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HomeMy WebLinkAbout032-2144-50-000 Wisconsin Department of Commeroll v u PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 552334 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)j. Permit Holder's Name: City Village X Township Parcel Tax No: Nordstrand, Scott Somerset, Town of 032-2144-50-000 CST BM Elev: Insp. ~~le- 71 v: BM Description: / Section/Town/Range/Map No: 07.30.19.1260 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER 12. CAPACITY STATION BS HI FS ELEV. h' Septic Z Benchmark Al p.? ad Dosing 144- It f Alt. BI~V A"agen R I Bldg. Sewer U '6.7 Q1 Holding St/Ht Inlet /~I 3 TANK SETBACK INFORMATION St/Ht Outlet TANK TO P/L WELL BLDG. nt to Air Int ke R AD Dt Inlet Septic Dt Bottom V . C /0 / ,I , , if ~ / Header/Man. Z -5 ~71 Z Dosing / Aeration ~ Dist. Pipe . Z. Holding Bot. System ~r5 • g 2-10 PUMP/SIPHON INFORMATION Final Grade S ~S•Z Manufacturer • r -Demand St Cover Z 97• r a .'ll.n. C.CJLt.. ' J d e! C~ Model Number , L / ( 9? 712. TDH Lift Friction s System Hea TD Ft V- ,s M th 11 rtr/Dist. to Well 2 AJ SOIL ABSORPTION SYSTEM Z. 15~ BED/TRENCH Width Length "I lee I No. Of Tren s PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS \ SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer: INFORMATION Type S stem: A);4~_ CHA uBER OR Model Number: 14, DISTRIBUTION SYSTEM Header/Manifold Distribution f I x Hole Size x Hole Spacing I V to Air Intake Length Dia Length Dia Spacing p..4 010 SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only G .,w Depth Over Depth Over xx Depth of xx Seeded/S dded y xx Mul !j.Yes Bedfrrench Center-•' Bed/Trench Edges Topsoil Yes o 0 No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1:__s Z Inspection #2: Location: 1618 40th Street Somerset, WI 54025 (SE 1/4 SE 1/4 7 T30N R1 9W) St. Croix coal atesNorth Lot 5 Parcel No: 07.30.19.1260 1.) Alt BM Description 2.) Bldg sewer length - amount of cover = > ` ow Cry-~-~ ?z Plan revision Required? 5 Yes No 5 4' I Z / _ S 'se other side for additional information. L (R.3/97) Date Insepctor's nature Cert. No. '-6710 fety and Buildings DivisidCl ' C 711 CID T 11'`101 W. ashington Ave., P .O. B162 r dison, WI 53707--7162 Permit Number (to be filled in b Co.) of - 55 r L ~ GQ~N F1G~ tAeparunent sco Mae - State Transaction- Numb ~ - Sa itary pplication 3 D _ In accordance with s. Comm. 53.21(2 ptrt ode, submission of this form to the appropriate governmental do 7 d l unit is required prior to obtainin a itaty permit. Note: Application forms for state-owned POWTS are roject Address (if different than mailing address) submitted to the Department of rce. Personal information you provide m used for seconda p c ~1' u oses in accordance with V the Privacy Law, s. 15.04 1 (m , Stats. (p d y(~ sr. 1. Application Information - Please Print All Information Parcel # ' Property Owner's Nam 2 1/ G) Property Owner's Mailing Address Property Location Govt. Lot • tJ City, Stat Zip Code Phone Number section orP}~ u__ cle oll Lot It N; R II. Type of Building (check ail that apply Subdivision N me or 2 Family Dwelling - Number of Bedroo (01 6~ Block # - i~ ❑ City of.._ - ❑ Public/Commercial -Describe Use r_,___--------- CSMNumber El Village of ❑ State Owned Describe Use own 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 (explain) - List Previous Permit Number and Date Issued - B. El Permit Renewal El Permit Revision ❑ Change of Plumber El Permit Transfer to New Before Expiration Owner , - - ~ ~ • _ Y~--------- IV. Type of POWTS 5ystemlComponentlDeticeCheck all that a 1 ❑ Non Pressurized In-Ground [I Pressurized In-Ground t-Grade [I Mound~ 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil ❑ Pretreatment Device (explai _ ❑ Holding Tank ❑ Other Dispersal Component (ex e V. Dis ersallTreat ent Area Information: Dispersal Area Require (sQ Dis ersat Area Propose (sf) System Elevation/ / Dest Flow (gpd) Design Soil Application Rat (gpdsf) 1 # of Manufacturer ~Tota VI. Tank Info Capacity in o Gallons Gallons Units lJ' w a c~a New Tanks Existing Tanks I k U vi u, v~ u C7 P Septic or Holding Tank Dosing Chamber 6 - VII. Responsibility Statement- 1, the undersigned, assume nsibility for installation of the POWT s MFRS Nhe at ached Bus iness Phone Number • PlumCber's Name (Print) Plumber's S re J lumber's / ~__A-!~ ~J•1 ~ Plumber's,Address (Street, City, State, Zip Code) C~ V Count /De ailment Use Onl Permit Fec Datc i sued Issuing t Signature Approved Avvcnn 6 ason for Denial 1-7r5fS~EM d ~p~ A~roval/Reasons for Disapproval 3 /D j, 4'0,,5 ~hrti 5h, rb VtNTVEFK: !i~!'e+C~ ~~i'w 1 Septic tank, effluent filter and 4A9 4A dispersal cell must all be serviced / maintained as per management plan provided by plumber. 2. All setback requirements must be maintained per app !cable t30000rt>.It wmPwB ror the system and submit to the County only ea paper nut Less than s t/z x i t inches hi size SBD-6398 (R. 01/07) Valid thru 01/09~i PLOT PLAN PROJECT Scott Norstrand ADDRESS P.O. Box 1000 Hudson Wi 54016 SE 1/4 SE 1/4S 7 /T 30 N/R 19 W TOWN Somerset COUNTY ST. CROIX SYSTEM ELEVATION 95.7' BEDROOM 3 CONVENTIONAL AT-GRADE XXX CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE 630 HOLDING TANK SIZE LOAD RATE .5 ABSORPTION AREA 900 # of chambers none BENCHMARK V.R.P. Top of survey iron ASSUME ELEVATION 100' Filter BEST GF10-8 ❑ BOREHOLE O WELL *H.R.P. Same as Benchmark 97' 95' 93' Property Line B. B-1 scale = 1/4 " =10' 0 AC 15% Slope Grading is to be B-3 Area 15' below done to divert run-off away system is to remain from system undisturbed Well is to meet all WDNR Setbacks B-2 95.7' Tank is to be properly Huffcutt Combo Tank bedded and provided with lockdown covers with approved warning labels ~a Pro 3 Bedroom Hous 458' Property Line 40th ST. 9 ART, 1fpN Safety and Buildings 3824 N CREEKSIDE LA o \1P HOLMEN WI 54636 J U a Contact Through Relay 3 S c www.commerce.wi.gov/sb/ S w www.wisconsin.gov { `G ~O'ssroNP1S~ Scott Walker, Governor Dave Ross, Secretary April 11, 2012 CUST ID No. 226900 ATTN: POWTS Inspector SHAUN R BIRD ZONING OFFICE BIRD PLUMBING INC ST CROIX COUNTY SPIA 1432 120TH ST 1101 CARMICHAEL RD NEW RICHMOND WI 54017 HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 04/11/2014 SITE: Identification Numbers Scott Nordstrand Transaction ID No. 2072130 40TH Street Site ID No. 778191 Town of Somerset Please refer to both identification numbers, St Croix County above, in all correspondence with the agency. SETA, SE1/4, S7, T30N, R19W Lot: 5, Subdivision: St Croix National Estates 9 FOR: Description: Three Bedroom At-grade System / 15% slope Object Type: POWTS Component Manual Regulated Object ID No.: 1366335 Maintenance required; 450 GPD Flow rate; 42 in Soil minimum depth to limiting factor from original grade; System(s): At-grade Component Manual, Version 2.0, SBD-10854 (N.03/07), Pressure Distribution Component Manual - Version 2.0, SBD-10706-P (N.01/O1); Effluent Filter The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. This system is to be constructecNUATE SEV~J and located in accordance with the enclosed approved plans and with any component manual(s) referenced above. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code • requirements. No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, 'PR stats. ; The following conditions shall be met during construction or installation and prior to occupancy or use: DIVISION OF 1.111, Reminders: • A sanitary permit must be obtained from the county where this project is located in accordance with the - ScE COR ES requirements of Sec. 145.135 and 145.19, Wis. Stats. • Inspection of the private sewage system 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. • 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 SPS 384 product approval conditions. • The area within 15' downslope of the dispersal cell shall remain undisturbed. Vehicular traffic, excavation or soil compaction is prohibited in this area. • A cop, owe 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. SHAUN R BIRD Page 2 4/11/2012 Owner Responsibilities: • The current owner, and each subsequent owner, shall receive a copy of this letter including instructions relating to proper use and maintenance of the system. Owners shall receive a copy of the appropriate operation and maintenance manual and/or owner's manual for the POWTS described in this approval. • 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. SPS 383.54(1). • 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 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 and the POWTS management plan to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Fee Required $ 250.00 Fee Received $ 250.00 Balance Due $ 0.00 Gerard M Swim POWTS Plan Reviewer, Integrated Services (608)789-7892, Mon - Fri, 7:15 am - 4:00 pm WiSMART code: 7633 jerry.swim@wisconsin.gov Note: Effective January 1, 2012, all codes under the jurisdiction of the Division of Safety& Buildings will be modified. Code references with prefixes starting with "Comm" will be replaced with "SPS" to recognize the relocation of the Division of Safety & Buildings from the former Dept. of Commerce to the Dept. of Safety & Professional Services. Additionally, all S&B codes will be renumbered and addressed in a "300" series. For future reference, the Wisconsin Commercial Building Code will be addressed by SPS Chapters 360-366. L SHAUN R BIRD Page 2 4/11/2012 Owner Responsibilities: • The current owner, and each subsequent owner, shall receive a copy of this letter including instructions relating to proper use and maintenance of the system. Owners shall receive a copy of the appropriate operation and maintenance manual and/or owner's manual for the POWTS described in this approval. • 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. SPS 383.54(1). • 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 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 and the POWTS management plan to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Fee Required $ 250.00 Fee Received $ 250.00 Balance Due $ 0.00 Gerard M Swim POWTS Plan Reviewer, Integrated Services (608)789-7892, Mon - Fri, 7:15 am - 4:00 pm WiSMART'code: 7633 jerry.swim@wisconsin.gov Note: Effective January 1, 2012, all codes under the jurisdiction of the Division of Safety & Buildings will be modified. Code references with prefixes starting with "Comm" will be replaced with "SPS" to recognize the relocation of the Division of Safety & Buildings from the former Dept. of Commerce to the Dept. of Safety & Professional Services. Additionally, all S&B codes will be renumbered and addressed in a "300" series. For future reference, the Wisconsin Commercial Building Code will be addressed by SPS Chapters 360-366. I RECEIVED Cover Page APR - 4 2012 SAFE`Y & BUILD, Shaun Bird Bird Plumbing Inc. 1008 192nd Ave New Richmond Wi 54017 715-246-4516 Date: 3/31/12 Owner: Scott Norstrand Location:SE1/4 SE1/4 S7 T30 N,R19W Lot 5 St. Croix National Somerset System type: At-Grade Manuals Used: At-Grade Component Manual version 2.0 SBD 10854 (N. 03/07) Pressure Distribution Manual version 2.0 SBD 10706-P(N. 01 /01) Page# 1. Cover Page AGE sY7rt 2. At-Grade Plot Plan O 3. At-Grade Cross Section 4. Pipe Cross Section/Pipe Layout 5. Pump Chamber Cross Section BUiLDI'v 6. Pump Curve 0 ' 7-8. Maintance and Contigency plan 9-11. Soil test 12. Filter Specifications Shaun Bird Signature License numbe 6900 PLOT PLAN 'PROJECT Scott Norstrand ADDRESS P.O. Box 1000 Hudson Wi 54016 SE , 1/4 SE 1/4S 7 /T 30 N/R 19 W TOWN Somerset COUNTY ST. CROIX SYSTEM ELEVATION 95.7' BEDROOM 3 CONVENTIONAL AT-GRADE XXX CONVENTIONAL LIFT HOLDING TANK MOUND SEPTIC TANK SIZE 1000 gallons LIFT TANK SIZE DOSE TANK SIZE 630 HOLDING TANK SIZE LOAD RATE .5 ABSORPTION AREA 900 # of chambers none BENCHMARK V.R.P. Top of survey iron ASSUME ELEVATION 100' Filter BEST GF10-8 ❑BOREHOLE O WELL *H.R.P. SameasBenchmark 97' 95' 93' Property Line B. B-1 scale = 1 /4" =10' 3.0 AC ~g~Get~ 15% Slope Grading is to be done to divert B - 3 Area 15' below run-off away system is to remain from system undisturbed Well is to meet all WDNR Setbacks B-2 95.7' Tank is to be properly Huffcutt Combo Tank bedded and provided with lockdown covers with approved warning labels Pro 3 Bedroom Hous 458' Property Line 40th ST. 10- At-grade System Sloping Site Cross Section and Plan View - ~ ~ E ► Dimension Fe ' rL•L.L•L w b L L L■L L L L• L+L■ • ■L■L•L■L• L h•L L+ ■L L• w 1 ' Sr•J,'~■■r~r J•r7'J A IZ 1 rr•{•rf~ j+L~4L■~,j~a{,!•j. a •J!■ j j■ .j■ J•j~jr •r r`~r.r r•rjJ.Jl. 1:J J~~! J r ! ~L■ ■'Y •L~~,{L• •L ~Lr Y• 'L•r"~•j• } f:dLJ~'' wyL. 5 ••4 L ;.w• JL Lr i' i rS j7 }jar r,•~ M~~ .JLL~ :■~!•~r:~:~:ti:L? ! J 1 r~rtir~ r;rr~ ~r:'j~r• J rJ r{ ~'•r r1~ r rti;rti~tirtirti r r r fr~•3•ti}~,r~• I B W A LrL• i L~•L L■ • ■ . • • ■ ■ 4r r~ J•r 1 .j.j~r'r~•.04,~ } rAird r J OF ~■L w1/6 B : ;w~ J' J j~ ~r J r r J r r P5.0 jalw:.R~•r+r}r ~•1L.L•'L.~.~ir r +r•+rM•r l1 .•+"ri'+■+rI}•iri ti. •■•+r1ir' 14 ~•j r Miyicleft . . . . r r L1 ! laj.r'Sr• ' jr r ' " •6 'Y■ L L•~ L; ■L■•J ■Lr~■LrL+ ~ .■~rwrLrL4 r . r'+1■ 0 ' r jryrjrj .•r~j•'ti ~5~~ r rti«~J■tJS! ~~Jti~r~J r iL~■: iLr ~ ~ :ti's"r+r r•r~JZr .L•ti•L.w } •j"~}'fr,~'~J ~.~.r J r~~" : r lLrtir~wr~rtiC}'~}!•~•'~rf t' :~:;'~r~, ! V 1 0 1. ! j•j• ■J j•j•, r • ■ . •S,• s • r • r•!■r■r r•r■!• '1 J 1 r ~ r r~'j}r. jr r F r+3~~r3~r~ $ ' i i•■~ir~' ! ~y~• ~ ~ • ~tid'y~'w •Lrw• ray LrL 1 L - 1 /6 B Vi/ _ _ _ 1 E - - Slope 0 L Plowed J a = Clean aggregate 0 = 4 in. sch. 40 pvc 1 basal area :"L• %2 to 2'/Z in. dia. observation pipe 6 _ d Lateral with 2" Topsoil Cap aggregate over pipe Observation Pipe GeotextileWith Cap Fabric Ms ■ 9~ ~ Ft Lateral Invert rr "rJ a• f~~r•~~r~{■ r"r' Topsoi 1 Cap MiF J•r• Ft Contour C w D - Plowed Surface X C Slope Direction GENERAL INSTALLATION: The at-grade area is staked out along the design contour. Existing vegetation is mowed and raked off the site. The basal area (L x W) is staked out and plowed with a moldboard or chisel plow. Plowing may not proceed if the soil is wet enough at the plow depth to form a `/a inch soil wire when a sample is rolled between the palms of the hands. The A x S area is covered by clean aggregate deposited overhead by a backhoe.. Special care must be used when placing the aggregate to minimize compaction of the plowed surface. After the topsoil cap is placed, the entire at-grade is seeded and mulched to promote vegetative growth, limit erosion and protect from freezing. The observation pipes are perforated in the lower 6 inches and secured in place. 03/05lgj Page of Pressure Lateral Layout One Lateral End Manifold 0 Threaded Cleanout Lateral Turn-up Plug Farce Main X L Long Sweep 90 Bend Pressure System Construction Distribution Network S ecifications Lateral Diameter Z In. Laterals are constructed of Schedule 40 PVC Orifice Diameter / 2_ In, pipe. Orifices are drilled perpendicular to X Orifice S acin In. the pipe with a sharp drill bit and face down. L Lateral Len Ft, Lateral turn-ups terminate with a threaded Force Main Diameter '2- In. cleanout plug and are enclosed in a 6-8 inch Force Main Len h Ft diameter lawn sprinkler valve box accessible TorAt- No. of ORR t F/ee5: 145 from finished grade. Grade :Q • 6-8 Inch Lawn Sprinkler Valve Box Aa, 03/05l9j Page of Septic'-Dose J'ank• Cross Section And Pump Performance Specifications - - p P Manufacturer `I"arrk N.lan~ufac#urer _ n l Dumber Tank 1VIode1 Numb rm purer T P C. - otal Tank Cavacity Model Numb rAlau er rm Bury De pth itah Typa lte -jai - narnic~ Read (rpm } Feet T - - 6r Manufacturer ~;7 - Elerration Read - - Sz - kilter lvlodel Number r -y.. _ Distal press ure Network 1,oes erfo quired P orce main Loss ` Minimum Pump ' - _ Ft TDYI i'otal - outlet lv[whole Mim 4" Above Grade With Manhole Min. 4" Above Grade Looking l]evice. Inlet Molhole Securely Mounted With booking Device fi" Below tirade healed Watertight Weather-proof Junction Box rwr W rrYw rir rrr Yon moo *am Y>r Fillished Grade • Ir. .r ++s {rr Vent Min. 12"' Disconnect Above Grade Means y With Vent Cop Y 1 Y a Y f >,f Y Y Y Y a 1„r,ar,,Y i ;<;1; rf iY ;r`rYl'r>:+if V;r;,;:+>Yi r r/'a'vYVa Y,a Yr a ,i,Y f;j r 'ara 1'r•Y Y•ltY ViaY taYta Y r r rrY ' : ()utlet Filter Is ,v Wet Baffle YtY +>v arr rr/r Inlet / _ yp ca 'A pac ty Weep uyvvitch Setns and Resere Tank, Volume - a Hole Inches Volume Gal. Dimension; - - r ; • -.,(reserveA a' s - v; 1 r Off Elevation Cr. r (_alarm) B. 2 ,Yap r (dose \ Jr 9-7,,.f ai f i i ;~Y Bottom (d d) D Elevation ' L Total i 0 'I'" ~rai,'YPTPi~i~i~ :f~a-ti<Y~ va"T,-'F Sri i .>a v ~V v v s tyvav~ ,a v vrs i r + ♦ s + + + + r v a„v, v,v,'r'r'.'r<rrYaayY'✓,'r >'v'ai .'i i a Y'3 r f Y'1 YsY Y','r'r hY'Yar r Y t+Y Y Y , I f r 1 1+ r s f,rrrf sa'> r. >a IaarV vaa is li „ of lv/tiV tv/ a +a i r•l~:lY,4; a,Y~ ~a„a; ~kri,ri i it/~l r i r 1 i+ V a t/ r{ r 1 a>{al 1 r, r 1 1 Y f 1 ~ r k filled in accordance with the 'a/dos$ tank is bedded and bac The se Old: Th ' R,AL IrNS''A~.•~TY ~ the manufacturer may root manutacturees GENE product approval ifications, Maximum depth of bury as spoatfied by be exceeded without prior approval. Manhole covers exposed to Wade have an affective looking device (padlock) and `wit th PVCm4tert °ghti fittings installed. Piping at the inlet and otttlat is of approved material, the,tank sn on with tank laid on stable soil to prevent settling or sagging. Th excavation and the sleevo is scaled watertight. Electrical service complies with NEC 300 and Gomm l 6.2Kr 02/05I,l Page of AP LaserJet 3100, 7 %tb bbL tltler ; xtay a-vo c. ~~rnis wd. F 9EM SERIES Sump/EFFLUENT PUMP 11.65 i 8.95 n scstions 9M1~ r01tCAR 9~N► )mca ut rK +nus =no arc MOM Ar MI rt LW AMIO~Iati p tf 1P 71 Ot) elf OW Ih+~Arq Ar 9111 OM 509330 UUM V.0 115 314 i9A 1000 70 64 55 41 32 13.8 2Q 24 9.11111.6/x8.94 ggt qµ 509340 UUC91a AlT 280 314 6.5 1000 70 64 55 4i 32 119 20' 24 9.11 111.6119.95 981434.1x8 50 80 910 406 115 314 19.0 1000 70 9d 55 d1 32 13.9 20' 27 8.11 111.6118.84 uraw 50M go cc M 1 g.8 V 27 9.11x11. x.84 6i&9w6Omrwhd-- LW146irawascerr W~npsanwbwca wafsd4{yasbnOaslMyamr,~wlNinrro b estar3lq.wnaua rLpw- ~1rElrsiHOUS crostPYCtion _ o kooa 1.000 aooo Motor Housing Epoxy Coated Cast Iron Cmpeller Material _ Poly Carbonate 1n impellec 7'ypc Closed Vane -..n . as - ADS Voluu 7.5 W Power Cord S tTW-A 20 " Mechanical Shaft Sea( Nitrile with carbon and ceramic faces w Fasteners Stainless Steel = 10 Shaft Stainless Steel e .s BearinKb I Upper Sleeve and Lower Ball Bearings f o _ 0 201 40 60 90 rLUW- GALLt1NSPNINOTE PUMP PERFORMANCE CURVE Little Giant Pump Co. 115V 60HZ j pt) Mee 12418.01dake®st City, OK 73157 r6axw.405.947.3511 Fo:405235.1580 E-aural: sus~o~nanrwkx~ritGsgiwt~po www tdttleG1autftmp.COM 0 form 945236--07103 pavers Ctwr4ews MANUAL & MANAGt~l4[ENT PLAN r=yue 1tNl=t?tiMA't veto 6eptlc'!'srsk WA Ow"r S C o S cx g '~'artk 1Nartulleraunar A tA offfril r NWrA ROr j 13 BHA Prl 3 1-a _F 10 N~4 MoQst - e. ci Na ~ium6raF~ _ . Pump mar* ~ 630 DNA cwn0wcw Ufa '1 Aow 1 3 X) Pomp Tank Mawct~l~l Mmr CI hL4 t~sriOR 1~w x 's.6} ~'v . Pittnp Marsi~ ,4 NA. MOM' 4*1 11,1rp1001lea p~ , S" Pump mom a MA " 0 Punt Ffl w NA rrrtru~ tZu monow 0 ammWitimel FEW FOW401 MM (FOG) Am OOMO/L C3 #Aectw*W Awafti ©Watbnd rWnW OMWen Dwimid (DOW MOAL D Dfu n 13 Mar- '1'{ w atom +ded ems. tT.taffi ma& pr+ebavAlid meant GlalrKy aesr aweWs" O tgnKmd (gaW) Q I~ p ) a~ CWOVS" Ownad (SOQ J Tool BuspetWed St~ib ~I S30 rte- At-grade D »ounCf §;;Nw Qowww Stf3` 0 7 T Q e 0 01har _ rnmhdiamaEK vrh~siil~floulb~ d (~n'oommeoaM~w~,ww~~rana am pw2cft Sim NAMMUM arrir+~lr..rswa.bn..orr- M C8 9w SGFVMe Event Ssrrteae FrrrgwncY inspect conditn offank(s) At 188 onw awry Gt fn*rdh r yaer(s) (Maxlmum 3 yrs.) pump aA contents of tank(s) When aambbned sludge and SCUM squab one-ltrtrrl (V of tank volume y p disper~el mss) At least once ovary l7;;.nt s) (M+wdmum 3 yrs.) } At 1 1 IN anca avert' , II nwrdhe . r(s} ~ :;fears dfflUenttfiber .nspaat purr. tsP o0tftrfals S elfattriri At least once every D mwAtlls a} 0 NA At W" a[= every C1 mores s) a rte plush hd b Sad prsssura 100 fir: sur least once every 13 r soft II yrtaf(s) (3 NA outer At least am* every a mvnft 13 yww' s) 0 NA mmcnwmwe lNff9li<lcrwM lloeraustir or i,epwaaans Bland and dbpmu* cow shell be, nugle by our irWh tall aarryV 017e , ig~pbmb . ua~Pfunsbsr itawkiNed w "i, or. PO1Af rD hap•swr. PbWT'D allab"brer. 8spape swvk" 4pa even Tints bwpsdfiloas must inoWde a vbual kWVS lWn of the tmdo(s) W WwW& any ndo*V or braiosn rwndwxM fdWw4 lr any oraaiss or jeltt0a. mwoure the Vokm a of ==bind dkOP and mum sued !o the ok ror any bw* up por tB cif sAMterst an #W ground surfloW The dot nnUd c6KB) Stoll bs V1011011Y lnatraanted to d"w k tiro etltrrarrt towels n tl o ob wrvadat pil w and tC do* ftr any ~ of $mus t tp111"Ig ptgWW giitl`aNe7e. I rim pond~li Of effluent on ttxr Tww sumacs MW k afto s awwow ww M quir+ss the tfrtrrtedtHla r v+r of the foael rogalseory snu8+oriLY Slav ti the oxnWW solwNdsOn of sus rt W source in any tents equate orte-tf>bbrid (Y.) o<>!rlots oft W* volume. the'tt ~bre caonlrrMriDt`11t0i ffYlltstel~ fle t+trlwvsd ~ a ~ °ib ~ rush f3, lNlltxitNtYrr~Ydtttinhttativrr Cade. pig; alb any of tl~kfettt tom. MW or pnMur PoWrS compohento. pmt ip W tfterrlt rlcae ornw&%fliftg at 1flttlfVW of.12 mo0s ©r k= shad be PWt+cttmed by a 01111101 d POWTS Ab* oft"t n ptW SW •be p fo gw boat' Mulatury su#tortiyr **In 10 +dW Of taomptl~n of SrfY 9er t►~ `ART UP AND OPERATION of pttlduds Or other --,,ar now cxWtW0 M ptbr am uas atow POWT S dW*.b' nt tank(#1br the pnmwm tiom ob fist aw 61hirula_tw -0 u aWld/ot anrag4 tEve dlspsraat Oa~li,~. fffth oetet"I g ar8 1Att tite {7vrlMr+ts df floss tond(o) rwmn ed by a setter selwlshV apuraiior prbr trr use. Sy3bjrrt start up shall not Occur wne" s il'conditions are frozen at the infiltrative surface.. Ourir:c1 OowW m"" pump taula wayfM above r7S]rtllal highwatier Levels, When pawnor is restxW the exams .rrasonrarngNu tarp be dischar~7ec1 to the d caetll;s} in one large dose, cnreliaadng the o~Jl(sM and may rtwA in the tr®dostp ar selrNRre► disdiatge Of ettlent To avoid ags sirtilStiort have the content of the PUMP farlk removeed by a € Ssorljo Swv5dng Operator prior Wrea0otlrig 'Power to Ma eMuent pump or contact a Pturrbber or POWTS Maintainer to ass bilin niamolyopemft dw puitli oanb'P(S tO 4 8S re normal levels within the pump tank Do rum: dime or park v mar f elld 1fsp~tisai s Do not drive or Palk OW, or dhwAlm dfttb or, cumpax;r, the a -to wbhln 15 fftf down skVe of WW MOUnd or at-grade SOO absdmfion area. RedvcWn or-alu iination of the Mowing lirnrrn the waMel+ mW stream may improve file perbrrrratM and ptntong the He of INt POINTS witiblaW "baWwOW- tte butts, condoms; otton swabs; degteasem; dental flow. dbpwr diMiedtaft : M fauidMb" draaitl (AMW PMP) waiter, fruit and vegetable ~ ff 9=M'. tterbtt dos; meat scraFr M6&8 o M 0tpebtffirlg pMdtsW; pesticides; sanitary napkins: tampons: -and wafer softener brine. ARAME113NOMENT When 1-he POW'11S fails andtor is parmartan0y.taken out of service the following steps shaft lee taken to insure that the system is prop w*-and safety abandoned in cormiiancae with ch- Comm 83..33, Wisconsin Administrafte Code- Alt p"V to tanks and pits shall -be disconnected and the abandoned pipe openings sealed. • The contents aotalf tanks and pits shalt be removed and properly disposed of bya Septage,Serviciing Operator- Aftr pumping. all tanks and pits shall be excavated and removed or their covers removed-and the void spy filled wfth ,sA gravel aranother inert solid material. CONW113ENCY PLAN It the POWYS lolls and cannot be repaired the following measures have been, or must be taken, to provide a code compliant t tent system, 0 A suitable r ephwernant-ama has begin evaluated and may be utilized for the location of a replacement soil absorption system. The replacement area should be protected from disturbance and Compacbon and should not be infringed upon by required setbacks from eadsting and proposed structure, tot lines and wells- Failure to protect the replacement area will r6sult in the need for a new soil and site revaluation to establish a suitable replacement area- Reptaoement systems must comply with the ruses in effect at that time. C] A suitable replacement area is not available due to setback and/or soil limitations- Barring advances in POWTS okxjy a hording tank. may be installed as a last resort to replace the failed POWTS- e sure has not been evaluated to identify a suitable replacement area- Upon failure of the P'OWTS a sod.and site evaluation must be perfi mined to locate a' suitable replacement area if no replacement area is available a 'folding tank may' be installed as a last resort 1P replace the failed POWYS. Mound and at-grade Std absotptton systems may be reconstructed in ptace following removal of the biomat at the i~ StrrfBtxk Reconstructions of such systevns must comply with the rules in etlt~ct at that time. <<WARWIMf;>> SEPTIC-', PUMP AND OTHER TREATMENT TANKS MAY coo TAtN LETHAL t? 'SE5 ANWOR LNSUFFIGUNT OXYGEN_ DO NOT ENTER A SEPnq, PUMP OR OTHER TREATMENT TANK UJYDER ANY CIRCUMSTANCES- DEATH MAY RESULI"_ . RESCUE OF A PERSON FROM THE INTERIOR OF A. TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDiT OVAL COMMENTS POWrS J14STALL.ER PONTS NWNTA1NER LlNla,m.n.e.. ame Phone ~J / ° C7 S SEPTAGE :yFRYICENG OPERATOR MP LOCAL REGULATORY AUTHORITY nlartre Tt rn [,ency c- i ~7` ✓42.L_k rl rJc LTi2 l~ Phone Phuae -7j 3 c~G" - rttis d--'*tt was drrr W 6Y fie sarftlr 01°the Lake, Wlqued& and Waushara County zoning mid Sancta tba Wades- ThIs domwnt wants me rnWmwn',egw*.rpwa* ar aL Comm 03.2~XlXd)&M and 63.5({1), (2)&(3). Wisconsin .Adnrrkasuz.um Cade the of Ods doewnwt does aor guarantee tht, petonnanno of the POlltfrS. r>atw (zmi) a a J:. W fs 10. f/. 1.. ua rt. . - olt. 1V 6// Wisconsin Department of Commerce SOIL EVALUATION REPORT Page / of Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code County C 0 r')e 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. l` percent slope, scale or dimensions, north arrow, and location and distance to nearest road. NZ ' iJ O b Please print all information. Reviewe y Date Personal information you provide may be used for secondary purposes (Privacy taw, s. 15.04 (1) (m)).~ Property Owner Property Location ) S L, Govt. Lot r 1/4 SC 1/4 S T 30 N R E (or 1w Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# An'o city State Zip Code Phone Number ❑ City ❑ Village Town Nearest ~oad l~ s') - U ems- t_ le ©T ` New Construction Llse,Residential / Number of bedrooms 5 Code derived design flow rate JZ~ GPD ❑ Replacement Public or commercial - Describe: Parent material Flood Plain elevation if applicable ft. General comments and reoommendatims: (i u ^ N (1 ~ ~j Q~ l r , Z O G')O we System Type System Elevation I Boring # El Boring El pit Ground surface elevl~ ft. 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 ®-1 / r A7 C AV, 119, I J' 44,--7 A,' -a. r¢ ~9 iv F! Boring # ❑ Boring 1~511 R Pit Ground surface elev~~s ' / ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDN In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •Eff#2 O' /Ov'_ z- Lt ~ 2- 3> ;g- 71 • Effluent #1 = BOD > 30 < 220 mg1L and TSS >30 < 150 mg/L ' Effluent #2 = BOD 130 mg/L and TSS < 30 mg/L CST Name (Please Print) Si CST Number Bird Plumbing, Inc. Shaun Bird 226900 Address Date Evaluation Conducted Telephone Number 1008 192nd Ave, New Richmond, WI 54017 715-246-4516 E Property Owner _ Parcel ID # Page of 1-31 ~ng # pit Boring Ground surface elev. ~3 ft. 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 _Z- ~r 3 ~S . ~ m rte ` Alj4 V4/ E 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 GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 •Eff#2 Boring F-1 Boring # Ground surface elev. ft. Depth to limiting factor in. ❑ pit Soil Application Rate Horizon ')epth Dominant Color Redox Description. Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 -Eff#2 Effluent #1 = BOD5 > 30 < 220 mg/L and TSS >30 1150 mg/_ ' Effluent #2 = BOD5 < 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. SBD4330 (8.6/00) Property Owner Parcel ID # Page of ❑ Boring F3_1 Boring # pit Ground surface elev. 0 ft. 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 16 1/ V 4V" Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. `Etf#1 'Efi#2 ❑ Boring Boring # Ground surface elev. ft. Depth to limiting factor in. ❑ Pit - Soil Application Rate Horizon ')epth Dominant Col Redox Description. Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. `Eff#1 'Eff#2 ` Effluent #1 = BODS > 30 1220 mg1L and TSS >30:< 150 mgA- ` Effluent #2 = BODS < 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 department at 608-266-3151 or TTY 608-264-8777. I SBD-6330 (R.6(00) Soil Test Plot Plan Project Name Scott Norstrand Sha ird Address P.O. Box 1000 Hudson Wi 54016 M #226900 Lot 5 Subdivision St. Croix National Date 3/31 /12 SE 1/4 SE 1/4S7 T30 N/R19 W Township Somerset ❑ Boring Q Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 100 ft. Top of survey iron 97' 95-93' *HRPSameasBenchmark Property Line n r~ B-1 scal = 1 /4" =10' f ys m oy 1 y 15 0 Slope B-3 B-2 1 95.7' U, r fi r a 458' Property Line 40th ST. 2(c 9 l h0. ^ha.~ ~ -.,.,•4 1 L }~t F 1 ,iii ,,..,,.,,a,s~'-~•~..\-.+--y_ ..s..x.:.=~'°"`.. F,`'t•-.._-,._._~..._..,F..:-}~.,.~.:- ` a ttp6 N B•9~0 ` -E ' a. lq~ . ji, t I e s [ S . s d w_, s IVII ' t -gREA=3 00' AC*'-' I r 7, ~r f. i c J• s 4 I 4 E ~ tt a I I ;i s j / ~IM .-'t r• I~ ~ ' _.r ~ ~ ..2 r~t :~13NF I - - I AREA-3.00 AC 'T P, 3 u) M t r rn ~r rn 00 U-\ _ I y `4 4 'N-J 1 ~ F ' r•.... , yr; I I~ N y~' ` ^ , ~ 1 4 ~ ms's I t i._, ~ r ~ I r?, a.t ss --^I- N -'AREA 3 00 AC I r rj a ( / J , i-~= - - - 096' u.. 77 '4 5' DRIVEWAY a M- '-t M f T- t 0•42,00"E 8.071 3 .00' DEDICAfTON .-.'1 253 r 0 ' 244.80 PUBLIC S0041'00"Ew- T . r •r ` •5 r' t""~ f 4 , y ,yF `tJ ~ Y t \ + % R F ~ °°E la•J - SE 4 COR, dF FE /41 OF SEC. 7 T30N R19 /00 f I 7ZL.I t AG/RESIDENTIAL ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP ~CERTIFICATION FORM Owner/Buyer C L A /C o 630 N _ Mailing Address . c'~S n l 1 Vic- L, Property Address (Verification required from Planning & Zoning Department for new construction.) U City/State Parcel Identification Number O 3 2, - 21 LEGAL DESCRIPTION Property Location 5 . Y,., 5 E Sec. , T N Rj~W, Town of Subdivision ~ GL'e F S Lot # Is Certified Survey Map # Volume , Page # _ Warranty Deed # ~t / r1 , Volume , Page # Spec house yes no Lot lines identifiable yes no SYSTEM MAINTENANCE AND OWNER CERTIFICATION 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. Owner maintenance responsibilities are specified in §Counn. 83.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance. The property owner agrees to submit to St. Croix County Planning & 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. I/we, 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 Planning & Zoning Department within 30 days of the three year expiration date. I/we certify that all statements on this form are true to the best of my/our knowledge. I/we am/are the owmer(s) of the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. Number of bedrooms SIGNA URE OF APPLICANT(S) DATE ***Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Department. Include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if reference is made in the warranty deed. (REV. 08/05) SAINT CROIX NATIONAL GOLF COURSE 1 I I _ Og 10"~ I 1 I ~ I I ~ I ~j i ~ j I J ~ 1 i W i E E ~~~bbb s m y 3k~t g¢~ (P R 5 z m b SOO 42'00"E p 286.01' 7 140TH STREET E z PP y ~a z m cp ~g g I (III l I State Bar of Wisconsin Form 2-2003 8 0 5 4 7 0 9 WARRANTY DEED Tx :4040718 954787 Document Number Document Name BETH PABST REGISTER OF DEEDS ST. CROIX CO., WI 04/19/2012 2:41 PM THIS DEED, made between Daniel C. Nustvold, a married person EXEMPT- NA ("Grantor," whether one or more), REC FEE: 30.00 and Scott J. Nordstrand, a single person, and Claire M. Sobon a single person, as TRANS FEE: 279.00 loint tenants with rights of survivorship PAGES: 1 ("Grantee," whether one or more). Recording Area Grantor, for a valuable consideration, conveys and warrants to Grantee the following described real estate, together with the rents, profits, fixtures and other appurtenant Name and Return Address interests, in St. Croix County, State of Wisconsin ("Property") (if more space is needed, please attach addendum : Lot5, Plat of Saint Croix National Estates North in the Town of Somerset, St. Croix County, Wisconsin. 032-2144-504100 Parcel Identification Number (PIN) This is not homestead property. (is) (is not) Exceptionsto warranties: Easements, restrictions and rights-of-way of record, ifany. Dated a ( oo l zol 'y (SEAL) (S EA L) * *Daniel C. Nustvold (SEAL) (SEAL) * * AUTHENTICATION ACKNOWLEDGMENT Signature(s) Daniel C. Nustvold authenticated on STATE OF ) ) ss. COUNTY ) *Kristina O eland TITLE: MEMBER STAT BAR OF WISCONSIN Personally came before me on , (if not, the above-named authorized by Wis. Stat. § 706.06) to me known to be the person(s) who executed the foregoing instrument and acknowledged the same. THIS INSTRUMENT DRAFTED BY: Attorney Kristina Ogland Hudson W154016 Notary Public, State of My Commission (is permanent) (expires: ) (Signatures may be authenticated or acknowledged. Both are not necessary.) NOTE: THIS IS A STANDARD FORM. ANY MODIFICATIONS TO TIMS FORM SHOULD BE CLEARLY IDENTIFIED. WAitRANTY DEED ® 2003 STATE BAR OF WISCONSIN FORD{ NO. 2-2003 * 1•ype name below signatures. INFO-PRO*" Legal Forms 800-655-2021 www.infoproforms.com 1 of 1 B I mil mil I H ~Zp o O F~P 4 H O o z a~ o a ~ 0 0 REE z 0 a ®F a ® o 19 19 a z~ 9 x yy - 4 UFF UH o Z u~ O 0 N 0 l7 ,o-,zf 8 ,M rA tlfgd F .YK 4,1 Moc= o Z 4 ESQ Q W ~ Z ® ~ o-a ZZp ryA I a dd b M x D C peJ y 0 tl ILL b ~ tun ~ MUM Q;p t~ ,0 11..11 ! 8 a z QmQ2 a p IV !mill .q .Q ~r S F I ~ 0 "v r - 4 n a~ $ H II101'~BI J Ian[ -Q 9 + ma m a N 3 GQ Qj V 4p 8 Z FdFdFd •4@ ~ Z .Q O JP~ I~ O ~A ~A 9 ~ Y2 g} IY i 4 - z rd a- ! i 6 rwuxc 2 yy,, .T___....__._., y . •.,c y ~ ~ 777 .fIG .fI.A 9 , o Q S i V o - V 0 _ ,f•.II f , Wisconsin Department of Commerce SOIL EVALUATION REPORT Page , of 3 GYvision of Safety and Buildings • in accordance with Comm 85, Wis. Adm. Code Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must County S~- C ~X include, but not limited to: vertical and horizontal reference point (BM), direction and percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D. Pf~r a so - cm 12(.o Please print all 1nfonrati Re sewed by Date Personal information you provide may be used for secondary o (Piivacy Law, s. 15.04 (1) (m)). Property Owner : , ` • t~ Props Location B~ SE1/4 S 7 T3D N R ~9 E(or W Property Owner's Mailing Address of lock # Subd. Name or CSM# 't 6o t 6 ~LV~, ct'DV 2.Q S; - s7-. ctz-ulx ~t'~o>ult-c. City State Zip Code Number N 3 CQ~, ~NT~jy,,_ ❑ ! ❑ Village ®Town Nearest Road (6 ~t 1C?~I+N6'0►tt 14 ~3 12 New Construction Use: ® Residential / Number of~edfo 1` p tams; I Code derived design flow rate GPD ❑ Replacement ❑ Public or commercial - Descn~G€----`• Parent material _ `U S C1y -TI I-L Flood Plain elevation if applicable N . R . General comments ft and recommendations: W1, puhl~ kj q 6~ f 1ST RL bu h 0 ki L°t. c_6 vt ~ AL+ r" l k" UM t Or- Ft LL, ( 0 , r > a Boring # ❑ Boring © Pit Ground surface elev. ~s S ft. Depth to limiting factor 3 b Sail Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2 In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 •Eff#2 -8 Vo-t 3 ) 2 si t Z- s b ►Z ti►1`Ft- z~ , S . 9 Z $_30 10`~ 2 316 - St I Z~Sb►z ~ • S 3 -~6 lb-fV_ ~lG `Fly' ~•SL12S/g %if S~~X Mlc _ . Z .3 a Boring # ❑ Boring ' ® pit • Ground surface elev. 0 ft. Depth to limiting factor 6 Z in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2 In. Munsell Qu. Sz. Cont Color Gr. SZ. Sh. + Eff#1 : - Eff#2 040 ~0-1'~_3tZ - So z-~ 6VL C w Z~ .S " t l0 - 2'1 ~o~ c~ ~l6 - S1 Z'~~k ►vi f C~ : S • g 3 Z-1 -6Z ~s4 2Wy - 154E My 1 S wl rn ~'i L SR~TS tuo ctvv •n Aju Ou.S - oZ- t Ti U ' Effluent #1 = BOD, > 30 < 220 mg/L and TSS >30 150 mg/L ' Effluent #2 = BOD, < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) Signature CST Number Arthur L: Wegerer rAg d, 220254 Address W e g e r e r Soil Testing & Design Service Date Evaluation Conducted Telephone Number 421 N. Hain St. River Falls, WI 54022 ~ 00 715-425-0165 I 0 Property Owner - GOLr 1" tAm/\ 6 ParcelID# I~QJ~fh/G Page Z of 3 Boring # ❑ Boring ® Pit Ground surface elev. Ct Q • o ft. Depth to limiting factor S In. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2 In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •Eff#2 D - 8 lb~i lZ.3l z ~ st I L`P~ b1e ►•n `~'h• c s L~ . S . g Z S:zo lo~~ ~ - s) i Z sbk h~ -Pl- cw 3 zO-27 -7 -Sy23! - L lcsbk w, cs - • Ll - b - syiz31y _ 1 s t~ sbk M v - Z ❑ ❑ Boring # Boring II ❑ Pit Ground surface elev. ft. Depth to limiting factor in. • Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft' In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •Eff#2 a 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 GPD/ft2 In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •Eff#2 ' Effluent #1 = BOD, > 30 < 220 mg/L and TSS >30 < 150 mg/L • Effluent #2 = BOD6 < 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-8370 (8.6100) w- y r Property Owner S• F. GOl G'C1`~iC)~T Parcel ID # i'C~I/V G Page L of F Boring # ❑ Boring ® pit Ground surface elev. Ct Q - 0 ft. Depth to limiting factor 1z S In. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2 In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •Eff#2 D -g tby I? 312 - s i I L`PJ b~2 Yn c s Z-~ s Z S 10 22.6 - s) I Z 3b4r h~ T, cw 1~` , s , G 3 Zo-Z.-7 -t-SYfZ M - L 1 O-sbk yn ; cs - • 14 - b y z~~s ~.sy2 y _ is tcsbk mvf~ Z ❑ 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 GPD/ft2 in. Munseil Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 F--T ❑ 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 GPD/ft2 In. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 'Eff#2 Effluent #1 = BODS > 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 (k6/00) Wisconsin Department of Commerce SOIL EVALUATION REPORT .,'division of Safety and Buildings Page , of 3 in accordance with Comm 85, Wis. Adm. Code Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must County 5-~ '-v' LX include, but not limited to: vertical and horizontal reference point (BM), direction and percent slope, scale or dimensions, north arrow, and location and distance to nearest road. Parcel I.D. PI;1 b I G Please print all information. Reviewed by Date Personal informadon you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Property Owner Property Location J- F. GQi iF )-Y1G04a- - GeA. t. Bl~ SE1/4 S Property Owners Mng Address Subd S T 30 N R l q E (or W Lot # Block # . Name or CS M# Got ~wL, cLL'~-c.~t- ~~z, `--r- S - ~ 0-Q-uIx 'UP C3xj L City State Zip Code Phone Number ❑CitY ❑ Village ®Town Nearest Road Yo X! ntV SS 3'j- 3 ( 6tZ) ct--,,s -!P10M I~NZS!_-?' 40 ?T:t- s7-. gj New Construction Use: ® Residential / Number of bedrooms Code derived design flow rate O O GPD ❑ Replacement ❑ Public or commercial - Describe: Parent material NZ:-,S (3 \,j `nk-L Flood Plain elevation if applicable lv , (-N , ft General comments and recommendations: y~pV yv~ g X- -Dt%'r tgj'n0ly C--LL Y" 1.1ki ~MUri 0 o- S FgLL, Boring # ❑ Boring © Pit Ground surface elev. ~S S it Depth to limiting factor 3 O Hin. orizon Depth Dominant Color Redox Description Texture Structure Consistence Bounda Roots Soil Application Rate In. Munselt Qu. Sz. Cont Color ry GPD/ft _ Gr. Sz. Sh. 'Eff#1 'Eff#2 p lo~ti:.:3t 2 - si I Z~sb ►z tin`f3- ~ : - z~ , S... s . Z g_3o )oH ri= 316 _ ..st I Z~'sb►~ vvl.~l.. 3 0-~l(, 1bYtz_ alt; ~l~ ~~S~i2Sl8 sil ~ 1~' •S •S YY1 ❑ Boring # ❑ Boring ® Pit Ground surface elev. q7- 0 ft. Depth to limiting factor ? E; in. [EDe Dominant Color Redox Description Texture structure Consistence Boundary Roots Soil A GPD/fton Rate Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. • Eff#1 Eff#2 toK cc- alt; - S~ I Z'vzi~k vvt c~ - S 8 3 Z-? 4Z ZLliZ3/y ~54L ics6k - - ;y .6 - NtV 1g W/ r'l L -SPOTS ljo cooj'PAj UOUS T ° l Ti U ' Effluent #1 = SOD, > 30 < 220 mg/L and TSS >30 150 m • g/L Effluent #2 = BODS < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) Signature - Arthur L Wegerer 0O- Z~Y CST Number Address Wegerer Soil Testing & Design Service _ 5 220254 Date Evaluation Conducted Telephone Number . . 421 N. Bain St'. River Falls, WI 54022 ~-Z~=OQ 715-425-0165' PLOT PLAN Page > of 3 Scale 1' = SO ' :toga' C%j -9'~HW-, 31~uD~►~. Qve PIPE- L-Q1.LAI-14. - G7 .n V) W C~ L m r- ~ 3 z~ ' gw. ~4- Z ' a I I - I~ 60 Do v~ o~- Ump "-T- Uri I o \STUtiZ `ni7S Aaz. ~ . I 6. • aI t3wi ~t-I L10 `n-t- sr. l1-ZI-00 715-425-0165 220254 b0-Z3 - S CST Signature Date Telephone No. CST N6. Job NO. X91 l r 0 m O N 1?TT~~ 1 nNnc ~ ~ 0 n V ~ ,AT T x N r 4 I s~ v y a o f l -F - a ~ S N- m y _ m i s y~ m I , HtaoN ~ i 1 CID Z o 8 9 r a+ A - - - 1 M hrn sg NMI A 177 9 --h3 _ - - - i s 4 Cy INO ~ Z a Parcel 032-2144-50-000 02/23/2005 09:21 AM PAGE 1 OF 1 Alt. Parcel 7.30.19.1260 032 - TOWN OF SOMERSET Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): * = Current Owner * FOSTER, THOMAS J & JOAN M THOMAS J & JOAN M FOSTER 481 NELSON FARM LA HUDSON WI 54016 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description * 1618 40TH ST SC 5432 SCH D OF SOMERSET SP 1700 WITC Legal Description: Acres: 3.000 Plat: 2497-ST CROIX NATIONAL ESTATES N SEC 7 T30N R19W NE SE LOT 5 SAINT CROIX Block/Condo Bldg: LOT 5 NATIONAL ESTATES NORTH Tract(s): (Sec-Twn-Rng 401/4 1601/4) 07-30N-19W SE SE Notes: Parcel History: Date Doc # Vol/Page Type 07/02/2004 767656 2608/421 WD 1200/189 QC 1117/415 WD 830/160 2004 SUMMARY Bill M Fair Market Valuer Assessed with: 11653 123,800 Valuations: Last Changed: 07/24/2003 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 3.000 105,000 0 105,000 NO Totals for 2004: General Property 3.000 105,000 0 105,000 Woodland 0.000 0 0 Totals for 2003: General Property 3.000 105,000 0 105,000 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00