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040-1057-40-005
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 Kyle Huerd TOWN OF TROY CST BM Elev: Insp. BM Elev: BM 1scription: 00 TANK INFORMATION TYPE MAN FACTURER CAPACITY Septic .� �^ b Dosing (0"Apb � Aerat io Holding TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Septic t 6 Dosing !020 Aeration Holding PUMP/SIPHON INFORMATION KtA� Manufacturer L6f 40 Demand GPM Model Number TDH Lift A Fricl s I Systemja I T Ft Forcemain I Leng . - Dia. Dist. to Well SOIL ABSORPTION SYSTEM E EVATION DATA County: St. Croix Sanitary Permit No: 648415 State Plan ID No: Parcel Tax No: 040-1057-40-005 Section/Town/Range/Map No: 14.28.19.223C T1 ewe St/Ht Outlet Dist. Pipe r, MW Bot. System Final Grade to Wk BED/TRENCH DIMENSIONS Widt Lengt • No. PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR UNIT TN Of Syst ✓ I ` 6I /a- Model Number: I I DISTRIBUTIbIV SYSTEM Header/Manifold Distribution, �. Pipe(s) ' x Hole ize I ( x Hole Spacing % Vent to Air Intake Length Dia Length Dia Spacing S SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only< ,7\uLLw)►arwr Depth Over Bed/Treys' Center % dL,. Depth Over Bed/Trench Edges xx Depth of Topsoil �_/ te/ xx Seeded/Sodde xx Mulched [J„Yes ❑ No XYes ❑ No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1:&wLos a Inspection #2: Location: 789 GLOVER RD 1.) Alt BM Description =�1` '��0� (AGO Lb %rO- ✓ Ski Of rQ� M a� �Q l Iron Coof1'�- 2.) Bldg sewer length = 4 .\-6 IX&VT f Is r �I - amount of cover - 7�� � • 1 �o 0'i 00, Plan revision Required? ❑ Yes 00; No Use other side for additional informa io . to 3 ?3 6t 9' 0 SBD-6710 (R.3/97) Date In e s Signature Cert. No. w Suer s� lint. srGo 4� 1. 2.A Fp-) R� (r�� 1� n \\/7 [�� Mn 2,0z� -0�461 toy J Industly Sel`V1CeS Division 4822 Madison Yards Way County 1 Sanitary Permit Number (to be filled in by Co.) •`;.S , ' AR0-8 2023 Madison, W1 53705 P.O. 716 �Madison JLD j ! �t , Croix County V.^,pm AppItcatioll— State Tra sactioll Nut In accordance witli SPS 383.21(2), Wis. Adm. Code, submission of this forrn to the appropriate govenimental unit is required prior to obtaining a sanitary permit. Note; Application forms for state-owned POWTS are submitted to Project Address (ifdiffe-ent than mailing address) the Dcpartment of Safety and Professional Services. Personal information you provide may be used for secondary putt)oses in accordance with the Privacy Law, s. 15.04(l)(in), Stats, ? - 1,.Application�.,info.rm`atioii w �P -All :Please tint, :7nformatlo>ti Property Owner's Name Parcel #iw -- P_0;g—_ Property Owner's M g Address Property Location 10, Gout, Lot C't ,,State Zip Code Phone Number ,d' _ C % ' Cc ti0I iiww � YY// ✓✓//ZY, rw ;hl. )e nf_I3: dic>! __ g (checks all:.that ap.pi).). Lot 4 T N R E . C Subdivision Name 1 or 2 Family Dwellin -- Number �""�+... y g u nber of drooins ✓� . D -S Block #"' Public/Commercial -- Describe Use i City of State Owiied -- Describe Use ri rQ CSM Number �1 ob DVillage of Town of SZ 111. Type of{I)OW'TS'.Pei!.illit' C—lieck eitlllel_ "New"o►• "-RepJ�acehien't",.and other:applica'ble on linc A:.' Check one box,o , ne B,,-CampleteJine-C if A. ew System Replacement System Modification to (explain)tTeatinent 110(herExisting S � stein y [—]Additional PreUillt (explain) B' Eltiolding Tank In -Ground 9-Grade Mound ❑ Individual Site Design Other Type (explain) (conventional) C. "' enewal Before evision [:]Change of Plumber ransfcr to New Owner ist Previous Permit NuiT.ber and Date Issued ► f r.,, piratioil .� -nrtio:1V, Dis w,S'9UTi1eatmenti ea and`Tank Infot 11*. X 2. ` - Design Flow (gpd) DesfDispersal Area Required (sf) Dispersal Area Propos (sf) System Elevation Capacity in Total # of Manufacturer Tank Information Gallons Gallons Units_ 4? v a `MU U v New Tanks V V) Tanks .0 ,o�ga . U in n w C7 a Septic or Holding Tarr4c •� Do51{ls Cltal11t1Cr �� � � V. 'Resl)onsibility- Sta#:etnellt- sIy;the: unclersigne i;. ussume sly �isttillit.y for iiristull fipn of the.°P 'W`l'S shown on the a"ached: plans} C 4-is Name (Print) C Piumbe ' i tore MPIMPRS Number � 2, 6 Bu.iness Plionc Nu er ' r - Plumber's Add s (S r�.i., Cit , St te, Zip Code) "► 7 VI's 7cou It partn1"6n`t"`Use C3nly Approved O Disapp ' Penriit Fee q5��- Date Iss ed 311 t) Issuing Agent Signatur e n Rea r Denial Z P 1,3 Conditions La 1'ov 1 -3) b SYSTEM OWNER: eptic tank, effluent filter and dispersal gel! must be serviced / maintained as per a a emen# 1 (. g an provided by plumber. � p setback requirements mmaintaineda- -�� h • must e e plaits for (lie systeand subinit to the County only on paper not less than 8 1/2x 11 laic tes In size as per applicable cod�'/tb�'�h�l���s�, m r S13U-6398 (R, 03121) System. PLOT PLAN PROJECT Travis Dankenmever ADDRESs 687 Coulee Trail Hudson Wi 54016 SE 1/4 SE 1/4S 14 /T 28 N/R. 19 W TOWN Troy COUNTY ST. CROIX SYSTEM ELEVATION 103. 01 DATE 2/28/23 5 BEDROOM CONVENTIONAL AT -GRADE X>O( CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1585 gallons LIFT TANK SIZE DOSE TANK SIZE" 950 HOLDING TANK SIZE LOAD RATE .6 ABSORPTION AREA 1260 # of Chambersnone BENCHMARK V.R.P. Top of survey iron ASSUME ELEVATION 1.00' Filter Lifetime 130REHOLE (D WELL * 11 - R. P. same as benchmark 1-11 Huffcutt Combo Tank Grading is to be done to divert run-off away from system B - 2 r- Pro 5 Bedroom House 6% Slope B 1 102 - I i, - 1031 1041 Well is to meet all WDNR setbacks Area 15' below system is to remain undisturbed Property Line' Wisconsin Department ofSafety and Professional Services Division of Industry Services *mzMadison Yards w° ,oBox r30z Madison, WI 53707 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 2022 Shaun Bird 1432l2OmSt New Richmond, VV| SITE: Dankrnmeyer 789Glover Road Town ofTroy StCroix County SEXSEY4Sl4-T]8N'R19VV pho"=u08-2u6-znz w= ron/E`ers, Governor Dan 11creth, Secretary Cmndidonvxx APPROVED DEPT. opSAFETY AND PROFESSIONAL SERVICES DIVISION opINDUSTRY SERVICES M�� UP - - 0 � SEE CORRESPONDENCE Description: 5 Bedroom-750 GPD — 42 ?1 to At -Grade Component Manual — Ver. 3.0 (May limiting factor -Maintenance required 2022-2027 Pressure Distribution Component Manual — Ver. "Manuals Have Been UPDATED!{~* 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 todoso by the Department per s.l45.OG stats. The following conditions shall be met during construction or installation and prior to occupancy or use: Reminders wThe site shall be properly prepared prior toplowing. Any grasses longer than 6" shall be cut short and removed. Toavoid matting, any leaves orloose organic matter shall beraked upand removed. Cut trees and shrubs flush to the ground and leave stumps. Avoid operating equipment onthe At -Grade site. |fnecessary, use only tracked equipment, during dry conditions, with minimal passes, to avoid compaction. ° Components and soil removed from anexisting drainfie|dshall beproperly disposed ofsothat there isno risk topublic orenvironmental health. ~ Asanitary permit must beobtained from the county where this project is located in accordance with the requirements of Sec. 145-19, Wis. Stats. = Inspection ofthe private sewage system installation isrequired. Arrangements for inspection shall Wisconsin Department =, Safety and Professional Services Division of Industry Services 4822 Madison Yards "'a), roBox r30z Madison, w/omr pho"=o08-2o6-znz Web- Tony Evers, Governor Dan Hereth, Secretary be made with the designated county official in accordance with the provisions of Sec. °Astate approved effluent filter is required. Maintenance information must begiven to the owner of the tank explaining that periodic cleaning of the filter is required. 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 Owner Responsibilities The current owner, and each subsequent owner, shall receive a copy of this letter. Owners shall also receive a copy of the appropriate operation and maintenance manual(s) and be responsible for ensuring that POWTS is operated and maintained in accordance with this chapter and the approved management plan under s. SIPS 383.54(l). In the evert this soil absorption system or any of its component parts malfunctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approved plans. The owner is responsible for submitting amaintenance verification report acceptable tothe county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized inthe POVVT3. |ngranting thbapprova|dheDivbionof|ndugry5en4cesnsemestherighttorequiredhangesor additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2),. nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may bemade tomeatthe telephone number listed below, or atthe address onthis letterhead. The above left addressee shall provide acopy ofthis letter and the POVVTSmanagement plan tothe owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Joshua Rowley POVVTS Man Reviewer, Division of Industry Services (715)634'5I24 Shaun Bird Bird Plumbing Inc. 1432 120th St. New Richmond Wi 54017 715-246-4516 Dates.2/28/23 Revision :052200765-C Cover Page Revised nq/n7/?09q I ?mq()*C;7 PKA Conditionally APPROVED DEPT. OF SAFETY AND PROFESSIONAL SERVICES DIVISION OF INDUSTRY SERVICES SEE CORRESPONDENCE Owner:Travis Dankenmeyer Location: SE1/4 SE1/4 S14 T28 N,R19W 789 Glover Road Troy 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 Attachments: Soil Test Shaun Bird Signature 44 License num/r 226900 Page 1 of 9 System PLOT PLAN PROJECT Travis Dankenmever ADDRESS 687 Coulee Trail Hudson W1 54016 SE 1/4 SE 1 / 4 S 14 /T 28 N/R 19 W TONNIN Troy COUNTY ST. CROIX SYSTEM ELEVATION 103.0' DAI'E 2/28/23 BEDROOM 5 CONVENTIONAL AT -GRADE XXX CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1585 gallons LIFT TANK SIZE DOSE TANK Sin 95© HOLDING I'ANK SIZE LOAD RATE .6 ABSORPTION AREA 1260 # of Chambersnone IL BENCHMARK V.R.P. Top of survey iron ASSUME ELEVATION 100" Filter Lifetime 4 [:]BOREHOLE NN ELL ji. it. 1). same as benchmark Huffcutt Combo Tank Grading is to be done to divert run-off away from system B - 2 6%© Slope B - 1 1020 AM 1041 Well is to meet all WDNR setbacks Area 15' below system is to remain undisturbed Pro 5 Bedroom House Property Line c2o- At -grade System Sloping Site Cross Section and Plan View a. al NAM r a" OEM moo *M ONO, an= an" Moo ... 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AD s� as Lateral with 215 'Ilopsoil. Cap aggregate over pipe Geotextile Fabric G 0 = 4 in. sch. 40 pvc observation pipe Dimension Feet A /?..w B Lftr!3L-- i z RPW 1/6 B lop ws"� C to D 2.0 5.0 E F 0.5 G 1.0 L ( �, W A F % Slope- - I Observation Pipe With Can 0 el 1:; is 0 a % Ft Lateral Invert onsolillill a solb a P%G%6%& 8%6%80 a q1Nb0M1m0ggq%8%0%ft%0 0 o0eadvalooleallso%vi a 9 ON also•allawas ■ rra Topsoil Cap WeRvalselsonselam%no6own 6 10% Mw§%0%868Mm a was I a 9 0 .0- Imiq 11 eal ales 0 16 Moolingloolve%olmosmalw0% %a olonso 0 neffilalm moloo moss j *1110, 110111 Ild In we a a 0, Ft Contow- leolmeni a dl Ml %-k� I., 7ZV-"-% %.% S. -a .0 ;to fe ;aw ;O!rdk ire a mosseaeolabol a a se 0 -0-0960411 mmwsdw221w0Mg8%5%o a a # a menieseseve al .0 .41 OIL a me Plowed Surface,11, C Slope Direction GENERAL INSTALLA"FION: The at -grade area is staked out along the design' contour, Existing vegetation. is mowed and raked off the site. 'The basal area (L x W) is staked out alld plowed with a moldboard or chisel plow. Plowing may not proceed if the soil is wet enough at the plow depth to form a 1/4 inch soil wire when a sample is rolled between the palms of the hands. * 'rhe A x B area is covered by clean aggregate deposited overhead by a backhoe.. Special caremust 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 . omlll Iiihit erosion and protect from freezing. The observation pipes are perforated in the lower 6 inches and secured in place. 2 03/05 IN Page of L ZI Page Of-� Distribution Pipe Detail For Two Lateral Network ACCESS boX \�j 41 Holes Locat0d On Bottom Are Equally Spaced --, IUKN-UF `LLV-ANOUT/ PVC Force Hain I j y X I PVC Distribution Pipe F d P P Last Hole Should Be Next To TuRN- UP 2— Inch P F t. Hole Diameter X Inches Lateral Diameter Inch(es) y Car 01�7 Inches Force Main Diameter Inches # Of Holes/Pipe C-�� `"�' Invert Elevation Of Laterals A2> Ft, Signed: License Number: I Date: I catiolls Sepfic-f)ose Tai�k. Cross Section And 'P urn P erfori r 4 pump manufacturer re Tank Manufacturer k./" es-e. T �- �..� . I'ank Model Nuaiiber pump Model Number Alarm Manufacturor ,1Lt0jg Total Tml Qipacity 15g .......... _ L 01 F Max. Bury Deipth I - Alarm Model Number 0 /%--- LIV � Switch Type L /o "C ifter Manufacturer Filter ModeNumber Minimum Pump Nrform ce Required Gpmi .21— F'tTDH - Oudat Manhole fqin. 41' Above Grade Wifli Locking Device. Inlet Manhole < 6" Below Cn-Ode Sealed Watertight how - "m Finished Grade 7 ;: 6 .:.b 0,-: .:; 4 4 0;6;1 4 q1 Outlet Filter Inlet fall Inlet Baffle rlla Switch Sett ings and Reserve Capacity 'rank Voiumo OPI Dimension;' Inches Volume Gal, __ (reserve) At (alarm) B: -2 (dose) C (dead) D, Total Total Dynamic V] ad (T1: H) - Feet Elevation Head Distal Pressure Network Loss f, � . � Force Main 1,oss 1*3 Total Secur-ely Mounted Weather-proof Junction Box son Vent Miri. 1217 Above Grade With Vent Cap Manhole.Min. 4"Above Grade With Locking Device, Disconnect Means ;.fir � .... _ .. ._ : _. ' .. `, �� X6 D► # 0 41 • A 41 bd Weep Hole Hof` ff Elevation 64Y 0 Ft i I t4 4: Bottom tX, D1fr FIevation b a *,IV _W_ry0_q" 7� 2 a a S-1k I GENERAL INSTALLATION: The septic/dose tank is bedded and back filled in accordance with dic ft manufacturer's product approval apwiric at ions. Maximum depth of bury as specified by the inanLifucttirer m(y [lot be exceeded without prior approval. Manhole covers exposed to grade have an effective locking device (pndlock) 9 installed, Piping At the inlet and'outlet is of approved material, connected to the tank witli watertight fittings, and force main Is alcov wi 4 S laid on stablip soil to prevent settling or sagging. The f ed th ch. 40 PVC to bridge the tank eXCLIVittivin nied the sleeve is sealed watertight. Electrical survi 9 icc complies with NEC 300 and Comm 16-28. 02/051-1.1 Page of 280—SERIES 1/2 hp Submersible Effluent/Sump Pumps The Liberty 280-Serios provides a cost effective "mid- range" pump for on -site waste water systems, liquid waste transfer and commercial heavy-duty 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 permittirig passage of solids LIP tO %" 416 stainless steel rotor shaft • Permanently lubricated upper and lower ball bearing Epoxy powder coat finish • All fasteners - corrosion -resistant stainless steel 11/2" Discharge Stainless steel bottom screen - easily removable *Maximum fluid tomperaturo: 140" Fe ' 280-Series Cord Lengths .Model 101 - 251(-2) 35" -3 50 6 [-�_ 280 Standard Optional Optional Optional 281 Standard Optional o tional Optional .283 Standard Optional optional N/A 287 Standard Optional N/A N/A 10' curd length standard on all models. For optional lengths, add "-2, -3 or -5" suffix to modal number. Example: for model 280 with 35' cord, order 280-3 Motor Specifications !/2hp 60 Hz 3450 RPM Oil filled, thermally protected (PSC) Permanent Split Capacitor 8.0 amps (1 15V) 4.0 amps (208/23OV) #]got 11 1 1 11 a 0 �10 0 .■■ ■■■■■■■■■■■ ,�■■■ men 35 30 4) 25 W LL %.-,20 15 X 10 40 i i 9 8 6 5 3 2 0 j I I I I 1..J__L%L 0 0 5 10 15 20 25 30 35 40 45 50 55 60 65 70 U.S. Gallons Per Minute _4 0 38 78 114 156 192 228 270 Liters Per Minute Dimensional Data: Weight: 29 lbs. Hoight: 13" Major Width: 10" (model 287) Minimum Sump Diameters: Model 281, 283... 14" Model 287 VMF...l 011 **E W Factory switch Model 281, 283 Model 287 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 dis- charge pipe or other mounting point. Vertical float model 287 is not adjustable. r7p_ rlza Model 280 Model 281 Mode1283 Model 287 VMF-Serieso 111111%.- Manual, n n, switch Wide angle float switch Wide angle float switch Vertical mag- with quick- with series netic float for disconnect (piggy -tack) smaller pits - will operate in n plug V a 10" diameter sump 1 SS 9 icp CE FIE D C US Certified Specificatlons are Subject to chango without MOUCe. Liberty Pumps * 7000 Apple Tree Avenue Bergen, Now York 14416 9 Phone 800-543-2550 Fax (585) 494-1839 www.fibertypumps-com Copyright ®r- Uborty Pumps, Inc. 2017 All rights resorved. LUT 2000 R05/17 F ch �ij ry tiw W 0 1�-- u chi) POWTS OWNER'S MANUAL & MANAGEMENT PLAN FILE INFORMATION VYLL7_L Owner Permit # ]ES IGN PARAMETERS Number of Bedrooms 73 [1 NA Number of Public Facility Units ;6-NA Estimated flow (average) ��072 gal/d TN Design flow (peak), (Estimated x 1-5) 7. SO em sal/day gal/day/ft2 Soil Application Rate Standard Influent/Effluent Quality Monthly average* Fats,' Oil & Grease (FOG) 530 mg/L Biochemical Oxygen Demand (BODE) :5220 mg/L [I NA Total Suspended Solids (TSS) _5150 mg/L Pretreated Effluent Quality Monthly average Biochemical Oxygen Demand (BODE) 530 mg/L Total Suspended Solids JSS) :530 mg/L Fecal Coliform (geometric mean) �j 04 CUI OOM, Maximum Effluent Particle Size X in dia. 0 NA Other: NA A *Values typical for domestic wastewater and septic tank effluent. 11AINTENANCE SCHEDULE SYSTEM SPECIFICATIONS Page _. of Service Event Service Frequency ------- Onspect condition of tank(s) At least once every: 0 month(s) (Maximum 3 years) © NA ig4ears ) Purnp out contents of tank(s) When combined sludge and scum equals one-third of tank volume 13 NA Rnspect dispersal cell(s) At least once every: 0 Mont (Maximum 3 years) gyear(s Cl NA 1::Iean effluent filter At least once every: month(s) D NA' I year(s) Inspect pump, pump controls & alarm At least once every: 0 month(s) Cl NA I:lush laterals and pressure test At least once every: 0 month(s) Xyear(s) © NA IDther, At least once ev": 0 month(s) --TINA 0 yeaqs) N 6ther: NA MAINTENANCE INSTRUCTIONS I iInspedons 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 t:;cmbined 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 (%) or more of the tank volume, the entire contents of J: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, 1-3nd 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. Page _ of , START UP AND OPERATION For new construction, prier to use of the POWTS check treatment tank(s) for the presence of painting products or other chemicals thElt and/or damage the dispersal celi(s). If high concentrations are detected have the contents of thO may impede the treatment process a g . tank(s) removed by a septage servicing operator prior to use. System start u shall not occur when soil conditions are frozen at the infiltrative surfa p Y ce. y During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will bo in one large dose, overloading the cell(s) and may result in the backup or surface discharge of effiuenit. discharged to the dispersal cell(s) q ewer to the To avoid th is situation have they contents of the pump tank removed by a Septage Servicing Operator pricer to restoring p effluent pump or contact a Plumber or POWTS Maintalner to assist In manually operating the pump controls to restore normal levels within the pump tank. and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area within Do not drive or park vehicles over tanks a p 15 feet down slope of any mound or at -grade sail absorption area, Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the POWTT.$: ; condoms; cotton swabs; degreasers; dental floss, diapers, disinfectants; fat; foundation dram antibiotics, baby wipes, cigarette butts, • vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting productis; (sump pump) water, fruit and veg+eta p � 9 . pesticides; sanitary napkins; tampons; and water softener brine. ABANDONMENT s errnanentl taken out of service the following steps shall be taken to insure that the system is pr�opefly When the POWTS fails and/or i p Y 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, a p all tanks and its shall be excavated and removed or their covers removed and the void space filled with soil, • gravel or another inert solid material. CONTINGENCY PLAN its and cannot be aired the following measures have been, or must be taken, to provide a Cade complli)nt If the PO TS fa rep replacement system: p L3 A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption systeim. area should be protected from disturbance and compaction and should not be infringed upon by requiijed The replacement setbacks proposed from existing g and ro osed structure, lot lines and wells. Failure to protect the replacement area will result in the neled for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rule.l in effect at that time. 0 A suitable replacement area is not available due to setback and/or sail limitations. Barring advances In POWTS technology a holding tank may be installed as a last resort to replace the tailed POVVTS. Thust e site has not been evaluated to Identify► s suitable replacement area. Upon failure of the POWTS a soli and site evaluation be performed to locate a suitable replacement area. if no replacement area is available a holding tank may be installed) as a last resort to replace the failed POWTS. Mound and at -grade soil absorption systems may be reconstructed in place following removal of the biorna�t at the infiltra-live ace. Reconstructions of such systems must comply with the rules in effect at that timo. <<WARNINGa> SEPTIC, PUMP AN D OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND/OR INSUFFICIENT OXYGEN. DO NOT SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE Q A ENTER A SE , PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLER Name �' ` �-' r Phone POWTS MAINTAINER Name , � . (x2. Phone ,�'-� f " z , SEPTAGE SERVICING OPERATOR PUMPER LOCAL REGULATORY AUTHORITY i Dame Z)4, �- `:* r ., L 771Name ,� - � �, t /7 /b Phone ( � Phone This document was drafted In compliance with chapter SPS 383.22(2)(b)(1)(d)&(fly and 383.54(1), (2) & (3), Wisconsin Administrative Cade. Wisoonsin D"Mmen Dvision of Satety and OIL EVALUATION REPORT Comm 85, Wis. Adm. Code Canty C,S r �a1 -yy� Page — of Attach wrnplets sit* plan on paper not lost than 8 1/2 x I I Inches in size. Plan must / 011 f Includa. W not Ilmhad to: %lartical and ho-rizontal reference point (SM), direction and P" ['D.' Vt 1) percent slope, scale or dimensions, north arrow, and lotion and distance tc nearest road. Pleirso prin( all information. R owed Ab. P monsi infompr etice; you oY164 mey be Lmod f cx s000ndary purposot (Privacy Low, c - 15.04 (1) W) - - Z I T;1 -qo - Date Pam; 0WrWr Proper4, Location V GM, Lot '�� 1/4� '00 114 S / T N R E (qvfw Pr"rty O*r^*v's "rig Address 01 Lot # -Block # Subd. Name or CSM#q Ile 6.�.. CRY.- State Zip Code Mr �srnber 13 City C] Viliage —)gj:pwn Nqprea Road -Py'ep �construclJon 4Z L'11� Use* sidential Number of Wroorns Code derived design flow rate -) I-,) GPD 'X 0 Replaoerneni Public or comm'910W -,09 cxibe: Flood Plain elevation If applicatAe fL Parent Material Cam! owner o 9Y1Uj- and rommivr4stlar1s- System Type System Elevation Structure N 1111111111111DO rw w_e_,m 4 1 C. N1111111111 111 Gt. Sz. Sh. 04 WAa,' O�JII�l1�J07I,�i4'7�G�ii77�1JI�lL��l:� [��li.#J��ll���'��f[�OVOCOO Redox Description Structure Ou, Sz, Cont. Color Gr. Sz. Sh. v�Ilall'�OG�I ROME v�71 !'.AO[[J��,3'l1IJ�'.�i7F1AJIl�6��l1 i'�,'�IliIH�71 E��1f�A_�Jfr�ri7O����il * Effkmt 01 a 8QU. > 30 < T-du "YL Sm I - MWL =111U01 it fp4c - PWW, - %xv I I %F L- %11 " 11 %~ Z %FW V t -W%- CST Name (Please Print) Signature CST Number Bird Plumbing, Inc. Shaun Bird 226900 Address Date Evaluation nducted Telephone Number 1432 120th St, Now Richmond, W1 54017 Xt, —1-1-:2 715-246-4516 Property Omer ParcellD FBodng # Baring /11" 31 Pit Ground surface elev. � ft. Depth to limiting factor In. Page of Dominant Color' Munsell Redox DescrlpV Qu. Sz. Cont. Ccoor stmcture Gr. Sz. sh. GPDff WIA4, www" M R F, r P3 W11A I VSAW f= WjPWAfA MA? -RAMMI Pit Ground surface elev. ft, Depth to Urniting factor In.' Dornkant Coic;-,) Munsell Redox De3cripflon 7. Qu. Sz. Cont.- Color Structure Gr. Sz. Sh. Boflng# [] Boring El Pit Ground surface elev. Depth to 11miting factor In. I rZAThnnfit-ofinn0ofal Porninant Color'! Munsell Redox Description. Qu, Sz, Cont. Color Effluent #1 = SOD > 30 220 mWL and TSS >30 < 150 mg& Effluent #2 a BODE :5 30 nV& and TSS < 30 nWL The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need -matenal-in-an-altemate-forrna4. -please-contact-the-department-at-608-266-315 I-or..T-T-Y-608.264,8777. SUD-3350(RAW) Project Nam Address PlarnSoil Test Plot;ITravis Dankeeyer s -d S 687 Coulee Trail Hudson Wi 54016 0 CSTM #226900 Lot Subdivision Date 12/1/21 SE 1/4 SE 1/4S 14 T 28 N/R19 W El Boring 0 Well 111, Property Line k IRM or VRp Assume Elevation 100 ft System Elevation TB Township Troy County ST. CROIX Base of survey stake H R pSame as Benchmark ST. CR01 SANITARY SYSTEM File #: rX Y 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 Property Files Scanned weblink. Owner/Buyer 411 /C.-, Mailing Address City/State/Zip Phone Number (required) Email Address (required) Parcel Identification Number (found on the property tax bill) OWNER4PUYER INFORMATION C_ sz%_ P-1 0 y 7 -- q 1,rV- NEW SYSTEM: LEGAL DESCRIPTION Property Location 1/4 1/4 Sec. A/ T 2--2?N RZZW, Town of Subdivision Plat: Lot # Certified Survey Map# Volume 32- Page# _tf0� Warranty Deed # —(before 2006)Volume Page# Number of bedrooms Spec house 13 ye no Lot lines identifiable-*4 es 13 no New Property Address (, to f Initials OFFICE USE ONLY (Verific tion of new address required from Community Development Department for new construction.) '0,3 (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 and a copy of the certified survey map if reference is made in the warranty deed. Community Development Department — Land Use Division 715-386-4680 St. Croix County Government Center 715-245-4250 Fax cdd-@sccwi.gov 1101 Carmichael Road, Hudson, WI 54016 www.sccwi..gov Parcel #: 040-1057-40-005 03/08/2023 02-33 PM PAGE I OF 1 Alt. Parcel #: 14.28.19.223C 040 - TOWN OF TROY Current � X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type # of Units 04/20/2022 00 0 Tax Address: Owner(s): 0 = Current Owner, C = Current Co -Owner KYLE HUERD 0 - HUERD, KYLE MADELINE HUERD C - HUERD, MADELINE 5755 W 132ND ST SAVAGE MN 55378 Districts: SC = School SP = Special Type Dist # Description SC 4893 SCH DIST RIVER FALLS SP 0100 CHIPPEWA VALLEY TECH Legal Description: Acres: SEC 14 T28N R19W PT SE SE SEC 23 PT NE NE CSM 32-7106 LOT 5 Property Address(es): = Primary 789 GLOVER RD Notes: 2022 FOR 2023 RETIRING 040-1057-40-000 & 040-1087-20-000 FOR NEW 040-1057-40-005 LOT 5 CSM 32-7106. (COMBINED 2 PCLS) 22.620 Parcel History: Date Doc # Vol/Page Type 07/11/2022 1155763 WD 04/20/2022 1151791 32/7106 CSM 10/14/2021 1141215 WD 08/01/2017 1051725 WD more... Plat: Primary Tract: (S-T-R 40% 1601/4GL) Block/Condo Bldg: 7106-CSM 32-7106 040-022 14-28N-19W SE SE LOT 05 7106-CSM 32-7106 040-022 23-28N-19W NE NE LOT 05 2023 SUMMARY Bill #: Fair Market Value: Assessed with: 0 Valuations: Last Changed: 06/02/2022 Description Class Acres Land Improve Total State Reason Totals for 2023: General Property 0.000 0 0 0 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch #: Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 789 GLOVER ROAD RIVER FALLS, WI OWNERS: KYLE AND MADDIE HUIERD 5755 W 132ND ST SAVAGE, MN 55337 218.280.2465 DESIGNER* GEOWALL DESIGNS, LLC KYLE HUERD, PE KYLE. HUERD@G EOWALLDE SIGNS.COM 952.303-4843 SYMBOLS FAN Tw = 990.00 FINISHED GRADE CALLOUT 8w = 984.00 OUTLET RIVER FALLS THIS DRAWING IS BEING FURNISHED FOR THIS SPECIFIC PROJECT ONLY. ANY PARTY ACCEPTING THIS DOCUMENT DOES SO IN CONFIDENCE AND AGREES THAT IT 4_1 1 SHALL NOT BE DUPLICATED IN WHOLE OR IN PART. NOR DISCLOSED TO OTHERS WITHOUT 1 3 THE CONSENT OF GEOWALL - 1 1 12 FEB2= STRUCTURAL AND CIVIL ADDED KH KHKH DESIGNS 0-1 09 JAN 2023 90% CONSTRUCTION SET KH _KH KH -Ch-o* to ® 2021 GooWal Designs. LLC. Q_ No 7--oaft— Rovoon Drawn Dow-, SHEET INDEX SHEET DESCRIPTION A-1.0 TITLE SHEET A-2.0 ELEVATION PLAN A-2.1 ELEVATION PLAN A-3.0 FLOOR PLAN A-3.1 FLOOR PLAN S-1.0 FOUNDATION & FRAMING PLAN S-1.1 FRAMING PLAN C-1 .0 EXISTING CONDITIONS C-2.0 SITE & GRADING PLAN RW-1.0 RETAINING WALL CONSTRUCTION NOTES RW-1-1 RETAINING WALL CONSTRUCTION NOTES Rw-2.0 WALL I ELEVATION RW-21 WALL 2 ELEVATION RW-2.2 WALL 3 ELEVATION RW-3-0 SECTION A -A RW-3.1 SECTION 8-8 RW4 0 CONSTRt IrTif)N nFTAII R GwWmxA TITLE SHEET DESIGNS 789 GLOVER ROAD "BUILT FROM THE GROU70 LrP' RIVER FALLS, WI MNNESMA 1541(IWF ROAD E,RlltNS'vlLLE, SAN 5531' 41.' Yll 41" SINGLE FAMILY HOME DEVELOPMENT PLAN ('44,06W)n 10150 W(N)f)%K FOR DIM k St I rtl-- '%)!. mo-41 - MF', 1 4_0*1117 7.19 816 t" W lhlh CEO% ALU)F SIGN S (XIM -No, L220DP029 OWA. ShoW No: 1 09 JAN 2023 N.T.S. A-1.0 �ars.e�e ��cse�elllf, a RIGHT ELEVATION (SEE SCALE) w Know What's BELOW. CALL belcm you dig. THIS DRAWING IS BEING FURNISHED 7 FOR THIS SPECIFIC PROJECT ONLY. 1 6 ANY PARTY ACCEPTING THIS - -�— �— -- ---_ _ DOCUMENT DOES SO IN + 1 CONFIDENCE AND AGREES THAT IT SHALL NOT BE DUPLICATED IN WHOLE OR IN PART, NOR � 4 - - — — - --- 3 - -- -------�-- —� DISCLOSED TO OTHERS WITHOUT THE CONSENT OF GEOWALL - DESIGNS 1 12 FES 2023 STRUCTURAL AND CW L ADDED KH KH KH ® LLC �P�• 2021 GeoWaN Des' 0 09 JAN 2023 90% CONSTRUCTION SET No Dow ------------------...- KH KH E KH -- ---- ----- - -�-�� � �� } ac Che NOTE: 1. REFER TO STRUCTURAL DRAWINGS FOR ELEMENT DIMENSIONS AND SPANS. 2. REFER TO CIVIL DRAWINGS FOR ENTRY PORCHES, PATIOS, STOOPS, WALKS, DRIVEWAYS, WALL STEPS, ECT NOT SHOWN HERE. 3. REFER TO CIVIL DRAWINGS FOR ALL BUILDING LOCATIONS, GRADING, AND FINISH FLOOR INFORMATION. 4. REFER TO RETAINING WALL PLANS FOR ALL STRUCTURAL RETAINING WALLS AND PLANTING INFORMATION, NOT SHOWN HERE. 5. ELEVATIONS ARE FOR VISUALIZATION. OWNER TO SELECT PRODUCTS SUBMITTED FOR APPROVAL. 6. FOUNDATION WALLS TO BE 8' ICF FOX BLOCKS OR APPROVED EQUAL. FOLLOW INSTALLATION METHODS AS SHOWN BY MANUFACTURER 7. LOCATE SUMP PIP, ELECTRICAL OUTLET, AND WATER SERVICE LOCATION. 8. ALL WINDOWS AND EXTERIOR DOORS TO BE MARVIN WINDOWS ESSENTIAL COLLECTION IN A STOCKED COLOR (TBD) UNLESS NOTED OTHERWISE. 9. STONE VENEER SHALL BE SELECTED BY OWNER 10. SEAMLESS OVERSIZED GLITTERS TO BE SELECTED FROM CONTRACTOR OPTIONS. f, r, III - Iffil j�ul 1 SCALE UNIT ---- e+e•+nao _ _ i 10 5 ^ 0 10 20 I i Tr.: ELEVATION PLAN DESIGNS 789 GLOVER ROAD "BUILT FROA! THE GROUND UP" RIVER FALLS, WI �i1`NESOTA. 1uA! LIFE Ru.►D E, St'R�S1'ILLE, �!` t��t^ SINGLE FAMILY NOVAE DEVELOPMENT PLAN j JS:.ipi i19tl (1N�)RAl1C1 Ixf,�W(N>t)iftK7RlKtl\'F.�IM',1201.WNT\ MF\1 M001:2 6rq Nm ID -WA- se"; - 6MMNO: :u x;b b+ao 220DP029 109 JAN 2023 v = IV A-2.0 www �:tiuw,u t pl.slcs rl1 FOUNDATION PLAN {SEE SCALE) 40 00' Know what's BELOW. 34.00' CALL before ym ft THIS DRAWING IS BEING FURNISHED 7 FOR THIS SPECIFIC PROJECT ONLY 6 ANY PARTY ACCEPTING THIS DOCUMENT DOES SO IN 5 CONFIDENCE AND AGREES THAT IT 4 SHALL NOT BE DUPLICATED IN WHOLE OR IN PART, NOR 3 DISCLOSED TO OTHERS WITHOUT I HE CONSENT OF GEOWALL DESIGNS 1 12 FEB 2023 STRUCTURAL AND CIVIL AWED KH KH KI, 0 09 JAN 2023 90% CONSTRUCTION SET KH KH KH (9) 2021 GeoWaft Dessgns. LLC No Dam Revtsm Drawn Des-gn Check BASEMENT PLAN NOTE:1. FOUNDATION TO BE ICF 8- FOX BLOCKS (OR APPROVED ;SEE SCALE) EQUAL) UNLESS OTHERWISE SHOWN. 2. INTERIOR FIXTURES, CABINETS, APPLIANCES, UTILITIES, ECT TO BE SELECTED FROM CONTRACTOR OPTIONS BY OWNER. 3. FLOORING FINISHED TO BE AS SHOWN BELOW - EL = ENGINEERED LAMINATE C=CARPET T = TILE PLANKS HC = HEATED CONCRETE 4. ALL EXTERIOR WALLS SHALL HAVE 3.5- (MIN.) CLOSED CELL SPRAY INSULATION. 5. ALL INTERIOR WALLS SHALL HAVE r TYPE 'X7 GYPSUM BOARD. WRAP ALL STRUCTURAL ELEMENTS. 6. OWNER TO SELECT OUTLET AND LIGHTING LOCATIONS WITH CONTRACTOR. ALL ROOMS SHALL HAVE MINIMUM OUTLET AND LIGHTING REQUIREMENTS PER LOCAL CODES UNLESS OTHERWISE SHOWN. 7. ALL BATHROOMS, STAIRS, HALLWAYS, AND CLOSETS SHALL HAVE LOW VOLTAGE LIGHTING PLACED AS DIRECTED BY OWNERS. 8, SMOKE DETECTORS SHALL BE PERMANENTLY WIRED. BE INTERCONNECTED, SHALL HAVE BATTERY BACKUP AND SHALL HAVE AN ALARM AUDIBLE IN ALL SLEEPING AREAS OF THE DWELLING. D" 9. ALL BEDROOMS SHALL HAVE CEILING FAN/LIGHT IN CENTER OF ROOM. r4EATRVvAdW&Y ROM fc) SIAM& COL" CIRJESTAkT-000W tfV OR I SCALE (,NIT 10 5 10 2 0 T&4 FLOOR PLAN Project --71"DESIGNS' 789 GLOVER ROAD "Bf 7L T I I -Rakl TFIF GROUND I'P" RIVER FALLS, WI I k4s a ffr Ruki) 1 11- RN+% 1: T r, NIN i� SINGLE FAMILY HOME DEVELOPMENT PLAN '-' 14114!*� ("I'l IR klx) INS., WN YMIN - W ITAI% I St I I! 'ul MON, 7410 (0 mill.- Ptopmd No Daft S<4ft show 140 VAA I zLO'A A[ I DSIWA ( (A! 220OP029 09 JAN 2023 1"= IV A-3 0 FIRST_ FLOOR PLAN SECOND FLOOR PLAN NOTE: 1. FOUNDATION TO BE ICF 8- FOX BLOCKS (OR APPROVED (SEE SCALE) ;SEE SCALE) DS EQUAL) UNLESS OTHERWISE SHOWN. o a"VAL� RSRaA DUAL ,=SHOON EL14EW, RGfJA H1CN -- 'lRC'ED OR Cfl Wfi *om ANDWALL "TOTAL) 2. INTERIOR FIXTURES, CABINETS, APPLIANCES, UTILITIES, - — - -- - ECT TO BE SELECTED FROM CONTRACTOR OPTIONS BY ' - OWNER. ooM 3. FLOORING FINISHED TO BE AS SHOWN BELOW FOR _ # r mook FAcx a,Ga ACCEI EL = ENGINEERED LAMINATE C =CARPET T =TILE PLANKS HC = HEATED CONCRETE )E] �, ' 4. ALL EXTERIOR WALLS SHALL HAVE 3.5' (MIN.) CLOSED I CAR GARAGE ' - JRODI/ 414/ M I G oly r . . ❑MAf�E $i�,1D NASA _ _ _ __ T)- I n r ( CELL SPRAY INSULATION. �MAT ES J r ' 5. ALL INTERIOR WALLS SHALL HAVE s TYPE `X' GYPSUM ' } SIB• - -- L s T. -451w_ BOARD. WRAP ALL STRUCTURAL ELEMENTS, ax w' FLOOR MOAN r s f :- YYfTN g4.TE - - --_ " ROTE sa 6. OWNER TO SELECT OUTLET AND LIGHTING LOCATIONS i 1 trTETTyROOM TONA,F=MJANC CkOEIAAAo i ._-�r+� _ _ „ WITH CONTRACTOR. ALL ROOMS SHALL HAVE MINIMUM I 1 VmT"l -EATER. AM WATER 5o YEWR � --4 a i r DwRa4PREs5uRER5LEALSEvx,*TOFLOOR ._ .po •- 7 DRAMOUTLET AND LIGHTING REQUIREMENTS PER LOCAL - re, CODES UNLESS OTHERWISE SHOWN 'Del I or _ 7. ALL BATHROOMS. STAIRS, HALLWAYS, AND CLOSETS -1 a» re, JACKAL SHALL HAVE LOW VOLTAGE LIGHTING PLACED AS SPIONCRE It OR PREGIST am., I T "w„ fc)a,osET :IT _ i' _ -�`= DIRECTED BY OWNERS. _ _ STEEL re'4b� - Tn 8. SMOKE DETECTORS SHALL BE PERMANENTLY WIRED, BE ram . _ _ , AVAILABLE, - .- + ! " 7r - - t +Rs ra i ' ra sr j INTERCONNECTED, SHALL HAVE BATTERY BACKUP AND II i DOW^ SHALL HAVE AN ALARM AUDIBLE IN ALL SLEEPING AREAS sn. VAX Rom .A)iTRT 467 PITCHED SPACE TP OF THE DWELLING. ftu sc FROM ROOF LINE r A I ' ,or Isr - t 47 - -I '- 92 l 9. ALL BEDROOMS SHALL HAVE CEILING FANILIGHT IN - RRC,*, - ti I=, t 4 m CENTER OF ROOM. sic DOW% 'RE£3ER i. Cr�M NV1G!� 100c DOW% 1 I -- i cn4R i+ Op" To �; vAULTED _ I - ;r. --J DO' - _-- _ ! _ „ LONER LEVEL Iou a yG•l [JOUtrER TiWrt I •. n � 1' � � 7SIT - � � ITv tA1MpRY KaCHEN - G' ,-OI�M0IG Rom- Soo f r . � '..' w - � T, S Dtr RaR r CAGW AREA OE.IA" `E> ' tEa, w.�a+ I , *TwsrO sM _ 11! up 9 5i - --- I t7 A, . T'. ..* vAt&IW low BEDRO�W-3 , +. Yt49R LHe1G ROBVACATED�FRF]Y 15T FLOOR ' TR , 4017 i? 034 - 1 t4. Z 1e SCALE UNIT Kmw what's BELOW CALL before you dig THIS DRAWING IS BEING FURNISHED 7 _ TW FLOOR PLAN FOR THIS SPECIFIC PROJECT ONLY 8 J ) ANY PARTY ACCEPTING THIS -- - DOCUMENT DOES SO IN 5bop° CONFIDENCE AND AGREES THAT IT 4 DE SIGNS 789 GLOVER ROAD SHALL NOT BE DUPLICATED IN - - - RIVER FALLS, WI WHOLE OR IN PART. NOR 3 "BUIL T FROXI THE GRO ' \ 1 I t P" DISCLOSED TO OTHERS WITHOUT 2 %MhEcoTA 1,4h- I tf•r Res%TIF B �; t„,• SINGLE FAMILY HOME DEVELOPMENT PLAN THE CONSENT OF GEOWALL DESIGNS 1 12 FEB 2023 STRUCTURAL AND CAM AD[ : k KH KH Kt -.- !R?IA LAI)r) 1RR iRl W— A)y[N)N I llifl I. q IIh:'IR�X7n'.''11\I I1)MRt R_ Vr0010No Date Scale. S�—t N,, 0 09JAN2C23 90%CONSTRUCT+''. !' KH KH KH 2021 GeoWall Designs. LLC No Dale RealssDn Drawn De--, Chf. zu'A R:;ttN tl i l� tI(AS (0'4 220DP029 09 JAN 2023 1' = 10' A-3 1 WARRANTY DEED THIS DEED, made between Travis Dankemeyer, a single person, Grantor, and Kyle Huerd and Madeline fluerd, husband wife, as survivorship marital property, Grantee, WITNESSETH, that the said Grantor, for a valuable consideration of One Dollar ($1 .00) and other good and valuable consideration, conveys to Grantee the following described real estate in St. Croix County, State of Wisconsin: See legal description attached hereto as Exhibit A- Together with all and singular the hereditaments and appurtenances thereunto belonging; and the Grantor warrants that the title is good, indefeasible in fee simple and free and clear of 1155763 BETH PABST REGISTER OF DEEDS ST. CROIX CO., WI RECEIVED FOR RECORD 07/11/2022 11:55 AM EXEMPT#: REC FEE 30.00 TRANS FEE 1,056.00 PAGES: 2 "The above recording information verifies that this document has been electronically recorded & returned to the submitter U N I L91 161142 a Kyle and Madeline Huerd 789 Glover Rd. River Falls, W1 54022 040- 10.5 7-40-005 Parcel Identification Number This is not homestead property encumbrances, except municipal and zoning ordinances and agreements entered under them, recorded easements for the distribution of utility and municipal services, recorded building and use restrictions and covenants, and general taxes levied in the year of closing, and will warrant and defend the same. DATED this day o 2022. ei . A UT H ENTICATI 0 N Signature of Travis Dankemeyer authenticated this day of _ 12022. (Print Name) TITLE: MEMBER STATE BAR OF WISCONSIN (If not, authorized by §706.06, Wis. Stats.) THIS INSTRUMENT WAS DRAFTED BY: Attorney Jordan C. Sundell Ruder Ware, L.L.S.C. Per Legal Description Provided do UB Travis Dincye�' O�c ms 0% +'10 fill 111"%, 4 ACKNOWLEDGMENT STATE OF WISCONSIN SS. COUNTY OF'%,--�, -1 cl-SOnifli came before rne this �2Tfbay of - I I -named Travis 1= 2022 the above 1),.�#Umeycr, to me known to be the person who execute the foregoing, iri-,,triinient, nd acknowledged the sam A errorA.,Stat)e-now (Print Name) Notary Public, State of W1sccns1116/,,,1Z,, My Commission:— St. Croix County 1155763 Page 1 of 2 EXHIBIT A Legal Description Lot Five (5) of Certified Survey Map filed in the office of the Register of Deeds for St. Croix County, Wisconsin, recorded in Volume 32 of Certified Survey Maps, Page 7106 as Document No. 1151791; said Map being located in the Southeast Quarter of the Southeast Quarter (SE 1/4 of the SE 1/4) in Section Fourteen (14) and in the Northeast Quarter of the Northeast Quarter (NE 1/4 of the NE 1/4) in Section Twenty-three (23), all in Township Twenty-eight (28) North, Range Nineteen (19) West, Town of Troy, St. Croix County, Wisconsin. Tax Key No.: 040-1057-40-005 Property Address: 789 Glover Rd., River Falls 4891-3324-7526, v, 1 St, Croix County 1155763 Page 2 of 2 1151791 BETH PABST MFR"rlFllE mAev m I REGISTER OF DEEDS ST. CROIX CO... WI LOCATED IN THE SE1/4 OF THE SEI/4 OF SECTION 14 AND IN THE NEII/4 OF THE NE1/4 RECEIVED FOR RECORD OF SECTION 23, T28N, Rl 9W, TOWN OF TROY, ST. CROIX COUNTY, WISCONSIN. 04/20/2022 09:21 AM CERTIFIED SURVEY MAP VOLUME:32 NOTE: PAGE: 7106 THIS CERTIFIED SURVEY MAP IS PLATTING TWO PARCELS OF LAND RECORDED IN REC FEE: 30.00 DOCUMENT NUMBER 1141215 AS ONE LOT. DESCRIBED PARCELS APPEARS TO PAGES:2 HAVE BEEN CREATED INITIALLY IN AUGUST1982 IN DOCUMENT NUMBER 379174. so� %%%$#Otto GLOVER ROAD ION =EAST - WEST llj LINE, SEC. 14 ------------------ 7- -----L-'f--S88'020'35"E 92-60' DRIVEWAY EASEMENT-----J AGREEMENT DOC. #972030 dO r-4 LO r, wt ro '-i CD c:) C3 c:) En 2M, UNPLATTED LANDS �Lu ; SOUTH LINE OF THE NORTH 1321 OF THE Lei 0 W1/2 OF THE SEI/4 OF THE SE1/4, SEC. 14 S8803314911E 651.28' /67.7 ly (_3 LU Ln LU Ln LU CX3 0 cn U-1 En Ln Uj U- 0 LU S1/4 COR. SEC- 14 N8804-7'08"W Q!�10298�.3f-- N1/4 COR. SEC. 23 U3 LU w CWD Q V) CV3 '4%r LL. -- LU LLJ = L.0 LL, c%j U-j C%4 0 F— F— cm LU C= LU LOT 5 22.62 ACRES 985,345 SQ. FT. SOUTH LINE OF THE SE1/4 OF SECTION 14 649.151 660.0-7— N88047'D8"W 2596-62' NORTH LINE OF THE NE1/4 OF SECTION 23 SOUTH LINE OF THE NORTH 330'OF THE NEI/4 OF THE NE114,SFC. 23 N88047'08"W 660-07' LEGEND ST. CROIX COUNTY SECTION CORNER POSITIONED FROM COUNTY COORDINATES. POSITION VERIFIED WITH FOUND ALUMINUM MONUMENT 1 0 1 1/4" IRON PIPE FOUND U LU to LU LO U-j F SURVEYOR U- 0 EDWIN C FLANUM 111- NORTHLAND SURVEYING, INC. V-4 LU P.O. BOX 152 Lf) En C/D AMERY, WI 540D1 LU U-3 U- T— nj OWNER C:) I r%l uj C:) TRAVIS DANKEMEYER R 687 COULEE TRAIL HUDSON, WI 54016 0 d— U— cm C:) CO3 wed "A BEARINGS ARE REFERENCED TO THE NORTH LINE OF THE NE1/4 OF SECTION 23, BEARING N88047'0811w. (ST. CROIX COUNTY COORDINATE SYSTEM). THIS INSTRUMENT DRAFTED BY MICHAEL ERICKSON JOB NO. 22-12 DWG - CSM DATE 2/09/22 COOOA -7jrirs,.r- I U.!j Z' SE COR. SEC. 14 N88047'08"W 638.24' Ln t NE COR. SEC. 23 c:2 LU rn C=; 3;: a- Uj �I '~L U- = 0 ® LU C= C= SCALE IN FEET 111 200' 0 200 400 UNPLATTED LANDS St. Croix County 1151791 Page 1 of 2 SHEET I OF 2 SHEETS 0(v 4V# L'-)ePa'Tn'en Dv'isior of Safety an-t % 011L EVALUATICN REPORT aomrr, 8.5-,FYis- Code I ant14 es k-I'le'S' If, siz tts%,^-! czmpiete site p�ar, o7 par peno'.. ic ttian i X e. Plar, !njsf. in,-lud6. bLA not limited tc- vet�,a� and lio-izonta; rep port. direcbvni aric-, t siaN , sc;aie or dimensions , nort-. arrow, an.,* loaabor, and distance tc nwesi road. i �' S I U PerMerit Flea.ce print all lnfo=aVor. Re kewedd tv hate Pm--ms &w; zaeoo-,posy Prowty Owner ProPer-'ti' Locall N R E Go4 LcK # Mraper-LY Ow►ner'fs Maiii.i.; Address Lof NaT* or 0SM91 v State ZP Coos Phone NLI-Mbper 1 27 city E: N gyres Fe,-,ac' —4 7;7L1�7 Z—O-Wrl ZZI-2Z 1 �2 Ne*A SOnStrJCbOr benta! 1r Numt, Y teirowns d fX—) Coje derivedf desig- 5ow ratle vi be 7 Pa-enff -20 't, o Floo,! Piain eievabor, appficabie pcv� Y) sty, 01 '13vste.-ni Tv�)e '41- Svsterr, Elevation 71 # I Fit 2! vul FUbut lcs. WICv. f F e*ZJL: I W IV i IIUI M� ;O�A�A '. C Depth in. tenant CNOrl Munseff IR&:iox Des--,�Pbcr- t O.J. SZ. cont '30ior Strllr,-tj!*e Gr. Sz Sh. Consistence sourldary Roots P 01F X7" AK� LZZ V-19L it -31 //t4/7 g 1! Boring -win g# Pit Ground surface elel If L Depth to limtng factor Anntin- R�,e Horizon Deptn Dorninan.. in. fi Munsel, Redox Desvipbon p QU, Sz, cont C'Nor Texture Stricture Gr. Sz. St-t. Consistence 5ounawy Roots 113", P D Iff < F T— ar•t 'SS 1-:ffi. jent #2 = BOD..!i 30 nV& and TSB < 3C Tr4fL Effkwt #1 = BOO, > 30 < ZZ imqj1L CST Name (Please Print) 5-:Z i, g r nature CST Number Bird Plumbing, Inc. Shaun Bird 226900 Address Date Evaluati ondicted Telephone Number 1432 120th New Richmond. W1 5401 715-246-4516 Property Owner Boring # � Boring EA Pit Parcel ID # Ground surface elev. ' 4---) ft. Depth to limiting factor Z in. • Page of 41lE Annlunafinn Q .,c MW Qu. Sz. Cont. Color — WL Gr. Sz. Sh. Eff#1 *E 2 =ME in, W rfA WA WA rom 0 �p LYA' Wr Frod 1 0, 1 Me Bori. # ❑ Boring pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Redox Description Structure Consistence Boring # ❑ Boring Ground surface elev. ft. Depth to limiting factor in. El pit Anil Onngiratinn Rats * Effluent #1 = BOD5 > 30 1220 mglL and TSS >30 ,� 150 mglL * Effluent #2 = BODs 130 mg/L and TSS < 30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608-266-315I or TTY 608-264-8777. SBD-9330 (R.6/00) Property Owner Parcel ID # Borling # Boring /11' 171 Pit Ground surface elev.> > ft. ypho, Depth to limiting factor - in. Page Of � I Rnil Annfii-nfinn _M=71 Munsell Redox Description Qu. Sz. Cont. Color Structure Gr. Sz. Sh. Consistence' *Eff#1 *Eff#2 W RM A- PjF rA W1,01 VA T / WA_ 424��o�oeeo Boring. # Boring --a 11 pit Ground surface elev. ft. Depth to limiting factor in. qnil Annfirpfinn F?ntin I 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 Boring # F] Boring Ground surface elev. ft. Depth to limiting factor i ron. n pit I I Runil AnNinatinn Rate Horizon ')epth in. Dominant Color Munsell Redox Description. Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/ff *Eff#1 *Eff#2 Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 mg/L Effluerd #2 = BODr 5 — — , �< 30 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 TTY 608-264-8777. SBD-9330(RAW) Project Nam Address Soil Test Pl;;4 la Travis Dankemeyer ird 687 Coulee Trail Hudson Wi 54016 CTM #226900 Lot ---- Subdivision ------ Date 1 2/1 /21 SE 1/4 SE 1/4S 14 T 28 N/R19 W Boring Q Well PL Property Line kBMorVRp Assume Elevation 100 ft. Township Troy County ST. CROIX Base of survey stake System Elevation TB D * H R PSame as Benchmark -COUNTY NO. 648415 -7 - ALL- - ST RY PER -A LN-41T PRIEVIO NO. IV 1 4 &117 OWNER K�L� � ey 1ftEl.l401,. PLUMBER SUBDIVISION CHAPTER 145.135 (2) VvNSCONSIN 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. ZED ISSUING OFFICER - DAT UNLESS RENEWED BEFORE THAT DATE OST P IN LAIN VIE'v,,A VISIBLEE OM THE ROAD FRONTING THE LOT DURING CONSTRUC •IO •� ��Tt�ltE �:oRoo�► N �w 11�+11�«�t{' ,�}.�u��.�Q vt 7"�i SBD-06499 (A11i20)%low� �� . 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)(a- )J Permit Holder's Name: City Village Township Travis Dankenmeyer TOWN OF TROY CST BM Elev Insp. BM Elev- BM Description: TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY Septic Dosing Aeration Holding TANK SETBACK INFORMAADN TANK TO P/L WELL DG. Vent to Air Intake ROAD Septic Dosing Aeration Holding PUMP/SIPHON INFORMATION Manufacturer Dema GPM Model Number TDH Lift Friction Loss System Head T Forcemain Length Dia Dist to Well SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. Of I hes DIMENSIONS I SETBACK SYSTEM TO P/L DG WELL INFORMATION Type Of System: DISTRIBUTION SYSTEM a County: St. Croix Sanitary Permit No 641974 State Plan ID No Par;:el Tax No 040-1057-40-000 Section/Town/Range'Map No: 14.28.19.223C STATION Benchmark Bldg. Sewer �St/Ht Inlet 'St/Ht Outlet 7sl�' i�via Too St Cover �l11i� r�►�l�a PIT DIMENSIONSN sInside Dia. Liquid Depth LAKE/STREAM LEA G Manufacturer: CHAMBE R UNIT Model Number: Header/Manifold Distribution x Hale Size x Hole Spacing Vent to Air Intake Pipe(s) Length Dia Length Spacing ,jUIL UUVLK x Press4e Svstems Only xx Mniinrf C?r At -(,ramp RvgtPmz C)nly Depth Over Depth Ov xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil _ Yes No Yes No COMMENTS: (Include code discrepancies, persons present, etc.) Inspection #1 Inspection #2, Location: 789 GLOVER RD 1.) Alt BM Description 2.) Bldg sewer length - amount of cover = . I Plan revision Required? - Yes No Use other side for additional information. Date Insepctor's Signature Cert No ]CLOD lq-) yART Industry Services Division County 4822 Madison Yards Way Madison, W1 53705 '7 Sanitary Permit Number (to be filled in by Co.) F 1621 P.O. Box 7162 i.IQ07_ Madison, WI A cWr�_u ............. �ermit Application State Transaction Number In accordance M4_S�2383.21(2), Wis. Adm. Code, submission of this fon-n to the app t overnmental unit 1pr 0 7 6 Project Address (if different than mailing address) is required prior to obtaining a sanitary permit. Note: Application forms for state-owned POWTS are submitted to 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(1)(m), Stats. L 0 Vek I. Applicationhf6rtnation Please Print — All Information Property Owner's Name &22 Parcel # (0 H 6 r 1 , 0/) Property Owner's Mai I ing Address Property Loca * Govt. Lot o0v 1111. 4, See n n4 C State L A Z' Code L Phone Number T N R P,,pe of Building :(check all that apply) Lot # division Name or I or 2 Family Dwelling - Number o edroo edr�Mp nubli _. a Block # c/Commercial - Describe U City OCity of State Owned - Describe Use illage of. 4D CSM Number(32 DDL 51 9ct 79T� Town of Id 111. Type of POWTS Perinik,(Check et NW" or "Replacement" and other apps, le oil e A. _.beck o bo line 13. Corn e line C if o bo line 13. appWgKe.) ew System []Replacement SystemN thcr Modification to Existing Sy Addi re eatment Unit lain) OHolding Tank E]In-Ground t de EINAund ual Site Design Other Type (explain) (conventional) C. Renewal Before ❑Revision Fichange of P er ransfer to New Owner ious, Permit NL er and Date Issued Expiration I I IV. DispersaVTreatment Area and Tank Information: X Design Flow (gpd) Design Soil Application Rate(gpd/so 0hp'e_rsg Area R ire Dispersal Area Proposed (so Sy,teni Hevativn Capacity in Tota #of Manufacturer Tank Information Gallons Gall Units R_V_� 'Co U 0 0 0 0 U 4) �4 .8 M C1 New Tanks Existing Tanks U Septic or Holding Tank h7Lf -6, Dosing Chamber : y Z V. Responsibility Statement- 1, the undersigned, asAvrest lsibility for installation of the POWTS shown on theNeed plans. Plumber's Name (Print) Plu rFs Signla6ire MP/MPRLS Numbe Business Phone Nu er 4 40 Plumber's Address (Street, City, Slate, Zip Z2i2 V1. County/Departinent Use Only 1K Approved 0 Disappro > n-nit Fee Date Issued Issying Sig ,)kgent,_ nature 0 -Q-wner en Reason or Denial renReason for De N Condition A I/ A T_ , LA^ 3YSTEM C,4A L,4 Septic tank, effluent filter and dispersal cell must be, serviced l maintairle _d ruvi as per management plan provided by Plornbe All setback requirements must be maintained _f5 as applicable code/ordinances. per Attach to compiete plans I -or the system and submit to the County only on paper not IeSS thall 8 1/2 X I I inches in size SBD-6398 (R. 03/21) System PLOT PLAN PROJECT Travis Dankenmever ADDRESS 687 Coulee Trail Hudson Wi 54016 SE 1/4 SE 1/4S, 14 /T 28 N/R 19 W TOWN Troy COUNTY ST. CROIX SYSTEM ELEVATION 103.09 17 acre parcel per GIS 3 DATE 4/24/22 BEDROOM CONVENTIONAL AT -GRADE XXX CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE 630 HOLDING TANK SIZE LOAD RATE .5 ABSORPTION AREA 900 # of Chambersnone BENCHMARK V.R.P. Top of survey iron ASSUME ELEVATION 1001 Filter Lifetime LJ BOREHOLE WELL *H.R.P. same as benchmark Scale = 1/4"= 10' Easement to Glove load as Property Line Huffcutt Combo Tank r Grading is to be done to divert run-off away from system NAll piping materials, fittings, and joints must comply with SPS 384.30-84.40 standards. A E9- 4 0' 80 B. M. B - 6% pe B - I 102 L IMP, 103' 7 D S� 3 gv 1041 Well is to meet all WD setbacks Area 15' belo stem is to remain undistur 0 3 Bedroom ouse roperty Line CO P S Ot ION May 5, 2022 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 2024-05-05 Plan Review: PWTS-052200765-C SHAUN R BIRD 1432 120th St New Richmond WI 54017 SITE: Travis Dankenmeyer Glover Road Town of TROY St. Croix County Total Amount: $250.00 DIVISION OF INDUSTRY SERVICES 2331 SAN LUIS PL GREEN BAY WI 54304-5211 Contact Through Relay http://dsps.wi.gov/programs/industry-services www.wisconsin.gov Tony Evers - Governor Dawn Grim - Secretary Conditionally APPROVED DEPT. OF SAFETY AND PROFESSIONAL SERVICES DIV SION OF I ST TRY SERVICES �I SEE CORRESPONDEWCE FOR: Description: Three Bedroom AV rade system \ Sloped Site 4n ry/ t nual G, e 'S /D c '\e q, ed, effluent filter, New construction Pressure Distribution Component nual—Ve. .0,SBD-10706-P(N.01/01,R10/12) At -Grade Component Manual - Ver. SBDI 0854 (N .03/07, R. 1/12), 450 gpd, 42 inches to limiting factor from original grade, Maintenance The submittal described above has been re ed for conformance with applicable Wisconsin re ed for conformance Administrative Codes and Wisconsin Statu " s. e submittal has been CONDITIONALLY APPROVED. c This system is to be constructed and loc/ad in a rdance with the enclosed approved plans and with v any component manual(s) referenced a e. Theo r, as defined in chapter 101.01(10), Wisconsin r . I Statutes, is responsible for compliance ith all code req ' ements. No person may engage in or work at Dfmbing in the state unfbcas licensed to do so by the Department per s. 145.06, stats. The following conditions shall be metturing construction or installation a rior to occupancy or use: Reminders • A sanitary permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.19, Wis. Stats. • Prior to construction of the dispersal area, check the moisture content of the soil to a depth of 8 inches. Proper soil moisture content can be determined by rolling a soil sample between the hands. If it rolls into a 1/4- inch wire, the site is too wet to prepare. If it crumbles, site preparation can proceed. If the site is too wet to prepare, do not proceed until it dries. • Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stats. • A state approved effluent filter is required. Maintenance information must be given to the owner of the tank explaining that periodic cleaning of the filter is required. Owner Responsibilities °The current owner, and each subsequent owner, shall receive acopy of this letter. Owners shall also receive a copy of the appropriate operation and maintenance manual(s) and be responsible for ensuring that POWTS is operated and maintained in accordance with this chapter and the approved management plan under o.SPS383.54(1). ° In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approved plans. ° The owner iuresponsible for submitting amaintenance verification report acceptable tothe county for maintenance tracking purposes. Reports shall besubmitted a1intervals appropriate for the component(s) utilized in the POWTS. A copy of the approved plans, specifications and this letter shall be on -site durinq onstruction and open to inspection by authorized representatives of the Department, which,. may include local inspectors. In granting this approval the Division ofIndustry Services reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, nrcomponent. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address onthis letterhead. The above left addressee shall provide ocopy ofthis letter and the POWTSmanagement plan tothe owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, POVVT8Plan Reviewer — Wastewater Specialist Department ufSafety & Professional San/ioeo I Division of Industry Services email: Cover Page Shaun Bird Bird Plumbing Inc, 1432 120th St. New Richmond Wi 54017 715-246-4516 Date:4/24/22 Owner -.Travis Dankenmeyer Location: SE11/4 SE1/4 S11\48 NR19W Glover Road Troy Manuals Used: At -Grade Compo's Pressure Distributio 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 nt Manual version 2.0 SBD 10854 (N. 03/07) anual version, 2 ,46SBD 10706-P(N. 01/01 R. 10/12) 8.-9. Maintance and Contingency Plan Attachments: Soil Test Shaun Bird Signature License numbi 226900 Conditionally APPROVE© DEPT. OF SAFETY AND PROFESSIONAL SERVICES DIV SION OF I STRY SERVICES SEE CORRESPOND /CEE Page 1 of 9 System PLOT PLAN PROJECT Travis Dankenmever ADDRESS 687 Coulee Trail Hudson Wi 54016 SE 1/4 SE 1/4S 14 /T 28 N/R 19 W TOWN Troy COUNTY ST. CROIX SYSTEM ELEVATION 103-01 17 acre parcel per GIS 4/24/22 DATE CONVENTIONAL AT -GRADE XXX CONVENTIONAL LIFT MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE BEDROOM 3 HOLDING TANK DOSE TANK SIZE 630 HOLDING TANK SIZE LOAD RATE .5 ABSORPTION AREA 900 # of Chambersnone BENCHMARK V.R.P. Top of survey iron ASSUME ELEVATION 100Filter Lifetime ❑ BOREHOLE (D WELL *H.R.P. same as benchmark system Area 15' below system isto remain undisturbed Pro 3 Bedroom House I Property Line All piping materials, fittings, and joints must comply with SPS 384.30-84.40 standards. At -grade System Sloping Site Cross Section and Plan View IMP we am am MM, am 0" 00 PPPP- MP;0*� P�PPP !��Pp�P* W A answer-0 a &Seale, ;'111-PP plo� 1/6 B = NOE am "M 1W asE B L Al Plowed -llj = \ean aggregate0 4 in. sGi. 40 pvc �':��%on to.As 1/7. to Y2in. dia. basal area M J observation pipe Lateral with 2" aggregate over pipe Geotextile G Fabric Tops'XI Cap 140i &O&V Ft 0 fr L I IL - 0 L OND 0% F 000 Nis Ftj Slope Direction Feet -Dimension A B 1 /6 B C A 2 D 2.0 E 5.0 F 0.5 G 1.0 L A W E%Slope Observation Pipe With Cap L ral In Topsoil Cap ae. ontour �- p P a eggs Plowed Surface,,,A C -y 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 (L x W) is staked out and plowed with a moldboard or chisel plow. Plowing may not proceed if the soil is wet enough at the plow depth to form a 114 inch soil wire when a sample is rolled between xhe palms of the hands. The A x B area is covered by clean aggregate deposited overhead by a backhoe.. 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. gtowth, limit erosion and protect from freezing. The observation pipes are perforated in the lower 61nches and secured in place. - ,�, 03/05 10 Page of R Pressure Lateral Layout One Lateral —end Manifold ', 7 r) - A / ' . 1-7 Distribution Network Specifications Lateral Diameter In. Orifice Diameter In. X (Orifice Spacing) c 2, In. L (Lateral Leng1h) W XFt- Force Main Diameter 0 1Z X Force Main Len sth 50 Ft7% 03/05 lgj Threaded Cleanout Plug Ll I _.ong weep 90 Bend Pressure Syst9construction Laterals are con 'acted of Schedule 40 PVC pipe. Orific., are drilled perpendicular to the pipe wi a sharp drill bit and face down. Lateral t -ups terminate with a threaded 'e p Late ral 6 t w rif 'C a _u s s clean'o plug and l_imd nc are enclosed in a 6-8 inch diem r lawn sprinkler valve box accessible fro finished grade. Grade jp 0 6-8 Inch Lawn Sprinkler Valve Box i Page of ........... tic-I)ose ai* Cross Section And Pump Performance Specifications lump Mallu acturer 'rank anufacturer Pump Model- Number 'I."" Modcl 11%1'wnber /-r( -To Alarm Manufacturer ;i, f _T a- n�K _6i,pacit yMax. BD(Tth AlarmModel Number �. ury Fsvtch Type L Filter Manuf� I_Cturer Filter Model 'Number / r'` Minimum Pwnp Performance Required GPM; @ Ft TDH Outlet Manhole in. 42" Above Grade With Locking Device. Inlet Manhole < 6" Below GrAde Sealed Watertight #4%W, low 0" tool -1 =m Finished Grade wo Total Dynamic Head (`I DR) - Feet Elevation Head 712 Distal Pressure - Network Loss Force Main Loss Total %r Manhole Min. 4".Above Grade SecurelMounted y With Locking Device Weather-proof Junction Box V I" MOW oft mow mww mm Vent Min. 112", Disconnect Above GO& Means With Vok Cap Outlet Filter film" Wet Baffle ,.switch Settj'ngs and Reserve Capacity Volume GPI _—Tank Dimension, Inches Volume Gal. (reserve) A: -s (alarm) B: (dose) C Z (dead) D' Total _m. I X* V4 :4: Weep B Plot 4 4 Hole Off Elevation Ft a►IrD F:- Bottom E41evation r-777: 4y':!,-!-Q F1 -1 PP ► 10 , _X po a d 4 777 t: 4" 4 1 4 4 a 4 A 0 4 'N"),""', 'N I 474 V I. t. -41►41* 4 q•q, GENER.A,L INSTALLATION: The septicidose tank is bedded and back filled in accordance with the, manufacturer's product approval specifications. Maximum depth of bury as specified by the manufacturer may not be exceeded without prior Approval. Manhole covers exposed to grade have an effective locking device (padlock) installed. Piping at the inlet and 'outlet is of approved material, connected to the tank with watertight fittings, and laid on sta6lsoil to prevent settling or sagging. The force main is sleeved with 4" Sch. 40 PVC to bridge the tank exuavatt(in aiid the sleeve is sealed watertight. electrical service complies with NBC 300 and Comm 16.2$. I ee'-- CD 02/05 U' Page. .� --of 280-SERIES 1/2 hp Submersible Effluent/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-duty 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 up to Y4 11 * 416 stainless steel rotor shaft * Permanently lubricated upper and lower ball bearing * Epoxy powder coat finish 9 All fasteners - corrosion -resistant stainless steel * 1 Y? Discharge * Stainless steel bottom screen - easily removable * Maximum fluid temperature: 1400 F. 280-Series Cord Lengths Model 101 25'(-2), 351(-3) 501 280 Standard 2ptional al Optional 281 Standard Optional Option Optional Optional l 283 Standard optional Optional N/A'r 287 Standard Optional N/A 10' cord length standard on all models. For optional l;en^, add "-2,-3 or -5" suffix to model number. ,Example: for model 280 with 35' cord, order 280-3 Motor Specifications Y2hp 60 Hz 3450 RPM Oil filled, thermally protected (PSC) Permanent Split Capacitor 8.0 amps (11 5V) 4.0 amps (208/23OV) P._,j Model 281 Wide angle float switch with quick - disconnect SSPMA CERTIFIED V icp C us Certified Specifications are subject to change without notice. Performance Curve: 280-Series 40 35 30 25 LL � 20 15 10 5 ii 9 8 6 5 3 2 01111111111 1XI 0 0 5 10 15 20 25 30 35 40 45 50 55 60 65 70 U.S. Gallons Per Minute 0 38 78 114 156 192 228 270 Liters Per Minute Dimensional Data: Veight: 29 lbs. Height: 13" Major Width: 10" (model 287) Minimum Sump Diameters: Model 281,283...14" Model 287 VMF ... 1011 Factory switch Model 281, 283 Model 287 settings VMF Turn on level 13 11 9.516 Turn off level 1 .- I 711 4.011 L I The Model 283 features a fully adjustable wide-angle float. Differential adjustments can be made easily by tethering the float to the d Is - charge pipe or other mounting point. Vertical float model 287 Is not adjustable. Model 283 Wide angle float switch with series (piggy -back) plug Fj Model 287 VIVIF-Series Vertical mag- netic float for smaller pits - will operate in a 10" diameter sump Liberty Pumps * 7000 Apple Tree Avenue * Bergen, New York Y4416* phone 800-543-2550 Fax (585) 494-1839 wwvv.1iberfypumps.com Copyright 0 Liberty Pumps, Inc. 2017 All rights reserved. LLIT 2000 R05/17 4 ^ SECTION A -A vm LIM pfa FILE INFORMATION Owner Permit # ESIGN PARAMETERS POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page of Number of Bedrooms Number of Public Facility Units Estimated flow (average) I Design flow (peak), (Estimated x 1.5) Soil Application Rate I Standard InfluentJEffluent Quality Fats,'Oil & Grease (FOG) Biochemical Oxygen Demand (130D 4� Total Suspended Solids (TSS) DNA Ad..NA aal/day/ft2 Monthly average* -530 mg/L 5220 mg/L 0 NA %ao m /L I Pretreated, Effluent Quality Mont verage t verage Biochemical Oxygen Demand (BODri) 530 Mont - Total Suspended Solids JSS) :530 mg/L Fecal Coliform (geometric mean) 510' efull 00m I iMaximum Effluent Particle Size )6 in dia. A6 N 1Other: 0 NA *Values typical for domestic wastewater and septic tank effluent IAINTENANGE SCHEDULE Service Event lInspect condition of tank(s) Pump out contents of tank(s) lInspect dispersal cell(s) C.Olean effluent filter Inspect pump, pump controls & alarm I:Iush laterals and pressure test Other: ether, SYSTEM SPECIFICATIONS Septic Tank Capacity P 16-r_ gal 0 NA Septic Tank Manufacturer x 114'r , 1, , I ze_ 0 NA ........... 0, Effluent Filter Manufacturer 0 NA Effluent Filter Model 0 NA 'Pump Tank Capacity al 0 NA Pump Tank Manufacturer NA Pump Manufacturer, 0 NA Pump Mode-1- 11 NA Pretreatrx*nt Unit NA I 0 Sa*?6ravel Filter 0 Peat Filter 06chanlcal Aeration 0 Wetland Disinfection 11 Other. I Y/ 4 Dispersal Cell(s) 11 NA 0 In -Ground (gravity) 11 In -Ground (pressurized) 10 L IjikA#-Grade 0 Mound Cl Drip -Line 0 Other: Other: 0 NA Other: C1 NA bN- I 0 NA Service Frequency least once month(s) once every: S Qlvear(�l (Maximum 3 years) 11 NA �Vhen combined sludge and scum equals )one-third (X) of tank volume 0 NA At least once every: 11 month(s)--Vvanrhc) (Maximum 3 years) 13 NA At least once every: 0 month(s) 13 NA P s ._jeHU_ At least once every: 0 Month(s) J2�year(s) 0 NA At least once every: ons) th( 0 m/-% 0 NA At least once every: mont [I h(s)% El year s) 0 NA 0 NA MAINTENANCE INSTRUCTIONS Onspections 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 linclude a visual inspection of the tank(s) to identify any mlssing or broken hardware, Identify any cracks or leaks, measure the volume of i0ombined 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 l,egulatory authority. INhen the combined accumulation of sludge and scum in any tank equals one-third (%) or more of the tank volume, the entire contents of 1:he tank shall be removed by a Sept.age 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 :512 months, shall be performed by a certified POWTS Maintainer. I� service report shall be provided to the local regulatory authority within 10 days of completion of any service event. Page .._, of i •► After pumping, all tanks and pits shall gravel or another inert solid material. START UP AND OPERATION nk s for the presence of painting products or other chemicals thElt For new construction, prior to use of the POWTS check treatment tank(s) C P a im ede the treatment process and/or damage the dispersal ceil(s). if high consentrations are detected have the contents of thj� . my p 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. levels. When power Is restored the excess wastewater will b� During power outages pump tanks may fill above normal higt�water result in the backup or surface discharge of effluent. discharged to the dispersal cellmay in one large dose, overloading the cell(s) and Y Operator prior to restoring power to the his situation have the contents of the pump tank removed by a Septage Servicing P controls to restore normal levels To avoid # the um c effluent um or contact a Plumber or POWTS Maintainer to assist In manually operating pump pump within the pump tank. not drive or ark over, or otherwise disturb or compact, the area within Do not drive or park vehicles over tanks and dispersal cells. Do P 15 feet down slope of any mound or at -grade soil absorption area, the life of the POWT$: he following from the wastewater stream may improve the performance and prolong Reduction or elimination oft 9 dental floss; diapers; disinfectants; fat; foundation dram antibiotics; babywipes; cigarette butts; condors; cotton swabs,, degreas�rs� � medications; oil; painting productls; sum pump) water; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; (sump pesticides; sanitary napkins; tampons; and water softener brine. ABANDONMENT following steps shall be taken to insure that the system is properly When the PO�WTS fails and/or is permanently taken out of service the f gGods:. and safely abandoned In compliance with chapter Comm 83.33, Wisconsin Administrative All 9 to in ip tanks and pits shall be disconnected and the abandoned pipe openings sealed. p The ontents of p all tanks and its shall be removed and properly disposed of by a Septage Servicing Operator. c be excavated and removed or their covers removed and the void space filled with MAI, CONTINGENCY FLAN measures have been, or must be taken, to provide a code compll�nt If the POWTS falls and cannot be repaired the followin g replacement system: been evaluated and may be utilized for the location of a replacement soil absorption systejm. 0 A suitable replacement area has be Y The replacement area should be protected fro m disturbance and compaction and should not infringed upon by requl��ed ure lot lines and wells. Failure to protect the replac ' ent area will result in the nEled setbacks from existing and proposed uct , for a new soil and site evaluation to .es fish a suitable replacement area. Replacement sysp6ms must comply with the rulefl In effect at that time. 0 A suitable replacement area is not ava�Iab ue to setback and/or sail limitations. BorIng advances In POWTS technology a holding tank may be installed as a last resort replace the failed POV TS. ;p Identify a s ble replacement area. Upon f re of the POWTS a soil and site evalual� on e site has not been evaluated to fy P suitable re laceme area. If no replacement ar is available a holding tank may be installed) as ust be performed to facets a s p Za last resort to replace the failed POINTS. constructed in l following removal of the biomat at the Infiltraive ound and at -grade soil absorption systems may be P ct at that time. su ace. Reconstructions of such systems must comply the rules In <<WARNING>> CONTAIN L HA GASSES AND/OR INSUFFICIENT OXYGEN. DO NOT SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY UE O� A ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER AN UMSTANCES. C,�EATH MAY RESULT. RESC PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR Im ISLE. ADDITIONAL COMMENTS POWTS INSTALLER POWTS MAINTAINER _ t Marne T_ - gameA ��,�,.� _X j 5ACZ la�� Phone -�- �__ -2 Phone I .- .- 11 --- SEPTAGE SERVICING OPERATO R PUlv1PER LOCAL REGULATORY AUTHORITY .� - Name Name ,,- ' :-- r` 71 F Phone 'I N -Phone, - --� _-. -� )lance with chapter SPS 383.22(2)(b)(1}{d)&{f) and 383.54(1), (2) & (3), Wisc;c�nsin Administrative Code. This document was drafted In camp p 0 WwconsrOn Department of Cornrnerc* SOIL EVALUATION REPORT Nvisior, of Safety and Buildings ir, a=rdance Mh Comm 85: Wis. Aft. Coda Counts �. A'Aach complete site plan on paper not less than 6 V2 x 11 Inches in size. Plan must inducts, bul, not limited to, vertical and hortzoita! reference point (BIV), direction and Parcel I.D. percent slope, scale or dimensions, north arrow, end location and distance to nearest road. Please. print all InformaVon. Reviewed by Parsomol information you providr, rosy � ui*d for soco"wy purposst (Privacy L2,A% 5.04 (1) (m)) 1n5,-*.1%1 Owner ror)erhp Location �l Page - of Date del 14 7,W Gout. Lot 1/4� _1 14 - S Z. N R/�� E - Property Owner's Mailing AddressLot # Block # Subd. Nw" or CS?4 Staim b N Phone Co de Zip oe n6umer C3 CRY 0 Village I /,Road, 00 J11-/ ' New cwstruction Use, idenbal Number of broomss Code derived design flow rate GPD C3 Rep1&:,*rnsnt Public or =nmejciy;scribe: Parent material Flood Plain elevation If applicable R. Gerwal oyTr)ents and recvrwnenda&ns: System type System Elevation Bodry BodN Pit Ground surface elev. ft. Depth to hm1ting factor -5-Z in. AM Anrdir-afinn Piato NORMReidox Descripbon Qu. Sz. Cont. Cdor I�p�Il.�Al�O'rl,�s1L,G7i, opl-WA A Vt4M I Bodry tt E Boring Ground surface ele Pit ft. Depth to limiting factor in. Soil licadon Rate Flofton Depth In. Dominant Color Munsell Redox Descn'pUon Qu. Sz. Cont Color Texture Structure Gr. Sz, Sh. Consistence Boundary Roots GPDM *Eff#1 *Eff#2 Y2--,ZW C.,/ `7 -v A41 EfflueM #1 a BOO.'$, 30 c 220 nVIL and TSS �Effiu�erndt #2�= BOD. 5 30 "VL and TSS� 30 mocjk CST Name (Please Print) Signature CST Number Bird Plumbing, Inc. Shaun Bird Zoe- 226900 Address Date Evaluation onducted Telephone Number 1432 120th St, Now Richmond, W1 54017 - -/,, -. w. 2- 7 715-246-4516 Property Owner _ Boring # El Boring A Pit Parcel ID # ' a �) Ground surface elev. L ft. BOM9.# [] Boring n P, Ground surface elev. EBoring # ElBoringpit Ground surface elev. Horizon "Iepth Dominant Color Redox Descripfion. Texture in. Munsell Qu. Sz. Cont. Color Effluent #1 = SOD, 30.i 220 mg/L and TSS >30 15o mglL Depth to lirniOna factor ��% In Depth to firriffina factor Death to firnitina Mdor In Page -- of Structure Gr. Sz. Sh. Low 1111116141im I * Effluent N2 = BODI < 30 mg& and TSS< 30 ffKVL The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. SOD-8330(RAM) Soil Test plot Pic Project Name Travis Dankem Address y 687 Coulee Trail S ird Hudson Wi 54016 S Et -- Subdivision ------ CSTM #226900 1/4 SE i/4S 14 T 28 Date 12/1/21 --- � _ N/R 19 W ---_. Township Troy []Boring 0 Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 100 ft. Base of survey stake System Elevation TBD *HRPSame as Benchmark ST. CR File #: �;NJTY SANITARY SYSTEM If ��edzrzoz�i��y OWNERSHIPIADDRESS FORM 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 app,"roved,this completed form and educational information will be sent to you by email. Owner/Buyer Mailing AddrE City/State/Zip Phone Number (required) Email Address (required)_A Parcel Identification Number (found on the property tax bill) 01C401- - 119( 1201o, -�5- Property Location� 1/4 1/4 T N R )A,,/ Subdivision Plat: Lot # Certified Survey Map # Volume Pa e # Warranty Deed # -15 %Own% (before 2006)Volume Page # Number of bedrooms Spec house E3 yes��o Lot lines identifiable3(ye no New Pro e A dress 0 LJDV FV, 6 p ......... (Verifica on of gew address required from Community Develop-m"en-—tDipartment for new construction.) (Stiff Initials) I U(Dat) This form must be submitted with all Private Onsite Water Treatment System (POWTS) applications. New System: Include with this form L7 recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if reference is made in the warranty deed. Community Development Department — Land Use Division 715-386-4680 St Croix County Government Center 715-245-4250 Fax odd 2scowl, ov 1101 Carmichael Road, Hudson, WI 54016 wMMScCWLg0V oil O VROOF oerA1L r, REAR F�.LEVATION �n n 7 INSERTED JD- F v 440 SO. FT. 2124 SO. FT. ,W • Ar GARAGE MAIN LEVEL z5) 3D DESIGN LLC Arckilectil Serrices (715)248-3010 cawMe AASwF Aas... rM.. i� crr� AMw F1�N FM "w Ca,rRt:r Ad**" Ad*Wo FliOr FM o.nr comowo ►mow A�rr. "Wo Fe ►wW NOTICE! BIpLDER TO VERIFY ALL DIMENSIONS. SIZES, AND LOCATIONS AND REPORT ANY ERRORS PRIOR TO PROCEEDING, ALL CONTRACTORS OMT FANLM E THEWELVR WnN ALL FEDERAL.STATE. AM Lom sURAsrGcmS WMf,M M ANY YATn*L AFFECT MATEIEALs OR mumil T DIED ON TM FRO/ECT. IF MOT IPWOW ALLY STATEC ON FLANS OR M 8FECIFICJ1TiOMf. TING AF'FNONIMTE CODE WALL GOVEM SCE. auALm. Aln GUAMnTiEs ANO OF ALL WORK A Travis Dankemeyer SINGLE STORY ELEVATIONS f R.21124-2l-3x oAN $442 c w a* cow""" n Al swft AE :+dKane 1A, ir•P ar.P g.o- sr •a Ad _ _ _ _ _ _ _ _ _ 30 OESIGN LLC Arc#itecteret Services (715)248-3010 FOOTOM CanM/IYk AA/r Adt,ra Faw �+wM ca.r�r AOl,m Adlaaa Fi �+„aI Gamowd AdE�a AdY PM fi C FAMYM Ad*� Ad��a F,LLI,L Fi awlu nine NOTICE! BUILDER TO VERIFY ALL DMNENSIOM. SIZES, AND LOCATIOIMS AND REPORT b ERRORS PRIOR TO PROCEEDWS, ALL dONTRAiCTOM MUST F"UAV iE TI�pELVM VAN ALL FEDERAL•STATE. AM LOCAL NU LDKG CODES WHICH K ANY LUT720L AFFECT MATERIALS OR EQUIPMENT USED ON THIS PROJECT. 0 NOT SPECIFICALLY STATED ON PLANS OR K SPECIF1GT10NS. THE APPROP"n OWE SMALL GOVERN UM OUAIM. AND QUANTTTSIS AND KM OF ALL wOOK Na CEO A EAlE Travis Dankemeyer SINGLE STORY FOUNDATION I PF"m rum" R•2124-2L42 „ •P ,r•P D" S 4-I2 wa.n W BIE I?•P EQ•ir i'�1FOIJfMaAT10N pETAIL Cho*" n 1w■V-w SZ-P ,�_P A2 w'•P r�- I I ' 1 I 1 I 1 I 1 { � � I I I 1 M. E%TFItl011 F11oET WALL — — — , — — 1 Ir x ra rAu POURED CONC 1 _ I 1 FOR LaASOIIRY� FIREPLACE I 1 DETANLSKOT,I9tS 1 1 b l ! 1 1 i I I 1 1 I k I 1 1 i I I I I I { { 1 I { { 1 1 1 I I k I I I I I 1 1 I I I k I I I I I 1 I I I I 31 I 1 1 1 I I 1 I I I PORCH�• TALL POURED CONC I I I wrroP++anoavrMa• I I 1 1 1 k Fpl sulE »urPOltr I I I I I I i 1 I k I k 1 f 1 1 I I I I I 1 i k 6 1 I 1 I I I INrERole FT1057 WALL r � ra• rAaa PouRED colic I i wIELASLEDO! I 1 -------------------------- I I I I I 1 1 � I b i I I I I I I 1 1 1 1 1 1 I 1 1 k i 1 = I I I I I I I 1 I I 1 1 I I I ! k I 1 I LLAEOIrMr oPEN.w soR k I +FG GAIV•pE DOOR I 1 I I I I I 1 I I 1 I I I I I i I At er - c• i 'k r A. 1 i 30 DESIGN LLC b4kchitecteril Seivices {715 j,248-3D 1 D 6. 3-0CusnJ� EAT IN KITCHEN 19•& X 16-4 Dw �qlsconstn Depart-nen Di-visior, of Safety' ans,' OIL EVALUATICN REPORT Coma omm 85. Wis. Adm. Code I Co untv I Attardh compiete site plan or, paper not less than 8 '112 x'; 'I inches in size. Plan Must 'tn�ude, but not limited to: Nfe.ftical and horizontal reference point (SM), direction and % Parc6 1. percent slope, scaie or dimensions, north arrow, and bcation and distance tc nearest road. I Flea,se print all inforrya gort. Rew*eweed by Pemon&! information you provide may be used for seoondary purposes (Privacy Law, r. 41 r.04 (I) (m))_ Prmarh,, Ovn r 'I Property ocation /I V �1 Page C' — ios� -�lO�nao Date TGovt. Lot 11 1 i�4 S LI_ N1 TZ R E Vvp') e�4_ O� 1I Property 0wr*-,`s Mailing Address Lot # Bloc*, # Subd. Name or CSNWrVV 7 �4zz I city State Zip Code Pl ane Number. M C4 C3 Village -0-W, N Road L 26L J New constrj&jon 'use - 'dental 1 Number of bedrooms Code derivaed design fiow rate GPD Replacement ubtic or co.mrne�ci e. chbe.: Parent material -� F-7iooj Plain elevation if applicable ft- _Zvi Gaiwal convnents gyl and reconrr*nda&ns: System Type'� C' — Svstem Elevation DBoriN D Boring 5� pit Ground surface elev. /0 ft. Depth to limiting clactor in. �l Anr-Jinnfinn Patrz Horizon Depth in. DorNnantColor' MunseU Radox Descnotion Qu. S7. Cont Coior I extxe Structure Gr. Sz. Sh. Consistence Boundaryl Roots GPDtff *Eff#1 *Eff#2 1~ J9 ' OeOI7 A /2 *01 X Boring # Bodng J� �1 ft, Depth to limiting factor in. ; 1 2 Pit Ground surface ele I �l Annfirnfinn P=tp Horizon Depth in.. Owninant Color Munsell Redox Description Qu. Sz- Cont C<Aw Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/T *Eff#1 *Eff#2 Z W J0 low EfftLmt #1 = BOD. > 30 < 220 mg& and TSS Effluent #2 = BODr < 30 mg& and TS5 < 30 mWL CST Name (Please Print) Signature CST Number Bird Plumbing, Inc. Shaun 226900 Address Telephone Number Dale Evaluation onducted 1432 120th St, New Richmond, W1 54017 715-246-4516 Property Owner Boring # Boring I S Pit Parcel ID # Ground surface elev. Depth to limiting factor in. Page of I So,il_ Annlinnfinn Pmt,-,l min ant Color' Munseli Redox Description Qu. Sz. Cont. Color i Stucture Gr. Sz. Sh. t ff W-AM A Ali_---��� Bonn .# [:] Boring E] pit Ground surface elev. ft. Depth to limiting factor in. Snit Annlirntinn Pnfin I Horizon Depth in. Dominant Color Munsell Redox Description Qu. Sz. Cont.- Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/ff Eff# 1 *EfftQ Boring # Q Boring El pit Ground surface elev. ft. Depth to limiting factor in. I I Soil Application Rate Horizon ')epth in. Dominant Color Munsell Redox Description. Qu. Sz. Cont Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/ff *Eff#1 *Eff#2 Effluent #1 = BODS > 30 < 220 mg/L and TSS >30 < 150 mg/L Effluent #2 = BUD, < 30 nxA 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-altemate-format,.-please-contact-the-department-at-608-266-315 Lor 177Y. 60&.26-4,87-77. - SBD-8330 (R.6/00) Project Nam Address Soil Test Plot: Pla Travis Dankemeyer S ird 687 Coulee Trail LA Hudson Wi 54016 CSrTM #226900 Lot ---- Subdivision ------ Date 12/1 /21 SE 1/4 SE 1/4S 14 T 28 N/131 9 '1J'V El Boring Q Well PL Property Line Jk BM or VRP Assume Elevation 100 ft. Township Troy County ST. CRoIX Base of survey stake System Elevation T B D * H H pSame as Benchmark ;t.���.c, CERTIFIED SURVEY MAP LOCATED IN THE SE1/4 OF THE SE1/4 OF SECTION 14 AND IN THE NE1/4 OF THE NE1/4 OF SECTION 23, T28N, R19W, TOWN OF TROY, ST. CROIX COUNTY, WISCONSIN. NOTE: THIS CERTIFIED SURVEY MAP IS PLATTING TWO PARCELS OF LAND RECORDED IN DOCUMENT NUMBER 1141215 AS ONE LOT. DESCRIBED PARCELS APPEARS TO HAVE BEEN CREATED INITIALLY IN AUGUST 1982 IN DOCUMENT NUMBER 379174. Lu Ln Lu =IF 0 CD Lo T-4 LU Lu cm LL. 0 S114 COR. S EC. 14 ejNN§8L8o47'0811W 0" 1298.31' N1/4 COR. SEC. 23 z u CIO Lu Uj = o cr) F- LL- uj ©� LU uj 0 Ln 0 LL- C= uj CL [ _, LF LE MAR 'o 7 2022 St, crolix county Comi-nunity Development 6,5m -,-z a a;>- - o I r GLOVER ROAD DRIVEWAY EASEMENT--� --588020'35"E 92.60' AGREEMENT DOC. #972030 � Lu Ln F14 Ln 0 C) C) 0 C) CD UNPLATTED LANDS 2f Ln SOUTH LINE OF THE NORTH 132.00'OF THE P Lo W1/20F THE SEI/4 OF THE SE114, SEC. 14 co S8803349"E 651-28' 167.79 1�y a a BORINGS 0 LEGEND LOT 5 22.62 ACRES 985,345 SQ. Fr. SOUTH LINE OF THE SEI/4 OF SECTION 14 NORTH LINE OF THE NEI[4 FOF SECTION 23 SOUTH LINE OF THE NORTH 330.00' OF THE NEI/4 OF THE NE1/4,SEC. 23 N88-47108"W660-07' -UNPLATTED LANDS ST. CROIX COUNTY SECTION CORNER POSITIONED FROM COUNTY COORDINATES. POSITION VERIFIED WITH MONUMENT AS NOTED OR TIES OF RECORD 3/4" X 18" IRON REBAR SET WEIGHING 1.50 LBS. PER LINEAR FOOT u Lu ul 1 1/4" IRON PIPE FOUND Lu SURVEYOR 0 u- EDWIN C FLANUM I- NORTHLAND SURVEYING, INC. Lu T-4 P.O. BOX 152 tn E" co AMERY, WI 54001 Lu U-j u- 0 OWNER r-4 Lu Q TRAVIS DANKEMEYER 687 COULEE TRAIL Lu HUDSON, WI 54016 Fm0 (= u- 0 w Ln BEARINGS ARE REFERENCED TO THE NORTH LINE OF THE NE1/4 OF SECTION 23, BEARING N88047'08"W. (ST. CROIX COUNTY COORDINATE SYSTEM). THIS INSTRUMENT DRAFTED BY MICHAEL ERICKSON JOB NO. 22-12 DWG - CSM DATE 2/09/22 S88"47'08"E 10.92' SE COR. SEC. 14 N88047'08"W 64 9.24' C/) NE COR. SEC. 23 m Lu Lu U z ul = �- ui 0 F of LLJ Ll- 0 LZU LLJ U) C:) �D SCALE IN FEET 1 200' 0 200 400 SHEET 1 OF 2 SHEETS C OWNER PLUMBED TOWN 19F %sop or wwr* elzol)(OUNTY No* 641974 III ij� MEN PREVIOUS NO. N"" A4FYEe LIC*# 22& SEt-- IT !A#j"' N, R AND/01'LOT BLC: ,a a HIS PERMIT EXPIRES 0 0 10 - I ULM k1 U11,61, CHAPTER 145.135 (2)-VISCONSIN 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. ORIZED ISSUING OFFICER - DATE 7JI4 7-/?n791 UNLESS RENEWED BEFO POST IN PLAI—N VIEW 02Z THAT DATE VISIBLE FROM THE ROAD FRONTING THE LOT DURING CONSTRUCTION SBD-06499 (RI 1/20) State Bar of Wisconsin Form 1-2003 WARRANTY DEED Document Number j Document Name THIS DEED, made between Nathan L, Maier and Brianne C, Hartung- Maier, husband and wife ("'Grantor, " whether one or more), and Travis Dankemeyer, a single person ("Grantee," whether one or more)_ Grantor, for a va.uable consideration, conveys to Grantee the following described real estate, together with the rents, profits, fixtures and other appurtenant interests, in Saint Croix County, State of Wisconsin ("Property") (It more space is needed, please attach addendum): 1141215 BETH PABST REGISTER OF DEEDS ST. CROIX CO., WI RECEIVED FOR RECORD 10/14/2021 03:26 PM EXEMPT#: REC FEE 30.00 TRANS FEE 600.00 PAGES: 2 "The above recording information verifies that this document has been electronically recorded & returned to the submitter Recording Area Name and Return Address: Travis Dankerneyer • -Va- e m. i t f! z4ri id E31 o ve T -R (!p it, & e. R6�vey- FMI �-,�5540,222 6 040-1087-20-000, 040108720000 and 040-1057-40-000 Parcel Identification Number (PIN) This is not homestead property. SEE EXHIBIT "A" ATTACHED HERE -TO AND MADE A PART HEREOF Grantor warrants that the title to the Property Is good, indefeasible in fee simple and free and clear of encumbrances except: Municipal and zoning ordinances and agreements entered under them, recorded easements for the distribution of utility and municipal services r c rdec bu'Iding and use restrictions and covenants, and general taxes levied in the year o' closing- Dated. - Nathan L. Maier 2-4 Brianne C Hartung -Maier AUTHENTICATION Sigr,ature(s): Nathan L. Maier and Brianne C. Hartung, Maier, husband and wife authenticated on TITLE: MEMBER STATE BAR OF WISCONSIN (If not, authorized by Wis. Stat. § 706.06) THIS INSTRUMENT DRAFTED BY. - Chris Staats, Scrivener FA-21-0809-P 4330 Golf Terrace, Suite 103 Eau Claire, WI 54701 ACKNOWLEDGMENT STATE 0, )-SS COUNTY OF Personally came before me on 9q, V the above named Nathan L. Maier and Brianne C. Hartung -Maier, husband and wife to me known to be the person(s) who executed the foregoing instrument and acknowledged the same. Notary signature Notary Public, A,�u, My commission ( is permanent) (expi res). 143JZ2- 1� (Signatures may be authenticated or acknowledged. Both are not necessary.) NOTE: THIS IS A STANDARD FORM. ANY MODIFICATIONS TO THIS FORM SHOULD BE CLEARLY IDENTIFIED. WARRANTY DEED 9 2003 STATE BAR ©F WISCONSIN FORM NO, 1-2003 "Type narne below signatures St. Croix County 1141215 Page 1 of 2 EXHIBIT"A'" Parcel 1: The West 112 of the Southeast 114 of the Southeast 114 of Section 14, Township 28 North, Range 19 West; EXCEPT the North 132 feet. Said land being in the Town of Troy, County of St. Croix, and State of Wisconsin. AND The North 330 feet of the West 660 fi :et of the Northeast 114 of the Northeast 114 of Section 23, Township 28 North, Range 19 West. Said land being in the Town of Troy, County of St. Croix, and State of Wisconsin. Parcel 2: Together with an easement for ingress and egress over a parcel of land located in the Northeast 114 of the Southeast 114 and the Southeast 114 of the Southeast 1/4 of Section 14, Township 28 North, Range 19 West, as described in Document No. 972030. Address: Vacant Land Glover Rd. Tax Key Nos.: 040-1057-40-000 and 040-1087-20-000 (Signatures may be authenticated or acknowledged. Both are not necessary.) NOTE: THIS IS A STANDARD FORM. ANY MODIFICATIONS TO THIS FORMA SHOULD BE CLEARLY IDENTIFIED. WARRANTY DEED ® 2003 STATE BAR OF WISCONSIN FORM NO. 1-2003 `Type name below signatures St. Croix County 1141215 Page 2 of 2 1151791 BETH PABST REGISTER OF DEEDS ST. CROIX CO., WI LOCATED IN THE SE1/4 OF THE SE1/4 OF SECTION 14 AND IN THE NE1/4 OF THE NE1/4 RECEIVED FOR RECORD ©F SECTION 23, T28N, R19W, TOWN OF TROY, ST. CROIX COUNTY, WISCONSIN. 04/20/2022 09:21 AM CERTIFIED SURVEY MAP VOLUME: 32 NOTE: PAGE: 7106 THIS CERTIFIED SURVEY MAP IS PLATTING TWO PARCELS OF LAND RECORDED IN REC FEE: 30.00 DOCUMENT NUMBER 1141215 AS ONE LOT. DESCRIBED PARCELS APPEARS TO PAGES: 2 HAVE BEEN CREATED INITIALLY IN AUGUST 1982 IN DOCUMENT NUMBER 379174. o GLOVER ROAD s OAI EAST - WEST I --- -- _L4 LINE, SEC. 14 --S88020'35"E 92-60' DRIVEWAY EA SEMENT---,] — AGREEMENT DOC. #1972030 -�: I U-j I ab rn ws rn T-4 %---4 -1 0 0 ED kn w su er 011811 Wt UNPLATTED LANDS SOUTH LINE OF THE NORTH 132'OF THE C3 W1/2 OF THE SEl/-1 OF THE SEI/4, SEC. 14 ' "Now S88033149"E 651.28' N ---------- /67.79' LEGEND ST. CROIX COUNTY SECTION CORNER POSITIONED FROM COUNTY COORDINATES. POSITION VERIFIED WITH FOUND ALUMINUM MONUMENT 1 1/4" IRON PIPE FOUND W V) Uj to LU SURVEYOR U- EDWIN C FLANUM 0 F, NORTHLAND SURVEYING, INC. LU P.O. BOX 152 U-j Ln En C/D AMERY, WI 54001 LU LL- C:) CD Lij U- v— C) OWNER U4 LOT 5 TRAVIS DANKEMEYER Em Uj 687 COULEE TRAIL 22.G2 ACRES HUDSON, WI 54016 Z)j 985,345 SQ. FF. Lj M 0 c� U-j U- C=:) C) Uj Ln BEARINGS ARE REFERENCED TO THE NORTH LINE OF THE NE1/4 OF SECTION 23, BEARING N88047'08"W. (ST. CROIX COUNTY COORDINATE SYSTEM). THIS INSTRUMENT DRAFTED BY MICHAEL ERICKSON JOB NO. 22-12 DWG - CSM DATE 2/09/22 S 1/4 COR. SEC. 14 N88047.08"W V 1298.31' N 1/4 CO R. SEC. 23 cn 1 L1 tip C= Q CV12 UL C) LU LU L-L c"4 c'*4 0 C= Uj 0 SOUTH LINE OF THE SE1/4 OF SECTION 14 649.151 660.0-T N88-47'08"W 2596-62' NORTH LINE OF THE NEI/4 OF SECTION 23 SOUTH LINE OF THE NORTH 330'OF THE NE1/4 OF THE NEI/4,SEC. 23 N89047'08"W 660.07' UNPLATTED LANDS St. Croix County 1151791 Page 1 of 2 S88047'08FlE 10.92- SE COR. SEC. 14 �N880-47'08"W 638.24' - — --0 NE COR. SEC. 23 v U-jca i;: '�r C)' LLJ 4 = LIJ F- Ln LL- Uj ti 0 LLJ LLJ LL- = 0 © U-j = C= Z::> � S "D kn to SCALE IN FEET 1 200' 0 200 400 SHEET I OF 2 SHEETS C) (0