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6yQ• /235 • So - OtSb EXCAVATING 26.'i couniry ROAD ss RIVER 0-M=, wr 715-425-6200 715.425•8166 FAX _ x r" r 04/10/2014 St. Croix County Zoning PFcmwr 1101 Carmichael Road APR 112014 Hudson, WI 54016 Re: POWTS/ATU Yearly inspection and mamtmceouNi Property Owner; Brian Schwab 531 Gilbert Rd Hudson WI 54016 Remediator Serial#KY00903 Date of Installation 5/19/08 State Sanitary Permit# 514876 Date of 1 year Inspection 9/10/09 Date of 2 year Inspection 10/22/2010 Date of 3 year Inspection 12/1/2011 Date of 4 year Inspection 11/3/2012 Date of 5 year Inspection 04/10/2014 delayed due to extreme cold&deep frost Inspected unit in Feb 2014, Found Air pump line frozen by condensate. Delayed Catalyst replacement until Spring thaw. Septic tank/ATU unit was inspected on 04/10/2014. Effluent Filter cleaned ATU Bacteria Catalyst Replaced ATU was working correctly Septic Tank Sludge less than 4".No scum POWTS appeared to be in good condition with no surface discharge of sewage or effluents. Mike Rodewald MPRS 931384 3, Z, r EXCAVATING 285 COUNTY ROAD SS Po 044 18M 5 715- 425 -5200 v t 800- 828 -3723 715- 4254MM FAX 12/6/2010 St. Croix County Zoning 1101 Carmichael Road Hudson, WI 54016 Re: POWTS /ATU Yearly inspection and maintince [{�� Property Owner; Brian Schwab 531 Gilbert Rd S j Hudson WI 540164 R& ZpNQNG o F�cE PLAN Remediator Serial #KY00903 Date of Installation 5/19/08 State Sanitary Permit # 514876 Date of 1 year Inspection 9/10/09 Date of 2 year Inspection 10 /22/2010 Septic tank /ATU unit was inspected on 10/22/2010. Effluent Filter cleaned ATU Bacteria Catalyst Replaced ATU was working correctly s e p � Septic Tank Sludge /Scum less than 2" � t frt ** *Septic tank was pumped this Summer * ** POWTS appeared to be in good condition with no surface discharge of sewage or effluents. Mike Rodewald MPRS 931384 i EXCAVATING 285 COUNTY ROAD SS R ► 2I "" 54� 715- 425 -6260 715 - 425-8466 FAX r � ff s r 9/21//2009 St. Croix County Zoning 1101 Carmichael Road Hudson, WI 54016 RECEIVED Re: POWTS /ATU Yearly inspection and maintince SEP 2 8 2009 Property Owner; Brian Schwab 531 Gilbert Rd PANNING a ZONING OFFIu- Hudson WI 54016 Remediator Serial #KY00903 Date of Installation 5/19/08 State Sanitary Permit # 514876 Date of 1 year Inspection 9/10/09 Septic tank /ATU unit was inspected on 9/10/09. Effluent Filter cleaned ATU Bacteria Catalyst Replaced ATU was working correctly Septic Tank Sludge /Scum less than 2" POWTS appeared to be in good condition with no surface discharge of sewage or effluents. 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C j � Z 0 A N cn N d CD A x 3 C2 ' O CD O w � q m cz i A O .7 N ti O (D ~ � Q. ^� i Wisconsin Department of Com#nerce , PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 514876 0 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: City Village X Township Parcel Tax No: Schwab, Brian I Troy, Town of 040 - 1235 -80 -000 CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range /Map No: 03.28.19.1184 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic , Benchmark Dosing Alt. BM -• r'.. ` Aeration y Bldg. Sewer Holding St/Ht Inlet SUHt Outlet TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic Dt Bottom Dosing Header /Man. Aeration 1 Dist. Pipe Holding Bot. System Final Grade PUMP /SIPHON INFORMATION Manufacturer Demand St Cover GPM Model Number TDH Lift Friction Loss System Head TDH Ft Forcemain Length Dia. Dist. to Well SOIL ABSORPTION SYSTEM BEDITRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS SETBACK SYSTEM TO a P/L BLDG WELL LAKE /STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR Type Of System: l UNIT Model Number: DISTRIBUTION SYSTEM Header /Manifold Distribution x Hole Size I x Hole Spacing Vent to Air Intake Pipes) Length Dia Length Dia Spacing SOIL COVER , x , ~� , ._.,c_,x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over epth Over xx Depth of xx Seeded /Sodded xx Mulched Bed/Trench Center Bed /Trench Edges Topsoil Yes E No 0 Yes Ej No COMMENTS: (Include code discrepencies persons present, etc.) Inspection #1: / / Inspection #2: / / Location: 531 Gilbert Road Hudson, WI 54016 (SE 1/4 SW 1/4 3 T28N R19W) Country Wood 1st Add Lot 47 Parcel No: 03.28.19.1184 1.) Alt BM Description = �-!° �:._ f,� ►...:�, :_ � �+ . - � °, ,._.� ', - Y ' 3 `�;� t<�.�; 2.) Bldg sewer length - amount of cover J tti Plan revision Required? [ Yes 1No d 1 1 /Y� Use other side for additional information. � � 00 SBD - 6710 (R.3l97) Date Insepct 's Sign rce Cert. No. ccmnwtrOe.wl.9ov Safety and Buildings Division County 201 W. Washington Ave., P O. Box 7162 S � , C tc a F a ft - wt of r sco nsin . Madison, WI 5370 2 itary Permit Number (to be fitted in by Co.) Sanitary Permit Application State Transact In accordance with s. Comm 83.21(2), Wis. Adm. Code, submission of ' tat / v J•T' unit is required prior to� obtaining a sanitary permit. Note: Applica fo� �WT are Project Address (if different than mailing address) rt submitted to the t of Commerce. Personal information p u ro ses in accordance with the Privacy Law, s. 15. l m , Stats. I. Application Information - Please Print nformation Property Owner's Name / Parcel # p Sc / wo, T. CR IX 0 - 1�3 — 80 - 000 Property O wner's �Mailing Address ZONING OFFICE Property Location �, , /o4 53 1 \ 6 / l C r D Govt. Lot O J City, State Zip Code Phone Number C /. , , c /. , , Section 2 � / J a D S O AJ �/(� S �U � �o �5 � J�l ` 9 cucle one) II. Type of Building (check all that apply) a Lot # T 4 N; R Eor� $1 or 2 Family Dwelling - Number of Bedrooms G / 7 Subdivision Name n Block # tr WO.-J ❑ PublidCotnmential - Describe Use J w. • i-, ❑ City of 0 State Owned - Describe Use CSM Number ❑ Village of Town of T"R 1IL Type of Permit: (Check only one bog online A. Complete tine B if applicable) A. ❑ New S stem 0 Replacement System en o lacement Onl r Modification to Exis Y eP Y Y ring System ) A;s B. 0 Permit Renewal 0 Permit Revision eiinit Transfer to New Before Expiration Owner IV. Type of POWTS 5 stem/Com onent/Device: Check all that apply) 0 Non - Pressurized ln- Ground g Pressurized In- Ground 0 At -Grade 0 Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil 0 Holding Tank 0 Other Dispersal Component (explain) 0 Pretreatment Device (explain) V. Dis ersallTren t Area Information: Design Flow (gpd) Design Soil Application Rate(gpdsf) ispersal Area Required (sf) Dispersal Area Frepeee4(sf) System Elevation 0� Q . to /000 /DOU Elevation 99.53 VI. Tank Info Capacity in Total # of Manufacturer Gallons Gallons Units o d v New Tanks Existing Tanks '; v a U rn M iw c7 a, Septic or holding Tank q 120 / z oo l �Tv a r,� reCooj Cbamber g Poo 8o U I x VII. Responsibility Statement I, the undersigned, a ssume responsibility loy installation of the PONM shown on the attacbed plans. Phunber's Name (Print) Plumber's Si umber Business phone Number M tiger R jewil D 1 13 13 9 q � �s - yzs - zoo Plumber's Address (Street, City, State, Zip Code) 6 cS Co R b SS 12(u etz G# ( 6 i-✓z� aLZ VIIL Vovra artment Use On pproved I 0 Disapproved F ermit Fee Date ssued Issuing ent ture ❑ Owner Given Reason for Deni � 50 IX. Condi§ ?Reasons for Disapproval 1. Septic tank, effluent fifter and �`� der °h '� "��"- Go,nv►ec, ar dispersal cell must all be services / maintained �i ,�,; b� G�ti�,,�. h a ► AX4,k 14k- as per management plan provided by plumber. 2. AN setback requirements must be maintained /1 q trade / ordininces. 7 f'f �'� Yd�� � 7 Z Attach to complate plans for the system aid - subralt to the Co on paper no less than 8 r2 111 Inches in sin SBD -6398 (R. 01/07) Valid thru 01/09 , Ccr°� 3i &Aefr 09b f wooA tee -V7 Zj t A, TOP 494--f- D rL = JA^ ! i /o y, 83 i ,qo' SC a I e „ ` Al. - - - / T.O of Veti� /Zoo v Z'� FiM oNf Cow►' o� t- Fro#K T *NK i �V��,� ti F;P �6ois. N�� Y 8Z 8q �n�e5c �EA i2p0 � r lcw3L A 4 w v y -, .� �f "'^ .h '� �ydc +.r W 3^.,✓�`�LL 5�titi_� ^Hiv' l , f Page Of SEPTIC TANX a'PUMP CHAMBER C: :TOSS SECTION AND SPECIFICATIONS 4 VENT PIPE 12" MIN. ABOVE Gli�,DE r; WEATHERPROOF 25' FROM DOOR, WINDOW OR JUNCTION BOX APPROVED FRESH AIR INTAK:7 T WITH CONDUIT MANHOLE COVE FINISHED GRADE— W/ PADLOCK � WARNING LABE 4" MIN. Li.v —� i INLET ' WATER T: G HT SEALS GAS- _ � TIGHT i A PPROVED A SEAL APPROVED -- ALM JOINTS WITH PIPE B APPROVED PIPE ' ON 3' ONTO ,h -- — - -- ' , SOLID SOIL �C' biA o _ C 6f4 I l & OFF RISER EXI D PERMITTED ON IF TANK MANUFACTURER 3" APPROVED BEDDING UNDER TANK HAS APPROVAL CONCRETE PAD // SPECIFI( " ATIONS SEPTIC / DOSE / TANK MANUFACTURER: „ !/j��WPsf�i</ � NUMBER DOSES PER DAY: ) J TANK SIZES SEPTIC /"0 GAL. DOSE VOLUME INCLUDING �— DOSE GAL, FLOWBACK: �_ GAL. ALARM MANUFACTURER: NG /Fiyokl,J CAPACITIES: A = ���� ' ,,C �INCHES = MODEL NUMBER: _ w ; ( Exa }:h sWfj�� r�o7 __,4 ( 6)(7 GAL SWITCH TYPE: Sit 4?cAsL 16 INCHES = Be ` m /p �� A,Z B = 2 78� 8 GAL PUMP MANUFACTURER : �_Vd v k) C. C = INCHES = I 0 9 � g GAL MODEL NUMBER: &eeo SWITCH TYPE: - pi oor 6 -� -Ae-ce tfolAs D = INCHES = 2 •# GAL REQUIRED DISCHARGE RATE — GPM PUMP E ALARM WIRING AS PER ILHR 16.23 WA( VERTICAL DIFFERENCE BETWEEN PUMP OFF AMID DISTRIBUTION PIPE . FEET + MINIMUM NETWORK SUPPLY PRESSURE + - 70 FEET FORCEMAIN X /,3 FT /100 FT. FRICTION FACTOR., FEE"' O. /7 FEET TOTAL DYNAMIC HEAD = S. 9 7 FEET INTERNAL - DIMENSIONS OF PUMP "TANK :LENC TH. w WIDTH 7 , DIAMETER I,IQt; ID lfiA" ..,. r}NC "fi F yyk- 'l2'zt CE n' ' .l 3 AMOK SAFETY AND BUILDINGS DIVISION Plumbing Product Review P.O. Box 2658 �' Madison, Wisconsin 53701 -2658 tric sconsi n e partment of commerce Jim Doyle, Governor Mary P. Burke, Secretary June 22, 2007 ,J 76 rs INFILTRATOR SYSTEMS INC. DAVID LENTZ 6 BUSINESS PARK RD. PO BOX 768 OLD SAYBROOK CT 06475 Re: Description: CHEMICAL OR PHYSICAL RESTORATION FOR POWTS Manufacturer: INFILTRATOR SYSTEMS INC. Product Name: REMEDIATOR Model Number(s): REMEDIATOR Product File No: 20070262 The specifications and /or plans for this plumbing product have been reviewed and determined to be in compliance with chapters Comm 82 through 84, Wisconsin Administrative Code, and Chapters 145 and 160, Wisconsin Statutes. The Department hereby issues an approval based on the Wisconsin Statutes and the Wisconsin Administrative Code. This approval is valid until the end of June 2012. This approval is contingent upon compliance with the following stipulation(s): • This product must be utilized in accordance with the manufacturer's printed installation instructions and this product approval. If there is a conflict between the manufacturer's installation instructions and the product approval, the product approval requirements will take precedence. • The elevation of the system's infiltrative surface must be above the estimated highest groundwater elevation or bedrock by the distance prescribed in column entitled "Fecal Coliform >10000 cfu /100 ml" in Table Comm 83.44- 3, W is. Adm. Code. • A copy of this approval letter and the manufacturer's printed installation instructions must be supplied to the buyer of this product. • The outlet baffle of the septic tank, which has this product installed, must have installed an effluent filter capable of filtering particles of 1/8 inch in size or larger. • This product must be installed by a properly licensed plumber. + A state Sanitary Permit must be obtained when this product is installed. • This product must be maintained at least annually. The department is in no way endorsing this product or any advertising, and is not responsible for any situation which may result from its use. Sincerely, Michael J. Beckwith, CIPE Plumbing Product Reviewer phone: 608-266-6742 fax: 608 -267 -9566 e -mail: mike. beckwith@wisconsin.gov SBD- 10564E (N.10/97) File Ref: 07026201.DOC Infiltrator Systems - wastewater, stormwater, septic Page 1 of 2 �N The Aquaworx Remediator is a simple, easy to install septic system remediation technology that renovates failing septic systems with minimal landscape disruption. This unique system is inserted into an existing septic tank of a malfunctioning system and reverses the drainfield clogging process. It is a permanent solution that requires minimal cost too Aquaworx Remediator operate and maintain. The A p q 5., was formerly marketed as the Pirana Aerobic Bacterial Generator by Piranaco. The Aquaworx Remediator is an airlift column. Cuspated plastic is F wrapped around the bottom outside of the unit and placed within and above the bubble diffuser within the unit. The cuspated plastic provides a substantial surface area for colonization of the introduced Click for larger image w bacteria. The Aquaworx Remediator aerates and circulates effluent within a septic tank for the express purpose of generating an active culture of the introduced bacteria. These bacteria create an aerobic 1. r environment within the unit and provide predicable disposal field remediation. The Aquaworx Remediator is not an Advanced Treatment unit and is certified by the Uniform Plumbing Code. The Aquaworx Remediator improves the performance ` of a � biologically clogged failing septic system by enhancing the natural treatment Click for larger image process. The unit works by introducing oxygen and bacteria which work together to reverse the clogging process. Under normal operation, a septic system will build up a biological slime (biomat) inhibiting the soils natural ability to absorb water. A healthy population of oxygen rich bacteria consumes the slime that has built up over time. The Aquaworx Remediator creates an ideal environment for this process to take place. Oxygen is added to the system by a small air pump. The unit serves as a medium through which wastewater can circulate and come in contact with the oxygen rich bacteria. Along with the addition of oxygen the Aquaworx Remediator has a bacterial catalyst inserted into the center of the unit to kick off the remediation process. The bacterial catalyst is a proprietary blend of facultative aerobic bacteria that accelerate the consumption of clogging matter. The oxygen rich wastewater first works to consume the waste materials built up in the tank and then moves out to the drainfield where it continues to consume the wastes there. It is expected that under normal conditions a homeowner will begin to see improvement in their septic system within the first couple of weeks. Benefits include: • Eliminates the need for a complete drainfield replacement http:// www. infiltratorsystems .com/aquaworx/remediator.htm 4/8/2008 Infiltrator Systems - wastewater, stormwater, septic Page 2 of 2 and the resulting landscape damage caused by heavy equipment. • Performance problems associated with a failing septic system such as odors and wet areas in the yard are eliminated in as little as two weeks. • Environmental solution that strengthens the natural process of wastewater treatment and groundwater recharge • Easy installation with no heavy equipment allows for minimal disruption and a quick return on investment. • Permanent solution that requires minimal cost to operate and maintain. Aquaworx Remediator specifications: Column diameter at top 12" Column diameter at base 15" Total height 36" Weight 38 Ibs Flow Rate 600 GPD / 4 bedroom house For more detailed product information and installation instructions, visit our Downloads page. Aquaworx 877 - 326 -4746 by Infiltrator Systems Inc. Fax: 860 - 577 -7001 P.O. Box 768 Email: info @infiltratorsystemscom Old Saybrook, CT 06475 U.S.A. http:// www. infiltratorsystems .com/aquaworx/remediator.htm 4/8/2008 08/24/05 WED 08:12 FAX 715 386 4686 Q001 ST. CROIX COUNTY SEPTTC TANK. MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer Mailing Address Property Address (Verification required from Planning & Zoning Department for new construction.) City /State �Al Sd r✓ Parcel Identification Number. LEGAL DESCR><PTION Property Location' /o , 5 I V,, Sec. 3 , '1, W-N R I-EW, Town of I w o `l Subdivision 0 , Lot # _4/ Certified Survey Map # , Volume .Page #f Warranty Deed # Volullae _ Page # Spec house yes no Lot lines identifiable yes no SYSTEM MAINTENANCE AND OWNER CERTIFICATION Improper use and ma. inteiiance of your septic system could result in its premature failure to handle wastes. .Proper maintenance consists of purnping out th.e scptic rank every three years or sooner, if needed, by a licensed. pumper. What you put into the system can affect the function of the scptic tank as a treatment stage in the waste disposal system, Owner maintenance responsibilities are specified in §Comm, 83.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance. The property owner agrees to submit to St. Croix County Planning & Zoning Dcpartmcut a certification forma, signed by tine owner and by a mastet plumber, 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. 1/we, the undersigned have read the above requirements and agree to inaintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Corrurterce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic systein has been maintained must be completed and returned to the St. Croix County Planning & Zoning Department within 30 days of the three year expiration date. 11 e certify that all statements on this form are true to the best of my /our knowledge. T /we anVare the owners) of the prop cribed above, by virtue of a warranty deed recorded in Register of 1)eeds Office. SIGNATURE OF APPLTCANT DATE * *" Any inforniation that is illisrepresented may result in the sanitary permit being revoked by the Planning & Zoning Department.* ** Include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if reference is made in the warranty deed. (RF,V. 0810 op I II111f fl {{{ 11111 illll 11111 IIIII IIII 111111 IIII it *87492 0 II 874990 1 Document Number Document Title KATHLEEN H. WALSH REGISTER OF DEEDS St. Croix County ST. CROIX CO., WI AEROBIC TREATMENT UNIT (ATU) RECEIVED FOR RECORD 05/16/2008 09:00AM SERVICING AGREEMENT AGREEMENT EXEMPT 0 State Plan Transaction Number - REC FEE: 11.00 COPY FEE: 2.00 &AN PAGES : 1 Name - (Owner) Typed or printed Being duly sworn, states, under oath, that: 1. He /she is the owner /part owner of the following parcel of land located in St. Croix County, Wisconsin, recorded in Volume i5 Page '"' 3 5 Document Number 634a8 7 St. Croix County Register of Deeds Office Recording Area A parcel of land located in the S E_ r V 4 of the .5& ) Y4 of Section Name and Returg Address T Z6 - R __/7 W, Town of B R/ I �� , St. Croix County, Wisconsin, being Hvdsa�, duly desa abed as follows (include lot no. and subdivision/CSM or detailed legal description): �' c f V7 C o u t Pj U © - Z_ - �� ' Parcel Identification Number (PIN) Agreement Date: 4rn /L � ' Av As an inducement to the county to issue a sanitary permit for a POWTS equipped with an Aerobic Treatment Unit on the above - described property, we agree to do the following: 1. Owner agrees to conform to all applicable requirements of Comm 83, Wis. Adm. Code relating to Aerobic Treatment Units (ATU) and the maintenance requirements for the proposed POWTS (Private Onsite Wastewater Treatment System) technology. If the owner fails to have the POWTS and ATU properly serviced in response to orders issued by the governmental unit or the Department of Commerce to prevent or abate a human health hazard as described in s. 254.59, Stats., the governmental unit (Town) may enter upon the property and service the tank or cause to have the tank to be serviced and charge the owner by placing the charges on the tax bill as a special assessment for current ` services rendered. The charges will be assessed as prescribed by s. 66.0703, Stats. 2. The owner agrees to maintain a contract with a licensed POWTS maintainer for the life of the system. The POWTS maintainer will perform periodic Inspections and maintenance as required by the manufacturer and the Department, including, but not limited to: the blower, electrical controls, and treatment unit operation and sludge depth. These inspections are to be scheduled every 6 months for the first two years of operation and yearly thereafter. 3. The owner agrees to contact the POWTS maintainer Immediately upon any malfunction of the treatment unit and to maintain the unit so as to not create a human health hazard as described in s. 254.59, Stats. 4. The owner recognizes that the county, Department of Commerce, or POWTS maintainer may make periodic inspections of the components to complete performance monitoring of the unit. 5. The owner or the owner's agent agrees to report to the department or designated agent at the completion of each inspection, maintenance or servicing event in a manner specified by the department or designated agent within 10 business days from the date of inspection, maintenance or servicing. 6. This agreement will remain in effect only until the county office responsible for the regulation of POWTS certifies that the aerobic treatment unit no longer serves the property. In addition, this agreement may be cancelled by executing and recording said certification with reference to this agreement In such manner which will permit the existence of the certification to be determined by reference to the property. 7. This agreement shall be binding upon the owner, the heirs of the owner, and assignees of the owner. The owner shall submit this agreement to the Register of Deeds, and the agreement shall be recorded in a manner that will permit the existence of the agreement to be determined by reference to the property where the Aerobic Treatment Unit is Installed. Owners) Name(s) - Please Print Subscribed and sworn to before me on this date: No rf �,Zlog �,Uwms /Z e Owners Slgnature(s) Notary Public i Go ernmental Unit Official Name, Tkle - Please Print ommission Expires A t zr� w gvINIJ - zo114ii,.&.. - SF1 Ai_t5r vernmentai nit Official Sigrt�alure Drafted by: n ID Personal inform tion you provide may be used for secondary purposes (Privacy Law s. 15.04(1)(m)1 ��CMh�p its! CO1NM*91%ft 1 "THIS PAGE IS PART OF THIS LEGAL DOCUMENT — DO NOT REMOVE" This information must be completed by submitter document title. name & return address and PIN (if required). Other information such as the granting clauses, legal description, etc. may be placed on this first page of the document or may be placed on additional pages of the document. big& Use of this cover page adds one page to your document and $2.00 to the recording fee Wisconsin Statutes, 59.517. i EXCAVATING RIPER FS M COUNTY ROAD SS AN 54022 800 828 - 3723 715-425 �• � � �� 71&4M-W FAX 2 Year Service Agreement Aquaworx Remediator System This service agreement (the "Agreement" is dated ,20� between Bettendorf Excavating (service provider) and Brian Schwab (Owners). THE PARTIES AGREE AS FOLLOWS: 1) SERVICES: Bettendorf Excavating shall provide the minimum services outlined in the Maintenance Schedule below. Bettendorf Excavating shall provide all labor, transportation and equipment needed to properly inspect and service the Aquaworx Remediator system. 2) REPLACEMENT OF COMPONENTS: Bettendorf Excavating will replace worn / non - functional parts and components at the Owner's expense. Such items may include but not be limited to: air pump components, air pump, generator components, bacteria catalyst, riser, riser lid, basin, basin lid, grommets, electrical connections and rubber seals. Bettendorf Excavating shall provide the Owner with a list and cost of proposed replacement components prior to installation. 3) MAINTENCE SCHEDULE: Bettendorf Excavating shall provide a minimum of one site inspection at each of the intervals listed below: A) Start up (1 -3 weeks of the first year) — Inspection of all accessible system components for proper fit and function. Verification of solid levels and reduced odors in septic tank and visual inspection for surfacing effluent above leachfield. B) Mid Year (6- months)- Inspections of all accessible system components for fit and function. Verification of solid levels and reduced odors in septic tank and visual inspection for surfacing effluent above leachfield. Cleaning of air pump filter and inspection of basin assembly, septic tank riser, riser lid and seals. C) Year End (12- months) - Inspections of all accessible system components for fit and function. Verification of solid levels and reduced odors in septic tank and visual inspection for surfacing effluent above leachfield. Cleaning of air pump filter and inspection of basin assembly, septic tank riser, riser lid and seals. Removal and replacement of Bacterial Catalyst assembly. 4) PAYMENT: The service for the first year is included in the initial cost of the system. For each additional year the Owner shall pay Bettendorf Excavating a service fee of $120 /year for inspections. The Service Agreement may be renewed 30 days prior to end of each one -year term. 5) TERM: This service agreement shall be in effect initially for a period of two years. The Service Agreement may be renewed annually thereafter. Bettendorf E va I x.011 Y { Ulh nted Name Printed Name 6/00P s 08 Date Date I 04/16/08 WED 09:46 FAX 715 386 4686 ST CR;i, CO ZONING im 001 Wisconsln Department of Commerce Safety and Buildirigs Division PRIVATE SEWAGE: SYSTEM y GENERAL INFORMATION NSPECTION RE ount PORT St. Croix NATION (ATTACH TO PERMIT) Personal inform ation you provice m secondary Purposes [Priva< ay be used for seconds Law 15.04 Sanitary VIM tNo.: � VaDo 2tl 36IM arNlame: V , (1)( ❑ City vii i� T of: State P an ID No.: i , - J f p CST BM E ev.:•. Insp. BM Elev.: BM Description: -� Farce 235 -80 -000 TANK INFORMATION ELEVATION DATA 3. 2 g.1 TYPE MANUFACTURER ,- CAPACITY STATION BS Ht FS ELEV. Septic • 'Rre-Ca op . Benchmark (, 00 Dosing L� 05 Aeration 0 p 33 Bldg. Sewer 6•`fZ 1' Holding 99 • . r TANK SETBACK INFORMATION St /Ht Inlet r� St /Ht Outlet _ TANK TO P/ L WELL BLDG- Vent to ROAD ` Air Intake Dt Inlet Septic ' , r �.q — NA Dt Bottom p 5:33 Dosing It w / ti 3b NA Header /Man. 5- Aeration NA Holding I'�PQ `-05 Set Bot. System ti PUMP/ SIPHON INFORMATION Final Grade Manufacturer Demand cover Model Number GPM Z TDH Lift Friction S fstem TDH Ft Forcemain Length '.�j r Dia. Z rr Dist. To Well SOIL ABSORPTION SYSTEM -/ RENCN Width r LenctFy No" Of Trenches p r II No. Of Pits Inside Dia. iqw eptb SETBACK SYSTEM TO P/ L BLDG WELL LAXE /STREAM LEA anu act urer: INFORMATION Type CH system: Iotw. S r y1 r L UNIT ° e Num er: DISTRIBUTION SYSTEM Hea er /Mani old Dlstributior Pipe(s� LengthL Di _yl_" R x Ho a Size x Ho a Spacing Vent To Air tnta e Lent[ Dia. Spacing _. _ I � r SOIL COVER x Pressure Systems Only xx Mound O I J r At -Grade Systems Only Depth Over Depth Dver Bed / Trench Center xx De: , th Of xx Seeded / Soddef2 Bed / T. ench Edges Topsa 1 171 Yes COMMENTS: (Include code discrepancies, persons present, etc ) NO Location: 531 Gilbert Road, Hucson, WI 54016 S 1/4 SW 47 14 3pe on #1 / 1<{ / pp Inspection #2: --� -- t-- _ 1.) Alt BM Description = L - 2 - '� C.I.e. ow 2.) Bldg sewer length = 5 - Ipb.r , t - 99. - f8 - amount of cover = 3) tax•4Fb b• �j° 5-3 4LLeC i S a 3L 1C 53 0.,., (E.aTd f e..� S S�'•�. S� � Plan revision required? (] No Use other side for additiVni rmati on. SBD -6710 (8.3/97) "� Grs �AL!i Inspector's Signature Cert. No. r 01/A6/08 WED 08:47 FAX 715 386 4686 ST CRX CO ZONING X002 r s" and Wildings Division SANITARY PERMIT Yt.QN 2201 W. Washington Avenue _ n In accord with ILHR 83.03; Wis. Adm. Code`' - � ` • � P O OW 7302 OepattaNlit of Coaunaroa ; ,.. P . " Madison. VIII 53707-7302 • Attach complete plans (to the county copy only) for thf'.s; not lesk ` unty than 8 1/2 x 11 inches in size. + • ` ', t r e r • See reverse side for instructions for completing this a cation ` to San" Permit Number Paraonal kifont>otlori you provide may be used for secondary purposes` ' mil 4 ►4 ts p Q�� 6 acic it n� No prwion application (Privaq Law, s. 15.04 (1) (m)]. \� - � • • � �. Plan t.D. Number APPLICATION INFORMATION PLEASE PRINT AW __71--- Pr rty Owner Name 7Subdivision l station 1 i4 T.9 N, R l E (or) Property Owner's Mailing Address ber Block Number City, State Zip Code Phone Number Name or CSM Number 11 . TYPE OF BUILDING: (check one) ❑ State Owned 611r vil NaarestRoad Public 1 or 2 Family Dwelling. No. of bedrooms T '� F 111. BUILDING USE (If building type is public, check all that appl Parcel Tax Number(s) • '. 9 . 1 1 1 ❑ Apartment /Condo Is!! rd 2 ❑ Assembly Hall 6 ❑ Medical Facility/ Nursing Home 10 ❑ Outdoor Recreational Facility 3 ❑ Campground 7 ❑ Merchandise: Sales/ Repairs. 11 ❑ Restauranti8m.. /Dining 4 ❑ Church/ School 8 ❑ Mobile Home Park 12 ❑ Service Station / Car Wash S ❑ Hotel /Motel 9 ❑ Office/ Factory 13' ❑ Other: specify IV. PE PERMfr'. (Check only one box on line A. Check box online 8, if applicable) A) 1. 13 Neu 2. ❑ Replacement Sys 3, ❑ Replacement of .4. ❑ Reconnection of S . Q Repair of an m te -- - - - - -- System --- - - - - -- Tank ON Existino lystem _ _ _ ---- -- p r eviousl y - - -- Y-- ------ - - - - -- A Sanitary Permit was ExlstiltQS B) Q reviousl issued. Permit Number Date Issued - - V. TYPE OF SYSTEM .(Check only one) Non - Pressurised Distribution Pressurised Distribution Experimental oftw' 11 ❑ Seepage Bed ❑ 12 Seepage Trench 21 Mound 30 ❑Specify. Type 41 (3 Holding Tank 220 In- Ground Pressure 0 Pit Pri 13 [] Seepage Pit / / 43 ❑ Vault Privy 14 ❑System -In -Fill �� VI. ABS RPTI N SMEN INF ORMATION: 1. Gallons Per Day 2. Absorp Area 3. Absorp. Area 4. Loading Rate S. Perc. Rate 6. yssem Elev. 7. Final Grade d Required (sq. ft.) Pro (sq. ft,) (Gals/day /sq. ft.) (Min./inch) Elevation e C Feet $ t+ Feet VII. TANK in al llo l n Total 0 of INFORMATION Manufacturer's Name Prefab- site Fiber Exper. New Existing Gallons Tanks concrete ��� steel glm plastic App. T Septic Tank or Holding Tank t ❑ Lift Pump Tank Si hon Chamber Vlll. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the or*te swage system shown on the attached plans. Plumbe Name: (Print) Plumber's Signature: (No Stamps MP W No.: Business Phone Number: Plumber's Address (Street, City State, Zi Code): ` Y IX. COUNTY/ DEPARTMENT USE NLY ❑ Disapproved nitary Permit Fait (I ndminGro 1 MWwow 04telnued lssuingAgent re (No.surn") *pproved ❑ Owner Given Initial suro ww" F ew - I Adverse ermination �•� -Z ZavO X. CON ITI 0NS OF APPR VAL / REASONS FOR DISAPPR VAL- AEI. VI" [_. rs' ` — • v , Q.Q.. —v+.at'�-'.�,ll c,t-t as � ✓ GenQQ,_ f °`ice SW SM (R.1111M OIsTaWrON: Od&W 10 covey. one any Te: safely a aeadinp o6pM@,% own«. iMw6w 04!'1C /08 WED 09:48 FAX 715 386 4686 ST CR)I CO ZONING Q003 � t c .. t1 c a �,t Vi- ..1561 335 gyp' STATE BAR OF WISCONSIN FORM 3 - 1999 KATHLEEN H. WALSH Document Number QUIT CLAIM DEED REGISTER OF DEEDS ST. CROIX CO., WI This Deed, made between Brian M. Schwab, a married person RECEIVED FOR RECORD 11 -21 -2000 10:30 AM QUIT CLAIM DEED Grantor, and Brian M. Schwab and Tammi Schwab, husband and wife EXEMPT # all -- CERT COPY FEE: COPY FEE: TRANSFER FEE: -- RECORDING FEE: 10.00 PAGES: 1 Grantee. Grantor quit claims to Grantee the following described real estate in St. Croix County, State of Wisconsin (if more space is needed, please attach addendum): Recording Area Lot 47, Country Wood First Addition in the Town of Troy, St. Croix County, Name and Return Address Wisconsin. EAGLE VALLEY BANK, N.A. 1301 Coulee Rd Unit 2 Hudson, WI 54016 040.1235-00 -000 Parcel Identification Number (PIN) This is homestead property. (is) pcdw) Together with all appurtenant rights, title and interests. Dated this day of November 2000 + • rian M. Schwab AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF WISCONSIN ) ) ss. . C C d • )c County ) authenticated this day of __� •� '1 came before me this / day of —_ ' NoverAlier' y 2000 the above named S.W.b, a married person TITLE: MEMBER STATE BAR OF WISCONSIN = 5c to tr be the person(s) who executed the foregoing (If not, .^ abstitu etttsagd ack d he same. authorized by § 706.06, Wis. Stars.) ' THIS INSTRUMENT WAS DRAFTED BY �C y o✓ %E 0 Atto Kristina Ogland Notary Public, State of Wisconsin Hudson, WI 54016 My Commission s permanent. (Ifnot, state expiration date: (Signatures may be authenticated or acknowledged. Both are not necessary.) " Names of persons signing in any capacity must be typed or printed below their signature. lnf m atlon Prorescimals company, Fond du tai, WI STATE BAR OF WISCONSIN e0D655-2021 QUIT CLAIM DEED FORM No. 3 - 1999 y I ►0 , ..._ 3 „9Z - 910 ,Z9'68Z _ �99'OV - �� ,96'8 �o W ��� \ ` ` ,00' 01 v� � � _ 7g'611�- fly ,Z9'68Z M _ y � OD O N N — — — - — `�►� — p N W W LR D M N JA` LA OD A A O w N p T+ p 0 w T'• M p N -1 D W 4 n N D 74 01 ,p W Cf � V � � W N V N 270.00' 260.00 263.53 N00050'36 �W 1073.00 T RY IN r 1 � I ! o ff $ n o z v A 40 . } 4 r g, Wisconsin department of Commerce PRIVATE SEWAGE SYSTEM Safety and Buildings Division Count t' Croix INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Sanitaryigr�r}itNo.: Personal information you provice may be used for secondary purposes (Privacy Law, s.15.04 (1)(m)]. 3 O0 ��44JJ Permit Holder's Name: ❑ Cit y [] Villa e o n.of: State Plan ID No.: chwab, Brian Troy "1 ownshlp — CST BM Elev. : - Insp. BM Elev.: BM Description: t� Parce T o .�3 C 83 r cS l. PFI�. f3►M. ttS b � X 235 -80 -000 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS c 1� FS ELEV. Septic p 1 z� Benchmark 00 Dosing hj Alt. BM E ldin Bldg. Sewer St /Ht Inlet TANK SETBACK INFORMATION St/ Ht Outlet - ---- -- TANK TO P/ L WELL BLDG. AirI to ntake ROAD Dt Inlet Air I Septic t .F 2 NA Dt Bottom lQ,� Dosing `' " 35 NA Header / Man. o 4L Aeration NA Dist. Pipe 4 s 0 Holding Bot. System • C. 0 PUMP / SIPHON INFORMATION Final Grade Manufacturer Demand St cover Model Number GPM TDH Lift Friction System TDH Ft oss m ead Forcemain Length it) I Dia. t a Dist. To Well SOIL ABSORPTION SYSTEM Mt, TkENCH Width / Len th No. enches PIT No.O i Inside Dia. Liquid Depth DIM 3 DIMENSION SETBACK SYSTEM TO P / L BLDG WELL LAKE/STREAM LEACHING Manufa INFORMATION Type O /����� Q i i CHAM Mo el Number: System: (-I'rw, v OR IT DISTRIBUTION SYSTEM Header! 4 Distribution Pipe(s), << x Hole Size x Hole Spacing Vent To Air Intake ii f Length �� Dia. Length Dia. Spacing — i SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over Depth Over xx Depth Of xx Seeded/ Sodded xx Mulched Bed /Trench Center Bed /Trench Edges Topsoil ❑ Yes ❑ No ❑ Yes ❑ No COMMENTS: (Include code discrepancies, ersonspresent, etc.) Inspection #l: 4 !� / d+? Inspection #2: Location: 531 Gilbert Road, Hudson, WI 54016 (SE 1/4 SW 1/4 3 T28N R19W) - 03.28.19.1184 Countrywood Addn. I -Lot 47 1.) Alt BM Description= 2.) Bldg sewer length = " Z`�• u� "``� y - amount of cover = > L(* " 50iDe- C v,* 8� - an revision required? ;'Yes ❑ No Use other side for additional Information. SBD -6710 (R.3/97) Date Inspector's Signature Cert No. I Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Y' Count Safety and Buildings Division INSPECTION REPORT St. Croix GENERAL INFORMATION (ATTACH TO PERMIT) Sanita"161 �r�iLS2i4J No.: Personal information you provice may be used for secondary purposes [Privacy Law, 15.04 (1)(m)]. �MAP,,lBrianame: El El v ray wns�lip State Plan ID No CST BM Elev.: Insp. BM Elev.: BM Description: Parcel IaxNQ'35 -80 -000 TANK INFORMATION ELEVATION DATA J, Z?,/ % //.'/-� TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic W• k1 " PrLC0.S4 12 D Benchmark 1. os 83 q- 83 Dosing So ' � `► l • o`� 33 Aeration Bldg. Sewer (o `fZ o)q 4 ( r Holding St/ Ht Inlet IS TANK SETBACK INFORMATION St/ Ht Outlet -- rio TANK TO P/ L WELL BLDG. ,Vqe Intake ROAD Dt Inlet — ' Septic $ + 2`f I NA Dt Bottom 0. Dosing 14 " 3S r NA Header / Man. S " Aeration NA [fi� s --�j C_ 4e_ Holding Bot. System See PUMP/ SIPHON INFORMATION Final Grade Manufacturer Demand cover Z . Model Number GPM TDH Lift Friction System TDH Ft Forcemain Length -+C ' Dia. Z ° Dist. To Well SOIL ABSORPTION SYSTEM - B$B -/ RENCH Width i Length No. Of Trenches PIT No. Of Pits Inside Dia. iclui epth DIME I N -5 3 DIMENSION SETBACK SYSTEM TO P / L BLDG WELL LAKE/STREAM LEA anufacturer: INFORMATION Type O r r CH B o el Number: System: &V\\). 8 41 L UNIT DISTRIBUTION SYSTEM Header/Manifold Distribution Pipe(s; N x Hole Size I x Hole Spacing Vent To Air Intake Length N Dia. Length - 10 Dia. T Spacing � SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over Depth Over xx Depth Of xx Seeded I Sodded xx Mulched Bed /Trench Center Bed /Trench Edges Topsoil ❑ Yes ❑ No ❑ Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) Inspection #1: 06/ / ob Inspection #2: — tom Location: 531 Gilbert Road, Hudson, WI 54016 S 1/4 SW 4 3 8 47 1.) Alt BM Description= 1 S• 9 = I>� b`f'r r 6-L- q9. � 2.) Bldg sewer length = S• UL = lo o . 1 3 c C • - amount of cover = Z 0 : cl S 3 3) gll vnetr, pQ►anN. S c r 'e. 3 1�.+� ZS a 3f• x"33 o.nar. (e ��Q acev"e w� 1 1! S� Plan revision required? e ❑ No Use other side for additions, Formation. l� -�on �c cxo Inspector's Signature Cert No. SBD -6710 (R.3/97) �" "'f' SS --- Safety and Buildings Division �iSCOnS %n SANITARY PERMIT APPLIeAP0, V 201 W. Washington Avenue In accord with ILHR $3 :05, Wis. Adm. Code ' P O Box 7302 Department of Commerce ; , e Madison, WI 53707 -7302 • Attach complete plans (to the county copy only) forth - systerr>r Q er nof unty than 8 vi x 11 inches in size. • See reverse side for instructions for completing this a pllation to Sanitary Permit Number Personal information ou p rovide ma be used for seconds `'� N� �` y p y ry purposes Check it revision to previous application IPrivacy Law, s. 15.04 (1) (m)]. �C \� State Plan I.D. Number 1. APPLICATION INFORMATION -PLEASE PRINT ALL41F Pro ertyOwnerName r ^Pro a ation -5' 1/4, S3 .1 , N, R E (or) Property Owner's Mailing Address Lot Number Block Number / /D 42.arde !J , 'v c /?� 7 City, State Zip Code Phone Number Subdivision Name or CSM Number II. TYPE OF BUILDING: (check one) ❑ State Owned ❑ It Nearest Road ❑ Village Public 1 or 2 Family Dwelling- No. of bedrooms _� Town OF rs I/ t 111 BUILDING USE (If building type is public, check all that apply) Parcel Tax Number(s) 1 ❑ Apartment/ Condo Q fo- /a 6 5 - 2 ❑ Assembly Hall 6 ❑ Medical Facility/ Nursing Home 10 ❑ Outdoor Recreational Facility 3 ❑ Campground 7 ❑ Merchandise: Sales/ Repairs 11 ❑ Restaurant./ Bar/ Dining 4 ❑ Church/ School 8 ❑ Mobile Home Park 12 ❑ Service Station/ Cat- Wash 5 ❑ Hotel /Motel 9 ❑ Office/Factory 13 ❑ Other: specify IV TYPE OF PERMIT (Check only one box on line A. Check box on line B, if applicable) A) 1. to New 2. ❑ Replacement 3_ ❑ Replacement of 4_ ❑ Reconnection of 5_ ❑ Repair of an System ________Syrs _e ________ Tank Only____________ ^ _ ExistingSystem ________ Existing System B) ❑ A Sanitary Permit was previously issued. Permit Number Date Issued V. TYPE OF SYSTEM: (Check only one) Non - Pressurized Distribution Pressurized Distribution Experimental Other 11 ❑ Seepage Bed 21 ❑ Mound 30 ❑ Specify Type 41 ❑ Holding Tank 12 [R Seepage Trench 22 ❑ In- Ground Pressure 42 ❑ Pit Privy 13 ❑ Seepage Pit / / 43 ❑ Vault Privy 14 ❑ System -In -Fill r4A4 VI. ABSORPTION SYSTEM INFORMATION: 1. Gallons Per Day 2. Absorp. Area 3. Absorp. Area 4. Loading Rate 5. Perc. Rate 6. System Elev. 7. Final Grade Required (sq. ft.) Proposed (sq. ft.) (Gals/day /sq. ft.) (Min. /inch) ✓ Elevation Qdej /,d IO r s1 Feet 3 & Feet Capacit VII. TANK in Ca allo g Total # of r Prefab. Site Fiber- Exper. INFORMATION Gallons Tanks Manufacturers Name Concrete Con- Steel glass Plastic App New Exist in structed Tanks Tanks Septic Tank or Holding Tank .z .e ' ❑ ❑ ❑ ❑ ❑ Lift Pump Tank /Siphon Chamber ❑ 1 ❑ 1 ❑ I ❑ I ❑ ❑ VI11. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite s age system shown on the attached plans. Plumber's Name: (Print) Plumber's Signature: (No Stamps) MP MPRSW No.: Business Phone Number: Plumber's Address (Street, City, State, Zip Code): :7 Z IX. COUNTY / DEPARTMENT USE ONLY ❑ Disapproved S nitary Permit Fee (Includes Groundwater D ate Issued Issuing Agent Signature (No Stamps) Approved ❑ Owner Given Initial ,m Surcharge Fee) Adverse Determination r� lJ X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: w — — ,� ct Ola—C t 1 r SBD- 6398 (R.11/97) DISTRIBUTION: Original to County, One copy To: Safety & Buildings Division, Owner, Plumber r ��1 Y��L1 wI r � G/1 L(�L� -� I.d�K� L�L� ✓L � ( , Yg !`f�L9 �' L" ,�� ,._... \. �i E24G�T��,�. • I � �l r 1 i I l I i Wisconsin Department of Commerce SOIL AND SITE EVALUATION Page 1 of 3 Division of Safety and Buildings in accord with Comm 83.05, Wis. Adm. Code AC.E. Soil &S ite Evaluations Attach complete site plan on paper not less than 8' /s x 11 inches in size. Plan must County include, but not limited to: vertical and horizontal reference point (BM), direction and St. Croix percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D.# APPLICANT INFORMATION - Pt a rat# ilk �o?r�ation. 040- 1235 - 80-000 `.P viewed By Date Personal information you provide maybe used,�r �e6idi ry purposes (Pri' cy w, s. 15.04 (1) (m)). _ 2 _ ��``�� Property Owner ; , r n Property Location Brian Schwab J Govt. Lot SE 1/4 SW 1/4 S 3 T 28 N,R 19 W Property Owner's Mailing Address f A nQOQ Lot # Block # Subd. Name or CSM# 1610 Redwood Drive #103 47 - Country Wood City State Zip Code h h ber L] City Village Fj Town Nearest Road Hudson WI 5401 , 9 5.,, Troy Gilbert Road New Construction , Use: N Residential / rooms 4 ❑Addition to existing building ❑Replacement PlabAc or con escribe Code Derived daily flow 600 gpd Recommended design loading rate •5 bed, gpd/ftZ .6 trench, gpd/ft Absorption area required 1200 bed, ft' 1000 trench, ft' Maximum design loading rate .5 bed, gpdtw .6 trench, gpolftz Recommended infiltration surface elevation(s) "99.75' ft (as referred to site plan benchmark) Additional design / site considerations install trenches using high capacity infiltrators. Parent material Glacial outwash Flood plai n elevation, if appli cable NA ft S= Suitable for system Conventional Mound In Ground Pressure AT - Grade System in Fill Holding Tank U= Unsuitable for system ❑ S U N S❑ U ® S U ❑ S❑ U EIS E U ❑ S® U SOIL DESCRIPTION REPORT Depth Dominant Color Mottles Structure GPD1ft Boring# Horizon in Munsell Qu. Sz. Cont. Color Texture Consistence Gr. Sz Boundary Roots Bed Trench 1 1 0 -17 10yr3/2 None sil 2fsbk mvfr cs 2 f,lm 0.5 0.6 2 17 - 1Oyr4/2 None sl 2msbk mfr gs if &m 0.5 0.6 Ground 3 32 -45 10yr5/4 None sl 2msbk mfr aw if 0.5 0.6 elev 103.72 ft 4 45 -89 10yr5 /4 None s Osg ml - 1 f 0.5 0.6 Depth to limiting factor tR. J� >as" Remarks: Horizon #4 contains bands of 2fsbk 10yr4 /41fs Horizon loading rate ad iusted to reflect reduced petmiability of finer textured banding found within dominantly sandy horizon. 2 1 0 -17 10yr3/2 None sil 2fsbk mvfr cs 2f,lm 0.5 0.6 2 17 -32 10yr4 /2 None A 2msbk mfr gs if &m 0.5 0.6 Ground 3 32 -45 1 Oyr5 /4 None sl 2msbk mfr aw 1 f 0.5 0.6 elev 106.19 ft 4 45 -95 10yr5 /4 None s Osg ml - - 0.5 0.6 Depth to limiting factor >95" Remarks: Horizon 44 contains bands f 2fsbk 10 /4 Ifs. Horizon ! eflect reduced permiability of finer textur bandm found within dominantlytdy horizo . CST Name (Please Print) Signature. Telephone No. James K. Thompson — 715- 248 -7767 Address A.C.E. Soil & Site Evaluations Date CST Number Ref # 340 Paulson Lake Lane, Osceola, 54020 3/11/00 3602 1182 i ,PROPEKrY0 NER Brian Schwab SOIL DESCRIPTION REPORT tte2 Page 2 of 3 PARCEL LD.# 040- 1235 -80 -000 A ite C.E. Soil & SEvaluations Depth Dominant Color Mottles Structure GPDIt� Horizon Depth Munsell Qu. Sz. Cont. Color Texture Gr. Sz Sh �or mistence � Boundary Roots Bed Trench 3 1 0 -15 1Oyr2 /1 None sil 2fsbk mvfr cs 2f,1m 0.5 0.6 2 15 -28 10yr4/4 None sicl 2msbk mfr gs if &m -0-3�- 4)-.& K � Ground elev 3 28 -36 10yr4 /4 None sil 2msbk mfr cw if 0.5 0.6 104.27 ft 4 36 -44 10yr4 /4 f2f7.5yr5/8 sil 2msbk mfr aw - 0.5 0.6 Depth to 5 44 -92 10yr5 /4 None s Osg ml - - 0.5 0.6 limiting factor _— Remarks: One foot rule applied to disregard redoximorphic features described in horizon #4 which are not indicative of groundwater saturation. t o a d in e rate Lust to refled reduced Den= t tv o s our w n onzon. 4 1 0 -23 10yr3 /2 None sil 2fsbk mvfr cs 2f,lm 0.5 0.6 2 23 -39 10yr4 /4 None sl 2msbk mfr gs if &m 0.5 0.6 Ground elev 3 39 -46 10yr4 /4 None IS lmsbk mfr aw if 0.5 0.6 106.48 ft 4 46 -86 10yr5 /4 None s Osg ml - - 0.5 0.6 Depth to limiting factor >89" Remarks: Horizon #4 contains bands of 2fsbk 105yr4/4 Ifs. Horizon loading r ate adjusted to reflect reduced penniability of finer textured banding oun w in mmant sandy honzon. 5 1 0 -23 10yr3 /2 None sl 2fsbk mvfr cs 2Qrn 0.5 0.6 2 23 -39 1Oyr4/4 None sl 2msbk mfr gs if &m 0.5 0.6 Ground elev 3 39 -46 1Oyr4/4 None is Osg mfr aw - 0.7 0.8 103.83 It 4 46 -86 10yr5 /4 None s Osg ml - - 0.7 0.8 Depth to limiting factor >86" 96 Remarks: Ground elev Depth to limiting factor Remarks: 1 / Y vo ? e k, nM r op of ep a ne r o�c.d � stag O cine,r: 8i .�i'� a� Soli urt-b �� ■ ■ i�io ltalki-AY01: AY /03 syst // ,, -d6on, co /. silo/(. o ,Lo ca&c" : ■ L oy 47 a-e Ati0F' �yun y uJ ! QeP /ace.►,�n� Sys�`er, T. o�Tay St. C( -O J' X (20; 01. CA a o � �i U � n N r 373. 7.2 A .o A o� �3 ,ZG3. in Department of Industry, SOIL AND SITE EVALUATION REPORT Page of 3 j( id Human Relations of Safety r£ Buildings in accord with ILHR 83.05, Wis. Adm. Code . CO UNTY Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must include, but St. ^ ,Groi - " :A ` 4 ... i not limited to vertical and horizontal reference point (BM PARCEL I.D. # ), direction and % of slope, scale or i .,. dimensioned, north arrow, and location and distance to nearest road. pendi APPLICANT INFORMATION PLEASE PRINT ALL INFORMATION REVIE 'DBY _:� t DATE PROPERTY OWNER: PROPERTY LOCATION Richard Stout GOVT. LOT 1/4 gg , SW,. IM, 5 3 `f 28, _ 19 for) W PROPERTY OWNER':S MAILING ADDRESS LOT # BLOCK# SUED:OR' 1353 Awatukee Trl. 47 na Co CITY, STATE ZIP CODE PHONE NUMBER EICITY ❑VILLAGE ®TOWN NEAR ST ROAD Hudson, WI. 54016 (715) 549 -6731 Troy I Tower Rd. [ j New Construction Use [x] Residential /Number of bedrooms 3 [ ] Addition to existing building I ] Replacement [ ] Public or commercial describe Code derived daily flow 450 gpd Recommended design loading rate • 4 bed, gpd /ft - trench, gpd/ft Absorption area required 375 bed, ft2 375 trench, ft Maximum design loading rate • 4 bed, gpd /ft • trench, gpd/ft Recommended infiltration surface elevation(s) 94.35 ft (as referred to site plan benchmark) Additional design/ site considerations system el. based on co n t our line of 93.35' Parent material pitted outwash plain Flood plain elevation, if applicable na ft S = Suitable for system CONVENTIONAL MOUND IN- GROUND PRESSURE AT-GRADE SYSTEM IN FILL HOLDING TANK U= Unsuitable fors stem ❑ S 1 S E] U 1:1 S ® U ID S ❑ U O S ®U EIS ® U SOIL DESCRIPTION REPORT H Depth Dominant Color Mottles Texture Structure Consistence Roots GPD /ft Boring # Horizon n o in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench 1 0 -12 10 r2/2 none 1 2msbk mfr gw if .5 .6 1 2 12 - 10 r4/4 none sicl 2msbk mfr gy if .2 .3 Ground 3 29 -80 10 r4 4 none sl 2msbk mvfr na na .5 .6 elev. 9 4.05 ft. Depth to limiting factor +80" Remarks: Boring # 1 0 -11 10 r2/2 none 1 2msbk mfr gw if .5 .6 `? 2 11 -22 10 r4 4 none sicl 2msbk mfr if .4'.5 U Ground 3 22 -36 7.5 r4 6 none < r. ` scl 2csbk mvfr CrW na .5 .6 elev. 4 36 -55 7.5 r4/6 c2 7.5 5 6 sl 1csbk mvfr na na .4 .5 94. ft. Depth to limiting factor 36 Remarks: CST Name: — Please Print Phone: Gary L. Seel 715 - 246 -6200 Address: 1554 200t Ave., New Richmond, WI. 54017 m02298 Signature: - - J.. Date: CST Number: 5 -3 -96 G - ^ PROPERTYOWNER Richard Stout SOIL DESCRIPTION REPORT Page,_ 0. $��o PARCEL I.D. # mending Lot #47 Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Boundary Roots GPD/ in. Munsell Qu. Sz. Carrt. Color Gr. Sz. Sh. Bed Trerch 3 ?; 1 0 -15 10 r2/2 none 1 2msbk mfr if .5 .6 - Oxon 2 15 -22 10 r4/4 none sicl 2msbk mfr aw I if .4 .5 Ground 3 22 -41 10 r4 4 none 1 2 elev. 92 ft. 4 41 -60 10 r3 6 Depth to limiting factor 41" Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: Boring # k•: :iv Ground elev. ft. Depth to limiting factor Remarks: Boring # Ground elev. ft. Depth to limiting factor Remarks: SBD- e330(R.05/92) ' STEEL'S SOIL SERVICE Gary L. Steel Richard Stout 1554 200th Ave. CSTM2298 SE4SW4 S3- T28N -R19W New Richmond, WI 54017 MPRSW 3254 town of Troy (715) 246 -6200 lot #47- County Wood N 1 =40' Bn.= top of 1 11 steel pipe C el. 100' Ll 2z5% Gary L. Steel 5 -3 -96 l ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer _AL, 4,4 s' � 1� .� h Mailing Address Z4� la e - Property Address zv (Voificalion mquked ftom Planning Deputtneat for new comfteioa) (L- city/state _�` �S °c,�1 Parcel Ideatifieadon N=ber A 2U RiP' =0N Property Location J- - L — y, ed' Y.. Soe. - 9 -- , T Z F N-R lt Town of Subdivision C� �.�� Lot # Oariffl ed SmW Map # _ - Volume . - - Psge # WiCtiaty Deed # Vokm ' _ Page # Spec ham ❑ yes P no Lot fives idea Wic &I yes 0 no Loareiad v&r7rvmr qjdmmdA =k& lobadexraN.Piapme s�oe amd:as otpumpiag eat tba septic teak vftW&mo yaw a somm Ntauasdedby a UmSOdpsang u. What yon pat bdo dte system asa affieet•Qa •Scmot3am� of dta sep4la tmtrss,a tAatmeatstse In tLs wyesbspopl syrete®. Tba paaopaeq owner apa b saboMo 8t. Cbsk Zm ft DqWkmd ti adMadn fain, sigood by dw e wmc sad ty a p i ►+�P'acaC�oeQSedpmapesteQutt(1) tlreoo�oe tra'di�osalsys� kin paoparapaotit� ooaadtioa imd/oc (� � � P .�' Y}. � tsaTris kas dam 113 Atli of Vw% do =d=*W bave mtd do tbm pqdmtpft ad gm to =Inuk the pdvale save diyal rom *Ado slsadst& set fact b m a,'m sat by dm D atcmamrne and the Dasatticaat of NstocalRiesoaroeai bw of Wisconsin. t' atiaa ft° ft — tm bean m e =* be oamplated tad a mud to Soft C mix Co mty Zed* Offs sic 30 days a time date, SIMA&W OF APPLICANT DATE I (ws) flat all saw om t h foam uv tau to the bat of my (omr Madge, I (we) am (are) the owne*) of abm by vWm of a ware nV dad recorded is Re&a of Deeds office. � !l i 1 Tim APPLwARr DATE ******Amy inibmati that is ails- reptesentedumy recall It die m dWypan dt bolog mood by the Zmft Dqa =mt.' ••••• •• Iaalade vrlth this appUadea: a sWupod wanaaty decd $om the Rs&W of DOC& 0M00 A copy of the smrtified sarvoy map if refemnca b mmic la the wammy deed