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040-1303-00-013
Wisconsin Oepartment of Commerce PRIVATE SEWAGE SYSTEM County. St. Croix Spfety and Iluilding Division INSPECTION REPORT Sanitary Permit 479456 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: Benedict & Associates, LLC Tro Town o 040 - 1303 -00 -013 CST BM Elev: Insp. BM Elev: BM Description: .4- ` p Sectionlrown /Range/Map No: 10 0,0 o L I Al" 6 M 0,b- SE 22.28.19.1748 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATIO, BS HI F ELEV. Septic Bench rk C / /00. Dosing Alt. BM S S S Aeration Bldg. Sewer�G SOS 3 1 2 0 3. 7d Holding fig rp SUHt Inlet GN Y0 d D 8 3.1' TANK SETBACK INFORMATION O SUHtOutlet � — TANK TO /L WELL BLDG. Vent to Air Intake ROAD Dt Inlet A f �. (6Y / �j 4 MT Septic , ,2 Dt Bottom `r �d - 7 Dosing 1 Z Head 1 4 A 4. _ � Aeration Dist. Pipe I - TU, ; n� {-t-r 7 0 q Holding Bot. System C�bjrL -___ 3• ( q3.9 S PUMP/ HON INFORMATION 4 0- fn Final Grade cturer V Demand St C r - o r !✓ PL 5 yl s jb Model Number T' �/ # 3 T Lift , Fricti n S,ss Syst m d Tl t 9 Zp U6 2 9�DS 7 Forcemai) Length Dia. �, Dist. to w 767 ell wn � S OIL ABSORPTION SYSTEM fft Z 7"' W . / G J BEDITRENCH Width j Length No. Of Trenches PI DIMENSIONS No. Of Pits Inside ia. Liquid Dept DIMENSIONS C o /.� SETBACK SYSTEM TO P/L � BLDG WELL LAKE /STREAM L CHI Manufacturer: INFORMATION CH OR Type Of Sy Vi �.� � �,f �j � �� � Model Number: C4 r�.. . 7 DISTRIBUTION SYSTEM ZO Header /Manifo �t Distribution j �/ x Hole Size x Hole Spa ent to Air Intake r L Dia a(j, Length Dia 2 ✓� Spacing `_ ' f1 Z�(� W SOIL COVER x Pressure Systems Only xx Mound Qr At - Grade Systems Only Depth Over ! Depth Over Depth of xx eded /Sodded xx Mulched Bed/TrenchCenter ! Bed/Treac Edges Topsoil ��� l Yes No s -Yes i No �' L �::, O� 41 Z COMMENTS: (Include code di crepe Cie$, persons pres nt, etc Inspection #1: /i / I nspec ti o n L IJ4 }} � r' ems- �-'�- 7� �'" ar S d o: 22.28.19.1748 143 Tribldte P rkMa�Falls, WI 54022( 1/4 SE 1/4 22 T28N R19W) Walnut H arm Lot 13 P N - 1.) Alt BM Description = 4Z,G � 2.) Bldg sewer length = ZJ f Wrl ( j .rye - amount of cover I - Vim/ Plan revision Required? es No A Use other side for addition ation 4Q(f f ; _ vim Date ® Inse ctorsSignature G 4 SBD -6710 (R.3/97) INr- Tro = +4A . , �w` Safety and Buildings Division County S. l _ (� I �! 201 W. Washington Ave., P.O. Box 7162 S ' tary it Number (to be filled in by Co.) ISConSin g 266 -3 �� Department of Commerce S Plan LD. Number Sanitary Per ' ti n NOV ;rfii) 2� 1 '71 'T/l� /vs. /,� . al informaii you provide rf different than mailing address) In accord with Comm 8321, Wis. Adm. Code, person Proi ct Address (' may be used for secondary purposes Privacy law, s15.04 )(m) ST CROIX CC (o �3 TiQI ��� /�,�w� L Application Infortation - Please Print All Information 1 Parcel # Lot # Block # l property Owner's Named / 3 3 �} 5 S a ��'°� Property Lora 6 Lt d " Properly Owner's Mailing Address 7 2 /� ���✓ �l �. t-t/ ' /,, '/y Section City, State Zip C one) Code Phone Number �►y / Q /� � 0 � 1 T � N; �i , ! e ,/ 0-v 74 # 1 E W TI• YP e of Building (check all that apply) Subdivision Nye C Number ily Dwelling - Number of Bedrooms ❑ Public/Commercial - Describe Use City ❑Village unship of ❑ State Owned - Describe tJse lIL Type of Permit: (Check only one box on line A. Complete line B if applicable) A - system ❑ Replacement System ❑ T Tank Replacement Only ❑ Other Modification to Existing System List Previous Permit Number and Date lss ermit Revision ❑ Change of E] permit Transfer to New () r B. ❑ Permit Renewal Plumber Owner a (� Before Expiration IV. T e of POWTS S stem: (Check all that appi ) At - Grade ❑ Single Pass Sand Filter ❑ ❑ inbound ❑ Mound > 2 in. of suitable soil El Mound 24 in. of suitable so ❑Holding Tank ❑ ❑ Peat Filter Aerobic Tr❑ aneT (explain circulating Sand Constiveted Wetland El Pressurized ' ,- G round Non - Pressurized Filter S � Recirculating Synthetic Media Filter [I Line El Gravel- Pipe Leaching Chamber ❑ Drip Line Dis erssV]rreatment Area Information: R equ i re d (sf) Dispersal Area Proposed (sf) System Elevation Design Soil, pplication Rate(gpdsf) Dispersal Area Req Sy D pn Fl ) r a OZ� l 0_2� anufacturor prefab site Steel Fiber Plastic Capaciiy in Total Number Concrete Construc[ed Glass VI. Tank Info Gallons M ans of Units New Existing Tanks Tanks Septic or Holding Tank 5 �s Aerobic Treattnont Unit Dosing C}mmba / VII Responsibility State nt- 1, the undersigned nme responsibility for in�stallati s OWTS shown on the attached Number Number pl W sName(Print) Plumber' ature L' Plumber's Address (street, City, State, Z* c IJ VIII ORB /De rtment Use Only 3 vu Dat ued mg Ag , , S , ign � ature ps) Sanitary permit Fee (includes Gro �- / �'!� Approved ❑ Disapproved Surcharge Fee) �/ Q Z S ❑ Owner Given Reason for Denial Conditions of ApprovaUReas ons for Disapproval 74 CSTJe W NER: �'4� TEM � l�(/YlS �'G� Q YS and � - Se is an ,effluent filter ed / main tained 1 dispersal ce GtJ /y" /,�iS�vwL v ll must all be _civic er management plan provided ba lumber. intained asp 2, All )yr G Y setback) cable co es. delordinanb 4 as per app A complete plans (to the County only for the ste� on paper t less than S1C1 % 1 � hes In ) fit SBD -6398 (R. 01/03 PLOT PLAN PROJECT Benedict and Associates LLC ADDRESS W10555 521st. Ave Prescott Wi 54021 SW 1/4 SE 1/4S 22 /T 28 N/R 19 W TOWN Troy COUNTY ST. CROIX SYSTEM ELEVATION 95.5' BEDROOM 4 CONVENTIONAL AT -GRADE XXX CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1255 gallons LIFT TANK SIZE DOSE TANK SIZE 765 HOLDING TANK SIZE LOAD RATE .5 ABSORPTION AREA 1200 # of chambers none ,BENCHMARK V.R.P. Top Of Survey Iron ASSUME ELEVATION 100' Filter Zabel A -100 O BOREHOLE O WELL * H. R. P Same as Benchmark Pro Town Road to.S_ loverRd Scale = 1/4" = 10' Pro 4 ank is to be properly Bedroom bedded and provided House �- ith lockdown covers () I I i I pproved warning 0 Is V >t PI Hu bo Tank 450' Property Line Well i to meet all setba ks found in Comm. B-1 0 83 Area 15' below system is to remain undisturbed 4% Slope B4� (o k 94' 3S B-2 95 95.5' 96' S� Grading is to be done to Alt.B.M. is top of Steel divert run -off away Fence Post @ 103.8' Pro ert Line from system ;y B. M. * � lyr''\ Safety and Buildings 4003 N KINNEY COULEE RD commerce.wi.gov LA CROSSE WI 54601 -1831 TDD #: (608) 264 -8777 sco n s i n w.commerce.wi.gov /sb/ www.wisconsin.gov i Department of Commerce Jim Doyle, Governor Mary P. Burke, Secretary November 07, 2005 CUST ID No. 226900 ATTN: POWTS Inspector SHAUN R BIRD ZONING OFFICE BIRD PLUMBING, INC ST CROIX COUNTY SPIA 1008 192 ND AVE 1101 CARMICHAEL RD NEW RICHMOND WI 54017 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 11/07/2007 Identification Numbers Transaction ID No. 1211718 SITE• Site ID No. 707012 Benedict & Associates LLC Please refer to both identification numbers, South Glover above; in all correspondence with the a enc . Town of Troy St Croix County SW1 /4, SE1 /4, S22, T28N, R19W Lot: 13, Subdivision: Walnut Hill Farm FOR: Description: Four Bedroom At -Grade System Object Type: POWTS Component Manual Regulated Object ID No.: 1049653 Maintenance required; 600 GPD Flow rate; 38 in Soil minimum depth to limiting factor from original grade; System: At -grade Component Manual, SBD- 10570 -P (R.6/99); Biofilter The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, stats. The following conditions shall be met during construction or installation and prior to occupancy or use: Reminders • This system is to be constructed and located in accordance with the approved plans, and with publication SBD - 10570 -P (R. 6/99) "At -grade Component Manual Using a Pressure Distribution System for Private Onsite Wastewater Systems ". • The pressure network is to be constructed in accordance with publications SBD- 10573 -P(R. 6/99) "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems" and/or the sizing methods of publication "SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST -SAS (01/81) ". Cont • Per manual cited above, limited activities are allowed in the area 15 feet down slope of the component area. I Soil compaction, excavation, vehicular traffic and other similar activities that impact the treatment and 2EPARIIrMIE dispersal are prohibited. N Qt_- • The well must be a minimum of 25 feet from any POWTS tank, and a minimum of 50 feet from the absorption SEE COR 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. SHAUN R BIRD Page 2 11/7/2005 • Inspection of the POWTS 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. 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 coxnponent(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 Cover Page Shaun Bird Bird Plumbing Inc. 1008 192nd Ave New Richmond Wi 54017 715- 246 -4516 Date: 10/30/05 Owner:Benedict and Associates LLC Location:SW1 /4 SE1 /4 S22 T28 N,R19W Lot 13 Walnut Hill Farm Troy System type: At -Grade Manuals Used: At -Grade Component Manual version 1.0 SBD 10570 -P (R.6/99) SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST -SAS (01 /81) Page# 1. Cover Page 2. At -Grade Plot Plan 3. At -Grade Cross Section 4. Pipe Cross Section /Pipe Layout 5. Pump Chamber Cross Section 6. Pump Curve 7 -8. Maintance and Conti ency plan 9 -11. Soil test ' ZO. "r Shaun Bird IT OF CO1'AhERCE , ;tTEYA B GS Signature ' EN License number 6900 iESPOND R�r`���i�� N"'! Z`05 SAI-L I Y 6 UUI PLOT PLAN PROJECT Benedict and Associates LLC ADDRESS W10555 521st. Ave Prescott Wi 54021 SW 1/4 SE 1/4S 22 /T 28 NCR 19 W TOWN Troy COUNTY ST. CROIX SYSTEM ELEVATION 95.5' BEDROOM 4 CONVENTIONAL AT -GRADE XXX CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1 255 gallons LIFT TANK SIZE DOSE TANK SIZE 765 HOLDING TANK SIZE LOAD RATE .5 ABSORPTION AREA 1200 # of chambers none ,BENCHMARK V.R.P. Top of Surv Iron ASSUME ELEVATION 100' Filter Zabel A -100 ❑BOREHOLE O WELL *H. R. P. Same as Benchmark Pro Town Road to S- CInvpr Rd Scale = 1/4" = 10' Pro 4 ank is to be properly ( -� Bedroom bedded and provided ✓y` 6 House 0 1- with lockdown covers with w approved warning I S � pp 9 © els PI Huffcu o Tank 450' Property Line Well i to meet all setba ks found in Comm. B-1 83 Area 15' below system is to remain undisturbed 4% Slope B -3 ❑ 94' B -2 95' 95.5' 96' Grading is to be done to Alt.B.M. is top of Steel divert run -off away Fence Post @ 103.8' from system Property Line B.M.* �5� B > 5 Pit= FOACEMA1... 21 "TURt1- UPS" #-- DtSTlii FlTtC�t I rIE -LAL -� STAgI�t ��.� O$: E�.t�tTters q�ELt A > 5F 8 = i 2 D L = / 3_a . G ELS- Of �a - Z %z AGG&F_&P-TE ,cEa SymTftnL Fabric Distribution Lateral �-- Soil Cover We l l � A } Plans View and Cross Section of i7iscorrsin At -$Y$� Unic with a Single Absorption Area on a Sloping Site �tiUt�itl�7u KE ; Page Of (Distribution Pipe Vet3il For Lateral Metwork Acre s + TuRM -uP (CLrA,ROUT) _ - PVC Force Main PVC Distribution Pipe _ P Owl * last Hole Should Be Next To tuR�• uP � / p _.L.1_U...— Ft_ Hole Diameter Inch X Inches Lateral Diameter Z-_ Inch {es} y inches Force Main Diameter _ Inches of Holes /Pipe p �.n- Invert Elevation Of Laterals 1 Ft. Signed; License hers Dates pump C4.4AM8£.R CROSS SEC T 5 FG*3 AND SP €CZ3 FC ---- �S SEPTIC TANK it£AnWRP;tooF E GxA�� £ Apggpd €D UNCTION BOX HOLE COV ER OK DOORv SENT DOPE ABOv IWIAiDOw OR WITH CONDUIT W/ pADLIDCK � FREa�= '� ;�tTAiCE r r} SriARt�I�IG LABEL P,n PINS :. GRADE ts u 4 f i INLET GAS a TIGHT s a` J WITli ,WI,TER 'FIGHT SEALS A Ste' APQROM PIPE _ #1 ; �r 3 LT ER B i ON 3 3 8 g 50IL APP:j C. = FF Pip£ OFT ' a1441k ` i OHM SOIL y L_ Tpl,�T�C � � e A APPRtI�E73 g DING UMD� CONCRETE PAD 3 SPECIE ;,CATI{}is5 ./ =� �y 1+FLIi'4B€ -� D 5£S FER DAY; `�.- ---- -- SEPTIC I DOSE C i1IIVG / pACT�3RER L4 13L35E v �sACx: T AISK IdAtSU GAL SEPTIC � 8 AL - TAIiK S ZES = DOSE 7 GAL. A = iNf iEs � AgAC�T��S = = w�' �, �� -- IKANtJFACTURI t/�G S C s = �_ INCHES W �� GAL A --- n MODEL 0J?48ER : L f �� � C ;NCHES ✓ L S ITCH TYPE: : ,� PUMP i'F murACw 15 WA MODEL fflitm�; /�L� WIRING AS PER I� SNITCH £ ALARM � � G ?� � £ET 'IiiED I3ISC�fAKGETEp? TIpN PIPE.£EET REQD pUt4I' Oi F AND DISTgiB . _ .�p• �. FEET RCTIo2 FACTOR FEET VERTICAL D IFFEgEjSCE HETWEL - "Fj + MIN;tf` N NETWORK SUPPLY XR�3 H T11€�Q FT- r7YN I FEET FORD A TOTAL DIAMETER ---- wIl 1116 LF_lgGTH LlQOID �° FNT£It13t�L DFl"tENSZOt'4S �}F PUMP 'EArtK= �'--= '--�'`- LICENSE NUMB _ SIGNED: I($S TOTAL QYNAbtiC i EAD /CAPACITY PER MINUTE HEAD CAPACITY CURVE EFFLUEIa~ AND DEWATERING MODEL 152/153 MrJQEL i 152 1 53 1 50 Feet ! Meters G. Lifers Gol. Liters 5 1.5 69 261 77 1 291 153 10 � 3.1 1 61 231 70 i 265 12 40- 152 i3 4.6 1 53 201 61 231 a ZD 6.1 44 , - ,67 52 197 30 25 7.6 I 34 129 42 159 g 30 9.1 23 ; 87 33 1 125 i n 35 10.7 1 -- - 22 85 1 20 40 12.2 1 -- -- 11 ! 42 Lock Valve 38.0 F?. (11.6m)� Ft (t??mJ� 4 014= I 10 1 1 D 20 40 60 80 100 GALLONS i-- S 1/4 --� LITERS 0 80 160 240 320 - 3 27 /sz- ;-- •--- i-�•-a , /e-• -i ! FLOW PER MINUTE ( I .� , 3 27/32 CONSULT FACTORY FOR SPECIAL APPLICATIONS _ 1 ti- I • Timed dosing panels available. = 3 27f32 • Electrical alternators, for duplex systems, are available and supplied with ! y an alarm. • Variable level control switches are available for controlling single phase systems. • Double piggyback variable level float switches are available for variable level long and short cycle controls. l' ` • Sealed Qwik -Bax available for'outdoor installations. See FM1420. r i • Over 130 °F. (54°C.) special quotation required. I , 1=53 "Series' 12 1/a r Contra Selection t I ii2r153 Na � ! Model Yohs -Ph Node lun Sim lex ! Duplex N152 115 1 Non 8.5 1 2or3 I 1 BN152 115 1 Aum a.5 in cluded —L SIM" E152 230 1 Non 4.3 1 2or3 ; BE152 230 1 Auto 4.3 Included 2 or 3 N153 115 1 Non 10.5 1 or SELECTION GUIDE BN153 115 1 1 Auto 10.5 Included , 2 or 3 E153 — 2 - 30 --- 1 Non 5.3 1 2 or 3 1. Single piggyback variable level float switch or double piggyback variable level float BE153 — 2 - 30 -- l -- F Auto 5.3 Included 2 or 3 Switch. Refer to FM0477. A eAUnoN 2 See FM0712 for correct model of Eleci ical Altemator E-Pak All installation of controls, protection devices and wiring should be done by a qualified 3. Variable level control switch 10 - D225 used as a cDairol activator, spe* duplex (3) licensed electrician. All electrical and safety codes should be followed including the most. or (4) float system. recent National Eleetrk Code (NEC) and the Occupational Safety and Health Act (OSHA). RESERVE POWERED DESIGN For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump. ..AWL To. P.O. BOX 16347 Louisville, KY 40256 -0347 Manulgchuarst. L• SHIP T0: 3649 Cane Run Road t� oe wrff, Louisvil le. KY 40211 -1951 �Y1 S Ifd�7 za ��� ,d (502) 7'8- 2731.1(900) 928 -PUMP t&p:Ow. wwzoe11er com /Y/FAX (502) 774.3 624 © Copyright 2000 Zoeller Co. All rights reserved. YSTEM SP PLAN Page of S OWNER'S MANUAL & MANAGEME Pis POWT S - ' 2 5 � ❑ N ai 1� Capacity FELE IrIFOI�wT ON - rap. [ Mano oar tvt peftrut Effluent Ater fVlan� -� 11 NA tGN PARAJE� p NA Effluent Fine r�Modet � 0 NA timber Of gednooms Pump "Tank CaPadtY ❑ NA Number of units aYd Pump Tank Martufadurgr ❑ NA" EOM*ed Ww (avf' V) attd . PumP Manuf f-� ❑ HA x 1 . 5 ) Model p,estyn flow (P�+ (�� . ayda Pump nt Unit " Soft P+PP " � t:ira9a Pr sandf Fatter - ❑Peat Fetter uent Quality G) S30 mgn- C3 Mechanical Aerafion 13 Other ltdttiea'�E'� Oa S Grease (FOG) :5220 mg/L [3 Disinfection Oxygert Demand { ass) s< l so m IL Manufacturer TOW B � Soros fT } e .. a persat Cett(s) round (pnsssurtzed) averag El Ind monthly p fd Effluent Qt wand (SODS) S30 mg/L 13 .graded (gra y) 0 Other_ B'rocherniC21 099 Solids { � } S si 0 30 mgn- Q ri ne Total Suspen ` cful4 QOmi vrast waW Fecal Coliforrn (9eQmetzie mean) �ralues lyP;� for danssb' tmn I old y inch diameter sesW sank etriuedL ly�mucn Effluent Particle Size .� Values types for preheated tivaste u Serylce Fre4u ncy NWNTENANCE SCHEDULE ears) (Maximum 3 yrs.) Service Event ❑ month At feast once every -z-, one -third (y) of ink volume inspect condfion of tanks) VYhen combined sludge and scorn e4 r(s) (Mimum 3 yrs -) p np out contents of tank(s) ❑months At least once every � � inspect dispersal c ell(s) At least once every ❑ months At least once every sl ❑ NA Clean e ffl ue nt filter At least once every ❑ months s) ❑ NA um p controls & atartr+ Q mon Fl {fiats and pressu ❑ months ❑ year( s) s (3 NA At least once every s) ❑ NA oC�er At least Once every C] months II year( oner_ INST aei shall be made by an individual carrying one Of OWT S Maintai MMuTEMANCE INST e _ Mairifaaner, Septage Inspee6OrA Plumber Restricted Sewe . iden5fy any m or brtoKen Mass Plumber; Master r 1� o Wl" Inspector thSe iariK(s) for any back up ChV Sam r. Tanis inspe'c d0 must include a visual ens om a and scum and �� �f effl Weis � y � or teaks. + sure the volume of oombirsed sludg t of effluent on me round s hall fie v T WW , round surface- The PO1d"� or ppn&V of etftuent on the g sur The dispersal OeU(s) s for any ponding o f effluent on the g Lion of the local r�egula "� in the obsenrafion pip" and to check uires the immediate notifx;a tank volume, the ground May indicate a fading >rond " "itieon and re4 uais one -third anne (X? or more Of the NR sludg $rid scum in any tank eq of In aacord'^�' � - Whenthe combined aprxitnufatrori of move a Septage Servicing Operator and disposes entire contents of the tank shall be re move d letr t" componen and anY 113 WfsWtWn Administrative Code anents, p ressurized POWTS Comp pe r for me d by a pOWTS Maintainer' The sefvidng of effluent filt m, mec ha Wipe or p of 12 months or less shall be p�' . oth matnftrnari a e or monitoring at ante" o f compiefion of arty Service event AsW15* MPOctShafl"be prrnrided to the local regulatory authority wbin 1(J days other START UP AND o p the resenc� � Q�Un9 produc For new ts or O PERATIO N 2M construction. Prior to use of the Pp1 7"S nd/or d atr l4e t er �il P , s entrations cnemieab ttrat may impede the treatment preoess and/or damage the cis c P i if � Cono defected tlaf(e the contents of the tanks) removed by a sept'age servicing o pe r a tor riot to use_ i; Page • �� nditions are frozen at the infilt surface- gysbt+arr stag up 2rt no[ occur Wtten saris °° is [esbD - ed the excess p D , parer outages pump tanks may IM abov cell( on eiarge dose overload g (S) and MaY result in the �rwlit be d'LSC3�ar9ed m ttre drape t To avoid this sifuafian have the contents of the pcimp tank removed by a baciouF or sores die Of to the effluent pump or contact a Plumber or POWT Mair{tainer to Septage Serv�9 pperator t res#oti� power a N Maw* operant tie PUMP con to restore normal levels w ithin the pump tank D o no drive or park ve hicles over f uft and dispersal sells- Do nat drive of park oven flr Of lerwise dis'lnrb orcOmpect, th e arm W ithi n 15 feet down s lo p e of any mound or at -grade so il strt;arn may impro so il absorption area - the a the performance and prolong Ow Gfe Reduction or- er"rrnination of the foffuwing from the wastewate of life POWTS-- atltitblotres; Y! P d�tte buffs; condoms; oDtton swabs: dead: dental floss: drapes.; dtaflt {stlrrlp pttmp) water, tVd and vegetable peelings, gasOft , grease, herbicides; meat drsinf : t tin naducW, pesbades-. sanitary napkins: tampons: vrater softener brine - scraps; rtrecGc�ons: ot>; ioain 5 P - ABANDOijMENT and/or i entry -taken out of service the following steps shalt � taken to insure that the When the Powrs flails abandoned in compliance with ch_ Comm 83.33, W Administrative Code system is proPedY and 5af�ty Alt piping to tanks and pits shall be disc�nrr mom d and the abandoned isopsed oo��Septa Se�cing Operator. The contents of an tanks and pits shall be removed an property • After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space fitted w th soil, gravel or another inert solid materiaL CoNMGENCY PLM aid the following measures have been, or must be taken, to provide a code if the POWTS fans and cannot be rep compliant replacement system has been and may be utilized for the location oa of a replacement so O A satiable t�epia�enCarea co The replacement area should be protected from disturbance and compaction and should not a bsorpti o n - required setbacks from existing and proposed structure, lot Tines and wells- Failure to be infringer upon by seta protect the replacement area tarirt result in the Head for a new sail and site =evaluation to establish a suitable replacement area Replacement systems must comply with the rules in effect at that time- r A suitable replacement area is not availabie'due to setback and/or soil limitations. Barring advances in POWTS technology a hording tank may be installed as a last resort to replace the failed POWTS. a suitable replacement area Upon failure of the POWTS a sod.and The site has not been evaluated to identify p t area is available a site evaluation must be p�rmed to locate a suitable replacement area- If no replacement hording tank may be installed as a Last msort to replace the failed POVYTS- removal the biomaf at and at -grade soil absorption systems may be reconstructed in place following Me rrifittrative surface, Reconstructions of such systems must comply with the Hiles in effect at that time <<VVARNING SEPTIC, PUMP AND OTE i1=R TREATMENT TANKS MAY CGASSES ANi3 /OR INSUFFICIENT O CONTAIN LETHAL GAXYGE1ti DO NOT ENTER A SEP73C, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES- DEATH MAY RESULT- RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLER POWTS LWNTAINER _ Name Phone / 3 L Piz' �/� — �Y b� SEPTAGE SERVICING OPERATOR PUMP LOCAL REGULATORY AfJTHORl7Y N3tn8 a9Cy Phone -;71 j , 7 ?hone This d"Wnesawas dratted by ttm sI 1 s of the G Care, Mamuette and Waushara County Zoning and Sanitation agt This do=,& t meets th e mkanwn requieenwaft of dL Carron 83- 22(23(b3tWAM and 83- 56(1). (2) & (3). Wisconsin Adminlstt2&e Ca& Ilse of ffth deetrment 6X6 00t quamatee the performance of the POVW'S_ (,MW (MJ) RECEIVED WisconsO Department of ommNQV Q 3 700 OIL EVALUATION RE Page l of 3 Division of Safety and Bui ings in accordance wit i Comm 85, Wis. Adm. Code ST. CROIX COUNTY County _�_ L Attach complete site pl on paWggfJjgs@PRUrg 1/2 x 1 inches in size. Plan must include, but not limited point (BM), direction and Parcel I.D.6 e�� percent slope, scale or dimensions, north arrow, and location and distance to nearest road. [/ G� —' w 7 Please print all information. Re ' wed by ` Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). / Property Owner Property Location Govt. Lot 1/4 1/4 S ZZT 2 N R R E ( r) Property Owner's Mailing Address Lot # Block # Subd. Na or CSM# / city State Zip Code Phone Number ❑ City ❑Village Town Nearest Road ew Construction Residential / Number of bedrooms Code derived design flow rate Too GPD 0 Replacement _ ublic or commercial - Describe: Parent material Flood Plain elevation if applicable ft. General comments and recommendations: FF1 Boiling Boring n9 Pit Ground surface elev. •� / ft. Depth to limiting factor i � n. 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 C-3_ 2 5 b Boring # Boring t Ground surface elev. &, oft. ft. Depth to limiting facto in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fY- in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. i - Eff#1 'Eff#2 •-1 Z- S — ti Ni,¢ �. . ' Effluent #1 = BOD > 30 1 220 mg/L and TSS >30 1 150 ' Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) CST Number Jn� Bird Plumbing, Inc. Shaun Bird 226900 Address 1 Date Evaluation Conducted Telephone Number 1008 192nd Ave, New Richmond, WI 5401 `' 715 - 246 -4516 Property Owner _ Parcel ID # Page of 1:3d Ong # ❑ Boring Pit Ground surface elev. ft. Depth to limiting factor �U in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 Z' a ��' m F 77 F-1 Boring # ❑ Boring C] pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fP in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 F-1 Boring # [] Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil ication Rate Horizon Depth Dominant Color Redox Description. Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 Effluent #1 = BOD. > 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BOD < 30 mgA. and TSS 130 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 (8.60)) Soil Test Plot Plan Project Name Benedict and Associates LLC S d Address W10555 521 st. Ave Prescott Wi 54021 M .#226900 Lot 13 Subdivision Walnut Hill Farm Date 10/30/05 S W 1/4 SE 1/4S 22 T 28 N/R 19 W Township Troy Boring 0 Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 100 ft. Top of Survey Iron System Elevation 95.5' *HRpSameasBenchmark Pro Town Road to S, Glover Rd d •wS�'� Scale = 1 /4" = 10' Pro 4 Bedroom 21 House 0 450' Property Line B -1 4% Slope B -3 ❑ 94' B -2 95 95.5' 96' Alt.B.M. is to p of Steel ence Post @ 103.8' �' Property Line .M.* ST. CROIX COUNTY WISCONSIN PLANNING & ZONING DEPARTMENT w u w — r�.■r ST. CROIX COUNTY GOVERNMENT CENTER 1101 Carmichael Road fAN . Hudson WI 54016 -7710 - —--- Phone: (715) 386 -4680 Fax (715) 386 -4686 Memo to File From: Pam Quinn, Zoning Specialis Date: 11/8/2005 Re: On -Site Soil Evaluations for Lots 12,13 & 14 of Walnut Hill Farm Subdivision (S 1/2 SE % and NW % of SE % Sec 22, Town of Troy) On November 1 2005 I met Shaun Bird, MP #226900 for an on -site evaluation of soil conditions on the above - referenced lots. Mr. Bird had been issued a sanitary permit for this lot to install a conventional POWTS based on the original soil reports completed by CST Robert Ulbricht (who was unable to attend the on- site). During house foundation excavation and tank installation, the soils observed did not appear to match the descriptions reported. The soil evaluation was done at 3:00 p.m. with late -day sunshine and partly- cloudy skies. Two test pits were excavated on lot 13 and another on lot 14 to determine whether or not the recommended conventional POWTS would be feasible. Lot 12 already had a recommendation for a mound, so the only concern is the direction of slope. The test pits excavated on lot 13 were in the vicinity of original flagged borings B2 and B3. These pits revealed soil profiles that were similar to those reported for lot 12, with massive sandy loams encountered at approximately 36" and soil colors ranging from 5 YR 3/4 to 5 YR 4/6. Due to the angle of sunlight, it was difficult to determine if there were redox features in the reddish brown soils or at the boundary with overlying silt loam horizon. Shaun has done additional soil work to create a new at -grade POWTS design, since B and B3 report moderate platy structure in Horizon #3 silt loams that have a maximum soil application rate of 0.0 gpd/ft2 for Effluent #1 [per Comm 83.44(4)(e)]. In addition, the slope direction on the system area is to the northwest, not southeasterly as indicated on the soil report. On lot 14 a test pit was excavated between B3 and B 1, approximately 48 ft. west of the existing fenceline shown on the soil report. Sandy loams were originally reported at 26 - 36 inches below grade with "weak, fine granular ("I fgr) structure, but granular structure primarily is found in A- horizons, not in deeper soils. The sandy loam horizon appeared to be massive 0m with the pp ( ), soils breaking into smaller units due handling, not as true individual peds breaking along planes of weakness. The soil application rate of 0.2 gpd/ft2 must be used to size a conventional POWTS for this lot, which will require a significantly larger system. The slope direction on the tested area is northwesterly, as reported. These items have been noted on the report for use in POWTS design. I notified Bob via telephone conversation that the slope direction on lot 12 needs to be re- checked and he is scheduling a site visit so that any necessary corrections can be made prior to preparation of a mound design. He was also informed of the discrepancies found in the soil conditions on lots 13 & 14 and that Shaun Bird will be re- designing the POWTS for lot 13. Cc: Todd Bjerstedt, Subdivision Developer Bob Ulbricht, MP /CST #226375 Shaun Bird, MP #226900 ( POWTS Installer) Leroy Jansky, DCOMM Regional Wastewater Specialist Soil report file t, `- rq n 1 t rn co A ! 7 J , OD X 4 ' z qL o to 1 z� z Ul z N v . _ 00 OD ►Y W � lD OJ � j ' J Q1 '.V OD \ ee J LO 4D OD C � , V I o0 J -0- °�° � /ap _`•'� . OD 7 w ! D rro _ OD OD 4 ,. � D PO vz D OD z D t t 1 1 c z W } Q ao CJ� XLA �� l rn A - Un q N i vl > CD X u> z OD I 0D f ' 1 rri rri r O Si 3 r1 7 CD CD h� A M # W • p_0j N G V C N ? °C • CD A CD a N Q FBI CA CA `w3 CL CO 0 O 7 9 y N 0 w p C Of Cy A Z D m a D y CL CD W � CL c co n o F; 12 I 0 0ty c1 r �n 0 C 3 ° c CD _ a CA ca (A w c v,Q vvv l CD Rn T t!1 -n 7 3 m _vr l y M D D z o CD ! l�l • y ' l l V l X n C C 3 a N D' 3 (D 7 R ' Z CD A CL A z 0 i c C n N N Q N c Z T 1 N I O 'f fn 8 3 m y z CD A 3 7 0 a rn � a ID f RL (D CD o w o� 3 CL CD C \ Q (LS CL 7. CD N CL � 0 s. a \ m O " T A S 7 O � CL CD (' = ya CD o. C n CD E A m o b 0 C Safety and Buildings t County 201 W. Washington Ave., x 7 ^ 2 /� Sanitary Permit Num (t e fi11�Co.) or Madison, WI 5370 - 7 jSconsi (608) 266 - 3151 \, Department of Commerce State plan l.D.Number Sanitary Permit App1 do I I A In accord with Comm 83.21, Wis. Adm. Code, personal information u prov&r^ dress (if different than mailing address) may be used for secondary Purposes Privacy Law, sl x.04(1 ) 1 !I'' 11 I P✓ f I. Application Information - Please Print All Information S f l Block # Parce Lot# Property Owner's Name - S T CROIX CO UN i — IIN 0 e ; ZO /CE Pro rty ocad (? D Property Owner's Mailing Address G✓ S ection Z w 1 0 J Zip Code Phone Number 1 City, State (circl on) r ? � � P �/ �) � � ) T�N, e/$ -1 7! L E rW 1 W CSM Number 3 B T II. Type of Building (check all that apply) Subdivision Name l or 2 Family Dwelling - Number of Bedroo s ❑ Public/Commercial - Describe Use QCity_Dvillage ownshi of ❑ State Owned - Describe Use III. Type of Permit: (Check only one box on line A. Comple line B if applicable) ❑ Replacement System [3 Treannent/Holding Tank Replacement Only ❑ Other Modificati on to Existing System A. New S stem List previous Permit Number and Date Issued ❑ Permit Revision ❑ Change of El permit Transfer to New Before Expiration B. ❑permit Renewal tuber Owner LO Plumber ' i 0 IV. T e of PO S stem: Check all that ap l > 24 in. of suitable soil ❑Mound < 24 11 ❑ in. of suitable soil At -Grade Single Pass Sand Filter Non - pressurized In- Ground [] Mound - ❑Aerobic Treatment Unit ❑ Recirculating Sand Filter A Constmcted Wetland Pressurized ized In- and ❑Holding Tank Peat Filter e e gin) gt,✓ Synthetic Media Filter hing Ch ❑ Drip Line ❑ Gravel -le Pipe Recirculating ) Elevat n roposed (sf) System V. Dis ersalfTreatment Area I P rmatton: s Dispersal Area Required (sf) Disp a 9 Design Flow WO) Design Soillion Rate(gpd fl l J 7 � 3 / ` Prefab Site S l Fiber Plastic VI. Tank Info Capacity in Total Number Manufacturer Concrete Constructed Glass Gallons Gallons of Units New Existing Tanks Tanks Septic or Holding Tank � Aerobic Treatment Unit Dosing Chamber MP/M PRS Number ssume responsibility for installation of the Business Pone Number POW shown on the attache plans. VII. Responsibility Statement I, the undersign l/6 / Plumber's Name (Print) Plumbe ' gn 2 Z .� 6 �.LUZ. Plumber's Address (Street, City, State, Zi e) Ps) /De partment Groun� ent Use On D t Is ed l mg �� Ignattue VIII• Sanitary Permit Fee (i ludes v rate � O � pproved ❑ Disapproved Surcharge Fee) ?�y� r t. G al 3 Given Reason for Denial IX. Conditions of Approval/Reasons for Disapprov SYSTEM OWNER: eat filter and dispersal cell must all be serviced / maintained as per management plan provided by plumber. 2. All setback requirements must be maintained OL as per applicable code /ordinances. O ` Z Z to the Cou only) for the system on pa not less than 81/2 x 11 inches in / . Attach comPtete plans ( A I - 398 .01/03) SBD 6 � PL 11TOwN PROJECT Benedict & Asscociates LLC 0555 521 st Ave Prescott Wi 54021 1/4. SE `1/4S 22 /T 28 N/ Troy COUNTY ST. CROIX MPRS Shaun Bird 226900 DATE 9/3/05 BEDROOM 4 CONVENTIONAL )00( IN- GROUND PRES CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1255 lions LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .5 ABSORPTION AREA 1212 # of chambers 39 IL BENCHMARK V.R.P. Top of 1/2" Steel Conduit ASSUME ELEVATION 100' Filter - Zabel A-100 ❑ BOREHOLE O WELL P. Same as Benchmark — � ite permits, SYSTEM ELEVATION 95.5/95.2/94.9' ease note: if s may install 2 -3' X 125' cells Plans Designed Using stead of 3 cells! Conventional Powts � o f t �,/,,' Manual Version 2.0 Well is to meet all W-- S G 4e* , Property Line setbacks required b WDNR Pro 4 Bedroom 1 House 0 ' M.#2 is top of /2" conduit @ zl ` 9.72' S ► �� 5 8 110, 6 B -2 Vents B.M. # B -1 15' 55' b. � _ � � � 280' 3' X ells with >3' spacing;' k n 0 Vent B -3 jrcdS > 6" Standard Biodiffuser \ o of Cove Leaching Chamber with 31.1 ft2 of Area ✓r b� C ` 6' Lon 11" � 3 4" Grade at System Elevation n Property Line 1' q3 I PLOT P PROJECT Benedict & Asscociates LLC ADD S 10555 521 st Ave Prescott Wi 54021 1/4 S E '1/4s 22 /T 28 N/R 1 TOWN Troy COUNTY ST. CROIX MPRS Shaun Bird 226900 DATE 9/3/05 BEDROOM 4 CONVENTIONAL )00( IN- GROUND PRES CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1255 Ilons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .5 ABSORPTION AREA 1212 # of chambers 39 IL BENCHMARK V.R.P. Top of 1/2" Steel Conduit ASSUME ELEVATION 100' Filter ZabelA -100 ❑ BOREHOLE O WELD , p, Same as Benchmark SYSTEM ELEVATION 95.5/95.2/94.9' ease note: if site permits, may install 2 -3' X 125' cells Plans Designed Using stead of 3 cells! ' Conventional Powts lJ 104 f Manual Version 2.0 Well is to meet all t 1 S�vr Property Line setbacks required b WDNR �� �,�,�✓ Pro 4 lA' � Bedroom House 0' M.#2 is top of /2" conduit @ 9.72' S U' 'd -- B -2 S' 1 110' B Vents B.M. # B -1 15' 55' 280' 3 3' X ells with >3' spacing Vent B -3 >6„ Standard Biodiffuser of Cove Leaching Chamber with 31.1 ft2 of Area 6' Lon 11" 3491 Grade at System Elevation Property Line wsconsin Departmen otcommeme SOIL EVALUATION REPORT Page / of 3 Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code C ST G� Dl x— • V Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must L 7 .. 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. P it10 //� 6-- b Please print all Information. wed b Date y Perso" kdonywtton you provkM may be used for seoondary purposes (Privacy Low. s. 15.04 ( (m))• P To P 133ERS T T_ 5 fj�/ /��f cwt. Lot 40 1A S v4 S Zt' T 2-6 N R If E (or) w �1 Property Owner's Mailing Address Lot # Block # Subd Name or CSM# & o 1 CA W LL AV-P— - IVAI O T Ri FA � city S)vULR State Zip Code Phone Number ❑ city ❑ Village (Town Nearest Road �1 bPPOE HT5 MA) 5SOWo ( &51 ay8• to9� - so. L f dvE R _ _ o New Construction t Use: (� Residential / Number of bedrooms Code derived design flow rate � � GPD ❑ Replacement ❑ Public or commercial - Describe: %A Parent material Io S 10 U.4(- — 4AYD Y 4907 �W'L d Flood Plain elevation if applicable ` General oonrnents and recommendations: r TE r S 0 / 7 Le— 7O/c 5971 1,V 6 v v A o -!,v - T S. AA &A lh&dlk z "<OaAN a # a 91.5"2 } y N Pn Ground surface elev. ft. Depth to lirraig factor Rate Sol Application Horizon Depth Da wwt Color Redwr Description Texture Structure Consistence Boundary Roots GPDff in Mrnsell Qu. SL Cont color Gr. Sz Sh. 'EfF#1 'E c l o � /D 3 /L am, (544 � L► &j 3 1 — S � �iL �u 7 � L / Z 7 GLcJ ! . S . IN dA 0 Y # a Boring 5 2- 7 , ® Pit Ground surface elev. ft Depth to limiting factor � in SoA Application Rate Consistence Horizon Depth Dominant ReuiQx Description Texture Structure Boundary Roots GPDff try. Munsell Qu. Sz Corn color Gr. Sz Sh. 'Etf#1 O - q lw 3 t- . s N z . 2- S 2,44s hik rG s N o M ��4 c S ^7 Yle Effluent #1 = BOD > 30 < 220 ng& and TSS >30 1150 mglL ' EMuens #2 = OD 1 30 mg& and TSS <_ 30 mglL csT Nam (Please Pfit) •R - -u L6 R i C iT— Signature Z 5 Address Uibricht & Assgciates Data Evaluation Conducted TelephoneNunver 2_.. Privat S , /7 • 0 3 71 s- 77A 3 2812 10th Ave. Spring Valley, WI 54767 l PiX !"°k 4PAR X . 2 yo 5 - o • /o S S o oyo - /10 . !o - o� dyo • /��G ZO • °� oyo - /o8�- GD•� oyo • /o �� - 70 a� -"ovV T,� JE L* s Taro7" Prope rtyOwner ParOLqjD 40 Q 17.7 > t Ground surface etev. ft- Depth to BOOM factor WL Fforixun Depth Daaiinsrit cok. Sail Rate kL Redox Desa�titxr Texture Structure Consistence Boundary Roots GPDAP Munseti Qu. Sz. Cont. Color Gr. Sz. Sh. "Eff#1 'Eff#2 2 �• /� f- 3 •30 o c � z 5 S' F—] � S # � [ Boring �--J Ground round sudfaOe elev. ft. _ .. P ... Depth tOitmiti factor i n. Sol Rate Horizon DOPE Redbx Desrxiption ' Texture S'fracbne Gorisi nce SWndary Roots trt. Munson Qa. Sz. Curti. Color Gr. Sz. Sh. `Eff#'t 'f`fff#2 . I 13oruig Pit Ground surface dlev. f. Depth to - ' factor irs Soil Application Rate Horizon Depth Dwrif mM Color Redox Description Texture Conswerice wx"M Roots in. Munseti Gtr. Sz. Cori Colo . Sz Sh. •Eff#1 •Eff#2 g e - r F Baring # C Q Eorrng t� Pit Ground surface efev. ft. Depth to Writing facts in. Sort 6MgAw Rate Horizon Depth DornhmM Cdor Redox Descd Texture Structure Consistence BOUrK ary Roots GPM Munsell Ou. Sz Color Gr. Sz. Sts. 'Eff#1 'Eff#2 ° Effluent #1 = 0OD,> 30 220 mg1L and TSS >30 < 150 mg1L • EfAtient #2 = BOD < 30 nsgli. and TSS 130 nmYL The Department of Commercc es 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 608-264-9777. seus�zio f22smo? + r PLOT PLAN WA LNUT HILLS FARM. LOT # Pg. 3 of 3 = Contour elevation lines. • = Backhoe Soil pits. i I - 0 = Benchmarks set, maRKED WITH FLAGGED .lathes. 1/2" steel conduit pipes. SCALE: 1" = 3 0 F � 1 2-07 .. o 7 sD jib U r 0 1 Igo - ISO 5 s 76 • Maintenance and Contingency Plan for a Septic System Maintenance Plan 1. Septic Tank is to be pumped once every 3 years. 2. Effluent filter is to be cleaned once a year. Please note: a larger filter is being installed in order to extend the maintenance interval of the filter. 3. Once every 3 years, cells are to be inspected via the inspections pipes at the ends of the cells. 4. Owner agrees to limit greases, garbage, and water conditioner discharge into the system. 5. The owner agrees to save this plan. 6. Do not plant trees nor park nor drive over system. 7. Watershed is to be diverted away from system. 8. Discharge into system is not exceed those required as per Comm. 83 7in cy Plan Optiof system fails, determine cause of failure, use alternate area and install new sy sted rep lacement area. Option #2. Install system at a lower elevation, by removing chambers, removing biomat, and install new system. Option#3. No adequate area is suitable for replacement area, and system elevation cannont be lowered. Install holding tank as last resort. 3. Replace any other failing components as needed. Plumber: Shaun Bird 715 - 246 -4516 St. Croix County Zoning 715 - 386 -4680 Pumper Tom Mondor 715 - 246 -5148 Shaun Bird #226900 ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM / Mailing Address �� v ss -� 5 a � s� �^� Sc:B -�' 40 S` 0 d- 1 Property Address n (Verification required from Planning & Zoning Department for new / construc City /State K / 6( Parcel Identification Number LEGAL DESCRIPTION f 1 0 Property Location t /4 , S� t /4 , Sec. 2- Z , T Z9 N �W, Town of �a -- Subdivision �u liu.� 6 ��/'^`� , Lot # Certified Survey Ma /� # T ' ` , Volume , Page # Warranty Deed # i5 V "T �drJ , Volume Z ,Page # Spec house 0 no Lot lines identifiable yes no SYSTEM MAINTENANCE AND OWNER CERTIFICATION Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed, by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. Owner maintenance responsibilities are specified in §Comm. 83.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance. The property owner agrees to submit to St. Croix County Planning & Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on -site wastewater disposal system is in proper operating condition and /or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. 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 has been maintained must be completed and returned to the St. Croix County Planning & Zoning Department within 30 days of the three year expiration date. Uwe certify that all statements on this form are true to the best of my /our knowledge. I/we am/are the owner(s) of the propert scribed above, by virtue of a warranty deed recorded in Register of Deeds Office. SIGNATURE OF APPLICANT(S) DATE * ** Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Department. * ** Include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if reference is made in the warranty deed. (REV. 08/05) Parcel' #: 040- 1303 -00 -013 09/08/2005 08:30 AM PAGE IOF1 Alt. Parcel #: 22.28.19.1748 040 - TOWN OF TROY Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner O - BRIGHTKEYS DEVELOPMENT BRIGHTKEYS DEVELOPMENT C - CORP CORP 707 COMMERCE DR STE 410 WOODBURY MN 55125 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description * 643 TRIBUTE PKWY SC 4893 SCH D OF RIVER FALLS SP 0100 CHIP VALLEY VOTECH Legal Description: Acres: 1.190 Plat: 2588 - WALNUT HILL FARM 1/75 040/03 SEC 22 T28N R19W PT NE SW & PT NW SE Block/Condo Bldg: LOT 013 WALNUT HILL FARM LOT 13 (1.190AC) Tract(s): (Sec- Twn -Rng 401/4 1601/4) 22- 28N -19W NE SW Notes: Parcel History: Date Doc # Vol /Page Type 12/10/2003 748766 2471/591 WD 11/19/2003 747018 9/92 PLAT 2005 SUMMARY Bill M Fair Market Value: Assessed with: 0 Valuations: Last Changed: 07/23/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 1.190 69,900 0 69,900 NO Totals for 2005: General Property 1.190 69,900 0 69,900 Woodland 0.000 0 0 Totals for 2004: General Property 1.190 69,900 0 69,900 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch M Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 B p �7 L` U, Z 1 J I 3 5 9 STATE BAR OF WISCONSIN FORM 2— 2000 3 Q>I 10 KATHLEEN H. WALSN WARRANTY DEED REGISTER OF DEEDS Document Number ST. CROIX CO., MI This Deed made between BrightKEYS Development Corporation, a RECEIVED FOR RECORD Minnesota Corporation Grantor, and Benedict & Associates, LLC a Wisconsin 08/24/2005 10:00AH Limited Liability Company, Grantee. WARRANTY DEED Grantor, for a valuable consideration, conveys and warrants to Grantee the EKEMM following described real estate in St. Croix County, State of Wisconsin (if more REC FEE: 11.00 space is needed, please attach addendum): TRANS FEE: 518.1@ COPY FEE: QL�s 13 d 53, Plat of Walnut Hill Farm in the Town of Troy, St. Croix County, CC FEE: PAGES: 1 consi . Exceptions to warranties: Easements, restrictions and right -of -way of Recording Area record, if any. Name and Return Address B edi & Associates, LLC W I 55 521" Avenue WI 54021 040- 1303 -00- 013:040 -1303- 00-053 Parcel Identification Number (PIN) This is not homestead property. Dated this 'day of August, 2005. Brighti S Development Corpo on * *_Donna M. Caywood - ACKNOWLEDGMENT AUTHENTICATION STATE OF ) At 1ke.SO ) ss. Signature(s) authenticated this day County ) of , Personally came before me this day of the above named BrightKEYS * Dev opment Corporation, a Minnesota Corporation to me known TITLE: MEMBER STATE BAR OF WISCONSIN to be the person who executed the foregoing instrument and (If not, authorized by § arJmowledged the same. 706.06, Wis. Stats.) skit THIS INSTRUMENT WAS DRAFTED BY BriehtKEYS Development Corporation. Donna M. Caywood. Notary Public, State of Wseansin (N a. 707 Commerce Drive. Suite 410. Woodbury. MN 55125 M Commission is permanent. If not, state expiration date: (, a01 ) ( Signatures may be authenticated or acknowledged. Both are not necess p . "Names of persons signing in any capacity must be typed or printed below their signature. Notary Public Wnnesota t;,,0,sion Expires January 31, 2010 y� WARRANTY DEED STATE BAR OF WISCONSIN FORM No. 2 — 2000 SPACE, OR 0: 721818 S. F. 16.57 Ac. N $5'46'37" E 1037.14' N 85.46'37" E 478.80' 47.01' i 3 . 50 N E 194.5a 203.99 i�E 188.97' 38.83' z I - \ Y ?� 2 �1 3 �• ST. w 48115 S.F. N 4 � \ \ 469 \ �r� 48169 S.F. 1 =1 1.10 Ac. I 48782 S.F. 5 s \ 1. C 070'' :\ 1.11 Ac. LBO = 965' I I 1.12 Ac. N \ LBC co LBO = 967' 1 toI v LBO = 965' T - @6 45670 S.F, w \ 39 Q O� { \1 I .05 Ac. 15 n \ \ T 3 °'• \ \ \ �\ 14 \ o\ 49159 S.F. S F �:� s �►� -� 1.13 A c. A c f 12 ®\ �= 13 \ 1 1_ _ I �1 \ \ \ \ 1;� N 87'56'57" W 219.22' 1 \ \\ UFFER \� :o PACE 1 \ .. 46794 S.F. 45072 S.F\ 51673 S.F .\ \ V 1.07 Ac. x.03 Ac. 1.19 Ac. —n 168.42' L 143.76' 2 46.38' N 88'25'46" W 672.35' N 82.18 --- �"` 7%' - 1 25' \ SHED HOUSE 3; , Pam Quinn Subject: 12, 13, 14 Walnut Hill Farm Location: soil on -site -use my car Start: Tue 11/1/2005 3:00 PM End: Tue 11/1/2005 4:00 PM 0 Recurrence: (none) Meeting Status: Meeting organizer Shaun was going to install a conventional POWTS and soils will not support it - mottles and massive sandy clay loam where Bob had reported loamy sands. At least one of us should go look at conditions and document change is necessary.