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012-1058-10-000 (2)
UIL Wisconsin Department of Commerce Safety and Building Division PRIVATE SEWAGE SYSTEM INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Personal information you provide maybe used for secondary purposes [Privacy Law, s.15.04 (1)(m)) Permit Holder's Name, City Village Township KRISTINE SCHMIDT I TOWN OF ERIN PRAIRIE TANK INFORMATION TYPE MANUFA URER CAPACITY Septic \kclv C Dosing W 46 cy b Aeration Holding TANK SETBACK INFORMATION I s,,.L< s NA 61 a TANK TO P/L WELL BLDG. Vent -to Arr Intake ROAD Septic .? • 1 --�oN S /' Dosing 7 ) 751 J Aeration Holding PUMP/SIPHON INFORMATION M ad,-e-, �- SOIL ABSORPTION SYSTEM ELEVATION DATA R3 ,.9 22 /AA MW�MmlM`m mmm ' BEDrTRENCH Width ` Length ` N s PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS 1 O D SETBACK SYSTEM TO P/L BLDG IWELL LAKE/STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR Ty0f S tem. Model Number UNIT UIS I KIbU1 I IVN 5Y51 EM Header/Manifold , , DistIb n • t Pi I x Hole Size ti x Hole Spacing T Vent to Air Intake Length Dia ngth� Dia Spacing 0 V •� SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Onl Depth Over 1 Olr' Depth Over xx Depth of Axx Seeded/Sodde xx Mulched Bedrrien Center rr Bed/Trench Edges Topsoil y I ;dyes Ink [�, Yes 0 NO COMMENTS: (Include code discrepancies, persons present, etc.) Inspection #1: Inspection #2: Location: 1326 200TH ST ROW ()F6JJ0 9l413,t� t--p 1.) Alt BM Description =1 t-�pn�, d� y 2.) Bldg sewer length =SOS - amount of cover = ?L f A Plan revision Required? U Yes No V I (% �} iJ/ 1 1l (l � y6 Use other side for additional information. �f `b UO vt Date Insepctofs Signature Cert. No. SBD-6710 (R.3/97) --1 1 s II — I I I—fl + I I V Ke Wit V a 0 al tol. Industry Services Division SI.Croix 0 1 Q 2�22 PS JUN 1400 E Washington Ave P O. BOX 7162 Sanitary Permit Number (tir be filled it by Co.) St. Croy County Madison, WI 537 7-7 2 , 1 cry etri7it Applicati 17 State Transaction Number In accordance with SPS 383.21(2). Wis. Adm Code, submisswo of this form tot Hate governments] unit is required prior to obtaining a sanitary permit. Note. Application forms for state-owned POWTS are submitted to the Department of Safely and Professional Services Personal information you provide may be used for secondary purposes In accordance with the Privacy Law, s. 15.04 I t m . Stets. Project Address (if different than mailing address) 1326 2W1 Street V I. Application Information - Please Print All Information Property Owner's Name Parcel N Paul 6t Kristine Schmidt 012.1058-10-000 Property Owner's Mailing Address Property Location 1326 200° Street Govt. Lot NE'A, SE A. Section 26 (circle one) f30N R17Eor 6) City, Stale Baldwin, , WI Zip Code Phone 54002 Number 11. Type of Building (check all that apply) Lot ® 1 or 2 Family Dwelling - Number o edrooms ` ❑ Public/Commercial - Describe Use d SI Itlock N Subdivision tame x ❑ Cilyof ❑ Stale Owned - Describe I Ise _ �1 CSM Sys l�i� X ❑ Village of ® Town of Erin Prairie Number 111. Type of Permit: Check only one box on line A. Complete line B if applicable) _. A. New System ❑ Replacement System ❑ Treatmentil folding Tank Replacenocnt Only ❑ Other Modification to Existmg System (explain) R. ❑ Permit Renewal ❑ Permit Revisron Before Expiation ❑ Change of Plumber ❑ Permil Transfer to New Owner List Previous Permit Number and Date Issued IV. Type of POWTS System/Component/Device: (Check all that apply) _ ❑ Non -Pressurized In -Ground ❑ Pressuriisd In -Ground ❑ At -Grade ❑ Mound > 24 in ofsuiIablC.WjICff Mound < 24 in of suttable soil ❑ Holding Tank ❑ Other Dispersal Component I lain i ❑ Pretreatment Device (explain) 12 V. Dis ersaVPreatment Area Information: u Design Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal Area Required (st) Dispersal A=ProwmmdSystem 1500 175004! F.Iev wn600 �wG VI. Tank Info Capacity in Gallons Total Gallons N of Units D k 7p�� P40 Manufacturer 2 S G v o = 2 •r. N u: ii J y 1 Ncx ranks Exisnra Tanks Septic or I Iolding Tank 1200 1200 1 _ Wieser Concrete Dosing Chamber goo 800 1 Wieser Concrete VII. Responsibility Statement- I, the undersigned, assume reepnnsihility for Installation of the POTS shawo on the attached plans. Plumber's Name (Print) pluryber's i are /J/ MPIMPRS Number Busirass Phone Number John Schmitt j> 223760 711-760-0496 Plumber's Address (Street, City. State, Zip Cade) 586 Valley View Trail, Somerset. WI 54025 Vlll. County/Department Use Only Approved ❑ Dnsap Reas_o for DenialI Permit P-see� (Lp�t/ks of g Agknt Sign IOwner STEM 8dii i of prov 3� 1 DSPS � pQ�.p� � d.•CJL .d -^ Septic tank, effluent Altar ?^d LO .�'7'0"- dispersal cell must br I c , %. ;ed / maintained 1 y -� as per management plar nrnvided by plumber.� _ i - - t be maintained �'nl'L1AMf\14-AL. %- - -- z, GII %ethark renU reMer " u5as per applicable codeluMil ilnoeelplere plan for the syum and submit -to the ( Goofy only oo paper t kn hen a I inch" fa was SBD4398 (R03/14) � I 1.16 June 9, 2022 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 2024-06-09 Plan Review: PWTS-062201187-C JOHN F SCHMITT 616 150th Ave Somerset WI 54025 SITE: Schmidt 4 Bedroom Mound 1326 200th Street Town of ERIN PRAIRIE St. Croix County Total Amount: $250.00 DIVISION OF INDUSTRY SERVICES 2331 SAN LUIS PL GREEN BAY WI 54304-5211 Contact Through Relay hitp:ltdsps.wi.gov/programs/industry-services www.wisconsin.gov Tony Evers - Governor Dawn Crim -Secretary Condltlom y APPROVED DEPT. OF SAFETY AND PROFESSIONAL SERVICES ION Of TRY SERVICES SEE CORRESPOND CE FOR: Description: Four Bedroom Mound System \ Sloped Site Mound Component Manual — Ver. 2.0, SBD-10691-P, (N.01/01, R 10112), Pressure Distribution Component Manual — Ver. 2.0, SBD-10706-P (N.01/01, R 10/12), 600 GPD, 16 inches to limiting factor from original grade, Maintenance required, Effluent filter The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. This system is to be constructed and located in accordance with the enclosed approved plans and with any component manual(s) referenced above. 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 • A sanitary permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.19, Wis. Stats. • Prior to construction of the dispersal area, check the moisture content of the soil to a depth of 8 inches. Proper soil moisture content can be determined by rolling a soil sample between the hands. If it rolls into a 1/4- inch wire, the site is too wet to prepare. If it crumbles, site preparation can proceed. If the site is too wet to prepare, do not proceed until it dries. • Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stats. A state approved effluent filter is required. Maintenance information must be given to the owner of the tank explaining that periodic cleaning of the fitter is required. Owner Responsibilities • The current owner, and each subsequent owner, shall receive a copy of this letter. Owners shall also receive a copy of the appropriate operation and maintenance manual(s) and be responsible for ensuring that POWTS is operated and maintained in accordance with this chapter and the approved management plan under s. SPS 383.54(1). • In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approved plans. • The owner is responsible for submitting a maintenance verification report acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. 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. In granting this approval the Division of Industry Services 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 and the POWTS management plan to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, POWTS Plan Reviewer — Wastewater Specialist Department of Safety & Professional Services I Division of Industry Services email: Katie. PetzelCaowisconsin.gov Cell: 608-574-1189 County Industry Services Division Stcmix 1400 Ave = P.O. Box Sanitary Permit Number (to be filled in by Co.) Madison, WI 53T07-7162 Sanitary Permit Application State Transaction Number In accordance with SPS 393.21(2), Wis. Adm. Code, submission of this form to the appropriate Sovemmental unit is required prior to obtaining a sanitary permit Note: Application forms for state-owned POWTS we w i fitted to Project Address (if different then mailing address) the Department of Safety and Prolessiom it Services. Personal information you provide may be used for secondary in accordance with the Privacy law, s. 15. I Xmj Seats. 1326 2000 Sum 1. Application Information - Please Print All Information Property Owner's Name Parcel a Paul & Kristine Schmidt 012.1059.10-W Property Owner's Mailing Address Prey Location 1326 2000 Street Govt. Lot NE'/4. SE %., Section 26 City, State Zip Code Pliant Number Baldwin.. WI MW2 (circle one) T30N R t1Gore) 11. Type of Building (cheek all that apply) Lot k ® 1 or 2 Family Dwelling - Number of Bedrooms —� Subdivision Name ❑ Pubir Commert:ial - Describe Use Block p ❑ City of ❑ State owned - Describe Use ❑ Village of CSM Number ® Town of Erin Prairie Ill. Type of Permit: ICbock only one box on line A. Complete line B if applicable) A. ® New System ❑ Replacement System ❑ TreatmentMoldir l Tank Replacement Only ❑ Other Modification W Existing Syattan (explain) B. ❑ Permit Renewal ❑ Permit Revision ❑ C'hengc of ❑ Permit Transfer to New List Previous Permit Number oil Oak Issued Before Expiration Plumber Owner IV. Type of POWTS S stem/Corn nent/Device: Check all thatapply) ❑ Non-Presv rircd In -Ground ❑ Pressurized In -Ground ❑ At -Grade ❑ Mound ? 24 in. of suitable soil ® Mound < 24 in of actable soil ❑ Holding Tank ❑ Orlin Dispersal Component (explain) ❑ Preuatmesm Oevict (explain) V. Dispetsalfrrealsoest Area Information: Design Flow (gpd) Design Soil Application Divpersal Area Required (sf) Dispersal Ara Proposed (sty System Elevation 6W Rme(gpdsf) I50o Imo 100.15• 0.4 VI. Took Info Capacity in Gallons TOW Gallons 0 of Umib Manufacturer A V Y New Tank, Existing Tanks C.r an rn u. lei G. Septic or Holding Tank 1 1200 1200 I Wieser Concrete Dosing Chamber I goo 800 1 Wieser Concrete VI I. Responsibility Statement- 1, the r aaame responsibility for Installation of the POVM sbowm no the athicbed plans. Plumber's Name (Print) PI s i nae MP/MPRS Number Business Pore Number John Schmitt 11 /7L 223760 715-760.0496 Plumber's Address (Street, City, Suse. Zip Cnde) 586 Valley View Trail, Somerset, WI 54025 Vlll. Court /De rtmeat Use Only ❑ Approved ❑ Disapproved Permit Fee Date Issued Issuing Agent Signature (timer Given Reason for Ocnial $ IX. Conditions of Approval/Reasons for Disapproval Arbca N avrrplere pYss ter be rynrr sad asaaft hI Ue ('awry salt' a peer zest Iran tluu ! IR % 11 1te1 is doe SBD-6398 (R03/ 14) MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Project Name: Schmidt 4 Bedroom Mound Septic System Owners Name. Paul & Kristine Schmidt Owners Address 1326 200th Street Baldwin, WI 54002 Legal Description: NE1/4, SE1/4, S26, T30N, R17W Township Erin Prattle County: St. Croix Subdivision Name: NA Lot Number: NA Block Number Parcel I D Number 012-1058-10-000 Plan Transaction No. Page 1 Index and title Page 2 Data entry Page 3 Mound drawings c APPROVED ROVED Page 4 Lateral and dose tank DEPT. OF SAFETY AND PROFESSIONAL Page 5 g System maintenancespecifications y SERVICES Page 6 Management and contingency plan DI SIGN OF I TRY SERVICES Page 7 Septic and Dose tank specifications Page 8 Effluent filter information Page 9 Pump specifications and curve Page 10 Plot plan SEE CORRE SPONDEWCE Page 11 Sanitatary System Ownership/Address Form Page 12 Warranty deed Page 13 CSM Attachment Soil evaluation report Designer: John Schmitt License Number: 223760 Date: 6/1/2022 Phone Number. 715-760-0486 Signature: Designed Pursuant to the Mound Component Manual for POWTS Version 2.0 SBD-10691-P IN 01101) and both SSWMP Publication 9.6 Design of pressure Distribution Networks for ST-SAS (10181) and Pressure Distribution Component Manual Ver. 2.0 SBD- 10706-P (N 01101) Version 7.0 (R. 03/2012) Page 1 Mound and Pressure Distribution Component Design Design Worksheet (R or C) R Residential or Commercial Design Estimated Wastewater Flow (gpd) Peaking Factor (e.g. 1.5 = 150%) Design Flow (gpd) Site Slope (%) - Contour Line Elevation (ft) Depth to Limiting Factor (in) In -situ Soil Application Rate (gpdM2) 400.00 1.50 600.00 5.00 89.08 16.001 0.40 Distribution Cell Information 100.00 Dispersal Cell Length Along Contour (ft) _ 1.00 Dispersal Cell Design Loading Rate (gpd/ft') 1 Influent Wastewater Quality (1 or 2) Pressure Disributlon Information (C or E) C Center or End Manifold 3.00 Lateral Spacing (ft) 4 Number of Laterals 0.188 Office Diameter (in) 2.50 Estimated Orifice Spacing 2.00 Forcemain Diameter (in) 200.00 Forcemain Length (ft) 88.00 Pump Tank Elevation (ft) 3.25 System Head (ft) x 1.3 12.41 Vertical Lift (ft) O 10.89 Friction Loss (ft) 0.00 In -line Filter loss (ft) 26.55 Total Dynamic Head (ft) Lateral Diameter Selection in. dia. options I choice 0.75 1.00 1.25 1.50 x x 2.00 x 3.00 x Treatment Tank Information 1200.001 Septic Tank Capacity (gal) Wieser Concrete IManufacturer NOW Sand fill (0) calculations naurne a Table 38344.3 in -ski sole bvsbneM for fecal cordorm of <= 36 inches. 6.00 Cell Width (ft) Are the laterals the highest t in the distributionY network? Enter Y or N If N above, enter the elevation ft of the highest point. (ft) = 7.50 W/orifice Does the forcemain drain back? Enter Y or N Forcemain Drainback (gal) 5x Vold Volume (gal) Minimum Dose Volume (gal) System Demand (gpm) A Manifold Diameter Selection in. dia. options choice 1.25 1.50 x x 2.00 x 3.00 Gallonsllnch Calculator (optional) Total Tank Capacity (gal) Total Working Liquid Depth (in) gal/in (enter result in cell B49) Dose Tank Information Effluent Filter Information 800.00 Dose Tank Capacity (gal) JPOLYLOK Fitter Manufacturer 22.241 Dose Tank Volume (gal/in) 1525 1 Fitter Model Number Wieser Concrete Manufacturer Project Master Mound Page 2 600.00 (fe) Dispersal Cell Area 1750.00 (ft) Basal Area Available 6.00 (gpd/ft) Linear Loading Rate 1 10.00 (ft) 1/10 B Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area Finished Grade 102.54 (ft) Shading Key Dispersal Cell See lateral details on Q _ Topsoil Cap 1.5 ft Page 4 for number, size, © ....... Subsoil Cap • O and spacing of laterals. ® Sand 1 Laterals are equally or, t ASTM C33 he v Tvoicai Lateral F spaced from tTilled Layer I distribution cell's © AggregateQ I centerline in the A distribution cell (AxB). Project: Master Mound Page 3 Project: Center Connection Lateral Layout Diagram Fact m or n c onntctror, wa rtt or cross to m wW old at ary pore 0 • Turn-upnl ball valvdor I� X—,J. olunoutpluq Flops dIAld on rht 4arom o1 rht IarHal Number of Laterals Lateral Diameter Lateral Length (P) Lateral Spacing (S) Lateral Flow Rate System Flow Rate Total Dynamic Head 4 1.50 in 49.34 ft 3.00 ft 13.11 gpm 52.43 gpm 26.55 ft Litt Ibis art.dtmrc Y Laterals 8 facemam Sch 40 PVC per SPS Table 384 30b Orifice Diameter Orifice Spacing (X) Orifices per Lateral Orifice Density Manifold Length Manifold Diameter Forcemain Velocity Dose Tank Information Electrical as per NEC 300 and —o SPS 310.300 WAC Dnrled Tank component is property vented Wieser Concrete Capacityl 800.00 Volume 1 22.24 Manufacturer Gallons gaVinch Dimension Inches Gallons A 18.43 409.96 B 2.00 44.48 C 5.54 123.16 D 10.00 222.40 Total 35.97 800.00 T A i B C Alarm Manuafacturer I SJE Rhombus Alarm Model Number 1036378 Pump Manufacturer lZoeller Pump Model Number 1140 Pump Must Deliver 52.43 gpm at F-2-6-5-5-1 ft TDH Master Mound tl T S in ft/sec Locking cover with warning label and locking device and sealed watertight 4 in. min. E— AMMONS outMi location Foroemain diameter 2 in. Weep hole or arltF siphon device Pump off elwalion ft 88.83 —pose tank elevation (R) 88.1)0 Note. Switches containing mercury may not be used in this system. Page 4 Mound System Maintenance and Operation Specifications Service Providers Name John Schmitt Phone 715-760-W6 POWTS Regulator s Name SL Croix County Zoning Phone 715-386 4680 System Flow and Load Parameters Design Flow - Peak 600 gpd Maximum Influent Particle Size 1/8 in Estimated Flow - Average 400 gpd Maximum BOD5 220 mg1L Septic Tank Capacity 1200 gal Maximum TSS 150 mg/L Soil Absorption Component Size 600 ftz Maximum FOG 30 mg/L Type of Wastewater Domestic Maximum Fecal Coliform >10E4 cfu/100 mL Septic and Pump Tank Effluent Filter Pump and Controls Alarm Pressure System Mound Other Service Frequency Inspect and/or service once every 3 years Should inspect and clean at least once every 3 years Test once every 3 years Should test monthly Laterals should be flushed and pressure tested every 3 years Inspect for ponding and seepage once every 3 years Miscellaneous Construction and Materials Standards 1. Observation pipes are slotted and materials conform to Table SPS 384.30-1, have a watertight cap, and are secured in as shown in the mound component manual. 2. Dispersal cell aggregate conforms to SPS 384.30 (6)(i), Wis. Adm. Code 3. All gravity and pressure piping materials conform to the requirements in SPS 384, Wis. Adm. Code. 4. Tillage of the basal area is accomplished with a mold board or chisel plow. 5. The mound structure and other disturbed areas will be seeded and mulched to prevent soil erosion and help reduce frost penetration. Lateral Turn -up Detail Finished Grade yr 6-8" Diameter Lawn i Threaded Cleanout Sprinkler Valve Box Plug or Ball Valve Distribution Long Sweep 90 or Two 45 Degree Bends Same Diameter as Lateral Project: Master Mound Page 5 Mound System Management Plan Pursuant to SPS 383.54, Wits. Adm. Code General This system shall be operated in accordance with SPS 382-84 Wls. Adm. Code, and shall maintained in accordance with itscomponent manuals (S83-10691-P (N.01/01, R. 10112), SSWMP Publication 9.6 (01/81). and Pressure Distribution Component Manual Ver. 2.0 SBD- 10705-P IN. 01101. R 10/12)) and local or state rubs pertaining to system maintenance and maintenance reporting. No one should ever enter a septic or pump tank since dangerous gases may be present that could cause death. Septic and pump tank abandonment shag be In accordance with SPS 383 33, Ws. Adm. Code when the tanks are no longer used as POWTS components. Septic or pump tank manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 84riches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into a tank or component. Septic Tank The septic tank shall be maintained by on individual certified to service septic tanks under s. 281.48, Stats. The contents of the septic tank shag be disposed of in accordance with NR 113, Wis. Adm. Code. The operating condition of the septic tank and outlet filter shag be assessed at bast once every 3 years by inspection. The outlet fitter shall be cleaned as necessary to ensure proper operation The filler cartridge should not be removed unless provisions are made to retain solids in the tank that may slough off the filter when removed from its enclosure. If the filter is equipped with an alarm, the filter shag be serviced it the alarm is activated continuously. Intermittent finer alarms may indicate surge flows or an impending continuous alarm. The septic tank shall have its contents removed when the volume of sludge and scum in the tank exceeds 113 the liquid volume of the tank. If the contents of the tank are not removed at the time of a triennial assessment, maintenance personnel shall advise the owner of when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank. The addition of biological or chemical additives to enhance septic tank performance is generally not required. However, if such products are used they shall be approved for septic tank use by the Department of Commerce. Pump Tank The pump (dosing) tank shall be inspected at bast once every 3 years. All switches, alarms. and pumps shall be tested to verify proper operation. If on effluent filler is installed within the tank it shall be inspected and serviced as necessary. Mound and Pressure Distribution System No trees or shrubs should be planted on the mound. Plantings may be made around the mound's penmeter, and the mound shall be seeded and mulched as necessary to prevent erosion and to provide some protection from host penetration. Traffic (other than for vegetative maintenance) on the mound is not recommended since soil compaction may hinder aeration of the infiltrative surface within the mound and snow compaction in the winter will promote frost penetration. Cold weather instaltations (October -February) dictate that the mound be heavily mucked as protection from freezing. Influent quality into the mound system may not exceed 220 mg/L BODs. 150 mg/L TSS, and 30 rg/L FOG for septic tank effluent or 30 rg/L 0003, 30 mg/L TSS, 10 mg& FOG, and 10' cfu/100 mL for highly treated effluent. Influent flow may not exceed maximum design flow specified in the permit for this installation. The pressure distribution system is provided with a flushing point at the end of each lateral, and it is recommended that each lateral be flushed of accumulated solids at least once every 18 months. When a pressure test is performed it should be compared to the initial test when the system was installed to determine if orifice clogging has occurred and if orifice cleaning is required to maintain equal distribution within the dispersal cell. Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the owner, and any levels above 6 inches considered as on Impending hydraulic failure requiring additional, more frequent monitoring. Contingency Plan If the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep the system in proper operating condition. If the dosing tank, pump. pump controls, alarm or related wiring becomes defective the defective component(s) shall be immediately repaired or replaced with a component of the same or equal performance. If the mound component fails to accept wastewater or begins to discharge wastewater to the ground surface, it will be repaired or replaced in its, present location by Increasing basal area if toe leakage occurs or by removing biologically clogged absorption and dispersal media, and related piping, and replacing said components as deemed necessary to bring the system into proper operating condition See Page 5 of this plan for the name and telephone number of your local POWTS regulator and service provider. Pretreatment Unfb The information and schedule of mananagement and maintenance for pretreatment devices such as aerobic treatment units or disinfection units are attached as separate documents and are considered part of the overall management plan for this system. Project: Page 6 Y w V =-7' III I 4" CAST -A -SEAL u Ir i illi _ til I^ ill I i FILTER OR I II i t RAFFLE ilr I —tiErtlI o: o J � n I Iau I f I ]e M SIDE VIEW OR EXCEED ASTM C-1227 r4' CAST -A -SEAL 4" VENT OUTLET � u CL n :5Y 1 PUMP PAD WLP1200/800—MR TANK SPECIFICATIONS DIMENSIONS: WALL: 3" BOTTOM: 3" COVER: 6' MANHOLE: 24" I.D. PRECAST CONCRETE RISER HEIGHT- 53' LENGTH: 13'-B" WIDTH: 8'-0" BELOW INLET: 410 UQUID LEVEL: 36" WEIGHT: BOTTOM 14,800 LBS. COVER 8,170 LBS. INLET AND OUTLET: 4" CAST -A -SEAL BOOT OR EQUAL GASKET INLET AND OUTLET BAFFLE AND FILTER: WISCONSIN. SEE DETAIL /10 (OTHER STATES SEE CHART) LIQUID CAPACITY: 33.46 GAL/IN (SEPTIC) 22.24 GAL/IN (PUMP) LOADING DESIGN: 8'-O" UNSATURATED SOIL TANK CAN BE USED AS: SEPTIC / HOLDING / PUMP OR SIPHON COVER: MIX DESIGN MB (NO FIBER) TANK: MIX DESIGN /9 (SMALL FIBER) CUSTOMIZED TANKS - FOR CUSTOM TANKS CONTACT WIESER CONCRETE REVIEWED BY REVIEW DATE DRAWINGS SUBMITTED FOR APPROVAL APPROVED BY: APPROVAL DATE: PRODUCTS NEEDED BY: of �� gldl � L W OF 1 PAL �x Inc Inno.,usl,n it.wt a,ul.gf zabei. IIL-525 Effluent Filter 4 Wxftw,tn PIOd,[!I O A Der w of PWy 1-�,. PL-525 Filter The PL-525 Filter is rated for 10,000 GPD (gallons per day) making it one of the largest filters in its class. It has 525 linear feet of 1/16" filtration slots. Like the Polylok PL-122, the Polylok PL-525 has an automatic shut-off ball installed with every filter. When the filter is removed for cleaning, the ball will float up and temporarily shut off the system so the effluent won't leave the tank. Features: • Rated for 10,000 GPD (gallons per day). • 525 linear feet of 1/16" filtration. • Accepts 4" and 6" SCHD 40 pipe. • Built in gas deflector. • Automatic shut-off ball when filter is removed. • Alarm accessibility. • Accepts PVC extension handle. IIL-525 Installation: Ideal for residential and commercial waste flows up to 10,000 gallons per day (GPD). 1. Locate the outlet of the septic tank. 2. Remove the tank cover and pump tank if necessary. 3. Glue the filter housing to the 4" or 6" outlet pipe. If the filter is not centered under the access opening use a Polylok Extend & Lok or piece of pipe to center filter. 4. Insert the PL-525 filter into its housing. 5. Replace and secure the septic tank cover. PL-525 Maintenance: The PL-525 Effluent Filters will operate efficiently for several years under normal conditions before requiring cleaning. It is recommended that the filter be cleaned every time the tank is pumped, or at least every three years. If the installed filter contains an optional alarm, the owner will be notified by an alarm when the filter needs servicing. Servicing should be done by a certified septic tank pumper or installer. 1. Locate the outlet of the septic tank. 2. Remove tank cover and pump tank if necessary. 3. Do not use plumbing when filter is removed. 4. Pull PL-525 cartridge out of the housing. 5. Hose off filter over the septic tank. Make sure all solids fall back into septic tank. 6. Insert the filter cartridge back into the housing making sum the filter is properly aligned and completely inserted. 7. Replace and secure septic tank cover. 1/16" Filtration Slots 10,000 GPD (- Accepts 4' & 6" -�C>* SCHD 40 pipe Alarm Switch � (optional) �`-- Accepts 1' PVC tension Handle Rated for 10,000 GPD 525 Linear Ft. oft/16- Filtratlon Slots CartMlad to NSFfAN51 Standard 46 Gas Deflector Automatic Shut Ball outdoor SmanFilter7: Alarm I.xti•nd & Ink` Polylok. Zabel & Best filters accept Easily installs the SmartFilter® switch and alarm. into existing tanks Potylok, Inc. 3 Fairfield Blvd. Wallingford, Cr 06492 Toll Free: 877.765.9565 Fax: 203.284.8514 www.potylok.com Page 8 PRODUCT SPECIFICATIONS Max Locked Min. Impeller Float Cord Power Discharge Max. Shipping Part No. HP Vohs Amps Rotor Circuit Phase RPM Diameter Switch Length Cable Connection Solids Weight Amns Breakar fin 1 Cw 1. 14 1 es__ ri_ r cx__ n�_ . 1/2 115 14.5 q6.0 27.5 15A 27.5 36.2 36.2 1 3400 Pi back 20' 14/3 2' NPT 3/4" 64.5 GFE0511M 3.56 Not Su lied GFE0712M GFE0712 30 GFE1012M GFE1012 30 3/4 1 230 10 Pi back 20' 67.5 4.32 Not Supplied 64.5 30' 4.32 Piggyback 67.5 12.5 20' 65 4.67 Not Supplied 30' 68 4.67 Piggyback PERFORMANCE CURVE u 4 2 i 90 80 70 _ 60 50 40 30 - GFE10 -- 20 GFE05 10 GFE07 0 0 20 40 60 80 100 120 FLOW/GPM MATERIALS OF CONSTRUCTION Part Name Material Impeller Cast Iron' Motor Adapter Cast Iron Cord SJTOW Fasteners Stainless Steel Float Bracket Stainless Steel 3/4 HP, high head is glass reinforced thermoplastic AGENCY LISTINGS 0S pe Tested to UL778 CAN 22.2 by c us CSA International (Canadian Standards Association) xylem Let's Solve Water DIMENSIONS A B C D E Al Models 1 16 lh" 1 11 Y." 1 7 7/8" 1 5 1/8" 1 3 7/8' I I I A 16-1/2 1 Optional 2' NPT Flange Adaptor I 1 112" NPT I FTD 5-1/8 1 3-7/8 C 7-7/8 Xylem Inc. 2881 East Bayard Street Ext., Suite A Seneca Falls, NY 13148 Phone: (866) 325-4210 a Fax: (888) 322-5877 www.xylem.com/goulds Goulds is a registered trademark of Goulds Pumps, Inc. and is used under license. 0 2022 xylem Inc. GFESERSALES R3 January 2022 13/16 R lem Let's Solve Water FEATURES • Cast iron motor housing allowing for optimal heat dissipation • Premium mechanical seal design provides superior protection against sand and abrasive damage (Silicon Carbide/Silicon Carbide/BUNA) • Engineered motor designed for peak hydraulic performance without overloading • Durable cast iron base for stability • Cast iron impeller with dual vanes. Balanced for smooth operation. (3/. HP, high head is glass reinforced thermoplastic.) • Corrosion resistant hardware for lifetime use • Capable of running dry without damage to components • Designed for continuous operation when fully submerged • All models have NEMA three prong grounding plugs • Available in automatic and manual models • Approved for residential use (CSA/CUS Listed) • 3 year warranty APPLICATIONS Specifically designed for the following uses: • Homes • Farms • Trailer courts • Motels • Schools • Hospitals • Small business • Effluent systems GOU LDS WATER TECHNOLOGY a xylem brand i I g PUMP PERFORMANCE CARVE NOOEL 140'414a104t43 I r • IN r M a a Y e RM PON ISO." CONSULT FACTORY FOR SPECIAL A • Electrical alternators, for duplex systems, are ahem • Mechanical alternators, for duplex systems, are a% • Control alarm systems are available for 1 phase pt. • Variable level 1xnitrd smichas are available for Oor • Double piggybad variable level float switches • Sealed Qwik-Box avail" for outdoor' • Refer to FM0606 for applications above 130*F TOTAL DYNAMIC HEADIFLOW PER MINUTE EFFLUENT AND DEWATERING MODEL 140/4140 145/4145 Feet latex Get. lln COL I Lln 6 1S 66 326 61 1 232 t0 3D 90 303 a0 I 2n 1s 4.0 73 276 56 1 213 20 $.1 45 250 53 201 25 7.6 s9 223 46 IN 30 9.1 tl 166 46 171 40 122 M 16 133 so 152 - — 2a 9s 60 U3 1a It 6h" 14eed. 50 4 &be 74 22*n tse0eo an alarm. MEalarms.�nn See FM k7r� cycle c 1420.\ \ 14014140 314514145 MODELS • SING E ControlSek on Model Model Vb b M Amps Simplex u x N140 N4140 115 V99 12 1 or 2 10 E140 E4140 230 6 1 or2 3 BN140 BM4140 115 Auto 12 — BE140 SE4140 230 Auto 6 — N145 N4145 11 Non 13 1 or2 3 E145 E4145 2 Non 6 1 or2 3 BN145 BN4145 Auto 13 — BE145 BE4145 Auto 6 — •ogle pi9gybeck switch OPTIONAL PUMPS AND P/N 10.2421 • Red2c4sc potential by debris. Replaces rocks a under Ute pump. Made of durable, nontflffosive ABS. Raises pump 2• 06 bCPDM of basin. Provides the ability to intake by addlrg sections of 154• or 2• PVC pprtg. Attaches securely to pump. AcoorlynodalessumP,dewatenng and effkYeM applications. NOTE: flake aloe flat Is free from obstruom. sy assembly' . kK►14e.I u 19 w k variable level float switch or double piggyback variable level Boat switch. Refer to FM0477. 2. See FM1228 for model of simplex control panel. 3. See FMO712 for of duplex control panel. aJmeta9atwnof CO3I,ul1. protecLa dw,cesandwklnp ehwld be tlMK1 by a puaYliM licensed rle<tnd4n. Ax ekctnul and safrty codn Should be followed mcludkly the mOsl MOM Napanal ElWAC Code INECI end the OCCYPAOMI 64fety 2rd hesnh Ad 10511M NKIs 4YI1af4e RESERVE POWERED DESIGN For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump. 0 Copyright 2011 Zoeller Co. All rights reserved. Page 9 SYSTEM PLOT PLAN Schmidt 4 Bedroom Mound D"n Flow 6WGP0 Pmyad Adenw. ,326 200gt Baea, Main ft&W flow nlwlet" for ooilw war plane. BM, syraa A i BM eavrir, ,00.oa Ppe MateNH /ASTM Srarkiard BM Dakilplion. Top of T PvC pkpa Taplae 384,30-3 d 384.30.5 BM2 SyrnW 0 SM E44rld,fro U' 4' SCH 40 PVC a4+a ASTM• 026M BM Daaviploo Top o12'PVC ppa r Sa 4o PVC Me AST"l705 Slope (Gotham of Trod Am 151 LIT SCk 40 PVC ASTM-01TM Wag SyrnOa (if appgceola) 00' 4' Sell 40 PVC Budinp Bawer Pmposed V" 120W600-MR Seplic0or Tank Pmpoead 4 Bedroom Hour 200' 2' SCH 40 force Man 0 P ow" VWYg 8B w 1 I I I I 5slope I I jSM2I e3 25 22•xl21.GV Maud I w/ 6'x, Co. rock A p4m Call I I I I I I I Contour Line El-99.06' I � I I BM, I I` 1 low �\ a4• property Lino N Scale: 1" = W 0 60 00 120 15' ST CKo tJN'I'Y SANITARY SYSTEM File *. �� OWNERSHIP/ADDRESS FORM Office �; ty Community Development Department will utilize this information to provide the property owner with information regarding operation and maintenance of your new or replacement sanitary system! This information will be provided as part of our ongoing efforts to protect public health, your well, groundwater, surface water, property values, and county resources. Once approved, this completed form and educational information will be sent to you by email. If you would like to view your issued sanitary permit online, you can do so by using the PropeM Files Scanned weblink. OWNER/BUYER INFORMATION Owner/Buyer Paul & Kristine Schmidt Mailing Address 1326 200th Street City/State/Zip Baldwin, Wl 54002 Phone Number (required) 715-760-0694 Email Address (required) Parcel Identification Number 012-1058-10-000 (found on the property tax bill) NEW SYSTEM: LEGAL DESCRIPTION Property Location NE '/4 , SE 1A , Sec. 26 T 30 N R 17 W, Town of Erin Prairie Subdivision Plat: Lot # _ Certified Survey Map # Volume . Page # Warranty Deed # 1146869 (before 2006)Volume . Page # Number of bedrooms 4 Spec house 0 yes ■ no Lot lines identifiable ■ yes 0 no New Property Address _ (Stad Initia ) OFFICE USE ONLY ZOO4\ ST z (Verification of new address required from Community (D ) G(3 Department for new constnxtion.) This form must be submitted with all Private Onsite Water Treatment System (POWTS) applications. New System: Include with this form 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. Community Development Department - Land Use Division 715-386-4680 St. Croix County Government Center cdd0sccwi aov 1101 Carmichael Road, Hudson, WI 54016 715-245-4250 Fax www.sccwioov Page 11 DOPNWWd SOIL'EVALUATION.R T 12ZM 1'�Mt SdA4 fat OW in somdanos v Comm as, Wk. Assn. Colo Paps 1 of 4 _ Pidmb Sar*w somm SON Too ft, lnc. Aaaeb cMc pion on pglcr act Na Cun RX x 11 sidles in etas. plan mal Babb. nal brAm b: wIYoY Md lmkm, aI referenos po" (BM), dActlon and peroeM allow *ad* or dbw. Mofn. nofrr amow, and bcafion and distenoe to rmmes road. Momm print all In/wmadon. Panda Ydr.vaan you praNe may be riled for ee00r4ry popaem M*mwl law, t 15.84 (1) (rn)). 1% Croix Parcel I.D. 012-1058-10-000 RrAswed BY Oats Propsm OMW SctwnM P&W & KrW*w Property Loatlon GWA Lot NE1/4, SEIM. S28. T30N, R17W Nop" Ownefa Me" Adtsesa 13M 200111 SL Lq r no Bb* r &M. Name or CSW 140 Aoro Panel CRY sob ZO Code Pl orre Nu dw sllll in I WI 1 54002 715-700*4 U C* ❑ VApp ❑ Town Neanssr Road Erin PrSide I 200Th St Q Now COW&Uodon Um E) RpalderAm I Number of bedroom 4 Code derived design Row role 800 OPD U R po c1 ❑ Putdo or mnmeaM - Dmrtm: Patent rricsericl Glacial TO (Fresco Sodn) Flood p1w 4Mevation M wpk" NA ft Gorwal conrrferib Amm is aWfffblc Is uillft for a rnm4 system SyMn sbwdon b 100.75 bmd drf* otM"v IM cMIbMW II II W- Slaps and McommWANOW of Its was is ft Do* b &WtN faro Is 160. r E] � Gm nd suAca alw. 99.08 R Depat lo IhrNMtp tatlor 19 In. Sol Appinaon Rats Hmtwi Depal in. DM*WdCObr MW" Rada1DftcM On CAL St Cont. Cob( Teidui Slrfrcarfe Or. 8a. ea. dour( m Roob OPW •aln on 1 0-9 10yr3/3 none A 2m9r mvfr as 2vf 0.6 0.8 2 9-19 10yr4/4 (tame sid 2rnsbk mfr yw lvf 0.4 0.6 3 19 29 7.SyrK/4 m jd 7.�' d lmsbk rttfr is 0.4 0.7 4 29-42 SyM/4 n jp 1 sl Om mA — 0.2 0.6 Ff • Pqo*p Otound w fm* abv. 99.06 It Deplh SO YntlYq kAWr 17 in. Sod AppReefon Rate Florlacn Depth e,. Dm* dColor rrltrra.8 Red- Deso"m at. SL cad. color Te*m svucbaa Or. (la. se. Boundry Roots �•+ 1 0$ 10yr3/3 none so 2mV mvfr as 2vt 0.6 0.8 2 8-17 IOyo4/4 (tone Sid 2msbk fv* Ow lvf 0.4 0.6 3 17-29 SW4/4 M jd 7 11 lmsbk mh 9w 0.4 0.7 4 29-% SW414 map 25oW6 $l Om rftli — -- 0.2 0.6 • Etlawrtt /i • awe 301220 mWL end TRS *W < 150 mglL - EMUOM R`no IKAJ S3v nwL a100 s,v ny� COT Number CST Nettle (Please Print) Signature: T(toroas J. SdWNU /��"�^ — 227429 Address 8dwrA fiec Tsm tp. Ina / OW EvWwsibn CaWodod Tebp WW Number ttta8 72nd SL New R1Wenord, VA 54017 S14M= 718-700 IM Raptly Owrwr Schmidt, Patti fi fCdOw psmw ID # 012-1058-10-M paps __I_of 4 8wli B O Bating Pit Grouts aurfaaa elev. 93.35 1L Depth to limiting factor 16 h VW Applicalion Rats liorizoa Depot In. Dominant Color MunsO Redox Dismak Yon Qu. Sr- Cont. Color Taodwa 8bucYae or. Ss Sh. BoundW Woofs OPOW Im '6112 1 0 8 10yr3/3 none se 2RW ntvr► as 2vf 0.6 0.8 2 6-16 10yr4/4 tore sM 2msbk mfr 9w 1vf 0.6 0.8 16-28 7.5yr4/4 7.3 mZd vr6/2 sf lmsbk I mfr 9w --- 0.4 0.7 4 2&44 7.Syr4/4 lOrWB sl Om ntfl — 0.2 0.6 Boone 0 Q PPit Gfowq sudam alay. 92.7 IL Depth a 111sn tp fadw _ 10 in. Sol R211101 hlorBon 000 In. Domhant Color MurA w Radoe in " i Du. Sz. Cort Color Te dune Strucom Gr. Sc Sh. Boundny Rom ot GPDAI' 'El -EM2 1 0-10 10yr3/4 nee so 2m9r Tmfr as 1vf 0.6 0.8 2 10-16 10yr4/4 C26 7 1 III 2anbk 9w lvf 0.6 1.0 3 16-22 7.Syr4/4 5 .Syrb/6 7.51V grsi lmsbk rs -- 0.4 0.7 4 22-42 5yr4/4 n'3p7 "0" sf Om mfl — -- 0.2 0.6 B ❑ soft ElGrouts aurfaa Nov. Ft Depth b wn4Mip facer in. Applicsi Radio Morhm NO In. Dominant Color Mui Radox Desulpi Qu. SL Cots. CWa Taature Structuw (ir. Saz Sh. foundry Rools GPON 'fit ' Eftord V-13005> 30 <- 220 Me& and TSS >30 c 160 welt. ' Effluent 02 a BW5 <_ 30 m9IL and TSS -30 m9IL lire Depwunart of Commerce is an equal opportunity savior provides and employer. If you need asdatance to soma aervicp or need matein an aemue hfommL plem coa w the department at 609-266.3151 or 77Y 60f1-264411M. sanane0rmoot rial ad,.+a sea Taatrq, u+c. Conducted For: Conducted By: St Croix County, WI w Paul & Kristine Schmidt Thomas J. Schmitt Legend 0 1326 200th St. c'' Baldwin, WI 54002a. '" R nn♦+7 Stros*f Q. PID: 012-1058-10-000 5CST 2022429 _ ± 1055' 40 Acre Parcel NE1/4 SE1/4 S26 T30N R17W Town of Erin Prairie US �4�ay, /97' 98, 99 "SEE PAGE 4 of 4 FOR FULL VIEW OF LOT R s:we Loun� "7hw,rys 100' "SEE B4 LOCATION ON PAGE 4 OF 4 Rn f R� 1 r j5'k I B 1 I RUe R Xu o'VIS) j Slope. 470' W 1 _.. 45' � i 1 j v I to Raa.nany IBM 2 492 = rco-:nr.•ne0.. ion j 183 1 I I o 60' N 0 I I Sloppe j i 475' IB2 i 30' I N I { !BM 1 474' ti { { �• too' BM 1 100.00' Top of 2" PVC Pipe { „ , o zo 4o eon 109 i 99' BM 2 99.14' Top of 2 PVC Pipe 013CIMWER 97' 98• Contour Line El. 99.08 Oco 1Wr "yM Contour Line Length 110' �» 1" = 50, IW SOUTH PROPERTY LINE cr a • a n 26 PAUL NE114 PIQ. sI 25 St Croix County, WI Legend iu Pa••tit To m C Ma V"9- stlla,. o Gat co Opw CLw ws La. a. a•.a R:..•s R.ra.s anE Straaln I.Itlflali!f') US tfgh 4/ Slaw tbal 't C-.Wy H*W*w s Ruth RaI" R., g., Rcao P wd a via, RRtruaas N 71flO yL t 6 't T z'` ="F ---.�— yy� w4r/� 7PU435 . . 9 m �w r 1 f w am .;F 1 Gil a �a Er �n •! ti Ls s YV1XJD@PrH 1 ..A s 13 ., i ,5 INI,N^�7'ISj(�Oti 1 WE r.�l�l,'1 w-= WOE WWAM ou!7suH 9 tned rNrrr i 1` { fill 4 ail I li k. I� • I� ! � I .-- ♦%% ��r•��w•wrr i....�r%.r 1 L =ti 5 `ss"SDw�-WMALPS }Q 41 f I r r r S tr- t Document Number T Ct{��m� Document Tdia 111111111111 Tx:474M 1146869 6ETX PASST REGISTER OF DEERS ST. CROIX CO., WI 01/12/2022 11:a4 AM EXEMPT*: REC FEE 30.00 TRANS FEE 69.10 PAGES: 4 Recording Area Name and Retum Addraaa P.,A LDW-f 41 Ua-,-- 5 4 - Parcal Identification Number (PIN) THIS PAGE IS PART OF THIS LEGAL DOCUMENT — DO NOT REMOVE. This Information must be completed by suboillter: document title name & ntum address and PIN (If required). Other Information Such as the granting clause, legal descrlptlan, stm, may be placed an this Arat pWe ofthe document or rtMy be placed on addNonv pages of the document. WRDA Rev. 12J22l2010 St. Crolx Page 12 State of Wisconsin PLEASE USE THE SPACE BELOW FOR THE COUNTY RECORDER'S OFFICE: This instrument was prepared by: Darla Ann Fem 1325 200th St. Baldwin, WI 54002 After recording, mail document and tax statements to: Paul Sch 13 St. Idwin, WI 54002 012-1056-10.000 QUITCLAIM DEED Rev.1343DOO This � i Deed (the `Deed') is made effective this 01 day of January, 2022 (the "Effective Date') betweel3'Je4Fem, Darla Fern (the "Grantor"), a married couple whose mailing address is 1325 200th St., Baldwin, WI 54002, and Kristine Schmidt, Paul Schmidt (the "Grantee"), a married couple whose mailing address Is 17220 9th Ave N, Plymouth, MN 55447. WITNESSETH, that the Grantor, for and In consideration of the sum of $0.00 (United States Dollars) and other good and valuable consideration, to It In hand paid by Grantee, the receipt whereof Is hereby acknowledged, does hereby quitclaim, convey and release unto Grantee all Interest Grantor has, if any, In , the real property (the 'Property') located In St. Croix County, Wisconsin, and more particularly described as follows: SEC 26, T 30 N, R 17 W, NE1/4 of SE114 Quitclaim Deed (Rev. 1343DOB) 1/3 ----St-r-roLx Co my -lac 24t -- — — — -- -- — - — - - - ---- -- • -- The Property is not homestead of the Grantor. TO HAVE AND TO HOLD unto said Grantee, its successors and assigns, forever. Grantor declares that the documentary transfer tax is W1.00, computed on the full consideration or value of property conveyed. EXECUTED this 3g day of 20 Z = Jeffrey Fern GAdvtor (Spouse) Signature Grantor (Spouse) Name Grantor pouse) Sign ture rant** (Spouse) Signature Grantee (Spouse) Signature Quitclaim Deed (Rev. 1343D08) Darla Fern Grantor (Spouse) Name Kristine Schmidt Grantee (Spouse) Name Paul Schmidt Grants* (Spouse) Name 2/3 -- St. Croix.County 1146869 Page 3of4-- --- — -- ACKNOWLEDGEMENT OF NOTARY PUBLIC STATE OF WISCONSIN. COUNTY OF ST. CROIX. A� DA(A(t F1f11\ On this day, personalty appeared before me, Ir;riSk�ntl�d � ) SG11.0to me known to be the person(s) described In and who executed the within Instrument, and admoHAedged that they signed the same as their voluntary act and deed, for the uses and purposes therein mentioned. Witness my hand and official seal hereto affixed on this day of Nro,me` 20 ZA_. FigW—M-11r 1 S 12oZ6' (Daft) My ommission Expires Quitclaim Deed (Rev. 13431308) d�Ilk, s �• SSA �'•. �y:. . . R 313 St�rolxCounty1146869Page 4of4—_-- — . 3 W9 � 9 fSi� 2022 ss o � OIL EVALUATION J2FRORT �s iIt coordance with Comm 86. Will Adm. Code CsT-sass - l�s Op- 1" n -�' K22o4 Pape - 1 of 4 Schmitt Soo Tatum. Inc. AR oanplete apH col leas sort BK x 11 Inches in a" Plan must Include, but not fbrraed to: vertical and hortaoniai reference point (9M), dlrsc n and Percent slope, scab or dimensions, north arrow. and location and distance to nearest rood. Please print all Information. Parsaau h,ram.txst you provide rosy tr used to seoondsry purpres IPrrv" Lew, s. 115.0/ (t) (m)). County St. CIOIX -„- Parcel I.D. 012-105e-10-000 Z Properly Owner Schrr 1, Paul 6 Kristine Property Location GOIA Lot NE1A. SE1/4, 828, T30N, R17W Property Owners Malang Address 1328 200th St. Lot a na Block AiSubd. Name a CSW 40 Acre Parcel City Stab Zip Code Phone Number Baldwin I WI 1 54002 1 715-760-0894 .�j Coy �J Ytoage I_] Town Nearest Road Erin Prairie 20OTh St ( ,-I Now Construction Use: Q Residential / Number of bedrooms 4 Code derived design flow rate 600 GPD jJ Replacement ❑ Pubtio or commercial - Doombe: Parent material G(acW Till (Frew Series) _ flood plain elevallen, 8 applicable NA k General comments Area is led ZT* saleable for a mound" m. System elevation Is 100.76 based ofrdv contour line alit lid at 99.08'. Slope and reeonvrfandatiore: of Ote area Is 5%. NO to limiting factor is 16. B«aw a LJ eorino �:, po Ground surface ebv. 99.08 fl. Depth to IMnillnp facia 19 in. Sole hppliation Rob Horizon Depth in. Domirerd Color Munsed Radom Description Qu, Sz Cant. Color Texture Structure Gr. Sz Sh. Conststancs Boundary Roots GPDAP *EBJ1 IM 1 0.9 10yr3/3 mone sit 2mgr mvfr as 2vf 0.6 0.8 2 9-19 10yr4/4 none sid 2msb1( mfr 9W 1vf 0.4 0.6 3 1 9 7.SyM/4 m2d 7.5�6 sL inl5bk mfr a 0.4 0.7 4 29-42 Syr4/4 m3F7 LOyr6/8 sl Om inn — -- 0.2 0.6 Ora F Boring Pit Ground surface elev. 99.08 R. Depth to f rolling factor 17 In, Sdt Appaatron Rate Horizon Depth In. DOMIMP(COW Muraell Redox Description Qu. Sx. Cont. Cola Texture Structure ConWtan Gr. SL Sir. Boundary Rolla OPD/W East VW 1 0-8 10yr3/3 none sit 2mgr i rnvfr as 2W 0.6 0.8 2 8-17 10yr4/4 none ski 2msbk mfr sf lmsbk mfr 9w lvf 0.4 0.6 3 17-29 5yr4/4 m2d5.5 2 6 gw 0.4 0.7 4 29-46 SM/4 map 2.5 F 6 SI Om mfl — 0.2 0.6 Effluent y1 a BOD? 30 c 220 mg/L and TSS 030 < 150 mg& - tmuem ow n6 x flv� aim , w i.r.. ""- CST Name (Please Print) Signature: W Number Thomas J. Schmitt 227429 Address 8Wna1 Sob Testing, Inc, i �' Date Evatwdon Conducted Telephone Number 1596 72nd et. Now RMunond, cal 54017 5/4/2022 71&780.1078 dlorgr/n tag Property Owner ShcntM Paul & Kristine Parcel ID 0 012-1058-10-M Pape 2 of 4 7 8orfng e D Boring )[j Pit Ground surface elev. 93.3S ft. Depth to limiting factor 16 in.FoiApplication Role Horton Depth In. Dominant Color Munsell Redox Description Ou. Sr Cant. Color Texture SUUdura Gr. Sz. Sh. Consistence Boundary Roots GPOW Emt I 0-8 10yr3/3 none sit 2mgr mvfr as 2vf 0.6 0.8 2 B-16 IWM/4 none Sit 2msbk mfr gw 1Vf 0.6 0.8 3 16-28 7.5yr4/4 m2d 7.5yr6/6 7.5 2 lmsbk mfr 9w - - 0.4 0.7 4 2" 7.SyM/4 ip 7m s1 y�/rl/6 sl Om mfi — -- 0.2 0.6 e n Poring Pit Ground surface elev. _ 92.7. __ a. Depth lo limiting factor Ica in, Sotl Application Rais Mahon Depth In. Dominant Color Munsell Redox Description Ou. Sz Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPOW Wall T1102 1 D-10 IOyr3/4 none sit 2mgr mvfr as IV 0.6 O.6 I 16 10yr4/4 e2d 7.5yr6/8 sl 2msbk mfr 9w lof 0.6 1.0 3 16-22 7.5yr4/4 m2d 7.5yr6/6 7.5 2 9 rsl imsbk mfr a — 0.4 0.7 22.42 Syr4/4 m3p510 rV8 7.4 51 Om mfl — — 0.2 0.6 J Boring Boring s Pit Ground surface elev. ft. Depth to Iknitlng factor In. II Application Rate Horizon Depth Dominant Color in. Munseg Redox Description Ou. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPDIR' -EM 1 -602 Emuent et - SODS* 30 < 22o mg& and TSS �30 . 160 mg/L ' Effluent p2 • SODS < 30 mg1L and TSS <_30 nglL The Departaront 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 M 608-264•8771, aaQlfUe (t1DUa1 idrae sal Taaap rnt Conducted For: Conducted By: St Croix County, WI Paul & Kristine Schmidt Thomas J. Schmitt Legend 1326 200th St. , Baldwin, WI 54002 "' F CST 227429 PID: 012-1058-10-000 5.4-2022 40 Acre Parcel NE1/4 SE1/4 S26 T30N R17W Town of Erin Prairie M.,�...,,n �97, 98, 99, "SEE PAGE 4 of 4 FOR FULL VIEW OF LOT R�� '''•'-"" X" 9 ...,„ r / / / inn '-SEE 134 LOCATION ON PAGE 4 OF 4 a J j r 1 5o�a B� ..........., j SIoPe. j 470' ULJ j I 45Of j I H I V U) h1 2 l �52 = ,, ,• ,-, O j 1 O 60' (V I � 3 5% 1 SIOpe' 4i5' t � . iE2 t 30' t 1 N j 474' t 100' 00 00' Top of 2" PVC Pipe M 99 14' Top of 2" PVC Pipe toy' 97 9a on our line EI. 99.08' - Contour Line Length 110' SOUTH PROPEP. TY L WE St Croix County, WI o v . ..=, 140TH AVE- .', l"`' - 4 t Legend m R•-:• = rF"t• 'i half „a•v. .,. ' \♦I. .� yy� '� (1�r�. ,. t7. .ice • ,., f..:,, �t let) , t • am.[. LU 1 `� ul 44 �'� • 7 S>� i PAUL 6 KRISTINE SC i, NE1/4 SE114 S26 T30N� ~ ' PID 012-1058-10-OCO , w ..d. n y B7 ^i 1 J NO., 644707 STAT SANTA,�Y PERMIT rm�i13Z6 ao OWNER PLUMBER TOWN OF _= SEC I2& ,T_3t;� N, R PREVIO LIC.# Z23%0 AND/OR LOT BLOCK - SUBDIVISION S NO. ftei e CHAPTER 145.135 (2) W19CONSIN STATUTES (a) The purpose of the sanitary permit is to allow installation of the private sewage system described in the permit (b) The approval of the sanitary permit Is based on regulations In force on the date of approval. (c) The sanitary permit is valid and may be renewed for ■ specified period. (d) Changed regulations will not impair the validity of a sanitary permit. (e) Renewal of the sanitary permit will be based on regulations in force at the time renewal is sought, and that changed regulations may impede renewal. (f) The sanitary permit is transferable. History: 1977 c. 169;1979 c. 34,221; 1981 c. 314 Note: If you wish to renew the permit, or transfer ownership of the permit, please contact the county authority. VAS Z SSUING OFFICER - DATEPERMIT EXPIRESD I + NLESS RENEWED BEFO THAT DATE POST IN PLAIN VIEW VISIBLE FROM THE ROAD FRONTING THE LOT DURING CONSTRUCTION SBD-06499 (R11/20)