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HomeMy WebLinkAbout008-1014-50-000V~lisoonsir! Department of Commerce PRIVATE SEWAGE SYSTEM ~ettety and Buildings Division INSPECTION REPORT GENERAL INFORMATION (ATTACH TO PERMIT) Personal Information you provice may lie used for secondary purposes [Privacy Law, s.15.(M (1)(m)). Permit Holder's Name: ^ City ^ Village ~ T~wrto Eau Galle Townshi CST BM E ev.i / Insp. BM Elev.: BM Description: ~t~o.a ~,~~' Tw~~it ~~~cnoneertnnl FI F TInN DAl TYPE MANUFACTURER CAPACITY Septic M,~~! u~,,, CT,~o SOD Dosing ~') ~~~ `-t Aeration Holding TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. vent to Air Intake ROAD Septic S'/~~ ? lon r 1 ~S ~ --~ NA Dosing }I~pl > t ~ ~ ~ 185 NA Aeration NA Holding STATION BS HI FS ELEV. Benchmarka'~ Ld2..`l pp, D Alt. BM St/Ht Inlet S 93.19 ~ St/ Ht Outlet '~ Dt Inlet '~~ ~' Dt Bottom ~ 3,~ ~ . 2~ f Header /Man. i `4'-~ qS.y~- Dist. Pipe ~Sx ~ ~~.`(S" Bot. System zrn ~ ` q ~-., Final Grade W; 1 ~ ~2+ Cdr : oe County St. Croix Sanitar~t p~rm~t No.: 383808 State Plan 10 No.: `f ~ S - ~ir~wls• ~ ~- Parcel Tax N~ A ,S 1~:~~~ ~y~ PUMP /SIPHON INFORMATION Manufacturer 0`~so Model Number ~ TDH Lift c~ ?jD aiy0 haAXK. ~ ~n Cs -Z..1 Demand `~~° GPM TDH h, q,1 Ft I Forcemain I Length ~ ~2r I Dia. Z tt I Dist. To well ~ Ip~ ~ I cntt eRCnaaTtnnl cvcTFne th d D ED TRENCH Width I Ln9t r f TTs~~eh~ s ~/~ ' ~ ~ IT N No. Of Pits ep Inside Dia. Liqui D MEN I N 0. ~• ~ MEN I anufacturer: SYSTEM TO P / L BLDG WELL LA E /STREAM LEA N SETBACK INFORMATION Type O ~'r } 13pt ''-$~'` `'~~ CH R UNIT o e Num er: System: nreroror rr~na~ ev~TC11A ! u~ t~es-t~ ~-~~ ) Header / Mani old ~ ~ Distribution''Pffi e(s) / ~J' ii r ~ " ~ `~ ~ 1z r, x Hole S~ e I r x Hol~/Spacing Vent To A~ it Intake ' Spacing Length T ia. Length ,0 Oia. 2 $ 20 L entf ~nvFa Y Pressure Systems Only xx Mound Or At-Grade Systems Only x~ Depth Over Depth Over xx Depth Of xx Seeded /Sodded xx Mulched Bed /Trench Center Bed /Trench Edges Topsoil ^ Yes ^ No ~. . ^ Yes ^ No COMMENTS: (Include code discrepancies, persons present, etc.) C1) Ylokr ~t-"'~-'^^D~- Inspection #1:4~-`/ I ~/ o ( Inspection #2: °~-- Location: 2203 55th Ave ue, Baldwin, WI 54002 (NW 1/4 SE 1/4 5 T28N R16W) - 05281674A /,, ~--~ 1.) Alt BM Description = ~iV/k~ ~ `1' 2.) Bldg sewer length = ~ p' -amount of coteff = ~," ~ . / 3.) contour= 96' l to•SDr o•'F~= IoZ.9'~-' ~.~~ PI~ re- vlsiofi equired? ^ Yes ,~No ~ # I Use other side for additional information. o~ ~ 1 e ~ ~ ~ SBD-6710 (R.3/97) Date Inspector's Signature Cert. No. ir~ Z t Lb ~z.~ :4anitar~ Permii .~.Irl~lication ~ Sa1e1y £u Su~tdir~~.~ Lscv,sl~r 1~: ac;nrd vri;i•i Comm R3.21. ~1,< ,4dn: Coec I Z~+! ~'~ `~v"SSh?Ti~ti)n AVC. I Sec r;:+~ersc side ier ms~ri,~turs i'or compiz;isle ~hls app cA',lon ~ , ~ 7;,_ ., ,,~., ~~scor-~rsin r ~, . }~~ ~~. ~~~~ nMSOrtr1; ;rfttr!!+a11Gf' VQU r0~tde 1118.; bC UseGi 10f SCt;Utl(i8n' UT 1SC5 !vtaft1S4S1. ~~+ . 3 ~~/•- ~~. Department of Commerce p P a' t;ubmit completed form to coulu? if t (Privacy La1s. s. 15.94(1 }im)j Attach com Sete Mans (to t>tr county co ~ oniv) fur the svsterr.. an a er nai less than 8-lip ~ ! ! ircnes in size. Conroy G State Sanliarv Fernti± Number t:7 Checl: if revis~oR to previous application St,;tc Alan 1. .. a tb r,_ t- 3 3 ~v I. A Iiration Information -Please Priat ail Information irocatiolr: _. Property Owner Name y Location P ~ Property C+wnar's Maiaing Address Lot Number 8toci; Nvmi:t: c7o~ ~,3 ~~ ~ ~t ~ - Ciry, State Zip Code Thane Numbat Subdivision Namr or CSM tvumber II Type of $uiitiing: (check one) of Bedrooms' © ! or 2 Family Dwelling - No ~ ~`ty Q~zliage . © PublicJCotrmercla! (describe use): t,7CTo1vn of ~A ~~ ~ G) State-owned ' ~ III Type of Permit; {~hec~: on!}tone fox an title A. Check boe on Fine B if applicable} Nearest Rc,~~-,~.,,~ ~~ A} I. l7 New System 2. Itepla~emc 3. '.1' Replacement of 4. ©Additior, to Parcel Tax Numtxr{s) ~S stem 'tank Onl • Exisdn S ~tcrt ~ - -Ock~ ~} i Permit Number S 2 . /(~. /4 Darr Issued II A Sanlta Permit was revi+susl issued ,. IV, Type of POWT System: (Chec3c al! that apply) Non-pressurized In-ground Mound G] Sastd Filter ~ Constructed Wetland D Pressurized In-ground 0 Hotdirg Tank D 5inelc Pass !:t Uryp Line p At.grade ^ Aerobic Treatment Lnit .J Recirculating D Outer: V Dill rs>tltfreatme 1. Design Flaw (Ppd) atAre~ Information: 9 - Z. DispersaiArea 3. Disperse! Aroa +t. Soil Application 5. Prxcolation Rate 6. System Elevation 7. Final L)tade ~c~~~ ~ Required Prop08eA Irate {Gats.ld yl9Q. ft.) (Klan.+inels) ~~ ,~ ~~~ ~ 6a=~ ! &trvaltbR ~ 9 r 7~ ~ r ,.~-~ VI Taak Capacity in Totat ~ of Manufacturer s Prefab Site Steel Fiber Plastic C ~ iaformatloa Gallons Gallons ' Tanks Con- crctC on' E strutted New Existing l Tanks Tanks O O ~L~ ~ ~ ~ f © l~ P VII Responsibility f5tatement I, the uaderai ed lissome res nsibili. • fer installation of ttte POWTS she ttso atta«hed lens. )3tu,ness Phone Number '~ Plumber's Name (prlrtt) .Plumber's igaature (no ps}: P PR5 No. ~ 3 ~~ ~ ~2- .~ j / .D n . _ Plum 's Address (Ssrert, City, tale lap da, , ~` cf~~'~ =~i L -- t \~ 2 Viii County/Deptirtrtnent Ilse only ,• ECEIV O Disapproved Sanitary Permit Fec (includes Groundwater Date lssuad Issuing Agent 5igit~Q~,INo ) u t~Approved O Owner Given Initial Adverse Surcharge Fer) d Z ~ 3 2 S ~ 7 . Determination IX. Conditions of ApprovA! /Reasons for Disapproval: ~ ~ N ~ ~ Ir/fPr Tp 4C /NS~ir~~c~ Qh.l~ Yr~atvValnPc~ PGA' k~Qnlti-~e~C~itvl/S r'CCoMr~GC•..6',LYJ~~~'• ~~ 5 5!/Cr~. ~d ~ e Q ~R -L QOh ~c~ ~ 3. 3j \ ~\(~ ~~ 58D•6398 (R. 07!00) ~ f -scons~n Department of Commerce October l9, 2000 CUST ID No.227618 TOM GUSTUM N 13450 937TH ST NEW AUBURN WI 54757 RE: CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 10/1' Safety and Buildings 1340 E GREEN BAY ST STE 300 SHAWANO WI 54166 TDD #: (608) 264-8777 www.commerce.state.wi.us/SB Tommy G. Thompson, Governor Brenda J. Blanchard, Secretary ATTN: POWTS /NSPECTOR ZONING OFFICE ST CROIX COUNTY SPIA --- ~ 1101 CARMICHAEL RD ~?~1 / 1 i 13t`IDSON WI 54016 ~y~.- _~ ~, ~. r R~~~'~r~ ~? ~~~ ' \ Identification Numbers ~- ransaction ID No. 444445 ~, ~'••' a i~Ud ~ to ID No. 200863 SITE: ~' S7 c;ROlx ~ - ~ lease refer to both identification numbers, Site ID: 200863, ELIZEBE'fH LAV J NI ~~~ - , above. in all correspondence with the agency. G UFF SCE ST CROIX County, Town of EAU GA ~. ~3 55TH AVE, B. NW1/4, SEI/4, S5, T28N, Rl6W `` ~` FOR: `" _ -~- Description: MOUND SYSTEM FOR ELIZABETH LA VELLE Object Type: POWT System Regulated Object ID No.: 767727 WIN 54002 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 installation: • The piping used for the manifold shall comply with Comm 84.30 (2)(e). • An access opening of sufficient size to allow removal of the filter must be provided over the outlet "tee" baffle of which this product is installed. This access opening must terminate at or above grade. 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. All permits required by the state or the local municipality shall be obtained prior to commencement of construction installation/operation. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. Sincerely, , KEIT WILKINSON , POWTS PLAN REVIEWER Integrated Services (715) 524-3630, FAX: (715) X24-3633 , M-F 7 AM - 3:45 PM KWILKINSON[~COMMERCE.STATE. WI.US DATE RECEIVED 10/12/2000 FEE REQUIRED $ 175.00 FEE RECEIVED $ 175.00 BALANCE DUE $ 0.00 WiSMART code: 7633 cc: ELIZABETH LAVELLE ~~~'~Q ~~~ a~~L~~~ o sP~~y Owner's Name Owners Address Legal Description Township County Subdivision Lot# Parcel ID THOYAS D. QUS1U111 1~'I total # of pages: Designer Name: License #: Date: Ph. #: Signature: Mound System Cover Page Elizebeth Lavelle 2203 55th Ave Baldwin, WI 54002 715.684.5056 NW'/+, SW'/4, S5, T28N, R16W Eau Galle St. Croix 008-101450-000 Table of Contents pg 1 of 8 F.Q.~~1.T.5. ~'n~ic~~~ior~c~~'~y ~~ ~ ~ DEPARTMENT OF COMMERCE DI`JISION OF SAFETY Q~ BUILDINGS _ ~ ~- SEE CORRESPONDENCE P9 1 Cover page 2 Mound Sizing Calculations 3 Pressure Distribution Layout and Dynamics 4 Dose Tank Calculations 5 Mound System Drawings 6 Management and Contingency Plan 7 Plot Map 8 Pump Curve Specifications 0 ® ~~~~~ ® ~ ~ . ~~ ~ ~~ D I ~I 10/10/2000 715 m 6 -3~ H t~~~~ ~L~ 4V4~ Mound Sizing Calculations Site Conditions Private Dwelling or Commercial (P or C) p Slope 2 # of Bedrooms, 1 or 2 family dwelling only 4 Depth to limiting facto 2 Absorbtion rate of fill material 1 In Situ Soil absorbtion rate 0.4 Max BOD effluent value 220 Max TSS effluent value 150 Design Wastewater Flow Design Flow -Private Dwelling 600 gal/day Design of the Distribution Cell Bottom area of Distribution Cell: 600 Ft"2 Distribution Cell Width (A) 7 ft Distribution Cell Length (B) 85.8 ft Ground Contour Elevation of Mound 96.45 ft Desi n of Entire Fill Depth at upslope edge of cell (D) 16.0 Inches Depth at downslope edge of cell (E) 17.7 Inches Distribution Cell Depth for Aggregate (F) 9.5 Inches Cover Thickness at Distribution Cell Center (H) 12.0 Inches Cover Thickness at Distribution Cell Edges (G) 6.0 Inches End Slope Width (Iq 9.6 Feet Fill Length (L) 105.0 Feet Upslope Width (J) 7.5 Feet Toe (Downslope Width) (I) 10.5 Feet Fill Width (W) 25.0 Feet page 2 of 8 Toe Adjusted to Increase Basal Area Basal Area Basal Area Required 1500 ft^2 Basal Area Available for Sloping Site 1500 ft^2 Available Basal Area Adjusted Observation Pipes Location from each end of distribution cell (Z) 14.3 Feet Pressure Distribution Calculations Lateral Layout Lateral Elevation 98.45 ft # of laterals Center or end manifold (c or e) c Distal Pressure Requirement 5 ft Orifice diameter ~+Bt iq Lateral Length -x-80 ft y2. `!~ Orifice Spacin /Distribution Est. Orifice Spacing in Inches 20 in Est. Orifice Spacing in feet 1.6667 ft Available Or7fce Choices: Actual Orifice Spacing in Inches ~9:a2 in 2v Fractional 1/s s/1s 1/4 Actual Orifice Spacing in Feet ~-~'t'ft I.6~ Decimal 0.125 0.188 0.250 Orifices per Lateral ~ Z(p Square feet per orifice 6 ft"2 Lateral/Manifold Design Lateral Diameterin Lateral Discharge Rate .1D-~J8`gpm /(~. ~ (p Manifold length 4 ft Manifold DiameterC~in System Discharge Rate.-498 gpm ~f 2. (o `f Lateral Spacing®ft Lateral to Distribution Cell Edge 1.5 ft Force main Friction Loss Forcemain Length 60 ft Forcemain Diameter 2 in ~g(16~ Friction Loss from Forcemain 2.091 ft 3~ -~- ~a $., IIIti Center Manifold Lateral Side View page 3 of 8 t~ Manifold ~ ~ . g Lateral ~ Lateral 4 Lateral Center Manifold Plan View Force main oonneotion via tee or Dross to maniFotd at any point. E-- GAtsral L~als are idendc al s OhtPessonbi~tanof IE-X-~Ifxr2~xr2~l GACeFaIsB~atisntawdSicNaOi°VC I~Sral squally spaced I,I Q~Trrn-xp rf ballYalYs a clsanadt'pluq Septic, Pump and Dose Tank Calculations page 4 of 8 Total Dynamic Head Calcs. Are laterals highest point in pressure system? y If not, list the highest elevation 0 GS ~ ~" n~,~'W~k.. l ~ SS ~ System Head (distal x 1.3) 6.5 -, ft Vertical Lift (pump off to lateral) 8.45 ft Friction Loss in the Forcemain 2.091 ft Total Dynamic Head (TDH) 17.05 ft Volume Calcs. Does forcemain drain back to tank? y Lateral Void Volume 17.72 gal Lateral Void Volume x 5 88.58 Manifold Volume 0.65 gal Forcemain Volume 10.45 gal Total Dosage: 99.03 gal Tank Information Tank Manufacturer l west rE Tank Capacity 800 c Tank Gallons per Inch Water Level 21 c Bottom of Tank Elevation 91 1 Pump Manufacturer/Model Hydromatic Septic Tank Capacity Chosen: 1280 Septic Tank Manufacturer: Midwest PrE Effluent Filter: Zabel A100 Pump Tank Diagram INaterF,gh~ lakinq caNar ~ Inch ~w~h warnhq label MMtTu Alternate Outlet. Loieabton ~nl~had Access opening of sufficient size to be provided to allanr remonr~+l of filter. Opening to terminate at ar above grade. 1~1, 3 ches Gallons ~lactreal par A= Conrn 16.28 and B= NAG X00 raa. C= D= LVeap Hda A Total= ar Antx5p4ran 17avica D L C7 1.5~ 407.0 2.0 42.0 4.7 99.0 12.0 252.0 38 800.0 Selected pump requires a minimum operating rating of: 17.05 feet of head pressure at 41 GPM Mound System Drawings page 5 of 8 Mound Plan View w A= 7 Ft. 6= 85.8 Ft. 1= 10.483 Ft. J= 7.5 Ft. K= 9.6 Ft. L= 105 Ft. W= 24.983 Ft. Z= 14.3 Ft. Mound Cross Section View (Typical} Cower ~la~er~al ~Inal Grade ~ Synthetac ~abrlc ~1b~ervatlon pipe _ I~I~trlbufaon Cell D (~ E= 17.71n. H F= 9.5 In. G= 61n. ~dl Ma+erlal ba '4,~ ~a ~ ~ H= 12 In. ~ Later # ~ ~...,,. °`°" ~ 1'Illed Area ~ ~~orce ~aln ~~~~ Final Grade: 99.58 ft C Slope= 2 % Bottom of Distribution Cell: 97.78 ft Fill material consisting of ASTM~33 Sand System Contour: 96.45 ft Distribution cell aggregate to comply with Comm 84.30(6)(1) Synthetic Fabric covering cell per Comm 84.30(6)(8) Lateral Cleanout Detail Clean-out plug ~~Inal Grade ~or ball valve Lawn Sprinkler I~ax Lang Sweep or two ~~'s Mound System Management Plan pursuant to Comm 83.54 W. A. C. page 6 of 8 Owner's Responsibility: The component owner is responsible for the operation and maintenance of the component. The county, department or POWTS service contractor may make periodic inspections of the components, checking for surface discharge, treated effluent levels, etc. The owner or owner's agent is required to submit necessary maintenance reports to the appropriate jurisdiction and/or the department. Septic Tank: Septic tank(s) are to be inspected routinely and maintained by department approved individuals when necessary in accordance with their approvals. The use of chemical/biological "treatments" is not required or recommended. If such additives are used, make sure they are approved by Department of Commerce, Safety and Buildings Div.. Effluent filters are to be removed & cleaned as necessary, with provisions to keep solids from passing the septic during removal. No more than 1/3 of the usable tank volume may be occupied by sludge/scum. 3 year inspection: If tank has greater than 1/3 volume sludge, tank contents must be emptied and disposed of in accordance with NR 113 Wisconsin Administrative Code by an approved individual. If the inspector does not recommend pumping of the septic tank, then the owner must be notified of when pumping should be done as to not exceed 1/3 sludge volume. Septic tank should be routinely inspected to be watertight and of good repair. Pump/Dose Tank If an effluent filter has been installed in the pumpldose tank, it must be removed 8~ cleaned as necessary, with provisions to keep solids from passing to the mound component during removal. The pump, float switches and alarms must be inspected at least every three years for proper operation. Pump/dose tank should be routinely inspected to be watertight and of good repair. Mound and Lateral System The mound system component must remain free of ponded surface water prior to pump operation. If 4 inches or more water level is detected in the observation pipes, the owner must be notified of possible problems/failure. The designed daily flow capabilities of the component should never be exceeded. Trees and any other deep rooted vegetation should never be planted, or allowed to grow anywhere on the component. Activities OTHER than mowing/maintenance (i.e. excessive walking, pets, vehicles, etc...) could compress the component and reduce it's absorbtion capabilities and/or possibly cause it to freeze in winter conditions. Lateral distribution pipes should be flushed out/tested every 18 months using the cleanout points at each end of the component to remove scum that may clog orifices. Performance Monitoring: Performance monitoring must be done at least once every three years following the installation or at the time of a problem, complaint, or failure. Contingency Plan: If the septic tank, pump tank or any of their components therein (inGuding floats, alarms, pumps, etc) become defective, the defective tank or component must be replaced immediately to ensure that the system can operate as designed. If the mound component cannot accept wastewater or ponds wastewater to the surface, the component must be repaired or replaced in it's current location by either: extending basal tce to provide added absorbtion area; or by removing the clogged bacterial mat,aggregate cell, and distribution piping within the mound and replacing said components in order to return system to proper working order as required. U / V 'T ~ 55th Ave cb~Jey~a. ~~Uh ~OnQ ^ = S01L BORINGS '~h~1TH BACKHOE ii'2~ ~ {130'} s E M 1 ~ = ELEV. 100.0' -Bottom of garage siding- also HRF [,yl~ ~~c ~ oc~f` ~t ~~~` P^ ~ aCt` S ~ ~ BPd2 ~ = ELEV. 96.39' -Top of ~/2" I.P.- also HRP ~~,s~'~~ ~Y oss~~~y ~ ~. ~ Fwd ~ ~~ fay 1 SCALE = 1:40 -~~"' ~„dor Existing par}+Y k 4 bedroom home % I Garage ASTM 3034 ~ or Sch40 4~ _~ PVC Pipe BM1 (~~- 1280-800 Gal{on combo tank 3 D J ~, X~ 96.45' C ontour ~, 61 96.45' 96.0' Contour, ~ ~ \~ \\~ F. \\ ~~o Q ~~o 7 2" Sch40 ~--PVC Forcemain 7 X 85.8 Aggregate Distribution Cell ~. ~~~ , a 2 ~ ~~ 6.45' ~~,~~,, ~ B M 2 ~.._ ~-v~ 5 4 C ~ L O r--~- Q IE Well ParcellD: 008-101450-000 Meets code setback requirements GUStUtTI Elizabeth Lavelle Plot Plan ~ Septic 2203 55h Ave Baldwin, VN 54002 Town of Eau Gabe NW/+of SWY+of Sec 5 T28NR18W AE ..o .e u~t =40~ I I 3 2 1 ~~ Performance Data Pum Characteristics c`k`~t ~ " Materials of Construction ~-7ra• (98.42) 3 7 (8' - (98.42) 11-3/8' (288.92 Pum /Motor Urdt Submersible Manual Models SHEF40M1 SNEF40M2 Automatic Models SHEF40A1 SNEf40A2 Hor wer 4/10 FuN load s 12 6.5 Motor T Shaded Pole (4 Pole) R.P.M. 1550 Phase 10 Voh e ' 115 230 Hert: 60 Tam rotors 120° F Max. Fluid Tem . NEMA Des A Insulation Class A Dischar Size 1 1/2" NPT SoBds Hand6 3/4" Wei bt 281bs. Power Cord 18/3, SJTW, ZO' std. (30' optanal) Handle Stainless Steel Lubric Oil......:. Dielectric Oil Motor Housin Cost Iron P tas Cast Iron Shaft Steel Medmndwl Shaft Seal Seal Facos: Carbon/Ceramic .Seal. Body: AnotBzed Steel Spring: Stainless Steel Bellows: Buns-N 1 En ineered Thermo last's U Bronze Sleeve Bear Lower Si Ie Row Boll Henri Bottom Plate Pol ester Coated Steel Fastea~s Stairdess Steel legs Engineered Tberan-plastk ©1998 ~~ HYDROMATIC • P 1840 Baney Road Ashland, Ohio 44805 Tel: 414-284.3042 Fax: 419-281-0081 Web Site: www.pentairpump.com SALES OFFICES IN ALL MAJOR CITIES AND COUNTRIES Refer to °Pumps° in the yellow pages of your phone directory for your local Distributor Item#: W-02.6680 1198 SM Dimensional Dat 3-7~a" 6-5/8• (168.z7) ~(se.a2>~s• (1a71~ 40 SHE F4 30 20 10 0 10 20 30 40 50 ~0 10 GPM ~Z-~`~ ~ Total Head (feet) 10 14 17 21 25 28 30 35 (m) 3.0 4.3 5.2 6.1 7.6 8.5 8.8 10.7 GPM (US GPM) 70 60 50 40 30 20 10 0 (liters/sac) 4.4 3.8 3.2 2.5 1.9 1.3 .63 0 a ).All dimensions in inches. (Metric for international use). 2. Component dimensions may vary t 1/8 inch. DISCHARGE 3• Not for construction purpose 1-112' NPT unless certified. Tcr1 4. Dimensions and weights are approximate. 5. We reserve the right to make revisions to our product and their specifications without notice. a I 10-3/16' (25876) ~- f 3-518" r (5o.e) (sz.o~) ydromatic® Pumps, Ashland, Ohio. All Rights Reserved. -Your Authorized Local Distributor - 8 ~ 8 o~jjtY SYfI~, ~l~l-~fil ~_ '°"v' O'~~MATICYJ~. ~ .t` ~ r- ?, °r.z. Wisconsin Department of Commerce SOIL EVALUATION REPORT Page ! of `~ Division of Safety and Buildings ~~~ VVVV,VO~~VC ..~~~~ VV,, ,111 VV, •11J. llV,1,. VVV6 ~ C~~!• County Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but not limited to: vertical and horizontal reference point (BM), direction and percent slope, scale or dimensions, north arsoww and location and distance to nearest road. Parcel I.D.OdS . /~//, s•Q •00 ~ 7 Please print all information. Reviewed by Date Personal information you provide may be used for secondary~urposes (Privacylaw, s. 15.04 (1) Cm)). ~ ~ Property Owner y ~~ ~j_ . /~ =-- - ~L/ ZE'/3i ~~ !d'L ~L ~•~`/' ~ " Property Location Gov~.~Lot N~ 1/4 ~ 1!4 S s T ~ N R ~ ~ E (o W Property Owner's Mailing Address ~ ~ - ~- ~+ - L ,L# Block # Subd. Name or CSM# N/~ ~ , City State 'Zip Code P.1>;pne er.. . G ^ Village own Nearest.Road ^ New Construction Use: ~ Residential ! Nu ~,of~ edrooms ' Code derived design flow rate ~Dtr'~ GPD ~~ ,Replacement ^ Public or cnnomwmerci = Dgacti ~:~^~ ~ Parent material ~ S ~ f~'~Jli P~ Flood Plain elevation if apdpNcable ft. ' General comments ~ ~e (s ,/ .~/.- /I N ~Z~ s'O/ L G(j~7.0 ~j~.7~' and recommendations: .wj' /j' 7 ~p~~~~ ?. <ovG- ,vii ~~v ~-I~vv~ ~v i~- /(n ~ sff'~!~ ~i'll ~P~QUfi'e~ • s-~- . 3 ~ ~. co~t~ ,~v¢-T~o.v s . ^ Boring # ^ Boring ~/ ' ~` Pit Ground surface elev. (O J ft. Depth to IimiGng 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 ~ o•io. ~oyR y/ L /fs ~ s c~ ~-~ • y . ~~ • ~ io ~~ c2~. Mots CL h /' .~.. .3 s. R s/D Z ^ Boring Boring # / Z, ~ - ~. Pit Ground surface elev. (9 ~ 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 ~ o• ~~- - io ye yf ~ ~,~s~~ ,~ ~~e cw ~f . ~ • o '/p ~Q Gz4~ ~•totS SG /Uf C ~oy~ ~~~ o. ,oy,~ ~~ s~~ i sd~ ~~,- . Z . 3 'Effluent ir1 = BUDS > 30 < zzu mgrL ana I ss >3u _< 15U mgn_ - tmuenr ~~ = rsvu < su mgi~ ana i ss < su mgi~ CST Name (Please Print) ~ LQ D i G ~~ Signature 2 ~, (~3 7 S o6~RT 1~ Address Date Evaluation Co ucted Telephone Number l ~ ~ -o~ 7~.5.38~ • 8/8S _ .._.....~.a.,~. rriva.v w..ay....-•-__ 655 O'Nefl Rd. Hudson, Wis. 54018 ORIGINAL -_-, Property Owner ~' ~~ ~~" - Parcel ID # Boring # ^ Boring ~ . ~. Pit Ground surface elev. ~ ___ ft. oo~~ /oty5 • ~-o ~ Page Z of Deoth to limitinn fartnr '2~ ~ ~., Horizon Depth • i Dominant Color ` ;~ .Redox Description Texture Structure '.Consistence Boundary Roots Soil Application Rate fGRD(ft? ~ Z 3 n. °-,o /D •~ Munsell Faye c ~/D Qu: Sz. Cont. Color - - G SG Gr. Sz. Sh. ifr ~ / s!>rE' s .~.,~ 7<,2 rcv. cs / ~ 'Eff#1 • .Y ~ `Eff#2 ~ . ~ .. to ~ • ~ S! C2 Mo7 CG ~ z, 3 .~ /~ ~ 2 ~. 5l t!v ^ Boring # ^ Boring ,' ... ,. (1 p;t Ground surface elev. ft. np~rn to i~m~r~.,., r~..r.,. Horizon Depth Dominant Color °Redox Description Texture Structure Consistence Boundary Roots . Soil Application Rate GPD/ft2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 `Eff#2 ^ Boring # ^ Boring Pit Ground surface elev. ft. Depth to limiting factor in. Horizon Depth Dominant Color "Redox Description Texture Structure Consistence Boundary Roots Soil Application Rate GPD/ftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. `Eff#1 `Eff#2 'Effluent #1 =GODS > 30 < 220 mg/L and TSS >30 < 150 mg/L `Effluent #2 = BODS < 30 mg/L and TSS < 30 mglL The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to ~access~ services or need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. SB0.6330 (R.N00) .S5" ~. .~9 u-e . FARMING NpN_C4N LL ALA TMEN? YAN A~pER1.Y A NO~NEp P BE~ABA p a3.o312~' FAA ItrH S~ ~s r~ ~o v~-~D s ~/ST . ~ S ~i ~ S~ti p ~i/l 9 ~r ~~ ~~ ~~ 0 ~~~~ ~,(N L~~N,~' sys i ~ ,~ ~ v1~ 1 t~' ~ %Y~ ~ R3 ~~ ~~D , p~QP I >vX~sr~N~ ~.. ~t~~ f{oM.~-- lg~ __ ~- ~} ~ ~"~ 2~ ~ o~ ~~ g~~ --- ____ S~ D~ ~ ~oo~D ---~-- yo '/.~ 2 ~r 9D 5~~~~~ / ~~" ~~ ~-3of3 - tifibricht 8 Assoclate• Private Sewage Consultants 655 O'Neil Rd. Hudson, Wfs. 54018 (o b ~~, ~~ ti~~'~ L ~~ W ~~~ ~ ~ T a~ b ~S , w. ~~ W ~ ~ ~'~ ~ ~i~b~ ~'-~- ~ y ~.~~~ s -. 3 ~. ~P- _--_ OCT.25'2000 14:08 6151 736 1516 3M HEALTH CARE 270 4N #1403 P.flfl2fCfl2 F,R[]M ~ NORTHLAND PI.JJf+?81t~iG, IlVC. FAK N0. 75~-54~-25~ Qct. 26 2000 0B:@7FI~7 P'2 ~tl~'~~1. ~a.:~r. ht~~~,'ti: r!1,+y'~fL~t. ~A.iJI~~~!tit~~-1 AND GW'~+B~SMiP G~RTLF1CaTtG*~ PORN! ~~ r' ~.~ 7~~ ~~"•~~ I~dsi ~-ddrge or ~ r- ~Y ~+e~ifiiciNoa teq~tnd pt ~bt ei'~r OOpetlp~ely ~.. ~ty/st~a ' ~+.'~ lei ~ mar .,. daft~/d./~y-moo P:oPestY Loc~tian, awl ~+. , ~, ~. ~ T ?;~..~.I~,~~~ "~bvv~ al ~~- C~1lMd ~tewy 11t~p ~ .~...,,.--- _ ...,,~ Y _ - _ - . Air ~ w~rr~rRs- ~d N ~~~z ~a vase .L. ~.~?~ ~ ,~.~--..~.~• ~peo ~ ~ y.e iJO-no t~ ~k Ct ys C3 na nre~uL ~gfe~o~s edges eyaaa~~ar~d stela ~re~+~tte ureeoee. ~eopec~ aer~ et ~ +1M arek eel ~uredgt ~ ~ e~ raaea, ft tam ~- R ~reiwd W~c l-~~vd+ ~e- +~. -~~"~~~~ic~s~,p~'~ ~ der ~~.:eF '~ ~eegr •waer e ~ remit ~ ~. t DaPetl^Nit a oee!l~ea lbe~, by ~ a•rae~ end bar mer~P~n6er-~aro~ ~pi~dplwre~..r~~lwwd~r^~pleweill+I~~Mt~t)MMO+I~t~ar~+riparuo. ~ la~r~O~+i~ t~~~i t~'d~+~t~ak~e tine dw~ sis ~.r.t~. thww eM+m~dri~-sa~~r~.a. twgplewe~b eedt~se m~~let+rtr erer~t,~pe4ieyere! m. ~ eetlbetk ~eertp, e~eaettip- ~ D~pge~eotata`~M atli~t- ~a atW+~ ~ ~ drat yeas t+pda ir~~ dot 1r egdt~ea~d sear ~ i~~amuty Fiareiai ol6oa + 3C ~ dies iae ~p~doade0r f7j r~+rrr~ ~~yr // ~~ 6~' t ~M~? ewit'Q-~ eM~ae~r+ ~- tl~ ~aw:~ ar retie ep itir ~ *f mir (,ov~j ~o~rtol~c, t {vrcf use ~sn) ~ onv~{r~ ~' t5s Nopee+~-1WwiN ~Mei ~ vieple At N Wy~pty ~M4 eMiaded ie{ ~{AMe of ~7eair L7I~M~ ~~M~* ~ ~ e~ ~ ~~~wi FY~Me ~ ~ ~P-~J ~ ~I~Y~Y ~ ~~~7 D~r~^'..~'• M*'IMr~ "' t~ ~R: a ~iNi ~ ~r~P /r r ~ at tae +wrglrr~ an+sy ~ U Ahelw fe i~e.1IN ww~r4rtt!' deeu ~. ~ ~ vot 1517PAGE240 624425 STATE BAR OF WISCONSIN FORM 2 - 1998 YATHLEEN H. WALSH REGISTER OF DEEDS WARRANTY DEED ST. CROIX CO., WI DocumcntNumber RECEIVED FOR RECORD 06-07-~CD00 IZ:10 PN This Deed, made between Arthur D. J®nsen Trustee of Arthur D. Jensen Trust dated July 6 1999 WARRANTY DEED EXEl~T N CERT CORY FEE: Grantor, CDPY FEE: and Elizabeth A. LeVelle a sinala o®rson TRRNSFER FEE: 467.50 RECORDING FEE: 12.00 PAGES: 2 Grantee- Grantor, for a valuable consideration, conveys and warrants to Grantee the following described real estate in St. Croix County, State of W isconsin: Sce Attached Recording Area [ur n Address Name and Re y ~ I C.rQp S. c~n`~ S'1~/P Of i~s~&-P-n cJ ( SoIO~ !o Qd 0/ ~ ~,Sz~' Ovc7 -~~~ ? ~ %vl na ' U - Parcel Idemificatinn Number IPIN) This is homestead property. (is) (is not) Exceptions to warranties: easements, roadways, and roatrictions of record Dated this ~ day of r +Arthur D. Jensen s AUTHENTICATION Signature(s) authenticated this day of , TITLE: MEMBER STATE BAR OF WISCONSIN (If not, authorized by § 706.06, Wis. Stau.) TH3S INSTRUMEN"r WAS DRAFTED BY Michael H. Forecki Attorney Eau Claire, Wisconsin (Signatures may be authenticated or acknowledged. Both are not necessary.) ACKNOWLEDGMENT STATE OF WISCONSIN ) ss. St. Croix County „P~sonalty came before me th' day of e above named Arthur D. Jensen to me known to be the person who executed the foregoing instrument and acknowledged the same. Tracy L Turner Notary Public, State of Wisconsin M}`Commission js,pgrmanent. (If not, state expire 'on daaa l k~ c~ / }.Sir/- !y 'Names of persons signing in any capaciq• must be typed Or printed lxlow their signatu7t. f~Qfary PUbIfC STATE 8AR OF W ISCONSIN St6te of Wllsconsfn WARRANTY' D};Ep FORM11 No. 2.1998 Produced wIU ZipFarm "' by Vaniwa Inc. 18025 Fiaean MiM Rwd, CYnlon Towruhip, Midii9en 48035, (800) 387-9805 Cemury2l Prcinicr Group 706Igh 31. Iludxn WI54016"2161 Phane: (713)1flafl207 fa.'. (713)186-6651 ~~~_ 151PAGE 241 Grantor-Jensen Grantee- LeVelle arter (NW 1/4 of SW 1/4) of Section Five {5), t Range Sixeeen (16) West, St. Croix Northwest Quarter of Southwest 4u Township 'twenty-eight f28) D1or~• ° A a=Cel of lard five hundred 1500) ,n„ency-eight (28) North, Range Six[een (26) County, Wiseonsiz, ~Cept the following: p feet in width, located in Township artez of the Southwest Quarter (A'W Fivc {5) in the Northwest Qu seventy bleat, Section within lines that are three fiiadred one hundred 1/a of SW 1/4) thereof, lying les northerly from and (370) feet distant radially and ac zight ang from at:d bath and at right angles southerly in Section Five thirty 1130) feet distant radially arter parallel [o the following deseribed994f9~efeetlSouth of thelWest {1/4) 4u (5) on the west lire a distance of a 5729.58 foot corner thereof, thence South 84 degrees 45 minutes 00 seconds West a distant of 252.52 feet to the point of beginning. thence easterly on radius (1 degrees 00 minutes) Curve, concave Southerly a distance of 1861.67 feet to the point of range-~cY with a line bearing South 76 degrees 38 minutes 00 seconds East. Sc- Croix County, Wisconsin. ~ r W 7 /4 COR. SEC. 5 ___ -- r - _ _ 55TH -' WA I~~~a~33 ~-e. l4(~~z3~ ~~v~e ~ ~ t~l~~ ~~(~ ,P~,Z°`' 74A a ~~Ue\~e- NW ~/4--SW ~/4 ____- -- --- --. --_.' I --__ - INTERSTATE 1 . ~~ ~ ~ t~,I~ID (~'~ -'~ ~~ is,~(~39 74B~~,, - - - - _~ ---- - .. I _... _ ..