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040-1277-70-000
County: rnsinDePaentoomiONR St, CfOIX E SYSTEM Sanitary Permit No: 567272 EPORT and Building Division INSPECT State Plan ID No: (ATTACH TO PERMIT) GENERAL INFORMATION [Privacy Law,s•15.04(1)(m)]. Parcel Tax No: provide may be used for secondary purposes X Township 040-1277-70-000 City Village Personal information you p Tro ,Town of No: Permit Holder's Name: SectionlTownlRangelMap ..28.19.1549 70 Mar. Elev. Ter Insp.BM Elev: BM Description:I \ / ' /�f CST BM Elev: ,. ® ��Q, j7 ELEVATION DATA TANK INFORMATION . . lill STATION J•G`l /D!� 9 /ds Septic j„ I__�` �ir■•• _- ' ! Bldg.Sewer � � Aeration ..� iiii.111111111111111Ammi Holding StIHt Outlet 4a' � K INFORMATION Intake ROAD Dt Inlet ■■- TANK SETBAC BLDG. Vent to Air Inta WWI TANK TO Dt Bottom IIIIIIIIIIIIIIIIIIIIIII Ilin® 11111 b,` ,, X5. 09 Septic �� HeaderlMan. Milli Dosing Dist.Pipe 111111111E Aeration Bot.System 111111111031011 Holding Final Grade PUMP Manufacturer N INFORMATION Demand St Cover �, �-Q.4o /41, z1 GPM +I '' �- • /0 Manufacturer �_ ` Ot Mod umber fir— �� 01,E 111111,61 DH TDH 14"111114111Friction Loss System Head iiiiimiiiiim Dist.to Well Forcemain Length Dia. Liquid Depth PIT DIMENSIONS No.Of Pits Inside Dia. _` SOIL ABSORPTION SYSTEM No.Of Trenches ■ .,` Length / Z _ _ BED/TRENCH Width 76 f�$Z LEACHING DIMENSIONS Ma BLDG CHAMBER OR v 5 t�- , �� UNIT Mod ember+ er.� / CO SETBACK SYSTEM TO t0� INFORMATION Type f System:, I 0 En ' �Q '� �J(,y��"Y d t Vent to Air Intake ,� eels, x Hole Size x Hole Spacing ���- DISTRIBUTION SYSTEM 1ribution � `"' �� Header/Manifold / +/ �... Pipe(s) pia— gpacing�— SOIL Dias Length_ xx Mound Or At-Grade Systems Only xx Mulched x Pressure Systems Only xx Seeded/Sodded _ No Ei SOtL COVER xx Dept of s No Depth Over Topsoil Depth Over / Bed/Trench Edges 1 Bed/Trench Center � I I Inspect' n#2:j resent,etc.) Inspection#1: persons p Pa I No: 1 .28.19.1549 COMMENTS: (Include code discrepencies,p �S���lG WI 54016(NW 114 NW 114 16 T28N R19W) Eagle Blu Lot 17 Location: es Cedar Ct Hudson a ta-/ F Gel, . 1.)Alt BM Description= � 2.)Bldg sewer length= 6 G1( / —T—_-. lJ -amount of cover= I �I 132_, 1 ?, E Cert.No. L' "O 1 Plan revision Required? Yes Insepctors� nature Ilb Use other side for additional information. Date SBD-6710(R.3/97) F I 50,7 pr/alua:6on,4/-6 by IoM a'/o03 •.5.2.7 4,/a/04.ien,oi e by OCCAnt////•24/03 7Cat e4 4,135/0 crt5gi1!a./,�c /c/ c"-r►6 l/L Sv�o/6 xc.i�T2 /5'cJS6.Croix G.,�/. ■ ,2o,Z.4/ / oho•,2?1-7o-uO e as1.01t, (Dr∎ve�A y`_, —k.i o n Q G.rk'I e Ii-..t (/ v � � d I3 �d o.q . 103.0 K-t r i, v i ,' ti d W EXis�t.�cl L- f ��3 •r r /6� I/�o, i ✓ , c) • t ,,c4, ,yt,,//:Tap o{'t'cncrib \.'_ l . }- c'1 —.W-- ,,,,),.0 Ey.:3 &J¢erS Cone. R !r ,,.. CrmtauT open 05-- '' F/:! aI j , d,1 rs, x /( _ wooded ✓,.c✓e A / grus 4,y uira t 63.t ks ley I APP rax.GLrck o ye So:l 1 \ eJada-'&o by/-hi//•'s6Y X o /c .o' o � f Prpfos.ci ad;se,,54./Ca//a.t.zu2o ) f,'enc1-(S °--6a1'A-66',4/L/ zn,4'it'a fO,-- V- /`,Q/ws 5 a- c d a Itadn be,-J/-r e464-,. /7 4/6x-6',/e 54.r4 ce e/e& -t. 6e. .g‘‹�' GS.88' c. k Orrtake( •=1. —*'" —' P c6/4 County Safety and Buildings Division St.Croix 201 W.Washington Ave.,P.O.Box 7162 Sanitary Permit Number(to be filled in by Co.) Madison,WI 53707-7162 56, 7Z-72-- oe State Transaction Number Sanitary Permit Application In accordance with SPS 383.21(2),Wis.Adm.Code,submission of this form to the appropriate governmental unit Na is required prior to obtaining a sanitary permit. Note:Application forms for state-owned POWTS are submitted to Project Address(if different than mailing address) the Department of Safety and Professional Services. Personal information you provide may be Atightor secondary purposes in accordance with the Privacy Law,s.15.04(1)(m),Stets. Same I. Application Information- lease Print All Information G°° r� Property Owner's Name 4'/jp � Parcel# Terry&Terri Marquardt 8e."(J; 040-1277-70-000 Property Owner's Mailing Address rid/ c Property Location (/54 392 Cedar Crt. Govt.Lot / Ci ty,State v I Zip Code Phone Number NW _'/+, NW v., Section 0 (circle one) Hudson,WI I 54016 (715)425-6015 T 28 N; R 19 E or W II.Type of Building(check all that apply) t# 17 Subdivision Name ❑1 or 2 Family Dwelling-Number of Bedrooms 4 ' Block# Eagle Bluff ❑public/Commercial � mercial-Describe Use Na ❑City of CSM Number ❑Village of ❑State owned-Describe Use Na ❑Town of Troy Z i od-Cells r,J1 .Zl GA -05 cc.c - III.Type of Permit: (Check only de box on line A. Complete line B if applicable) A. !': .."-.,. Replacement System ❑Treatment/Holding Tank Replacement Only ❑Other Modification to Existing System(explain) List Previous Permit Number and Date Issued B. ❑Permit Renewal ❑Permit Revision ❑Change of Plumber I ❑Permit Transfer to New 420678,issued April 4,2006 Before Expiration li Owner IV.Type of POWTS System/Component/Device: (Cheek all that apply) on-Pressurized In-Ground ❑Pressurized In-Ground ❑At-Grade ❑Mound>24 in.of suitable soil ❑Mound<24 in.of suitable soil ❑Holding Tank 0 Other Dispersal Component(explain) 0 Pretreatment Device(explain) V.DispersaVlreat nt Area Information:42 Infil or"Q-4 Plus"Standard ch bers&4 endcaps xistin:�abel A-100 effluent fillst Design Flow(gpd) Design Soil Application Rate(gpdsf) Dispersal Area Required(st) Dispersal Area Propos-4 600 Gpd 0.70 Gpd/Sq.S .Ft. 857.15 sq.ft. 860.40 Sq.Ft. 94.00' VI.Tank Info Capacity in Total #of Manufacturer �, Gallons Gallons Units o c, New Tanks Existing Tanks L 1 604' P.L..pk. Eo a a. Septic or Holding Tank 1,260 1,260 1 Weeks Concrete X Dosing Chamber VII.Responsibility Statement- I,the and, igned,ass me responsibility for installation of the POWTS shown on the attached plans. Plumber's Name(Print) Plumber'. Signature MP/MPRS Number Business Phone Number James K.Thompson 1►!., - -a.---- MPRS 30021 (715)248-7767 Plumber's Address(Street,City,State,Zip Code) 340 Paulson Lake Lane,Osceola,WI 54020 4 / / -VIII ounty/Department Use Only / Approved Permit Fee Date sued Issuing/Signature t Signature en Reason for Denial 175' "� ii /2�/3 , !�` IX.Condseasons for Disapproval is Septic tank,effluent filter and dispersal cell must all be services/maintained as per management plan provided by plumber. 2. Ali setback requirements must bo maintained — as eer eppUceble code orduiances, . Attach to complete plans for the system and submit to the County only on paper not less than 81/2 a 11 inches in size SBD-6398(R. 11/11) 2340 Wisconsin Department of Commerce SOIL EVALUATION REPORT Page 1 of 2 Division of Safety and Buildings in accordance with Comm 85,Wis.Adm.Code A.C.E.Soil&Site Evaluations Attach complete site plan on paper not less than 8%x 11 inches in size. Plan must County St.Croix include,but not limited to:vertical and horizontal reference point(BM),direction and percent slope,scale or danemsions,north arrow,and location and distance to nearest road. Parcel I.s, j/ 040-1-70 ,+1 Please print all information. Ravi, By Date ■Personal information you provide may be used for secondary purposes(Privacy Law,s.15.04(1)(m)). 1•I�� / Z -I.._ i Property Owner Property Location Terry&Teresa Marquardt Govt.Lot NW 1/4 NW 1,/ 16 T 28 N R 19 W Property Owner's Mailing Address Lot# Block# Subd.Na or CSM# 392 Cedar Crt 17 Plat Of Eagle Bluff City State Zip Code Phone Number J City _J Village t Town Nearest Road Hudson 1 WI 1 54016 i 715-425-6015 Troy i Cedar Crt.&Omaha Rd. J New Construction Use: e Residential/Number of bedrooms 4 Code derived design flow rate 600 GPO 1✓l Replacement J Public or commercial-Describe: Parent material Glacial Outwash Flood plain elevation,if applicable na General comments and recommendations: Soil evaluation completed to verify suitability of site for POWTS dispersal cell. Loading rate to be 0.7 gpd/sq.ft./day. Infiltrative surface elevation to be=94.00'. Boring# J Boring p Pit Ground Surface elev. 101.10 ft. Depth to limiting factor >135" in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDIft in. Mursef Qu.Sz.Cont.Color Gr.Sz.Sh. *Eff#1 •Eff#2 1 0-8 10yr3/2 none fsl 2fgr dsh gw 2fm,1 c 0.4 0.8 2 8-17 10yr4/3 none fsl 2fsbk dh cw 2fmc 0.4 0.8 3 17-52 10yr4/6 none Ifs Osg dl cw 2f,1 m 0.5 1.0 4 52-72 7.5yr4/6 none fsl lmsbk mfr aw lfm 0.2 0.6 1 5 72-84 7.5yr4/6 none Is Osg ml cw lfm 0.7 1.6 6 84-135 10yr5/4 none ) s Osg dl - - 0.7 1.6 q4 1,t 2 Boring# J Boring i✓ l Pit Ground Surface elev. 102.77 ft. Depth to limiting factor 0" in. Soil Application Rate 1 Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft' in. Mu sell Qu.Sz.Cont.Color Gr.Sz.Sh. `Eff#1 *Eff#2 1 0-48 10yr2/2 none 81 fill na dsh gi 2vf,f 0.0 0.0 2 48-57 10yr2/2 none sl lmsbk dsh gw - 0.4 0.7 3 57-69 10yr4/1 none sicl lfsbk mfr 9w - 0.2 0.3 4 69-90 7.5yr4/6 m1 p 7.5yr5/8 scl Om mfr aw - 0.0 0.0 r 5 90-112 7.5yr4/6 none / sI Om mfr - - 0.2 0.6 Location unsuitable for POWTS-_) Effluent#1=BODS>30<220 , and TSS>r a <150 m.. *Effluent#2=BOOS<_30 mg/L and TSS<30 mg/L CST Name(Please Print) S', ature: CST Number James K.Thompson e,..._________ 3602 Address A.C.E.Soil&Site Evaluati• - Date Evaluation Conducted Telephone Number 340 Paulson Lake Lane,Osceola,WI 54020 8/9/2013 715-248-7767 • a Soil Rdalua,-ion/0. by '7X oen/oSort d/o?i •5a%49da/ua6%oe7Ale dy °Coane// z/. 4/o �,2 Rcf. #,Z3T/O 7'«ry • ece54�a.�9cca/o' 392 cedes ,' . o /4.4.c/6c4-4 r,A7r. ScO/` .Co6/7,p/a4o,cErtl/ed/uter; i114,)%y ow*mac./L,>.,78Ay R./fcti; �oz.Q/, %7.ester oy.5E.Croix 6.,fir, -ZTI-X)-az, e Q5/04.424. ki ofi- Qa.rtfe a • 1-..t �d 0 • 103.0 K, p Wil.tt i v v 14 1 Ex/ 4 . / . L 3 " I h / / • 02.0' M i �eS,./c'ic II // 0 0 / ..2/ ey) t7, z a 1 / / �2 (4.14 Arar'e: Tap o an erdi �' - 1>-�,:•c'-1—-t —— /aao. I/ed.=/oag7' i iol.o' Er•;j�i�j ltJetlE's cane. �•_ i �y i� I - -tout /i16U�jc� Cr:witc. ;t ,- �<. / or si I X 1 ' " ' — `_I ' woodcol cJW A l ti/ d 6(101, , $rsh, j a Agola cox.0.4r't4 0,4 56/ 4 \ e a/ua .:on by lled:rbrr' X 0 ■ /a 6. 4 i .o Ccrr&-ou-✓ gX de-da►- GS.08' Qrr1a44 A z 1 Conventional POWTS Index & Tilte Sheet Project Name: Marquardt 4 bedroom Replacement Conventional POWTS Owners Name: Terry&Terri Marquardt Owner's adress: 392 Cedar CM, Hudson,WI 54016 Site address: Same Project Location: Subdivision: Lot 17,Plat of Eagle Bluff Legal Description: NW1/4 NWI/4,Sec.1/,T..8N.,R. 19W.,Tn.of Troy,St.Croix Co.,WI. Parcel ID#: 040-1277-70-000 Page 1 Index and Title Sheet Page 2 Site Plan Page 3 Dispersal Cell Sizing Calcualtions Page 4 System Cross Section Page 5 System Management Plan Page 6 Parcel map Page 7 Certification for Utilization of existing septic tank Page 8 Waranty Deed Attachments: Soil Evaluation Report Mater P1 r Res 'cted Service: James K.Thompson,DSPS Credential#30021 Signature: it e.5......— Date: ) e-y.`.. 5/...20/3 Page 1 Of 8 Design pursuant to In-Ground Soil Absorption Component Manual for POWTS,version 2.0 SBD-10705-P(N.01/01) • Sod'edilica-'6er7/ . b 7X0i'7,75(41 b/o/%' •60,%.e✓a uaQ o r/pit by OCD4ne//.=,/,2G/o3 N '1'4 Ai. #,Z31/O -r-e//y • et-es<n1..7ka d>< 392 Cif"Co /0- Acc15cir,l,.2r. ss<o/6 I.oc/y,'iazl o,CEa /e&t ,4' S v Ac)%y ii&.";sec./L,7:-.28,1•,,e./F“)) 2.0A.9/, %T.o oy,.5E.Cro/x6,,‘Jt. ize/. 10./o-/,t77-7o- r) e aspitta I— artve�p y uV d i4 1 '3 7 QkrrciQ v • • ;n Ii-.'t I i 4" ..t ,0 604-.. ___ , - Qy ■:v _ 3 . �i ✓ I / • • 1a.0' M I �es,Jrace '� II // ' Q o l •2� r iN Kt 121 c. / 1/4--- ../...;.--. Z • A �p A ,,,��; _101.0 EYi f1/i GcJeslf S c 717 . yy!� /i 'tow- /.160 c.0 S.T. W i t{. i /it Zuth.e _. • t-tf / r Ql o/Oi'n (40/905" '�► 46 O,4 41 alixrse.� s� / `��►- - _ _ wooded c)60cied r ✓ A / '( it"k51,7,, 6rks1\7 I APPcox.a-.c4 o, So:r 1 \ e✓4/u4Otn by/ /i s cc % 4 \ a crrtou.r g X etda,- e b f Pr01005u)d,s`/crsa./Ce//et't 4 O 4) t er,ci-As a:6.1'Xd?610-51.2./ Zq{'/t`.ea ar- vO- /°d0/5 sandcvdc/to nbccs r t✓enc4,7n4/6 t6'de54I54Ce elect 65.88" On1a44 /for. -------J )P ,.2ole MAROUARDT DISPERSAL CELL SIZING CALCULATIONS 1. (4 bedroomsx100 gallons estimated flowxl.5 design factor)=600.00 Gpd design flow 2. Infiltrative capacity of native soil=0.7 pd/sq.ft. 3. Absorption area required: 857.15 sq.ft. 4. Absorption area as proposed: 860.40 sq ft.(42 chambers total) Infiltrator"Quick 4 Plus"=20.00 sq.ft.EISA per chamber,Infiltrator"Quick 4 Plus"end cap=5.10 sq.ft.EISA 857.15 sq.ft.—(4 endcapsx5.10)=836.75 sq.ft. 836.75 sq.ft./20.00=41.84 chambers required Number of trenches: 2(a,21 chambers per trench Trench width: 2.83' Trench length: 86.00' Trench spacing: 9.00'on center Total system area w/9'center spacing: 12.00'x 86.00' Pg.3 of 8 Soil Absorption System Cross Section 99,s"- 1 �cY.5 ft 4"Schedule 40 Final Grade PVC Vent Pipe With Vent Cap _ _____ P5.0 ft Leaching __.),„n Chamber 9s(ed ft ♦— System Elevation .2.83ft 4, ft Soil Absorption System Plan View ,g4 ft .2.e3 ft I I I I I Iu Q to ft Leaching I Trench Vent Or Observation Pipe Chambers —� III! I I I— '\ 4"Dia. Trench 2 Header Leaching Chamber Specifications Manufacturer And Model . 7''/ a, -i'Q-4'"//us 56c„oity-a' EISA Rating .O sq ft per chamber Soil Application Rate 0.7 gpd/sq ft 60 0O gpd Design Flow+ 0.7 Soil Application Rate + .20.0 EISA= $12_ Chambers 2 rows of 2-/ chambers each. Page of Conventional Septic System Management Plan Pursuant to SPS 383.54,Wis.Adm.Code General The conventional septic system shall be operated in accordance with SPS 382-384 Wis.Adm.Code,and shall be maintained in accordance with component manual SBD-10705-P(N.01/01). All local and/or state rules pertaining to system maintenance and maintenance reporting shall be complied with. Questions on the operation or maintenance of the system should be directed to the installing plumber,Jim Thompson at(715)248-7767 or the St.Croix County Zoning Department at (715)386-4680. Septic Tank Septic tank servicing mechanics comply with SPS 383.54(lXe). Septic tank to be located within 150'of service pad,with bottom of tank to be 5 15'below service pad elevation. The operating condition of the septic tank and outlet filter shall be assessed at least once every two years by inspection. The septic tank contents shall be removed when the sludge and scum in the tank exceed 1/3 the liquid volume of the tank. The contents of the septic tank shall be disposed of in accordance with NR 113,Wis.Adm.Code,by an individual certified to service septic tanks under s.281.48,Stats. If the contents of the tank are not removed at the time of a biannual assessment,maintenance personnel shall advise the owner of when service will be needed to maintain less than 1/3 scum and sludge accumulation in the tank.The outlet filter shall be cleaned as necessary to ensure proper o ration. The filter cartridge should not be removed unless provisions are made to retain solids in the tank Pe g P that may slough off the filter when removed from its enclosure. If the filter is equipped with an alarm,the filter shall be serviced if the alarm is activated. Septic tank manholes risers,access risers,and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed 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 effective locking device to prevent accidental or unauthorized entry into the tank. No individual should ever enter the septic tank as dangerous gases may be present that could cause death. Septic tank abandonment shall be in accordance with Comm83.33,Wis.Adm.Code when the tank is no longer used as a POWTS component. The addition of biological or chemical additives to enhance septic tank performance is generally not required. If such products are used they shall be approved for septic tank use by the Department of Commerce,Safety and Buildings Division. Soil Absorption Cell Trees or shrubs should not be planted directly on the soil absorption system. The area above and around the system should be seeded and mulched as necessary to prevent erosion and provide some degree of frost protection. Traffic(other than for vegetative maintenance)over the system is to be avoided. Soil compaction may hinder aeration of the infiltrative surface within and above the system and will promote frost penetration during cold weather months. Cold weather installations (October-March)dictate that the system be heavily mulched for frost protection. Influent quality into the system may not exceed 220mg/L BOD5, 150 MG/L TSS,and 30 mg/L FOG. Influent flow may not exceed maximum design flow specified in the permit for the installation. Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the owner. Levels above 4 inches indicate an impending hydraulic failure requiring additional,more frequent monitoring. Effluent flow shall be alternated between dispersal cells on a two-year schedule by use of diversion valve. Effluent to be diverted from new cell to old Drainfield at 3 year anniversary of new system installation. Old drainfield to be utilized for a 1 year period. Effluent dispersal to be alternated between systems on a two year rotating basis thereafter. Contingency 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. Excessive ponding within the dispersal cell will be eliminated by installing a new soil absorption cell to bring the system into proper operating condition. Pg.5 of 8 U fl._ ` _ �` v ` _ — Inc. 1 1 �—_ 18 � r 1 TOP OF f" r �i R.+80' \ \ El£VA • ++ 1 �" 1.182 ACRES 1 cj ( •` �, ? 51.479 SF. _ V 4. Iv \\ (NAV027 1 /et, -• ,$m 1 t LIlT! s I _ " f.477 ACRES`3 17 _ ,, n+ ACRES I 1 N 64.354 S.F. z ,53 S.F. ; N.277 ACRES � :I i r i ! si ;/1 :. S • rte. : 2• ' 2.009 - CM I y %,-.�..6492 : .-,„ • -• ,• .........44...Se•-•---wr . . :": o, •- • .„, Auer zo°o'�n�--' ..---- — l - i1.r - I 31 ,..1. , 1.228 ACRES 1 , a •r 1.299 ACRE 53.5°9 S F. "") / '. 2; , N;133 .+ '• : 56,590 SF �. 1.202 ACRES 32 9E ii'�' t•, ;,, 32.346 S.F. w 1 ‘' �, �.1 7\ ...„1 1 ` 34 N t. s •'t ` ! /1.093 ACRES %.'� ~`�.... I?L$_ ;� , •s t ■ 47,6111 S.F. Q": r zi 26 s Ai , r,, , N ;•-•- , � `"��� 1.164 AV1?RES / M\ \..!1,\/` \. 154• VI • ,a` \.� mac/ . 50,701 S.F. i r .\ 'f ' 7 I s ,```�' •► I' .AO' * /-4°••• ' 6/' . 4/' ai , to ,,,,_ ,,♦ ,•;s VV . 2 28 / �" � cv..y 27 if —%.--.----.- , 4 19 4 / 1200 ACRES 1 ° 1.239 ACRES ��'��� " N 52,294 5F. a 53,908 S.F. A I _ A 81 THE-NE T' i ' •.- •.. ,..• TEMPORARY CU• • -SAC ■� SOUTH LNiE OF 4 T TED LAND EASEMENTS. Rge90 . • f o 2P �,�. UNPLA T TED LAND eg9.2 There are no objections to this plat with respect to ��S`+��3 j 1,�IE5 0. Secs.236.15,236.16,236.20 and 236.21(1)and(2), 11E1 Wis.Stats. > FILKINS3 '1 1113EWEWEST 11142411 i RIVER FAL 171ftg CertifiedDi-tfijskiiije 10-1 , 20.V.._ e INIVER FAA via 42`p ''� ��jr e:01 DATED TN r , �` i (i ,� l O S11� •'�"�`` REVISED 1 :. +:r. REVISED 1 t o i ,n " 1 t ' REVISED 1 , - - - -- — -- - Pg. tedice s • • • • • • ■ • • • • • • • . . ST. CROIX COUNTY ZONING OFFICE CERTIFICATION STATEMENT FOR UTILIZATION OF EXISTING SEPTIC TANK(S) This is to certify that I have inspected the existing septic and/or dose tank presently serving the following residence: (Street address)392 Moonbeam Crt.,Hudson,WI 54016 located at: NW 1/a, NW '/4, Section )41(0 , Town 28 N, Range 19 W, Town of Troy , St. Croix County Wisconsin. Upon inspection, I certify that I have found the tank(s), to the best of my knowledge, will conform to the requirements of SPS. 384.25, and it (they) appear(s)to be functioning properly. Most recent date of inspection or service October 3,2013 Did flow back occur from absorption system? Yes No X (if no, skip next line.) Approximate volume or length of time: Na gallons Na minutes Tank Capacity: 1,260 gallon Construction: Prefab Concrete X Steel Other Manufacturer(if known): Weeks Concrete Age of Tank(if known): 7 years,installed 4/04/06 Permit number(if known) 420678 James K.Thompson (Licensed Plumber Signature) (Print Name) MPRS MPRS#30021 (Title) (License Number) MP/MPRS November 4,2013 (Date) Form to be completed by licensed plumber(Dept of Safety and Professional Services Chapter 305 and s. 145.06, Wisconsin Statutes)or licensed disposer (NR 113 Wisconsin Administrative Code) Rev. 2/2012 • • 11 pp p u 8 • STATE BAR OF WISCON,,tt SIN f6RM g9d 2 i v WARRANTY DEED KATHLEEN H. WAALSH a&,,,,,a„Morose REGISTER OF DEEDS S7. CROIX CO., VI This peed,made txlwee _ RECEIVED FOR RECORD Troy Development Corporation, a Minnesota Corporation 83-12-2002 6:20 AN Grantor. E }}OEED and merry Marquardt and Teresa„Marquardt,__.T Husband arta Wife REC FEE: 11.80 w TRANS FEE: 299.70 -._ Grantee. COPY FEE: Grantor. for a valuable consideration. conveys to Grantee ow the following PAGE. COPY F1 described real estate in St. Croix County.State of Wisconsin (the'Propeny): . . .. erne wo Reran Aeeaa Lot 17 of the Plat of Eagle Bluff in the Town of Troy, St. Croix County, Wisconsin. Subject to Declarations of Covenants, Conditions and Restrictions for Eagle Bluff, recorded in Vol. 1589 , Page 514 , as Doc. No. 638946 , as appearing in the office of the Register of Deeds for St. Croix County, Wisconsin, and such other easements, 040-1277-70-000 restrictions and reservations of record, or in use, and the "Buyer" obligations contained in the anvcrkNnaaeetat Numb*1pM Purchase Agreement for this lot. This is not homestead property Bs) (Is not) Together with all appurtenant rights.title and interests. Cramer warrants that the title to the Property is good.Indefeasible in fee simple and free and clear of encumbrances except Dated this 19th day of February 2002 . 4 .e slit► I den-•et (SEAT.) (SEAL) . Charles S. Cook, President • Troy Development Corporation (SEAL) �.. (SEAL) • AUTHENTICATION ACKNOWLEDGMENT es) Minnesota State of Weat:enaiee-. se. Anoka._ CaratY. aulhemicated thb ,day of —..—._ Personally came before me this 19th day of February 2002.the above named Charles S. Cook, President _Troy Develo: nt Corporation TITLE.MEMBER STATE BAR OF WISCONSIN to (If not. me known to be the person_,r„_,who executed the foregoing authorised by 5706.08.Wis.$tau.) trwnnmet rnl aeknowleed the sam1C1e i/�(J�jaa.,n� //�a•� %rn$tNSTRVMENT WAS URAF/ID BY it;;�,AlIti214 t•/1" Troy Pevelogment Cor ration Rick A. Johnson Notary Public,Sat. L lscaaanAnoka County, Minn. Charles S. Cook, President My commission is permanent. Of not. state expiration date: (Signatures may be authenucaned to acknowledged.Both are not January_31 3006_ .) nmasary) 'Nana.d �..u.*my ma n.. t<.r W ,,d be..even.wp.. , q w t.s STATE CAR Or WISCONSIN womb.tape stew Co..mc. WARRANTY MO CORM No -tsar au..aa.we • RI(RAJOIIIS 4 MAW Rake-MVO= MY 00141550N O(PIRES JANUARY 31.2006 8.(8 r Wisconsin Department of Commerce V County: St. Croix Safety and Building Division PR IVATE SEWAGE SYSTEM INSPECTION REPORT Sanitary Permit No: 420678 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: Mar uard Terry Tro Township 040- 1277 -70 -000 CST BM Elev: kO ' ce, 4K dJL I Insp. BM Elev: BM Description: Section/Town /Range /Map No: P��•S�ov.'s i ' I l 0b ►+^ �.►�sw B, ( �� . - S.u,, Bun Ip 16.28.19.1549 TANK INFORMATION ELEVATION DAT TYPE MANUFACTURER CAPACITY I STATION BS HI FS ELEV. Septic S Z� Benchmark r I ) 4L dD Dosing U Alt. BM N�A Aeration Bldg. Sewer � gl �•� r Holding St/Ht Inlet 3� 13 (� , b (� TANK S TBACK INFORMATION St/Ht Outlet r TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic f , 5 r r Dt Bottom \ `� t d Dosing r Header /Man. �q / Aeration Dist. Pipe Ilp •`� I / ;v Holding dot. System � .s9 Final Grade r `% PUMP /SIPHON INFORMATION St.J ) ` 3fl ( g Manufacturer De and St Cover w__ uJG G 6) Model Num r r" tt j TDH Lift iC ion Loss System Head T Ft Forcemain Length Dist. to Well I SOI ABSORPTION SYSTEM � r R NC Width Length t No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIME ONS ?2 -SD 2\ SETBACK SYSTEM T 0 T P/L JBLDG IWELL LAKE /STREAM LEACHING Manufac qr: _ C6 INFORMATION CHAMBER OR T ,� Type ( / O � f stem: � Sy � , �r I �D� UNIT Model Number. 1.2 p 0 . J DISTRIBUTION SYSTEM Header /Manifold Distribution x Hole Size x Hole Spacing Vent to Air Intake N PiP %. ZO f Length Dia + Length Dia Spacing SOIL COVER x Pressure Systems Only xx M Or At - Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded /Sodded xx Mulched � Depth Over Center Bed/Trench Ed es Topsoil g p � Yes No Yes I :° No `5 TS: CO M N (Includ o y�y Iscrepencies, persons present, etc.) inspection #1��/pl����3 Inspection #2: -- f �"T'` -)P- �K- - - W, 9w, Location: 392 Cedar Ct Hudson, WI 54016 (NW 1/4 NW 1/4 16 T28N R19W) EAGL �L Lot 17 A Parcel 16.2 . 9.11549 �p L, MMhJ'`it� p • n 1.) Alt BM Description = ArIA 3) s�� (} r S S c�o>L > 2.) Bldg sewer length - amount of cover = 2 Use other l side for d i o I e CN o 1 mation. a SBD -6710 (R.3/97)5 nn ` _ n 6,.,,t� rtce -4/4 . Safety and Buildings Division County N JIM 201 W. Washington Ave., P.O. Box 7162 ✓ ,S'CQ�s,� Madison, WI 53707 - 7162 Sanitary Permit Number (to be filled in by Co.) Department of Commerce (608) 266 -3151 . Sanitary Permit Application state Plan I.D. Number In accord with Comm 83.21, Wis. Adm. Code, p information you provide /V /y may be used for secondary purposes Pri La Project Address (if different than mailing address) ED L Application Information - Please Print All Inform ion # Ap Property Owner's Name AR 4 2686 Parcel # ( Lot # 7 Block # Property Own 's Mifilinj Property Location / Ci , State Zip Code Phone Number Y ' ' w` Ly, Section - �— s © (circle o o� 1 V Type of Building (check all that apply) Tc2_J N; R_ZLE Ior2 Family Dwelling - Number ofBedrooms Subdivision Name C3ir ❑ Public /Commercial - Describe Use ❑ State Owned- Describe Use ❑City ❑Village OTownship of III. Type of Permit: (Check only one boa on line A. Complete line B if applicable) A. ❑ New System ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System B- ❑ Permit Renewal Per mit Revision ❑ Change of ❑ Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration — -' Plumber Owner ZO b U 1> F69 D } i 749V3 3 IV. Type of POWTS System: Check all that apply) Non - Pressurized In- Groun ❑ Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil ❑ At -Grade ❑ Single Pass Sand Filter ❑ Constructed Wetland ❑ Pressurized In- Ground ❑ Holding Tank ❑ Peat Filter ❑ Aerobic Treatment Unit ❑ Recirculating Sand Filter ❑ Recirculating Synthetic Media Filter JAhingCharnber ❑ Drip Line ❑ Gravel -less Pipe ❑ Other (explain) V. Dispersal/Treatment Area Iu ormation: Design Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal Area Required (sf) Dispersal Area Proposed (sf) System Elevation 0-7-0 $ST I q � VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Units Concrete Constructed Glass New I Existing Tanks Tanks Septic or Holding Tank _ Aerobic Treatment Unit Dosing Chamber VII. Responsibility Statement- 1, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumb am (Print) - Plum 's Si M Business Phone Number / � _ Plumbers Address (Street, City, S Zip ode VIIL Coun /De artment Use On , Approved ❑ Di roved r / ^ Sanitary � Permit F �CIUG�r�oundwatE Date Issued Issuing ent Signature o Stamps) ❑ ven Reaso`n�fBtHertial� IX. Conditions of pro R (2_c S t CA 1) SSE A.) 676 &AJ &f2- Ct I a ! �{ L V ^� S 6- C 7/ ea,1 9-EP6i2T_ Z� e-& I S I Ow `rU L"&- N &--to Sb I L 4-24 � t L �1 ST&es Sty t Aye -'M uN Ot Cc�7 ytg1 Fa2 Cn►a L)6-$U_" aN 4: Ibt tDLL) If6 SD RP77 @A3 r7f=1,6., Attach complete plans (to the County only),for the system on paper not less than SW z 11 inches in size SBD -6398 (R. 01/03) /// �PoT l✓k���" dyf Ll io e � �c 3 M -As 6� { Am x a 3G Wisconsin Department of commerce SOIL EVALUATION REPORT Page l of Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code County Attach complete site plan on paper not less than 8 112 x 11 inches in size. Plan must include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. percent slope, scale or dimensions, north arrow, and location and distance to nearest road. F - P/ease print all infonnation. R vie by Date Personal Information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). 0 I ' 20 Property Owner Property Location Govt. Lot 1/4 SA 1/4 S N R (or Property Owrre7s Mailing AddiG WEE114 Ziage ' �RTown Subd. Name or-GSW City Stat Zip Code Phone Number Nearest Road J �z New Construction User] Residential /Number of bedrooms Code derived design flow rate GPD ❑ Replacement ❑ Public or commercial - Describe: Parent material _ )rtS Flood Plain elevation if applicable ft. General comments and recommendations:�f r--/� Boring # Boring f f 1 Pit Ground surface elev. ft. Depth to limiting factor > / in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF / in. Munsell Qu. Sz. gont. Color Gr. Sz. Sh. *Eff#1 I *Eff#2 - / / - - n Boring # Boring da/ I � Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Qu. Sz. Cent. Color Gr. Sz. Sh. *Eff#1 *Eff#2 Al s 'V /J ZI &I- Effluwli #1 = BOD > 30 220 mg/L and TSS >30 150 mg/L uent #2 = BOD < 30 mg/L and TSS < 30 mg/L • CST Na ease P ' ) - , Signature C§T Number Address' Date Evaluation rand 1 Telephone Number Property Owner " Parcel ID # Z? Page � of , Boring # 0'-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/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *EM12 Z2— A C /s �tfa • � r lO • IL i�L- I L ❑ 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 GPDM 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/fP in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 * Effluent #1 = BOD, > 30 < 220 mg/L and TSS >30 < 150 mgA- * Effluent #2 = BOD < 30 rng/L. and TSS 5 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. SB - 8330 OL07i00> A - r��A/- X'lItJ / L.fa ov S � /cm7 G iaa l ' I y, 06-+ s y w <;T C _. �, � �G SPA.► �-�-� ��-- 96 �f s ter' i - BENCH MARK: °ry � / 18 R =80' \ G� \ EOP ATI 1 =9 7.0 rv 1 1.182 ACRES 51,478 S.F. i 2 vil V 17 \ S 81 °�� 75 0 ., - mil V ^ I \ ° 48" E 302 56.7 0 5.65' 0 E 30 8.56' ro 3' 202. , BEN 24 r TOP w 7 \ n t °D. i W � ELE $ - ACRES ' 33 M I ; (NA 2.515 c� 33 �i . f t 5 109,563 S. _ F �' 16 $ m -6 % % 1.477 ACRE ; 1.055 ACRES 41 1 7 00' 00 N 85 °" $ N 4354 S.F. • N 6, i ; 45,953 S.F. g 3 .S X1 5,609 o) ACRES S 01 . 1 " o $ . 1 io 1 2 o 0 g6 - \ '� o 2.008 5 I o N t*+ C33z C 34 _ Z 18 ll� ti °° �-- .D7 ° t 100. C32— S 3' 33' ° E~ 81 00 00" E 211.84' N - / - M 63 N 819 ,, _ 4111 �E - �'C65 C64 1 DO W S 8 1 °00' 00 W�3 H f N 78 00 0 A p 578 Og �0 3 8 5.88 81 00' 00 R , „ W I v $ "w OM A 5 A8 °p0 p0 9 g �0' cn Z 20' - - • N °°j - 0. 00 $ g 211 41 ' ' C 20• ..o I 30 I � . 0 T 31 12 i 1.228 ACRES ! �o •/ N I N o 1.299 ACRES 53,509 S.F. / c�/ l �ro 25 S / c Q - 56,580 S 1.202 .F� h v ACRES 1 W N • 32 - Se , �• \ 52,346 f `?�► / S.F. to � r^ 1 , � ?? � h � w . t 34 >r� g'- `�i '9 t w J t , 'e� 29 1 ° r o 1 a+o .� w �i / 1.093 ACRES o d h 0 �+' 1 9 47,619 S.F. a' ° O t o' 1- N 1,;\ , Q ° 1.164 ACRES A46) N "1' 134. „ W ?$ 10•. �/ " �C/ 50,701 S.F. v o W / CJ 1- • 10 3.8 0'? ? c ' S t 1� 0' 13r64 `� 75 3 3 .61• 8 41• W 3Off E`er/ 4r 13 00 ' p0 „ W U� 5 78 I "hi �o / U o I 28 / N°p h �/ 1.200 ACRES J o / I °~ 27 1.238 ACRES N °� 52,284 S.F. , o� --"' 53,906 S.F. N 81 L41 7.18' _ 300.06' - /4 Oi? THE" -NE 1/4 I 120.42' S 88 W 1 02.44' TEMPORARY CUL -DE -SAC SOUTH LINE OF 4 T TED LAND I - " EASEMENTS, R =80' . N 04 0 50'42" E 80.00' — A T — L AND I TO RADIUS POINT � ,, �� ���,tlpit1111M�►I�� / � / There are no objections to this plat with respect to 'l�'�e�( 7 /� Secs. 236.15, 236.16, 236.20 and 236.21 (1) and (2), `� �� qEGISTERE1 Wis. Stats. JAMES D. OGDEN EN( FILKINS _ 113 WEST �111ER A" RIVER FAL Certified 7 L& " A, ! f ' It , 20 6 W1 Q• U��`��� DATED TH S REVISED 1 REVISED 1 part ent A m nistrat n REVISED 1 Safety and Buildings Division County / 201 W. Washington Ave., P.O. Box 7082 ��/ _ i Madison, WI 53707 - 7082' Site Address oe'artment of Commerce 3r12- C 2 'Ct RT Sanitary ermit Application Sanitary Permit Number Y PP 1-fzo67 -? In accord with Comm 83.21, Wis. Adm. Code, personal information you provide ❑ Check if Revision may be used for secondary p urposes Privac Law, s15.04(1) (m) I. Application Information - Please Print All Information RECEIVED State Plan I.D. Number Property Owner's Na me Parcel Number 0 6 7003 Property Own 's M ailing Add ss Property Locatio/S,/", / ST Gf -:G`IX r(_OUW Y ZONIfJG OFFICE 14 ! N, R City, State Zip Code Phone Number Lot Number r Subdivis' r Name C4A444umber II. Type of Building (Check that apply.) ity 1 or 2 Family Dwelling - Number Bedrooms Village _ ❑ Public /Commercial - Describe Use ❑ Townshi State Owned _ s�w�• L t , n earest Road III. Type of Permit: (Check only oAe b tberittg is for internal v eta line B, if applicable.) A. New ant of G ❑Addition to System 2 ❑ Replacement System T Onl Exis S ste For County use B. ❑Chuck if Sanitary Permit Previously Issued )nit Number Date Issued IV� 13 El ype of POWT System: (Check all that apply. mber 44 ing is for i rnal e.) + Non - Pressurized In- Ground 21 ❑ Mound 47 , and Filter 50 Construc�eed We 22 CI Pressurized In Ground 41 Holding Tank 48 ;S Pass 51 ❑ h}rrip 45 El At -Grade 4G ❑Aerobic Treatment Unt ❑ circulating 30 ❑ V. Dispersal/Treat ent Area Information: Design Flow (gpd) Dispersal Area Dispersal Area SA Alp Iion Pe o Syste evation Final Grade Required Proposed ate(Gals. ays /Sq.Ft.) (Mi h) Elevation 7 VI. Tank Info Capacity in Total Nu er Manufac er Prefab Site Steel Fiber Plastic Gallons Gallons of anks Concrete Constructed Glass New Existing Tanks Tanks Septic or llolding "tank Dosing Chamber VII. Responsibility Statement- I, the unde igned, a responsibility for installation of the POW'F shown on the attached plans. Plumber's a m (Print)• Plu r' i u MP /MPRS Number �, Business Phone Number PI mber's Ad ss (Street, City, Late, Code) VIII. County/Department Usgonl Y Ll Disapprove Date Issued l�su' g Agent Signature (No Stamps) (,Approved C Owner G' n Initial Adverse Sanitary Permit Fee eludes Groundwater Deter ' ton Surcharge Fee) 22 �g IX. Conditions of A 0p���tj� �1 IAP provahRe�r Disapproval tn/1�Ab' a. a_ �,o�e �et1�J+�o.+1C2S, v-A s `� Attach complete plans (to t. a County only) for the system on paper not less than 81/2 x 11 inches in size SBD -6398 (R. 05/01) �? 9i „ scr lw5 e MP c;� Wisconsin DepartmentofCommerce SOIL EVALUATION REPORT Page of Division of Safety.and Buildings in accordance with Comm 85, Wis. Adm. Code County cJT G1Z0 Attach complete site plan on paper not less than 8 112 x 11 Inches in size. Plan must include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Please print all information. Re iewed by Date Personal Information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). 0 3. Property Owner Property Location CHARU, S S, CObK Govt -6.ot N V1 1/4 AJW 1/4 S I b T Z8 N R 19 bio W Property Owner's Mailing Address Lot # 7 Block # Subd. Name or CSM# 11800 AGeKl eEN 'ST .1WFe �u%T I o0 I 7 �Lav 13CaxFF City State zip Code Phone Number ❑ City ❑ Village ($Town Nearest Road TBLAIN'E IMN I SSLILf (7(03 75 - 75(o m2oy oWK1�A1IA0 -eI rCL� ,® New Construction User Residential / Number of bedrooms y Code delved O,estgr}ttow rate (7 O V GPD ❑ Replacement ❑ Public or commercial - Describe: ; Parent material Na 5j01JE _ Flood -elaip elevation inapplicable ft. General comments ZA 10b r C0N t>E NT I oAi AL-1 r2kA0"--5 fa r and recommendations: 5� gTeM Q 1q, 50 1 ff----II ,. C i N" 'Y �� F-41 Boring # lJ Boring r , IC)r�IN:3 :af . pit Ground surface elev. 42Z q (o ft, Depth tb I}�rliting factor' Soil ADDlication Rate Horizon Depth Dominant Color Redox Description Texture Stfttclufe / C�rsil;t de oundary Roots GPD /fg In. Munsell Qu. Sz. Cont. Color Gr. Sz. 8 - - 'Eff#1 •Eff#2 I D y ��2 1 l (Y\ 1 z _ l o 2 s h 0.b of rn O ,L( 016 - 511 1 m5bl d5 C5 1 -m r Z I 3 2 _ . yIc ul — S0 2--Fsb W I f -rn 0 5 0 S Z$- 75 6 16 r Boring # Boring pit Ground surface eiev. g � 2 -1 9 ft. Depth to limiting factor _ q in. Soil plicatIon Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /fP in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •Eff#2 6- I ova �Z 1 j r QS 3 -� 0. S Z (0 -10 1041; �Z 1 zFsbl< rr1�-r 010 -m O. S 0.8 3 10 -2-1 16,40 _ S► I msblG rrrFr 5 IF -m 0,7-- 0, 2-1 -4 - 3 10 1115-414 Is r r yll a.t,J I f'-n 0, 1.2- 5 431Z I avfK`7 5 �, r 05 ( GLW I Or 1.z fo b2 (7 r,,4 4/ 0 .� I. Z 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) ignature CST Number V 0 2-2-Li 8 3Z Address Date Evaluation Conducted Telephone Number WA8'IS (,Aa \)�, Rlu FA L L - 5 , T S LID ZZ Io -Z(O -00 C-1 11s)L426 -1-11s r 1_DT 17 Property Owner COOK �C t"LK Parcel ID It _ Page Z of F V Boring # E] Boring Pit Ground surface elev. 922, _ ft. Depth to limiting factor 79L in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDtfg In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 1 ()- -t-I r M r Gs 3V(+ 0.8 Z- Ll A \4K _ 1 2- b ab Z f 0 . 5 a, it 3 q —Zl 10 W-4Z — sl 1 rr\abK ,-r4 C�S 1 D. t4 0.10 `I 21 -31 1 9-- — 15 LShK n,-A aW -F- S 3(0 -"-V- 7.5 lw `I S 03 rrt 1 — I IF 5 # 0 Boring 0 Pit Ground surface elev. qZb • ft. Depth to limiting factor 1 L in . Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 I 0 - 10 3E3r ds a5 32LE 0,5- o, z 3 -9 o rLZ1Z I 2 SbK A 0,b f- 0 ,-S - 0, 3 f - 19 10`f2 -- L-I lmsbl< aSV CS Z4-- 012_ 0,3 ' I% -ZS love- Ji► 2-P-SW d6l ZT -m O.S o S Z1� 1o tiie�l 1 s 1 m ds 0, If 0.7 1. Z 44-1-102 7.svc F Pit Boring # Boring ❑ Ground surface elev. it. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BOD S 30 mg/L and TSS 5 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. SBD -2130 (R.6=) - - r PLOf PLAN WX-��ff y IL; MOVERN OWNM ` C—MK CH A VZLF LVC4rNt2: / ' = YO' I.EGfV VE : L GLCE Lu r F [3M= *Fl -To p of IN 1.A iEAm LO CA W VA NWT 0F1MtENW G 01.1^1 4RFACE• t#2- Q OF /" S C. I b 2- M W 'C 0 TROY PVC P IPE 12" o f ouN n SwR s. sT. crcol t w�5 — r LoTI g 6 501L PRING W/ PXKNa — ---- __---- NO__GOM.M 65 %IPAGK PROPLEM5 C cJ�2 i LOT 7 Bi'lA Q E L 9 Z7.Oy' EL 922,96' �ti, gm�t� QBt i • L tit 9 26.2-4' D EL `TZ3.42' El EL QZI.79' EI_ g2,2.SY' i i I 57ft� ont e- 4i El Z.ZLI 3z PATF: 16-26-00 Fie y of y Col YTOW& LA NES F-oK LOTS IN) EAbt6 !SLUFF SUMD . 8 -16 A I X / B -16C 922 0 \ � I Tsx I B— 17B r 1 _ G POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page Lof,:2 FILE INFORMATION SYSTEM SPECIFICATION Owner' Septic Tank Capacity al o NA Permit # p Septic Tank Manufacturer S o NA Effluent Filter Manufacturer - ,C ❑ NA DESIGN PARAMETERS Effluent Filter Model a ❑ NA Number of bedrooms o NA Pump Tank Capacity al 2r NA Number of Commercial Unit NA Pump Tank Manufacturer 5 NA Estimated flow avera a gal/day Pump Manufacturer _tg NA Design flow (peak), (Estimated x 1.5) a day Pump Model ANA Soil Application Rate gal/day/ft" Pretreated Unit Influent /F,ffluent Quality Monthly Average* i_j Sand /Gravel filter ci Peat Filler Fats, Oils & Grease (FOG) <30 ntg /L ri Mechanical Aeration u Wetland Biochemical Oxygen Demand (BODs) <220 mg/L ❑ Disinfection ❑ Other: Total Suspended Solids (TSS) 5 150 m L Manufacturer Pretreated Effluent Quality ❑ NA Monthly Average ** Dispersal Cell(s) �In- ground (gravity) ❑ In- ground (pressurized) Biochemical Oxygen Demand (BODs) <30 mg /L ❑ At -grade ❑ Mound Total Suspended Solids (TSS) <1 <_ 10 cfu / 04 cfu/ 100mL o Drip-line o Other: Fecal Coliform (geometric mean) Maximum Effluent Particle Size '/ inch diameter * Values typical for domestic (non - commercial) wastewater and septic tank effluent. ** Values typical for pretreated wastewater. MAINTENANCE SCHEDULE Service Event Service Frequenc Inspect condition of tanks At least once every o months c� ears (Maximum 3 rs) Pump out contents of tanks When combined sludge and scum equals one third '/3 of tank volume Inspect dispersal cells At least once every ❑ months ears Maximum 3 rs) Clean effluent filter At least once every ❑ months ear(s Ins ect P11111P, Pump controls &alarm At least once every a months ❑ year(s) NA Flush laterals and pressure test At least once evety ❑ months ❑ ear(s) aNA Other: At least once every ❑ months o ear(s) ,it NA Other: I At leas once every ❑ months ❑ year(s) ®-NA MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications: Master Plumber; Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer; Septage Servicing Operator. Tank inspections must include a visual inspection of the tank(s) to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of combined sludge and scum and to check for any back up or ponding of effluent on the ground surface. The dispersal cell(s) shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a failing condition and requires the immediate notification of the local regulatory authority. When the combined accumulation of sludge and scum in any tank equals one -third (' /s) or more of the tank volume, the entire contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with ch. NR 113, Wisconsin Administrative Code. The servicing of effluent filters, mechanical or pressurized POWTS components, pretreatment components, and any other Maintenance or monitoring tit intervals of 12 months or less shall he performed by a certified POWTS Maintainer. A service report shall be provided to the local regulatory authority within 10 days of completion of any service event. START UP AND OPERATION For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or other chemicals that my impede the treatment process and/or damage the dispersal cell(s). If high concentrations are detected have the contents of the tanks(s) removed by a septage servicing operator prior to use. Owner Page Systdm start up shall not occur when soil conditions are frozen at the infiltrative surface. During power outages pump tanks may fill above normal high water levels. When power is restored the excess wastewater will be discharged to the dispersal cell(s) and may result in the backup or surface discharge of effluent, To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to restore normal levels within the pump tank. Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact. The area within 15 feet down slope of any mound or at -grade soft absorption are. Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat; foundation drain (sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting products; pesticides; sanitary napkins; tampons; and water softener brine. ABANDONEMENT When the POWTS fails and/or is permanently taken out of service the following steps shall be taken to insure that the system is properly and safely abandoned in compliance with ch. Comm 83.33, Wisconsin Administrative Code: • All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. • The contents of all tanks and pits shall be removed and properly disposed of by a Septage servicing Operator. • After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil, gravel or another inert solid material. CONTINGENCY PLAN If the POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide a code compliant replacement system: A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system. The replacement area should be protected from disturbance and compaction and should not be infringed upon by required setbacks from. existing and proposed structure, lot lines and wells. Failure to protect the P q g P P P replacement area will result in the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rules in effect at that time. ❑ A suitable replacement area is not available due to setback and/or soil limitations. Barring advances in POWTS technology a holding tank may be installed as a last resort to replace the failed POWTS. ❑ The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluation must be performed to locate a suitable replacement area. If no replacement area is available a holding tank may be installed as a last resort to replace the failed POWTS. ❑ Mound and at -grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltrative surface. Reconstructions of such systems must comply with the rules in effect at the time. <<WARNING>> SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASES AND /OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALL R POWTS MAINTAINER Name Name Phone — Phone SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Narnel Name Phone Phone 09/2612000 10:40 7152473038 BELISLE EXCAVATING I rraut 01 I • ST CROIX COUNTY SIsPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM OwnerBuyer � uo L L �A ' f 7 � CIS Mailing Address of Q tx r LIC V_ ) —7 Property Addess r (Verification required from Planning Department for new construction) City /State -al l_� Parcel Identification Number LE (:A1 DESCRIPTION Property Location ' /•, " /., Sec. > TN - RW, Town of Suhdivision Lot q . Certified Survey Map # , Volume , Page # Warranty Deed b l 73 �;� , Volume 1 fi�S_�__ , Page # Spec house D yes t ffl no Lot lines identifiable yes O no SYSTEM MAINTENANCE, Improper use and maintenance of your septic system could result in its premature failure to handle Wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system, The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a master plumber,)ourneynian plunibcr, restricjcd plumhcr or a licensed ptimper verifying that (1) the on -site waste water disposa I systern is in proper operating condition antlinr (2) aftrr 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 Commeice and the Department of Natural Resources. State of Wisconsin. Certification stating that your septic system has been rnyinta d otust he compicled and rrtumcd to the St, Croix County Zoning office within 30 days of the three year xp"ration date. 12, 361 oZ OF APP NT DATE SI NA OWNER CERTIFICATION I (we) tenify that all staicinenis on flees form are true to the best of my (our) knowicdgc. I (we) am (are) the owners) of the propeny described above, by vinuc of .1 %•arranty deed recorded in Register of Deeds Office. 2 301 02- SIGNATURE OF APPLI AN1 DATE • *• Any information that is mis- represented may result in the sanitary permit being revoked by the Zoning Department. •' Inttude with this application. a stanipcd `Warranty deed from the Register of Deeds office a copy of the ceritfied survey map if reference is made in the warranty deed I • tl V 2130P 292 - 71tD 8 2121 .4 Document N umber Document Title KATHLEEN H. WALSSH REGISTER OF DEEDS ST. CROIX CO., MI St. Croix County RECEIVED FOR RECORD Occupancy Affidavit 02/04/2003 99:15AN EXEMPT # Terry W. / Teresa L. Marquardt REC FEE: 11.00 TRANS FEE: Name — (Owner) Typed or printed COPY FEE being duly sworn , states, under oath, that: CERT COPY FEE: PAGES: 1 1. He/she is the owner /part owner of the following parcel of land located in St. Croix County, Wisconsin, recorded in Volume 14 5Z Page 2 L Document Number 61 3234 St. Croix County Register of Deeds ufTiice: Recording Area Name and Return Address A parcel of land located in the K 1 /. of theNkL % of Section i 6 e r - y A_�,.� "� T N - R W, Town of Troy St. Croix Co Wisconsin, g duly described as follows (include lot no. and `l 5 ) 2 N subdivision/CSM or detailed legal description): g� (� f� -I �D W 5 O [a��e 040-1277-70- Parcel Identification Number (PIN) As I owner of the above described property, I acknowledge that the septic system serving this residence is sized for a 4 bedroom home, or a design flow of t; n n n n gpd. The design flow is calculated by assuming 150 gpd for 2 Individuals per bedroom. There are currently _ occupants living in this residence; IL occupants are permitted based on the design flow. Therefore the septic system serving this residence is code compliant. However, I understand that if there are intentions to exceed the number of permitted occupants, the system will need to be modified to accomodate any increased wastewater flows and /or contaminant loads. I also acknowledge that I will make this information available to any future parties interested in purchasing this property. Dated this `'I � day of a .^ AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF WISCONSIN ) day of ASS. authenitcated this St. Croix County. . ) c Personally came before me this �_ day of T 1' r above named TITLE: MEMBER STATE BAR OF WISCONSIN (If not, to me known to be the person(s) who execu d the foregoing authorized by'§ 706.06, Wis. Slats.) instrument and acknowledge the same. THIS INSTRUMENT WAS DRAFTED BY r 01 a r c�+ • ova te, c GfO a,QOk in * > g l P, e ki Wa. I5kI • m : 3 Notary Public, State of Wisconsin (Signatures may be authenticated or acknowled ` rbt� : I My Commiss' permanent. If not, state expiration date: necessary.) t v! Z Q 1— Date: .3 0 - THIS PAGE IS M* DOCUMENT— DO NOT REMOVE" r This inlarr Wn must be completed by submlfter i g i w.- name 6 rwwn and EM !N re4uked1. Odd ration such as the pratov clauses, leagal description. etc. may be placed on this /first page of bye datwrrwW or may be placed on additbW pages Of 1110 document. hkft Use of this cover page adds one page to your document and ;2.t10 to the mam9w MO, WlsconsM Statutes, 59.517. ' t 1 C5 Q i ` STATE BAR OF WISCON FO 5IN RD AA Iv �96 p 2 4 U 6 7 3 2 9 4 WARRANTY DEED KATHLEEN H. YALSH REGISTER OF DEEDS °ocxo " nb° ST. CROIX Co., MI This Deed, made between _ _ RECEIVED FOR RECORD Troy Development Corporation, a Minnesota C _ 03- 12-2002 8:20 Ad Grantor, WARRANTY DEED and Terry Marquardt and Teres tJar uct ard t.____ -- EXEMPT t Husband and Wife ___ -_.- REC FEE: 11.00 TRANS FEE: 299.70 --- -- _ - -- - -- Grantee. COPY FEE: Grantor, for a valuable consideration, conveys to Grantee the followin g PAGES: CERT COPY FEE: 1 described real estate In St. C roix County. State of Wisconsin (the •Property'): I. Lot 17 of the Plat of Eagle Bluff in the Town of name and Rel— Mani., Troy, St. Croix County, Wisconsin. Subject to Declarations of Covenants, Conditions and Restrictions for Eagle Bluff, recorded in Vol. 1589 , Page 516 , as Doc, No. 638996 , as appearing in the office of the Register of Deeds for St. Croix County, Wisconsin, and such other easements, 040- restrictions and reservations of record, or. in use, _ and the "Buyer" obligations contained in the Pwcet lciemiccaron Numoar(PIN) Purchase Agreement for this lot. TMs is not homestead property (Is) (Is not) Together with all appurtenant rights, title and Interests. Crantor warrants chat the tide to the Property is good, Indefeasible in fee simple and free and clear of encumbrances except Dated this 19th day or February 2002 �•ta f 4 - 0 � — (SEAL) _ (SEAL) Charles S. Cook, Presid Troy Development Corporation - -- - - - - -- — (SEAL) (SEAL) AUTHENTICATION ACKNOWLEDGMENT Signature($) _ _ Minnesota State of Wtaeonshr; County. authenticated Ihls day of Personally came hofore me this .__ day of February 2002 the above named Charles S. Cook President Troy Development Corporation TITLE MEMBER STATE BAR OF WISCONSIN _ �— to (If not. _ __._...�. me known to be the person _who executed the foregoing authorized by §706.06. Wis. Stats.) :n owledge the same. THIS INSTRUMENT WAS DPAFTED BY Troy_ Development Corporation _-__ Rick A. Johnso Notary Public, Suwsd.l4Lsca Anoka County, tlinn. Charles S. Coo k, Presi _ My commission Is permanent. (If not, state expiration date: (Signatures may be authenticated or acknowledged. Both are not _ January 31 200_6_) ncr.nssary) u„ nlx„i n ... v �ii.i I I ,. Im .,inl lx� li,w i n .i. iii n Y,., .. �,i i, i, �. , i � STATE BAR OF WISCONSIN ves<ons+` t.egW Bunt Co_ mc. WARRANTY DEED FORM No.I -1998 ml-.— wu • Ra AJOHNSON NOtA YFI1Bl1C- 11,111 OT,A MY COMMISSION EXPIRES JANUARY 31, 2006 111 1A r