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008-1094-40-100
y m O O N n O 7 Cn Z N ~ D W rnn c O ^. z O C_ ~ of ~ a CD ~ ~ IC W d a ,~ ~. o ~ ~. ~ O N _, fD 0 7 N 7 ~ V ~ S am ~ ~' ~ ~ ~ Q ~ M~' c C ~ ~^ O N N O ~ ~ ~ m &'Qyw~~ ~i ~ •°.°.:.o ~~~~' ~ ~ ~ a'~ ~ ,. ~ a ~+ m m ao ~' a d tD (aD O ZW~ Q d~ O O y d O N QNp r. O ~O ~^' O 3 ~D °' co ~'• v f'o~y N N ~ ~ O Z p: ~ f/1 ~ O O 7p9-' o ro m n N ~vaiFoN N O X Q ~~~a (y/1 O d O1 ~ ~ N N N (p N N 61 3 m M m ~'f~ a m ~ a a w °' o' ai O to ~. 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N N ~ ~ fD CD Q' 7 p"j ~ y O O N d O (Op ~ 7 ~ cn m ° Zp. ~ ~ ~ ~ v y ~ n 6 O O N ~. fl. . `2 N O N O Q O O O N d N W S Q O y Q N Q ~ ~+ O N N. p~j O O O ~~ . ~ m ~ O y O. ~ X .:' as w m d a a N y N m 0 m o ~ o~ n N O °c °: ~ 3 ~ m ~ ~ ~ 3 3 ' oACn Z N to O ~ W ~ ~ N (p A O N O ~ ~ N -z ~ W 3 N v'i to w d c o - a s o. ~ m o :°. m n • ~ ~~ No j. A ~^+ v v~ .. N .. O1 ~ 3°'. m 3 D o n A O w ~ O fD y C N CD O ~ A Q' 3 C "•' y Z N C 7 a ~ m o ~ ~ 3 ~? v ~ ~ m c w N _ ~ ~ O ~ ~ ~ ~ ~ A A p ~ O D °o ~o O C e~ O N D N W ,P ? n ~ ~ A ~Z ~ ~ ~ w Z A ;I1 A d ?:. A'+ C ': A'+ L7 Z A~ O C ~1 0 ~• O • 1 ~• Q 5 ~a a w N O w b ~° A a ti a ~, a Parcel #: 008-1094-40-100 Category Alt. Parcel #: 33.2$.16.499A 008 -TOWN OF EAU GALLE 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 BRIAN A SCHOLZ O - SCHOLZ, BRIAN A 1239 OAKWOOD LA HUDSON WI 54016 Districts: SC =School SP =Special Property Address(es): * =Primary Type Dist # Description " 2302 PIERCE/ST CROI RD OR SC 5586 SPRING VALLEY SP 0100 CHIP VALLEY VOTECH Legal Description: Acres: 5.000 Plat: 0552-CSM 12/3318 '97 SEC 33 T28N R16W PT SW SW BEING LOT 2 Block/Condo Bldg: LOT 2 CSM 12/3318 S.OOAC 2302 PIERCE/ST CROIX RD OR 5 230TH ST Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) 33-28N-16W Notes; Parcel History: Date Doc # Vol/Page Type 10/25/2004 777946 2681 /629 EZ-U 05/22/2002 679716 1896/182 WD 01/05/1998 570806 1286/330 WD 07/23/1997 969/146 9nn~ cl IMMeRV Bill #: Fair Market Value: Assessed with: -- - - - - ------- -- - - 0 Valuations: Last Changed: 07/19/2004 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 5.000 28,500 1,200 29,700 NO Totals for 2005: General Property 5.000 28,500 1,200 29,700 Woodland 0.000 0 0 Totals for 2004: General Property 5.000 28,500 1,200 29,700 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: 04/17/2001 Batch #: PRGRM Specials: User Special Code 08/03/2005 02:39 PM PAGE 7 OF 1 Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 t p ~ ~ ~`~ 8 1:'ILEp p ~~C~~d JUL 3 1 1997 - 1 L ~-~tv H. wnrsH FEB -- 6 ~ ~DlsterofDeeds 2 St Croix Ca., Wj 3 , w ~~' ~~ 5631.82 ~ S7. CR~JIX COUNTY - CERTIFIED SURVEY MAP ' BEING THE SW li4 OF THE SW fi4 OF SECTION 33, T28N, Rf6W, TOWN OF EAU GALLE, ST. CRO I X CO. , W I . WEST QUARTER CORNER ~ SECTION 33 -FOUND ~W~ 3~4" REBAR PREPARED FOR: TYRONE OTTINGER NOTE: BEARINGS ARE REFERENCED TO THE WEST LINE OF THE SW 1i4. iASSUMED BEARING) o ' ~ UNPLATTED, ................ LANDS ........ Im WEST L / NE OF THE SW l i4 I 466. 69' 433, 55' S84°42' S4"E /320. 09' I I 33.14' 1286. 95' 853.40' 33 I 33' H 1 GHWAY I f SE TBACK L 1 NE 100' I I ~~ m ow w 4 I oo I °' "' '~ y ~' c~°n ~ • N ~ I ~, r ~ ~ ~ ~ ~ .p °~ O w ~ ~ O>I W' pp W -I .~ W O O> _ N ~ _ to -1 O ; { w ]~ c~ ao ~ -I :p 2 I O Irt1 N m ~ ~ D cn y D O ~ A X O w A rn n~y~ ;~ Io S84°42 00"E y ~ y ' p p i I i O N N ~ r*i V W cp Io , 433.56' w ~ ~' O ^ N ~°°~V I ~ $ $ ~- ~ a. ao w. r w 32 ~ ~ O ~ ~N~~ ~ o~ n "~' I ~~o~° No n~ o, H /GHWAY SETBACK L E .......y.~.y'~ ,~.. w . _ J6 6{ ~ _ 33 5 fi, ~ ~ ...A.......'288. 06 . ..............~....... .............:".. 466. 7r0=-.._... .. N8„4°4.,2.~00'W ~ .• .r. "'-- 54. 50' - N8.4_°.421~0" w ~ z' 8 4. 5~' • --- • -~ .. I., :r ~n :--I :v ~D :Q ;(A ' ~- SOUTHWEST CORNER ~ ~v~ ~r« -' ._. _ _ ~'3~_2,3' I I SECTION 33 -FOUND • F ~ ~RCE-ST. CRO 1 X RD -/ N84° 42' o-o-"w'r COUNTY MONUMENT ••"" "••••••••••..: I I I~R•1..ATTED LANDS I -e.•~s SOUTH QUARTER CORNER SECTION 33 -FOUND COUNTY MONU~NT 08/24/04 TUE 14:41 FAX 715 388 4686 ST CRX CO ZONING r Wisconsin DApartment of Commerce PRIVATE SEWAGE SYSTEM Sa1ay and 8uilding Division INSPECTION REPORT GENERAL INFORMATION (ATTACH°T~ P~~MIT) Personal Inlormarbn you provide may be used for secondary purposes (Privacy Law, s.15.04 (i)(m))• Permit Holder's Neme: City Village X Township c.-F,.,h Rrian Eau Gaffe Townshi TeNK INFORMATION TYPE MANUFACTURER CAPACITY Septic ~~,•~! ~o 00 /Goo Dosing Aeration Holding ?.-~-~ 14 - I a d TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Septic ] So NOT :~ .~- 3Q' ,.-~.S--r. ... Dosing 7 ~U , • ~ .... 3 5..+ Aeration Holding PUMpISIPHON INFORMATION Manufacturer Demand ~owt-dS GPM Model Number Z. l EPo~ TDFi Litt loss em Head -~ TDH Ft /Z.3 Forcemaln Length, Dia. Dist. to Well io ~ 'Z '' N ( h SOIL ABSORPTION SYSTEM BF~fiRENCH WId1h Length No.OiTrenches DIMENSIONS ~ S INFORMATION Type Ot System: nISTRIR11T1AN SYSTEM >Yo I ~i~a ~ - - . .~awT~n~l RATA i~ 009 county St. Croix Sanitary Permit No: a53~6 0 state Plan ID No: parcel Tex No: Sectlon/Tovm/Ranga/MaP No: 33.28.16. /.~~ D.... ~..~ tcs .7~ ` STATION - _ _ - Benchmark At+• 3rd BS s •3~ HI foy. FS ELEV. ~00.4'~" AIt.BM / lZ.3L 9/.~$ 81dg. Sewer "" u /•3,15 ~'D• 3s' SUHt Inlet SdHt Outlet !5• p 88 ~c/~- Dt Inlet \ Dt Bottom ~ 9 .1~ g'f.Z'S' Header/Man. ~, y~j 96_ s-7 Dist. Pipe sw rvw SG .J E 7,St Z.'t t 7.5 t y So qG..`/~ Bot. System s ~ • t S .Is 9 ~ ~ 1 Final Grade \ St-6eve~ ~ ~ e Ma•~ loo e• 8 • v 9~.. ° n,., ~ 2 3 . ~ goy .3 ~ ~ t90. ~~ 'O~i ~,~ Z ~~` ~ /.3 ~ 7. ~ /p UNIT . y' S 7. ~.7'-0 MeadeNManltold Lengin~_Dia~ DlsMbution ~ Length Ly•Z Dia._ Spacin®~ x Hole Sizo •~~~ x Hole Spacing ? I` 3.23 Vent t0 Alr Intake 27 ~l SOIL COVER z Pressure Systems Only x>< Mound Or At-Grade Systems Only Depth Over Depth Over xx Depth or xx Seeded/Sodded xx Mulched IBedrTrench Center BedrTronch Edges Topsoil ._._ `~ yes q;l; No ~!!~ Yes !~i! No COMMENTS: (Include code discrepancies, persons present, etc.) inspection #1: 8 / Z~ / °`/ ~pection #2: / / Location: G Unknown (SW 1/4 SW 1/4 33 T28N R16W) NA Lot 2 ~~~~~ r. Parcel No: 33.28.16. 1.) Alt BM Description = T° r °'b ~° "' ar `'~ `" ~ ~`~~~ 2.) Bldg sewer I®ngth ~ 3L• - amount of cover = > fa 3.) Contour = .._ __. Plan revision Required? ~iyi Yes , No rp c~ I+ ~ lp~~~/~ _ _ _.. Use other side for additional informatl O ~~ ~ ~ -' ~ ~.__ __._ .. _._~~_. Can. No. S6D•6710(R.3/A7) Oate ~~~ - ~--- n~epctor's ipnature _ 08/24/04 TUE 14:41 FAX 715 386 4686 i i f 7 I a 6 ST CRX CO ZONING „ :~ _ !" 1~t. O!. ~3 ~~ 1y ~ t• U~~ ~ /~' X / ~ ,. ~~ ~f ~. ;~ . ~~ ~C' ~ ~ l X ~-~. ~ ~ I x f~ 010 --~~~ .. ~~ . °7° °~ . "~ ~_ R o~ O'~ ~~ ., G ~ ~~. . . ~;~. ~~ ~ - ~~ 4686 ST CRX CO ZONING Mound Plan View 1_ • ~ /j. 10 ~ •Observetion Pipe• •Q • K • •ti•4•~•-••~y. ~••ti••.•L•v1.1 1,•1••r•'ti•ti•y•.•ti•y.ti.'\.L.•.•ti L \•ti. • •~•\• t•r•r r• t t-t•r•r•r•r•r. t•t•r.f.t-t•r•rv .r•t+r-t•:^/• t•/ 4•L \.1•1.1•ti•ti.LH. .S ~•1•~•L•4•ti•ti.ti•ti•ti•yti•\•ti 1••- ' ~};•..•.~ r•r.r.r•t.t.t•r~-r.'.t.,•.r.r•t•J.J.r•r.r t•1 r•~•t• ~.ti.ti. ~•ti.~.ti.~.ti•ti.ti• •..• ti ti-5~•ti•'.•L•ti-ti•ti.ti.v•ti•\ ••~•'. ti- ' r.rpr;t+t;t•r.t;r.~.r.t•t-r•r•r•r•r•t-r•r~r;t•t,r.t•r•r.r•r;f•r.r•r- . F:• ' S - - - - - - -7i.. L!- _t Jl T A I L Mound Component Dimensions A 6.00ft E 11.76 in B 50.00 ft F 9.00 In D 6.00 in G 0,50 ft 300.00 (ftZ) Dispersal Cell Area 6.00 (gpd/ft) Linear Loading Rate H 1.00 ft K 7.47 ft z 8.80 ft L 64.94 ft J 4.23 K W 19.04 ft 740.13 (ftZ) Basal An:a Available 5.00 (ft) 1/10 B Obs. Pipe Placement Mound Cross S®ction Vi®w Aggregate Dispersal Area Fnished Grade 97.25 (ft) ..,..., 95.50 (ft)---,.i F Dlspersal Cell Elevation Shading Key Q1 ~ Topsoil Cap ~~~rf Subsoil Cap ©• -. •~•.'~•. A5TM C33 Sand (®Tilled Layer Q r:~:%ti Aggregate ~I H ~ispensal ceu ~ • 96.00 (ft) Lateral InveR .D : ~ t "„"" "~"~"~~ ~'~" ~ ~ 95.00 (ft) Contour Elevation 8.0 °!o Site Slope Geotextil® Fabric Cover ~ ~ a ~- Disp®rsal Cell See lateral details on a p C m o 1.5 ft +••.•ti-ti•.• ~•ti•ti•ti•~• ..r.r.r.t.}.s.r.r.r.t S•• •h•b LA•\• ,r, r.r.r 5 `}; Page 4 for number, size, and sparing of laterals. ~ a ~ • ~ -~-- r. ;tir. rtir t' ;: ; ?~rtir •L • 4W' '~• Laterals are equally ~ m F ~ L• •ti. ..\ •. . v ~ L•ti•' 0.5 ft ;:r;Typ~cel Lateral :.t.r spaced from the b r.r.r.r•r+r•t•1•r•r•. .,..,.ti ;a.,.ti.ti.•..ti.a. 5 distribution cell's . . centerline in the ~ r A _TT~ distribution cell (Ax8)_ ~ 011 Project: BRIAN SCHOLZ Page 3 of 9 08/24/04 TL1E 14:42 FAX-.715 386 468f3 ST CRX CO ZONING ,. Center Connection Lateral Layout Daigram Fofee main connection Vla tee or cross to manifold at any polr>< Laterals arc Identical . S I i? ~ •~ Turn-up wlball v!h-e or ,E- X--~IE~ttl2 ` x127+1 Lateralt & force main of P1+C Seh 40 aoan~utpluQ pet COMM Table 6~-30-5 Rotes dr~led on the Eottom of the lateral, Number of Laterals Orifice Diameter 0.188 in Lateral Diameter Orifice Spaang (X) 3.23 ft Lateral Length (P) Orifices per Lateral 8 38 9 f1~lorific Lateral Spacing (S) Orifice Density . 00 3 ft Lateral Flow Rate Manifold Length . 25 1 in System Flow Rate Manifold Diameter Foroemain Velocity . 2.14 ft/sec Total Dynamic Head Dose Tank Information ~;~g cOUerMricn v~drrting label and locking device and sealed watertlgM Electrical as per NEC 300 and ---~- ~ 4 In. min. Comm 1628 WAG Oiaconnect ---~-~_ Tank component is ProPedY vented _ ' E~ Alternate outlet location WF~45ER Ca aci 600.00 Volume 11.76 Manufacturer Gallons gaVinch A Dimension Inches Gallons A 33.95 399.29 6 2.00 23.52 C 3.07 36.07 D 12.00 141:12 Total 51.02 600.00 B C D Alarm Manuafacturer LEVEL Alarm Model Number DLV Pump Manufacturer GOUL_DS Pump Model Number EP04 Pump Must Deliver 20.97 gpm at 16.25 ft TDH Project:. -'`'BF~fi~I ~SCHOLZ Forcemafn deter ~ 2 in. Weep hole orant!- slphon de+rice Pum oil elevation (ft) 84.00 p~tank etevaMon (et) 83.00 Page 4 of 9 @1012 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Safety and Building Division INSPECTION REPORT GENERAL INFORMATION (ATTACH ~n_P~MIT) Personal information you provide may be used for secondary purposes (Privacy Law, s.15.04 (1)(m)l. Permit Holder's Name: Scholz, Brian City Village X Township Eau Galle Townshi CST BM Elev: Insp. BM Elev: BM Description: TANK IN FORMATION TYPE MANUFACTURER CAPACITY Septic Dosing Aeration Holding TANK SETBACK INFORMATION TANK TO P!L WELL BLDG. Vent to Air Intake ROAD Septic Dosing Aeration Holding PUMP/SIPHON INFORMATION Manufacturer Demand GPM Model Number TDH Lift Friction Loss System Head TDH Ft Forcemain Length Dia. Dist. to Well SOIL ABSORPTION SYSTEM ELEVATION DATA county: St. Croix Sanitary Permit No: 453446 0 State Plan ID No: Parcel Tax No: Section/TownlRange/Map No: 33.28.16. STATION BS HI FS ELEV. Benchmark Alt. BM Bldg. Sewer StJHt Inlet SUHt Outlet Dt Inlet Dt Bottom Header/Man. Dist. Pipe Bot. System Final Grade St Cover h„ ~ 2 3. ~ ~ eo. c~5 `'O""~ 1 BED/TRENCH Width Length No. Of Trenches PI ENSIGNS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR Type Of System: UNIT Model Number: DISTRIBUTION SYSTEM Header/Manifold Distribution x Hole Size x Hole Spacing Vent to Air Intake Pipe(s) Length Dia Length Dia Spacing SOIL COVER x Pressure Svstems Onlv xx Mound Or At-Grade Svstems Onlv Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil f~ Yes No L ~ ~ Yes i~ No COMMENTS: (Include code discrepencies, persons present, etc.) Location: PENDING Unknown (SW 1/4 SW 1/4 33 T28N R16W) NA Lot 2 1.) Alt BM Description = 2.) Bldg sewer length = -amount of cover = 3.) Contour = Inspectio 1:~/~/~ ~ ~ection #2: / /, 'l~L ~-?/U(/y1, :33.28.16. ~~ r ~ __ _ __ _~ Plan revision Required? i~,.~ Yes ,_] No Use other side for additional information. ~ _J ~_ _ _ _ _ _.______ Date Insepctors Signature Cert. No. SBD-6710 (R.3/97) a 0 ti .y . V ~.~ ~~' ~~ , . 1 / ` ` ~~ •~ ! ~ ~+ f 1 ~~ ~' ~. ~r~ ~ ~ / ,.~ 1 ~~ ~~( ~ r~ ~`~ J ~ ' ~ ` ~ X ~-~- t ~~ k ` ~' `j ~ ~ ~ coP~ ~ ;- _ , ~~ ~ ~.h ~ ~ ~ ~ ~° ~ ' ~~ r. ~~ g~ ~ l~ Mound Plan View I 1_ ------------------------------------- •: 1110 B ~ ~ .Observation Pipe 'L?J' L`I• I L - - - - - -~ Mound Component Dimensions A 6.00 ft E 11.76 in B 50.00 ft F 9.00 in D 6.00 in G 0.50 ft 300.00 (ft2) Dispersal Cell Area 6.00 (gpd/ft) Linear Loading Rate H 1.00 ft K 7.47 ft z 8.80 ft L 64.94 ft J 4.23ft W 19.04ft 740.13 (ftZ) Basal Area Available 5.00 (ft) 1/10 B Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area Finished Grade 97.25 (ft) ~I H I F Dispersal cen 96.00 (ft) Lateral 95.50 (ft)-- Invert Dispersal Cell ~~ ' ~ ~ ~ ~ ~ : ~ .• •.•.•. Elevation E ~ D ~ ; ~: ... . . . ....... ~' ...... - ....... .•:•• . ...•:... 95.00 (ft) Contour Elevation 8.0 °!o Site Slope Geotextile Fabric Cover Shading Key ~ $, ~- Dispersal Cell See lateral details on 1~ _ Topsoil Cap c = 1.5 ft . ;ti••.••.• ..,.•L• L. • ' Page 4 for number, size, © {"f'' Subsoil Cap ~ o : ~ ~ 5 s~~;?~r,(r:,r r•: :.: •: r• .• . ••j • :• :'• '' 'r~• I ~• and spacing of laterals. ASTM C33 Sand .~ ~ t~L ~1 ;,, ;ti . ..,.• :~ti r.; . _ .:,; r F T i l l ae l : : ' Laterals are uall e4 Y ® Tilled Layer ~ m yp ca era _ ; . ; :; : 0.5 ft L . - •• ti spaced from the Q5 :~r~:ti Aggregate ~ ~p ; ~: ~ rtir; '~r ~ ~':rr:•r ~rrLr~ distribution cell~$ • .:.:. A ~* centerline in the distribution cell (Ax6). -} _~y _I -I Project: BRIAN SCHOLZ Page 3 of 9 Center Connection Lateral Layout Daigram Force main connection Via tee or cross to manifold at any point. ~E P Laterals are identical #=Turn-up+a~ballualua or I~~--~I~xt2 I x12~~ Laterals~forcemainofPVCSch40 cl as n autplug per COMM Table 84.0-5 Holes driNed an the bottom aF the lateral. .~ Number of Laterals Lateral Diameter Lateral Length (P) Lateral Spacing (S) Lateral Flow Rate System Flow Rate Total Dynamic Head 4 1.00 in 24.23 ft 3.00 ft 5.24 gpm 20.97 gpm 16.25 ft Orifice Diameter Orifice Spacing (X) Orifices per Lateral Orifice Density Manifold Length Manifold Diameter Forcemain Velocity 0.188 in 3.23 ft 8 9.38 ftz/orifice 3.00 ft 1.25 in 2.14 ft/sec Dose Tank Information Locking cov+erwith warning lal~ anti locking device and sealed watertight Electrical ~ per NEC 300 and -- Comm 16.2$ WAC _ ~'1 ~ 4 in. min. Disconnect Tank component is propery vented WEASER Ca ci 600.00 Volume 11.76 Manufacturer Gallons gal/inch Dimension Inches Gallons A 33.95 399.29 B 2.00 23.52 C 3.07 36.07 D 12.00 141.12 Total 51.02 600.00 3" -~ A B C D Alarm Manuafacuurer LEVEL ~- Alarm Model Number DLV Pump Manufacturer GOULDS _~ Pump Model Number EP04 _______r `Pump Must Deliver 20.97 gpm at 16.25 ft TDH E-- Aftemate outlet locadion Forcemain diameter ~ 2 in. Weep hole or anti- siphon device Pump ofif elevation (ft) 84.00 ~ Dose tank eevation (ft) ~- 83.00 Project:..:- ~~A1~I SCHOLZ Page 4 of 9 Safety and Buildings Division 201 W. Washington Ave., P.O. Box 7162 County r ,5 ~i ~ n Madison, WI 53707 - 7162 ns Sanitary P rmit Number to be filled in by Co ) ~ ~seo (bog) 266-~., ~: ~ 3 Department of Commerce State Plan LD. Number ~ p - • i Sanitary Permit Application ~ ~ ~ ~ 5 : ~.~. I a ~ ou provide rmation f l i Ad d Wi C y e, persona n o m. s. o In accord with Comm 83.21, may be used for secondary purposes Privacy Law, s15.04(1xm) ress) add mailing ia n Project Address (ifdifferent . ~ ( 1. Application Information -Please Print All Information x _ L(d s( - Prope Owner's tame Parcel # Lot,# Block # Property Owner's Mailing Address e J' PAID Property Locati / ~ ~ ® ~ , .. . Su-( %.. ~'a-tl., Section ~_ City, State Zip Code Phone Nu ber ~~ ~ ~~5,.' ~ ~ n ~ a / T ~ N' R ~ ~(cEcley9~g) ~YI.J II. Type of Building (check all that apply) ~ ~ _. _ ~ ~. ,.,., , , ~ CSMN m ~ ,4x , ~ ~or2FamilyDwelling-Number of Bedrooms `/ ~/n~ ~p~, ~7 to U VV ^ Public/Comtneroial -Describe se k ~ ' / ity ^Village ~ ship of ^ State Owned -Describe Use III. Type of Permit: (Check only one box on line A. Complete ' e B if applicable) A' f New System ' \ ^ Replacement System ^ TreatmentMolding Tank Repia¢iement Only„ _. ^ Other Modification to Existing System B. ^ Permit Renewal ^ Permit Revision ^ Change of ^ Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Plumber Owner • e IV. T of POWTS S stem: Check all that a 1 In-Ground ^ Mound > 24 in. of suitablesoil /~ Mound < 24 in, of suitable soil ^ At-Grade ^ Single Pass Sand Filter ^ ^ Non -Prrssurized _ Constructed Wetland ~ 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) I ~ ' tS0 V. Dis ersaVTreatment Area Information: Design Flow (gpd) Design Soil Application Rate(gpdsf) Dispersal Area Required (sf) Dispersal Area Propos f1 System Elevation I i/, © Old OO S -~'b VI. Tank Info Capacity in Total Number Manufacturer Prefab Site Steel Fiber Plastic ~~~ ~-IOD oncrete Constructed Glass Gallons Gallons of Unit w New Existing ~ ~'~-. Tanks Tanks Scptic or Holding Tank ~ ,___ bO~ .~- Aerobic Treatment Unit _ Dosing Chamber Q ~- ~ •~ VII. Responsibility Statement- I, the undersigned, assume responsibility for i Ilatioa of the POWTS shown oa the attached plans. siness Phone Number B u Plu tier's a e (P 'nt) Plumber' atu MP PRS Number ,~~'~ ~ ~~~,~ aa-~s ~ ~~s- a - 9s Plumber's Address (Street, ity, Stat Z' Code) VIII. Count /De artment Use Onl Sanitary Permit Fee ~ cl s Groundwater Date Issued 1 suin Agent Signatur (No Stamps) ~~lpproved ^ Disapproved Surcharge Fee) 2rn < // __ J~ ~ • ©~ ~ ^ Owner Given Reason for Denial J _.p, IX. Conditions of Approval/Reasons for Disapproval ~ ` S ~p Ctl.-rQd ~ ~J4/'•~ SYSTEM OWNER: > ~ . p~ S ~s`E~-~ 1 S ti k ff l ep c tan , e ter and 1 d~:,~u~~- ~ ~~uy luent fi ~ ~ ~ dispersal cell must all be serviced /maintained ~L~ A 1,C GQ `fin„ / ~" as per management plan provided by plumber. [[ ^ _ All 2 tb k i t b i t t i d ~~~ ~-~°~ - . requ e ma n se ac remen s mus a ne ~~Q ~,~, - as per applicable code/ordinances. nRaea eampere pw.a tav sac away oaq~ . SBD-6398 (R. Ol/03) ~o ~) '~ tan a per not 1 thaq.31/Z :11 ~hes ~ *~l~'~ ~~p,,~ t1-r..~v-d s~:~ .~"~"~ ~ ~ T ~ commerce.wl.gov isconsin Department of Commerce Safety and Buildings 10541N RANCH ROAD HAYWARD WI 54843 TDD #: (608) 264-8777 www.commerce.state.wi. us/sb www.wisconsin.gov Jim Doyle, Governor Cory L. Nettles, Secretary July 21,2004 CUST ID No.220357 BRADYJUTGARD 110 KELLER AVE N APT 112 AMERY WI 54001-1034 ATTN.• POWTS Inspector ZONING OFFICE ST CROIX COUNTY SPIA 1101 CARMICHAEL RD HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 07/21/2006 SITE: Identification Numbers ' Transaction ID No. 1019631 Site ID No. 686464 Brian Scholz Please refer to both identification numbers, 230TH St above, in all correspondence with the agency. Town of Eau Galle St Croix County SW1/4, SW1/4, S33, T28N, R16W FOR: Description: New mound, 2 bedroom residence Object Type: POWTS Component Manual Regulated Object ID No.: 968949 Maintenance required; 300 GPD Flow rate; 30 in Soil minimum depth to limiting factor from original grade; System(s): Mound Component Manual -.Version 2.0, SBD-10691-P (N.O1/O1) 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. No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, StatS. The following conditions shall be met during construction or installation and prior to occupancy or use: General Approval Conditions: • This system is to be constructed and located in accordance with the enclosed approved plans and with the design manuals noted above. i • 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. In addition, the owner must insure that the operation, maintenance and monitoring duties as described in section VIII of the mound component manual are complied with. A copy of this information must be given to the owner upon completion of the project. Key Item(s) • The tank access openings shall be per Comm 84.25(7). ~,Q.~~. ~` ~ a7M~0 SEE GO • The designer proposes to install a state approved effluent filter to achieve the requirement of wastewater particle size. Pursuant to outlet filter product approval stipulations, maintenance information must be given to the owner of the POWTS explaining that periodic cleaning of the effluent filter is required. The access opening used to service the filter shall terminate at or above fmished grade with a watertight cover. Note • The bottom of the distribution cell shall be level per the Mound Component Manual. The "D" dimension shall be a minimum of 6". The maximum finished slope of the mound surface shall be equal to or less than 3:1 per the Mound Component Manual. BRADYJUTGARD Page 2 7/21/04 Reminder • The orientation of the mound system must be such that the longest dimension is oriented along the surface contour per COMM 83.44(6)(a)2. • Limit activities in the area 15' beyond the down slope edge of the mound per Mound Component Manual. • Surface water drainage shall be diverted away from the system area per Mound Component Manual. • Materials shall conform to the requirements of COMM 84. • Maintain well and waterline set backs per COMM 83.43(8)(1). Consult the Department of Natural Resources for well setbacks and exceptions to the setbacks. 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. 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, / Patricia L Shandorf POWTS Plan Revi er , teQrated Services (715) 634-7810, Fax: (715) 634-5150 , M-f 7:45 am - 4:30 pm pshandorf@commerce. state.wi.us Fee Required $ 175.00 Fee Received. $ 175.00 Balance Due $ 0.00 WiSMART code: 7633. cc: Leroy G Jansky, Wastewater Specialist, (715) 726-2544 MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE Project Name: BRIAN SCHOLZ Owner's Name: BRIAN SCHOLZ Owner's Address: P.O. BOX 231 HUDSON, WI 54016 Legal Description: SW1/4SW1/4S33T28R16 Township: EAU GALLE County: ST. CROIX Subdivision Name: CSM Lot Number: 2 Block Number: N/A Parcel I.D. Number: PENDING .~ • t' ? 1 -1(L~~ Plan Transaction No.: _, Page 1 Index and title ~o ~NGs Page 2 Data entry ~ , Page 3 Mound drawings ~ Page 4 Lateral and dose tank -~ pENGE' Pn~ Page 5 System maintenance specifications ~ Page 6 Page 7 Management and contingency plan Pump curve and specifications ~ - D ~ Page 8 PLOT PLAN r Page 9 soil test Designer: BRADY UTGARD License Number: 220357 Date: 07/12/04 Phone Number: 715-268-6995 Signature: Designed Pu to the Mound Component Manu for POWTS Version 2.0 SD&10691-P (N. 01/01), and SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST-SAS (01/81) Version 3.11 (R. 06/01) Page 1 of 9 Mound and Pressure Distribution Component Design Design Worksheet Site Information (r or c) R Residential or Commercial Design Nate: Sand fill (D) calculations assume a 200.00 Estimated Wastewater Flow (gpd) Table83.44-3 in-situ sal treatment for fecal 1.50 Peaking Factor (e.g. 1.5 = 150%) colrform of <= 36 inches. 300.00 Design Flow (gpd) 8.00 Site Slope (%) 95.00 Contour Line Elevation (ft) 30.00 Depth to Limiting Factor (in) 0.50 In-situ Soil Application Rate (gpd/ft2) Distributio n Cell Information 50.00 Dispersal Cell Length Along Contour (ft) = 6.00 Cell Width (ft) 1.00 Dispersal Cell Design Loading Rate (gpd/ft2) 1 Influent Wastewater Quality (1 or 2) Are the laterals the highest int in the distribution Y Pressure Disribution Information network? Enter Y or N (c or e) C Center or End Manifold 3.00 Lateral Spacing (ft) If N above, enter the elevation ft 4 Number of Laterals of the highest point. 0.188 Orifice Diameter (in) (e.g. 0.25) 3.00 Estimated Orifice Spacing (ft) = 9.38 ftZ/orifice 2.00 Forcemain Diameter (in) 100.00 Forcemain Length (ft) Does the forcemain drain back? Y 83.00 Pump Tank Elevation (ft) Enter Y or N 3.25 System Head (ft) x 1.3 12.00 Vertical Lift (ft) 1.00 Friction Loss (ft) 16.25 Total Dynamic Head (ft) Lateral Diameter Selection in. dia. o tions choice 0.75 1.00 x X 1.25 x 1.50 x 2.00 x 3.00 x Treatment Tank Information 1000.00 Septic Tank Capacity (gal) WEASER~~ Manufacturer Dose Tank Information 600.00 Dose Tank Capacity (gal) 11.76 Dose Tank Volume (gaUin) WEASER Manufacturer 16.31 Forcemain Drainback (gal) 19.76 5x Void Volume (gal) 36.07 Minimum Dose Volume (gal) 20.97 System Demand (gpm) Manifold Diameter Selection in. dia, o tions choice 1.25 x X 1.50 2.00 3.00 Gallons/Inch Calculator (optional) 600.00 Total Tank Capacity (gal) 51.00 Total Working Liquid Depth (in) 11.76 gal/in (enter result in cell 649) Effluent Filter Information Zabel _ Filtet^ Kanufacturer A100 Filter Model Number Project: BRIAN SCHOLZ Page 2 of ~. Mound System Maintenance and Operation Specifications r~ Service Provider's Name UTGARD PLUMBING Phone 715-268-6995 POWTS Regulator's Name ST. CROIX ZONING Phone 715-386-4680 System Flow and Load Parameters Design Flow -Peak 300 gpd Maximum Influent Particle Size 1/8 in Estimated Flow -Average 200 gpd Maximum BODS 220 mg/L Septic Tank Capacity 1000 gal Maximum TSS 150 mg/L Soil Absorption Component Size 300 ftz Maximum FOG 30 mg/L Type of Wastewater Domestic Maximum Fecal Coliforrn >10E4 cfu/100 mL Service Freauency Septic and Pump Tank Effluent Filter Pump and Controls Alarm Pressure System Mound Other Ins and/or service once eve 3 ears Should ins and clean at least once eve 3 ears Test once eve 3 ears Should test month) Laterals should be flushed and ressure tested eve 1.5 ears Ins for pondin and see a e once eve 3 ears Miscellaneous Construction and Materials Standards 1. Observation pipes are slotted and materials conform to Table Comm 84.30-1, have a watertight cap, and are secured in as shown in the mound component manual. 2. Dispersal cell aggregate conforms to Comm 84.30 (6)(i), Wis. Adm. Code. 3. All gravity and pressure piping materials conform to the requirements in Comm 84, Wis. Adm. Code. 4. Tillage of the basal area is accomplished with a mold board or chisel plow. 5. The mound structure and other disturbed areas will be seeded and mulched to prevent soil erosion and help reduce frost penetration. Lateral Turn-up Detail Finished •~~~~~~~~~a~~~• •~~~~~.~~~~~~~~• Grade 6-8" Diameter Lawn ~. ~ . Threaded Cleanout Sprinkler Valve Box ' ' ~ Pfug or Ball Valve Distribution Lateral Long Sweep 90 or Two 45 [)agree Bends Same Diameter as Lateral Project: BRIAN SCHOLZ Page 5 of 9 Mound System Management Plan Pursuant to Comm 83.54, Wis. Adm. Code General This system shall be operated in accordance with Comm 82-84 Wis. Adm. Cade, and shall maintained in accordance with its' component manuals [SBD-106J1-P (N.01/01) and SSWMP Publication 9.6 (01/81)] and local or state rules pertaining to system maintenance and maintenance mating. No one should ever enter a septic or pump tank since dangerous gases may tie present that could cause death. Septic and pump tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the tanks are no longer used as POWTS components. Septic or pump tank manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be enlaced. Exposed access openings greater than 8-inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into a tank or component. Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Stats. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code. The operating condition of the septic tank and outlex filter shall be assessed at I~st once every 3 years by inspection. The outlet fitter shall be cleaned as necessary to ensure proper operation. The filter cartridge should nd be removed uhless provisions are made to retain sdids in the tank that may slough off the fitter when removed from its enclosure. If the filter is equipped with an alarm, the fitter shall be serviced ff the alarm is activated continuousy. Internittent filter alarms may indicate surge flows or an impending continuous alarm. The septic tank shall have its carterrts removed when the volume of sludge and scum in the tank exceeds 1/3 the liquid vdume of the tank. If the contents of the tank are not removed at the time of a triennial assessment, maintenance personnel shall advise the owner of when the next service needs to be performed to maintain less than ma>omum scum and sludge accumulation in the tank. The addition of bidogical or chemical additives to enhance septic tank performance is generally not required. However, if such products are used they shall qe approved for septic tank use by the Department of Commerce. Pump Tank The pump (dosing) tank shall be inspected at least once every 3 years. All switches, alarms, and pumps shall be tested to verify proper operation. If an effluent filter is installed within the tank it shall be inspected and serviced ~ necessary. Mound and Pressure Distribution System No trees or shrubs should be planted on the mound. Plantings maybe made around the mound's perimeter, and the mound shall be seeded and mulched as necessary to prevent erosion and to provide some protection from frost penetration. Traffic (dher than for vegetative maintenance) at the mound is not recommended since sdl compaction may hinder aeration of the infiltrative surface within the mound and snow canpaction in the winter will promote frost penetration. Cokt weather installations (October-February) dictate that the mound be heavily mulched as protection from freezing. Influent quality into the mound system may not exceed 220 mg/L BODS, 150 mg/L TSS, and 30 mg/L FOG for septic tank effluent or 30 mg/L BODS, 30 mg/L TSS, 10 mg/L FOG, and 10' cfu1100 mL for highly treated effluent. Influent flow may not exceed martimum design fkr+u spec'rfied in the permit for this installatiai. The pressure distribution system is provided with a flushing point at the end of each lateral, and it is recommended that each lateral be flushed of accumulated sdids at least once every 18 months. When a pressure test is performed it should be canpared to the initial test when the system wars installed to determine if orifice clogging has occurred and if orifice cleaning is required to maintain equal distribution within the dispersal cell. Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the owner, and any levels above 6 inches considered as an impending hydraulic failure requiring additional, more frequent maritoring. Contingency Plan If the septic tank or any of its r~mponents become defective the tank ar component shall be repaired or replaced to keep the system in proper operating condition. ff the dosing tank, pump, pump coMrds, alarm w related wiring becorrres defective the defective component(s) shall be immediately repaired or enlaced with a component of the same or equal performance. If the mound component fails to accept wastewater or begins to discharge wastewater to the ground surface, it will be repaired or replaced in its' present Vocation by incr~ing basal amya ff tce leakage occurs or by removing bidogicelly clogged absorption and dispersal media, and related piping, and replacing said components ~ deemed necessary to bring the system into proper operating condition. See Page 5 of this plan for the name and telephone number of your local POWTS regulator and service provider. Project: BRIAN SCHOLZ Page 6 of 9 APPLICATIONS Specifically designed for the following uses: • Effluent systems • Homes • Farms • Heavy duty sump • Water transfer • Dewatering SPECIFICATIONS Pump: EP04 • Solids handling capability: 31a" maximum. - • Capacities: up to 55 GPM. • Total heads: up to 24 feet. _ • Discharge size: 1'/z"NPT. • Mechanical seal: carbon- rotary/ceramic-stationary, BUNA-N elastomers. • Temperature: 104°F (40°C) continuous 140°F (60°C) intermittent. • Fasteners: 300 series stainless steel. • Capable of running dry without damage to components. Pump: EP05 • Solids handling capability: 3/4" maximum. • Capacities: up to 60 GPM. • Total heads: up to 31 feet. • Discharge size:lYz"NPT. • Mechanical seal: carbon- rotary/ceramic-stationary, BUNA-N elastomers. • Temperature: 104°F (40°C) continuous 140°F (60°C) intermittent. ©1995 Goulds Pumps • Fasteners: 300 series stainless steel. • Capable of running dry without damage to components. Motor: • EP04 Single phase: 0.4 HP, 115 or 230 V, 60 Hz, 1550 RPM, built in overload with automatic reset. • EP05 Single phase: 0.5 HP, 115 V, 60 Hz, 1550 RPM, built in overload with automatic reset. • Power cord:l0 foot standard length,16/3 SJTO with three prong grounding plug. Optional 20 foot length,16/3 SJTW with three prong grounding plug (standard on EP05). METERSIFEET 10~ 0 a W S U a z 0 H a s a 7 s 5 4 3 2 1 0 • Fully submerged in high grade turbine oil for lubrication and efficient heat transfer. Available for automatic and manual operation. Automatic models include Mechanical Float Switch assembled and preset at the factory. FEATURES ^ EP04 Impeller: Thermo- plastic Semi-open design with pump out vanes for mechanical seal protection. ^ EP05 Impeller: Thermo- plastic enclosed design for improved performance. ^ Casing and Base: Rugged thermoplastic design provides superior strength and corrosion resistance. ,_ t , 30~-_ _______. __, __.. ___ _ __ __ _ ..-- . _. i ' t 25 }- - ___ _ _ _ ___-~ -- ~~~-- ~ ~ t I ~! 1 ~ ~ ~ ~ ~ 0 2 4 ti 8 _ 10 `~ 12 m,/h CAPACITY ~j Effective May, 1995 {J 83871 ^ Motor Housing: Cast iron for efficient heat transfer, strength, and durability. ^ Motor Cover: Thermoplas- tic cover with integral handle and float switch attachment points. ^ Power Cable: Severe duty rated oil and water resistant. ^ Bearings: Upper and lower heavy duty ball bearing construction. AGENCY LISTING SA Canadian Standards Association (CSA listed model numbers end in "F" or "AC".) _ __ ~ __ i ___ ._. _ ~~4-5 GPM _-__ _ . ` '~-zSF-r J i i y it z•d ~,~ X v l r, r r 00 ~ o~ ~ t f `l ~ ~ a! t x L~ !~ ~ <<, ~~ ~. °~~ .... ,`, t ~ ~-t ~~ r~ ~~. ~;~ ~s~ ~ ~ ~ ~,~v. ~ 1 2,, ~o y J'un 2a 04 02:55p 'qPR-21-2062 12:25 PM LISR RNN KROLL KE'J I H _ $RfaTHOL 715-246-5700 p.2 715 684 7983 r. oo Esc zas ~a~ afaf:>z.~-2s FAd1 +EDINCI {iLTY M~~d RTCN1"10N~.~ ...a. art ~ . a. ~ ~rv~.ar•• ..r• 4+ r~e~e FluleM fiNilan ~ o~itl~+ ~ ~1- ~ e~^o` ~~ ' ~ ~ l 1n al~cord with I IHA 83.06 W l4. Adm. Cody , ~~ ~•,~: Attach ooMpk>>• ~ a*n oa aao~ not Isla than 8 ~~ >< t t inC110~ ~ SG of i~oPa• /CaN Or 'but not Mfilad to va+'tieaf and horts~ -alsranca poiflt (8W. QEracda+ d~titeead, no+lh crew, and teoaltor+ and dalanaa b eaaraN +oad. ~ APPLICANT INFORMATION-PI.EAgE PlIINT ALl 1N~OIIMATION si+2p it766 v.03l0'7 a~. emu cx ~EFfTYOYrIVEfI: -~ppPER1T WGR~wn ~. 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') ~~ ~~g ~, i~~~ 'i =r ~" ~ p ~ « ~~•e'Y`~ :1 ~ ~~~ N # NIlM111' 4ETBiACYt L eNE ~~.. ~ sourMrEar oaelE>t ,ptEAC -ST.CAoJx+ ~• " ~~ ~ ~ ~ ~ - UNRLATT[O', LAl~! ~ soum owA7EA ConalEA i CER71F ~Efl SURVEY MAP ~o~x ~. wr-~ of Till ri- IM of SECTION aa, T~Nt. alw-. Tw~N o- INII 9AL~E. ~T• . ~~ pM: rl'IRONE OTTIb6iR K!T OYARTE! COll1ER lEAR i Kps SAE J1ECT1l0-- ~! - f01M10 LNCEO TO THE MEET ~~~ ~ DIME OF 7NE p I~~. .4Rl~llwTTEY..!•!U1R4 .~ NEl7 L 1 N6 of R1E tM, ~s w aaw'+i' os•E rpa ~• ~' ~ !~• 1 1 ~ !i. ~~' HMO' ._... ~ ~, .t ~ l • ' O • 9Cr 1 " 1 t+~ ,1lON i NE Y! !6M 11fQ ~. r! tila. PEA t JNEw<t FOOL j t••sei' e 60 t!0 i00 YMEET 1 OF >< j i1N~ r+/i nH/Ag1EA1~ oYRlEI !y J!Y ~ErEn 1 f 1 ae~Tar~gu>ro ~'~ Wiscw*~si;tDepartmentoflndustry, .,SOIL AND SITE EVALUATION REPORT rt.abor and Human Relations Division of Safety & Buildings kr~ y~,- in accord with ILHR 83.05, Wis. Adm. Code ~~` ~`~,~ 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 % of slope, scats or dimensioned, north arrow, and location and distance to nearest road. APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION Page ~ of 3 ~T•e-~iLx PARCEL I.D. # B~ PROPERTY OWNER: PROPERTY LOCATION I 'l„ p~ W ~ S L GOVT. LOT S W 114 S W 1/4,S 33 T~ ,N,R ~ b E (or~W PROPERTY OWNER':S MAILING ADDRESS LOT # BLOCK # SUBD. NAME OR CSM # ~Ox ~~ Z - - ~LzUp OS ~ C,S7r7 CITY, $TATE ZIP CODE PHONE NUMBER []CITY ^VILLAGE ~JTOWN NEAREST ROAD ~'~'R1~h~iJlv1~,(.cll sut,ts (~IS1 ~a6_ sZ~6 ~ C~r~~~L._ z3oTw- sT'. [~ New Construction Use ()Q Residential / Number of bedrooms 3 [ ] AddiriQn to existing building ()Replacement [ j Public or commeraal describe Code derived daily flow y. ~ gpd Recommended design loading rate - bed, gpd/ft2 ~ - 3 trench, gpd/ft2 Absorption area required 3-1 S bed, ft2 31 S trench, ft2 Maximum design loading rate a - S bed, gpd/ft2 ~ • b trench, gpd/ft2 Recommended infiltration surface elevation(s) °L ~ ~ O ' ft (as referred to site plan benchmark) Additional design /site considerations Parent material 7't t_ ~ Flood plain elevation, if applicable N- A , ft S = Suitable fOr System C~IVENTIONAL MCUND IN-GROUND PRESSURE AT-GRADE SYSTEM IN FILL HOLDING TANK U =Unsuitable for system ^ S ~ U ®S ^ U ^ S ~ U ^ S (~ U ^ S ~ U ^ S ~ U SOIL DESCRIPTION REPORT ~~-~-~~I t~•~~ Boring # Ground elev. °-b~o ft. Depth to limiting factor , ~~ 1 l Boring # Z r`l. ~:~~r:;:>~< Ground elev. a~~.a ft. Depth to limiting factor ,~ Depth Dominant Color Mottles T t Structure Consistence Bouridal Roots GPD/ft Horizon in. Munsell Qu. Sz. Cont Color ex ure Gr. Sz. Sh. y Bed rerldl ~ O-~ Lo `1 R' 3l~ - S ~ ~ Z'~ S h1-t ~"'~.~ ~^'S - b.S ~•6 Z 8-L8 10 `~Q 316 - s i ~ Z-'E'3hk yn ~t+ ~S - o• S o.6 3 18-3`f 1-o`~1z. Y/b _ ~s ° s~ ~~ c.S ~ ~' S °'~ ~ 3`I -63 t,p `1, R- Y~~ a ~~ Sri y6 i/$ `~ s °`''~ ~ v f~- J -- e~n~ S ~- S ~ Yl ovh , w ~~ c s ~ ~ s Remarks: .~ ,~ S~ 1 0-9 tioti.~Z ~/y - stI 2`FSbk w,f~ ~s - o.so-6 Z °I -2.~ 1.p'Z 2- 316 S 1 ~ Z~ S~k yn 'F~- c 5 - o. S o. l 3 Z6-4.a ti~`~R X16 - ~S v g ~, ~ ~~7 ~ , 6 oq~ . ~{ ~_ ~ '~$ lo`?R YJG ~~ 1.SYR 51'~ ~S C~`'h lm U~1.. ~~ y :. - "? S'1' , ~V~ ~` ~ i '~, '1 .~ Remarks: ,-~_ ~ . .b •~I •SI CST Name:-Please Print Phone: '~ ` ~ ' ~ ` ~-°'~ Arthur L. We erer 715-425-016` ergerer Soil Testing & Design Service-P.O. Box 74 River Fal1s,WI 54022 Signature: Date: CST Number: ,~ '~~~~s~c. q3- z.~2 Lo=R.S_93 M00576 PROPERTY OWNER ~'~-ESL SOIL DESCRIPTION REPORT PARCELLD.# __ Boring # `. v~ Ground elev. ft. Depth to limiting factor Boring # Y.~:-<, ~..•,::. Ground elev. ft Depth to limiting factor Page` Hof ,.3 Horizon Depth Dominant Color Mottles Texture Structure Consistence Bardary Roots GPDJft in. Munsell Qu. Sz, Coat Color Gr. Sz. Sh. Bed Trench I o-\Z tio~-t`Z 3/ ~ S 1 ~ -L`FS~~2 Yn~H a5 - p. 5 0~ b Z ~z--z.g do `2fZ ~1~ - S i l Z~ sbk rn ~~ c.s -- o_ s o_ b 3 ?~3-~!o LO `1iZ Ali, ~S l~ Sep inn ~ cS ~' ~. S v. 6 y ~(b fir, loyR y/L ~ l~ ~•S`trz.slg ,~S ~ti-, ~ ~.Ft~ _ _ S ~ n~uTt: l S ~ ~l Remarks: Z 8- 3o t Oy 2 31C - S 1 1 Z `~ s ~k yvt f~, c s _ o• S v, 6 3 ~u_6~ ~ ~~ iZ uJ6 ~~ .s yrzs~~ ~ s mow, >n u ~. - - - .3 S~ NbTN, R S ~-., ~! ~`1T B 1. Remarks: Remarks: .~ . rp -S" .b ~~ i Remarks: SBD-8330 R.05/92 • .w PLOT PLAN ~~ Page 3 of 3 SCALE 1"= 3d ' ~ ~ ~ 5~., .~ ~.~ / ~~ / is ~ ~ r ~/ t~, ~ ~. ~t 6°_ ~ ~~ ~ ~ ~~ / ~~ ~ e~ ~' • / . ab 1 ~_ / ~ ~ / db ~ o ~ f, ~ S ~ ~ ~ A ~ / $l ~ o i N ``~\ 2S. \ ~( ~?. O f~ i ~:l t3. Z ~ ~ ~q-, a ~ ~ 3 a ~ o~~ ~ ~ L~ 9.L~ W 000 ~~ 3w- - ~1.. LoU.O ON _'* 't~t~tL 2.' t'n3o~F ~- ~-. Wu.6s' owl 1~T~ O, ~ 6 \zov-v~? lti 28' I Tx-~1' o F Co~v c~~~s ~ ,J 1=ov~vOhTlo~l w~t~~ , v 1.~p~i ~~~~ st ~~ W ~u Lo ~o~J ~ Q~ > s o ' sov`T~} nF w~ tw-~ p PtR.~ . P~PeS~ l.uT 1.1ti~:S ~ ~~ i~T ~.~nss 5 ~ F-R.o~ ~~v~-p~ ,_~ pp q3_ z6Z ~~~!~ d. ~o-,LS_g3 (71 ) 42.5-n~ ~5 T~I00576 CST Signature Date Signed Telephone No. CST # LEGAL ST. CROIX COUNTY, WISCONSIN OLD TXSCR02 REAL ESTATE TOWN OF EAU GALLE COMPUTER NUMBER 008-1094-40-100 Parcel Number 33.28.16.499A OWNER NAME: First BRIAN A Last SCHOLZ PROPERTY ADDRESS: Hse # 1/2 PD --Street Name-- Type SD Apartment 2302 PIERCE/ST CROI RD OR SECTION 33 TOWN 28N RANGE 16W'/4160 '/440 Line Description Line Description TOTAL ACREAGE 5.000 PLAT CSM 12/3318 '97 LOT2 BLK 01 SEC 33 T28N R16W PT SW SW 15 02 BEING LOT 2 CSM 12/3318 16 03 5.OOAC 17 04 2302 PIERCE/ST CROIX RD OR 18 05 5 230TH ST 19 06 20 07 21 08 22 09 23 10 24 11 25 12 26 13 27 14 28 F1-General, F4-Prev. Parcel, F5-Next Parcel, F7-Valuations, F8-History, F10-Exit ST CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM OwnerBuyer ~~ C ~'"''v ~~ ~'° ~°'~ - Mailing Address Property Address --,~ w a v ~ ~ l-~-c a.ro-.~., Gt~~ S'4~~ w i ~/ GC! > "o~3v~ (Verification required from Planning Department for new City/State ~S~ ~- ~ ~-~' i~ Parcel Identification Number U d ~ ~ ~~ 9 ~ 4~0- ~ ° ~ L•FGAL DESCRIPTION property Location ~ ~ '/,, _~ '/4, Sec. 3 3 . T ~g N-R~ Town of ~~- ~ ~ ~- ~E Subdivision N ~~ _- .Lot # o? Certified Survey Map # ~ ~O ~ ~ ~ ~ ,Volume f~ . ,Page # .~.~ l 0 ,.~~o,~,~_. ~a. Warranty Deed # ` " - - ` u ° ,Volume ~ Page # ~~~71~P Spec house ^ yes~no Lot lines identifiable 'yes ^ no SYSTEM MAINTENANCE ' Z~rproFer 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 throe 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. Grout Zoning Department a certification form, signed by the owner aad by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site wastewater disposal system iS is 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 a three yea • ex ' 'on t _ ~ ~ ~" ... . , it ~~. a ''"~ DATE SIGNATURE OF APPLICANT 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 ty d ri'Ged' irlue of a warranty deed recorded in Register of Deeds Office. ~l ~ Z~ A OF APPLI ATE Any information that is mis-represented may result in the sanitary permit being revoked by the Zoning Department. ****** *•ss*« ** Include with this application: a stamped warranty deed from the Register of Deeds office a copy of the certified survey map if reference is made in the warranty deed U 1896P 182 STATE BAR OF WISCONSIN FORM 2 - 1499, Document Number WARRANTY DEED This Deed, made between Loren E. Frasl and Murri M. Frasi, husband and wife - Grantor, al~d Brlan A. Scholz Grantga Grantor, for a valuable consideration, conveys and warrants to Grantee the following described real estate in St. Croix County, State of Wisconsin (if more space is needed, please attach addendum): Part of the Southwest Quarter of the Southwest Quarter (S W 2/4 of S W 1 /4) of Section Thirty-three (33), Township Twenty-eight North (T28N), Range Sixteen West(R16W), Town of Eau Galle, St. Croix County, Wisconsin, more particularly described as: Lot Two 2 of that Certain Certified Survey Map,dated the 27th day of May, 7, revised the 1 tth day of June, 1997, and recorded at the Register of Deeds for St. Croix County, Wisconsin on the 31st day of July 1997 at t :30 p.m. in Volume twelve L2) of Certified Survey Maps/Records, page 318, Document No. 3182. ""--- -~ Exceptions to warranties: all easements and restrictions of record. Dated this /} ~ day of ~t/ 2002 s AUTHENTICATION Signature(s) authenticated this day of s TITLE: MEMBER STATE BAR OF WISCONSIN (If not, authorized by § 706.06, Wis. Stats.) THIS INSTRUMENT WAS DRAFTED BY Thomas A. McCormack Bal win, 1540 ' (Signatures may be authenticated or acknowledged. Both are not necessary.) Names of persons signing in any capacity must be tvoed or orinted below thei WARRANTY DEED Recording Area 8797' 1 Es XATHLEEH H. MALSH REGISTER OF DEEDS ST. CROIX CO., MI RECEIVED FOR RECORD 05-22-2002 9:30 A~! WARRANTY DEED E%ElDT ii REC FEEz 11.00 TRANS FEE ; 135. 00 COPY FEE: p G'eSCOPY FfiE: Name and Return Address WESTconsin Credit Union ~ P.O. Box 269 New Richmond, Wi. 54017 008-1094-40-]00 Parcel Identification Number (PIN) This is not homestead property. (is not) • Loren E. Frasl 13. T .L i ------- • Murri M. Frasl ACKNOWLEDGMENT STATE OF WISCONSIN ) ss. St. Croiz County ) Personally came before me this js" t day of 2002 the above named Loren . Frasl and Murri M, Frasl, husband and wife as survivorship marital property to me known to be instrument and ac ary Public, My C:ommis~ STATE 8AR OF WISCONSIN FORM No. 2 - 1999 who executed the foregoing :same. G Company, FonC du lae, YVI eoo~6s5-2oz~ >/ i FLED JUL 3 1 1997 - lui>u~ ~. w,v,srf r~i Co.Wl 563182 ._ 'f _ _. ~-'•r F'- _ CERTIFIED SURVEY MAP BEING THE SW I/4 OF THE SW I/4 OF SECTION 33, T28N, R16W, TOWN OF EAU GALLE, ST. CRO I X CO. , W I . 3 ~~ 1 I N W I O :C ; _ :~ •~ :r :A : ~ I ~ : -1 :~ ~v :r , :a :z :~ .N PREPARED FOR: TYRONE OTTfNGER ~- WEST QUARTER CORNER SECTION 33 - FOUND " ~ BEARINGS ARE ~= REFERENCED TO THE WEST REBAR 3i4 LINE OF THE SW 1 /4. (ASSUMED BEARING) _UNPLATTED• LANDS 1 WEST LINE OF THE SWl/4 466. 68' S84°42' S4"E i /320 09' ~ 433. 33' . 33. 14' 853.40' 1286.95' __~ 3' H ! GHWAY f SE78ACK L fNE 1 100' . Im _ 0 ~~~~ 1 ~ ',1 ~ n co'~ co V' f"" - ~~. w ~ ~ w w ~ cw,,r -..1 I= ~ ~~oci'yo pp m ~. l.QO ~ H; 1 y: i `voo W Im S84°42'00"E -~.~ii... '~ 33: /4' 433. 36' ~- ~ ~ ~ .,, n w o . °° r ~„ I ~Iw N~ o O V ~ ~ ~nH V! A cNi, -~ o ~° ro t- W ~ 0 0 ~ O~0 Q~i A W nn o0 ~ 0 cA-, O ~' n ~ ~ y ~ y H ~c Q •Z tt~~ :'p m cr :r- rn N :n :~ v, m .m ~ :o W ~r :z ~° :v m :cn I o1 ~- m ~ '~ N ~ ~ H / GHWAY SETBACK L ! NE :......~.~.y W .....o.. ........ y ....... ... .......... A W ' 433. 56' .............. . 6 6 !288.06' ..... _ tO '_... '".'-" ~ -.-• . • .. N84 ° 42' 00' W g i' '-^ ~ ~ 854.30' ~' '- --- --._ N8~-.42...0" '-- .. ~,... -_....._-_ .. ___, I ' _ !4' I ,s2 ' SOUTHWEST CORNER / - P I ERCE-ST. CRO 1 X RD.--/ -~ -~L84°g~' ooh ...... I ( SECTION 33 - FOUND ••••••• COUNTY MONUMENT •~~~••~•"""""•• i ~ {~}R.LATTED LANDS ~....,ir SOUTH QUARTER CORNER ' OUND -'iP'~h''FIUVi`E) O SET ! " X 24" IRON P 1 PE WE 1 GH 1 NG ~L,I~ ~ ~' ~'~~ !. !3 LBS. PER LINEAR FOOT. i:'omprehcrr;v W._I'lanning l.3f~ttTfj @,iU PerscF Ga}timitteq 1" •250' ;f ,iur r ecurded •~ithin 34 Ucrys of 0 so 25o soo SHEFp ~ro~v~la~o~ 97087 THIS lNSTRUk£NT DRAFTED BY JIM WEBER nuil~ndvoid Vo1.12 Page 3318 ~, . m O m ~"' m .p ao w p S 8 SECTION 33 - F COUNTY MiONUMENT !~Z S ~! 0 taSO;oyp7 ~~ g-~'' SAMr'S lYl. '~ Z w~e3tR S • i 804 SPiiiN3 VALLEY ww. ~r NELS E ~YINO DATED