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HomeMy WebLinkAbout036-1031-60-100 ' T Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix Safety and Building Division INSPECTION REPORT Sanitary Permit No: 561044 0 GENERAL INFORMATION (ATTACH TO PERMIT) State Plan ID No: Personal information you provide may be used for secondary purposes (Privacy Law, s.15.04 (1)(m)]. Permit Holder's Name: City Village X Township Parcel Tax No Ailts Christopher & Rae Ann Stanton, 036-1031-60-000 Town of CST BM Elev: Insp. BM Elev: BM Description: Section/Town/Range/Map No IL, 3 S aeLk_~ 13 NVl 14.31.17.201 A TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER ,Lf CAPACITY STATION BS /p Hl FS ELEV. Septic Benchmark/ 166 %6 cat- /r 5 posing Alt. B 7.3 S - 5 ti , c5d- ✓b G;1~_. CL 165- Aeration Bldg. Sewer DS /d Holding St/Ht Inlet TANK SETBACK INFORMATION St/Ht Outlet S 162 / S TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet ` 1 Septic 97 Dt Bottom Dosing Header/Man. 5'1' 160 3 Aeration Dist. Pipe 7, SS 166 .3 Holding Bat. System ~0 75• Z S ?t, V> 917. Z PUMP/SIPHON INFORMATION Final Grade 163 ✓ 5 Manufacturer Demand St Cover GPMr Co ye.`~ Z . 35 165-5 Model Number TDH Friction Loss System He H Ft Forcemain ia. Dist. to Well SOIL ABSORPTION SYSTEM BED/TRENCH Width / Length No. Of Trenches PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth 11 - DIMENSIONS 3 96 7j./ Z- I(Grn c SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufactur r: INFORMATION Type Of System: i r 5 CHA uBET OR f c~ v f 7 JO / Model tuber: (p ~1-1 US ~ V DISTRIBUTION SYSTEM r 1 I Z Ues11 ZZ s~- Header/Manifold I Distribution x Hole Size x Hole Spacing V:V6 Air In ake I Pipe(s) \ r -S Length Dia Length Dia Spacing SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only Depth Over / Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center d 76 Bed/Trench Edges Topsoil 1 s I~ No Yes No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: Inspection #2: Location: 1829 220th Ave New Richmond, WI 54017 (NE 1/4 NW 1/4 14 T31N R1 7W) NA Lot 1 Parcel No: 14.31.17.201A ~ C6✓f~ 1.) Alt BM Description = I 2.) Bldg sewer length = Z t3 - amount of cover Plan revision Required? 7 Yes No 5 3 F_5 Z175 Use other side for additional information. SBD-6710 (R.3/97) Date Insepct s Signal e Cert No. \ X-, 2 oc Gl~ \ J t 16 g ~ U RL," s. SaW and Buildings Dhdslon comity S -I 0 Rb 3 . 201 W. Washington Ave., P.O. Box 7162 Sanitary Permit Number (to be flied in by Co.) APR- 1 0 LU t_ Madison, Wt 53707-71 62 art ST CROIX cout& Sanitary Permit Application Transaction A accordance with sPS 38321(2), 6Vis_ Adu1 Code, submission of this turn to the apprcrpriabe go is required prior to obbur ir ga sanitary permit Nate: Applicati rt forms for state-owned POUTS are submitted to Project dffacut than marling address) the Department of Safay and Froftssionai Servles. Personal iffionnation you pravide may be used for secondary in accordance with the Privacy Law s. 15. 1 m , Stars. L Application Wormation -Please Print All In rmation Property Owner's Name ;C'Iro 4- C' n Parcel W2~OOD - LL r- IS E~ t 0 `S 63 i L'31- (e - property owner's Malling Addr= Property Location (201A 1415 1,13 RD 5-r Govt Lot l~ YI s '1a, Section 7 city, Stabe 1 Tap Code Phone Number ICI E- wvij QI e wow) S i6 I (n ~ ` . ~3 "~L Z T 3 N; R I7 (cur SubdivisiaaName rIor2FAmiIYDwclli1W--NUMbCrof a Building (check all that apply) Lot D Block# ❑ Pubes -Describe City of CSM Number ❑ Wt age of ❑ S#abe Owned-Desenbe Use ~'Towa of STN 0TO M M. Type of Perrnib (Check o one box on litre A. Complete fine B if Applicable) A_ ,New System ❑ Replacement System ❑ Treatment/Holding Tank Replacesseat Only ❑ Other Modification to Existing System (explain) List Previous Pe maliumbcr and Datc Issued B. ❑ Permit Renewal ❑ Permit Rr;vision ❑ Change of Plumber ❑ Permit Transfer to New Before F.apitaiion Owner N. Type of POYM m/Coutnent/Device: Check all that apply) .Non-Pressurized la-Ground ❑ Pressurized In-Ground ❑ Trade ❑ uud> 24 in. ofs ' l soil ❑ 24 . Of suitable sod retreatimertt Device~~{) 2 Z Z 3 u~Yl ❑ Holding Tank Dispersal (app V. Dis rsa11T at Area information: t 1 Design Flow (gpd) Design Soil Apreation Rate(gpdsQ Dispersal Area Dispersal Area (sf) system Elevation VI. Tank Info GcqmciLy allozusni GaTotal 9 Of Manuftcam llons units a U New Taulz Exhaig Tanks 5 u rn m c- t7 4-140L., {O k- JG q o Y ,a 6 at Septic orBoldm9Tank LXd Dosing Chamber VII. Responsibility Statement- L the undersiened, assume responsibility fo installation of Hue POWTS shown on H,e attached Plans. Plumber's Name (Print) _ Plumber's RS Bttslnas Ph= Numb" Plumber's Address (Street City, Stab- Zip code) 6Ji Cou /De rtment Use Du - PermitFee Gate Issuing g~nafure i ApProved =ZRRean-SM-fforDen2adI s y 75. co DL Condli3t'IfTiT~ w.wwM ons for Disapproval 'J t epGd tak, ef"nt filter and 3J dispersal ceU must all be services! maintained as per management plan provided by plumber. Cis~rA C l.✓C.t • 2.. All setback requirements must be maintained ]J as per afpp icabW coda / Ordinances: Attach to complete plans far the system and submit to the County only an =W not Iess Man 8 M 111 inches in size SBD-6398 (R.11111) CONVENTIONAL COMPONENT DESIGN Residential Appocation PAGE gVDEX AND TITLE `I Pm7'ect Name: ~CEI- A IAN Ownees Name: SidM Ownets Address: 11S I i13 Q~`j' Nevi Pi od mu)vl wr 1 Z10/ 1 L"gal i]es OWW. W112 NW'/l S Iy 7_11 ~j 21-7 VIV Township: STS on N County: S`~ CRQ\ Subdivision Name: Lot Number: Parcel ID Number: ®3 r 1031- 66 - fftt page 1 Index and We Page 2 Plot Plan Page 3 Swam Stung & Cross-Section Page 4 Fftr Specs_ Page 5 Maintenance information Page 6 Management Plan Page 7 St. Crobc Ct Se tic Tan intenance Form page 8 Warrant teed Page 9 Attachments: Soil Test & House Plains T~sigrenlPiumb~ FF 1 Lh~ License Number. tAVRS 2 Z S2117_ Date: L{ I - L Phone Number I S- ~Sa -2'-I to I sig rill onow P to In Sod AWWPWn Owwano t MwrW for Pow= Yesswa 2A $D-10705-P P4.01MI). Pape t \ r U.J ~ t. J ~J 4 ~ ~ c s x (V! a . vi t } Sofi Aboor of3on Ow"M Cross Section 163, s 4' Schedule 40 Final Grade PVC Veal Pipe With Vent cap ft LeachkV Chamber ? ft ~ System Elevation Soil Absomtion" Svstem Plan View f t I Vent Or Observation Pipe Leaching Trench 1 Chambers 4' Dia. Trench 2 Header Leachinu Chamber Specifications FEEISAA urer And Model I KN : RA-y 6t~ 9 ft Per chamber Soil Ap plicatio Rate O gPd/sq ft w Soil Application Rate EISA = Chambers 2 rows of O -4 Z. chambers each. Page_ of INSTALLATION INSTRUCTIONS Joe_ PL-525/PL-625 FILTER PL-525/PL-625 FEATURES & BENEFITS Features & Benefits: Rated for 10,000 GPD _ PL-525 = 525 Linear Feet of 1118" Filtration PL-625 = 625 Linear Feet of 1/32" Filtration PL-525 PL-625 o Accepts 4" and 6" SCHD. 40 pipe o Built in Gas Deflector The PL-5251625 Effluent Filter should operate efficiently for several years under normal conditions before oAutomatic 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 o Alarm Accessibility three years. If the installed filter contains an optional alarm the owner will be notified by an alarm when the o Accepts PVC Extension Handle filter needs servicing. Servicing should be done by a ,.,ertified septic tank pumper or installer. RECOMMENDED PRODUCTS r- - - - Polytok PVC Filter " s Extension Handle I ; z tabi - j€ Risers & Riser Covers Extend & Lok- Riser Safety Screens Filter Alarm Panel and SmartFiiter'm Control ' Polylok risers bring your Polylok Extend & LokT°~ PolYlok safety screens switch septic tank cover to grade. is a simple, easy to use prevent tragic accidents This allows locating and solution that can extend from happening by children Polylok filter alarm panels servicing your fitter easier the inlet or outlet pipe and and pets falling into open and switchs provid a visual F a nd time saving by elimi- make filter and/or baffle septic tank entrances. and audible notification of #ing digging to find tank installation a snap. impending fitter and tank entrance. Fit3' and V pipe. servicing. For a full list of Polylok products please visit our web site at: www.polylok.com Z- INGROUND SOIL ABSORPTION MANAGEMENT PLAN PURSUANT TO COMM. 83.54, WIS. ADM CODE General This system shall be operated in accordance with Comm.82-84 Wis Aden Code and shall be maintained in accordance with its component manual [In-ground Absorption Component Manual for POWTS Version 2.0 SBD-10705-P (n.01/01) and SSWMP rules pertaining to system maintenance and maintenance reporting. ugh (01/8 ) and local or state "cation 9.6 1 publication ~ No one should ever enter a septic tank or pump tank since dangerous gases may be present that quid cause death- Septic and pump be in accordance with Comm. 8333, Wis Adm. Code when the tanks are no longer used as POWTS tank abandonment shall 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 and 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. 281AS, 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 offthe filter when removed from it 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 scurn 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 the triennial assessment, maintenance personnel shall advise the owner of when the next service needs to be performed to maintain less than maxium 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 Dept of Commerce. Pump Tank The pump tank shall be inspected at 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. Soil Absorption System No trees or shrubs should be planted on the absorption area. Plantings may be made away from the cell's perimeter, and the area shall be seeded and mulched as necessary to prevent erosion and to provide some protection from frost penetration- Traffic (other than foot or for vegetative maintenance) on the area is not recommended since soil compaction may hinder aeration of the infiltrative surface within the system and snow compaction in the winter will promote frost penetration. Observation pipes within the dispersal cell shall be checked for effluent ponding_ Ponding levels shall be reported to the owner, and any levels above 4 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 shall be immediately repaired of replaced with a component of the same or equal performance. If the dispersal area fails to accept wastewater or begins to discharge wastewater to the ground surface, it will be repaired or-replaced in ifs' present location by biologically clogged absorption and dispersal media, and related piping, and replacing said components as deemed necessary to brim the system into proper operating condition Replacement in a suitable area nearby is also an option at which point a diversion valve will be installed between the old and new systems to allow dispersal cell rotation at a schedule to be determined at the time of cell replacement_ f ST. CitQMC0 i S`[CTr*iNK 1wLdtIl'iltANC~ ~~FAIENT AND > Aa$ - - _v ii A►rhttvss l`J2~ctiw~o~ c~ L S'~/o! ? Waiilwmkm regdmd romn Piannan A ZvOng I1epat n i* qtr mw taon6ls%Aktr.i relntt€rtliSn Numb ©3 0000 rC14Y hltd ~W] ' ati ii N!!1/Y F So* , 1.`~ . T ' , Town a ~ Jan C ti Suter Map # Vd7lunic p 5 , Put 2013 it p tr use miff of your Fiern tx idd ttAWL in its j>r IW Iii - w bsd1a Vnews. i'r _ tBt~ j i+ F4np i~r,t tirr aej 3r rn ark tint v w ,w.a a ~~`ar a lk rwmm. tar t ~*rs put it la f n cacti aLfii t # ftIR43'€us of" a4vtia tad, As A it -W a> ea the ~A e i s rt 't qsim, 0"r mak' i rc p ns it>iiiit•B spWRod an arnartr 015,20) WA in Lb CT ias A t; r Catbrrtx Sari 04nOW, aidA j arj v tttiat s to Submit u? ;fit, mix (IJUOtY Piftirrii~ ~ ~i~ci p a r rr~~k r~ t~tili as faer~ ~d sl ~ th,t ~ wkd Div by a nmiet phwAw, ja meow-m f~iumi it cedLr{~ 1 t ilk p;en lreri#yir~t 1 [ [j tip vt►•~tt s4Ist'- d6perse) syt= IF is pnji& 0"fi ft rL.*Itlilon M d.* 11j tiler jWpCCt M and pwn ing grrs n ) chi W tt traL it i+ th .m id of Sbos - e is WWAV i4 r ra rt t + tiff tk 4ie kfw Ot and have and do sbinv vaqukeww wW aofft of, tr wok j axmknk %A R AI, Iwwk as set IT 4he IjgwIrar~nt of Mal tip and ft- Deperuniew vi ~Narr w i mvxv r. maw of `M't iist. C iFK-V dW'&Wi% tit YINT VCPfiC 4%WW h" t tlrair iai t o W a.mplewd And wtinn+.sa W %C grime r :ouat v Himin ztni % oWn ,v on's or rPte € Cgbtt d#I4 i1 we iii'y tint idi 1tatertis on its Amm RM ow ut the w-d arm;•ior t;rr~,}ic e. V"-- ro ov mnaw of *a ptupwty d r W ni dvt, by vM&w $f ai v > rty sdead rmwM im Rtsiovt orDftA5 offi- DAIT ON &TUPX OF "Any Infknv&n that is Wiatpmonicd ifty rNUM in dw a it lwnmt heal mmkod by Lre i'i ih* & Mn Dgmrbnvnk. Tr i+yls vaimte th r appiis rat r rd~d i~ oto tim Ra<jEt ate O rocvpy of Iw Cetus sitivq top If rent ~ h a in 0* #Aw doW• }j (REV. "47) i ( I r , I f f I 972510 BETH PABST REGISTER OF DEEDS CE1471 FI E® SU IRVOY MAR ST. CROIX CO., WI RECEIVED FOR RECORD LOCATED IN PART OF THE NE1 /4 OF THE NW1 /4 02/01/2013 3:25 PM OF SECTION 14, T31 N, R1 7W, TOWN OF STANTON, EXEMPT V: ST. CROIX COUNTY, WISCONSIN. REC FEE: 30.00 COPY FEE: 3.00 PAGES: 2 OWNER SURVEYOR WAYNE & MARY JO AILTS EDWIN C FLANUM 1881 220TH AVENUE NORTHLAND SURVEYING, INC. DEER PARK, WI 54007 P.O. BOX 152 AMERY, WI 54001 LEGEND ST. CROIX COUNTY SECTION CORNER MONUMENTED AS NOTED cl 3/4" X 18" IRON REBAR SET WEIGHING Z Z 1.50 LBS. PER LINEAR FOOT Wt~ 8 O " x FLAW" _ 1 5/16" O.D. IRON PIPE FOUND r AID . O SOIL TEST (BACK HOE) FIELD LOCATED V o va w cn- 7 A SOIL BORING PLACED FROM SOIL w w W w SUR`I O` EVALUATION REPORT w ~s EXISTING FENCE LINE (FENCE LINE HAS pppwp~ Q w X X NOT BEEN MAINTAINED) CD Z_ 2 4 / I 0 FS CD z wow O cm Zco U UNPLATTED LANDS NW COR. SEC. 14 N1/4 COR. SEC. 14 1" SURVEY MARKER FOUND M 220TH AVENUE 1' SURVEY MARK FOUND N89°46' "E 16' m - co - N89°46'20"E 335.22' EXISTING CENTERLINE N89°46'2 E 998.64' g NORTH LINE OF THE NW1/4 crv S89°58'20"E 335421' N 441 X O ?co x e4) ~I ~I °z~ o ~ LOT 7 ~ gl cm 3.00 ACRES INC. RNN A C-2 u~ 130,682 SQ. FT. - Q ;L Lij L .uea m 2.79 ACRES EXC. R/W ao I-. o :z 121,366 SQ. FT. e d J^ I X Z y 0- ^C I W ~I a A w Z x = 0 W z J N W x~ N89°58'20"W 335.21' I UNPLATTED LANDS SCALE IN FEET 1" = 80' THIS INSTRUMENT DRAFTED BY EDWIN FLANUM Now JOB NO. 13-01 DWG - CSM DATE 1/02/12 SHEET 1 OF 2 SHEETS 80 O 90 1 of 2 Vol 25 Page 5903 8 1 4 3 5 5 2 State Bar of Wisconsin Form 1-2003 Tx: 4116274 WARRANTY DEED 975836 BETH PABST Document Number Document Name REGISTER OF DEEDS ST. CROIX CO., WI 03/29/2013 1:08 PM THIS DEED, made between Gregory D Ailts, Ann M Niederhauser and EXEMPT#• 8 Wayne G Ailts REC FEE: 30.00 ("Grantor," whether one or more), TRANS FEE. • 1.20 and Christopher M Ailts and Rae Ann Ailts husband and wife PAGES•2 ("Grantee," whether one or more). Grantor, for a valuable consideration, conveys to Grantee the following described real Recording Area estate, together with the rents, profits, fixtures and other appurtenant interests, in I St. Croix County, State of Wisconsin ("Property") (if more space is Name and Return Address needed, please attach addendum): Wayne Aiillts 1881220 Avenue Parcel of land located in part of the NEIA of the NW 1/4 of Section 14, T3 IN, Deer Park, WI 54007 R17W, Town of Stanton, St. Croix County, Wisconsin; being Lot 1 of Certified Survey Map recorded in Volume 25 of Certified Survey Maps, Page 5903, Document Number 972510. 036103160000 Parcel identification Number (P]N) This is not homestead property. (is) (is not) Grantor warrants that the title to the Property is good, indefeasible in fee simple and free and clear of encumbrances except: Dated 3-)6--1-3 Dated (SEAL) (SEAL) 'C4 A0 * Gregory D. Ailt * A P/ ~~lq /I (SEAL) (SEAL) * Wayne G. Ailts AUTHENTICATION ACKNOWLEDGMENT Signature(s) ) STATE OF WISCONSIN ss. authenticated on 7LC~~ COUNTY ) * Personally came before me on '02 b " TITLE: MEMBER STATE BAR OF WISCONSIN the above-named (If not, " to me known to be the person(s) who ex6t:4`d'th~? forbgoi ' ~s authorized by Wis. Stat. § 706.06) : Q instrum nt and acknowledged the safn ~i =•F~• ; ~ .D r,• • ~ THIS INSTRUMENT DRAFTED BY: L_ &e 1/ 0 Marv Jo Ailts Notary Public, State of Wisconsin i My Commission 06-pem+aaff expires: : - ) (Signatures may be authenticated or acknowledged. Both are not necessary.) NOTE: THIS IS A STANDARD FORM. ANY MODIFICATIONS TO THIS FORM SHOULD BE CLEARLY IDENTIFIED. AVkV0ANTV nFVn e70(13STATF RAR OF WESCONCIN FORM NO. i_7.n13 1 of 2 i EL`4L.1£ 31tlC1 ANYJLYOJ-IIV.L34HEI.L [ZZWLI fi's L -119 loots m "'wava U990 tr. p r{ QN :Afl 03V:?]H] C ^ Q1L:A0 NMVYlq sCfil^~'4Z~SIL 7Nd it NKV E Id V S YEbt 897 S'L'l' SJIIVNY3VUttiHO B'L~3fONd AnrvdllroJ 11aleZaZE1 LL F WASInaa ~s w I s: FS t a p 4 p s: Q b ~ i Ss i. } y tgE e s } F iE ~ ~t at,n . 4-. w ,c L "i I I 1 I I ~ ~ I ..1 L--.--J ?1 L.----- ' ~ 1 J L.----- r l Ct K S a t , ~ ~ Ti Li L 1 - l R Il r 6 • d b9bZ-95L-9 6L- L xo j per eL£:80 £ 6 t0 add i XKVIIWOJ 7ldi'3d 3Hi " U r~1 EIISi,iC31VC1 K in l ~1 ILZo-LLVi1L1133 GdIKIk1`71UVdM3a0 v SEWRVZ-g1L=Xdd 3AV AWZZ GZBI ON:AA8 S aN.Ia (L~IJHHJ "d tEGt"HrvSIC AM SL"IlV rely 3V11 SRUia Z p '1~B [OZId Aldd WO.3 '11Y.130 AHL Z) 41(Nfil A3N i 4 [f S Yr L's fc; 1 r„ yf 3:f!j - - - - - - - - - - - - - - - - - - - - Ifl - --.-----------~I I I i I I I III I r---- I I I I i ~j ~ ~ I I L-___J I I I I 'I I II _ I II II I l l I I II i~ ;I I k I 1 JJ ;I I I ~ 1 [ I II I L-~---- - - I I I I I I I I I I I l 11 I I I l A LCD. 11 I I I I i . 2;' 11 i t :I I 11~ k l I I .I t I I 1 1 r`I I l l o~ I I ~ 2 I I I I I I .._1 I I I I ( i I I I I I i'' I i I I I I I L Z- d ~9bZ-~9L-s 6L- L xo=i or L,L£:80 £ 6 t0 ady i A Anvaxoo ux>~a aria. o M EvcZrE atVa IZUI'UrSIL~'ri3~ u>oLS[ro"AxYati3sn QN=A0 claNjaHJ 9AYMf1AZ 6zgl O'd AO KA0.Y M pL-6"PZ-S [L 'Hd SlTry My Ovil 7 SnPD n'.IOafolla Awv.Iwo~~laLaa al.rs -S NOlslAl71 t. 41 kl Ll -t Ell 0 0 EEII ED 0.1 3 o 'L ED ❑S I E E'd ti9bZ-9~L-9 LL- L XO=l clef e8E:80 CL t~0 adV z ~ Wisconsin Department of Commerce lv: * SOIL EVALUATION REPORT Page I of 3 Division of Safety and Buildings Q '1 Lj I th Comm 85, Wis. Adm. Code c d~ i County St. Croix Attach complete site plan on paper not less than,8 fires in size. Plan must include, but not limited to: vertical and irr fgSl ence point (BM), direction and Parcel I.D. 036-1031-60-0000 ZUr< percent slope, scale or Nrrow, and location and distance to nearest road. Please print all information. eviewed Date Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). Property Owner (Y'Y e Property Location r rriis & Rae Ann Ailts Govt. Lot NE 1/4 NW 1/4 S 14 T 31 N R 17 E( ® Property Owner's Mailing Address Lot # Block # Subd. Name or CSM# > 1415 143rd street _ - City State Zip Code Phone Number E]City Village Town Nearest oad New Richmond WI 547 ( 6)51-353-5042 2 20th Ave Stanton E] New Construction LlseE] Residential / Number of bedrooms 3 Code derived design flow rate 450 GPD 11 Replacement Public or commercial - Describe: na Parent material Glacial out wash Flood Plain elevation if applicable f ft. General comments Install in ground non pressure , standard component mpual design. >60% transported igneous gravels in C and recommendations: horizon matrix, Use .5 loading rate and 60" separation from liming fact ( Bottom soil reported pit/ boring) . Install two cells 5'x 90' @ 99.5' or 48" below surface contours. Fl Boring # 11 Boring Pit Ground surface elev. 103 ft. Depth to limiting factor >108 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 Al 0-4 7.5yr3/3 sil 3fgr mvfr gs 2m2f .6 .8 A2 4-15 7 5 3/2 sil 3fsbk mvfr cs 2m2f .6 .8 BT3 15-36 5yr4/6 - sil 3msbk mvf as 2m2f .6 .8 e4 36-108 5yr4/6 >60% and <90% rock fragment s Osg ml - 2n► 5 5 74- FBI] Boring # Boring 103.5 >120 11 Pit Ground surface elev. ft. Depth to limiting factor in. Soil A lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/f? in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 Al 0-4 7.5yr3/3 sil 3fgr mvfr gs 2m2f .6 .8 _ A2 4-I6 7.5 r3/2 sil 3fsbk mvfr cs 2m2f •6 •8 BT3 16-36 5yr4/6 - sil 3msbk mvfr as 2m2f .6 .8 C4 36 120 5yr4/6 >60% and <90% rock fragment s Osg ml - 2m .5 .5 r * Effluent #1 = BOD > 30:< 220 mg/L and TS >30 _ 150 mg/ * Effluent #2 = BOD < 30 mg/L and TSS < 30 mg/L CST Name (Please Print) Sign ture CST Number Lewis Bork 253976 Address Date aluation Conducted Telephone Number E7818 County E Menomonie WI 54751 12-27-12 715-231-7375 1 "Q Property Owner Ailts Parcel ID # 036-1031-60-0000 Page 2 of 3 B F 2 Boring # ® Boring 104 <126 Pit Ground surface elev. ft. Depth to limiting factor in. Soil A lication 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 Al 0-4 7.5yr3/2 - sil 3fgr mvfr cs 2m2f .6 .8 A2 4-13 7 5 3/2 - sil 3fsbk mvfr cs 2m2f .6 .8 BT3 13-36 5yr4/6 - sil 2msbk mvfr as 2f2m .6 .8 C4 36-126 5yr4/6 >60% and <90% rock fr s Osg ml - 2m .5 .5 C4 5YR Fades as deeper in the Horizon to a 7.5yr 5/6 E Boring # Boring ORIGINAL Pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate i Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/fP in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. *Eff#1 *Eff#2 Boring El Boring # Ground surface elev. ft. Depth to limiting factor in. Pit 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 * Effluent #1 = BODS > 30 < 220 mg/L and TSS >30 < 150 mg/L * Effluent #2 = BOD, < 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. SBD-8330Test (R.07/00) r.1 '3 a r z 1 ell c~6 <mr + rld co 03 a- `ZZI ~ ~ z .c - O ~ cc: Cl- 11 ~ Q ~ cl: LL '40 4- 2 V 1 ,S c r-D r N ~ P e 0