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
❑ on(s) (Maximum 3 years) NA
Inspect condition of tank(s) At least once every: I earls)
Pump out contents of tank(s) When combined sludge and scum equals one -third W of tank volume ❑ NA
❑ r�onth(s1 (Maximum 3 years) NA
Inspect dispersal call(s) At least once every: Z C�yeaN5)
❑ th(s) ❑ NA
Clean effluent filter
h NrC� At least once every: —� earls)
❑ month(s) ❑ NA
Inspect pump, pump controls & alarm At least once every: ( 0-few(s)
'Gkifhonth(sl ❑ NA
Flush laterals and pressure test At least once every: � ❑ 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 IY 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 Z of Z�
START UP AND OPERATION
For new construction, prior to use of the POWTS check treatment tank(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 cells) 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
pr operly 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.
❑ 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.
CD/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 T D a S /- Name
Phone - 7/ ; 5 - - Z 3 S� oZf/o Phone
SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY
Name
Name ST GjQ0 /J %/J — �- `
Phone Phone 9 — -(
This document was drafted in compliance with chapter Comm 83.22(2)(b)(1)(d) &(f) and 83.54(1), (2) & (3), Wisconsin Administrative Code.
�46c� 25 02 09:25a Bonte Excavating (715)796 -2519 p.l
v y ST CROI K COUNTY
SEPTIC TANK MAINTENANCE AGREEMENT
0 OWNERSHIP CERTIFICATION FORM
►wnerB yer slc --e
failing pddress t y o g J.j i n P e r R .Ar z G
roporty �ddress b `t F3 E+ c r c u
(Verification required from Planning Department for new construction)
.ity/State H -d s i Parcel Identification Number q
.EGAL DESCRr
S lz
' roperty lion Y4, %,, Sec. 3 . T _ : — N - Town of T r c
3ubdivi n Gv u V%4 r W o o C- . Lot # '
F8YYne r(y '7+
Certifi Survey Map # . Volume , Page #
Warran l y Deed # (ock 3 8$ S . Volume Zo 0 9 . Page # 28 1
Spec 'o O yesAno Lot L ❑ es ❑ no yes identifiable
SYSTE MAINTENANCE
roper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance
consists o r 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
mastcrpI r.Journeymanplumber, restricted plumber or a licensed pumper verifying that (1) the on -site wastewaterdigx=I system
is in pea r operating condition and/or (Z) after inspection and pumping (if necessary), the septic tank is less than 113 full of sludge.
Uwe, the 1 igned have read the above requirements and agree to maintain the private sewage disposal system with the standards
act forth. erein, as set by the Department of Commcwc and the Department of Natural Resources, State of Wisconsin. Certification
meting c stem has been maintained must be completed and returned to the SL Croix County Zoning Office within 30
days to year expiration date.
OF PLICAN'f DATE
I
O I
i
CATION N
( e) re that all statements on this form a true to the best of ray (our) kn owledge. I (we) am (are) the owncr(s) of
C pro cribed above, by virtue of a warranty deed recorded in Register of Deeds Office.
OF APPLICANT DATE
•ss ny • o
A rmation that is axis- represented may mutt in the sanitary permit being revoked by the Zoning Department. •� * s••
e with this application: a stamped warranty deed from the Register of Deeds of'Fico
i a copy of the certified survey map if reference is made in the warranty deed
1
Nov 21 02 11:58a Bonte Excavating (715)796 -2519 P.6
u.2009P 281 "
6 938trS5
STATE BAR OF WISCONSIN FORM 2 - 1999 KATHLEEN H. WALSH
WARRANTY DEED REGISTER OF DEEDS
Ua:unanl �umhcr ST. CROIX Co.. YI
This Deed, made between Rrandon M. Sc hmidt, a s ing)_ p erson RECEIVED FOR RECORD
and Nanc • W Moy, a sin person JO -19 -2002 8:30 AN
_. - - -- -' 4AR"Tr DEED
......... _. EXEWT t
Granter, and Dlakc liufldcrs, Inc., a Minneso Corpor aflott
- ---` -' - - - -' REC FEE: 11.00
— ..--- ...._..._..___ —,- TRANS FEE: 129.60
...... COPY --- - - - -- .... COPY FEE:
CERT COPY FEET
Grantee.
— - PAGES: 1
Grantor, for a valuable consideration, conveys io Grantee the
R,tlawing des real estate in St. Cruix County,
State or W isconsin (if more space is needed, please attach addendum):
Recording Area
Nam- and Return Address
0Lo; 2, I'lat of C entry Wood in the 'ruwn of Troy, St. Cruix Couutp,
1Viscur_sin.
WO-123 r -2U _
Parcel Identi6catiwt Number (PIN)
This is nnl hnaesteml property.
%) (is flat)
Exceptions to warranties: Easements, restrictions and rights -of -way of record, if any.
Dated this day of October 2002
Brnndon M. Schmidt
AUTHENTICATION AC KNOW LEUGME T
Signawrets) S' ' OF WISCONSIN 1
-- ) Ss.
County )
iftuhcMiccacd thiS - day of
-- Pc(sonuliy cane before one this Iluy of
October 2002 the above named
Itrandon M. Schmidt, a sinyln ) xr%on rnd Nancy WaI Mny, a —
TfTLE: MEMBER STATE BAR Oh WISCONSIN
(11'not• u, wn tub the per (s) tuba executed the foregoing
. —_ i st u ) t n Ic tl anc.
aud:nrized by § 706.06, Wis. SLnIS.)
'THIS rNSTRUMENT WAS DRAT -11 [IV
�uurne Kristine O gland - - +_ Not try 1'ub i . State of Wisconsin
f udson _t .__ , _ My Comm. siou is j quill � n (11'not, state expirut ion dutc:
(Signatures mar he authenticated or uckauwledgcd. Both ere nut nccessary .) . — •)
• Names of persons signing in any eapachy:nust be typed or prinlcd below Their sigfulnre. h'armuan, taaauiartr eonpny, F" L... VA
YFATE OAK OF WISCONSIN r "' eoaossaoz,
WARRANTY nP.EU FORM No. 2.11)99 -
,
10 -17 -02 11:16 HOLABIRD ROOT ID= P.94
� -09 Opt c Use oohs! Department of Regulation and UceneNt� LAC"" Homo Realty :F
1.1-00 (Mandabry Use Date)
WW-13 VACANT LAND O FEER TO PURCHASE Pass 1 of 5
t BROKER DRAFrd% THIS OFFER ON os/ge/2ooi IDA74 M OGEM OF SE (AGENT OF i8tnr6Tf) � s+arrm ciao
2 1)te sayer, Z.
3 01111amtopumhase fri mpody krwm 8s s wd Addreaej t ct 2 C tzvlmgd. Budsoa 54
4 into Town Hudson cmXdy d et:. Croix ,
5 �ARs —A 1 (Insed adclbxW de*%Vjon, I any, at Mina 179 -187 or aosdt as an Addovwdu tt,1ne IBM. on the io &** iemw
6 a PURC - NM E PRICE Porte -21mm Thousand i4ang nRta w"
7 Dallas ($ 47.900. ) .
k a EARNEST MONEY d $ goo. oo acccmp "w Fitts WA somiesk wmw d
9 will -be pdd wbl h days d aeoepWas,
m a THE BALANCE OF PURCHASE PRICE will to paid in cash oregwitV** at dosing unless oflerwfae protiided below.
11 a ADDFWNAl_ ITEMS INCLUDED IN PURCHASE PRCE: Seder shat inGlyde in ft par hs" Pons and hander. 1100 and doer of
12 OrOttttt MVes, d tbdtxes, err. I at Cites 15 - 1S and as metr be an to Property on to dote d fliw Often, apses aomkgbd at line 14,
14 • TEMS ft NNOT INCLUDED IN THE PURCHASE PWCE
15 A 'Ftxtlme' Is deleted as an Item of property which is phyarcady ditched b or to cb dy associaled wits land pro as to be beaded as part
1s of fhb Feat 6010101, inducing, willoA writelim, pttyeia * ailaotted dents not 6esiy removable wIthotlt deln0ge to ltte pmpxv, %ems
17 spedrw* adepw to I* pmpoay, and items aabmm* boated as 6&m mkldrtg but not rented b aft pe @mW aaK garden
10 boos; plants; *mbs and tees. CAUTION; Annual rxops are rat mduded in the purdtan price wim ofltelwiss ogneed at be 13.
19 ■ ZONING rapre w& that the Property is gonad
20 L,A92 L Adoepfara0 owum when ail 13tNm and Sellers too signsd an identical copy of ft Oiler, scald tg mpnakm on
21 but idp wral c0a of ft 01Jier. CAUIfOM Dommilo w iN die OW an hpafdar .
22 drat *M dear0raas rarrn Iran aocep1411ncer provide 8164=6 iiFnn� clod ed N am pkim Ca
bkft aooapowe and peldanAmim
23 1 mmm migz2m This Oiler W ttm tg tapm bolt Parbe only i a Dopy of the evoepled 0lfer is delivered b &w an or
24 016 �•• S 2001 C'Jt11ff�0lik 1ft 1316 RMy be nafytdn8m prior to detrary Of Om saaspisd doer:
25 8 (lr> w Odterwn staled 111 ft Offer delivery d dOCtlta16nts and wntlen nOfCes
a to a Party shop be effective arty rFFtert aDOOOrrpNsFted by one d d rrlelads speoifed at rmes 27 - 38. =
v (1) By depDSidng fa document or wriflert police posfape at fees prepaid In the US _ Masi or fees prepaid or dwrged b an acmA with
201 a cmvrwdal deptrary service. addressed sifter to fie Party, or b Ute Party's 10ap W for delivery dettpnabd at rmas 30 or 32 (1 airy),
29 for dermy to the Part' darmy atdtii m d fines 31 or 33.
30 SelWs recoW for delivery (opdortal):
31 Sellars d*my addrose: Cg idgen Banker BUMat
32 &*Ws fe*wt for d" (apftW):
33 GuvWs d*4wy address: S73 Qg=W Road A - Audsoe► WX 54016
34 (2) By giving the doa na t or wnffert hobos peraanally to to Paty Or ft Patt)I's reapiertt for del my if an frdividud i8 designaled at scree 30 or 32. 1 `
35 (3) BY fax trartsmiwjm of Ow doauraent or widen ndice b Sae fdk w q teiephart0 mater:
337 Brayer WL Y ) 381 -6541 Sew. ( 710 ??
occupancy d the er►t[n► Property strap be gtarert b Buyer d tittle of ta>tess abee provided n this Offer (Imes
38 1 M - Iff or In an adderdwsn pet irte 188). Ooaxrparwy shall be fm sL*d to to mfe " , l eny. Calffa , Coinider as sp mrwA
wh ich addresea res nsrbUly far clearing dm Property of pmmd pro"and debris, d apps &
4D ASa s
LE If PropwW is Y leased and leases) extend beyond closing, - Se dWI assign Seileha rights wider said
4 leases) and tansler d a ► deposits and prepaid rends twounder b Buyer at dosing. The terms d lr0 (wn ban) (crap sTRr1cE oNE. i
42 kmot s k i1 Kh
43 LBLACE OP cios DO kxwacbm f5 to to dosed at to place despnaled by Mayers na tpapee or Lacaaae ao®ea Raalbt, me
4 4 no later Ihan July 9 , 2001 wjww annew do OF is agt'oed to in wfhtlf.
j 45 Tire following items shah be ponied at dosing: reef estate taxes, rents, p wmo and m ncipd drones,
t 46 Property ~3 assaca km assenffw a, fuel and
47 Arty noodle, tones or 9*ms66 t;hafl a xm b Seger, and be prorated, 160* the day Pw b dig•
48 Net gametal real estate taxes shag be prorated breed on (the net general neat estate Ism tar the Docent year, d known, dterwrse on
49 the stet gwwW real estab Was for the preoerirtp year) (
50 ). LETE AS APPUCABLE
51 NUTIOM N p mdw on lire basis of Flat gtena W Mal esI auras h not sooephba frW erampirt, ooArpbted�pend1119► i
52 1 ftmVq a* aft Win 1.ra t , man ecdmW ammm flax or ~!ocarina for proration.
• 54 a PRO a
s ATiONS: Seder repreeertu to Buyer fNat as of the dale of aceeplonoo Seger has no nonce 1
I 65 or WS d condtions d(actirp fte property or (nee below) oihar fawn those idertfified fn Seders iced Estala Cartdban
y 56 Report dated , vnhiCtt by Stayer pier tD 57 rence COMPL E DA OR STRIKE AS AP � was=
E end
1 T T DY tNGLUDED IN THE CONDI w10N REPORT
LaCasw Heron Rml/y 573 Canty Road A. Hudron W154016.7007
Pkonc:(715) 381.0405 Fax: (715)381-W41 Jw*w Howard T46687D4.Zn
PIOLireu!% ft ZW- wm- byREFonrL! U .0 IS= FAwmMssRoadGb*wTwoft.Vidigm OM, 00a3R►MS
j Vs ° ;consin Department of Industry,
Labor and Human relations SOIL AND SITE EVALUATION REPORT , e 1 of 3
Division of Safety & Buildings in accord with ILHR 83.05, Wis. Adm. Code
' COU
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 % of slope, scale or PPt6VL I.D. # RtWVEU
dimensioned, north arrow, and location and distance to nearest road. / n e
APPLICANT INFORMATION - PLEASE PRINT ALL INFORMATION �U fJl AT fa
PROPERTY OWNER: PROPERTY LOCATION
Richard Stout GOVT. LOT NE 1/4 SE v4, r)W
PROPERTY OWNER' MAILING ADDRESS BLOCK # SUBD. NAME 0
1353 Awatukee Trl. 7 kr-,;JfT4r t..
CITY, STATE ZIP CODE PHONE NUMBE ]VILLAGE OWN NEA REST ROAD
Hudson Wi . 5 16 ( 1 Tower Rd..
[ )q New Construction Use [Xj Residential /Number of bedrooms 3 [ j Addition to existing building
] Replacement [ ] Public or commercial describe —
Code derived daily flow 450 gpd Recommended design loading rate • 4 bed, gpd/ft2 . 5 trench, gpd/ft
Absorption area required 375 bed, ft 375 trench, ft Maximum design loading rate .4 bed, gpolft .5 trench, gpd/tt
Recommended infiltration surface elevation(s) 96.2 ft (as referred to site plan benchmark)
Additional design 1 site considerations sytem el . based on contour line of e14 95.2'
Parent material limestone uplands Flood plain elevation, if applicable na ft
S = Suitable for system CONVENTIONAL I MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM IN FILL HOLDING TANK
U = Unsuitable fors stem ❑ S :06 ®S 1:1 U ❑ S ®U ❑ S ®U EIS ®U ❑ S ® U
SOIL DESCRIPTION REPORT
Boring # Horizon Depth Dominant Color motheS Texture Structure Consistence Boundary Roots GPD /ft
in. Munsell Gu. Sz. Cont. Color Gr. Sz. Sh. Bed 1Trench
1 0 -10 10 r4 3 none 1 2msbk mfr aw l f .5 .6
2 10 -18 10 r4/4 none scl 2msbk mfr qw if .4 .5
Ground 3 1 18-25 7.5yr4/4 none scl 2mgr mvfr gw na .4 .5
elev. 5yr5/2
96.3 ft. 4 25 -55 7.5yr4/4 c2p5yr5 /6 scl lmsbk mfr na na .2 1.3
Depth to
limiting
factor
25"
Remarks:
Boring #
1 1 0-11 10 r4/3 none 1 2msbk mfr qw 2f .5 .6
2 1 11-25 10yr4 /4 none sicl 2msbk mfr 9w if .4 .5
Ground 3 25 -39 7.5yr4/4 none scl I 2msbk mfr qw na .4 .5
96 elev. ft 4 39 -55 2.5y5/6 none cl m na na na n n
W /Lim stone Particles
Depth to
limiting
itot
Remarks:
CST Name: — Please Print Gary L. Steel Phone. 715 246 - 6200
ress: 1554 20,0th. Ave. New -R' chmond Wi . 54017
Signature: cl a: CST Number.
a' 0 -29 -95
A
PROPERTY OWNER Richard Stout SOIL DESCRIPTION REPORT p of 3
PARCEL I.D. u pending
Boring # Horizon Depth Dominant Color Mottles (Texture I Structure Consistence Bwxlary i Roots GPD /ft
in. Munsell Qu. Sz. Cont Color I Gr. Sz. Sh. i Bed iTw&
3 1 0 -10 10 r4/3 none 1 2msbk mfr aw 2f .5 .6
2 10 -24 10 r4/4 none sici 2msbk mfr crw if .41 .5
Ground 3 24 -31 7.5 r4 4 none scl 2msbk mfr aw na .4 .5
elev.
93 ft. 4 31 -55 2.5y5/6 none ci W Fractu ed Lime one
Depth to
limiting
factor
31"
Remarks:
Boring #
Ground
elev.
ft.
Depth to
limiting
factor
Remarks:
Boring #
Ground
el ev.
ft.
Depth to
limiting
factor
Remarks:
Boring #
Ground
elev.
ft. �
Depth to
limiting
factor
Remarks:
SBD- 8330(R.05/92)
' 4
STEEL'S SOIL SERVICE
Gary L. Steel Richard Stout 1554 200th Ave.
CSTM2298 NE 4SE a S3 T28N - R19W New Richmond, WI 54017
MPRSW 3254 town of Troy (715) 246 -6200
lot #71- Country Wood
K(w °�...
N
1 " =40'
BM.= top of 1 steel pipe C el. 100'
Alt. BM.= top of 1 steel marker pipe C el. 102.4'
N
My u r y D ` E A
Gary L. Steel
10 -29 -95
00
589°41'26 "W 289.55'
LOT Lu ���,.�� Lu
P
uti z
Z
r
If A
l ei I
I
_ ' � 192 ��► �„r,�---- .-��
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W , r
CURVE DATA TABLE (ALL LENGTHS ARE IN FEET)
Curve Radius Central Chord Chord Arc Tangent 8eatinge
Number Length Angle Bearing Length Length Tangent in Tangent out
C1 267.00 15 S08 08'47 "E 74.15 74.39 S0009'53 "E S16'0 -'41 "E
C2 433.00 19 1471 149.69 150.45 N6105'27 "E N80 "E Z
J
I, Douglas J. Zahler, Registered Wisconsin Land Surveyor, hereby certify that this Stake -out Plan was a t....
prepared under my direct supervision and is correct to the best of my knowledge and belief. 0 G
O
' W
LOT 2
in
Y
112,558 SQ FT 15 f
rC3
?O �
Q DENOTES IRON PIPE FOUND M U
x DENOTES WOOD STAKE SET 2VAM N
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