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HomeMy WebLinkAbout040-1308-00-154 n CO) 0C - 0 c k ) /k ! t # 7 � ■ � /ƒ 2 e 0 & 0 ® k 2 2 « E a / E C.0 E } \ \ k \ \ c CO CD — — I 2 ® , , ƒ g c / /§ % k $ co \ CD ® $ \ 8 / \ \ / 2 E CA . � « \ ■ � � � } 0 0 0 \_- � * / $ ) -C -C k �� ���� k ` m Or / % N) \ CL i §7f \ \ g 9 / / / @ 2 § § ° , & � / g E / 7 / / � n � � ■ & » § $ \ \ � a R / q ] k � \ 2 q § / . � c, § % &a2� "n GC - o % / /%57 3 6 ; [\iQ =CL (a m� E s zr BL ) a §e, o a � CD mi \i � 3 CD CP a ;- (} k CL CL CD ] E . ƒƒ[ 3 Q g22 �S \ � �� � ■ , ; � \� �} � k WiscbnsiODepartment of Commerci PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division r INSPECTION REPORT Sanitary Permit No: .. 463276 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: Coleman, Larry Troy, Town of CST BM Elev: Insp. BM Elev: BM Description: R/ B Section/Town /Range /Ma No: o ( - 41 '$ r 0'- eAjs - 16+ [A� 24.28.20. TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic / 2 5­0 Ben ma I $ b D 1 4 7 Dosing A l � "7�"V Alt. BM d "' � I Z. p Aeration Bld ewer -30, s •� Holding St/Ht Inlet - 7. 3 I -� 1" / • 3 JD / • 3 St/Ht Outlet (� ,�• 3 � , TANK SETBACK INFORMATION SC, -f-4 -- 3 TANK TO P /t� WELL B DG. Vent to�lptake ROAD DtInlet Septic S? / , ( 2 �/ Dt Bottom Dosing S'Y ✓k H eader /M an. �7 "1 • Aeration Dist. Pipe T47 t / Holding I oB�tem * P(e✓ ( 7 �p 2v PUMP /SIPHON INFORMATION , Final - 2 L 7 Y Manu D GPM and St Cover ! o '� I �•�' d Model Number , � � B � � 0 � � • TDH Lift Friction L System Hea TDH Ft 6t 7 �4/ "' a ,^ Forcemain gth Dia. Dist. to Well i``D- SOIL ABSORPTION SYSTEM a ` BEDITRENCH WidthL h N0. Of rench PIT DIMENSIONS No. Of Pit Inside Dia. Liquid Depth DIMENSIONS '3 q 4 —� SETBACK SYSTEM TO P/L BLDG WEL LAKE TREAM LEACHING Manufa rer: p IN CHAMBER O Typ f System: , C f ' , �/ UNIT Model Number: s� IBUTION SYSTEM Header>)fold Distribution �n ' /' 7 x Hole Size x Hole Spacing _ Vent to Air In A Pipe(s) 4 lX� Length Dia Length Dia Spacing ' f SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over 6r – Depth Over xx Depth of xx Seeded /Sodded xx Mulched Bed /Trench Center Bed/Trench Edges Topsoil 1 - 1 Yes €, No Yes No r COMMENTS: (Include code di repencies, persons present, etc.) Inspection #1: / Inspection #2: S / /� Location: 316 Lindsay Road Hudson, WI 54016 (SE 1/4 SE 1/4 24� R20W) Troy Village 6 ditio Lot 15 Parcel NO: '24.28.20 l 1.) Alt BM Description =/ � Of -5 tF0(4:5 , ,�1�1 , �" 4-4t �'� GUkA �Q.C�Y�- a- : Vt` 2.) Bldg sewer length = - amount of cover = d �j I G qA 19�� j04 - 9A k4w � '3 �ou3' 4; � f ��2 of -9d� - 7�' �"1'a � � Plan revision Required? Yes I V Use other side for additional information. �� ff `1 Inse ctor' Signature 9D-6710 (R.3/97) Date �'�v�"`r^"' �✓ 0��.�J b ✓�(f (/(l�D L C��`�'fl r i 40 s j c^ i a_ � opo,.d � H«s. � (Aaa9a) � l s a" � r 237.84' \ 4qs 1 � 1 992 I Safety and Buildings Divtston Coulty Ny 201 W. Washington Ave., P.O. -Box 7082 ST. CROIX Madison, W 1 53707 -- 7082 Sanitary Permit Number (to be filled in by Co.) Department of Commerce (008)261-6546 Sanitary it Appllcati ECErrVE PI I.D.Nwnber State In accord with Comm 83.21. ' infortioaCion pro may he t ew our s13.U4( x } Project A4d rca (if differe:ri than mailing address) L Application laformatioa - Plcaae Print Aft inform _ Pnaperty owner's Nano ZONING OFF 1 Lot # 154 Block -COL AN HO /L N Property owner's Mailing Adtlinss 0 r Z 5 0 to t l o�4cvtQ p� S 3 1 SE v. SE � s ` edioa 24 City, State A �� Zip Code Photic Number -- — Vt st zs I - -a (11 � , T 28 N , R 20 , w IL Type of Building (check all that app {Inr2Familylhvellimg - Nnmiherof� BD RMS PER SUB HSE P ivisioaiN cs lvitiumber LJ Public%f:onumial- 0— ib-Use ROY VILLAGE (s7 �` ❑ stateOwnwt ,cam,it t,.2 TRENCHES @ 87.5/FT EA. -14 CHA EA Ocim_ a� . LIviti�hmvm --4*ot TROY III. Type of Permit: (Check only one bole on Brea A. Complete line B if applicable) __ -- A. i!P New System i J Replacement System ❑ TreatmentaUding T.& Replace mg Only ❑ odw Modification to P>ei s System 8• Permit Renewal Permit Revision ❑ Change of U Permit Trast�er to New l i Previous Permit Number and Dale Lsstuvl 11etixe Exliiration PI owner t� IV. T of POWTS System: Check all that a t 1 13 Nom -Yx=, ized in- Ground I J mound > 24 in of le s ' ound < 24 mf of suitable soil ❑ Atfiirade IJ Single Pass Saud Pithx I Coils u ed Wetland I] Prmlrtrotl In- Ground IJ Holdim - rw* U Peat Fitter I I Aerobic Tnmunent limit ex iit"ating Sant Fill= IJ Recirculating Syndwtic Media Filter I'? F.eachtng H Drip Line ❑ ❑ 01hes (e l j�- V. DispmaliTreatineut Area Information: t?eeigp now (wd) D. gn Soil Application Ratggip&) Drspereal Area RagnirM (-d) Tlikrerwl Amer 3yslem Elevation 600 .7 857.14 882 UPPE 889.5 LOWER 888.7 VL Tank Info Capatit in Total Numkaer manufacturer Prefab site Steel F ibLT Plastic Cations (;&Monks ofii»itc Concrete Camslrutxed (tears New Fx Taaka Taelts s nrU& rank X 1250 1 WIESER YES .Aerobic TreabmerN Unit Dostn Chamber VII. Responsibility Statement 1, the whersigwiIl, ttaarbMa" of FONWS shown an the attached pl aar. Plurrd,es's Nanw(Print) ' Number Harmers Winne Murder 77 r z e�1�0 TODD FEATHERSTON 242514 71 5 -381 -1704 Plumber's Address (Street, City, Statc, Zip & W -- - PO BOX 467 HUDSON, WI 54016 ! V own IDe artmeni Use Only 1Dproved IJ Disapproved Sanitary PPv Fee includes Groundwater Date Issued ssuimg Sq�nture tamps) se„aw rte) # zv � / �� ❑ Owner Given Reav m for Denial L IX. Conditions of Approval/Reasons for Disapproval _ SYSTEM OWNER:�t 1 Septic tank, effluent filter and 0-40 dispersal cell must all ¢e §Qfyiced / maintained as per management plan provided by plumber. Lam/ 2. All setback requirements must be maintained te as per applicable code /ordinances. y Attach caspiaEe plan (t. the Ceaa // ) tLe syricm w taper �dl_gq � A A , - �'�GLdZ{f��A a � c1�-d y � �d Proposed / House \ (9aa9s) � / log/S AITI \ ° ?,( - S'G'f/[� ' � `� 0 ,� r • r s in s �r�. K' i SYSTEM CROSS SECTION COLEMAN HOMES, INC. LARRY COLEMAN - LOT 15 TROY VILLAGE MAN HOLE INSPECTION PIPE GRADE 893.0 f E ZABEL FILTER 1250 GAL. .87.5 SYSTEM ELEV. UPPER - 889.5 LOWER - 888.75 14 BIO DEFUSER CHAMBERS 0 0 1250 (� - ----- 87.5 14 BIO DEFUSER CHAMB R PID PENDING SE 'h SE '/4,S 24 T 2.8 2Z E LOT 154 BL_ SUB TROY VILLAGE C o M PRS%N 242514 SOIL EVALUATION REPORT Page_ of - Wisconsin Department of Commerce { Division of Safety and Buildings i In accordance with Comm 85 Me. Adm. Gods 1 County 5T. C-90k Attach complete site plan on paper not less than 81/2 x 11 Inches In size. Plan must Include, but not limited to: vertical and horizontal reference point (8M), direction and Parcel I.D. percent slope. scale or dimensions, north allow. and location and distance to nearest road �. DfN �� Re wed b Dal Please print all Information. j '3 6 r Personal Inrorrnauon you provide may be used for secondary purposes (Privacy law, 1° PropertY P NT GDf�P' cw� -Eot S� 1/4 Sio 1I4 S ;L14 T 29 N R 2D W Property Owner's MaNing Address Lot # Block # Subd. Name or CSM# 11%0() ABEKD �T su,�E M ISiI — TK01 u -� Gty Slate Code Phase Ntmber ❑ City ❑ village 0 Town Nearest Road r LA1NE 554' 9 (763) 7 - 75o f)y LtA;�Sl1�/ 1Zfl• 7 �{ Code derived design now rate (0 -- GPQ ! . qg N Construdlon Usa:� Residential /Number of bedrooms ❑ Replacement ❑ Public or commercial - Describe: Food Blain elevation it appYcabie Parent material , 1 Genera) comments ; and recommendations: C0AVeAMvY _1:Q -&sCQ .LAUD - 0KZAW_+W_ i 0.7 LO AMY& P i a;'I:wSen �c�t flFTE WfaL EX�AVflTI�A� BaZw6s f1 �r C N�° �c�N►�I�%6 - F A] ❑ Boring goring # to I factor 9�o in. Pit Ground surface elev. _�� ft Depth Sal Application a Horizon Depth Dominant Color Redox Description Texture Sbucture Consitence Boundary Roots P7)114 �ler •E(f#1 'Eff#2 in. Munsel Q Sz, Cont. Color Gr. Sz. Sh. 1 0 -1 1 4 I OvK2/1 L - d z /1-18 0'k �Z St) Z-F d� 0.l Ztf {-tn 0. i 3 fig, _ s ►1 Zinn dk ag z>+�F ��� o�� + = y Z9 - 37 10 v K e — I S I rn-i._K _ J5 O z p.7 iz 5 3�-y4 b � 5 �• Y qL j 7Z rW4ehe — s 0 di c5 0.7 .Z s _ ; 7 7 Z-9 L 0 `I 5 fQ `t Fe 4 4 5 b Z nn\ 0. - r t• i ❑ Boring cltlo�tz�� �-f +mss aU rte. R � IW> �R. �o �,)� kc , . a# Pit Ground surface elev. ft. D�n9 factor _ _ _ n•(• Uon Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPI ' i in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •EN#1 •Efl#2 1 I - t 1 4 Z iC'SJ3 l5 _ Ci L-m 7 -13 `! Z i 3 13 fu 411tzh — ski 3rh -t_ ZvF -n� S t t} 25-3Z o 3 — c5 2 ] S 34-43 1 0 `tR — .5 Q 0.5 _ I. ' tt 43-yg a �t - 5 d1 .7 , ti- re'�b S d CS 0- ov t Effluent 91 = BCO > 30 _< 220 mglL and TSS >30 < 150 mgll. ' Eflkrent 82 BOO < 30 mgll. and TSS -< 30 Mg/L CST Name (Please Print) Signature CST Number j hl JO H Ol L sTE ZZ g Addra9S Data, Evacuation Cnnductad TelePt1or Number W9fl ?5 640 Ate, 1Z1VE FAu-S WT 540 22 0� -ZR -03 �tS yob -1�7S N l --" p y p . COATiI{ . JTAI_ UMAEtW Peroe1D * ._f 1DW�o 1 Z- -�— � --1 Bo�kug �f•A F161 � # la elev. � . b '"'�" Sa Raft Cm�t+� pit Horizon Depth D kwd Redox Description Texture Settdue c a ee Boundary Roots G PDW a in Muse! Qu- Sz. Cont. color Gr- SL SIL 1 lov it r� AV4170,42 to HAS SWO tea. Bodng# O B—m 884.0 b taaor > tot ;,� © Pit Ground suriaoe elev - -2:r' it. Depth Sol Rob 7 � Teocdxe Stnx�ure Cortetxe Boundary Roots �` Korb= Depth D*Y*mnt Redox DescdPOan in Munsell Qu. Sz. Conk color Gr. Sz. Sh. 'EI�1 'EifR2 L O Sul Q -5 -1 :y l 'm (�' 0 -5 3 zA► �f s . .z 4 -4Z o�rR s O ."7 i.Z s -s 0 sr ql s LZ (0 ►_, ,pc siy s k �. Z 7 70–All- o�ICy S d 1 0.'t 1.z. /O/ #t7b /Q g" (� Bdirg sp c 'rein Cclawm) � 1 1 ❑ pit i surface AGv. —1L 0 ^9 SoNAPPkealon Role t Horizort� Depth Dom WV Color RedoxDeeor *m Textrae Struchas Corte Smith" Roots GPM #; In. Mursoo Qu. Sz. Cont Color Gr. Sz- Sh. *EM 'EM i 4 • Epluent #1 = BOD, > 30 _< 220 mg& end TSS >30:150 fro& ' ! #i2 = WD, : S 30 nVA. and TSS' 30 n & I � The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an ahernate format, please contact the department at 60 &266 -3151 or TTY 608- 264 -8777. s�awla.iWOO) ( t PAGE- "A �_ C41JT1 �,IJ'fiA vli.rc& ryo&Ar.A [ C'eRP• P of , p a! Cv \ , s AP ..-- o - o-sm t dsw - SOS, PING W/ t3ACga NO COMM 83 % 4 . LDT � T , 0 j B 1548 B 154A LEV. ELEV. ` + s 92 71.44' /ELEV. 894.26 ZLE N� 237.84' rz 896. s .9 BBC ELEV. B 157B 8 ELEV.92�1- — - B 158A 516W2 Of ZZ4Y3 1 - - PA 11;: b -O Dec 22 04 09:,30a owner ���� P• 2 DEC 2 2 2004 SOIL EVALUATION REPORT page_ f or r � ' wtsconsin Department of Commerce r Olvlslon of Safety and Buildings ' In accordance with Comm 85, W s. Adm. Code County I 5T. CRot X Attach campte(e site plan On paper not less than 8 112 x 1 inches to size. Plan must Include, but not limped to: verticat and horizontal reference point (84t }, daredlon and Pal I.0 1 purcenl slope. scale or dimenntons, north arrow. and location and distance to nearest rnad. �p �NC?rAS oat r R w /� Please print alt information: ?J t/ 1l, ` 1 Puaanai In /o rrn�UOn you provide may b yro6lar aecon0ary 9w Posen IF, Necy Lev.. t. 15.e t1) S�+`1)_ ptop" Location or' � Q S� 114 �jr S!4 S �4 T d� N A 2,r,) W cl]1J�INEN CAL DE 1ML( 'M EIJr C ofZC'; L me or Mailing Addre CSMq property Owner's es i_1 hGE E SIQv 100 Town Nearest Road state p Code Pharre Number ❑city village aly _.LLti t 155 1 i743 )7�^7 - ?SG�S TP.pY - --;- _ -• GPD gg New Construction Use: W ResJdentlai r Number or bedrooms _ Gode derived design flow tale �_�� - -- k 0 Repiacurnent D Publife or commercial - Describe: I Ill Parent matenal Flood Plain elevation If epplicabie -�` - -- General con rents i and recommendations C[:lJUFJ+ %Y4At- .S-M -C tWi l ` Ar-_ iCt1_ 0.7 LCAOt. it - JZATE p�-Ev158SapcT gP��. 1tAL �Xe A V flT 1 D!� -.C, N�u;�1 EA C] Boring ��• "r • B ell it Pit Oroundsurracealev. �b _, tt. Depth to limiting (actor 9�? __ in- Sod ;ration Rate I PO Horizon beplh Dominant Color RedoxDescripbon Texture Structure Consistence Boundary Roofs ,Ftt #1 -Ftl#2 in" Munsef< Oa, Sz. Cont. Color Gr. Sz. Sh. i z 1� -( -f8 a r z/z d Sid Zab Ill a:t rn t:. •`f i i rl �4•. lx 5 zvl- C. S C: � � t (- 3S t o v t:3 �, i s 1 rn a1rC s v -�►. z Z I i L 7Z ruit pt4 [ j7 n (41 5 r (tIQP l .0 fact eray. H!k • Boring e C r�u r I ® Bodl9 k' —_ imI11� •� I rrzce h. f3 lolh to I rg or �__� in• Pit Ground eu Sots toatlon Rate j Horizon Depth Dominant Col Redox Description Texture Structure Consistence Boundary Roots GPDtIf in. Munsel Qu. Sz. Cont. Color Gr, Sz. Sh. firttFi C Z r 0 0 7/ sl cb cs o.�i I 1 -tom u' +le 1 s - ci z�r4 -w> r j It 3 M . 32 'S S 3t. -43 C 'yR S 3 0 - 4 — 5 at. l , z C _W6- I a4i�' �1� S C2. d Effluom rtt = BOO > 30 220 ml and TSS >30 1 150 rr,a/L ' ERluant 02 - BOO 5 30 rr'K)/t. and TSS < 30 m9fL CST Nutril Name {Please Pill . ' Signature f r I A. ZZ g�� ry h1 Zo H a s, �� l Gi �(r (.� Addroas � Date Evaluntlan C.r>ntlkrOnA Telephone Neunber o W9fl75 b$O�hAt1E, vE FALLS t.JS S�fa22 O'S -2 -'ff 3 {��S V175 12- -2- ► -0 4 E Dec 22 04 01:,08p owner 7154264827 p.1 r I 1 Property Owner CAS Wi;h1TAt_ � Alkn"T Parcel ID # Page of Bo # ❑ oaring I 6 1 L Pit Ground surface elev. �! ' – 8. Depth to limiting fac0oe 7 't4_— in. t Rate jHcAmn Depth Dwdnent Redox Description Texture Struchre Consistence Boundary Roots 't ff #C,PD/IFEtf#2 Munsell Qu. Sz. Cora. Cobh Gr. Sz Sh. Eon f} roP l Fob zan3 A A5 A 1 N g.a , # p;t Ground surface elev. – ft. �t� to "fang factor iR on Rafe Horizon Depth Dominant Color R Description Texture Stnrclure Consistence Boundary Roots GPDfff in. Munsell Qu. Sz Cont. Color Gr. Sz. Shy �flt l ���� s.l ai 34 -5 41� �/ tt -m cb Z.j 0.5 3 zU -34 0 ►e *ce. s d l zvf-rti .z . z 4 -4 o-crc 5 p dl 5 q -S fo �'�l � s S - 0.7 1 fo 51 -70 1 o - W-51(4 s D d 7 70 =A I I l! oYl��! -� S ' o SA d 1 -- 0. 101- 7 8� ng ~ Z�ew CGilts J Ong # ❑ Pk Gro d surface �lev..__.— ft F Depth to tirNtirg tailor in. son lion Etatu3 Horizon Depth Dominant Color Redox Description Texture Struchre Consistence Boundary Roots taPON in. Munseil Qu. Sz. Cont. Color Gr. Sz. Sh. 'E1t#1 'Eff#2 i a Effluent #t = eOD, 30 220 mgFL and TSS >30 160 mg& ' Effluent 02 m 800.: 30 rnglL and TSS _< 30 rr4L The Department of Commerce is an equal opportunity service provider and employer. if you need assistance to aectss services or need material in an alternate format, please contact the department at 608 -266 -3151 or TTY 608 -264 -8777. seo•a»arrc.6,00x j v J 'r Dec 22 04 03:31a owner 7154264827 P.3 - T}�sc_s naPntFw:T R P• i D ' 1LIA6t� D�ti1- • '�P OF _!' w' . * C CO a--^- IA & s $OG �'• p go,eO5r`0 ' -50p. 130mr, W/ OAC,KN05 UO COMM 83 5EIT PPOPaM5 f \ C �C B 154A ` 81546 E� ELEV. 91.7 \ ELEV. 89 0 c o o 9� 7 ELEV. 894.26 LEV. ` E X37.8 � 8 % B15 81578 8 - ELEV. 8?Z4 _ — _ ._-- -_ 8158A i 516TP C5t zz+�83Z I PATE! Wisconsin Department of commerce SOIL EVALUATION REPORT Page _ F of - r Division of Safety and Buildings In accordance with Comm 85, Wis. Adm. Code County Attach compiete site plan on paper not less than 8 112 x 11 In es In include. but not limited to: verllcal and horizontal reference pal it (BM) 4W ED P L 0 t percent slope, scale or dimensions, north arrow. and location nd distance to nearest road. p�N�IN C- pate ' viewed b Please print all Information Personal InrortnaUpn you provide may Or. u sed for secondary purpofa (PrNacy w.. .. J(1 Property Owner ST. C CON�INElJZ t DE Et_OPMEM Cpt1 ZO I IC�t t SE '/4 S :;04 T N R ?O W Property Owner's Meiling Address Lot 0 Block # Subd. Name or CSMN W 100 � EtcD 6T. E SutTE 100 )5L1 _ TR4y Ut t_t..f+`E lo��D� . City State p Code Phone Number' C3 city ❑Vill Town Neared Road LR1NE 1 55449 12-:5)75 oY ��� go. (� Now Construction User Residential I Number of bedrooms Code derived design Mow rate (0 00 - GPD ! ❑ Replacument ❑ public or commercial - 0escrlbe: .�_ "• ' � Parent material _ (�L.CCr'�Atitf ! � �F111A t_ _ Flood Hain elevation if appl icaole � —� General comments and recommendations: CCW %)*AT - - M -loWOuND Z]tEUC#1 - 0.7 LCAOW& TZATE O �� Vi a' 1 9 � I •,�� s� C�� �'� ����o i Boring E�] Boring if pit Ground surface elev. $_q7 ] M. Depth to limiting factor _. 9W0 in. Ilcation Rate ' T Structure Consistence Boundary Roots GPOH Horizon Depth Dominant Color Redox Description exture Eqpt 'Ett#2 It Gr, Sz. Sh. o -w ;n. MunseU Qu. Sz. Cont. Coo j O•Sj I aYf�2l1 � _�• d z � -iB o �I 4 s i) z it 141- X11 0.g zv� 3 5 m z 4 - 34 ) o y 3 t — I S l s 0. 0.7 1 i t . C-5 0.7 1. Z I d ( — . 7 l.Z Boring C410Qt7JD�J 4 }yaS f 5- o Ge- i B ring ti �.-. in. M. i Depth to IIm1Ung (actor __ — Soll ' Icallon Rate Pit Ground surfgCe elev. GPO /ff Horizon Depth Dominant Col Redox Description Texture Structure Consistence Boundary Roots i n. MunseU Qu. 5z. Cont, do 7 Gr. Sz. Sh. 'Elt#1 'EfHt2 t sl 0.15 0.9 I o -H o �z - - � 3 3 -Z to 6 all 3m- ZvF -rn zS -3Z l S - .-7 } S 31 -43 0.5 G 43 1 0 ,4K 41 4 — 5 60 • Z - yst- POW- S d CS D: t 1. Z, i Effluent #1 - BOO > 30 220 mglL and TSS >30 150 mg1L Eftluenl ft2 BOO 5 30 mg1L and TSS <_ 30 rrVL CST Number CST Name (Please Print) gnatUre MAU Z 0 H 0 t- L ST E Telephone Number Address to Evaluation Conducted W9a75 64o R1vE FAuS WI 51-402Z OK- Zq -03 L N -1-7 7 s r ' r - r Y ti 1 (PF.�1DW Page Z of Property Owner _ QP — L DtiVF�LCP Parcel ID # t ' ® boring # Boring C GG1A1 i Pit Ground surface elev. - r z ft. Depth to limiting factor > �O n• g . 1 lication Rats *izonDepth inant Color Redox De scription Texture Structure Consistence Boundary Roots GPD/ft' unsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#Z I 4 Ffo� ZOO) p d l 0, '1 �. Z N 10 64L r N . v y Y v e Boring # Boring > 101 Pit Ground surface elev. g4s_ ft. Depth to limiting factor ' ^• Sal AD lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPofif Gr. Sz. Sh. 'Eff#1 'Eff #2 in. Munsell Qu. Sz. Cont. Color V t0yt -4Z S +� - b 0.l AL 0 - Z �0� 4f? 3 / tti -mdb Cb zu - p -S 3 zi -t -34 o K�` s r d I 5 zuf -M .z 4 -4Z OYKy J 5 Q� dl . I.Z E S S �- 0.7 N Os d 0.7 1. Z- 7 70-101 1 Yfcyl S d l 0. 1. Z ❑ Boring E] Boring # Ground surface elev. tt. Depth to limiting factor. in. 1 C] pit Soil A lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPOM in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. - Eff#1 'Eff#2 1 i 'I • � i 1 j Effluent #1 = BOD > 30 220 mg/L and TSS >30 < 150 mg/L Effluent #2 = BOD, < 30 mg/L and TSS < 30 rnglL i r 'fhe Department of Commerce is an equal opportunity service provider and employer. if you need assistance to access services or 1 need material in an alternate format, please contact the department at 608 -266 -3151 or TTY 608 -264 -8777. s seo•utotK.uoor � Y h p ROF'EEI2tY OV�ME� t�ti - 'a• t �: � � � �— r vplr'rtnti r.T l�� T2�V vIUA" 0 0 1 , 1 501L �00NC+ VXgN.JL , COMM 83 5FTDACK pWUM5 l The site �cas graded after soil evaluations %sere completed (see page wth final glade cic%ations). � S, stem elevations should not be atfcctcd- but depth bclo" grade v,°ill need to be determined based on the amount of'cut 01 13\1 elevations should ha�c remained consu +nt � � /� L�r „�/'v IS '`' fy B 154A B 154B �- . 89$� U LEV. 97 ELEV � A1 1� 9 9 7 1A, 4' E894.26 LEV. 237.8 5 B 1580 ELEV. 894.1 81�5 - B 158A SIG ZL9 C5t L A -S FLO PLAN Pt yPew OWNER• C of nL - C M�hm co 9F �- 509. [jok% W/ (3Pma 1' I iy AL G RADt V LG%J RT IO N 5 LET 154 ti Jr3re .�, r 8 1 54A 81548 ELEV. gqy.� ELEV. Q�S; g ® J� N 84 °53' 49" E 237.84' PALE: 01 Wisconsin Department of Industry SOIL AND SITE EVALUATI0��I REPORT Page I of .3 Tabor and Human Relations Division of Safety & Buildings in accord with ILHR 83.05, 8� Adm. Code A COUNTY Attach complete site plan on paper not less than 81/2 x 11 inches in size Lary must irjclude, but ST • C�z-u 1 K not limited to vertical and horizontal reference point BM direction PARCEL I.D. # po ( ), and / of sdope, scale or t'D LN 6. dimensioned, north arrow, and location and distance to nearest road. APPLICANT INFORMATION- PLEASE PRINT ALL INFORMATI6N. ' AEVI DBY _ DATE 1 PROPERTY OWNER: PAOAER yLOOARON.;._ C�J u_rL tv ` Sk 1/4 Se 1 / /SZY T - 2-b ,N.R Z.0 E ( W PROPERTY OWNER':S MAILING ADDRESS • L01 . `BLOCK # WA ME OR CSM # _ TCtO U l CITY, STATE ZIP CODE PHONE NUMBER ❑C! OVILLAGE OrOWN ' NEAREST f B S q'jV f' R�URD New Construction Use [4 Residential / Number of bedrooms y Addition to existi building Replacement [ j Public or commercial describe Code derived daily flow bOZ gpd Recommended design loading rate - bed, gpd/ft - 8 trench, gp Absorption area required b S? bed, ft - I SO tench, 11 Maximum design loading rate •"t bed, gpd$ • $ trench, gpd/ft Recommended infiltration surface elevation(s - S C8o't!�'lvecS\ ft (as referred to site plan benchmark) Additional design / site considerations S EE 1voTZ 'PO vu S7 t 12 po'j T�'ftdtr 'S Parent material Lu%�7%S a ef'z, C�t L,#j jLwtSN - Flood plain elevation, if applicable �1q ft S = Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE AT -GRADE SYSTEM IN FILL HOLDING TANK U =Unsuitable fors stem ELS ❑ U Ir S ❑ U a S ❑ U EIS ❑ U ®S ❑ U I EIS RI U SOIL DESCRIPTION REPORT Depth Dominant Color Mottles Structure GPD /ft Boring # Horizon Texture Consistence Bouxtary Roots in. Munsell Cu. Sz. Cont Color Gr. Sz. Sh. M Trench lo`L 3l — St Z`4` T3 >x I-_N6 !o'lcZ 316 — s i I 7-m s6v- IM - � - - s •6 Ground 3 $ -tly -SLiR3Jy 6r+ 0 S5 elev. ft Depth to limiting factor ? tI Remarks: Boring # >.' I o--t3 t o y R- 3 (z _ s i 1 Z--rn s k �• , :.� Z i� -�s �o�tQ 3 /t, S► I Zwt3bk m'& cg s 6 3 4S -U6 ,.s 'IR 3t - S g G►• o sg I — ,� .�a Ground elev. Depth to limiting factor ?llbs Remarks: CST Name: — Please Print Phone: Arthur L. We erer 715- 425 -0165 egerer Soil Testing & Design Service -P.O. Box 74 River Falls,WI. 54022 Signature - °l `� Date: CST Number:. 9 220254 PROPERTY OWNER COh) lQk:bMVk- tZQ, SOIL DESCRIPTION REPORT Page Zof PARCEL I.D, # I F , IS K !v C; B g # Horizon Depth Dominant Color Mottles Texture Structure Consistence Bmidary Roots GPD /ft Q� in Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Tnrch t? 0 -11 10`t2 - Sl( 2 �Z n .S sit Ground 3 3$ -ll$ -)• S `t2 sly - S g 61• U Sg elev. & g - ►, b it. i Depth to limiting factor yy� i Remarks: Boring # ��1....� I o - �z 1 �� 2 3 lZ. — si 1 Z - '�Shk ►�'E'r e.h, - . s' ' .6 s:< D �<x .:,..2> 2 �Z � 1oKR 3l�, . — s i ► Z� Sbk m'F► cg - - S • 6 3 3$ - LZl '7•S K R Ground -It — S bE G► - 5g Y►a - •1 $ elev. 8 Q - j• Z f t. Depth to — limiting factor r - lzi 1 1 Remarks: Bo�r)g # - ? 10 4Q- t2 3 L 2. Cj-,j - " • b >? E �<� Z tZ -l(j 1O � R 3! 6 � S 1 I Z-� S bk vn•F�- �S — - S I. b 3 �l3 -Iw �•S `i Ground 3[y - S t& U S9 elev. j Depth to I limiting factor ? 12.x' . I Remarks: 3oring # around ,lev. it. )epth to imiting actor Remarks: __ PLOT PLAN Page 3 of �3 SCALE 1 "= SD' sr "T lyZ v` j 7 ct�C11� : �� -SEF- �FyhTtOti,S -_ s�� z o �oriyt 10 %•,° LoT l�l.d e•� �e a, (!LA-:1 - (!LA-:1 c�ti I p. orJ 0 1P _ .. _ - - - - -s(sy 1tiSTh'Cl, Z- IZN�.✓�t e 3 S' Lu)- w/ .:..Lte t-N. CL" "BE'1ZS. COI o'r . zZoZSy.. 1Z- t1'�}� ( 715 ) 47,5 -0169 A CST Signature Date Signed Telephone No. CST # Wisconsin Department of Industry, SOIL AND SITE EVALUATION REPORT Page I of ..3 Labor and Human Relations Division of Safety 8 Buildings in accord with ILHR 83.05, Wis. Adm. Code I C Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must include, but - not limited to vertical and horizontal reference point (BM ), direction and % of slope, scale or 0 dimensioned, north arrow, and location and distance to nearest road. ' I APPLICANT INFORMATION- PLEASE PRINT ALL INFORMATION REVIEWED BY _ DATE PROPERTY OWNER: PROPERTY LOCATION CbU- `t.1"1 T�JCZ1�1.�U�'-A T C0rLTZ -GG4.6G; St~ 114 Slr 1 /4,SZ4 T Z$ ,N,R Z•0 E( W PROPERTY OWNER':S MAILING ADDRESS. LOT " BLOCK;# SUED. NAME OR CSM # �Z3u 1 �U� tJ.� .► Z 3v 1 ` \ — TTZU`i Ull.1.PCCE 4 ` PtDfl . CITY, STATE ZIP CODE PHONE NUMBER ❑CITY (]VILLAGE ®TOWN ' NEAREST ROAD BLMN� ri-t SS 4ay ( l �'Q - O`f Ll JvOS RuRD [xJ New Construction Use Residential / Number of bedrooms [ J AddibQn to existing building j J Replacement (J Public or commercial describe Code derived dairy flow bOD gpd Recommended design loading rate - bed, gpd$ - a trench, gpd/ft Absorption area required b S? bed ft - 1 S o 2 eq trench, ft Maximum design loading rate bed, pd /ft • $ trench d/ft g , 9p Recommended infiltration surface elevations ° t l - S 13u'tt�'T1ZC1v ( �S 18_ )i ft (as referred to site plan benchmark) Additional design / site considerations S EE7 lvoTE - M llu sTfVLL_e12 co 3 Parent material Lo SS oU _eTt GL�ft_(_ 0x,11 Flood plain elevation, if applicable KJ A ft S = Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE AT -GRADE SYSTEM IN RLL HOLDING TANK U= Unsuitable fors stem ILS O U OS O U ` as O 10SOU IR S O U l [IS RI U SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Structure GPD /ft Texture Consistence dly Roots I I in. Munsell (Qu. Sz. Cont Color I Gr. Sz. Sh. I Bed Tterxfi .:.•.:S - -y 0_11 to`tV 31Z Si -3bk Aas) Zti) •5 ,� w Z ll 36 1 Ll 2 3!(, — S i I r z " k k4 LS - • S -b Ground 3 $ -Uy S`-t231y _ S et 6t- Sg elev. g Depth to limiting factor ? llg Remarks: Boring # r O — t0 `1 31 2 S 1 I Zrn Sb1t w� Th t;W i 6 - Z_VK 3 us -116 7.S 3tY - g �[Gr+ O Sg W1 Ground elev. E Depth to limiting factor Remarks: CST Name: — Please Print Phone: Arthur L. We erer 715 -425 -0165 egerer Soil Testing & Design Service -P.O. Box 74 River.Falls,WI. 54022 Signature q q _ Z q 7 _ L (41 Date: CST Number: _ �Z_ L1 - 220254. PROPERTY OWNER CJ)► 1WeQ110, b'ZQ- SOIL DESCRIPTION REPORT page of PARCEL. I.D. # I XT)) /v G 8 # Horizon Depth Dominant Color Mottles Structure 4��} in. Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. insistence Botartdary Roots GPD /ft .......... # Bed Trer� =.4` �p`tV�-3tZ Si f Zrn Sb�C i�t'ft- �g 1 .5 .6 Ground 3 3$418 7. S 'tfz "31 $ B 6►. elev. �9 (- it. 3 Depth to ; limiting i factor ; ? t(8 f f Remarks: Boring # < `;1 0 -k lTL 3 lZ. — s z ��bk ►nor e : >:;....... >_ `t 3 t'10 s►► 2 w, S bk ►n'F►- c g - S Ground 3 3$ -L2J •S'1tZ 3t y p elev. S QL• Z tt. i Depth to limiting factor y i r Remarks: BM' g# .: .. Z`F,� bk wt`s CA ,. ` :::k < Z ZZ -�(3 �0 6 s i 1 Z-wr Sl�k m�£�- �S - . S �• � t 3 u3 •tw �• S �tR 3ty - Ground S � G>• � S9 yn 1 — .1 � _ �', elev. Depth to limiting factor l-Zoy - I I , --- - I --- -- 7 Remarks: 3oring # ;round ;lev, ft. )epth to imiting actor Remarks: — PLOT PLAN page 3 of 3. SCALE 1 "- 50' ti� c,` r� ti r, z5' �z' ln� i tpct. T�� mot. ga �. S 10 CAMS r 1- -f � s• B.»� a �� LOT l�Lo g.��Ll tn-V Lr 8q-tb \ CAN L IP %e - A _1 5'tYi TI?t�vCS L I S'.:LO>✓G _ w/ 4g- 2°�7 -7y� O A J A4 t - CST Signature Zzo� 5 y 715 4 7,5 - ()1 A s Date Signed Telephone No. CST # tall I Z I I " m-< a o:� to rn �+ ti IS4R�RRg4g94g X T p I v I I ..n..�n.u.a..a :a o 0 0 -TI ^ nsQ I pUJ w � ZZii=MNZNZ=i 21101 "1Z1Z_ -i -no r � � rn rn F zzzizxzzNzii 0- '� G) o � n z —I 0Nm 01 �� \ I�,' / �zn o mono — ;ate = i p�c m m� `.Z� 3�' +fit , � � � / • : \ \ 1 'I L. J � r L E I 01 lit FIT 11 1 ta g Z P .� q Ike IF -!- . �_ � _ I � I< I: �'��a } ����s �� -ilk I � I _ ' gg =$N C l- a� Ag IIE s 1 1A 11 Stij IROMA / TEY 1 d!;Gr f aiWN AQDVTi N a s Q� A$ -jo T ` .-. --1(n (n O r— \ z � : , 66' WIDE INGRESS AND —INGRESS FASZWNT o� SAC_ — — — I -A z ' v 1 � I m Qrl � O 1 QA N 01 °02' 20" E 244.32' ~ 33' 33' I r 4 I - v I - - --- .27' 2070 OD r 1 ~ � ' I aO D - '0 I I Q O N VARIABLE o f 00' n I `C o I I�I� I N%TbTf � _ 1 1 -I Imo► a I I I y w r . Ir1 z I oo cn I N 01 E m' I \ °-' I vl C O - 244.35' L4 ^� y cm I ! TO ' I I 100' 14 D O� l O� O I PD N t O I I I t ,56'L�Z 1 1 I ' M ,.00.000 N 1 I I � mo 1 I WTdTIT °' 1 z 34, OD h3 co zo CD Ic�l�l z 100' P�� m \ �� I V I ° I 1 s I Ul a I ^IC I �' A po > >, �, /� � \ � ,, ��g j� \�\ \♦ \�/ IV J I o2 IC�it I I 1~ � �, Q) I ;' � O i °D U , �♦ X 9 \ \ 1 / N � Sc (n ,t `\ 220 \ , 7 ION CA o 0) 1 CD z . m 6 I I rn 1 � g 1 6' �D Cn O I s 04 00' 00" W , -� 312.65' - l0 I� I VI I t IM co u _ 1*1 Q I I 1, G_7 "6 NI Imo' Z VN O Iv,l~ I�II\ O Z I OO cn W bp I / i �_. O0O Nn 1 J V �/ � (,j _a L,m N 00 °3 1' 46" E m I .�� 325.00' OD ' \, I .. I_ - _ RECEIVE[ SEPTIC TANK MAINTENANCE AGREEMENT JAN ► p 2005 ' AND ST. CRUIX COUNT OWNERSHIP CERTIFICATION FORM ZONING OFFICE Owner/Buyer LARRY & SUZAN CO E A N Mailing Address P.O. BOX 25706 WOODBURY, MN 55125 property Address 316 LINDSAY ROAD (Verification required from Planning Department for new contraction) City/State HUDSON, WI 54016 parcel Identification Number PENDING LEGAL DESCRIPTION Property Locatioa SE ' / SE /, Sec. 24 . T 2 8._I -R 20 W, Town of TROY Subdivision TROY VILLAGE - 6TH ADDITION , Lot # 154 Certified Survey Map # _ Volume . Page # Winrnmty Dead # 7 K �k- 3 S ? . Volume 1 7 L ..� Page # !a Spec house 0 yes n no Lot liars identifiable LS yes Q no SYSTEM MAW— —NANCE . . 1wropermseand maintenzaccof yoorsepticsystemeouldresaitiaitspc b - fa&etohaadlewastmPropecmabDenance consists aarpigg out the septic tank every three years or sooner. if needed by a licensed pimape> : What ym put hito the system can affect So £onctim of the septic tank as a treatmat stage in the waste disposal system. Thu propccty ew= agrees to submit to Dew t oet1t5cafi=f0am. Rand by the owner and by a sP -phmubcwjoumeymanphmAmmtestdcwdphmd=orali=sodpwnperveffyingthu(I)lfieon-gitewastvwatcrdiWosdggOcm is in props operating cmditim and/or M after inspection sad pim;mg.(if necessary). the septic tank is less loan U3 tall of sludge- Uwe, due undersigned have read du above requirements and agree to mxintsia the private sewage disposal system with du standards at forth, herein, as set by dw Department of Commerce and tine Deputmaat of Mab=1 Resoamm State of Wisconsin_ Mien stating the your septic r h2a beea maimsined must be completed andrstumod to the Owe vUhin.30 days of thtoe year expiration date— (5 F APPLICANT DATE . PWNER CERT�CATION I (we) certify that all statements on this foan are true to the best of my (oar) knowledge. I (we) am (are) the ownet(s) of the property desc nIed abo by virtue of a warranty deed recorded in Register of Deeds Office. deAfPUCANT DATE « Any information that Is raft4epresentod may result in the sanitary pennit being revoked by flee Zoning Department- •• Include with this application: a stamped warranty dad from Me Register of Deeds office a copy of the ccxtifizd sumy map if reference is made in the warranty diced ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM 74-1 J�11 Owner/Buyer � L �- �0. Mailing Address i ne— Property Address 3 f& L I. n d S a C ct , CL N 14 Ct 0 0 k/.L SY O n _ ' (Verification required om Planning Dep ent for new construction.) VJ4 � City/State , W i s c o n s i n Parcel Identification Number LEGAL DESCRIPTION Property Location S '/4 , ' / 4 , Sec., T ZN R .Z 0 W. Town of r i^ O Subdivision Tr oy V/ 1 gle, Lot #. Certified Survey Map # , Volume , Page # Warranty Deed # 7 01 Volume a-7 , Page # &/ Spec house DO yes ❑ no Lot lines identifiablen yes ❑ no SYSTEM MAINTENANCE Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. The property owner agrees to submit to St. Croix County 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. I/we, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Department within 30 days of the three year expiration date. d' /I / 23 � SIGNATURE OF APPLICANT 1 3 J �� DATE OWNER. CERTIFICATION Uwe certify that all statements on this form are true to t best of my /our knowledge. Uwe am/are the owner(s) of the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. // / 231 p Y SIGNATURE OF APP ICANT DATE * * * * ** Any information that is misrepresented may result in the sanitary permit being revoked by the Zoning Department. * * * * ** Include with this application a stamped warranty deed from the Register of Deeds Office and a copy of the certified survey map if reference is made in the warranty deed. POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page 1 of 2 FILE INFORMATION SYSTEM SPECIFICATIONS Owner /COLEMAN HOM Septic Tank Capacity 1250 ga l ❑ NA Permit # Septic Tank Manufactur ❑ NA o� ! %IESER DESIGN PARAMETERS Effluent Filter ManufacturT ❑ NA Number of Bedrooms 4 ❑ NA Effluent Filter Model A100 ❑ NA Number of Public Facility Units ❑ NA Pump Tank Capacity al ❑ NA Estimated flow (average) 600 gallday Pump Tank Manufacturer ❑ NA Design flow (peak), (Estimated x 1.5) 900 gal/day Pump Manufacturer ❑ NA ` Soil Application Rate • 7 gal/day/fl? Pump Model ❑ NA Started Influent /Effluent Quality Monthly average* Pretreatment Unit Xa4,A Fats, Oil & Grease (FOG) 530 mg /L ❑ Sand /Gravel Filter ❑ Peat Filter Biochemical Oxygen Demand (BOD 5220 mg /L ❑ NA ❑ Mechanical Aeration ❑ Wetland Total Suspended Solids (TSS) 5150 mg /L ❑ Disinfection ❑ Other: Pretreated Effluent Quality Monthly average Dispersal Cell(s) ❑ NA Biochemical Oxygen Demand (BOD <_30 mg /L [Yln- Ground (gravity) ❑ In- Ground (pressurized) Total Suspended Solids (TSS) 530 mg /L ❑ NA ❑ At -Grade ❑ Mound Fecal Coliform Igeometric mean) 510 cfu /100ml ❑ Drip -Line ❑ Other: Maximum Effluent Particle Size Y in dia. ❑ NA Other: RCI�JA Other; WNA Other. 4CNA i "Values typical for dorre stir wastewater and septic tank efflwnt. Other' AifNA MAINTENANCE SCHEDULE Service Event Service Frequency Inspect condition of tanks) At least once every: 3 months) ❑ NA {� ear(s( Pump out contents of tank(s) When combined sludge and scum equals one -third (Y) of tank volume ❑ NA Inspect dispersal cell Y s) At least once every: 3 ❑ ear(s)(s) ❑ NA Clean effluent fitter At least once every: 1 -2 ❑ m onth � e ar(s) l ❑ NA ❑ month(s) ❑ NA Inspect pump, pump controls & alarm At least once every: ❑ year(s) ❑ month(s) ❑ NA Flush laterals and pressure test At least once every: ❑ year(s) Other; C month KNA At least once every: p year(s) Other: qQL.NA 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) f l 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 tank(s) 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 cell(s) 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; tat; 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: • 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 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. N� T r I i evaluation mus a pe or t o e r p a ❑ Mound and at -grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time. < <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 Named Name FEATHERST Phone _ 1- ?©r(� Phone 715- 381 -1704 El SEPTAGE SER VICING OPERATOR (PUMPER) LOCAL REGULATORY AUTHORITY Name PINKY'S Name ST. CROIX CO. Phone 651 -436 -5788 Phone 715 - 386 - 4 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. i I U 2 7 1 3 P 6 1 5 71323 - 7 KATHLEEN H. WALSH REGISTER OF DEEDS STATE BAR OF WISCONSIN FORM 2 - 1998 ST. CROIX Co. MI WARRANTY DEED RECEIVED FOR RECORD Document Number 12/13/2004 01:00P11 lj This Deed, made between _. WARRANTY DEED EXEMPT # �j Troy Development Corporation, a Minnesota Co rporation REC FEE: 11.00 Grantor, TRANS FEE: 329.70 it and Larry A. Coleman and Suzanne M_ Coleman, COPY FEE: Husband and Wife CC FEE: PAGES: 1 !I Grantee. Grantor, for a valuable consideration, conveys and warrants to Grantee the following f� described ro X - --at _ta a isconsin: .- Tro g Recording Area j' zot 154 of the Plat of Villa 6th Addition in the Town of Troy, St. Croix County, Name and Return Address consin. La y A. & Suzanne M. Coleman P. Box 25706 Subject to Declarations of Covenants, Conditions and Wotabury, MN 55125 Restrictions for Troy Village, recorded in Vol. 1241, Page 256, as Doc. No. 559964, and the Declaration of 1gl.,i' Golf Course, Covenants, Conditions and Easements, et r ecorded in Vol. 1241, Page 301, as Doc. No. 559969, all as appearing in the office of the Register of Deeds Part of 040 - 2251 -90 -200 i for St. Croix County, Wisconsin, and such other Parcel Identification Number CiN) easements, restrictions and reservations of record, This is not homestead property.I or in use, and the "Buyer" obligations contained in (is) (is not) .I I the Purchase Agreement for this lot. �i r Exceptions to warranties: Dated this 8th day of December 2004 `i _ (SEAL) (SEAL) ichard Halu tz Vice-President 4 Troy Development Corporation ii (SEAL) _ (SEAL) , r r AUTHENTICATION ACKNOWLEDGMENT �f Signature(s) !_ Minnesota .; State of L5r>fse-o•rrstrr, � l Anoka Countyy. �I authenticated this day of , Personally came before me this Sti1 day of December 2004 , the above (tamed is ar Ha uptzok, Vice - President Troy DeveloFanent Corporation TITLE: MEMBER STATE BAR OF WISCONSIN to j) Of not, me known to be the person who executed the foregoing authorized by 5706.06, Wis. Stats.) iratrvment and acknowledge the same. I; THIS INSTRUMENT WAS DRAFTED BY ` � �a.� TROY DEVELOPMENT CORPORATION . David F. Lamers j i NotaryPubllc , sr-ta.et- Wtseos+6la.Anolca County, Minn. ;I Charles S. Cook, President My commission is permanent, (If not, state expiration date: li (Signatures may be authenticated or acknowledged. Both are not January 31 2009 ) necessary.) F :f t • Nunes or persons signing In any rapulry roan be typed or printed below their signature. � ii STATE BAR OF WISCONSIN Wlsaonaln L I Blank Oo.. Ina. WARRANTY DEED FORM No. 2 - 199B Mswwkse. Wk. DAVID F. LAKIM NORWPLU0•80868M wa•++•ar.�s.sw SKETCH PLAN for C0LE11MAN HOMES, INC. ❑ Denotes Wood Stake Set For Excavation Only Denotes Surface Drainage ( ) Denotes Proposed Elevation X Denotes Existing Elevation 900.4 Top of Block Elevation Scale: 1" = 40' 900.0 Garage Floor Elevation O Denotes Iron Monument 891.6 Lowest Floor Elevation Type of Building: A Wood Frame House No title commitment was provided for this survey, therefore, there may or may not be easements or encumbrances that are not shown on this survey. Building to be field staked at a later date. Proposed grades and contours must be field ALL BUILDING DIMENSIONS verified prior to construction. AND FLOOR ELEVATIONS MUST BE VERIFIED BY BUILDER. .p * i i 'o JIG / / / I � IP ((/ / s ue• \ Z6 / Proposed t90Q0), / 891.8 �`b House I I 9orage ( ) ro r \ -1 0/ i Proposed 2' i ti `br \ a 22.87' v; 8988) \ / I (899.7) ( \ I i O / � � ° /(� /'� •— "Foot Setback Une 7. 2384' Y S8453'49 "W X89 gig I C tenet/ \ 1 4 r C E tn h'a dV� Y1 / em ei 41 Cool rapid NIN SURV Lot 154 ,'II1��3gRW74��� TROY VILLAGE SIXTH ADDITION, St. Croix County, Wisconsin. l hereby certify that this survey, plan or report was prepared by me or under my direct supervision and that ! MIDWEST am a duly Licensed Land Surveyor under the laws of the State of Wleconsln. and Land S & Civil Engineers, In c. No certlikotion whatsoever Is extended to subsequent owners, mortgagees or title Insurers, unless this survey has been redated for this purpose by the surveyor. 710 East River Road Doted tat da of December , 2004. Anoka, Mn. 55303 Ph. 763 - 712 -9099 Fox:. 763 - 712 -9055 By Registration Na S -1850 Job No. 04414. •Book -Page OCF Acad File 04 -414 R odney vorson – Wisconsin Licensed land Surveyor Asbupt Dated this day of -20— ©2004 – Midwest Land Surveyors. d: Civil Enginesm, Ina – All Rights Reserved