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HomeMy WebLinkAbout020-1478-19-000 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County. St. Croix Safety and Building Division Sanitary Permit N INSPECTION REPORT 538784 ) 0 GENERAL INFORMATION (ATTACH TO PERMIT) State Pla I D N k t r Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: City Village X Township Parcel Tax No: Oeverin Homes LLC, c/o Kenneth J. Oeverin Hudson, Town of 020 - 1478 - 19 -000 CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range /Map No: ���► f 6vt Z- "�' 13.29.19.3018 TANK INFORMATION ELEVATION DATA 'I TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark � ' � ��,`, Z � ` �. 0 / ��• �l. Dosing G O d Alt , A 14 16 • 7 Bldg. Sewer er �t Q ' G y 7 A l , Holding St/Ht Inlet St/Ht Outlet -� TANK SETBACK INFORMATION TANK TO P/� WELL BLDG. V t to Air Intake ROAD Dt Inlet --� J Septic z9 Z 7 Dt Bottom Dosing 1 ?5 Header /Man. � 7 3, Aeration Dist. Pipe _ /63 33 Holding Bot. System 3 /6z Final Grade t Z • 2 /� PUMP /SIPHON INFORMATION Manufacturer 1 �j Demand St Cover GPM �' �,� r /�� t7 Model Number Cow, ! 3 /dZ TDH Lift Friction Loss System Head TDH Ft Forcemain Lengt Dia. Dist. to Well SOIL ABSORPTION SYSTEM l lf• BEDITRENCH Width Length N PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS Iz - �� _ 1 SETBACK SYSTEM TO P/L JBLDG WELL LAKE /STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR Type Of Sy tem. ( �7 / w )/� . / UNIT Model Number: / DISTRIBUTION SYSTEM rHeader/Manifold Distribution It x Hole Size J11 x Hole SpacinP Ven Air Intake —� Pipe(.) 3 ' b Z V gth ` Dia Length Dia Spacing "-- SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only f 4r Depth Over j Depth Over xx Depth of \ xx Seeded/ odded xx Mulched Bed/Trench Center Bed/Trench Edges .._ Topsoil es n No Yes No COMMENTS (Include code discrepencies, persons present, etc.) Inspection #1: // Inspection #2 Location: 891 Hillside Trail Hudson, WI 54016 (NE 1/4 SE 1/4 13 T29N R1 9W) Alexander st Addition Lot 32 Parcel No: 13.29.19.3018 1.) Alt BM Description = Y • % `l 6 G ' �. ' G I,�c.� �"—� 4 ��d 2.) Bldg sewer length = Z Os'`- - amount of cover � � a r� Plan revision Required? Fm� Yes XINO Use other side for additional information. t � Date Insepctor' Signat e Cert. No SBD -6710 (R.3/97) RECEIVED s PAID —++ - U _ - -_ __ Count L - -- -- � " etse tlt 1.w Safety and Buildings Division y ;.KUIX COU TY 201 . Washington Ave., P.O. Box 7162 LrL ZONI OF FICE Madison, WI 53707 -7162 Santary (to be filled in by Cr.) _ e"t of Commaroe --- -- - - - - -- -- State Tranution Number Sanitary Permit Application ��aa ce with s. Comm. 83.2 ( 2), Wis. Adm. Code, submission of this form to the appropriate governmental —_ Gordan ( addr In ac dross if different th m mailing addr s unit is required prior to obtaining a sanitary permit, Note: Application forms for state -owned POWTS are Project Address { submitted to the Department of Commerce. Personal information you provide may be used for secondary p u n ►es in accordance with the Privacy L.aw, s 15 04(1)(m) Stets Cq ��I / i C � S �G{ 7 t I. Aqt lication Information - Please Print All Information - -- parcel # — Property Owner's Nattte 020 - l y 7Y N - 0 Property Owner's Mailing A se Property Location / , O� City, State Zip ode Phone Number y, %,, Sct e ion _ II. ' e or Banding (check an that apply) Lot # -- - - - -- Subdivta n erne 2 Fatuity Dwelling --Number of Bedrooms vn' ,,'/` � Block # ' C K 4c ❑Public /Cormnercia� l--Desen Use___ ___ �� ❑City of___�.___-- _,—---- - - - - -- C, Py a - -- - - -- - CSM Number ❑Village of .___ --- - - - - -- ❑ t ;I ate owned-- Describe Use Town of _ HL Cype Permit: (Check only one box on line A. Complete line B if applicable) A. New System ❑ Replacement System ❑ Tteatment/Holding Tank Replacement Only [I other Modification to Exist rig System (explain) List Previous Permit Number a td Date slued B. ❑ Yermi �Revision t Rene wal ❑ Change of Plumber ❑permit Transfer to New v �/ r Before Expiration Owner - L_ of PO IV„ Type TSMs omp teml Check all that app _ ____ - - - - - -- - -- — ❑ talon- Pressurized in- Ground El pressurized In- Ground adc ❑ Mound ? 24 in of suitable soil Mound < 24 in, of suitable soil ❑ I folding Tank [I other Dispersal Component (explain)_,,—____ — ___�___-- � ❑ Pretreatment Device V. 011speraitUTreatment Area Information: , Design Flow (gpd) Design Soil Appl'cation Rate(gpdsf) Dispersal Area Required M Dispersal Area Prop (af) ystem Elev 'o W. Tank Info Capacity in Dotal # of Manufacturer I; Gall Gallons Units' U New Tanks Existing Tanks' w a Sep: is or Holding Tank -- Dosing Chamber - - -- - G� - V 1. Responsibility Statemen -1, the ersigned, assume a risibility for Installation of the POWTS shown on the attached plans. Plumber's ture MP!MPR umber Business Phone Num Plumber's a rint) Plumber's Address (Street, City, State Zip Cod �7[I ount 1De artment Use Onl — -- pate Issued issuing Agent S tuw t — Permit Fee.. +approved ❑ Disapproved ❑ Owner Given Reason for Denial_ 1.K vaUReasonsforDisapproval 1 Septic tank, effluent filter and dispersal cell must all be serviced / maintained' . as per management plan provided by plumber. 2. A setb ack requirements must be maintained as per app -- Rcabt for the system and submit 10' hounly only on paper nol less than 811! s 11 inches In size g1J313 -6398 (R. 01/07) Valid thru 01 /09 PLOT PLAN PROJECT Oeverina Homes ADDRESS 1433 Cernohous Ave Suite A New Richmond Wi 54017 NE 1/4 SE 1 /4S 13 /T 29 N/R 19 W TOWN Hudson COUNTY ST. CROIX SYSTEM ELEVATION 101.8' BEDROOM 3 CONVENTIONAL AT -GRADE X . CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE 630 HOLDING TANK SIZE LOAD RATE .6 ABSORPTION AREA 750 # of chambers none IL BENCHMARK V.R.P Top of 3/4 pipe ASSUME ELEVATION 100' Filter BEST GF10 -8 ❑ BOREHOLE O WELL *H. R. P. Same as Benchmark Road Tank is to be properly bedded and provided with lockdown covers with approved warning labels Well is to meet all setbacks found in Comm. 83 Pro 3 Bedroom House Huffcutt Area 15' below system is to Combo tank remain undisturbed 101' 3 %Slope B.M.* B -� B -1 101.8' ❑ 102' Grading is to be done to - divert run -off away from system Property Line 413' Property Line 2-0 l� Safety and Buildings commerce.wi. OV 141 NW BARSTOW ST FL 4TH g WAUKESHA WI 53188-3789 Contact Through Relay isconsin commer isco n sin.go l Department of Commerce uwvw.wiscosin.gov Scott Walker, Governor Paul F. Jadin, Secretary June 14, 2011 CUST ID No. 226900 A77N: POWTSInspector SHAUN R BIRD ZONING OFFICE BIRD PLUMBING INC ST CROIX COUNTY SPIA 1008 192ND AVE 1101 CARMICHAEL RD NEW RICHMOND WI 54017 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 06/14/2013 Identtficauon Numbers Transaction ID No. 1952126 SITE: Site ID No. 768546 Oevering Homes Lot 32 Please refer to both identification numbers, Lot 32 above, in all correspondence with the Town of Hudson agency. St Croix County NE1 /4, SEI /4, S13, T29N, R19W Lot: 32, Subdivision: Alexander Meadows First Addition FOR: Description: At- Grade, 3 bedroom Object Type: POWTS Component Manual Regulated Object ID No.: 1320927 Maintenance required; 450 GPD Flow rate; 40 in Soil minimum depth to limiting factor from original grade; System(s): At -grade Component Manual, Version 2.0, SBD -10854 (N.03/07), Pressure Distribution Component Manual - Version 2.0, SBD- 10706 -P (N.01 /01); Effluent Filter 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. The following conditions shall be met during construction or installation and prior to occupancy or use: This system is to be constructed and located in accordance with the enclosed approved plans and with the At- grade Component Manual, Version 2.0, SBD -10854 (N.03/07), and the Pressure Distribution Component Manual -Version 2.0, SBD- 10706 -P (N.01 /01) The float switch shall be a type that does not contain mercury. 2009 Wisconsin Act 44 prohibits the installation of float switches or relays that contain mercury. Please specify an alternativff prior to applying for a sanitary permit. The building sewer and distribution network piping shall be of material listed ir�'�Ff,�4�30 and 84.30- 5, Wis. Adm. Code. In the event this soil absorption system or any of its component parts malfunctions s64s� Bate a health hazard, the property owner must follow the contingency plan as described in the approved plans. 91 addition, the owner must comply with the operation, maintenance and monitoring duties as described in section VIII of the at -grade component manual. A copy of this information must be given to the owner upon completion of the project. SHAUN R BIRD Page 2 6/14/2011 Maintenance information must be given to the owner of the tank explaining that periodic cleaning of the filter is required. Access to the filter for cleaning must be provided per Comm 84 product approval conditions. A Sanitary Permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.135 and 145.19, Wis. Stats. 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. Owner Responsibilities: • Comm 83.52 Responsibilities. The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s. Comm 83.54(1). • Comm 83.52(2) A POWTS that is not maintained in accordance with the approved management plan or as required under s. Comm 83.54(4) shall be considered a human health hazard. • Comm 83.55 The owner is responsible for submitting a maintenance verification report acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. A copy of the approved plans, specifications and this letter shall be on -site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of construction /installation/operation. In granting this approval the Division of Safety & Buildings 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. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter and the POWTS management plan to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Fee Required $ 250.00 Fee Received $ 250.00 Balance Due $ 0.00 Julia Lewis- Osborne POWTS Reviewer 2 , Integrated Services WiSMART e+� (262) 397 -6005, Fax: (608) 283 -7481 julia.lewis@wisconsin. gov Cover Page Shaun Bird RECE IVED Bird Plumbing Inc JUN 10 2011 1008 192nd Ave SAFETY & BUILO'NG New Richmond Wi 54017 715- 246 -4516 Date: 6/6/11 Owner: Oevering Homes Location:NE1 /4 SE1 /4 S13 T29 N,R19W Lot 32 Alexander Meadows Hudson System type: At -Grade Manuals Used: At -Grade Component Manual version 2.0 SBD 10854 (N. 03/07) Pressure Distribution Manual version 2.0 SBD 10706 -P(N. 01 /01) 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 -8. Maintance and Contigency plan 9 -11. Soil test Shaun Bird Signature t pr License n er 226900 P L r ' /VC � PLOT PLAN PROJECT Oeverino Homes ADDRESS 1433 Cernohous Ave Suite A New Richmond Wi 54017 NE ' 1/4 SE 1/4S 13 /T 29 N/R 19 W TOWN Hudson COUNTY ST. CROIX SYSTEM ELEVATION 101.8' BEDROOM 3 CONVENTIONAL AT -GRADE . CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE 630 HOLDING TANK SIZE LOAD RATE .6 ABSORPTION AREA 750 # of chambers none IL BENCHMARK V.R.P. Top of 3/4" pipe ASSUME ELEVATION 100' Filter BEST GF10 -8 ❑ BOREHOLE O WELL * H. R. P. Same as Benchmark Road Tank is to be properly bedded and provided with lockdown covers with approved warning labels Well is to meet all setbacks found in Comm. 83 • Pro 3 Bedroom House Huffcutt Area 15' below system is to Combo tank remain undisturbed 101' 3% Slope B.M.* B -2 B -1 101.8' 102' Grading is to be done to B-3 divert run -off away from system Property Line 413' Property Line At -grade System Sloping Site Cross Section and Plan View E I 1 1 Dimension Feet ti�ti ti ti� Y . �• �• ti ff s a ti ti�ti 1 fYr Sa � }ti tirL }.} r�}�} r ■,� r }■r rY} �Y}Yr } ; } } r } � {Mfr , I A r' }�S }'i r ■rY?�J rr fti7�ti�tiJ7Y� ■FtirYr� rYrr�Yrtirtir ■rtir r r r. . '; • ; �' }'y'� {r ''�' L' '; '� •r '� rr �} '� r , } ;•r }�.. Y'. 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J r r r•r r•r•r• r r r ■ : {��' �' �ti { �� dti. {.� 4.ti {. ti ti �• { ■�.ti'C ;. {.{ �■ • R�' {■ ■{ ti■r� I F 0.5 �' Y � ■r Y r.�Y }. Y'. .� r r r ■; r� r } Y }•rY ,� ,� r�'� r•; ■ {Y r{ trti {:{d raf}y �' { ■•. ti �!' ti ■ 'Y ,Y•ti.Y { • a ;• •. r I r ■ }•r ■� r r ■{� • ■r } r }fir �•F• r r r r r �,� r�r'r ■rtir rti G 1.0 L S E i► 1/6 B/ B - -T ' o Slope L F —� = Plowed }1 = Clean aggregate 0 = 4 in. sch. 40 pvc basal area %Z to 2'/2 in. dia. observation pipe Lateral with 2" Topsoil Cap aggregate over pipe Observation Pipe Geoterile'(j G ' ���E With Cap a �� � � � � to ., i� �ti ir �r� ' ��(S�ii f Fabr.c � � � � S ; $$ ,, �'� ti ■ ,� } � Ft Lateral Invert _ / n _ '> 13; �`i r■ Y j Y � rrrS■P r r� ■j r■ j N ! { }Y W . Z _ •tf� 3 IOp$011 Cap ti•ti•ti r,, /, / , Y ' Ft Contour ,rY }�' } NMI D Plowed Surface � C `""' Slope Direction •,�♦ GENERAL INSTALLATION: 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 and plowed with a moldboard or chisel plow. Plowing may not proceed if the.soil is wet enough at the plot' depth to form a '/4 inch soil wire when a sample is rolled between the palms of the hands. The A x B area is covere 3 by clean aggregate deposited overhead by a backhoe. Special -care must be u ied when placing; the aggregate to minimize compaction of the plowed surface: Afterthe topsoil cap is placed, the ern ire at -grade is seeded and mulched to promote vegetativet growth, limit erosion w.d protect from fi•eezing. The observation pipes are perforated in the lower 6 inches and secured in ph ce. 03/05 .gj Page of i j Pressure Lateral Layout One Lateral — End Manifold � - 4-- Threaded Force Main Lateral Turn -up —� Cl Plug t Plug X ----� 1 L Long Sweel 90 Bend Distribution Network S ecifications pressure System Constructio ►]down Lateral Diameter 2 In FLaterm are constructed of Schedule , 1 Orifice Diameter In. Orifices are drilled perpendicular X Orifice S acin In. the pipe with a sharp drill bit and face. L Lateral Len th Lateral turn -ups terminate with a thrce Main Diameter In. cleanout plug and are enclosed in a E c L . Force Main Len th Ft• diameter lawn sprinkler valve box acc Assible from finished grade. 0 0909 Grade 000000 ;Q 0 000••• 6 -8 Inch Lawn Sprinkler Valve Box 03/05 lgj Page __ of Septic••Dose 'dank Cross Section And Pump Performance Specifications Ta Manuf acturer Pump Man ufacturer Tank M odel Number d Pump Model Number Total Tank Capacity 63 , 0 Alarm Manufacturer Max. Bury Depth Alarm Model Number Switch Type P er Manu:.'acturer C � j Total Dynamic Head (TDF:) - Fe er Mod e. Number G Q - Elevation Head A19 - Distal Pressure, Network Loss $ Mini am P ump Performance Required Force Main Loss S GPMj Ft TDH Total Outlet Manhole Min. 4" Above Grade With I. ocking Device. Inlet Manhole � Manhole Min. 4" Above Grade < 6" Below Grade Sealed Watertistht Sec lVlounted With I.ockinjI Device Weather -proof , Junction Box Finished Grade Vent Min. 12" Disconnect Above Grade Means With vent Cap ;:;,; 1 1 .•:.•. . .•.. ;:`,.,; . Y, / :. Y : /Y: . . ,; • , 1 , Outlet Filter Inlet Not Baffle ' '• _ _ _ _ - A Sw itch Settings and Reserve Capa '' /a» Tank Volume = /S GPI' �/� ' r p L imension : Inches Volume Gal. B Hole (reserve) A � 3 6 7 � 0klarm) B' \ 2 3 0 Off levation C dose C Ft (dead) D `: Bottom _Total :•'1 D Elevation Ft ' >•�.: I t, l ..1�� r�� o f f�i 1 , t 1 e r 1�� 1 , 1< 1, e. t s• (1 1 1. 1 e .( . s v e I ,1„ 1,> / 1' / ,,/ ,' 11 7,1 'Y I,Y . Y,Y; > Y 1 1 / / ::::: : :: •, •. <,. 1 r, { ••• . f .{ 1< I{ I t/ r{ I f I t f t t I t s::i 1 GENERAL INSTARLLATION The septic/dose tank is bedded and back filled in accordanc a 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 devic a (padlock) installed. P.ping at the inlet and outlet is of approved material, connected to the tank with watertight sittings, and laid on stable soil to prevent settling or sagging. The force main is sleeved with 4" Sch. 40 PVC to bric ge the tank excavation and the sleeve is sealed watertight. Electrical service complies with NEC 300 and Comm 16.28. 02/05 L.1 Page j of Sett# ey: HP LaserJet 3100; 9 E HI SERIES SUMP /EF"F"LUENT Pl.i'iN11 a �voltl asdoas rtm ear � m > 11 tewm9wrr� � DRHL ass ter~ K tNAW ara3Na Y st >P ! Rt 1139 W Ow 1124411 ON401l = wim ve 115 39 1 3.0 1000 70 14 65 41 39 111 w 24 9.11 i17.atN&N 911"m 500310 mm 4rO WO ffiI as 1000 10 34 55 41 31 11 w 24 Ml211bt2bIR 8114w I8 we em 4 1 15 sr 13.0 1000 TO 04 sa 0 1111 110 w n 8.41 MOM >e1 Irs ealr13 rem We m art as Imn 72 64 is n ae In air V !11 :11iEii7 .�.�•�� mow• r��. �..��� Ca1�MOd{�R46M —' li���AIIF�Y1p�lMyail7yiil��far111MiF� /IR�IM(Mt�N11NM0011�i' FLOW- LITEft/HMR 011621 No UM a 000 eooa 3000 Motor E�ax�► t',oacsd Mast Iron imp !Pil . Materw Pol Cwbonsto ao to or TAM Closed vw° wute ASS M E POVAW Cord . A ._.a... . 110 Mechsoicad Shag See[ Nittiie with carbon mid comic faces is 5 1 ._�... t FasEenets Stainless Soee1 Shaft -- - SrainkarE S"neel Haacitiogc Upper Sleeve end LuwW ul Hearings a ao 444 so 60 n.VV- G4L.t.ONi/ OWYE d,W P'ERFU MANGE CURVE Lie Qlaet>rtt P C AL tray 4i0Hi t►p Sr w IYmn Cft 93997 st�a.2:4Oad�4R7999 • >t12� 4as3ri9aers VnVVAL dttleOkmtftmp coos GraR+t9ve>m --a7xo �' pow owrtER`s MANUAL & MANAGEMOT PLAN Aiy. T SP (W�..,�M,�,���w P.arm�Tta. t�pdaT mwuoi*uw p twa oON PiU hA ONA o f OalauWdld urn Pun tp _Tw* cV#dlV d Pwp To* M"lflftu � � G M IA TOW mop 0 9 Abalwo M") Ciao mg Aowr (Odbuded x I.-* �v 't7 . pi#nrA lkimtt�t+�dr t ` NA floil�p�erderr Mi�Nts Ptrrrsp thltodal Q ttdgr/rts m - utrt Daft liltorrlby Unit Fab,,.4X & GVSMes �m � UVIL E3 so wNw4val FWW D Peat lf6 Nr I* im I I OlwM DMSetsnd ( s220 mg/- a Mph A n d Other. MaowW ltglfuuirtt'QudW Mcb'lg+ly everage"' C►b :) Boduwnbst OXWOM t aO mom- 0 In -gnx&W (#Ar iCy'1 © )l*V= I (prmsudOM risde © Mound 'Cold � O�' � �Lt rrtgVl. '� Fsrad G'Qwbnrs 1!3' 400tnt C� t1f�err: Mw*nura eMulu t Pam $fame Ijr inesbel va urs er��a+'d.ea..IbtR+onew�eurdr) ti�r�nd tawrtnt ttervtrss Fragwncy _, trr�rpaat as of msnit(s) A't least arm every (Msxln um 3 l �ra.) PUMP out cortbnb of t wwai) Wh en con *mod sludge and swM 04ufb ott84" (4) of tt 01: VOI UM s tnspsdt dlsperagrt c�ottC *) At least once evat y Clean w6knut Mar At Tease once svery Ww ntw r(s) µ I pip, pump conbcds aY alar M T t pleat arm* evwy D +p)' 1 : f 7L1 rrfbrab asd 1asL t lest OdCa awry j moerlfrs 4 Otlrsrc t: �pt+st osiae evwy D Mond" l:I YON(s) C) lV�l MAC t roast: and* 40*ry t7 ntrxrq w 0 ysa(s) 0 NA drapsotYons or I Ice and dbponma modus br n%*de by an indh* ad coTyft am of Uw WWAW tl MOIS o: tsar . LjwW mbar; Momw Pkunbet' Prwkk bd SOW. PO'41 TS Trop dbr.' P&A" >Alll ; gi g 00 OPrr*W. Tank kopedbes must kwk ds s vb W kwpondon of ew Mnk(s) tv Waft wV mtssbp ar t n*wnr frardetaNe, ictr nW arWo sG4 or lasks. r 'tho v *jme of cunbbad s and amm avid to duick for au 1 bock up +nr' pors9 d` GR VW 9fund 'i'btlt diapalAal tlall{�) s)ladl ba 111aL i0 tifle0f[ tlM etlt N1t ie+web 5n *w +obesrw dart jfVw and t dttedr tar any pc u ft of dAueat on fm around agufam Tlra fMwbV of or" n t on ':Pie grovel mW Iatito a Ct+rtdfltorr wW req the it nmodit neffffooftn of the WWI nsgrrN "Y al a fwttq who go aoOMW aooulntrttd an afaufts and troltm In arty to* a pots aturf d (V ar n was cf r d Llh lei o rt o t m * *MbomoondbysSOPOWSOvkftopWgWoW dbpowdothi 113, %%Wtwm NOW -- Tft Wt*% of fibtlrs. nW&AffitO or prmuftd PO W'M SIN pfgVgSjpjwg fib, t tr id strur Ogw ga%orom or mar i&ft at in b of. 12 nw" or, few SWI be PwbwW by a whiled PC)1MM Mt i tblfww. A Mi* rlrp *sddfbel pr itfs6 to go IoaaY tguWby muft* wldF n 10 days of WMPhOn Of guy �rvioo e n wrL START ice' 11AO OPGQ1lTlt3N Forrtswv ombz . Per' to rase of Vw P� d'rotdc,ttgo+ofmtttt•� U7k(s) frrr' difs p>alfstnos ofpt A Pf+�� C'! other chrrnwo td!>ad may bV ds ft 6asadtan! proasu >andlor dnrfge tha dmpa iM Cws)Y, If W go c 6 Odaw a n f dellcled ham do w im to of to ttsryicrs) removed by a xwvk S oper&Wr pdar to use. tJ :� 1 Sysktrrt shunt up shalt not occur wr en'soil'conditions are frozen at the infittrative surface. P�Rge oui*61 pomwoutag" pump tatlfCS tnsyfi0 above rnonnal higtnWa w+ec ter levels. When pv is rested the r M mess vrtsoueeia wwo be dl9c1%w9W 00 thO dllpetsal CON) in one large dose, ovedaadng the aeff( and may baolo ,4P ar =VfiK s dhK*wMe cf t TD a�vrAd fulls situation have the conhmfs of the wed i the us aw'�W PdDr W th POWer to o effluent um P or P hlui�c tam i wed b a P caataat a Pion ber or POWI' S a sdst In am=* opentrrtp' fire pt MP 00tH 031 to Matom n ormal Wets within the pump lank � to i3o nt�; tidtl� or park Iides o+ turd d�per�cal Do nOt drive or perk owl or 0ffwwiw disc 1 rb stct>mpaGL Me taint vMh 15 feet dowt slope of aW mound or at- grade soli abs6rptbn area Redwtion or aWnMon of the lafiavg frnm the wasateyraW strum may imprm the perfomnanve and i Nowq me � Of tilt: PM R" 0090W •bdWWp r-cgarette butis condoms; ;oatton swabs; degmesets; denial ffm t diutirilk f t lundngon dt�tita (scrmp pump) water; fiat and vegetable pee(in9s fIe r ; , =W'!;; n e$ produoW, p wfiddes; sanitary napkins. Iampow. - and waGar lofts w but 1 3. ASAMMMIUSa Whorl ihe POWTS fft and/or is nawilly.ta out Of 5e1"Yic7e the fngowing stops ske tp bdmn Io Im N Ire that tine syaftn is PmPedy and.slyabandoned In aornprranae wrth ch_ Comm 83.33. Wisconsin AdM1n Candy • AN P%*V tin tanks and pits shag 'be discwnrnecked and the abandoned pipe openkVs *eeted_ The 0*"ftn9e of all fnks and oft shag be removed and property disposed of by s A Septaige S�ervlcl i g Ot�tor f bnr pmrq*lS, all banlas and puts SW be excavafled and removed or #hrilr covers ramovrd 4nd the aced sp s Wed with soft, gra W orano&erlrtertsogd rnatwi�at CONTMH.iENCY PI.M If the IkijVVTS fags and cannot be rgpoWe the fioltowtng measures have been, car must be taken, 10 P x" de ; i code cornpbrant repbowmet t system- ❑ A suuthte dement area has been evaluated and may be utilized for the location of a absorPdion systorrr. The r ephwernent area should be protected finorn disttrr'bance and CentpaWon a I d Should not be i'"Ved upon by M quftW setbacks from existing and proposed structure, tot Imes and welts. Ft ii rum to Pmt are 11 8F61comeclt area will result in the need for a new soil and siM °evaluation to establish a s t ifable ate- Replaoer""rit systems must comply with the rules in affect at that time. 13 A sine Mpboertrent area is not avau7able due ti) setback and/or soil rimitarrorts_ Barring advarnu c in POWTS. tectroalogy a hokfing tank may be installed as a last resort W replace the faded POWTS- rho sibs has not s Owftr q to Adeu�fify e+ratuatiun mu t a Suitable replacement area Upon fagure of fhe POYM c t sodand b be parTormad to locate a'suitable / eplacement area, if na rue 'carding tank may be iinaiNdW 86 a last nesart W re pl2ioement area is � v able a place the failed POVV'f'S_ ❑ Mound and at -glade stg abootption systems may be reWnstructed in ace srualsatas4 ReaonstrucW ns of such pt following romov of the 1 i n anal at systems must a�mpry with the rotes in e}Iect at that tin gee,. SEPTIC.'. PU n7E R A apn'TIC, AND c LETHAL R DO NO'Y ENTE TI�F.A7MENT TANKS MAY CONTAIN LETHAL GL*j M ANDIAR INSUFF'IC G wr OXYGEN. PUMP Oft OTHER 7RF.ATMENT TANK UNI)ER Amy CIRCUMSTANCES. DE A.T" MAY RESULT_ . RESCUE OF A PERWN FROM TJiE INTERIOR OF A TANK MAY BE 00 OR 1WIPOSgt13 L.E AOOMONAL CUMlillFNTS POWTS 1145TALLER POWTS MAWTAINER Name 4 ---- �t K' _ Name C2 Ll rt Ph2T 2 6 ! Jj Z Phone SEPTAM '19MCIAfe OPERATOR f!!M!pM LOCAL REGULATOWAMOR" lVarne r n Rttorne Agency r ` 01 d - !J - O� Phone This doaemeaQ was at d g.lAe air afiM C1q aeon LAM. ura mltbmrsn: r �� Cam OaB turd VViushara County Zoning and' S=V%I&n apwwb&. This daorrtrr w, t mwb rte. itbxt Kd>s(rl aura 83.5({1), (1 not (31. Wsswn3 in A&n' ft lsr atfi m cod- usi. of dsk doewn o d ae;s ultraradOre ft pd'formaaoe of the t�G1tNT� CMW (BDI) � � 4 NV iscon s i n SOIL EVALUATION REPORT #2033 Department of Commerce in accordance with Comm 85, Wis. Adm. Code Page 1 of 3 Division of Safety and Buildings Steel's Soil Service ^� Y Attach complete site plan on paper not less than 8'/2 x 1 7n size. 1 inches Plan must Count St. Croix include, but not limited to: vertical and horizontal reference point (BM), direction and percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D. c P Please print `' Revi d Date Personal information you provide may be use �env�acy Law, s. 15.04 (1) (m)). Property Owner 2007 Pr perty Location U LaCasse Development, Inc. MAY 2 9 Go Lot na NE1 /4, SE1 /4, S13, T29N, R19W Property Owner's Mailing Address Lo # Block # Subd. Name or CSM# 573 Cty Rd "A" ST. CROIX COUNTY 32 na Alexander Meadows Firs $ Addition City State Zip t. City Village ; Town Nearest Ro C' Hudson WI 54016 1 715 - 381 -5405 Hudson Hillside Trail New Construction Use: Residential/ Number of bedrooms 4 Code derived design flow rate 600 GPD Replacement Public or commercial - Describe na Parent material Stream tted outwash plains Flood plain elevation, if applicable na ft. General comment Mpun r At Grad besign, system elevation 102.30ft based on contour line elevation 101.80ft. Minimuum and recommendati . inc es 33 mound sand. 2V 4Y-) Boring # 1 ] Ground surface elev. 101.30 ft. Depth to limiting factor 80 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistenc Boundary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 1 0 -6 10yr3 /1 none sil 2msbk mfr cs ivf .6 .8 2 6 -28 10yr4 /4 none sl 2msbk mfr cs na .6 1.0 3 28 -80 7.5yr4/4 none Is osg ml cs na .7 1.6 4 80 -110 10yr 5/4 c2d 7.5yr5/6 sicl om na na na .0 .0 Fi -1 Boring # I_ Ground surface elev. 101.35 ft. Depth to limiting factor 40 in. -. p g Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure ConsistenCE Boundary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 'Eff#2 1 0 -5 10yr3 /1 none sl 2msbk mfr cs 1vf .6 1.0 2 5 -40 7.5yr4/4 no Is osg mvfr cs na .7 1.6 3 40 -75 10yr3 /3 f1f 7.5yr5/6 scl /sl om na na na .0 .0 Effluent #1 = BOD 30 < 220 mg /L and TSS >30 < 150 mg /L ` Effluent #2 = BOD < 30 mg /L and TSS < 30 mg /L CST Name (Please Print) Signature CST Number David J. Steel 248956 Address Steel's Soil Service Date Evaluation Conducted Telephone Number 1396 141st St. New Richmond, WI 540 7 5/22/2007 715- 760 -0347 SBD -8330 (R.07 /00) Property Owner LaCasse Development , Inc. Parcel ID # Pending Page 2 of 3 ❑ Boring # Ground surface elev. 102.10 ft. Depth to limiting factor 45 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ftZ in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 •Eff#2 1 0 -5 10yr3 /1 none sl 2msbk mfr cs 7na .6 1.0 2 5 -45 7.5yr4/4 none Is osg mvfr cs 7 1.6 3 45 -75 10yr3/3 f1f 7.5yr5/6 scl /sl om na na na .0 .0 F-1 Boring # =, Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 •Eff#2 Boring # - L_,, Ground surface elev. ft. Depth to limiting factor in. ISoil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ftZ in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 * Effluent #1 = BOD 30 < 220 mg /L and TSS >30 < 150 mg /L * Effluent #2 = BOD < 30 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 -3151 or TTY 608 - 264 -8777. SBD -8330 (8.07/00) Steel's Soil Service STEEL'S SOIL SERVICE 3 of 3 David J. Steel LaCasse Development Inc. 1396 141st St. CST - POWTSM NE1 /4,SE1 /4,S13,T29N,R19W New Richmond, WI 54017 Lic. #248956 Town of Hudson, St. Croix Co. Direct 715- 760 -0347 Alexander Meadows 1 st Addition Lot 32 Fax 715- 246 -0318 This soil evaluation was conducted to satisfy a zoning requirement, it may or may not be suitable for your use. The location of this test may or may not be as shown, as permanent lot lines were not established at the time the soil test was conducted. Legend N 1 " =40' ♦ = Benchmark Ele. 100.00 ft Top of 3/4" pvc pipe • = Alt Benchmark El 100.35 ft Top of 3/4" pvc pipe = Borings Boring Elevations 1= 101.30 ft B = 101.30 ft B3 — 102.10 ft B4 = .00 ft oy r 0 h w' 76 t � q5 ST. CROIX COUNTY SHMC TANK MA1NT E ANCE AQRBEMENT AND OWNERSHIP CERTMCATION FORM Ownetrsuye r r ; 1 M&MngAddvm j j ('n p PMmtY Act t.=s ivy Mquked �g Piaaa & Zoning Depantmeeet 1pa r now co wftedaa. r CrtylStt;tC_ Parael cation Number �L� '�/ y r j Proper ty Loc atioa J/ of Subdirvisitm — Lot # J� Cea tlifled Sn rsaap 1VLtp ## Vohnno WAnsnty D sod. # ( volume page # spach yft no Lot Tina, W ong yes $� AROYMA AM OW�R ['iMRTrlPrf"sTrnur Impeo >er nas and of 3 oottid xeealt m its p lidlm ib bmdle wastw pauper manroo of odW rnfpamo� oft & sepdc took evssy iiacee years om , ifusedad, by a Hoamed pt� Wbet you p W iGo the sq�tdam oar tfltetst dw of dw sgpdc lank as a UORU 9 90P in the waft dbpomd apsU m. Ownw mdtatemimce r*oPmalbiiit w are sPoaffisd fn # Comma. 83.52(1) and m Chapter 12 - St Croix Cotatty Sammy CkdWswe. Mlo off• and b P �Y owaeae agceaa to submit to SL Croix CO MAY planning 2a a oes�ion fW^ by the y P Phi', msttta0d phw*w or a Lice ood peat�op$cr vemtt� dent (i) ibe om� -sfoe wamwaxm dh E OW "MM is in PWPW qmm tiog oomdidw and/or (2) ate issepac = and P=Wiag (ifneooMMY). the septic tank is law Awn 1/3:0 Olaf dadSC mss, k 30 hwo read dw above smquiremvanb and ogre to ==tM the p dvaes t+i "V diepoaai syseema with tb e ■tw&wds met ! o effi, hA90fo6 a sst by dw Dopor4z%M of Comaoaeroe and b ffie Depwan n# of Nat oW itemmo,. Same of Vr==zin. Certification 9, *g that yoonr septic sytrtema w been m Wdoad, taam$t be cou plated aced nbawd to the St Croft Cannily Pbmaiag at Z0t&9 Dee r yW within 30 days of &* datoe year ao�ieaticne =„ 1/we a wdfY tit all SWAIMMS.an this folma are true to &a bait of my/ow kmoviedSL pw"ct * deem d led above, by vktne ofa wawat dead recar&d in pn&W OfDOO& 0SM v" atn/aa a ibe owner($) of the Number of t o drooms OF CANT S � DATE * * *Azy in tox m Simon that is mid miy resoh ita dw moafty pam* ba#ag z ed by dw p dt ZmloS * ** hichade with t M apps a Zoomdedvatcomy deed from the Regis w of Deeds Ofoa amd a copy aftbe oerd5ed survey map if Office me is in sd a in the rnatsmy deed. M"r. 08/0; Jill IIII IIII IIII IIII II IIII III 8 028683 STATE BAR OF WISCONSIN FORM 1 -2000 Tx: 4020119 OOCUm nlNumber WARRANTY DEED 936625 THIS DEED, made between The ItiverBaIt a BETH PABST corporation, Grantor, andOevering Homes, l.LC, a W sconsinblimited REGISTER OF DEEDS liability company, Grantee. ST. CROIX CO., WI Grantor. for a valuable consideration, conveys to Grantee the following described real estate in St. Croix County, State of Wisconsin (the 05/24/2011 2:19 PM Property "): EXEMPT #: N/A REC FEE: 30.00 Lot 32, Plat of Alexander Meadows First Addition in the Town of TRANS FEE 90.00 Hudson, St, Croix County, Wisconsin. PAGES: 1 L ding Area and Return Address: uks County Abstract d '1'itk: Co.. Inc. . Knowles A %e hmond. W1 54017 SS'I'7536 Together with ell appurtenant rights, title and interests. 020 - 1478- 19-000 Parcel Idemifrr ..Number(PM) Grantor warrants that the title to the Pro This is not homestead property. easements, covenants, i s gad indefeasible i and conditions of record. n fee simple and free and clear of encumbrances except Dated thi(:� of May, 2011. S The R' erBank, a Minnesota bank' a corporation Jeanine andber CFO y AUTHENTICATION Signature(s) ACKNOWLEDGMENT STATE OF WASCONSIN ) authenticated this COUNTY I ) ss. Personally came before me this -` ' day of May, 2011 the above named The RiverBank, a Minnesota banking corporation to me known to be the TITLE: MEMBER STATE BAR OF WISCONSIN fore of person(s) who executed the (If nut g nt / 7�wUow(edged the same. authorized by § 706.06. Wis. Slats.)µ A 3 v< THIS INSTRUMENT WAS DRAFTED BY No Public, State of Wisconsin Robert L. Lober My commission ' e (nanent. ()f not, state expiration date; ���� ; � t J � Lobe Law Office C al � (SrEmatures may be auarenucated a utnowkdged. 8oN are mn eeessary) r , � �i 'games of pawns '"Ping rn am• ea rh must be P�� . aped or printed below th si Bnnture r WARRA.VrV Dt?[D A STATE BAR OF WISCONSIN FORM Ne. 1.2000 �j ,s . l t' •` `V • ` l. ,� alraj'17t7 �`°��`r OFtn „St d 1 of 1 F O 5 C u Y N 1 I I 843.1 8 LEGEND SOIL BORING 944.9 c 9 16 94� 3 z� 448.5 IQ r u .944. O 1. 11 il O Q ;5 .9 4e / x;551.4 948.9 _ BENCHMARKS 9494 a o 3.174 AC. \ Gj y� Sj �O� i 4.0 ( p, 4j• f LOT 32 960 ED� 956.6 / O Of \ Y / , -970 I rn // / /� Q Q z ®. 959 1 0 U !. z Ld m / A 0 f ® 961.8 I\ I O 0 (n 'v 0 x o 0 \ \\ W 0 z �., N O [If \\ \ W o � 0W o Z (n QU) x SCALE IN FEET 1 " = 100' J Q f 100 0 100 ° Q J SHEET NO. 1 • � ' � � / ��K / f �+ �r 'h am - - ' /. `,�' . \ \ - � �, ��•('� �,/� ,�� �.� � . e ...... ....... V 3 rE 230.46 LOT 33 �•'' 1� SIDE TRAIL -� ` " -�� ' f � •• j • - ORAJNAG£ (�Ap FA-X- -M 23 ow St��Nr Q .................... �..�;: / i mi 1w, LOT 3S + . LOT 34 + �1 ik r � f �1 JaP xv / o XsJ� -� 1 1N2 4 i � P Y"LOT 32 ORA 04 HWE =955.0 o LOT LOT 31 '; DR AZ EASEM T X" 393.69' CH MARK: TOP �. OF 1 -1 / 4' MBAR. UNG'W7l'ED LANDS N"� "TION 964.2 souM UNE op NWIA OF J� THE -- ���� LL 4 z DRAlNAt IRM MONITOR WELL ACCESS A O Lot 28 to subject to an easement granted to the Xf N7773 �73 e1n n. X2 N4136 Parcel #: 020 - 1478 -19 -000 06/07/2011 03:38 PM PAGE 1 OF 1 Alt. Parcel M 13.29.19.3018 020 - TOWN OF HUDSON Current ❑X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type # of Units 07/25/2007 0 Tax Address: Owner(s): 0 = Current Owner, C = Current Co -Owner RIVERBANK 0 - RIVERBANK 304 CASCADE ST OSCEOLA WI 54020 Districts: SC = School SP = Special Property Address(es): ' = Primary Type Dist # Description ' 891 HILLSIDE TRL SC 2611 SCH DIST OF HUDSON SP 1700 WITC Legal Description: Acres: 3.174 Plat: 11- 022 - ALEXANDER MEADOWS 1STADDN 020 -07 SEC 13 T29N R19W PT NW SE ALEXANDER Block/Condo Bldg: LOT 32 MEADOWS 1 ST ADDITION LOT 32 Tract(s): (Sec- Twn -Rng 401/4 1601/4) 13- 29N -19W NW SE Notes: Parcel History: Date Doc # Vol /Page Type 10/20/2010 925075 DEED 07/25/2007 856211 AGREE 07/25/2007 856210 11/22 PLAT 03/02/2007 845719 TD more... 2011 SUMMARY Bill M Fair Market Value: Assessed with: 0 Valuations: Last Changed: 08/17/2010 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 3.174 57,000 0 57,000 NO Totals for 2011: General Property 3.174 57,000 0 57,000 Woodland 0.000 0 0 Totals for 2010: General Property 3.174 57,000 0 57,000 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch M Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 �1 AIM - AWA TlLtu ��Iyy N AM= MM srd try if 4 a 1 YYY \ Y � _.�- - .�....�.��..�� -� -�. �.— .....•. -fir.. ��.....- r N� i ti � r • t v , - 1 i I - . 77 - RAW cornrtmaCa.wi.gtw Sa'S�ty an g � I dings Division s County 201 W. ashin n Ave., P.O. '162 It , soo S i M icon, W[ l Sanitary Permit Number (to be died in by Co.) e l t of Contmeroe OVr1I Sanitary Permit Appli tl �NG &Z stat Transaction Npmb In accordance with a. Comm. 83.21(2), Wis. Adm. Code, submission of this rg ppropriate govern tal ► a ___ unit i:i required prior to obtaining a sanitary permit. Note: Application rrns for state -owned POWTS a Project Address (if different th in mailing address) submitted to the Department of Commerce. Personal information you provide may be used for seco P n ies in accordance with the Privacy Law, s. 15.04(1)(m) Stats I. Ap plication Information - Please Print Ali Information D r I l { r (�C 4�' Property Owner's Natitc Parcel # — -- �J� , C� % v o Oo? 7L? Property (hvner's / Mailing �Address Property Location r 30 I � —� -` Govt Lot City„ St - ' I, ,) f Zip Cade Phone Number �/ � y V,, Secl ion II 'If ype of Building (check all that apply) Lot # -- or 2 Family Dwelling -- Number of Bedrooms _ Subdivision Natne Z 6 r if -3/td j�✓ �(/ 'Y! , Block# I le- l ❑ Public/Commi -- Describe Use - _ ❑City of ------- - - - --- -- - - - - -- -.. ❑ ! }late Owned - Describe Use CSM her - -- -- ❑ Village of IIL, 'type of Permit: (Check only one box on A. Complete line if applicable) - cw System --_ - -- - --- y ❑ Replacement System atntent/H ing Tank Replacement Only O) Modifica8012 to Exist ng System (explain) B. ❑ Permit Renewal ❑ Permit Revision ❑ Change her ❑ Permit 'transfer to New reJ6u&jp i I a I d Before Expiration Owner IV Type of PO W TS System /C omponentlD evice: Chec II that apply) n- Pressurized In- Ground ❑ Pressurized In- Ground At -Grade ❑ M und? 'n, ofsui le soil ❑ Mound � 24 in, of sui lots soiJa ❑ 1 folding Tank ❑Outer Dispersal Component (explain) _ __ treatment Device (explain). V. Dis ersaUTreatment Area Information: _ _ t Ae,sign Flow (gpd) Design Soil Applic n Rate T Dispersal Area Required (so Disperse ea Proposed (so System Elev rtign Vi(. Tank Into Capacity in Total # of Manufacturer Gallons Gallons Units 8 New Tanks p. Ling Tanks ca V V r° y rn A. C7 P. Sepsis or Noldittg Tank busing Chamber V11 1. Responsibility Statemen -1, t undersigned, nos in sibillty for installation of the POWTS shown on the attached plans. Pb.imbe r's N (Print) Plumber' to MP/MPRS Number Business Phone Nu rber Pi umber's Address (Street, City, te, Zi C - - -- VII.Coun /De artm entUs e On - - _ -- -- — - - _ - __ —_ -- — ___._.— _-- _--------- - - -_ -. Approved Disapproved Permit Rc_ Date Issue Is ing Age Sign re $ _ ❑ Owner (liven Reason for Denia! ( / "' / 17 G �_ `�Y!/� 1:SY8tpg}o&fflF$yp for Disapproval b �� 1 Septic tank, effluent filter and n n^A dispersal cell must all be serviced / maintained df YLC Vl-% ° 6 n 7 J as per management plan provided by plumber. 2. All setback requirements must be mai ntained ^_ �_ !� ��� h LO �0. per _ for the system and submlt to the County only on paper not less than g In x 11 inches in $1ze 6th tVk - 4t ewv(o& (° `k YlWit � SlID -6398 (R. 01 /07) Valid thru 01109 PLOT PLAN PROJECT Oeverina Homes ADDRESS 1433 Cernohous Ave Suite A New Richmond Wi 54017 NE 1/4 SE 1 /4S 13 /T 29 N/R 19 W TOWN Hudson COUNTY ST. CROIX MPRS Shaun Bird 226900 6/6/11 DATE BEDROOM 3 CONVENTIONAL XXX IN- GROUND PRESSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 garions LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RA3'E .7 ABSORPTION AREA 651 # of chambers 32 BENCHMARK V.R.P. Top of 3/4" pipe ASSUME ELEVATION 100' Filter BEST Filter ❑ BOREHOLE O WELL * H. R. P. Same as Benchmark SYSTEM ELEVATION 97.0/96.8' Well is to meet all Road setbacks required by WDNR Plans Designed Using Pro 3 B -3 Conventional Powts Bedroom 64' 40' Manual Version 2.0 House 5 , 2-3'X 66' cells with >3' spacing Vents t 3% Slope House is to not be in the 10 B -2 _1 45' drainage easement 33' 20' 98' 30' jL Quick4 Standard -W Leaching Chamber 478' property Line with 20.0 ft2 of Area 5.8ft ^2 /pair of end caps 3 4" Grade at System Elevation „� Cover Page Shaun Bird Bird Plumbing Inc. 1008 192nd Ave New Richmond Wi 54017 715- 246 -4516 Date: 6/6/11 Owner: Oevering Homes LLC Location: NE1 /4 SE1 /4 S13 T29 N,R19W Lot 32 Alexander Meadows 1st. Add Hudson System type: In- ground absorbtion system (conventional) Manuals Used: In- ground absorbtion system (version 2.0) Page# 1. Cover Page 2. Plot Plan 3. Chamber Cross Section 4 -5. Maintanance and Contingency Plan 6. Filter Specifications S e Signature License nub PLOT PLAN PROJECT Oeverino Homes ADDRESS 1433 Cernohous Ave Suite A New Richmond Wi 54017 NE 1%4 SE 1 /4S 13 /T 29 N/R 19 W TOWN Hudson COUNTY ST. CROIX e MPRS Shaun Bird 226900 DATE 6/6/11 BEDROOM 3 CONVENTIONAL XXX IN- GROUND PRESSURE CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 ga' lons LIFT TANK SIZE DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .7 ABSORPTION AREA 651 # of chambers 32 IL BENCHMARK V.R.P. Top of 3/4" pipe ASSUME ELEVATION 100' Filter BE Filter ❑ BOREHOLE (DWELL * H. R. P. Sarne as Benchmark SYSTEM ELEVATION 97.0/96.8' Well is to meet all setbacks required by Road WDNR Plans Designed Using Pro 3 B -3 Conventional Powts Bedroom 64' 40' Manual Version 2.0 House 59 2 -3' X 66' cells with >3' spacing Vents t 3% Slope 45 House is to not be in the 10' B -2 -1 drainage easement 33' 20' 98' 30' Vent > 6» Quick4 Standard -W of Cover Leaching Chamber with 20.0 ft2 of Area 478' Property Line 4' Long 12" 5.8ft ^2 /pair of end caps 34" Grade at System Elevation Cross Section of Quick 4 Standard -W Leaching Chamber Typical cross section for 2 of 2 cells Quick 4 Standard -W Leaching Chamber with 20.0 ft2 of Area per Chamber 5.8ft ^2 pair of end plates To be >1' above grade / Finish grade elevation Typical Installation 101.0 Vent Grade Vent 4 ' 4„ 4' ,A;�30/34 Septic Tank 4' Long 191 5 4' Long 195 3 4 99 Grade at System Elevation 34" Grade at System Elevation Spacing 5' 2 - 3' X 66 Cells Observation tubeNent Sakne on other end Located at ends of Cell A 16 chambers per cell B System elevations: A_97.0 B__96.8 - Z O M E2 H � t � tuu � Q LL ri 0 co C Z C Ch Q O O O LU . - -- Z < — 2 __ z LD W W Q Z I-- J � � J W m LL � J O L �i o N Z 0 F ui u F- J S� �ae � � O w CV I S O 0 N I I 01 T 0 Q tu- a a ti 7 M Y U = N 25 P r 0 !6 r r o o O �w I . ma N Ol Maintenance and contingency Plan for a Septic System Maintenance Plan 1. Septic Tank is to be pumped once every 3 years. 2. Effluent filter is to be cleaned once a year. Please note: a larger filter is being installe in order to extend the maintenance interval of the filter. 3. Once every 3 years, cells are to be inspected via the inspections pipes at the end.", of the cells. 4. Owner agrees to limit greases, garbage, and water conditioner discharge into the sy. 5. The owner agrees to save this plan. 6. Do not plant trees nor park nor drive over system. 7. Watershed is to be diverted away from system. 8. Discharge into system is not exceed those required as per Comm. 83 C� 1 n n Plan Option #1. If ystem fails, determine cause of failure, use alternate area and install new system in tested replacement area. Option #2. Install system at a lower elevation, by removing chambers, removing bioniat, and install new system. Option#3. No adequate area is suitable for replacement area, and system elevation cannont be lowered. Install holding tank as last resort. 3. Replace any other failing components as needed. Plumber: Shaun Bird 715- 246 -4516 St. Croix County Zoning 715- 386 -4680 Pumper Tom Mondor 715 - 246 -5148 Shaun Bird #226900 . � � RECEIVED i' EVALUATION REPORT #2033 Department of Commerce ith Comm 85, Wis. Adm. Code Page 1 of 3 Division of Safety and Building Steel's Soil Service Attach complete site plan on papq not iels t61 Gc0b in ize. Plan must County include, but not limited to: vertical nd horiz tal reference point (B ), direction and St. Croix percent slope, scale or dimension , condary oses Date stance to nearest road. Parcel I.D. en` dMf� Please print all i do P evi ed Personal information you provide may be use e ry Law s. 15.04 (1) (m)) va , . R By !L �y Property Owner Property Location LaCasse Development, Inc. Go . na NE1/ , SE1/4, S13, T29N, R19W Property Owner's Mailing Address of # 3 Block # Subd. Name or CSM# 573 Cty Rd " A" na Alexander Meadows First Addition City State Zip Code Phone Number C' ❑ Village N Town Nearest Road Hudson I WI 1 54016 1 715 - 381 -5405 Hudson I Alexander Rd. ❑ New Construction Use: Z Residential / Number of bedrooms 4 Code derived design flow rate 600 GPD N Replacement I] Public or commercial - Describe: na Parent material Stream terraces and pitted outwash plains Flood plain elevation, if applicable na ft. General comments Conventional system, system elevation 98.35ft. Trenches spaced and depth to code 3.00ft below grade or and recommendations: to be adjusted to sand depth at the time of ins allation. ❑ Boring # Z Ground surface elev. 101.10 ft. Depth to limiting factor 100 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistency Boundary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0 -11 10yr3/3 none sl 2msbk mfr cs is .6 1.0 2 11 -42 10yr4/4 none grcos osg mvfr cs lc .7 1.6 3 42 -10 7.5yr4/4 none cos osg ml na na .7 1.6 ❑ Boring # Ground surface elev. 101.35 ft. Depth to limiting factor 100 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistenc Boundary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff #1 *Eff#2 1 0 -10 10yr3/2 none sl 2msbk mfr cs is .6 1.0 2 10 -100 10yr4/4 none Is osg mvfr na na .7 1.6 �, 35 ,l t� Effluent #1 = BOD 30 < 220 mg /L and TSS >30 < 150 mg /L ' Effluent #2 = BOD < mg /L and TSS < 30 mg /L CST Name (Please Print) Signature CST Number David J. Steel 248956 Address Steel's Soil Service Date Evaluation Conducted Telephone Number 994200th St. Baldwin, WI 54002 11/21/2006 715- 760 -0347 SBD -8330 (K07 /00) Pr'aperty Owner LaCasse Development , Inc. Parcel ID # Pending Page 2 of 3 F il Boring # 11 3 -b b 9 5 Z Ground surface elev. 99.55 ft. Depth to limiting factor 100 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD /ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0 -17 10yr3 /2 none sl 2msbk mfr cs is .6 1.0 2 17 -44 7.5yr4/4 none grcos osg mvfr cs is .7 1.6 3 44 -100 7.5yr4/6 none cos osg ml na na .7 1.6 of / F-1 Boring # El ❑ Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP0/ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff #2 F-1 Boring # ❑ Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#t *Eff#2 * Effluent #1 = BOD 30 < 220 mg /L and TSS >30 < 150 mg /L * Effluent #2 = BOD < 30 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 -3151 or TTY 608 - 264 -8777. SBD -8330 (R.07 /00) Steel's Soil Service STEEL'S SOIL SERVICE 3 of 3 David J. Steel LaCasse Development, Inc. 994200 th St. CST - POWTSM NE1 /4,SE1 /4,S13,T29N,R19W Baldwin, WI 54002 Lic. #248956 Town of Hudson, St Croix Co. Direct 715- 760 -0347 Alexander Meadows First Addition, Lot 10 Fax 715- 684 -3449 This soil evaluation was conducted to satisfy a zoning requirement, it may or may not be su table for your use. The location of this test may or may not be as shown, as permanent lot lines were not established at the time the soil test was conducted. Legend N 1" = 40' = Benchmark Ele. 100.00 ft Top of 3/4" pvc pipe • = Alt Benchmark Ele. 99.85 ft Top of 3/4" pvc pipe ❑ = Borings Boring Elevations B1 = 101.10 ft B2 = 101.35 ft 99.55 ft B4 — 0.00 ft /04 16fi— G'3 Z . r • �. - ;. - ; -a- r /. /�,� -� �. LOT 43 t , , ;\ \ \ l 'L� �,• �'' ♦-' . h� -� ��� ........ \2.553 AC. �% t \ (0,84 AC. #k X 944. \ \ \, C7 i \ � �.•+ } \� - �, / } t ♦ LB v k \ _ \ ♦ / OT \ \ � Z \ ,\ - , 025 GC. � t •,`�`�" � �1 \`� , \ /. ' 950 ., \ % ` • 0 •, \ \ \ \ \ ! „ ' - -.. , / 949.0 fto 1 �•'; • -• ........ \., _ \ �, ANT . \ '- O �' DRI"Y PICAL =.•, r{ f f{ // _ \� � �'�:'�; X951.0 \ X947.0 DRN &4 LOT toi '\ / / •. r 955.0 s •?�, i (1.29 AGE)., LOT a- �\ \ \ ' /,. ♦! J. \ i-.J 30' 957.0 -' i — -. - 970 972:8 i,.�; %l t ^• `�' f ` \ \ \ !�, ��I��Ei'M "7�.���1.� -r / —"- pp • - — �` \'$ \ \ \ \ \ \f /, / ���11!/' •yet 'p�^!E' » �' `\ `\ \ \ `+. \ ! s. \� � '+y Y � � . ^l � ,,,, �\,,, '• - ' M , \ •4 �\ `•.. �� ^\ \. • \. .+ � •' \` �" • .. y�...t'" \ \' \\ \ • `\ V wR` 9 !' 1 ♦` •••, X 982 . 0 11 `,"'•�`' ZI -`..,< X968.4 \ ,... IJOWT rd, , / .% � . \i\ ` \ ••... 1 , a / /• � r� 'r'" - �' SAY `\\ ` ` \ 0 MG1/4 OF TM �SE1 /4 UNPLATTEDL . ...................... . • `` X34�� _ 1 � 1 � �P. z c \ \' • 'i ..... \... \ /i i LOT 3 \ 30' 4 I 't T 5 I to, Los LO 3 v e q X42 . � ` 0 •w ry % / �� ry% 3p' � �\ �\ `� / / X23- 1X24 i e�62 �C� ��•� i i� 3 9 , 0 , , o �P��, / o T 32 do N C O 1a 9 O� ORA /NAGE \ -�' ?� LO } 1 EASEMENT ,Y- 3 HWE =955.0 \ X 20 B =957.0 X: oOr $p,�`�� •�/ o LOT 31 6 DRA /NAGE ••• _ 828. EASEMENT ;�-' •. P 97' - -- BENCH MARK. TOP 393.69 o vgnav 6EBAR N89 °31 '03 "E \ 877.0 \ 5 \ \ SOU1H LINE N OF THE \ Wt /4 OF THE SE1 /4 UNPL A77EDD LANDS DDS - - - - - N47 �RAII MONITOR S MAY BE AFFECTED BY Lot 28 is sub WE LL ACCESS # DI) S MAY OPENING MULTIPLE Natural to an easement X Ni ) RESTRICTIONS Resources for ement granted to X2 N '-DER PLACEMENT OF THE STRUCTURE is for pedestrian travel access to THE P the exlatin a Wisconsin D SHALL BE RESPOFISSTR F iRE sold monitor � Only for the 9 monitor Well Th ea s e ment of X.3 N4 ` STRUCTURE Ei•EVATI The route of well by the Dept. of Natural OR of Co ntinued obstj X4 Noy GRADING, EL EVATION AND access shop b at the discretion f e8 or Its representative. of CONSTRUC the lot o��eaentative, Xs N3� 'TY IS LOCATED WITHIN q CTION E,gSEMENTS N ob 7RUCTiON AREA, Lots X7 No REQUIRE VARIAN ALL WELL 28 and 29 are sub X8 N oa N DNR. CE APPROVAL granted to the To subject to temporary construction X9 'T ZONE M WITHIN THE be exorcised, at t � ° f Hudson or their a ss i gns. Th� easements hereby X10 N27; VENTS, BE SUB Tp It is deemed desirable d iscretion of the Town of Hudson In dents are east boundary of this onatruct Scout Trail from the event thatO X11 N6c c easements Plat, Upon completion of sold illside to the X12 527 SHOWN ON right —of —wa °ll be exterminated Troll THIS MAP IS as well Y is vacated, these construct► n ant ta S put Troll the X 1, N47 , 6 %OUNTY AND TOWNSHIP cut Trail X14 N087, GULAl1 (I.E.. "that Moil be ht vacated X15 .OT SIZE. ACf'�•ce ,•., N75'-;1,