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010-1086-50-200
» o » o o _ o - _ m \ k � $ i ) � 0 7 / � V ( �2 CL $ � - Cc �Cc 7 C*4 Z W e ��/ o-a 2777 $ 2 \§0 ) ) 7282 \ 3 t $a W ■ q < §$% J f \ k Cl) ! c \ E E 0 k LO k } E (L m C'S e z o § ( o z $ # 2 $ 7 [ Q / Q E _ E § 04 0) k A f n e 7 � n \ . iLO / T CL k \ / 3 § Q � ) z z� ) z z R 2 c k] § E 2 m E R « G R ƒ ' \ g § k 0 � \ E Lo § \ \ ' 7 3 o a £ A � 0 § o a .0 A < o [ U) m m k o � _ m m EL k o } ~ ( \ k k k � k k 00 m a a a 7 � m a s CL U) 2 v : s \ ) z � 2 ] z o ) § z ® � ) \ ® ° � . � _ ° � \ \ \ % < k ; (L ® < n Cl) � a _ < z m � � 06 G / 2 0 § 'a § _ a )° ` E \ ` d 2 � - \ . 2 a § & ■ �) 2 k § § k m 3 G m ] : ) Q o 2 / £ p ) G o 2 / £ k 2 { .. 2 \ 2 7 . 2 k \ IL a. , § §CL L: CL Z m \ ( $ o §CL 0 c 0 CL L o US 6 , o ■ u Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: Z Z 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: Rose, Jerry& Pam I Emerald, Town of 010-1086-50-200 CST BM Elev: Insp.BM Elev: BM Description: Section/Town/Range/Map No: 35.30.16.522E TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FS ELEV. Septic Benchmark Dosing Alt. BM Aeration Bldg.Sewer Holding St/Ht Inlet SVHt Outlet TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic Dt Bottom Dosing Header/Man. Aeration Dist.Pipe Holding S em ill Gra oor PUMP/SIPHON INFORMATION Manufacturer TH n ov Model Number TDH Lift Friction Loss SystV Ft F orcemain Length Dia. SOIL ABSORPTION SYSTEM BED/TRENCH Width Length No.Of Trenches PIT DIMENSIONS No.Of Pits Inside Dia. Liquid Depth DIMENSIONS SETBACK SYSTEM TO P/L BLDG ELL LAKE/STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR Type Of System: 004000- UNIT Model Number: DISTRIBUTION SYSTEM Header/Manifold Distribution r le Size x Hole Spacing Vent to Air Intake Pipe(s) Length Dia Length Dia Spacing SOIL COVER x Pressure Systems Only xx Moun Or At-Grade Systems Only Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center Bed/Trench Edges Topsoil Yes A No Yes No COMMENTS: (Include code discrepencies,persons present,etc.) Inspection#1: / / Inspection#2: Location: 1247 250th Street Glenwood City,WI 54013(NW 1/4 SW 1/4 35 T30N R1 6W) NA Lot 2 Parcel No: 35.30.16.522E 1.)Alt BM Description= 2.)Bldg sewer length= -amount of cover= Plan revision Required? F51 Yes ❑ No I J Use other side for additional information. F7 L Cert.No. Date Insepctor's Signature SBD-6710(R.3/97) Commerce.wi.gov Safety and Buildings Division County 201 W.Washington Ave.,P.O.Box 7162 St.Croix i s co n s i n Madison,WI 53707-7162 Sanitary Permit Number(to be fiI4 by Co.) Department of Commerce 5�5 z g Z /�.,Q�Y�iGC/'� Sanitary Permit Application 15548 SnsactionNumber In accordance with s.Comm.83.21(2),Wis.Adm.Code,submission of this form to the pn governmental Project Address(if different than mailing address) unit is required prior to obtaining a sanitary permit. Note: Application forms for WTS are submitted to the Department of Commerce. Personal information you provide may fde 1247 250g'Street purposes in accordance with the Privacy Law,s.15.04 1 m I. Application Information-Please Print All Infoi natioR Property Owner's Name Parcel# Jerry&Pam Rose 010-1086-50-200 / 5� Property Owner's Mailing Address Property Location (, 1243 250'Street ST,CROIX COUNTY I pi ING OFFICE I Govt.Lot City,State Zip NW '/., SW '/., Section 35 Glenwood City,WI. 54013 715-684-4756 (circle one) T- 30 N; R 16 E or W H.Type of Building(check all that apply) �� Lot# ❑ I or 2 Family Dwelling-Number of Bedrooms--& O Subdivision Name 40 A, t� Block# Na El �Public/Commercial-Describe Use r' W%— Na ❑ City of ❑State Owned-Describe Use CSM Number ❑ Village of / Of / / Vol.23,Pg.5537 Town of Emerald 5Z) Moto-; Ctrl III.Type Permit: (Check only one box on line A. Complete line B if applicable) A. New System ❑Replacement System ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System(explain) B. fF ermit Renewal ❑Permit Revision ❑ Change of Plumber ❑Permit Transfer to New List Previous Permit Number JDate Issued r e Ex's n—'ratio Owner 514924 issued 7/11/08 -�. IV.Type of POWTS S stem/Com onent/Device: Check all that app 1 ❑Non-Pressurized In-Ground ❑Pressurized In-Ground ❑At-Grade ❑Mound>24 in.of suitable soil Mound<24 in.of suitable soil ❑Holding Tank ❑Other Dispersal Component(explain) ❑Pretreatment evice(explain) V.Dispersal/Treatment Area Information: SymTech STF 100-A2 effluent filter at pump dischar e Design Flow(gpdV I Design Soil Application Rate(gpdsf) Dispersal Area Require(sf) Dispersal Area Proposed(sf) System Elevation 450 gpd 1.00 gpd/sq.ft.ASTM-C33 san d 450.00 sq.ft. /`ZLJ 450.00 sq.ft. �6 109.04'at 24"above 0.40 d/s .ft.in-situ soil ,4 I I 107.04'contour VI.Tank Info Capacity in Total #of Manufacturer Gallons Gallons Units s, U$ N Y New Tanks Existing Tanks Septic or Holding Tank 1,000 1,000 1 Wieser Concrete X Dosing Chamber 600 Na 600 1 Wieser Concrete X VII.Responsibility Statement- I,the and reigned,assn a responpibility for inst0lfiTo of the POWTS shown on the attached plans Plumber's Name(Print) Plumber' Sign a MP/MPRS Number Business Phone Number James K.Thompson MPRS 30021 (715)248-7767 Plumber's Address(Street,City,State,Zip Cod 340 Paulson Lake Lane,Osceola,WI 54020 VIIL Coun /De artment Use Only Approved �n Permit Fee Dat.�Iss1u h Issui gent Sign Reason for enial IX.Condi"!hg4 teasons for Disapproval 3, /0 � .4 (b0 1. Septic tank,effluent filter and G M � � dispersal cell must all be services/maintained as per management plan provided by plumber. f 2., Attsetback requkements must.be maintained a ., Code/orditAWAa. Attach to complete plans for the system and submit to the County only on paper not less than 812 x 11 inches in size SBD-6398(R.02/09)Valid thru 02/11 comrnerce.wi.gov Safety and Building lsion County 201 W. Washington A ., P. 7162 St. CTO1X ~~~~ ~' ~ Madison, WI 53 -71 Sanitary Permit Number (to be filled in by Co.) Department of Commerce ,s~ Sanitary Permit Application State Tr ~ a,io5 .r,,c ~L In accordance with s. Comm. 83.21(2), Wis. Adm. Code, submission of this form to the appropriate govern ental project Address (if different than mailing address) unit is required prior to obtaining a sanitary perrr-it. Note: Application forms for state-owned POWTS aze submitted to the Department of Commerce. Personal information o ondary u oses in accordance with the Privac Law, s. 15.04 1 m ,Stars. ~ /~ ~~ ~~ I. A lication Information -Please Print All Information Property Owner's Name / ~ ®~~~~ Parcel # Jerry & Pam Rose J~~ 010-1086-50 0 Property Owner's Mailing Address ST. CROIX COUNTY Property Location C~ ~ J ZONING OFFICE i ~ th 1243 250 Street Govt. Lot 35 SW NW ' City, State Zip Code Phone Number Y<, Section /<, (circle one) Glenwood City, WI 54013 (715) 684-4756 T 30 N; R 16 w e of Building (check all that apply) fjk q.~ II T Lot # . yp ^ 1 or 2 Family Dwelling -Number of Bedrooms 3 2 Subdivision Name Sv ~~: ~'e ~ ~` Block # Na ^ Public/Commercial -Describe Use Na ^ c;ty °f ^ State Owned -Describe Use CSM Number ^ illage of i / CSM #876463 Town of Emerald ~ ~ ~j ~ ~ ~,~,~/ ~~ Vol. 23, P .5537 III. Type o Permit: (Check only one box on line A. Complete line B if applicable) `~' New System ~~. ^ Replacement System ^ Treatment/Holding Tank Replacement Only ^ Other Modification to Existing System (explain) B• ^ Permit Renewal ^ Permit Revision ^ Change of Plumber ^ Permit Transfer to New List Previous Permit Number and Date Issued / Before Expiration Owner ltv. T e of POWTS S stem/Com onentlDevice: Check all that a 1 ^ Non-Pressurized In-Ground ^ Pressurized In-Ground ^ At-Grade ^ Mound > 24 in. of suitable soil Mound < 24 in. of suitable soil ^ Holding Tank ^ Other Dispersal Component (explain) ^ Pretreatment Device (explain) ~ ~ V. Dis ersal/Treatment Area Information: Design Flow (gpd) Design Soil Application Rate( sfl Dispersal Area Re ~ d (sf) Dispersal Area Pro sed (sf) evation 450gpd 1.0 ASTM C-33 sand ~.~• ~ 450 sq. ft. L) ~ 2 450 sq. ft. ~ , 7 ~ 1 t 24" above ' ` 0.46 in-situ soil ~ ~ ~ conto 107.04 VI. Tank Info Capacity in Total # of Manufacturer Y Gallons Gallons Units ~ ~ U ~ ti New Tanks Existing Tanks ~ ~ / , ~ ` ~ c a U ;; ~ iii H y v~ ~ ~ w C7 A. P.LN. I /I Septic or Holding Tank 1 ~~~~ _ 1,000 1 Wieser Concrete X Dosing chamber 600 _ 600 1 Wieser Concrete X VII. Responsibility Statement- I, the and rsigned, ass me responsibility f ation of the POWTS shown on the attached plans. Plumber's Name (Print) Plumbe s Signa MP/MPRS Number Business Phone Number James K. Thom son /~ ~--- 30021 (715) 248-7767 Plumber's Address (Street, City, State, Zip Code 340 Paulson Lake Lane, Osceola, WI 54020-5413 VIII. Coun /De artment Use Onl .~/Approved y'C Isapprove Permit Fee Date sue Issuing nt Signatur $ /_~j Ob 7~/ d~ ^ Ow iven Reason r Denial t0 IX. Condit~t~~~~~r~~l/Reasons for Disapproval 3> ~ ~ ~ ~5 ~r+~ ~^4.~ ~~ ~,~~" o KK t [ 1. Septic tank, ef fluBnt filter and J (~ ///~~~ dispersal cell must all be services /maintained ~ ~.. ~itt^GG.~ ~ f ~ ~rM"~' ~' as per management plan provided by plumber. 2. AN setback ret#uirements must be mairttairtad Attach to complete plans for the system and submit [o me coun[y omy on paper auueas wau o iic a .. u.c..~ u. ~..~ SBD-6398 (R. 01/07) Valid thru 01109 \ / V a I~ pfo posed ~v, cs~'C'o~,c~e ~cp~-cfPu,,,lo ~,,,C. T~.,yr't'x b~ -bo bC gPre /Veal ~ ~j'W.A yo/a i-ists~' ~ ,,~ ~ o i ~5. Q~.c~'~Y dcPtf. o~-~,F uf' `\ ~ C buoya.na sr.,i/~"ecJ. ar'F-ico.4 y~ ~~ i ~ li ~e if ~/ta t~n't, F'l ~e,~ ~:o be N J V C J cb ~~ ~ ~ /o~• Y9 ~ V ~% be/viv ~[;~;skcp/~,-axle. J~ o ~ /0 3.93' C ~ 3 Proposed wlo~ d ~ x~ 3! x /as: ~[ ' ~ ~~ ~ TcJd Cz~ d.'sv'ibc.~o7 /mtc~a/S a-L .. !~ X SS. yy',..y yB won i~'ces aloe eQC/ U t /, 9Yo: ~~ ~~ ~ (~ . / L ~ ~(0~. ~ ~ /070/ /o ,vy \ /r~ ~ii~~ ;,Ji t G. ~ ~ 7v of ,' tib,~ ,- i' ____~~ ~ r,,~: ;cc,~`'~ ' ~ -' ~ ~ '• M ~B !'e bo~o.~ /02 / ~~ ~' ~' ~~ ~ /ol. '_vr'rce.i Elcv.~- ioG.49' ~ ~ ~~ ~ ' ~o~°3~i 1 8, ~,~ ~.BoF'9 .m' .3 ~ ~ ~.~ ~k~rlar~t =•_~1~+:/:n ~1aod~, f'o.rce,onsE. Eick = /09. c s~' A \ J~, O~ 'y~ ~. ~ ~\ N h 6 . /5.~+'(. ~ TAP ~' ~B~!'e 6~ar-a-~ /off c~Ke. ; Er~v.-=.x.~~ Q''~u\ \~ ~~ Jam, `~~ pro posed w, cse/'eare~e ~ i can/load -.,~,~ canb~'^a~'~,-, 1 /a/•~b' Syo6e./Pu.njo{~„rC: %~Art'~bc to be qp~o /i ed L`v A'I~n bo/a r'.:Ses^ J o i its. (3ur'~r delo~ o~-dcA °f~ ~ /m.ei' ~,t~t~lt ~ 36'~ Cvu~6e~ac.~ b.+oya.nc}~, S.z'~t/t'icJ~ sr'~'.ico.l ~ /o~• Y9' a d 0 ~ ~ 3 ~ /0 3. 93' Pro~sed r~ou..~ d ~ z~ 3! X /3s. `r ' w/ '~ ~r //.2. Sp' di:T ~' b cct~i o.~ Ct//. T~oC~ al,'s~ibc.~i07 /atc~alsat l~urSS.yy'~/B'o~,~;'cas s~ouced Ut/, No' ~--, ~~ i~ -~-"-- / i ~-S ~ ~ ,~ i~b~~' ,•-- ' ti. .' -- -~~ ~ -' %~ ~~ ~ i 5 8 ~ ,', ~~ ~ Soy/ e da/c.az:'o~-, ~o, f ~,C13u~~g ~~c12 e%rl. ~-- ~Xi'S~ihcU{-t+,ce%~rJe (Aat'/ot/~c~ e~~ ~ 5~ 8"-r°`~e ~' ~ Lot, c~Md~P.~3, .ss3~ Q ~wy~sw`y,Sec.,3s ..3r.r; ,~ 3 be,d.roei~n st _Cr» ~ Coy ~,J1. r'c s, /ctce Pc.(. ~ o/o - /avG-so -CVo ~:,~ ~. ~9.4~s `/i3. ~ ~ ~ "sue. s~ P. /.C.. bu.Yd,-.rf. se.cve~' jai: Z' ~, 7 U A ~~t~,= ~f, ~,>~2~~ -__ l~/' ~i r(' W/ rat. L: ~(D1 ~`w' /o~co' ~ o7.S~' /~. B~' 9 ~.~ h'l.~r~f =•_~o:/:n W onda.~ ~~KCePasE. E~e~! ~ /09, o f~' - commerce.wi.gov i ^ isconsin Department of Commerce Jim Doyle, Governor Jack L. Fischer, A.I.A., Secretary July 03, 2008 CUST ID No. 30021 JAMES K THOMPSON A.C.E. SOIL AND SITE EVALUATIONS 340 PAULSON LAKE LN OSCEOLA WI 54020 ATTN: POWTS Inspector ZONING OFFICE ST CROIX COUNTY SPIA 1101 CARMICHAEL RD HUDSON WI 54016 Safety and Buildings 3824 N CREEKSIDE LA HOLMEN WI 54636 TDD #: (608) 264-8777 www. commerce.wi. gov/sb/ www.wisconsin.gov Identification Numbers Transaction ID No. 1554825 Site TD No. 739255 SITE: Jerry & Pam Rose Please refer to both identification numbers, 250TH Street above, in all corres ondence with the a enc . Town of Emerald, 54013 St Croix County NW1/4, SW1/4, 535, T30N, R16W Lot: 2, FOR: Description: Mound /Three Bedroom /Sloping Site Object Type: POWTS Component Manual Regulated Object ID No.: 1188976 Maintenance required; 450 GPD Flow rate; 12 in Soil minimum depth to limiting factor from original grade; System: Mound Component Manual -Version 2.0, SBD-10691-P (N.O1/O1), Pressure Distribution Component Manual- Version 2.0, SBD-10706-P (N.O1/O1); Biofilter CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 07/03/2010 The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s.145.06, (•Ol'1l stats. ~! The following conditions shall be met during constructionor installation and prior to occupancy or use: pE ptTME Reminders /bt~t of (.~ ~ ~ , • This system is to be constructed and located in accordance with the enclosed approved plans and with the SEE COF~ component manuals listed above. • Per manual cited above, limited activities are allowed in the area 15 feet down slope of the component arm. Soil compaction, excavation, vehicular traffic and other similar activities that impact the treatment and dispersal are prohibited. • The well must be a minimum of 25 feet from any POWTS tank, and a minimum of 50 feet from the absorption area. chs. NR 811 & 812c • 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 POWTS installation is required. Arrangements for inspection shall bemade with the designated county official in accordance with the provisions ofSec. 145.20(2)(d), Wis. Stat JAMES K THOMPSON Page 2 7/3/2008 • Comm 83 22(7) A copy of the approved plans specifications and this letter shall be orrsite during construction and open to inspection by authorized representatives of the Department which may include local inspectors. Owner Responsibilities: • Comm 83.52 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. Comm 83.54(1). • Comm 83.52(2) A POWTS that is not maintained in accordance with the approved management plan or as required under s. Comm 83.54(4) shall be considered a human health hazard. • Comm 83.55 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. All permits required by the state or the local municipality shall be obtained prior to commencement of construction/installation/operation. In granting this approval the Division of Safety & Buildings reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sincerely, Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 Charles L Bratz POWTS Reviewer II ,Integrated Services (608)789-7893 , 7:45 am - 4:30 pm Monday -Friday charles.bratz@wisconsin. gov WiSMART code: 7633 cc: Leroy G Jansky, POWTS Wastewater Specialist, (715) 726-2544 ,Friday, 7:00 A.M. To 3:30 P.M. y MOUND AND PRESSURE DISTRIBUTION COMPONENT DESIGN Residential Application o Z INDEX AND TITLE PAGE ~ N U N m Project Name: Gerry & Pam Rose 3-bedroom residential mound _ '~ ~ Owner's Name: Gerry & Pam Rose y Owners Address: 1243 250th Street Legal Description: Township: County: Subdivision Name Lot Number: Parcel I.D. Number: Glenwood City WI 54013 Site Address: 1245 250th Street NW1/4SW1/4, Sec. 35, T.30N., R.16W. Emerald St. Croix CSM Vol 23, Pg. 5537 2 Block Number: na From 010-1086-50-000 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 ''flt?~?~7j~ Page 7 Pump curve and specifications ,,~ .~ Page 8 Site Plan ~, Page 9 Attached soil evaluation report ' of co ~rM~~c~ ~ ~ t.Dtl~GS `~SPOND - ~ CNC,S Designer: Ji Thompson License Number: 30021 Date: 06/1 8 Phone Number: (715) 248-7767 Signature: 3--- 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. 06106) Page 1 of 9 Mound and Pressure Distribution Component Design Design Worksheet Site Information (R or C) _ R Residential or Commercial Design 300.00; Estimated Wastewater Flow (gpd) 1.50 Peaking Factor (e.g. 1.5 = 150%) 450.00 Design Flow (gpd) 3.00 ~ Site Slope (%) . _ -_. 107.04' Contour Line Elevation (ft) 12.00;, Depth to Limiting Factor (in) 0.40' In-situ Soil Application Rate (gpd/ftZ) Distribution Cell Information 112.50! Dispersal Cell Length Along Contour (ft) 1.OOf Dispersal Cell Design Loading Rate (gpd/ft2) __ _ . 1 I Influent Wastewater Quality (1 or 2) Pressure Disribution Information _. _ _ (C or E) C! Center or End Manifold 0.00 Lateral Spacing (ft) 2; Number of Laterals 0.125; Orifice Diameter (in) 1.75' Estimated Orifice Spacing (ft) _ 2.00: Forcemain Diameter (in) _. 425.00!. Forcemain Length (ft) ___.. 90.50 Pump Tank Elevation (ft) 6.50 System Head (ft) x 1.3 18.04 Vertical Lift (ft) 6.49 Friction Loss (ft) 0.50! In-line Filter Loss (ft) 31.53 Total Dynamic Head (ft) Latera_I Diameter Si in. d'ia o tions 0.75 1.00 1.25 x 1.50 x 2.00 x 3.00 x Note: Sand fill (D) calculations assume a Table 83-44-3 in-situ soil treatment for fecal colifomt of <= 36 inches. 4.00 Cell Width (ft) Are the laterals the highest point in the distribution Y network? Enter Y or N If N above, enter the elevation raft) of the highest point. ___ 7.03 ftz/orifice Does the forcemain drain back? Y Enter Y or N 69.32 Forcemain Drainback (gal) 50.87 5x Void Volume (gal) 120.19 Minimum Dose Volume (gal) 26.36 System Demand (gpm) action - Manifold Diameter choice in. dia. o tions --x_ Treatment Tank Information 1000.00 Septic Tank Capacity (gal) Wieser Concrete Manufacturer Dose Tank Information _ -.- . _. 602.821 Dose Tank Capacity (gal) 11.82! Dose Tank Volume (gal/in) Wieser Concrete !Manufacturer choice ~ .au 2.00 _ 3.00 . Gallons/Inch Calculator (optional) 602.821 Total Tank Capacity (gal) 51.00 Total Working Liquid Depth (in) ---- 11.82 gal/in (enter result in cell 649) Effluent Filter Information Sim/Tech Filter Manufacturer STF 100-A Filter Model Number __ . _. _ _ Project: Gerry & Pam Rose 3-bedroom residential mound Page 2 of 9 Mound Plan and Cross Section Views 1 • • 1 / 10 B • 'Observation Pipe ' 0 ' 'S " {{ . ~~Qt ~. ..• ~- Mound Component Dimensions A 4.00 ft E 25.44 in B 112.50 ft F 9.50 in D 24.00 in G 0.50 ft 450.00 (ft2) Dispersal CeN Area 4.00 (gpd/ft) Linear Loading Rate -, -+ _1 _l H 1.00 ft K 11.56 ft ~ 11.25 ft L 135.61 ft J 9.06 ft W 24.31 ft 1715.32 (ftZ) Basal Area Available 11.25 (ft) 1/10 B Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area Finished Grade 110.83 (ft) -~ .....~ .... G ~ H ~ i~~1r,~fr 2 ~rii~~.~. ft) Latera F , .:::: ~ : ~~Dispersal Cell 109.54 ( Invert I 109.04 (ft) --- Dispersal Cell ;[~ ; ~ ' ~' ~ t Elevation E ~ D 3.0 °!° Site Slope di K ~ $ Sh ng ey . a 10 _ Topsoil Cap ~ ~ 1.5 ft © ~~~~~ Subsoil Cap '~ c j ASTM C33 Sand ~ Z ,_ _._ T `:`=~`-~~ Tilled Layer ~ m 0.5 ft ^5 ~ Aggregate v 10'7.04 (ft) Contour Elevation Geotextile Fabric Cover See lateral details on Page 4 for number, size, and spacing of laterals. Laterals are equally spaced from the distribution cell's centerline in the distribution cell (Ax6). Project: Gerry & Pam Rose 3-bedroom residential mound Page 3 of 9 Center Connection Lateral Layout Diagram I P IE X -~ IE Holes drilled on the bottom of the lateral, equally spaovd x12 ~I Laterals & force main of PVC Soh 40 (per CONIM Table 84.30.8? • ~ Tu rn-u p vd bs I Ivr Iv® or tsl e~ n out pl u p Number of Laterals Lateral Diameter Lateral Length (P) Lateral Spacing (S) Lateral Flow Rate System Flow Rate Total Dynamic Head 2 1.50 in 55.44 ft 0.00 ft 13.18 gpm 26.36 gpm 31.53 ft Orifice Diameter Orifice Spacing (X) Orifices per Lateral Orifice Density Manifold Length Manifold Diameter Forcemain Velocity 0.125 in 1.76 ft 32 7.03 ft /orifice 0.00 ft 0.00 in 2.69 ft/sec Dose Tank Information Electrical as per NEC 300 and --- Comm 16.28 WAC Disconnect ~- Locking cover with warning label and locking device and sealed watertight ~4 in. min. Tank component is property vented Wieser Concrete Ca aci 602.82 Volume 11.82 Manufacturer Gallons gal/inch _t A B C D Dimension Inches Gallons A 26.83 317.15 B 2.00 23.64 C D Total 10.17 12.00 51.00 120.19 141.84 602.82 under tank. Project: Alarm Manuafacturer JH Rhombus Alarm Model Number Tank Alert 1011421 Pump Manufacturer Zoeller Pump Model Number BN153 Pump Must Deliver 26.36 gpm at 31.53 ft TDH Gerry & Pam Rose 3-bedroom residential mound E- Alternate outlet location Forcemain diameter ~ 2 in. Weep hole or anti- siphon device P~ um~ off elevation (ft) 91.50 Dom elevation (ftj 90.50 Page 4 of 9 Mound System Maintenance and Operation Specifications Service ProvidePs Name James K. Thompson Phone (715) 248-7767 POWTS Regulator's Name St. Croix County Zoning Dept. Phone (715) 386-4680 System Flow and Load Parameters Design Flow -Peak 450 gpd Maximum Influent Particle Size 1/8 in Estimated Flow -Average 300 gpd Maximum BODS 220 mg/L Septic Tank Capacity 1000 gal Maximum TSS 150 mg/L Soil Absorption Component Size 450 ftz Maximum FOG 30 mg1L Type of Wastewater Domestic Maximum Fecal Cotiform >10E4 cful100 mL Service FreQUency Septic and Pump Tank Effluent Filter Pump and Controls Alarm Pressure System Mound Ins ect and/or service once eve 3 ears Should ins ect and clean at least once eve 3 ears Test once eve 3 ears Should test month) Laterals should be flushed and ressure tested eve 1.5 ears Inspect for ponding and seepage once every 3 years Miscellaneous Construction and Materials Standards 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. Dispersal cell aggregate conforms to Comm 84.30 (6)(i), Wis. Adm. Code. All gravity and pressure piping materials conform to the requirements in Comm 84, Wis. Adm. Code. Tillage of the basal area is accomplished with a mold board or chisel plow. 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 ~ • . • 6-8" Diameter Lawn Threaded Cleanout Sprinkler Valve Box ~ ~ Plug or Ball Valve Distribution Lateral ll !\ Long Sweep 90 or Two 45 Degree Bends Same Diameter as Lateral Project: Gerry & Pam Rose 3-bedroom residential mound Page 5 of 9 Mound System Management Plan Pursuant to Comm 83.54, Wis. Adm. Code neral 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.01l01), SSWMP Publication 9.6 (01/81), and Pressure Distribution Component Manual Ver. 2.0 SBD 10706-P (N. 01l01)j 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. ~gptic Tank The septic tank shall be maintained by an individual certified to service septic tanks under s. 281.48, Slats. 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 fitter 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. Puma 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 Svstem 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 BODS, 150 mg/L TSS, and 30 mg/L FOG for septic tank effluent or 30 mg/L BODS, 30 mg/L TSS, 10 mg/L FOG, and 10' 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 condition. 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. Project: Page 6 of 9 ~w ~LL Sa t4 45 lz .~ 3/.S3' ~ '~ -r. v.,~ a 0 8 25 a 5 20 15 a 7c 5 0 PUMP PERFORMANCE CURVE MODEL 151(1521153 FLOW PER MINUTE etI50aA r 2~. 3<0 ~ ~ wt, r~; o; mu..n .5~,oioly na.-6c ~~ d. • Timed dosing panels available. • Electrical alternators, for duplex systems, are available and supplied with an alarm. • Variable level corrtrol switches are available for controlling single phase systems. • Double piggyback variable level float switches are available for variable level long and short cycle controls. • Sealed (1Wik-Box available for outdoor installations. See FM1420. • Over 130°F. (54°C.) special quotation required. 751!1521'153 ~reries 151115211 53 MODEL S Control S electlon Model Volts-Ph Mode s Slm kx Du lex N151 115 1 Non 6.0 1 2 or 3 BN151 115 1 Auto 6.0 Included 2 or 3 E151 230 1 Non 3.2 1 2 or 3 BE151 230 1 Auto 3.2 Included 2 or 3 N152 115 1 Non 8.5 1 2or3 BN152 115 1 Auto 8.5 Included 2 a 3 E752 230 1 Non 4.3 1 2or3 BE752 230 1 Auto 4.3 Incuded 2 or 3 N 153 115 1 Mal 10.5 1 2 a 3 BN153 115 1 Auto 10.5 Included 2 or 3 E153 230 1 Non 5.3 1 2 or 3 BE753 230 1 Auto 5.3 Included 2a3 O CAUTION ;,B i=~staiatioe ui cnn2r<rEs, prdre~dion devices and wiring sHcold be ~.fo2~e 5y a yualiried !tC EntiEd eiervlcian, A!f Yiectriral and safeq~ codes sl~cald be Foifowed inriudng tlaa moot ~o-i vv ~~~,~i i~ t„cvudF(NECjandlhe0scupall~nafSafekysn!3rieafti7ltct(OSHAj. TOTAL DYNAMIC HEADIFLOW PER MINUTE EFFLUENT AND DEWATERING MODEL 151 152 153 Feet Meters Gal. Liters Gal. Lilers Gal. Lders 5 1.5 50 189 69 261 77 291 10 3.0 45 170 61 231 70 265 15 4.6 38 144 53 201 61 231 20 6.1 29 110 44 167 52 197 25 7.6 16 61 34 129 42 159 30 9.1 - - 23 87 33 125 35 10.7 - - - - 22 85 4p 12.2 - - - - 11 42 Shut-0ir Head: 30 ft. (9.tm) 38 R. (11.6m) 44 ft. (13.4m) Model 151 01450aB Models 152 1153 :2 32 I 12 1/8 5 t/ SEL.E:CTION CUIt.IE d~L.~~(~Y~ ~V1rV~R~L,R ~'L:~iV~ Far unusual conditions a reserve safety factor is engineered into the design of every Zoeller pump. MAIL ro: P.o. sox 1s B ~]li ~, ~ Louisville, KY 40256-0347 Manu/acturersof • . ~tir' IIG~'`~~~\N SHIP 70: 3649 Cane Run Road O Louisvila, I<r aoz1119s1 Qaeurr P~Mas S~'E /939 p,i ® (502) 778-2731.1 {800) 928-PUMP http:/Avww.zoelfer.com /-u~~ ~~ FAX(502) 774 3624 © Copyright 2003 Zoeller Co. All rights reserve . ~. 7 ~F'9 Wisconsin Department of Commerce Division of Safety and Buildings SOIL EVALUATION REPORT ,n onnnrr~enro udfh (`rmm Rri Wic Gr1m C:nr1P 2103 Page 1 of 3 A.C.E. Soil 8 Site Evaluations County Attach complete site plan on paper not less than 8%: x 11 inches in size. Plan must St. Croix __ include, but not limited to: vertical and horizontal reference point (BM), direction and parcel I D percent slope, scale or dimensions, nodh arrow, and locatbn and distance to nearest road. . . 010-1086-50-000 Please print aii information. Reviewed ey Date Personal information you provide may be used for secondary Purposes (Privacy Law, s. 15.04 (~) tmU• Property Owner Property Location Gerald T. & Pamela Rose Govt. Lot NW 1/4 SW 114 S 35 T 30 N R 16 W Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# 1243 250th St Proposed CSM City State Zip Code Phone Number ~ City Village rJ Town Nearest Road Glenwood City ~ WI 54013 (715) 684-4756 Emerald 250Th Street ~ New Construction Us®~ ~ Residential / Number of bedrooms 3 Code derived design flow rate 450 GPD J Replacement J Public or commercial -Describe: Parent material Glacial Till Flood plain elevation, if applicable na General Comments and recommendations: Onsite conducted by Pam Quinn. Site suitable for mound with 24" of sand fill placed on 107.04' contour. Chisel plowed to >13" when preparing site for mound installatation. a Boring # J Boring „ 15 i ~J n. Pit Ground Surface elev. 107.05 ft. Depth to limiting factor SoN Application Rate H~izon De th Dominant Color Redox Descri ton Texture Stnxture Consistence Boundary Roots ' p p 'Eff#1 'Eff#2 in. Munsell Qu. Sz. Cont Color Gr. Sz. Sh. 1 0-7 10yr3/2' none sil 2fsbk mvfr as 2fm 0.6 0.8 2 i 7-9 10yr3/2 none sil lthin pl mvfr as 2vf,fm 0.4 ~ 0.6 3 9-11 10yr4/4 none siI 2fsbk mvfr as 1vf,fm 0.6 0.8 4 11-15 7.5yr4/6 none sicl 2fsbk mfr gw 1vf,fm 0.4 0.6 5 ~ 15-20 7.5yr4/4 f2d 7.5yr5/8 scl 1 csbk mfr cw 1 of ~ 0.2 i 0.3 6 20-30 7.5yr4/4 c2d 7.5yr5/8 & c2f 10yr6/2 sl lcsbk mfr cw 1vf i 0.4 0.7 F4# 2 parts to 1 bk structure when disturbed. Loa ing rate re ects anticipat permeability o horizon after platy structure is broken dunng plowing of site. Boring # ~ Boring Pit Ground Surface elev. 106.43 ft. Depth to limiting factor 16„ in. Sal Application Rate Horizon Depth Dominant Color Redox Description Texture Stn~cture Consistence Boundary Roots GP DIft' _ in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 1 ~ 0-8 10yr3/2 none sil 2fsbk mvfr as 2fm 0. 2 I~ 8-10 10yr3/2 none sil 1thin pl mvfr as 2vf,fm 0.6 ~ 0.8 3 10-13 10yr4/4 none sil 1thin pl mvfr as 1vf,fm 0.6 ~ 0.8 4 ~ 13-16 10yr4/4 none sil 2fsbk mfr gw 1vf,fm 0.4 0.6 5 16-20 7.5yr4/4 f2d 7.5yr5/8 scl 1 csbk mfr cw 1 of 0.2 0.3 6 20-38 7.5yr4/4 c2C2f i5~ 6/2& sl 1 csbk mfr - 1 of ; 0.4 ; 0.7 H#'s 2 8 3 part to 2fsbk sVucfure when Lo 'ng rate reflects anticipated permeability of horizon after p aty structure is broken during plowing of site. ' Effluent #1 = BODS> 30 <_ 220 mg/L an TSS >30 < 15 mg/L ffluent #2 = BOD < 30 mg/L and TSS <30 mg/L CST Name (Please Print) ignature~ CST Number James K. Thompson ` 3602 Address A.C.E. Soil 8 Site Evaluations Date Evaluation Conducted Telephone Number 340 Paulson Lake Lane, Osceol , WI 54020 _ 11/1/2007 715-248-7767 Property Owner Gerald T. & Pamela Rose Parcel ID # 010-1086-50-000 Page 2 of _3 Boring # ~ Boring ~/ Fit Ground Surface elev. 106.86 ft. Depth to limiting factor 12" in. Soil Application Rate H i D th min lor D t C tion Redox Descri Texture Stricture Consistence Boundary Roots or zon ep in. o an o Munseu p Qu. Sz, Cont. Cobr Gr. Sz, Sh. 'Eff#1 'Eff#2 1 0-6 10yr3/2 none sit 2fsbk mvfr as 2fm 0.6 0.8 2 6-8 10yr3/2 none sit lthin pl mvfr as 2vf,fm 0.4 0.6 3 8-12 10yr4/4 none sit 2fsbk mvfr as 1vf,fm 0.6 0.8 4 12-18 7.5yr4/6 c2d 7.5yr5/8 sl 1 csbk mfr gw 1 vf,fm 0.4 ~ 0.6 5 18-34 7.5yr4/6 m2d 7.Syr5/8 & m2d 10 /2 fsl 0 m mfr cw 1vf 0.2 0.5 I H# 2 parts to 1&2fsbk structure when disturbed. Loading rate reflects anticipated permeability of horizon after platy structure is broken during plowing of site. ^ Boring # Boring Pit Ground Surface elev. ft. Depth to iimiting factor in. Sod Application Rate Horizon Depth Dominant Color Redox Description Texture Stricture Consistence Boundary Roots in. Mur~sell Qu. Sz. Cont. Color Gr. Sz, Sh. 'Eff#1 'Eff#2 I i I ^ Boring # Bor9ng Pit Ground Surface elev. ft. Depth to limiting factor in. Sod Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Conslstence Boundary Roots in. Mansell Ctu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 I 'Effluent #1 = BOD 5> 30 ~ 220 mg/L and TSS >30 < 150 mg/L 'Effluent #2 = BODS < 30 mg/L and TSS <30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. SHA8330 (807/00) AGE. Shc & Site Evaiuatlas ~,2,50`~ 5~r c e-f. •• ~errr ~ ~rA~, ~oS~~9rvN. i2 ~3 ~ SU`R y~, ~ l~ wmd ~'~, ~ ~i.~ ~ r ~~ /GAo~es t /occ,~~cd,'~ ~iJ6grScJYy~ Sui~'.ce Scc., 35 T. Son. ,Q, ilo~., T. o~ d,'s~kargc- Enic~a/d SE• ~roiX ~., cJ/. ~o d,~~ C.~~.~ ~` ~ ice. ~' 8~ ~~ ~~. ~. ~ . ~. ` ia7.Of~ ~ ~ ~ ~ ` ~ ` ~ . ~ ~ ~ . . ~ ~ ~ ~ ~ \ ` ~ ~ .\ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ^ ~ ~ ~ ` ~~ ` ~ 82 ` ~~~ 1 1 1 ~ ~ ` ,` ` 1 J ~ 1 1 1 1 1 C h 1 1 i ~~ i 1 1 1 • 1 ~ 0 i ~ 1 1 1 1 Yo , ~ \ ~ p i 1 ~ ~ ~~ i 1 1 ~ ~ I ~ ~ ~ r I ~ ~~ 5 ca/e ~ / ~ DLO " /. '~ 2/a3 ~ A sscc.»cc~ el.u~ = i~• co ui~i ,SewtT e(, = ~'o,glg~r ~'~'~ui~i'o,-+ d /oca.8-'cr~ u.n,t/Art~.+'i. E~is~~ 0 U d fC~ /oS! 07' io3, ~ ~d • 49~, C'-or'n ~'c.-/d I ~~ ,~ ~I ~ I '~ ~ ~ ~~ i - Concr~~t Par~;•J S/ab ~ yr ' ~ ' : Wisconsin Department of Commerce Division of Safety acrd Buildings SOIL EVALUATION. REPORT in atxerdance with Comm 85 Wia. Adm. Cede 2103 Page 1 of 3 A.C.E. Sofl & Site Evaluations Attach complete site plan on paper rrot less tlran 8%: x 11 irrcl~ss in size. Plan must ir~dude but rrot limited tiD: v rti nd h i l ~ nt f int BM di cti d County ix , e c a or zo erence po a re ), re on ( percent sbpe, state or dimensions, north arrow, and brxtion and di9tanr~ to an rcet LD. D ~'~- 0 1086-50-000- P/ease print all information. cawed By Date Persond ~rrnauw, you provta~ ~r ~ '~~ t.~, $. /~- 3/ 0 . Property Owner roperty Location Gerald T. & Pamela Rase Q] NW 1k SW 114 S 35 T 30 N R 16 W Property Owner's Mailing Address t # lock # Subd. Name or - 1243 250th St NTY Proposed CSM City State p Code~tOp6(3~itiir~6~E ~ City ~Ilage Town a Glenwood Ciiy i Wt 54013 15) 684-4756 Emerald 250Th Street ~ New Construction Use: Residential / Number of bedrooms 3 Code derived design flow rate 450 GPD ~ Replacement J Public or commercial -Describe: ~`~ f ~ ~l f~jv1 ~JrS - Parent material Glacial Titl Hood plain eleva , i appl ~ na General Comments and recommendations: Onsite conducted by Pam Quinn. Site suitable for mound with 24" of s ced on 107.04' contour. Chisel plowed to >13" when preparing site for mound installatation. ~_ Gtr-r... Boring # ..~ Boring P %/ ~ (/12G{ ~ 5" it Ground Surface elev. 107.05 ft. Depth to limiting fador t~ in. Sctl Applkation Rate Horizon Depth Dominant Colox Redox Description Texture Structure Consisten ce Boundary Roots in. Mansell Qu. Sz. Cont Color Gr. Sz. Sh. 1 "E 1 0-7 10yr3/2 none sit 2fsbk mvfr as 2fm 0.6 0.8 2 7-9 10yr3/2 none sit 1thin pl mvfr as 2vffm 0.4 0.6 3 9-11 10yr414 none sit 2fsbk mvfr as 1vf,fm 0.6 0.8 4 11-15 7.5yr4/6 none sic! 2fsbk mfr gw 1vf,frn 0.4 0.6 5 15-20 7.5yr4/4 f2d 7.5yr5/8 sG 1 csbk mft cw 1 of 0.2 0.3 6 20-30 7.5yr4/4 c2 2f 10yr6 ~& sl lcsbk mft cw 1vf 0.4 0.7 2 parts to 1 structure when disturbed. L ing rate re ds anticipated permeability o horizon a r platy structure is roken dunng plowing of site. a Boring # --} Boring ~ Pik Ground Surface elev. 106.43 ft. Depth to limiting fador ~ 6~~ in. S~ ApplEatlori Rate Horizon Depth Dominant Color Redox Description Texture Stnuiure Consistence Boundary Rools in. Mansell Qu. Sz. Cont. Color Gr. Sz. Sh. "Eff#1 " 1 0-8 10yr3/2 none sil 2fsbk mvfr as 2fm 0,6 0.8 2 8-10 10yr3/2 none sil lthin pl mvfr as 2vF,fm 0.6 0.8 3 10-13 10yr4/4 none sil Rhin pt mvfr as 1vf,fm 0.6 0.8 4 13-16 10yt4/4 none sit 2fsbk mfr gw 1vf,fm 0.4 0.6 5 16-20 7.5yr4/4 f2d 7.5yr5/8 sG 1 csbk mfr cw 1 of 0.2 0.3 t3 20-38 7.5yr4/4 c2 2f 1 5 l2~ sl lcsbk mfr - 1vf 0.4 0.7 's 2 $ 3 part to 2fsbk structure when rbed. L 'ng rate reflects anticipated permeability of horizon after platy structure rs broken during plowing of site. * Effluent #1 = BODS> 30 < 220 mg/L a TSS >30 < 15 mg/L ffiuent #2 = BOD <30 mg/L and TSS < 30 mgfL CST Name (Please Print) ignature' CST Number James K. Thompson ~ 's 3602 Address A.C.E. 3oit 8< Site Evaluations Date Evaluation Conducted Telephone Number 340 Paulson Lake Lane, Osceoi , WI 54020 11/1/27 715-248-7767 ~~L ,Qa~ f~ ~i ~ZcryiS Property Qwner Gerald T. & Pamela Rose parcel ID # 010-1086-50-000 Page ~_of 3 Boring # .~ Boring r/ pit Ground Surface elev. 1~•~ ft• Depth to limiting fador 12" in. ~ q~ ~ Horizon Depth in. Dominant Cokx MurrseU Redox Description Qu. Sz, Cont. Cobr Texture S#nrcture Gr. Sz. Sh. Co~aistence Boundary Roots 'Eff+y1 'Eff#2 1 0-ti 10yr3/2 none sil Zfsbk mvfr as 2fm 0.6 0.8 2 6-8 10yr3l2 none sil 1 thin pl mvfr as 2vf,fm 0.4 0.6 3 8-12 10yr4/4 none sil 2fsbk mvfr as 1vf,fm 0.6 0.8 4 12-18 7.5yr4/t3 c2d 7.5yr5/8 sl lcsbk mfr gw 1vf,fm 0.4 0.6 5 18-34 7.5yr4lt3 ~md2d 10 5//2~ fsl 0 m mfr cw 1vf 0.2 0.5 H# 2 parts to 1 &2fsbk strudure when disturbed. Loading rate refleds anticipated permeability of horizon after platy strudure is broken during plowing of site. ,. ~,_,! l.~ Boring # -~ Boring ~ Pit Ground Surface elev. ft. Depth to iimiting fador in. ~ gp~~on Rye Horizon Depth in. Dominard Color Mansell Redox Description Qu, St. Cont. Color Texture Stnrdure Gr. Sz. Sh. Consistence Boundary Roots *Eff#1 'Eff~2 ^ Boring # ,J Boring TJ Pit Ground Surface elev. ft. Depth to limiting fador in. ~ gppiicatbn Rate Horizon Depth in. Dominant Cdor Mansell Redox Description Qu. Sz. Cont. Color Texture Structure Gr. Sz. Sh. Consistence Boundary Roots *Eff#ri 'Eff#2 * Effluent #1 = BCrD 5> 30 < 220 mg/L end TSS >30 < 150 mglL * Effluent #2 = BODS <_3Q mg/L and TSS <30 mglL The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608-266-31 S 1 or TTY 608-264-8777. SBU-8330(8.07/00) ace. son & Brae Evak~atlorts ' ~"e,rrY ~ pa.~ ~ost~orv~. is'~l3 ~~±~ y~, /DA~res t /oca,~.cd;~ /IWWScJ!%t Su.r{.ce Sew, 35 ~- 3on., .Q. iGc~., T, of d;s~ha.-gc- En~C/'~/n! 56• c/'oix ro., cJl. to d,t~ P~ ~ ono - id~6 - so-cm `Jy.S~C.y1. SPLGF'c Co~+ri~lOA`ntS, eu+~'c~u~a~i'on d /oca.$%ar! u.~,fnc>''.+~t, U 0 L. 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I Q1 W ~ ` ~ V\ o ~ ~~ a ~ !~ ~ ,., ~~' ~ L~ ~ y a~ ~ ~ r M ~ ,~\ O Z N~ ~ °' ~, i O 'a h '~ m ~ I Q C~ Q I I I I I ~ I N y I I a o ~ E c p Y ~ d I Z II ~ I ._. E I ~ a I Z m ~ i ~ ~ E M 1~ N ~ p ;. W Obi O~ ~ ~ .E ~ ~ c~ c a~ ~ m ~- v y -moo -op ~ r m i ~ O O U Z Z : t0 I I I o \\q ~~ ~ o ~~ ~~ ~ ~ ~.~. ~ ~ ~ ~ ~~ ~ "~, ~ .~ ~°~,~~ ~~ ~ ~ ~~ v .~ .~ , ~~ c ~, ~~~~ v \\~\ \J ~ 1 v °~ G ~~'~ ., ~2 ~~ '1 ff~~ ~_ ~ -~ v ,~ ~ ~ ~ ~ ~~ EMERALD ~ ~~ ~, .~~1~ _ -. ~ ~ 4~ 1 ~ T30N. R.16 W SE~ PAGE 59 ~ SEE PAGE 60 S vsePh£ . S fie derson '~ Larr¢rse O C SD .2u sse// E y C f Eiie,Eson • Gi//en p cTames H! Cro es~~f' ~ ~ ~ o ^ L t G/ebs>aZ ~ t '~ Q l n a z rz/ 1 9 / z i a a s i LL toW U ~ F h E y p Pat .c.E a a \ •,Z w0i zv7 Vn •Hend~r~son Jo se~oh S 4 :F; O r°adde,-, 7s { Eiic,Eson Laroaine z4-.B Kr,-..~eifi y 0 y~ '3 z 1 'aC~ S a s v s ~ ~':/ten eS¢i on pQ o Q Ma~oref Meath s~ a s ~~ C 7 B~ 'S s .~ ez ~ N ,~9/ L G e ~ s F~ R. 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Roger Smith -Manager Glenwood City, Wisconsin DEALERS IN: for all our seeds, call: Grain -Flour -Feed ~ BRIAN HURTGEN Seeds -Hay & Fertilizers - Grinding & Mixing S Glenwood City, 265-4966 ~ , , , Headquarters For - Chevrolet Sales & Service ® Climatized Feeds New Cars -New Trucks Phone: 265-4214 ~.~~~~ ST. CROIX COUNTY WISCONSIN PLANNING & ZONING DEPT. ST. CROIX COUNTY GOVERNMENT 1101 Carmichael Road Hudson, WI 54016-7710 (715) 386-4680 FAX (715) 386-4686 COUNTY ON-SITE VERIFICATION FORM ~-y '~ %~ ' D ~ ~~ci~~C~-dim y PropettyOvnar 1~ PropertyLocatian '~~7?~Li f"'f DSO Gvvt. Lot ~ti~~,~1~t~(J1i4 S 3~ T j(~ hJ R %(-J E ( IN Property Ovners tVlailinq Address Lot >r Block # Sutd. Marna a CSfvti: Oily State IipCode Phrne tdumber ^Cily ^~Ilage ®fi4fvn Flearest Rand ~L' ~ ~ W 5~'6/~3 i ~7i ~; ~~/~z%ru lC~ v~~0 ~~' S7- ^ hJevrConstruction Use:I~Pssidential Numberafbedrooms 3 ___ ~2eplacemant ^ Public or Comm rcial -Describe: Parentmaierial ~tri~ctC,~,z~-fa.(j'1~~2~~Y -~~~?!!n~-- --~ Ganeral comments 6~~5 T7 ill ~ ~ ~Z-~~"t~ ~ l T and rccammendations: ~}"rt/`~ /S S ~ !I r ~d(J S C° O/tiJ SO I ,-- _... , _ Cale den•,~d deign ftwr rate _._.y~~__ _ __ _ _ ______ _ GPD Flocd Plain eleti~alian rf applicable _____ ___ _ ___ ft. -- --_ L;S JUST l~G""'~:~"yv~~ ~.~.y'- ~~r~~sT~~, 6r_ting ~ h.fd~P 9 _ _ .- it Ground surface eL?•v: _._ _ __. __ _.__ ft. Depth to limitin3 factor _______. __ in. Sal Ncation Rate Homan L~pth D~minaM Cobr Rs~dax Desr_riptic~i Texture Structure Consistence Boundary Rocts GPQ~1F in. tvlunsNl t]u. Sz. Cont. Cola Gr. Sz. Sh. 'E1hY1 'Eff#2 ^ 6uing >s ^ Boring ^ Pil Ground:,~~rtacee4w..__...__._______ft. DepthGc~limitingfador______.____in. Sal A lication Rate Horizan Depth Di,rninant Cobr Rerbx Descriptbn Texture Structure Cmsistence Boundary Rods GP DIff' in. Wlunsc~l Qu. Sz. Cant. Cobr Gr. Sz. Sh. 'Etff±1 'Eff#2 ~~~ *~G~~zsy /~~ `. ~ 8 1 ~ 4 6 3 2 ~~~~~~ KATHLEEN H, WALSH REGISTER OF DEEDS ST, CROIX CO., WI RECEIVED FOR RECORD 06/10/2008 OE:OOAM CERTIFIED SURVEY MAP CERTIFIED SURVEY MAP LOCATED IN THE NORTHWEST 1/4 DF THE SOUTHWEST 1/4 ^F SECTION 35, T30N, R16W, TOWN OF EMERALD, ST. CR^IX COUNTY, WISCONSIN. OWNER/SUBDIVIDER GERALD AND PAMELA ROSE 1243 250TH STREET ' GLENWDOD CITY, WI 54013 Q;~; BEARINGS REFERENCED TO THE ~i ~i ST. CROIX COUNTY COORDINATE ~i ~i SYSTEM, WI WI ~i ~ ~I al I I NI J ~I ~I LIJI 1 ' p.~l wll I ~~ ~~ I WEST 1/4 CORNER, SEC 35 UNPLA7TED LANDS ~I -~~ (ESTABLISHED FROM COUNTY "----"---"-"--'"---" ~ ~~ I COORDINATES). U. ~ 1 -~ I I 33.02' I 33' 33' i ` ~ ~ ._ `~ oo . I~ ~ z I I I ~ I~ ~ ~, In ice, o gl I I ~ r' N IrJ ~ ~ 'I Q I I I LL1 ; I I I PROPOSED DRIVEVAY I I I _ N89.42'S1' 7.44'09'W 655.97' 622,95' VOL: 23 PAGE: 5537 REC FEE: 13,00 COPY FEE: 3.00 PAGfS: 2 dOS W. ' * ; GRA RG S- 5 = NEW RI HMONO = t WI d' lq~ .~~.. ~~; COQ` IW ~° suR~~ tEa~v -INDICATES SECTION CORNER ( 'AS NOTED ) ~ -INDICATES 1" X 18" RE-BAR WEIGHING 1.502 LBS. /LINEAR FOOT SET AT POSITION 4' ~ I I F- 33.00' 262.64' ~' ~ ~ I w l I CNRO X COUNTY ZONING 1 I ' •+~ I I 3 ORDINANCE WILL BOCAT T I I E ~ ED 2 O FROM THE P ROPERTY IN % I I U N I ^ I ~ I R 6HT-0F WAY EVER HOUSE3 L ESTOCK OR ANIMAL UNITS Q I = ~ ^ I . slcD ,~ I I- I I o I N ~~ ~ ~ i (~ I _ I _ ~WEII ~ 3 - _ L - DRIVEWAY J I ~ w s ° I ~ v ch ~ I~ I~ I ° ~ I + o N c ~ I ~ ~ XISTING SEPTIC I I I I LOT 1 I I 130,655 SQUARE FEET I I (3.00 ACRES) INCLUDING R.O.W. - I I 116.266 SQUARE FEET I I (2.67 ACRES) I EXCLUDING R.O.W. I I 3 3.02' 298,02' 265.00' LOT 2 EAST-WEST 1/4 SECTION LINE IN87.44 09'W 4602.51' 308,994 SQUARE FEET L (7.09 ACRES) INCLUDING R.O.W. a 0 301,254 SQUARE FEET (6.92 ACRES) I a ~ EXCLUDING R.O.W. Sri V' V' 624.39' ~salL resr ~ OIL TEST ~ 0[L TEST ~ S87'S1'S9'E 657.41' 3 I UNPLAl~"Ep-LANDS o~ I ^~ :o ° N SOUTHWEST CORNER SCALE IN FEET I•=lzo• SECTION 35 C1' STEEL SURVEY MARK NAIL FUND ) Ito DRAFTED HY~ TJS EAST Ya CORNER, SEC 35 (2,375" IRON PIPE FOUND) ZI ~I I I 1 I ~I W ~I I q I 1 1 JI ~I I Z I ~~ --___ ~~ Steve ns ENGINEERS & PLANNERS 1658 LIVINGSTONE ROAD • HUDSON, vn 54016 (715) 388-5819 • (651) 436-2075 • FA%: (715) 386-5879 WWW.STEVENSENCINEERS.COM SHEET 1 ^F' ~ 13 Vol. 23 Page 5537 sT. cROIx couNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CERTIFICATION FORM Ownerlr~ .~-~e~'/~ Mailing Address ~„~~ 4~ ~~~ ~~~'~-~ Property Address /~ 5~ LL (Verification required from Planning & Zoning Department for ew construction.) ~ ~ Ciry/State ~, ~~n Lc~ e~~-s'~u•1.Parcel Identification Number ~ ~'- o td - ions ~ - 50 -- z~ LEGAL DESCRIPTION Property Location ~ t/a , ,.5~ t/a ,Sec. 3S , T ,~ _N R~,_W, Town of ~/7C~G~ Subdivision ~C~ ,Lot #~ Certiffed Survey Map # 8 7G `'~~3 ,Volume ~3 ,Page # 5~"t37 Warranty Deed # ~a?br,~S~ ,Volume ,.2.23/ ,Page # -2~3 Spec house no Lot lines identifiable es~ 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. Tbe 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. 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 tbe three year expiration date. Uwe certify that all statements on this form are true to the best of mylour knowledge. Uwe amlare the owner(s) of the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. Number of bedrooms •3 ~~ ~ ~loq/O~' SIGNA OF APPLIC 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. gyros) ' l 2231P 293 STATE BAR OF WISCONSIN FORM 2 - 2000 Document Number WARRANTY DEED This Deed, made between Gerald T. Rose, Sr. and Kathleen S. Rose, husband and wife Grantor, and Gelreld T. Rose, Jr. and Pamela Rose, husband and wife Grantee. Grantor, for a valuable consideration, conveys and warrants to Grantee the following described real estate in St. Croix County, State of Wisconsin (if more space is needed, please attach addendum:) West Half of North Half of Northwest Quarter of Southwest Quarter (W I/2 of N I/2 of NW 1/4 of SW I/4) of Section Thirty-five (35), Township Thirty (30) North, Range Sixteen (16) West. 720258 KATHLEEN H. wAL5H REGISTER OF DEEDS ST. CROIX CO., WI RECEIVED FOR RECORD 05/06/2003 11:55AM NARRANTY DEED EXEIXrT ~ REC FEE: 11.00 TRANS FEE: 330.00 COPY FEE: CC FEE: PAGES: 1 Area Name and Return Address ~~ '~~ 010.1086-50 Parcel Identification Number (P[N) This is homestead property. (is) 6ixzoot) Exceptions to warranties: easements and restrictions of record. Dated this ~ day of , 2003 * AUTHENTICATION Signature(s) authenticated this day of , * TITLE: MEMBER STATE BAR OF WISCONSIN (If not, authorized by § 706.06, Wis. Stats.) THIS MSTRUMENT WAS DRAFTED BY Thomas A. McCormack Baldwin, WI 54002 * Gerald T. Rose, Sr. 7 ~~ ~~~ ~ ,. Kraft,loan A Rnca ACKNOWLEDGMENT STATE OF WISCONSIN ) ss. St. Croix County ) Personal a before me this day of 2003 .the above named Gerald T. Ros Sr. and Kathleen S. Rosh; husband and wife -:~, - . to own to be the p (s~:.' .executed the'.f~ ~ 'rag i tru ent I t amQ t 1 ,.. d:: ~, ~ .. . ~. * A ~ ~ d O N.~ ~ '° Notary Public, State of WISCONStA1 -. •"?~A,1. My Commission is permanent. (If->a,.ot;,~ta)et:kiSoi>,~$ate: (Signazures may be authenticated or acknowledged. Both are not necessary-) * Names of persons signing in any capacity must be typed or printed below their signature. 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