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Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Safety and Building Division INSPECTION REPORT GENERAL INFORMA~'ION (ATTACH TO PERMIT) Personal information yAU provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: S an nber ,Patric City Village X Township Baldwin Townshi CST BM Elev: Insp. BM Elev: BM Description: TANK INFORMATION TYPE MANUFACTURER CAPACITY Septic Dosing Aeration Holding 1 AIVtI JC 1 t3Al:K IIVtVKMAI IVN - TANK TO P/L WELL B G. ent to Air ntake RO D Septic Dosing Aeration Holding \ PUMP/SIPHON INFORMATION \ Manufacturer D GP Model Number TDH Lift Friction Loss System H ad T Ft Forcemain Length Dia. Dist. to Well county: St. Croix Sanitary Permit No: 430101 0 State Plan ID No: Parcel Tax No: pot - /v~ Z - (ov -vci~ Section/Town/Range/Map No: 06.29.16. `~ ~ STATION BS HI LEV. Benchmark Alt. BM Bldg. Se SUHt left St/Ht O let Dt Inlet Dt B tom ader/Man. Dist. Pipe ot. System Fi I Grade St Cover ELEVATION DATA e and SOIL ABSORPTION SYSTEM /I BED/TRENCH Width Length . 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 Type Of System: UNIT Model Number: DISTRIBUTION SYSTEM Header/Manifold Distribution x Hole Size x Hole Spacing Vent to Air Intake Pipe(s) Length Dia Length Dia Spacing SOIL COVER x Pressure Svstems Onlv xx Mound Or At-Grade Svstems Only Depth Over Depth Over xx Depth of xx SeededlSodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil Yes U No `~ Yes No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / / Location: 1174 220th St Baldwin, WI 54002 (SE 1/4 NE 1/4 6 T29N R16W) NA Lot 1 1.) Alt BM Description = 2.) Bldg sewer length = -amount of cover = 3.) Contour = Plan revision Required? ~ ~,, Yes [] No I Use other side for additional information. ~ Date Insepctor's Signature SBD-6710 (R.3/97) Inspection #2: / /, Parcel No: 06.29.16. Cert. No. ~ ~ t ~ ~ ~ 2Z~ ~ ~E-. / ~~~~ ~~ Sanitary Permit Application In accord with Comm 83.21, Wis. Adm. Code Safety & Buildings Division 201 W. Washington Ave. ` ~ ~ See reverse side for instructions for completing this application PO Box 7302 iscons~n Department ct commerce Personal information you provide may be used for secondary purposes [Privacy Law, s. 15.04(1)(m)] Madison, WI 53707-7302 (Submit completed form to county if not state owned.) Attach complete plans (to the county copy only) for the system, on paper not less than 8 -1/2 x 11 inches in size. County ~- CRS r>C. State Sanitary Permit Number ^ Check if revision to previous application 30 101 S to Plan I. D. Number BIZ I ~ - Tra,,~s. /Q.'~' I. Application Information -Please Print all Information Location: Property Owner Name v ~ Property Lor~ca/~t~~ion i ~ 1/4~~~-1/4, S Ta/,~I, )r ~or Property Owner's Mailing Ad ss 1 ~'T ~ Lot Number Block Number City, Sta ~ Zip ode ~~ ~ „~Ut~tber fi ~ Se~~iiuisiati~+Ta~e o M Number v ~ c ~ 4 ` ( L3~F' x;30 . ~1~- 3z.( ~ P 3~ 9~ . Type of Building: (check one) ~ g ~ , , ~tS , .; t~) } t or 2 Famil Dwellin - No of Bedrooms ^ City ^ V'llage ,~7 y g : ~ ~~ ~~ . ^ Public/Commercial (describe use):_ own of I /~ ~ ~ 5T ~ ~' State-Owned ZC~'.t.'_, - -, dC fG GI~/mil q~ 30 ~~ ~ ~ (~ ~~.. ~/,v-c> ~ Nearest Road /~~ -7~/ ? ~1 / K S lam' r JV1 M+~V`Bl ~XX `` D u - 1.O' (! ~ 2 ~ ~ ~j C~ Qt` ~'~ Parcel Tax Number (s) - 0 X01 Gam' II .Type of Permit: (Check only one box on line A. Check box on line B if applicable) A) 1. ew 2. ^ Replacement 3. ^ Replacement of 4. 5. 6. ^ Addition to System System Tank Only Existing System $) Permit Number Date Issued ^ A Sanitary Permit was previously issued IV. Type of POWT System: (Check all that apply) ^ Non-pressurized In-ground ~lVlound ^ Sand Filter ^ Constructed Wetland ^ Pressurized In-ground ^ Holding Tank ^ Single Pass ^ Drip Line ^ At-grade ^ Aerobic Treatment Unit ^ Recirculating ^ Other: V. DispersaUTreatment Area Information: 1. Design Flow (gpd) 2. Dispersal Area 3. Dispersal Area 4. Soil Application 5. Percolation Rate 6. System Elevation 7. Final Grade /~ C -~ Required opo~P~ -.ate (Gals./day/sq. R.) (Min./inch) ~j Elevation VII. Tank Capacity in Total # of Manufacturer Prefab Site Steel Fiber- Plastic Information Gallons Gallons Tanks Con- Con- glass New Existing Crete strutted Ta n ks Tanks ~ / VIII. Responsibility Statement I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plu 's Name (print) Plumber's a e (no stamps): MP/MPRS No. Business Phone Number P u er's Ad dress (Stre et, City, State, Zip Code) t / ~f /A/ b ~/~ GYL ~ GAY /' ~~~~ IX. County/Department Use Only Approved ^ Disapproved ^ Owner Given Initial Adverse Sanitary Permit Fee (Includes Groundwater Surchazge Fee) Date Issued ssui Agent Signature (No stamps) Determination 3'ZS-- z ~ tlp - ,X~. Co ons~ o~ royal /Reav son fo approval: ~(I _ /~ ~ -~_ ~~c t ' ~ 't'om ~ `~1~` ~ ------- as ~ o,,~„ l~ P,~=-V'. (/ . Ill ~ ac.l~ ~ ww~A~ ~ tM ~ SBD-6398 (R. 07/00) ~~ "-~ PLOT PLAN PROJRCT Pat Soanaenbera ADDRESS 497 Nelson Farm Ln. Hudson Wi 54016 --~ SE 1 / 4 NE 1 /4 S 6 /T 29 N/R 16 W TOWN Baldwin COUNTY ST. CROIX MPRS Byron Bird 1r. 220527 DATES/13/03 BEDROOM 3 CONVENTIONAL AT-GRADE CONVENTIONAL LIFT HOLDING TANK MOUND XXX SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE 848 HOLDING TANK SIZE LOAD RATE 1.0 ABSORPTION AREA 454 # of chambers none BENCHMARK V.R.P. Base of property line stake ASSUME ELEVATION 100° Filter Zabel A-100 ^ BOREHOLE O WELL •H.R.P. Same as Benchmark SYSTEM ELEVATION 92.3' 88' 90' 10% Slope ~/~ B% 92' Alter N N ~ Area 15' Below System is to ~ remain undisturbed Grading is to be done to divert runoff away from system B-2 Well is to meet all setbacks found in Comm. 83 Tanks are to be properly DT bedded and provided with lockdown covers with approved warning labels ST Line Pro 3 Bedroom House B.M. . ._, .is~onsin Department of Commerce May 27, 2003 CUST ID No.220527 BYRON BIRD JR BYRON BIRD JR. PLUMBING, INC 896 68TH AVE AMERY WI 54001 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 05/27/2005 SITE: Pat Spangenberg 220`'' Street -lot 1 Town of Baldwin St Croix County SE1/4, NE1/4, S6, T29N, R16W Safety and Buildings 4003 N KINNEY COULEE RD LACROSSE WI 54601-1831 TDD #: (608) 264-8777 www,commerce.state.wi.uslsb www.wisconsin.gov Jim Doyle, Governor Cory L. Nettles, Secretary ATTN: POWTS Inspector ZONING OFFICE ST CROIX COUNTY SPIP' 1101 CARMICHAEL RD HUDSON WI 54016 taenur~.a~.,.... ». Transaction ID No. 872417 Site ID No. 659464 Y above, in all FOR: Description: Proposed Three Bedroom d Ob ect ID No.: 904583 Object Type: POWT System Reg ubmittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes 'The s and Wisconsin Statutes. The submittal has been CO eDor c0ompliance wPth x011 code requirement as define in chapter 101.01(10), Wisconsin Statutes, is responsib The following conditions shall be met during construction or installation and prior to occupancy or use: Conditions of Approval: • This system is to be constructed and located in accordance with the enclosed approved plans. • Limited activities are allowed in the area 15 feet doiwns that mpact the treatment and dispersalare prohibited. excavation, vehicular traffic and other similar acts tate a roved effluent filter is required. Maintenance information must be given to the owner of the tank • A s pp q must be rovided explaining that periodic cleaning of the filter is re uired. Access to the filter for cleaning P per Comm 84 product approval conditions. where this project is located in accordance with the • A Sanitary Permit must be obtained from ~ S 5tats. requirements of Sec. 145.135 and 145.19, ection of the private sewage system installation is requirens of Sece145.20(2)(d)pWis. Stat 11 be made with • Insp the designated county official in accordance with the provisio A co of the approved plans, specifications and this letter shall be on-site du ~glude local Comm 83.22(7) - pY construction and open to inspection by authorized representatives of the Department, which may inspectors. ~Ct~IC~`~~t ~ ~,J~"~ ~l d~e~~~ ~~x ~ S. I ~ Ra iYi ~ it ii • Comm 83.52(1)(a) -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. In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approved plans. • The owner is responsible for submitting a maintenance verification report per Comm 83.55, that is acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. 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 left addressee shall provide a copy of this letter to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Gerard M. Swim POWTS Plan Reviewer -Integrated Services (608)-789-7892, Mon. -Fri. 7:30 am to 4:1 S pm jswim@commerce.state.wi.us Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 WiSMART code: 7633 cc: Leroy G Jansky, Wastewater Specialist, (715) 726-2544 Cover Page Byron Bird Jr. Byron Bird Jr. Plumbing Inc. 896 68th Ave RECEIVER Amery Wi 54001 MAY ~ 6 2Q03 715-246-4516 SAFETY & BLDGS D~V, Date: 5/13/03 Owner: Pat Spangenberg Location: SE 1/4 NE 1/4 S 6 T29 N,R 16W Lot 1 220th st. Baldwin System type: Mound System Manuals Used: Mound Component Manual version 2.0 (01 /31) Pressure Distribution Manual version 2.0 (01/31) Page# 1. Cover Page 2. Mound Plot Plan 3. Mound Cross Section 4. Pipe Cross Section/Pipe Layout 5. Pump Chamber Cross Section 6. Pump Curve 7-9. Maintance and Contigency plan 10-12 Soil test Signature License ni GI PARTMENT OF CG ~FlERC~ DIVISIQN flF AF YANG Bt11LDINGS a SEE G~RRES NGENCE ~ , s PROJECT Pat S~anaenbera SE i/4 NE 1/4S 6 /T 29 PLOT PLAN ADDRESS 497 Nelson Farm Ln. Hudson Wi 54016 N/R 16 w TowN Baldwin couNTY ST. CROIX MPRS Byron Bird Jr. 22057 DATE5/13/03 BEDROOM 3 CONVENTIONAL AT-GRADE CONVENTIONAL LIFT HOLDING TANK MOUND XXX SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE 848 HOLDING TANK SIZE LOAD RATE 1.0 ABSORPTION AREA 454 # of chambers none BENCHMARK V.R.P. Base of property line stake ASSUME ELEVATION 100' Filter Zabel A-100 ^ BOREHOLE O WELL '"H.R.P. Same as Benchmark SYSTEM ELEVATION 92.3' Property Lin 8 8' 9 0' 10% Slope -3 B/ 92' Alts N N 0 w Area 15' Below System is to remain undisturbed Grading is to be done to divert runoff away from system B-2 Well is to meet all setbacks found in Comm. 83 Tanks are to be properly DT bedded and provided with lockdown covers with approved warning labels ST Pro 3 Bedroom House Line B.M. Designer Date r 4" Observation Pipe Perforated Non-Woven Filter Fabric Below Filter Fabric ~D;stribu tion p;pt AS12i C-33 5 a n d~ /~ ~ " Topsoil ~H . ; __ G _ J ~i ~ _ :,_ _- '"_ ~ E ~ ~ r Q ~~ i ~ ~ ~U 7. Scope . Bed Ot j~- 2 Force M.oin ,~F(owed Qrain Rock From Pump Layer ' ~ ~ ~n . ' E ~/ Cress Section Ot A Found Sysitm Using - F ~~/ A Bed For Tht Absorption Arto ' _ G ? A Z7 Ft. i Fi ~ ~ 6~^C Ft. 1 (~~~ Ft.~ J ~, ~ Ft. _ _ , ~, L ~ Ft. ~ _ t_ ~ 4-Observation Pipe ~ K ~ o A ~ - . W `~ {-------------- -- l° f ------------------- f Force Moin c 3 p _.___ ~ .. -., _.,_ Distribution . ~ ,._.. _.. , ,,._ bed Of %2~- 2 % From Pump Pipe 2 ~ Orain RocK j ` ,~ 4 Obcarvetion Pipe Permonent Morker Pipe or Rods Pion View Of Mound Ut-inp A Bed For Ttte Absorption Areo _~-~~ No PAGE OF C1~~ s Located On ¢ottom. re Equat}y Stsocee ~tRST Hatt T~1-KT 'ro Conr~ec~ron Qi5lribtttit)n Pipe ~QyOVi ~ ~7 F~. Signed: License Nur~her: Gate: ~S ~~ ~{. X~ inches Y Inches Flole Diameter ~-= Inch Lateral .t' ~ Inch~es~ Man i fol d Inches_ Force Main --~ Inches of holes/pip~~ Invert Elevation of Laterals/~ ~ Ft. Per¢orote0 ~iR! t)etoii 0 sae +'~eaa~ td'A~. t:£tt~~ E~ - -rurwl~ jr.s~.~t ts~as ss;c-~ a~G ss~~ei~.t~~-r~~-~~ I""T wtwT~tC~e~ROa~ ~ wss~pvto i,OCKet-i6 .:ri~1G`%Ot+i ,~Y ~'~ttici~ICtt GOVtR fs°w~•at. t+ Q.~wac i = - -~ v . - `'~~ AtR!"1~iKT iCOL _ # ~ r ~~ ~ ~ ~~1 - - ~ i c t# t '~Apvt~ f l ,iOTH'tS itiT~ ~ _i ~PP1~fiEfl PdA~ ~ 5{lLIO SOIL ''' ~..,.,.____ ___ coatc~r~ xoc~c ~~K ~sr 't'1~ ~~. '~ Rt!!lE ~XtT ~CR~ti~j Oki1.5 tG '!'AWt JuCTLilt;.R MIt! jitCli AitRplti4 "~uw~rlri~TYROR: ~~~~ ~' S' plc slss ..~s~ ~` ~ ~ru-c~ o. aaus: acs ~, ~t'v~t>tni: /~- ~~~~f~.~~si.Qr~is you vOt.i~el: vciutizt~ li~tK~i~-t ~, iMnTClt ~'~',~ ' -:~ ~ r ~ ,~ M/CAt~ Olt :r~ '.~ +~lyii11~1bt'IY~IR# ~+u° O ~.i7~•..~ M~iC~ii ~ ~- ' ~ ~OOiI. ~iOfrRS t./~ t"~6fi+[u01t•~~~1'~~rw =~tKM 't`ti~t ~' ",,~ /~'~ ~~ ...... l~#..~,~,~t~iiC.~ii~ s~rC,;ib.4i11.~0io MNdiMif~ O/jCiiR~~ ~n ~~ tYM! A~iO OlrOitl~t 4RS `!R iR t~-~t ~WT~liirtC Otrt ~Xlti-f~l~n ~{Rii#Ti ~'K~ lei/#R,iyrj MR'!`iwliiitii 'iti~!/r O~ + riryertl~~t MCTwI+QltK /Ml0 OllTilitiT:OR~ ~„ ~ ~itr'i' +~~ rtss ae rOltee e~lsl x~;.3.,,..:~a.:c~i~,.u~,~~ "~ ,~e~ >~ '~~xs„ O'~Ml~. Nt~lp ~ Este: ~'Ftitidi~s. ntl+Etii~tCwlf ar '~'aklK: s.c~uatrk ~~ ....r..s~rtot~ ..,,,,.~.r.., i i.,~ittD L~~~T~ ~~ ~~;E t: s.lCC ~1: S W.i~tgg R: 0 w z v z r 0 J Q ~- 0 TOTAL DYNAMIC NEAR/CAPACITY PER MINUTE EFFLUENT AND DEWATERING ~0 `""~~ 0 80 160 240 JLU FLOW PER MINUTE CONSULT FACTORY FOR SPECIAL APPLICATIONS • Timed dosing panels available. '` " • Electrical alternators, for duplex systems, are available and supplied with an alarm. • Variable level control switches are available for controlling single phase systems. • Double piggyback variable level float switches are available for variable level long and short cycle contro-s. • Sealed Qwik-Box available foroutdoor installations. See FM1A20. • Over 130°F. (54°C.) special quotation required. 1521153 Series 1521153 MODELS Control Selection Model I Volts•Ph Mode s Sim Ip ex Du lex N152 115 1 Non 8.5 1 2 or 3 BN152 115 1 Auto 8.5 Included 2 or 3 E152 236 1 Non 4.3 1 2 os 3 BE152 230 1 Auro 4.3 Included 2 or 3 N153 115 1 Non 10.5 1 2 or 3 BN153 115 1 Auto 16.5 Included 2 or 3 Et53 236 1 Non 5.3 1 2or3 BE153 230 1 Auto 5.3 included 2 or 3 D CAUTION All installation of controls, protection devices and wiring should be done by a qualified licensed electrician. All electrical and safety codes should be followed including the most recent National Electric Code (NEC) and the Occupational Safety and Health Ad (OSHA). MODEL t52 153 Feet Meters Gal. Liters Gol. Liters 5 1.5 69 261 77 291 10 3.1 61 231 70 265 15 4.6 53 201 61 231 20 6.1 44 167 52 197 25 7.6 34 129 42 159 30 9.1 23 87 33 125 35 10.7 -- -- 22 85 40 12.2 -- -- 11 42 Lock Volve: 38..0 Ft. {ll.6m) 44.0 Ft. {13.4m) 3 27 32 32 I I ~ I l2 1/8 ~~ 5 t/ _L SELECTION GUIDE 8 1. Single piggyback variable level float switch or double piggyback vadat>le level float switch. Refer to FM0477. 2. See FM0712 for correct model of Electrical Attemator E-Pak. 3. Variable level control switch 10-0225 used as a control activator, specify duplex (3) or (4) float system. RESERVE POWERED DESIGN For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump. MAIL T0: P.O. BOX 16347 Louisville, KY 40256-0347 Manu/achxersof. . SRIP T0: 3649 Cane Run Road ® Louisville, KY 40211-1961 QuaurrPa~rr•PS S,rcE /9~~9` 's' (502)178-2731.1(800) 928-PUMP hftp://www.zoeUer.com ' ~~ PUM~' !O. FAX (502) 774.3624 ~~. © Copyright 2000 Zoeller Co. All rights reserved. . ~ ~ Maintenance and Contingency Plan for a Mound System Maintenance Plan 1. Septic Tank is to be pumped once every 3 years. 2. Dose Chamber is to be pumped at the same time as the septic tank. 3. Effluent filter is to be cleaned once a year. Please note: a larger filter is being installed in order to extend the maintenance interval of the fitter. 4. Once every 3 years the mound is to be inspected via the inspections pipes in the at- grade. The laterals are to be inspected via the cleanouts. 5.Owner agrees to limit greases, garbage, and water conditioner discharge into the system. 6. Pump and electrical components are to be checked at the time of the pumping. 7. Owner agrees to leave the area 15' below mound undisturbed. 8. The owner agrees to save this plan. 9. Trees, shrubs, and other similiar vegitation are not be planted on system. The system is not be driven over. 10. Effluent Quality is not to excede the requirements found in Comm. 83 Contingency Plan 1. Pump alarm goes off, call pumper and pump out dose chamber and septic tank if needed, then bypass pump float and try pump with out float. If this works, float is bad, replace float. If pump still does not work, check power at the pump with a electrical device such as a hair dryer. If no power, check breaker inside house and call a electrician. If there is power, then pump is bad and needs to be replaced by a plumber. 2. If mound fails, determine cause of failure, test another area or remove pipe and sewer rock, retill soil, install new mound system. 3. Replace any other failing components as needed. Important Phone Numbers Plumber: Byron Bird Jr. 715-246-4516 Pumper: Tom Mondor 715-246-5148 St. Croix County Zoning 715-386-4680 ,.....-,r..,-- .__._._ _ i __ Owner Permit # I S OWNER'S MANUAL ~ MANAGEMENT PLAN P011VT SYSTEM SPECIFICATIONS l ~ Septic Tank Capac,ItY Septic Tank Manufacturer Effluent Filter Mangy ~ OESIGN PARAt++-~ ~ ""' ^ NA Number of Bedrooms Number of Commercial Units _ ~ a1/da F,stirttated flow (avet'a9e) ~'~l~ aUda pesign fbw (Peak). (Estimated x 1.5) I l ~ aUda /ft2 Rate Sots APPr~~ Monthly average InfluentlEffluent Quality FOG) Oil 8~ Grease ( Fats 530 mg/L , Biochemical Oxygen Demand (BODS) ended Solids (fSS) l Sus ~0 mglL 5150 m /L p tota .-~r~a alit Q " '` _ Monthly average'+ u y l Pretreated Effluent ) dtemigl Oxygen Demand (BO i ~0 mgn- /L SS B o Total Suspended Solids R ) rm (geometric mean) fd 530 mg 510, cfu/100m1 o Fecal Co Y inch diameter Maximum Effluent Partite Size MAINTENANCE SCHEDULE ~~- Service Event Inspect condition of tank(s) Pump out contents of tank(s) Inspect dispersal cell(s) Clean effluent filter Inspect pump. Pump controls 8~ alarm Flush laterals and pressure test _ E{ fluent Flter Model Pump Tank CapadtY Pump Tank Manufacturer .Pump Manufacturer Pump Model Pretreatmenvel Fitt--- e f - ~ Sand/Grd ^ Mechanical Aeration ^ Disinfection Page ^ Peat Flter ^ Wetland ^ Other. of ^ NA ^ NA ^ NA ^ NA ^ NA ^ NA ^ NA ^ NA NA Dispersal Cell(s) ^ In-ground (pressurized) ^ In-ground (gravity) Mound ^ At~rade ^ Other. ^ Dri ine • Values typical fa domestic (non~ornrnerdaQ wastewater and septic tank effluent _•* Values typical for Pretreated wastewater. Service Frequency O months ~ year(s) (Maximum 3 yrs.) At least once every .~ When combined sludge and scum equals one-third (Y} of tank volume At least once every ,~ ^ At least once every At least once every Af least once every At least once every At least once every s) (Maximum 3 yrs.) ^ months ~yeansl ^ months year(s) ^ NA ^ months~Year(s) ^ NA ^ months ^ year(s) ^ NA ^ months ^ year(s) ^ NA MAINTENANCE INSTRUCTIONS one of the following licenses or Inspections of tanks and dispersal cells shall be made by an individual carrying ctor' POWTS Maintainer, Septage certifications: Master Plumber, Master Plumber Restricted Sewer, POWTS Inspe missi or broken Servicng Operator. Tanks opecti aks measu Uthe vo ume of ~ti ned s edge a(nd scum and to check fo any back up hardware, identify any cra y ed to check the effluent levels or ponding of effluent on the ground surface- The dispersal cell(s) shall be visual) ins me ndiR of effluent on the in tl~e observation pipes and to check for any ponding Of efflU@Af OII file 9PDUf1(f SUrfiiCB. ~ 9 ground surface may indicate a failing condition and requires the immediate notification of the local regulatory aUthOn(y. When the combined accumulation of sludge and scum in any tank equals one-third (X) or more of the tank volume, the entire contents of the tank shalt be removed by a Septage Servicing Operator and disposed of in accordance with ch. NR 113, Wisconsin Administrative Code. _ The servicing of effluent filters, mechanical or pressurized POWTS components, pretreatment components; and any other maintenance or monitoring at intervals of 12 months or less shalt 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. START UP AND OPERATION For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or other chemicals that may impede the treatment process and- Jor damage the dispersal cell(s). If high concentrations are detected have the contents of the tank(s) removed by a septage servicing operator prior to use. %' ~'~. ! ~ ~' . , e Page of - System start up shalt 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 Dell(s) and may result in the backup or surface disdtarge of effl.~ent. To avoid this situation have the contents of the pump tank removed try a Septage Servicing Operator prior.t+o"restoring Power to the 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 vehicles over tanks and. dispersal cells. Do not drive or park over, or otherwise disturb or compact, the area within 15 feet down slope of any mound or at~rade soil absorption area. Reductiort or~elimination of the following from the wastewater stream may improve the performance and prolong the life of the POWTS: antibiotics; baby wipes; dgart3tte butts; condoms; Dolton swabs; degreasers; denhat floss; diapers; disinfectants; fat; foundation drain (sump pump) water, fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting pmdtxtts; pesticides; sanitary napkins; tampons; and water softener brine. ABANDOt+1MMENT When the POWTS faits andlor is petmanently.taken out of service the following steps shall tie taken to insure that the system is properly and safely abandoned in oot»pliance with ch. Comm 83.33, Wisconsin Administratrve Code: • All piping to tanks and pits shall be disconnected and the abandoned pipe openings seated. • The contents of all tanks and pits shat) be removed and properly 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 soil, gravel or another inert solid material. CONTINGENCY PLAN If the POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide a code compliant replacement system: ^ A suitable replacement atea has been evaluated and may be utilized for the location of a replacement soil absorption system. The replacement area should tie protected from disturbance and compaction and should not be infringed upon by required setbacks from existing and proposed structure, lot lines and wells. Failure to protect 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 rules in effect at that time. ^ A suitable replacement area is not available due to setback and/or soil limitations. Barring advances in P0IIVTS technology a holding tank may be installed as a last resort to replace the failed POV1rT'S. 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 ~ e infiltrative surface. Reconstructions of such systems must comply with the rotes in effect at that time. «WARNING» SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES ANDlOR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE 1NTERlOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLER Name ~. ~; ~ Phone ~ ^ ~~~,.~ ~ ''- SEPTAGE SERVICING OPERATO~t (PUMPER) Name ~,,~ Phone ~~~ ~.'~' ~'~~~ PnWTC Ma1NTA1NER Name ,j~cc tG ,.,..~ b'% s" Phone y.~. ~y6 ~- ~' t nrer RFra rr aTARY AUTHORITY Agency c~jf L r a r"~ ~r~-c . Phone ~1.,°- ~ .~ This dowment was drafted by the staffs of the Green Lake, Marquette and Waushara County Zoning and Sanitation agerldes. This document meets the minimum requirements of ch. Comm 83.22(2)(bxi)(d~(f) and 83.54(1), (2) 8 (3), Wisconsin Adminlstrativs Code. Use of this document does not guarantee the performance of the POWTS. GMW (?!ot) 06/23/2003 08:50 6087859330 t4-ri8~ Pos#-it' FaX Note 7671 rata 23 pa9~~ . w(+or~ith ; ~;i3(p101! To '1": G~~~ ~O+ FrolitJ Sw • " 8iUe0lY'Ot l CoJDepL oAr1 Co. L~ AtleCh etxr Ph ~ e s~ Phone # ~ , ~ 89~ include, !N: ez ~ percent wo SCIC~ ax M gPP1.ICANT INFORMATION - Please pri<rrr ,trr rrrrvr nry~~~+~~• ~°OS(Prluacyl~w g•1~.a d ~ mvilerrtay0c POta~+~ Inlormr{ian you p r YP u8~dlo s.cor r A~ A/~a G . _ ..._.- _ n f 3• ~ -' Stafs 21p Cade phone Number / ~ ~ ~ •. o ~ f,~ SAFETY AND BLDGS ~~c ~ I~PAGE 01 ~.Q znr i N~ r cQ~ ~ r JJ .is. Adrn. Cade-~v~ Sw w`- a7 Ceurdfl` •.~ ~ ~" ~ r o, _ ny ,•,r,o,,,... Y~ ,NCR /114,$ ~,ali~~ G _,._«,~ ' l l- ~ - ,~r~ yo~ -;~, r,l uilagr „ ~ Town n ~ E AAdibon to e>risting Duilding .~ NsW Construction Uae: ~gesidentJal ~ Number bl bodreoms --~.- Ngplgcer»ent ^Public or canrt+~reisl • desrriba: • G trench 9P~ ~ Rrrecmrnerrded deii9n Ivadln9 raGS bad, iiPd~--~- CcdB der(ve4 •eaily cow ~ SPd ~- ~-- bed, 9i+w'~ -~••~~-trenA~. 9P~~ AbsorpT 6 had, rte, 3~/1 q.nch, a 2 Nezilriwn ~Ign loading rs:s ~~ Ion area rrrqutre~+ ~~ ~~ G '.~ ~.. ' j ft (4t rvbrred ro alto plan benchm8rk3 l;epvrnrne~ed ktIU7Taliwt 5urtece e1sYalfon(S) _..--. O~Y Adddion+~ deGignlerte considerations ~ ~, , Flood plain eleverion, if OppMCabIP g Parent me~trrrid Crrr in ill }lplpirrg anl~ ConrertlbnM Mound In round Praisuro AT•GrAde >~ V L] S ,~U s ~ Suitable for SYs:am ~g Q V ~] S~ U ^ s ~' u ^ s •~ U e Unsuitable for system ~ S 'J SpI1..DirSCRIPYION R~POHT GP * Morison DeDtl1 DotNmm~t Cobr Mot4vs Texture StrV~ure Consistence Boundary Roars Bod , Trerdr Bottng in ytunsgl Du. ISz. Cart. CalOr Gr. Sz. Sh. ~'~ n e ,~ Ground n p ~C ~_ ,~ ~• . paD~ ~ i Iier+leng ' tar p~-`'~ Remarks: ~L, ~ _ Ground eY. ~. peplh W 06/2312003 08:50 6087859330 SAFETY AND BLDGS PAGE 02 -~ 1(.-i 18; OD, FYED 08' 9,2 FAQ 715 X88 ST CRx r,u Lun +itia ~6ae ~,••. N AEPORY O~SGRIRTIG P°g0 ~" °I'` • SOII. _ ~ pwoP~1~TM awr~~p z PARe~t I.D.* Btruc4~re Cpnsistenw 6ound~Y floors Sod Tretrctr ~} hiortzon CeVLti Dortrirtwnn GObf 1JLytUes Tenure pr, Sz. Sh. Qu, ga. Cont. Color _ _ / S~ 1 tea'-~ 9oring n,, Ulu l~~~ t~. / ;;k.4 ( r. G9- ! ~ aroma t, to limidrl9 i a 90~f1g ~ %~ Cxround ~1ev. ft. hepth b tlmidog ',~CICi i~' Remarks: • Stru~iufs Con~iller~ce Bo~ndarY R~ Dominant Co1of ~~ 7e><turo Gr. St. Sh• ~~"~ DepA+ MunaeU 04. 9i. Cant Color in. BOriCI~ ~ ,5 GramG glgv. _`~tt. Dapl^ to umllinp raolar -,~ _in, wring # ~ ~ ~~-• GroUrd eleV h. pepU- tv Ilmitifl9 laotor --~^~ ~tBmalrks: a i SBU8330 (R.9l9B; 06f23f2003 08:50 6087859330 SAFETY AND SLDGS PAGE 03_ 1DE18:fl0 W5`D 08:~1~ FAb 715 388 {6813 S'T CR% CO ZON1Nc: • /,i~ -- S olx Test Plnt Plan . •~ Byror +rd Tr. .Project Name• '~• ~•~ address ~ .3 CS i GZo~p-J``-~ ~ _ ~--- sub~lvlsfon --- D®te '- -- L 0 t - - err. ~~ /~q ~~Z 14 S~T~ N/A~ W-~- Townshi~,~,~ ~ ~d.%~ - • (-'! ISorir.~~ Q 'Pelt PL ~cbperiy Line County ,t.,¢- li ~ G~ /~; 3 ~levatlon '100 fi. ~,.~~~ ~~/~~ ~~=s~~ ~c 5v5rem EfevBtion gp ~ _ RHR~~^ ,/_ y Scale 1/d" ~ 10 f''t. 1V1~ern Dimensions aCen't s~a[ed POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page of FILE INFORMATION Owner .es r• Permit # 3 ~ (0 ~ DESIGN PARAMETERS Number of Bedrooms ^ NA Number of Public Facility Units ^ NA Estimated flow (average) ,5c~ al/day Design flow Ipeak), (Estimated x 1.5) al/day Soil Application Rate ~. C) al/day/ftz Standard Influent/Effluent Quality Monthly average * Fats, Oil & Grease (FOG) _<30 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 (BOD5) 530 mg/L Total Suspended Solids (TSS) 530 mg/L ^ NA Fecal Coliform (geometric mean) <_10° cfu/100m1 Maximum Effluent Particle Size Ys in dia. ^ NA Other: ^ NA *Values typical for domestic wastewater and septic tank effluent. SYSTEM SPECIFICATIONS Septic Tank Capacity ~~ al ^ NA Septic Tank Manufacturer ~,~~ ^ NA Effluent Filter Manufacturer l,~ ^ NA Effluent Filter Model ~/m o ^ NA Pump Tank Capacity ~. ~ al ^ NA Pump Tank Manufacturer ~ ~ ~ ^ NA Pump Manufacturer `., ^ NA Pump Model ~ ~ ^ NA Pretreatment Unit ^ Sand/Gravel Filter ^ Mechanical Aeration ^ Disinfection ^ Peat Filter ^ Wetland ^ Other: ^ NA Dispersal Cell(s) ^ In-Ground (gravity) ^ At-Grade ^ Drip-Line ^ NA ^ In-Ground (pressurized) ~l~llound ^ Other: Other: ^ NA Other: ^ NA Other: ^ NA wewwr~u Awlf~C Cf~YCf1111 C mr+u~ ~ "~r+~w~ .. Service Event Service Frequency Inspect condition of tankls) At least once every: ^ earl 11s) (Maximum 3 years) ^ NA Pump out contents of tankls) When combined sludge and scum equals one-third IY31 of tank volume ^ NA Inspect dispersal cellls) At least once every: ^monthls) (Maximum 3 years) ^ year(s) ^ NA Clean effluent filter At least once every: ^monthls) ~ year(s) ^ NA Inspect pump, pump controls & alarm At least once every: ^ month(si Ja year(s) ^ NA Flush laterals and pressure test At least once every: ^monthls) ^ year(s) ^ NA Other: At least once every: ^ month(s) ^ year(s) ^ NA Other: ^ 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 include a visual inspection of the tankls) 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 cellls) shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a failing condition and requires the immediate notification of the local regulatory authority. When the combined accumulation of sludge and scum in any tank equals one-third IY31 or more of the tank volume, the entire contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113, Wisconsin Administrative Code. All other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment units, and any servicing at intervals of 512 months, shall be performed by a certified POWTS Maintainer. A service report shall be provided to the local regulatory authority within 10 days of completion of any service event. GMW (4/01) Page of START UP AND OPERATION For new construction, prior to use of the POWTS check treatment tankls) for the presence of painting products or other chemicals that may impede the treatment process and/or damage the dispersal ceII1s1. If high concentrations are detected have the contents of the tankls) 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 ce(lls) in one large dose, overloading the cellls) and may result in the backup or surface discharge of effluent. To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring power to the 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 vehicles over tanks and dispersal cells. 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 POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat; foundation drain (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 properly and safely abandoned in compliance with chapter Comm 83.33, Wisconsin Administrative Code: • All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. • The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator. • After pumping, att tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil, gravel or another inert solid material. CONTINGENCY PLAN If the POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide a code compliant replacement system: ^ A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system. The replacement area should be protected from disturbance and compaction and should not be infringed upon by required setbacks from existing and proposed structure, lot lines and wells. Failure to protect 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 rules in effect at that time. ^ A suitable replacement area is not available due to setback and/or soil limitations. Barring advances in POWTS technology 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. Reconstructions 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 TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. enn~Tln~uel CnMMFNTS POWTS INSTALLER Name ~-Y1 ~i^ 1'; Phone l~ j''~6G~ 7 ~G sFPTer,F sFRVICING OPERATOR (PUMPER) Name ~,vz ~ y' Phone 5 ~ POWTS MAINTAINER Name ~ ~ s 4 K ~ Phone ~~ f' 3~ ~ nr_ni RFGl1LATORY AUTHORITY ----Name- --- -- - ~ ~ O / ~ ~ ~® ~ Phone ~ ~-~ This document was drafted in compliance with chapter Comm 83.221211b111i(d-&Ifl and 83.54111, (2) & 131, Wisconsin Administrative Code. ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM OwnerBuyer Mailing Address Property Address City/State ~~ SYo ~~ Parcel Identification Number LEGAL DESCRIPTION 1 Pro Location ~~'/., ~'/., Sec. ~~, T ~ N-R_~W, Towa of a ~~w~''l . P~3' Subdivision .Lot # ~_. Certified Survey Map # ~ ~ ~'3°~ / ,Volume ~ Page # ~ Warranty Deed # ~ ~ ~ ~~~6 ,Volume ~ Page # Spec house ^ yes ~ no Lot lines identifiable yes ^ no SYSTEM MAINTENANCE Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumping out the septic tank every three years or sooner, if needed by a licensed pumper. What you put into the system can affect the function of the septic tank as a treatment stage in the waste disposal system. The~property owner agrees to submit to St. Croix Zoning Department a certification form, signed by the owner and by a mastor plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. " ~ Lwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 days of. a year a tion date. q ~ /~= ~" / ~.-O/ A OF LIC DATE OWNER CERTIFICATION I )certify that all statements on this form are true to the best of my (our) knowledge. I (we) am (are) the owner(s) of the prope des 'bed abov , virtue of a warranty deed recorded in Register of Deeds Office. ~ , ,a S GNATURE OF LIC DATE «*s*** Any Formation that is nus-represented may result in the sanitary permit being revoked by the Zoning Department. ****** Z 2D ~' (Verification required from Planning Department for new ** Include with this application: a stamped warranty deed from the Register of Deeds office a copy of the certified survey map if reference is made in the warranty deed U 2132P 178 ~ ` STATE BAR OF WISCONSIN FORM 1 - 2000 Document Number WARRANTY DEED This Deed, made between Allen L. Mock and Ann M. Mock Grantor, and Patrick Spandenbere Grantee. Grantor, for a valuable consideration, conveys to Grantee the following described real estate in St. Croix County, State of Wisconsin (the "Property"): Lot one of Certified Survey Map in Volume Fourteen (14) of Certified rvey Maps, Pa a as Documenx.Numlter 617321, filed in St. Croix County Register of Deeds office on January 24, 2000, being located in part of the Southeast Quarter of the Northeast Quarter (SE 1/4 of NE 1/4) of Section Six (6) Township Twenty Nine (29) North, Range Sixteen (16) West, Town of Baldwin, St. Croix County, Wisconsin. This deed is given in satisfaction of a land contract recorded on October 27, 2000 in the St. Croix County Register of Deeds office in Volume 1554, Pages 74-75 as Document No. 632518. Together with all appurtenant rights, title and interests. ?~g4~8 KATHLEEN H. WALSH REGISTER OF DEEDS ST. CROIX CO. , MI RECEIVED FOR RECORD 02/05/2003 01:15PK EXEMPT ~ 17 REC FEE: 11.00 TRANS FEE: COPY FEE: CERT COPY FEE: PAGES: 1 Recording Area Name and Return Address Bakke Norman, S.C. 900 Main Street PO Box 54 Baldwin, WI 54002 002-1012-60-000 Parcel Identificatim Number (PIN) This is not homestead property. (is) (is not) Grantor warrants that the title to the Property is good, indefeasible in fee simple and free and clear of encumbrances except easements, highways, utility rights and reservations of record, and will warrant and defend the same. N a.6•+/- °' °' z a ~ w~ ~ = U f..W W pyN ;C ;, ° `Z I a n a ~ ~ac~ ,~ r n Z~y i I D WZ I~ I O+ O~ Q l~ W W ~ ~ Z - F °° W I fTI ~ I ~ z o e ld IV a ao W4° aoQ I ~ ~ W W W ? ~r : Z y IZ ~ y QyNa t~ ~, U Et1 W .0 N W ~ }~+ ~ W Z W I Z l ~ a ~-< W ~ 0 o ~ z ~ i ~ ~ N ~ 11'+/- N Z H -- G m N -a r 0 x rti H m 0 z a N89 '40'09"E 1325.87' ~ ; C 784.07' 51.03 83' 1292 ~ N ~ Z ~ "'0 N . LOT 1 ;33.04' Ir o + i ro ? 4.674 ACRES INC. R/W oR~vewg4.___vN. 619 S0 FT ~ ° ~ 203 ~ ~ , iD `-i 0 ~ . , . 4.478 ACRES EXC. R/W M °I°o I 1= ~~ Z 195,039 S0. FT. • ' IN ~~ °w N89.40'09"E 784.07' 33.04 516.03' 235.00' ~~ 1 r ro 751.03' ~~ 4D ~ LOT 2 FIELD DRIVE ; Nfti ~~ ~~ ro ,t, o 4.674 ACRES INC. R/W • , o ~P .1 ~ (/' 0 0 203,619 SQ. FT. ~ o `0 1 I o ~ 4.478 ACRES EXC. R/V • 195,039 SQ. FT. • ~; _~ _ 1C 1£ ~ N ~ 516.03' 751.03' ~ h S69.40'09"W 784.07' Q~ ~~~$ 5 ~~~~ LOT 3 Q S 25.651 ACRES 1NC. R/W _ ,~ 1,117,367 S0. FT. • • • 25.174 ACRES EXC. R/W 1,096.596 SD. FT. 1297.08' ~ S89'40'09"W 1330.12' UNPLATTED LANDS DWNED BY OTHERS ~ T 0 ~ I 0 O~ I N ~ ` W P~ ~ N .o ~I. onrvewar__y 1~ 33.04• ~~ m~ ~r-~ A f`1 O DWNER ALLEN MOCK N44153 JACOBSON ROAD OSSEO, WI 54758 LEGEND ALUMINUM COUNTY SECTION CORNER MONUMENT FOUND ~ 1' IRON PIPE FOUND O 1' X 24' IRON PIPE WEIGHING 1.13 LBS. PER LINEAR FOOT SE ~--~- 100' ROADWAY SETBACK LINE m STEEL SURVEY MARKER FOUND • EXISTING SOIL BORINGS -~c-x-x- EXISTING FENCELINE { NOTE: Field drive to be relocated to ~tion C7 p~~ ~sT. cadx cbtlHrv •'~""^N ZOIIfIQ 811d Parks C0111111111le N i I~ ~aN 2 4 zooo ~D ~ ~ I N H nol nsoordad vldtllh 30 days of • ' approval ~N dal a1rsN bs ~ SCALE IN FEET 1' = 200' 200 0 200 400 ~N 03'0 11 t7o.a2' 1 E1/4 CORNER l~"~SECTION 6 CERTIFIED SURVEY MAP ~ m I SECTOORNE6R LOCATED IN PART ^F THE SE1/4 ^F THE NE1/4 OF SECTION 6, ~~~ T29N, R16W, TOWN ^F BALDWIN, ST, CRDIX CDUNTY, WISC^NSIN. UNPLATTED LANDS OWNED BY DTHERS ~c~~ NORTH LINE OF THE SEI/4 OF THE NE1/4 :o f (~ :r o~ n M a: O~ a wisc,~;h Department of Commerce SOIL AND SITE EVALUATION lion of Safety and Buildings ..,_.,. _ Page of '"F#ureau ~~f Integrated Services In accordance with Cgmtt 83;09, Wis. Adm. Code Attach complete site plan on paper not less tllan 8 1/2 x 11 inches in size. Plan must ~.,~ County . \ include, but not limited to: vertical and horizontal reference point (BM), direction and . ' j/r.~ r ~/ yr®~ percent slope, scale or dimensions, north arrow, and location and distance to nearest road. ~' Parcel f.D. # <" APPLICANT INFORMATION -Please print all information. -~ c,~~,.~ I P~evie by Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04,: UNTy 3 Property Owner '~ Property Loca i ~ij ©~ Go~rt. Lot 1/4,S T~ ,N,R E Property Owne s ailing Address Lot Su d. Name or/C M# ~ ~ ~ -- -- _ 7' S 3 Cit/y~~ Sta~te~ • Zip Co/d/e ~,^~yPhone Num~bye'r/ Nearest Road //;7' ~~ ~ I /Nr I ~Y'~J711 ~7/~)~J7~/~~~~~ ^~ ~~illage ., ,~. Town ` l `'New Construction Use:Residential / Number of bedrooms ~`~ Addition to existiny building ^ Replacement ^ Public or commercial -Describe: Code derived daily flow ~~ gpd . Recommended design loading rate - -bed, gpd/fi2 ~ ~ trench, gpd/ft2 Absorption area requires' ~~5 bed, ft2. _ 2 3~~ trench, ft2 Maximum design loading rate _y7 bed, gpd/flz . trench, gpd/ft2 Recommended infiltration surface elevation(s) ~G~ / sP ft (as referred to site plan benchmark) Additional design/site considerations Parent material r c, Flood plain elevation, if applicable ft S = Suitable for system Conventional Mound In-Ground Pressure AT-Grade System in Fill Holding Tank U = Unsuitable for system ^ S ~- U ~S ^ U ^ S ~ U ^ S ~ U ^ S ~U ^ S .~ ~~ SOIL DESCRIPTION REPORT Boring # i Ground v. Depth to limiting f m. Z ~ rr Boring # Ground lev. ~. Horizon Depth Dominant Color Mottles Texture Structure Consistence Bounda Roots GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. ry Bed ,Trench • b- o S ~ ~ ~ .s~~ l ~ ~ ~ .7" /~~ rQ tittu Ads .~ .~ ,S Depth to limiting factor 2 (p'' in. Remarks: CST Na (Please Print) Signature Telephone No. Addre Date CST Number '~ /Sf7~i ~~•-e.- ~lih..~.~ s- ~~ ` S-~L~Q / 9~~ ~'~' oho? o .S -~ 7 Remarks: ~~ '~ ~ Go G /o ? ~ PROPERTY OWNER /1.~- -~G SOIL DESCRIPTION REPORT PARCEL I.D.# Boring # Ground ft. Depth to limiting facto in. Z$ Boring # Ground elev. ft. Depth to limiting factor in. Boring # Ground elev. ft. Depth to limiting factor in. Boring # Ground elev. ft. .. ,;r-. Page of ~ ''~ ~; Horizon Depth Dominant Color Mottles Texture Structure Consistence Bounda Roots 2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. ry Bed ,Trench G~ ~,>e~ r~-j ~ /~'~ Remarks: ti~ ~t .s ,s ,~ Remarks: Horizon Depth Dominant Color Mottles Text r Structure Consistence Bounda Roots GPDlfiz in. Munsell Qu. Sz. Cont. Color u e Gr. Sz. Sh. ry Bed ,Trench Remarks: Depth to limiting factor in. Remarks: SBD-8330 (R.9/98) ` / , ~ SOIL DESCRIPTION REPORT ,PROPERTY OWNER ~ ? PARCEL I.D.# Boring # Ground tt. Depth to limiting facto ~in. Boring # Page of ~ Horizon Depth Dominant Color Mottles Structure Consistence Bounda Roots 2 in. Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. ry Bed ,Trench - ~ IG ~ G ..~'- C G~ ~re.~ r~ ,.~ Remarks: Ground elev. ft. Depth to limiting factor in. Remarks: Boring # Ground elev. ft. Depth to limiting factor in. Boring # Ground elev. ft. Horizon Depth Dominant Color Mottles Structure i C B d R ts PD/ftz in. Munsell Qu. Sz. Cont. Color Texture Gr. Sz. Sh. stence ons oun ary oo Bed ,Trench Remarks: Depth to I limiting factor 'n' Remarks: SBD-8330 (R.9/98) • ~ + ~ ~ Soil Test Plot Plan M" ~ G Project Name ~~~ li~o~/! -Byron ird Jr, - Address ~~ ~ .~ ~- .a ~ ~ s~ Cs ~Z ~ s ~ ~ Lot - Subdivision -- Date q~~~,. yl. ~~02 7_~~ ~~1 /4 ~1 /4 S~TG? N/R~ W-,- Township ~~~~~~~ I3orin~ O Well PL Property Line COUnty~~ f lir,Qilc G ® I31~~I or VRP Assume Elevation 100 ft, " ~~• yca ~ ~~~~~~~ ~~ System Elevation _r9D ~ * H R P ~,~,~~~ ~~~~ 1I Z. . ~ ~ h ~~ ~ l . ~-~ ~_~ . ,~ ~ _ _~ . ~ ~~ ^~ 1 IK • ~// / ~J G~ ~J ' ,. ~~- Scale 1/4" = 10 rt. When Dimensions aren't stated ~pP~,~ ~O ~Oe ~e~ ~ m \~ V CERTIFIED SURVEY MAP ' m tNE CORNER ~ , ~ SECTION 6 N 6 LOCATED IN PART OF THE SE1/4 OF THE NE1/4 OF SECTIO CROIX COUNTY, WISCONSIN, ST BALDWIN ~ ~ . , T29N, R16W, TOWN OF ' UNPLATTED LANDS OWNED BY UTHERS ~ ~~~ '+o NORTH LINE OF THE SEl/4 Of THE NE1/4 ~ N89'40'09"E 1325.87' ~ ~ ; Z 5 1.80 + 1292.83' 784 07' 51.03 - - - - - - - ; ~ N LOT 1 ~ 33.04' . ~ 4.6'+/- ~ C R/W D Y N N ~N Io i'p ;r 1'D m z ~` o \ i~ u W ~ ANN N W ~ r` ~0 F- QOa A W v Cl z .~. r°n °, ~zo! ~ WIC o ~r Z moo ~' a a ~ WW 7 ZJV z o ~ ,- a Y wa U rs7 W ~D J ., } ~ PO D ~ W \ li - t~u~ Q ~_ x~ A __ _. ~~ U. _ r -~ Q rp ~~ W ~ cn _ ~ , :E u.': ~ _ . ; • Z~• ' N 4.674 ACRES IN . plvEwq ~_~o I~ I i= I ~ ~ 0 203,619 SQ. FT. o ' ~ ~ ~ Io ~ ~ i (1~ 0 4.478 ACRES EXC. R/W',~ ~ I o ~ ]95,039 SQ. FT. ~ ~ I(~j {d N89'40`09"E 784.07' 33.04' ~ ~~ I I w OWNER ALLEN MOCK N44153 JACOBSDN ROAD OSSEO, WI 54758 LEGEND ALUMINUM COUNTY SECTION CORNER MONUMENT FOUND a 1' IRON PIPE FOUND • 516.03' 235.00! _.__ d' A '~r Z I ro .~.-X1.03' ~ ~ N ~pT 2 FIELD DRIVE ', 'ir 1 N £ N i~ 1 ~ N o 4.674 ACRES INC. R/W FT SQ ~ - o a . . 203,619 1 } I Q l~ O I ~ 0 4.478 ACRES EXC. R/W . ~ d N o 195,039 SQ. FT. I N I ~' N 516,03' 751.03' 23 w ~ 'r - -~ ~ ~ ~ s89•a0'o9"w 7a4.ar ' ~ o ~ m l~ ° ~°~~ ' ~ ~ ~ ~ ' ~ N 3 , ~ I ~ ~ y ~ tt ~ N~~~ 5 LOT 3 I ~ Z N ~ ~` ~ s 25.651 ACRES INC. R/W ~ ~ ~ ~ ,~ 1,117,367 SQ. FT. ~ I 25.]74 ACRES EXC. R/W 1,096,596 SQ. FT. ~ i ~ 1~ ~~ ~ ~ I , 11'+/- --+a 1297.08' S89'40'09"W 133012' ~ UNPLATTED LANDS OWNED BY OTHERS If'1 ID 0 Z N~N I„~ i~ o, c ' o c 33.04'- 5'00' ' N ! o ~ I ~ ~; !o ' N 1 ~ i N ' ~ 1 i l ,~ A i ~ , ~ N IO` ~ ~ ~ I' i I ORIYEWAY__` '_ 1 ~, i ~ I 33.04' 1' X 24' IRON PIPE WEIGHING 1.13 LBS. PER LINEAR FOOT SI ~ ~ ~ -" ~ 100' ROADWAY SETBACK LINE i I ~~ m STEEL SURVEY MARKER FOUND 1 'IZ ~ EXISTING SOIL BORINGS ~ ~ %~~-X-x- EXISTING FENCELINE q ~ ~' ' Z I~~ NOTE: Field drive to be relocated t1 .a r1 '-~ to ,p~pti on `~ ' ~ I ST. CROIX COUNTY ~~~JJJ 1~ Planning Zoning and Parks Committee ~ I~ JAN 2 4 2000 I iT INN It not recorded within 30 da}5 of approval date approval shall be nutl and void SCALE IN FEET 1` = 200' 200 0 200 400 1 I N 03'0 170.82' E1/4 CORNER ! l~?'-$ECTIDN 6 Q1 n eM. tT rL 0