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040-1304-05-000
Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division Sanitary Permit No: INSPECTION REPORT 567206 0 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)). Permit Holder's Name: City Village X Township Parcel Tax No: Fe ereisen, Arthur & Marilyn Troy, Town of 040-1304-05-000 CST BM Elev: Insp. BM Elev: BM Descriptio Section/Town/Range/Map No: -3 406 08.28.19.1811 TANK INFORMATION ELEVATION DATA b TYPE MANUFACTURER • w f CAPACITY SAT OIL - r BS HI~ FS ELEV. / rv 1 i Septic [Benchmark ^ ~3 5. F6 Ab 473• C Alt. BMA pp a f C ~Z (C'~ Ge LA~ Aeration Bldg. Sewer Z 19. Holding St/Ht Inlet 4- VZ 477.7 TANK SETBACK INFORMATION St/Ht outlet TANK TO 11Lj WELL BLDG. Ven o Air Intake ROAD Dt Inlet Septic 7 / Dt Bottom Dosing Header/Man. 4 ~ G ex- 7i gZ . Aeration Dist. Pipe •d 7/'40'-S 4.9 0 , d Holding Bot. System 9• b Final Grade PUMP/SIPHON INFORMATION S• 3• Manufacturer Demand St Cover` GPM P 6Z " i Model Number . 2• el TDH Lift Friction Loss System Hea TDH Ft Forcemain Leng 777a. I Dist. to Well SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS Z ~,~r SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer INFORMATION Type Of System- CHAMBER OR YP~ r `Q S~ Z-to I r UNIT Model Numbers . + A DISTRIBUTION SYSTEM All / A/ = 3Z Header/Manifol~ I/ Distributiop x Hole Size x Hole Spacing Vent to Air Intake c I Length \ Dia Spacing \ W~L Length J Dia T SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over xx Depth of Teeded/ odded xx Mulched Bed/Trench Center 3.5 Bed/Trench Edges ]Topsoil Yes No Yes 0 No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: Inspection #2: Location: 420 Townsvalleeyy Ro d Hudson, WI 54016 (SW 1/4 SE 1/4 8 T28N R1 9W) upset Valley Lot 5 Parcel No: 08.28.19.1811 1.) Alt BM Description i 2.) Bldg sewer length = %f - amount of cover 60 revision Required? Yes No j5- Plan Use other side for additional information. Date Insepcto s ignature Cert. No. SBD-6710 (R.3/97) Pg of Private On-Site Wastewater Treatment System (POWTS) PLOTPLAT FILE INFORM-ATION PROPERTY LOCATION Owner 1 ~r t ~ 177LLrl ~ 111 %a,S4,,)_ 1A, Section TAI__N, R E or W PIN # OCity, Ovillage, OTown of CrN,lrcounty, WI W E S %rerr}i ~ it 66~ r ~ra~~ ~d~rGOr` /►Or~~ ,jf 9JrQ lrrf" J 6 3ra4 can&vr 3 ~x(6~1 7_0 ~2/:k1e, 16r4 (I? gd-s ~I Od 0 SP~~,e r ~p 'e- A CLO _X_ fw County. Safety and Buildings Division v ~ro f X p S ~I 201 W. Washington Ave., P.O. Box 7162 Sanitary Permit Number (to be filled in by Co.) Madison, WI 53707-71 fi2E ;1 s~ i~' CEI V p 6~9 7Z 6 (,a State Transaction Number 4 rmit Application SEP 12 ~~113 ~41 In accordance with SPS 31M(2), dm. Code, submission of this form to the appropriate govemmenta is required prior to obtaini s rtary permit. Note: Application forms for state-owned POW I/arta ~b~xm~itted to Project Address (if different than mailing address) the Department of Safety and Professional Servies. Personal information you provide may be used f1or 4 ~ ur oses in accordance with the Privacy Law, s. 15.04 1 m Stats. A~N ''YW ~.VQ,~ `f1 vt 1. Application Information - Please Print All Information Property Owner's Name ' Parcel # Ufa ari ererse o #v -130 -D 5 -UCH Property Owner's Mailing Address' I Property Location Govt. Lot C O City, State Zip Code Phone Number 5'_ y,, - Section j~ i j (circle one Audsoll W /,7 C1 ~r T;9N; R Eo.QY II. Type of Building (check all that apply) Lot # J4 1 or 2 Family Dwelling - Number of Bed oo Subdivision Name f f 16- Blo SUnSe`~ rl El Public/Commercial - Describe Use CG.mvit-4 A~r_ ❑ City of CSM Number ❑ Village of El State Owned -Describe Use Z Town of rQ 111. Type of Permit: (Check only o box online A. Complete line B if applicable) A. ❑ New System Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System (explain) B. ❑ Permit Renewal ❑ Permit Revision ❑ Change of Plumber El Permit Transfer to New List Previous Permit Number and Date Issued Before Expiration Owner 6('._.E :!~z 117 IV. Type of POWTS System/ omonent/Device: Check all that apply) Non-Pressurized In-Ground ❑ Pressurized In-Ground ❑ At-Grade ❑ Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil #55 Ciet. ❑ Holding Tank ❑ Ot r Dispersal Component (explain) Pretreatment Device (explain) V. Dis ersal/Treat nt Area Information: Design Flow (gpd) Design Soil Application Rate( dsf) Dispersal Area Required (s Dispersal Area Propos (sf) System Elevation VI. Tank Info Capacity in Total # of Manufacturer Gallons Gallons Units n w j y Y New Tanks Existing Tanks fO~C C o IN ~ a 11/ / J a U ~n Septic or-kekkag.Tisk x Wxzc~ XI Dosing Chamber VII. Responsibility Statement- I, the undersigned, assu a responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print Plumber' Si ature MP//~MP,RLSpNumber Business Phone Number c7o 11 3 ~Od D!9(OO Plumber's Address (Street, ity, State, Zip Code) /40650-0 f W _401,01 VIII. County/ eartment Use Only Permit Fee Date 7/-4/3 ed Issuing t Signatur ved ❑ D' Appro 11 bwwerGiven'Reason for Denial $ / 7✓ / IX . ConditSMITi~App"OReasons for Disapproval ^ 1_ 1:.-teptiC tank, effluent filter and 6~ dt 5 c4e~`- o 6f-- Q dispersal cell must all be services 1 maintained as per management plan provided by plumber. GO Z - ao►M se ack requlremertk must be mairttaiet d IS PiK Wk" *ode i ordin~rtce : Attach to complete plans for the system and submit to the County only on paper not less than 8 r/z x t t inches in size SBD-6398 (R. 11/11) Pg of Private On-Site Wastewater Treatment System (POWTS) Index and Title Sheet Owner: r f C, I ~ 0 iea- oe /,t, arn Project Name and System Type: - cot, reA-1417 ct Location: To~~ /d~ Asl V,~, //4a/ 9~el 41 Street Address Legal Description 1 Township/County Design Criteria (Check one): Holding Tank Component Manual: In-Ground Soil Absorption Component Manual: ❑ SBD-10571-P (6/11/1999) ❑ SBD-10567-P (R. 6/1999) ❑ SBD-10855-P (3/2007) Version 2 J4 SBD-10705-P (N. 01/2001) Version 2 Contents: Page 1:,q &.T [ f g ~Page 2: V1 U7 P/CL~'I Page 3: tar) Y I r2 u) ° Cc=, Page 4: Y~ 1 ~,eG S "C_ Page 5: J Page 6: r Page 7: Page 8: Page 9: TF C PP G Attachments: Plumber/Designer:Signed: - Credential Number: ~Q N" Date: 10 ,AV Pg O7 of Private On-Site Wastewater Treatment. System (POWTS) PLOTPLAN FILE INFORMATION PROPERTY LOCATION Owner /:e~_~f..~// / . / • `Qr 1 n yere~~(~e,-) ~ 1/4,5_ 1/4 , Section ~ I'v v T-47 N, R A9 E or W PIN # OCity, OVillage, OTowri of DY C(,4County, WI N W s T~ h# ~3~r66~ rand co dour 93.p /6A ~rr>7 Q 9~,p QV004 cvx~~vr' aD 9. 51 ~j G~ co ~3 ~ xGbl~ _70~~e /-_/'~le i 1,ar ~ A ~ c 1 0~3 ~l Oo0 se r,1 f G`?Gr~s2 ~p 17t$'~'ri6U~/dl BdX ~/d(CI Y64 Ilie,,vA ,,T,rfs p lp SAO a~ SoU bsorption System Cross Section ft k4' Final Grade ule 40 nt Pipe nt Cap ♦ - Leaching 89 Chamber System Elevation S ~e(eda~ray► l(~ ft Soil Absoa'nt10n. S tem Plan View ft ro / ft w /ends I Leaching Trench 1 6~ • ft Vent Or Observation Pipe Chambers 4' Dia. Trench 2 Header Leachln~t Chamber aelfir-ati-0-ns Manufacturer And Model lam. r/ ~ r- r~ EISA Rating 6 sq ft per chamber Soil Application Rate • ( gpd/sq ft gpd Design Flow + Soil Application Rate T EISA Chambers 2 rows of chambers each. P E: yp E ~ ec 34' roP view 4 FRONT VIF.W ; z t r,~ v Louver Height ..............................8" (20 cm) Size (W x L): H) ........34" x 53' x 12" (86 cm x 135.cm x 31 cm) .48" (122 cm) Invert Height ................................8" (20 cm) Effective Length o~ 91 o a 0 N LO O - M M O M M i r N 00 L[7 co ~ CC O Lq r r Z O ~ v z ~ _ U W W co w w x w U a Z s w- was O X cl~ m w o UJ (L Z 0- 0 ~ C7 a_ co cn N C7 M =5 L9 K I-- O N cn ui ® r d„ _ F,- m 0 =D U-:1 F- M O O co ? J O m E u ~ Cl- 0- ~i O o 1 EAU N O 1C.) Crl M C7 ~O N Ch CC) Lc, GD O LQ r r z M „Z, w W C=n X 'a z w w = W cn f-- N U a w? CnC-SO CL m ~ r X w~ U.J Cn J z p C.7 CO _ acv C7H~ ® O N U) Fj = d- :D m =D U-) °OC6 o ~W Q O O p y D 0 n T 7 2 Z O -1 r-1Wr.~~ ;o ~m0 -O;N C', Lrl Z -tip 'T7 a x Ln m m - ~ ;u C-n w m 6 m o cn m FIIIA m fJ~ v 23 G) X n a -o ~ 0~ m vC2 co ~ 8 T CD -1 rnKN o N$ cn 0 C/) ~ Z n r cn a~ S 0 r CA v OO N ` CJ7 IV n W cn I- S 7C Cv -mi Na s~ pO m O V IV O u a> n u 't IOI~IWMI f0 W ~ 4 n Cn O n Co 00 n r~ W IV O N N N G olj O ZT ^ W co NN N_ u O N c co u II Q ~ 0 O ® ® ® ® O II POWTS OWNER'S MANUAL AND MANAGEMENT PLAN ~ to v FILE INFORMATION SYSTEM SPECIFICATIONS Owner V s j&re Septic Tank Capacity al ❑ NA __L a Permit # Septic Tank Manufacturer ❑ NA DESIGN PARAMETERS Effluent Filter Manufacturer 0 NA Number of Bedrooms 100 d/bedroom ❑ NA Effluent Filter Model o? 0 NA Number of Commercial Units Pump Tank Capacity al NA D~ A Estimated flow (average)* gal/day Pump Tank Manufacturer .0 NA Design flow (peak), estimated x 1.5* aUda Pump Manufacturer M NA P Model M NA Soil Application Rate aI/da it Pretreatment Unit LXi IN?. .Influent/Effluent Quality (NA❑) Monthly Average** ❑ Sand/Gravel Filter ❑ Peat Filter Fats. Oil & Grease (FOG) < 30 mg/L `p Mechanical Aeration ❑ Wetland Biochemical Oxygen Demand (BODS) < 220 mg/L ❑ Disinfection ❑ Other: Total Suspended Solids (TSS) Manufacturer: Model: :5 250 rn L Dispersal Cell(s) Pretreated Effluent Quality ❑ Monthly Average" X In-ground (gravity) ❑ In-ground (pressurized) Biochemical Oxygen Demand (BOD5) < 30 mg/L ❑ At-grade ❑ Mound Total Suspended Solids (TSS) < 30 mg/L ❑ Drip-line ❑ Other: Fecal Coliform (geometric mean) <10 efu/ 100m1 ❑ Leaching Chamber Manufacturer Maximum Effluent Particle Size 1/8 inch diameter Model QutCV- V Laying'Length/Chamber *Wastewater Flow Verification and Calculations: Soil Application Rate .1' gpd/ft2 Area Req. 6J13 ft (Other than bedroom based) Infiltrative Surface/Chamber-ESIA Rating.` 0 ft Minimum Number of Chambers ❑ Aggregate Design Flow/Loading Rate= - ft2 min Values typical for domestic (non-commercial wastewater Materials: all materials must comply with WI Adm. Code and septic tank effluent. COMM84 and be installed per manufacturers specifications ***Values typical for retreated wastewater. and approval letters. DESIGN CRITERIA ❑ "Wisconsin At-grade Soil Absorption System, Siting, Design & Construction Manual" (Converse et.a1.1990) ❑ "Wisconsin Mound Soil Absorption System: Siting, Design & Construction Manual" Converse, J.C. and E.J. Tyler. Publication 15.22 "Design of Pressure Distribution Networks for Septic Tank-Soil Absorption Systems" Publications 9.6 "Design of Conventional Soil Absorption Trenches and Beds". R.J. Otis - ASAE Publications 5-77 and "Design Manual - Onsite Wastewater Treatment and Disposal Systems". EPA 625/1-80-012 October 1980 ❑ SBD - 10570-P (R.6/99) "At-Grade Component Manual Using Pressure Distribution" ❑ SBD - 10567-P (R.6/99) "In Ground Absorption Component Manual" ®,SBD - 10705-P (N.01101) "In Ground Soil Absorption Component Manual" Version 2.0 ❑ SBD - 10628-P (N,6199) "Recirculating Sand Filter System Component Manual" ❑ SBD - 10656-P (N.6/99). "Split Bed Recirculating Sand Filter System Component Manual" ❑ SBD - 10572-P (R.6/99) "Mound Component Manual" ❑ SBD - 10691-P (N.01101) "Mound Component Manual" Version 2.0 ❑ SBD - 10595-P (R.6/99) "Single Pass Sand Filter Component Manual" ❑ SBD - 10657-P (R.6/99) "Drip-line Effluent Disposal Component Manual" ❑ SBD - 10573-P (R 6/99) "Pressure Distribution Component Manual" ❑ SBD - 10706-P (N.01/01) "Pressure Distribution Component Manual" Version 2.0 ❑ Drip-line Effluent Dispersal. Component Manual for Multi-flo Onsite Wastewater Treatment Units MAINTENANCE AND,MANAGEMENT MAINTENANCE MONITORING SCHEDULE Service F{vent Service Frequency Inspect condition of tanks At least once eve ❑ months year(s) Maximum 3 s. Pump out contents of tanks When combined sludge and scum equals one-third 1/3 of tank volume Ins ect dis ersal cell s) At least once eve months 0 e s Maximum 3 s. Clean effluent filter At least once eve ❑ months ® year(s) Inspect pump, pump controls & alarm At least once eve ❑ months ❑ ears NA Flush laterals and pressure test At least once eve p months ❑ year(s) ® NA Valves At least once eve ❑,months C3 year(s) ® NA Other: At least once eve p months ❑ ears NA Page of ' POWTS OWNER'S MANUAL AND MANAGEMENT PLAN FILE INFORMATION SYSTEM ::SPECIFICATIONS Owner Septic Tank Capacity al ❑ NA Permit # Se tic Tank. Manufacturer ❑ NA DESIGN PARAMETERS Effluent Filter Manufacturer ❑ NA Number of Bedrooms 100 d/bedroorn ❑ NA Effluent Filter Model NA Number of Commercial Units Pump Tank. Capacity al -I3 NA Estimated flow (average)* aUday Pump Tank Manufactures 1 NA P Manufacturer 22 NA Design floyv, eak),,estimated x 1.5* al/da Pump Model 91 NA Soil Application Rate gal/day Pretreatment Unit JC NA. .Influent/Effluent Quality (NA❑) Monthly Average** ❑ Sand/Gravel Filter ❑ Peat Filter Fats, Oil & Grease (FOG) < 30 mg/L "p Mechanical Aeration ❑ Wetland Biochemical Oxygen Demand (BOD3) < 220 ing/L Disinfection ❑ Other: Total Suspended Solids (TSS) Manufacturer: Model: <-.250 m /L Pretreated Effluent Quality ❑ Monthly Average*** Dispersal Cell(s). X In-ground (gravity) ❑ In-ground (pressurized) Biochemical Oxygen Demand (BOD5) < 30 mg/L p At-grade ❑ Mound Total Suspended Solids (TSS) < 30 mg/L ❑ Drip-line ❑ Other: Fecal Coliform (geometric mean) <10 cfu/ 100m1 ❑ Leaching Chamber Manufacturer QUrOhr Maximum Effluent Particle Size 1/8 inch diameter Model QutCL- 4 Laying'Length/Chamber *Wastewater Flow Verification -and Calculations: Soil Application Rate s gpd1W Area Req. 6ft2 (Other than bedroom based) Infiltrative Surface/Chamber-ESIA Rating f 0 ft Minimum Number of Chambers ' :~a~ ❑ Aggregate Design Flow/Loading Rate - min Values typical for domestic (non-commercial wastewater Materials: all materials must comply with WI Adm. Code and septic tank effluent. COMM84 and be installed per manufacturers specifications ***Values typical for--retreated wastewater- . and approval letters, DESIGN CRITERIA ❑ "Wisconsin At-grade Soil Absorption System, Siting, Design & Construction Manual" (Converse et.al.1990) ❑ "Wisconsin Mound Soil Absorption System: Siting, Design & Construction Manual" Converse, J.C. and E.J. Tyler: Publication 15.22 ❑:"Designof Pressure Distribution Networks for Septic Tank=Soil Absorption Systems" Publications 9.6 p "Design of Conventional Soil Absorption Trenches and Beds". R.J. Otis - ASAE Publications 5-77 and "Design Manual - Onsite Wastewater Treatment and Disposal Systems". EPA 625/1-80-012 October 1980 p SBD - 10570-P (R.6/99) "At-Grade Component Manual Using Pressure Distribution" ❑ SBD - 10567 P: (R:.61,99) "In Ground Absorption Component Manual" ®,SBD - 10705 Rf(N.01/01) "In Ground Soil Absorption Component,Manual" Version 2.0 ❑ SBD -10628'--P (N.6/99) "Recirculating Sand Filter System Component Manual" ❑ SBD - 10656-P (N.6/99)."Split Bed Recirculating Sand .Filter- System Component Manual" ❑ SBD - 10572-P (R.6/99) "Mound Component Manual" ❑ SBD -10691 -P (N.01/01) ."Mound Component Manual" Version 2.0 ❑ SBD - 10595-P (R6/99) "Single Pass Sand Filter Component Manual" ❑ SBD - 10657-P (8.6/99) "Drip-line Effluent Disposal Component Manual" ❑ SBD - 10573-P (R 6/99) "Pressure Distribution Component Manual" ❑ SBD - 10706-P (N.01101) "Pressure Distribution Component Manual" Version 2.0 ❑ Drip-line Effluent Dispersal. Component Manual for Multi-flo Onsite Wastewater Treatment Units MAINTENANCE AND MANAGEMENT MAINTENANCE MONITORING SCHEDULE Service Event Service Frequency Inspect condition of tank(s At least once eve ❑ months it ears Maximum 3 s. Pump out contents of tank s) When combined sludge and scum a uais one-third 1/3 of tank volume Inspect dispersal cell(s) At least once every 3 `o months 10 e s Mn-rimum 3 s. Clean effluent filter At least once eve ❑ months 0 year(s) Inspect E~M, pump controls & alarm At least once eve ❑'months ❑ year(s) NA Flush laterals and pressure test At least once eve p months [I year(s) ® NA Valves At least once eve ❑,months ❑ ears ® NA Other: At least once eve p months ❑ ears NA Page of START UP f l a p For new construction; prior to use of the POWTS check treatment tank(s) for the presence of painting pro is or other c emlcals that may impede the treatment process and/or damage the dispersal cell(s). If high concentrations are detected have the contents of the tank(s) removed by a septage servicing operator prior to use. System start up shall not occur when soil conditions are frozen at the infiltrative surface. OPERATION The property owner is responsible for the operation and maintenance of the POWTS and submission of required reports: The quantity and quality of the wastewater stream will affect the performance and longevity of your POWTS. The installation of water-saving appliances and fixtures along with prompt repair of leaks reduces the wastewater volume. Also the brine or waste from water softeners, iron removal units, other clear water treatment devices and foundation drains should be discharged to the ground surface whenever possible. Note: this does not include laundry waste, showers, dishwater, etc. This system is designed to handle domestic strength wastewater, however the disposal of food based greases and oils, vegetable/fruit peels and seeds, bones, and food solids such as those produced by a garbage disposal should be minimized. Toilet tissue is the only paper that should be discharged into the system. Other non-biodegradable items such as baby wipes, tampons, sanitary napkins condoms, cigarette butts, dental floss, and cotton swabs should not enter the system. Chemicals such as petroleum products, paint, disinfectants, pesticides, antibiotics, solvents, etc., should not be flushed into the system as they can seriously damage your POWTS and contaminate your drinking water supply. I Maintain a regular steady flow by spreading laundry washing throughout the week. Avoid vehicle traffic over all system components. Compaction of snow over the dispersal unit may cause it to freeze up. ❑ Valves Valves shall be operated in the following manner: ❑ Alarms Alarms should be tested on a regular basis by the home owner. If an alarm sounds, contact an individual licensed to service POWTS, There is normally a 1 day reserve under regular operating conditions, however water should be conserved until any problems with the system are corrected to prevent back-up-of sewage into the dwelling or surfacing. INPECTIONS Inspection shall be made by an individual carrying one of the following licenses or certifications: Master Plumber, Master Plumber Restricted Sewer, POWTS Maintainer or Septage Servicing Operator (per the attached Maintenance Schedule). gyp, Septic Tanks Component Tank inspections must include a visual inspection of the tank to identify, any missing or broken hardware, identify any cracks or leaks, measure the volume of combined sludge :and scum and to check for any backup or ponding of effluent to the :ground surface. Access openings used for service or assessment shall be sealed and/or locked upon completion of service. Any defects shall be promptly corrected. Exposed openings :greater than 8 inches in diameter shall be secured with an effective locking device to prevent accidental or unauthorized entry into the tank. When the combination of sludge and scum in any tank exceeds one-third (1/3) or more of the tank volume, the entire contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NRl 13, Wisconsin Administrative Code. The outlet filter(s) shall be inspected and cleaned to remove any accumulated solids according to manufacturer's specifications. Provisions are to be made to retain solids in the tank. Filter cleaning may be necessary at more frequent intervals than stated in the maintenance schedule to keep the system operating. ❑ Pump Chamber/Treatment Tanks Component" The inspection 'must include a test of all electrical equipment such as pumps, alarms and floats. A visual check must be made for leaks, backups, surfacing, missing or broken security devices and other hardware and the condition of any filters. Any service needs or repairs shall be promptly taken care of. R In-Ground Gravity Component Dispersal Cells The inspection shall include recording the levels of ponding, if any in the observation tubes and a visual inspection for any evidence of surface seepage or discharge. Any discharge to the ground surface must be promptly reported to the regulatory authority. Ponding at depths greater than 75%,of the height of the component may indicate overloading or impending hydraulic' failure necessitating more frequent monitoring. Page of r f/ ❑ Mound, At-Grade, In-Ground Pressure / G29'2 O The inspection shall include recording the levels of ponding, if any in the observation tubes and a visual inspection for any evidence of surface seepage or discharge. Any discharge to the ground surface must be promptly reported to the regulatory authority. Ponding greater than 75% of the height of the component may indicate overloading or impending hydraulic failure necessitating more frequent monitoring. The pressure distribution system is provided with an opening at the end of each lateral to be used for flushing. The laterals should be flushed at least once every three (3) years. Pressure checks of systems with multiple laterals should be done to ensure that equal distribution of effluent is occurring to promote the longevity of the system. REPORTS Reports for maintenance, inspection, and monitoring shall be submitted in accordance with COMM 83.55 Wisconsin Administrative Code. ABANDONMENT When the POWTS fails and/or is permanently taken out of service the following steps shall be taken to ensure that the system is properly and safely abandoned in compliance with Ch. COMM 83.33, Wisconsin Administrative Code. - All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. - The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator. - After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil, gravel or other inert solid material. CONTINGENCY PLAN If the POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide a code compliant replacement system: ❑ A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system. The replacement area should be protected from disturbance and compaction and should not be infringed upon by required setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result in the need for a new soil from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result in the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rules in effect at that time. ❑ A suitable replacement area is not available due to setback and/or soil limitations. Barring advances in POWTS technology a holding tank may be installed as a last resort to replace the failed POWTS. g3 The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluation must be performed to locate a suitable replacement area. If no replacement area is available a holding tank may be installed as a last resort to replace the failed POWTS. ❑ Mound and at-grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time. <<WARNING>> SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTIAN LETHAL GASSES AND/OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POWTS INSTALLER POWTS MAINTAINER Name Name Phone genjiS A / - - Phone SEPTAGE SERVICING. O ERATOR (Pumper) LOCAL REGULATORY AUTHORITY Agency. M Phone Name Phone - 10/2006 K:\WPDATA\EH\POWTS OWNER'S MANUAL.doc Page of ❑ Mound, At-Grade, In-Ground Pressure T 9'e O The inspection shall include recording the levels of ponding, if any in the observation tubes and a visual inspection for any evidence of surface seepage or discharge. Any discharge to the ground surface must be promptly reported to the regulatory authority. Ponding greater than 75% of the height of the component:may indicate overloading or impending hydraulic failure necessitating more frequent monitoring. The pressure distribution system is provided with an opening at the end of each lateral to be used for flushing. The laterals should be flushed at least once every three (3) years. Pressure checks of systems with multiple laterals should be done to ensure that equal distribution of effluent is occurring to promote the longevity of the system. REPORTS Reports for maintenance, inspection, and monitoring shall be submitted in accordance with COMM 83.55 Wisconsin Administrative Code. ABANDONMENT When the POWTS fails and/or is permanently taken out of service the following steps shall be taken to ensure that the system is properly and safely abandoned in compliance with Ch. COMM 83.33, Wisconsin Administrative Code. - All piping to tanks and pits shall be disconnected and the abandoned pipe openings sealed. - The contents of all tanks and pits shall be removed and properly disposed of by a Septage Servicing Operator. - After pumping, all tanks and pits shall be excavated and removed or their covers removed and the void space filled with soil, gravel or other inert solid material CONTINGENCY PLAN If the POWTS fails and cannot be repaired the following measures have been, or must be taken, to provide a code compliant replacement system: ❑ A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system. The replacement area should be protected from disturbance and compaction and should not be infringed upon by required setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result in the need for a new soil from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result in the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rules in effect at that time. ❑ A suitable replacement area is not available due to setback and/or soil limitations. Barring advances in POWTS technology a holding tank may be installed as a last resort to replace the failed POWTS. Ig The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluation must be performed to locate a suitable replacement area. If no replacement area is available a holding tank may be installed as a last resort to replace the failed POWTS. ❑ Mound and at-grade soil absorption systems may be reconstructed in place following removal of the biomat at the infiltrative surface. Reconstructions of such systems must comply with the rules in effect at that time. <<WARN [NG>> SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTIAN LETHAL GASSES AND/OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDITIONAL COMMENTS POOWTS INSTALLER POWTS MAINTAINER Name /j Name Phone n(~fin/S T/`ewl.ll N67_"/_ Phone SEPTAGE SERVICING. OPERATOR Pum er LOCAL REGULATORY AUTHORITY Name Agency. Phone ? Phone - 1012006 K:\WPDATA\EH\POWTS OWNER'S MANUAL.doc Page of ST. CROIX COUNTY F d7 SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer Mailing Address 33 S'1 ~iil/ S 7' Property Address (Verification required from Planning & Zoning Department for new construction.) City/State _IZL~ 4. ` Parcel Identification Number Z,,/00 LEGAL DESCRIPTION Property Location S i~ '/4 '/4 , Sec. , T af0 N R/l/ W, Town of Ir% Subdivision , Lot # 6 . Certified Survey Map # , Volume , Page # Warranty Deed # .S 3 7 99: , Volume Page # Spec house yes no Lot lines identifiable es 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 §Comm. 83.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance. The property owner agrees to submit to St. Croix County Planning & Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1/3 full of sludge. I/we, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Planning & Zoning Department within 30 days of the three year expiration date. I/we certify that all statements on this fo are true tp xhe best of my/our knowledge. I/we am/are the owner(s) of the property described above, by virtue of a warranty ed recorded in Register of Deeds Office. Number of bedrooms 3 1 212- 1/-E dl GNATP~~FA PL ICANT(S) DATE ***Any information that is misrepresented may result in the sanitary permit being revoked by the Planning & Zoning Department. Include with this application a recorded warranty deed from the Register of Deeds Office and a copy of the certified survey map if reference is made in the warranty deed. (REV. 08/05) % TOP or I I" PFE ~t LOT 9 (Nrwzs) i N ~i► , SAW ACMES ,s I I • I / 73.161 SF. > DRAINAGE EASEMENT LOT 6 ` • • 7.424 ACKS / 1h 323.406 SF. i►' q LOT 10 Leo-8e7.0 IAN ACKS "CONSERVAflON I ~ ~I ` 23.1!7 SJ. E:ASEUENT AREA" LOT 11 y 14 04MW- " IAN ACKS j IM148 SF. N 00'41' 29,.~ , I 40.00' SLOT 5 ~ $ S W16'31• 24,701 AarS s w SMS040.00' I 1 J MR1212 SF. 1!' } , M-W5.0 _ 1 . 51 3 -14' 'COMKWATMM EAArSAEMT AREA, ~+AwO5EP7V AMA_J~ fXXISl~ - I ,~L' RI £XISTAC AriYVFW4/' aRs a ,ab~'TA......~ I i .........,1 IN FM'MOW SE-SW ewes -q*A cE I h Lor 4•~•~ Yok UYE 1l BA-9,C 4577 1 2 l DEC 2. D !995 FA, 9:00 y QUITCLAIM DEED ARTHUR N. FEYEREISEN and MARILYN E. FEYEREISEN, his wife, hereby grant and convey, to ARTHUR N. and MARILYN E. rEYEREISEN, TRUS- TEES OF THE FEYEREISEN REVOCABLE TRUST, all the real estate they own in St. Croix County legally described as: The E 1/2 of the SW 1/4, the S 1/2 of the S 1/2 of the SE 1/4 of Section 8, the W 1/2 of the NW 1/4 of Section 16, the N 1/2 of the NE 1/4 and the SE 1/4 of the NE 1/4 of Section 17, all in Township 28 North, Range 19 West, EXCEPTING parts previously conveyed. FEE - ARTHUR N. FEYER SEN MARILYN E". FEYER~OISEN L STATE OF WISCONSIN) ACKNOWLEDGEMENT ST. CROIX COUNTY ) Personally came before me on December 28, 1995 the above:-named ARTHUR N. and MARILYN E. FEYEREISEN, to me known to be the per- sons who executed the foregoing instrument, and acknowledged the same. n Notary Public. Permanent commission. Dtafter: C. W. Malick, 413 Brookwood Dr., Hudson. s~'Sq f t a Wis. Dept. of Safety and Professional Services SOIL EVALUATION REPORT Pagel of Division of Safety and Buildings V in accordance with SPS 385, Wis. Adm. Code County C-71 L Attach complete sr h not less than 8 1/2 x 11 inches in size. Plan t include, but no i rtical orizontal reference point (BM), direction AW- ~ I.D. percent slope a or di ions, north arrow, and location and distance, to nearest road ~7Q ~ 4.1 ~~~~~~WWWWWW Please print all information. SEP 1 ~ 2 Review Z1 Dante Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (mj). 13 Property Owner / Pro rlQit&j~e']pn !y77-yy~~,~~f qL ! ~r S° Govt: Lot 134 1? 1 i4J 114 S /T/Z N R E (or) W® Property Owner's Mailing Addre Lot # Block # Subd. Name o SM# S" svr~s I~ lle City State Zip Code Phone umber ity ®Village own Nearest goad 1 490"5-on owjs j, ® New Construction Useo Residential / Number of bedrooms _ Code derived design flow rate Sr~ GPD Replacement ® Public or co mercial - Describe: Parent material -Q&7(/S >7c{ Flood Plain elevation if applicable 1- ft. General comments and recommendations: C04 Ve'7701nl 1,;7 JrO& / 7~en ch~s r ` -XX Boring # ® Boring F 7/ 0 pit Ground surface elev. ft. Depth to limiting factor 0/ in. Soil A lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft s in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. ff#1 ff#2 o ,U /try S p r Boring # Boring 4Y, ® Pit Ground surface elev. y ft. Depth to limiting factor 7 7 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft Y in. Munsell Qu. Si. Cont. Color Gr. Sz. Sh. ff#1 02 - - -9 / - - - f Effluent #1 = BOD > 30 5 220 mg/L and TSS 30 < 150 mg/L / l * Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L CS ~ame (Please Print) Signature ✓ j CST Numb Wf ~7" Address Date Evaluation Con ucted Telephone Number r`3 SU Or ile SBD-8330( 11/11) Frel-IR el) Parcel ID # Page of Property Owner Boring # onng 21 ow pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure onsistence, Boundary Roots ff#1 GPD/ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 1( Boring Boring # a Pit Ground surface elev. ft. Depth to limiting factor in. Soil A lication Rate Horizon Depth Dominant Color Redox Description Texture Structure onsistence Boundary Roots ff#1 GPD2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Boring# Boring Ground surface elev. ft. Depth to limiting factor in. Pit Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure onsistence oundary Roots ff#1 GPDtft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. ff# Effluent #1 = BOD 5 > 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BOD 5 < 30 mg/L and TSS < 30 mg/L you need The Dept. of Safety and Professional material in an saltan equal ernate format, opportunity cont contact the department at 608 266 31511or TTY thr ugh Relay. access services or need maer I M-6330Test (RI 1/11) Parcel ID # Page ' of- - Property Owner Boring ~ Soit lication late Boring # IM- Ground surface elev. ft. Depth to limiting factor in. Pit Horizon Depth Dominant color Redox Description Texture Structure onsistence, oundary Roots ff#1 GPD1'02 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. .3% Boring # Boring ft. Depth to limiting factor in Soil A lication Rate Pit Ground surface elev. Sh. onsistence Boundary Roots ff#1 GPD/ftff#2 Horizon Depth Dominant Color Redox Description Texture Structure in. Munsell Qu. Sz. Cont. Color Boring in. Boring# Ground surface elev. ft. Depth to limiting factor Soil Application Rate ® Pit Horizon Depth Dominant Color Redox Description Texture GrtSz. re onsistence Boundary Roots ff#1 GPD/ft 2 in. Munsell Qu. Sz. Cont. Color Effluent #1 BOD > 30 < 220 m91L and TSS >30 < 150 mg/L ' Effluent #2 = BOD 5 < 30 mg/L and TSS < 30 mg/L = 5 The Dept. of Safety and Professional Services is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, contact the department at 608-266-3151 or TTY through Relay. SBD-9330Test (RI 1/11) PLOT PLAN C'r]NER r °f S' SCALE 1"= -*-FT. PAU .3 nf' BORING ELEVATIONS BENCHMARK ELEVATIONS B-1 BM #1 DESCRIPTION OF #1 /61~T~Qo B-2 Wg BM #2 - 3 DESCRIPTION OF #2 B-4 LEGEND--- BM (BENCHMARK) B-5' _ ► 0- SOIL BORINGS WELL NORTH NOTES: ~r 9 o CeJ&r CUD , ~ y ~ Igo 'j2nS Irv y~o ~(o I DriV'W 3 ~ ~ / ~l avse rv~f l yor C 1 ok `~rICK Q! T 2 ~S ~ f 1710 221483 715-647-4682 4 / 60 ) CSTMO SIGNATURE CSTMO# CREDINTIAL# TELEPHONE # DATE Q o O 6e v ao ao N C3 c o I > I o ~ d (o r°., om 3 c.~rn YcD. - C> ca°iai O o ) 0 N C L N l0 O O •X m m w t O L N C E y > C U y C j 0 3 N O N O N l0 L-r O U O N N r O N-p O w N c N 5 a cL V07 o E' 2 N h O. E cc .0 U) -aENEdfOaN_a O O Z LO m, (n 1>1 U) 7 N CO U Vl f0 O U LL Ct (O r1C\L C C 3 L o a~O 12.9 - LO A? 0 ,o u•ia a 2r'm 0 0 ¢ Q o `o ar.. c O N N V! N Q_ > L1J E N O O C m 0 co 3: m d N G. m ° L aD I- (n N U o c C7 o m O Z d c m v r ' fn C C o aVi Z a ° C 0 O O rn (q H r! O E N N N C N cl C N O ~w N =3 N M L co Q' V.~f N f0 7 7 O (o w a L u~ no y - 9 N p N y f0 N N • d Q p O> V` f0 v 0 a) O Z (4 Z N N C o o > a v D d v H es m F- L 5 N~ U) Lo c 0 0 0 •►V o a a a CL g o 7 p U) N N M J U m Z to a) zi~ O "a o C> ~l O co O O - C p N N T O O C, D c a CL c m (o < Z) Cl) cc i elf H y ~ V O j t fp C Iv O O r Q U O O E (O O N_ O 8 ap C C N C C CL O O O It 7 r \ E E N N_ C V 40. 0 T An M N` N N 'O O r s N 'O 'O C N O *0 N T III O t=x,1 O O T O O H LL rn Z N Z Z cL U O ~ U E at a CL m a c~ m .2 m a E ` c `~1 A V a O w U f y i /d 3-7 - i0 - Parcel 040-1304-05-000 2 12/08/2005 09:32 AM z PAGE 1 OF 1 Alt. Parcel 08.28.19.1811 040 - TOWN OF TROY Current X'' ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 09/08/2004 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner O - FEYEREISEN, ARTHUR & MARILYN REV TR ARTHUR & MARILYN REV TR FEYEREISEN 420 TOWNSVALLEY RD HUDSON WI 54016 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description * 420 TOWNSVALLEY RD SC 2611 SCH D OF HUDSON SP 1700 WITC Legal Description: Acres: 24.708 Plat: 10/24-SUNSET VALLEY 040/04 LOTS 5/21 SEC 8 T28N R19W PT SE SW BEING SUNSET Block/Condo Bldg: LOT 05 VALLEY ('04) LOT 5 4.708) CONSERVATION EASEMENT Tract(s): (Sec-Twn-Rng 401/4 1601/4) 08-28N-19W SE SW Notes: Parcel History: Date Doc # Vol/Page Type 09/08/2004 773695 10/24 PLAT 11/20/2003 747093r/ 2459/594 EZ ~d 4 2005 SUMMARY Bill M Fair Market Value: Assessed with: 104439 Use Value Assessment Valuations: Last Changed: 09/06/2005 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 2.000 55,000 231,200 286,200 NO AGRICULTURAL G4 21.708 3,300 0 3,300 NO UNDEVELOPED G5 1.000 100 0 100 NO Totals for 2005: General Property 24.708 58,400 231,200 289,600 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 Parcel 040-1037-10-050 08/06/2007 08:58 AM PAGE IOF1 Alt. Parcel M 8.28.19.122A 040 - TOWN OF TROY Current X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 09/08/2004 00 4 Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner O - FEYEREISEN, RETIRED RETIRED FEYEREISEN Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description SC 2611 HUDSON SP 1700 WITC Legal Description: Acres: 0.000 Plat: N/A-NOT AVAILABLE 28N R19W SE SW EXC PT TO CSM Block/Condo Bldg: 17-4 SERVATION EASEMENT NKA PT SET VALLEY ('04) Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) 08-28N-19W SE SW Notes: ? dL~ Parcel History: Date Doc # Vol/Page Type 11/20/2003 747093 2459/594 EZ (.~J 07/30/2003 732925 17/4577 CSM 07/23/1997 5/,154 OC 07/23/1997 418T476 ) (aCf s 2007 SUMMARY Bill Fair Market Value: Assesse with: 0 Valuations: Last Changed: 03/16/2005 Description Class Acres Land Improve Total State Reason Totals for 2007: General Property 0.000 0 0 0 Woodland 0.000 0 0 Totals for 2006: General Property 0.000 0 0 0 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 W, Wisr=sin Department of Industry, SOIL AND SITE EVALUATION REPORT Page of Z Labor and Human Relations Divksionofsafety aBuildings in accord with ILHR 83.05, Wis. Adm. Code COUNTY - S j f''iPo~JC Attach complete site plan on paper not less than 8 1/2 x 11 inches in size. Plan must include, but not limited to vertical and horizontal reference point (BM), direction and % of slope, scale or PARCEL I.D. # dimensioned, north arrow, and location and distance to nearest road. © 6- r3 v "W U eb APPLICANT INFORMATION-PLEASE PRINT ALL INFORMATION REVIEWED BY DATE ~J PROPERTY OWNER: PROPERTY LOCATION AST f E I/it- REI SEA.1 GOVT. LOT SE 1145;V 1/4,S f T 20 N,R /9 E (o ro PROPERTY OWNER':S MAILING ADDRESS LOT BLOCK # SUBD. NAME OR CSM # gaD 7oarvs~A~/Ey fP' v jse{- VGAI L2 CITY, STATE ZIP CODE PWy~NE NUMBER ❑CITY VILLAGE r]fOWN NEAREST ROAD tf vOSa~ ~/S . SYo/ ~ 715 ) 916 - Z/ZZ- ?'R 0'y I Tow,vs VA!/E y RD [ ] New Construction Use [XJ Residential / Number of bedrooms oT/,/iLt7_;& 2- (J Addi ' to existing building (J Replacement (J Public or commercial describe ,PE - Co v y EST/'o,.., MEW Code derived daily flow 300 gpd Recommended design loading rate 7 bed, gpd/ft2 ° oO trench, gpd/ft Absorption area required y2-9 bed, ft2 37✓~ trench, ft2 Maximum design loading rate . 7 bed, gpd/ft2 ' trench, gpolft2 Recommended infiltration surface elevation(s) ft (as referred to site plan benchmark) Additional design/ site con ' tions D~'~ Parent material SCS' o S/B Flood plain elevation, if applicable It S = Suitable for system CONVENTIONAL MOUND IN-GROUND PRESSURE AT-GRADE SYSTEM IN FILL HOLDING TANK U = Unsuitable fors stem ®S ❑ U ®S ClU IRS ❑ U ®S ❑ U ®S ❑ U ❑ S •K, U SOIL DESCRIPTION REPORT Boring # Horizon Depth Dominant Color Mottles Texture Structure Consistence Bourxby Roots GPD/ft in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench / S`• .2 r h * -L /,f 56E ewOe as lu 3 C /9 //o o yyX L-7 Ground elev. ft. Depth to This test to APPROVED limiting or a convent! nal septic system. factor` > 1 1~G7f) Remarks: 50115 IMZ- e~oD'5" I D j~7Az 71b fX Boring # r 7-, ISO 77e-f-I Grou d elev s ~~d ,J ft. D pth to li iting f for - I Remarks: CST Name:-Please Print - 655 O'NEIL RD., HUDSON, WIS. 54016 Phone: Address: I .N►S. MASTER PLUMBER LIC. NO. Signature: ",'INN. INSTALLER & DESIGNER LIC, 140.00663 Date: du y 20_ CST Number -A&tA 664= PROPERTY OWNER SOIL DESCRIPTION REPORT Page _o! PARCEL I.D. # a n Boring # Horizon Depth Dominant Color Mottles` Texture Structure Consistence Boundary Roots GPD/ft l~ in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. Bed Trench ~ Al:x Ground } elev. ' ft. i Depth to limiting it factor Remarks: i Boring # i Ground elev. ft. Depth to limiting factor Remarks: Boring # ia% f Jam:?::?}:°a Ground elev. ft. Depth to limiting factor Remarks: Boring # Ground 1AIJ Z I elev. a ft. JA-VI rr ' 'L Depth to' limiting factor Remarks: SBD-8330(R.05/92) ~S, Zof III, r s y-s 7~~Ivl I~ 0 7-- F -30 HOKIESITE SEPTIC PLUMBING CO. $ Cfi L t 65b O'NEII. RD., HUDSON, WIS. 54016 i _ ROBERT ULBRIGHT GS'T y,'~-Z yW' 2- X16. h1P.51'E8 PLUMBER LIC. N0.'3307 M.P.R.S. ~ VINN. 116" A LER & DESIGNER LIC. NO. 00663 I yAR~ g J ~rIS?in~) G- - o ' Sc/vrlc T.k II ` 8 y vea r ro I 4, /I 71N G- 'aeywtii - C L. ~ x ~ Sr~N p~PIf, J Fitu,+r~o.v 9y. % o This test site APPROVED for a conventionai septic system- I M. ~s To/O aF s./~,s ~oNCktrE 1014D IAAse E L C VA T/a.c> 5 / II~FT/O.J = /OD. p u r3, 99. Go 130 77a,--i oc 2- 0 NoT~ : D~yw~// Ca-v T--40 lp 227 70 f r, ~~~p , I _ 4 , r i Ca' ~'c ~ tC: S i r4r 11 \ti yAo; N , Uri rn O 01 \ - ! 'HOUSE mow.... t • C5 o (j) 0 00 94 t-, NCr -11%A ` Cxj' _ _ -r-- - x -7t V Q ; ~ri 3 9~ a HOUSE C \ I ° \ i Op o r /0 x \ v, r w ?1 x O -no i~ O 14 I A r \ x~~ \ \S~ O ~i ca a o,___~ LL\ Q w Q ` \m x L \ O_ x 2 82' ;s R ° x - - - - - - - - - - - _ - y~_ - - - - ca J / cfl 016 oho x Z7 X cn 00 ~oxmm a) > cnm -I -I rnmz mD / x _ x -m r~''c~ om rri Q) m rn r D<s x m m / m ° m Z0 x~ y Z7 D x (nn ~o ~ a X o `O C7 G) \ rn /4 x c) /I x C C x m UNPLA T TED LAND tix ~ z b O X00 00~r-'W t7" C) M °y o>o r- tri~~~ oz~OZ~~ rn~Od0-i rn cn X m Pdo0C ~1t r r ~o~o >z>> m N>>yy~rn~nn d~~~o,Ow.po~oa z0 z yt"'~Otri b ITJ tri d ~rnoo Noo v, ~b o oooa~n 9 z z o o o o d~yI-Ti En X '~~-C mO o D x x r o n m m Z cn P O tr7 i0 ~•=i -ri o w~ d x z c z a>~ 0 + o o + o o b=i 0 g - - z rr1 ITl ~o o o cn 8 m o zz ,d O o O~! w 0 r cn o~ xv,,~ u u ii nr'~cf, 0~~ I ~w~ t-'w•P ~~OC C) co m oz C n v~ tv oo ?o oho O m d y N00 00 cn CD o s i 7 r C { S Ul NSA i VALLEY LOCATED IN THE NE 1/4 OF THE SW 1/4 AND THE SE.1/4 OF THE SW 1/4 OF LOCATION MAP THE SOUTH 1/2 OF SECTION 8 AND THE NORTH SECTION 8, T28N, R19W, TOWN OF TROY, ST. CROIX COUNTY, WISCONSIN. "TRO , ST.TMax CTOUNTY. WR19 TOWN OF ISCONSIN. N 1/4 CORNER I I SUNSET J OI I T28N, R19W I I I VALLEY $ Ih~I01 I LOT 6 I C-5 M.- I / I I LOT 1 I I Nw-sw / I AE sE I I vl~Cl VOLUME 10 /x -1 III I PAGE 2734 -1 10 C. S. M. VOL. -7 I I - - - I sw-sw y 11 I DOCUMENT iL5L3828 I RED BRICK I ADDITION I Ir PAGI;4_576 E 1/4 CORNER - W 1/4 CORNER SECTION 9W 11A 2852.56• T28N. R I9 Rp,U SEC710NR79W8 I N 88(R-41. N14 88 " E JT'4 5308.71" E)8' I T28N, 1328.11' N 88°41' 14" E 132AST-NEST 1/4 SECTILW L/I Nw-lyW A£ AE 2 •7 5000 - - 1 F-~ 7.42' (R-E32 10') 283.40' 257.66' z m BENCH MARK: I ~I I I 6• 1310.89' I POWER E I A 'w, I SE-AM1Y I SW-A'E I sr-AL I N-900.84 III( o 1 _ g I' LOT 19 LOT 20 ELEVATIOPOLE 1 \ R c 1.604 ACRES 'a - 1.502 ACRES I 50' N (NOVD29) I 1 - - -I_ LOT 15 \ - 69,875 S.F. I ' . 1 655,446 S.F. LOT 14 1 1 1.557 ACRES - a - - - - - SCALE: 1" = 2000' \ 1.757 ACRES I 67,844 S.F. / f JZ _ I Y, 765534 S.F. I I a, / aO~ 'po. I r YA p ~ w"m LOT 18 \ p \ \ 1.500 ACRES R'te's ;ol 65.356 S.F. 73' C` BENCH MARK: 4Dd LOT 16 N PPOOWER KPOLE A 3 Gg . C10 ELEVATKIN-890.87 VAR. O LOT 13 \ 65909ASY b r (NGVD29) r~ GI 1.504 ACRES 65,492 SF. 7s, R-80' ''R \ / J~QG Cs~ rn ° II 4 0 ~31 I LBO-904.0 w. ' 75' /6J I a o 7"4 /V 'cry71 * /I 50' ~I o W I V 05 hl Q/ N ~55ry9oNryi \ ~6/" I m V illggIn G \ ~ LOT 17 \ or >s H II !C $~d JI 255 7' Oj 1.501 ACRES 5 9D*W00 LOT 21 " OI ~I 65,378 SF. n 33• r° 1.570 ACRES .I SCALE IN FEET NE-SW \ u _ W I 68.395 S.F. 150' I o4 4 \ ry~o{~r, `Qr. ~j°° of $ Y Y n 50.01' ZI ~1 c13• 71.85' Sol 256.53' I II .sI o so 120 240 360 \ ~5~~8. \ ~ ~ / S °00' 00' E 201.05' z ~ S 90°00' DO" E 306.54' ~ ~I r 1`25 _ _ _ _ I h h I y VO 90°00' DO" W 574..39' \ I OUTLOT 2 z\ g'J59 gOA~ Cf' / / 167.43' :r 336.95' 3 JI 3.o7sACSF.RES \g0' OUTLOTI --5oota, :n I1 133.959 / 's, Z 6.625 ACRE I NOTES, 1. ALL LINEAR MEASUREMENTS HAVE BEEN WIDE TO THE r 27,206 S.F. = ; 1 ~OF A AND ALL ANGULAR ~ ! / N~ r LOT 7 $ m l I 1= AENEAREST ONE ASU2EMENTSNH1 AVVEEEBEEN MADEFOOTTO THE "EST FIVE 5 SECONDS AND COMPUTED TO THE VALUES SHOWN. a • 5 "i 1-506 .624 S.F. ACRES Nz." Fyry- \~Ca/ ry0 / h'1 ,62z °m LOT 8 RG LBO=888.0/ II m 2. THE PARCELS SHIM ON TSHIS MAP ARE SLBJECT TO 1.765 ACRES ` "m8 \ REGU LATIONS ((I HWETLANDS LAMS I ACCESS TO PARCEL MUM L OTASZE, I o . 76,867 S.F. BEFORE PURCHASING OR DEVELOPING CANY E PARCEL ETC.. CONTACT OF OF ) THE 5T, ADVICE. COIMTY ZONING OFFICE AND THE TOM TROY FOR ADVIC CE. try ' ry7ry JS \ ✓ rk6 F"• m J. BUILDING SETBACKS ARE AS FOLLOWS: ^N y\ / / ryo po-• II S 89° -MINIMAL OF 75' FROM THE ROAD RIGHT-OF-SWAY 61.789^ W CHIN_r_ OTHERWISE W SIDE . Ir / \ ✓ a••4'b" -MIN OF F 25 25, • FROM S LOT LINES. M47 BE TEMPORARY aj REDUCED TO 10• IF THE DISTANCE TO THE NEAREST CUL- LOT 9 BUILDING ON THE ADJOININNO LOT IS A MINIMUM OF 50' EASEEEMENT AC -MINIMUM OF 25' FROM THE REAR LOT LENFS. NOTE ye) 1.680 ACRES DRAINAGE EASEMENT . (S 733A8 ,18 FOR / 1 S.F. 4. AN EXCEPTION BA DESIGN STANDARDS Is REQUIRED 30' e THE FRONT SETBACK ON LOT 5 FROM 150' T TO m 1 3 5. NO OMNER OR RESIDENT SHALL DO ANYTHING WHICH LOT 6 44 WOULD INTERFERE WITH OR CHOM THE OPERATION OF ~s 7.424 ACRES THE APFROVED COMPREHENSIVE WATER DRAINAGE AND 323,406 S.F. 'V n SOIL EROSION PLAN FOR THIS PLAT. THIS INCLUDES LOT 10 z y LBO -887,0 ti I a.l • I p_p Bur Is NOT LIMITED O: BUILDING UPON, •wsiN NC, Y ALTERI. FILLING, OR EXCAVATING OR PLANTING G IN ANY PONGND EASEMENTS, WATER DRAINAGE DITCHES, WATER 73 1K JS, $ I $ RUNRAYS, WATER CULVERTS, BERMS, OR GRASS SEEDLINGS. a % ,4 1.,699 997 S.F. ACRES / Lary _ 1`~' z 6. ALL OF OUTIOTS 1 2, AM 3 ARE SUBJECT TO A DRAT WAGE EASEME4. - - ems- / bq 4L j O I N 7. LBO - LOWEST 1UILDING OPENING ELEVATION. n \ / \MN < 8. TIETEMPORARY ROAD CUL-DE-SAC EASEMENT IS TO BE / p, ,h ~fi I RELEASED UPON ROAD EXTENSION AND RESOLUTION LOT 11 N 8 01003 BY THE TROY TOM BOND. n 9, THE OUTLOTS NOTED ON THIS PLAT SHALL NOT BE USED N 00-41' 29 DRAINAGE FOR BUILDING DEVELOPMENT: THEIR INTENDED USE IS z n l 84,145ASF.3 ~P\~pdC , • ° ~p 40.00' J EASEMENT OPEN SPACE AND STORM WATER DRAINAGE. LOT5 589.18'31"Wr- I 24.706 ACRES y"y' • 5 8148.' W 40.00 q 1.076.292 S.F. 6~ 01P 31' N 77- sECOAO cWwwAY ACCESS i } - LBO=665.0 - - 'Stx 0 1g .I p6„ W m, o 6 /Is FLAt77v Lor E HIV/~ 5 / -~°14'04: :E", / / I I pl 230-Oa' APPRoX/MA TIC AREA 7E HOUSE Sh.EU I1 I I N,.~ SEP LEGEND JI o' L12'0 13LL 16' n I Q I (9 COUNTY SECTION CORNER MONUMENT, - I \ \ EX/ST.NG URNEWAY A!~ I- ALUMINUM " CAP, FOUND. 6~` ~ I O 1 1/4 1/4" 9RON PPE, FOUND, _ &A6 D Q 2 3/8" IRON PPE, FOUND. ' - 2~B~SOr W.. VAB 1;x.5/II~L~jI _ -L~ L I O 2 3/8" x 18" IRON PPE WEIGHING SET. \ \ f %///J (I Z I 16 %44" 16"FIRON' PPE SET AT ILg I~LILLJ (,~,~),~,y]~~ ALL OTHER NOT AND OUTLOT CORNERS. la 6J \ \ ()/yS S/£U J- n EXISTING BULGING. " SE-SW •2laP\ t° " . EXISTING FENCE. ' LOT 4 W 1 qQ 9, 00 1 BLfD9D SETBACK LINE. ci C,SM.7. W - _ PROPOSED 12' WIDE UTILITY EASEMENT. I J VOL UME 17 T A O - - - - - DRAINAGE EASEMENT. 10' WIDE ~1 M I O'pq i UNLESS OTHERWISE SHOWN. PAGE 4577 a QC. ~32925 (R- ) PREVIOUSLY RECORDED RFORMIATION. NOTE: ALL 'RON PIPE (FOUND OR SET) ARE IQ LOT iF 1\ f%or[G~ /I I \ \ \ ~c" L~.I I p by e$ C ~M_ i j \9c1~` j I H VOL 1/YE 17 I I PAGE 4577 ~ ~ \ ~~CG I / m '$v, LOT 1 Is0' I ° ` LOT 2 / L..S.A~ I , CSM_ / VOLUME 17 \ V(L UME 17 -PEE 4577 1 1 \ \ PAGE 4577 / DOG. -,#73Z925-_ I J I \ I Ng DOG. ~7329~5 _ / m I / lul I _ - POINT OF / I JAMES D. FILKINS 5-2246 (LL__ 1 REGISTERED LAND SURVEYOR BEGINNING " n Lu I OGDEN ENGINEERING COMPANY 1326.11' 628to 1 96, 71w.ao• " _ 1234 S. WASSON LANE s03.1z' DTI RIVER FALLS, WISCONSIN 54022 - - 588°23' 30" W 2658.21' IN L /hE OF TEE SW 114 SECTION 8 NER 1 DATED THIS 9TH DAY OF JUNE, 2004. SW CORNER T28N, R19W UNPLATTED LAND THIS INSTRUMENT DRAFTED BY DANIEL P. KUGEL SHEET 1 OF 2