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020-1002-70-000
Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: (ATTACH TO PERMIT) 567261 0 GENERAL INFORMATION State Plan ID No: Personal information you provide may be used for secondary purposes[Privacy Law,s.15.04(1)(m)]. Permit Holder's Name: City Village X Township Parcel Tax No: Lorenz, Eric& Rebecca Hudson, Town of 020-1002-70-000 CST BM Elev: Insp.BM Elev: BM Description: Section/Town/Range/Map No: 89. 52 Fl 4, lv..)<..... 766 07.29.19.5C6D7F TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER R, _ CAPACITY STATION BS HI FS ELEV. Septic �,� - 1 Benchmark �� 35 9"S,B� �9- SZ ZS-C.&_ t t.,.. I,5 `75 U F / Alt.] PO Lo U (o (__ 5-Z5 NG� 75b toca 3, 114 96 . 7/ Aeration Bldg.Sewer 3,`l g6. Z Holding St/Ht Inlet S 5 TANK SETBACK INFORMATION St/Ht Outlet S.92- TANK TO Pq/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet / Septic 7 50 ' 7 2 66 / 5 / i Dt Bottom Dosing Header/Man. Aeration Dist. Pipe Holding Bot. System Final Grade PUMP/SIPHON INFORMATION V V Manufacturer Demand St Cover�,r / GPM Yu>°� f"+ 11A, (,A."' 3. /(0 76 , ? Model Numb. OAQ,,,Ix- 750 TDH Lift 1 Loss System Head T Ft Forcemain Length Dia. Dist.to Well SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No.Of Trenches PIT DIMENSIONS No.Of Pits Inside Dia. Liquid Depth DIMENSIONS SETBACK SYSTEM TO P/ I BLDG WELL LAKE/STREAM LEACHING Manufacturer: INFORMATION Type Of System: N ;S CHAMBER OR UNIT Model Number: DISTRIBUTION SYSTEM Header/Manifold Distribution / x Hole Size x Hole Spacing Vent to Air Intake Pipe(s) hid 5 4--i1 ,∎ Length Dia Length Dia Spacing (1., SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil Yes D No Yes E No COMMENTS: (Include code discrepencies,persons present,etc.) Inspection#1: / / Inspection#2: / / Location: 324 Krattley Lane Hudson,WI 54016(SW 1/4 SW 1/4 7 T29N R19W) metes&bounds Lot Parcel No: 07.29.19.5C6D7F 1.)Alt BM Description= / G�.cc.,. /� �--- l t3(Jr-- G v`_ 2.)Bldg sewer length= / o -amount of cover= �D // t-14,e'"-- it'A.60141. -S) i Plan revision Required? 'A Yes eNo ` I i 3 p— G,� E (plO ✓I . Use other side for additional information. SBD-6710(R.3/97) Date Insepctor's gnature Cert.No. '6(.5.7:/if.3o3s/ • Ex;sf�r�r/ e/Jleda (,,7 i-44.5.7M. 30,3 U.);e5a-r Can c./ 750'0.1). ,S. ' 1,0u,/c1;l Se‘o°'r. Cake: /=5O r PL-sus ecl lL - - lu; ss&A 5 iI N 3.2 / /e9cr- a < 4l"AsTA Gr Proposed ?303 0 jh44- 447, c.D/. Sf1O/6 Fr�'/kEM� �iK� arc. SLJyfIS SAC 7,T 294.14/940. r f Ir ( ( Tn•OT^ 1-4c.cso r f, 5‘,e('Ol,$:l0,cc7/. ' r , . i ,pc/. 020-/G27z-70-COO t ! t '1 1 1 1 \ /730 4cre.s. t1\ iof t ■ \ t \\.g,)-4.5 6-,-) U j/./S4/ ' \ t C 1/i4 S t^1- 1/2C Co/20j - - 3,. 1 e(f'/ut, / e 6c,m6 1 Gya6c�unX �i f/1 , ' ,r 1- I e".6-5.6', 4 3SC7;u Q czi tS�f C/Y..4.4_Marl r 1 / / �d¢/s y�i'l.(os/ (// 1 ' 1 I 1 rroS-. SttQut 12f 4r1 6z kre SC.- &c.,erc& I ' ' (\ I 1 �c,51<�45 �Ci�-r,Vr ba:/d�,y wGA-1som25epEL � X33 t `� � { Sc-�4rClto.,,oc,.'E.. ✓ . .ew/Polyl..e ' *M i P� 57-S e�/cuwrb - r/ /der. T.1 EX/56irc /7s1f ,,e- / ` __ -- 0---�L . As/da,rCe. AkenSa.,f.77 ID N - DNer"Si1M �� �� \ „7,,7,_74,,,,,v7 ►w, \ .7" Voide / Both m of 3;di ,/ i \ v ` // A wined el.=ln®/ 1 Vat / 1 °\ 1 &Q[/ ` j Z \)1 ',I\ t h ' 9 N ` bw;ed ., 4al na t --t. .-2s-'r l \ P ,roP County f?#191"4"414).4,t Safety and Buildings Division St.Croix 1 S$ 201 W.Washington Ave., P.O.Box 7162 Sanitary Permit Number(to be filled in by Co.) Pa Madison,WI 53707-7162 A� �� 5 7 ZG / State Transaction Number Sani �� In accordance with SPS 383.21(2),Wis. vi 1..C 74plication mission of this form to the appropriate governmental unit is required prior to obtaining a sanitary permit. Note:Application forms for state-owned WTS are submitted to Project Address(if different than mailing address) the Department of Safety and Professional Services. Personal information you provide used for secondary purposes in accordance with the Privacy Law,s.15.04(!)(m),Stats. Same r L Application Information—Please Print All Information 1�/ � ��� I�d Property Owner's Name ' "t'o 4 ) Parcel# Eric&Rebecca Lorenz �r c 01 A 020-1002-70-000 Property Owner's Mailing Address Property Location / 7 O C , 1v 324 Krattley Lane �'4)- Govt.Lot City,State Zip Code Phone Number SW 1,,SW '/s, Section 7 j Hudson,WI 54016 (715)377-0648 (circle one) ( ) T 29 N; R 19 E or W II.T of Building(check all that apply) Lot# or 2 Faamily Dwelling—Number o Bedrooms(Accessory Structure Na Subdivision Name �.Q( I"1�Y�`� )6.-' � t<- VBlock# Na O Public/Commercial—Descri bc'Use Na O City of O State Owned—Describe Use CSM Number 0 Village o Na own of Hudson III.Type . (Check only ox on line A. Corn. to line B if applicable) A. / ew System,/ eplacement System '! reatment/blding Tank R.eplaeernent Only Other Modification to Existing System(explain) B. 0 Permit Renewal ❑Permit Revision ❑Change of Plumber ❑Permit Transfer to New List Previous Permit Number and Date"5711. Before Expiration Owner Sl r / 0/ 7 N.Ty .-of POWTS System/Component/Device: (Check all that apply) [on-Pressurized In-Ground O Pressurized In-Ground 0 At-Grade O Mound>24 in.of suitable soil 0 Mound<24 in.of suitable soil O Holding Tank 0 Other Dispersal Component(explain) 0 Pretreatment Device(explain) V.DispersalTreatment Area Information:PolyLok PL-525 effluent filter Design Flow(gpd) Design Soil Application Rate(gpdst) Dispersal Area Required(st) Dispersal Area Proposed(sf) System Elevation Na Na Na Na Na VI.Tank Info Capacity in Total #of - Manufacturer Gallons Gallons Units y, § al v New Tanks Existing Tanks /64 1 5 C! l u Septic or Holding Tank 750 ■ : 750 1 i Wiesrtr Concrete X Dosing Chamber VII.Responsibility Statement- I,the underiiigned,ass t, responsibility for in a of the POWTS shown on the attached plans. Plumber's Name(Print) Plumber's :ignature MP/MPRS Number Business Phone Number James K.Thompson �pyn ignature /5--- MPRS 30021 (7151248-7767 Plumber's Address(Street,City,State,Zip Code 340 Paulson Lake Lane,Osceola,WI 54020 VIII. unty/Department Use Only / Approved Permit Fee Date Issuing t Signature / , �en Reason o Denial $ 25b 0o f/i 7 /3 IX.CondilOWIMB ,QV N 9 easons for Disapproval / 11111111b 1.,".5eptie tank,effluent filter and dispersal cell must all be services/maintained as per management plan provided by plumber. 2.,:Alt setback requlements must be maintained as per applicable code/ordinance8. Attach to complete plass for the system and submit to the County only on paper not less than 81n a 11 inches in size SBD-6398(R. 11/11) Conventional POWTS Index & Tilte Sheet Project Name: Lorenz Accessory Structure Septic Tank Owners Name: Eric&Rebecca Lorenz Owner's adress: 324 Krattley Lane Site address: Same Project Location: Subdivision: Na Legal Description: SWI/4 sWt/4,Sec.7,T.29N.,R. 19W.,Town of Hudson,St.Croix Co.,WI. Parcel ID#: 020-1002-70-000 Page 1 Index and Title Sheet Page 2 Site Plan Page 3 Filter Specifications Page 4 Septic Tank Cross Section Page 5 Septic Tank Maintenance Agreement Page 6 Accessory Structure Affidavit Page 7 Parcel Map Page 8 Deed Mater PI ,-r Restri' ed Service: James K.Thompson,Dep't.of Comm.Credential#30021 Signature: . . 247-- Date:6 Ge. 029 cif Page 1 of 8 Design pursuant to In-Ground Soil Absorption Component Manual for POWTS,version 2.0 SBD-10705-P(N.01/01) l •So./eda/ua-4vr-Vie. Iti.5.T. 0(.303s/303s/ • EX.;S&rr/ eleiIa&e,r) 0.5.7 M. 3431 LA...);e 5 ur Con c.(ete 7.50$0.1). ui!d v Sewer. Chi/8. /r it/ epl;c-&i�+i 41,--0/44/AK immemv<� ,cod �� yi�iA�� Q 2309 � ,AT Propostd Y Ct 3.2s/ki/YL.66/y I-0 c M 303 y Q iirc,¢l.Sr 41, tJ/. 6-110/6 el:aken I;ne • Carc,e,e_ 540Y515u ;See 7, '7-:.2. (.,,e,/91.Z, t f i l ( Tit.ol4 f44k.c,5rr2, 54.C'ro;xG.,“)/. t$` � t BOG. F6 0.24,-/00 2.-70-WO gm t t ■ Mg t \ 7/7,30 ocr r'e.S. 1 \ ‘ 0 \x�� t 2 ■ % \t' \h�o�P \ %1 t \\s g/'3 6.- Q .Sp,t�sa./ \ 8r e / s.,e /.fie 6cncae d�v .' y. , , 1-7,i,i 4, I fl ( j /' , I 'Jcia6. c` n1C. lop off' 0x.SuL%-q ma,'iti C 1 i </1 I ‘ Cave/=965. �"ros� Sle4uc�o 6<curlfn _ ie3ee- Cc.,C- 1 1 • t. 1 QXrSfi?S ex - bu.:/d,), • Loa-rsom,25tto&t. 1 83! i 1.,..j Sc�y�/ Gc -.,O.64..,t/w/poly zee 1 �►4 ,oL-s- c e6/ccs. '6 , A • ;ven-�cM l l \ ,v7 va.Pde 1 1 \ Bared,1 Nu/e , A \ v ` / ,4�st&dned el'IM m/ t, ‘ eXis 4/ / % k. yJ I `e'/ 9 \ ::„,,,,,-7- 1 �aJ l:na l -.4 yo%.z s'f ,l !►* y p .20/2 .-/ , . '.i' ..' • . POJL K Filters PL-525 EFFLUENT FILTER ( `C. IV1L'CIAL) Polylok, Inc is pleased to add its new commercial filter to its existing line of quality effluent filters.The • PL-525 is rated for over 10,000 GPD Alarm (gallons per day) making it one of accessibility Accepts PVC p y g extension handle the largest commercial filters in its class. It has 525 linear feet of 1/16" filtration slots. Like the Polylok PL-122, the new Polylok PL-525 has an automatic shut off ball installed 525 linear feet with every filter. When the filter is of 1/16" removed for cleaning, the ball will filtration slots v F' __ -,, Rated for over float up and temporarily shut off 10,000 GPD the system so the effluent won't leave the tank. No other filter on wthe market can make that claim! Accepts 4"& 6"SCHD.40 Pipe'PL-525 Maintenance: The PL-525 Effluent Filter should operate efficiently for several years under normal conditions before ,,requiring cleaning. It is recom- mended that the filter be cleaned every time the tank is pumped or 0 f'-, at least every three years. If the installed filter contains an optional �; .'` alarm, the owner will be notified 'uW by an alarm when the filter needs :` servicing. Servicing should be `""'",,"' i;Gas deflector done by a certified septic tank ~'' it u l Automatic shut-off pumper or installer. ball when filter is removed 1. Locate the outlet of the U.S.Patent No#6,015,488 septic tank. 5,871,640 2. Remove tank cover and pump tank if necessary. PL-525 Installation: 1. Locate the outlet of the 3. Do not use plumbing when septic tank. filter is removed. Ideal for residential and corn- 2. Remove the tank cover and 4. Pull PL-525 out of the housing. mercial waste flows up to pump tank if necessary. 5. Hose off filter over the septic 10,000 Gallons Per Day (GPD). 3. Glue the filter housing to the tank. Make sure all solids fall 4" or 6" outlet pipe. If the filter is not centered under the back into septic tank. access opening use a Polylok 6. Insert the filter cartridge back Extend & Lok or piece of pipe into the housing making sure to center filter. the filter is properly aligned and 4. Insert the PL-525 filter into completely inserted. its housing. 7. Replace septic tank cover. 5. Replace the septic tank cover. 14 Id- -4 D z x U) > A m > c 61^ 84" m > n 70 42" N Im o �- m II I UP 41" I C N� m x rn p 4" CAS 0 m 3" 37^ n )r1 o 4" CAS /D tv /1111 � m C II`,� win o D a C 0_-0 m K o 40" D 0 f�1 m 0nzo > Z -( Kr-D N cn m D r -4 0 W r > <-r, --1 N TIAn r O m< ><73 I > z 0 m C D0 D r 2 r 2 Z o cA z z O O p r r m o '� '� > 0 - -4 - g m Am - Z O CO-)0 D ONZ >.Z rr�QmcC �Z00D� > CCD v to rP,..ICD 17 �0 �np 2p0 2��OrZ -,D N0 m �rx n �zC �-NiC �rr--m !O .N Z G7- -•� I-0 m o.. K ZZ I 000*1 Z py �Zfr*1 ( ��m- r0 W� -1N r0 0 my N DN-( I �r;-l� �m� N (./) Z Oco 0 D O �C7 O MmW N r m ' o -a v N Z N = C-( co (np,m1 Dr co;N� A0p n Ui L7•' I t**ti c c v > n �0 'V Z my D mDm NO p �1 °< �1 OZ n'-1 c N p co r 0-y D O • w�' cn m m >° o [] H i O \ 2rZ r-1 'w- Z n AA C C) Z Amp 0 O =D ,.-\-- o m < G1 -1 D xo D r v O m 0 0.17 p A o-, ° D N r m p r -+m '• c7 — 0 CO n . Z 4r m < O C m D H C I- m r1 m N m . CD \ i WLP750-MR \ m DRAWN BY: SME SCALE: 1/4"=1'-0" PRE-POUR: O m m --a SEPTIC MANUAL WIESER COHORT REV. W3716 US HWY 10 MAIDEN ROCK, WI 54750 DATE: JANUARY 2012 DATE:. POST-?OUR: \ ° REVISED JAN. 2012 800-325-8456 FILE: 111P750-14R 4 ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer Eric & Rebecca Lorenz Mailing Address 324 Krattley Lane, Hudson, WI 54016 Property Address Same (Verification required from Planning&Zoning Department for new construction.) City/State Parcel Identification Number 020-1002-70-000 LEGAL DESCRIPTION Property Location SW '/4, .SW '/4, Sec. 7 , T 29 N R 19 W,Town of Hudson Subdivision Plat: Na ,Lot# Na Certified Survey Map# Na ,Volume Na ,Page# Na Warranty Deed# 924266 (before 2007)Volume ,Page# Spec house Clyes +[fro Lot lines identifiable o 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§SPS.383.52(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 Safety And Professional Services 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 owner(s)of the property described above,by virtue of a warranty dee recorded in Register of Deeds Office. Number of bedrooms Na C.7.-A31" Po/31 / 13 SIGNATURE PLICANT(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.04/12) III) Document Number Document Title I. LIIIUI)ILIIIUU 8 Tx:4150350 2 St. Croix Count 988614 y BETH PABST REGISTER OF DEEDS Accessory Structure Affidavit ST. CROIX CO., WI � RECEIVED FOR RECORD 1-. ( \C C o re. . 11/04/2013 4:39 PM Name—(Owner) Typed or printed EXEMPT #: being duly sworn,states, under oath,that: REC FEE: 30.00 PAGES: 1 He/she is the legal owner of the following parcel of land located in St. Croix County, Wisconsin, recorded in Volume NA Page NQ Document Number 9,2 y.l,G St. Croix County Register of Deeds Office, Recording Area being duly described as follows(include lot no. and subdivision/CSM or Name and Return Address detailed legal description): •Cr'oiK ' Ce, n; 0ep • of a s6 14:n/.-2-6- ices / IZ r of 5.4.7/.4 5[e. 7 -7 j94, 42.6744.2.,jr1 /7 'r7Z r7. OA..`1"e Parcel Identification Number(PIN) ,c 7 "- "t goad ,r--,CC �! ./6z,fke-6 O.W-fooz-7o-OCO `t-.as-eo�i.7-eh 72 744)01 o><r5��d•S ," Gro;'')r c ., (--.)1. As owner of the above described property,T acknowledge that the Private Onsite Wastewater Treatment System (POWTS)services both an existing principal dwelling and an accessory building on this lot and is sized for a iX (40 ) bedroom home,or a design flow of 940 gpd. This accessory building may not be used as a second residence on this parcel. I also acknowledge that I will disclose this information and stipulation to any future parties interested in purchasing this property. Sf r� Dated this of LIL. I , ZCj/S /C. c.LoiQn� C. e AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF\YISC:ONSIN ) )ss. SI.Croix County. ) authenticated this day of Personally came before me this ,3/ day of -2O/.3 the above named & C, C• 1-c)r•enZ TITLE: MEMBER STATE BAR OF WISCONSIN to me known to be (If not, the person(s)who executed the foregolk httruntcfdlt*.at•k,iowledge the •authorized by$706.06,Wis.Stats.) same. ` _ r� •-• •THIS INSTRUMENT WAS DRAFTED BY .1.3. PCIATtela al Nil Z--01 Sz a:- N Public,State ol'Wiscnnsi� $__aa'•, 4lY . • (Signatures may be authenticated or acknowledged. Both are not y Cont_missJ'on is permanent.. ItcnpT, op• xpiti 1'• • .4 24415-- necessary.) Date: ( • 34..2OA-3• •'ot„• `� • -••. • ••nun, ° • "THIS PAGE IS PART OF THIS LEGAL DOCUMENT-DO NOT REMOVE” This information must be completed by submitter' document title,name de return address and PIN(If required). Other information such as the granting clauses,legal description,etc.may be placed on this first page of the document or may be placed on additional pages of the document.Note: Use of this 1 of lover page adds one page to your document and$2.00 to the recording fee. Wisconsin Statutes,59.43. • 9192952 Document Number Document Title Tx:416035I (1 St. Croix Count 988614 Y BETH PABST REGISTER OF DEEDS Accessory Structure Affidavit ST. CROIX CO., WI RECEIVED FOR RECORD i c C E� re -- 11/04/2013 4:39 PM L— EXEMPT #: Name-(Owner) Typed or printed REC FEE: 30.00 being duly sworn,states,under oath,that: PAGES: 1 He/she is the legal owner of the following parcel of land located in St. Croix County, Wisconsin,recorded in Volume NA Page NA Document Number 9,2 1/2 C St. Croix County Register of Deeds Office, Recording Area being duly described as follows(include lot no. and subdivision/CSM or Name and Return Address detailed legal description): • Cr^oix Q. •an/ pep6• 1101 Ca.int•cl.a� EaS� c,Go/•.2 -7.�e m,C' 4JQse /, s�T�,z5 °� f.l sue,, 02/. 50/4 OF 54•01/ 5[C. 7 7.29// ,p./9,„..),/y/%1 /,r Cr" iy el' Parcel Identification Number(PIN) e'er)&I'/,nc oic )11,n h d e,rc 4 4/5V cee`6 02+0.4002-7O-000 t424-¢o�in-eAeTOwrto11cuA/Sol cro71K6y c,J/. As owner of the above described property, I acknowledge that the Private Onsite Wastewater Treatment System (POWTS) services both an existing principal dwelling and an accessory building on this lot and is sized for a (k) bedroom home, or a design flow of 900 gpd. This accessory building may not be used as a second residence on this parcel. I also acknowledge that I will disclose this information and stipulation to any future parties interested in purchasing this property. Dated this day of V'l- , 7 0i3 * �� C_•L.o/er7A, * �riC c ./olC/IA _Aft.._ab. * * AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF WISCONSIN ) )ss. St.Croix County. ) / /'�� authenticated this day of , Personally came before me this .3/ day of Cx 2.O/3 the above named Err C.. C• s!orenz to me known to be TITLE: MEMBER STATE BAR OF WISCONSIN �.• (If not, the person(s)who executed the forego Otrumei t/t 'ar:knowledge the same. Q �E►''•. authorized by§706.06,Wis.Stats.) �.�• t 0 THIS INSTRUMENT WAS DRAFTED BY X71 . N. Public,State of Wisconsi 0%. L y:•• •' (Signatures may be authenticated or acknowledged. Both are not y Commiss�}ion is permanent I n9 xpit •4 necessary.) Date: ©c • 3/.20/(3 �o•,,, •• II "THIS PAGE IS PART OF THIS LEGAL DOCUMENT—DO NOT REMOVE" This information must be completed by submitter: document title,name&return address,and P/N(f required). Other information such as the granting clauses,legal description,etc.may be placed on this first page of the document or may be placed on additional pages of the document.Note: Use of this cover page adds one page to your document and$2.00 to the recording fee. Wisconsin Statutes,59.43. uy e Xi Ems.' gig ;. '?, I Iiig 7:4"`•!`;''...',E- 0 , at!1 N.f..--,-7,-. r' N , s-s ,fray y.. 7, V '� S °°.zur Y t° 1"T" Q� WWW Pick t•`- r" (7 �a ,4 �� arm _ I ` m O : i 'IP ..., 'at N & f c r �p v , V.'Q" y,7 1r!",Ya, F,.�, . "'� ''"S" s.;`;c} r,� -A i r. d- ,.a, t.v >:..' x-#� .,:�,y 4_r A '" .i ' . # , ere 'Ott' ` KM W,rt t S4. t "' v: ""1 — 4 e .� ..i yiWS C i",..:.1,,,> 3MJ63 ._.._ W .fin 1 gr. �r O j 44 k,,,,::: s�.t ',° w a,.. �' O t i r, k � t k 's: ^w 0 14 /x'r, ) " ' '4 p..` y.4 ; ? N" a fi f. ,. S OZ OBt )� 4 ��} tsc L; 14 to 5 - t y 3',, OVI r't: us,. 4" tar § '• W r0 'b' IVp F. WARRANTY DEED 0 s�71ag 1 Ann L. Hansen, a single person, conveys and 924266 warrants to Patrick A. Fillmore, a single person and BETH PABDT Eric C. Lorenz and Rebecca S. Lorenz, husband and ST. CROIX OF WI wife, all three as joint tenants with rights of CE RECEIVED FOR R RECORD CO survivorship, the following described real estate in St. 10/07/2010 FOR 3:06 PM �g 10/07/2010 3:06 PM Croix County, State of Wisconsin: EXEMPT nit: N/A, REC FEE: 30.00 TRANS FEE: 1089.90 Exception to warranties:ail easements and restrictions of record. PAGES: 1 This is homestead property. Parcel Identification Number(s): 020-100240-000 and 020-1003-40-000 Name and Return Address: RIVER VALLEY ABSTRACT&TITLE 1200 HOSFORD STREET.SUITE 201 HUQ 2`2b541 314 East 357 feet of West 1071 feet of that part of Southwest Quarter of Section 7,Township 29 North,Range 19 West lying Northerly of centerline of Town Road,except North 115D feet thereof in the Town of Hudson, St.Croix County,Wisconsin. and East 401.25 feet of West 1472.25 feet of that part of Southwest Quarter of Section 7,Township 29 North,Range 19 West lying Northerly of centerline of Town Road,except North 1150 feet thereof in the Town of Hudson, St.Croix County,Wisconsin. Dated this 1 1 day of October,2010. Ann L.Hansen E =r.C.-,:iK. rev :.O!IG ACKNOWLEDGMENT I '''�~Ai' 1'`' LiC STATE OF WISCONSIN) ; =ATE OF WS ;>NSii'1 ST.CROIX COUNTY ) i--...... ._....... .,._. Personally came before me this'day of October,2010 the above named Ann L.Hansen to me known to be person who executed the foregoing instrument d acknowledge the itke Notary t.Croix ,VT • bri .D My Commission expires:date:a 3 1 3 J This Wiaburnent drafted by Robert F.W . 1of1 Fe_ Az' 8 Wisconsin Department of Commerce Safety and Building Division PRIVATE SEWAGE SYSTEM County: 17 INSPECTION REPORT Sanitary Permit No: St. 0Croix GENERAL INFORMATION (ATTACH TO PERMIT) 561017 Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: State Plan ID No: Lorenz, Eric m Rebecca City Village X Township Parcel Tax No: CST a Elev: Insp. BM Elev: BM Description: Hudson, Town of ~t 020-1002-70-000 q'y I ~ Section/Town/Range/Map No: TANK INFORMATION G 5 ELEVATION DATA 07.29.19.5C6D7F TYPE MANUFACTU 5 CAPACITY STATION Septic RER BS FS ELEV. / 3 56 Benchmark ~9, SL t_ 11 _ ~ , ~t 5 Aef2tF9n Z / 75co Alt. BM 9S / D. 7y. <o5 Holding PO I d L52 Bldg. Sewer ° St/Ht Inlet TANK SETBACK INFORMATION St/Ht Outlet TANK TO P/L WELL BLDG. Vent to Air Intake ROAD gt-kAlet ~V3 - 7id y 4 r ' /O3 t 56 26 1 Dt Bottom Dosing Ito 75v ! 5~ / 7 Header/Man. T. B ' 2y Aeration c~ s 870 • 05 Dist. Pipe 7`7 Holding ~p Bot. System 7 1, os PUMP/SIPHON INFORMATION /z 7 Final Grade Manufacturer ft Sy Demand St Cover 7. Z6 Mod umber GPM '1 IL~_ CO J U 7 q& J 5g <7c7• Sz TD Lift Friction Loss System Head T Ft 1/ 4~~ ~ J 76 Forcemain th Dia. Y a ®J 0~ c, 7L to Well 7 ~Cr SOIL ABSORPTION SYSTEM 5.7 7 BED/TRENCH Width Len g DIMENSIONS 3 g / No. Of h; PIT DIMENSIONS No. Of Pits lD 1 ~e Inside Dia. Liquid Depth SETBACK SYSTEM TO INFORMATION P/L BLDG WELL Type Of System: LAKE/STREAM LEACHING Manufacturer 7~r Qi( I CHAMBER OR v l6g ~A . UNIT Model Number: DISTRIBUTION SYSTEM j, 44 72~g Heade/Man f 7 Distribution Z! tL --Z/ - 4' Length `Dia Pipe(s) x Hole Size x Hole Spacing Length-_ Dia Vgntjto iir I ake SOIL COVER spacing--- ~ r Depth Over X Pressure Systems Only XX Mound Or At-Grade Systems Only Center S Depth Over Be Depth xx eeded/Sodded J Bed/Trench Edges Depth of Topsoil xx ulched COMMENTS: reS ~ No Yes ( (Include code discrepencies, persons present, etc. / No Inspection #1: Location: 324 Krattley Lane Hudson, WI 54016 (SW 1/4 SW 1/4 7 T29N R1 9W) metes & bound Lot_ sparcel No o:: 07.29./19 5C6D7 1.) Alt BM Description = 5~ C- GOJQ,J~ F/rcel . 2.) Bldg sewer length = D'1 -amount of cover 756 ~'~~.lJ~-s ~ ~"tiwks Plan revision Required? Fft~ Yes 6 V~ - - Use other side for additional information. No F7J J-1i 1 SBD-6710 (R.3/97) Date - Insepctors ignature - Cert. No. ■ So./ed~/uQ~,~,a.~ E~,3tI~j e/e~lct<,rJ 0,9 v, qqD eCCS~ I-or " Z O D f rrI r!`P~,. ,r' CdrY~ul SG~?Y515u r l r t r a flu~%5~rrcr.l T, -r.15W.,4194Z 7, o>c ' 1 e $at I roposeel cl; fur Sa Q Ce Lf ."T{tr ec ~3~ ' r r c./. " oZO -icVz-70 -cOO enC4 5 4~ 3 X 8 l0 'w~ Z l z,,F'/fi✓° t ` c sru-r",t eleif ix A 7. ' O' `h~dP -77 , t, r ~ err /z~r~lc~ide~~> cc efe4`=9300,E , - i 5~ zoscc/Serer/ 4-57WI-30-W i~.SccL~`ed Coss o r 1 eWlu-1 ,Z A c 6enea.~ e/-iveax, soy bc~mX ~ ~ y. ~lJieSar ~'nC/'~ ~ wC~-75t~nt// Serof,Y-` Ir 83~ 'D eX+S~ ~5 ~►^r7i+~ ba.: /o by Y p~ SAS eo~;F/a4,,6 -~''/her. / rJ `~d ~1G3EIrr, `I-C3__ , QaSiofa,ttCa AeaSri.~Z` 7-i: v ~ o d` / Al 5 weed eJ. = t mj h ~ / v1 t ~X,S ~rnc / ~ 9~ l wyll `I / 3` C b 9\ bwr, ed o ~a~ l:na Copy P~ . 20P County i~ Safety and Buildings Division St. Croix it 201 W. Washington Ave., P.O. Box 7162 Sanitary Permit Number (to be filled in by Co.) =P= Madison, WI 53707-7162 pg it w Permit Application State Tr sactionNumber In accordance with SP 3831( ode, submission of this form to the appropriate governmental unit ~V~I P is required prior to obta 8 ie[t rpermit. Note: Application forms for state-owned POWTS are submitted to Project Ad ess (if different than mailing address) the Department of d Professional Services. Personal information y olway be used for secondary es in accordance with the Privacy Law, s. 15.04 1 m , Stats. Same 1. Application Information - Please Print All Information Property Owner's Name I / Parcel # Eric & Rebecca Lorenz ~~r Y i C '6 (Mb re (,t7 DW VJ 2 rs 020-1002-70-000 Property Owner's Mailing Address Property Location + s 324 Krattle Lane Govt. Lot City, State Zip Code Phone Number SW _ y. _SW Section 7 (circle one) Huds , WI 54016 715) 377-0648 T 29 N; R 19 E or W II, pe of Building (check all that apply) Lot # 1 or 2 Family Dwelling - Number of Bedrooms Z61~UM~ Subdivision Name Na l L~ Block # Na ln v Zip ❑ Public/Commercial - Describe Use Na ❑ city of ❑ State Owned - Describe Use CSM Number ❑ Village of Na I&Kown of Hudson III. Type of Permit: (Check only one box on line A. Complete line B if applicable) A' ❑ New system lplacement System ❑ Treatment/Holdin Tank Replacement Only El Other Modification to Existing System stem eP g Y g Y (explain) El Permit Renewal El Permit Revision El Change of Plumber ❑ Permit Transfer to New List Previous Permit N and Date Issued Before Expiration Owner ( (l ( 11 11 IV. T e of POWTS S stem/Com onenVDevice: Check all that a 1 Non-Pressurized In-Ground ❑ Pressurized In-Ground ❑ At-Grade ❑ Mound > 24 in. of suitable soil ❑ Mound < 24 " f sui soil J ❑ Holding Tank ❑ Other Dispersal Component (ex I ' - -r.__._._- ❑ Pretreatment Device (explain) V. Dis ersal/Treatment Area Informati Pol Lok PL-525 effluent filter, 63 Infiltrator "Q-4 Plus" standard plus chambers & 6endc s ..e azl - Design Flow (gpd) Design Soil Application Rate(gpdsf) equi 71,2go. persal Area Propose ton 900 Gpd 0.70 Gpd/Sq. Ft. ✓ 1,285.72 sq. ft. 60Sq. Ft. 87.088.0 & 89.0' -A Y_ VI. Tank Info Capacity in Total # of Manufacturer Gallons Gallons Units d o g v New Tanks Existing Tanks w C ~7i w C7 G. 2.► Dn A. U in y Septic or Holding Tank 750 1,350 ;,Q" 1 & 1 Wieser Concrete X Dosing Chamber b I o 1L 5_2 C' -der VII. Responsibility Statement- I, the un signed, assn a responsibility for install 'on of the P WTS shown on the attached plans. Plumber's Name (Print) Plumber' ignature MP/MPRS Number Business Phone Number James K. Thompson r MPRS 30021 715 24$-7767 Plumber's Address (Street, City, State, Zip Code) 340 P lson Lake Lane, Osceola, WI 54020 VIII oun /De artment Use Only Approved ❑ Disapproved Permit Fee "ate issued suin A e tgn re i 1 Iq L1 Owner Given Reason for Denial / IX. tUMHddQ*%0WrovaI/Reasons for Disapproval 1. Septic tank, effluent filter and - dispersal cell must _b serviced / maintained 4/ C~np, b d/~~S as per management plan provided by plumber. 2. All setback requirements must be maintained x 15T nJ- S-P-VfLye '-d 1~1 0/17 as per applicable code/ordinances. Attach to complete plans for the system and submit to the County only on paper not less than 81/2 x 11 inches in size SBD-6398 R 11111 Conventional POWTS Index & Tilte Sheet Project Name: Lorenz 6 bedroom Replacement Conventional POWTS Owners Name: Eric & Rebecca Lorenz Owner's adress: 324 Krattley Lane Site address: Same Project Location: Subdivision: Na Legal Description: SWI/4 SWI/4, Sec. 7, T.29N., R. 19W., Town of Hudson, St. Croix Co., WI. Parcel ID 020-1002-70-000 Page 1 Index and Title Sheet Page 2 Site Plan Page 3 Dispersal Cell Sizing Calcualtions Page 4 System Cross Section Page 5 System Management Plan Page 6 Filter Specifications Page 7 Septic Tank Cross Section Page 8 Parcel map Page 9 Septic Tank Maintenance Agreement Page 9a Existing Septic Tank Certification Page 10 Deed Attachments: Soil Evaluaiton Report ~I Mater PI ber Res 'cted Service: James K. Thompson, Dept. of Comm. C ntial #30021 Signature: a---- Date: ~d Page 1 of 10 Design pursuant to In-Ground Soil Absorption Component Manual for POWTS, version 2.0 SBD-10705-P (N.01/O1) ♦ E,~, strrr~ Owa c,,., C6c/,u / ^ 5~r %~Qi~ 23 09 c= G fl K ~-O eCCA ~Y'a~ g Bo qp~ 3~2 9(, its" /ey La.,t comer r r i i r Tn , o~ f./u ~5 r~r), 56. C'roZx ~'o., cJ/. i , ( z ; prop°see/d;SP'~so cc U .T{~re~(3) G. Po.20 -1G0.Z--70 -cao r . Yj* r ' /7 30 rs . ~ ~ \ -5f plu.sc•~o.,.J~.s/6-~r+GL..~-v~/6a~%~t 0 5w mac elect tube= 6 zo; 26-00B 0. \h~o~ 6c c~ Y3. 00't a 5 ~ ~ ! ` SL~~..rgSce/Sea/ ifSTM- jo3`/ %~Scc,~.vL~td ccss e r eFf/u~„~ /.-ne 6,enca66 er'i,/ec y. 1 aro be i ~ 4- i ( Fr•os~ Sle4ue ~=a be c~ldca/fc W ieSar CcnC~G¢e ' ( Q,c~s£~~~ exid rr7n~ wcA-7svm,QSV6,c- 8.3 ( Se~.,sr(/Clea.,aw~• ,ol 5::?S eFF14,4r6 ~1G'SEircJ / 7S Ear. r w~ d"A ~ 6ot'~rrr ~ ~;di , / R.swr►►ed el.=gym/ all o b` cue J l 11 6-r. cd Pq 20~' /O LORENZ DISPERSAL CELL SIZING CALCULATIONS 1. (6 bedrooms)(100 gallons estimated flow)(1.5 design factor) = 900.00 Gpd design flow 2. Infiltrative capacity of native soil = 0.7 gpd/sq. ft. 3. Absorption area required: 1,285.72 N. ft. 4. Absorption area as proposed: 1,290.60 sq. ft. (63 chambers total) Infiltrator "Quick 4 Plus" = 20.00 sq.ft. EISA per chamber, Infiltrator "Quick 4 Plus" end cap = 5.10 sq.ft, EISA 1,285.72 sq. ft. - (6 endcaps)(5.10) = 1,255.12 sq. ft./20.00sq.ft. EISA = 62.76 chambers required Number of trenches: 3 na, 21 chambers per trench (63 chambers total) Trench width: 2.83' Trench length: 86.00' Trench spacing: 8.00' on center Total system area w/ 6' trench spacing: 21.00'x 86.00' Pg. 3 of 10 Soil Absorption System Cross Section 9,z .0 ?5. ft 9i so 9 sn, ft 4" Schedule 40 Final Grade PVC Vent Pipe With Vent Cap ft Leaching x--869 7aChambr ft System Elevation ,2.83 ft S 60 ft 5, cO ft Soil Absorption System Plan View 96.60 ft ft 6-.66 ft Leaching Trench 1 Chambers 4" Dia. Trench 2 Header Vent Or Observation Pipe Trench 3 Leaching Chamber Specifications Manufacturer And Model J&-,, e 'S EISA Rating 20•~sq ft per chamber Soil Application Rate 0.70 gpd/sq ft ~d6~ 66 gpd Design Flow + 0•70 Soil Application Rate 20•6'0 EISA = 6-9•7 Chambers 3 rows of 21 chambers each. Page _ of ~d Conventional Septic System Management Plan Pursuant to SPS 383.54, Wis. Adm. Code General The conventional septic system shall be operated in accordance with SPS 382-384 Wis. Adm. Code, and shall be maintained in accordance with component manual SBD-10705-P (N.01/01). All local and/or state rules pertaining to system maintenance and maintenance reporting shall be complied with. Septic Tank Septic tank servicing mechanics comply with SPS 383.54(l)(e). Septic tank to be located within 150' of service pad, with bottom of tank to be 15' below service pad elevation. The operating condition of the septic tank and outlet filter shall be assessed at least once every two years by inspection. The septic tank contents shall be removed when the sludge and scum in the tank exceed 1 /3 the liquid volume of the tank. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code, by an individual certified to service septic tanks under s. 281.48, Stats. If the contents of the tank are not removed at the time of a biannual assessment, maintenance personnel shall advise the owner of when service will be needed to maintain less than 1/3 scum and sludge accumulation in the tank. The outlet filter shall be cleaned as necessary to ensure proper operation. The filter cartridge should not be removed unless provisions are made to retain solids in the tank that may slough off the filter when removed from its enclosure. If the filter is equipped with an alarm, the filter shall be serviced if the alarm is activated. Septic tank manholes 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 replaced. Exposed access openings greater than 8 inches in diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into the tank. No individual should ever enter the septic tank as dangerous gases may be present that could cause death. Septic tank abandonment shall be in accordance with Comm83.33, Wis. Adm. Code when the tank is no longer used as a POWTS component. The addition of biological or chemical additives to enhance septic tank performance is generally not required. If such products are used they shall be approved for septic tank use by the Department of Commerce, Safety and Buildings Division. Soil Absorption Cell Trees or shrubs should not be planted directly on the soil absorption system. The area above and around the system should be seeded and mulched as necessary to prevent erosion and provide some degree of frost protection. Traffic (other than for vegetative maintenance) over the system is to be avoided. Soil compaction may hinder aeration of the infiltrative surface within and above the system and will promote frost penetration during cold weather months. Cold weather installations (October-March) dictate that the system be heavily mulched for frost protection. Influent quality into the system may not exceed 220mg/L BOD5, 150 MG/L TSS, and 30 mg/L FOG. Influent flow may not exceed maximum design flow specified in the permit for the installation. Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the owner. Levels above 4 inches indicate an impending hydraulic failure requiring additional, more frequent monitoring. Effluent flow shall be alternated between dispersal cells on a two-year schedule by use of diversion valve. Effluent to be diverted from new dispersal cell to old cell at 4 year anniversary of new system installation. Old cell to be utilized for a 1 year period. Afterwards, effluent dispersal to be alternated between cells to allow use of each cell for a two year period. Contingency Plan If the septic tank or any of its components become defective the tank or component shall be repaired or replaced to keep the system in proper operating condition. Excessive ponding within the dispersal cell will be eliminated by installing a new soil absorption cell to bring the system into proper operating condition. Questions on the operation or maintenance of the system should be directed to the installing plumber, Jim Thompson at (715) 248-7767 or the St Croix County Zoning Department at (715) 386-4680. Pg. 5 of 10 0 Filters PL-525 EFFL DENT FILTER Polylok, Inc is pleased to add its new commercial filter to its existing line of quality effluent filters. The PL-525 is rated for over 10,000 GPD Alarm (gallons per day) making it one of accessibility Accepts PVC the largest commercial filters in its extension handle class. It has 525 linear feet of 1/16" filtration slots. Like the Polylok PL-122, the new Polylok PL-525 has an automatic shut off ball installed 525 linear feet with every filter. When the filter is of 1/16" removed for cleaning, the ball will filtration slots Rated for over float up and temporarily shut off 10,000 GPD the system so the effluent won't leave the tank. No other filter on the market can make that claim! Accepts 4" & 6" h SCHD. 40 Pipe PL-525 Maintenance: The PL-525 Effluent Filter should operate efficiently for several years under normal conditions before requiring cleaning. It is recom- mended that the filter be cleaned every time the tank is pumped or at least every three years. If the installed filter contains an optional alarm, the owner will be notified by an alarm when the filter needs servicing. Servicing should be Gas deflector done by a certified septic tank Automatic shut-off pumper or installer. ball when filter 1. Locate the outlet of the U.S. Patent No# 6,015,488 is removed septic tank. 5,871,640 2. Remove tank cover and pump tank if necessary. PL-525 Installation: 1. Locate the outlet of the 3. Do not use plumbing when septic tank. filter is removed. Ideal for residential and com- 2. Remove the tank cover and 4. Pull PL-525 out of the housing. mercial waste flows up to pump tank if necessary. 5. Hose off filter over the septic 10,000 Gallons Per Day (GPD). 3. Glue the filter housing to the tank. Make sure all solids fall 4" or 6" outlet pipe. If the back into septic tank. filter is not centered under the access opening use a Polylok 6. Insert the filter cartridge back Extend & Lok or piece of pipe into the housing making sure to center filter. the filter is properly aligned and 4. Insert the PL-525 filter into completely inserted. its housing. 7. Replace septic tank cover. 5. Replace the septic tank cover. P3 . 61 0l /o ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer Mailing Address Property Address 6a,ne (Verification required from Planning & Zoning Department for new construction.) City/State Parcel Identification Number d -102 -70 -6tZ LEGAL DESCRIPTION Property Location 6 44)/4 , SCe~ '/4 , Sec. 7 , T ,2-9 N R_Z__W, Town of ~ec ol~ir~ Subdivision Plat: {1C , Lot # Certitied Survey Map # /74 , Volume , Page # - Warranty Deed # - / 2 7 2 (before 2007)Volume , Page # Spec house 0 },ps Z-66' Lot lines identifiable 91esEl w 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 §Comm. 83.52(l) 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 o~+ner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that ( I ) 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. l/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. Uwe certify that all statements on this form are true to the best of my/our knowledge. 1/we am/are the owner(s) of' the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. Nu r of bedrooms SIGNATURE OF APP ANT(S) QUA E "*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. 09/07) q W/o ST. CROIX COUNTY ZONING OFFICE CERTIFICATION STATEMENT FOR UTILIZATION OF EXISTING SEPTIC TANK(S) This is to certify that I have inspected the existing septic and/or dose tank presently serving the following residence: (Street address) .,z Z/ l-Az~Klev /-o,7e located at: (-J '/4, 5co '/4, Section Town 2-~? N, Range Zg \V, Town of St. Croix County Wisconsin. Upon inspection, I certify that I have found the tank(s), to the best of my knowledge, will conform to the requirements of Comm. 54.25, and it (thee) appear(s) to be functioning properly. Most recent date of inspection or service 1?av! 4 ;2-01-2- Did flow back occur from absorption system? Yes No k/ (if no, skip next line.) Approximate volume or length of time: Al gallons n1iMllre:S Tank Capacity: o Construction: Prefab Concrete P--- Steel _ Other !Manufacturer (if known): cre,& Age of Tank (if k-nown): ~l ass ~r1sEa.QQxr~ 1-8 8 Peber(if known) ax~.'-- 44<censed Plumber Signature) (Print Name) (Title) (License Number) N11'RS Q .2d ate) Form to be completed by licensed plumber (Dept of Commerce Chapter and s. 14 .06, Wisconsin Statutes) or licensed disposer (NrR 1 1') \\'isconsir: Administrative Code) Rev. 9/2008 ~5. 9Q a '(io D Z N D m ~ I D z 61., 84" c m D 42" m z v r- m O nN mm m ~ I UP 41" m m N 4" CAS \ o m E5 0 3" 37" 4' ( r D co I M l N Ln -n ;0 IT UP 39" < D v [4" CA`~ m J ;0 C m rJ v 0 -u m n OC A n = r. v 40" rd '<O D t~/1 m co >1 0mD cn <m~ m O 0 r mA A X nZ7 2 n Z 0 m n <n r = r v D c m m m Om OD COJO 2~nW ~N AF4 xr- m n p coo 0 O~z Dzz ~nfm-C 1?1D00-4 r-0 0M xX -0 Z o A~~ ->o ~ v) x(70 2p0- =2~OrV/ z N~ mm n m N ~~Z n XZg ~ccn8 - *m ~D NN 0 N , F1Z m? .c AC Z0 2 c(n Z OD ~ ~z~ n I id 0<mr-o -r-O0.. =W\ 1N Z p my 00 mD D ~ ND-4 or-1m ~m~ N r N N (n m v a z ooo z D o Nmy I m r~n~ir* On m ~I v D N O N ' C~ ONO Nv-n Dr N s a;u Ov Vl AA. C) ° v AA O O -v Z M -4 O mom m o v 00 ~ Tl 0 vii G Z n~ -D{ v0 \ =rn > ° .P w-m z v o O H D ~m -0 C O Z Div C01 O 'D o rn< Z --I yA O D r AO-1 ,On Ml A N g r p r m 0 w m l (n p Z p0 O 0 0 m 00 2 N N A A D p 0 Z C O O mr rn U) < co Z z r A H r X ;0 ZA r -I m 0 \ N WLP750-MR = DRAWN BY: SME SCALE: 1/4"=l'-O" PRE-POUR: m MIESER CODCAETE REV. -n I m SEPTIC MANUAL DATE: JANUARY 2012 DATE:. POST-POUR: \ Z W3716 US HWY 10 MAIDEN ROCK, WI 54750 ° REVISED JAN. 2012 800-325-8456 FILE: YU750-MR 70~'l ~ y 2309 Wisconsin Department of Commt i:` `y ~ SOIL EVALI 'TI~ Fi~PjP T Page 1 of 4 Division of Safety and Buildings in~r'sCblydance with Comm 85, Wis. Adm. Code A.C.E. Soil & Site Evaluations Attach complete site plan on paW not less than * lnches in size. Plan must County E~ St. Croix include, but not limited to: vertical and horiz0rk3 '*1erence point (BM), direction and parcel I.D. percent slope, scale or dimemsions, noo Arrow, and location and distance to nearest road. -1020-1002-70-000 Pleave print all information. Rev' Date Personal information you provide may be used for secondary purposes (Privacy Law, s.15.04 (1) (m)). ~ w 1,1131L Property Owner Property Location Eric & Rebecca Lorenz Govt. Lot SW 1/4 SW 1/4 S 7 T 29 N R 19 W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# 324 Krattley Lane na na Na City State Zip Code Phone Number City __]Village a Town Nearest Road Hudson WI 54016 (715) 377-0648 Hudson Krattley Lane & Pheasant Trail - IC New Constru 'on Use: N' Residential/ Number of bedrooms 6 Code derived design flow rate 900 GP0 Replacement -J Public or commercial - Describe: rent mat Glacial Outwash Flood plain elevation, if applicable na General comments and recommendations: Site suitable for conventional POWTS dispersal cell with 0.7 gpd/sq.ft./day loading rate. Proposed infiltrative surface elevations to be 4.5' - 6.0' below existing grade. Boring # J Boring ./f Pit Ground Surface elev. 94.84 ft. Depth to limiting factor 122~~ in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft' in. Munsell Qu. Sz. Cart. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-10 10yr3/3 none I 2fgr mvfr cs 2fm,1c 0.6 0.8 2 10-23 10yr5/4 none sit 2msbk dsh cw 2fm,1c 0.6 0.8 3 23-38 7.5yr4/6 none sil 2msbk dsh gw 2fm 0.6 0.8 4 38-46 10yr5/6 none sit 1msbk dsh aw 1vf,f 0.4 0.6 5 ` m6-52 7.5yr4/6 none Is Osg dl cw 1 of 0.7 1.6 6 122 1Oyr5/4 none s&gr Osg dl - - 0.7 1.6 o = d.o t a)~ Boring # Boring 16 Pit Ground Surface elev. 94.08 ft. Depth to limiting factor >118" in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft' in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-9 10yr3/3 none I 2fgr mvfr cs 2fm,1 c 0.6 0.8 2 9-20 10yr5/4 none sil 2msbk dsh cw 2fm,1c 0.6 0.8 3 20-34 7.5yr4/6 none sit 2msbk dsh gw 2fm 0.6 0.8 4 34-39 Wyr5/6 none Ifs Ogg cil aw 1vf,f 0.5 1.0 5 39-50 7.5yr4/4 none [cos Osg dl cw - 0.7 1.6 6 50-118 10yr5/6 none sc&gr Osg dl - - 0.7 1.6 'Oi a K / d / * Effluent #1= BOD 5> 30 < 220 mg/L nd TSS >30 < 50 mg/L * Effluent #2 = BOD5 <30 mg/L and TSS <_30 mg/L CST Name (Please Print) Signat : CST Number James K. Thompson - 5---- 3602 Address A.C.E. Soil & Site Evaluations Date Evaluation Conducted Telephone Number 340 Paulson Lake Lane, Osceola, W154020 12/4/2012 715-248-7767 Property Owner Eric & Rebecca Lorenz Parcel ID # 020-1002-70-000 Page 2 of 4 3] Boring # J Boring Pit Ground Surface elev. 94.29 ft. Depth to limiting factor >124" in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPM? in. Muncell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 "Eff#2 1 0-25 1 Oyr3/3 none sl fill na dh aw 2fm,1 c 0.0 0.0 2 25-35 7.5yr4/6 none fsl Imsbk ds 9w Ifmc 0.2 0.6- 3 35-45 10yr5/4 none fsl 1msbk ds 9w 1fm 0.2 0.6 4 45-54 1 Oyr5/4 none Ifs Osg dl ow 1 vf,fm 0.5 1.0 5 54-124 ' 10yr5/6 none loos Osg dl - - 0.7 1.6 F-1 Boring # I Boring Pit Ground Surface elev. ft. Depth to limiting factor in. Sod Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots in. Munseli Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 ❑ Boring # - I Boring _f Pit Ground Surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. "Eff#1 *Eff#2 I " Effluent #1 = BOD 5> 30 < 220 mg/L and TSS >30 < 150 mgA- * Effluent #2 = BOD5 <_30 mg/- 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. A.C.E. Soil & Sue Evaluations SSD-8330 (R07/00) PROPERTY OWNER: Eric & Rebecca Lorenz SOIL AND SITE EVALUATION 2309 Page 3 of 4 PARCEL I.D.# 020-1002-70-000 A.C.E. Soil & Site Evaluations REPORT MEMO Topography is very uneven and irregular. Site should be sub-cut prior to system installation. Finished grading should be completed to provide smooth contour over system area and divert surface water runoff beyond system area. -3f-EX.:s~r✓~~ f'"xe%nc wu FE~ x t p,.Z3 09 Iffr, G f~ A ttj eCCA 4W" r- D , J S4DY~/5"20Y, Se,-y, T-zq r., e /91J. f Ir t ~ Tn.O~ /~cce/S~, 56.C'r'oi,K(a., cJ/. r 1 ,g~2 ~ P~, f, F6Q20 -~lAZ-TO -Uk~ crime . 17.30 ~6 1o c e ele N a 93 00't 1 Clst ~ ~ 1 1 i 8g ~'~'r "T i rr t 1, j r I ~ 3 gX,"St<: / 3SU~a~ Q ~i c Ste!' ~n ca 4e- ~ r r rt I L'0~= Pak/ ' t r ~ i 1 ' 1 Qis~d~~. ~Ok~xSartT~ ~ J~ Wei/ - 44 / ~aS l:na / Q L~rIC. P5. ~o~ •M n v_ ?8 p 0 80 0. m o La B P "d fps ~CI ~ W > m V O y z 1 O f Om ~P m r r- 04 r ~ fll Cl' ~ z ~ _ 4. s r m w 04 Q ,o. CD CA OD v t st-fe~;~rv r Riji F7. IOD ol m OD m U) c ~,r e : ` Y j c.y C1G Q + (ter Ql -4 O C)o (Ji 0~ ~ c76 co 0 ~ rid r, ' Irv QDrs, rtJ~ r- -4 r Iv --j <A~ -.e 4.w -4 fJ1 -J OD WARRANTY DEED 8 Tx04007109 1 Ann L. Hansen, a single person, conveys and 92426 warrants to Patrick A. Fillmore, a single person and BETH PA ST Eric C. Lorenz and Rebecca S. Lorenz, husband and REGISTER OF DEEDS wife, all three as joint tenants with rights of ST. CROIX C RECEIVED FOR RECORD survivorship, the following described real estate in St. 10/07/2010.11:06 PM Croix County, State of Wisconsin: EXEMPT N/A REC FEE': 30.00 TRANS FEE: 089.90 Exception to warranties: all easements and restrictions of record. PAGES: 1 This is homestead property. Parcel Identification Number(s): 020-1002-70-000 and 020-1003-40-000 Name and Return Address: RIVER VALLEY ABSTRACT TIT LE 1200 HOSFORD STREET. SUITE 201 HU SON. Wl 54016. 12 5 3 2 East 357 feet of West 1071 feet of that part of Southwest Quarter of Section 7, Town hip 29 North, Range 19 West lying Northerly of centerline of Town Road, except North 115 feet thereof in the Town of Hudson, St. Croix County, Wisconsin. and East 401.25 feet of West 1472.25 feet of that part of Southwest Quarter of Section 7, ownship 29 North, Range 19 West lying Northerly of centerline of Town Road, except North 150 feet thereof in the Town of Hudson, St. Croix County, Wisconsin. Dated this I'd day of October, 2010. _ I Ann L. Hansen k.. ' '.C-0, ACKNOWLEDGMENT ' i0 STATE OF WISCONSIN) ST. CROIX COUNTY ) ' _ _ Personally came before me this r I day of October, 2010 the above named Ann L. Hansen to me known to be the person who executed the foregoing instrument ,#d acknowledge the sanw, Notary bhc, t. Croix Co , Wisconsin yi ewz_LJ My Commission expires: date: This instrument drafted by Robert F. Wall. manwnF-- 2oio-2 j i i I 1 of 1 Parcel 020-1002-70-000 PAGE E 1 1 12/31/2012 OF A 1 1 Alt. Parcel M 07.29.19.5C.6D.7F.81 020 - TOWN OF HUDSON Current ❑X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type # of Units 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner 0 - E, PATRICK A PATRICK A FILLMORE - LORENZ, ERIC C & REBECCA S ERIC C & REBECCA S LORENZ _ 324 KRATTLEY LN HUDSON WI 54016 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description 324 KRATTLEY LN SC 2611 SCH DIST OF HUDSON SP 1700 WITC Legal Description: Acres: 17.300 Plat: N/A-NOT AVAILABLE SEC 07 T29N R19W PARCEL IN CENTER OF Block/Condo Bldg: SW1/4 BEING E 401.25FT OF W1472.25 FT OF THAT PT OF SW1/4 LYG NLY OF CL TN RD EXC Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) 1150' AS IN V471 P236 ASSESSED WITH 07-29N-19W P6C,7B Notes: Parcel History: Date Doc # Vol/Page Type 11/09/2012 967133 EZ-U 10/07/2010 924266 WD 02/21/2006 818927 EZ-U 05/21/1996 543988 1179/144 TI more... 2012 SUMMARY Bill Fair Market Value: Assessed with: 182200 244,500 Valuations: Last Changed: 07/17/2012 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 17.300 89,300 153,400 242,700 NO 10 Totals for 2012: General Property 17.300 89,300 153,400 242,700 Woodland 0.000 0 0 Totals for 2011: General Property 17.300 163,600 155,900 319,5000 Woodland 0.000 0 Lottery Credit: Claim Count: 1 Certification Date: Batch 134 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 MEN" • AS BUILT SANITARY SYSTEM REPORT OWN e , TOWNSHIP_ 0 bSO1) SEC . T Z7 N, R 19 P. 0.., ADDRESS tqA Lt lq,~SE. CROIX COUNTY, WISCONSIN. SUBDIVISION LOT -LOT SIZE PLAN VIEW -Distances & dimensions to meet requirements of H62.20 SHOW EVERYTHING WITHIN 100 FEET OF SYSTEM d 12I L 7b uau W e!/ N f 1 Aso ~p~.: T~► our SEPTIC TANK(S) MFGR. (Aj e (S CONCRETE X STEEL NO. of rings on cover Depth DRY WELL TRENCHES NO. of width length area BED no. of lines width= length ~O area depth to top of pipe AGGREGATE A~ Ne I 12oC~ . a PERK RATE AREA REQUIRED AREA AS BUILT a d Disclaimer: The inspection of this system by St. Croix County does not imply complete r compliance with State Administrative Codes. There are other areas that it is not possible to inspect at this point of construction. St. Croix County assumes no liability for system operation. However, if failure is noted the County will make every effort to determine cause of failure. GREASES AND OILS SHOULD NOT BE DISPOSED THROUGH THIS SYSTEM. ¢1 INS T R DATED ~p ^ Z~ PLUMBER ON JOB A A)-r 14 Q pi PM LICENSE NUMBER f • A.} REPORT OF ITTSPECTION--I-IDIVIDUAL SLMAGE DISPOSAL SYSTEM Sanitary Permit ' State Septic 7 TOWNSHIP St. Croix County SEPTIC TA'. Size gallons. `umber of Compartments Distance From: Well ft. 12% or greater slope ' Building 3 ft. Wetlands f. liighwater _Y,/ ft. DISPOSAL SYSTL4 Tile Field or Seepage Pit(s) _X_ Distance From: Tlell (P~ ft. 12% or greater slope Building; ~~-ft. Wetlands f FIELD ~Viphwater ft. Total le~gth of line4/ ft, !Number of lines 2 Length of each line -71 ft. Distance between lines _~Z_ft. Width of the trench ft. Total absorption area `Z sq. ft. Depth of rock below the /Z--in. Dpapth of rock over tile 2 in, Coven aver rock; Depth of the below grade - in. Slops of trenches in per 100 ft. Depth to Bedrock ft. Depth to ground water ft. PITS. Number of nits Outside d' et r ft. Depth below inlet ft. Gravel around pit: a no, :Total absorption area . sq.-ft. Square feet of seepage trench bottom area required `square feet of see nit ar a uire.d - Inspected Title: Approved Date .197-. Rejected Date 197. - - k i J State and County State Permit #1 PLB67 Permit Application County Perm' Y for Private Domestic Sewage Systems Count i *DENOTES STATE APPROVAL REQUIRED Date Approval Received from State if Required State Plan I.D. # A. OWNER OF PROPERTY Mailing Address: o N t~ . F~~ ti s R-rez NRATrtc ~9ti~ .1-~vatti B. LOCATION: % Section 7_, T N, R E (or) W Lot# -City_ Subdivision Name, nearest road, lake or landmark Blk# Village Township UD d) 01 C. TYPE OF OCCUPANCY: Commercial *Industrial *Other (specify) *Variance Single family X Duplex No. of Bedrooms ii No. of Persons D. TYPE OF APPLIANCES: Dishwasher YES -->f_ NO Food Waste Grinder YES X NO # of Bathrooms- 7-Automatic Washer YES NO Other (specify) E. SEPTIC TANK CAPACITY To al gallons No. of tanks *Holding tank capacity Total gallons No. of tanks New Installation -Addition- Replacement _ Prefab Concrete *Poured in Place Steel Other (specify) F. EFFLUENT DISPOSAL SYSTEM: Pe olat' n ate 1) ~222)J,11 3► o r _ sq. ft. New Addition Replacement *Fill Syste Seepage Trench: No. Lin. Feet idth Depth Tile Depth No. of Trenches Seepage Bed: Length Width 12- Depth -3~- CTile Depth No. of Lines Seepage Pit: Inside diameter Liquid Depth Tile Size Percent slope of land Distance from critical slope I, the undersigned, do hereby certify that the information I have reported is in accord with Section H62.20, Wisconsin Administrative Cod , and that I have sized the effluent disposal system from the EH-115 prepared by the Certified Sit Tester NAME -t~ C.S.T. # 2~Oand other information obtained from (owner/builder). / Plumber's Signature MP/MPRSW# Phone Plumber's Address ° PLAN VIEW: Provide sketch below of system (include direction of slope and all distances in accord with H62.20, including well). ~.tlvE-S I' III i N USE _ 9TIC _ 1 _ we( I Do Not Write in Space elo FOR DEPARTMENT U~ 5SE ONLY Date of Application /t f ~ F e Paid: State C~ t ? 0 Cou ty 1 Date Permit Issued/R ' ( te) Issuing Agent Nam Z Inspection Ye No Valid# Date Rec'd 1. county hi copy) 3. owner (green copy) DIVISION OF HEALTH, P.O. BOX 309, M ISON, WI 53701 2. state (pink copy) 4. plumber (canary copy) ~ Revised Date 6/1/76 . EH 1 ~ 5 . • ` WISCONSIN DEPARTMENT OF HEALTH AND SOCIAL SERVICES ` DIVISION OF HEALTH, BUREAU OF ENVIRONMENTAL HEALTH • may- P.O. BOX 309 MADISON, WISCONSIN 53701 +-REPORT ON SOIL-BORINGS AND PERCOLATION TESTS LOCATION: '/a, Section -1-, TZN, R 19 E (or) W, Tow, nship or Municipality ~1)n`5' Lot No. , Block No. County ``ii Subdivision Name Owner's Name: _NIL H. LN Mailing Address: `T U i'J LJ k - L 14 TYPE OF OCCUPANCY: Residence - No. of Bedrooms Other. EFFLUENT DISPOSAL SYSTEM: NEW ADDITION REPLACEMENT DATES OBSERVATIONS MADE: SOIL BORINGS I '77 PERCOLATION TESTS NO&B SOIL MAP SHEET ,clsFE SOIL TYPE !tit PERCOLATION TESTS TEST DEPTH CHARACTER OF SOIL HOURS WATER IN TEST TIME DROP IN WATER LEVEL, INCHES RATE NUM- INCHES THICKNESS IN INCHES SINCE HOLE HOLE AFTER INTERVAL MIN/IN BER 1ST WETTED SWELLING IN MINUTES PERIOD 1 PERIOD 2 PERIOD 3 P k. P ~ ~C7 SOIL BORING TESTS TEST TOTAL DEPTH DEPTH TO GROUNDWATER, INCHES CHARACTER OF SOIL WITH THICKNESS, INCHES NUMBER INCHES OBSERVED ESTIMATED HIGHEST (DEPTH TO BEDROCK IF OBSERVED) B- N do S B_ q~ (l Iv s s z PLAN VIEW (Locate percolation tests,soil bore holes and suitable soil areas.) Indicate on the plan the location and square feet of itable areas In irate number of square feet of absorption area needed for building type and occupancy. ZC-S ~ © Indicate scale or distances. Give horizontal and vertical reference points. kicate slope. N L/e t~ PWL "7Z t t4 MEMO mn!m OEM Ql ` C I, the undersigned, hereby certify that the soil tests reported on this form were made by me in accord with the procedures and methods specified in the Wisconsin Administrative Code, and that the data recorded and location of test holes are correct to the best of my knowledge and belief. Name (print) :E~ IM Certification No. S'E _4_0 Address fi+ 62 L t• S4 Q 2'Z _ Name of installer if known I CE: CST Signature COPY A -LOCAL AUTHORITY -