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HomeMy WebLinkAbout040-1308-00-148 Wisconsin` Department of Commerce PRIVATE SEWAGE SYSTEM County: St. Croix 'Safety and Building Division _ INSPECTION REPORT Sanitary Permit No: 561081 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: Tribella Properties, LLC Troy, Town of 040-1308-00--148 CST B Elev:` Q Insp. BM EI BM DescriptQn: / Section/Town/Range/Map No. 66 1 fq S erN- f- 24.28.20.1967 TANK INFORMATION ELEVATION DATA TYPE MANUFACTURER CAPACITY STATION BS HI FSL , V. Septic Benchma 40(a (a Z- N &_(o + i D9 i d p Alt. BM ~yy1- 4H 3, 3 S- 9'9 2 Aeration Bldg. Sew r `off i, ny, 3 Holding St/Ht Inlet p 03, g TANK SETBACK INFORMATION St/Ht Outlet Og y~ 59 3 TANK TO P/5 WE L BLDG. Vent to Air Intake ROAD Dt Inlet Septic / , Dt Bottom / Hea an. /0, Aeration Dist. Pipe% /O l~ Y! Z Holding Bot. System PUMP/SIPHON INFORMATION t F; al Gtr a S, (0 Manufacturer errand t Cove GPM yf sCi-J 3, (,,Z 103,0 03 0 f~7 Model Number #-y1 _P 7 CMh, 41 r - TDH Lift Frictio oss System Head ITDH Ft 7V ~f .04 1' 1 ICJ-#W 0 I 7.1 Forcemain Le h Dia. Well ~ J~ ~ s6 ~ Z SOIL ABSORPTION SYSTEM f ~sX 2 r t cn BEDITRENCH Width Length No. Of Trench PITIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS 5 Q / D ~ SETBACK SYSTEM TO P/L BLDG I( -1 WEL LAKE/STREA LEAC Man fact e INFORMATION T f System: StAgBg OR ype%O 61 n-' UNIT Model Number: I , ~q ~Ze DISTRIBUTION SYSTEM l r -W~ _ Q1--/ 0 lei He anifold DisVibution x Hole Size F x Hole Spacing Vent Air Intake //j (1 ~1 Pipe(s) ` I r L Length Dia Length Dia Spacing ~l i2i LiLc~ 1 fT SOIL COVER x Pressure Systems Only xx Mound Or At-Grade Systems Only C Depth Over Depth Over xx Depth of xx Seeded/Sodded xx Mulched Bed/Trench Center C(N~ Bed/Trench Edges Topsoil E,- j Yes No Yes No l COMMENTS: (Inclu de discrepencies, persons present, etc.) Inspection #1: /;!I/ jlnspection #2:__/ Location: 304 Lindsay Rd Hudson, WI 54016 (SW 1/4 SW 1/4 24 T28N R20 X) Troy Village 6th Addition Lot 148 Parcel No: 24.23.20.1967 1.) Alt BM Description = -Fop o f f ~ kr jW cal 'j'Q 3 y - 2.) Bldg sewer length = EQ ' 7 - amount of cover Lf 2„ c f S / OC - 0 J ~~Co Plan other ls de for Required? additional inforYes U I / `__II~,lt (li(l/ J U S mation. o SBD-6710 (R.3/97) Date Insepctor's Signature Cert . No. ScacE l" yo' Ja I' LdiY~li9Y G7~vG" ZOT / ✓/ZdY 041,4GE~ (.V r!Z/YL7SA A o 'o Diet v~l+~a ~'~'"/i~2vF W6GG iF'r~aAa.cc~c, Yo°Y~. S . .,~c~v c. YO Q r vG -Al 4A,,Oas`E,0 ,,,,t s-o G,a.. 1-►~.Fr~ it . rwzrc 1'EW6/R T,epiY~: 1^%27.y /~i't ycv/c .~"L .S"~.S" Erftur.~rT fscTt'R. ~Ftrs,ENT dz'NB 4rr© }~~~oSFY &,a) ZWOXI Q) - .T vr~r3,rzoTO~a. i1-Y °.f'Trvn~.~AR4 C'i~i~~r~ !y9 A~ g 1D AEA Jr c.~ ,P°wwo fr 7 o'w CE.►~ o r -Z'T".E f .L~l7i'N ~ ~ i~ r W LJ f !f'GE d /r / U County s~, I Safety and Buildings Division j 201 W. Washington Ave., P.O. Box 7162 Sanitary Permit Number (to be filled n by Co.) IA4 Madison, WI 53707-7162 5(p <E Sanitary Permit Application State Transaction Number In accordance with SPS 383.21(2), Wis. Adm. Code, submission of this form to the appropriate governmental unit sa / A is required prior to obtaining a sanitary permit Note: Application forms for state-owned S are submitted to Project Address (if different than mailing address) the Department of Safety and Professional Servies. Personal information you provide in IFQK 'secondary4 4 304 Lindsay Road purposes in accordance with the Privacy Law, s. 15.0 1 m Slats. ' L Application Information-Please t Information Hudson, WI 54016 Property Owner's Name Parcel # Tribella Properties, LLC ( '3 22 2013 040-1308-00-148 Property Owner's Mailing Address O/ Property Location P.O. Box 210 ~O Mr Govt Lot 9. Z r~J(0 City, State Zip Code Phone Number SW Y" Section 19- Hudson, WI 54016 715-377-0909 (prele one IL Type of Building (check all that apply T 28 N; R E orb N 1 or 2 Family Dwelling -Number of Bedr ms Four (4) 148 Subdivision Name B Oe Troy Village G~ ❑ Public/Commercial -Describe Use a_ AA O J ❑ City of State Owned - Describe Use CSM Number ❑ Village of N Town of Troy 3 / 14 Ill. Type of Permit: (Check on1 one box on line A. Complete line B if applicable) A. pq 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 IV. Tvpe of POWTS S stem/Corn nt/Device: (Check all that apply) ® Non-Pressurized In-Ground ❑ Pressurized In-Gro ❑ At ade ❑ Mound > 24 ' suitable soil ❑ Mound < 24 in. of suitable soil 42 In rator Q-4 Chambers ❑ Holding Tank W Other Dispersal Component (exp ) Pretreatment Device (explain) V. Dis ersal/Ire tmentArea Wormation: Design Flow (gpd Design Soil Application Rate( f) Dispersal Area Required (sf) Dispersal Arca Proposed sf) System Elevation 600 .7 857.0 857.00 896.00 VI. Tank Info Capacity in Total # of Manufacturer , Gallons Gallons Units Polylok 525 (PL) v ° u New Tanks Existing Tanks v c 3 a R Effluent Filter 4 U Septic or Holding Tank 1,250 1,250 1 Wieser Concrete 7L V Dosing Chamber VII. Responsibility Statement- I, the undersigned, assume responsibility for installation of the POWTS shown on the attached plans. Plumber's Name (Print) Plumber's Si tore MP/MPRS Number Business Phone Number Gary Zappa I ZW4_~, 222373 715-386-2850 Plumber's Address (Street, City, State, Zip Code) 715 Sixth Street N., Hudson, WI 54O e6 VII oun /De artment Use Only Approved pro Permit Fee Date Issued { Issuing A Signature en Reason for ial S / 75 ' 1 IX. Condi asons for Disapproval T tank, effluent, f fter and 3~ ~rti o/t vn G1J t/ l , b✓; dim rsal cell must all e k /.maintained ✓U' es Per management plan n provided by plumber. 9r°"~ ~Iv ~ T i~ t 2~ aeialcK requirements must. be maintain6d~ 3ti, ~f 6 s (p t~Nb 44Z ' Yis W ooi9s it of arii ~ Attach to complete plans for the system and submit to the County only on paper not less than 81/2 s 11 inches in size SBD-6398 (R. 11/11) CONVENTIONAL POWTS DESIGN INDEX AND TITLE SHEET Project Name: Tribella Properties, LLC Conventional Powts Owners Name: Tribella Properties, LLC Owners Address: P.O. Box 210, Hudson, WI 54016 Site Address: 304 Lindsay Road Project Location: Town of Troy, St. Croix Co., WI Subdivision: Lot 148 Troy Village, Sixth Addition Legal Description: SW SW Section 19, T28, N:R 19 W Parcel ID Number: 040-1308-00-148 Plan Transaction Number: Index and Title Sheet Page 1 Site Plan Page 2 Dispersal Cell Sizing Calculations Page 3 System Cross Section Page 4 System Management Plan Page 5 Filter Specifications Page 6 Treatment Wor Filter Tank Cross Section Page 7 Parcel Map Page 8 Septic Tank Maintenance Agreement Page 9 Warranty Deed Page 10 Attachments: Designer/Plumber: Gary Zappa, Dept. of Comm. Credential #222373 Signature: Phone No: (715) 386-2850 Date: Page 1 of 10 / 'GALE / Yo 3aY Can~,ctr~vr /?o,orl sbzz .c` ✓~9L 1/ATIt~/V ~r LDT A'? .ray 1441 lc ~ ~ irr~.~,o, zcv s Oret v.~r+.r~ y y,o~on~ GAAAAsE' sze~NGf /~ltv~csCe30 Y%°i~G r ..C'cNEe. YO ,l~~rnrG p ,/~i2oNoxE~ ,/v2s'o GAS ~.F.r~'r¢ •.i,~/P.TX'G ..!'.Ew6R p ~',~P~~ l•%riv ./a`+tY,cv~c ~''"L SvLS'r~FLt~~r ,F./`FLrsEN7 1.zNE NYY8A ~Qrv4 i`✓E~,o6~1 *X vr~ia-r~roea. v - Y ''.1'r,~ovaA~7 G✓,.+.•~r~~ /Y9 A AFA 772'ErvUy J°/"i CEO pr- o'w aww~ DISPERSAL CELL SIZING CALCULATIONS ow 1. (4 bedrooms) (100 gallons estimated flow)(1.5 design factor) = 600 Gnd design fl 2. Infiltrative capacity of native soil= 0.7 gpd/sq.ft. 3. Absorption area required: 857.15 sq.ft. 4. Absorption area as proposed 857 40 sg ft. (42 chambers total) Infiltrator "Quick 4"=20.00 sq.ft. EISA per chamber, Infiltrator "Quick 4" end cap (pair) = 5.80 sq.ft, EISA 857.40 sq.ft = (3 pair endcaps)(5.80) = 17.40 sq.ft. 840.00 sq.ft/20.00 = 42 chambers required Number of trenches: 3 a@14 chambers per trench Trench Width: 2.83' Trench Length: 58.67' Trench Spacing: 7.00' on center Total system w/5' trench spacing 17.00' x 59.00' Pg. 3 of 10 r $0I~1 Ab~o~Dfi011$YS1b6111 Cross 12 ftn eft 4' Schedule 40 Final Grade P1/C Vent Pipe w ft Vent Gap ft Chamber r ~ oo ft ~ ystem -stem-Elevation % „~-8~T- ft Yooft y,vo ft Soil Absort~tion $vstierel 00 NOW ft ft C) Uwching Trench 7 ao ft 7- M bers 4°Dia. Trench 2 Header Vent Or Observation Pipe Trench 3 Etta ChWbw catlons Manufacturer And Model, r.4(42 z d2 d'~~ ~~7.g vaip~ EISA Rating o v sq ft perchamber Soil Appdcadon Rate _a,? gpd/sq ft 1, k. o gpd Design Flow 4 D. 2 Soli Application Rate AQ - EISA Chambers 3 rows of chambers each. , Page ,,,Y_ of /D POWTS OWNER'S MANUAL & MANAGEMENT PLAN Page of FILE INFORMATION SYSTEM SPECIFICATIONS Owner Tribella Properties, LLC Ta anufacturer Wieser ❑ NA Permit # Ckteptic ❑ Dose ❑ Holding vol. 1,250 gal DESIGN PARAMETERS Tank Manufacturer ❑ NA Number of Bedrooms 4 ❑ NA ❑ Septic ❑ Dose ❑ Holding vol. gal Number of Public Facility Units ❑ NA Effluent Filter Manufacturer POlylok ❑ NA Estimated (average) flow 400 gal/clay Effluent Filter Model PL525 Design (peak) flow = (Estimated x 1.5) 600 gat/clay Pump Manufacturer 9 NA In Situ Soil Application Rate .7 aUda e Pump Model Standard Influent/Effluent Quality Monthly average` Pretreatment Unit ® NA Fats, Oil & Grease (FOG) 530 mg/L ❑ SandiGravel Filter ❑ Peat Filter Biochemical Oxygen Demand (BODO 5220 mg/L ❑ NA ❑ Mechanical Aeration ❑ Wetland Total Suspended Solids (TSS) <_150 mg/L ❑ Disinfection D Other: Pretreated Effluent Quality Monthly average Manufacturer a Biochemical Oxygen Demand (BODO 530 mg/L )kNA Dispersal Cell(s) NA Total Suspended Solids (TSS) 530 mg/L ❑ In-Ground (gravity) ❑ In-Ground (pressurized) Fecal Coliform (geometric mean) <40`C-N1 00ml ❑ At-Grade ❑ Mound Maximum Effluent Particle Size '/ain dia. ❑ NA ❑ Drip-Line ❑ Other: Other: ❑ NA Other: ® NA 'Values typical for domestic wastewater and septic tank effluent. Other: ® NA MAINTENANCE SCHEDULE Service Event Service Frequency Inspect condition of tank(s) At least once every: 2 ear ss) (Maximum 3 years) ❑ NA Pump out contents of tank(s) ❑ When combined sludge and scum equals one-third ('A) of tank volume ❑ NA ❑ When the high water alarm is activated year(s)s) (Maximum 3 years) El NA Inspect dispersal cell(s) At least once every: 2 Qjftnth Clean effluent filter At least once every: 1.1 ❑ m th ❑ NA ear(s) ) month(s) Inspect pump, pump controls & alarm At least once every: ❑ year(s) NA Flush iaterals and pressure test At least once every: ❑ month(s) 8 NA ❑ year(s) Other: At least once every: ❑ month(s) ® NA ❑ year(s) Other: I@ NA MAINTENANCE INSTRUCTIONS Inspections of tanks and dispersal cells shall be made by an individual carrying one of.the following licenses or certifications: Master Plumber; Master Plumber Restricted Sewer; POWTS Inspector; POWTS Maintainer; Septage Servicing Operator (pumper). Tank inspections must include a visual inspection of the tank(s) to identify any missing or broken hardware, identify any cracks or leaks, measure the volume of combined sludge and scum and a check for any back up or ponding of effluent on the ground surface. The dispersal cell(s) shall be visually inspected to check the effluent levels in the observation pipes and to check for any ponding of effluent on the ground surface. The ponding of effluent on the ground surface may indicate a failing condition and requires the immediate notification of the local regulatory authority. When the combined accumulation of sludge and scum in any treatment tank equals one-third ('h) or more of the tank volume, the entire contents of the tank shall be removed by a Septage Servicing Operator and disposed of in accordance with chapter NR 113, Wisconsin Administrative Code. Ail other services, including but not limited to the servicing of effluent filters, mechanical or pressurized components, pretreatment units, and any servicing at intervals of <_12 months, shall be performed by a certified POWTS Maintainer. A service report shall be provided to the local regulatory authority within 10 days of completion of any service event. GMW (12/02) '46's /0 START UP AND OPERATION For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products, solvents or other c :emicais that may impede the treatment process and/or damage the soil dispersal cell(s). If high concentrations are detected have the contents of the tank(s) removed by a septage servicing operator prior to use. System start up shall not occur when soil conditions are frozen at the infiltrative surface. Ljuring extended power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will t;e discharged to the dispersal cell(s) in one large dose and may overload them resulting in the backup or surface discharge of effluent. Tc avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring power to the effluent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to 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 area within 5 feet down slope of any mound or at-grade soil absorption area. Peductlon or elimination of the following from the wastewater stream may improve the performance and prolong the life of the POWTS: anti.blotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; drapers; disinfectants; fat; foundation drain (sump pump) discharge; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting products; pesticides; sanitary napkins; tampons; and water softener brine. ABMNDONMENT 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 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: X A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system. The replacement area should be protected from disturbance and compaction and should not be infringed upon by required setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result in the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rules in effect at that time. 0 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. _ The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a soil and site evaluation must be performed to locate a suitable replacement area. If no replacement area is available a holding tank may be installed as a last resort to replace the failed POWTS. L_j Mound and at-grade sal 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. <<V#ARNING>> SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND/OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE ADDITIONAL COMMENTS POWTS INSTALLER POWTS MAINTAINER [Name Zappa Brothers, Inc. (Gary Zappa) Name Tri-County (Ben Morgan) Phone (715) 386-2850 Phone 715 386-2130 SEPTAGE SERVICING OPERATOR PUMPER LOCAL REGULATORY AUTHORITY Name Tri-Count Ben Morgan) Name St. Croix County Zoning Office [Phone (715) 386-2130 Phone (715) 386-4680 This document was drafted by the staffs of the Green Lake, Marquette and Waushara County Zoning and Sanitation agencies in compliance with chapter Comm 83.22(2)(b)(1)(d)&(f) and 83.54(l),(2) & (3), Wisconsin Administrative Code. START UP AND OPERATION For new construction, prior to use of the POWTS check treatment tank(s) for the presence of painting products, solvents or other chemicals that may impede the treatment process and/or damage the soil dispersal cell(s). If high concentrations are detected have the contents of the tank(s) removed by a septage servicing operator prior to use. Systems start up shall not occur when soil conditions are frozen at the infiltrative surface. During extended power outages pump tanks may fill above normal highwater levels. When power is restored the excess wastewater will be discharged to the dispersal cell(s) in one large dose and may overload them resulting in the backup or surface discharge of effluen:*_. Tc avoid this situation have the contents of the pump tank removed by a Septage Servicing Operator prior to restoring power to the erftuent pump or contact a Plumber or POWTS Maintainer to assist in manually operating the pump controls to 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 area within 4 feet down slope of any mound or at-grade sal absorption area. Reduction or elimination of the following from the wastewater stream may improve the performance and prolong the life of the POWTS: antibiotics; baby wipes; cigarette butts; condoms; cotton swabs; degreasers; dental floss; diapers; disinfectants; fat; foundation drain (sump pump) discharge; fruit and vegetable peelings; gasoline; grease; herbicides; meat scraps; medications; oil; painting products; iei . 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 property and safety 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 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 repiacement system: ag A suitable replacement area has been evaluated and may be utilized for the location of a replacement soil absorption system. The replacement area should be protected from disturbance and compaction and should not be infringed upon by required setbacks from existing and proposed structure, lot lines and wells. Failure to protect the replacement area will result in the need for a new soil and site evaluation to establish a suitable replacement area. Replacement systems must comply with the rules in effect at that time. =i 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. _ The site has not been evaluated to identify a suitable replacement area. Upon failure of the POWTS a sal and site evaluation must be performed to locate a suitable replacement area. If no replacement area is available a holding tank may be installed as a last resort to replace the failed POWTS. L~l Mound and at-grade sal 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. <<V4ARN11NG>> SEPTIC, PUMP AND OTHER TREATMENT TANKS MAY CONTAIN LETHAL GASSES AND/OR INSUFFICIENT OXYGEN. DO NOT ENTER A SEPTIC, PUMP OR OTHER TREATMENT TANK UNDER ANY CIRCUMSTANCES. DEATH MAY RESULT. RESCUE OF A PERSON FROM THE INTERIOR OF A TANK MAY BE DIFFICULT OR IMPOSSIBLE. ADDoTIONAL COMMENTS POW rS INSTALLER POWTS MAINTAINER Name Zappa Brothers, Inc. (Gary Zappa) Name Tri-County (Ben Morgan) Phone (715) 386-2850 Phone 715 386-2130 SEPTAGE SERVICING OPERATOR PUMPER LOCAL REGULATORY AUTHORITY ' Flame Tri-Coup Ben Morgan) Name St. Croix County Zoning Office Phone (715) 386-2130 Phone (715) 386-4680 This document was drafted by the staffs of the Green Lake, Marquette and Waushara County Zoning and Sanitation agencies in compliance with chapter Comm 83.22(2)(b)(1)(d)&(f) and 83.54(1), (2) & (3), Wisconsin Administrative Code. EFFLUENT FILTERS "The PL-525 has 525 linear feet of 1/16" slots. It has an automatic shut off ball. When the filter is removed for cleaning, the ball will ry Aa.P„PVC float up and temporarily shut off the system so the eff luent won't leave the tank. No other filter on the market can make that claim!" a u,r lola Mtaa g« ow ,0.000 GPO Aeoapy r 6 6" SC"D Pigs :S 1 1. Cra da0act« Aa,«nxle a0ut-aM ball -A- #A- b'Orm-«I "The PL-122 has over 122 linear feet of 1/16" slots. Rated for 1500 gallons per day, and A"'P,,,,rP„C can be manifolded together with other PL- *A-- 122's to double or triple the GPD. It has an automatic shut off ball that stops flow when Fkw as ft. the filter cartridge is removed for cleaning. Comes complete with it's own housing, no gluing of tee or pipe and no extra parts to with buy. Pa. Ae.,« 1 6aa Wiec,or Aalam«kC snw.db Bap MAlan P6c« is Mma.ad ir«n Tank Order # Model I D@8C~ O(1 List Price PK-525 PL-525 Effluent Fdter System 203 50 PK-122 PL-122 Effluent Hter System 62 50 /Qyc ~ o~ /b sr~eN ra 9S1'8-M-009 OLOL •Nvr emu d slscss w ~aoa Beam, o&,ass on s umm ivnNy" oacm z Wall am Amvfwvr : 31111111 ~ L1. z g A t! Gda i n iW- Li. s +O 1 g °.t 0- Lc) C-4 N lit- :i e! LL. a got A r r 1 ~y SV3 .01' do O sf swo .tQ do ~ I all o _es .~p ~ ~ . ~ r 1 .t 144 146 4%M SF. 143 / ~ r , + - 147 sr. )42 148 X41 ~ ♦ 149 ~ ~ • . • ~Jr,•MO SF. 150 Imo Am / 4&M Sr. '1► ~ mil" 151 / o `co 152 lim *an `~a~,ias sF ~ JAWS D. F1. 153 12.34 S. WOW RIVER FALLS. =3 ACNM ~ . ` DATED THIS 15 A's E do of /D REVISED TH I S ST CROI1t COUNTY SEPTIC TANK MAIN'iBNANCE AGREEMENT AND OWNERSHV CE'K'TIFICATIO I FORD Ot;s~ r. 1J~ ~,~d,~ 'ate, LLG Mailing gK Zl0 . fltcd„w _ SYO J b foc l (Veiscain roeisirad Avg PlaMM4 N"MIMS ~~wn e Ta.y . tt Pwxi Idesatiftc ian Number Q yo -130$ ~po i qS LEGAI: fJ)~'~~N. Pm t .bec>d a tl,, Soe;. !T r_N R_- 4_W, TOM of ~Calffw ►zy Map f YOI=w Page # Wirrsea#~+ Deal # Volume Page # Spoe h yes Q no Lot Bees idemtifisble `y ' D tw ' - =Iaaproparmasmdc~yoars~pacsys~mmoe~atdremkis~pra~e.P~er~ . awes psseapiog eudt tfte aegrtic buck a tfsoee) e>< such aeedrd by s licemed pitmpa~ What you ,put iAw the syxftw c aka fire. of tba septic tat as a had ownt stW in dw wawa digm t system. - .The pro~ty ttsveear ~ tsst+seufE to St: Ckcax Zug Dart a eesfi6adioa torso, b]' dse eitsaeer atd s obey phimbet, ci~edp~iberorafyoes,seaWcepw 6101) the s3 ► is 3ta pitopa ,n dag condilm =Welt (2) after imVe km and paaup" (if wcewaty} the eev& teat a loss dm 113 the of sbtdg L Vw% dw mdarpobdLwr+ md dw above: regos+ammis and s&e to vomum dw pdvaw sewar disposal 440= widithe set , b=h6 as sett by do Depausa tef C.omm="do DeparimeaNt of Natural fLeaoetaees► StaEe of wiaeeensia ioo tb~-yaw septic sysee m fns hens mawaoeadmast be campleled aad ratesmed to do St. Cm= tloet W Zama Off= within 30 OWN . : ` ~ Pb,rdCbe,~..,...&: ,r•«..,.~y~~, M<..,,~. ~ 1;,8 J ~i3 T faF AFlLIt A BATS : X (era) cattfy sheet afl slaeemesms oa this b= ate tme to the best of aey (aw) tuowI=*e. 1(we) am m) the asmet{s) of I domed aboas; by virtue: of a wata+aht dead mcarded in Rem of Deeds Offim APPLrANt DAI l1a ► HaK is gain. r PI e1aaooeod mslr rauft is fhe avw:;aty t by s,•••'ev 't!:ttiiclnde t tide qWhexom a daV ed wamuty deed f am tLe Rc&w of to afte a COY of docird"auM =ap if re oe is. aiw& ib do wanin ty deed 8 1 3 7 8 5 9 State Bar of Wisconsin Form 1-2003 Tx :4111460 WARRANTY DEED 974661 BETH PABST Document Number Document Name REGISTER OF DEEDS ST. CROIX CO., WI NA PM THIS DEED, trade between Troy Development Corporation E 03/XEf4PXEMP3T#: NA ("Grantor," whether one or more), REC FEE: 30.00 4= TRANS FEE: 390.00 and Tribella Pro rti LLC PAGES: 1 ("Grantee," whether one or mom). 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 St Croix County, State of Wisconsin ("Property") (if more space is Name and Return Address ease attach addendum): River Valley Abstract & Title needed, I 1200 Hosrford St. Suite 201 Lo 1 153,163 and 164, Plat of Troy Village Sixth Addition in the Hudson WI 54016 Town of Troy, St. Croix County, Wisconsin. File' 2810573 ala130-oo-t4a: ato-t 1153: OW1399419-163 & 918-11308460-tf3 Pared Identification Number (PIN) 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: Easements, restrictions and rights-of-way of record, if any. Dated Ma h 1 2013 Troy Dev Corpor lion (SEAL) (SEAL) * Courtaie irvela , Vice ident (SEAL) (SEAL) s * AUTHENTICATION ACKNOWLEDGMENT Signature(s) STATE OF WISCONSIN ) ss. authenticated on LORNE L. DEMARS ST CROIX COUNTY ) STATE OF WISCONSIN Personally came before me on March 1. 2013 TITLE: MEMBER STATE BAR OF WISCONSIN the above-named Courtaie Kirvelay, Vice President of Troy Develo meat Co ra (If not, Lin me known to be the per (s ' o executed the foregoing authorized by Wis. Stat. § 706.06) trument a ask ow a same. THIS INSTRUMENT DRAFTED BY: L.,®eMR Au Berg ID2oQ0 Hosford St Suite 201 Hudson WI 54016 NO gu a of My o(is perma nent) (expires: March 20.2016 (Signatures may be aatben sated acknoBoth are not accessary.) NOTE: THIS IS A STANDARD FORM. ANY D TIONS FORM SHOULD BE CLEARLY IDENTIFIED. WARRANTY DEED ® 2003 STATE BAR OF WISCONSIN FORM NO. 1-2003 +"ai w below signatures. /~66 /O aF /D Parcel 040-1308-00-148 05/22/2013 03:15 PM PAGE 1 OF 1 Alt. Parcel M 24.28.20.1967 040 - TOWN OF TROY Current ❑X ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type # of Units 02/10/2004 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner O - TROY DEVELOPMENT CORP TROY DEVELOPMENT CORP 11806 ABERDEEN ST NE STE 290 BLAINE MN 55449 Districts: SC = School SP = Special Property Address(es): * = Primary Type Dist # Description * 304 LINDSAY RD SC 4893 SCH DIST RIVER FALLS SP 0100 CHIP VALLEY VOTECH Legal Description: Acres: 1.000 Plat: 09-100-TROY VILLAGE 6TH ADDN 146/168 040-04 SEC 19 T24N R19W PT SW NW ; BEING TROY Block/Condo Bldg: LOT 148 VILLAGE 6TH (04) LOT 148 (1.000AC) Tract(s): (Sec-Twn-Rng 401/4 1601/4) 19-28N-19W SW NW Notes: Parcel History: Date Doc # Vol/Page Type 02/10/2004 753934 09/100 PLAT 2013 SUMMARY Bill Fair Market Value: Assessed with: 0 Valuations: Last Changed: 11/09/2009 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 1.000 75,000 0 75,000 NO Totals for 2013: General Property 1.000 75,000 0 75,000 Woodland 0.000 0 0 Totals for 2012: General Property 1.000 75,000 0 75,000 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch M Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 r • Wisconsin Department of Commerce SOIL EVALUATION REPORT Page Division of Safety and Buildings In accordance with Comm 85, "a. Adm. Code Courtly I ST. C 1 ! Attach complete site plan on paper not less than 8 112 x 11 Inches In size. Plan must include, but not firrl(ed to vertical and horizontal referent n f('•~~ Parcel I.D. i percent slope, scale or dimensions, north arrow. and local nand ~rdad. N 1 + Ravi ad by Oats Please print all lnformati n. P*nonar mrotTnauon you provide may be used for secondary p+H ass (PIX61rrw, I• I 2. 9 0( i( Property Owner Property Location -2,1, 2-0- ! C0MTWEMTAL OE ~LC%PMEM Q0 P, ST.CR TSW 1/43x% 1/4 S T LSf N R -l- W 1 . -7 nhlL~ Property Owner's Meiling Address Subd. Name CSM# 11900 R EKB sT. E gu1TE I OD Ii1 S _ TROD( U I L AGE ion AD P3 City State ZJ0 Code Phone Number ❑ City ❑ Village ~R Town Nearest Road + oV LlNOS1RV Rid lAINE 55449 (743) 7,67 -75(.2: GPD ! New Construction User Residential / Number of bedrooms ~f Code derived design now rate Co 00 i ❑ Replacement Pubic or commercial - Describe: _ Parent material uAIM t t+~gIAt_ Flood Blain elevation i(epplicabie tt' + n1 L~.r• General comments and recommendations: Cp13vF.nr ~lor\1f11~ TN-~VLO WJD TICFNCkkES t b.7 1,0A1)iNG Y}}1E C1 Boring I !l~ Boring # in. i ~ 01. ~ . Depth to limiting factor _ Spit licauon Rate ' 1 ' • 1 ~ Pit Ground surface elev. _ft Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roofs GPD& in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Etf#t Eft#2 -5 0 K241 _ L 3F r As 3vE- 0.5 { p.8 { Z -13 ►o KZ 1 - af--mab as{, at zv~-~ 5 o.Y 3 i - sit Zf=rnab dh cs z3 r - o 1014e tf-M Y).S CA I.z 4 5 51K 15 asbK d s C5 'If-M 0. -7 F ' 5 35-4 R - s 5 1► -+M 0.7 . z_ ► z ovRyl s d l cs 6•~ I• Z- 7 102-1141 !o t2A, 5 d 1 - J o I.Z t4oR~2" y **s i5 o Cg., HotclZCru 5 AS G logs Zx-, NORt2.43Ai w ms 30-:W 0a 40 fdoeizr ~ B 11 Boring lOV1o Boring # Pit Ground surface elev. n. Depth to Writing factor in. 14S G • , Sul • Icalion Rate Horizon Depth Dominant Col Redox Description `ezture Structure Consistence Boundary Roots o GPO/tf n. MunseU Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eli#1 Ert#2 j 341 .S o.$ it) -4 iLZ4 r t d-5 1 _m c.b L - 0.i •5 10 4e-241 3 10-04 10`1K31 - , F-~nab d as 2-4 a.~ i , 44 4 -z.5 to vr. -3- 1 zf-m abK Al, C S z - 0.5 0. r 5 zs-33 7.5 `AC3 15 W\ 5b d 5 CS lvf-M 0.7 I.7 I E 3-i5 V~3f1 S Q cla 1 CS - 0.1 1-Z 55-78 o y-514 - s Ott d 1 cS 0. I. Z (am) - Effluent 91 = BOO > 30 220 mg/L and TSS >30 < i 50 rngA. Effluent #2 . BOD < 30 rrg/L and TSS 130 mg/L + CST Name (Please Print) Ignature n CST Number 41ndAt s6.,, MARV Z0 HOWL GME Address Date Evaluation Conducted Telephone Number L4 2.6 -1 '17.5 I 51022 0~- 30-03 Ll IS W IoQO AVE V E FL, F A LLS W 87 9 5 r i i v i a- ' t ~toT 1~Iq> I Property Owner ON71N&I~J'fAL OFlJF1C,PME Parcel 10 # Page of i CC/LP. ❑ - { Boring # Boring 1 CcoNS1 Pit Ground surface elev. _ Q Depth to limiting factor > 10 _ in. l ll Soil ication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence I Boundary Roots GPD/ff i in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'EH#1 Eff#2 ; I -OK to - S d( - 0.7 l'Z• n S 5-zo r, I. Core. K-0 s 1 ~R. zo 7 µ 35 z C i s o ~1a ` I f 149 Boring # Boring f W► Pit Ground surface elev. ft Depth to limiting factor 10~ _ in. Soil Application Rate Horizon Depth Dominant Color Redox Description texture F Structure Consistence Boundary Roots GPOIfP t in. Munsell ()U. Sz. Cont. Color Gr. Sz. Sh. Eff#1 Eft#2 ? i t U-7 IOVR~z - L_ _ g 17 f-eo .S p. i L Zf LobK s ai 0•$ i 1 i 3 11-30 inxit Zf-►M OK Ilk s z - 0.5 o•st 1 -a5- IUC--M 30-5L 16 Ilk 3/ - 5 ©S Al 5 - oy25/ p i f Al It. Z ~5 - r r 5 35 (oQ. !to ~c e_ 0 S c 0 o c gjw Baring a 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 GPO/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'l:ff#1 'EfW r L ' Effluent #1 = Boo, > 30:< 220 mgIL and TSS >30 < 150 mg/L ' Effluent #2 = BODE < 30 mg/L and TSS < 30 mg/L 'ncc 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. Se04330411.6Ml ti i ;i FLO-r PLAN Py T. MliA -50L 00" W/ PAaj a FtMAL GR.ADt sLEVAT10N -902- L oY 148 ti See . w B 1488 B 148A ELEV. qCD - i ELEV. jq%-7 ,y w B149A B 149B ELEV. 597.4 ELEV. 'rte cAn v 1- Iq-o y f . X1.01' ~~AN PROPEm OWNeR; L~GcN~: 410 1 D S ,T A, PE591PIOW! jqT I'd T K~V Ni i u 3M- 0 The I -r . k m DE ;K s , CKpiY co u L:TV . oo e ups t 0 Pro o~D ' o Td u S i -501L (OQNG W/ f3ACr4a NO COMM 83 5ETAr-K PFOPLEM5 The site+as aded atier soil evaluations ~,rrc annplctcd (scc page ilh final ~a n.) SvS crn Ciev ations should not be uffccCiev.bt t depth bclo\c grade "ill need to be determined based on the amount of cut or fill. B,A4 clc\ations should have rcnuuncd constant. i Lc-r 148 o \ B148B B 148A E 9 901.3 ELEV.- 901.0 O \ / 8149A ELEV. 900.8 / cP _ ELEV. 896.08 51699 C5t 0 ~J Z4 LA ~d 3Z i 36 1,310 5.1=. LOWER i ~ ~ ~ 'r~/~I I•n IL~~ GIAII~u z ROOM FUTURE---. fV - ~ I FINISH I REGE55ED CEILING, FLOOR TRU55E5. 10'x12'-- BAR I - - - - - - - - - - - - - J I G.T. SLR. COPPER GLG. 3 FST la'-10" (4)12x6 5UD5, N I ~ ) x36 x T GONG. FAD. la'-a" I -J TONEFIREP E r- i OOR T© 0E11 1 G. 2x6 L 5 MICRO LA 2x6 -2x 2_j 1 6 BEAM 14 ,L - - - D (4) 2x6 5TUD5, W/ L J REF. N 3611x36"x1211 GONG, 14 WINE HwR -r~- FAD. co GLLAR lIINEN O oo N YV/ I=AGE - - - UP -Li o I1R. m -10," 121-10" T- O L 2x6. A FF ry 0-10 ol~ 1 W.H. FURN. o LL 0 :z I J FLU5H MICRO-LAM, BEAM IOO'-0" T.O. FOUND. Li 4 T.O. Vi 1011-01 FOUND. 2 1 A3.0 A3.0 A3.1 2'-2" b'-5" 2'-a" 9'-6" 2'-2" b'-5" a'• 0 7124 z 10 D z D u N kin- (D N ~z D ~m r i i ~ c ul -70 _ a X > n D rn w I 5,-0„ 2xb c ? - UPPER CAB_ - - - ? -0" FOLDING COUNTER t- < c N o 1 :2n Q, ~I Z r - h 0 rF= o- O I\ , 2xb t 48" f~. I \ - - - I ! I e'er""------ - I I I - - - CA > LINEN I ~ rn ! -i I I z A Fri I W I f rtl I ~ 1