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HomeMy WebLinkAbout617880 040-1294-00-000Wisconsin 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 Pamela Rohde TOWN OF TROY CST BM Elev: Insp. BM Elev BM Description: TANK INFORMATION TYPE MANUFACTURER CAPACITY Septic Dosing Aeration Holding TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Septic Dosing Aeration Holding PUMP/SIPHON INFORMATION Manufacturer Demand GPM Model Number TDH Lift Friction Loss System Head TDH Ft Forcemain Length Dia. Dist. to Well SOIL ABSORPTION SYSTEM ELEVATION DATA CountySt. Croix Sanitary Permit i--7-350 State Plan ID No: 1 Parcel Tax No. 040-1294-00-000 Section/Town/RangelMap No .!. 16.28.19.1685 STATION BS HI FS ELEV. Benchmark Alt. BM Bldg, Sewer St/Ht Inlet SUHt Outlet Dt Inlet Dt Bottom Header/Man Dist. Pipe Bot. System Final Grade St Cover BED/TRENCH Width Length No Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer INFORMATION CHAMBER OR UNIT Type Of System: I d Model Number: DISTRIBUTION SYSTEM Header/Manifold Distribution Hole Size x Hole Spacing Vent to Air Intake Pipe(s) Ix Length Dia Length Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At -Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil E Yes [_ No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: Inspection #2: Location: 504 E COVE RD 1.) Alt BM Description = 2.) Bldg sewer length = - amount of cover = Plan revision Required? U Yes L No Use other side for additional information. SBD-6710 (R 3/97) Date Insepctor's Signature Cent. No. WERIVA I �.�i, C and Buildings Division County 01 W. Washington Ave., P.O. Box 7162 .. Madison, Wl 53707-7162 Sanitary Permit Number (to be filled in by (T-) 4= APR 10 2020 l 600 AL' Corn mt� ttPerm t Applicati r� Y StatcTonNttmber J n- In accordance wT ev tub 'ssion of this form to the appropriate governmental unit is required pror to obtaining a saaiiazy permit Note: ,4pplicazion fortes for state owned POWTS are submitted to the Depart= /�/ �T Project Addre. (if different than mailing address) of Safety and Professional Servies. Personal information you provide may be used for secondary _PLaposcs in accordance with the Privacy Law, s. 15.04(1 m), Stats. / L✓� Parcel # L Application Information - Please Print All Information Property Owner's Name Property Owners Mailing Address .I Property Location QovL Lot '/,4�/1 Sectiontom/ Zip Code Phone Number t UA-a S I circle on I T - N; Rt/� E a I l0 U. Type of Building (check all that apply) 1.ot 4 or 2 Family Dwe11llling - Number of Bedrooms / Subdivision Name 1�1 Block # ❑ Public/Commercial — Descnb Use �j lib n1 ` + fA O � �( 1 ❑ City o ❑ village of ❑ State Owmed — Describe Use CS;Nt mber �U_Tv.of of Permit: _ (Check only one boz on line A. omplete line B if applicable) A. Svsicm ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only I El Other Modification to Existing System (explain) t Renewal ❑ Permit Revision ❑ Change of Plumber ❑ Permit Transfer to New Previous Permit Number and Date Issued Before xpiration Owner o Com onent:/Device: Check all that a 1 -Pressurized In -Ground Pressurized In -Ground ❑ At -Grade ❑ Mound _> 24 in. of suitable soil ❑ tm < i 1 it Holding er ispersal Component (explain) ❑ Pretreatment Device V. Dis rsal/TreatmentAres Information: Design Flow (gpd) DesignSoil h APphoan dsf) Dispersal Area Reqused (y Di/spersal Area Proposed Systc�mj Ele/v� o 5/ G' VL Tank Info Capacity in Total # of Manufacturer Gallons Gallons Units hew Tanks Existing TatrlS �� LI J /.I� At • �' I U ... 2 ;m c C P Septic or Holding Tank l '•" Dosing Chamber I VR Responsibility Statement- I, the undersign , • ume responsibility for installation of the POWTS shown on the attached plans Plumber's Name (Print) s Signature MP/1YTRS Number Business Phone N ber 7 1/ _`� Plumber's Address (Street, City, State, Zip de �f VIIL Corn /De artment bse Only proved Di nit Fee Date Issued Issuing Agent Si er Given R Denial S / 176 DC Conditions of Approvai/Reasons for D oval A, A ^ ./J , SYSTEMC`h'�.E v`V ► alc; p14U 1. Septic is tk, etfit.e;tt fitter ail, raintained dispersal rei' most c Pr by plumber. rou;riEd ps Pot managm eent r,!a+l 1= ,n '�ntain¢d a, All ser ailtc icabie Ode/O must ce a ��&A.f S �11 r /l 1 1,4 ✓1 �CJ L( k4 e< I A .. fir aanlit;Wllt¢ codetordinances SBD-6398 (R. 11/11) Attach tc complete plans for the system and submit to the County only on pert less than 8 in 11 ineLes in ' 0 71 plebe plans for the system and submit to the County only on paper not 1e tbau S tr_ z 11 iathes io SBD-6398 (R. 11/11) County Safety and Buildings Division "Ca u!^t 201 W. Washington Ave., P.O. Box 7162 Nladiso 5 Se��• p� Number (m be filled in by Co.) M 13J7-f 3g9 rmit Applicat' s� T � 5t, In accordance with SPS',�21 is. Ad- Code, submission of this form to the appropriate governmental unit is required pri to a sanitary permit. Note: Application farms for stain -owned PORTS are submitted to the Department afety and Professional Servies. Personal information Project Address (if different than mating address) you provi may be used for secondary 2urPoses in accordance with � Law, s. I5. 1 m , Srats. L Application Informafi n Please int All Information C✓ Property Owner's Name Ol M �• azcel # Prope System PLOT PLAN PROJECT Doua Rohde ADDRESS 617 Diamond Drive Hudson Wi 54016 SW 1/4 NW 1/4S 16 /T 28 N/R 19 W TOWN Troy COUNTY ST. CROIX SYSTEM ELEVATION 89.0/88.9/88.8 4' below grade 5/9/18 4 DATE BEDROOM CONVENTIONAL CONVENTIONAL LIFT %XX HOLDING TANK MOUND SEPTIC TANK SIZE 1255 gallons LIFT TANK SIZE765 DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .4 ABSORPTION AREA 1516 # of chambers 75 BENCHMARK V.R.P. Top of power box ASSUME ELEVATION 100' Filter Lifetime Filter ❑ BOREHOLE O WELL *H,R.P, same as benchmark Oq Property Line Scale = 1 /4 = 1 0' B.M.' Replace area to be original soil test for county plat Vents .1 Scale is 1" = 40' poor soils 20' B-1 -unless otherwise noted Please note: this sight has been disturbed 3-3' X 102' Cells with >3'spacing and appears to be a old gravel pit. The tested area was the only spot I found undisturbed soils suitable for a conventional system. Pro 4 Bedroom House All piping shall be ASTM SDR 30/34, within 10' of tank, piping shall be ASTM F891 t `i c ()P V East Cove Road B-2 40' 20' 0% Slope 3 0' 10' Poor soils at a 2' lower grade Huffcutt Combo Tank Vent >6" of Cover 4' Long 12 ' Property Line Quick4 Standard Leaching Chamber with 20.0 ft2 of Area 5.6ft^2/pair of end caps Grade at System Elevation Cover Page Shaun Bird Bird Plumbing Inc. 1432 120th St. New Richmond Wi 54017 715-246-4516 Date: 5/8/18 Owner: Doug Rohde Location: SW 1/4 NW 1/4 S 16 T28 N,R19W 504 East Cove Road Troy System type: In -ground absorbtion system (conventional) Manuals Used: In -ground absorbtion system (version 2.0) Pressure Distribution Manual (version 2.0) Page# 1. Cover Page 2. Plot Plan 3. Chamber Cross Section 4-6. Maintanance and Contingency Plan 7. Filter Specifications Sheet 8. Dose Tank Cr ss Section 9. Pump Curve �� Signature License nunteY#226900 System PLOT PLAN PROJECT Doua Rohde ADDRESS 617 Diamond Drive Hudson Wi 54016 SW 1/4 NW 1/4S 16 /T 28 N/R 19 W TOWN Troy COUNTY ST. CROIX SYSTEM ELEVATION 89.0/88.9/88.8 4' below grade 5/9/18 BEDROOM 4 r DATE CONVENTIONAL CONVENTIONAL LIFT XXX HOLDING TANK MOUND SEPTIC TANK SIZE 1255 gallons LIFT TANK SIZE765 DOSE TANK SIZE HOLDING TANK SIZE LOAD RATE .4 ABSORPTION AREA 1516 # of chambers 75 IL BENCHMARK V.R.P. Top Of power box ASSUME ELEVATION 100' Filter Lifetime Filter ❑ BOREHOLE O WELL *H.R.P. same as benchmark Property Line Scale = 1 /4" = 10' B.M.*'� Replace area to be original soil test for county plat Vents 30' 20' B-1 Scale is 1" = 40' poor soils 45' 1 unless otherwise noted W/o Slope Please note: this sight has been disturbed and appears to be a old gravel 3-3' X 102' Cells with >3'spacing pit. The tested area was the only spot I found undisturbed soils suitable for a conventional system. Pro 4 Bedroom House All piping shall be ASTM SDR 30/34, within 10' of tank, piping shall be ASTM F891 East Cove Road B-2 40' 20' -3 0' 10, Poor soils at a 2' lower grade Huffcutt Combo Tank Vent ALo 2" Property Line Quick4 Standard Leaching Chamber with 20.0 ft2 of Area 5.6ft^2/pair of end caps ,-Grade at System Elevation Cross Section of Quick 4 Standard Leaching Chamber Typical cross section for 2 of 3 cells Quick 4 Standard Leaching Chamber with 20.0 ft2 of Area per Chamber 5.6ft" 2 pair of end plates Typical Installation Vent Grade 4" A�30/34 Septic Tank 4' Longzl 11 34" Spacing 5' System elevations: A 89.0' B 88.9' C 88.8 5' Grade at System Elevation 3-3' X 62' Cells To be >1' above grade Finish grade elevation 93.0' Vent a 4' Long 1 34" at System Elevation Observation tube/Vent Same on other end To be located on end of Cells z C�� % O� 25 chambers per cell POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page of FILE INFORMATION Owner Permit # DESIGN PARAMETERS Number of Bedrooms ❑ NA i Number of Public Facility Units NA j Estimated flow (average) / �U gavday Design flow (peak), (Estimated x 1.5) r/�caUda Soil Application Rate aUda lffz Standard Influent/Effluent Quality Monthly average" Fats, Oil & Grease (FOG) 530 mg/L Biochemical Oxygen Demand (BOD5) <220 mg/L ❑ NA Total Suspended Solids (TSS) <150 mg/L Pretreated Effluent Quality Monthly average Biochemical Oxygen Demand (BODs) 530 mg/L Total Suspended Solids (TSS) 530 mg/L NA Fecal Coliform (geometric mean) 5104 cfu/100m1 Maximum Effluent Particle Size 7f3 in ❑ NA Other. L NA "Values typical for domestic wastewater and septic tank effluent NIAINTENANCE SCHEDULE SYSTEM SPECIFICATIONS Septic Tank Capacity Ste` ❑ NA Septic Tank Manufacturer ❑ Nq Effluent Filter Manufacturer 9/ ❑ NA Effluent Filter Model '� ❑ NA Pump Tank Capacity - 7 '^ NA al Pump Tank Manufacturer NA Pump Manufacturer L ❑ NA Pump Model ❑ NA Pretreatment Unit q ❑ Sand/Gravel Filter ❑ Peat Filter ❑ Mechanical Aeration ❑ Wetland ❑ Disinfection Cl Other. Dispersal Cell(s) ❑ NA round (gravity) ❑ In -Ground (pressurized) ❑ At -Grade ❑ Mound ❑ Drip -Line ❑ Other: Other. ❑ NA Other: ❑ NA Other. ❑ NA Service Event Service Frequency linspect condition of tanks) At least once eve ry' ❑ month(s) (Maximum 3 ❑ -�' ea s years) NA (Pump out contents of tank(s) When combined sludge and scum equals one-third (36) of tank volume ❑ NA (Inspect dispersal oell(s) At least once every: ❑ months) (Maximum 3 years) Year(s) ❑ NA (Clean effluent filter At least once every: ❑ ;3-year(s) ❑ NA Inspect pump, pump controls & alarm At least once every: ❑ month(s) >,-�ear(s) ❑ NA i:lush laterals and pressure test At least once every: ❑ month(s) ether ❑ year(s) ❑ NA ether: At least once eve ❑ month(s)ry: ❑ year(s) ❑ NA ❑ NA MAINTENANCE INSTRUCTIONS !Inspections of tanks and dispersal cells shall be made 'by an individual carrying one of the following licenses or certifications: Master !Plumber; Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer; Septage Servicing Operator. Tank inspections must iinclude a visual inspection of the tank(s) to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of combined sludge and scum and to check for any back up or ponding of effluent on the ground surface. The dispersal cell(s) shall be 'visually inspected to check the effluent levels in the observation pipes and to check for any ponding of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a failing condition and requires the immediate notification of the local I-egulatory authority. When the combined accumulation of sludge and scum in any tank equals one-third ('!) or more of the tank volume, the entire contents of I:he tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113, Wisconsin Administrative Code. )NI other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment units, land any servicing at intervals of <12 months, shall be performed by a certified POWTS Maintainer. A service report shall be provided to the local regulatory authority:within 10 days of completion of any service event Page of START LIP AND OPERATION presence of For new construction, prior to use of the POWTS check treatment tank(s) f huh concentrations, are detected or other chemicals d*t the contents of the may impede the treatment process and/or damage the dispersal c:ell(s). tank(s) removed by a septage servicing operator prior to use. System start up shall not occur when soil conditions are frozen at the infiltrative surface. During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will be discharged to the dispersal cell(s) in one large dose, overloading the oell(s) and may result in the backup or surface discharge of effluent.di avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring power to the To effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to restore normal levels within the pump tank. Do not drive or park yehides over tanks and dispersal ce0s. Do not drive or park over, or otherwise disturb or compact, the area within 15 feet down slope of any mound or at -grade soil absorption area. Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the POWT$: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfedarrts; fat: foundation dralin (sump pump) water, fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps, medications; oil; painting products; pesticides; sanitary napkins; tampons; and water softener brine. ABANDONMENT When the POWTS fails and/or is permanently taken out of service the following steps shall be taken to insure that the system is propefily and safely abandoned in compliance with chapfer Comm 83.33, Wisconsin Administrative Code: All piping to tanks and pits shall be disconnected and the abandoned pipe openings seated, n The contents of all tanks and pits shall be removed and property disposed of by a Septage Servicing Operator. After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with sail, gravel or another inert solid material. CONTINGENCY PLAN If the POWTS faits and cannot be repaired the following measures have been, or must be taken, to provide a code comp6M replacement system: A suitable replacement area has been evaluated and may be utilized for the location of a repUmement soil absorption systelm. The replacement area should be protected from disturbance and compaction and should not be infringed upon by requirled setbacks from existing and proposed structure, lot lines and wells. Failure to prated the replacement area will result in the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rule;/ in effect at that time. ❑ A suitable replacement area is not available due to setback and/or soil limitations. Barring advances in POWTS technologlt a holding tank may be installed as a last resort to replace the failed POWTS. ❑ The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluation must be performed to locate a suitable replacement area. if no replacement area is available a holding tank may be installed) as a last resort to replace the failed POWTS. ❑ Mound and at -grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltrative surface. Reconst uctons of such systems must comply with the rules in effect at that time. «WARNING» SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND/OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TAN(UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE O� A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLER E Name %1./hone (y = — 4%J POWTS MAINTAINER -1 Name Phone �IJ SEPTAGE SERVICING OPERATOR P MPER LOCAL REGULATORY AUTHORITY EName I Name Phone '���� 6 --I-) Phone This doaunent was drafted in compliance with chapter SPS 383.22(2)(b)(1)(d)&(f) and 383.54(1), (2) & (3), Wisconsin onsin Administrative Code• 04.5200-, 19.8000 18.0000 A ;.1921 9.8464 9.3 W Case and Serpentine 9.4356 .0 1 Clap between C. iwi-AT A SECTION A -A Septic -hose Tank Cross Section And Pump Performance Specifications Tank Manufacturer Tk Model Number ' ^J � ' 7 Total Tank Capacity an� !off Ss Max. Bury Detpth Filter Manufii Filter Model Number -- Minimiun Pump Performance Required t TDH -170 Inlet Outlet Manhole Min. 4" Above Grade With Looking Device. Inlet Manhole < 6" Below Grade Sealed Watertight Switch Settings and Reserve Capacity Tank Volume = GPI Dimension . inches Volume Gal. (reserve) A: &` ' �9, (alp) B -- 2 3 (dose) C 1 (dead) D r' y- Total Pump Manufacturer Pump Model Number_ Alarm Manufacturer Model Number Alarm M � Switch Type Total Dynamic Head (TDH) - Feet Elevation Head Distal Pressure Network Loss �^ - Force Main Loss Total Manhole Min. 4" Above Grade Securely Mounted With Locking Device Weather-proof l Junction Box Vent Min. 12" Disconnect Above Grade Means Bottom Elevation 4EL Z— Ft GENERAL INSTALLATION: The septic/dose tank is bedded and back filled in accordance with the manufacturer's product approval specifications. Maximum depth of bury as specified by the manufacturer may not be exceeded without pFior approval. Manhole covers exposed to grade have an effective locking device (padlock) installed. Piping at the inlet and outlet is of approved material, connected to the tank with watertight fittings, and laid on stable soil to prevent settling or sagging. The force main is sleeved with 4" Sch. 40 PVC to bridge the tank excavation and the sleeve is sealed watertight. Electrical service complies with NEC 300 and Comm 16.28. 02/05 U Page of 250-SERIES 1/3 hp Sump/Effluent Pumps for Professionals! ALL MODELS FEATURE.- * Rugged 1/3 hp motor, oil filled with thermal overload protection. • 1/2" solids handling. • 1-1 /2" discharge. • Hermetically sealed motor and switch cavities, and permanently lubricated bearings. • Liberty's UNI-BODY casting - a solid, one- piece housing that eliminates the lower motor seal ring found on other pumps. • Epoxy powder coat finish • Vortex style impeller for superior solids -handling. Made of high temperature engineering polymer. • Fasteners - all non -corrosive stainless steel. • 416 stainless steel rotor shaft. 250-series Cord Lengths Model 10' 25'(-2) 35'(-3) 50'(-5) 250 Standard Optional Optional Optional 251 Standard Optional Optional Optional 253 Standard Optional Optional N/A 257 Standard Optional N/A N/A 10' cord length standard on all models. For optional lengths, add "-2, -3 or -5" suffix to model number. Example: for model 250 with 35' cord, order 250-3 Model 250 Manual, no switch EFFLUENT MODELS Model 251 Quick -disconnect wide-angle float, mercury -free. r7ri� COUS Dual safety certification for CERTIFIED C US Certified the United States and Canada. Specifications are subject to change without notice. MOTOR SPECIFICATIONS: 1 /3 hp 115V 5.2 amps 60Hz Thermally Protected & Permanently Lubricated (PSC) Permanent Split Capacitor Maximum Fluid Temperature:140°F DIMENSIONAL DATA: Weight: Model 257: 20lbs. Height:10.5" Major Width: 9.6" (manual model 250) PERFORMANCE CURVE 25 20 0 D U.S. Gallons Per Minute 38 78 114 156 192 Liters Per Minute Model 253 Wide-angle float with series (piggy -back) plug, allows manual operation of pump. 6 0 w 5 = m ii 3 m 0 Model 257 VMF VMF switch, magnetically operated vertical float - operates in a 10" diameter sump. Liberty Pumps • 7000 Apple Tree Avenue • Bergen, New York 14416 • Phone 800-543-2550 Fax (585) 494-1839 www.libertypumps.com Copyright © Liberty Pumps, Inc. 2017 All rights reserved. LLIT2500-R5/17 n LJ CORNER --o" ' -- F OUND u, 'AP MONUhEN T Q w w r4 — X = 138. 09 `--•-�— X . : • • O :LOT 9 : 1. 19 ACRES 52, 034 SO. FT, w cx N (TO NE CORD ( N88.57' 520 E ) . N88 0 5 7' 43" E LOT 28 LOT 13 302m 44 26 7. 16' 1 1 417. 18' 1• 1• 1• 1• 1• roe• O'• LOT I 1 1. 73 A CRE ' • 75, 456 SO. F z;- t 1• N88°5 .01 1•• Z� ,- l4p. "- ♦. 1 , AZ" 1p �' ✓ rro • iWMr1 �• � ��aZ � �r rrr ♦♦ • 030 _ / � 6 00 00 3 136.-97' 3 7, 60' N/ 44' X - 150. 02' ---- x �•• FND. • .2'. • IRON • PIPE N50'03' 52' E 0. 54' FROM SET IRON �. LOT I O -- W 1.27 ACRES': 55,289 SO. F T! N ; , be 3 � 4i- sTswO3'' (1 unread) - slai rdWronfiernet. net - Frontier -Yahoo Mail 5/3/18, 4:02 PM -ontier - Mail News spoils Finance Weather Groups Answers Flickr More - sbird(Dfrontiernet. net, search your mailbox Search Mail SeIrGh Web 41 / Compose Inbox (1) Tt a ";h f;esiii v 3 * <4% -* a Ai -chive 13 Move , ta Delete 110 Sparr. � --- Fw: Septic Agreement "a SWW TAW MAWggkW9 * 4 �x Free Shipping People Easy Return N, :7 W, T~ ot Warr aso P. Wmr -109j, Wollaw Page v #p*k" tmwd 1TWk rvtowtwt haw# *'rb&WOC.*Oc. Pt"r" rP)' IWA fvtq "W-sW WAW.", it Ufa" by# twfvow rvW#W %%aw.p" > P-*Nkr, to*W*4 0W*a W A V1-1VW0*ft**44t0* *WIN& IAWA*t .4 zit t)v. gcw a-POAsaM: A*" M L" #*W'K'c Ow of dw 4-- Douglas Rohde President & CEO LHR Hospitality 432 Wabasha Street South St. Paul, MN. 55107 Empire Building, Suite 700 651-340-1880 Main 651-340-1624 Fax LIM https://maii.yahoo.com/#mail Page 1 of 1 N • � - I, � d^ Norte+, °rt3: — f e --- r I 00 / �z ._ '[-t Snb 3ii Y � ey1 .'ZLn4 MUl1k . cp 'ip: s1v71 \ VI\ w ems{' Wisconsin partment of Comm aty SOIL EVALUATION REPORT Pa e of Division of S 4fety and. ilk 0910g ent g nit ` accordance with Comm 85, Wis. Adm. Code -- County Attach com` site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel Percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Please print all information. Re ed by Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). 5 �7 / Property Owner Property Location _ Govt. Lot 1 /4 l4 / T L, N R E ( W Property Owner's Mailing Addreo Lot # Block # Subd. Na or CSM# I ') r..w xlr,,2 r i �_- State Zip Code Phone Number ❑ City ❑ Village _4�aTo Nearest Road ,17 O.New Construction Use: esidential / Number of bedrooms Code derived design ow rate GPD ❑ Replacement ❑ Publi or commercial -Describe: Parent material Food Plain elevation if applicable General comments<-l�CL�1— . `7l s �� , -�,�..1_ U t% �� � and recommendations: y l���Cc✓ y _.-� System Type ��tiJ/'i! iiy.0 / System Elevation MBoring # Boring 6EJ pit Ground surface elev. ` tt. Depth to limiting factor in. 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 lv' -i L 104L3 /_ Out 14 Boring # Boring FCf' a pit Ground surface elev. � � . L� ft. Depth to limiting factor Jim. 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 cmuem rr1 = 1svu. � YJ < "U rngrL ano f JJ >jU < 1 bU MZ' Effluent #2 = BOD, < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) turt� CST Number Bird Plumbing, Inc. Shaun Bird 226900 Address Date Evaluation Conducted Telephone Number 1432 120th St, New Richmond, WI 54017 j _ 715-246-4516 Property Owner _ Boring # ❑ Boring '<"% F, � Pit Parcel ID # Ground surface elev.� ft. Depth to limiting factor / ) in. Page of Snil Annliratinn Pnta 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 It aBoring # ❑Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth in. Dominant Color Munsell Redox Description Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/ff 'Eff#1 'Eff#2 Boring F-1Boring # Ground surface elev. ft. Depth to limiting factor in. El Pit Soil Application Rate Horizon ')epth in. Dominant Color Munsell Redox Description. Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/ff 'Eff#1 'Eff#2 Effluent #1 = BOD, > 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BOD, < 30 rng/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.6/00) Property Owner Boring # ❑ Boring Pit Parcel ID # Ground surface elev. t 3 ` 0 ft. Depth to limiting factor &0 in. Page of 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 /r t/ , l O 1� 1( a Boring # ❑ Boring r ❑ pit Ground surface elev. ft. Depth to limiting factor in. Horizon Depth in. Dominant Coiorl Munsell Redox Description Qu. Sz. Cont Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPDIFf -Eff#1 •Eff#2 F-1❑ Boring Pit Boring # Ground surface elev. ft. Depth to limiting factor in. ❑ I Rnil Annliratinn Rate Horizon ')epth in. Dominant Color Munsell Redox Description. Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/ff 'Eff#1 -Eff#2 ' Effluent #1 = BOD, > 30 < 220 mg/L and TSS >30 < 150 mg/L • Effluent #2 = BODS < 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. Sa48330 (R.6100) Soil Test Plot Plan Project Name Doug Rhode Shau rd Address 617 Diamond Drive Hudson Wi 54016 1VI Lot 10 Subdivision Piney Woods Date C5/9/18 #226900 S W 1/4 N W 1/4S 16 T 28 N/1319 W -- Township Troy [� Boring Q Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 100 ft. Top of power box System Elevation 89.0/88.9/88.8 *HRPSame as Benchmark Property Line Scale is F = 40, unless otherwise noted poor soils Please note: this sight has been disturb, and appears to be a old gravel pit. The tested area was the only spot I found undisturbed soils suitable for a conventional system. Replace area to be original soil test for county plat East Cove Road B.M.*\ 30' 20' B-1 45'� 0' 0% Slope B-3 50' B-2 0, 10' Poor soils at a 2' lower grade Property Line Wisconsin Department of Commerce(YS��OIL EVAL=UA N REPORT Page of !'ivisicn of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code — ' County Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but not limited to: vertical and horizontal reference point (BM), direction and Parcel I.D. percent slope, scale or dimensions, north arrow, and location and distance to nearest road. L1. Please print all information. Revi .,NPx Date 1�/1 / Personal information you provide may be used for secopdary purposes (Privacy Law, s. 15.04 (1) (m)). J r IJIL ,. '4&t.,� Property Owner I `�(/ �� C Propery Location . QD : � cE RD OY�[AN GG —Lot Sitil 1/4NW 1/4 rS T ZF'] N R 1_q E W Property Owner's Mailing dd�s Lot # Block # Subd. Name r C # City / State Zip Code Phone Number ❑ City ❑ Village ® Town Nearest Road jz1uLZ FPFi.J bU) oZZ 1 lS ) L4ZS- b-)4Z -T7 � New Construction Use: a Residential ! Number of bedrooms 3 Code derived design flow ratd . � �.SO GPD ❑ Replacement ❑ Public or commercial - Describe: " Parent material oU R/ll f `a Flood Plain elevadcn if applic le IV ft. General comments d recommendations: tML)KI Z(3 0K Sy1hh7 OF- d-ED—L CZ.., 1 Z U y ❑ Boring # Boring a � I ® 'pit Ground surface elev. fL Depth to limiting factor ��+rr' Gnil Annliration Rate1 Horizon Depth in. Dominant Color Munsell Redox Description Ou. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots GPD/ft2 'Eff#1 'Eff#2 Z -1 >o�c�z VA— I`�s 1cSbk m V f1- CUS 3 ► 16 C6-�s�re_ s�v 1�S lc��hk y,�v � as - •�1 -�(8 I�Z�ZZ( — S1I lcsbk yll-Ft- Gti) ovn �,,-q Boring17—# ❑ Boring q 0t` ® pit Ground surface elev. ft Depth to limiting factor �� in. Soil Application Rate Horizon Depth Dominant Color Redex Description Texture Structure Consistence Boundary Roots GPD/ftz 0—� to 1 Cc 3/3 — �> �Ub2 BUT �Iw z- -y (� )o Ll P, V — s It 6 ' Fffluent #1 = BOD_ > 30 < 220 ma/L and TSS >30 < 150 r11g/L - tmuent iFt = cuus � su mg1u ana 1 JJ � JV 1 nyiL CST Name (Please Print) Signature CST Number Arthur L. Wegerer 01-31,6 `» 220254 Address I'l e g e r e r Soil Testing & Design Service Date Evaluation Conducted Telephone Number 421 N. !lain St. River Falls, WI 54022 �Z_��I-p� 715-425-0165 Property Owner _ Zb p/a �-� L Parcel ID }v [ 3 Boring # ❑ Boring Page of Pit Ground surface elev. 7 ft. Depth to limiting factor in. HorizonEMTex,tu,e Color Redox Description Texture Structure Consistence BoundaryRoots Soil Application Rai ll Qu. Sz. Cont. Color Sz. Sh.'Eff#1 GPD/ftGr. ! 3 ._ � �z •Eff#2 L c) Sg �1 �2( Slt ❑ Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in t lorizon Depth Dominant Color Redox Description Texture Structure Consistence Boundar RootSoil Application Rate if). Munsell Qu. Sz. Cont. Color y Gr. Sz. s GPD/ft Sh. 'Eff#1 I •Eff#2 ElBoring # ❑ Boring - ❑ Pit Ground surface elev. ft. Depth to limiting factor in. !orizon Depth Dominant Color Redox Description Texture Structure Consistence Bounda Roots Soil Application Ra in. Munsell Qu. Sz. Cont. Color rY GPD/ft Gr. Sz. Sh. 'Eff#1 I •Eff#2 • Effluent #1 = BOD, > 30 < 220 mg/L and TSS >30 < 150 mg/L • Effluent #2 = BOD < a _ 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 die department at 608-266-3151 or TTY 608-264-8777. . SB"330 (R.6/00) Property Owner l� d pia L Parcel ID #L fl1 G Page �' of F�] Boring # ❑ Boring ® Pit Ground surface elev. T 6 , -7 ft. Depth to limiting factor l(� in. Horizon Depth in. Dominant Color Munsell Redox Description Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots r.NNw uvll r�aic GPD/ft2 'Eff#1 •Eff#2 o-� In2 313 — \% �asbk �,vf� ew _I . SO Z �f s b ►� h, u `Pt— a w • S .� 11 F-1 Boring # ❑ Boring ❑ Pit Ground surface eiev. ft. Depth to limiting factor in. Horizon Depth In. Dominant Color Munsell Redox Description Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots U vll /1Ppi t.d LIVII r dtu GPD/ftt 'Eff#1 I 'Eff#2 HBoring # Boring Pit Ground surface elev. ft. Depth to limiting factor in. Horizon Depth in. Dominant Color Munsell Redox Description Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots ouu Hppncarron rare GPD/112 'Eff#1 'Eff#2 Effluent #1 = BOD5 > 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BODS < 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 M 608-264-8777. SBD-8330 (R.6/00) wsconsin Department of Commerce SOIL EVALUATION REPORT Division of Safety and Buildings. Page � of J in accordance with Comm 85, Wis. Adm. Code County o include, but not limited to: vertical and horiz Attach complete site plan on paper not less than 8 112 x 11 inches in size. Plan must ntal reference point (BM), direction and Parcel I.D. percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Please print all information. Reviewed by d Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Property Owner Property Location S-) N ►`1D r_E R.ODP-i4 L Gevt-Lcf S1NJ 1/4Nw 1/4 S T N R l E (OR Property Owner's Mailing Address Lot # Block #[ISubd. Na�ec�#'�K3�1— ty0 —sRc,,,_", State Zip Code Phone Number ❑ City ❑ Village ® Town Nearest Road ��Z Ff'�LlS Ij sgoZZ I (-) L4ZS-6��Z New Construction Use: Residential / Number of bedrooms 3 Code derived design flow rate ❑ GPD Replacement ❑ Public or commercial -Describe: Parent material _ OU`M1 Flood Plain elevation if applicable tv • , ft. General comments and recommendations: 11Q�UYv� l`J tyc s�' D lS`�Z(aU`f101�1 GeZ L, Boring # ❑ Boring -pit Ground surface elev. 9 I�S• -7 ft Horizon Depth in. Dominant Color Munsell Redox Description Qu. Sz. Cont. Color Texture lo`1tz313 _ �S z -7- ► ><,�j-1M_ V1 Ids -S Y Depth to limiting factor ` b Structure Consistence Gr. Sz. Sh. in. Boundary Soil Application Rat Roots GPD/ftz 'Eff#1 'Eff#2 1 �S b�c m • O -.Z c_'-s b k oV-A HL'�- Boring # ❑ Boring ❑ pit Ground surface elev. fL nep h to limiting `cctcr ? 44 in Horizon 22 Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots Soil Application Rate GPD/ftz � �so'2 r✓I UT� � w � I_. ' Effluent #1 - BOD > 30 < 0 mg/L and TSS >30 < 150 mc/L • Ffflupnt t!'J = R(ln - �' _ -—...__....._ ,..,...5=.,v ­y,� aiiu I JJ c JV mg/L CST Name (Please Print) Signature Number Num Arthur L. Wegerer L_3 �16 — ) 0 CST CSTNum Address Vegerer Soil Testing & Design Service Date Evaluation Conducted 220254 Telephone Number 421 N. Hain St. River Falls, NI 54022 lZ_�°I-0Ir 715-425-0165 PLOT PLAN P a a e 3 of 3 Scale 1'=��' 3o+rzD FL�� QM*\ - NE�voo-0' o►V 0 t2Ory PIRA Lor enfzlue\'z�_ / @''Ii+Z- a 103-7'O�J 113P OF 5.-2�vooz Aw'-f CST Signature �I-V� -01 715-425-0165 220254 C')l-3t$-10 Date Telephone No. CST No. Job NO. I CL a•7 State Bar of Wisconsin Form 2-2003 WARRANTY DEED Document Number 11 Document Name THIS DEED, made between Donald O. Rodahl and Joyce J. Rodahl, husband and wife ("Grantor," whether one or more), and Pamela S. Rohde a married person ("Grantee," whether one or more). Grantor for a valuable consideration, conveys and warrants to Grantee the following described real estate, together with the rents, profits, fixtures and other appurtenant interests, in St. Croix County. State of Wisconsin ("Property") (if more space is needed, please attach addendum): LOT TEN (10), PINEY WOODS SUBDIVISION IN THE TOWN OF TROY. Exceptions to warranties: easements, restrictions, and rights of way of record, if any. Dated J� ROGH ✓/ ���Z * AUTHENTICATION Signature(s) AL) (SEAL) authenticated on JULIE E. JENSEN Nntaly.Public StatQ_af_WisLaruin- TITLE: MEMBER STATE BAR OF WISCONSIN (If not, h, . authorized by Wis. Stat. § 0Tq THIS INSTRUMENT DRAFTED.B06,6 * r K+1 River Falls, WI 54022.0138 NOTE: THIS IS A STAND WARRANTY REED *Type name below signatures. 8052605 Tx:4039200 953247 BETH PABST REGISTER OF DEEDS ST. CROIX CO., WI 03/27/2012 11:49 AM EXEMPT#: NA REC FEE: 30.00 TRANS FEE: 186.00 PAGES: 1 Recording Area Name and Return Address la!Q :2 040-1294-00-000 Parcel Identification Number (PIN) This is not homestead property. (is) (is not) (SEAL) * onald O. Rodahl (SEA L) * Jo a J. Rodah ACKNOWLEDGMENT STATE OF W-I' ) ss. COUNTY ) Personally came before me on !the above -named Donald O. Rodahl and Joyce J. Rodahl -to me known to be the person(s) who executed the foregoing instrument and acknowledged the same. {-- —-t?—k3;k 'Notary Public, State of tN7- I" My commission (is perniattem}(expires: �}{bc Huilicnricalcd or acknowledged. Roth are not necessary.) r1 l 1N011IFICATION'rO THIS FORM SHOULD BE CLEARI,Y IDENTIFIED. �IMIIC1�003 STATE BAR OF WISCONSIN FORM NO. 2-2003 INFO -PRO^'—. inlopmfo—s. com 1 of 1