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Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Cr01 Safety and Building Division INSPECTION REPORT Sanitary Permit No� 420633 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: Stepan, Gary Troy Township 040 - 1296 - 40-000 CST BM Elev: Insp. BM Elev: BM Descri iorri 0 , U -D p� o� —.�- TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark pa a °� Q b __ _ Dosing v 7'0 J q 1 Aeration � Bld S wer 4 rw, r r / (g Ht Ht inlet ( � �61� -Z 1, (a� • r TANK SETBACK INFORMATION S t Outlet `I 7 TANK TO PAL WELL BLDG. Vent to Air Intake ROAD Dt Inlet r nor Septic ' �, f ^ DtB m S �� D + -Z Dosing }- �' ,/ Healer /Ma 7 • ': 2 Aeration Dist. Pip q IF rf- I LAO E�� Holding ot. Syste g 21 a I Final Grade ,,• �� PUMP /SIPHON INFORMATION (� (� L? Manufacturer (� CJ� -+-� Demand St Cov . b GPM Model Number CC(/✓L G TDH Lift Friction Loss System H TDH Ft 1.� T. a Forc main L t � Dia. � �,� Dist. to Well ( � w 1�.,, o >. b i S6ILAI§SORPTION SYSTEM 07 jZkX + - BED/TRENCH Width J Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS � SETBACK SYSTEM TO P/LW JBLDG IWELL LAKE /STREAM LEACHING Ma aature {� INFORMATION CHAMBER O .44- 1 u Type f System: r � 7 / UNIT Model Number: DISTRIBUTIO SYSTEM 2" " * Header /Manifold ib Di S pacin ution x Hole Size x Hole Spacing Vent to Air Intake Length Dia Length 1 / Pipes) If 1 ,/— , [ / SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded /Sodded xx Mulched Bed/Trench Center Bedrrrench Edges Topsoil M Yes No ❑ Yes h, No COMMENTS: (Include code discrepencies persons present, etc.) Inspection #1: / / Inspection #2: / / Location: 393 Mitchell Road Hudson ( WI 54016 NE 1/4 S ) y 1/4 19 T28N R19W Trebus Valle E�s Lot 14 Parcel No: 19.28.19.1706 1,) Alt BM Description= S�' �D _40 f 0— W4 ( Sea 2,) Bldg sewer length= 3q v " 6 Z� �� '{7 4R.�.•cl - amount of cover = 3.) Contour= -� Plan revision Required? [] Yes No �� — LG � >„ L Use other side for additional information. & Date Insepctor's i nature Cert. No. SBD -6710 (R.3/97) Safety and Buildings Division County W 201 W. Washington Ave., P.O. Box 7162 C �) �seonsnn Madison, WI 53707 - 7162 Site Address De artment of Commerce 3CI3 M Sanitary Permit Application Sanita Permit Number f ` In accord with Comm 83.21, Wis. Adm. Code, personal information you provide V Check if R evision e� 3 J may be used for secondary purposes Privacy Law s15.04(1 m I. Application Information - Please Print All Information State Plan I.D. Number N A Property Owner's Name (` w. _ Parcel Number 14 , 2 0 � Property Owne s Mailing A dress u U �� .) 3 /'700 2003 Property Location , /'700 3 // // Ale V , J ^YI4 ; S T N. R Q City, State [ ip Code' , 9 - eNum r Lot Number Block Number Subdivision Name CSM Number II. Type of Building (check all that apply) � ❑City X 1 or 2 Family Dwelling - Number of Bedrooms ❑Village ❑ Public /Commercial - Describe Use grownship 'T rG ❑ State Owned 2 / 7 Nearest Road / A4 III. Type of Permit: (Check only one box on line A (numbering scheme for internal use). Complete line B if applicable) A. I >,New 2 ❑ Replacement System 3 ❑ Replacement of 6 ❑ Addition to For County use System Tank Onl Existing System B. Check if Sanitary Permit Previously Issued Permit Number Date Iss S s ue _1712-e:6 3 /Z Z 7/1:S IV. Type of Permit: (Check all that apply) (numbering scheme is for internal use) 44 �Jon - Pressurized In- Ground 210 Mound 47 ❑ Sand Filter 50 11 Constructed Wetland 22❑ Pressurized In- Ground 41 El Holding Tank 48 El Single Pass 51 El Drip Line 45 ❑ At -Grade 46 ❑ Aerobic Treatment Unit 49 ❑ Recirculating 30 Other V. Dispersal/Treatment Area Information: ✓ /• / Design Flow (gpd) Dispersal Area Dispersal Area Soil Application PercolatioK Rate System Elevati tnal Grade Required Proposed Rate(Gals. /Day s /Sq.Ft.) (Min. [Inch) Elevation VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic Gallows Gallons of Tanks /( �1A� �� U Concrete Constructed Glass New Existing vim/ /� Tanks Tanks Septic or Holding Tank /Z 60 -- Dosing Chamber 49(X3 VII. Responsibility Statement- I, the undersigned, assum responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plumber's Signature MP/MPRS Number Business Phone Number ,A-V 'f) W VV , ` 2?.C�y Z 71 f _ - 2 T z , Plumber's I Address (Street, City, State, Zip Code) 3 r g Z-� }� l,J�, S Lc� rv�� �1 VIII. oun /De artment Use Onl a .! 7- 3 Approved ❑ Disapproved Sanitary Permit Fee (includkh Groundwater Date Issued s ent Signature (No Stamps) U El Owner Fe Owner Given Initial Adverse . 6" Determination 5� TX. Conditions of pprovaUReasons for D' pproval fie/ QO� 4V h� IOG��LOn. �•e� �GGt >�JTT bus N( ��r� d • � ch complete p (to the County only) the "em on Ps not less than 81/2 z Il Inches In ' SBD 6398 (. OS /Ol) JOB TIMM EXCAVATING SHEET NO. OF Route 1 Box 192 WILSON, WISCONSIN 54027 CALCULATED BY DATE (715) 772-3214 (715) 386-5443 MPRS #3224 WI MPCA #696 MN CHECKED BY DATE SCALE ........... ............ ........... .......... ........... ....... ... . . . .......... .......... .......... .......... .......... ........ ...................... ........... ........... .......... ............ . ........... ....... ..... ........... ........... ........... ..... ......... .. ........ ... ......... . . .. .... ............ ........... ..... ..... .... ................. ..... ....... ..... ..... ..... ......... . .......... ........... ........... ........... . ...... .. ........... .......... ........... ........... . ..... ........... ........ . .......... .......... ........... ..... ..... ........... ........... ........... ...................... ........... ........... ........... .... ........... ........... .......... ........... ........... ......... ........... .............. .. ...... ... .......... ................................. . ........... ........... ........... ........... ........... ... .... . .... ......... ........... ... ...... . . ........ .......... .................... 1IR . .. ........... . ........ .......... .......... i ............... ........... ........... ........... ...... ... . . ....... . ........ . ......... .......... . ......... ......... ............ ... ....... ...... .... i ........... . ........ ........... ........... .... ........ .......... ........... ........... ....................... ........... .......... ---------- ........... .......... .......... ........... . .......... ........... ........... ........... .......... .......... .......... ........... ........... ........... . ........ ... .. .................... .......... .......... .......... ........... ..... ........... ...... ........... ............................ .......... . .......... ..................... ........... ........... ........... ---------- ........... .......... ...... ....... ........... .......... ...... .... ........... ............. ..................... ........... .... .. ...... ........... ....... — .......... . .................................. ........... ........... ........... ......... .......... ........... ............ . ........... . ......... ........... ........... .......... ........... ........... ........... .......... . .......... ........... ........... ........... ........... ......... ......... . ........... - ------------ .. .... ......... ..... ...... ........ ........... . ........ ........... ........... ........... .......... .. ................. ---------- . .......... ..... ..... ........... .... ..... . ........ ........... ........... ........... .. ... .......... ............ ...... .......... ........... ........... .......... .......... ........... ........... ........... ........... .......... . . ...... ........ ... . ..... ... ... ........... ........... 1 5� . ........... ........... ........... ........... .......... ................ ............ ; . ........ ..... .......... r ........... ........... ........... ............... --- ........... ............... ........ .. ........... ....................... ... ......... ......... ............ ........ ........ ................... . ........... .......... .......... .......... . .......... ............. . ... .......... - ..................... ......... .......... ........... ........... .............................. - .......... .......... .......... --- --------- .. ......... .... ........... ............................... .............. ........... ..................... ...... ..... ............. .......... ........... ................. . ............ ....... ........... .................. .............. .. .. ......... . .......... ..................... .................... ........... ......... ... — QN ................. .......... .......... ............. . .............. .......... f . ........... o ............... ............. ........... ........... ...................... ........... ... v 43 ............ ........... ............ ................ .......... ..................... .......... ................. .......... .. ......... . . ............ ............ ...................... ........... ........... .. .......... .......... ................... ............... .............. ..... .............. ........... .......... . ........ .......... ........... ......... .. ..... ...... .. .......... ....................... ............. ...................... ........... .............. ........ .. ................... ................... ...... .. ... .. .. C-1 0 p PROWU 105-1�lx, Groton, fts. 01471 To Oldv PHONE TOLL FREE I-M225-M iY lie d Yl - r r z� PAGE O PUMP CHAMBER CROSS SECTION A SPECIFICATIONS - -VENT CAP 4 "C.Z. VENT PIPE WEATHER PKOO APPROVED LUCKING _ JUNCTION BOX MANHOLE COVER ? 2-5' FRCM D GOR, j —1 WINDOW OR FRESH 12 "MIU. AIR IMTAKE I GRADE I y„ MIIJ. 18 ° MIA!. COMDUIT - - PROVIDE I -- INLET � AIRTIGHT SEAL I I v APPROVED JOINT A I I APPROVED W1C.Z. PIPE I II W/C.I, Pip[ EICTENDINI, 3' I I ALARM Ex TENDIUv OWTO SOLID "(,I B I I I ONTO Soy I r: I 1 I I oN c I PUMP —� - -� OFF D ' CONCRETE BLOCK �L 74,0 RISER EXIT PERMITTED C)ML9 IF TAUK MAUUFACTURER HAS SUCH APPROVAL SPCCIFICATIOUS .PTIC AND iSE TANKS M'ANUF'ACTURER w�'`' C� e, NUMBER of DOSES: � ._- PER DAY TAMK :AZE: cC GALLOMS DOSE VOLUME: Y3� GAI L�U ALAR MANUFACTURER: _ �_� GI�L�r� CAPACITIES: A= Z" L - IIJLHES OR t" MOUEL NUMBER: Y - K d JAL SWITCH TYPE: ✓t�`ryf ���� C= 7 _ INCHES ORI:9!L GALL, PUMP MANIIFA(..TURER: �dLl� U= _ W(HES OR MODEL NUMBER. CPO '53 NOTE: PUMP AND ALARM ARE TO BE SWITCH TYPE: Y"uyC -t-�u b INSTALLED ON SEPARATE CIRCUIT~ PUMP DISCHARGE RATE 70 GPM VERTICAL DIFFERENCE BETWEEN PUMP OFF ARID DISTRIBUTION PIPE.. Ai C FEE1 + MIAIIMUM NETWORK SUPPLY PRESSURE . . . . . . . . . . . _51._ FEET a � i '"j �G� /I �d yl ..� _ FEET OF FORCE MAIN X °- N FRICT10 FACTOR FEET d TOTAL DYNAMIC HEAD - �a oSFF_ET E:Yc1?A.A.. '11MFWS+(.IEIS OF TANK: LENGTH _ _ ____;W'�TH -y .- ;LI(a' Ff. H J r o 0 IV E,I W° x S 2 b A— t PA o •a � iw F s s c 4j e •� P s r i. 4 t/� s r i C o p 14\ P 3 r J s lT� s N �ir l JOB 5 �e a2m,4 TIMM EXCAVATING SHEET NO. OF Route 1 Box 192 WILSON, WISCONSIN 54027 CALCULATED BY ✓ h" r`�- DATE II Z� -G, (715) 772 -3214 (715) 386 -5443 MPRS #3224 WI MPCA #696 MN CHECKED B J/ DATE SCALE �y .......... .......,__ ........., ... ..... M .... ..... .......... :..... ..... ........... ...... ........< .......................... ............................... .... ..... .... i .............. ................... .... . ;... ..... .... .. ..... ........................:.. .... ... .. .... .... J ......... �i �-- ---- t ... >,� ..... .... .. . w .�, ...... .. .. qp .. ..... .... ,9 r ........ C ..... ... ... .... .. .... .......... ......... ....... -. ..... ....... ... :...._ ...... J V a .. - ........... ....._ _...... ....... .. .. .... ._._. ... ,. .............. ... ,_. .. �n �e. ... .................. ., .. \.. � .... PRODUCT 206-1 . Inc ., Groton, Man . 01471. To Order PHONE TOLL FREE 1- 800.225 -M 51y� Goulds Submersible - Effluent Pump { EPO4 387 EP05 0 s - 4 �IP!PUP "O' NS !.Fasteners: 300 series • FuRy submerged in high ■ Motor Housing: Cast iron designed for the stainless steel.' grade turbine oil for for efficient heat transfer, 5 f • Capable of running lubrication and efficient strength, and durability. dry without damage to heat transfer. ■ Motor Cover. Thermoplas- Efflu ems components. tic cover with integral handle • Ho AvaPable for automatic and g •' Motor sum manual operation. Automatic and float switch attachment • Hea P • Single P EPO4 Single phase: 0.4 HP, 115 or 230 V, 60 Hz, 1550 models include Mechanical poin r- transfer Float Switch assembled and ■ Power Cable: Severe duty • Dewafe(n - -RPM, built in overload with rated oil and water resistant. no preset at the factory. automatic reset. t • EP05 Single phase: 0.5 HP, ■ Bearings: Upper and lower SPECIFI TIONS FEAYfURES 115 V 60 Hz, RPM heavy duty ball bearing , , , r construction. mp EhOd tf built in overload with ■ EPO4 Impeller: Thermo - r •Solids handling capability: automatic reset. plasf Semi -open design 3/i ril - -mum. •Power cord: 10 foot with pump out vanes for AGENCY LISTING .• standard length, 16/3 SJTO :Cap tl ::up to 55 GPM. 9t . mec.tanical seal protection. Co. Canadian Standaft hmiauon s up to 24 feet. with three prong grounding m EP05 Impeller Thermo- ' • l)i size: l' /z' NPT. plug. Optional 20 foot (CSA listed model numbers length, 1613 SJTW with plastic enclosed design for „ F „ "AC".) seal: carbon- end in or a.: rotary/ 'rdmic- stationary, three prong grounding plug improved performance. `,- BUNA- kilastomers. (standard on EP05). ■ Casing and Base: Rugged Temperature: thermoplastic design provides ' 104 continuous superior strength and 140 F,(60C) intermittent. corrosion resistance. •.Faste 300 series METERS FEET -- StainIBSS:St681: 10 - - - — -- !,jCapable running dry without damage to 9 30 I - 5oPM components. Pump. EP05 8 L 2.5 Fr • Solids handling capability: c 25 - '/4' maximum. -- - -- - - - . Capacities, up to 60 GPM. = s 20 f 4TotaJ peds: up to 31 feet. DiscU oe size: l'ft' NPT. < -- - -- - -- - L _...... ..... - -..__ __._._____ .... ... _ ______.. _- +►'Mecha�tiaal . seal: carbon- 5 - rotary Ce 4 famic- stationary, _j 15 BONA elastomers. - +nTempe tore: 3 10 104 40C) continuous 140 °F WT) intermittent. 2 - — — - _ - ' - -- - -- - w4 v 1 0 OC 10 20 30 40 50 GPM C 2 t S fi 8 10 12 m� CAPACITY / f p 1896 Pun", Inc. V Effective May. 1995 rK 83871 / \ ROAD E'XTENSIO OF -' LOT 19 ,5 0 I � 12 5567 S) 2.88 P(c, 31.89' DRAINAGE LOT 13 N H K _ a / <s � �o\ 20.1' M 108328 S.F. / CV to 2.49 Ac� M.F.E. = 922' �• ' �' / ���• � � � \ �� Off~ � A� 1 �,�'y N 41 • EASEMENT 6 M s T - 14 �°� 3 s8o 87789 7 7 19 X02 AC I O, DRAINAGE P AZ M. F. E>-; 920 0l, 100' ,. HWE _ 1 \ 912.6' 51�►; ,� 0 "TO\\ LOT�15 '� � �FqS ?qo ?R'6FygY•\ 102274 \ \ I N � FM 3, 6 S.F. 2.35 Ac. (fi v� �g M . F� _� 915' / ' /ly EASEMENT ` S � Y S4, < LOT 16, f0- 2 119650 S. F. c ` 2.75 Ac. M. F`E,. = 913' I ' . I 50' 00 0 18 , 19 � ` DRAINAGE i J \ 5 4,2 4 , ly V °i o� 1 w CN N (3 ? X 33 o N c in LOT 1 ' 7 \ N 'Lo 3 o, cv 3 px 140148 S.F. Z o CD ,�. 3.22 Ac. W \ a n N . 9 M FEE. 910' I O o p o \ fn 1B � S 6 � I I 1 150, N 1702 Wisconsin Department of Commerce SOIL EVALUATION REPORT Page 1 of 3 Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code Certified Soil Testing 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 parcel I.D. O 0 _ percent slope, scale or dimemsions, north arrow, and location and distance to nearest road. — O Q Please pr rused _ g o ;� tl py .___ view d y D to Personal information you provide may s ' V 1� y Law, 15.04 (1) (m)). �� a Property Owner Property Location Stepan, Gary & Cindy uI`j 2 Govt. Lot NE 1/4 SE 1/4 S 19 T 28 NR 1 Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# 915 Ridge Pass 14 Trebus Valley Estates City Stat _t - i4er Lj City Village ✓1 Town Nearest Road Hudson WI 1 54016 715 - 386 -9142 Troy Trebus Valley Rd. ✓ New Construction Use: Residential / Number of bedrooms 4 Code derived design flow rate 600 GPD Replacement Public or commercial - Describe Parent material sa ndy /loamy outwash -Flgpd plain elev ion if a plic l NA General comments c,� v ' 'e 7� - -a and recommendations: install 2 X 2.83' x 87.08' (St'd - Infiltrator, 28 shells) stipulation 1099 chamber tr nches @system `n s elevation of 94.5 Boring # I Boring ✓f Pit Ground Surface elev. 98.7 ft. Depth to limiting factor > 108 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 10YR 3/2 - sl 1 f sbk mvfr gs 1f /m .4 .6 2 7 -44 10YR 4/4 - Is 2 f -m sbk 3pvfr cs 1 m 7 1.2 3 4 -108 10YR 4/4 - s 0 sg ml - .7 1.2 do I i ,44- R , �' = Sb q `' 2 � Aj I S � Boring # Boring Pit Ground Surface elev. 96.3 ft. Depth to limiting factor > 110 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence I Boundary Roots GPD /ft' in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 `Eff#2 1 0 -8 10YR 3/2 - sl 1 f sbk mvfr cs 1f /m .4 .6 2 8 -25 10YR 4/4 - sl 1 m sbk mvfr cs 1 m .4 .6 i 3 25 -110 10YR 4/4 - s 0 sg ml - - .7 1.2 I I Effluent #1 = BOD 30 < 220 mg /L and TSS >30 < 150 mg /L ' Effluent #2 = BOD < 30 mg /L and TSS < 30 mgr CST Name (Please Print) Signature CST Number Henry F. Grote 222774 Address Certified Soil Testing Date braluation Conducted Telephone Number E. 4366 353rd Ave., Menomonie, WI 54751 3/3/2003 715 - 233 -0398 1 . f Property Owner Stepan, Gary & Cindy Parcel ID # Page 2 of 3 ' 37 Boring # Lj Boring Pit Ground Surface elev. 9$• ft. Depth to limiting factor > 110 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots P ' j in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. "Eff#1 "Eff#2 1 0 -6 10YR 3/2 - sl 1 f sbk mvfr cs 1 f/m .4 .6 2 6 -17 10YR 4/4 - sl 1 m sbk mvfr gs 1 m .4 .6 3 17 10YR 4/4 - Is 2 f sbk mvfr cs 1m .7 1.2 4 36 -110 10YR 4/4 - s 0 sg ml - .7 1.2 l I . 1 F-1 Boring # = Boring d j Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots P ' in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. "Eff#1 'Eff#2 i i j I I j i i I , ❑ Boring # Boring j Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots ' in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. - Eff#1 - Eff#2 I � I ' I - - -- - I i - T I � i i i i ` Effluent #1 = BOD 30 < 220 mg /L and TSS >30 < 150 mg /L " Effluent #2 = BOD < 30 mg /L and TSS < 30 mg /L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608- 266 -3151 or TTY 608 - 264 -8777. SBD -8330 (8.07/00) Certifed Soil Testing I• s y e � J d � 7 0 n 6 It s s� 3 0 m JvOOJC 1. ey D c 4 4 1 ci K �� Safety and Buildings Division County 201 W. Washington Ave., P.O. Box 7162 6' T C" SCOOSjO Madison, WI 53707 - 7162 Site Address , Department of Commerce Sanitary Perini pplication sam�';a�6N d In accord with Comm 83.21, Wis. Adm. Code, personal information you provide ❑ Check if Revision maX be used for secondary purposes Privacy Law, s15. 1 m I. Application Information - Please Print All Ifformat State Plan I.D. Number RECEIVED • "D 3 �� „ PQRe rity Owner's Name Parcel Number DEC 2 6 7002 Property Owner's fling Addr s P perty Location 2G�� �' ST. CROIX COUNTY ,/� ` /r/ V. j� is ; S T R / City, State Zip Code Lot Ntgbe�, Block_ju ber /((// Subdivision Name CSM Number ki V f s 4JT_ 00 71638& L2 t 61 II. Type of Building (check all that apply) ✓ -ftl ❑City 1 or 2 Family Dwelling - Number of Bedrooms ❑Village ❑ Public/Commercial - Describe Use _ ownslup - 7_1 ❑ State Owned /' �D k/jtG� w/ d J' &0 Nearest Road III. Type of P it: (Check only one box on line A ering scheme fointernal use). Complete line B if applicable) A. 1 New 2 ❑Replacement System 3 ❑ Repla ent of tAn to For County use ' System Tank Onl Syste B. El Check if Sanitary Permit Previously Issued Permit Nu r Date Issued W. Type of Permit: (Check all that apply umbering sche is use) 44 El Non - Pressurized In- Ground Mound te r 50 El Constructed Wetlan22 El Pressurized In- Ground 41 Holding Tank ass 51 ❑ Drip Line 45 El At -Grade 46 El Aerobic Treatment Unit ting 30 ❑ Other V. Dispersal/Treatment Area Information: i SDI! 2'' = O S o Design Flow (gpd) Dispersal Area r Dispersal Area 1 Appit on Percolation Rdte System Eleva on Final Grade Required � pose ate(Gals, s/S ,Ft. (Min./Inch) / t}�., u C -AW Elevation VI. Tank Info Capacity in Total Numbe M VinstaUthe Prefab Site Steel Fiber Plastic Gallons Gallons of Ta Concrete Constructed Glass New Existing Tanks Tanks Septic or Holding Tank �? - Dosing Chamber VII. Re s ponsibility Stateme I, the undersigned, a responsibility for WTS shown on the attached plans. /Phirri Name (Print) Plumber's Sig are M P/MPRS N r Business Phone Number 7 ` Z7i PI&3 6er'l Address (Street, City, State, Zip Code) lso> a 2 VIII. Ootumnty /De artment Use Onl pproved ❑Disapproved Sanitary Permit Fee (includes Groundwater Date Issued Is m Signature (No Stamps) Surcharge Fee) ❑ Owner Given Initial Adverse Determination IX. Conditions of Approval/Reasoias for Disapproval ��- z oun_ .?it/htcca tom` �2c • /� Attach complete plans (to the County only) for the system on paper not lea than P M x 11 Inches in size t 1 C / (% a0 l � W� NV� • �ke, d � Gv rl�(4 SCQ c.e W/ e -r d o l o� d o warts 'v vla'rz SBD -6398 (R. 05101) wee VO- VK c1.a- 4 aj'P riIxt s/z-"4� f .� r ' QI► • � �. .A i 7 .. "a, ';t j r So ;l edc/ua�,'or�P;E y Ol �N� STS f�rb pa s c.�l ►� � • ` � T 1� an o p of .2 ,. pd,C. P�j F o. 6 ' y s n c4 rz ctt - I E5 -d cute At . Safety and Buildings 4003 N KINNEY COULEE RD LA CROSSE WI 54601 -1831 TDD #: (608) 264 -8777 iseonsin www.commerce.state,wi.us /sb Department of Commerce www.wisconsin.gov Scott McCallum, Governor Philip Edw. Albert, Secretary December 03, 2002 CUST ID No.226524 ATTN: PO WTS Inspector ROGER L TIMM ZONING OFFICE TIMM EXCAVATING ST CROIX COUNTY SPIA 3128 20TH AVE 1101 CARMICHAEL RD WILSON WI 54027 HUDSON W1 54016 CONDITIONAL APPROVAL 4 PLAN APPROVAL EXPIRES: 12/03/2004 Identification Numbers Transaction ID No. 816311 SITE: Site ID No. 653936 Gary & Cindy Stepan Please refer to both identification numbers, Trebus Valley Road above, in all correspondence with the agency. Town of Troy St Croix County NE1 /4, SEl /4, S19, T28N, R19W Lot: 14, Subdivision: Trebus Valley Estates FOR: Description: Four Bedroom Mound System Object Type.' POWT System Regulated O ject ID No.: 883993 The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. The following conditions shall be met during construction or installation and prior to occupancy or use: General Approval Requirements: • is system is to be constructed and located in accordance with the enclosed approved plans and with the Mound Component Manual for Private Onsite Wastewater Systems VERSION 2.0" SBD- 10691 -P (N.01 /01) and the "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems VERSION 2.0" SBD - 10706 -P (N.01 /01). • 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. Ic n(fil • The well must be a minimum of 25 feet from any POWTS tank, and a minimum of 50 feet from the absorption APPR area. chs. NR 811 & 812c OE MENT • 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. SEE C ORRE • 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 • 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. ROGER I. TIMM Page 2 12/3/02 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 /instal lation /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 $ 17500 Balance Due $ 0.00 Charles L Bratz POWTS Reviewer 11 , 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 Henry F Grote , Certified Soil Testing i Gary & Cindy Stepan - Mound Transaction # `` �° „ o'? `s•y 'q Construction Materials and Techniques C All materials must comply with Comm 84 and be installed in accordance with manufacturer's specifications. Construction methods must comply with the following Component Manuals: Mound, SBD - 10691 -P (01 /01) Pressure Distribution, SBD- 10706 -P (01 /01) Location: Lot 14, Trebus Valley Estates NE 1/4, SE 1/4, Sec. 19, T 28 N, R 19 W Town: Troy County: St. Croix Date: November 26, 2002 Owner: Gary & Cindy Stepan Address: 915 Ridge Pass Hudson, WI 54016 Plumber: Roger Timm Signature: cfGc, License # MPRS 226524 Attachments: 6748 -Plan Approval Application SBD -8330 page l: cover 2: design criteria & calculations 3: plot plan 4: system cross section 5: plan view, lateral detail OVED 6: pump tank exit detail 7: pump curve f i ,,��� 8: system management Z" N" i S�1 page 1 of 8 I , Design Criteria Residential Wastewater Contaminant Load: 30 mg /L < BOD < 220 mg /L Anticipated septic tank effluent 30 mg /L < TSS < 150mg /L Fecal Coliform > 10,000 cfu/100 mL Fats, oils, grease < 30 mg /L Bedrooms x 100 gal /bedroom /day x 1.5 6 C''° gallons /day hydraulic load Design Calculations In situ designed loading rate 0 .14. gallons /sq. ft. per day Depth to estimated high ground water '. in. Depth to bedrock 3 in. Cross slope at system % k Force main length ft. of 2 in. Manifold /header length 6 ft. of Z in. Drain -back 510 !' gallons Lateral length 3 @ S6• ft. of t'�z in. Lateral elevation ft. @ bottom of lateral Lateral hole size x)16 in. @ 4 zyo in. ft.) Spacing l�'( holes /lateral S 1 holes total Lateral volume \S'. g allons Total lateral discharge rate 33.66 gallons /minute @ Z' ft. head Network pressure compensation losses 0' -+ � ft. Elevation difference \0.0 Z ft. Friction loss •L9% ft. @ 3 S gallons /minute Total dynamic head 1•q Z ft. Pump /sil*on gpm @ ��� ft. of head Manufacturer .0'\ a Model # \,'- 0 4' Dose volume gallons Lift /siptton tank gallons Septic tanks gallons Effluent filter Measurement pump on and off 4' •0 in. lleight alarm from tank bottom Z ' O in. Reserve capacity S gallons specs calcs.res Page Z of Ir LA 12,21 sod f7 40' Twn cad vo A P/QEol Ti,4as T 91n�h � Assumed elev` _ /oo•cv' Lf 5 c o 0 y �o -Etc. E�Ev = /a7 37 /n N B' 4,c / G `b O r a -fa 5 t rrz d 4 r , v-2 ( -�, • � 4d r S ail edaluau�'o> -�P� E c 6Ca_l .Q, a nG}1 /YtW'll- opF.2 6� c jn /C9 37 BO O � �o nn r ?F.oV S tin. 4-o MN. v 1 � 4" C a 160 wQ� `8v0 nn l _ c4 O ' �' s� �r,�o d �10 fi p lx syS46 '�I( 4 e4,4 Jlf 06 I OIL \fl I r n w►a� ` \ �o i••�io:� 2 0 p v. i r I ' 1'. e 0 j r �E --t'o� O T z , O 7 w; ��,o� ►ts' 433 •�,' N vw w Q..� CA.;- 0 4 - 4 � n• �. n"c o�OSa- r��+:cy .,.a`�� i-o �o.��o v� rpc� b�, 1 I I � �•�Q��r•bl --/ V 16\110- y� xaL or k vR�aw? U 3 ll r b � o \ � o .., 1 .� A.a. � 2n.•. � �. � c�! o .-. \ ; � � � �Z •� o, e-►� (` 3 . � ' j \y � � l .9 . L9 �o w \ = J 3 . is V � �- o'T •. 1 din � � 1�" r VEKJT CAP `I C.I vE!JT PIPC WEATHER PROOF APPROVED LOCKIMr, =ROM DOOR, JUUCTIOU BOX MAKJHOLE COVER. — 25 � wARN�w� WIIJCOW OR FRESH I LAQgr✓ AIR IIJTAKE GRADE COIJDUIT ` -- PROVIDE _ AIRTIGHT SEAL 1 11I i ili APPROVED E011J75 ate, I I ALARM EXTE►JDiw(, 3' ONTO SOLID SOIL << 0 1 I om � I PUMPS __1 OFF t DLOCK MGOULDS PUMPS Submersible Effluent Pump 3871 EPO4 EP05 APPLICATIONS • Fully submerged in high ■ EP05 Impeller: Thermoplas- ■ Bearings: Upper and lower grade turbine oil for tic enclosed design for heavy duty ball bearing Specifically designed for the lubrication and efficient improved performance. construction. following uses: heat transfer. ■ Casing and Base: Rugged • Effluent systems •Homes Available for automatic and thermoplastic design provides AGENCY LISTING • Farms manual operation. Auto- superior strength and corrosion • Heavy duty sump matic models include resistance. 9' Canadian Standards Association • Water transfer Mechanical Float Switch ■ Motor Housing: Cast iron (CSA listed model numbers end • Dewatering assembled and preset at the for efficient heat transfer, in "F" or "C ".) factory. strength, and durability. SPECIFICATIONS ■ Motor Cover: Thermoplastic Goulds Pumps is ISO 9001 Registered. FEATURES cover with integral handle and • Solids handling capability: float switch attachment points. 3 /4' maximum. ■ EPO4 Impeller: Thermoplas- 0 Power Cable: Severe duty • Capacities: up to 60 GPM. tic Semi -open design with rated oil and water resistant. • Total heads: up to 31 feet. pump out vanes for mechanical • Discharge size: 1'/2" NPT. seal protection. • Mechanical seal: carbon - rotary/ceramic - stationary, BUNA -N elastomers. • Temperature: 104 °F (40°C) continuous 1401(60°C) intermittent. METERS FEET 10 • Fasteners: 300 series ......... stainless steel. 9 • Capable of running 30 sGPM I dry without damage to $ 2 5 Fr components. 25 Motor: _ s ........... ... _ .. ._ _ .... ....... , __ ._.... - . -- - — _.. _ • EPO4 Single phase: 0.4 HP, � 6 .__ 20 , 115 or 230 V, 60 Hz, 1550 5 RPM, built in overload with . _ .... _ ... _ . ........._ _._ - ...... _. D 15 , automatic reset. 4 • EP05 Single phase: 0.5 HP, o 115 V, 60 Hz, 1550 RPM, 3 10 ....._.. ..._.._... EPO4 EPOS -..._. .__...._..__._.._._._ built in overload with ............... ............. automatic reset. z • Power cord: 10 foot 5 standard length, 16/3 1 .... S1TOW with three prong ; grounding plug. Optional 20 ° o r 10 20 30 40 50 GPM foot length, 16/3 SJTW with three prong grounding plug ' (standard on EP05). ° 2 4 6 8 10 12 ml /h CAPACITY Goulds Pumps �- g © 2000 Goulds Pumps C�/� ; ITT Industries Effective February, 2000 � 63871 i System Management Management of this system is critical. As a condition of approval of these plans this system management section must be reviewed with the owner, and the owner must be provided with a complete set of plans including this management section. If problems develop with the adsorption system or any other system components, the installing plumber, Timm Excavating, 715- 772 -3214, or the St. Croix County Zoning Office, 715- 386 -4680, should be contacted for assistance. General Proper functioning of an on -site disposal system, "septic system," is significantly dependent on the volume of water which flows into the system and the level of contaminants in that volume. The lower the volume of water and the lower the level of contaminants, the better and longer the system will function. Typical system components include a septic tank or compartment to settle out solids and contain Oreases and oils, a filter on the outlet of the septic tank to retain small particles of the same density as water, a pump tank or compartment to allow a dose to be accumulated, a pump and controls, and finally some type of soil adsorption cell to recycle the water in a manner to protect ground water quality and public health. I . If the septic tank is installed prior to sheet -rock and /or painting, pump the septic tank before normal use begins to ensure adherence to contaminant load design criteria. 2 Install water - saving appliances whenever and wherever possible. 3. Repair even small water leaks as soon as possible. 4. Never pour grease or oil down any drain or stool. 5. Garbage disposals are not recommended; if you must have one, use it sparingly. 6. No paper products other than tissue should go into the system. 7. No chemicals should go into the system. S. Avoid surge flows of water; try to spread laundry throughout the week. 9. Septic tank effluent must be less than or equal to the design criteria specified in page 2 of these plans, 10. If septic or pump tanks are no longer used, they must be properly abandoned. 11. If construction timing and weather could create a frozen infiltration system, weather - proofing with plastic sheeting and heavy mulching may be required to maintain a functional system at start-up. Maintenance 1. The septic tank must be inspected every three years by a properly licensed person. 2. if necessary, the septic tank must be pumped to remove solids and scum; pumping is required if the combined scum and solids volume equals one third of the tank volume. 3. When the septic tank is pumped, any solids in the bottom of the pump tank must be pumped, and the filter must be back - washed into the septic tank to remove accumulated material. 4. Periodic observation pipe inspections should be made by the homeowner to examine the state of the in -situ soil adsorption cell. Quarterly inspections are recommended; a licensed plumber should be notified if effluent is consistently ponded in the adsorption cell. 5. If this system contains specific treatment components other than those mentioned here, maintenance requirements will accompany their specifications. 6. The pumping components for this system include an alarm which must be installed and remain on a separate circuit from the pump. If the alarm is activated, minimize water use and notify a licensed plumber for service as soon as possible. The system allows reserve capacity to accumulate some necessary flow until normal service can be restored; this volume is minimal, and no more than one or two days should pass before any necessary repairs can be made. 7. Avoid compaction such as vehicle traffic within 15' down -slope of the adsorption system. 8. Avoid disturbing the system itself such that might encourage erosion or disturb the required seeding of the system. 9. Particularly avoid winter traffic such as sliding or snowmobiling which might compact snow and lead to increased frost depth. 10. Surface drainage must be diverted around the system; avoid landscape changes which might send surface run -off into the system area. 11. Warning: Do not enter septic, pump or other treatment tanks; death may result because they may contain lethal gases or insufficient oxygen. Contingency Plan Wastewater monitoring of volume and quality is not a normal requirement for low effluent strength systems; such monitoring may become necessary if problems develop. Any necessary monitoring shall be done in accord with the requirements of Comm 83.54 (2). Pumping and hauling of wastewater may be necessary while analysis and repairs are implemented. Additional testing, designing, and /or installation of additional treatment components or conversion to a holding tank may be necessary. Page 8 of 8 �f 0 �1 D ad 1507 Wisconsin Department of Commerce SOIL EVALUATION REP T �qe 1 of 3 Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code A C.E. Sal & Site Evaluations Attach complete site plan on paper not less than 8% x 11 inches in size. Plan must County St. Crok include, but not limited to: vertical and horizontal reference pant (BM), direction and Parcel ( D percent slope, scale or dimemsions, north arrow, and location and distance to nearest road. 040- 1078- 20 -000, ID#19.28.300 fJ re S) Please print all InformaSon. evi y - Data Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). r Z( T/ Property Owner Property Location J.T.B. Properties, L.L.P. C/O John W. Nielsen Govt. Lot NE 1/4 SE 19 S 19 T 28 N R 19 W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# 1564 West University Avenue 14 1 Trebus Valley Estates City State Zip Code Phone Number I City �j Village e Town Nearest Road Saint Paul MN 55104 1 651 -646 -1967 Troy I County Highway "F" New Construction Use: 0 Residential / Number of bedrooms _ 3 Code derived design flow rate 450 GPD j Replacement - J Public or commercial - Describe: Parent material Glacial drift Flood plain elevation, if applicable na General comments A I uAt6 ff D 21 YL�/kl, and recommendations: Soils suitable for At -grade system. Recommend installing mound system at elev. = 104.27' at 6" above 103.77 ' contour to increase dispersal of effluent through system area. Boring # _i Boring vi Pit Ground Surface elev. 103.62 ft. Depth to limiting factor 36" in. Sal gpplication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft *Eff#1 'Eff#2 1 0 -7 1Oyr3/3 none sl 2fcr mvfr cs 2fm 0.5 0.9 2 7 -16 1Oyr4 /3 none Is 1msbk mvfr cs 2fm,1c 0.7 1.2 3 16 -36 1Oyr4/4 none Is 1msbk mvfr cw 1 f 0.7 1.2 4 3 0 1 Oyr4 /4 f2f 7.5yr 5/8 Is 1 msbk mfi gw - 0.5 0.9 H#2 contains 15% gravel & cobbles. H#4 contains discontinuous 1 "- 2" s of 10yr4/4 Om sl. Redox concentrations appear at intertface of tedural changes throughout horizon. Loading rate reduced to reflect permiability restriction assoc. with banding. ❑ Boring # Boring Pit Ground Surface elev. 103.75 ft. Depth to limiting factor — 60" in. Sal Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDlfF 'Eff#1 'Eff#2 1 0-8 1Oyt3 /3 none sl 2fcr mvfr cs 2fmc 0.5 0.9 2 8 -20 10yr4/3 none sl 2fsbk mvfr cs 2fm,lc 0.5 0.9 3 20 -31 7.5yr4/6 none Is 1 csbk mvfr cw 2f,1 m 0.7 1.2 4 31 7.5yr4/4 none Is/sl 2ms mfr gw 1 0.5 0.9 5 60 - 3 1Oyr4 /4 m1d 7.5yr5/8 sil On, mfr - - 0.0 0.2 H#4 contains ed ma of 71yr4/61 msbk Is & 7.5yr4/4 2msbk sl. " Effluent #1= BO ? 30 < 220 mg1L and TSS 30 < 50 mg/L ' t #2 = BOD -S mg/L and TSS <30 mg/L CST Name (Please Print) Sig ure: CST Number James K. Th ompson 3602 Address A.C.E. Sal & Site Evaluaions Date Evaluation Conducted Telephone Number 340 Paulson Lake Lane, Osceola, WI 54020 12/5/01 715- 248 -7767 f - property owner J.T.B. Properties, L.L.P. C/O John Parcel ID # 040- 1078 -20 -000, ID #19.28.300 Page 2 of 3 3 ] Boring F # � Pit Ground Surface elev. 98.97 ft. Depth to limiting factor 36" in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots 'Eff#1 *Eff#2 1 0 -9 10 Y r3 /3 none sl 2fcr mvfr es 2fmc 0.5 0.9 2 9 -21 10yr4/3 none SI 2msbk mvfr cs 2fm,lc 0.5 0.9 3 21 -36 7.5yr4/4 none Sl 2msbk mfi cw 2f,1m 0.5 0.9 4 3"6 \ 7.5yr4/4 f2f 7.5yr5/8 sl 1 msbk mfr cw 1 fm 0.5 0.9 5 46-62 10yr6 /4 m 1 d 7.5yr 5/8 sil Om mfr - - 0.0 0.2 H#4 contains an unsorted mix of 7.5yr4/6 I msbk Is & 7.5yr4/4 2msbk sl. Boring F-I # n9 Bori 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 *Eff#1 *Eff#2 ❑ Ong # �j 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 GPDW *Eff#1 *Eff#2 i * Effluent #1 = BOD ? 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BOD a 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 ahernate format, please contact the department at 608 -266 -3151 or TTY 608- 264 -8777. Sail edc/ua�, ,'t ♦ E /e�kz�;on s e d �►' awn oad `poi /off /f; ,A�a�o,rTi�6us (" �opo {, Assumed eletA = ioo.cz; tad ae ♦ o �ree. Ac 1,1. 44 � lo �,v s i �J� ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND 0 RSHIl' CERTIFICATION FORM Owner/Buyer Mailing Address i Property Address (Verification required from Planning Department for new construction) �, Pa nn City /State , cw" w Parcel Identification Number LEGAL DESCRIPTION Property Location Al '/4,' �7 ' /,, Sec. T N -RjJ_W, Town of //�� s Subdivision Lot #. Certified Survey Map # Volume . Page # Warranty Deed # 7�7 . Volume Page # z Spec house El yes )n 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 fors, signed by the owner and by a T master plumber, journeyman plumber, 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 undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system fkas been maintained must be completed and returned to the St. Croix County Zoning Office within 30 da 4th three y date, SIGNATURE PF APPLICANT DATE OWNER CERTIFICATION ' I (we) certify that all s tements on this form are true to the best of my (our) knowledge. I (we) am (are) the owner(s) of th rty describej,abov virtue of a warranty deed recorded in Register of Deeds Office. ✓ u /( SIGNATURE Of APPLICANT DATE * *s*s* * *sss* Any information that is is-represented may result in the sanitary permit being revoked by the Zoning Department. , i ** Include with this application: a stamped warranty deed from the Register of Deeds office a copy of the certified survey map if reference is made in the warranty deed JS STATE BAR OF WISCONSIN FORM 2. 1999 8 5 4 2 9 WARRANTY DEED K GTR OF DE DS Document Number ST. CROIX GO., WI This Deed, made between J.T.B. Properties, LLP, a Minnesota RECEIVED FOR RECORD Limi Liability Partnership _ _ 07- 30-2002 11:55 AN — - - -_ - - WARRANTY DEED Grantor, and Gary T. Stepan and Cynthia L. Stepan, husband and wife EXEMPT i REC FEE: 11.00 -- _ - TRANS FEE: 313.50 COPY FEE: CERT COPY FEE: Grantee. PAGES: 1 Grantor, for a valuable consideration, conveys to Grantee the following described real estate in St. Croix County, State of Wisconsin (if more space is needed, please attach addendum): Recording Area Name and Return Address Lot 14, Plat of Trebus Valley Estat in the Town of Troy, St. Croix County,i' 0 -20, 040 - 1078 -40, 040 - 1078 -50 Parcel Identification Number (PIN) This is not homestead property. %) (is not) Exceptions to warranties: Easements, restrictions and rights -of -way of record, if any. Dated this ? of Jul y_ 2002 J.T.B. Properties, LLP AUTHENTICATION ACKNOW LE GMENT Signature(s) TEOF WISCONSIN ) - - - - -- � ) ss. /�� County } authenticated this_ day of Personally coma before me this day of July 2002 the above named - - - "— - -- " J.T.B. Properties, LLP, a Minnesota Limited Liabilty Partnership by TITLE: MEMBER STATE BAR OF WISCONSIN it' to me kno be n(s) who executed the foregoing (ll not, - instrun a lodged the same. authorized by § 706.06, Wis. Stats.) THiS INSTRUMENT WAS DRAFTED BY •� -- Att ornay Krishna Ogl and _- No ary Public, a of Wisconsin Hu dson , WI 54016 M o mission is pe , nent. (If not, state " ti' n dot : 1Signatures may be authenticated or acknowledged. Both are not necessary.) ) Names of persons signing in any capacity must be typed or printed below their!siig Lure. Ord- tionProtesssonels company, Fond du Lac, wt aoo- sss.zozi WARRANTY DEED STATE BAR OF ISCONSIN FORM No. 2 - 1999 '- 1507 Wisconsin Department of Commerce SOIL EVALUATION REPORT Page 1 — of 3 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 8Y: x 11 inches in size. Plan ounty n must _ St. Cro _ix_ — include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. percent slope, scale or dimemsions, north arrow, and location and distance to nearest road. 040- 1078 - 20100, I0#19.28.300 Please print all information. Reviewed By Date Personal intorrnation you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Property Owner Property Location J.T.B. Properties, L.L.P /O J ohn W . Nielsen Govt Lot NE 114 SE 1/ 4 S 19 T 28. W Property Owners Mailing Address - Lot # Block # Subd. Name or CSM# 1564 W est U niversity Av 14 -- Tre V alley Estates _ City — — State Zip Code Phone Number #j City . 8 Village Z Town Nearest Road Saint Paul MN 1 55104 1 651 - 646 -1967 1 Troy i County Highway "F" Vi New Construction Use: M Residential / Number of bedrooms 3 Code derived design flow rate 450 -- GPD J Replacement Public or commercial - Describe: -_ —_ —_- —_ -- -_— _ -- --- Parent material Gla d rift _ Flood plain elevation, if applicable -- _na._ - -_ General comments and recommendations: Soils suitable for At -grade system. Recommend installing mound system at elev. = 104.27 'at 6" above 103.77 ' contour to increase dispersal of effluent through system area. Fq g Pori Boring # � Pit rig Ground Surface". 103.62 ft. Depth to limiting facto _- 36 in. Soil Appicat(on Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots � GPD /ft' 1 ! 0 -7 10 yr3 /3 no sl 2fcr mvfr cs 2fm 0_5 I 0.9 2 7 -16 1Oyr4/3 none Is 1msbk mvfr cs 2fm,lc 0.7 1_2 3 i 16 -36 1 Oyr4 /4 none Is 1 msbk mvfr cw 1 fm 0.7 1.2 4 3 6 60 10yr4 /4 f2f 7.5yr 5/8 Is 1 msbk mfi gw - -- 0_5 - - 0.9 — R#2 caitains 15% gravel 8 ccCbles. H#3 contains discoritinuous 1 "- 2" bands of 10yr4 /4 Om sl. Redox concentrations appear at intertface of textural changes throughout horizon. Loading rate reduced to reflect permiability restriction assoc. with banding. Boring # Boring - — �/ Pit Ground Surface elev. _1 03.75 ft. Depth to limiting factor _ 60" in. Soil Applica ion Rate Horizon i Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots I -Ef GPDIft� E 1 �0 -8 - � 1O yr3/3 — - -- no sl ! 2fcr mvfr - cs 2fmc 0_5 _ 0 2 8 -20 10 r 4/3 none SI 2fsbk mvfr cs 2fm,1c 0.5 0.9 3 20 -31 7.5yr4/6 none Is 1csbk mvfr cw 2f,lm 0.7 1.2 4 - 31 _ - __ none Is /sl 2msbk mfr gw 1fm 0.5 0.9 5 160 - 1Oyr4 /4 m1d 7.5yr 5/8 sit Om mfr _- OA - 0.2 -- H#4 contains ed mix of 7.5yr4l61msbk Is 8 7.5yr4/4 2msbk sl. Effluent #1 = BOD ? 30 < 220 mg/L and TSS 30 < 50 mg/ ent #2 = B00 S30 mg/L and TSS < mg/L CST Name (Please Print) Sig lure: CST Number Jam K . Thom 5-- - 3602 Address A.C.E. _ Sal 8 Site Evaluations ' Date Evaluation Conducted Telephone Number 340 Paulson Lake Lane, Osceola, WI 54020 12/5/01 715 248 - 7767 i SiEwin 14 -T(-P ` Property Owner J.T.B. Propertie L.L. C/0 Jo hn , Parcel ID # _ 040- 1078 -20 -000, ID #19.28. — Page . 2 of 3 -- F 3 ] Boring # Ij Boring — 98.97 ft. Depth to (uniting factor _36" in. i6 Pit Ground Surface elev. Soil Application Rate Horizon I Depth I Dominant Color Redox Description Texture Structure Consistence Boundary Roots PQIQ' — "Eff#1 'Eff#2 1 0 - 10yr3 /3 n one sl 2fcr mv fr cs 2fmc 0.5 0.9 — 2 9 -21 10yr4/3 none sl 2msbk mvfr cs 2fm,1 c 0_5 - 0.9 — 3 21 -36 7.5yr4/4 none sl 2msbk mfi cw 2f,1m 0.5 - 0.9 4 36-46 7.5yr41 -- f 2f7.5yr5 /8 s1 lmsbk mfr cw 1fm 0.5 0.9 5 46-62 10yr6 /4 m1d7 .5yr5/8 sil O m mfr = _- - 0_0 0.2 — — H#4 contains an unsorted mix of 7.5yr4/61 msbk Is & 7.5yr4/4 2msbk st ❑ Baring # J Boring Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon i Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots "Eff#1� Eff#2 I i I I J Boring # Boring S Pit Ground Surface elev. — ft. Depth to limiting factor in. Sal Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots *Eff#1GP0L[IEff#2 _ Effluent #1 = BOO 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BOD <30 mg/L and TSS <30 mg/L The Depa mnent 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. r 5a ;�ed�lua�,�r,P.E • E /etkz�on c I tl ►�r� pa s e.�l /ot /s� P /a�o�Ti�dus l/r�r Assu.ne.d e le W = ioo. ex E�ee. 37' v V � �o d 8► faf a I or