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040-1310-00-029
Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: (ATTACH TO PERMIT) 561019 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 DCCI Land Planners LLC, C/o William H. & Ma ro , Town of 040-1310-00-029 CST BM lev:d Insp. BM Elev: B escn tion: ~ Section/Town/Range/Map No: 3 0 17. 8.19.2016 TANK INFORMATION ELEVATION DATA m 5L_ lvlllc~ TYPE MANUFACTURER CAPACITY ST TI N BS FS LEV Septic Benchmark 11q ATit Dosing / Alt. BM ~o~+a 3 7 5 I i d1'n d o-a SII / off- 3 . I Bldg. Sewer Holding St/Ht Inlet # Sg'.5 95-7. S TANK SETBACK INFORMATION St/Ht Outlet 1_~ TANK TO ~/Lft WELL BLDG. V94ttoAirIntake ROAD Dt Inlet Septic G 7 Dt Bottom 12 1 ~33 Dosing -1 Header/Man. 7~~ Z > T Z~ /d 3Z 39~ Aeration Dist. Pipe 9.21161-51 Holding Bot. System 4,()Q4 ✓aa 9s Final Grade 'J PUMP/SIPHON INFORMATION 6 ~7 ` vt 3 7, Z CJ~Q . Manufacturer b/GP Rand S ov r /0tf.s2 gb 7 P4 1" A1-4 aC t 'l.ol Model Number Z~, 3 o N3 TDH Li Friction Loss Sy m He d TDH 4 Forcemain Length / Dia. /i Dist. to well SOIL ABSORPTION SYSTEMS 30~_~tp~3 BED/TRENCH Width Length No. Ofzrench PIT IM NSIOGIS Po. P s Inside Dia. ~aV iquid Dept DIMENSIONS SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM L C G Man t e 7D ~(y0 INFORMATION Type Of System: CHA ER OR 12- Model Num r/ VW_ /t S_ DISTRIBUTION SYSTEM ,WVS 17 SZ = J0093y,fi` Header/Manifold / Distribution x Hole Size Hole Spacing VAir Intake Pipe(s) Length Dia 56 Length Dia Spacing 3 SOIL COVER x r `ssure Systems Only xx Mound Or At-Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded/Sodded ' Mulched UT Bed/Trench Center / T5 Bed/Trench Edges Topsoil ' es No s ] No COMMENTS: (Include code discrepencies, persons present, etc.) InsZ #1: Inspection #2: 1,13 a Court Hudson, 8N'~ 1/~C.Gt 2 a ~i►'S Location: 324 Meadow Rid ow V dge of Troy L t 29 Parcel No: 17.28 .19.2016 9 , Mead 1.) Alt BM Description t ~dWI l~ f 3, I (~0 &S (,U W/ - L "7~y 2.) Bldg sewer length - amount of cover = 1 J-y JQQ, r - - - !s Plan revision Required? Yes ~No r - I Use other side for additional einformation. - _ 7 SBD-6710 (R.3/97) Date Insepctor' gnatur ;CI LAND PLANNERS 0. BOX 445 i,W RICHMOND, WI 54017 ./28/13 ;ALE 1"-40' sNCHMARK #1 TOP OF CONDUIT 100.0 III ,NCHMARK #2 TOP OF CONDUIT 102.32 i 'STEM ELEVATION 100.0 1/4SE 1/4 SEC 17 28 N R 19 W )WN OF TROY ,250 GALLON SEPTIC TANK _ESER TANK WITH 758 )MBO TANK IL , 7 ? o w►K.~c'se`yc , 4d.~ \G a r~ ,.I 4 4 commerce.wi.gov Safety and Buildings Division County 201 W. Washington Ave., P.O. Box 7162 ST. CROIX i sco n s i n e. IV,Iadison,-N 53 707-7 1 62 Sanitary Permit Number (to be filled in by Co.) Department of Commerce 5 ~j/D! 9 , , 1 ' State Transaction Number Sanitary Permit Application 203495 In accordance with s. Comm. 83.21(2), Wis. Adm. Code, submission of this form to the approqq~~pt o riv t unit is required prior to obtaining a sanitary permit. Note: Application forms for state-oCvf>el P are Project Address (if different than mailing address) submitted to the Department of Commerce. Personal information you provide may be used for secondary; , ur oses in accordance with the Privacy Law, s. 15.04 1 (m), Stats. 1. Application Information -PleasePriInfo Property Owner's Name Parcel # DCCI LAND PLANNERS, INC. ✓ d LIA _/tj/d - ~Z Property Owner's Mailing Address Property Location In1 P.O. BOX 445 Govt. Lot t "r J City, State Zip Code Phone Number SW y, SE Section 17 NEW RICHMOND, WI 54017 715-246-2320 (circleoneA T 28 N; R 19 Eor II. Type of Building (check all that apply) Lot # 1 or 2 Family Dwelling - Number of Bedrooms 2 9 Subdivision N e / Block# I dF ICO ❑ Public/Commercial -Describe Use l- ❑ City of C OJ Ovw- ❑ State Owned - Describe Us t t CSM Number ❑ Village of -T-- C~ Town of TROY (o X /CYO o III. Type of Permit: (Check only one 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. El Permit Renewal El Permit Revision 11 Change of Plumber El Permit Transfer to New List Previous Permit Number and Date Issued / Before Expiration Owner IV. Type of POWTS System/Component/Device: Check all that a I ❑ Non-Pressurized In-Ground ❑ Pressurized In-Ground ❑ At-Grade L2[ Mound > 24 in. of suitable soil ❑ Mound < 24 in. of suitable soil ❑ Holding Tank ❑ Other Dispersal Component (explain) ❑ Pretreatment Device (explain) V. Dis ersal/Tre ent Area Information: J.J L! t ` Design Flow (gpd Design Soil Application Rate( sf) Dispersal Area Required (sf) Dispersal Area Proposed ( system Elevation 600 .4 S00 1';,800 100. ' VI. Tank Info Capacity in Total # of Manufacturer Gallons Gallons Units o $ 2 New Tanks Existing Tanks ~c H Z a _`d a U vi h a C7 a Li/ p !Q~ 325 Septic or Holding Tank 1,250 1,250 WIESER X Dosing Chamber 750 750 WIESER X VII. Responsibility Statement- I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plumber's Signature MP/MPRS Number Business Phone Number PAUL KOEHLER 226410 715-246-26E0 Plumber's Address (Street, City, State, Zip Code) 321 WISCONSIN DRIVE, NEW RICHMODN, WI 54017 VIII. unt /De artment Use Only qla" ~ ; rove Permit Fee Date I sued Issuing a it Signat re 13 pproved Given for Denial IX. Condit. M-f9lawstweasons for Disapproval 14- 3 r~l~.• o traaCt. A ern 1i Septic tank, effluent filter and 41 :dispersal cell must all be services I malntsln.d ~t Q$ per management plan provided by plumber, 2. All'selback requirements must be rriaintalned rip Attach to complete p ans or he system and submit to the County o II t less th 2 x 11 inc in size ` P SBD-6398 (R. 02/09) Valid thru 02/11 Q~F `RT Safety and Buildings c=g' °N 141 NW BARSTOW ST FL 4TH WAUKESHA WI 53188-3789 Contact Through Relay www.dsps.W.gov/sb/ www.wisconsin.gov serox~+1 Scott Walker, Governor Dave Ross, Secretary January 31, 2013 CUST ID No. 225410 ATTN.• PO WTS Inspector PAUL R KOEHLER ZONING OFFICE COUNTRYSIDE PLUMBING & HEATING INC ST CROIX COUNTY SPIA 321 WISCONSIN DR 1101 CARMICHAEL RD NEW RICHMOND WI 54017 HUDSON WI 54016 CONDITIONAL APPROVAL Identification Numbers PLAN APPROVAL EXPIRES: 01/31/2015 Transaction ID No. 2203495 SITE: Site ID No. 787693 Dcci Land Planners Please refer to both identification numbers, East Cove Rd above, in all correspondence with the Town of Troy agency. St Croix County SWl/4, SE1/4, S17, T28N, R19W Lot: 29, Subdivision: Meadow Ridge of Troy FOR: Description: Mound, 4 bedroom Object Type: POWTS Component Manual Regulated Object ID No.: 1411251 Maintenance required; 600 GPD Flow rate; 36 in Soil minimum depth to limiting factor from original grade; System(s): Mound Component Manual - Version 2. 0, SBD-10691-P (N.01/01), Pressure Distribution Component Manual - Version 2.0, SBD-10706-P (N.01/01); Effluent Filter The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. This system is to be constructed and located in accordance with the enclosed approved plans and with any component manual(s) referenced above. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s. 145.06, stats. The following conditions shall be met during construction or installation and prior to occupancy or use: This system is to be constructed and located in accordance with the enclosed approved ps and with the "Mound Component Manual for Private Onsite Wastewater Systems VERSION 2.0" SBD-106y _1VPrM ~dthe it, MAI. "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment S ste llk " SBD-10706-P (N,01/01). . The orientation of the mound system must be such that the mound's longest dime sio is F 'ular to the direction of maximum slope. The upslope edge of the aggregate is to be insta ur. LGi=~t~F The building sewer and distribution network piping shall be of material listed in Table 384.30-3 and 384.30-5, Wis. Adm. Code. In the event this soil absorption system or any of its component parts malfunctions so as to create a health hazard, the property owner must follow the contingency plan as described in the approved plans. In addition, the owner must comply with the operation, maintenance and monitoring duties as described in section VIII of the mound component manual. A copy of this information must be given to the owner upon completion of the project. t PAUL R KOEHLER Page 2 1/31/2013 ~ r All holding/treatment tanks are to comply with SPS 384.25(7)(a). Maintenance information must be given to the owner of the tank explaining that periodic cleaning of the filter is required. Access to the filter for cleaning must be provided per SPS 384 product approval conditions. A Sanitary Permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.135 and 145.19, Wis. Stats. Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stats. Owner Responsibilities: • SPS 383.52 Responsibilities. The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s. SPS 383.54(1). • SPS 383.52(2) A POWTS that is not maintained in accordance with the approved management plan or as required under s. SPS 383.54(4) shall be considered a human health hazard. • SPS 383.55 The owner is responsible for submitting a maintenance verification report acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. A copy of the approved plans, specifications and this letter shall be on-site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of construction/installation/operation. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter and the POWTS management plan to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Fee Required $ 250.00 This Amount Will Be Invoiced. e,e When You Receive That Invoice, Julia Lewis-Osborne Please Include a Copy With Your POWTS Reviewer 2, Integrated Services Payment Submittal. (262) 397-6005, Fax: (608) 283-7481 WiSMART code: 7633 julia.lewis@wisconsin. gov Note: Effective January 1, 2012, all codes under the jurisdiction of the Division of Safety & Buildings will be modified. Code references with prefixes starting with "Comm" will be replaced with "SPS" to recognize the relocation of the Division of Safety & Buildings from the former Dept. of Commerce to the Dept. of Safety & Professional Services. Additionally, all S&B codes will be renumbered and addressed in a "300" series. For future reference, the Wisconsin Commercial Building Code will be addressed by SPS Chapters 360-366. MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN Residential Application INDEX AND TITLE PAGE RECEIVED JAN 8 0 2013 Project Name: DCCI LAND PLANNERS IN gU~TR'~ ~I=RVI~€~ Owner's Name: DCCI LAND PLANNERS Owner's Address: PO BOX 445 NEW RICHMOND WI Legal Description: SW 1/4 SE 1/4 S17/ T28 NR 19 W Township: TROY County: ST CROIX Subdivision Name: MEADOW RIDGE OF TROY Lot Number: 29 Block Number: N/A Parcel I.D. Number: Plan Transaction No.: Page 1 Index and title Page 2 Data entry Page 3 Mound drawings Page 4 Lateral and dose tank Page 5 System maintenance specifications Page 6 Management and contingency plan Page 7 Pump curve and specifications Designer: PAUL KOEHLER License Number: MP 225410 Date: 01/28/13 Phone Number: 7152462660 Signature: .0-33 Designed Pursuant to the Mound Component Manual for POWTS Version 2.0 SDB-10691-P (N. 01/01), and both SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST-SAS (01/81) and Pressure Distribution Component Manual Ver. 2.0 SBD-10706-P (N. 01/01) Version 5.1 (R. 06/06) Page 1 of 7 C ^f Mound and Pressure Distribution Component Design Design Worksheet Site Information (R or C) R Residential or Commercial Design Note: Sand fill (D) calculations assume a 400.00 Estimated Wastewater Flow (gpd) Table 83-44-3 in-situ soil treatment for 1.50 Peaking Factor (e.g. 1.5 = 150%) fecal coliform of - 36 inches. 600.00 Design Flow (gpd) 5.00 Site Slope 100.00 Contour Line Elevation (ft) 36.00 Depth to Limiting Factor (in) 0.40 In-situ Soil Application Rate (gpd/ft) Distribution Cell Information 100.00 Dispersal Cell Length Along Contour (ft) = 6.00 Cell Width (ft) 1.00 Dispersal Cell Design Loading Rate (gpd/ft) 1 Influent Wastewater Quality (1 or 2) Are the laterals the highest point in the distribution Y Pressure Disribution Information network? Enter Y or N (C or E) C Center or End Manifold 3.00 Lateral Spacing (ft) If N above, enter the elevation ft 4 Number of Laterals of the highest point. 0.125 Orifice Diameter (in) 3.00 Estimated Orifice Spacing (ft) = 9.38 ft2/orifice 2.00 Forcemain Diameter (in) 40.00 Forcemain Length (ft) Does the forcemain drain back? ~Y 92.00 Pump Tank Elevation (ft) Enter Y or N 6.50 System Head (ft) x 1.3 6.52 Forcemain Drainback (gal) 8.00 Vertical Lift (ft) 90.45 5x Void Volume (gal) 0.61 Friction Loss (ft) 96.98 Minimum Dose Volume (gal) 0.00 In-line Filter Loss (ft) 26.36 System Demand (gpm) 15.11 Total Dynamic Head (ft) Lateral Diameter Selection Manifold Diameter Selection im dia. options choice in. dia. options choice 0.75 1.25 x 1.00 x 1.50 x x 1.25 x 2.00 1.50 x x 3.00 2.00 x 3.00 x Gallons/inch Calculator (optional) Treatment Tank Information 1.00 Total Tank Capacity (gal) 1250.00 Septic Tank Capacity (gal) E4E3.00 Total Working Liquid Depth (in) WIESER Manufacturer 02 gal/in (enter result in cell B49) Dose Tank Information Effluent Filter Information 750.00 Dose Tank Capacity (gal) POLYLOCK Filter Manufacturer 15.00 Dose Tank Volume (gal/in) 525 Filter Model Number WEISER Manufacturer Project: DCCI LAND PLANNERS Page 2 of 7 ~ r Mound Plan and Cross Section Views ' 1/10 B r-f J Observation Pipe . r•~ rr. ~ r ~ A '4rS r,rS 'L/✓ rr r+" r,*. " r4,. W l' B : 2 0 -F L i Mound Component Dimensions Down slope toe extension made. A 6.00 ft E 9.60 in H 1.00 ft K 7.33 ft B 100.00 ft F 9.50 in z 9.00 ft L 114.65 ft D 6.00 in G 0.50 ft J 4.67 ft W 19.67 ft 600.00 (ft2) Dispersal Cell Area 1500.00 (ftz) Basal Area Available 6.00 (gpd/ft) Linear Loading Rate 10.00 (ft) 1/10 B Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area Finished Grade 102.29 (ft) . . . . . 101.00 (ft) Lateral F Dispersal Cell 100.50 (ft)-01 - Invert Dispersal Cell Elevation D 4 77M 100.00 (ft) Contour Elevation 5.0 % Site Slope Geotextile Fabric Cover Shading Key m Q Dispersal Cell See lateral details on 10 Topsoil Cap c c 1.5 ft Page 4 for number, size, 02 flff./f Subsoil Cap a ualater Laterals spacing ASTM C33 Sand H o r`r~xr:r1 . x xz~r4 are of . . • R ~ r•r•r•r=r=r•r• =r=r=r•r=r•s=r•r=r• and -a a L 4 Ys © ' ti 4 ti ,.ti=~ F spaced from the rgrti Ty ical Lateral rti y? Tilled Layer c N 0.15 ft ;.r r r.r.r r r=r.r.r r r r distribution cell,s r.r•r=r=r"r•r"r•r ,"r=r"r•r•r- © 00 Aggregate 14 o ;..r.r.s.j~.=r.r=s•trr•r•r•s-.. centerline in the A ~ distribution cell (AxB). Project: DCCI LAND PLANNERS Page 3 of 7 i , Center Connection Lateral Layout Diagram ~$M1't1~J1 M~atetflEt~t~#95an~F~#ddtar,y~trr~. La)axal_.at~;-snc,r..~ IP S kil- Oft Turn-up Vbatl vshe P or J(- ._-41 La-0fa ut, fc,r(e rnaan of PVC SM 40 ol~anoutplu t per COMM lade €~4W-5 i s Wiled on 0* bottom of the taotA Number of Laterals 4 Orifice Diameter 0.125 in Lateral Diameter 1.50 in Orifice Spacing (X) 3.18 ft Lateral Length (P) 49.29 ft Orifices per Lateral 16 Lateral Spacing (S) 3.00 ft Orifice Density 9.38 ft2/orifice Lateral Flow Rate 6.59 gpm Manifold Length 3.00 ft System Flow Rate 26.36 gpm Manifold Diameter 1.50 in Total Dynamic Head 15.11 ft Forcemain Velocity 2.69 ft/sec Dose Tank Information Locking cover with warning label and locking device and sealed watertight Electrical as per NEC 300 and 0 ` Comm 16.28 WAC 4 in. min. Disconnect Tank component is properly vented Alternate outlet location Forcemain diameter WEISER Manufacturer 2 in. Ca acit 750.00 Gallons T Volume 15.00 gal/inch A Weep hole or anti- Dimension Inches Gallons B siphon device A 29.53 443.02 B 2.00 30.00 C Pump off elevation (ft) C 6.47 96.98 93.00 D 12.00 180.00 D Total 50.00 750.00 Dom se tank elevation (ft) 3' Bedding under tank. 92.00 Alarm Manuafacturer ALDERON POWER POST Alarm Model Number Pump Manufacturer HYDROMATIC Pump Model Number SHEF 40 J_ Pump Must Deliver 26.36 gpm at 15.11 ft TDH Project: DCCI LAND PLANNERS Page 4 of 7 4 , Mound System Maintenance and Operation Specifications Service Provider's Name COUNTRYSIDE PLG Phone 715246-2660 POWTS Regulator's Name COUNTRYSIDE PLG Phone 715-246-2660 System Flow and Load Parameters Design Flow - Peak 600 gpd Maximum Influent Particle Size 1/8 in Estimated Flow - Average 400 gpd Maximum BOD5 220 mg/L Septic Tank Capacity 1250 gal Maximum TSS 150 mg/L Soil Absorption Component Size 600 ft2 Maximum FOG 30 mg/L Type of Wastewater Domestic Maximum Fecal Coliform >10E4 cfu/100 mL Service Frequency eve 3 ears Septic and Pump Tank Inspect and/or service once Effluent Filter Should inspect and clean at least once eve 3 ears Pump and Controls Test once eve 3 ears Alarm Should test month) Pressure System Laterals should be flushed and pressure tested eve 1.5 ears Mound Ins ect for pondin and seepage once eve 3 ears Other Miscellaneous Construction and Materials Standards 1. Observation pipes are slotted and materials conform to Table Comm 84.30-1, have a watertight cap, and are secured in as shown in the mound component manual. 2. Dispersal cell aggregate conforms to Comm 84.30 (6)(i), Wis. Adm. Code. 3. All gravity and pressure piping materials conform to the requirements in Comm 84, Wis. Adm. Code. 4. Tillage of the basal area is accomplished with a mold board or chisel plow. 5. The mound structure and other disturbed areas will be seeded and mulched to prevent soil erosion and help reduce frost penetration. Lateral Turn-up Detail Finished Grade vl 6-8" Diameter Lawn Threaded Cleanout 10 - Sprinkler Valve Box Plug or Ball Valve Distribution Long Sweep 90 or Two 45 Degree Bends Same Diameter as Lateral Project: DCCI LAND PLANNERS Page 5 of 7 i Mound System Management Plan ' Pursuant to Comm 83.54, Wis. Adm. Code General This system shall be operated in accordance with Comm 82-84 Wis. Adm. Code, and shall maintained in accordance with its' component manuals [SBD-10691-P (N.01/01), SSWMP Publication 9.6 (01/81), and Pressure Distribution Component Manual Ver. 2.0 SBD-10706-P (N. 01/01)] and local or state rules pertaining to system maintenance and maintenance reporting. No one should ever enter a septic or pump tank since dangerous gases may be present that could cause death. Septic and pump tank abandonment shall be in accordance with Comm 83.33, Wis. Adm. Code when the tanks are no longer used as POWTS components. Septic or pump tank manhole risers, access risers and covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be 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 a tank or component. Septic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Stats. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code. The operating condition of the septic tank and outlet filter shall be assessed at least once every 3 years by inspection. 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 continuously. Intermittent filter alarms may indicate surge flows or an impending continuous alarm. The septic tank shall have its contents removed when the volume of sludge and scum in the tank exceeds 1/3 the liquid volume of the tank. If the contents of the tank are not removed at the time of a triennial assessment, maintenance personnel shall advise the owner of when the next service needs to be performed to maintain less than maximum scum and sludge accumulation in the tank. The addition of biological or chemical additives to enhance septic tank performance is generally not required. However, if such products are used they shall be approved for septic tank use by the Department of Commerce. Pump Tank The pump (dosing) tank shall be inspected at least once every 3 years. All switches, alarms, and pumps shall be tested to verify proper operation. If an effluent filter is installed within the tank it shall be inspected and serviced as necessary. Mound and Pressure Distribution System No trees or shrubs should be planted on the mound. Plantings may be made around the mound's perimeter, and the mound shall be seeded and mulched as necessary to prevent erosion and to provide some protection from frost penetration. Traffic (other than for vegetative maintenance) on the mound is not recommended since soil compaction may hinder aeration of the infiltrative surface within the mound and snow compaction in the winter will promote frost penetration. Cold weather installations (October-February) dictate that the mound be heavily mulched as protection from freezing. Influent quality into the mound system may not exceed 220 mg/L BOD5, 150 mg/L TSS, and 30 mg/L FOG for septic tank effluent or 30 mg/L BOD5, 30 mg/L TSS, 10 mg/L FOG, and 104 cfu/100 mL for highly treated effluent. Influent flow may not exceed maximum design flow specified in the permit for this installation. The pressure distribution system is provided with a flushing point at the end of each lateral, and it is recommended that each lateral be flushed of accumulated solids at least once every 18 months. When a pressure test is performed it should be compared to the initial test when the system was installed to determine if orifice clogging has occurred and if orifice cleaning is required to maintain equal distribution within the dispersal cell. Observation pipes within the dispersal cell shall be checked for effluent ponding. Ponding levels shall be reported to the owner, and any levels above 6 inches considered as an impending hydraulic failure requiring additional, more frequent monitoring. 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. If the dosing tank, pump, pump controls, alarm or related wiring becomes defective the defective component(s) shall be immediately repaired or replaced with a component of the same or equal performance. If the mound component fails to accept wastewater or begins to discharge wastewater to the ground surface, it will be repaired or replaced in its' present location by increasing basal area if toe leakage occurs or by removing biologically clogged absorption and dispersal media, and related piping, and replacing said components as deemed necessary to bring the system into proper operating condifion. See Page 5 of this plan for the name and telephone number of your local POWTS regulator and service provider. Pretreatment Units The information and schedule of mananagement and maintenance for pretreatment devices such as aerobic treatment units or disinfection units are attached as separate documents and are considered part of the overall management plan for this system. I Project: Page 6 of 7 API uV Page 2 of START UP AND OPERATION For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products or other ehemic 9 that may impede the treatment process and/or damage the dispersal cell(s). If high concentrations are detected have the conterit of the tank(s) removed by a septage servicing operator prior to use. System start up shall not occur when soil oonditions are frozen at the infiltrative surface. During power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will b discharged to the dispersal cell(s) in one large dose, overloading the cell(s) and may result in the backup or surface discharge e effluent- To avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restorin! power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls t, restore normal levels within the pump tank. Do not drive or park vehicles over tanks and dispersal cells. Do not drive or park over, or otherwise disturb or compact, the are; within 15 feet down slope of any mound or at-grade soil absorption area. Reduction or.elimination of the following from the wastewater stream may improve the performance and prolong the life of th< POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat foundation drain (sump pump) water; fruit, and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; ail, painting products; pesticides; sanitary napkins; tampons; and water softener brine. ABANDONMENT When the POWTS fails and/or is permanently taken out of service the following steps shall be taken to insure that the system is properly and safely abandoned in compliance with chapter 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 j soil, gravel or another 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: 4 A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorptkm 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 vt III result in the need for a new soil and site evahation 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. T alu - - it low 115placen.-Ilt WISH o a~g arrk e ar - ~fZDK[BTT~ ~oi2-l~/~1.✓ GONS'?72d~ ❑ Mound and at-grade soll 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 CONTAIN LETHAL GASSES AND/OR INSUFFICIENT OXYGEN. DO NC T PNTii;R 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 - POWT9 MAlNTA1NER Name COUNTRYSIDE PLUMBING & HEATING, INU Name PAUL KOEHLER Phone 715-246-2660 Phone 15-246-2660 SEPTAGE SJERVICING OPERATOR (PUMPERI LOCAL REGULATORY AUTHORITY Name WER LIQUID WASTE MANAGEMENT Name G(p ( 2 IAJ Phone 715-246-5738 Phone This document was drafted in compliance with chapter Comm 83.22(211b)(1)(d)WO and 83.64(11. (21 & (3), Wisconsin Administrative Code. DCCI LAND PLANNERS P.O. BOX 445' NEW RICHMOND, WI 54017 h~ l~ 01/28/13 SCALE 1"-40' BENCHMARK #1 TOP OF CONDUIT 100.0 BENCHMARK #2 TOP OF CONDUIT 102.32 i SYSTEM ELEVATION 100.0 SW 1/4SE 1/4 SEC 17 T 28 N R 19 W TOWN OF TROY 1,250 GALLON SEPTIC TANK WIESER TANK WITH 759 COMBO TANK I 6 5 91 r \ Pt r~ 0 g3s? IT CCI LAND PLANNERS .0. BOX 445, EW RICHMOND, WI 54017 1/28/13 CALE: 1"=40' l~ YSTEM ELE4ATION 100.0 W 1/4 SE j/4 SEC 17 28NR11W OWN OF TR Y ,250 GALLON SEPTIC TANK WIESER TANK WITH 750 OMBO TANK AAO' y ` .o, IZP zso ~(vwNoF~~ P- Y ell INSTALLATION INSTRUCTIONS & PL-525/PL-625 FILTER 3r Was!ewa:ar ProC~:.`s ADivisi°o o'~°Wgiok tnc. Wasm`"SMF =D` Ea PL-525/PL-625 FEATURES & BENEFITS Features & Benefits: ` . Rated for 10,000 GPD • PL-525 = 525 Linear Feet of 1/18" Filtration . PL-625 = 625 Linear Feet of 1/32" Filtration PL-525 PL-625 *Accepts 4" and 6" SCHD. 40 pipe The PL-525/625 Effluent Filter should operate efficiently • Built in Gas Deflector for several years under normal conditions before :Automatic Shut-Off Ball when Filter is Removed requiring cleaning. It is recommended that the filter be cleaned every time the tank is pumped or at least every *Alarm Accessibility three years. If the installed filter contains an optional alarm, the owner will be notified by an alarm when the *Accepts PVC Extension Handle filter needs servicing. Servicing should be done by a certified septic tank pumper or Installer. RECOMMENDED PRODUCTS Polylok PVC Filter Extension Handle Ilia , 4.4 a r_ Risers & Riser Covers Extend & LokTM Riser Safety Screens Filter Alann Panel and SmartFilterTM Control Polylok risers bring your Polylok.Extend & LoVI.1 Polylok safety screens Switch septic tank cover to grade. is a simple, easy to use prevent tragic accidents This of Pol lok fitter alarm panels tows locating and solution that can extend. from happening by children Y p servicing your filter easier the inlet or outlet pipe nd pets fatting into open and switchs provid a visual and a of and time savin b elimi- make filter and/or baffle septic tanks entrances. and audibke notification g by natfng digging to find' tank installation a snap. impending filter and tank entrance. Fits 3" and 4" pipe_ servicing. For a full list of Polylok products please visit our web site at: www.polylok-com INSTALLATION INSTRUCTIONS 401 VA Pin X P tfri"ste tead"!f'raf;:°e n~{~E~E PL-525/PL-625 FILTER & iYaztw-sir p Pwas,s Zabel .a'Fetyla:'r. INSTALLATION INSTRUCTIONS Center filter with opening W tZ J D:.. LLO 2 J Additional pipe or - Polylok Extend & Lov ° Glue - fog ntarnq- Step 1: Step 2: Step 3: (A) Locate the outlet of the septic tank. (A) Before installation, place the (A) Glue the filter housing on the (B) Remove tank cover and pump tank filter housing on to the outlet pipe. outlet pipe. if necessary. (B) Make sure that the housing (B) Insert the filter cartridge in the is positioned so the filter can be housing, making sure the filter removed from the tank for cartridge is properly aligned and maintenance and service. completely inserted in the housing. MAINTENANCE INSTRUCTIONS Step 1: Step 2: Step 3: Locate the outlet of the septic tank. (A) Remove tank cover and pump (A) Insert the filter cartridge back if necessary. into the the housing making sure r s (B) Pull the filter out of the housing, the filter is properly alighed and completely inserted. (C) Hose off the filter over the septic tank. (g) Replace septic tank cover IISE RUBBER GLOVES Make sure all solids fall back into the WHEN CLEANING FILTER septic tank. 1 at-T~OGZUt '311 99-v9-9Zc-009 OLOZ 'Ndf a3SLA38 0 \ 09L49 IM 'NOON N30IVri Ot AMH sn 9LLCM Z :8nod-isod 731va otoa AavnNVr 31vo -ivnNyW OLLd3S w o =anod-3ad .o-,t=.b t 31vos 3WS Aa NMVaa 31383 Non 1313'm 8v4-OSL/05ZVA N ~ \ z ~ ww Z w V) 0 o z H W J ^ U Q U to 1.- O W W C) O0 0W: Fa U m to OC cy O J a. wD k' o? a J O V) U W z N U OO ~p~ `iv ~ 0: a~ a^~ ~ O Q CL m p rkQ Z Z F7 Z \ W N I--I w E w m ¢ U W ~J ZJ= Q O U mU Z f¢ G Q n~. 0 N mN WIQ.W UQ Q Z Z O a o~ U m N m z>¢ (A W W p W3 Q U 0 , m Ja ptn . _ 9 F N O vN. Y 0 v F a °m U • e O . t0 1 V! N~ ao O Q p F fn ~k vi H ~LLJ \_R NiO~: m~' LyQ0 WZIQ- = N W U ~Z Y~ M° 0.-m~>~ K 1 0h~ Z W J O N F t12 O co (n C4 :i m Z~. =O cn z of U VI a J W U W O LLJ W N O V) CV (/i OIL: F 3O= VY ow a W m F to a pV Y °QOo<WWZ°w=v2~J << ° U z YJZ VNo o Z z3m0mSJ~3m~3 p Q ta-*a I-a w Q p z z 0i U J W N I F- F- cn W p U z D~ d W O > a a z w Sv0 « nr"" 09 do I i U L Q a J ~ ¢ aw w w U JI N « t~ x I ~Q I w ¢ m w 1 _J O «9 «L9 ti W Sv0 «s «as do \ s / W cl: U N W Z J Q z ~ «£5 W 0038 N .99 sd «99 x a Lf~j ~~tS ~ yr', a F40 Y' SHE r.. Submersible High Head Effluent Pump Applications • Septic Tank Effluent • High Head Sump <ry • Dewateri ng: CM { tylj 4'~y L " y yL,r i y, 0.. y Pentair r Wate [77 Submersible Effluent Pump FEATURES The Hydromatic SHEF40 submersible pump is specifically designed to meet the demands of residential high head septic tank effluent or sump applications. The 1-1/2 inch NPT discharge pump features an energy efficient 4/10 horsepower motor, 115 or 230 volts, and is available in both automatic and manual configurations. The SHEF40 can handle capacities up to 70 gallons per minute and heads to 36 feet. The SHEF40 features a heavy-duty cast iron construction that provides durability for a long service life, as well as dissipates heat from the motor for cooler operation. All fasteners are stainless steel for corrosion resistance. The pump's semi-open, non-clog design impeller passes 3/4" (spherical) solids and is made from a super tough engineered plastic that provides the highest level of corrosion resistance and the toughness to withstand the impact of solid materials. The impeller, molded to a bronze insert, also features pump-out vanes to preclude material from building up around the shaft and seal. The pump's unique (patent pending) non-clog design baseplate has an electrostatically applied polyester coating for corrosion resistance and provides a strainer-free inlet capable of passing two (2), 3/4" (spherical) solids simultaneously. The inlet area is raised off the bottom of the septic tank or sump basin by the pump's y 2" high legs constructed of engineered s thermoplastic material for maximum corrosion resistance. The SHEF40's oil filled motor provides superior cooling characteristics, allowing the motor to run cool and quiet. The oil- filled design also provides permanent lubrication of the shaft bearings, minimizing maintenance and extending the service life of the pump. The oil- filled motor design allows for even heat dissipation. The windings feature a built-in thermal overload that resets automatically. Automatic models feature. an easily adjustable wide-angle float switch, incorporating a unique piggyback plug arrangement. This plug allows for simple conversion to manual operation by removing the switch plug and inserting the pump's motor II IFL10 HYDROMATICO Pentair Water Page 2 SHEF40 Submersible Effluent Pump BENEFITS plug into the electrical outlet. This feature A. Oil-filled motor provides superior cooling and provides an easy way to periodically cycle the permanent lubrication of bearings, minimizing pump to ensure it is operating properly. maintenance and extending service life. The SHEF40 is a completely submersible B. Water resistant power cord with molded plug is pump for use in residential septic tank effluent available in 20' & 30' lengths and is easily field pumping applications and is available in automatic serviceable. Unique four point cable entry and manual configurations. Automatic models provides superior protection against leakage. feature a wide-angle float switch with piggyback C. Lower ball and upper bronze-sleeve bearings plug-in arrangement. Switch is adjustable, easy support motor shaft, minimizing the effects of to service and allows for simple conversion to impeller loads. This design results in minimum manual operation. AL~I friction and perfect alignment of rotor, for longer service. D. Heavy-duty, cast iron construction provides long life and assists in heat dissipation for cooler motor operation. j E. Energy-efficient 4/10 HP motor runs cool and quiet ` for long life. Motor windings contain automatic reset, thermal overload protection. F. Mechanical shaft seal is carbon- and ceramic-faced a for long leakproof life. G. 1-1/2" Discharge NPT H. Corrosion resistant non-clog base with strainer-free ' inlet capable of passing two (2), 3/4" diameter spherical solids simultaneously. R+ I. High corrosion resistant, semi-open non-clog t,~ x impeller passes two (2), 3/4" spherical solids. J. 2 High corrosion resistant legs raise pump's inlet s from bottom of septic tank pump chamber. 4.~ ¢ , back switch Pr I HYDRQMATIC' Pentair Water Page 3 SHEF40 Submersible Effluent Pump DETAILS Pump Characteristics Performance Data Pump/Motor Unit Submersible 40 Manual Models SHEF40Mf SHEF40M2 Automatic Models SHEF40AI SHEF40A2 30 Horsepower 4/10 Full Load Amps 12 6.5 SHEF40 Motor Type Shaded Pole (4 Pole) FT20 R.P.M. 1550 Phase 10 10 Voltage 115 230 Hertz 60 Temperature 120°F Max. Fluid Temp. 0 10 20 30 40 50 60 10 NEMA Design A GPM Insulation Class B Discharge Size 1 1/2" NPT Solids Handling 3/4" Dimensional Data weight 281hs. 3-718"-+ 6-5l8" (168.27) Power Cord 18/3, S1TW, 20' std. (98.42) ~5' (127) (30' optionel► 3-7.-8" (98.42) Materials of Construction 3718" DISCHARGE (98.42) 1-1/2" NPT 1 (38.1) Handle Stainless Steel Lubricating OB Dielectric Oil FLOAT SWITCH Motor Housing Cast Iron Pump Casing Cast Iron Shah Steel Mechanical Seel Faces. Carbon/Ceramic Shaft Seal Seal Body: Anodized Steel Spring: stainless Steel 11-3✓8" 1o-3/1s° (288.92) {258.76) Bellows: Bursa-N Impeller Engineered Thermoplastic Upper Bearing Bronze Sleeve Bearing t (s2 07 ) 2° {so.ej Lower Bearing Single Row Bab Bearing Bottom Plate Polyester Coated Steel Fasteners Stainless Steel All dimensions in inches. Component dimensions may vary t 1/8 inch. Dimensional data not for construction purpose unless certified. Dimensions and weights are approximate. On/Off level Legs Engineered Thermoplastic adjustable. We reserve the right to make revisions to our product and their specifications without notice. - I'no YAuthorized Local Distributor HYDR4MATLC~ ~ Pentair Water USA CANADA 740 East 9th Street Ashland, Ohio 44805 269 Trillium Drive Kitchener, Ontario, Canada N2G 4W5 Tel: 419-289-3042 Fax: 419-281-4087 www.hydromatic.com Tel: 519-896-2163. Fax: 519-896-6337 © 2005 Hydromatic' Ashland, Ohio. All Rights Reserved. Item W-02-6680 1.5M 3/05 ST. CROIK COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Owner/Buyer % ,,2 7 Mailing Address ( 'o x ft t 1. Property Address (Verification required from Planning & Zoning Department for new construction.) City/State 3 t Marcel Ideritxfication Numbex - LEGAL DESCRIPTJQN Property Location - V4, V4, Sec. T N R Vj W, Townof , Subdivision CertWied Survey Map , Volume , Page # Warranty # [ a Volume , Page # Spec house rye~l no Lot lines identifiableY yes no SYSTEM MAINTENANCE AND OWNER CERTIFICATION Improper use ani3 maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists ofpumping out the septic tattle 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 tnantene responsibilities are specified in §Comm. $3,52(1) and in Chapter 12 - St. Croix County Sanitaty Ordinance. The property owner agrees to submit to St. Croix County Planning & Z6- 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, 113 full of sludge. Uwe, the undersigned have read the above requirements and agree to maintain the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Planning & Zoning Department within 30 days of the three year expiration elate. Uwe certify that all statements on this form are true to the bes f my/our knowledge. Uwe am/are the owner(s) of the property described above, by virtue ofa warranty deed recorded in gister of Deeds Office. f I Number of edroa s SIGN TURF OF API' CANT(S) DATE. ***Aay information that is misrepresente may result in the san itaty permit being, revoked by the Planning, & Z=oning 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. 08105) r . roc ZE35~i~3 73 1 P S S. KATHLEEN Ff.. WALSH REGISTER OF DEEDS ST. CROIX Go., VI RECEIVED FOR RECORD LEVEGM WARRANTY DEED eZ/1412865 0L:08BK WARRANTY DEED Document No. EXBPT s REC FEE: 15.00 This Deed made between VALLEY LAND TRANS FEE: 18958.88 COMPANY, a Minnesota corporation, Grantor and COPY FEE: _ p FEE . DCCI LAND PLANNERS, INC., Grantee Q Witaesseth, Thai the said Grantor conveys to Grantee certainreal estate in'St. Croix County, State of Wisconsin, legally described on Exhibit A hereto (the "Property-), Together with all and singular hereditaments TURN T grid appurtenances thereunto belonging. aJ''~~f1 This conveyance is without wa wql except Grantor covenants and represents the Grantor has not .made, done, executed -or Tax LD.. -/4:o suffered any act or thing whereby the above- descnlxd property or any pact thereof, now or ID1 7 at any time hereafter, shalt or may be ago_ _1297 -10;kf G!'~L7 imperiled, charged or encumbered in any -wanner, and Grantor will warrant title to the above-described property against- all persons ' claiming the same from or through Grantor as a result of any such act or thing, provided, however, that the conveyance hereby made and the warranty of Grantor is further limited by and subject to those matter set forth on Exhibit.D,hereto. _ Dated this day of January, 2005. . VALLEY LAND COMPANY; A Man corpora ply: s~ Its: ACKNOWLEDGEMENT STATE O ) SS COUNTY OF Personally came before me this day of January, 2005, the above named Gary B. Valley, as President of Valley Land Company, a Minnesota corporation, having Ul authority to-do so and to- We known to be the person who executed the foregoing instrument and aclmo*ledged the b ic, taste of commission (expires): U 2 7 31 P 5 5 2 122704 LEGAL DESCRIPTION/PLANNERS EXHIBIT A PARCEL A i. l.OCATED.IN THE - SE'/4.OF THI--SE'/a' SW:'/ OF THE, SE'le AND PART OF ~THtNW %oF THE SE l; -NE 'V4 OF THE S~ % SW % OF THE NE % AND*THE SE OF THE NW % ALL IN SECTION-17., TOWNSHIP 28 NORTH, RANGE 19 WEST, TOWN OF `(ROY, ST. CIROIX COUNTY, WISCONSIN: BEGINNING AT THESE CORNER OF SAID. SEQ-hQN 17; THENCE 888061'3i-W. ALONG THE SOUTH 'i LINE OF THE SE V. OF SAID SECTION, 2629.36 FEET TO THE WEST LINE OF THE SE OF 'SAID SECTION; THENCE N00005'44"E, ALONG SAID WEST LINE, 2660.38 FEET TO THE CENTER OF SAID -SECTION; -THENCE 588645'22nW, 18,79 FEET. TO A, POINT ON A 148.00 FOOT- RADIUS CURVE CONCAVE NORTHWESTERLY, WHOSE . CENTRAL ANGLE MEASURES. 'I U°10'57", WHOSE CHORD BEARS N45°44'3C°E AND MEASURES 26.27 FEET; THENCE NaRTHERLY ALONG THE ARC OF SAID CURVE'AND SOUTHERLY RIGHT OF WAY OF EAST COVE ROAD 26.30 FEET TO SAID WEST LINE -OF THE SE-%; THENCE N00°05'44°E, ALONG SAID WEST LINE 124.75 FEET; THENCE N88°51'31."E, 249.43 FEET; THENCE S00°05'44°W, 41.3.44-FEET; THENCE N88°51'31"E, 2042.11 FEET TO THE CENTERLINE -OF TOWN • ROAD (TOWNSVALLEY ROAD) BEING A POINT ON A. 3754,00 FOOT RADIUS CURVE, CONCAVE SOUTHWESTERLY WHOSE CENTRAL ANGLE MEASURES 9°28'28°, VI DOSE CHORD BEARS S36°43'35"E AND MEASURES 620.06 FEET; THENCE SOUTHERLY ALONG THE ARC OF SAID CURVE, 620.76 FEET TO THE EAST LINE OF THE SE % OF SAID SECTION; THENCE S01°07'30"W, ALONG SAID EAST LINE, 1886.26 FEET TO THE POINT OF BEGINNING. EXHIBIT A - N4 STATE OF WISCONSIN BILL NUMBER: 188076 REAL ESTATE PROPERTY TAX BILL FOR 2012 IMPORTANT. Correspondence should refer to parcel number. See reverse side for Important information. TOWN OF TROY Be sure this description covers your property. This description is for property tax bill only and may not be a full legal description. ST. CROIX COUNTY 10/085 2732/3702731/551 2509/328 SEC 17, T 28 N, R 19 W, SW;1 of SE;-4 DCCI LAND PLANNERS LLC SEC 17 T28N"-R19W PT SW SE MEADOW RIDGE PO BOX 445 OF TROY ('05) LOT 29 NEW RICHMOND WI 54017 Parcel 040-1310-00-029 Property Address: 324 MEADOW RIDGE CT_ Alt. Parcel#:_17:28--19.2016 Assessed Value Land Ass'd. Value Improvements Total Assessed Value Ave. Assmt Ratio 55,200 55,200 1.1411 Does NOT endectclreeditsjta 0.014659317 Est Fair Mkt Land Est. Fair Mkt Improvements Total Eat Fair Mkt A Star In this box School taxes reduced by 48,400 4 8 , 4 0 0 means Unpaid Prior School levy tax credit $79.79 Year Taxes. 2011 2012 - 2011 2012 % Tax Taxing Jurisdiction Est State Aids Eat State Aids Not Tax Net Tax Change Allocated Tax Dist Allocated Tax Dist STATE OF WISCONSIN 8.25 8.21 -0.5% ST. CROIX COUNTY 181,116 212,729 201.72 200.58 -0.6% TOWN OF TROY 230,155 232,810 68.12 67.83 -0.4% SCH DIST RIVER FALLS 2,910,954 3,092,745 446.81 447.31 0.1% CHIP VALLEY VOTECH 109,676 107,506 84.72 85.27 0.6% Total 3,431,901 3,645,790 809.62 809.20 -0.1% First Dollar Credit Parcel 040-1310-00-029 Lottery & Gaming Credit Net Property Tax 809.62 809.20 -0.1$ Make Check Payable to: Full Payment Due On or Before January 31, 2013 Net Property Tax 809.20 ST CROIX CTY TREASURER $809.20 LAURIE A. NOBLE 1101 CARMICHAEL ROAD Or First Installment Due On or Before January 31, 2013 HUDSON WI 54016 715-386-4645 $404.60 And Second Installment Payment Payable To And Second Installment Due On or Before July 31, 2013 ST CROIX CTY TREASURER LAURIE A. NOBLE $404.60 1101 CARMICHAEL ROAD HUDSON WI 54016 • a FOR FULL PAYMENT Pay By January 31, 2013 $ 809.20 Warning: If not paid by due dates, installment option is lost and total tax is delinquent subled to interest and, if applicable, penalty. Failure to pay on time. See reverse. a m * ASSO , 0 0 g. 51 7 1 -114 locus - 10 jl~~01 ~ .LL RD,~ 04 w a yp~ LOT 29 o~ z a 9 atlNweeF s• wawweP' A 4 wfw~ a s a7~"'a N84 '23wE 27894 c .rweweb x ° ~p f o a6wa'~ 8 ° w r w.r~es ° e c 4 (n 00 . Wisconsin Department of Commerce L EVALUATION REPORT page 1 of 3 Division of Safety and Buildings in dan Wis. Adm. Code pp ~'~~nn ~"tY St. Croix Attach complete site plan on paper n th 1/2 x Inche$~lial>te.~IIrYrtRJ include, but not limited to: vertical and h I c point (BM), direction and Parcel I.D. percent slope, scale or dimensions, north arrow d loca on and I nce to-nearest road. Please print a I info Ma n. 2 2005 Rev' y Date Personal information you provide may be used for secondary pur oses ( f~ Property Owner ZONIN RwoR Vd-ocatio DCCI Land Planners Inc Govt. Lot SW 1/4 SE 1/4 S 17 T 8 N R 19 E (or) Property Owner's Mailing Address Lot # Block # Subd. Name or CS 1505 HWY 65 29 Meadow Ridge Of Troy City State Zip Code Phone Number L]City ©VIlage ■ Town Nearest Road New Richmond WI 54017 ( ) East Cove Road El New Construction UseEJ Residential / Number of bedrooms 3 to 4 Code derived design flow rate 450 to 600 GPD Replacement Public or commercial --Describe: Parent material Loess over glacial till Flood Plain elevation if applicable 1►] A & General comments * with several continuous layers, 1 Ifs, Osg, 7.5yr4/4 and recommendations: with several continuous layers, 1", sl, Om, 7.5yr4/4 Asvl•~ FT] Boring # Boring Pit Ground surface elev. 938.58 ft. Depth to limiting factor >98 in. Sal Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fl2 in. Munsefl Qu. Sz. Cont. Color Gr. Sz. Sh. -Eff#1 -Efi#2 1 0-12 10yr3/1 sil 2msbk dsh as 2f .6 .8 2 12-24 1 /4 - sil lmsbk dsl cw if .4 .6 3 24-35 10yr4/4 sicl 1 msbk dsh cw - -2 .3 4 35-90 7.5yr5/8 Is* Os * dl cw - .5* 1.0* 5 90-98 7.5yr5/8 fsl Om dh - - .2 .5 2 Boring# Boring 936.17 >110 Pit Ground surface elev. ft. Depth to limiting factor in. Soil lik~tion Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDRP in. Mtmsell Qu. Sz. Cart. Color Gr. Sz. Sh. 'Eff#1 *Eff#2 1 0-17 10yr3/2 sil 2msbk dsh as 2f .6 .8 2 17-31 1 4/4 - sil lmsbk dsh cw if .4 .6 3 31-36 10yr4/4 sicl Imsbk dsh cw - .2 .3 4 36-46 10yr4/4 Qd7.5yr6/2 sicl lmsbk dsh cw - .2 .3 5 46-94 7.5yr4/4 Is Osg** dl cw - .2 .6 6 94-110 5yr4/4 ifs Osg dl - - .5 1.0 * Effluent #1 = BOD > 30:5 220 mg1L and TSS >30:5 150 mg/L ' Effluent #2 = BOD < 30 mg/L and TSS < 30 mg1L CST Name (Please Print) Signature CST Number Thomas C Nelson 227387 Address Date Evaluation Conducted Telephone Number 1432 120th Street, New Richmond, Wl 9/18/05 715-246-2454 Property Owner DCCI Land Planners Inc Parcel ID # Pending Page 2 of 3 FTI Boring # 11 Boring 938.40 >120 E] Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 1 0-13 10yr3/2 - sil 2msbk dsh as 2f .6 .8 2 13-32 1 Ovr4/4 - sil lmsbk dsh cw if .4 .6 3 32-90 7.5yr4/4 - is Osg dl cW - .7 1.6 4 90-120 7.5yr4/6 - s Osg dl - - .7 1.6 Boring # Boring Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPDW in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 'Eff#2 ❑ Boring # H Boring Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rabe Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fF in. Munsell Qu. Sz. Con t. Color Gr. Sz. Sh. *Eff#1 *Eff#2 ill ' Effluent #1 = BADS > 30:E 220 mg& and TSS >30:s 150 mgA- * Effluent #2 = BODS < 30 mglL and TSS 30 mglL The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-2648777. SBD4330rest (8.07!00) DCCI LAND PLANNERS, INC. J-' Lot # 29 -MEADOW RIDGE OF TROY ® SOIL BORING SW 1/4 OF THE SE 1/4 OF SECTION 17, BENCHMARK T28N, RI 9W, TOWN OF TROY, ST. -TOP OF CONDUIT r„„ CRODC COUNTY, WISCONSIN. Q ALT BENCHMARK • -TOP OF CONDUIT • NOTE: THE CONTOURS IDENTIFIED TOM NELSON CST - LTC. # 227387 i : • ~ ENVIRONMENTAL ARE PRIOR TO CONSTRUCTION. BY DESIGN CONSTRUCTION GRADING WAS IN 1432 120TH ST. PROCESS DURING SOIL TESTING. • NEW RICHMOND, WI 54017 CONTRACTOR MAY NEED TO =1 • h. # 715-246-2454 CONFIRM FINAL CONTOURS wrn t p DURING INSTALLATION. • 300 *--Ida SCALE IN FEET 1' _ AI0' 0 s11 • 100 0 100 wr'. 40. CPO , , J V ` B \ 938.40 t \ 0 14" 9;8.49 s t 938.09 938.58 4~ \ t \ i , - B2 ® 936.'17 6 2 46X78 3E NE