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HomeMy WebLinkAbout022-1017-60-060 (2)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 COLE R SMALL TOWN OF KINNICKINNIC CST BM Elev: Insp. BM Elev: BM Description: W0.00 NCI Couw o: wl- TANK INFORMATION TYPE MANUFACTURER CAPACITY Septic 'A f1ba-r C0 __VL(00 Dosing $DD AcrA+invti 01 lo�� 52.5 TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Septic IC0, 3 Dosing Aeration Holding PUMP/SIPHON INFORMATION Manufacturer Demand �041 GPM G3 � Model Number 'If2, 141 TDH Lift Friction Loss System Head TDH Ft I`-,n i.� Forcemain Length Dia. Dist. to Well 2� I SOIL ABSORPTION SYSTEM ELEVATION DATA County: St. Croix Sanitary Permit No: 648486 State Plan ID No: Parcel Tax No: 022-1017-60-060 Section/Town/Range/Map No: 07.28.18.100A-60 STATION BS HI FS ELEV. Benchmark ::r-o?t.YT* *_1 �.28 1 , Alt. BM %f 4 Bldg. Sewer °I2.5 St/Ht Inlet c+iu+ ni I+iot vv I IL vMLI%. Dt Inlet Dt Bottom 13 05 $$ y l Header/Man. Dim-90ell ",roe of 4r.-Ahi 2 , Cos Bot. System Fin al Grade St Cover cowrov'?, fi,IJGNMARI� �Q 411 BED/TRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS �a' 2 SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR UNIT �,Ot�l►�r Type Of System: Model Number: DISTRIBUTION SYSTEM 25- �b edge_ D� (D44. Header/Manifold Distribution x Hole Size x Hole Spacing Vent to Air Intake Pipe(s) k �.5 ` 61e Length .25 Dia i Length �V Dia Spacing ,3 Z5 F SOIL COVER x Pressure Systems Only x Mound Or At -Grade Systems Only Depth Over Depth Over fT x Depth of ` xx Seeded/Sodded xx Mulched Bed/Trench Center Bed/Trench Edges opsoil �❑, )( Yes ❑ No ❑Yes ❑ No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: II 3I2D23 Inspection #2: Location: 994 COULEE TRL 1.) Alt BM Description - Nor 1.7_1 ft.t 4 sand U fkA4 4 46, co-polek 2.) Bldg sewer length = 21 - amount of cover Plan revision Required? ❑ Yes [:4 No 2 23 Use other side for additional information. 5 15 SBD-6710 (R.3/97) Date Insepctor's Signature Cert. No. Department of Safety County RECEIVED & Professional Services, ST. CROIX P 06/07/2023 Industry Service,&D i v i n— Sanitary Permit Number (to be fillcd in by Co.) S S -n- Sanitary Permit Application State Transaction Nuniber In accordance with SPS 383.21(2), is. Adm. Code, SL[bllliSS1011 of this form to flic appropriate governmental unit PWTS-062301024-C Project Address (if different than mailing is required prior to obtaining a sanitary permit. Note- Application forrns, 'for statc-o-vncd POWTS are submitted to the Dcpar tinent of Safety and Professional Services. Personal information You provide may be used for secondary address) purposes in accordance with the Privacy Law, s, 15.04(l)(m), Mats. 994 COULFF TRIL 1. Application Information — Please Print All n " Information Property Owner's Name Parcel COLE & ERICA SMAL-.I-.-. 022 - 1017- 60- 000 Property Owner's Mailing Address Property Location 2245 NAMEKAGON STIZI'l-'T Govt. Lot NA City, State Zip (,.,odc Phone N L1171 be[' 1 IUDSON, Wi 5-10 16 507 - 696 - 5653 S E 114 NE 1/4 Section 07 11� 28 N R 10 . XXV IL Type of Bu ilding (check all that a pp!y) Lot # Subdivision Name al or 2 Family Dwelling — Number of Bedrooms 4 6 1-3 I NA 1 o uk 4 P U b I i c/Co in inerc i a] — Describe Use NA 11 City of El State Owned — Describe Use EJ Village of CSM Number DD60. Ittl7q2 W-owil of III ICI F—USF, X V30nP6856 if Ill. Type of POWTS Permit: (Check either "New"' or "Replacement" and other applicable on line A. Check one box on line B. Complete line C if ,I P P A, -ANe—W Sys el 1ieplacenlent System Other Modification to Existing System (explain) El Additional Pretreatment Unit (explain)'" CONNECTING BATHROOM FOR SHED' Holding tank IN GI-Offlld F1 At-Crade �'X M ound E1I11djVidL1�'11-SitC1)eS(T11 I RhUTN Ile (CXPIZ1111) (C-onvelitional) C. 0 Renewal Before L-1-1 Revision El Change Of Number Ll Transfer to New Owner List Previous Permit NUmber and I)RtC ISSLICd Fxpiration IV. Dispersal/Treatment Area and Tank Information: L, , 5-o' X J, 6' C,& vmA-V 1211(1-0- I)CS14,111 Flow ((-7Pd) Design Soil Application Ratc(gpd/s Dispersal Area Required (sf) Dispersal Area Proposed (SO System I'devatl . oil 600 10 300 390 101.50 FT. Capacity in Total ;i of MantifilCtUrer Tatill.- liff0i-mation Gallons Gallons t.� i i i ts Ncw'rarks Existing Tanks r. 4-j con V) Scptic or Holding 'rank 1200 1 120 1 WIESER (COK4130) X Dosing Chaniber 800 800 V. Responsibility Statement- 1, the undersigned, assume responsibj1ity for In to ption of the POWTS shown on the attached plans. Plumber's Name (Print) Plum s Si RaW MP/MPRS Number Business Phone Number MICHAEL RODEWALD 931384 715 - 4'-')') - 6200 Plumber's Address (Street, City, State, Zip Code) 285 C.T.H. SS, IUVER FALLS, WI 54022 I. County/Department Use Only Approved El Disc l2l2roved Permit Fee Date issued Issuing gent Signature /l� ror Det�/ nor Cjiv �icason for Doti' ohm Conditions f- Approva1 1-- 3) At[ BPS CAM +-r- M 0 QA.D- aAL L;A 3*c;e— Lj,;,* SYSTEM OWNER -tias per M;,L+! It Sepfic tank, effl LIOP t filter and dispersal reli must be serviced / maintained as per management plan provd by plumber. 2. All setback rah remerts Tnust be maintained as per appliaabl� cede / oidint,inces. Attach to complete plans for the system and submit to the County only on pater not less than 8 1/2 x 11 inches in size SBD-6398 (R. 03/22) COPY + S47L P� 7 L A g LM SVRW' V - Ci "n 0. 57, vi SIM TPA I -TA Ov 4 "4C) I ee Mel sr-4, Oka ME A 5.5 IF I ti v d-r PA If z Aft A 41 go sit -TF'dw--'1C45 ::: Wisconsin Department of Safety and Professional Services Division of Industry Services 4822 Madison Yards Way PO Box 7302 Madison, WI 53707 IONP V June 6, 2023 CUST ID NO.: 224832 MARY JO HUPPERT 25720 FIREFLY LANE WEBSTER, WI 54893 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 06/06/2025 MUNICIPALITY: TOWN OF KINNICKINNIC ST. CROIX COUNTY SITE: COLE & ERICA SMALL 994 COULEE TRAIL ROBERTS, WI 54023 SE 1/4 OF THE NE 1/4, SEC. 07, T28N, R19W FOR: Design Wastewater Flow Value: 600 Bedrooms: 4 Limiting Factor(s): 24" Maintenance Required: Effluent Filter Phone: 608-266-2112 Web: http://dsps.wi.gov Email: dspsAwiscons in. oovv Tony Evers, Governor Dan Hereth, Secretary Identification Numbers Plan Review No.: PWTS-0623 01024-C Application No.: DIS-052324743 Site ID No.: SIT-116608 Please refer to all identification numbers in each correspondence with the Department. Conditionally APPROVED DEPT. OF SAFETY AND PROFESSIONAL SERVICES DIVISION OF INDUSTRY SERVICES 1/Jc.,.fit SEE CORRESPONDENCE Geomat Mound Component Manual - 5/18/22 Pressure Distribution Component Manual - Version 2.1 (May 2022-2027) SITE REQUIREMENTS • A full size copy of the approved plans, specifications, and this letter shall be on -site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. A Department electronic stamp and signature shall be on the plans which are used at the job site for construction. The following conditions shall be met during construction or installation and prior to occupancy or use: • Preserve dispersal area prior and during construction to avoid disturbance, compaction and use of the site. • With new construction; it is recommended not to activate the pump in the dose tank until the tanks are pumped prior to homeowner occupancy. • Wastewater generated from contractors cleaning of equipment and tools and/or left over construction products shall not be discharged into the drains discharging to the private onsite wastewater treatment system (POWTS). Waste generated shall be properly disposed of on -site or off site. • Any tall grasses, leaves and shrubs shall be cut short and removed prior to tilling the surface for installation to prevent matting under the dispersal area. All loose organic material to be removed from POWTS Dispersal Area. • Divert surface water from all POWTS Areas. • Prior to construction of the dispersal area, check the moisture content of the soil to a depth of 8 inches. Smearing and compacting of wet soil will result in reducing the infiltration capacity of the soil. Proper soil moisture content can be determined by rolling a soil sample between the hands. If it rolls into a 1/4- inch wire, the site is too wet to prepare. If it crumbles, site preparation can proceed. If the site is too wet to prepare, do not proceed until it dries. • All piping shall conform to SPS Table 384.30-3 and SPS Table 384.30-5 • Insulate building sewer beyond 30 feet per SPS 382.30 (11)(c) • Well setbacks to meet chs. NR 811 & 812 • Tank Installation to follow all manufacture's recommendations. • Verify property line(s) prior to installation. • Pump Floats to be set and verified per approved plan. Any changes may result in pump resizing to meet TDH and GPM Specifications. • Areas that are occupied with rock fragments, tree roots, stumps and boulders reduce the amount of soil available for proper treatment. If no other site is available, trees in the basal area of the mound must be cut off at ground level. A larger fill area is necessary when any of the above conditions are encountered, to provide sufficient infiltrative area. Owner Responsibilities • The current owner, and each subsequent owner, shall receive a copy of this letter including instructions relating to proper use and maintenance of the system. Owners shall receive a copy of the appropriate operation and maintenance manual and/or owner's manual for the POWTS described in this approval SPS 383.54(1). • In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approved plans. OWNER RESPONSIBILITIES • The current owner, and each subsequent owner, shall receive a copy of this letter including instructions relating to proper use and maintenance of the system. Owners shall receive a copy of the appropriate operation and maintenance manual and/or owner's manual for the POWTS described in this approval and Wis. Admin. Code § SPS 38 • In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approved plans. The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. This system is to be constructed and located in accordance with the enclosed approved plans and with any component manual(s) referenced above. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, stats. All permits required by the state or the local municipality shall be obtained prior to commencement of construction/installation/operation. In granting this approval, the Division of Industry Services reserves the right to require changes or additions, should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. The Division does not take responsibility for the design or construction of the reviewed items. Inquiries concerning this correspondence may be made to me at the contact information listed below, or at the address on this letterhead. Sincerely, Fee Required: $250.00 r , Fee Received: $250.00 f�41{ 4ill-"/1-1'4-%;/ Balance Due: $0.00 Tim Vander Leest Refund Expected: $0.00 POWTS Plan Reviewer Division of Industry Services Phone: 608-516-6134 Email: tim.vanderleestgwisconsin.gov INTO AND COMPONENT DESIGN GeoMat MOUND AND PRESSURE DISTRIB INDEX AND TITLE PAGE lem ( wner in Conditionally APPROVED DEPT. GF-SAFETY AND PROFESSIONAL SERVICES DIVISION OF INDUSTRY SERVICES Project NaMe'. COLE & ERICA SMALL Owreef' s Narne, (SAME) Owner's Addre<35' 2245 N.AMEKAGON STREET f i U L). VV I ultu I SEE CORRESPONDENCE Property Info Property Address, Legal Description, Township Subdivision Name, Lot Number, Parcel I.D_ Number. Plan Transaction No.: Index Pages 994 COULEE TRAIL SE NE S 7 T 28 N R 19 W County: T. CRUX KINNICKiNNIC NA 6 Btock Number-, NA CSM#'. 30/6856 022 - 1017 - 60 - 0100 Page 1 Index apd title Page 9 Tank, cross sections Page 2 Data entry Page 10 Site Diagram Page 3 GeoMat mound drawings Page 11 So ' it ' tes,t, Page 4, Lateral and dose tank Page 12 Sailtest Page 5 Distribution media Page 13 So'I tt Page 6 System maint.enance specifications Page 14 Aeri-:-il Page 7 Management and contingency plan Page 8 Pump curve and specifications d ll -M I Jaj�,UPPERT License Number: Phone Number: 715-426- 41775 5 Y4P '4A 0 ignat vk_ W a r State of Wisconsin Approval Starn.p. I er �_4 1 44 iL L Designed Pursuant to the GeoMat Mound Component Manual 5)18/22 SSVVMP Publication 9.6 Design of Pressure Distribution Networks for ST-SAS (01181) and Prey sure Dimrd?uwn Qomponcnt Manuat 'der. 2.1 (May 2022 - 2027) Page 1 of 14 Mound and Pressure Distribution Component Design Design Worksheet All water treatment systems shall be kept out of septic system Site Information R Residential or Commercial Design N ISD Required? 400.00 Estimated Wastewater Flow (gpd) 1.50 Peaking Factor (e.g. 1.5 = 150%) 600.00 Design Flow (gpd) 5.00 Site Slope (%) 101.50 �24.00 Depth to Limiting Factor (in) 0.40 In -situ Soil Application Rate (gpd/ft2) 80.00 Contour Length Available (ft) Distribution Cell Information 6.50 Cell Width (ft) 3.25, 6.5 or 9.75 Only_ 60.001. Designer Input Cell Length (ft) 2.00 Dispersal Cell Design Loading Rate d/ft 60.00u p g g (gp 2) Dispersal Cell Length Required (ft) Influent Wastewater Quality (1 or 2) Pressure Distribution Information E Center or End Manifold 2 Number of Laterals 3.25 Lateral Spacing (ft) 37.52 Forcemain Drainback (gal) 1.90 Forcemain Filter Loss (ft) 2.00 Forcemain Diameter (in) 230.00 Forcemain Length (ft) 89.50 Inside Pump Tank Elevation (ft) 0.188 Orifice Diameter (in) (e.g. 0.25) 3.00 Estimated Orifice Spacing (ft) _ System Head (ft) x 1.3 Vertical Lift (ft) Friction Loss (ft) Total Dynamic Head (ft) 5x Void Volume (gal) Minimum Dose Volume (gal) System Demand (gpm) 3.25 12.25 3.47 20.87 54.04 91.56 26.21 Diameter Selection Lateral Diameter Selection in. dia. options choice 0.75 1.00 1.25 1.50 x x 2.00 x x 3.00 Manufacturer Information Are the laterals the highest point in the distribution Y network? If N above, enter the elevation (ft) of the highest point.w ,w Does the forcemain drain back?i Y 9.75 ft2/orifice Manifold Diameter Selection in. dia. options choice 1.25 x 1.50 x X 2.00 F_ 3.00 Treatment Tank Information Effluent Filter Information Optional 1200.001 Septic Tank Capacity (gal) Polylok Inc./Zabel Filter Manufacturer Wieser Concrete Products, Inc. I Manufacturer 3014-525-1/16-107000 GPD Filter Model Number Dose Tank Information Gallons/Inch Calculator (optional) 800.001 Dose Tank Capacity (gal) Total Tank Capacity (gal) 22.241 Dose Tank Volume (gal/in) Total Working Liquid Depth (in) Wieser Concrete Products, Inc. Imanufacturer gal/in (enter result in cell DoseTankVolume) Project: COLE & ERICA SMALL Page 2 of 14 Mound Plan View W T J - T A I � I L ................................................. 1/10 B :::::::::::::::::: Observation Pipe .................................................. �p,; ,; ,; ,■�. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .•.•.•.•.1•...•.•.•.•.•.•.•.•.•.•.•.•.•.•.•.•.•.•'...'•.•.•.•.•.•.•.•.•.•.•.•.•.•.•.•.•.•.•.•.•1.-.•.•.•. ... B , . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .... ........JJ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Mound Component Dimensions Down slope toe extension made. A 6.501 ft E 3.90 in H 1.00 ft K 7.11 ft CB 60.00 ft F 14.50 in I 18.50 ft L 74.23 ft (S 0.00 in G 1 0.50 ft J I ft W 1 29.46 ft 390.00 (ft2) Dispersal Cell Area 1500.00 (ft2) Basal Area Available 10.00 (gpd/ft) Linear Loading Rate 1 6" End of B Obs. Pipe Placement Mound Cross Section Vie GeoMat Dispersal Area Observation Pipe 12" ASTM C 33 sand as GeoMat required for Geo Mat Distribution Cell component GeoMat + 12" ASTM C-33 sand 103.71 Finish Grade + -+T+ + �, Cover Material 102.58 Lateral Invert Elevation. �` *� � ++fit .��� � +++ ++ + 101.50 Dispersal Cell + + - + �+ +m +* Slope 5.0 Elevation . . . . . 4 4E ++ + + + . . .++ + + + + + + + + + ++ * + , Contour Elevation 101.50 Tilled Area Uhl Forcemain In situ soil In situ soil hading KeyWw 1 Topsoil Cap Subsoil Cap + ASTM C 33 sand F) 4 ASTM C 33 sand D) Tilled Layer, 1w eo Mat See details on page 4 for number, size, and spacing of laterals. Project: COLE & ERICA SMALL Page 3 of 14 End Connection Lateral Layout Diagram • = Turn -up w/ball valve or cleanout plug 1st orifice located at Z 1 z All orifices point down P I ' i Laterals &force main of PVC Sch 40 per SPS Table $4.30-51 Number of Laterals 2 Orifice Diameter 0.188 in Lateral Diameter 1.50 in Orifice Spacing (X) 3.10 ft Lateral Length (P) 59.45 ft Orifices per Lateral 20 Lateral End (Z) 0.55 ft Orifice Density 9.75 ft2/orifice Lateral Spacing (S) 3.25 ft Manifold Length 3.25 ft Lateral Flow Rate 13.11 gpm Manifold Diameter 1.50 in System Flow Rate 26.21 gpm Forcemain VelocityE 2.68 ft/sec Dose Tank Information 4" ltilet • E 13,1110 Project: 1=inished Grade " Clean out Pipe Clearflow NSSCFF324 Locking cover tivith %�-arning label, lucking device and water tight seal Electrical box as per NEC 300 and SPS 31628 WAC r- Wires From Electric source Boss stop and water - Ak tight gasket High water alarm Ba- ,,. f Pump On Float Putnp 017C Float " Bedding. under tan Dimension Inches Gallons A 19.85 441.56 B 2.00 44.48 C 4.12 91.56 D 10.00 222.40 Total 35.97 800.00 4" Vented Covet- T sconnect Optional bal v lve to control spe d of effluent bein dosed Optional o tlet Forcemain diameter 2 in. 4" ASTM 303 pipe to encase forcem in onto solid ground Weep hole or ant Fut nco siphon device Pump off elevation (ft) Pump 90.33 Mock Wieser Concrete Products, Inc. Capacity 800.00 1 Volume 22.24 Dose tank elevation (ft) 89.50 gal/inch Filter Manufacturer Clearflow Filter Model Number NSSCFF324 Alarm Manufacturer SJE Rhombus Alarm Model Number AB Tank Alert Pump Manufacturer Liberty Pumps Pump Model Number 280 Pump Must Deliver 26.21 gpm at 20.87 ft TDH Note: Switches containing mercury may not be used in this system. COLE & ERICA SMALL Page 4 of 14 GeoMat Distribution Cell Media Layout 6.50 Cell Width (ft) 1.63 Sidewall to Lateral (ft) Distribution Cell Cross-section Arranqements 00000c�0000a000000000 �oaoa000000coaaac(D U U__ 7U 0- `- oa`�cC� Component Legend O Distribution Pipe With Pressure Lateral L-.--I Orifice Shield Turnup Enclosure — — — — — Pressure Lateral GeoMat is covered with approved geotextile fabric as per the their product approval. Distribution Cell Plan View Layout - Typical 6.50 ICell Width -A (ft) 60.00 Cell Length - B (ft) End Connection Lateral Layout Diagram G OC�C�00O�JOC�D�,,��D■■��C���C�(�Ci�DOC�C�C�0�C7r7r_�o �00 � 0�� C 6 C C 7C O CUOOC CC) C Q O C O O7 C7 C7 C7 t C] C7 O O C 7 C C O CJ O O 0 0 0 J00C C OO C}0 (0) L C O OOC C C7OpOC C DpC C C MW Typical Dispersal Cell Sand Fill Recommended Distribution Lateral • Orifice Shield Pipe Dia. Approved Infiltrative Fabric GeoMat IF Component Infiltrative Surface/Plow Layer t Observation Pipes Water Tight Toilet Flange 4" Min - r-I ebarN Shading Key Topsoil Cap Subsoil Cap f A TM C 33 sand F ATM C 33 sand (D) 1" Min Install at �_ Tilled Layer nd/Geo 1' Min IF �4F .: _- ; eo Mat Ik WAMCWErTqg + /8 Min Dig Retm + d'3 + See details on page 4 for number, size, and spacing of laterals. Project: COLE & ERICA SMALL Page 5 of 14 Mound System Maintenance and Operation Specifications Service Provider's Name DARRELL'S SEPTIC SERVICE Phone 715-425-1025 POWTS Regulator's Name St Croix County SPIA - Zoning Office Phone (715) 386-4680 System Flow and Load Parameters Design Flow - Peak 600 gpd Maximum Influent Particle Size 1/8 in Estimated Flow - Average 400 gpd Maximum BOD5 30 mg/L Septic Tank Capacity 1200 gal Maximum TSS 30 mg/L Soil Absorption Component Size 390 ft2 Maximum FOG 10 mg/L Type of Wastewater. Domestic Maximum Fecal Coliform 10E4 cfu/100 mL Septic and Pump Tank Effluent Filter Pump and Controls Alarm Pressure System Mound Other Service Frequency Inspect and/or service once every 3 years Inspect and clean as necessary at least once every 3 years Test once every 3 years Should test periodically Laterals should be flushed and pressure tested every 3 years Inspect for pondina and seeaaae once every 3 vears Miscellaneous Construction and Materials Standards 1. Observation pipes are slotted and materials conform to Table SPS 384.30-1, have a watertight cap and are secured in as shown in the Synergy Systems GeoMat Mound Component Manual Version 1, 2017. 2. Dispersal cell media conforms to GeoMat products approved for use with the Synergy Systems GeoMat Mound Component Manual Version 1, 2017. Media is covered with an approved geotextile fabric. 3. All gravity and pressure piping materials conform to the requirements in SPS 384, Wis. Adm. Code. 4. Tillage of the basal area is accomplished with a mold board or chisel plow. 5. The mound structure and other disturbed areas will be seeded and mulched to prevent soil erosion and help reduce frost penetration. _ 6-8" Diameter O o8 0 8 2 C)O O'O 01c)' °( Finished OOo()c, Lawn Sprinkler 0 ��0-c" Grade Box 'o coo ° °o0 c"�. .. . Q G 0 C C7 C7 OrC) .)o 0�0 __ c7 c 00000 Lateral Ends at Last Orifice Wherenr n 8b� 1 0p0p000r� Q0p G�0C�0C�0�0i:�0C30C� [30000�O�O�c�� . 00000000000000 0000000 C� 0100 .. 00000000 00 0 0[. 00000 C 10 0 0�01 � �c p��j�00 (_ }c 00 CC700 0, C700 00C]000 c Oc 00 0c � 40000C700C�C�C30C�0�00 � C�O0OC]OGOC��OOC]�U���C'�0000�"��Oc 000---------------- Distribution Lateral Lateral Turn -up Detail °0�'��-M 00000 Threaded Cleanout �0 CO 0 Plug or Ball Valve Lateral Cleanout 1.6 Feet Long Sweep 90 or Two 45 Degree Bends Same Diameter as Lateral Project: COLE & ERICA SMALL Page 6 of 14 Mound System Management Plan Pursuant to SPS 383.54, Wis. Adm. Code General This system shall be operated in accordance with SPS 382-84 Wis. Adm. Code, and shall maintained in accordance with its' component manuals [Synergy Systems L.L.C., Geomat Mound Component Manual version 1, 2017, Pressure Distribution Component Manual Ver. 2.0 SBD-10706-P (N. 01/01) and SSWMP Publication 9.6 (01/81)] and local or state rules pertaining to system maintenance and maintenance reporting. Septic and pump tank abandonment shall be in accordance with SPS 383.33, Wis. Adm. Code when the tanks are no longer used as POWTS components. Septic or pump tank manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 8-inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into a tank or component. Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Stats. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code. The operating condition of the septic tank and outlet filter shall be assessed at least once every 3 years by inspection. The outlet filter shall be cleaned as necessary to ensure proper operation. The filter cartridge should not be removed unless provisions are made to retain solids in the tank that may slough off the filter when removed from its enclosure. If the filter is equipped with an alarm, the filter shall be serviced if the alarm is activated continuously. Intermittent filter alarms may indicate surge flows or an impending continuous alarm. The septic tank shall have its contents removed when the volume of sludge and scum in the tank exceeds 1/3 the liquid volume of the tank. If the contents of the tank are not removed at the time of a triennial assessment, maintenance personnel shall advise the owner as to when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank. The addition of biological or chemical additives to enhance septic tank performance is generally not required. However, if such products are used they shall be approved for septic tank use by the Wisconsin Department of Commerce. Pump Tank The dosing (pump) tank shall be inspected at least once every 3 years. All switches, alarms, and pumps shall be tested to verify proper operation. If an effluent filter is installed within the tank it shall be inspected and serviced as necessary. If the force main has a weep hole, it should be noted if it is functional during pump operation, and if not, it should be cleaned. *****No one should ever enter a septic or dose tank since dangerous gases may be present that could cause death.**** Mound and Pressure Distribution System No trees or shrubs should be planted on the mound. Plantings may be made around the mound's perimeter, and the mound shall be seeded and mulched as necessary to prevent erosion and to provide some protection from frost penetration. Traffic (other than for vegetative maintenance) on the mound is not recommended since soil compaction may hinder aeration of the infiltrative surface within the mound and snow compaction in the winter will promote frost penetration. Cold weather installations (October -February) dictate that the mound be heavily mulched as protection from freezing. Influent quality into the mound system may not exceed 220 mg/L BOD5, 150 mg/L TSS, and 30 mg/L FOG for septic tank effluent or 30 mg/L BOD5, 30 mg/L TSS, 10 mg/L FOG, and 104 cfu/100 mL for highly treated effluent. Influent flow may not exceed maximum design flow specified in the permit for this installation. The pressure distribution system is provided with a flushing point at the end of each lateral, and it is recommended that each lateral be flushed of accumulated solids at least once every 3 years. When a pressure test is performed it should be compared to the initial test when the system was installed to determine if orifice clogging has occurred and if orifice cleaning is required to maintain equal distribution within the dispersal cell. Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the owner, and any levels above 4 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring. Contingency Plan If the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep the system in proper operating condition. If the dosing tank, pump, pump controls, alarm or related wiring becomes defective the defective component(s) shall be immediately repaired or replaced with a component of the same or equal performance. If the mound component fails to accept wastewater or begins to discharge wastewater to the ground surface, it will be repaired or replaced in its' present location by increasing basal area if toe leakage occurs or by removing biologically clogged absorption and dispersal media, and related piping, and replacing said components as deemed necessary to bring the system into proper operating condition. See Page 6 of this plan for the name and telephone number of your local POWTS regulator and service provider. Project: COLE & ERICA SMALL Page 7 of 14 bberol, S& V,y ump Pump Specifications UTERS PER WNUTE 5C; 200 250 300 50 "IN ku� 12 10 0 Lu z E 4C uj .!H 0 0 10 20 30 40 CC. 70 80 90 GALLONS PER MINUTE NJ NO P I RO 1 (11 no 15 iCCopyngW2Af5Lim A=nMhic. Alftn&sn-.,mN-rd. - - - - - - - - - - - iil` J I� 4" CA'ST—A—SEAL I �I I i t F FR 0 R iLTr RAFFLE ` I to to I 4" CAST —A —SEAL 4" VENT PUMP PAD OUTLET < WLP1200/800-MR TANK SPECIFICATIONS S a. DIMENSIONS - LU WALL: S� 0- a - BOTTOM: 3" COVER: 6" Li . MANHOLE: 24" I.D. PRECAST CONCRETE RISER HEIGHT: 53" LENGTH: 130-8" J _001 IDTH: 8 W BELOW INLET: 41 E LIQUID LEVEL: 36" 0 WEIGHT: BOTTOM 14,800 LBS. CL COVER 8t170 LBS. I Li INLET AND OUTLET- M 0 Li 4" CAST ——SEAL BOOT OR EQUAL GASKET dr U < cc < Lj INLET AND OUTLET BAFFLE AND FILTER: M col - M, U_ WISCONSIN, SEE DETAIL #10 mw�� wj 2 (OTHER STATES SEE CHART) LIQUID CAPACITY: 33.46 CAL IV (SEPTIC) 22.24 AL Ili (PUMP) LOADING DESIGN: 8"-0" UNSATURATED SOIL Lo TANK CAN BE USED AS: SEPTIC / HOLDING / PUMP OR SIPHON n COVER: MIX DESIGN #8 (NO FIBER) 0 00 TANK: MIX DESIGN #9 (SMALL FIBER) CUSTOMIZED TANKS: FOR CUSTOM TANKS CONTACT WESER CONCRETE REVIEWED BY 0 0 REVIEW DATE F- 2DE-VIEW DRAWINGS SUBMITrED FArPOPROVED FOR APPROVAL APPROVED BY: SHEET NO. 5 SHEET: By Glen Schlueter at 11:07 am, Jan 18, 2022 APPROVAL DATE: TANKS ARE mANUFACTURED TO MEET OR EXCEED A.STM C-1227 REQUIREMENTS PRODUCTS NEEDED BY: PL O)N A r� LM VRW' Ci Towtj cjF O—Opa SIM TPA A goo "14 vi FILI _S Mely sr-4, -Tvr Oka ME A 5.5 0 0,00 IF I ti v d-r PA 74Y If z Aft A 41 go sit -TF'dw--'lC45 ::: ST. CR0 N-ry SANITARY SYSTEM File #: OWNERSHIP/ADDRESS FORM ot�t�euseo�ry Created lilon 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 INFORMATION Owner/Buyer Cole &Erica Small Mailing Address 2245 Namekagon st Cit /State/ 1. Hudson WI, 54016 y p Phone Number (rea uired) 507-696-5653 Email Address (req uired) Colesma1110@gmail Parcel Identification Number 022-1017-60-060 (found on the property tax bill) Property Location SE 1/4 p y NEW SYSTEM: LEGAL DESCRIPTION NE 1/4,Sec. 7 ,T 28 N R18 W,Town of KINNICKINNIC Subdivision Plat: ,Lot # 6 Certified Survey Map # 30-6856 I/l/792— ,Volume 0 ,Page # (o Warranty Deed # 1154642 (before 2006)Volume ,Page # Number of bedrooms 4 New Property Address (Staff Initials) Spec house 0 yes 0 no Lot lines identifiable E yes 0 no OFFICE USE ONLY 9�q CouL �. (Verification of new address required from Community Development Department for new construction.) (0j/ / Z4? Z -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.ec�ov State Bar of Wisconsin Form 1-2003 WARRANTY DEED Document Number I Document Name THIS DEED, made between John D. Bettendorf and Candace R. Bettendorf husband and wife as survivorship marital propeqy ("Grantor," whether one or more), and Cole R. Small and Erica R. Small husband and wife as survivorship marital propert ("Grantee," whether one or more). Grantor, for a valuable consideration, conveys to Grantee the following described real estate, together with the rents, profits, fixtures and other appurtenant interests, in Sa4itCroix County, State of Wisconsin ("Property") (if more space is needed, please att h addendum): LOT SIX (6) OF CERTIFIED SURVEY MAP IN VOLUME THIRTY (30) OF CERTIFIED SURVEY MAPS, PAGE 6856, AS DOCUMENT NUMBER 1111792 FILED IN ST.. CROIX COUNTY REGISTER OF DEEDS FFICE SEPTEMBER 16, 2020, BEING LOCATED IN THE SOUTHEAST QUARTER OF THE NORTHEAST QUARTER (SE1/4OF NET) OF SECTION SEVEN (7), TOWNSHIP TWENTY EIGHT (28) NORTH, RANGE EIGHTEEN (18) WEST, TOWN OF KINNICKINNIC, ST.. CROIX COUNTY, WISCONSIN, INCLUDING LOT 5 OF THAT CERTIFIED SURVEY MAP, RECORDED IN VOLUME 26, PAGE 5078, DOCUMENT NO. 088065 OF ST. CROIX COUNTY CERTIFIED SURVEY MAPS. 1154642 BETH PABST REGISTER OF DEEDS ST. CROIX CO., WI RECEIVED FOR RECORD 06/ 16/ 2022 10:34 AM EXEMPT#: REC FEE 30.00 TRANS FEE 270.00 PAGES: 1 **The above recording information verifies that this document has been electronically recorded & returned to the submitter Recording Area Name and Return Address: File# 2148605 Cole R. Small and Erica R. Small q Cot ITO u S. 022-1017--60-060 Parcel identification Number (PIN) This is not homestead property. 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, recorded building and use restrictions and covenants, present uses of the Property in violation of the foregoing disclosed in the Grantor's (Seller's) Real Estate Condition Report, if any, and in the Offer to Purchase for the Property between the Grantor and Grantee, if any, and general taxes levied in the year of closing and will warrant and defend the same. Dat s . Bettendorf Candace R. Bettendorf AUTHENTICATION Signatures): John D. Bettendorf and Candace R. Bettendorf, husband and wife as survivorship marital property authenticated on ---------- - TITLE: MEMBER STATE BAR OF WISCONSIN (If not, authorized by Wis. Stat. § 706.06) THIS INSTRUMENT DRAFTED Y.- Elizabeth Johnson Scrivener / 4���r� Knight Barry Title United LLC °�vr �'`'�p 116 E. Elm Street River Falls, Wl f��� ACKNOWLEDGMENT STATE OF WISCONSIN COUNTY OF PIERCE Th instrument was acknowledged before nee on this :r day of , .2022, by John D. Bettendorf and Candace R. Bettendorf (the signer). The signer was: X- physically in my presence OR in my presence involving the use of communication technology Notary Public: Sys Notary Public Printed N me• FA Notary Public, State of Wisconsin 1 My commission (is permanent){expires: W1 2 y (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 Q 2003 STATE BAR of WISCONSIN FORM No. 1-2003 *Type name below signatures St. Croix County 1154642 Page 1 of 1 LEF T �E� _ 1� 18 _OYATION INSERTED 313-1 18�! ELEVATIONJE. _ V_0 !'v, n'� —1— 411�1z--� 4,1 =oil VI GHT ELEVATION 8 _O 1 -1 1624 SQ. FT. MAIN LEVEL 780 SQ. FT. GARAGE 1624 SQ. FT. LOWER LEVEL z I 30 OESIGN LLC Architectural Services (715)248-3010 NOTICE! BUILDER TO VERIFY ALL DIMENSIONS, SIZES, AND LOCATIONS AND REPORT ANY ERRORS PRIOR TO PROCEEDING. ALL CONTRACTORS MUST FAMILIARIZE THEMSELVES WITH ALL FEDERAL,STATE, AND LOCAL BUILDING CODES WHICH. IN ANY MATTER, AFFECT MATERIALS OR EQUIPMENT USED ON- - - THIS PROJECT. IF NOT SPECIFICALLY STATED dN PLANS OR IN SPECIFICATIONS, THE APPROPRIATE CODE SHALL GOVERN SIZE, QUALITY, AND QUANTITIES AND SIZE OF ALL WORK. Cole Small SINGLE STORY ELEVATIONS Project number R-1624-2R-22 Date 11-8-22 Drawn by Bill Checked by Ryan Al scale As indicated E a � -1 0: - � §� z za ziwv 0a w �gw ' I i I1 I I I< 5 LU LL a C' Of < " MH w z a w C� IL IL BRACED WALL LINE 111-1 5.0 BRACING REQUIRED I w cr a- D m C� 'j M a. 8.0SUPPLIE W/4-OPANELS 16 1 : D I I I m;: wq BRACED WALL LINE R2-1 I 1 11.7 BRACING REQUIRED 12.0 SUPPLIED W/ 4-0 PANELS o i i I i i i , I ' � I BRACED WALL H RECT. #1 G A4 BRACED WALL C T.? WALL C RECT. #2 VSL4836 3-JO VSL3636 FW06068 2LYI 3WX91ir VDH3060-2 �t L UNEN PLVL H EADER VDH3060-2 Ll'w LE 8'- 0 3/4" KITCHEN 4- 0" 2-6 6D 11-0 X 13-0 DIJ 3-0 IT a j LIVING ROOM M. BEDROOM 3-0 1 16-2 X 15-6 12-10 X 11-6 4--0- 9'- 6" H 2-8 4-0 w z :3 0 NOTICE! Al F U) > FAN, 3-0 > BUILDER TO VERIFY ALL DIMENSIONS, SIZES, AND LOCATIONS AND ------ v ED --------------- 3-0 REPORT ANY ERRORS PRIOR TO PROCEEDING. 10-0 X 8-0 O.H. LL9& 3-0 O i W 2-6 01 T T zo 4 Al ALL CONTRACTORS MUST FAMILIARIZE 2 PLY 1 W X 11 7W LVL HEADER 10-0 X 8-0 O.H. 2 PLY I Y4* X 117/8- LIA HEADER - — - — - - 1 1 i 3-0 1 — I I 2'-6- —I n - w v 7 3/4" — LINEN FAN > I= T W THEMSELVES WITH ALL FEDERAL,STATE, AND LOCAL BUILDING CODES WHICH. IN ANY MATTER AFFECT MATERIALS OR EQUIPMENT USED ON THIS PROJECT. IF NOT SPECIFICALLY STATED ON 2 5'- 8 1/4" 12'- BEDROOM LIN DINING ROOM T- 5 3/4" DNz jA FOYE FAN 3-0 jo 3 0 PLANS OR IN SPECIFICATIONS, THE APPROPRIATE CODE SHALL GOVERN SIZE, QUALITY, AND QUANTITIES AND SIZE OF ALL WORK. --------- - A4 - 12-0 X 10-0 1 11-0 X 10-2 C14 5-3 X 11-6 17 RISERS 3 SHELVES 2-8 No. A Description INITIAL RELEASE D11ate -8-22 L VDH3D60-2 3060-2 L- b, BRACED WALL LINE 111-2 6 ' 0 BRACING REQUIRED 10.0 SUPPLIED W/ COMBINATION 4-0 PANELS & EXT. HEADERS I I - - - - - - - CC I i j D � VDH3048 m L I D i t BRACED WALL LINE ' I 1 I � I I l i i I ON I , i i i I I� I I i I I ► I 11.7 12.0 BRACED WALL LINE R2.2 BRACING REQUIRED SUPPLIED W14-0 PANELS PANEL DETAILS BRACED WALL DOUBLE RECTANGLE 14 1'-0" BRACED WALL LINE RECT- #130-0 X 26-0 11-0 WALL HEIGHT WALLS SUPPORTING ROOF AND CEILING ONLY EAVE-TO-RIDGE HEIGHT 10-0 1 'I II V, I T 14'- 0" PANEL DETAILS BRACED WALL DOUBLE RECTANGLE RECT. #2 58-0 X 28-0 Cole Small CONTINUOUSLY SHEATHED BRACED WALLS 4-0 STRUCTURAL PANEL SHEATHING EXTENDED HEADER (SEE A4) II, I1II 91-91 6'- 9' 1 1 5'- 7 3/4" 5'- 7 3W 1 1 9-0 WALL HEIGHT WALLS SUPPORTING ROOF AND CEILING ONLY EAVE-TO-RIDGE HEIGHT 12-9 CONTINUOUSLY SHEATHED BRACED WALLS SINGLE STORY 12'- 6 3/4" 2'- 6" 1 1 1 V- 3 1/2" 4'- 7 3/4" T-6" 5'-y' 4 111 8'- 13/4" 2' - 0" i 4-0 STRUCTURAL PANEL SHEATHING MAIN LEVEL (-,-,�-MAIN LEVEL f/ 30'- a" T — 14'- Y' 9'-6" 58, - 0" Project number R-1624-2R-22 T 1624 SQ. FT. Date 11-8-22 Drawn by MAIN LEVEL Bill Checked by ---____Ryan At Scale A3 114" 0 Wisconsin Department of Commerce SOIL EVALUATION REPORT Page 1 of 3 Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code County ST. CROIX Attach complete site plan on pgWr not less than 8 1/2 x 11 inches in size. PlaUnust 7 include but not limitejW�: rti nd horizontal reference point (BM), directic� Parcel I.D.I , (Pending), percent slope, north arrow, and location and distance to ne ad. L2-A vip � " nt all information. Reviewed by Date !MO I Personal informs �Ion yvou provide May be used for secondary purposes (Privacy Law, s. 1 m)). Property Owner c J:Irope tion .1 K,111�0 M E JOHN D. & CANDACE R. BETTENDORF of ---- SE 1/4 NE 1/4 S 7 T 28 N R 18 E (or) W Property Owner's Mailing Address Lot # lock # Subd. Name or CSM# 970 Coulee Trail 2 CSM Pending City State Zip Code Phone Number f"'V- ity Village ETown Nearest Road U-1 Roberts, WI i 5401_7715 425-6200 . - Coulee Trail New Construction Use Residential / Number of bedrooms NK Code derived design flow rate NK GPD Replacement Public or commercial - Describe: Parent material loess over till Flood Plain elevation if applicable NA General comments Mound System -- 1.25 ft. sand fill -- 0.4 loading rate and recommendations: Bodng# Boring Ground surface elev. 102.05 ft. Depth to limiting factor 24 in. Pit I Soil Annfication Rate Horizon Depth in. Dominant Color Munsell Redox Description Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/ff *Eff#1 *Eff#2 1 0-12 10YR3/3 sil 3fa&sbk ds as 3vf-m 0.6 0.8 2 12-24 1 OY R4/4 sil 2fabk m fr CS I vf-f 0.6 0.8 3 24-30 1 OY R4/4 fl f I OY R4/6 sil I fabk m fr as I vf-f 0.6 0.8 4 30-36 7.5YR3/4 f2f7.5YR5/6 scl Om mfi 0.0 0.0 2 Boring# Boring 30 pit Ground surface elev. ft. Depth to limiting factor in. :nil Annfiration Rate Horizon Depth in. Dominant Color Munsell Redox Description Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/ff *Eff#1 *Eff#2 1 0-11 IOYR3/3 A 3 f-ma&sbk ds as I vf-M 0.6 0.8 2 11-20 1 OYR4/4 sil 3fabk ds CW I vf-f 0.6 0.8 3 20-24 1 OY R4/4 CI 2 fabk m fr aw I Vf-f 0.4 0.6 4 5 24-30 30-36 7.5YR3/4 7.5YR3/4 f2f 7.5YR5/6 si scl I mabk om mvfr mfi ate' I of-f 0.4 0.0 0.7 0.0 * Effluent #1 = BOD5 > 30 < 220 mg/L and TSS >30 < 150 mg/L Effluent #2 = b0u� < 3u mg/L ana I - Z)b < JU mg/L CST Name (Please Print) S ture CST Number Ma g Jo Huppert (Hollister's Soil Testing & Des t 224832 Address Date Lfv uation Conducted Telephone Number W9875 690th Avenue,, River Falls, W1 54022 07-27- 13 (715) 426 - 1775 C, V% 1-,% ONl n j " n"I In 4N Property Owner BETTENDORF, John & Candace -�r3 Boring # Boring 0 pit Ground surface elev. _ Parcel ID # Lot 2 (Pending) Page 2 of 3 96.35 ft. Depth to limiting factor 24 in. Sniff Ann1iratian Rate Horizon Depth in. Dominant Color Munsell Redox Description Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. I Consistence I Boundary Roots I GPDM *Eff#1 *Eff#2 1 0-13 10YR3/3 -- sil 3fgr&abk ds as 1 vf-m 0.6 0.8 2 13-21 1 OYR4/4 -- sil 2f-mabk mfr as 1 of-f 0.6 0.8 3 21-27 10YR.4/4 m2d 7.5YR5/6 sicl 1 fabk mfr as l of f 0.2 0.3 4 27-35 7.5YR3/4 m2d 7.5YR5/6 sl 1 f-mabk mvfr as -- 0.4 0.7 5 3540 7.5YR3/4 m2d 7.5YR5/6 SO 0m mf -- -- 0.0 0.9 Boring # BoringPit Ground surface elev. ft. Depth to limiting factor in. 461 AnnficaMn Rate Redox Description Structure Boring # Boring Pit Ground surface elev. ft. Depth to limiting factor in. Salpplication Rate Dominant Color: Munsell Redox Description Qu. Sz. Cont. Color Structure Gr. Sz. Sh. * Effluent #1 = BOD5 > 30 5 220 mg/L and TSS >30 c 150 mg/L * Effluent #2 = BODE c 30 mg/L and TSS < 30 mg/ - 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. MD-8330Tea (R07/00) Plot Plan for Site and Soil Evaluation Property Owner Sao LqW Desc*don oFTHE NE�� S7. im I R1E4J, MWK) DF L"I )91A-fjlC� ST. cRDV C�Ou AITYh„W4Y`ONS IIJ tjV�*4, oMp o P F&WE PW ,q 00 1 A6096 Aqo""O .or LOT COXNE40- 0 A4&,uueu ioo, o0 14 e,#040WAO fi�,J 47 ►oz�c�s oksau sm,cE w Q+itOWYD AT G.wMP OF Sfi. Tx6pc IOx"'r SueLocadons x �4W - • OW-0 106,0" csvWf:OA CpNTpbtR 'yD at SSMOW t:xaS4wUOO StAKirD Page 3 of 1" =4Ojt (accept where noted) lzo I = Backhoe Pit pr,VcN#U& z Aca.& North Parcel #: 022-1017-40-000 08/29/2013 03:28 PM PAGE 1 OF 1 Alt. Parcel M 07.28.18.99A 022 - TOWN OF KINNICKINNIC Current FX-1ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type # of Units 00 0 Tax Address: Owner(s): 0 = Current Owner, C = Current Co -Owner O - BETTENDORF, JOHN D & CANDACE R JOHN D & CANDACE R BETTENDORF 970 COULEE TRL ROBERTS WI 54023 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description * 970 COULEE TRL SC 4893 SCH DIST RIVER FALLS SP 0100 CHIP VALLEY VOTECH Legal Description: Acres: 38.300 Plat: NIA -NOT AVAILABLE SEC 7 T28N R18W 38.30A SW NE EXC 1.70A Block/Condo Bldg: TO CSM VOL 5/1302. Tract(s): (Sec-Twn-Rng 40 1 /4 160 1 /4) 07-28N-18W SW NE Notes: Parcel History: Date Doc # Vol/Page Type 11 /19/2012 967743 WD 07/23/1997 425/602 05/19/1997 559546 1239/418 WD 11 /10/1994 523345 1102/296 LC more... 2013 SUMMARY Bill #: Fair Market value: Assessed with: Use Value Assessment Valuations: Description Class RESIDENTIAL G1 AGRICULTURAL G4 AGRICULTURAL FOREST G5M Totals for 2013: General Property Woodland Totals for 2012: General Property Woodland Last Changed: 09/07/2010 Acres Land Improve Total State Reason 5.000 80,000 278,000 358,000 NO 18.300 21900 0 21900 NO 15.000 37,500 0 37,500 NO 38.300 120,400 278,000 398,400 0.000 0 0 38.300 120,400 278,000 398,400 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: Batch #: 520 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 Certified Survey Map John D. and Candace R. Bettendorf e 4%41: 06d 0040,704 Part of the Southeast 14 of the Northeast Y4 and the Southwest Y4 of the Northeast Y4 of Section 7, Township 28 North; Range S 00"48'13"W k696-76' 2-J-S�;-M-p —VO4--1 5, P -9 7 4 10 2 18 West, Town of Kinnickinnic, St. Croix County Wisconsin. .1k --� -4 ' T-Un-6 &W-714- 0b NU- 2332.16 26.4,60T 610 c. TH. ,ss R N 00'40'13"E ID �- 231.60' N6,00 )-7- cl� E 114 Cot -,Sep;. 7, T26N, f? 113 W CL U Uj 04 C6 V) Q3 4 FIZ W I'll Feet I q.0 0, .200 100 0 200 All bearings referenced to the EastAlVest Y4 line of Sec. 7, T 28 .r11, R 18 W, assumed N 68"11'55'W \`\jj I I I I I If.*,* / \SCON LAURD W. MUR NY • s S17 3 UL m 4 'I' SwoZb 0 W1 Poo ***o LAND g `��� Dated., August 5, 2013 Legend: 0 Indicates I Y4" O. D. x 16" iron pipe set. (min. weight 1. 13 lbs.17in. ft.) 0 Indicates I Y4" O.D. iron pipe found. R (10. 00') Indicates previously recorded data & Indicates Berntsen Alum Mon. Fd. V Indicates designated driveway position ti CLI Z) U.1 � CV Nco Unplatted Lands S 0002822"W 922.46' 1269,01' N 00"20'22"E 1302.02' T LO C\j C) Co JD ti m 231.71 33,?0' C N 0 04 62 9 -E 264.7 R(Nodh 264.81 cV LOCV LO ?Ib S 01 `4 7'57 W 264. 231.0,1' 33. W, R(South) co cc -j C) (n Cl) ?) C0 �2 CL33 33 345,24' 34,00' N 01 "46'07"E 378,24' R(North 3 78.3 V) co CL co low 345.17' 3 S 01 "4 8'61 "W 3 78. f 7K -1 (So378.31) RR(South Vj Owner's Address: nu 4) I 970 Coulee Trail co oo r--� River Falls, WI 54022 ca 4) Unp la tied L a n ds "Tt t1- tz rCL W 114 Cor. See. 7, M Sheet I of 2 Sheet. T28 N, R 18 W ri sm DiWa"nt Of COMmce YrOA SOIL EVALUATION REPORT Macm4tre pap' i Cff 3 11 Boring 24 Boring 0 Pit CnwndgmrfaCe646v, 102-05ft Depth to limMrig faCtW in. sod Rate H=m DMepinant Cobr Redox Descrotion. Textufe Structure Con5istence! Bmpdary ROM ,om GP" *Ef1#1 *Eff#2 in- Qu. Sz- Cont. for -Gr- Sz Sh. --munsell 0-12 1 OYR3/3 SLI 3fa&sbk ds as 3vf-m 0,6 - 0.8 2 12-24 10YR4/4 sil I I 2fabk I of-f 0.6 0,8 3 24-30 10YR4/4 n f I OYR4,i6 I fabk m as I of-f 0�6 0,8 4 30-36 7-SYR3/4 scl Om mfi 0.0 0,1D Bon-ing 30 Swing .100.95 Elpit Ground sMfaoeelev- Depth to 1-trn" fact0f Heron OWh 00miront QAW Redox Dwjip . tion Texture StnXtum Inc urdary' Rooft GPDff *Eff#1 ,Elff#2 in. Qu. Sz- Cont. Color Gr. Sz. Sri. 10YR33 SO 3f-11Lia&sbk ds as I vf-m 0,6 0.8 11-20 10YR4/4 S 3 fabk ds Cw v I f-f 0.6 09 . - 3 20-24 10YR4/4 Cbk 1 2fa m.ft ate' 0 4 0.6 1 4 24-30 7.5 Y R314 I mabk mv rr ;aw I Vf-f 0.4 0,7 -- s - - - - 30-36 7,5YR3/4 t'-) f 7,5Y R 5/6 scl om Infi 0.0 0.0 I mot and Tss:� 30 m9k Effluerd #1 = 800 > 30 f 220 nv�L and TSS >30,� 15G nV& Eftent #2 80D-k < 30 M Numbw CST Nam Pleaw Ph nQ ture 224832 M!a Jo Ruppert (Ho...Jfistees Soil Testing & AWnm -1-j ckma 9Wu*inn Canduded Ted NuTbv W9875 690th Amain e, Rjvcr Falls, W1 5402-2 07-27- 13 (72715) 426 - 1775 Pr-opertwner B F-TrEN DORF, John & Candace y O IE0 "L U Boring 96.35, Boring El pjj Ground surface SkBv ft- p Soft pit Boring # Boring 1:1 9 PH Lot 2 (Pending) ps�p of 4- Parcel ID * - Depth to �mding factOf 24 in. ----------- Depth to limdIng fact Of in. Depth io I'mMng failm - Effitwrit 01 = OM,5 > 30 <- 220 rrg& 8nd I -SS >30 f 150 n4L * Eft #2 = BMI ± 30 mgA- a nd TSS � 30 mg& T-ft D"anment of Commerce is an equal apportunity 5ervice provid:er and cMPl()Yclr- if you need assistance to access services or need material 'in an alternatc fomat, pjea-contact the dcpartment at 6W266-3151 or TT 608-264-8777. �R ollpol v plot Pla+for Site and Soil Evalwation propwy Owner A) begat l�est�ipdm 2 &1 111 MAL DE 6%wl1�lmdla —uj F&,VCE Pta Alive Aftwo LO do KNE4- I A 1W .M 5mrz ijpj s&LMJ> AT OF SA- TXOW& 10 0 Site Location: -0 Fm ts�&WA &—svmp -AFMIR Wav �M AKS 0 ) Otw--d5mTH Pit- IFOp, Page 13 of 3 40ft where noite* CEI = Backh oe pit P&j Ex OJ& 0 '44! R-E North I 1111"792 BETH PABST REGISTER OF DEEDS ST. CROIX CO., WI RECEIVED FOR RECORD Certified SurveyMa 09/16/2020 01:30 PM CERTIFIED SURVEY MAP John D. and Candace R. Bettendorf Trust VOLUME: 30 PAGE; 6856 Part of the Southeast % of the Northeast l of Section 7, Township REC FEE-. 30.00 28 North, Range 18 West, Town of Kinnickinnic, St. Croix County, PAGES: 2 Wisconsin, including Lot 5 of that Certified Survey Map, recorded in Volume 26, Page 5978, Document No. 988065 of St. Croix County Certified Survey Maps. r` " E 114 Cor. Sec. 7, T 28 N, R 18 W, ro (Bemtsen Alum. Mon. F.D.) ro Lot 1 C.S.M. Vol. 95, Page 4102 r 4 NE Car. Sec. 7, T 28 N, R 18 W, Lot 2 0 (Bemtsen Alum. Mon. Fd.) S 00"48'13"W 2596. 76' -4 S 00048113"W 393.06` E Line NE 1/4 10Ad C.T.H. "SS� S 00 -48 `13 "V I/ 4903. 70' oo S 00'48'13 "W 360. 06' l � �� o• Q. o � � CV) 0 1a, ti 3333' m 6 6' 44a co ~ N Cie Q`\ N !► N v v b .� 1 N O i a o cV cV y V'3 eu 360.02' oi 33.00' a V" CO a to t= S 01 °17'33"W 393.02' O C to co h co co co rC o O co t- v.. to ti ca W y L O o o� I ° �, a� S7` oQoN� N C ro X,` Q .� p .a cV N o tq o~o�� � ft a ya L cy ► p tp a 360.00 33.00' to aE T. t.. ° v Unplafted Lan N 01'46'29'E 393.00' R(NorthIT CO 0) CO b a .--- --- ds ) N a 2 -c n = ° Lot 2, C.S.M., Vol. 5, . _ — k a� amv�� Pae1 W 114 Cor. Sec. 7, T 28 N, R 18 W, a Dated. May 28, 2020 �. 3/8O.D. Iron ' 4 (2 " Pipe Fd.) -. 00 o � N������►�Ilulllru���ri 'n s a . RE .MU Hy w S1 13 # RIVER FALL .. � v,�.�� S w •c'°'�� NS wl r �' to zzz� ~ /1/1j111t4i1tN��� Sheet 1 of 2 Sheets 3o-OA,5Co St. Croix County 1111792 Page 1 of 2 Certified Survey Map John D. and Candace R. Bettendorf Trust Part of the Southeast % of the Northeast % of Section 7, Township 28 North, Range 18 West, Town of Kinnickinnic, St. Croix County, Wisconsin, including Lot 5 of that Certified Survey Map, recorded in Volume 26, Page 5978, Document No. 988065 of St. Croix County Certified Survey Maps. Description. - That certain parcel of land located in the Southeast % of the Northeast X of Section 7, Township 28 North, Range 18 West, Town of Kinnickinnic, St. Croix County, Wisconsin, including Lot 5 of that Certified Survey Map, recorded in Volume 26, Page 5978, Document No. 988065 of St. Croix County Certified Survey Maps, described as follows; BEGINNING at the East % corner of said Section 7, thence N 88011'55"W (recorded bearing on the East/West % line of said Section 7, previously recorded as West) a distance of 522. 66' (recorded as 522. 72) thence N 01 °46'29"E (recorded as North) a distance of 393.00 .. on the West line of said Lot 5, and the Northerly extension thereof thence S 88011'55"E 515. 99 ; thence S 00°48'13"W 393. 06' on the East line of the Northeast % of said Section 7, to the POINT OF BEGINNING, containing 4.685 aces or 204, 097 square feet, being subject to easement for Town Road and County Trunk Highway "SS" right of way purposes over Southerly and Easterty portions of said parcel as shown on this map and also being subject to easements of record. Dated: May 28, 2020 State of Wisconsin) County of Pierce) 1, Laurence W. Murphy, Professional Land Surveyor, do hereby certify that by direction of the Owners, John D. and Candace R. Bettendorf Trust, that I have surveyed and divided the lands shown hereon in accordance with official records Chapter 236.34 of the Wisconsin Statutes and the Ordinances of St. Croix County and that this map and description are a true and correct representation thereof. General Notice Statement: Note: each parcel shown on this map is subject to State, County and Township laws, rules and regulations (i.e. wetlands, minimum lot size, access to parcel, etc.). Before purchasing or developing any parcel contact the St. Croix County Community Development Office and the Town of Kinnickinnic. St. Croix County Treasurer. 1, Denise Anderson, being the duly elected, qualified and acting Treasurer of the County of St. Croix, do hereby certify that the records in my office show no unredeemed tax sales and no unpaid taxes or special assessments as of , 2020 affecting the lands included in this Certified urvey Aop. OOP Doo 3 DAte: C unty su v/ a f. LgV;nlE ''• w • UR Approved y S 1 �Y3 = O A FALLS SEP 1 6 2020 o .• LAND St. crux County ;nmmun ty Development Sheet 2 of 2 Sheets 30-W5(e St. Croix County 1111792 Page 2 of 2 5�G-CReik COUNTY [Lkll- ........ . . ..... . .... ..... 17 cout'-ee S� r%cinLivLvJti'� PREVIOUS NO. OWNER �A1.E � ER ICA GVV4qLL CO&V\& t3D — SBD-06499 (RI 1/20) t� :1...... .... . . ZDNEX CHAPTER 145.135 (2) WISCONSIN STATUTES (a) The purpose of the sanitary permit is to allow installation of the private sewage system described in the permit. (b) The approval of the sanitary permit is based on regulations in force on the date of approval. (c) The sanitary permit is valid and may be renewed for a specified period. (d) Changed regulations will not impair the validity of a sanitary permit. (e) Renewal of the sanitary permit will be based on regulations in force at the time renewal is sought, and that changed regulations may impede renewal. (f) The sanitary permit is transferable. History: 1977 c. 168; 1979 c. 34,221; 1981 c. 314 Note: 1f you wish to renew the permit, or transfer ownership of the permit, county authority. lease contact the cvun P . .. . .. ......... . . ...... ... ... ... . ...... . ... .. ............. . .. .. . ...