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HomeMy WebLinkAbout002-1020-90-200 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division • INSPECTION REPORT Sanitary Permit No: 453055 0 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: 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: Gerhardt, Josh I Baldwin Township 002 - 1020 -90 -200 CST BM Elev: Insp. BM Elev: BM Description: Section/Town /Range /Map No: 10 D 1 l) 6 r a 71 _e atkv 10.29.16.141 B TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic / Benchmark /,jv14y I .Bv I or,gv Irv. a Dosing - Alt. BM q / J I - Ull ��� r 0 Aeration Bldg. Selver Holding St/Ht Inlet TANK SETBACK INFORMATION St/Ht Outlet TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet r Septic IZ/� r ` o f VY\ Dt Bottom 1-' ', ` 7a o _ S ` u� vvj Dosing 5ua* ('491 '4 a 1 r t Header /Man. , Z 7 1 Aeration Dist. Pipe Z` 7 162.1 Holding Bot. System 2•Z Inl.ZZ � PUMP /SIPHON INFORMATION Final Grade Q• �S ✓Ca S 1^] tom! Manufacturer /1 6 � GPIM n / St Cover 7 Model Number E j1 P WILIkk ` OV, TDH Lift Friction Loss System Head Ft C1 11 3 ..Z5 Z �5 z q, 0C 7 ,� Forcemain Length t Dia. i/ , z1� z IDist (09 `l; SOIL ABSORPTION SYSTEM , 4 Z /60 BED /TRENCH Width t J# Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS � SETBACK SYSTEM TO P/L BLDG IWELL LAKE /STREAM LEACHING M anufacturer: INFORMATION CHAMBER OR Type Of System: 13, / / V 4- UNIT n �� Model Number: u DISTRIBUTION SYSTEM Header /Manifold Distribution 1 i x Hole Size / t x Hole Spacing Vent Vent to Air Intake Pipe(s) L // 60 �J (o `L Length i . Dia Length �� Dia , / — Spacing \ � 't SOIL COVER x Pressure Systems Only xx Mound Or At - Grade Systems Only Depth Over t I Depth Over xx Depth of Sded /Sodded xx Mulched F ee Bed/Trench Center / Bed /Trench Edges ` Topsoil ('I ' �.-+- No Yes No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: / .7q Inspection #2: t n sEu l�iG( Location: 2417 55th Avenue Baldwin, WI 54002 (NW 1/4 NW 1/4 10 T29N R16W) NA Lot 2 i� Parcel No: 10.2 16.141 8 i �i.acGt? /1-U" 1`t O �O 1.) Alt BM Description = �� �i 1 ] & GI t 0.( - D ov I S /IZL Th - 9 b • CA: t �. /vC'� -� �� c- ' 2.) Bldg sewer length = A I_ - n r u �..CF- I t v.S i � S f� U� 6, amount of cover = +_ % P�wmLw� will stl bivJ iu (� Ivl� 1:u 1�� �� ae 11�s�lr�rvn " old k;n uk Plan revision Required? Yes No y f �j Use other side for additional information. (� o - - -. - � 3 Date Insepct s Signa re Cert. "No SBD -6710 (R.3/97) g i g s fi ic ^, ,om� E v. Ir s s ... , T _ f li p w C E { 00 N , 1 F t , ,i " I.J JFJ fit I O M q M A Z 1 f i w 4 ; [lei 00 RE V a � rnT .... a �+ N i, v� L _sf Q� S" ' � a batm arts isuumngs Llvtstut � 201 W. Washington Ave., P.O. x 71 S& r! ,p N) Pl i consln Madison WI 53707 162 ft Address Department of Commerce 2111 ` �y Sanitary' Permit Applicatio s, 9�� X53 o ss In accord widi Comm 83.21, Va. Adm. Code, persoml hftma6m �. (Tl tf Revision be used Law s15. 1 In 2 U I. Application InfWandw - Plem Prhd All Infarawdou . Number T Property Owner's Name Number Property Owner's Address Property Location . J 4I 5 S ^ty t ✓R ";S UT � N.R City. Stan Zip Cade Phone Number 2 HodHJemsber qTd Number =Geq- 5-q �Q75:7) 6305 2 II. ape of Banding (dwk an taunt apply) S ocny 1 or 2 Panay Dwelling - Number of BedrooM oviilsge 0 PublidCommercial - Qrmmiblp 12 /d r 0 State Owned =Um IA_ .2S i � IS e l� t 4 b _ � `- IJL Type of • (Check only one box on line A (ntanbetcing tub for Internal use). Compkte line B tr appiicahk) A ' 1 miew 2 0 R SJAM 3 0 Rqftoneat of b 0 Addition to For Coniq ase Talc B. 0 Check if Saaltuy Permit Pmvionsty h9nd Permit Number Date Is med IV. Type of Perm#: (Check an th JFo SIP scheme imor internal use) 44 0 Nan- Ptessuriud hi-Ground 21 :_-4t' 12f" �� 47 * Filter so 0 Constructed Wedand S. 22 0 Pressurized la- Ground gk Pass 510 Drip Line 45 O At -Grads 46 0 Aerobic Treatment Unit 49 ❑ 30 0 Other V. Area Information: p Rate SYSUM Hevation Final Grade > Flow (lam / Area Soil Applicadoa Required Proposed Raoe(Gats./Days/Sq.lh.) (Min./lticW Elevation q5 L 6 - 6 0 /. (D 16 Z' ?J VL Tank Info Capacity in Toni Number Muadaaurer Prafab Site Steil Fiber Plastic Gallons Gallons of Tardy Concnte Construe Glass Now 8tvstii Tacks Teob � / Seput or Talc - % UG �/ 1 /.✓, e X e nort Ctmaber , % VII. RespondWft Statement- I, the ltad mme for mina of d a POWTS down on the aottached plash. Plumber's Name (Print) s Signs = Number Business Phone Number Phuti � ber's Address (S'tree4 City Zip > ` S — C Co 2 V VIII. Corm rDe Use Date Issued Signature (No Stamps) la Approved 0 Disapproved surchap Fee) (includes Gmtmda+ater / 0 owner Given InAW Adverse 35� T- (3 Z U. Conditions of ApprovaUReasORI fa• DMPProvsl SYSTEM OWNER: 1 Septic tank, effluent filter and dispersal cell must all be serviced / maintained as per management plan provided by plumber. 2. All setback requirements must be maintained as per app IC le 1> (Not Comy Q7) rK do syWn m paper sat tan" x 11 hwb" "m SBD -6398 (R. 05101) h1w- �w��0- 2 2 4 ( • x %6 S ( ?.�T� •� Qut a a) cp z P M �` 4-tx� • � 4t rn sZ.1 �l t, dot 4 � -�• Qom+ w h V� s weal V 50 . 8 a ol 1A,r Sao io�to.P Ri - k cX a � v.ot �C.l"1 �r �`�o $or.a S� �¢�c ��1ce - wo� < tY� , a� � � -;,��� a� 3 a Safety and Buildings 4003 N KINNEY COULEE RD LACROSSE WI 54601 -1831 TD #: (608) 264 -8777 *iSconsin www www.commerc . s i n.gov .wisconin.gov Department of Commerce Jim Doyle, Governor Cory L. Nettles, Secretary October 14, 2003 CUST ID No.222774 ATTN: POWTS Inspector HENRY F GROTE ZONING OFFICE CERTIFIED SOIL TESTING ST CROIX COUNTY SPIA E4366 353RD AVE 1101 CARMICHAEL RD MENOMONIE WI 54751 HUDSON WI 54016 CONDITIONAL APPROVAL Identifi 9 2 7 Nilmbers PLAN APPROVAL EXPIRES: 10/14/2005 Transaction ID No. 927021 SITE: Site ID No. 666220 Josh Gerhardt Please refer to both identification numbers, 110th Avenue above, in all correspondence with the agency. Town of Baldwin St Croix County NW1 /4, NW1 /4, S10, T29N, R16W FOR: Description: Proposed Three Bedroom Mound System Object Type: POWT System Regulated Object ID No.: 924199 The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. 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 "Mound Component Manual for Private Onsite Wastewater Systems VERSION 2.0" SBD- 10691 -P (N.01 /01) and the 'Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems VERSION 2.0" SBD - 10706 -P (N.01 /01). • Limited activities are allowed in the area 15 feet down slope of the component area. Soil compaction, excavation, vehicular traffic and other similar activities that impact the treatment and dispersal are prohibited. • A state approved effluent filter is required. Maintenance information must be given to the owner of the tank explaining that periodic cleaning of the filter is required. 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. • Comm 83.22(7) - 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. r , 4 � GEi'i +R31u,E]iTUF C� �:'! =i�!�E Duke r mrQ _ Josh Gerhardt - Mound Transaction # Construction Materials and Techniques All materials must comply with Comm 84 and be installed in accordance with manufacturer's specifications. Construction methods must comply with the following Component Manuals: Mound, SBD - 10691 -P (01 /01) Pressure Distribution, SBD- 10706 -P (01 /01) Location: NW 1/4, NW 1/4, Sec. 10, T 29 N, R 16 W Town: Baldwin County: St. Croix Date: October 10, 2003 Owner: Josh Gerhardt Address: PO Box 32 Woodville, WI 54028 Designer: Henry Grote — 6 n99 '* D- 1 � MENOMONIE : - Signature: License # WI D- 699-007 Attachments: 6748 -Plan Approval Application SBD -8330 page 1: cover 2: design criteria & calculations 3: plot plan 4: system cross section 5: plan view, lateral detail 6: pump tank exit detail V I : � � "" ` • plVl�' 7: pump curve 8: system management StE C G��cS RECEIVED page 1 of SEP 2 5 2003 SAFETY & BLOGS 01% HENRY F GROTE Page 2 10/14/03 Owner Responsibilities: • 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 above 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, Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 Gerard M. Swim POWTS Plan Reviewer - Integrated Services (608)- 789 -7892, Mon. - Fri. 7:30 am to 4:15 pm jswim @commerce.state.wi.us WSMART code: 7633 cc: Leroy G Jansky, Wastewater Specialist, (715) 726 -2544 t f5 Design Criteria Residential Wastewater Contaminant Load: 30 mg/L < BOD < 220 mg/L se Anticipated tic tank effluent 30 mg/L < TSS < 150mg/L P septic Coliform > 10,000 cfu/100 mL Fats, oils, grease < 30 mg/L Bedrooms x 100 gal/bedroom/day x 1.5 Ab gallons /day hydraulic load Design Calculations In situ designed loading rate gallons /sq. ft. per day Depth to estimated high ground water in. Depth to bedrock ? g in. Cross slope at system 3• S % Force main length 7,%T ft. of in. Manifold/header length Mr+ ft. of in. Drain -back LO 4 gallons Lateral length @ ss•S ft. of ��� Z in. Lateral elevation °t�'�5 ft. @ bottom of lateral Lateral hole size 3 �t in. @ 3 bo in. ( 3 ° ft.) Spacing holes /lateral 3 `� holes total Lateral volume "°. zt 2 gallons Total lateral discharge rate 2!�" o g gallons /minute @ 2 '� ft. head Network pressure compensation losses Elevation difference Friction loss ft. @ gallons /minute Total dynamic head Pump /sipi�pn gpm @ ° ft. of head Manufacturer �ae��� Model # Z Dose volume t 5 6 gallons Lift/sip?fon tank gallons Septic tank gallons Effluent filter - Measurement pump on and off c in. Height alarm from tank bottom c in. Reserve capacity gallons specs.calcs.res Page 2 ' of i s h1k+- 4.1w— to- 2 4 -1(eW R" pvc `` %JO o u � Ore i. V..hCM C \pµte� 4 t3 t'l caQQ w! 5w 1 0..•� S 8g�g (�15' Or n > \ t o1r�+Q 13`� `ouie'1oC �l« gogoo as wy akl� w.�a � ovC S� ¢QX � �Yti�ce `�w ` , -,o U Y 3 a sa ! (L r� Ova r \J I � f 4b o � t T a�..�, c� •. w ..5� `rJ 1 rr Say \ S 4 .1..E 0 `�'I t_•�,�,.�..�...� s Ord -�t' o vi �• M r C P ri Cx - - r j t 0 Vi Y r (' vi WEATHERPROOF LQ KI N G�GOVfi R TJ N t: I C N f�c OWCK D��C.o�lytGT --, n -� .L r-0 177177777 rl777r77,777,WIV-IffVllr4ll7714ilot'r,," I 7r,/7,% 4° pin 3' v no NDIST ua6�C `w So�L 24" Z.t�, 4a p� ROVL.O A SKET *ZM'J WFLE l 4 c L. Pmt �VIECTIO I " / K J, �~ -tc�``db I i C7i.7a►.O Oct p"kp D Corvc�eF i 51PTIC t _ 5PEGIFI OOSC (( T,-,w,.S MAWUFACTLlRCR: WMEER OF DOSCS: PCK TAWK SIZE: ti lswo GALLOWS DOSE VOLUME INCLUDING 6ACKFLOW: 1 �' �' ,►.,�ti; ALARM ?lk/ UFACTUQCR: ^00CL WUP%bElt. CAPACITIES: A= 19.0 WCHCS OK 3 tg '`F ;.k. ,:," SWITCH TyP[: ' 11 g= Z lucks OR Pump ?1AIUUFACTUREIR: MODEL NUMBER: X52, • DO 9 INCHES OR ,,A,._•_. SWITCH TbPE: � Q.v`•tiv {DOTE: PUMP AUD ALARM ARC TO bC M1►JIMUM DISCHA RATC GPM INSTALLEO O 5EPARATC CIKC_ " YCRTICAL DIFFEKEIXl CETWCEW PUMP OFF A1JO OIJTRIDUTIOW PIPE,. 12.'2•J FEET + MIQ IMUM NETWORK SUPPLE PKCSSUKE . . . . . .. , , . , z '� FCCT + ��� FEET OF FORCE MAIN X , -141 F /ppFtFKICTlO►J FACTOR. � FEET -- TOTAL O�WAMIL HEAD = FE.Er ILTERAJAL DIME.W61OWF► • OF TAWK: LEKI(PTH N - ;W,DTH ;LIQUID DEPTH 3b f e TOTAL DYNAMIC HEAd /CAPACITY HEAD CAPACITY CURVE PER MINUTE EFFLUENT AND DEWATERING Lo MODEL 152 /153 w w MODEL 152 153 50 Feet Meters Col. Liters Gol. Liters 153 5 1.5 69 261 77 291 12 40 152 10 3.1 61 231 70 265 15 4.6 53 201 61 231 a i 20 61 44 167 52 197 30 a 8- 25 7.6 34 129 42 159 0 30 9.1 1 2 8 7 33 125 20 35 10.7 -- - 22 83 0 40 12.2 I -- -- 42 4 Lock Veive. 38.0 Ft. (1 1.6-1 44.0 F;. ' 3. ") 0145M 0 20 40 60 80 100 GALLONS LITERS 0 80 160 240 320 6 ,/4 3 27/32 5/8-+j � I FLOW PER MINUTE - !x /32 CONSULT FACTORY FOR SPECIAL APPLICATIONS e • Timed dosing panels available. e 3 2 • 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 controls. Sealed Qwik -Box available for'outdoor installations. See FM1420. • Over 130 °F. (54 °C.) special quotation required, 1521153 Series 152/153 MODELS Control Selection Mo del_ Volts -Ph Mode Amps simplex Duplex N 1 52 115 1 Non 8.5 1 2or3 BN152: 115 1 Auto 85 Included 2or3 E 152 230 1 Non d.3 1 2 or 3 _ L SK2 - B E 152 230 1 Auto 43 Included 2or3 N153 115 1 Non 10.5 1 2or3 6 N153 115 1 Auto 10.5 Included 2or3 SELECTION GUIDE BE BE1 53 230 1 Auto 5.3 Included 2 or 230 1 Non 5.3 1 2or3 1. Single piggyback variable level float switch or double piggyback variable level float I 1 ' 3 switch. Refer to FMO477. O CAUTION 1 2. See FMO712 for correct model of Electrical Altemator E -Pak. All installation of controls, protection devices and wiring should be done by a qualified 3. Variable level control switch 10 -0225 used as a control activator, specify duplex (3) licensed electrician. All electrical and safety codes should be followed including the most recent National Electric Code (NEC) and the Occupational Safety and Health Act (OSHA). or (4) float system. RESERVE POWERED DESIGN O For unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump. MAIL TO: P.O. BOX 16347 Z Louisville, KY 40256 -0341 Manufacturers 01 SNIP TO: 3649 Cane Run Road t+ oo Louisvile, KY 40211.1961 http: / /Www.zoelter.com p4 (502)118 -21 (5 2 1(600) 928 -PUMP FAX (5 02) 774 -3624 , © Copyright 2000 Zoeller Co. All rights reserved. i System Management • Management of this system is critical. As a condition of approval of these plans this system management section must be reviewed with the owner, and the owner must be provided with a complete set of plans including this management section. If problems develop with the adsorption system or any other system components, the installing plumber or the St. Croix County Zoning Office, 715- 386 -4680, should be contacted for assistance. General Proper functioning of an on -site disposal system, "septic system," is significantly dependent on the volume of water which flows into the system and the level of contaminants in that volume. The lower the volume of water and the lower the level of contaminants, the better and longer the system will function. Typical system components include a septic tank or compartment to settle out solids and contain greases and oils, a filter on the outlet of the septic tank to retain small particles of the same density as water, a pump tank or compartment to allow a dose to be accumulated, a pump and controls, and finally some type of soil adsorption cell to recycle the water in a manner to protect ground water quality and public health. 1 . If the septic tank is installed prior to sheet -rock and/or painting, pump the septic tank before normal use begins to ensure adherence to contaminant load design criteria. 2 Install water - saving appliances whenever and wherever possible. 3. Repair even small water leaks as soon as possible. 4. Never pour grease or oil down any drain or stool. 5. Garbage disposals are not recommended; if you must have one, use it sparingly. 6. No paper products other than tissue should go into the system. 7. No chemicals should go into the system. 8. Avoid surge flows of water; try to spread laundry throughout the week. 9. Septic tank effluent must be less than or equal to the design criteria specified in page 2 of these plans. 10. If septic or pump tanks are no longer used, they must be properly abandoned. 11. If construction timing and weather could create a frozen infiltration system, weather - proofing with plastic sheeting and heavy mulching may be required to maintain a functional system at start-up. Maintenance 1. The septic tank must be inspected every three years by a properly licensed person. 2. If necessary, the septic tank must be pumped to remove solids and scum; pumping is required if the combined scum and solids volume equals one third of the tank volume. 3. When the septic tank is pumped, any solids in the bottom of the pump tank must be pumped, and the filter must be back - washed into the septic tank to remove accumulated material. 4. Periodic observation pipe inspections should be made by the homeowner to examine the state of the in -situ soil adsorption cell. Quarterly inspections are recommended; a licensed plumber should be notified if effluent is consistently ponded in the adsorption cell. 5. If this system contains specific treatment components other than those mentioned here, maintenance requirements will accompany their specifications. 6. The pumping components for this system include an alarm which must be installed and remain on a separate circuit from the pump. If the alarm is activated, minimize water use and notify a licensed plumber for service as soon as possible. The system allows reserve capacity to accumulate some necessary flow until normal service can be restored; this volume is minimal, and no more than one or two days should pass before any necessary repairs can be made. 7. Avoid compaction such as vehicle traffic within 15' down -slope of the adsorption system. 8. Avoid disturbing the system itself such that might encourage erosion or disturb the required seeding of the system. 9. Particularly avoid winter traffic such as sliding or snowmobiling which might compact snow and lead to increased frost depth. 10. Surface drainage must be diverted around the system; avoid landscape changes which might send surface run -off into the system area. 11. Warning: Do not enter septic, pump or other treatment tanks; death may result because they may contain lethal gases or insufficient oxygen. Contingency Plan Wastewater monitoring of volume and quality is not a normal requirement for low effluent strength systems; such monitoring may become necessary if problems develop. Any necessary monitoring shall be done in accord with the requirements of Comm 83.54 (2). Pumping and hauling of wastewater may be necessary while analysis and repairs are implemented. Additional testing, designing, and /or installation of additional treatment components or conversion to a holding tank may be necessary. Page 8 of 8 1868 Wisconsin Department of Commerce SOIL EVALUATION REPORT Page I of 3 Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code Certified Soil Testing Attach complete site plan on paper not less than 8' %x 11 inches in size. Plan must County St. Croix include, but not limited to: vertical and horizontal reference point (BM), direction and parcel D. 0 percent slope, scale or dime and distance to nearest road. 20 acre CSM Ct e, -24Yc Plea prim falrartt iewed By Date Personal information you provi may be used for secondary purposes (Priv taw, s. 15.04 (1) (m)). �Z Property Owner Y 3 ZUO3 Property Location Gerh Josh Govt. Lot NW 1/4 NW 1/4 S 10 T 29 N R 16 W Property Owner's Mailing Addr ss COU�i7Y Lot # Block # Subd. Name or CSM# ZONING OFFICE POB 32 ! �h M ,,,,� t 4 3Qt City State Zip Code Phone Number City Village 14 Town Nearest Road Woodville I WI 1 54028 715 - 698 -3576 Baldwin 110Th Ave. VJ New Construction Use: jo Residential / Number of bedrooms 3 Code derived design flow rate 450 GPD Replacement Public or commercial - Describe Parent material loess over till Flood plain elevation, if applicable NA General comments and recommendations: install 4' x 114' rock cell mound on 100.0 contour as upslope edge of rock w/ 1.25' sand fill FT] Boring # °�b� Boring � I Pit Ground Surface elev. 99.4 ft. Depth to limiting factor 21 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 -4 7.5YR 2.5/1 sil 2 f sbk mvfr cs 1f /m .5 .8 (p 2 4 -13 10YR 4/3 - sil 2 f -m sbk mvfr gs 1 m .5 .8 ( 3 13 -21 10YR 4/4 - sicl 2 f sbk mvfr cs 1M .4 .6 4 21 -36 7.5YR 4/4 f2d 7.5YR 5/8,5/3 scl 0 m mfr - - 0 0 .�— , horizon 2 sbk occasionally parts to 2 f pl; redoximorphic features in horizon 4 become c3p below 27" Boring # = Boring j Pit Ground Surface elev. 100.0 ft. Depth to limiting factor 26 in, Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/W in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 1 0 -4 7.5YR 3/1 - sil 2 f sbk mvfr cs 1f /m .5 .8 t� 2 4 -17 10YR 4/3 - sil 2 f sbk mvfr gs 1m .5 .8 ( 3 17 -22 7.5YR 4/4 - sl 1 m abk mvfr gs 1 m .4 .6 4 22 -26 7.5YR 4/4 - Is 1 m sbk mvfr cs 1 m .7 1.2 } 5 26 -32 7.5YR 4/4 f2f 10YR 6/2 Is 1 m sbk mvfr cs 1 m .7 1.2 r 6 i 32 -38 7.5YR 4/4 c3p 7.5YR 5/8,5/3 scl 0 m mfr - - 0 0 I Effluent #1 = BOD 30 < 220 mg /L and TSS >30 < 150 mg /L ' Effluent #2 = BOD < 30 mg /L and TSS < 30 mgt CST Name (Please Print) jgnatur CST Number Hen F. Grote 222774 Address Certified Soil Testing Date Evaluation Conducted Telephone Number E. 4366 353rd Ave., Menomonie, WI 547 1 6/13/2003 715- 233 -0398 Property Owner Gerhardt, Josh Parcel ID # 20 acre CSM Page 2 of 3 > F3 I Boring # Boring lift Pit Ground Surface elev. 100.0 ft. Depth to limiting factor 21 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0 -3 7.5YR 3/1 _ sil 2 f sbk mvfr cs 1 f/m 5 .8 2 3 -14 10YR 4/3 - sil 2 f sbk mvfr gs 1M .5 .8 G 3 14 -21 7.5YR 4/4 _ sl 1 m sbk mvfr cs 1 m .4 .6 4 21 -33 7.5YR 4/4 f2f 7.5YR 5/3 sI 1 m sbk mvfr cs 1m .4 .6 5 33 -38 7.5YR 4/4 c3p 7.5YR 5/8,5/3 scl 0 m mfr - - 0 0 I I redoximorphic features become c3p below 28" in horizon 4 a Boring # _j Boring Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 I ❑ Boring # Boring Pit Ground Surface elev. ft. Depth to limiting factor Soil Application Rate in. Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 I I I i I i * 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) Certified Soil Testing Nw - b —�O- 2q - ( hbw Qy 4L r � OL 1 +- ( + rz .+ � 3 �b S4iav:ee •.�� -k94.8� X 1 u1 O O 4 Z VAI ui e a U a S , Qf2Q / �� ��� — �•+o� � � . c7 ST CROIR COUNTY SEPTIC TANK MAMMANCE AGREEMBNT AND > OWNERSHIP CBRMCATION FORM Owner/Buyer SG S' LL L? 'e- e h 11-r d Mailing Address � 2 y! ?��� 4 �"► �� � �� �� . � property Address (verification required from Planning Department for new eonshuch0u) City/State �� r ��- `� Parcel Identification Number Lgg" DESCRIPTION ` Property Location !'� � y., e / "i4, Sec. C . T � �l N_R_f W, Town of / ' Subdivision Certified Survey Map # , G3��' p Z-' . 't olume I �'( Page 3 ? Warranty Deed # 3 o G �' . Volume , Page # 3 ? Spec house Q yes tto Lot lines identifiable GL-yes 0 no SysTEM MAYNTENANCE improper am and maintenance of your septic system could result in its prom uw failure to haudle wastes. Proper in"teaance consists of purupMg out the septic tank every thrte years or sooner, if needed by a hoensed pumper. mat You put WO the system can affect the fu motion of the septic tank as a ft4tniout sure = the waste disposal system The property owner agrees to submit to St. Croix Zoning Department a ea b cab= form. signed by the owner and by a master plumber. jowmey>nanplumber. r+esfnctedphtmber or a licensed pumper verifying ftt (i) ttte ou site wastewaterdisposal system is in proper operating condition and/or (2) after inspection and pumping (if neeessUrY), d= 5 ' W Wk's less than 113 full of sludge. Ilwc, flue undersigned I (v�ro) am (are ) have toad the above vXP*euteuts and agree to maintain the private sewage disposal system with the standuds set fordo, lut+ein, as set by the Department of Cotamerce and the Department of Natural Resources. State of Wiscws Certification stn ' that your septic system has beta unchained must be completed and returned to the St. Croix County Zoning Office within 30 of the tierce year expiration date. DATE SI(3NATURE OF APPLICANT OWNER CERTIFICATION the- owncr(s) of 1 (we) cettify that all statements otu this form are ttae to the best of my (our) lmowledge . the p r�l descn d above, by virtue of a warranty deed recorded in Register of Deeds Office. DATE S N' APPLICANT Any inibcMdou that is mis- represented may result in the sanitary patmit b revoked by rho ZaninB Department- «« Include "ith this application; a stamped warranty deed from the Registes of Deeds oifiCC a copy of the carti6ed survey map if reference is trade in the warranty deed + V. 1sconsin Department of Commerce SOIL EVALUATION REPORT Page ____ of D�ision of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code �/ County c am. Attach complete site plan on paper not less than 8112 x 11 i Ian must include, but not limited to: vertical and horizontal n3fere �t B )i and Parcel I.D. percent slope, scale or dimensions, north arrow, and tt0 (a t road. 1?e,"64 Please print 811 lnf on Reviewed b Date Personal information you provide may be used for se 4 purpos 4�. s. 15.0 (l ))• Property Owner � `L f c 1GbvtgL tl� 1/a la S T 2 f N R! U E Property Owner's Mailing Address Sj G Lot # ck # Subd. Name or CSM# ,' GOU�?'v .S b Gtr M CL +-/ - '� city G O ✓� State Zip code Ph u r ❑ village JE,Town �� rest R ^ , New Construction Us Residential / Number of bedrooms Code derived design flow rate S` GPD ❑ Replacement ❑ Public or oom al - Describe: Parent material - Flood Plain elevation If applicabl � l� ft General comments and recommendations: 7" / Boring # ❑ Boring in. -�/' a Pit Ground surface elev. _ _ ft. Depth to limiting factor S 4p teation Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots G In. Munsell Qu. Sz Cont Color Gr. Sz. Sh. �Eifp1 •Effp2 6 ❑ Borin ® Being # , L Pit Ground surface elev - ' Zft . Depth to limiting factor in. Sol A pp k el d o n Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/W in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. '001 - EW Effluent #1 = BOD > 30 220 mg/L and TSS >30 150 mg/L • Effluent #2 = BOD t 30 mg& and TSS 5 30 mg/L CST Name (P lease Print) S na CST Number Address ate Evaluation Conducted Telephone Number J l Property Owner Parcel ID # i Page of Boring # [3 Boring 'R. Pit Ground surface elev. ft. Depth to limiting factor , ZY in. ikon Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDflP In. Munsell Qu. Sz. Cont. Color Gr, Sz. Sh. "Ef #1 "Em (2 -7 lei, e-RL 6 3 f 1 . 2` ❑ ��� # ❑ gin ❑ pit Ground surface elev. _ ft. Depth to limiting factor in. cep Ilcation Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPOM In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. "Eff#1 •EN#2 Boring # Boris ❑ Pit Ground surface elev. _..._� ft. Depth to limiting factor in. Soil App lication Rate Horizon Depth Dominant Color Redox Description Texture structure Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Cclor Gr. Sz. Sh. 1 'Eff#2 • Effluent #1 = BOD > 30 1220 mglL and TSS >30 150 mgll • Effluent #2 = SOD, _< 30 mglL and TSS <_ 30 mgll. 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. M -8330 (R.6=) - Soil Test Plot Plan , Project Name Robert Harer Shaun,B' Address 7850 Bowman I. Inver Grove Heights Mn 55076 C #226900 Lot 2 Subdivision -- ----- Date 8/26/00 NW 1/4 NW 1/4S 10 T 29 N /R W Township Baldwin R Boring ()Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 100 ft. Top of Nail in Tree System Elevation N/A *HRPSame as Benchmark Alt. BM Top of Nail in Tree @ 102.1' 110th Ave Alt .M. 20' 15' B. B - 3 5 99' 35' 98' 50' 97' AF B -2 5 50 B -1 lope a� a� a 0 0 N M I( U 2 3 1 8 P 3 7 0 73��8� KATHLEEN H. WALSH STATE BAR OF WISCONSIN FORM 2 - 1999 REGISTER OF DEEDS Document Number WARRANTY DEED ST. CROIX CO., WI RECEIVED FOR RECORD - This Deed, made between Ari Sommerfeld and Martha 07/17/2003 10:30AN Sommerfeld, husband and wife WARRANTY DEED EXEMPT # Grantor, and Barbara Loomis and Joshua Gerhardt, REC FEE: 11.00 TRANS FEE: 290.00 COPY FEE: CC FEE: PAGES: 1 Grantee. Grantor, for a valuable consideration, conveys to Grantee the following described real estate in St. Croix County, State of Wisconsin (if more space is needed, please attach addendum): Recording Area I Part of NW '/. of NW '/. and Part of SW '/. of NW '/* of Section 10 Name R etu A ddres s t Township 29 , Range 16 West, St. Croix County, Wisconsin described as follow :Lot 2 f Certified Survey Map fried September 27, 2000 Vol. 1_,, 3 , oc No. 630592. 002 - 1020 -90 -200 Parcel Identification Number (PIN) This is not homestead property. 0j) (is not) Exceptions to warranties: Easements, restrictions and rights -of -way of record, if any. Dated this / day of July 2003 Z� * * Ari Sommerfeld y a-j =C 2� * * Martha Sommerfeld AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF WISCONSIN ) ) ss. County ) authenticated this day of YA Personally came before me this /a day of July , 2003 the above named Ari Sommerfeld and Martha Sommerfeld, husband and wife TITLE: MEMBER STATE BAR OF WISCONSIN (If not, to me known tq.be "P r•so o executed th e foregoing authorized by § 706.06, Wis. Stats.) instrument aplchow ed' THIS INSTRUMENT WAS DRAFTED BY * h . Attorney Kristina Ogland Notary Pu `Wg of iscondiVV,` Hudson, WI 54016 My Corn,44A is �r� ,Gtjj rtit, state expiration date: (Signatures may be authenticated or acknowledged. Both are not necessary.) ft ) * Names of persons signing in any capacity must be typed or printed below their signature. WIF I a jnf.,Aawn Professionals c ompany, Fond du Lac, tM WARRANTY DEED STATE BAR OF WISCONSIN 800-655 -2021 FORM No. 2 -1999 CERTIFIED SURVEY MAP OWNER ROBERT HARER & LOCATED IN PART OF THE NW1 /4 OF THE NW1 /4, AND IN PART SANDRA HOOGENAKKER - -- ��-@- OF THE SW1 /4 OF THE NW1 /4 SECTION 10 T29N, R16W, TOWN 4492 W ARM RD. 00 NW OF BALDWIN, ST. CROIX COUNTY, WISCONSIN SPRING PARK, MN 55384 CORNER 110TH - A VENUC SECTION 10 S 87 040'5 "E 1317.88' Q — N1/4 CORNER 625.96' 1 _ X87 °40T�S"E— — ACTIO 10 p T C Np S87°40'56 "E `8 1284.65' 658.69' co I T ........... ................ "' r; .� M S3f'�'Oti NOR LINE OF THE NW1 /4 J I z 0 o x ' i F 135' % p' ,� p 9 • I 0 �; Ip I I W v w dOl`� 9 I L@U L�2 z --- - - - - -- I � v 210 1 I 0 W - - -� I APPROVED 0. 0 _ - 0 �� N ` N p � O - O ST. CROIX COUNTY z 3 m n w :" I I rn o n J =\ i I Planning Zorirg and Parks Committee z a rn z `� r W LOT 1 LOT 2 ~ 3 " U W m Y ti � .Z T �, � z M I I S E P 2 7 2000 W a / ( � I I � J 20.000 ACRES INC. ° _ o W v w- r p R/W ° ' r H 871202 SQ FT ,. . r N 20.0 NC. z LO 0, rn R/W 871,200 SO. 19.501 ACRES EXC. FT. � CD �, �, If not recorded within 30 days of a w w - 18.520 ACRES EXC. erU]; o w .n � N �� z : R/W 806,743 SQ. FT. H approval date approval shall ° W pQ; �; lt be z Z) R/W 849,462 SQ. FT. W 10 �� i Z c cn null and void m ~ a o �;�I h � ; �p m ° > N T LEGEND W SOUTH LINE OF N �� ® o O � Z THE NWI /4 OF THE NWl /4 STEEL SURVEY MARKER FOUND VERIFIED 33' �soi 1 WITH WITNESS MONUMENTS OF RECORD �. z �i 0;'� 655.75' 6 55.42' �� O J 1" IRON PIPE FOUND _ O, = N87 ° 37'27" �/ 11 131 1.17, SW EAST LINE ❑ 1. BS PER L N ~ ° I/4 OF THE NWI /4 - � pL ����- DO --- L- �- �^?a�� • • • SCALE IN FEET 1 300' • `• • ..100' ROADWAY SETBACK " = W1/4 CORNER O 1" IRON PIPE SET FROM WITNESS SECTION 10 MONUMENTS OF RECORD 300 0 300 600