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HomeMy WebLinkAbout040-1293-90-000 , tment of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Division 1, , INSPECTION REPORT Sanitary Permit No: 430462 0 AL INFORMATION (ATTACH TO PERMIT) State Plan ID No: information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. At Holder's Name: City Village X Township Parcel Tax No: Sethi, San'il I Troy Township 040 - 1293 -90 -000 CST BM Elev: Insp. BM Elev: BM Descriptio Section/Town /Range /Map No: p a " " 0 17.28.19.1684 TANK INFORMATION ELEVA ION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. D S° llb d Septic Benchmark ko Dosing 7-7,S, Aft. BM Aeration Bldg. Sewer iQ 'jb ! D 5 Holding St/Ht Inlet TANK SETBACK INFORMATION St/Ht Outlet ?(� TANK TO P/L WELL BLDG. Pen Intake ROAD Dt Inlet a g 2 l oo, 1j Septic I � t Dt B �Dosing / Header /MWn._ Aeration Dist. Pipes I / Holding Bot. System PUMP /SIPHON INFORMATION Final Grade Manufacturer Demand St Cover I V�P� GPM Model Number 6 i/ �i I v TDH Lift V Frictio -3 Loss System Head TD 6 � Ft ewyely-4— Forcemain Length � I Dia. p Dist. to Well SOIL ABSORPTION SYSTEM l L BED/TRENCH Width / Length No. Of Trenches PIT DIMEN IONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS SETBACK SYSTEM TO f PILVJ BLDG W L LAKE /STREAM tgACHING Manufacturer: INFORMATION Type Of System- CH CH E > I - / c I __1 Model Number: DISTRIBUTION SYSTEM Header /Manifold Distribution x Hole r x Hole Spacing V to Air I t ke i/ Pies p to a A Length Dia 1. S Length Dia Spacing d G SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded /Sodded & Mulched Bed/Trench Center _„p Bed/Trench Edges Topsoil ..n5r "� � Yes 2 No Ll Yes = j No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: /cam / 27 3 Inspection # / Location: 500 East Cove Road Hudson, WI 54016 (SE 1/4 NE 1/4 17 T28N R1 9W) Piney Woods Lot 9 Parcel No: 17.28.19.16 4 1 � Alt BM Description = �✓' T - + r �'`-' c4 tA.C� � J fV 2.) Bldg sewer length =Z� / y(,�, ) t p �i — yt"O - amount of cover = >) / X 1 w Plan revision Required? r Yes No Use other side for additional information. SBD -6710 (R.3/97) Date Insepetor's gnature Cert. No. I� , f o c j � Q75 D Safety and Buildings Division County �^ 201 W. Wa Ave., P.O. Box 7162 / fT l Vsconsin Madison, WI 53707 - 7162 Sanitary P mit Number (to be filled in by Co.) Department of Commerce (608) 266 -3151 4-3 Sanitary Permit Application State lan I.D. Number Z 6 'Z In accord with Comm 83.21, Wis. Adm. Code, personal information you provide T —S. %. may be used for secondary purposes Privacy Law, s15.04(1)(m) Project Address (if different than mailing address) I. Application Information - Please Print All Information� v' s1. A, Property Owner's Na me tt ParrPl b Lot k Block N 0 -12- � 90 Property Owner's M ailing Address Property Location City, State Zip Code L - — ��4 /a,Section U,bW &XK iYo T N R (ci cle e) II. Type of Building (check all that apply) a.e S -a I or 2 Family Dwelling - Number o /Bedrooms Subdivision Name CSM Number ❑ Public /Commercial -Describe Us ❑ State Owned - Describe Use 4 — 0 City_ ❑village XTownship Of III. Type of Permit: (Check only one box 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 ❑ Permit Revision ❑ Change of ❑ Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Plumber Owner IV. Type of POWTS System: (Check all that ap ply) ❑ Non - Pressurized In- Ground .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 ❑ Leaching Chamber ❑ Drip Line ❑ t�v;&less i e Other (explain) V. Dis ersal /Treatment Area Information: Design Flow (gpd) Design Soil Application ate(gpdsf) Disp al rea Required rsa Area Proposed (st) System Elevation / /C ® . VI. Tank Info Capacity in Total Number Manufa Prefab Site Steel Fiber Plastic Gallons Gallons of Units Concrete Constructed Glass New Existing Tanks Tanks Septic or Holding Tank Z 5-0 Aerobic Treatment Unit Dosing Chamber VII. Responsibility Statement- I, the undersigned, assume responsibility for installat of th e POWTS shown on the attached plans. Plumb is Na me (Print) / Plumber' Si gnature MP /N�iLS *Number Business Phone Number Plumber's Addre ss (Street, City, State, Zip C e) VIII. County/Depart ent Use Onl Approved ❑Disapproved Sanitary Permit Fee ( eludes Groundwater Date Issued u A Is Signature (No S mps) Surcharge Fee) _ ❑ Owner Given Reason for Denial l% Q ]X. Conditions of Approval /Reasons for Disapproval f SYSTEM OWNER: 3) 1-6+ (Z'%ks w.4 a* Le v er. , - &4 t.X 1 Septic tank, effluent filter and 'zo S r &,.t dispersal cell must all be serviced / maintained �� 1 tt as per management plan provided by plumber. 2. All setback requirements must be maintained as per applicable code /ordinances. (o C-- . Attach complete plans (to the County only) for the system on paper not less than 81/2 x 11 inches in size SBD -6398 (R. 01/03) PLOT PLAN ` Scale 1 'Page 3 of 7 v a�� m � r C) tyl M C4 a -- - cW� � � � � -ti�►�1 - 5.�.�nc 1 C) LLJ c.� M Dv � t' Du NOT "- -Ipft WCA}F -J �TZf tS OP lab . Soo` To NOTES: - 1. Elevations shown are existing ground elevations unless otherwise noted. 2. Install 4 "..observation pipes with approved PProved caps. ( Z required). 3. Septic tank to be Z O gallon capacity manufactured by wt Qttt� Gbu�,tt 1= �L`�tR • l�1 P �'firk � .@ � 4. Bench mark 5. Divert surface water around system to revent P, ponding at the uphill side. Safety and Buildings ( j 4003 N KINNEY COULEE RD f LA CROSSE Wl 54601 -1831 r ( 4_ ��,�, ! TDD #: (608) 264 -8777 \ Visconsin I www.commerce.statemi.us /sb Department of Commerce www.wisconsin.gov --° w --= �- Jim Doyle, Governor Cory L. Nettles, Secretary October 09, 2003 CUST ID No.267341 ATTN POWTS Inspector ARTHUR L WEGERER ZONING OFFICE WEGERER SOIL TESTING & DESIGN SERVICE ST CROIX COUNTY SPIA PO BOX 74 1101 CARMICHAEL RD RIVER FALLS WI 54022 HUDSON WI 54016 CONDITIONAL APPROVAL Identification Numbers PLAN APPROVAL EXPIRES: 10/09/2005 Transaction ID No. 926262 SITE: Site ID No. 666051 Sanjil Sethi Please refer to both identification numbers, East Cove Road above, in all correspondence with the agency. Town of Troy St Croix County SE1 /4, NE1 /4, S17, T28N, R19W FOR: Description: Four Bedroom Mound System Object Type: POWT System Regulated Object ID No.: 923697 The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes COI. #'d'l:~l 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. APP 1 The following conditions shall be met during construction or installation and prior to occupancy or use: DEPARTMENT( General Approval Requirements: N OF. FTE • This system is to be constructed and located in accordance with the enclosed approved plans and with the SEE CORREt "Mound Component Manual for Septic Tank Effluent for Private Onsite Wastewater Systems" SBD- 10572 -P (R.6/99) and the 'Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems" SBD - 10573 -P (R.6/99). • The location of the lot line in question is to be verified. The county shall request proof of the location prior to the issue of the sanitary permit. • Per manual cited above, limited activities are allowed in the area 15 feet down slope of the component area. Soil compaction, excavation, vehicular traffic and other similar activities that impact the treatment and dispersal are prohibited. • The well must be a minimum of 25 feet from any POWTS tank, and a minimum of 50 feet from the absorption area. chs. NR 811 & 812c • A Sanitary Permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.135 and 145.19, Wis. Stats. • Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stat ARTHUR L WEGERER Page 2 10/9/03 • Comm 83.22(7) A copy of the approved plans, specifications and this letter shall be on -site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. Owner Responsibilities: • Comm 83.52 Responsibilities. The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s. Comm 83.54(1). • Comm 83.52(2) A POWTS that is not maintained in accordance with the approved management plan or as required under s. Comm 83.54(4) shall be considered a human health hazard. • Comm 83.55 The owner is responsible for submitting a maintenance verification report acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. All permits required by the state or the local municipality shall be obtained prior to commencement of construction /installation/operation. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 Charles L Bratz POWTS Reviewer II , Integrated Services WiSMART code: 7633' (608)789 -7893 , 7:45 am - 4:30 pm Monday - Friday cbratz@commerce.state.wi.us cc: Leroy G Jansky, Wastewater Specialist, (715) 726 -2544 .RFC TITLE SHEET FS EP �'P \ of `7 2 MOUND SYSTEi ��� 3 j UU� FOR 4f Q A BEDROOM RESIDENCE This plan has been prepared in accordance with the Mound Component Manuai SBD -1057 P and the Pressure Distribution Manual SBD- 10573 -P ' CtZ. b! g9� , 'C 61 LOCATED IN THE SL 1 /4 OF THE N C 1/4 OF SECTION 1 , T Z-g N, R 1 9 W, TOWN OF ST • i2_mu LX COUNTY, WISCONSIN. INDEX PAGE 1 of 7 TITLE SHEET PAGE 2 Of 7 SYSTEM MANAGEMENT PLAN PAGE 3 of 7 PLOT PLAN PAGE 4 of 7 PLAN VIEW -CROSS SECTION PAGE 5 of 7 DISTRIBUTION PIPE LAYOUT PAGE 6 of 7 PUMPING CHAMBER CROSS SECTION PAGE 7 of 7 PUMP PERFORMANCE CURVE PREPARED FOR _ SY't"NSIL S CTI-i -- Zo I �_k_ )v DNZ.�f N 1 L_ C.UZV E w ri 0 %v\'�_Y s S L zS %'ly JVtD ¢ CommER � ILDIN PREPARED BY pONpEN WaCGEE::ZER SO I L - TEST I NCG AND. DES I CBM S1 I CE P.O. Box 74 421 N.11ain.St. River Falls, WI 54022 Phone 715 - 425 -0165 Fax 715- 425 -6864 SC oPy / + '� i' .• ~` : ARTS1l1Y t 4 t WEGEkEN j j D S EIISWOR7w W • W I N- a _t --u JOB N0. Mound System Management Plan page Z of 7 Pursuant to Comm 83.54, Wis. Adm. Code Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Slats. The contents otthe 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 shall be serviced if the alarm is activated continuously. Intermittent filter alarms may indicate 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 shall advise the owner of when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank. The addition of biological or chemical additives to enhance septic tank performance is generally not required. However, if such products are used they shall be approved for septic tank use by the Department of Commerce, Safety and Buildings Division. 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 Distribution System No trees or shrubs should be planted on the mound. Plantings may be made around the mound's perimeter, 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. Cold weather installations (October - February) dictate that the mound be heavily mulched for frost protection. Influent quality into the mound system may not exceed 220 mg /L BOD5, 150 mg /L TSS, and 30 mg /L FOG. Influent flow may not exceed maximum 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 solids 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. Pcnding levels shall be reported to the owner, and any levels above 4 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring. General This system shall be operated in accordance with Comm 82 -84 Wis. Adm. Code, and shall maintained in accordance with its' component manual [SBD- 10572 -P (R. 6/99)] 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 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 a tank or component. Continaencv 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 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 biologically clogged adsorption and dispersal media, and related piping, and replacing said components as deemed necessary to bring the system into proper operating condition. Questions about the operation or maintenance of this system should be directed to: The County Zoning Office at "1 L J — 3�`j —4817 ST- �°2U l K The- system installer at `1 LS — Z� 3 _LL(igq 1'�jL'tSO�v The tank manufacturer at &r)0 - 1 ZS— i 1n.1ttMk' The effluent filter manufacturer at 0 - Z / - S z ^$LF The pump manufacturer at ' Ll y iv1��ZS PLOT PLAN r Scale 1"= �2 - Page 3 of - 7 LA I l -Yov�� IZP r m (YI Cl- N o � VA U. 7 � F � , 10 \•0� • �� e��M nr- � lbs. S PL P( ° ` S Dv h�oT evrtiprh - cT " J t 36 . - . TIP Sop � NOTES: I. Elevations shown are existing ground elevations unless otherwise noted. 2. Install 4" observation pipes with approved caps. ( Z required). 3. Septic tank to be ZZSp gallon capacity manufactured b ti Ca y w � t'2. Cttt!j"i; 4. Bench mark. 5. Divert surface water around system to prevent pond ing at the uphill side. Pace Of — 1 Approved Ssrr_theti c Covering ASTH C33 Distribution Pipe Medium Sand Topsoil -" o-� -H "> to E 0 b Slope Distribution Cell of Force Main Flowed 2" to 2 aggregate From Pump Layer Ft'. F Ft. CROSS SECTION OF A MOUND SYSTEM F o < o Ft. C 0 S Ft. A Ft. y i.o Ft. Linear Loading GPD /TN FT E b7 Ft. Design Loading Rate= o- 1_ 7G?D /SQ FT - 1 j Ft. -i Kra. Position L Ft. of Force Main i� `� Ft• L ' Pi �} -Observation e p r - - - - - -- ------- - - - --- - - -- -- =� A a----- X68 - sti - -- --- - - - - -- -------- - - - - -- --- - -- — Distribution 1 „ Pipe Cell of 'z to 2 = aggregate Observation. Pipe (Anchor securely) - PLATT VIEW OF A MOUND SYSTEI4 Distribution Pipe Layout Page S of — 7 Place the holes at the bottom of the distribution pipes at equal spacing. Remove all burrs from the pipe and holes. Extend the end of each lateral up with the use of long turn or 45 fitting to a point within six inches of the final Bade. Terminate the ends of the laterals with a valve,:threaded cap or threaded plug. Provide access from final grade for the valve, threaded can or threaded plug. T cC�`gS BoX_ 7 - 0 P_ 1 crR (_ . C\Izs \j C. Fv� Lateral Manifold �� C Lateral x x x x x!Z x2 x x x x Lateral Length - Lateral Length - p Distribution Une F?Ccwas sflx — -o h�1Ffl� S 1 O -- _ � q �'uC YoAC.0 M�lv P 3 3 Ft . Hole Diameter lli; Inch S 3 Ft. Lateral n I Inches) X Z-4 Inches Manifold " I �" ZInches Force Main " 2 Inches # of holes /pipe Invert Elevation of.Laterals l'"hc o q l L. L GP�11 PUMP CHAMBER CR055 SECTION AND SPECIFICATIONS ' PAGE OF 7 VCUT CAP `i'C.T VENT PIPE WEATHER PKOoF APPROVED LOCKING MANHOLE 10' FROM DOOR, JUAJCTIOIJ 80X COVER WITH WARNING LABEL WIIUDOW OR FRESH I2�M1U. AIR IMTAKE I GRADE I CZ � 01 I . I ti' 1111.1. COUDUIT _ I13'MIAI. — �� —_ ---- il.ILE PROVIDE ArRTIGli7 SEAL I I V APPROVED JOINT A I Ii� APPROVED JOIIJ I I I I I ALARM 15 I I c I ow CLEV.�� = FT-- I i PUMP,, - -� �. OFF 0 t n5 00' COLICKETE DLOCI( PROVE Y RISER EXIT PERMITTED ONLY IF TAWK MAIJUFACTURER HAS SUCH APPROVAL 3,•AolIbw, 8>c00 t JVr; SPEC-IFICATIOMS DOSE T_A!J S MAMUFACTU0.ER: IJUMDER OF DOSES: S - � PER D" TANK SIZE: S GALLONS DOSE VOLUME z ALARM _ J!IANUFACTURER: S . S�'LS >�~! INCLUDING 6ACKFLOW: j Z �• 7 . GALLONS MODEL NUMBER: CAPACITIES: A =- ZD - - - --� UJCH �' �' - -- - ES OR .7__� GALLONS SWITCH TyPC: - �L -L1 INCHES OR L 'I•u • (00�LLOIJS PUMP MANUFACTUitER: L t �ZS C = 6 IIJCHES OR "1� 2 GALLOWS MODEL WUMBER: �- L� O C t IAIC 16 2-- $ GALLON' S SWITCH TYPE' IJOTE: PUMP AMD ALARM ARE TO D I MIWIMUM DISCHARGE RATE IAISTALLEO OW SEPARATE CIRCUITS VERTICAL DIFFEILE OETWEEN PUMP OFF AU0.0ISTRIBUTIOW PIPE 6 FEET + MlAIIKUM • NETWORK SUPPLY PRESSURE 6. • S O - FEET S - xt.3� + 1 r FEET OF FORCE MAIM X 3 - S q F - o itFRICT►ou FALTCa. � � b FEET TOTAL OyWAMIC HEAD = ^_.. FEET As per:nanufacturer • Z.O- gal /in. _ Liquid depth 3-7r' ME40 Series M 4/10 HP Effluent and Drain Water Pumps Performance Curve MODEL ME4O EFFLUENT PUMP CAPACITY LITERS PER MINUTE 0 50 100 150 200 250 300 350 40 12 35 10 W 30 W + W H 25 8 f Z p � z 20 6 J = 0 1 3.t► 4 i 10 ut. 8 z 5 2 0 0 0 10 20 30 40 50 60 70 80 90 100 CAPACITY GALLONS PER MINUTE 1101 Myers P arkway, - y rs a ay, Ashland, Ohio 44805 1923 419/289 -1144 FAX 419/289 -6658 Telex 98-7443 K3326 7/91 Printed in U.S.A. r Wisconsin Department of Commerce SOIL EVALUATION REPORT Page 1 of 3 Division of Safety and Buildings 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 Parcel I.D. percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Please print i ill infbrnmfLon _ ev' ed by Date Personal inforrnahon you provide may be used or sec R, ur o ey(F.a ` 1 vaCy Law, 5. 15.04 (1) (m)). Property Owner Property Location )�SI Nf� 0C" f 1 4 !00 S� 1/4 1/4 S t T Z� N R E (o W Property Owner's Mailing Address Lot # I Block # Subd. Name or CSM# Z � - ) -- "E�'�D N L S City State Zip Code "`- ❑City ❑ Village ® Town Nearest Road 2.Ly MCI SS 1Z S 1 ( 6S I ) - 1 - 1 S - 5'Z - T -- az l y I L ET (!Z\) 1Z. L ® New Construction Use: ® Residential / Number of bedrooms Code derived design flow rate (3 O GPD ❑ Replacement ❑ Public or commercial - Describe: [� Parent material Flood Plain elevation if applicable ft General comments and recommendations: W /9 rx 6 ' D LS1'iZL 3 V`R CW C ) ,nj ( )-A U M O )_ -S f iLL © Boring # ❑ Boring ® Pit Ground surface elev. ft. Depth to limiting factor S 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 - S M4 R- 317 Z tis -3`1 n-1Z3 sz I ?rns mfr 3 ��l -s� to�trz3! — s i 1 Sbr` rn Cw • z 3 L L 5.0 - ' 0 logl 31 ISLIRS /15 s� � OJ-� -, Irt�c� •� �Z El Boring # ❑ Boring ® pit Ground surface elev. c - � ft. Depth to limiting factor 3 7c in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /11 in. Munsell , Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Etf#2 0- to v- 1Z tZ _ s i 2`r b Z P-33 It-1tz 31Z S i l 2.wt S b�T � CW S _8 3 33 -L) 3 %1 tZ 3/b st 1 tieSb lz '17f1. ck, ,z. . 3 1� 1 � S`I QS �� Effluent #1 = BOD, > 30 < 220 mg1L 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`. We'gerer a4 vi_ 03--1 3 220254 Address W e g e r e r Soi Testing & Design Service Date Evaluation Conducted Telephone Number 421 N. 1-iain St. River Falls, RI 54022 C1 Z-0 _03 715 -425 -0165 Property Owner 5 �� 1 Parcel ID # Page 2 of M Boring # ❑ Boring ® Pit Ground surface elev. �(]Z ft. Depth to limiting factor 3 In Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD / In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •Eff#2 ' O- iVy� 3 LZ — SL Z`Fsbk YvL C1 • S -c� Z $ —�Z 1p�-fR 31b — S`i Zht M — C A J 3 32 - qU V - IF- " 513 ❑ 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 ❑ 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 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. SBD -8330 (R.6/00) I PLOT PLAN Pacre 3 of 3 Scale 1'=q\3 ' , .o !ZP d � � J r N M F EL CKJ 0 N J 5' $.3 � �-� , to \•fir � L,-3A/ 9rM PUe P� PE w /L�'TJ Du NOM "Kpf J _ Te'-� t�tfvlJ� P� rtrinZT- i 715- 425 -0165 220254 CST Signature Date Telephone Ito. CST No. Job NO. 10/09/03 THU 09:56 FAX 715 386 4686 ST CRX CO ZONING 0 001 ST CROEX COUNTY SBPTIC TANK MAINTENANCB AGREBMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer <_x- � Mailing Address b 3 3 e_ <n - c Property Address / 7 t r L A- Loa e a� (Verification rcquired from Planning Department for new construction)_ city /State r Parcel Identification N 7 O b YO - 12 -qo - cm LEGAL DESCRIPTION (. 1`W4 ) Property Location V/., 1 /s, See. /7 , T w, Town of ' ` /Z V Subdivision e , <' ^d Lot It Certified Survey Map # Volume �^ Page # Warranty Deed # _ "71.x- Volume 2 ( Page # ��- '-spec House ❑ yes 0 no Lot lines identifiable yes ❑ no SYS= MAINTENANCE Improper use and maintenance of your septic system could result in its premature failure toindle 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 t=eatment stage in the waste disposal system. The property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a masterplumber, journeymanplumber, restrictedplumber or a licensedpumper verifying that (1) the on -site wastewaterdisposal 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. Uwe, the underugned 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. Cettificatioa stating that your septic system has been maintained must be completed and returned to the St Croix County Zoning Office within 30 days three year . ration date. "OL . ul, OF APP ICANT DATE OWNER CERTIFICATION I (we) certify that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owner(s) of the pr descn' bed alive, by virtue of a warranty deed recorded in Register of Deeds Office. lJ � � t3NA OF APPLICANT DATE ssssss Any information that is mis- represented may result in the sanitary pormit being revokeAy the Zoning Department fas`sf as Include with this application: a stamped warranty deed float the Register of Deeds office a copy of the certified survey map if nfettince is made is rho warranty deed Z III /III / '11113 111:18 St. C'rol\ (Count" Sharon Full el - +Stwthl, Sonj11 112 y U 2 4 2 9 P 4 7 2 74ie - 7 E�9 KATHLEEN H. WALSH STATE BAR OF WISCONSIN FORM 2 - 2000 REGISTER OF DEEDS Document Number WARRANTY DEED ST. CROIX Co.. WI -- RECEIVED FOR RECORD This Deed, made between Donald 0. Rodah and Jovice J. Ro dabl, 10/07/2003 08:00AI! husba and wif Grantor, and SaW Sethi and Dian K. Sethi, husband I a n d wife a s su rvivor sh ip mar ital propert Grantee. WARRANTY DEED Grantor, for a valuable consideration, conveys and warrants to Grantee EXEMPT M the following described real estate in St- Croix County, State of Wisconsin (if REC FEE: 11.00 more space is needed. please attach addendum): RAMS FEE: 254.70 LOT NINE (9), PINEY WOODS SUBDIVISION IN THE TOWN OF COPY FEE: CC FEE: TROY. PAGES: 1 i i f Recording Area i Name and Return Address i St. Croix Valley Title Services, Inc. P. O. Box 750 i River Falls, WI 54022 -0750 040-1065 ,04 0-1068.70-100, 040-1068- 040 - 1068 -70 -000 Parcel Identification Number (PIN) j I This is not home. Lead property. ii5i iii Exceptions to warranties: easements, restrictions and rigbts of way of record, if any. orb• Dated this day of September, 2003. _ Q ' Donald O. Rodahl " — Joyce J. kodahl AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF WISCONSIN ) ss. ST. CROIX Countv. ) .tom authenticated this __ day of %O Personally came before me this day of s ( September , 2003 the above named Do nald O. Rodahl and Jovice J. Rodahl _ • I TITLE: 'vfFM8ER STATE BAR OF WISCONSIN (If not, v..U%% to me known to be the person(s) who executed the foregoing j authorized by §706.06. Wis. Stats.) R Y A th t and acknowledged the same. r i THIS INSTRUMENT WAS ' .D SY Joseph D. Boles - Attorenv at Law — , fj�M z3v O , Krl River Falls, WI 54022 r 'Notary Public. State of Uj 1 S eon/ S i' ? \4v Commission is germane (If not, state expiration date: I (Signaturc> may he authenlicated sir aeknowle y il i are not nccSyS� I 911 �QS y • dames of persons signing in any capacity must be ry r rr signature INTO - PRO (8001655 — ( w »a..iulwuG :om tl� 9AR Or WISCONSIN wARR , kNn' DEED FORM No 2 - 21WM UBDIVISION OF SECTION 17, AND INCLUDING OR DED IN VOLUME 8, PAGE 23731 1 �4 OF SECTION 161 HE N W H, RANGE .19 WEST, - COU N T Y, W1 S C ON S IN THEAST CORNER � ,� 28, CTION 17 - FOUND $ :� J UMI NUM CAP MONUMENT :C I ' NOR y l c ( TO NE COR. L OT 13) Ch , (N88 S7 52 E) 33' 3' N88 57' 43" E 1302. 44' 267. 16' 1 fND� 2' IROA X 1 Z N49 WE p3' X X• 138. 09' X X- 150. 02 IRON PIPE 1: ' .. - E T )' O . 0 FROM SET IR[ I g' .( THIS SHE , I FND. 2� '4 17 • ' M NSO' 03' 31'' E 0. D4' FROM SET f RON - W E LOT 33. 33' 1.73 ACRES , I c w = s 75,456 SO. FT. ro O ` G; Q ; fr,' is N88* 57' 43 8 : LOT 9 LOT � o. 78' ORES A 1.27 ACR ro CA 55,289 S0. FTi T. w w 52, 034 SO. FT. � CA '~ i 9p •fi5 3 6• w u '--136.97'-"- 37.60'' / L.t Wisconsin Department of Commerce SOIL EVALUATION REPORT Page � 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 1/2 x 11 inches in size. Plan must S �' C M lx include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. 1 Z_' ) tDQZV I h.1 G percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Please print all information Rev' wed by Date Personal inforrnation you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Property Owner Property Location O N I�IJD R ODA �{ L 6evt, -Lot S 1/4 NE 1/4 S 1 1 T Z8 N R 1 9 E (oCW) Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# �D ) )UE% WOD D� 2 1 7 L t-•j e 9 — City State Zip Code Phone Number ❑ City ❑ Village Z Town Nearest Road RIU kll Ft.LS LN Z -� New Construction Use: ® Residential / Number of bedrooms H_ Code derived design flow rate GPD ❑ Replacement ❑ Public or commercial - Describe: Parent material OU YV . Flood Plain elevation if applicable "' � ,' i V `� '��. General comments and recommendations: ► -AUV Kj�Z ►til g r k .� • D l �(, 1�! n [a ' r ST'ktl eU`C1 UK/ dQZ. C . N'1 lI�1U�UM -1 G " OF . S ST CFKJtX r LL \ ()ODUINTf COrv "'o t I - - 0 1 o f .O i =' j \ ZONING OFFICE F I Boring # ❑Boring f' i' 'ty- 00� pit Ground surface elev. q8 • a ft. Depth to limiting factor i n. Soil Application E Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 - 1 L Z'� m U'fir Z 6 -ZS �.S72 yly — Z n`D .b 36 -yy 8/) - 1 SL-t2 /s A ov.t mv'f1.- f a Boring # ❑ Boring pit Ground surface elev. Q ft. Depth to limiting factor 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 o - %'lV_31 L Z'�9 � - rn w Z %_s I'sLayly L 1,as M �w • u , 3 33-gq scftz V I y s '1 fZ S /l; L Cwt yn- - - • 3 s Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 _< 150 mg/L • Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) S' nature CST Number Arthur L. Wegerer :S l'6 —� 220254 Address 4d e g e r e r Soil Testing & Design Service Date Evaluation Conducted Telephone Number 421 N. Main St. River Falls, (•7I 54022 l2_lq_� 715 - 425 -0165 1 t Property Owner �Z d V>/a H L - Parcel ID Page Z of F:�] Boring # ❑ Boring a S ® Pit Ground surface eiev. ft. Depth to limiting factor b S 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 4 -9 1Z SO 2�sbh wl'F C'S - • s •8 .� Z 9 - t��2 stI Zw '-Ar m clv • - .to 3 is .39 z SyIZ 3 t y _ s f 1 e.s � �c YnU'F►- �' -. ° � - � ,`' f � -6S �•S`�2 3ly _ SC) ILSb� M- '� • 3 .2 F] Boring # ❑ Boring ❑ Pit Ground surface eiev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD 1ft In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •Eff#2 F-1 Boring # ❑ Boring Pit Ground surface elev. IL 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 • Effluent #1 = BOD, > 30 < 220 mg/L and TSS >30 < 150 mg/L • Effluent #2 = BOD < 30 1ng /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 T.t'Y 608 -264 -8777. SBD -8330 (R6/00) PLOT PLAIT Page 3 of 3 / Scale 1' =SV' X38 -vq� x " F 8.3 �o�ow1 O M L � ?, \�� cat: �\.S`tvVtz Coh i of ° PtGj;� w! LIM 3t4Z NZ. I t�3- Z 'Oiv7 "�m�;��y''Dtq. 0 a0 00 r r fur 9 L.uT to i Z -1q-01 715- 425 -0165 220254 - i I -S IS � CST Signature Date Telephone No. CST No. Job N O. Wisconsin Department of Commerce SOIL EVALUATION REPORT Page 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 1/2 x 11 inches in size. Plan must include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. I G percent slope, scale or dimensions, north arrow, and location and distance to nearest road. 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 O N f�IJ J O ROD R IA L 6eut, -Lot S (_ 114 NE 1/4 T Z8 N R 1 9 t E (ocw) Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# �) yV 1. WOo D'I 011 tvNo CA-c LY E 9 — — City State Zip Code Phone Number ❑ City ❑ Village ® Town Nearest Road I lti s� n ZZ (� lS) �I ZS- 6�4 Z '� e'RsT C4)u E 1Zo New Construction Use: ® Residential / Number of bedrooms _ �_ Code derived design flow rate 600 GPD ❑ Replacement ❑ Public or commercial - Describe Parent material ` ts% S O U Z -- n L Flood Plain elevation if applicable ft General comments and recommendations: V`* UV KjZ h l Cj r k �, .� • D L S 12 i �� U1�J L . M I um 6 ` OF- S`t?,A a Boring It ❑ .Boring ' pit Ground surface elev. 98 $ ft. Depth to limiting factor 3 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 1 0 -(o LD - m-31Z - L Z m ufy - zs 3b )0�2 X16 - 1� 1,esb dish c� � • � , 6 36 -yy Boring # ❑ Boring pit Ground surfaces eiev. 0 ft. Depth to limiting factor I S in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots . GPD /ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff #1 'Eff#2 -� )OylZ31z - L Z`�9r rnv- S -U 3 33-gq SVtZ illy in+ — • 3 •S ' Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BOD, < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) S' nature CST Number Arthur L. Wegerer 0 1 -31$ -9 220254 Address lie g e r e r Soil T e s t i n¢ & Design Service Date Evaluation Conducted Telephone Number 421 N. 1 St. River Falls, NI 54022 1Z_l�_�� 715 -425 -0165 I Property Owner �Zb Ala H 1_ - Parcel ID # lVp 1 )"j r. Page �- of Boring # ❑Boring a Z . S ® Pit Ground surface eiev. ft. Depth to limiting factor } 6 S 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 0-9 v0)-m IZ s l l Z` -sb�t WIT. - C , - , s . F3 Z q - i s tD �231 y — st I ZWisVh vn`N s -a lQ r� • z, , 3 ❑ 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 /fl= In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •Eff#2 F-1 Boring # Boring Ground surface elev ❑ ❑ Pit . ft. Depth to 1(miling factor in. Soil Application Rate Horizon I Depth Dominant Color Redox Description Texture 1 Structure Consistence Boundary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. • Eff#1 Eff#2 Effluent #1 = BOD, > 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BOD < 30 mg /L and TSS < 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•8330 (Rb/00) - PLOT PLAN Page 3 of 3 � Scale 1' =sD' r38•vq� C.0►uTCJ•.+2 �L. �lq •0� �� 8.3 � �0 Wl OF M L �O ►VOT �0 Ch 0 0 \\ :� � S. 1 3 g�N1 ill � ISM t4Z -.Qc. 1 X13 -Z'.pN 7 "JYML Iq b q . `•'uC °tom= :�lLP'7'�. 03 LL)s 9 i LuT to 715 - 425 -0165 220254 C 1 -318 q CST Signature Date Tplanl�n"a f.T �(7T .., _ - - 24 u.