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HomeMy WebLinkAbout040-1241-40-000 /* 1 4 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Safety and Buildings Division Count y St. Croix INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Sanitary jr�{gi bb No.: Personal information you provice may be used for secondary purposes [Privacy Law, 15.04 (1)(m)j. 33 b6 ZZSSJJ 1fewga of e % n"d�11 ❑ City ❑ ViVrig %Tow State Plan ID No.: trce CST BM Elev.: Insp. BM Elev.: BM Description: a dvq.241 -40 -000 ao .0 1 rs0 i) , 3 /y N JC_ 4l1 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic U 0 K S Benchmark �S lob 0 Alt. 131V Dosing (C s I o6.83 9• o Aeration Bldg. Sewer 12. ?-2- 9'f • �2 f ' Holding St/ Ht Inlet IZ,:1-0 9q.1.3, TANK SETBACK INFORMATION St/ Ht Outlet z 73.95 Veritto TANKTO P/L WELL BLDG. Ai Intake ROAD Dt Inlet 3• I( 13• Septic 5 321 NA Dt Bottom (o ( �p . [Z' Dosing y ' W „ 4c, > q0 NA Header / Man. Aeration A Dist. Pipe Holding Bot. System 2 .fig 03.gS' PUMP/ SIPHON INFORMATION Final Grade � K EL4� Manufacturer 61 -SUDS Demand cover l � Model Number 3 1 L Zj_ TDH Lift kg-V Friction 2 (> SystemZ S� TDH k g3%Ft He Forcemainj Length qS Dia. 2 " Dist. To Well Cj W1I SYSTEM H Width Q Len g-I , t � (e i No. Of T [ PIT No. f Pi P s Inside Dia. Li uid De th DIMEN I N S DIMENSIONS Q SYSTEM TO P / L BLDG WELL LAKE/STREAM LEACHIN Many f rer: SETBACK CHAMBE INFORMATION Type OT n M Number: System: M 4 OR DISTRIBUTION SYSTEM L­p 4z , -.�p�+ - D � �'�° u r& 6 '` - Header/Manifold Distribution Pipe(s) Hoe Size x Hole Spacing Vent To Air Intake ``������ J I n Ir Length -4- - Y Dia- 2 Length r•o Dia. I'2 4 Spacing � q SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over Depth Over xx Depth Of xx Seeded/ Sodded xx Mulched Bed /Trench Center Bed /Trench Edges Topsoil ' ❑ Yes ❑ No ❑ Yes ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) Inspection #1:oS/ /�DInspection #2. etc.) -61 / 110 Location: 578 Wyngate Drive , H dso WI 54Q16 (SE 1/4 NE 1/4 21 T28N R19W) - 21.28.1 .1225 Wyngate -Lot 4 1.) Alt BM Description = cQ°sys ��" &Aar 2.) Bldg sewer length = 55 ,,' t,� • - amount of cover = � 0-4c- ' 3.) contour= 1�1.9s`C [ °�•`FS� 4 - lob Plan revision required? ❑ Yes No Use other side for additional i nfor ation. b 3 ) o I Z SBD -6710 (R.3/97) Date Inspector's Signature Cert. No ADDITIONAL COMMENTS AND SKETCH SANITARY PERMIT NUMBER: a _ w r d § i - 1 - 4 . 4 . 0 . 1 . 4 vd-, � 9 0-1 t­l kt 1, A- s � ...«.. V ,a� t .. .. t E e s -4_4 1.1 - 12175 . z. T— A.n.j All g A b g [ F € [ I 4 i t e ?, , J-1-JA 23-T 'I t ------- --- °m t ttiv: 4- a..... ....,..;. e ... �.�.mm.° ELL I °.�,....�. eti a t ..m me 3 � Lit 4 �_..x.- _. w. 1 i Lk 14-4--h 1 A t 1 J x _ gm_ �.._ - ----- --- ------ -- - - ®m_ r N� i S t � s 4 w e" { A AA 1, L s 1 H Safety and Buildings Division NVisconsin SANITARY PERMIT APPLICATION 201 g Washington Avenue Department of Commerce In accord with Comm 83.05, Wis. Adm. Code Madison, WI 53707 -7302 • Attach complete plans (to the county copy only) for the system, on paper not less County than 81/2 x 11 inches in size. • See reverse side for instructions for completing this application State Sanitary Permit Number 363 8 3 � Personal information you provide may be used for secondary purposes ❑ Check if revision to previous application [Privacy Law, s. 15.04 (1) (m)]. State Plan I.D. Number I. APPLICATION INFORMATION -PLEASE PRINT ALL INF RMATION U a4me. /46 3 0 3 Prope Owner Na a Property Location t/a 1 /4, T , N. R E (or)&P Property Owner's lVrpiling Address Lot Number Block Number City, Sta Zip Code Phone Number Subdivisiorl Name or CSM umber I ( > d II. TYPE OF BUILDING: (check one) ❑ State Owned ❑ i t y Neares Road ❑ Village Public 1 or 2 Family Dwelling - No. of bedrooms 3 J [w Town OF 111 BUILDING USE (If building type is public, check all that apply) Parcel Tax Number(s) �'. 7 Q, .'q i 215 1 ❑ Apartment/ Condo 2 ❑ Assembly Hall 6 ❑ Medical Facility/ Nursing Home 10 ❑ Outdoor Recreational Facility 3 ❑ Campground 7 ❑ Merchandise: Sales/ Repairs 11 ❑ Restaurant /Bar /Dining 4 ❑ Church/ School 8 []Mobile Home Park 12 ❑ Service Station/ Car Wash 5 ❑ Hotel /Motel 9 ❑ Office/Factory 13 ❑ Other: specify IV. TYPE OF PERMIT: (Check only one box on line A. Check box on line B, if applicable) A) 1. jX New 2. ❑ Replacement 3. ❑ Replacement of 4. ❑ Reconnection of 5. ❑ Repair of an System System Tank Only Existing System Existing System B) ❑ A Sanitary Permit was previously issued. Permit Number Date Issued V. TYPE OF SYSTEM: (Check only one) Non - Pressurized Distribution Pressurized Distribution Experimental Other 11 ❑ Seepage Bed 21 JR Mound 7(e ❑ Specify Type 41 [3 Holding Tank 12 ❑ Seepage Trench 22 [] In- Ground Pressure 42 C] Pit Privy 13 E] Seepage Pit K } G4 43 ❑ Vault Privy 14 ❑ System -In -Fill ( oz- O VI. ABSORPTION S STEM INFORMATION: 1. Gallons Per Day 2. Absorp. Area 3. Absorp. Area 4. Loading Rate 5. Perc. Rate 6. System Elev. 7. Final Grade Required (sq. ft.) Proposed (sq. ft.) (Gals/day /sq. ft.) (Min. /i ch) Elevation Feet Feet VII TANK Capacit in g Total # Of Prefab. Site Fiber- Exper. INFORMATION Manufacturer's Name Con- Plastic Gallons Tanks concrete steel glass App. New Existin Tanks Tanks 1 11 strutted Septic Tank or Holding Tank ❑ ❑ ❑ ❑ ❑ Lift Pump Tank /Siphon Chamber — ❑ ❑ ❑ ❑ ❑ VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for iriptallation of the onsite sewage system shown on the attached plans. Plumber's ame Pri ritil. Plumb r's5 natur Q MP /MPRSWNO.: Business Phone Number: z Plumber's ddress (Stre� ­ C ty, S te, Zip Cod IX. COUNTY / DEPARTMENT USE ONLY ❑ Disapproved S nitary Permit Fee (Includes Groundwater D ate Is sue Issuing Agent Signature (No Stamps) pproved E] Owner Given Initial Surcharge Fee) Adverse Determination vo25 • ��� X. CONDITIOIYS OF APPROVAL / REASONS FOR DISAPPROVAL: SBD -6398 (R. 4/99) DISTRIBUTION: Original to County, One copy To: Safety & Buildings Division, Owner, Plumber INSTRUCTIONS 1. A sanitary permit is valid for two (2) years. 2. Your sanitary permit maybe renewed before the expiration date, and at a time of renewal any new criteria in the Wisconsin Administrative Code will be applicable. 3. All revisions to this permit must be approved by the permit issuing authority. 4. Changes in ownership or plumber requires a Sanitary Permit Transfer / Renewal Form (SBD -6399) to be submitted to the county prior to installation 5. Onsite sewage systems must be properly maintained. The septic tank(s) must be pumped by'a'licensed pumper whenever necessary, usually every 2 to 3 years. 6. If you have questions concerning your onsite sewage system, contact your local code administrator or the State of Wisconsin, Safety and Buildings Division., 608-286 -3151. - To be complete and accurate,this sanitary permit application must include: I. Property owner's name and mailing address. Provide the legal description and parcel tax number(s) of where the system is to be installed.' II. Type of building being served. Check only one and complete # of bedrooms if 1 or 2 Family Dwelling. III. Building use. If building type is public, check all appropriate boxes that apply. IV. Type of permit. Check only one on line A. Complete line B if permit is for tank replacement, reconnection, or repair. V. Type of system. Check appropriate box depending on system type. VI. Absorption system information. Provide all information requested for numbers 1 through 7. VII. Tank information. Fill in the capacity of every new /or existing tank, list the total gallons, number of tanks and manufacturer's name, indicate prefab or site constructed and tank material. Complete for all septic, pump /siphon and holding anks for this system. Check experimental approval only if tanks received experimental product approval from 9 Y P PP Y P P PP DILHR. VIII. Responsibility statement. Installing plumber is to fill in name, license number with appropriate prefix (e.g. MP, etc.), address and phone number., Plumber must sign application form. IX. County/ Department Use Only. X. County/ Department Use Only. Complete plans and specifications not smaller than 8 1/2 x 11 inches must be submitted to the county. The plans must in6ude the following: A) plot plah, to scale or with complete dimensions, location of holding tank(s), septic tank(s) or other treatment tanks; building sewers; wells; water mains/water service; streams and lakes; pump or siphon tanks; distribution boxes; soil absorption systems; replacement system areas; and the location of the building served; B) horizontal and vertical elevation reference points; C) complete specifications for pumps and controls; dose volume; elevation differences; friction loss; pump performance curve; pump model and pump manufacturer; D) cross section of the soil absorption system if required by the county; E) soil test data on a 115 form; and F) all sizing information. ---------------------------------------------------------------------------------------------------- GROUNDWATER SURCHARGE ' 1983 Wisconsin Act 410 included the creation of surcharges (fees) for a number of regulated practices which can effect groundwater. The monies collected through these surcharges are used for monitoring groundwater contamination investigations and establishment of standards. Safety and Buildings 2331 SAN LUIS PL STE 150 GREEN BAY WI 54304 TDD #: (608) 264 -8777 visconsin www•commerce.state.wi.us Department of Commerce Tommy G. Thompson, Governor Brenda J. Blanchard, Secretary April 19, 2000 CUST ID No.224263 ATTN: POWTS INSPECTOR ZONING OFFICE KIM A O'CONNELL ST CROIX COUNTY SPIA 504 3RD AVE 1101 CARMICHAEL RD OSCEOLA WI 54020 HUDSON WI 54016 RE: CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 04/19/2002 Identification Numbers Transaction ID No. 309503 Site ID No. 190215 SITE: Please refer to both identification numbers, Site ID: 190215 WENDELL NEWGAARD above, in all correspondence with the agency. ST CROIX County, Town of TROY; WYNGATE DR SE1 /4, NE1 /4, S21, T28N, R19W FOR: Description: NEW RESIDENTIAL MOUND Object Type: POWT System Regulated Object ID No.: 658198 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. P ( ), P P The following conditions shall be met during construction or installation and prior to occupancy or use: All permits required by the city, village, township or county shall be obtained prior to installation. D AP This plan action is subject to designer comments on the plan. IVISio C.; au 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. All permits _ E required by the state or the local municipality shall be obtained prior to commencement of construction /installation/operation. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. Sincerely, DATE RECEIVED 04/12/2000 �, FEE REQUIRED $ 180.00 FEE RECEIVED $ 180.00 WESLEY GRUBS , PLUMBING PLAN REVIEWER BALANCE DUE $ 0.00 Integrated Services (920)492 -5613 , M -R 7:00 - 16:30, F 7:00 - 11:00 WGRUBE @COMMERCE.STATE.WI.US WiSMART code: 7633 cc: KIM A O'CONNELL WENDELL NEWGAARD e �%s MOUND SYSTEM DESIGN A ��L Residential Appllcatfon ,y INDEX AND TITLE SHEET COQ Project WENDELL NEWGAARD Ovmer WENDELL NEWGAARD Address P.O. BOX HUDSON WI 54016 Legal Description SE- NE- SEC21- T28N -R18W Township TROY County ST. CROIX Subdivision Name Lot No. #### Parcel ID Number Plan Transaction Number �-• r r*- Index and title sheet Page 1 , Mound calculations Page 2 J Mound drawings Page 3 ` c Q N^ R ° F r ev AND Pres. dist. calcs. and laterals Page 4 aui il�cs TDH and pump tank drawing Page 5 C- PUMP CURVES Page 6 ESFONDENCE PLOT PLAN Pane 7 Designer KIM A. O NNELL License Number 224253 Signature Phone No. 715 - 755 -3145 Date 4-5-00 Notice: Tampering with this file by unauthorized persons is prohibited. Deliberate modification wtil result in disciplinary action under s. 146.10, Ms. scats. Personal information you provide may be used for secondary purposes [Privacy Law, x15.04 (1)(m)[. SBD- 10492 -E (R.05M) Page 1 of 7 MOUND SYSTEM DESIGN Complete red boxes as necessary. 1000 gpd maximum design flow. Inch - pounds Metric Residential or commercial? R (r or c) (y or n) �� Replacement system? Creviced bedrock site? Y (y or n) Slope 3 % Wastewater flow rate 450 gpd 1703 Lpd Depth to limiting factor 26 in 66.0 cm In situ soil infiltration rate 0.4 gpd/ft 16.3 Lpd/m Contour line elevation 102.0 ft 31.09 m Use standard fill depths? x OR Design depth? in cm Place X in box to use standard depths (24 and A +4 inclusive) OR specify design fill depth. Center or end manifold a (c or e) Hole diameter r - 0 - - 25 1 in 0.125, 0.156, 0.188, 0.219, 0.25, 0.281, or 0.313 inch only. Lateral spacing 4.00 ft Use 0 lateral spacing for trenches. Estimated hole space 4.00 ft Not a final calculation. Number of laterals Pump tank elevation 89.5 ft Outside bottom of tank Forcemain length 140.0 ft Forcemain diameter 2.0 in 1.s, 2 3 or 4 inch only. 2.067 in Actual I. D. HOLE DIAMETER CONVERSIONS 1M =0.125 1/4 =0.250 SYSTEM SOLUTIONS Inch-pounds Metric 5/32 = 0.158 W32 =0.281 Estimated daily flow �gpd F 1703 iLpd 3116=0.188 &16 =0.313 7W G219 Absorption cell Design load rate & area 1.2 gpwe 375.0 ft 34.84 m Linear loading rate (LLR) 9.57 gpd/ft 118.7 Lpd /m Design width (A) 8.00 ft 2.44 m Cell length (B) 47.0 ft 14.33 m Depth of cell (F) 9.5 in 24.1 cm Sand filter Upslope fill depth (D) 24.0 in 61.0 cm Dovmslope fill depth (E) 26.9 in 68.3 cm Basal area required (gpd/infiltration rate) 1125.0 ft 104.52 m Supporting components Topsoil depth 6.0 in 15.2 cm Subsoil depth at center 12.0 in 30.5 cm Subsoil depth at cell wall 6.0 in 15.2 cm End slope toe length (K) 13.24 ft 4.04 m Up slope toe length (J) 10.40 ft 3.17 m Down slope toe length (1) 15.90 ft 4.85 m Basal adjustment made. Total mound length (L) 73.48 ft 22.40 m Total mound width (W) 34.30 ft 10.45 m Project: WENDELL NEWGAARD Transaction Number: Page 2 of 7 MOUND PLAN VIEW observation pipes (typical) J 34.3 ft A A= 8.00 ft 2.44 m 10.45 m B = 47.0 ft 14.33 m W B J= 10.40ft 3.17 m I K 1= 15.90 ft 4.85 m K = 13.24 ft 4.04 m L _ 7K T81 ft 22.40 m typ. obs. pipe (anchored securely) I = down slope dimension = absorption cell (AxB) J = up slope dimension = plowed area (LxW) K = end slope dimension T (152 mm) T MOUND CROSS SECTION subsal cap D = 24.0 in 61.0 cm lateral topsoil .� o E = 26.9 in 68.3 cm invert ft _ . _ _ _ F = 9.5 in 24.1 cm elev. 31.85 m G = 12.0 in 30.5 Cm D ASTM CC3`i H = 18.0 in 45.7 cm Sand FRI E sys. 104.00 ft y elev. 31.70 m 102.00 ft contour 31.09 m elev. 3 % slope D = upslope fill depth plowed layer E = downslope fill depth Note: Absorption cell media will consist F = absorption cell depth of aggregate and pipe with laterals G = Subsoil + topsoil depth at cell wall centered across AxB media. The cell H = subsoil + topsoil depth at cell center media is covered with geotextile fabric. Designer notes: I Project: WENDELL NEWGAARD Transaction Number: Page 3 of 7 I PRESSURE DISTRIBUTION CALCULATIONS Absorption cell Inch ounds Metric Width (A) 8 ft 2.44 Im Length (B) 47.0 ft 14.33 m Lateral specifications Number laterals 2 Holesllateral 12 holes Lateral length (P) 44.00 ft 13.41 m Hole diameter 0.2 n 6.35 mm Lat, dis. rate gpm, 0.88 L/s Sys. dis. rate 27.96 gpm 1.76 L/s Hole spacing (X) 48 in 121.9 cm Lateral diameter Pipe diameter Deelgn options Design choice Designer must 1 in (25 mm) Place X in red "X" one choice 1 1/4 in (32 mm) x box of chosen from the options 1 12 in (40 mm) x X - diameter. provided. 2 in (50 mm) X 3 in (75 mm) X Manifold diameter Pipe diameter Desimoptione Deeignchdce Designer must 1 in (25 mm) 'X" one choice 1 1/4 in (32 mm) x Place X in red from the options 1 12 in (40 mm) X box of chosen provided. 2 in (50 mm) X X diameter 3 in (75 mm) X 4 in (100 mm) X Distribution system contains: 2 Lateral(s) LATERAL DIAGRAM - END CONNECTION Place correct lateral diagram by clicking in one of the drawings at right and dragging the diagram into this area. Lateraft centered over the A IN dimension Last Mote drilled next to end cap `l + P --- -� • PF rals are identical I*- X--*I Holes drilled on the bottom of the lateral equally spaced S • oonneotion via tee or oross to manifold at any point. Laterals a force main of PVC son 40 • e permanent and marker (per COMM Table 84.30 -5) Inch - pounds Metric Lateral length (P) 44.00 ft 13.41 m Lateral spacing (S) 4.00 ft 1.22 m Hole spacing (X) 48 in 121.9 cm Manifold length 4.00 ft 1.22 m Hole diameter 0.250 in 6.4 mm Lateral diameter 1.50 lin 40 mm Forcemain diameter 2.00 lin 50 mm Project: WENDELL NEWGAARD Transaction Number: Page 4 of 7 I i TDH and Pump Tank Drawing Total Dynamic Head Operational head 2.50 ft 0.76 m Vertical lift 14.10 ft 4.30 m Are laterals the highest point in the Friction loss 1.91 ft 0.58 m system? Yes W here. L� Total dynamic head 18.51 5.64 m If no, what is the highest elevation Dose Volume downstream of pump? L�1� ■ Dose is > 10 times lateral volume Forcemain drain Lateral void volume 9.3 gal 35.2 L back to tank? ("x" one) Minimum dose 112.5 gal 425.9 L x Yes Drain hack 24.4 gal 92.4 L No Dose volume 136.9 gal 518.2 L Typical Pump Chamber Layout In combination with state approved treatment tank. Tank construction as per Comm 83.20(3) WAC. approved manhole cover with weather proof warning label and locking device grade levels junction box —"'� grade levels disconnect alternate 4" vent pipe electric as per NEC 300 and F— outlet Comm 16.28 WAC location 18" (48 cm) min. wall of pump �"" approved chamber or outlet joint combination tank A Provide 1!4" weep hole or anti - alarm on siphon device as necessary pump on B Grade levels pump 90.4 ft C - pump tank manhole = 4'(10 cm) off eiev. 27.6 m minimum above finished grade D - vent =12" (30,5 cm) minimum above finished grade 89.5 ft Pump tank elevation 3 " (75 mm) of bedding under tank 27.3 m bottom of tank Tank manufacturer WEEKS CONCRETE PRODUCTS Pump tank capacity 19. gallln Pump tank volume 8 gal Pump manufacturer GOULDS Inches Gallons Pump model number WE0311 L A 24.2 _ 469 .1 'as B 2 38.8 Alarm manufacturer S.J. ELECTO SYSTEMS C 7.1 136.9 Alarm model number HW 101 i5 D 8 155.2 Project: WENDELL NEWGAARD Transaction Number: Page 5 of 7 .turves P umps U mcrim FEET E 65 wE, sn - -- _ - wtwki A wEQl►t— — I { I i 1 — IS � • 1 1 , 1 0 10 70 0 �0 50 4J �v W l w 1 10 :V G Y M 2�.g6�P'"A CAPACI7Y �••:.r,� r. •.;r• • t,1 T.•I. •lry'. • .�„ >., .. - UIC:) PUMPS, INC. M4TER6 fEL 1 _ r- -i-- T--r -i EL 3305 7-7 �� — r-- - - —I_ I ' • ' � I 5 ','�" Solids I 1 � T E Q Q ` Q 10 20 10 SO 1.0 lu w �.v 11') 1:1) GPM CAPAC f • 1 r�8 O W Wi hMnW. IM. L 4G1rN carry. 1 yN C71 /. r , ; mss'' Alosad i W=nsin Departrnent of Industry, SOIL AND SITE EVALUATION REPORT Page 1 of 3 tabor and Human Relations Division of safety & Buildngs in accord with IL.HR 83.05, Wis. Adm. Code F COUNT Y Attach complete s ite plan on paper not less than 81/2 x 1 inches in size. Plan must include, but not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or # dimensioned, north arrow, and location and distance to nearest road. APPLICANT INFORMATION PLEASE PRINT ALL INFORMATION Y DATE PROPERTY OWNER: PROPERTY LOCATION - DCON L: GBY�eT SI�F 1/4 fQ)E' 1 /4,S2-1 T 2 -8 ,N,R lq E(or W� PROPERTY OWNER':S MAILING ADDRESS LOT # BLOCK# SUED. NAME OR CSM # S°t ck L PVKi — W `INGK 1 E CITY, STATE _ ZIP CODE PHONE NUM ER []CITY []VILLAGE ®TOWN TNEAREST ROAD R t U�IZ° 1 "Prt� ,lam l S�ozz 30 `cE biz. [4 New Construction Use p() Residential / Number of bedrooms 3 [) Addition to existing building ( I Replacement [) Public or commercial describe Code derived da1ily flow LSD gpd Recommended design loading rate o y bed, gpd$ — trench, gpd/111 AbsorpWA area requited bed, ft 3-1 S trench, 9 Matamum design loading rate y . 5 bed - gpd/ft © - 6 trench, gpd* Recommended infiltration surface elevation(s) b (4 . b ft (as referred to site plan benchmark) Additional design I site considerations Y U t,b w / Qj X �� $C _ h'1 ! �c , . Z F Sf Itivp [=-t l.L Parent material s %--YL4 OQI�M 'Zm-m-N t Flood plain elevation, if applicable Nl-. k ft rU Stable or system CoNNBlf►oNaL MOUND IN- GROUND PRESSURE AT -GRADE SYSTBat IN FlLL HOLDING TAW le for s tem ❑ S ®U ®S ❑ U ❑ S ®U ❑ S G U S ®U O S 1011 SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Bw - day Roots GPD /ft �.W in. Munsell Qu, Sz, Cont Color Gr. Sz. Sh. Bed rends „ "� � � -� 1`1 `'t 2 3 ! 3 `-' S 1 � �' M. S �rJk n'1.� � - S .' • S . Ground S`t R- 31 - - S to 0 fL fL 31 y , � 1''t S �n 1z wt ; - • 2 •3 Depth to fimi& g factrr I Remarks: Boring # C3 5 i Z wt S bin m_ k z z -� _ l3 �o�f 31 le — s i l Z � b'r v� `F� cs s Ground elev l )t. Depth ID Z fL limiting 5 War 2. ' SAD Remarks CST Namw--Please Print one Arthur L. We erer 715- 425 -0165 regerer Soil Testing & Design Service -P.O. Box 74 River Falls,WI 54022 Sig�ure: _ Date;- - CST Number._ : ��, -OQ- �=�b M00576 i ~ PROPERTY OWNER NZ-Awz�p\H L SOIL DESCRIPTION REPORT Page? of 3 ' PARCEL I.D. # Depth Dominant Color Mottles Structure ,.GPDLft.,., Boring # Horizon Texture Consistence Bo6rdq' y Roots In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Treridt 3 <�:. z g - 2.� to � 2.3 � - s ' l Z s yn ��. cs • s -� Ground elev. tioft . - 1S`1R 31 Lf SA'- Depth to limiting facto I T Remarks: Boring # U } Ground elev. I ft. i Depth to limiting i i factor Remarks: Boring # k ' 4 Ground elev. ft. I Depth to ' limiting I factor I Remarks: Boring # Ground elev. ft. i Depth to limiting factor 'i r Remarks: SSO- 8330(R.05192) ' PLOT P LAN Page 3 of 3 • SCALE 1 "= SO ' \ r . S e w /wouo U" T i INT • i 3 B .3 •wq . J —` f, t 715 1 42.5-016S _ _M00576 CST Signature Date Signed Telephone No. CST # ST CROIX COUNTY • SEPTIC "TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer `i'D�9z�s� I2dS Mailing Address Property Address - (Verification required from Planning Department for new construction) City /State _? I— / Parcel Identification Number eZ LE GAI. DESCRIPTION Property Location Y4, ,d�L '/4, Sec. ��1 ' Z - 9 W, Town of Subdivision__ , Lot # CertiCed Survey Map # Volume , Page # Warranty Deed # l /l ?`�_ ,Volume �`/%� ,Page # a / Spec house Q yes JZ 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, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site wastewater disposal system is in proper operating condition and. %or (2) after inspeclron and pumping (if necessary), the septic tank is less than 1/3 full of sludge. I /we, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 days of the three year expiration date. V u � V1A SIGNATURE OF APPLI ANT 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 property described above, by virtue of a warranty deed recorded in Register of Deeds Office. rl� SIGNATURE dr AP ICANT DATE * * * * ** Any information that is mis- represented may result in the sanitary permit being revoked by the Zoning Department. " * *" ** Include with this application: a stamped warranty deed from the Register of Deeds office a cope of the certified survey map if reference is made in the warranty deed VOL 1460FACE - 0i DOCUMENT NO. WARANVW DEED r=3.3- 1 2 2 7 KATHLEEN H. WALSH REGISTER OF DEEDS ST. CROIX CO., WI Donald O. Rodahl and Joyce J. Rodahl, Grantor, conveys and warrants to RECEIVE FOR RECORD Wendell M. Newgaard and Barbara J. Newgaard, husband and wife as 09 - 29 - 1999 10 AM survivorship marital property, Grantee, the following described real estate in St. Croix County, state of Wisconsin: WARRANTY DEED EXEMPT # CERT COPY FEE: Lot Four (4), Plat of wyngate, Town of Troy. COPY FEE: TRANSFER FEE: 135aDO RECORDING FEE: 10.00 PAGES: 1 . NAME AND RETURN ADDRESS %� i MAN is not homestead property. Exception to warranties: ,1 All easements, restrictions and rights -of -way of record, if any. ova- -(/o ' 00 / Parcel Identification Number (PIN) Dated this / C day of August, 1999. (SEAL) y�1l \J Donaldl (SEAL) Cdr - � (SEAL) (-A— - v — ,SEAL) Joyj6 . Ro " " "ahl AUTHENTICATION l ACKNOWLEDGMENT Signature(s) STATE OF WISCONSIN ) ) Be. ST , "Q O COUNTY ) authenticated this day of 19_ Personally came before me this d day of fifer od 19" the above named Donald O. Rodahl & Joyce J. Rahl to me known to be the persons(s) who executed the foregoing instrument and acknowledge the same. 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