HomeMy WebLinkAbout040-1118-20-000 Wisconsin Depa•..tment of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix
Safet)`and Building Division Sanitary Permit No:
INSPECTION REPORT 430056— ` 0
GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: r l
Personal information you provide may be used for secondary purposes [Privacy Law, 05.04(1)(m)]. c �
Permit Holder's Name: City Village X Township Parcel Tax No:
Dado, Mike I Troy Township r040-1118-20-000
CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Ran e/Map No: 04
100 16 ( b ��� a� � �� hti ee . 31.28.19. y g
TANK INFORMATION ELEVATION 15ATA
TYPE MANUFACTURER CAPACITY STATION BS HI FS EV.
�. ba•v
Septic / i i � Hl Benchmark /0 / I 0 q 1-06-6
Dosing —> V Alt. BM
Aeration _ - Bldg. Sewer
Holding St/Ht Inlet
o6•�S
TANK SETBACK INFORMATION St/Ht outlet
D ' -,�e j � dS• 9
TANK TO P/L WEIR, BLDG. Vent to Air Intake ROAD Dt Inlet
, – -
Septic
O l r 2 6' Dt Bottom v� O
111111 Vhf
Dosing Header /M n..T� v 0
Aeration _ Dist. Pipe /
— G4 svrn 1 q
Holding Bot. System_
rem z v
PUMP /SIPHON INFORMATION Fin Ct i e P- /
✓
Manufacturer Demand St Cover / C 35 ' /�•
GPM r
Model Numb
TDH Lift i n Loss System Head TDH Ft
Forcemain Length Dia. Dist. to Well
SOIL ABSORPTION SYSTEM i
BED /TRENCH Width Len th No. Of Trenches P,IT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth
DIMENSIONS i'] /� fit//
SETBACK SYSTEM TO J P/L BLDG WE L LAKE/STREAM, EACH G Manufeetur ; L
INFORMATION h 7 dr
Typ Of System: IJ `;,,,/ �/ U Model Number:
�rnv��nrn�e,o S' �
DISTRIBUTION SYSTEM �p•,,�,d
Header ifold Distribution (� x Hole Size
I x Hole Spacing Vent to Air Intake
f Pipe(s) � r t•f � � b � �.
Length Dia e Length_ Dia ng
SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only
Depth Over I Depth Over xx Depth of xx Seeded /Sodded xx Mulched
Bed/Trench Center Bed/Trench Edges Topsoil
q Yes ] No ]Yes No
COMMENTS: (Include code discrepencies persons present, etc.) Inspection #1: / ( / Inspection
Location: 354 Indigo Trail Hudson, WI 54016 (NW 1/4 NE 1/4 31 T28N 19W) East Mead ws Lot 1 Parcel �`�o: 31.28.19.
1.) Alt BM Description = 5T' • +'
2.) Bldg sewer length = 201 rVt4 /4y � 7� t✓ � � v Q���
- amount of cover
Plan revision Required? T Use other side for additional information. No SBD 6710 (R.3/97) Date Insepctor's S Cert. No.
I -
N vi sconsin Safety and Buildings Division County 201 W C n . Washington Ave., P.O. Box 7082 ,S + Madison, WI 53707 - 7082 Sanitary it Number (to
fi in by Co.)
De artment of Commerce (608) 261 -6546 1
Sanitary Permit Application st . umber
In accord with Comm 83.2 1, Wis. Adm. Code, personal information you provide 040— ' ( 1 ;/-
may be used for secondary purposes Privacy Law, s 15.14(1 xm) r ' 'n
I. Application Information - Please Print All Information �-L/ IN 01 '� 0 t1e41
Property s Name Parcel # ( 1 t � Block #
Property Own Mailing A dress Property Location
City, tate k v., 4 =%a Section
l
ty+ ) }r / Zip Code N/
Phone Number
V e re y /4 / / t 1 G 2, Z / r� I, /1 C/ N; R c E or W ircle one)
T R T G —
II. Type of Building (check all that apply)
94 or 2 Family Dwelling - Number of Bedrooms oAt
Subdivision Name CSM Number
❑ Public/Commercial - Describe Use f We Q o 4-_
❑ State Owned - Describe Use - 71 % []City ❑Village STownship of mac' y
III. Type of Permit: (Check only one box on line A. Complete line B if applicable) -
A. Q:New System ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System
B • ❑ Permit Renewal ❑ Permit Revision ge of ❑ Permit Transfer to New List Previous Permit Number and Date Issued } n,
Before Expiration PI Owner 300 SZ::�>
IV. Type of POWTS System: Check all that apply)
on -P avri�.vi to (;routed _ n Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil ❑ At -Grade ❑ Single Pass Sand Filter ❑
Constructed Wetland ❑ Pressurized In -Ground ❑ Holding Tank ❑ Peat Filter ❑ Aerobic Treatment Unit ❑ Recirculating Sand Filter ❑
Recirculating Synthetic Media Filter ❑ Leaching Chamber ❑ Drip Line ❑ Gravel -less Pipe ❑ Other (explain)
V. Dispersal/Treatment Area Information:
Design Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal Area Required (sf) Dispersal Area Proposed (sf) System Elevation
VI. Tank Info Capacity in Total Number Manufactu Prefab Site Steel Fiber Plastic-
Gallons Gallons of Units „ /l Concrete Constructed Glass
New Existing V” 1 r` - '� - '�
Tanks Tanks
Septic or Holding Tank /Z 5V
Aerobic Treatment Unit
Dosing Chamber
VII. Responsibility Statement - 1, the underffigned, assume VsRonsibility for installation of the POWTS shown on the attached plans.
Plumber's Name (Print) Plum 's Signature A4WPRS Number Business Phone Number
S6 4411
Plum Address (Street, City, tale, Zip e) / / q
VIII. oun /De artment Use Onl
pproved ❑ Disapproved Sanitary Permit Fee includes Groundwater D Issued lAsuing Agent :ZM
Surcharge Fee) Cly � �
11 Owner Given Reason for Denial T � 7i?i Q
IX. Conditions of Approval/Reasons for Disapproval -
au 7, fAmkArlx�
V
AttaeY a pkte ns (ter tYe County only for the system on paper not Ins than 81/2 x t t Inches In size
SBD -6398 (R. 08/02)
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Safety 9M Buildings Division county
m m 201 W. Washington Ave., P.O. Box 7082 ST. CROIX
� ������ Madison, W1 53707 -- 70$2 Satnta v P
Department o1 Commerce (008)26 1-6546
W
,,,� , •.
Sanitary Permit Application
onan
In accord.vith C x3.21. Wis. Adm. Code, personal information you provide 040- 1118 -20 -000
may be used for sowadary purposes Privacy taw, si 7_04(1 Xm) Project Address (if different than mailing ad&ess)
L Application Information — Please Print All Information
354 INDIGO T
Pretty (Avner's Nance - / Parcci #E Lot # 1 Block # N/A
MIKE DADO
__...- - -
Ytoperty Chvnct's Mailing Add css og
16 GOLDEN ACRES ROAD y,, NE S �.. 31
City, stab Zip Zip C
rsrcle e,tte)
RIV FA LLS, WI 54022 5-425- 28 N; R 191fV ���,
IL Type of Building (check all that apply)
ix I or 2 Family Dwelling - Number of 4 A S PER SUBMITTED HOUSE PLANS Su�wSIO" Name CSM'Number
U Pubire/Corwrt rcoal - Ddscribe Ulu n " p � EAST MEADOW
❑ State Owned - Dcrgilr 1 tsc :�, -, Cl LO Dvil4v I!?Township of TROY
rVil -- - Oj
HL Type of Permit: (Check only one Ir)x tam" A. Complete line B if *pplic* e)
F B. A - W- New System Sri. ❑ Tre n;n alntll�toklg Tis R —nnt (kily ❑ Qdw Modification to Eiasting System
❑ P.amR tt xange of ❑ PA, Tran mer to New , b
� eta
More Expiration
IV. T e of POW'I`S System: Check L A -1 EFF FILTE M TRENCH all that l
ZA . ED
+ Non - Premttized tn- (3roaind ❑ li.A 24 in. ofsuitab1c sail nd < 24 im of suitable so m- Gradc: ❑ Single Pass Sam Filter
` Cnnstnicted wetland ❑ Presattfcod In- eiraona Ll Holdir l snk i ;)ter f - 1 Aerobic TwAme t Unit ❑ Recirculating sand Filter ❑
Reeirnilating Synthetic Media giber ❑ t caching Chamber ❑ ])ri ine ❑ Gravel-less Pip: ❑ (Utter (explain)
V. DispEnalffreatment Am* Information: x
Design Flow (gpd) Design Soil AMhcabon hate( tswe w Area a virnd of) D4crsal Area
pr Pru� Q (st) seem Elevation
600 .7 857
VL Tank Info ('opacity in Total acftx er - Prefab site Steel Fiber Plastic
Gallons (;alk'm 0 00 r ofunits Concrete Conamc'ted Glass
New Exastog
Twkx I Twtks
Septic or Holding Tank X 12V 1 WIESER X
Aerobic Tn- alincrt iJnil
X 1 WIESER
VII. Responsibility Staterneut I, '.&r'xn a' respttaily for lar� drr the POWTS a.. ew trre attsdled Foam.
Plumber's Name (Print) P MP /MFRS Number Ilia -%- Phone Number
TODD FEATHERSTONE 242514 71 5 - 381 -1704
Plumber's Address (Street, City, State, tp code)
P.O. BOX 467 HU DSON, WI 54016
VIII Cone !De artmeet Use Only_
g Approved ❑ Disapproved &Mnary Permit Fee (mchuies Groundwater Dale Issued IssumOrgeni Signatarc (N tamps}
Surcharge Fox) �^y�
11 Owiwr Given Reason for Decrial
!X � d� ;ops of App easons for Ifisapprnval yyV
Lk CA-14
Q � cmtpkie (to the Csrus (Y only) for "sum oo paler Y t sta 1 €€ t to star
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1338
Wisconsin Department of Commerce SOIL EVALUATION REPORT P age I of 3
Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code Steel Soil Service
Attach complete site plan on paper not less than 8% x 11 inches in size. Plan must County St. Croix
include, but not limited to: vertical and horizontal reference point (BM), direction and
percent slope, scale or dimensions, north arrow, and location and distance to nearest mad. Parcel I.D.
Please print all information. iewe_d By
Personal information you provide may be used for secondary purposes (Privacy law, s. 15.04 (1) (m)). = O Q3
Property Owner _ y�Jy' e Pro erty Location
Mann Valley Contracting Go Lot na NW 19 NE 1/4 S 31 T 28 N R 19 W
Property Owner's Mailing Address Lot Block # Subd. Name or CSM#
i.J _.
14 Dry Run Rd I f Z O 1 na East Meadow
City State Zip ode Phone Number City J Village 1/ Town Nearest Road
River Falls WI 1 54V221 , ,`' ' Troy Cty Rd "F"
f6 New Construction Use: 01 Residential / Number of bedrooms 4 Code derived design flow rate 600 GPD
Replacement I Public or commercial - Describe
Parent material Loess over Outwash Flood plain elevation, if applicable na
General comments
and recommendations: System elevation 99.00ft, trenches spaced and depth to code 5.00ft below grade.
Boring # I Boring
set Pit Ground Surface elev. 104.00 ft. Depth to limiting factor 120 in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Stricture Consistence Boundary Roots GPD/W
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
1 0 -12 10yr3/1 none sil 2msbk mfr cs 2f .5 .8
2 12 -24 10yr4/4 none sicl 2msnk mfr gw 1vf .4 .6
3 24 -60 7.5yr4/4 none sl 2msbk mfr gw na .5 .9
4 60 -120 7.5yr4/6 none cos osg mvfr na na .7 1.6
Boring # I Boring
16 Pit Ground Surface elev. 104.00 ft. Depth to limiting factor 130 in. Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Stricture Consistence Boundary Roots GPD/ft=
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
1 0 -10 10yr3/1 none sil 2msbk mfr cs 2f .5 .8
2 10 -17 10yr4/4 none sicl 2msnk mfr gw 1vf .4 .6
3 17 -37 10yr4/4 none scl 2msbk mfr gw na .4 .6
4 37 -58 10yr4/4 none scl /sl 2msbk mfr cs na .4 .6
5 58_ 102 7.5yr4/4 none cos osg mvfr cs na .7 1.6
6 102 -130 7.5yr4/4 none sl 2msbk mfr na na .5 .9
(o
x
Effluent #1 — BOD 30 _ 220 mg /L and TSS >30 < _ 150 mg /L *Effluent #2 — BOD _30 mg /Land TSS _30 mg /L
CST Name (Please Print) Signature: CST Number
David J. Steel 248956
Address Steel Soil Service Date Evaluation Conducted Telephone Number
1564 CR GG, New Richmond, WI 54017 7/16/2003 715 -246 -5085
O ,
Property Owner Mann Valley Contracting Parcel ID # Page 2 of 3
3� F Boring # Boring
V' Pit Ground Surface elev. 99.10 ft. Depth to limiting factor 120 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
1 0 -12 10yr3/1 none sil 2msbk mfr cs 2f .5 .8
2 12 -36 10yr4/4 none sicl 2msnk mfr gw 1vf .4 .6
3 36 -54 10yr4/4 none sl 2msbk mfr gw na .5 .9
4 54 -82 7.5yr4/4 none Is osg mvfr cs na .7 1.2
5 82 -120 7.5yr4/4 none ms osg ml na na .7 1.2
Boring #
J Boring
g v. ft. Depth to limiting factor in. Application e
� F J Pit Ground Surface elev. Soil Rat
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
F-1 Boring # I 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
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2
* Effluent #1 = BOD 30 < 220 mg /L and TSS >30 < 150 mg /L * Effluent #2 = BOD s 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.
Page 3 of 3
STEEL'S SOIL SERVICE INC.
David J. Steel 1564 Cty Rd GG
CST- POWTSM Mann Valley Contracting New Richmond,WI 54017
Lic. 4248956 NWl /4,NE1/4,S31,T28N,R19W Bus .(715) 246 -6200
Town of Troy St.Croix Co. Fax (715) 246 - 9372
East Meadow Lot,1 Legend
]"=W
♦ =Benchmark Ele. IOO.00Ft
Top of Electric Ped base
= Alt Benchmark Ele. 102.1 Oft
Transformer
IV � G t Boring Elevations
B 1 = 104.001
B2 = 104.00Ft
B3 = 99.10ft
B4 = OO.00ft
H
AR
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1 R
3 36,
-7-
- 152.85' NSWSO02"IN 672.96' - -=_- = ------- - - - = --
G Gs
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W - 131. T-
50.00' � � '
8'41'E 0 ' ! ` 38 -E 369.59'
_ as PC � �D 0.
l CD T G j
cop �� ! /�
T 09 Q n O Q w 115
(n cuoi a ,Q IQIo! � LOT 2 _l
I "E 2 -680 ACRES ) -
j (116,749 SQ. FT.) I
i 0
549.2 '23 1 1E
27.14'
;'S2'E 334.38'
SYSTEM CROSS SECTION
- 71
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PID 1 142 ° d
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LOT BL'�W SUB
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SW 242514
Safety and Buildings Divis -ion
County
201 W. Washington Ave,, P.O. Box 7082 ST. CROIX
consin Madison, W1 53707 - 7092 sarticary Pennit Number (to be filled in by Co.)
is
f�epartment of Commerce (608) 20 1 -6546 --y3c7o 5-G
tate
Sanitary Permit Application s 04 I.D. Number
18-20-000
In accord with Contin 8121. Wis. Adm. Code, personal u p-
information yo V
may be usW for sI purposes Privacy Law, sVi-04(l Xm) V, NE s 31
"ev[ A differ dress,
trailing address)
Application Information Information - Pkaw Print All Info I V E D TiME - INDI
Property Owner's Name Paruci # Lot ma'
ft N/A
MIKE DADO _J N' U 3 2003
llro�rly Owner's Mailing Additm PI 01J."iTy txt
1
16 GOLDEN ACRES ROAD Zi 1, C)FFI('[-
-- iiNG - N NE
city, Statcr ;6p Code 11bome Nunva
C YY--9'&
RIVER FALLS, WI 54022 715-425-5057 28 N; 10
IL Type of Building (c 11 that apply) OAS
I or 2 Family Dwelling - N "PA*00= 4 ? Subdivision Natne CSM i"'I
T
I
I # �Z
E (
IN
DI , dres il"M
er
-ling ad
Mock
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N 31
1 91
28 N it � EoII
t
EAST MEADOW
[]city__Ljviltw AT.Valip Of T
❑ State Owned - Dcrih, I 1w
III. Type of"Permit: (Check only oI on line k Complete line D if applicobw A
Am Mew System ❑ Replaceumd TMWMffl0Mio&T.'k
P
f
- -------- -P '�K Previous: Permit an d Dam
B. Parrut Renewal ❑ k-ernutyeviston ❑ change of fte' -'-
Before Expiration IJ Plumber If
IV. type of POWTS S n Chee all t—W"P% 0'
Non PTcmffiI Iii-Oround ❑ Moiind> 24 in. of suitab - I F1 M 24 im of suitable soil PajoLd Fi
Coltstrtmcted Wetland ❑ Premuizeiirr-orouvd ❑ nkiis ❑ ate, F1 Aerobic Tredmem unit ❑ Recircula
R[* g
Rirodmin Synthetic Media Filter rlizachingCharnber \Hiuir] Pit. 11odw(expla.)
V. DispenvVrmtmeutAnent Information:
Req Design flow (gpd) Design Soil Application Rate(gpdsf) Di. ReWircd (1.) Dispersal Are Pr-posed (st) stem Elevation G .� 97
601 .5 0
VL Tank Info capacity in Total Number F Manufacuirer site steel Fiber Plastic
Gallons (Wkwts Of I I Co Constructed (Aga
New Existing,
Tanks TwAs - 7
Septic or Holdirg Ta& X 1250 WIESER X
Aerobic Treatn"t Unit -�C L
Drmrw (71"Wnher
V11. Responsibility Statement- 1, the uniersimf .'WbMY for Lawlor. rOR 7 5 qhvIm Im aw afteched rhmm
Plurnlwr's Narne (Print) re MPI Nu
' I
1 0-
F1 7
Plumber's Address (8 ItTed, City, Same, Z+<'o&
4 7
VFIL Count ent Use 001
Approved ❑ Disapproved Sanitary Permit Fee (includes Groundwater Ewe Issuing eat Sigmetcrre stamps)
11 0%NWrGiVcnRqjrrDenial Surchargr Fee) 2 2,
IX. Conditions of ApprovalFRI s for Disapproval
'� N c C� l l � `�. �lo�— L�MI�,(�'tJ'P�K e.'t�4 .-U^ �.^°."t^°`�,e. Q(y'�..�""Q�' C1�L°`°
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N (116,749 SQ. FT.)
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27.14'
\ ` � i8' E 334.38'
I"
Wisconsin Department of Commerce SOIL EVALUATION REPORT p age I of 2
• Division of�afety �! Buildings
In accordance with Comm 85, Wis. Adm. Code
County St Croix
Attach complete site plan an paper not less than 81/2 x 11 inches in size. Plan must
include, but not limited to: vertical and horizontal reference pant (BM), direction and Parcel I.D.
percent slope, scale ordimensions, north arrow, and location and distance to nearest road.
pie ldnt 8N jnfor ttil;tkw. Re wed by Date
Peraanat irrrtimration you provide may be used torseeorrdary purposes (Privacy taw, s. 15.04(1)
Property Owner Property Location
Dann Valley Contracting Govt Lot 1/4 h 1M S T N R -
Property Owner's Mailing Address L # Black # Subd. Name ar CSMf
14 Dry Run Road 1 � 01 - s i �0.cX
City State Zip Code Phone Number oCity []Village IDTown Nearest Road
River Falls WTI 54022 ( ) 1 e.T
New Construction Use F Number of bedrooms 3 Code derived design flow rate 9,5 0 GPD
Replacement Q Public or commercial -
Parent material tn= if applicable n ft.
NN
GerwM eommertLs
and r
C pC
01 -
t 'I Boring
El Pit Ground surface elev. fimi ' r O in.
c, Sal ADolleation Rate
Horizon Depth Dominant Color Redox Description a Consistence Boundary Roots GPDff
in. Munsell Qu. Sz. Cont. Color . Sh. 'Eff#1 "Eff#2
► y r //J -- 15 2m s6K ,r,f C w �'� . 7 �. •L
3 14 -11 1,5 r S! — -FS OS -- •s
o
I 7L Boring # Q Boring
0 pit Ground surface elev. 99 6 � ft. Depth to limiting facto in.
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture' Structure Consistence Boundary Roots GPDN
in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 "Eff#2
i0 t- 3 /L •— S L Zr) s6 r ew Z S
2 - Stu �' y S ir%�b� �r to
3 . . 2 5 - 1 (- rs S � I s J g
31.97 c. - q -X7z
" Effluent #1= SOD > 30 220 mg/L and TSS >30 150 mg/L = BOD 1 30 mg/L and TSS:a 30 mg1L
CST me Please Print) Signatur CST Number
7 a .0 V^ 22 e ?
Address Date Evaluation Conducted Telephone Number
S4 9- 2- 9 ,01 71.5 -Zqt -2ySY
r -
A
Property- Owner. Parcel ID# Page of
-Boring # Boring
U' pit Ground surface elev. ft Depth to limiting factor 7 /00 in.
Soil 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
f 0T I Z o 4ir l/3 Sr a S 6 t; r C w �S
Z 12 to l" 3 2- Sj Lr1 dk Tel r C1-J M17
e
Boring # Boring -
Pit Ground surface elev. ft. Depth to limiting factor in..
Soil Application Rate
Horizon Depth Dominant Color. Redox Description Texture Structure Consistence Boundary Roots GPD/ff
in. Munson Qu. Sz. Cont Color Gr. Sz. Sh. *Eff#1 *Eff#2
F-1 Boring # Boring
pit Ground surface 616V. ft. Depth to limiting factor in.
Soil Application Rate
Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff
in Munson Qw Sz, Cont Color Gr. Sz. Sh, *M1 *Eff#2
F 1 1 1
* 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.
M- 8330Test(R.07 /00)
�c— CD 0 L.
3 1 ' `121 q �J
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POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page 1 of 2
FILE INFORMATION SYSTEM SPECIFICATIONS
Owner MIKE DADO. Septic Tank Capacity al ❑ NA
Permit # 3 oo5to Septic Tank Manufacturer WIESEg ❑ NA
DESIGN PARAMETERS Effluent Filter ManufacturI ❑ NA
Number of Bedrooms 4 ❑ NA Effluent Filter Model A100 ❑ NA
Number of Public Facility Units XJ NA Pump Tank Capacity al ❑ NA
Estimated flow (average) 600 gal/day Pump Tank Manufacturer ❑ NA WIESER
Design flow (peak), (Estimated x 1.5) gal/day Pump Manufacm ❑ NA
Soil Application Rate .5 al /day /ft' Pump Model ❑ NA
Stang WA Influent /Effluent Quality Monthly average* Pretreatment Unit 3"A
Fats, Oil & Grease (FOG) S30 mg /L ❑ Sand /Gravel Filter ❑ Peat Filter
Biochemical Oxygen Demand IBOD 5220 mg /L NA ❑Mechanical Aeration ❑Wetland
Total Suspended Solids (TSS) _ <150 mg /L ❑ Disinfection ❑ Other:
Pretreated Effluent Quality Monthly average Dispersal Cell(s) ❑ NA
Biochemical Oxygen Demand (BOD <_30 mg /L ❑ In- Ground (gravity) ❑ In- Ground (pressurized)
Total Suspended Solids (TSS) <_30 mg /L XXNA ❑ At -Grade ❑ Mound
Fecal Coliform (geometric mean) S10 cfu / 100m1 ❑ Drip -Line ❑ Other:
Maximum Effluent Particle Size Y in dia. ❑ NA Other: A
Other: WINA Other: $1; NA
Other:
'Values typical for domestic wastewater and septic tank efflusrrt. NA
MAINTENANCE SCHEDULE
Service Event Service Frequency
Inspect condition of tank(s) At least once every: — 3 4 ean,$)(S) (Maximum 3 years) El NA
Pump out contents of tank(s) When combined sludge and scum equals one -third (Y of tank volume ❑ NA
Inspect dispersal cell(s) At least once every: ❑ moa j(s) (Maximum 3 years) ❑ NA
Clean effluent filter At least once every: ❑ month(s) ❑ NA
51:�Vear(s)
Inspect pump, pump controls & alarm At least once every: 13 Yea�� )(sl ❑ NA
Flush laterals and pressure test At least once every: 11 yea r(s) ❑ m ! ❑ NA
r(s)
Other: At least once every: ❑ month(s) 4KNA
❑ year(s)
Other: G.N A
MAINTENANCE INSTRUCTIONS
Inspections of tanks and dispersal cells shall be made by an individual carrying one of the following licenses or certifications:
Master Plumber; Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer; Septage Servicing Operator. Tank
inspections must include a visual inspection of the tank(s) to identify any missing or broken hardware, identify any cracks or leaks,
measure the volume of combined sludge and scum and to check for any back up or ponding of effluent on the ground surface.
The dispersal cell(s) shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding
of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a failing condition and requires the
immediate notification of the local regulatory authority.
When the combined accumulation of sludge and scum in any tank equals one -third (Y or more of the tank volume, the entire
contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113,
Wisconsin Administrative Code.
All other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment
units, and any servicing at intervals of :512 months, shall be performed by a certified POWTS Maintainer.
A service report shall be provided to the local regulatory authority within 10 days of completion of any service event.
GMW (4/01)
Page 2 of 2
START UP AND OPERATION
For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or other chemicals
that may impede the treatment process and /or damage the dispersal cell(s). If high concentrations are detected have the contents
of the tanks? removed by a septage servicing operator prior to use.
System start up shall not occur when soil conditions are frozen at the infiltrative surface.
During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will be
discharged to the dispersal cells) in one large dose, overloading the cell(s) and may result in the backup or surface discharge of
effluent. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring
power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to
restore normal levels within the pump tank.
Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area
within 15 feet down slope of any mound or at -grade soil absorption area.
Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the
POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat;
foundation drain (sump pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil;
painting products; pesticides; sanitary napkins; tampons; and water softener brine.
ABANDONMENT
When the POWTS fails and /or is permanently taken out of service the following steps shall be taken to insure that the system is
properly and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code:
P Y Y
• All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed.
• The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator.
• After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with
soil, gravel or another inert solid material.
CONTINGENCY PLAN
If the POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide a code compliant
replacement system:
A —A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption
system. The replacement area should be protected from disturbance and compaction and should not be infringed upon by
required setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will
result in the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must
comply with the rules in effect at that time.
❑ A suitable replacement area is not available due to setback and /or soil limitations. Barring advances in POWTS
technology a holding tank may be installed as a last resort to replace the failed POWTS.
❑ The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site
evaluation must be performed to locate a suitable replacement area. If no replacement area is available a holding tank
may be installed as a last resort to replace the failed POWTS.
❑ Mound and at -grade soil absorption systems may be reconstructed in place following removal of the biomat at the
stems must
comply with the rules in effect at that time.
surface. Reconstructions of such s p y
infiltrative Y
< <WARNING> >
SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND /OR INSUFFICIENT OXYGEN. DO NOT
ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A
PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE.
ADDITIONAL COMMENTS
POWTS INSTALLER POWTS MAINTAINER
Name Name FEATHERST
Phone _ _ 7dy -cl Phone 715- 381 -1704
SEPTAGE SERVICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY
Name E Name ST. C ROIX CO Phone 715 -3
This document was drafted in compliance with chapter Comm 83.22(2)(b)(1)(d) &(f) and 83.54(1), (2) & (3), Wisconsin Administrative Code.
ST CROIX COUNTY
SEPTIC TANK MAINTENANCE AGREEMENT
AND
OWNERSHIP CERTIFICATION FORM
OwnedBuyer MIKE DADO
Mailing Address 15 GOLDEN ACRES ROAD RIVER FALLS, WI 54022
Prop" Address S -
(Vcrificatioo mquircd from Pwmigg Dcpuunc it for now coa>F"
at TROY, WI P Ida Whitt adon Number 040 - 1118 -20 -000
LF,,CAL, D1LSCPJMQN
—J
Prapetty Location N'`t ' /., IJ _!,, Sec. 3 . T Z � .�`i R,. �� w Town of 1'K I
$Y pt� AST MEADOW
Car Twd Sumq Map # _ . volume —` Pw #
WuTxm ty Deed # _ 6 8 3 . volume , l S I . Page, # b
Spec Fuse 17 yes ® no Lot lines idaWfmble O ya 0 no
hopmper uwudmdntmumofymwpticsydmcmu=mh iaits p , e•a fi. — to Landie wsstcs. p&vpesmai2bMw
consist: ofpumping oat the septic tankev+ay throe yew at ifnnedadby s 0Cenaed j" M j - r What Yea pat hd* the
we, affat dw Lcactioa of the septic soak m a stop is dw assts 4&Vc d Vxo=
The pwp" owttet ag, ees to submit b St Craim Zoniat Depsttmaot a cafficadoa farm, z*m od by flee owoec and b;
ms�eOQptwmabe��Predph�mberocaic�eaaod vr: ifyiag *at(I)t6eoarsstmvabee�espoats�6
P�
n m pwper opcmtmg condition anftr M aftcr k pad m And pwopuq;. {If tuoo . the sgrtirrtaak is kss t'baun 1/3 fufl of siEmdg
Yw% the vndcCd8 ed Lrn read dw abow requirementg and agme to walasin Ilse private se>mge disposal system WwL to st RE&
set Bomb, Irma. as ad by dre Depae www of Commune and Ow Deft of Natomt Rimes; State of Wiaooasio.
Stadag chit you septic symns In beeat taaintainad mast be completed and rammed to tibe St. Qi= Conay Zoning Office,ritbin
days of the dK= date.
mcmim OF APPLICANT DATE
C� O
I (me) eatifY that all statr aunts an this fora are tone to dw bast of uW (oar} kww� I (are) acts (am) the ownet(s)
paopaty Barre,
by virw of a wanes y dead reootdod in itesatec of Deeds Office.
SItT11'i�&8 F DATE
ssa +ss AxW in>bortnatioa that is mi: catod may insult in the wdwy pc:wk being revofmd by do Zoning Department
•' include w1tb this applieadoa: a stamped warranty decd fiats the R,egMw of Doads office
a cagy of the cwtified many map if mlemace u mode in the waninty deed
A U 1881P 116
STATE BAR OF WISCONSIN FORM 2 .1999 K -7' E 6 BM 3
Document Number WARRANTY DEED REGISTER OF DEEDS
ST. CROIX CO., NI
This Deed, made between Mann Valley Contracting, Inc., RECEIVED FOR RECORD
04 -30 -2002 11:35 Ah
WARRANTY DEED
Grantor, and Michael L, Dado and Diane M. Dado, husband and wife EXEMPT #
REC -_�
TRANS FE E. 239000
COPY FEE:
Grantee. CERT COPY FEE:
Grantor, for a valuable consideration, conveys to Grantee the PAGES: I
following described real estate in St. Croix County,
State of Wisconsin (if more space is needed, please attach addendum):
Recording Area
( 2D E ast Meadow, St. Croix County, Wisconsin. Name and Return Address
-� Edina Realty Title
Outlot 1, s Meadow, I. Croix County, Wisconsin. 400 S. 2nd St., #115
Hudson, WI 54016
t l l entift 0o onN
ru
Par mbcr(PI
This is not homestead property,
Exceptions to warranties: Easements, restrictions and rights -of -way of record, if any. Ot) (is not)
n 5 q �
Dated this Cj day of April 2002
Mi nn Valley Contracting, Inc.
•
a
AUTHENTICATION ACKNOWLEDGMENT
Signature(s) STATE OF WISCONSIN )
) ss.
St (ro[ k County )
authenticated this day of RRON Aril _�7l��
Personally came before me this C - day of
20p2
Notary Public Mann Valk Contractin ,Ina , the above named
,� „„, 0115
TITLE: MEMBER S OF WISCONSIN
(If not, to me known to be the person(s) who executed the foregoing
authorized by § 706.06, Wis. Stats.) instrument and acknowledged the same.
THIS INSTRUMENT WAS DRAFTED BY • Q�� Q , , y ��>
Attorney Kristina Ogland _
Hudson tiI54016 Notary Public, State.,of }Wisconsin
My Commission is permanent. (If not, state expiration date:
(Signatures may be authenticated or acknowledged. Both are not necessary,)
• Names of persons signing in any capacity must be typed or printed below their signature. kg Prof—waft Cm
p”, Faq du L•C, wl
WARRANTY DEED STATE BAR OF WISCONSIN BOO-WS-2021
FORM No. 2 - t999
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Subject: final for Joe Stang @354 Indigo Trail, Troy
Start: Mon 09/22/2003 10:00 AM
End: Mon 09/22/2003 11:00 AM
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LIC N01103S
Parcel # : 040 - 1288 -1 0 -000 11/03/2005 04:47 PM
PAGE 1 OF 1
Alt. Parcel #: 31.28.19.1636 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
MICHAEL L & DIANE M DADO 0 - DADO, MICHAEL L & DIANE M
354 INDIGO TR
RIVER FALLS WI 54022
Districts: SC = School SP = Special Property Address(es): * = Primary
Type Dist # Description * 354 INDIGO TRL
SC 4893 SCH D OF RIVER FALLS
SP 0100 CHIP VALLEY VOTECH
Legal Description: Acres: 2.540 Plat: 1927 -EAST MEADOW 01
SEC 31 T28N R19W NW NE LOT 1 EAST MEADOW Block/Condo Bldg: LOT 1
ASM'T INC 040 - 1288 -70 -000
Tract(s): (Sec- Twn -Rng 401/4 1601/4)
31- 28N -19W NE NE
Notes: Parcel History:
Date Doc # Vol /Page Type
04/30/2002 677683 1881/116 WD
08/22/2001 654452 1703/586 QC
06/21/2001 649000 1665/308 QC
01/26/2001 637445 1579/187 (�C
mor ...
2005 SUMMARY Bill #: Fair Market Value: Assessed with:
0
Valuations Last Changed: 07/23/2004
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 2.540 90,000 289,600 379,600 NO
Totals for 2005:
General Property 2.540 90,000 289,600 379,600
Woodland 0.000 0 0
Totals for 2004:
General Property 2.540 90,000 289,600 379,600
Woodland 0.000 0 0
Lottery Credit Claim Count: 0 Certification Date: Batch #:
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
Parcel #: 040 - 1288 - 70-000 11/03/2005 04:47 PM
PAGE 1 OF 1
Alt. Parcel #: 31.28.19.1642 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
MICHAEL L & DIANE M DADO O - DADO, MICHAEL L & DIANE M
354 INDIGO TR
RIVER FALLS WI 54022
Districts: SC = School SP = Special Property Address(es): " = Primary
Type Dist # Description
SC 4893 SCH D OF RIVER FALLS
SP 0100 CHIP VALLEY VOTECH
Legal Description: Acres: 0.397 Plat: 1927 -EAST MEADOW 01
SEC 31 T28N R19W NW NE OUTLOT 1 EAST Block/Condo Bldg: LOT 01-1
MEADOW ASSESSED W /040- 1288 -10 -000
Tract(s): (Sec- Twn -Rng 401/4 1601/4)
31- 28N -19W NE NE
Notes: Parcel History:
Date Doc # Vol /Page Type
04/30/2002 677683 1881/116 WD
08/22/2001 654452 1703/586 QC
06/21/2001 649000 1665/308 QC
01/26/2001 637445 1579/187 QC
2005 SUMMARY Bill M Fair Market Value: Assessed with:
0
Valuations: Last Changed: 11/12/2001
Description Class Acres Land Improve Total State Reason
Totals for 2005:
General Property 0.000 0 0 0
Woodland 0.000 0 0
Totals for 2004:
General Property 0.000 0 0 0
Woodland 0.000 0 0
Lottery Credit: Claim Count: 0 Certification Date: Batch #:
Specials:
User Special Code Category Amount
Special Assessments Special Charges Delinquent Charges
Total 0.00 0.00 0.00
Parcel #: 040 - 1288 -10 -000 09/27/2004 11:30 AM
PAGE IOF1
Alt. Parcel M 040 - TOWN OF TROY
Current EXI ST. CROIX COUNTY, WISCONSIN
Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type # of Units
00 0
Tax Address: Owner(s): " = Current Owner
*
MICHAEL L & DIANE M DADO DADO, MICHAEL L & DIANE M
354 INDIGO TR
RIVER FALLS WI 54022
Districts: SC = School SP = Special Property Address(es): " = Primary
Type Dist # Description
SC 4893 SCH D OF RIVER FALLS
SP 0100 CHIP VALLEY VOTECH
Legal Description: Acres: 2.540 Plat: 1927 -EAST MEADOW 01
SEC 31 T28N R19W NW NE LOT 1 EAST MEADOW Block/Condo Bldg: LOT 1
ASM'T INC 040 - 1288 -70 -000
Tract(s): (Sec- Twn -Rng 401/4 1601/4)
31- 28N -19W NE NE
Notes: Parcel History:
Date Doc # Vol /Page Type
04/30/2002 677683 1881 /116 WD
08/22/2001 654452 1703/586 QC
06/21/2001 649000 1665/308 QC
01/2612001 637445 15791187 QC
more...
2004 SUMMARY Bill #: Fair Market Value: Assessed with:
83,100
Valuations: Last Changed: 07/23/2004
Description Class Acres Land Improve Total State Reason
RESIDENTIAL G1 2.540 90,000 289,600 379,600 NO
Totals for 2004:
General Property 2.540 90,000 289,600 379,600
Woodland 0.000 0 0
All 2.540 90,000 289,600 379,600
Totals for 2003:
General Property 2.540 80,000 0 80,000
Woodland 0.000 0 0
Total 2.540 80,000 0 80,000
Lottery Credit: Claim Count: 0 Certification Date: Batch #:
Specials:
User Special Code Category Amount
es
Special Assessments Special Charges Delinquent Char
P p g Q g
Total 0.00 0.00 0.00
I,