Loading...
HomeMy WebLinkAbout004-1058-80-000 Parcel #: 004 - 1058 -80 -000 04/22/2008 05:11 PM PAGE 1 OF 1 Alt. Parcel #: 25.28.15.399 004 - TOWN OF CADY Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co -Owner O - BAUER, EUGENE N & JUDITH R EUGENE N & JUDITH R BAUER 144 330TH ST WILSON WI 54027 Districts: SC = School SP = Special Property Address(es): • = Primary Type Dist # Description ' 144 330TH ST SC 3444 MENOMONIE AREA SP 1700 WITC Legal Description: Acres: 40.000 Plat: N/A -NOT AVAILABLE SEC 25 T28N R15W 40A NE SE EXC HWY Block/Condo Bldg: Tract(s): (Sec- Twn -Rng 40 1/4 160 1/4) 25- 28N -15W Notes: Parcel History: Date Doc # Vol /Page Type 06/30/2004 767360 2606/258 EZ -U 07/23/1997 702/171 2008 SUMMARY Bill #: Fair Market Value: Assessed with: Use Value Assessment Valuations: Last Changed: 03/31/2008 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 2.000 28,000 238,000 266,000 NO AGRICULTURAL G4 35.000 3,400 0 3,400 NO UNDEVELOPED G5 1.000 100 0 100 NO AGRICULTURAL FOREST G5M 2.000 3,000 0 3,000 NO Totals for 2008: General Property 40.000 34,500 238,000 272,500 Woodland 0.000 0 0 Totals for 2007: General Property 40.000 34,700 238,000 272,700 Woodland 0.000 0 0 Lottery Credit: Claim Count: 1 Certification Date: 04/17/2001 Batch #: PRGRM Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 St. Croix County Planning and Zoning Tuesday, April 22, 2008 at 5:15:50 PM Detail Sanitary Information Page 1 of l Computer #: 004 - 1058 -80 -000 Sub /Plat: 40 acres Section: 25 Parcel #: 25.28.15.399 lot: TN /RNG: T28N R15W Municipality: Cady, Town of CSM: 1/4 1/4: NE 1/4 SE 1/4 Owner: Bauer, Eugene 144 330th Street Wilson, WI 54027 State Permit: 430010 Issued: 05/29/2003 POWTS Dispersal: Mound less than 24" suitable s Permit: New County Permit: 0 Installed: 08/1212003 POWTS Detail: NA Bedrooms: 3 WI Fund: POWTS Pretreatment: NA Notes Issuer /Inspector As Built Plumber Other Requirements Additional Notes Money Owed Kevin Grabau >4/1/00 - Not Required Pelke, Herb $0.00 Rod Eslinger Sighed Off`. Yes Maintenance Scheduled Pump [late Pumped 8/12/2006 10/24/2006 10/24/2009 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM 4 � County: St. Croix Safety and Building Division ' - -' INSPECTION REPORT Sanitary Permit No: 430010 0 (ATTACH TO PERMIT) GENERAL INFOR ATION y State Plan ID No: Personal information you provide may be used for secondary purposes (Privacy Law, s.15.04 (1)(m)]. % = T11144S•, ,0 f Permit Holder's Name: City Village X Township Parcel Tax No: Bauer, Eugene -— 1 Cad Townshi CST BM Elev: Insp. BM Elev: BM on: Section/Town /Range /Map No: ( OD / vD C T' Wl 25.28.15. TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER " CAPACITY STATION BS HI FS ELEV. Septic , mil_ O � Benchmark T / � pf a ova osing Alt. BM VJ � COVA t, 5,1 /05 ► 1106 Aeration Bldg. Sewer ► a Holding Inlet ► Z •� R � 3 St/Ht Outlet TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet e / Dt Bottom > so 2 -G �` i- boa osing ' 5 S-0 Header /Man. ��• g (o a 1 � Aeration Dist. Pipe Holding Bot. System / Final Grade .DS PUMP /SIPHON INFORMATION Manufacturer Demand St Cover 17 d L GPM Model Number $W3 2- 6f TDH Lift Friction Loss( I.co System Head TDH Ft ��.. taa 3.3 I�• Forcemain Length Dia. Dist. to Well D a2 t SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid De th DIMENSIONS SETBACK SYSTEM TO P/L BLDG f WELL LAKEISTREAM LEACHING a cturer: INFORMATION CHAMBER OR Type Of System: UNIT Model Number: DISTRIBUTION SYSTEM Header /Manifold Distribution x Hole Size x Hole S / acing Vent to Air Intake 3 1 ll t l Pipe(s) t I �Z p/ 31 (0 7 Length Dia d Length 3$ Dia Spacing J 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 Depth Over Center Depth Over Edges Topsoil No Yes F', ] No } Yes 1 COMMENTS: (Include code discrepencies persons present, etc.) Inspection #1: / L / 6 Inspection #2: Location: 144 330th St Wilson, WI 54027 (NE 1/4 NE 1/4 25 T28N R1 5W) NA Lot Parceljlo: 25.28.15. 3 �• 1.) Alt BM Description r�-w� ,p,� C 2.) Bldg sewer length = �� 44v � S T ,� amount of cover = e 10� (M - 7��� revis Plan Use others de for additional information. d - — – -- - informati J '0 -6710 (R.3/97) Date Insepctor's ature ert. \ v Safety and Buildings Division County J� C rU �, 201 W. Washington Ave., P.O. Box 7162 11SCS,n Madison, WI 53707 - 7162 Sanitary Permit Number (to be filled in by Co.) Department of Commerce (60g) 266-3151 3 o Sanitary Permit Application State Plan I.D. Number CQ In accord with Comm 83.21, Wis. Adm. Code, personal information you provide �L' t x� may be used for secondary purposes Privacy Law, s15.04(1)(m) Project Address (if different than mailing address) I. Application Information - Please Print All Information E C E VE # / �[ .2�� S + Property Owner's Na me Parcel A' / Lot # Block # &k O& h2 MAY 1 9 2003 -� auQ Cw-2.Q Property Owner's M ailing Address ST Property Location h CROIX COUNTY s �` ► 3`"19 N ZONING OFFICE Nn�C IV !4, S4,Section City, Sta Zip Code Phone Number I' 1� W I s on , � ( S�}Oa� 1� 1 ���� - 1� 1 (circle o e) H. Type of Building (check all that apply) T O N; R �S E of W 1 or 2 Family Dwelling -Number of B s Subdivision Name CSM Number p oom /❑` Public /Commercial - Describe Use Zo ❑ State Owned - Describe Use t t mw"k au �� _ �= � t (Z ❑City_ ❑Village Township of III. Type of Permit: (Check only one box on line A. Complete line B if applicable) A. New System ❑ Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of D Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Plumber Owner IV. Type of POWTS System: (Check all that appl ' 2 14 - too isni ❑ Non - Pressurized In- Ground ❑ Mound > 24 in. of suitable soil I x Mound < 24 in. of suitable soil ❑ At -Grade El Single Pass Sand Filter ❑ Constructed Wiliam! ❑ Pressurized In- Ground ❑ Holding Tank ❑ Peat Filter ❑ Aerobic Treatment Unit ❑ Recirculating Sand Filter ❑ Recirculating Synthetic Media Filter ❑ Leaching Chamber ❑ Drip Line ❑ Gravel -less Pipe ❑ Other (explain) V. Dispe rsal/Treatment Area Information: Design Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal Area Required (st) Dispersal Area Proposed (sf) System Elevati n 0 VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic Gallons Gallons of Units Concrete Constructed Glass New Existing Tanks Tanks Septic or Holding Tank 1 L lx �/1 W 1 Q �_ Q � Q C �� r t * Aerobic Treatment Unit VI �J t J�J^�� 1 Dosing Chamber a l / I LID VII. Responsibility Statement- I, the'undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Na me (Print) Plumber' a /� ty0 Business Phone Number Plumber's Addre ss (Street, City, State, Zip ode) ix u r)�ng `tea +e-- VIII. County epartment Use Onl Approved ❑ Disapproved Sanitary Permit Fee (includes Groundwater Date Issued Issu' g ent Signature o Stamps) Surcharge Fee)��. ❑ Owner Given Reason for Denial Yt'f C( IX. Conditions of Approval/Reasons for Disapproval ' , etc / Attach complete plans (to the County only) for the system on paper not less than 81/2 x 11 inches in size \ SBD -6398 (R. 01/03) ` ,, &,k= C ` � /s✓ ��JwrJ fi /s.0 Q �. _ /oS:e uric i.✓ 1 � /.e.w tii �i.✓.r� e/ %•eA.rs ♦ // l'rAr - . �it �AoJIO • � �J oo,pt .Z "Aw �• %sN /e•o� /•o �' 99. Z 3- Ai. Lera. x jA.,►K Q4i4vra o Y /eo clot red l ow ✓f ore✓�i rr /r - /s- Ae. ✓r 1 . W GoO t L.o/4r /O �` /Ocs� /.e�4ta AI'r�•Y /VLL �o.,rx 13. y� rrr,Orarj isrT DAIJ Llwrl 357 ! /1e40C . t`ta - SY.f. F1e►K o /e% 2 t e.� 9y. 2 o iSow Torw. iG/a r, «a9,r• . . Safety and Buildings 4003 N KINNEY COULEE RD LA CROSSE WI 54601 -1831 TDD #: (608) 264 -8777 �scons�n w,Nw.commerce' n s i www. n.gov wiscosin.gov Department of Commerce Jim Doyle, Governor Cory L. Nettles, Secretary May 05, 2003 CUST ID No.3412 ATTN: POWTS Inspector HERB J PELKE ZONING OFFICE PELKE PLUMBING ST CROIX COUNTY SPIA N6298 STATE HWY 25 1101 CARMICHAEL RD DURAND WI 54736 HUDSON WI 54016 CONDITIONAL APPROVAL Identification Numbers PLAN APPROVAL EXPIRES: 05/05/2005 Transaction ID No. 864496 SITE: Site ID No. 658582 Eugene & Judy Bauer 330TH St Please refer to both identification numbers, Town of Cady, 54027 above, in all correspondence with the agency. St Croix County NEIA, SETA, S25, T28N, R15W FOR: Description: Three Bedroom Mound System Object Type: POWT System Regulated Object ID No.: 901639 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: General Approval Requirements: • 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 /O1) and the "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems VERSION 2.0" SBD - 10706 -P (N.01 /01). • Per manual cited above, 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. Condi • The well must be a minimum of 25 feet from any POWTS tank, and a minimum of 50 feet from the absorption APPR area. chs. NR 811 & 812c dEFARTMENT • A Sanitary Permit must be obtained from the county where this project is located in accordance with the N O" requirements of Sec. 145.135 and 145.19, Wis. Stats. SEE CORRE • 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. Stat • 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. Owner Responsibilities: • Comm 83.52 Responsibilities. The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s. Comm 83.54(1). • Comm 83.52(2) A POWTS that is not maintained in accordance with the approved management plan or as required under s. Comm 83.54(4) shall be considered a human health hazard. I • Comm 83.55 The owner is responsible for submitting a maintenance verification report acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. All permits required by the state or the local municipality shall be obtained prior to commencement of construction /installation/operation. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter 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 Glfj zza Charles L Bratz POWTS Reviewer II , Integrated Services WiSMART Code: 7633 (608)789 -7893 , 7:45 am - 4:30 pm Monday - Friday cbratz@con I cc: Leroy G Jansky, , Wastewater Specialist, (715) 726 -2544 I I i g MVED MAY 012003 SAFETY & BLOGS DIV.• Private On -Site Wastewater Treatment System (POWTS) Index and Title Sheet Owner: �u� E.✓e' r J a,o y ����� Project Name and System Type: rs Location: no Sr. Street Address Z_X Al Legal Description Township /County Contents: Page 1 : / .v .OdX ANO fir« Sl"rr' Page 2: 6'c o r Page 3: G /t0,f f - _<re r /i .J .o.✓o Aim ��.✓ .f /f �..io Page 4: Page 5: ��- .�r.�,�.� /��,ro C�✓w e�.� C/�o.rr- ���r..r Page 6: �✓uyi �� ��,...� Page 7 : �pW r,S O .v.✓r.e s l-MiW-004. �.owl.rsrir�.✓r /ti.J Page 8: :Page 9: �tutfy Attachments: ` So r- )VFn COMA RCE 2. �./.at'L fi1T're /"�.yi:✓l'i'.✓.�cr f.✓rdo � ILOIN" PONDENC Plumber/Der: �ira 44X.rr Signed:` ,� Credential Number: ,ter ® - -?# z Date: y 8- e 3 41sE0 ,fBD - !off 9/•> 17ou.vo � o � . / yPo.vrvr/7.✓aoG 7,0,1 1 AfAr V4 ,f i� /11'itiON rii,✓ Lo �►��✓��r /wnwa� c ~ dr. t�.,r J -e .✓ /ae.,rcr rnPr .Ao rN u o oDs y fd a y !✓rc fawcr /yll.✓ !1/'`, • y"4e /esN /oo /!oo �' 9R Z 3 -,Air. Lora. re.�K ' 00,JivtwsY tS rl. - /eo'- �rsic i.✓ 1'.r /e- / - riv� ✓r• s Aar) t✓Ooit ye /O +` Aced s✓.lR4�a �I' /�eY. , ; A « L! ow.X 11. y.l s! rc�r1 is`T D.lt�/ 14w1J 3sr� C X 71 /1oc,C G s'�c• ir"WAP s rs re r . ,frs, EtE� o ov/ 2 q.✓ 9 �e,yTOr4- • F X330 � ST" H.CIO td �' • 1 i •1 ' ! 11 to • • • • • • - 3 r b . • p o •r i ,,d t M p . � . � N z >7 Cl of w to F • t rr• r• o z ,V n t `, x o a ►+o * ca . lb h o 0 g 0 I n /� ` � �► `. i R � n H.; to • y C .• tC1'C • ,. ,� I I I 1 O� +' % tn o ty ' MMMM�C �R�c• ppsyp .. • • � �• � , . ^.C% 1 lk 11 � L � .� t • M .�'-� a wM o . Page •S' Of 4 'SEPTIC TANK E'PUMP CHAMBER CROSS SECTION'AND SPECIFICATIONS ..t 4" Cl VENT PIPE 12" MIN. ABOVE GRADE 8 WEATHERPROOF ?' /p" FROM DOOR, WINDOW OR JUNCTION BOX APPROVED FRESH AIR INTAKE WITH CONDUIT MANHOLE COVERS W/ PADLOCK E f'i.✓r1kda WARNING LABEL MIN. y v ,✓aP�� rAW dA0 INLET I` • WATER TIGHT SEALS Z.00r� GAS- � '` ficrr, T SEALT APPROVED JOINTS WITH APPROVED i ; ALM APPROVED PIPE B 3' ONTO PIPE 3' 0 PTO SOLID � ON SOLID SOIL SOIL' PUMP OFF ELEV . Bto FT. -- OFF '� RISER EXIT D PERMITTED ONLY IF TANK MANUFACTURER 3" APPROVED BEDDING UNDER TANK HAS APPROVAL CONCRETE PAD SPECIFICATIONS SEPTIC./ DOSE TANK MANUFACTURER: �/�E �,cA �rr NUMBER DOSES PER DAY: S. Z /f.Jg) TANK SIZES SEPTIC /no o GAL. DOSE VOLUME INCLUDING ��'8 '4 DOSE moo GAL.. FLOWBACK: GAL. ALARM MANUFACTURER: S. ✓. E'�s"c rt o CAPACITIES: A = INCHES = .�.�C ' GAL. MODEL NUMBER: SWITCH TYPE: B = 2 INCHES= GAL. PUMP MANUFACTURER: ter C = INCHES AL. MODEL NUMBER: SWITCH TYPE: D = g INCHES = , G AL. REQUIRED DISCHARGE RATE ?, GPM PUMP 6 ALARM WIRING AS PER ILHR 16.23 WAC ,, VERTICAL DIFFERENCE BETWEEN PUMP OFF AND DISTRIBUTION PIPE /,18 FEET .+ MINIMUM NETWORK SUPPLY PRESSURE 3 FEET + px FEET FORCEMAIN 'X _ . G _ FT/100 FT. FRICTION FACTOR ,.'yY FEET T.OTAL DYNAMIC HEAD s FEET INTERNAL DIMENSIONS OF PUMP TANK: LENGTH s'1'� ; WIDTH 8" ; DIAMETER LIQUID MU— • • I I� SW/S D / VS25 1 Typical A IKation" Sum /Effluent pump Typical APPI Sump/Effluent pump (op acities SW /SD/VS25 - to 44 GPM (2.8 Vs) Ca 'ties SW/SD/VS33 - to 48 GPM (3.0 Vs) Heads SW/SD/VS25 - to 24 h (1.3 m) Heads SW/5D/VS33 - to 26 ft (1.9 m) Electrical SW/SD/VS25 - 115V l e, 8.0FLA, 6011z Electrical SW/SD/VS33 - 115Y, 111,1O.OF(A, 60Hz Motor SW/SD/VS25. 1/4 HP shaded pole w /thermal overload Motor SW/SD/VS33. 1/3 HP shaded pole w /thermal 1550 RPM overload 1550 RPM Minimum Recommended SD/VS25 =12" (304.8mm) Minimum Recommended SD/VS33 =12" (304.8mm) Sump Diameter SW25 =18" (451 mm) Sump Diameter SW33 =18 "1451 mm) Automatic Operation SW =Wide angle float Automatic Operation SW =Wide angle foot switch (manual available) SO = Diaphragm pressure switches (manual available) SD = Diaphragm pressure switch VS = Vertical float switch VS = VerUcal Hoot switch YS = Single cord Materials of Construction Cast iron and engineareil thecumplask Materials of ( onstruction Cast iron and engineered thermoplastic Impeller Thermoplastic vortex Impeller Thermoplastic vortex Discharge Size 1- 1 /2'NPf(38.1mm) Discharge Size 1 -1/2" NI'1(38.lmm) Solids handling 1/2" (12.8 mm) Solids hardin 1/2" (12.8 mm) Power cord 10', S11W (20' Tonal) Power cord 10', S1TW, (20' optional) Superior Features • CarWV(eromk mechanical seal Superior Features • Corboa/Ceramtc mechanical seal • Oil filled motor w /automatic reset • Oil filled motor w /automatic reset thermal overload thermal overload • Uses single row ball bearing construction • Uses single row hall bearing construction • Piggy -bock plug available for easy maintenance and • Piggy -back plug available for easy replacement maintenance and reply merit 9 - 30 I SD3 SW33 S33 6 W 20 r _ I C = 3 -° TO • i • • t y OL 0`: Capacity- U.S. G.P.M.O 10 4 `20 40' NN — 3 m ,.. Liters /Second •,; 1 � � !+riff► =�: PO,WTS OWNER'S MANUAL AND MANAGEMENT PLAN FILE INFORMATION SYSTEM.SPECIFICATIONS Septic Tank Ca ci o0o D NA Owner f Se tic Tank Manufacturer NA Permit # Effluent Filter Manufacturer D NA DESIGN PARAMETERS Effluent Filter Model D NA Number of Bedrooms 100 room 3 D NA Pump Tank Capacity o gal D NA Number of Commercial Units — NA p Tank Manufacturer ex em D NA Estimated flow (average)+ 30o gal/day Pump Manufacturer ,� ,.,,�c DNA Design flow (peak), estimated x 1.5+ so aVda Pump Model s �/ .i'3 O NA Soil Application Rate / gal/day R Pretreatment Unit 0'NA Influent/Effluent Quality (NAO) Monthly Average'• D Sand/Gravel Filter D Peat Filter Fats. Oil & Grease (FOG) 5 30 mg/L D Mechanical Aeration O Wetland Biochemical Oxygen Demand (BODs) D Disinfection O Othu: Total Suspended Solids (TSS) S 220 mg/L Manufacturer. Model: S 250 m Dispersal Cell(s) Pretreated Effluent Quality C3... Monthly Average• •• D In- ground (gravity) O In-ground (pressurized) Biochemical Oxygen Demand ($ODs) S 30 mg/L D At -grade p -gound Total - Suspended Solids (l SS) S 30 mg/L C'] Dri line [�'Otherf • Fecal Coliforra (geometric mean) • clo cfu/100m1 D Leaching Chamber Manufacturer Model Laying LengWChamber Maximum Effluent Particle Size 1/8 inch diameter Soil Application Rate_ gpd/ft Area Req. _---- ft *Wastewater Flow Verification and Calculations: Infiltrative Surface/Chamber -ESIA Ratin _ (Other than bedroom based) Minimum Number of Chambers D A e ate Desi Flow/Loading Rate- min *+ Values typical for domestic (non-commercial wastewater Materials: all materials must comply with WI Adm. Code COMM84 and be installed per manufacturers specifications and septic tank effluent. and approval letters. ** *Values typical for retreated wastewater, DESIGN CRITERIA C3 "Wisconsin At -grade Soil Absorption System, Siti ng Design & Construction Manual" (Converse eta1.1990) D "Wisconsin Mound Soil Absorption System: Siting, Design 8c Construction Manual" Converse, J.C. and E.J. Tyler. Publication 15.22 D "Design of Pressure Distribution Networks for Septic Tank -Soil Absorption Systems" Publications 9.6 D "Design of Conventional Soil Absorption Trenches and Beds ". R.J. Otis - ASAE Publications 5 -77 and "Design Manual - Onsite Wastewater Treatment and Disposal Systems ". EPA 625 /1 -80 -012 October 1980 D SBD - 10570 -P (8.6/99) "At -Grade Component Manual Using Pressure Distribution" D SBD - 10567 P (8.6/99) "In Ground Absorption Component Manual" p SBD - 10705 -P (N- 01101) "In Ground Soil Absorption Component Manual" Version 2.0 D SBD - 10628 -P (N.6199) "Recirculating Sand Filter System Component Manual" D SBD - 10656 -P (N.6/99) "Split Bed Recirculating Sand Filter System Component Manual" -M SBD - 10572- P..g6/99) "Mound Component Manual" BD - 10691 P (N.0110 1) "Mound Component Manual" Version 2:0 D SBD - 10595 -P (8.6/99) "Single Pass Sand Filter Component Manual "• D SBD - 10657 P (8.6/99) "Drip -line Effluent Disposal Component Manual" D SBD - 10573 P (R 6/99) "Pressure Distribution Component Manual" SB - 10706 -P (N.01/01) "Pressure Distribution Component-Manual . Version 2.0 Lys D Drip -line Effluent Dispersal Component Manual for Multi -flo Onsite Wastewater Treatment Units D MAINTENANCE AND MANAGEMENT MAINTENANCE MONITORING SCHEDULE Service Frequency Service Event • In condition of tank(s). At least once eve D months 3 ear s mum 3 Pump out contents of tank s When combined sludge and scum equals one -third 1/3 of tank volume mum 3 inspect dispersal cells At least once eve D months 03 Clean effluent filter At least once eve [0'months Dear s Inspect um um controls & alarm At least once every D months 3 ears D NA Flush laterals and pressure test At least once eve l7 months ear s D NA Valves At least once eve D months D ears D NA At least once eve O months D ears D NA Other Page-7—ofL START UP redacts or other chemicals tha use of the POWTS check treatment t For new construction, prior to tanks) for the presence of painting p' may impede the treatment process and/or 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. System start up shall not occur when soil conditions are frozen at the infiltrative surface. OPERATION eq repo rts. The quantity The property owner is responsible for the operation and maintenance of the POWTS and submission of r repo and quality of the wastewater stream will affect the performance and longevity of your POVITS. The installation of water- savin from water appliances and fixtures along with prompt repair of leaks reduces the foundation volume. drains should be e discharged to ground surface softeners, iron removal units, other clear water treatment tins c. dishwater, etc. whenever possible. Note: this does not include laundry wastewater, however the disposal of food based greases and oils, vegetable/frult This system is designed to handle domestic strength peels and seeds bones. and food solids such as those produced e a g arbage disposal should be minimized. Toilet time is the only Apo, sanitary napkins paper that should be discharged into the system. Other non biodegradable items such h baby wipes, condoms, cigarette butts, dental floss, and cotton hould not be flushed into rythe em. ystm as � can seriously ri damage your S disinfectants, p antibiotics. solvents, etc., and contaminate your drinking water'supply. Maintain a regular steady flow by spreading laundry washing throughout the week. Avoid vehicle traffic over aU system components. Compaction of snow over the dispersal unit may cause it to freeze up. O Valves Valves shall be operated in the following manner: Alarms to service Alarms should be tested on a regular basis by the home owner. u ann condit an as s ounds, etact� you d be conserved until any POWTS, There is normally a 1 day. reserve under regular operating problems with the system arc corrected to prevent back -up of sewage into the dwelling or surfacing. INSpEC'TIONS Inspection shall be made by an individual carrying one of the following licenses or certifications: Master Plumber, Master Plumber Restricted Sewer, POWTS Maintainer or Septage Servicing Operator (per the attached Maintenance Schedule). lZieptic Tanks Com tion of the tank to identify any missing or broken hardware, identify any cracks Tank inspections must include a visual Inspection or leaks, measure the volume of combined o ud sludge e � �tcheck o ��� �n � p e ion of service. Any surface. Access openings used for service defects shall be promptly corrected. Exposed openings greater than 8 inches in diameter shall be secured with an effective locking device.to prevent accidental or unauthorized entry into the tank. VVl►cn the combination of sludge and scum S erv icing pera to and disuposed (1/3) or more of the of in accordance �Chaptez volume NRl 3�Wisconsin of the tank shall be removed by a Sep g Administrative Code. . The outlet filter(s) shall be inspected and cleaned to remove any accumulated solids according to manufacturer's specifications. Provisions are reta maintenance sch dule to keep the system pe m ng be necessary at more . frequent intervals than state] ("Pump ChamberfTreatment Tanks Component of all electrical equipment The inspection must incline a meet such as pumps, alarms and floats. A visual check must be made for leaks, backups; surfacing, missing or broken security devices and other hardware and the condition of any filters. Any service needs or repairs 'shall be promptly taken care of. C3 In- Ground Gravity Component Dispersal Cells The inspection shall include recording the levels of pending, if any in the observation tubes and a visual inspection for any evidence of surface seepage or discharge. Any discharge to the ground surface must be promptly reported to the regulatory authority. Ponding at depths greater than 75% of the height of the component may indicate overloading or impending hydraulic failure necessitating more frequent monitoring. Page,,,&,_of•� �Mound,`At- Grade, In- Grofind Pressure on for any The inspection shall include recording the levels of ponding, if any in the observation tubes and a visual inspecti evidence of surface seepage or discharge. Any discharge to the ground surface must be promptly reported to the regulatory authority. Ponding greater than 75% of the height of the component may indicate overloading or impending hydraulic failure necessitating more frequent monitoring• The pressure distribution system is provided with an opening at the end of each lateral to be used for flushing. The laterals should be flushed at least once every three (3) years. Pressure checks of systems with multiple laterals should be done to ensure that equal distribution of effluent is occurring to promote the longevity of the system. REP R Reports for maintenance, inspection, and monitoring shall be submitted in accordance with COMM 83.55 Wisconsin Administrative Code. ABANDONMENT When the POWTS fails and/or is permanently taken out of service the. following steps shall be taken to ensure that the system is properly and safely abandoned in compliance with Ch. 'COMM 83.33, Wisconsin Administrativk Code. . All piping to tanks and pits shall be disconnected and the abandoned pipe.openings'sealc& The contents of all tanks and pits shall be removed and. properly disposed by aSeptage•Ser -Ai wgoperator. . After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void span filled with soil, gravel or other inert solid material. CONTINGENCY PLAN If the POWTS fails and cannot be repaired the following measures have been, or musaken, provide a code compliant t be t to replacement system: C3 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 an compaction and should not be infringed upon by required d compa 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 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. E3 A suitable replacement *area is not available due to setback and/or soil limitations. Baring 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. 12( 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 CON LETHAL GASSES AND/OR INSUFFICIENT AMENT TANK UNDER ANY CIItCUMSTANCES. OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER THE DEATH MAY RESULT. RESCUE OF A PERSON-FROM THE IN`TERIOF�'OF ArTANKMA'C:PE� Y ?ITCUI'T OR IMPOSSIBLE. • . ADDITIONAL COMMENTS POWTS INSTALLER POWTS MAINTAINER G/,✓,r,re •✓ Name ��� �sx�- /ri°-.�s'!Z Name Phone Phone SEPTAGE SERVICING OPERATOR (Pumper) - �,/,✓.�r,�.w,J L CAL REGULATORY A�THORITY Name phone ' 80 Phone KAWPDATAWAPOWTS OWNER MAN -do page 9 of—l- Z abel A 100 an C ommercial Ef SPECIFICATIONS APPLICATICNS: The A100 is used in residential and commercial septic systems. It �► 5� is effecrive in multifamilyhoustn�, rental property, schaok, offices and everywhere wastewater has high suspended solids content. 9 FLOW RATE: 3, ODOgpdperfilter. InstalltwoormorefiltetsinaFVCorconcrete i manifold to achieve flows of 6.000 gpd or more. Check with Zabel for deans. I LTRATnON: The 26 Disc Dams ®1!16 inch provide 198 lineal feet of filtration. 2 INSTALLATION: The filter may be installed inside the tank or installed in a Zabel Container Assembly outside the septic tank. SERVICE: Service residential installations whenever you pump the tank. O 0 r O.D. 4-IM I.G. p �• 4 1,9V16' - •I • DtA ji �- 3 -9/16' 16' In 1 un + + 11 li fe ' 11 11 � --11 -W DIAL --� ' ttem Desai Ma�[!al SpectACBdons I Cases, Lida, Reducers Rigid Vinyl PVC 87371 u" 2 26 Filter dire LW Discs High Impact Polystye 3 l Cover ren 4 3 � Rod, Nuts High Density Polyethylene 5 1 3 +n U.S. Patent No. 4,710,295 Call 1 - 800 -221 -5741 or Fax (502) 267 -8801 for further information. k'. x ti Maintenance The interval for servicing septic tanks is set by state and local code. Throughout the United States there is a wide difference of opinion on what this interval should be, but most regulatory agencies suggest two to five years. The Zabel' filter, which does not increase the frequency of servicing for the tank, should be cleaned when the septic tank is normally inspected and pumped. However, our filter is virtually self- cleaning. The continued action of the anaerobic organisms on the Zabel filter causes lodged particles to disintegrate and fall to the bottom of the tank. If your filter contains a SmartFilter"' alarm, you will be notified by an alarm when the filter needs servicing. To service the filter: "Servicing any Zabel filter should only be done by a certified septic tank pumper or installer. Locate the outlet of the septic tank. Firmly pull the filter handle " and slide the cartridgB but Remove the tank of the and pump the * Note: A tee handle may necessary to p to be used it the filter is t any solid below Around level to escaping to th contact Zabel for info i when the f handles rem s 4 While holding the crttid e : ' en id the access o p l� Y Insert the fltl<0 dlil,�: cartridge with fr�f , back in the careful to rinse all sure the fiat b properi "Note: It is not neces completely 1 lspoffess" The biome aides in the pretreatme be left on the filter. (Ifn may bedisess Replace t . MA DE IN USA The product(s) shown are covered by one or more of the following patents: U.S. 5,762,793, 5,580,453, 5,591,331, 5,759,393, 5,683,577, 5,582,716, 5,779,896, 5,593,584,5,795,472,5,736,035, 4,710,295, 5,382,357, 5,482,621 U.S. Des. 386,241, 349067, 4605501,5098568, Des. 309007, Australia: 134440; Canada: 2,135,937; Israel: 111574; New Zealand: 264824, Other Patents Pending Call for a free ZABEL ZONE An Onsite Wastewater Magazine 1- 800 -221 - 5742 - Website http: / /www.zabeLcom A100 /300- 1- M,61499 . 4k. r' . 1. . Wisconsin Department of Commerce SOIL EVALUATION REPORT Page / of I Division of Safety and Buildings In accordance with Comm 85, Wis. Adm. Code . county Attach complete site plan on paper rat less than 81/2 x 11 Inches in size. Plan must >- Nude. but not ftin)ted 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. , . , „ • c: . , , kt .. _ .. Reviewed by _ Date ... please print all Information. 'T ", .�. :.. . 1. I -' Pentonel Information you provide may Nor used for secondary purposes (Privacy Law. a. 15.04 (1) (m Property Owner Property Location • ..,..k.,,: • _ ... . ' ; AW Govt lot 1/4 "fir 1/4 S.,7f T 8 >li ore Property Owner's Matiirig Address t.ot # Block # Subd - Herne or CSAA# _ . �.3• :.�.�D .fl' ' City State 21p Code Phone Number 9-ay 9 Vftge El Town Nearest Road : y ......._... _.. ..,.i . „/ ! �� va /t 77 — y �� X30 . Sr ..._....., I 0 New Construction Use: ® Residential / Number of bedrooms 3 Code derived design flow rate �.sy GPD . _... . - _._ -. ❑ Replacement ❑ Pubic or commercial - Describe: � Parent material ` Agrz SL/f.L Lt. e,w l"i« - ' Flood Plain elevation if applicable � '6 I< General comments i _ _ and recommendations- /V &.-'0'0 .4 _? .r•00+o a iF . s✓oowes .0.fr4 xroi - ;IAiC rAo'r1 y`.Q.I4 r t/rI t y.y ,Q�` .2!/1 +did "!lSt. xpx. Ea. of /c% 2 r a.r 9P.2 Genfror.G . . a #, [�] pit Ground surface elev. 9 9 * & Depth to limiting factor � in• . Soil Rate . I'Icrfzon Depth Dominant Redox Description Texture Structure Consistence Boundary Roots G ti ..,... in. - Munsell Qu. Sz. Cont. Color Gr. ft Sh. ...._ ... . •FM1- . TIM /. i. .. . / p. �._ ,._. s _. . I " ._... y s- ,� S . " -G. .,r _.. 8 .i --m i _ . ..... . + r °� [�' Pit Ground surface elev. ,f 2 it t>a�h to irniting factor �5 h SoA Rate ,° �° - Hod= - Depth_ Dorritnant. RedoxDesciption Texture Structure Boundary Roofs GPDW IrL Munsei Qu. Sz. Cont. Color Gr. Sz. Sh. *011#1 ,. 'Eff#2 Li. / O- oYa .?/,& A S JM S a - G S - - . I i I I .' • Ett tent #1' = B01) > 30 5 220 rngC aril 5 150 mg& ' Mont #2 = 8013 < 30 mg& and TSS _< 30 nVL CST Name (Please Print) . ig CST Number 7 Address Date Evaluation Conducted Telephone Number E I d SO .0 'fu•I �: u - .T "Y- J14149 — .11. T__ evil r C .: H ; t� ,� ' �sd t 8 �. C'1 v � � � Q ((�� ee x g r } _LZ ', 5c "rs," .. �'t' °L t tl+ - \ , a. . , 41 T �eP' t x }i+, i, C S, - •• Y w �1 li, �; ' - A , w' N 0w '- .,.:::: .11 , , , !'L: - L r.: : - r I I . r -� * ) r , "��' ' r . r - � 1, .L �rr­ - - r' - 1 M1 h� 3 r % A { a r. t§ t % Iy ,. � I - . L , , I 1 . . . 141b % g r , " a * L ' e '* ; O„ a 0 ; W. t rr -` . t h .1444 �0. r - K f 2 $ , 1 I 3 ^ ,' 4 s i * 8041� ','�:� , ) : * I r ! . , . I I I L . � � .1 ... I . , , , . I r r ' L ' �' ��, �L � I k� .� I I r �� C . � ' #'�kx v: D k OM a M v, ,r a u r li b. �jt r I_ \ ` F •j a t O i O . v3 H ,� t ' k \\ r - 'A 'Col o.. t Y r� t = , r �,.: , '�' . :� '�' � , : . r 'r ,L� , Lr . - . � I I I . , . ' r ' __� . 9 p .,C Ip �� � • .O t r w � - a .': LL w h a , ,; i - - C) , 7 ,� �� a :, .w: < Z I*— r~ �� � '.' 0 �. �� b \ * i ` wit """ ' x L r `c . � , t : � > . r �' a\ ,. \ a 1i r. r . h , • ` r 'h. J u •- ' -y i .. i Y is � re 'j��" ' "" . _ .� � . h �;4 � 1xx _ i 1.0 a �� s A % S7 k tf 3 �5- •` h 4 �t V ,'' A ire + 3 1 O a a \\ \J + - 7 ; .0 •., 50 . ► 4 J < �" � a L�� I �� l ' ' \\ O fC� V _ . I .1 Property Owner �y�E.✓d f Parcel ID # Page of - ,lair .O v`.t _ ? 3 .3 Boring Boring Ground l Depth to Ami # roun surface elev. �8 9 R pB factor_ _ n9 fator Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure' • Consistence Boundary Roots GPD/ff . In. MunseA Qu. Sz: Coat. Color Gr. Sz Sh: >{; `� : ., ,,, �° ?" ' •Eff#1 'E8#2 4e S CIL— 1 z s v E l �g # ❑ . Boring ❑ Pit Ground surface elev. R Depth to limiting factor in. Sol Application Rate Horizon Depth Dominant Color Redox Description Texture Struchn Consistence Boundary Roots GPD/fP in. Munsell tau.. Sz Cont. Color Gr. Sz Sh. _ . _ . •Etf#1 •Eff#2 A. Owns; If. 0 Boring .11 ❑ r Ground surface elev. ft. Depth to lW ft factor In. Pit Sol Application Rat Horizon Depth Dormant Color Redox Description Texture Structure Consistence Boundary Roots In. MunseA ___. Ou.Sz Cox. Color - Gr. Sz Sh. _:.;:._... •Etf#1 •Eff#2 30 5220 Ef fluent #1 �= BOD > and TSS >30 < 150 mgIL _ mg& Effluent #2 POD I . , < 30 mg 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- 2648777. s sansuo QAXI M V Vc! Wisconsin Department of Commerce SOIL EVALUATION REPORT Page / of .3 Division of Safety and Buildings In accordance with Comm 85, Wis. Adm. Code Attach complete site plan on paper not less than 81/2 x 11 inches in size. Plan must r e/ Include. but not limited to: vertical and horizontal reference point (BM), direction and Parod I.D. percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Please print all Informadon. R awed by Date Personal information you provide may be used for secondary purposes (Privacy law, s. 15.04 (1) (m)). ` . � Property Owner Property Location .v a Govt. Lot Al 1/4 SE 1/4 S dS T �� N R /.� it (� Property Owner's Mailing Address Lot # I Block # SdxFN&: +e or CSLM city State Zip Code Phone Number ❑-"y image .E) Town Nearest Road New Construction Use: ® Residential / Number of bedrooms Code derived design flow rate ins a GPD ❑ Replacement ❑ Public or commercial - Describe: Parent material /n 6',f1 du L Flood Plain elevation if applicable A/W ft. General comments and recommendations: �a��a �o�✓r� aT sp�o ��f� i�000ra .Q.t�a Srde".r�� 1`�t ail �.rlv4ri� Z"s moo' !l f/ya�/r0� dr cc. fYS. Ei. of /a /. 2 o ✓ PR 2 , Go JToa�C © Boring # Boring Pit Ground surface elev. 9 9. g ft. Depth to limiting factor _� in. Sold Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD In. Munsell Qu. Sz. Cont. Color . Sz. Sh 'Eff#1 •Eff#2 ' 4 / 0-7 'V 0'. ie G S 0 Yit S; S /' G ro S 8 S`YR: / R -5; C- Boft # ❑ Boring [' Pit Ground surface elev. YX z ft. Depth to limiting facto' .t in. Soft �lication flats Horizon Depth. Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fP In. Munsel Qu. Sz. Cont. Color Gr. Sz. Sh. 'Effff1 1. 'EfM2 Li. .? a -,t S. o? 6 G S 2.4 V S syt s%L F _ • Effluent #1 = BOD > 30 220 mg& and TSS >30 _S 150 mg/L ' Effluent #2 = BOD < 30 mg& and TSS S 30 mg/L CST Name (Please Print) Sig a CST Number 0 7 Address /V / Date Evaluation Conducted Telephone Number nnn 1,11n TM M/�� + w n Property Owner Y Parcel ID # Page of .3 Boring ❑ Boring F # 0 Ground surface elev. efd 9 R Depth to limiting factor In. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 •Eff#2 s z s v S - 2 s .t �✓ sY .e 2 -S re - S/L ,r ` — F Boring # ❑ Boring ❑ Pit Ground surface elev. __ _ ft. Depth to limiting factor in. Soil ApDlicatlon Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fP In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh •Eff#1 •Eff#2 ❑ Boring # ❑ Boring Ground surface elev. ft. Depth to limiting factor in. ❑Pit Soq tication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD In. Munsel Qu. Sz. Cont. Color Gr. Sz. Sh - 'Eff#1 •Eff#2 7 ' Effluent #1 = BOD > 30 <_ 220 mg/L and TSS >30 < 150 mg/L • Effluent #2 = BOD < 30 mgA- 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 dep�Kent at 608- 266 -3151 or TTY 608 - 264 -8777. sao4330"M) �. .` , 7 N 0 �O b H ca r H H n n cn aCj C t7 � H H Q 9 r a Il e w G o a � o I O O � H -o t• o x b � � R p SL ri o� ON 1 # a \ O a i � e Z r� 4 1 • O J 0 ST CROIX COUNTY ` SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer Mailing Address Z 3 � � l 5D h 5 Property Address (Verification required from Planning Department for new construction) City/State V y 1 l SD ! Parcel Identification Number 00 Li 1 UCJ� _ ?0 LEGAL DESCRIPTION Property Location %a;: %., Sec. 2, T N =R W, Town of Subdivision Lot # Certified Survey Map # , Volume , Page # Warranty Deed # 1 YC* M O `15b , Volume �� Page # Spec house ❑ yes)t1no 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 master 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. Uwe, 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 your septic system has been maintained must be completed and returned to the St. Croix County Zoning Office within 30 days of the three year expiration date. L � ; O� �A C'to��_ SIGNATURE OF APPLICANT DATE OWNER CERTIFICATION I (we) 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 property described aabbov�e, by virtue of a wa ty deed recorded in Register of Deeds Office. p SIG MATURE OF APPLICANT DATE * * * * ** Any information that is mis- represented may result in the sanitary permit being revoked by the Zoning Department. * * * * ** ** 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 Wisconsin Department of Commerce SOIL EVALUATION REPORT Page l of 3 Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code Coun"y 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. Please print all Info matii�E(�E��E® by Date Personal information you provide may be used for secon ry purposes (Privacy Law, s. 15.04 (1) )). S /Zqr� 3 Property owner J U N 1 3 U U'L - don C Gt e h c I' Govt. Lot T t. 1 /4SE 1/4 S aj!� �)g N R ! S� E( W Pro perty ees Mailing Address 57. CROI X C LWTfK lock # Sulxi Name or C" �a3 DO F _Sfi� �� ZONING OFFICE — o— �y ^ State Zip Code Phone Number ❑ City ❑ village own Nearest Road 5��7 ( is -��/�� ��� 330 ew Construction Use: esidendal / Number of bedrooms _ Code derived design flow rate S� GPD' ❑ Replacement ❑ Public or commercial - Describe: J � R Parent material-- � avP� 7�1� Flood Plain elevation Kapplicable General comments d e� 6Y Ye and recommendations: GGS X 7 - (-c �� 9 F E] Boring Boring # C Ground surface elev: ft. Depth to limiting factor ._ in. Sol[ Appl ication Rate Horizon Depth Dominant Color Redox Description Texture structure Consistence Boundary Roots GP in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'EW1 # Boring E] Boring • ® it Ground surface elev. ft. Depth to limiting factor _L Soll Appl ication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDO in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. - Eff#1 'Eff#2 lu S r 3 c 1 Effluent #1 = BOD > 30 5 220 mg/L and TSS >30 150 mg/L ' Effluent #2 = BOD _< 30 mg& and TSS _< 30 mg/L CST Name i2lease Print) Signature �2 CST Number .t, cSo ,.^,`4 Address ate Evaluation Conducted Telephone Number Property Owner LL N e � -� Parcel ID # Page 3 of 3 Boring # ❑ 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 •E GPD/fFEtT#2.. in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. t o S ` .Lj to a� s au [] Boring Boring # ft, Depth to limiting factor in- El pit Ground surface elev. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff •Eff#1 'Eff#2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Boring in. Boring # Ground surface elev. ft. Depth to li niting factor Soil Application Rate ❑ Pit GPD/fF Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary •Eff# •Eff#2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Effluent #1 = BOD > 30 220 mg/L and TSS >30 150 mg/L ' Effluent #2 = BOD 1 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 of need material in an alternate format, please contact the department at 608 - 266 -3151 or TTY 608 264 - 8777. S13D -8330 (R.6=) �vsf iJr�c.; Q - �C c j Q� rcX lco, N 0 - 1 � y e� al I 7 y� I \n w M Sm\ g2.95 f P, r SOIL EVALUATION REPORT Page l of Wisconsin Department of commerce Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code CWtty n� Attach complete site plan on paper not less than 81/2 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. Reviewed by Date Please print all Information. Personal infomratlon you provide may be used for secondary purposes (lacy Law. a. 16-04 (1) (m)). Property Owner Property Location "—!T: 1/4Sf 114 S c�,�T c�c� N R I E ( W Property er's Mailing Address d. Name or CSIWI -. A) --43 3 x) -- C State Zip Code Phone Number ❑ City Village own Nearest Road ~� (5o rte.. u - h J /� ew Construction f Use: esidential / Number of bedrooms �_ . Code derived design now rate `�Sd ❑ Replacement ❑ Public or convnerdal - Describe: Parent material s c�P< Flood Plain elevation 9applic / AA +. General comments and recommendations: at. 5, X 7 5 E M Q Boring , l Boring # n ---- Ground surface elev: 7S ft. Depth to limiting factor � I n. son Rate Horizon Depth L� mi nt Color Redox Description Texture Structure Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Ef 1 (" S -/ o V - 41J. I U F 3 _ 3 ►i 10 3 Boring # _��sJ1 it Ground surface elev. ft. Depth to limiting factor l T In. Sol RoW Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPWff In. Munseil Qu. Sz. Cont. Color Gr. Sz. Sh. •F�f#1 . 1 u� S I d S' ► i �-cJ l" S- 3 C 1j l I I ,) ..� C3 ;. • Effluent #1 = BOD > 30 _< 220 mglL and TSS >30 1150 mgll. ' Effluent #2 = BOD 130 mg& and TSS _< 30 nVL CST Name LOOM Print) Signature CST Number n , c " . - Address ate Evaluation Conducted Telephone Number Y K page 3 of Property Owner Parcel ID # ❑ Boring # ❑ ng Dep to Urr)iting factor ❑ � • ft. P �' Soil ication Rate Pit Ground surface Slay. Structure Lure Consistence Boundary Roots GPDa'f1` Horizon Depth Dominant Color Redox Descriptor Texture Gr: Sz. Sh. •Eff#1.. •Etf#2- in. Munsell Qu. Sz. Cont. Color a S- S 4�- cJ to -� ❑ Boring ❑ Boring # ft, Depth to limiting factor In. Sol Ication Rate ❑ Pit Ground surface elev. Texture Structure Consistence Boundary Roots GPD/H' Horizon Depth Dominant Color Redox Description Gr. Sz. Sh. •Eff#1 •Etf#2 in. Munsell Qu. Sz. Cont. Color Boring Depth to I')miting factor In El Boring # ❑pit Ground surface Slay. ft SON ication Rate Texture Structure Consistence Boundary Roots GPD Horizon Depth Dominant Color Redox Description Gr. Sz Sh. 'Etf#1 •Eff#2 in. Munsell Qu. Sz. Cont. Color • = Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 _< 150 mg/L Effluent #2 BOD •- < 30 mg& and TSS 5 30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services o[ need material in an alternate format, please contact the department at 608 - 266 -3151 or TTY 608- 264 - 8777. SBD -6330 (R.6N0) 'T be- IOc (5w ice' N U) o4 � ly it 7� a' ��pe DOCUMENT 140. WARRANTY 0KE0 THIe erACa e99911V[O IOa 0600001Ne CAVA P19 rw , STATE H OF- WISCONSIN FORK l--LM .77 Y01► T2FA6E j'I 1 RWA&TE OPitE .. Frg . Adams.. .single man. and ........ ............................... W 4 fW RBcord i 11th singie roan ................. ............................... coy /�,D. 1984 e t:ortw and warrants to ....Eta ene N _.and .......................... at 8:30 A M. I .. ���s 'tl �.Zk1....... al7�X..... ..N( et ....................... ............................... .....................................•................................... ............................... .... ............................................................................. ............................... *CTUeN TO _ 1 - ....................................................... SC .. ... the following escribed real estate in -- g ............................ °------............County. - - — state of Wisconsin: i Tax Parcel No: .............................. The East One Half (E 1/2) of the Southeast One ( Quarter (SE 1/4) of Section Twenty -five (25), Township Twenty -eight (28) North, Range Fifteen (15) West lying North of Highway 29, i g y R • Except That part of the Southeast One Quarter (SE 1/4) of the Southeast One , Quarter (SE 1/4) of Section Twenty Five (25), Township Twenty -eight 1� (28) .Korth, Range Fifteen (15) West, Town of Cady, St. Croix County, Wisconsin described in Volume 5 of Certified Survey Maps on ?ape 1480 as Certified Survey No. 1480, as recorded in the Register of i Deeds Office, St. Croix County. Wisconsin. I 'I•R�I�ISF� M.R This -•_ is .................... homestead property. (is) •(is - " f Exception to warranties: II +i Dated this .............. 2 . ....................... day of .........October 19 -- R4 ..... - .... n . ......................_........ ..... ........ ............................... .........................(SEAL) J7._&LZ ...... z .................(SEAL) Fred Adams • ................................... .................................................................................. ...... ... ..... ..................... .........................(SEAL) .GG�.� ? �e��...��f !.lL (SEAL) • • Harold Adams ................................... ..........•- •- ...._............ ........................................................ .I....... AUTHENTICATION ACBNOWLSDGKZNT Signature(s) .....................•---.... ........._-- .............._._.. STATE OF WISCONSIN as. _.._....................................................................... Dunn ..-- • ..............•.. ...........County. authenticated this ........day of .... ...................... 19...... Personally came before me this ..... ??!!d .day of October . 19.84.. the above named ..........................•-•-•.................. ........................._..... Fred Adams and ................. ............ •--- ..........._... Harold Adams TITLE: MEMBER STATE BAR OF WISCONSIN (It not 0 .... ..................... ,.�� E anthorired D7 i ?8.OA, Wis. Ststs.) s ............ ... . . .. to me known to be the person ._....._.... who I& 4 foregoing instrument and acknowledge the paiVe. r- / THIS INS s. `I . TIIUM[NT WAS 6RARTt;O BY � = _Rt__F uz t ...Ma. Atorney .............. .:,t�. Robert .. ... ........... .. . .o. ..s��© =y� Sonya beck :� ........... ................ .... .................•• -_...; , Wisconsin . Dunn Menomonie +' .................... ........._. ............................... Notary Public • (Signatures may bo authentieated or acknowledged. Both My Commission is rmanent. (If not, state %r,�cpirati� rJ�� U _ are eot necessary.) expires &+ 3 -88 •• , , 5 I ) , date: ........ ............ ........•--- ................ - -- • 18 •Yana' of Comm dfaiY is any capacity sMuld M t7pad or priotad Edow titdr signaturaa. ` ssw FORK N . 11 to ;ustrk Stock No. 13002 j