Loading...
HomeMy WebLinkAbout040-1265-70-025 I WisconseyDeparttrentofCommerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Buildii:g Division INSPECTION REPORT Sanitary Permit No. 506268 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: Metzler, Matthew I Troy, Town of 040- 1265 -70 -025 CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range /Map No: f V 6 (01/ n '� Z y 2 �, f� - 16.28.19.1439A TANK INFORMATION 1 ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION B j r l� HI FS ELEV. 1 6* Septic - (. y,,� Z� f Benchmark r ! Alt. Dosing tt Aeration 4 Bldg. Sewer 2 CZrL y 3 Holding t/Ht inlet _ 7 '� 97.E St/Ht Outlet / �— TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic cSb ; 36 Dt BQttorr f r/ (p , 73 Dosing , , Header /Man. a /e ( ,v r Aeration n, �.� -^ Dist. Pipe V U0 Holding Bot. System z < Final Grade , -67 �C� PUMP /SIPHON INFORMATION 3 Manufacturer Demand St Cover �, �. `� T• �� O J GPM T Model Number r � b � 1/411 /f TDH LI + Friction l,os),v System ad TQl;1 G // 1, O `.jt/ .!/ Ga.0 Forcemain Length Dia. Dist. to Well Zrl dJQ7 r d SOIL ABSORPTION SYSTEM A BED/TRENCH Width Length No. &:; PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS LO /�v �- SETBACK SYSTEM TO P/L BLDG IWELL LAKE /STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR Type Qf system 4 / UNIT Mode! Number: 5 h. DISTRIBUTION SYSTEM oC HMani f �Id �r Distribution �. �f x Hole Size x Hole Spacing ! Ven it Int e c Pipes) - +�( - / e, t 1 h Dia ' J Length �+� Dia I Spacing � U T 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 V "Nvs No �- N > COMMENTS: (Include code discrepencies, persons present, etc.) InspP on #1: �/ I / f Inspection #2: / <s I O ., , � Location: 321 Gandy Daircle Hudson, WI 54016 (SE 1/4 SW 1/4 16 T28N R19W) Glo S h A Lot �' Marcel No: 16.28.19.1439A 1.) Alt BM Description 2.) Bldg sewer length = - amount of cover = , 2 1 4& '7 � /2 n X , I Plan revision Required? Yes No Use other side for additional information. —1— - -' Date Vinsepctor's S' nature Cert. No. SBD -6710 (R.3/97) cairrnrter+t:ewi gov Safety and Buildings Division Carty._ 201 W. Washington Ave., P.O. Box 71 I-S n Madison, Wi? 53707 ?i Sanitary Permit Nmnbor (to a 61bd in by Co.) OSo V Sanitary Permit Application state T:aoaaction Number In accordance with s Comm. 83.21(2), Wis. Adm. Code, submission of this fate to governumtal unit is required prior to obtaining a sanitary permit. Note_ Application forms for state-owned POWTS arc PM Address (if different than mailing address) ) submitted m the Department of Commerce. Personal information you provide may be used for secondM a in cenrdaoce with the Privacy Law s. 15. ! m Stets. ( t11 I. Application Information - Please, Print AM Information Property Owncts Name Parcel # Adftlo"..) 2e i1 �� © l a IoS 70 -O Property Ownces Mailing PnlputyLocation /, f y 9�� Ty Govt Lot l C' , State p Code J � y., w yM Section - D l �D (einte T_x; R 1 _E w II. Type of Building (ebeek all that apply) Lot# �y Subdivisiou Name - - 1 or 2Family DwoNing- Number of Bedrooms._ _ . -. _ _ - - / - - - - - -- - -- `' {!'��, � Block # ❑ Publi r Use N N O City of CSMNum v ❑ Village of ❑State Owned - Describe Use J / L/ / /- fly „ •L����J11 ` J i'� tP `jr Town of III. Type of Peanut: (Check only one box on lin A. Complete tine B N apptiatble) A. Neva System O Replaceorent system O Treatmendx kb g Tank Rephi..ment only O other MW-ftfton 1e- g System (,ban L Previous Permit Numdrer and bond B. O Permit Renewal O Permit Revision ❑ Change of Number O Permit Tramfer to NcWw- 13aoe Before Expitation rv. Type of POWTS sys6micoinponel t/Device; Check all that a pply) O Nom - Pressurized In Ground O Preaurized la O At - Grade ound> 24 in. of suitable soil Moumd < 24 in of suitable soil / t O Hotdimg Tank O other Dispersal Componeat (explain) ❑ Pretteamteot Device (explain V. reatsnenY Area Information: Design Flow (gpd) Design Soil lication Rate(gpdst) Dkplersai AmaR (s1) Dispersal Ana (sf) SYs� b Elevation � a� - Vi. Tank Wo Capacity m Gallons Units New Tanks Existing Tanks a HoWing Tsak ' O O "" VII. Respendbft Statement 1, the aadersigaed, assutae Installation of the POWTS s the attached Pisan PI s Name Plun= /M Bwiness Phan Number r d�-=iS S (oSi Plumber's Address (Street, City, State, Zip Code) VIII. an /De eat use Onl Approved ❑Disapproved Permit Fee Date Issued Ins ' g Agent ' ❑ Owner Given Reason for Denial s D ` 2 3 v IX. Conditions of Approval/Ressons for Disapproval, ., S r SYSTEM OWNER: (`- 1 Septic tank, effluent filter and 4�4 �� T dispersal cell must all be serviced / maintained as per management plan provided by plumber. 2. A" setbac sad bolt to ea e (aaoty only ea paper not leis dou s U2 a 11 hwjm in aim as per applicable code /ordinances. SBD -6398 (R. 01/07) Valid thru 01/09 �� �� I ��� ?� i ,t x 7 tk '. i i '� � L, ,�. �• r • t ��, ���' S - � .. ��' , r '*, � , . I ,.. .; � .v M � �T � - s i V Y1{ Sw y y S i (OTa W /q s7� ,o to` 79 ea s `t —70QZ (} 3c to4*s_ec�s � �Y ��K 5�S �f•b7 ACAES - �-`- - - - it (00 - h. -T 3 4`� :ii I4 v _ 4 a 5 Safety and Buildings commerce.wi. OV 4003 N KINNEY COULEE RD g LA CROSSE WI 54601 -1831 TDD #: (608) 264 -8777 It lisconsin www.w www.commer isco / epartment of Commerce isconsin.gov Jim Doyle, Governor Mary P. Burke, Secretary July 18, 2007 CUST ID No. 220537 ATTN: POWTS Inspector CALVIN W POWERS ZONING OFFICE POWERS EXCAVATING, INC ST CROIX COUNTY SPIA 1969 185TH AVE 1101 CARMICHAEL RD NEW RICHMOND WI 54017 HUDSON WI 54016 CONDITIONAL APPROVAL identifi o. 14172 Nu PLAN APPROVAL EXPIRES: 07/18/2009 Transaction ID No. 1416272 SITE: Site ID No. 727788 Matthew Metzler Please refer to both identification numbers, 321 Gandy Dancer Circle above, in all correspondence with the agency. Town of Troy St Croix County SE1 /4, SW1 /4, S16, T28N, R19W FOR: Description: Four Bedroom Mound System / New construction Object Type: POWTS Component Manual Regulated Object ID No.: 1141684 Maintenance required; 600 GPD Flow rate; 40 in Soil minimum depth to limiting factor from original grade; System(s): Ezflow Mound Component Manual, (N.6/03), Pressure Distribution Component Manual - Version 2.0, SBD- 10706 -P (N.01/01) The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, stats. The following conditions shall be met during construction or installation and prior to occupancy or use: • This system is to be constructed and located in accordance with the enclosed approved plans and with the component manual(s) referenced above. • 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. • The area within 15 feet horizontally down slope of the dispersal cell shall remain undisturbed. Vehicular traffic or soil compaction in this area is prohibited. • A state approved effluent filter is required. Maintenance information must be given to the owner of the tank explaining that periodic cleaning of the filter is required. Access to the filter for cleaning must be provided per Comm 84 product approval conditions. • Comm 83.22(7) - A copy of the approved glans 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. P.O.W.T.S. Conditionally AP P Rk' E D - CALVIN W POWERS JR Page 2 7/18/2007 Owner Responsibilities: • The current owner, and each subsequent owner, shall receive a copy of this letter including instructions relating to proper use and maintenance of the system. Owners shall receive a copy of the appropriate operation and maintenance manual and/or owner's manual for the POWTS described in this approval. • 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). • 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. In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approved plans. • The owner is responsible for submitting a maintenance verification report acceptable to the county for p g P P 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 / �' ;� erard M Swim 1 Balance Due $ 0.00 POWTS Plan Reviewer, Integrated Services (608)789 -7892, Mon - Fri, 7:15 am - 4:00 pm WiSMART code: 7633 jerry.swim@wisconsin.gov cc: Leroy G Jansky, POWTS Wastewater Specialist, (715) 726-2544, Friday, 7:00 A.M. To 3:30 P.M. I I I I Gf .D EZFLOW MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN 0 0 Residentia! Application `'- INDEX AND TITLE PAGE U2 N m 4l t 0 6 C- Project Name: MATTHEW METZLER U Q Owner's Name: MATTHEW METZLER Owner's Address: 571 TWIN OAKS CIRCLE HUDSON, WI 54016 Legal Description: SE1 /4 SW1 /4 SEC16 T28 NR 19 W Township: TROY County: ST CROIX Subdivision Name: GLOVER STATION Lot Number. 78 Block Number. Parcel I.D. Number. 040- 1265 -70-025 Plan Transaction No.: Page 1 Index and title Page 2 Data entry Page 3 EZFlow mound drawings Page 4 Lateral and dose tank Page 5 Distribution media Page 6 System maintenance specifications Page 7 Management and contingency plan Page 8 Pump curve and specifications Page 9 PLOT PLAN Page 10 PERK TEST Page 11 SEPTIC TANK & PUMP STATION SPECS Designer. CALVIN POWERS License Number. 220537 Date: 07/03/07 Phone Number. 715 - 246 -5135 Signature: /,?— D ,, , , �. Designed Pursuant to the EZFlow Mound Component Manual (N. 06/03), and SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST -SAS (01/81) EZFIow Mound Version 1.2 (R. 02/04) Page 1 of 11 DEPARTMItJ D,. L0tM,1iLh6E OIVISlON OF SAVETY AND BUiLDMGS �SEEORR �PONDENCE EZFIow Mound and Pressure Distribution Component Design Design Worksheet Site Information (r or C) r Residential or Commercial Design Note: Sand fill (D) calculations assume a 400.00 Estimated Wastewater Flow (gpd) Table 83-44 -3 in -situ soil treatment for fecal 1.50 Peaking Factor (e.g. 1.5 = 150 %) coliform of - 36 inches. 600.00 Design Flow (gpd) 12.00 Site Slope ( %) I 105.50 Installation Contour Line Elevation (ft) _ 120.00 1 Contour Length Available (ft) rJ � 40.00 Depth to Limiting Factor (in) 0.40 In -situ Soil Application Rate (gpd/ft Distribution Cell Information 6.00 Cell Width (ft) 3. 4. 6, 7. 9. or 10 Only 100.00 = Dispersal Cell Length (ft) 1.00 Dispersal Cell Design Loading Rate (gpd/fe) 1 Influent Wastewater Quality (1 or 2) Are the laterals the highest point in the distribution L Y Pressure Disribution Information network? Enter Y or N (c or e) c Center or End Manifold 3.00 Lateral Spacing (ft) If N above, enter the elevation (ft) 4 Number of Laterals of the highest point 0.125 Orifice Diameter (in) (e.g. 0.25) 2.00 Estimated Orifice Spacing (ft) = 6.00 fe /orifice 2.00 Forcemain Diameter (in) 150.00 Forcemain Length (ft) Does the forcemain drain back? F Y _± 94.00 Inside Pump Tank Elevation (ft) Enter Y or N 6.50 System Head (ft) x 1.3 24.47 Forcemain Drainback (gal) ( / 11.67 Vertical Lift (ft) 90.37 5x Void Volume (gal) L) ' 5.23 Friction Loss (ft) 114.84 Minimum Dose Volume (gal) 23.39 Total Dynamic Head (ft) 41.19 System Demand (gpm) Lateral Diameter Selection Manifold Diameter Selection in. dia. o tions ch in. dia. options choice 0.75 1.25 x 1.00 _ _ -. 1.50 x _ - ^ z 1.25 x 2.00 x 1.50 x _x 3.00 2.00 x 3.00 x , Gallons/inch Calculator (optional) Treatment Tank Information 800.00 Total Tank Capacity (gal) 1200.00 Septic Tank Capacity (gal) 36.00 Total Working Liquid Depth (in) WIESER COMBO I Manufacturer 22.22 gavin (enter result in cell B49) Dose Tank Information Effluent Filter In 800.00 Dose Tank Capacity (gal) POLY LO CK_ Filter Manufacturer r_ 22.22 Dose Tank Volume (gal/in) PL5' 25 Filter Model Number WIESER COMBO _Manufacturer Project: MATTHEW METZLER Page 2 of 11 Mound Plan View T l� B � :::::::::.:::. r� J � :.: :- Observation Pipe L1 :. ..T:' :... :_..._ ..... l K �T r A W 5 I — B �{ I L1- . ......... . I L Mound Component Dimensions I A 6.00 ft E 14.64 in H 1.00 ft K Aft ft B 100.00 ft F 12.00 in z 12.75 ft L ft D 6.00 in G 0.50 ft J 4.41 ft W / 600.00 (fe) Dispersal Cell Area 1875.00 (fe) Basal Area Available 6.00 (gpd/ft) Linear Loading Rate 1 10.00 (ft) 1 /10 B Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area Finished Grade 108.00 (ft) I . G * H l I F 1 :: Dispersal Cen 106.50 (ft) Lateral 106.00 (ft) —i►♦ — 6 : .:.:.:.:.:.:.:.:.:.:.:. : .:.:.: invert Elevation Dispersal Cell . - .- .. :. :. :.:.: .:.: .: • • - - • - - Elevation :::: E s 105.50 (ft) Contour Elevation 12.0 % Site Slope 7 Typical Dispersal Cell Shading Key ° See Page 5 [1 j Topsoil Cap c Geotextile Fabric over Subsoil Cap 2.0 ft t ASTM C33 Sand � =° I C Tilled Layer 0.5 ft'' N1 EZFIow Media 0 —{-- See details on page 4 for number, size, and spacing of laterals. Laterals are located in the 4" gravity distribution pipes as shown on page 5. Project: MATTHEW METZLER Page 3 of Center Connection Lateral Layout Diagram Place Appropriate Lateral Diagram From R,��h* Belo. Force main connection via tee or cross to manifold at ang point. Laterals are identical orifices point u pt p, exce every 5th one K-- P points down for drainage. $ •= Turn -up wf ball valve or X- .xUI2 Wi>1 Laterals & force main of PVC Sch 40 eleanoutpiug per COIAM Table 84.30 -5 Number of Laterals 4 Orifice Diameter 0.125 in Lateral Diameter 1.50 in Orifice Spacing (X) 2.01 ft Lateral Length (P) 49.25 ft Orifices per Lateral 25 Lateral End (Z) NA ft Orifice Density 6.00 If/Orifice Lateral Spacing (S) 3.00 ft Manifold Length 3.00 ft Lateral Flow Rate 1020 gpm Manifold Diameter 1.50 in System Flow Rate 41.19 gpm Forcemain Velocity 4.21 ft/sec Dose Tank Information Locking cover with warning /''�- label and locking device, and sealed watertight Electrical as per NEC 300 and —► Comm 16.28 WAC Disconnect 4 in. min. - - -- Tank component is properly vented E— Alternate outlet location Forcemain diameter WIESER COMBO Manufacturer_ 2 in. Capacity 800.00 Gallons Volume 22.22 gal/inch A Weep hole or anti - Dimension Inches Gallons B siphon device A 18.84 418.52 C B 2.00 44.44 , Pump off elevation (ft) C 5.17 114.84 94 D 10.00 222.20 D Total 36.00 800.00 i l Dose tank elevation (ft) Min. 3" Bedding under tank. 94.00 Alarm Manufacturer 1 SPI Alarm Model Number [OB SERVER 100 Pump Manufacturer I GOULDS 388 Pump Model Number IWE _____ Pump Must Deliver 1 41.19 gpm at 23.39 ft TDH Project: MATTHEW METZLER Page 4 of 11 Par EZFlow Distribution Cell Media Layout 8.00 Cell Width (ft) 1.50 Sidewall to Lateral (ft) Distribution Cell Cross-section Arrangements Drag appropriate drat to space be!ovv. /. 6 ft Wide Component Legend g 6" EZFIow Bundle - EZ0601A, 5 or 10 Foot Lengths 12" EZFIow Bundle - EZ1203H, 5 or 10 Foot Lengths 12" EZFIow Bundle - EZ1203HP, 5 or 10 Ft Lengths Q 4" Distribution Pipe With Pressure Lateral Inside Tumup Enclosure — — — — Lateral Distribution Cell Plan View Layout - Typical 6.00 Cell Width - A (ft) 100.00 Cell Length - B (ft) Center Connection Lateta! Layout Diagram Drag appropriate dra, from left to space helo -- Force Main 4v — -- — — - - — - — — — — — — — — — — — 6ftWide Center Manifold Mound System Maintenance and Operation Specifications Service Provider's Name CALVIN POWERS Phone 715- 246 -5135 POWTS Regulator's Name T ^ ST CROIX ZOI I Phone 715- 386 -4680 System Flow and Load Parameters Design Flow - Peak 600 gpd Maximum Influent Particle Size 1/8 in Estimated Flow - Average 400 gpd Maximum BOD5 220 mg/L Septic Tank Capacity 1200 gal Maximum TSS 150 mg/L Soil Absorption Component Size 600 fl Maximum FOG 30 mg/L Type of Wastewater Domestic 1 Maximum Fecal Coliform >10E4 cfu/100 mL Service Frequency Septic and Pump Tank inspect and/or service once every 3 years Effluent Filter Should inspect and dean at least once every 3 years Pump and Controls Test once every 3 years Alarm Should test month Pressure System Laterals should be flushed and pressure tested every 1.5 years Mound Inspect for ponding and seepa once every 3 yea rs Other Miscellaneous Construction and Materials Standards 1. Observation pipes are slotted and materials conform to Table Comm 84.30 -1, have a watertight cap, and are secured in as shown in the EZFIow mound component manual. 2. Dispersal cell media conforms to EZFlow products approved for use with the EZFIow Mound Component Manual approved 6/3/03. EZFlow media is covered with an approved geotextile fabric. 3. All gravity and pressure piping materials conform to the requirements in Comm 84, Wis. Adm. Code. 4. Tillage of the basal area is accomplished with a mold board or chisel plow. 5. The mound structure and other disturbed areas will be seeded and mulcted to prevent soil erosion and help reduce frost penetration. Lateral Turn -up Detail Finished .• ............. ••••••••••••••• Grade ,>1 6-8" Diameter Lawn Threaded Cleanout ...... r Ball Valve PI o Sprinkler Valve Box g Lateral Ends at Last Orifice Where Variable Length Cleanout Begins Long Sweep 90 or Two 45 Degree Bends Same EZFIow Media 1.26 Feet Diameter as Lateral 4 Distribution Lateral Lateral Cleanout Project: MATTHEW METZLER Page 6 of 11 Mound System Management Plan Pursuant to Comm 83.54, Wier. Adm. Code CUM MI This system shalt be operated in accordance with Comm 82-84 Wis. Adm. Code, and shall maintained in accordance with its component manuals [EZFI ow Mound Component manual 613/03 and SSWMP Publication 9.6 (01!81)] and local or state rules pertaining to system maintenance and maintenance reporting. No one should ever enter a septic or pump tank since dangerous gases may be present that could cause death. Septic and pump tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the tanks are no longer used as POWTS components. Septic or pump tank manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sear watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 8- inches in diameter shall be secured by an efkmbw locking device to prevent accidental or unauthorized entry Into a tank or component. Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, State. The contents of the septic tank shall be disposed of In accordance with NR 113, Wis. Adm. Code. The operating condition of the septic tank and outlet filter shall be assessed at least once every 3 years by inspection. The outlet filter shall be cleaned as necessary to ensure proper operation. The filter cartridge should not be removed unless provisions are made to retain solids in the tank that may slough off the filter when removed from its enclosure. If the filter is equipped with an alarm, the filter shaft be serviced If the alarm is activated continuously. Intermittent filter alarms may indk*ft surge flows or an impending continuous alarm. The septic tank shall have its contents removed when the volume of sludge and scum in the tank exceeds 113 the liquid volume of the tank. If the contents of the tank are not removed at the time of a triennial assessment, maintenance personnel shaft advise the owner of when the nwd service needs to be performed to maintain less than maximum scrim and sludge accumulation in the tank. The addition of biological or chemical additives to enhance septic tank performance is generally not required. However, I such products are used they shall be approved for septic tank use by the Department of Commerce. Pump Tank The pump (dosing) tank shall be inspected at least once every 3 years. All switches, alarms, and pumps shall be tested to verify proper operation. If an effluent filter is installed within the tank it shall be inspected and serviced as necessary. Mound and Pressure DN&Nxdiw 8vmm No trees or shrubs should be planted on the mound. Plantings may be made around the mound's perkneter, and the mound shall be seeded and mulched as necessary to prevent erosion and to provide some protection from frost penetration. Traffic (other than for vegetative maintenance) on the mound is not recommended since soil compaction may hinder aeration of the infiltrative surface within the mound and snow compaction in the winter will promote frost penetration. Colt weather installations (October - February) dictate that the mound be heavily mulched as protection from freezing. Influent quality into the mound system may not exceed 220 mg/L BOD 150 mg/L TSS, and 30 mg/L FOG for septic tank effluent or 30 mg/L BOD 30 mg/L TSS, 10 mg/L FOG, and 10 du/100 ml- for highly treated effluent. Influent flow may not exceed maodmum design flow specified in the permit for this installation. The pressure distribution system is provided with a flushing point at the end of each lateral, and it is recommended that each lateral be flushed of accumulated solid at least once every 18 months. When a pressure test is performed it should be compared to the initial test when the system was installed to determine if orifice clogging has occurred and if orifice cleaning is required to maintain equal distribution within the dispersal cell. Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be repotted to the owner, and any levels above 6 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring_ Continuenchr Plan If the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep the system in proper operating condition. If the dosing tank, pump, pump controls, alarm or related wiring becomes defective the defective component(s) shall be immediately repaired or replaced with a component of the same or equal performance. If the mound component fails to accept wastewater or begins to discharge wastewater to the ground surface, it will be repaired or replaced in its' present location by Increasing basal area if toe leakage occurs or by removing biologicafly dogged absorptionh and dispersal media, and related piping, and replacing said components as deemed necessary to bring the system into proper operating condition. See Page 6 of this plan for the name and telephone number of your local POWTS regulator and service provider. Project: MATTHEW METZLER Page 7 of 11 p � � , c ., ., . r i,. a n •+r. / ct 'e u 1 1 :, -.1 Sri I 1 t IT 1 r SI 1 1 ,'1 ■i' f:7 1 2- ( , r 1 r:! 1 :n' ter. i.i t i l l r 1 r 1 1 l I , fit r r 1 1. / \ I 1 1 f'1' ■1 1 r i• i1' 1 tip 1' lung M II I 1 rl ■/ 1 / t f i -:n 1. 1 li •ni :1 . ' i' M al' 1 .n rl.• . M i• sr' N .. .a,l: r •i i�1L `iiiii7r�il�ill�.�li��li�ilii�a �•. .' 1 Otmwlsl FA ,,, ! !a ■ E0�i��i!!! 1' t !ilii!l�iMOWN ■!�!liisi rll i i ilii!! ii 111 isl� iii iL..� ',�_Jii ~ !!0�t►ii�iiiii�i�imm"MMi.ii r' - .:. 1 : • � r. �� \� iriii�Isiil�i _ 1. t iLat 1 ■• , r ` �'� ii►`�iii\'Smi�iiiiiiiiis i i !a i,'Iris.,�iis�►ilii imi imltiiiiii iiisi!!!i i1:,�mli�i`! now liw! iiiHowwwwo EL l �ino /! lilw! 1 , i.y �i >i��i!ll�..��f��s!l1�1��1i!!�!! / 1 • 1 , " ` ;.." r , i'F'""!A ��a i! tiylii��iii�iiilfililii ■:. Na..� "� �!i \C� i�1►ili>,`1iilii la�sr\a \llir�iaa!!i iii�flli� =.:'!1�1� �Si>!ti�li!!l / ►�s!'r! �• . '� 1 !!` iiiiiii�� r.��= !��►.lir>,`lliiiii!�ia!!i '�: 1 1 ' l�it!!!iillt�►ir: �'!�lliiili!!ii!!i! ! s! i!!!!i!!!iliirlillilii!!�!!!ii! r.0 I '�t •1.. i .nr. r :, L fill' 1 1 i ,1 L e ' 1 _ e YIN - �q'�"�ew °� � n;s � ���`z 1 � � S � Y� s s ► - rag N �Q /q w _ Cow 7g scour, 1 _ �t`O /s7-_Cro T �.1 e® - p4{b - tares -?a-0aS ► oa /gbo c�cs9 s F�., ��uw� s � o� 3,R �w, y_ b4 h Q-Q..A- ( c� x loo coo i 3 - W ID a � a - _ 0 42 P (t e w is s ion Department of Commerce SOIL EVALUATION REPORT Page - of Division of Safety and Buildings in accordance with Comm 25, Wis. Adm. Code Count/ , t'� XD0 Z X- -, - 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 int po tBM), direction and Pares! I.D. percent slope, scale or dimensions, north arrow, and location and distance to nearest road. O y = Z 6 !s Please print all information. Reviewed by Date Personal information you Provide may be used for secondary purposes (Privac/ Law, s. 15.04 (1) (m)). Property Owner Property Location GavL-L� C 1 /4SW 1/4 S l !b T z v N R l E Property Owner's Mailing Address Lot n Block } Subd. Name or CSM# , - 7 F3 1 — i G 1� �1 �Q ST �`� r j pr. bb City State Zip Code Phone Number City ❑ Village 0 Town Nearest Road i L�1�1JCNiZ On New Construction Use: ® Residential / Number of bedrooms i Code derived design flow rate b t71) GPD ❑ Replacement ❑ Public or commercial - Describe: Parent material —_ . L\D o z S ! "C'7 L L. Flood Plain elevation if applicable A { . General comments and recommendations: W1 kJi jAj C� t X X0 ' �\ 11Zt LL /` -/ N;- . ►� tv 1 1th V ilzi 1 ' bF- j LL C�>vvtiZ FT I Boring ? ❑ Boring © pit Ground surface eiev. ft. Depth to limiting factor L Z - in. Soil Application R2-- Horizon Depth Dominant Color Redox Description Texture Structure Consistence 3oundarl Roots GPD /ftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •E(f:1 •Ec _` i C7 -) k 4 i L'-t �Z- I '2 J S q -7 S 1 �' S f OEM 'tf \j F Boring # ❑ Boring ❑ pit Ground surface etev. t O 3 S ft, Depth to limiting factor Q _ in. Sol Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD1W in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •Eff #2 Z N 30 to��z3lb Si 1 3`gs�k w�'R- ctv 1� . S 3 3 tO -FLU �{ �l u .S 6 ► r? a � 6 't� lr S 2 S�9 S 1 (!� vnlf - - • O i a Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 _< 150 mg/L ' Effluent #2 = BOD, < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) S' nature CST Number I Arthur L. Wegerer 220254 Address If e g e r e r Soi T e s t i n; & Design S e r v i c e Date Evaluation Conducted Telephone Number 421 N. %lain St. River Falls HI - -/ 54022 Lj LI _O Lj 715 - t25 -01b5 i E Proper Owner Parcel ID tt Q — IZ O S ti Q 0 Page of � Boring # ❑ Boring ® Pit Ground surface elev. K3 r � ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft In. Munseil Qu. Sz. Cont. Color Gr, Sz. Sh. 'Eff #1 "Eff#2 ' Z 1 3 � 1 D' R. 31� �-- �) 4 3 `� � b►-� �- �, "t,J l. y n - S . � LI —61 - 1 S y fZ V ! F-1 Baring # Bo ❑ ring ❑ pit Ground surface elev.. it. Depth to limiting factor in. Soil Application Rate St Horizon Depth Dominant Color Redox Description Texture ructure Consistence Boundary Roots GPD /ftz In. Munseli Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 El Boring # ❑ Boring ❑ Pit Ground surface etev. ft. Depth to limiting factor In. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft in. - Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 •Eff#2 r Effluent #1 = SOD > 30 < 220 mg/L and TSS >30 < 150 mgr1. ' Effluent #2 = SOD, < 30 mg/L and TSS < 30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608 -266 -3151 or TTY 608 -264 -8777. sen -9330 QL&W) PLOT PLC`' Pa ore of Scale 1' " 9� , s., C� � / l �.3 • � I �ls• �'SZ A Z3 VORN-swym CV a � � .�Q�• ELF y ry ��• ` 1 -• ^ 2 732 50. FT. .; e LOT79 +•61 A. �: - �O Y�f 1 8.30 SG. rS. �i n L lT ar 3.63 ACRES ,� :� 3 IWA(r . SAID 0 ar•!/ ^' � 9► •� .� .� X a� 041 W Q�i h . L0T77 '; LOT78 Y( o lb. 0 141,873 S0. Ff p 203.685 50. F;. gib• � t �. �: . i° 3.28 ACRES &.: 4.67 ACRES N89'1B' Y! 750.00 357.34' �r y --1 -Oy 715- 425 -0165 220254 -117 CST Signature Date Telephone I CST No.. Job 210. bre- aoaloozs ► 99 *8 -5z£ -008 Spot •NVP %\3a woa Awnwr rvo accts a woa r omm sn aum ldt1NHW OLLd3S $\ ° 31V0 'ON AM ti: t L aW— pOS /ppztdw Ix z �Z z J � � _ U C, a. X Q ``' a M a I F= m � ��.. �_ Q ;—m Q Q p �N O Q p 00 y Na a `d'd •• - . F .. 1 t J M co ta! W U V O O q as �h�t q N 4 `W W Y 04J N O � U to 4 Z a r B£ » 7V w ,r , + z „a « tti .96 � RECEIVED Wisconsin Department of Comr ierce SdIL EVALUATION REPORT Page of -� Division of Safety and Building d ith C mm 8E, Wis. Adm. Code Attach complete site plan on aper8ig t�F�Y1W(500f2fx-11 in hes in size. Plan must County include, but not limited to: ve ical an7_&flN®t0FrFfe*nce po it (BM), direction and per ;ent slope, scale or dimen Parcel ..D. L ion and distance to nearest road. _000 Please print all Information. Reviewed by Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Property Owner Property Location �\J s'�� `` r''� U 1�� ?� •,? Gevt -Le4- 5 11d S W 114 S T Z °J N R 1 �i. E {or UJ i Property Owners Mailing Address 1rl Lot # Block # Subd. Name or CSM# � �� ­7 `E� I _ CL�)v S' F�L� City State Zip Code Phone Number -❑ City ❑ Village 0 Town Nearest Road ' 3 S' 0 7LAC. i z'v 5t-1 bo G � New Construction Use: ® Residential / Number of bedrooms �_ Code derived design flow rate GPD ❑ Replacement p Public or commercial - Describe: Parent material \—\D l' S L L Flood Plain elevation if applicable ft General comments and recommendations: \� U j 1^ 1 f <a ex �') \. S�Z1 LLiQ7 6)•J C -0ki v \Z a Boring # ❑ Boring ® pit Ground surface elev. �. 3 ft. Depth to limiting factor L4 Z in, Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz Sh. 'Etf#1 I `EffY � Zb S �1Z 31yt F1T � . S `C 'R _S 0V11) E Boring # ❑ Boring ® Pit Ground surface elev. O 3 S ft. Depth to limiting factor _ in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •Eff#2 1 b -\q \0-1V. 3t — s, ti 7.1�s6 �L *_FY_ cw , s . 8 Z 1�[ _3� l��- l�z3L6 — Si l 3`�sbk w�.'H- c�v l� .S •6 3 30 .. ) v'-i R 31 U o-1 P_ 3 sit Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 mg/L • Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) - S' nature CST Number Arthur L. Wegerer - A'7 220254 Address N e g e r e r Soil Testing & Design Ser vice Date Evaluation Conducted Telephone Number 421 N. !lain St. River Falls, 111 54022 t4 -C3V 715 - 425 -0165 Property Owner �-U g �'{ M O)J h.M l ` P Parcel ID // C N O – K �j S - 0 – 6 00 Page Z of 3 Boring # ❑ Boring ® Pit Ground surface elev. �� ? ft. Depth to limiting factor — 1 in. Soil Application Rate Horizon Depth I Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /fts in. Munsell Qu. Sz. Cont, Color Gr. Sz. Sh. •Eff#1 •Eff#2 i � -�`l �o� �3�z -- ; i) Z�s yv� -�.. C-+� Z•�` • s _g YY1 v j e �! rLVI /g Ow► `�," — .� .O r F-1 Boring # Boring ❑ ❑ pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPO/ftz in. Munsell Qu. Sz. Cont, Color Gr. Sz. Sh. •Eff#1 `Eff#2 F-1 Boring # ❑ Boring ❑ Pit Ground surface elev, ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft In. Munsell Qu. Sz. Cont. Color Gr. Sz, Sh. •Eff#1 `Eff#2 r i Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 mg/L ` Effluent #2 = BOD < 30 mg/L and TSS < 30 m – S _ g/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608- 266 -3151 or TTY 608- 264 -8777. SBD -8330 (R.6/00) l PLOT PLAN Page 3 of � Scale 1' = SO' C f ' � T*ts pm�o i _ ____ 3 Vim • 6r- CAL a \ yaePf- SOUI,I� 00 s ' ,�4 Low G4� F C . \ j`# u 200.737_ FT. LOT 79 4.61 ACRES 158040 S0. FT. 3.63. ACRES L OT B 3 r pay yN 3.•f I, , X ".� v 5� 3pp•OOW `'i LOT77 ..;` LOT78 g 141,873 50. FT. 703,685 S0. F'. Iso• y . r �; 3.26 ACRES 4.67 ACRES 8= NI .2 ........... :300.00' ' 4 :00 " " "' in N8 9'19 ' 0B - W N8919709 W 750.00' 35 7 .34'^ ti(, 3 I4 ` D1 1). PVC P1 W/ L"14 0y 715- 425 -01 2202 CST Signature Date Telephone Ito. CST No. Job NO. I " Wisconsin Department of Commerce SOIL EVALUATION REPORT page \ Division of Safety and Buildings of in accordance with Comm 85, Wis. Adm. Code Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must County ^ include, but not limited to: vertical and horizontal reference point (BM), direction and percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D. C yo- 1 Zbs��o -goo Please print all information. Revie by Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Property Owner I Property Location \> Ge+rt LeF . tE 1 /4 S W 1/4 S I T z - Property Owner's Mailing Address N R E (or Lot,. Block # Subd. Name or CSI * - �' S - 7 `�, - , G �o v �e Sl (ry City State Zip Code Phone Number -❑ city ❑ Village Town Nearest Road ll �\ - Z�LCl�MW�1> ® New Construction Use: ® Residential / Number of bedrooms `1 Code derived design Flow rate _ �j U3 r GF„ ❑ Replacement ❑ Public or commercial - Describe: Parent material — \— t`` '-C S Flood Plain elevation if applicable Jv 1r1 General comments f . and recommendations: v\ ,>\� m1 L3''J n 6( j Boring # ❑ Boring © Pit Ground surface elev. V� t, 3 ft. Depth to limiting factor Z in. Soil Application Ra,e Horizon Depth Dominant Color Redox Description Stru I Texture cture Consistence Boundary Roots GPD /ftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 I *Eft 2 — �[Z_b� s�-ttiZ Sly �c ��-t )Z S l E Boring # ❑ Boring ® Pit Ground surface eiev. t 0 3 ft. Depth to limiting factor U _ in, Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD / ft 2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 'Effn2 3 30 -q0 31t, - S i( Zm S b k �►1'R- Ct - S y ►Cy � sit i Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 mg/L • Effluent #2 = BOD, < 30 mg/L and TSS < 30 mWL CST Name (Please Print) Si nature CST Number Arthur L. Wegerer 'j 220254 Adds W e g e r e r Soil Testing & Design Service Date Evaluation conducted Telephone Number Address +21 N. M ain St. River calls, F7I 54022 x1_Ov 715 - 425 -0165 ` Property Owner e of Pa z- 9 F�ls Boring # ❑ Boring r — ® pit Ground surface eiev. )Qi d . G ft. Depth to limiting factor _ In. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •Eff#2 Q- ),J 1 - S �"J - U R vl V sye s/8 S 1c l ow, i F-1 Boring # ❑ Boring ❑ Pit Ground surface elev. it. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft= in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 i F-1 Boring # ❑ Boring Ground surface iev. ❑ Pit e. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 •Eff#2 i I Effluent #1 = BOD > 30 < 220 mg /L and TSS >30 < 150 mg /L ' Effluent #2 = BOD < 30 mg /L and TSS < 30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608 -266 -3151 or TTY 608- 264 -8777. seD4330 ta.crool PLOT PL Page -s of $. Scale 1 = SO _ S J 9�, , L7" cv2 U \S`�V1Z.. i B.3 8 r� � �- �' Co vim, 'tb a rc �Z• 1 � S , j �Z �u6. a ;- 200.732 50. FT, . O, n . 4.61 ACRES : Y \ , �/• 158 FT. � n - ; '�• v * S 7 . �p 3.63ACRE o � . � •Z a LOT80 I N :a I4£Nl QOrER 4 Z�Y yi•. S y,13 5 Ir,.N tr ..•.� I, .sN ~ 5 LOT78 W c; g 141,673 S0. FT. 203.665 S0. FT. Jso• r ; i� 126 ACRES v' 4.67 ACRES •y a_ N1 2 :.......... 1 ":]00.00•• 4 .DO " " "' ' H N89'1 ?'09 NE998'04 W 750.00' 31y ` FN L\ - 1 K Wl LYN.114 . _ _ 715 425 - 0165 220254 CST Signature Date Telephone Ido. CST No.. Job NO. Wisconsin Department of Industry, Labor and Human Relations SOIL AND SITE EVALUATION R Page I of 3 Division of Safety 8 Buildings in accord with ILHR 8rla 6�fnust Oode `: COUNTY Attach complete site plan on paper not less tha n 81/2 x 11 inches in size but not limited to vertical and horizontal reference point (BIVi), direction and o �.� P L I.D. # �� W G dimensioned, north arrow, and location and distance to nearest road. APPLICANT INFORMATION- PLEASE PRINT ALL INFORMAT A DBY DATE PROPERTY OWNER: PROP� _ fTY06AMN _ eL� fl,tA�11.1 \S S C L� Z 1 ,S J {jT ,N,R 9 E (oi W PROPERTY OWNER':S MAILING ADDRESS • V 'P CIS # , �U`M ME OR CSM # - Z S8 1z 1vEl� lDE X21 uE S nO)u S ft \b . CITY, STATE ZIP CODE PHONE NUMBER ❑CITY ❑VIL GE MOWN ' NEAREST ROAD 1Z1U��2 lJ-S wl 5g0j:Z CIS) qZS- jatl,I �Zt3�{ Sao 11N 20#nj New Construction Use (X] Residential / Number of bedrooms Y [ j Addition to existing building j J Replacement [ ] Public or commercial describe Code derived daily flow t) gpd Recommended design loading rate - bed, gpd$ • 3 S trench, gpd1ft Absorption area required Sr% bed, ft Spo trench, ft Ma:amum design loading rate • S bed, gpd/ft2 `b trench, gpd1ft Recommended infiltration surface elevation(s) 0- Q) It (as referred to site plan benchmark) Additional design / site considerations o� W / S ' x l A u `nz@� . YM I Jv . l2 , n� S" Ft u.. Parent material \ -CoESS oQVZ GL�+ I,PrL, - LL- Flood plain elevation, if applicable Nj� ft S = Suitable for system CONVENTIONAL MOUND IN- GROUND PRESSURE I AT -GRADE SYSTEM IN FILL HOLDPIG TANK U= Unsuitable fors stem I 13S ®U I ®S ❑U I ❑S IOU ES ❑U EIS ®U I ❑S • IU SOIL DESCRIPTION REPORT* Conk" \Q1MARcpjp�,j NtQ'z� , Boring # Horizon Depth Dominant Color I Mottles Texture Structure I Consistence IBotnclary I Roots GPD /ft unse in. Mll Qu. Sz Cont Color Gr. Sz. Sh. > x Bed Toxh I >,— 10 t o �t 1z- 3 cz = s' I z� v�,'Ft� �S 1� • S � - Ewa Z to - t9 I(w- -�j si I `�sbh Ynfl 0 Ground 3 19 -qZ - 1-54R- Sl — S) 1 d-.sbk � ALA, _ . , S elev. 9 23. 5 fL y � .S Lf f- 31 w � Y ��s� lZSlS s 1 D�., ct�,�,>� — ►� € u� Depth to limiting factor Zy Remarks: Boring # 13 0 -1 1 51 J Z'(�Sb h1 - • 5 . � fZ Ground elev. L4 uz S `1(Z MY I � •S`1 S S i 1 �� !nT q�•S ft - :- Depth to _ limiting factor Remarks: T Name: - Please Print Phone: Arthur L. We erer 715- 425 -0165 Address' Soil 4 i esting & Design Service -P.O. Box 74 River - Falls,WI.54022 . Signature: Date: CST Number:. 5-9 -�0 220254 PROPERTY OWNER 6'I E - / SCW J L Z •• T SOIL DESCRIPTION REPORT Page? of PARCEL I.D, # p>;JpJw 6 Boring # Horizon Depth Dominant Color Mottles Texture Structure GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Consistence Botx>da�y Roots Bed Trer>d� =` 3 ? _ °' �� 10 � 2 3 1 z. — s i I Z'Fsb12 wL C•�v 1 Z vq 39 to , -I r z 3/( Ground 3 34 to K 2 316 s r r J elev. 'I - Lt 2 S/$ Otivt tw.S it. Depth to limiting factor 39 " • Remarks: Boring # Ground elev. it. Depth to — limiting factor Remarks: Boring # xK Ground elev. rl. Depth to limiting factor Remarks: 3oring # around Aev. rt. )epth to imiling actor Remarks: _ y PLOT PLAN Page 3 of 3 S AD L � F z�f1D i I s I 1 j lU T E Bn1* e 6 m6t+, 31y" IPe H P%JQ I`lvmko2 iz Pl? I Wisconsin Department of Industry, Labor and Human Relations SOIL AND SITE EVALUATION REPORT Page I of 3 Dsyisian of Safety & BuilcSrgs in accord with ILHR 83.05, Wis. Adm. Code y COUNTY Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must include, but not limited to vertical and horizontal reference point (BIN), direction and % of slope, scale or PARCEL I.D. dimensioned, north arrow, and location and distance to nearest road. ' APPLICANT INFORMATION- PLEASE PRINT ALL INFORMATION REVIEWED BY DATE PROPERTY OWNER: PROPERTY LOCATION C S C IJU L j Z GGVT_6 SE_ 1/4 SW 1/4,S f JOT ? i:� ,N,R 1,q E (or w PROPERTY OWNER':S MAILING ADDRESS • LOT w BLOCK SUED. NAME OR CSM # 7� ZSS �1vE12S _DCz1UF_ - 1a — GL ) S ox, S CITY, STATE ZIP CODE PHONE NUMBER OCTTY OVILLAGE QTOWN ' NEAREST ROAD 1ZlU�� P;r�S w1 5y.0ZZ(jL5) qz-S albs �z�K Sao liru Z �q New Construction Use P<1 Residential / Number of bedrooms L/ [) Addition to existing building j) Replacement [ ] Public or commercial describe Code derived daily flow 6 pQ god Recommended design loading rate — bed, gpd/ft • trench, gpd/ft Absorption area required SDD bed, ft Sp0 trench, ft - Maximum design loading rate • S bed, gpd/ft - b trench, gpd/ft Recommended infiltration surface elevation(s) 100.0 ft (as referred to site plan benchmark) Additional design / site considerations 1 'l',�13KJb W / S 'Xl �, o' TZZi`) jae-, . M Ihi . lZ 0f St'1k t R u..., Parent material Lots ouVZ GL -n Lk Flood plain elevation, if applicable N{" ft S = Suitable for system CONVENTIONAL MOUND IN- GROUND PRESSURE AT-GRADE SYSTEM IN FU HOLDING TANK U= Unsuitable for system CIS ®U I ®S 0 U I CI S JZ U , JE S 0 U 0S BU I ■S R3 SOIL DESCRIPTION REPORT* Cou*n`f VmkFLof lloO') ZZ.z'z , Boring # Horizon Depth I Dominant Color I Mottles I I Structure I 113curdary GPD /ft in. Munsell Cu. Sz. Cont Color Texture Gr. Sz. Sh. Consistence I Roots Bed rrmr& 3LZ. — n s i i Ynfl•- �. • 6 Ground 3 19 -4 Z Z S 4 R _ 3! y ci S fL y' yZ-SS . -� -SLtIZ 3LV Depth to limiting factor Zh Remarks: Boring # 13 1 o -f 1o�t2 311 - . si I Z•'� m'�i- �-S L-� , s �� Z 1 t z3 ju'l TL 376 �S. 3 Z3 -L12 IZ Yl - wt i 1 s k Ground � s) >n� � S elev. It y 41-63 S `2 R- Y/V 1 -� •S`1 SZ .S/8 SD 1 0i n trr_`k _ tiP ` • 2 Depth to _ limiting factor Remarks: T Name.— Please Print Phone: Arthur L. We erer 715- 425 -0165 ' egerer _Soil esting & Design Service -P.O. Box 74 River Yalls,WI. 54022"' . Sgnature: Date: CST Number. . NC..- Ip3 -78 5-9 -00 220254 I ' PROPERTY OWNER ' M 5CHIJ LT z SOIL DESCRIPTION REPORT Page? ot. 3 PARCEL I.D. # p�lyp� N 6 Boring # Horizon Depth Dominant Color Mottles Texture Structure GPD /ft in. Munsell Qu. Sz. Cont. Color Consistence Bouxiary Roots > , :•; ...... < Gr. Sz. Sh. Bed Trerxh s Z �q 39 1 IL -S �6 Ground 3 39 .S8 16LI P— 316 .S Li 2 S ,/ $ s ► owl yyr f _ I.jv> . 2 elev. lops It. Depth to limiting factor 39" Remarks: Lit Boring # Ground elev. It. Depth to — limiting factor T - 1 Remarks: Boring # XXX Ground elev. Il. Depth to limiting factor Remarks: 3oring # around 'Iev. it. )eplh to imiling actor Remarks: _ ' •r\ n -r •rnrr. ..r ....• __ P LOT P LAN j Page 3 of 3 SU D I s I 1 4 C� T B"1e4 tT1 X1. a,j 6 31y" piA. puc VAIPe ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND Ar 7 j1 ; 7LJ OWNER SHIP / CERTIFICATION FORM OwnerB uyer � & h1 f S c /Ue7 L -�e�7L Mailing Address S t 7� t hJ 0 Aks (f4 12 C - t C S Property Address - 32-/ G 4+4kb ` 6 A- - &JC4s L C! rz C- (Verification required from Plan6ing & Zoning Department for new construction.) City /State 1 7 4 WO-sat-j oc CJY Parcel Identification Number C 7' G - 12- r - 7'0 - <D - ?-S LEGAL DESCRIP'T'ION 6 Property Location � t/a , V" Sec. `fo , T " N R / W, Town of �'a Subdivision b 51:�' � d ,Lot # - 7 v / T Certified Survey Map # 760 ! 77 3 , Volume , Page #�. Warranty Deed # �J , Volume , Page # Spec house yes no Lot lines identifiab yes no SYSTEM MAINTENANCE AND OWNER CERTIFICATION Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed, by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system 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 Department a certification form, signed by the owner and by a master 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. I/we, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system 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. Uwe certify that all statements on this form are true to the best of my /our knowledge. Uwe am/are the owner(s) of the property describ above, by virtue of warranty deed recorded in Register of Deeds Office. Number be 6 7 il'x� - JNATURE OF APPLIC S) DATE ** *Any information that is misrepresented 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. (REV. 08/05) E336.� 1 1 KATHLEEN H. NALSH REGISTER OF DEEDS ST. CROIX GO., NI THIS DEED made between Brushy Mound Partners, LLP, a RECEIVED FOR RECORD Wisconsin Limited Liability Partnership ( "Grantor") and Matthew R. 116/17/2006 10:30AN Metzler and Denise M. Metzler, husband and wife, as survivorship marital property ( "Grantee "), WARRANTY DEED WITNESSETH, that the said Grantor, for valuable consideration EXEMPT # conveys to Grantee the following described real estate in St. Croix County, State of Wisconsin: TRANS FEE: 407.70 COPY FEE: Recordin Area CC FEE: Part of lots 77, 78, 79, and 80, Plat of Glover Station Fifth Addition Name and Return in the Town of Troy, St. Croix County, Wisconsin described as follows: Lot 78 of certified survey map filed June 3, 2004 in Vol. Brushy Mound Partners, LLP 18, page 4766, Doc. No. 764773. Brushy Box 445 New Richmond, WI 54017 040 - 1265 -70 -025 (Parcel Identification Number) This is not homestead property. Grantor, Brushy Mound Partners, LLP, a Wisconsin Limited Liability Partnership, is an affiliate of Derrick Homes, LLC, a Wisconsin Limited Liability Corporation. Grantor develops land and Derrick Homes, LLC is a home construction contractor. Grantor agrees to sell this lot to Grantee on the condition that Derrick Homes, LLC will be the builder of the home for Grantee. If Grantee does not commence construction with Derrick Homes, LLC as the contractor /builder Within two (2) years of the date of sale of this lot to Grantee, Grantee gives Grantor the irrevocable right to re- purchase the lot for the same price as Grantee paid Grantor for it when Grantee bought it from Grantor. If Grantee desires to sell the lot to another purchaser before constructing a home upon this lot, Grantee gives Grantor the right of first refusal to re- purchase the lot for the same price as Grantee paid Grantor for it when Grantee bought it from Grantor. Dated this 1M day of October 20Qfz. Rona ichael R. Stevens AUTHENTICATION Signature(s) ACKNOWLEDGMENT STATE OF WISCONSIN authenticated this _ day of , 20_ ST. CROIX COUNTY Personally came before me this 10th day of October 201f, the above named Michael R. Stevens and Ronald L. signature D rrcTc, partners o shy Mound Partners, LLP, a type or print name isconsin L *rn ability 0111itnership to me known to be the persons ecuted th foregoing instrument and TITLE: MEMBER STATE BAR OF WISCONSIN acknowledge s e. (If not, authorized by ' 7os.06, Wis. Slats.) tore PAME J. RUTLEDGE type or print name P ela J. R tled N I PtibHC THIS INSTRUMENT WAS DRAFTED BY State Wisconsin Brushy Mound Partners, LLP Notary Public n Expires: County, Wisconsin. PO Box 445 My Commission Expires: ,�Iv 27th 244$. New Richmond, WI 54017 "Names of persons signing in any capacity should be typed or printed below their signatures. l i 7 4 Q Ty f.. •• DOD( ;i_ a Sr�4 i -4-- 7 Ea 7 7 • t 4 3 8 CLEAIi LdfCE,; 3 wt VOL 1 8 PAGE 4766 tR"f� l�N••...... RATALEEA H. REGISTER OF DEEDS nrnatnv n�'�`� ST. CROIX CO. MI hECORD - CERTIFIED SURVEY MAP RECEIVED FOR 0 06/03/20 3: 45PH 04 3:45PM Located in part of the Northeast Quarter of the Southwest Quarter and part of CERTIFIED SURVEY MAP the Southeast Quarter of the Southwest Quarter, all in Section 18, Township 28 REC FEE: SURVE North, Range 19 West, Town of Troy, St- Croix County, Wisconsin; being Lots COPY FEE: 3.00 77 -80 of the Plat of Glover Station Fifth Addition as recorded in the St. Croix PAGES: 2 County Register of Deeds Office. Prepared for and at the request of: BEARINGS ARE REFERENCED TO THE NORTH —SOUTH Brushy Mound Partners, LLP QUARTER LINE OF SECTION 16, TOWNSHIP 28 N., RANGE 1505 Hwy 65 19 W. WHICH IS ASSUMED TO BEAR N0149'24 E. New Richmond, WI 54017 Drafted by- Howard H. HerTild 111 CURVE TABLE CURVE RADIUS DELTA ARC CHORD CHORD BEARING TANGENT BEARING C11 80.00 B224' 6' a7.13' 82.89 N7 '3 'E S71'1V13'E 4624' 1'E C2 883.00 13'54'31' 214.35' 213.82' N39'27'15.5 "E N4624'31 "E N32'30'00 "E C3 600.00 3 7'09' 46.83' 342.02' S74'O '34.5' S57'30'00 "E N 9 1'E 200 ° zoo \ \ GLOVER STA 77 NO TH GRAPHIC SCALE FOURTH ADD /T7ON SCALE IN FEET: 1 inch = 200 feet 66 NCWTH 1/4 CORNER 72 \ - -- SAC. 16 -28 -19 AP of OV �D , �/ 6 � \ 64 Planning Zoning aril! Parks COMMReZ^ �, \ JUN 0 ` 2004 � 1,14 L I N E- sou If not recorded with' of 7.3 \_ `� •'�� rn g9 date a a be -- ry approval ll � null \ ap VV v , , P- d ,ice N s 200,732 SQ. FT. LOT 79 4.61 ACRES 158,040 SO. FT_ 75' ' :so Z� 75 �e�Dpo 3.63 ACRES .z =�L OT 80 _ �O �"',,••�- / '� � = � 3 - mss_ EA SEA T >t Sb1r3 Ql AS SHOWN s�'�O R - F. .W �a� N ON O - GLOVER r ,,SrA 776W o � 3F 29 ... w AZMW77CW � 5d S' 6-20 41,w 84 LOT77 ~': LOT78 76 +� mss- so O t 0 141,873 SQ. FT. s° �' 203,685 SQ_ FT_ _ 1 I 3.26 ACRES. 4.67 ACRES 81 N 2 2 _ "300.00' " ' 2 ' " " " ' 450.00'' " " r i N 8 W N89 W 750.00' 357.34 )/ )O4 A TTEQ- L V/ 2OS ° 82 N0 7E 7N /S IS A RECONF GURA AOW OF LOT LINE LOCH 770MV BETWEEN `t LOTS 77-8Q ALL COWNAN75,� REWRIC770NS, EASEMENTS, E7I ; co SHOWN ON 7HE PLAT OF "G OVER STA 770VV FIFTH ADDI770N' APPLY z F1 _ 70 L07S HER4EaW. JOB # WI057SU155 I FGEND °j „ W Prepared by. y N� Section Comer Monument O (;gfyyV Cwy I/JG of Record I . CF) - • Set 1' x 18' Iron Pipe weighing rO Phone No. (715) 248 -4319 1.13 pounds per linear foot n2n�� OI O Found 1' Iron Pi r a Z Fax No. (715) 248 -3830 P e P.O. Box 325 ® Found 1 -1/4' Iron Pipe Shoat Richo 2d, WI 54017 0 Found 2' Iron Pipe PO - - -- - - - - • Building Setback Line (As Dimensioned) Vol. 18 Page 4766 Trial And Road Map For Glover Station n a N c=.._......_�.. . 8 7 6 5 4 f0 3 � tlprFw trap 2 t1 19 20 21 22 23 1 12 24 s' 25 31 26 30 t6 27 14 26 29 ' 32 ? 15 40 35 41 a 43 39 38 37 36 33 34 42 44 47 1 141p r 48 4 5 6 46 50 59 52 53 b 54 55 49 80 - 2 67 56 92 57 f .• 69 58► 4 70 62 61 91 : 66 71 90 64 89 65 ea 74 73 79 8o as 93 SCALE IN FEET 9 � mello —�- - :75 85 94 95. 0 200 400 am 84 76 77 78 81 "( 83 96 97 98 82 t261i7AM00i1R C1dNE g ivarm CUM anllEwnsE ictEU f�sEIG CQ. yob cm tt3 tt. tt�uR flirt figs 6W 8 101 � (715) 425 -763t 100 99 103 102 J�ttlLE. .......... .. .... _i... ) sLltai�= S g Car. on arc DI RE L. 9YE trans R. SCHULYZ no SWWA C. 9CHKTZ OATS 5-30—W P.O. e01t 1d7 • 711 25 to AMM *iV FAt.LS, , VnsOWmK 94022 cj**ft m. WI -, Rim 91929 99 -2380