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Home My WebLink About040-1242-30-000 C c ° c O v � I o I I N n O r � I I 0 Z a C Z L (p lL C ! O_ Q 3 `* o Z iri E o-, w O o L Z 00 0 d m 04 cwn ! a m o zv' N H CD *+� S o I � o 0 0 o C 2 U N N U w O O !' Q Q ..... N N I O Q Z Z O Z O O N � E O C .. CL '�o � o � N 0) c " G G d E E •� y n `n O O O a H w 3 a a a "'i a � o co 00 in J U - 0 0 0 rn rn Ay = co ao 73 0 0 O N O O N J O O .� 3 \ 1:33 0 r U) `� • _ ti d Q � c1? ro ! LO o -o E O o 0 0 p M O 0 N c c,7 Q. O O O ]' Lr N r 3 2 0 E - c '0 N N N V °'°°;� G� N a N N O N O 00 C CU -0 0 -0 `mac r O t1y I�1 N • Y, v m o 0 o 0 0 L) 0 o I- ! O c) o Z_ Z d' cn O . w w E � E m M CL CL w • a. d 0 a y o R � 3 is o' A U a 2 0 N c) Wisconsin Department of Industry SOIL AND SITE EVALUATION REPORT Page 1 — of _ Lahr ano Human Relations Di lion of Safety &Buildings in accord with ILHR 83.05, SIT��GQde Oo' / COUNTY Attach complete site plan on paper not less than 8 1/2 x 11 inches in s' p,, n mustlude, 8t • Croix not limited to vertical and horizontal reference point (BM), direction a f slo PARCEL I.D. # dimensioned, north arrow, and location and distance to nearest road t `` ' pending APPLICANT INFORMATION PLEASE PRINT ALL INFORM k N , -,, - ,-VIEWED BY TE PROPERTY OWNER: PROP 1`Y ATION Richard Stout ` GOa(T� 1 /(SE 1/4,S 3 T 28 ,N,R 19 { (or) W PROPERTY OWNERS MAILING ADDRESS � # BLOC K# ' SSUJRD. NAME OR CSM # 1353 Awatukee Trl. 7� p na Wood second Addn. �H'son WI. 5416 (715) 549-6731 ❑ Troy GE [x]fOWN NEAR D Tower Rd. (�] New Construction Use (xJ Residential / Number of bedrooms 3 [ ] Addition to existi building j J Replacement [ ] Public or commercial describe Code derived daily flow 450 gpd Recommended design loading rate _IW ed, gpd /ft trench, gpd/ft Absorption area required XIP bed, ft 375 trench, ft Maximum design loading rate gi bed, gpd /ft • 2 - trench, gpd/ft Recommended infiltration surface elevation(s) 103.00 ft (as referred to site plan benchmark) Additional design / site considerations system el. based onacontour line of el. 102.00 , Parent material limestone uplands Flood plain elevation, if applicable na ft FU = Suitable for system CONVENTIONAL MOUND IN- GROUND PRESSURE AT -GRADE SYSTEM IN FILL HOLDING TANK = Unsuitable for s stem ❑ S ®U ®S ❑ U ❑ S ®U ❑ S �7 U ❑ S [2 U ❑ S CCU SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Botxtdary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench 1 - 2 14 -28 10 r4 4 none sicl 2msbk mfr C4W if •4 .5 Ground 3 28_ elev. 102. ft. Depth to limiting factor 38" Remarks: Boring # 1 0 -1.2 10 r cpl_ mfr 2f Ground 3 32 -82 7. a elev. 10 ft. Depth to limiting factor +82 Remarks: CST Name: Please Print Phone: Gar L. Steel -,- Address: r T , Signature: Date: CST Number: 25�IA� 8 - - r1 STEEL'S SOIL SERVICE Gary L. Steel Richard Stout 1554 200th Ave. CSTM2298 SE4SE4 S3- T28N -R19W New Richmond, WI 54017 MPRSW 3254 Town of Troy (715) 246 -6200 t lot #74- Country Wood Second Addn. N 1 =40' EM-= top of SW lot corner stake el. 100 N �YI / N 00 Y � Gary L. Steel 8 -14 -96 J ST. CROIX COUNTY ZONING DEPARTMENT - • AS BUILT SANITARY REPORT Owner fk _ q Address TV 1 11 �' �:f t 7 o �9 City /Stat ' S?,urRUx Legal Description: Lot Block Aa W Subdivision/CSM # Sec. ,�, T .0 2& N_R Zf Town of PIN # 0Lt - I 2 - 3 p p IR �k . Aq. lei. 12-3 SEPTIC TANK -- DOSE CHAMBER -- HOLDING TANK INFORMATION: Tank manufacturer iesp4' Size ST/PC Setback from: House / , - - Well Pump manufacturer �' Model fl'o S - Alarm location (HOLDING TANKS ONLY) Setbacks: Service road Vent to fresh air intake Water Line Meter location Alarm location SOIL ABSORPTION SYSTEM: z Type of system: Width Length /fin Number of Trenches l Setback from: House / y - Well 14 7 ' P/L i 7 - Vent to fresh air intake ELEVATIONS Description of benchmark %p a,- I' Ar4 A � t ' �,� �, u Elevation -`o° Description of alternate benchmark Elevation Building Sewer ST/HT Inlet �'y S"3 ST Outlet PC Inlet PC Bottom 86) a5 Header/Manifold / �;4 Top of ST/PC Manhole Cover Distribution Lines Bottom of System Final Grade () () ( ) Date of installation Permit number .3 /,S�arZ State plan number Plumber's signature c License number ��Z ?y Date Inspector Complete plot plan Or Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Coun 'Safety and Buildings Division . CROIX INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Sanitaty tit, �lo.: Personal information you provice maybe used for secondary purposes [Privacy w, s.15.04 (1)(m)]. 31 Permit Holder's Name: ❑ Cit ❑ Villag ❑ Town of: State Plan ID No.: UNLAP, MIKE TROY CST BM Elev.:- Insp. BM Elev.: BM Description: Parce ld410,91234-00-000 1 V O 4, 1 yo A r TANK INFORMATION ELEVATION DATA A9800238 TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic �/�/ GSA.✓ 125D Bench o i; era loa.�F(o ! ors Dosin tow•lo1nA, 757 girn 3.7 cit> Aeration _ _ Bldg. Sewer Ho Ing il.� Inlet I ?7-82 'Rq, q TANK SETBACK INFORMATION St /14f Outlet TA K TO P/ L WELL BLDG. Airi to ntake ROAD Dt Inlet Air I PA eration 4 t561 (e 01 3 � NA Dt Bottom NA Header /Man. eq� 2•"t jo0 g N Dist. Pipe 3,3y 3.2-1 /D D. y Holding Bot. System 1 0 , PUMP/ SIPHON INFORMATION 3 W1 Final Grad Manufacturer Demand 54, 1 :1r Model Number D� d2 GPM Q M - 7,2t �f'(r -D 1 TDH Lift2p,'7I Lrictionl �— System, t- TD I �. t Forcemain Length ! Zp Dia. ..p [ Dist. To Well SOI SORPTION SYSTEM BED NCH Width Length No. Of Trenches PIT No. Of Pits Inside Dia. Liquid De th MEN I N S Id DIMENSION SYSTEM TO P / L BLDG WELL LAKE /STREAM ILEA C G Manufacturer: SETBACK CHA ER INFORMATION Type O , Model er: System:}DL� 1'1 1 CAI 1 0-7 � - OR UNI i DISTRIBUTION SYSTEM �-i -►r Header/Manifold Distribution Pipe(s) x Hole Size x H I S acing Vent To'p3 Intake Length T Dia. Length Q'S Dia. Z Spacing Ylf s SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over Depth Over xx Depth Of xx Seeded/ Sodded xx Mulched Bed /Trench Center It y Bed/ Trench Edges ) ' Topsoil 67 n Yes ❑ No es ❑ No COMMENTS: (Include code discrepancies, persons present, etc.) 3,8 a1g.'1&T LOCATION: TROY 3.28.19,SE,SE 540 TRILLIUM LANE - COUNTRYWOOD LOT 74 C r4it'vilk i V `- 3,to-7 _r q$.1 Plan revision required? ❑ Yes U/No Use other side for additional information." SBD -6710 (R.3/97) Date Inspector' Signature C Safety and Buildings Division *6consin SANITARY PERMIT APPLICATION 201 B Washington Avenue Department of Commerce In accord with ILHR 83.05, Wis. Adm. Code Madison, WI 53707 - 7302 • Attach complete plans (to the county copy only) for the system, on paper not less County than 81/2 x 11 inches in size. • See reverse side for instructions for completing this application State Sa:�l nit Nurfi Personal information you provide may be used for secondary purposes E] Check it revision to previous (Privacy Law, s. 15.04 (1) (m)]. State Plan I.D Nu mbe r I. APPLICATION INFORMATION -PLEASE PRINT ALL INF RMATION / Property wne Name Propert Location AeA- S 1/4 1/4, S 3 Tag , N, R (or) Property Owner's Mailing Address fir Lot Number Block Num City, to Zip C e Phone Num Subdivision Name qr CSM Number II. YP F B ILDING: (check one) ❑ State Owned Nearest Road Public 1 or 2 Family Dwelling - No. of bedrooms o ro ws o f III BUILDING USE (If building type is public, check all that apply) Parcel Tax Number(s) �/ 1 E] Apartment/ Condo b — f�37 DO 2 ❑ Assembly Hall 6 ❑ Medical Facility/ Nursing Home 10 ❑ Outdoor Recreational Facility 3 ❑ Campground 7 ❑ Merchandise: Sales/ Repairs 11 ❑ Restaurant /Bar /Dining 4 ❑ Church/ School 8 ❑ Mobile Home Park 12 ❑ Service Station / Car Wash 5 ❑ Hotel / Motel 9 ❑ Office/Factory 13 ❑ Other: specify IV. TYPE OF PERMIT: (Check only one box on line A. Check box on line B, if applicable) A) 1 M New 2 ❑ Replacement 3. ❑ Replacement of 4. ❑ Reconnection of 5. ❑ Repair of an - ___!__System ________System _____________ Tank Only______________ Existing System - --------- Existing System B) ❑ A Sanitary Permit was previously issued. Permit Number Date Issued V. TYPE OF SYSTEM: (Check only one) Non- Pressurized Distribution Pressurized Distribution Experimental Other 11 []Seepage Bed 21 MMound 30 ❑ Specify Type 41 ❑ Holding Tank 12 ❑ Seepage Trench 22 In- Ground Pressure 42 ❑ Pit Privy 13 ❑ Seepage Pit 43 ❑ Vault Privy 14 ❑ System -In -Fill VI. ABSORPTION SYSTEM INFORMATION: 1. Gallons Per Day 2. Absorp. Area 3. Absorp. Area 4. Loading Rate 5. Perc. Rate 6. System Elev. 7. Final Grade Required (sq. ft.) Proposed (sq. ft.) (Gals/day /sq. ft.) (Min.. /i ch) /2 Elevation 6� � 1 .3/ /�� 77" Feet d Z..3 Feet VI1. TANK Capacit in g all o ns Total # Of Prefab. Site Fiber- Exper. INFORMATION Gallons Tanks Manufacturers Name Concrete Con- Steel glass Plastic App New Exist in structed Tanks Tanks Septic Tank or Holding Tank =7-0 / ie4ek- ❑ ❑ ❑ ❑ ❑ Lift Pump Tank /Siphon Chamber '750 rjQ aSO ❑ ❑ I ❑ I ❑ 1 ❑ VIII. RESPONSIBILITY STATEMENT I, the undersigned, assume responsibility for installation of the onsite sewage system shown on the attached plans. Plum is Name: (Prin - Plumb is Signature: o Stamps) MP a Business Phone Number: Itk.� 7 7Z -- 9:;2Ae Plumbe s Address (Street, City, State ip Code): IX. COUNTY / DEPA RTMENT USE ONLY ❑ Disapproved Sanitary Permit Fee (includes Groundwater D ate Issue Issuing A ent Si ature ( Sta s) Approved ❑ Owner Given Initial Surcharge Fee) �/ (O Adverse Determination � l —� X. CONDITIONS OF APPROVAL / REASONS FOR DISAPPROVAL: SBD- 6398 (R.11/97) DISTRIBUTION: Original to county, One copy To: Safety & Buildings Division, Owner, Plumber Safety and Buildings 2226 ROSE ST LA CROSSE WI 54603 -1905 isconsin Tommy G. Thompson, Governor Department of Commerce William J. McCoshen, Secretary June 09, 1998 CUST ID No.226524 ATTN: POWTS INSPECTOR ROGER L TIMM 3128 20TH AVE WILSON WI 54027 RE: CONDITIONAL APPROVAL Transaction ID No. 82132 APPROVAL EXPIRES: 06/09/2000 SITE: Site ID: 8776 St. Croix County, Town of Troy NEIA, SE1/4, S3, T28N, R19W MIKE DUNLAP FOR: Description: MOUND Object Type: POWT System Regulated Object ID No.: 22016 The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The following conditions shall be met during construction or installation and prior to occupancy or use: • A Sanitary Permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.135 and 145.19, Wis. Adm. Code. • 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(d), Wis. Stats. A copy of the approved plans, specifications and this letter shall be on -site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of construction /installation/operation. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. When making an inquiry or submitting additional information, please refer to Transaction ID No. in the regarding line. Sincerely, t e DATE RECEIVED 06/05/1998 FEE REQUIRED $ 180.00 &ERARD M SWIM, POWTS PLAN REVIEWER FEE RECEIVED $ 180.00 Integrated Services BALANCE DUE $ 0.00 (608)785-9348, MON - FRI, 7:15 AM - 4:00 PM JS WIM @COMMERCE. STATE. WI.US Mike Dunlap - Mound RECE�V ED Transaction # 82132 JU N _ 5 1998 SAFETY & 13 DGS. Dlv Location: SE 1/4, SE 1/4, Sec. 3, T 28 N, R 19 W Town: Troy County: St. Croix Date: June 9, 1998 Owner: Mike Dunlap Address: 3217 York Drive Woodbury, MN 55125 Plumber: Roger Timm Signature: - --- ' License # MPR 226524 Attachments: 6748 -Plan Review Application SBD 8330 page 1: cover 2: calculations 3: plot plan 4: system cross section - 5: plan view, lateral detail 6: pump tank exit detail 7: pump curve page 1 of 7 pO•WT.S �onditionu A f 4ERT O O VED dly p DEPARF C lV1SION U FET AND B RCE NGS S EE CORRESP ENCE �"�� System Calculations One family residence bedrooms Loading rate x gallons /sq ft per day Depth to grougd water >.- Z6 in Depth to bedrock �' in Cross slope tO % Force main length 1 ft of Z in Manifold /header length N ft of in Drainback Z 2.1 gallons Lateral length t @ q ' T ' o ft of in Lateral elevation lo-013 ft (bottom of pipe) Lateral hole size �` ' in @ �'"'° in ( 5' o f t) spacing Z� holes /lateral, ° holes total Lateral volume ' gallons Total lateral discharge rate �'�'� gpm @ ft head Elevation difference ft Friction loss ' ft @ L� gpm Total dynamic head ZI ft Pump /sibn gpm @ 2L ' ft of head Manufacturer C� aWA ' Model # Dose volume gallons W ; � a, t sa'o - ' C.a Lift /sioon tank gallons Septic tank , gallons Measurement pump on & off �' `� in Height alarm from tank bottom 19 '� in Reserve capacity 4 �'� + gallons calcs page Z of b f n J cic 't o (• i " J= Z. �^ r' k i:Z3 9 f.4" ,n o f Ci C O a ° � o 3 ,P g =J ,- CA s o \ 3 �4 -i ,-4 a cl pi .� �► -� ` J S }t.•�► C �o 1 L L V: ova a I O 1 1 0 \ 1 lo ss Av per. 9, � • b ` o q � WOW .• G 2s�g I N 4 L Mi " Z!;. K , 121.4' x: ��1. S T a. Qr�,.,q, Zo. �..: V' � 1 4 _ 't' o� .mil � .�e,� 1 s�.:.... }0 1 }: ` _.S1 S"%Pd.1�a.. �..�.L YJo o of �r•c1� 4� zs 2 . T Spa•« o. o � r o�.� `� 9 4 i / t • /g' Y►�1 �'� O� 1 aT 41r� 4�.�►`i��1► `O \•�Oti. l:�+t � b 0. 0�� 0 . wY S,'O, MASH .- WEATIIERPR00F 1=10 MG COVER JUNCTION �t 4�iln'A+ A�08E�!. p1►ItIC D��ts��tacT --� 4" C.T. tM ��t61IdI --.� i &,o % j— I N T.. PIPL s' ,[TO Nolbsuauo VENT 1SE Ww M4NU01 - K MIN. �4A6if "wtcv � Zq • to �I/ROVSO� A c.z. KET terra WFLES SAL I. P c i I .,�- ON - W tp�szyso. *wECT10Mi 1 T ,' ,. c I E.0 44 pyKp . Co AiCRET'� C � 6coCK SEPTIC _ SPECIFI'CATI OWS O DOSE l+J ; ••tom..- �� TAWAS MAIJUFACTURER: WUMbER OF DOSES: PER DAU TAAJK SIZE. %%ro - ,+T\:) GALLOWS DOSE VOLUME ^� ALARM MANUFACTUILEW J 1 \a,',' INICLUDIAIG 5ACKI 1 }� GALLONS MODEL AIUMPER: I ° N `'`� CAPACITIES: A = Z9 IWCAES OR � b� -S GALLOWS SWITCH TUpt: M..II�.G►r y "` 5. z• INCHES OR � GALLOWS PUMP MANUFACTURCR: GO " C" 11.E IucHES OR 1�g WALLOWS MODEL MUMOER: I `� tS� D• INCHES OR �' }Z GALLOWS SWITCH TAPE: V- " 404° v NOTE: PUMP AWD ALARM ARE TO OE MINIMUM DISCKAIt" RATE � GPM INSTALLED OW 5EPARATE CIRCUITS VERTICAL DIFFERENCE 6ETWEEW PUMP OFF AUD 013TRIbUTI01J PIPE.. FEET I + MIU114UM NETWORK SUPPLY PRESSURE .... ..... . . 2.5 FCCT ♦ FEET OF FORCE MAIN X I � ` F /pprEFRICTIOW FACTOR. (._. FEET quo-•► e UO TOTAL DYNAMIC. HEAD = ZI•'�4^ FEET ;LIQUID DEPTH IIJTERIJAL. DIMEIJS10Wi OF TAAJK: LEW&TH `� ;WIDTH 9 4g • t'a� -� _6 vF �-� M ODEL 1 MO Vertical • Pump i GOULDS � " 4 , Pump Specffic Ons T />tHP METERS FEET Up to 40 GPM ' MODEL: 3871 Discharge size 1'/." NPT • 30 Solids: �•" maximum 6 Motor 7 Single phase: 115V 6 20 Materials of Construction C 6 Brass/thermoplastic 15 � � EPOS Features and Benefits 3 10 •Top suction eliminates impeller clogging. 6 EPO6 • Corrosion resistant construction. ° Q 10 20 w .° w La w • Float actuated switch. 0 2 . 6 • 10 ;z Xft CAPACITY METERS FEET ' MoDELaFtPO3 Pomp Specifications Features and Benefits '/m and % HP • EPO4 impeller- semi -open design 6 20 ,. Up to 60 GPM with pump out vanes to protect 6 16 Maximum head to 32' mechanical seal., ' €Ia.` Discharge size V /:" NPT • EP05 impeller - enclosed design 3 10 Solids:' /." maximum for improved performance. 0 Y • Rugged glass-filled thermoplastic 6 All motors feature ball casing and base design provides 0 o bearing construction. superior strength and corrosion o • 10 16. 10 26 a° 1 .o u. :.w resistance. o i ; c e Iwo phase: 115V . Cast iron motor housing for CAPACm Materials of Construction efficient heat transfer, strength, Cast iron and durability. Thermoplastic . Corrosion resistant threaded Stainless steel stainless steel shaft. • Available for automatic and manual operation. • CSA listed models available. All Models are designed for continuous ration and feature stainless steel hardware. o Wisconsin ctepartmentofCommerce .SOIL AND SITE EVALUATION Page I of 3 Divisirm of- Safety and Buildings 1n aoi* Comm 83.05, Wis. Adm. Code I � 7 Attach complete site plan on paper not less than 6% x 11 incheg in i z _ e. Plan must Coun include, but not limited to: vertical and horizontal reference point (BM), direction and St. Croix percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D.# _ 7 APPLICANT INFORMATION - e3irs print ali information. �o / 7.47 - 3 Personal information you provide may r secondary purposes (Privacy Law, s. 15.04 (1) (m)). R e By D Property Owner ,. �,: ` € , Property Location Dunlap Mike t l Govt Lot SE 14 SE 1/4 S 3 T 28 N,R 19 W Property Owner's Mailing Addr#W Lot # Block # St>bd. Name or CSM# 3217 York Drive _ 74 Country Wood, Second Addition City l>4fe. Zip CiOd� r, phone umber ; El City Village ®Town Nearest Road Woodbury MN of Listed Troy Z New Construction Use: i otial { Number 6 ' f bedrooms 4 []Addition to existing building ❑ Replacement 1aArrlercial describe Code Derived daily flow 600 gpd Recommended design loading rate .5 bed, gpd/W .6 trench, gpd/ft' Absorption area required 1200 bed, ff 1000 trench, fe Maximum design loading rate .5 bed, gpdff .6 trench, gpd/ft= Recommended infiltration surface elevation(s) 99.8 ft (as referred to site plan benchmark) Additional design / site consideration . nstall 5' x 100' rock led mound on 98.8 as upslope edge of rock w/ V sand fill _ t Parent aterial loess ove r limestone Flood plain elevation, if a licable NA ft e for system Conventional Mound In -Ground Pressure AT -Grade System in Fill Holding Tank able for system El ®U ® S El U ❑ S ®U ❑ S ®U ❑ S ® U ❑ S ® U SOIL DESCRIPTION REPORT Depth Dominant Color Mottles Structure GPD/ft Boring# Horizon in Munsell Qu. Sz. ConL Color Texture Gr. Sz. Sh. Consistence Boundary Roots Bed T rench 1 1 0 -6 10YR 3/3 - sil 2 f sbk ds cs 1 f/m .5 .6 2 6 -14 7.5 YR 4/4 - sl 2 m sbk mvfr cs if .5 .6 Ground 3 14 -30 5YR 4/4 - sl 1 m sbk mvfr cs if .4 .5 elev 97.3 it 4 30 -44 2.5Y 6/6 - scl 0 m mfi cs - NP .2 Depth to 5 44+ LSBR limiting factor 44" Remarks: occasional gr below 6 "• LS frags below 30 "• BR is greater than 50% rock w/ some scl ................. 2.....' 1 0 -5 10YR 3/3 - sil 2 f sbk ds cs If/m .5 .6 2 5 -22 l 7.5YR 4/4 - sl 2 m sbk mvfr cs if - .5 .6 Ground 3 22 -26 5YR 4/4 - sl 1 m sbk mvfr cs if .4 .5 elev 96.6 ft 4 26 -45 5YR 4/4 f2d 7.5YR 5/3 sl 1 m sbk mvfr cs - .4 .5 Depth to 5 45+ 2.5Y 6/6 - scl 0 m mfr - - NP* o. Z limiting factor 26" Remarks: CST Name (Please Print) Signature: Telephone No. Henry F. Grote 715 -665 -2681 Address P.O. Box 57, Knapp, W1 54749 Date CST Number Ref# 5/5/98 222774 288 MI No b Of 4 ft- N cr �- -� i a C o Nr J G � e � a ,�� 8 rj� s 4 'A fj -� 90 o � o 2 Viiscon'sin Department ofCommerce SOIL AND SITE EVALUATION Page 1 of 3 Division of Safety and Buildings r 83 an Wis. Adm. Code Attach complete site plan on paper not less th e. ran must County include, but not limited to: vertical and horizontal re eren in M), d and St. Croix percent slope, scale or dimemsions, north arrow, and location and distance to nearest road. Parcel I.D.# APPLICANT INFORMATION - Please print all infonlnation. 10 1 Z`1-1- ^ 3 v Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Reviewed By Date Property Owner Property Location Dunlap, Mike Govt Lot SE 14 SE 1/4 S 3 T 28 N,R 19 W Property Owner's Mailing Address Lot # Block W l gubd. Name or CSM# 3217 York Drive 74 Country Wood, Second Addition City State Zip Code PhoneNumber ❑ City ❑ Village ®Town Nearest Road Woodbury, MN 55125 Not Listed Tro ❑ New Construction Use: ® Residential / Number of bedrooms 4 ❑Addition to existing building ❑ Replacement ❑ Public or commercial describe Code Derived daily flow 600 gpd Recommended design loading rate .5 bed, gpd/fF 6 trench, gpd/ft' Absorption area required 1200 bed, fF 1000 trench, ftr Maximum design loading rate .5 bed, gpd/fts .6 trench, gpd/f ! Recommended infiltration surface elevation(s) 99.8 ft (as referred to site plan benchmark) Additional design / site consideration4 5' x 100' rock bed mound on 98.8 as upslope edge of rock w/ V sand fill Parent material loess over limestone Flood plain elevation, if applicable NA ft S= Suitable for system Conventional Mound In Ground Pressure AT - Grade System in Fill Holding Tank U= Unsuitable for system ❑ S ®U ®S ❑ U ❑ S ® U ❑ S ® U ❑ S ®U ❑ S ® U SOIL DESCRIPTION REPORT Depth Dominant Color Mottles Structure GPD/ft Boring# Horizon in. Munsell Qu. Sz. Cont. Color Texture G r. Sz Sh Consistence Boundary Roots Bed Trench l ... 1 0 -6 l 0YR 3/3 - sil 2 f sbk ds cs l f/m .5 .6 2 6 -14 7.5YR 4/4 - sl 2 m sbk mvfr cs If .5 .6 Ground 3 14 -30 5YR 4/4 - si 1 m sbk mvfr cs if .4 .5 elev 97.3 It 4 30 -44 25Y 6/6 - scl 0 m mfi cs - NP .2 Depth to 5 44+ LSBR limiting factor 44" Remarks: occasional gr below 6 "• LS frags below 30 "• BR is greater than 50% rock w/ some scl 2 1 0 -5 10YR 3/3 - sil 2 f sbk ds cs l f/m .5 .6 2- 5 -22 r 7.5YR 4/4 - sl 2 m sbk mvfr cs if. .5 .6 Ground 3 22 -26 5YR 4/4 - sl 1 m sbk mvfr cs if .4 .5 elev 98.8 ft " 4 26 -45 5YR 4/4 f2d 7.5YR 5/3 sl 1 m sbk mvfr cs - .4 .5 Depth to 5 45+ 2.5Y 6/6 - scl 0 m mfi - - NO $ �o • Z limiting factor 26" Remarks: CST Name (Please Print) Signature: Telephone No. Henry F. Grote 715 -665 -2681 Address P-O.' 13ox 57, Knapp, WI 54749 Date CST Number Ref # 5/5/98 222774 288 .• I Mf b O C N cl f - 0 - �- , j 9 r +- ,,, r o 3 r---j o U 4 8 o � �+ 2,z) �/ 0 Sc ` co c/� p ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND O CERTIFICATION FORM Owner/Buyer Mailing Address Property Address I C�- (Verification required from Plan g epartment for new construction) City /State A Parcel Identification Number LEGAL DESCRIPTION _ Property Location %4, '/4, Sec. 3 , T 2 N - R -- !� 7 W, Town of _ / o o Subdivision L'J60CL , Lot # Certified Survey Map # , Volume , Page # Warranty Deed # , Volume , Page # Spec house ❑ yes EJ no Lot lines identifiable X5,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 Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on -site wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. Uwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 days of the thoe year a lion WgXfUn 3T W1VfrdA DATE OWNER CERTIFICATION I (we) certify that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owner(s) of th op�e de ri ab e, b vi a of a warranty deed recorded in Register of Deeds Office. S GNA OF APPL DATE * * * * ** Any information that is mis- represented may result in the sanitary permit being revoked by the Zoning Department. * * * * ** ** Include with this application: a stamped warranty deed from the Register of Deeds office a copy of the certified survey map if reference is made in the warranty deed r Q� m r r -, . , O • o � tD N O OD A � �(� N O \1/ Co O 0 I(1J -n U N g 07 039'07"W I0.I N 29 4.57' I \ m \ 1 1 � ' 02"E .43' � QI - N 41 N E) N ° � v U :0 n ° n M 0 m N \ �n N �� I m -+ N S 00 12'37 "w 958 .55' °� \ 513.55' 220.00' 225.00' 140.00' N N2 OD � w A O O ODD N O v W \� ® O m N m OD �� . N W N W W �� t 0� 0 cn w 0 O �? �.. 0 8 �� Lj N u n 0� D N D 9° OOa l w m O to ;o cn rJ m — N 0� 0 �m ' n N p N ° _ D p m G m N -4 7-1 0? / Ln N \ \ 01 \ N \ ► - goo. ,� � i