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034-1033-20-200
Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Safety and Building Division INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: City Village Township Elizabeth Best TOWN OF SPRINGFIELD CST BM Elev: : p. BM Elev: n BM scription: 6ta I U Iulol TANK INFORMATION - X ELEVATION DATA TYPE MANUFACTU ER CAPACITY Septic Dosing C Aeration 1111"�i TANK SETBACK INFORMATION I Ar�� •�►� I�e�w TANK TO P/L WELL BLDG. WnWbNirinitake ROAD Septic k6 � \ ??-V ?�0' Dosing 7 1 1 ys � 5a Aeration Holding PUMP/SIPHON INFORMATION ,nAucJ• aolt.nt 1l Manufacturer Demand • 60g GPM Model Number % TDH Lift Fricti n ss Sys em Head JTAJ. .$ Ft Forcemain Length ` �So Dia. Dist. to Well 601 SOIL ABSORPTION SYSTEM County: St. Croix Sanitary Permit No: 651275 State Plan ID No: Parcel Tax No: 034-1033-20-200 Section/Town/Range/Map No: 15.29.15.228 F-20 STATION BS HI FS ELEV. Benchmark A BM kLe Bldg. Sewe St/Ht Inlet St/Ht Outlet Dt Inlet Dt Bottom Header/Man. Dist. Pipe Bot. System Final Grade Cover . �•I l •� R 0 - yff BED/TRENCH DIMENSIONSI Width 1 r Length 1 �O1 No. PIT DIMENSIONS 1 No. Of Pits Inside Dia. Liquid Depth SETBACK INFORMATION SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING CHAMBER OR UNIT Manufacturer: Tie Of S stem: "I,, • t5 1 I �o '501 Model Number: DISTRIBUTION SYSTEM Header/Manifold Distribution x Hole Size x Hole Spacing Vent to Air Intake Pipe(s) % 3 A Length Dia Length_!l% Dia Spacing SOIL COVER x Pressure Svstems Only xx Mound Or At -Grade Svstems Only Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil 7 Yes ❑ No ❑ Yes ❑ No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: Inspection #2: Location: 3091 96TH AVE 1.) Alt BM Description =� Y - fie•% i rpe.�• l t GO�+G � � ` 4�`� � Ion,► d Q�-inS 2. � Bldg"1 sewer length 9 = a-� - amount of cover = 70 � � IVA Plan revision Required? ❑ Yes $.No 000 Use other side for additional information. 10 11 5 *Kgz4o__� 1 1) 1 � 4 6 SBD-6710 (R.3/97) Date 66nsepctor's Signature Cert. No. inaustry services uivision %.A)MIL " ' 4822 Madison Yards Way!�x/ co Madison, Wl 53705 Number be filled in by C6.) S P AUG 2 9 Z02'.' Sanitary Permit (to P.O.Box 7162 A# t Madison, W1 53707-7162 r,(A ,X Sa-ev)PPerwit Application State Transaction Numhcr A rV7 In accordance with SPS 383.21(2), Wis. Adm. Code, submission of this form to flic appropriate governmental unit is required prior to obtaining a sanitary permit. Note: Application forms for state-owned POWTS are Submitted to Project Address (if different than mailing address) the Department of Safety and Professional Services. Personal information you provide may be used for secondary purposes in accordance with the Privacy Law, s, 15.04(l)(m), Stats. Parcel # I. Application Information —Please Print All Information Property Owner's N le TV A3 ZC Property Owner's Mailing Address Property Location C17� Ar- Govt. Lot PIN 1/4, SeCtiO ClSte e L T1 Zip Code Phone Number A 15Aq 0()7 _'/4, lle-) ?� I N R E or Subdivision Name 11 Type of Building check all that apply) di I or 2 Family Dwelling - Number of Redroonis l'ot # 11public/Commercial - Describe Use Block 9 -mmm"woomm"o. ❑City of State Owhed - Describe Use ❑Village of CSM Number tlI _16-1:r Town of _.. 100� LZ III. Type of POWTS Permit: (Check either "New" or "Replacement" and othica'ble on line A. Check one box on—line B. Complete line C it applicable.) A. New System 111ieplacenient System [:]other Modification to Existing System (explain) EAdditional Pretreatment Unit (explain) 0Holding Tank In -Ground *t-Grade E]Mound Individual Site Design Other Type (explain) (conventional) C. E] Renewal Before [:]Revisionlahange of Plumber E`ransfer to New Owner List Previous Permit Nurnberand 11ite Issued Expiration IN'. Dispersal/Treatment Area and Tank Information: Design Flow (gpd) Design Soil Ant)lication Rate pd/so Dispersal Area Required (so Dispersal Area Proposed (sf) System Elevation Capacity in Total 4 of Manutacturer Tank Information Gallons Gallons Units U New Tanks Existing Tanks 0a, U V) Septic or Holding "Tank Dosing Chamber 4?"' A V. Responsibility Statement- 1, the undersigned, 1141e,/Sponsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) P I IX4 ign attire MP/MPRS Number Business b Phone N e ""7 Cal PILI'mber's Address (Street, City, yr, Zip Co -1-0,ol -7 woo,/ I. County/Departm6t Use Only 6 Approved 0 Disapproved Permit Fee 0.2 Date Issued Issuing Agent Signature El Owner Given Reason for Denial 45 bo a4ftoj �&g Conditions of Approval/Reasons for Disapproval 00� SYSTEM OWNER: 1. Septic tank, effluent filter and dispersal cell must be serviced / maintained as per management plan provided by plumber. 2. All setback requirements must be maintained as per applicable code / nrdinances. Attach to complete plans for the system and submit to the County only on paper not less than 8 1/2 X 11 inches in size SBD-6398 (R. 03/2 1) Wisconsin Department of Safety and Professional Services Division of Industry Services 4822 Madison Yards Way PO Box 7302 Madison, WI 53707 August 29, 2023 CUST ID NO.: 226900 SHAUN R BIRD 1432 120TH ST NEW RICHMOND, WI 54017 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 08/29/2025 MUNICIPALITY: TOWN OF SPRINGFIELD ST. CROIX COUNTY SITE: ELIZABETH BEST 3091 96TH AVE GLENWOOD CITY, WI 54013 SE1/4 NEl/4 S15 T29 N,R 15 W FOR: Design Wastewater Flow Value: 600 Bedrooms: 4 Limiting Factor(s): 42" Maintenance Required: Effluent Filter �g ARTATL_�,T o %P 10 NP+i-�ti�- Phone: 608-266-2112 Web: http://dsps.wi.gov Email: 612§(L)wisconsinjzov Tony Evers, Governor Dan Hereth, Secretary Identification Numbers Plan Review No.: PWTS-082301878-C Application No.: DIS-082336218 Site ID No.: SIT-120094 Please refer to all identification numbers in each correspondence with the Department. At -Grade Component Manual - Version 3.0 (May 2022- 2027) Pressure Distribution Component Manual - Version 2.1 (May 2022-2027) SITE REOUIREMENTS • A full size 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. A Department electronic stamp and signature shall be on the plans which are used at the job site for construction. The following conditions shall be met during construction or installation and prior to occupancy or use: • Preserve dispersal area prior and during construction to avoid disturbance, compaction and use of the site. • With new construction; it is recommended not to activate the pump in the dose tank until the tanks are pumped prior to homeowner occupancy. • Wastewater generated from contractors cleaning of equipment and tools and/or left over construction products shall not be discharged into the drains discharging to the private onsite wastewater treatment system (POWTS). Waste generated shall be properly disposed of on -site or off site. • Any tall grasses, leaves and shrubs shall be cut short and removed prior to tilling the surface for installation to prevent matting under the dispersal area. All loose organic material to be removed from POWTS Dispersal Area. • Divert surface water from all POWTS Areas. • Prior to construction of the dispersal area, check the moisture content of the soil to a depth of 8 inches. Smearing and compacting of wet soil will result in reducing the infiltration capacity of the soil. 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. • All piping shall conform to SPS Table 384.30-3 and SPS Table 384.30-5 • Insulate building sewer beyond 30 feet per SPS 382.30 (11)(c) • Well setbacks to meet chs. NR 811 & 812 • Tank Installation to follow all manufacture's recommendations. • Verify property line(s) prior to installation. • Pump Floats to be set and verified per approved plan. Any changes may result in pump resizing to meet TDH and GPM Specifications. • .Areas that are occupied with rock fragments, tree roots. stumps and boulders reduce the amount of S011 available for propel - treatment. If no other site is available, trees in the basal area of the mound must be cut off' at ground level. A larger fill area is necessary when any of the above conditions are encountered. to provide sufficient infiltrative area. OWNER RESPONSIBILITIES • The current owner, and each subsequent owner, shall receive a copy of this letter including instructions relating to proper use and maintenance of the system. Owners shall receive a copy of the appropriate operation and maintenance manual and/or owner's manual for the POWTS described in this approval and Wis. Admin. Code 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 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. All permits required by the state or the local municipality shall be obtained prior to commencement of construction/instal lation/operation. 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 scats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. The Division does not take responsibility for the design or construction of the reviewed items. Inquiries concerning this correspondence may be made to me at the contact information listed below, or at the address on this letterhead. Sincerely, Fee Required: $250.00 Fee Received: $250.00 ZW M4424f ,e,t_74 Balance Due: $0.00 Tim Vander Leest Refund Expected: $0.00 POWTS Plan Reviewer Division of Industry Services Phone: 608-516-6134 Email: tim.vanderleest@wisconsin.gov Cover Page Shaun Bird Bird Plumbing Inc. 1432 120th St. New Richmond Wi 54017 715-246-4516 Date: 08/12/2023 Owner: Eizabeth Best Location: S E 1 /4 N E 1 /4 S 15 T29 N, R 15W 3091 96th Ave Springfield Manuals Used: At -Grade Component Manual version 3.0 (May 2022-27) Pressure Distribution Manual version 2.1 (May 2022-27) Page# 1. Cover Page 2. At -Grade Plot Plan 3. At -Grade Cross Section 4. Pipe Cross Section/Pipe Layout 5. Pump Chamber Cross Section 6. Pump Curve 7. Filter Specifications 8.4 Maintance and Contingency Plan Attachmeri_. T_ _' Shaun Birc Signature License ni Page 1 of 9 PROJECT Elizabeth Best System PLAT PLANADDRESS 2378 20th Ave Baldwin Wi 54002 SE 1/4 NE .1 /4 S 15 /T 29 N/R 15 W TOWN Springfield COUNTY ST. CROIX SYSTEM ELEVATION 98.5' 8/12/22 4 DATE BEDROOM CONVENTIONAL AT -GRADE XXX CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1200 gallons LIFT TANK SIZE DOSE TANK SIZE 801 IIOLDING TANK SIZE LOAD RATE .6 ABSORPTION AREA 1040 # of chambers none IL BENCHMARK V.R.P. Top of power box ASSUME ELEVATION 100' filter Lifetime Filter [:]BOREHOLE neWELL * u tD n _qamn ac hanrhmnrLe 20-�5 PROJECT Elizabeth Best System PLAT PLANADDRESS 2378 20th Ave Baldwin Wi 54002 SE 1/4 NE .1 /4 S 15 /T 29 N/R 15 W TOWN Springfield COUNTY ST. CROIX SYSTEM ELEVATION 98.5' 8/12/22 4 DATE BEDROOM CONVENTIONAL AT -GRADE XXX CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1200 gallons LIFT TANK SIZE DOSE TANK SIZE 801 IIOLDING TANK SIZE LOAD RATE .6 ABSORPTION AREA 1040 # of chambers none IL BENCHMARK V.R.P. Top of power box ASSUME ELEVATION 100' filter Lifetime Filter [:]BOREHOLE neWELL * u tD n _qamn ac hanrhmnrLe 20-�5 At -grade System Sloping Site Cross Section and Plan View 11 F W. v? W A 0 J. R." v ve so -*On an a a M a■noun as M., 04M @am a ti ICJA� %as arm a M % % a -t �..t �11 :: �. V. - I'm 16 7■ E 1/6 B MM N 1101" "M E B L Dimension Feet A B 1/6 B Ile— C D 2.0 5.© 0.5 1.0 L _&O W -'7 Id., _Slope:::� I " Plowed Clean aggregate Q 4 in. sch. 40 pvc basal area '/2 to 2 V2 in. dia. observation pipe Lateral with 2" Topsoil Czap aggregate over pipe Geotextile G Observation Pipe Fabric With Car) of son 04%0�s % 0 Ft Lateral Invert Topsoil Cap !ticti' F 0 Avon 11 span Ft Contour e;e;-; D f Plowed Surface Slope Direction GENERAL INSTALLATION: The at -grade area is staked out along the desigri contour. Existing vegetation is mowed and raked off the site. The basal area {I, x W) is staked out and plow'ed with a moldboard or chisel plow. Plowing may not proceed if the soil is wet enough at the plow depth to form a '/,, inch soil wire when a sample is rolled between the palms of the hands. The A x B area is covered by clean aggregate deposited overhead by a ba'ckhoe. . Special care must be used when placing the aggregate to minimize compaction of the plowed surface. After* the topsoil cap is placed, the entire at -grade is seeded and mulched to promote vegetative gr'owtli,' liffift erosion and protect from freezing. The observation pipes are perforated in the lower 6 inches and secured in place. 03/05 lgj `2 Page Of R Pressure Lateral Layout One Lateral — End Manifold Sn' (5 r Ik 4IV,- Distribution Netw rk Specifications Lateral Diameter '2, In. Orifice Diameter L In. X Orifice Spacing) In. L Lateral LengthLengthj Ft. Force Main Diameter In. Force Main Length Ft. �--- Threaded Cleanout Plug L,ong weep 90 rend Pressure System Construction Laterals are constructed of Schedule 40 PVC pipe. Orifices are drilled perpendicular to the pipe with a sharp drill bit and face down. Lateral turn -ups terminate with a threaded cleariout plug and are enclosed in a 6-8 inch diameter lawn sprinkler valve box accessible from finished grade. 03/05 Igj Page 4. . .. 0 — r ..Specificat'ions . k. Cross Section And Pumn Per �'nan. 0 Pump mwiufacturer Tank ,Manufacturer � c e. __._.._ ..�...._...�.._._.._.._.. Model 1umb ' "ank. Model Number Pump er f oture' r lI �'c�tal 'Tank C��pacity : 1,90 _Alarm Manua _ ._�..�. - ..- Alarm Model Number Max. Bury Dcipth. ......_ .,.._. .,. Svritch Type1, lelo, 'Flitter Ma.nufficturer `t Filter Model Number " Minimum Pump ferformance Required —� GPM; Ft TDB Outlet Manhole Min. 4" Above Grade with Looking Device. Inlet Manhole < 6" Below Grade Sealed watertight %%W am MOW NMI "" Finished Grade NMI Outlet Filter Wet Baffle Llawitch Settings and Reserve Capacity Tank. volume Z V GPI Dimension a Inches Volume Gal. (reserve) A: Z 73 (alarm) B 2 (dose) C / 7 5" 9 (dead)_0_5' Total � g Total Dynwnic Head (TDH) - Feet ... Elevation Head 112 — .._._. Distal Pressure Network Loss _. r Force Main Loss r .---.__.._.... Total.s.... Manhole Min. 4" .Above grade � Secu��el Mounted with sacking Device Y Weather-proof Junction Box --- ""� w law op Vent in. l 2" Above Grade With Vent Gap Off Elevation gLl_ L2 Ft a/itaEt+Ilfrttt••s/�rtlitlilttlft/ttltitttitt•rlrlt�art��•�tata�rrat.rtr.a�la..�ra.r •'•'<'1*a'i'a'1'.'.'�'.Xr'•'a?yf• ..►.y.'...L�./rra'a�.',/.'.�.►a'r'rja'r+i'rya'�►•tiltiallifl�al•�a�e�ala�a}��.>a�illlrl�t+���tlt�a►r'r►�14rtIt►r'1'4'fVl'1++'r' Disconnect Means rim 1 te, ►fl t Weep `t t ► •'' ►;t t�1 Hole } 1 Iyst Bottom 61ovation r�l • lai•�•/ 1�t , sl •atrllr I�Ir►•s�.�tlr+r C] Ft i GENERAL INSTALLATION: The septic/dose tank is bedded and haak filled in accordance with the manufacturer's product approval specifications. Maximum depth of bury as speoffied by the manufacturer may not be exceeded without prior 4pprovaia lvlanhote covers exposed to grade have an effective looking device (padlock) installed, Piping at the inlet and 'outlet is of approved material., corinected to the tank with watertight fittings, and 41 laid on stabl1 soil to prevent settling or sagging, The force nutin is sleeved with 4" Sch. 4011VC to abridge the tankexcavation and the sleeve is sealed watertight. Electrical service omplies with NBC 300 and Comm 16.28. 02/05 L.,i' page of 280-SERIES 1/2 hp Submersible Etfluent/Sump Pumps The Liberty 280-Series provides a cost effective "mid- range" pump for on -site waste water systems, liquid waste transfer and commercial heavy-dLity SUMP PUMP applications that require higher head or more flow. Designed around Liberty's unique "Uni-Body" casting, the 280-Series will provide years of reliable performance, All models Feature. * Vortex style impeller permitting passage of solids Lip to 3 /4 o 416 stainless steel rotor shaft * Permanently lubricated upper and lower ball bearing # Epoxy powder coat finish * All fasteners - corrosion -resistant stainless steel 9 11/2" Discharge * Stainless steel bottom screen - easily removable * Maximum fluid temperature: 140" F. ' 280-Series Cord Lengths Model 10' 251(-2) 35' -3 50'(-5L 280 Standard Optional Optional _Optional 281 Standard Optional Optional Optional 283 Standard Optional Optional N/A 287 Standard Optional N/A N/A 10' cord length standard on all models. For optional lengths, add "-2, -.3 or -Y suff Ix to model number. Example: for model 280 with 35' cord, order 280-3 Motor Specifications Y2 hp 60 Hz 3450 RPM Oil filled, thermally protected (PSC) Permanent Split Capacitor 8.0 amps (1 15V) 4.0 amps (208/230V) Model Manual, no switch Model 281 Wide angle float switch with quick - disconnect SSP'0 CERTIFICD C .;Oous Certified Specifications ar© subjoct to chango without notice. 35 30 25 U. 20 15 10 *1 111 9 5 3 2 0 5 J U It) ;4u 40 ov J:J -tv -t�J %av WW W. -- - - U.S. Gallons Per Minute 0 38 78 114 156 192 228 270 Liters Per Minute Dimensional Data: Weight: 29 lbs. Height: 13" Major Width: 10" (model 287) Minimum Sump Diameters: Model 281, 283...1411 Model 287 VMF...l 011 Factory switch- Model 2811 283 Model 2877 tj r: Settings VMF Turn on level 1311 9.511 Turn off level 711 4.011 The Model 283 features a fully adjustable wide-angle float. Differential adjustments can be made easily by tethering the float to the dls- charge pipe or other mounting point. Vertical float model 287 Is not adjustable. Model283 Wide angle float switch with series (piggy -back) plug Model 287 VIVIF-Series Vertical mag- netic float for smaller pits will operate in a 10" diameter Sump Liberty Porn ps •9 7000 Appie Tree Avenue * Bergen, New York 14416 9 Plione soo-543-2550 Fax (585) 494-1839 www.liberlypuniPsXOM Copyright 0 Ubarty Pumps, Inc. 2017 Ail rights renived, LLIT200OR05/17 04-52 M- I Goo between Case and Serpentine A SEECTION A -A 00 9.1 1.17.41 59 M1 11-10WTS OWNER'S MANUAL & MANAGEMENT PLAN Page of FILE INFORMATION Owner Permit # )ESIGN PARAMETERS Number of Bedrooms 0 NA Number of Public Facility Units vq �GA Estimated flow (average) _ - .gal/day I Design flow (peak), (Estimate x 1-5) elide Soil Application Rate Standard Influent/Effluent Quality galMayJA2 Monthly average* Fats,' Coil & Grease (FOG) �30 mg/L Biochemical Oxygen Demand (BODti) �220 mq/L ED NA Total Suspended Solids (TSS) 50 mg/L Pretreated Effluent Quality —:�l Monthly average Biochemical Oxygen Demand (BOD,5) �30 mg/L Total Suspended Solids (T5,5) —<30 mg/L 0 NA Fecal Coliform (geometric mean) �j 04 cfu/1 00MI 'Maximum Effluent Particle Size '� In dia, 0 NA 1Other: I . 0 NA *Values typical for domestic wastewater and septic tank effluent. 1JIAINTENANCE SCHEDULE SYSTEM SPECIFICATIONS Septic Tank Capacity A;[ 0 NA Septic Tank Manufacturer J �-. 0 NA Effluent Filter Manufacturer 4 0 NA Effluent Filter Model 0 NA Pump Tank Capacity al 13 NA Pump Tank Manufacturer 0 NA Pump Manufacturer Pump Model 0 NA 0 NA Pretreatment Unit NA • Sand/Gravel Filter 0 Peat Filter • Mechanical Aeration IJ Wetland El DIsInfection 0 Other: Dispersal Cell(s) 0 NA 0 In -Ground (gravity) 0 In -Ground (pressurized) At -Grade 0 Mound 0 Drip -Line 0 Other: Other: 0 NA Other: EJ NA Other: 0 NA Service Event Service Frequency Inspect condition of tank(s) At least once every: 0 month(s) (Maximum 3 years) 7�eyears ) 0 NA Pump out contents of tank(s) When combined sludge and scurn equals, one-third of tank v6lume 0 NA Inspect dispersal cell(s) At least once every; months) 00� years) (Maximum 3 years) 0 NA lean effluent filter At least once every: At least once every: month(s) 'year(s) months) earls 0 NA El NA nspect pump, pump controls & alarm lush laterals and pressure test At least once every: 0 month(s) j4jearls) 0 NA ether: - sM At least once every: �E] month(s) Cl NA )ther: NA MAINTENANCE INSTRUCTIONS Onspections, of tanks and dispersal cells shall be made ,by an individual carrying one of the following Ilconses or certifications: Master IPlumber; 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 lCombined sludge and scum and to check for any back up or ponding of effluent on the ground surface. The dispersal cell(s) shall be Ivisually inspected to check the effluent levels in the observation pipes and to check for any ponding of effluent on the ground Surface. 'flie ponding of effluent. on the ground surface may Indicate a failing condition and requires the immediate notificatlon of the local I-egulatory authority, When the combined accumulation of sludge and SCLIM in any tank equals one-third (l) or more of the tank volume, the entire contents of I'he 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, land any servicing at Intervals of �l 2 months, shall be performed by a certified POWTS MaIntalner. A service report shall be provided to the local regulatory authority within 10 days of completion of any service 'event. page, of START UP AND OPERATION presence of painting products or other chernicals th"'It For new constructlon, prior to use of the POVV'TS check treatment tank(s) for the pres ntrations are detected have the contents Of thj:! may impede the treatment process and/or damage the dispersal cell(s), If high conce tank(s) removed by a septage servicing operator prior to use. System start up shall not Occur when soil conditions arefrozen at the infiltrative suOace• restored the excess wastewater will bo During power outages pump tanks May fill above normal highwater levels- When eower issuit In the backup or surface discharge of effluenit. discharged to the dispersal cell(s) In one large dose, overloading the cell(s) and may rrator prior to restoring power to this the pump tank removed by et Septage Servicing Ope To avoid this situation have the contents of the pump controls tc restore normal levels effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating area within S over tan within the pump tank, r park over, or Do not drive or park vehicleotherwise disturb or compact, the a tanks and dispersal cells, Do not drive o 15 feet down slope of any mound or at -grade soil absorption area, 3 the performance and prolong the life of the POWT:�"* elimination of they from the wastewater stream may improve # fat; foundation dralin 110�5, diaper** .disinfectants; Reduction or condoms, coijon gwnhg,, dAarnsers', dental I 'i; palwlg produclig" antibiotics; baby wipes; cigarette butts; con peelings; gasoline-, grease; herbicides', meat scraps; medications; ol (surnp pump) water; fruit and vegetable P Pesticides; sanitary napkins-, tampons-, and water softener brine. is propel"lY ABANDONMENT llowlng steps shall be takers to insure that the system When the POWTS fails and/or is permanently taken out of service the fo .33, Wisconsin Administrative Code: and safely abandoned in compliance with chapter Comm 83 • 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. and the void space filled with soil, • After pumping, all tanks and pits shall be excavated and removed or their covers removed gravel or another inert solid material. to provide a code cornpllilint CONTINGENCY PLAN bnor must be taken, if the POWTS fails and cannot be repaired the following measures haveee, replacement systern'. ent area has been evaluated and may be utilized for the 100ation of a replacement soil absorption systeirn. [IA suitable replacement and compaction and should not be infringed upon by requiij protected from disturbance aed The replacement area should be . Failure to protect the replacement area will result in the nEled setbacks from existing and proposed structure, lot lines and wells ement systems must comply with the ruled In for a new soil and site evaluation to establish a suitable replacement area, Replac effect at that time. limitations. Barring advances in poVv7S technologli a 0 A suitable replacement area is not available due to setback and/soil lim holding tank may be Installed as a last resort to replace the failed POWTS. the pC)WTS a soil and site evaluation a suitable replacement area. Upon failure of The site has not been evaluated to Identify placement area, if no replacement area is available a holding tank mabe installed/ as y must be performed to locate a suitable re a last resort to replace the failed POVVTS• removal of the biornat at the infiltrative and at -grade soil absorption systems may be reconstructed in place following surface. Reconstructions of such systems must comply with the rules In effect at that time. <<WARNING>> GASSES AND/OR INSUFFICIENT OXYGEN. DO NOT SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL TANK UNDER ANY ciRCUMSTANCES. DEATH MAY RESULT, RESCUE Off- A ENTER A SEPTIC, PUMP OR OTHER TREATMENT PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMpOSSIBLE. ADDITIONAL COMMENTS pOWTS MAINTAINER POWTS INSTALLER ot Name Narne Phone ozyPhone LOCAL REGULATORY AUTHORITY SEPTAGEE-SERVICING OPERATOR (PUrOPER) Narn Naive 11011 Z e'17,11 Phone -� )Ile Pholle -A Administrative Code. This document was drafted In compilance with chapter SPS 383.22(2)(b)(1)(d)&(q and 383.54(l), (2) & (3), vvisoonsin V, File #: Sr. CROI "a,, SANITARY SYSTEM Office Use Only OWNERSHIP/ADDRESS FORM Created 212021 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 Pror)erty Files Scanned weblink. OWNER/BUYER INFORMATION -or ��&Owner/Buyer e , %e�li J9— Mailing Address z 3 7 City/State/Zip � J � oZ Phone Number (required)�S ��— �'�l y%6 Email Address (required) 10 CZO ZeLle, I Parcel Identification Number 03 A9 2-11'%V (found on the property tax bill) NEW SYSTEM: LEGAL DESCRIPTION Property Locat 1/4 i 0 n-.e.., 25 1/4 Sec./-57T Z"71\1 RL-5W, Town of V Subdivision Plat: Lot # Certified Survey Map # Volume— Page # Warranty Deed # --(before 2006)Volume Page # Number of bedrooms Z/ Spec house 0 yeno Lot lines identifiable gf-yes 0 no OFFICE USE ONLY New Property Address (Verification of new address required from Community Development Department for new construction.) Z (Staff Initials) (Date) 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 Gild 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 715-245-4250 Fax cdd@sccwi.gov 1101 Carmichael Road, Hudson, Wl 54016 www'sCc Document Number WARRANTY DEED Document Name THIS DEED, made between Larry A Hillstead and Julie A Hillstead, married to each other {"Grantor," whether one or more), and Elizabeth Best and Colton Purfeerst, both single persons, as joint tenants ("Grantee," whether one or more). Grantor, for a valuable consideration, conveys to Grantee the following described real estate, together with the fixtures, profits, rents, and other appurtenant interests, in Saint Croix County, State of Wisconsin ("Property") (If more space is -needed, please attach addendum): 1168070 BETH PABST REGISTER OF DEEDS ST. CROIX CO., WI RECEIVED FOR RECORD 06/ 21 / 2023 08:03 AM EXEMPT#: REC FEE 30.00 TRANS FEE 276.00 PAGES: 2 **The above recording information verifies that this document has been electronically recorded & returned to the submitter Recording Area Name and Return Address: Elizabeth Best and Colton Purfeerst W10294 370th Avenue Prescott, WI 54021 034-1033-20-200 Parcel Identification Number (PIN) This IS Wr homestead property. (is or is not) SEE EXHIBIT "A" ATTACHED HERETO AND MADE A PART HEREOF Gran 7�s that the title to the Property is good, indefeasible in fee simple and free and clear of encumbrances except: Non Dat d R AUTHENTICATION Signature(s): Larry A Hillstead and Julie A Hillstead, married to each other authenticated on TITLE: MEMBER STATE BA F WISSIN (If not, e�C� authorized by Wis. Stat § 70 This instrument was drafted by. Edina Realty Title, Inc. Cheri Brawn 400 South Second St, Suite 115 Q C Hudson, WI 54016 *Type name below signatures ACKNOWLEDGMENT STATE OF I &I t SLQ 09 -1 COUNTY OF -!E< C& Personally came before me this ' 2 the above -named Larry A Hillstead and Julie A Hillstead, married to each other to me known to be the person(s) who executed the foregoing instrument and acknowledged the same. Cheri Brown . Notary Public, State of (N I.SCh M411-% My commission is p rm nent (If not, state the expiration date: ) (Signatures may be authenticated or acknowledged. Both are not necessary.) St, Croix County 1168070 Page 1 of 2 EXHIBIT "A" Lot Seven (7) of Certified Survey Map as recorded in Volume 16 Certified Survey Maps, Page 4289, as Document No. 677931; Located in part of the Southeast Quarter (SE 1/4) of the Northeast Quarter (NE 1/4) of Section Fifteen (15), Township Twenty-nine (29) North, Range Fifteen (15) West, Town of Springfield, St. Croix County, Wisconsin. St. Croix County 1168070 Page 2 of 2 GENERAL NOTES 1) ALL WORK SHALL BE PERFORMED WITH ALL APPLICABLE LOCAL, STATE, AND NATIONAL CODES ARID ORDINANCES AND ALL AUTHORITIES HAVING JURISDICTION 2) THE CONTRACTOR SHALL EXAMINE THE PROJECT DRAWINGS AND SHALL NOTIFY THE DESIGNER OF ANY DISCREPANCIES FOUND BEFORE PROCEEDING WITH THE WORK. 31 THE CONTRACTOR SHALL VERIFY CONDITIONS AT THE SITE AND REPORT ANY DISCREPANCIES TO THE DESIGNER BEFORE PROCEEDING WITH THE WORK. 4) EACH CONTRACTOR SHALL INCLUDE LABOR, MATERIALS, TOOLS, EQUIPMENT, ETC. FOR THE COMPLETE CONSTRUCTION OF THE WORK INDICATED AS SPECIFIED BY THE DRAWINGS AND SPECIFICATIONS, UNLESS OTHER ARRANGEMENTS HAVE BEEN MADE BETWEEN CONTRACTOR AND CUSTOMER. S) MATERIALS AS SPECIFIED ON DRAWINGS AND CONTRACTUAL DOCUMENTS SHALL BE USED. THE CONTRACTOR SHALL BE RESPONSIBLE FOR ALL DETAILING AND COORDINATION IN CONJUNCTION WITH SUBSTITUTIONS MADE TO SPECIFIED MATERIALS. 61 VIZION DESIGN GROUP SHALL NOT BE RESPONSIBLE FOR CONSTRUCTION MEANS, METHODS, TECHNIQUES, SEQUENCES OR PROCEDURES, OR FOR SAFETY PRECAUTIONS AND PROGRAMS IN CONNECTION WITH THE WORK OR FOR THE ACTS OR OMISSIONS OF THE CONTRACTOR, SUB -CON TRACTORS, OR ANY OTHER PERSONS PERFORMING THE WORK OR FOR THE FAILURE OF ANY OF THEM TO CARRY OUT THE WORK IN ACCORDANCE WITH THE INTENT OF THE CONTRACT DOCUMENTS- ALL PLUMBING, MECHANICAL, AND ELECTRICAL WORK IS TO BE COORDINATED BETWEEN THE TRADES AS PART OF THEIR INSTALLATION LAYOUT. 71 CONTRACTOR SHALL PROVIDE ADEQUATE BRACING AND/OR SHARING TO ENSURE STRUCTURAL STABILITY OF BUILDING DURING CONSTRUCTION. 8) ALL MATERIAL FINISHES AND STYLES INCLUDING BUT NOT LIMITED TO EXTERIOR SIDING. WINDOWS, EXTERIOR TRIM, AND INTERIOR AND EXTERIOR MILLWORK, ETC. SHALL BE APPROVED BY CUSTOMER. 9) DO NOT SCALE THE DRAWINGS. WRITTEN DIMENSIONS ALWAYS TAKE PRECEDENCE OVER SCALED DIMENSIONS- 10) THE CONTRACTOR SHALL VERIFY ALL DIMENSIONS AND/OR DISCREPANCIES IN PLAN AND REPORT ERRORS TO VIZION DESIGN GROUP PRIOR TO COMMENCEMENT OF THE WORK, AND TO BE RESPONSIBLE FOR SAME. 11) PRIOR TO THE START OF CONSTRUCTION, THE CONTRACTOR SHALL VERIFY THE REQUIRED DESIGN LOADS WITH GOVERNING CODES AND SITE CONDITIONS. VERIFY WITH THE LOCAL BUILDING AGENCIES THE WIND, SEISMIC, SNOW, AND OTHER SPECIAL LOADING CONDITIONS. VVION DESIGN GROUP SHALL BE NOTIFIED OF ALL DISCREPANCIES. 12) IN NO CASE SHALL WORKING DIMENSIONS BE SCALED FROM PLANS, SECTIONS, OR DETAILS ON DRAWINGS. 131 ALL DIMENSIONS TO OPENINGS ARE ROUGH FRAMING UNLESS NOTED OTHERWISE. 14) ALL DIMENSIONS TO STUD PARTITIONS ARE TO THE FACE OF STUD UNLESS NOTED OTHERWISE - 15) CEILING HEIGHT DIMENSIONS ARE FROM FLOOR SHEATHING TO UNDERSIDE OF ROOF TRUSS OR FLOOR JOIST. 16) DETAILS MARKED "TYPICAL" SHALL APPLY IN ALL CASES UNLESS NOTED OTHERWISE. 17) WHERE NO SPECIFIC DETAIL IS SHOWN, THE FRAMING OR CONSTRUCTION SHALL BE IDENTICAL OR SIMILAR TO THAT INDICATED FOR LIKE CASES OF CONSTRUCTION ON THE PROJECT. 18) FOLLOW ALL MANUFACTURER'S RECOMMENDED SPECIFICATIONS AND INSTALLATION PROCEDURES UNLESS OTHERWISE DIRECTED. 19) PROVIDE ADEQUATE ANCHORAGE, BLOCKING, BACKING, AND FRAMING FOR LIGHT FIXTURES, ELECTRICAL UNITS. HVAC EQUIPMENT, ETC. 20) SLOPE ALL CONCRETE WALKS AWAY FROM EXTERIOR DOORS TO PREVENT WATER FROM RUNNING OR BEING BLOWN UNDER DOORWAYS AND TO PREVENT STANDING WATER FROM ACCUMULATING IN FRONT OF DOORS. 211 PROVIDE FIRE -BLOCKING AND DRAFT -STOPPING IN SPACES CREATED BY CHASES, FURRING, ETC, IN ACCORDANCE WITH THE APPLICABLE CODES. 22) SMOKE ALARMS SHALL BE INSTALLED IN ACCORDANCE WITH THE APPLICABLE CODES. 21) WINDOW DESIGN INTENDED TO BE IN COMPLANCE W[TH APPLICABLE CODES IN REGARDS TO EGRESS AND SAFETY GLASS. ALL WINDOW SIZES AND REQUIREMENTS TO BE VERIFIED BY CONTRACTOR WITH MANUFACTURER TO ENSURE COMPLIANCE WITH APPLICABLE CODES, SHEET INDEX Al - COVER SHEET A2 - ELEVATIONS A3 - ELEVATIONS A4 - FOUNDATION PLAN AS - FIRST FLOOR PLAN A6 - ROOF LAYOUT A7 - DETAILS A8 - CABINET LAYOUTS / ELEVATIONS A9 - A10 - All - Al2 - A13 - A14 - 4� eo5r GLENWOOD CITY, WI C C u ry u 3 a In 0) w u cY E 3: s` a 00 c v E n 3 .-I 0 rn la Ln w i C-4 iC 'y � c' Caj �1 aJ +u CJ t DATE: 6/27/2023 DRAWN BY: L DG : APV SHEET: A-1 Everest Homes LLC - Wisconsin o 2378 20th Ave ELIZABETH & COLT CUSTOM RANCH rrM N Baldwin, WI 54402 N n Z o m 651-491-4963 PRELIMINARY SET c W GLENWOOD CITY, WI joe@everesthomeswi.com 62'-6' 61'-0' 12'-4" f 201-6" i ----------------------------- — — t ----- ---- : i-___--___----____--_---i r------------------------------ IIL i f l I r! II -J----------•-------------- I I I I I °• I I I I I � I I I I i I I I L_ IS xrestl 7 WY u rn&%M AT 1e- 10' 6" 10,-0" 10'-0" 10'-0" 101-0" SO'•6"-� _L_J I I !1 I I I I 4 e - - - - - - - - - - I I r-------J T I I IL_----------------------------� ir------------------------------- � I I I I I f I I I I I I � I I F1NE0L I I ! 1 1 L---------� ----- ---J 9 Q----------- ! 1---------- I L---------- f 10'-0 10 -4" 10 -0" 24'-0" 4 Q FOUNDATION LOWFR LEVEL PLAN 1/4" = 1`-0" j22x34j 1/8" = 1'-0" IIIx17) Futurc Fin,shed Square Footage: --- 8'-0" FOUNDATION WALL HEIGHT Concrete Aligns w/ Wall Sheathing All Dimensions Are To Concrete readers or Beams Sized By Supplier 2 ~ V w Z } cc a z o t/1 -j Lu U CL r0 V Ca u O u~, o CO 3 N z J � W C E 0 0 r4 u a'�r'� 3 ' Q tr m � s � c DO EF, 0 rn -0 u+ = N rO > N L! � Uj DDATE: /27/2023 RAWN BVDG: AP SHEET: A-4 4 9D 4 m r , , r+EEwr�� i L Wail Bracing © [Ow,w*N wxKDWS. 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Q VVK W A DOOR [S M[STAW O WIVA [M 1ST FLOOR PLAN PORCH P0R[H TYE HOUSE AND GARAGE, STATEROCA[ Coots MAY R[AUM[ASELF flOSIMGO(1+c7 1/4"x1'-0"(22x341 . lam'+ r W FIRE coot G"541M WARD Q 118" - 1'-0" (11x17) REQUIRED UTMEN HOUSE AND R G►RA" PER STAntJOC.At CODES ry Floor Square Footage: 1831 Garage Square Footage: 573 1 l 9'-1 1/8" Wall Heights (u-n.o.) 94-7/8" Header Nei& ju.n.o.) Dimensions Are Framing To Framing ! I Headers Sized By Supplier ! I , I { ! 9. 9 ON 00011 9. a OH DOOR 10'-0" 10'-31 10'-0' 37'-0" 23'-11" c C E O ry O 3 > :gLon) fn W tD a aL+ E J C4 -C � 00 qT v E F, � 0rn-Au, a =N�`D a a... a a a •0 W DATE: 6/27/2023 DRAWN BY: VDG : APV SHEET: A-5 Wisooi;�zin T""*.,partmentbf Commerce OIL E ATION REPORT - Page of "OMsion of Safety and B01dings 3ofi( I b t1i Vl.(- C o 0 Wft Comm 85, is. Adm. Code De�je 3 County Attach complete site pi n an 8 1/2 x 11 inches in size. Plan must include, but not limited . e 'cal and horizontal reference point (BM), direction and Parcel I.D. percent slope, scale or dimensions, north arrow, and location and distance to nearest road. 0-, 2�o -, Z Please print all information. Reviewed by Date Personal infoffnation you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). 0 tZ Property Owner Property Location .17 1/4 T E Cole Govt. Lot 114k,1,6 N R /S 1 Property Owner's Mailing aFe ress Lot # Block # Subd. NaName or CSM# Y1 5-10 7"/vt City State Zip Code Phone Number El City El Village Yea est Roq4 10, OL ew Construction Us esidential / Number of bedrooms Code derived design flow rate GPD Replacement Public or commercial - Describe: Parent material Flood Plain elevation if applicable '�i� ft. oet General comments and ndations: _74- System Elevation System Type— n Boring # ❑ Boring L 4 lq..� I I j Ul--- P i t Ground surface elev. ft. Depth to limibng factor — in. Soil Application Rate Horizon Depth in. Dominant Color Munsell Redox Description Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/ff *Eff#1 *Eff#2 ............. ICA. 'Y C v IY Boring # Q Boring r10 C �.,P�t Ground surface elev. t `7 ft. Depth to limiting factor in. r Soil Application Rate Horizon Depth in. Dominant Color Munsell Redox Description Chu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/ff *Eff#l- *Eff#2 11 Z A9 mom ------ /Zdoo 6 000, 14-7Z A t * Effluent #1 = BOD. > 30 < 220 mQ-/L and TSS >30 < 150 Effluent #2 = BOD. < 30 nxA and TS3 < 30 mg/L CST Name (Please Print) CST Number Bird Plumbing, Inc. Shaun Bird 226900 Address Date Evaluation Conducted Telephone Number 1432 120th St, New Richmond, WI 5401r -- Z 1- 2, 715-246-4516 Property Owner Parcel ID # Boring# ❑ Boring Ground surface elev. Depth to limiting factor in. .BOW Page of Snil Annlimtinn R oto Horizon Depth in. Dominant Color Munsell Redox Description Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD1ff *Ef1#1 *Eff#2 1 C9 +J� ,_I `t.rL2 )rAc, l ,� r Z, 41 X 6 b '3-> 1di.1 /S000- q4 c/ k/ BRoring # ❑ Boring C Pit Ground surface elev ft. Depth to limiting factor in. Anil Annlirafinn Rate Dominant Color Munsell Redox Description Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. FAgArlINl�=Vo!/�l.�Il f�r�JII��Gl� Boring # ❑Boring ❑Ground surface elev. ft. Depth to limiting factor in. Pit Soil ADMication Rate Mai Dominant Colorih Redox Description MW Effluent #1 = BODs > 30 < 220 mg/L and TSS >30 < 150 mg& * Effluent #2 = BOD5130 mgA. and TSS < 30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608-266-3151 or T"TY 608-264-8777. SBD-9330 (R.6=) Soil Test Plot Plan Project Name Larry Hillstead Shau Address 520 Main St. Wilson Wi 54n27 CJ�T #226900 Lot 7 Subdivision Date 5/8/20 SE 1/4 NE 1/4S 15 T 29 N/R15 W Township Springfield Borin Nell PL Property Line County ST. C RO I X El g � P y kBMorVRP Assume Elevation 100 ft. Top of power box System Elevation 98•5' *H R pSame as Benchmark 3' I.M. 1.5' I of t(j -tV B'�11dinqs Wisconsin [Y -part:ment f COMMOC OIL `Division Safety B ll� E6LUATION REPORT age Of 30N of and n r qpp�,Witt Comm '. �1 " 85, is, Adm. Code 7`b'tA--APvt, st . rr �-) 0, County Mach complete site pl n c5r�.-tp an 8 112 x 1 ts4i! 0 than 1 Inches In size. Plan must P1 Include, but not limited o-V&fical and horizontal reference point (13M), direction and Parcel I.D.percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Ll 7, 2,o 2,07? Please print all Information, Reviewed by Date Personal Information you provide may be used for secondary purposes (Privacy Law, s, 15.04 (1) (m)). Property Owner -1 7, a Z c( r r k., Le, (11 Property Location Govi, Lot 'e,'r 1/4 1,16 114 S Z,�—T N R E _I Property Owner's Mailing Md—ress Lot N Block # Subd, Name or Mn N1007 jow"69 u City State Zip Code Phone Number 0 city [3 Village 1,Qw 6ka-Lest Road) L (I *gfflew Construction Us esidential Number of bedrooms Code derived design flow rate GPD ❑ CD Replaoement Public or commercial - Describe.Parent _. _r_ _.__._____� _____ _ .. _ �_..--�.-- _--_.. material . 71:;e Flo©d Plain elevation If applicable ft. General oonvmnts and reoonvne nda U on s: System Type System Elevation { _ Ekxing # BoHnq -1d p I t Ground surface eleva. ft. Depth to limit.Infactor In. g Horizon Depth in, Dominant Color Munsell Redox Desc(ip0on flu, Sz. Cont. Color Texture Structure Gr. Sz. Sh, Consistence Boundary Roots GPDtff 8Eff#1 'Eff#2 14 Ll 4r XZ Boflng # C] Boring ro .5 . a..Pltr-7 t Depth to limiting factor n, 0 Ground surface elev, I qnit Anntir-qtinn MMA Horizon Depth In. Dominant Colof Munsell Redox Description Qu, Sz, Cont. Color Texture Structure Gr. Sz. Sh, Consistence Boundary Roots G P D/ff *Eff#1 *Eff#2 ,3 316� 16v VIX444 4U . I I Effluent to = BOD, > 30 5 UQ MWL ana 155 >3u 5 1 5u nWL Z triluenj ffZ 19; C5VLJ, � JV I I VL di 1U I Q%a —1 .IV I I W L- CST Name (Please Print) r CST Number Bird Plumbing, Inc. Shaun Bird 226900 Address Date Evaluation Conducted Telephone Number 715-246-4516 1432 120th St, New Richmond, W1 5401Y- 4� Z— 2,-, D Property Owner Parcel ID # Boling # ❑ Boring �/ pit Ground surface elev, i 9 f b Page -of Depth to limiting factor in. Snit Annlit-alinn Roles Horizon Depth In, Dominant Color Munsell Redox Description Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD!`ff 'Eff# l 'Eff#2 Ll V(&r V /7 41 //,., -5e-....J -MA �14 V 14 R Boring # ❑ Boring �l ZLGround surface elevl � ' ft. De th to limitin factor In. fit � ! Soll Annlle-afinn Rate 97. - .4 M RM, M V,`*`MrA SF�'EI►l�iil,��i��lflG1�1►T.Tilf��JII��I EM my fffi Y%YA rZI 1A MIA 1A M A 0 1 d WaM 11 Iwo IS7' Boring # ❑ Boring ❑ pit Ground surface elev. ft. Depth to limiting factor In, CAI AnAii+olinn Palo Dominant Color, Redox Doscription. Structure ' Effluent #1 = BODE a 301220 mg/L and TSS >30 1150 mgAL • Effluent #2 = BODO i 30 mg/L and TSS < 30 mgtL The Department of Commerce is an equal opportunity service provider and employer. if you need assistance to access services or need material in an altcmate format, please contact the department at 608-266-3151 or TTY 608-2(A-8777. seo-13)0 (RAM) Project Name Larry Hillstead Address 520 plain St. Wilson Wi 54027 Soil Test Plot Plan Shan rd C TA #226900 Lot 7 Subdivision Date 5/8/20 SE 1/4 NE 1/4S 15 T 29 N/R15 W field S rin Township Springfield Boring ( Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 100 ft, Top of power box System Elevation 98.5' *HRpSame as Benchmark CERTIFIED SURVEY MAP VOL. 18 PACiE 4289 KATHLEEN H. WALSH REGISTER OF DEEDS ST. CROIX Co., wl }DECEIVED FOR RECORD Located in the SE 1 /4 of the NE 1 /4 and the SW 1 /4 of the NE 1 /4 05-02-2002 2:00 PM of Section 15, TZ9N, R 15W , Town of Springfield, St. Croix CERTIFIED SURVEY MAP County, Wisconsin, being part of Lot 1 of that Certified Survey REC: FEE: 15.00 Map recorded in Volume 1, page 290, and containing Lots I and COPY FEE: 4.00 2 of that Certified Surve M PAGES.- 3 y an recorded in volume 4 gage 1149. and part of Lot 5 of that Certified Survey Map r ec or rye in V olurne 12, page 3375. EAST L /NE Ov THE IVE If4 UNPL ATTED- LANDS RUSTI S 00' 12' 10"w ROAD 3r� 47 9 0 5 ' e ; ,�----- NE Corner soo-►2 ro w1 .1o7 o g 00-' 12' 10"W 32.4p . � 3 ,+ E 1/ 4 C � 32.40 ......• ..� �T9.a Q'• . Sec . 15 -29 -15. _. ........ __ � i - cu: �IIVE o r x� e r Sec . 15 -2 - 15 9 ram, (aluminlurn cap r a v)1 CD 3 (PIS ni.il found.) o ^ + found.) o v � C) a t�� � • o i C O cV tY7 ..I t I m LOT 6� �-I�.I a Q Owned by:: Wayne & Teresa v Tu lk � O in m I I Schilling. ro co : � `' ~J io: z 4 L 1 l 412.07' 263.00` n1 '' N 00' 19'59"E 875.07' ' UJ v = t uoo 000'5 s"w ) Legend LOT 7 CU Section corner Lo�0 m rnrmum•�nt. • 1 "X24" Iron pipe i m 580 .54' Q� /0 weighing 1.68 lbs . . � L3 �n _ S 00'19,59"w r r Lin; ft ,. set. (n � I LO ' o r tpe q X I iron pipe found. 1 3 a) LOT 8 of Found 3 /4" rod. ND n va r R) Previously recorded L2 information . 248. 54' ' o iv' �I r (U Lat .Areas V m Lij APPRCSVtiO CO Q ' ST. CROIX COUNTY in z I two- Lot b - 205829 Sq.. ft . Planning Zonino and P,,ks rr;•,n,;��R __.! I w a ( 4.725 acres) . Q MAY U 2 2002 �r � Lot 7 - 203987 Sq. �I o a� o r ( 4 . b 8 3 acres) . 3 Lot 8 961134 Sq ft 1 ? If not recc}fc�ea wlu ii� i :iU Q�ys �� , , o as (22 . Ob5 acres) . o a W approval date approval shall he null and volr+ ao t NDQ�46' 16 "w 1 (No opoo'2e" w) w w o N 00 11407 E 984.91' W UNPL ATTED LANDS z o ti Line Data LINE BEARING DISTANCE � `'} 0 1 S 00' 19'59"W 263.00 "' W 1 /4 Corner 2 S 00' 17 ' 03"W 246.54 Sec. 15 -29 - 15 3 S 01:00;56"w 80.00 4 S 88 59 04 E 167.31 (survey nail set) Bearings referenced to the East line of the Northeast quarter of said Section 15, assumed S00* 12 = 1011W . Sheet 1 of 3 This instrument drafted by: 4012711 VO1.16 Page 4289 T. w COUNTY !( t3a! e 4 No. 651275 khOANITARI( PERMIT .;,:s VON N A Ldft- - I ITRANSFER/R,ENEWAL PREVIOUS NO. OWNER �1111&&bpg Ileor+ PLUMBER TOWN OF SEC T AND/OR LOT r(A hk V *1% LICe# i4r, -F N R E/ BLOCK a,SUBDIVISIO... CHAPTER 145.135 (2) WISCONSIN 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 a 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. 168; 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. ' AUTHORIZED ISSUING OFFICER - DATE -b IS PERM EXPIRES UNLESS RENEWED BB/FOIRE �HAT DATE ,-New 41 - 6 mr — OST IN PLAIN VIF.,W VISIBLE FROM THE ROAD FRONTING THE LOT DURING CONSTRUCTION SBD-06499 (R 1 1 /20)