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014-1024-60-100
Wisconsin,Department of Comrnerce PRIVATE SEWAGE SYSTEM fety anuf Building Division INSPECTION REPORT GENERAL INFORRtIATION (ATTACH TO PERMIT) Personal informati:ir.-you prow de may be used for secondary purposes IPrivacv Law, s.15.04 (1)(m)l. Permit Holder's Name: City Village X Township Everts, Jered Forest, Town of CST BM Elev: Insp. BM Elev: BM Description: /oc~ (~jIM '$" t C.5"r TANK INFORMATION TYPE MANUFACTURER ~ w CAPACITY Septic Dosing ' Go~~ ~ P~ s ~ so Q°raLon ~: t'+bLu. PO ~ 6 ~. S Z Holding TANK SETBACK INFORMATION TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Septic / 7 ioa / ~ X60 / 3 9 ~ 3g Dosing / 7 /~ ~ 7too 3y ~ ~~ ~ ~_ Aeration Holding PUMP/SIPHON INFORMATION ,_ t Manufacturer ~ ~ Demand a ~ ~ GPM Model Number r ' ~ Z~'1 , (~(,~ TDH Lif Friction Loss System Head TDH Ft %b.~l ~ f~.st~ Z7, a Forcemain Length / Dia. /~ Dist. to Well / SOIL ABSORPTION SYSTEM ELEVATION DATA county St. Croix Sanitary Permit No: 499226 0 State Plan ID No: Parcel Tax o: -. ~Qz~- Section/Town/Range/Map No: 11.31.15. STATION BS HI FS ELEV. Benchmark 3.6 (fl3 . b / ~ Alt. BM /Z• 35 sa . ~S Bldg. Sewer t ~ . rj ~5~ 5 SUHt Inlet St/Ht Outlet ~ ~ Dtlnlet ` `• Dt Bottom Z1.7~j ~~~ ~~ Header/Man. 3.3~/ 9 9. (r(P Dist. Pipe 3.3~{ 5r• L~ Bot. System 'r y , ~y Final Grade • 3 ~ /~ , (oho St Cov~ ~ rz~35 s 9d't G C6,~~-oar 5.5 ~7. S b BEDITRENCH Width i Length ~ No. Of Tre hes PIT DIMENSIONS No. Of Pits Inside Dia. Liquid Depth DIMENSIONS s ~~ (~e~ ~,// ~ ~ SETBACK SYSTEM TO P/L BLDG WELL LAKE/STREAM LEACHING Manufacturer: INFORMATION CHAMBER OR ~ Type Of em: /6L / ~ I ~ ~~ / , (~ /I/ UNIT Model Number: avw DISTRIBUTION SYSTEM ~o~kJ Header/Manifold y / Distribution / (Z I / f / I Pi e(s) x Hole Size ~ ~ ~ ~ x Hole Spacing / ~ Vent,tp Air Intake ~ 3~ Z p ~~ 3~ ` Z ~ 3~ ~ Go ---~ Length Dia Length Dia Spacing ~ SOIL COVER x Pressure Svstems Only xx Mound Or At-Grade Svstems Only Depth Over Bed/Trench Center / , ~ / _~ ~(/ Depth Over Bed/Trench Edges \ xx Depth of Topsoil xx Seeded/Sodded Yes IVo xx MulcPied es No COMMENTS: (Include code discrepencies, persons present, etc.) Inspection #1: /~ / t / ark Inspection #2: / / Location: Unknown (N~1~/,4~NpW 1~ 11 T31N R15W) NA Lot G~p,~. ~a~ ~arcel No: 11.31.15. 1.) Alt BM Description = ~" /I 1.•~~'~'L- ~~"u• w~ ~-• (Ibl~ O~` ~J• 2.) Bldg sewer length = 3 `~ ~-. o ~5 o r - amount of cover = ~ ) Plan revision Required? s Yes No ' ~ I ~~ Use other side for additional information. Date SBD-6710 (R.3/97) /, s ~,~ __ ~~3~ ~S Cen.No „ ,,, Safety and Buildings Division 241 W. Washington Ave., P.O. Box 71(12 County ~ : t"~ I s~~nsl~ Madison, WI 53747 - 7162 Sanitary Permit Nutnher rrn he eu~rt in by Co.) DepartrYlent of Commerce (~8)2tib-3151 ~,~ I ~)~ Sanitar Permit A li ti State Plan I.D. Number y pp ca In accord with Comm 83.21, Wis. Adm. Code, personal information vide / 3 31O / 3 = T2RilJS , //J~ may be used far secondary purposes Privacy Law, sl roject Address (if different than mailing address) J I I. Application Information -Please Print ll Inf r . ZZ 73 '~ ~~ Property Owner's1N~a t~~ C~ O C~ 2 3 Pare b Lot tt Block k ~' ~ - ~ rs ~ 3~- o ~ . Property Owner's M ailing Address ST. R~ Pr rty Location Cy ~ Y. ~ - .-a ~ .~ ///~ ~ l1Lc~=ti S ti ~l City, State ip Code Phone Number , . , ec on / ~ 1 ~.eL/ 5'yps' circle o ~ ~ ,~ ~ ~ ~ IL Type of Building (check all that apply) ~ E o , T >>~l N; R l ~ ^ 1 or 2 Fattiily Dwelling -Number of Bedrooms ~ 5 ^ Public/Commercial -Describe Use ` ____ s , ' me '"E~"~ ?j~.Q Q~ll1, ~11~,f1X _ _ ` ~ ~'~ I T __ _ ___ ^ State Owned -Describe Use ~ ~_ --~ '^Ciry~^Village ~fownship of~~g~' III. Type of Permit: (Check only one box on line A. Complete line B if applicable) _ 'T ____ A. ~,1Vew System ~ I ^ Replacement System -- _._.-_____ ^ TreatmentlHolding Tank Replacement Only Tu Other Modification to Existing System ~ i $ • _ _ __ ^ Permit Renewal ^ Perrnit Revision ^ Change of ^ Permit Transfer to Now ~ Lt•4t PreviQUS Permit Number and Date Issued II Before Expiration Plumber Owner ~ 1V. " tt ~r r T of POWTS System: (Check all that appl )T Q g~ ~ = ,Q . ___ _ f ^ Non -Pressurized In-Ground _ s ,Mound < ?.4 in, of suitable soil ^ At-Grade ^ Single Pass Sand Filter ^ Constructed Wetland ^ Pressurized In-Ground 1 Holding'1'ank ^ Peat Filter Aerobic Treatment Unit ^ Recirculating Sand Filter ^ Recirculating Synthetic Media Filter ^ Leaching Chamber ^ Drip Line ^ Gravel-less Pipe n Other {explain) ~ ____ -~ ~ V. Die rsal/Treatment Area Information: - _ _ Design Flow (gpd} ;Design Soil Application Rate(_gp,,dnsf) Dispersal Area Required (sf} Dispersal Area Proposed (st) yytem Elevation i °4 S ~ ~• ~ C~ ~ d ~ S°D ~ _ ~ 1 _ ~~ VL Tank Info Capacity in Total + Number Manufacturer Prefab Site Steel Fiber Plas[ic Gallons Gallons of Units ~'~ () ~_e_ ~L~ S- Goncreto Constructed Gtass New Existin w C ~ ~ ~ ~ g . E t ~ Tanks Tanks , A M,~ ~ Sep[ic or Holding Tank • ~ ~ ~ ~// Zr s~ ~ c CC ( C Aerobic Treatment Unit - - -~ Dosing Chamber / ~~ GC _ ~_~s ~.~ --~- i I VII. Responsibility Statement- I, ttt~ undersigned, asstmte responsibility for installation of the PO'WT5 shown on the attached plans. Pl b ' N ' um er s a me (Print} Plumber s Si gnature MP, PRS Number Business Phone Number Pl ' b um er s Addre ss (Saeet, City, State, Zip Cade} / i VIII. Count /De artment Ilse Onl Approved ^ ~ ved Sanitary Permit Fee (i •ludes Groundwater-~ riTDate Issued Issuing ent Signatu ;No Srampsl ^ O _ 'ven Reason r Denial Surcharge Fee) SSo-- V IX, Conditions ppro r /R _ -- ~ o~~ -- SYSTEM OW ER: 3~ ~~^•t~S 1~. ~ ~ Jeg;cQ0..~-Ce 0-v~ 1 Septic tank, effluent filter and ~~ ~ _ o n dispersal cell must all be serviced /maintained ~ 1 ~ I ~~"~ ~-~Q, ao C.PX i as per management plan provided by plumber. ~ S ~~ ~ l~,.Q„ n ~~,~, rh ~ '~j 2. All setback requirements must be maintained ""'~ tK as per applicable code/gr~linances. (_~,,,Q X41 ~Y'~ ;~„ ,~,- ,~~ ,~ _ „~ -•..--•.` . .. I Attach complete plans (to the County ody) for the system on paper not less than 8112 x 11 'srtches in size SRT~-fi~AR tR nt m~~ -i~~ 1 /. ,/e. ~ So,% a f/a/u4t~c/NP: E Scale : / '~• s/D' T i/ad Edei`fslorq°•, Awyynw~; sec. //, T..3 //l. Q /scJ., T . o{~-a,-e3E; S+6 • C/'o,,c Co' ., cJ/.,PaJ. '~ o/~-/osi~ ~o-GAD ?~;.4crts Pa/. (~-used we !/ ~ • wcP/Deo/r. so CeR,b,~a.~:or, of S.>. c~ f 7ep o{' wCll/,(Xt~ o{' 3 L atlydom ~ /fir ha.,d pa.,ho•,gssu.,,cc/ekd.`=loxJ•c0' GSidenCL .,P ,. 4 ~/'soK• voP~~• h T~` e (/ ~~o/Z c fallow ~. /a„d Proposed elrive,wa~/ wooded/Brushy ¢..ree~ne /GYo ~~ ~'; c /d /a,u ~` ~ ~Sc~• s/0 RdC_ .~e Id la r+c ~olctela~/l. ~ dF Cor/! ~'t/d \ ~ ~\ i~Su./ cd a Corn .~.'t/d \ cod c ~ F ~t /d /a.+e ~ Pro(,wst.d ~o~cr.daf~.SSSx!//zS' \ e , ~ W S ~XQO ' oC: SptlSa/Cc /% 7'..,~o (z,~ ~ ~yn\J /a~/a./S of /,~. x ~B..Sr'uy ~ • \ ~~ ~ `~ ors ~'GtS 1~Oa cl d s~ 2• S.3 ~~ ~ \ \ ~~ ~ ~ c ~ a \ ~~ ~ ~ ~9 \ ~~ ~ ~ \ \ ~~ ~~ ~~ ~1 \ ~~ ~ \a / \ ~ ~ ~ ~? ~ ~\ ~ ~9 ~ ~ ~ ~S \~~ \ ~ ° ~ `~`~ ~ ~' \ ~ g~.o' ' ~ 47.0' 1 9B. o' ~• 80~ 9 cow 7 1 . s commerce.wi.gov ^ isconsin department of Commerce Safety and Buildings 4003 N KINNEY COULEE RD LA CROSSE WI 54601-1831 TDD #: (608) 264-8777 www. co m m e rce. wi. g ov/s b/ www.wisconsin.gov Jim Doyle, Governor Mary P. Burke, Secretary October 16, 2006 CUST ID No. 227990 WILLIAM C SCHUMAKER SCHUMAKER PLUMBING 1070 SCOTT RD HUDSON WI 54016 CONDITIONAL APPROVAL PLAN APPROVAL EXPIRES: 10/16/2008 ATTN: POWTS Inspector ZONING OFFICE ST CROIX COUNTY SPIA 1101 CARMICHAEL RD HUDSON WI 54016 Identification Numbers Transaction ID No. 1331013 SITE: Site ID No. 719453 Jarrod Everts Please refer to both identification numbers, County Road P above, in all corres ondence with the aaenc Town of Forest St Croix County NW1/4, NW1/4, S11, T31N, R15W FOR: Description: Mound /Three Bedroom /Sloping Site Object Type: POWTS Component Manual Regulated Object ID No.: 1102569 Maintenance required; 450 GPD Flow rate; 18 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 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, stats. The following conditions shall be met during construction or installation and prior to occupancy or use Reminders • This system is to be constructed and located in accordance with the enclosed approved plans and with the component manuals listed above. • Per manual cited above, limited activities are allowed in the area 15 feet down slope of the component area. Soil compaction, excavation, vehicular traffic and other similar activities that impact the treatment and dispersal are prohibited. C.~i 1'II~PtI ~~ ~e~ D I'ARTMENT `~/IDI~I! OF FTE <"'~~' SEE CORRE: • 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 be made with the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stat • Comm 83.22(7) A copy of the approved plans specifications and this letter shall be on site durine construction and open to inspection by authorized representatives of the Department which may include local inspectors WILLIAM C SCHUMAKER Page 2 10/16/2006 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 maybe 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, Charles L Bratz POWTS Reviewer II ,Integrated Services (608)789-7893 , 7:45 am - 4:30 pm Monday -Friday charlie.bratz@wisconsin. gov cc: Leroy G Jansky, Wastewater Specialist, (715) 726-2544 Fee Required $ 175.00 Fee Received $ 175.00 Balance Due $ 0.00 WiSMART code: 7633 9Fc MOUND AND PRESSURE DISTRIBUTION COMPONENT N .l ~ O Residential Application ~p6 INDEX AND TITLE PAGE 4a~/ ~ ~~~~~ Project Name: Jarrod Everts 3-bedroom residential mound s Owner's Name: Jarrod Everts Owner's Address: 451 14th Ave. Baldwin, WI 54002 Site Address: XXX Co. Hwy. P ' Legal Description: NW1/4NW1/4, Sec.11, T.31N., R.15W. Township: Forest County: St. Croix Subdivision Name: Lot Number: Block Number: Parcel I.D. Number: 014-1024-60-000 Plan Transaction No.: Page 1 Index and title Page 2 Data entry Page 3 Mound drawings ~~?,~/'y Page 4 Lateral and dose tank ~~ ~ ~^. . `,<' Page 5 System maintenance specifications ,~~~ Page 6 Management and contingency plan r cor~;~~RC~ Page 7 Pump curve and specifications iHOs Page 8 Site Plan l ,~ Page 9 Soil Evaluation Report 'PONQENCE Designer: Bill Schumaker License Number: 227990 Date: 10/04/06 Phone Number: 715-386-3121 Signature: ~~,/~~~~~^ Designed Pursuant to the Mound Component Manual for POWTS Version 2.0 SDB-10691-P (N. 01/01), and SSWMP Publication 9.6 Design of Pressure Distribution Networks for ST-SAS (01/81) Version 3.0 (03/01/01) Page 1 of 9 Mound and Pressure Distribution Component Design Design Worksheet Site Information _. (r or c) R Residential or Commercial Design 300.00 i Estimated Wastewater Flow (gpd) 1.501 Peaking Factor (e.g. 1.5 = 150%) 450.00 Design Flow (gpd) 10.00 Site Slope (%) ___,, 97.50! Contour Line Elevation (ft) 18.00 Depth to Limiting Factor (in) 0.60' In-situ Soil Application Rate (gpolftz) Distribution Cell Information i 90.00' Dispersal Cell Length Along Contour (ft) _ 1.00; Dispersal Cell Design Loading Rate (gpd/ftz) ~! 1' Influent Wastewater Quality (1 or 2) Pressure Disribution Information (core) e! Center or End Manifold 2.50 Lateral Spacing (ft) 2 Number of Laterals 0.125 j Orifice Diameter (in) (e.g. 0.25) 2.50; Estimated Orifice Spacing (ft) _ _ ; 2.00! Forcemain Diameter (in) ~' 170.00, Forcemain Length (ft) 76.501 Pump Tank Elevation (ft) 7i~ ~ 6.50 System Head (ft) x 1.3 / 22.00 Vertical Lift (ft) 3.23 Friction Loss (ft) ~~ ~ 31.73 Total Dynamic Head (ft) Lateral Diameter Selection in. dia. o tions choice 0.75 1.00 1.25 1.50 x x 2.00 x 3.00 x Note: Sand fill (D) calculations assume a Table 83-44-3 in-situ soil treatment for fecal coliform of <= 36 inches. 5.00 Cell Width (ft) Are the laterals the highest point in the distribution Y network? Enter Y or N If N above, enter the elevation (ft) of the highest point. 6.25 ftZ/orifice Does the forcemain drain back? Y Enter Y or N 27.73 Forcemain Drainback (gal) 81.25 5x Void Volume (gal) 108.98 Minimum Dose Volume (gal) 29.66 System Demand (gpm) Manifold Diameter Selection in. dia. o tions choice 1.25 x 1.50 x x 2.00 - ___ _ _ ,. 3.00 Gallonsllnch Calculator (optional) __ .__ Treatment Tank Information 646.00! Total Tank Capacity (gal) 1000.00' Septic Tank Capacity (gal) 38 00' Total Working Liquid Depth (in) '.Wieser Concrete Manufacturer 17 00 gal/in (enter result in cell B49) Dose Tank Information 646.00' Dose Tank Capacity (gal) 17.00! Dose Tank Volume (gal/in) Wieser Concrete Manufacturer Project: Jarrod Everts 3-bedroom residential mound Effluent Filter Information __ PolyLok Filter Manufacturer PL-525 Filter Model Number Page 2 of 9 Mound Plan View I 1_ 1 /10 B • . ' Observation Pipe :~' K ,.5,. ~~Qr~': "~~""~`r~r~'~'~:~'r • .°. :I. 'B' -T _+~ -I _l Mound Component Dimensions A 5.00 ft E 24.00 in H 1.00 ft K 10.63 ft B 90.00 ft F 9.50 in z 14.11 ft L 111.25 ft D 18.00 in G 0.50 ft J 6.44 ft W 25.55 ft 450.00 (ftz} Dispersal Cell Area 1719.64 (ft2) Basal Area Available 5.00 (gpd/ft) Linear Loading Rate 9.00 (ft) 1/10 B Obs. Pipe Placement Mound Cross Section View Aggregate Dispersal Area Finished Grade 100.79 (ft) ~ ,.rir .. G ~ H rrrrfrirrnrriifrrr... ~ .rrririr rirrr r r rirrrirri~~. . atera ~ I F , . ; ::: ~ ai ceii 99.50 (ft) L I Dispers -~ 99.00 (ft)-- - ~ : ~ Invert Dispersal Cell : 3~ ; ~ ~p ~ ~ ~ ~ ~ Elevation E . ~. _, r. • • ~, ~:• ~.•!. {•i._J. i i ]~ ,t _.{ ,i i. ~. a.•.~ J { J. J, i a { ~] ~]~) i i ]~ ~." .: ,~,ti 4 ,~ t ;i ,{ ~%` 7 }. { { ~ ~`~. ] i ] ~{ ~4~ { ~] ] ~ .i { j, ~, i i v ]: % ~{ _~] ]` j, i ~ ,{ }1 ,),~ :{. ~ `1,.: i.: ~, {..{.: t. l.. ~• ~, t 1 -• ~ ~ ~ ~ 97.50 (ft) Contour Elevation 10.0 % Site Slope Geotextile Fabric Cover Shading Key '~ o. ~ Dispersal Cell See lateral details on 1^ _ Topsoil Cap c °~ 1.5 ft .: ;; ~ ~ Page 4 for number, 'r'r• Subsoil Cap ~ ~ ,5,?~ ~''~'~f~~~ ~ ~ ~~~ ~~ size, and spacing of ©~ :°Q :' ASTM C33 Sand ~ Z ~ '•t• ~'•='~ ~'•`•'•~:~ :~. F laterals. Laterals are Till d L yer 'TypicalLaterai r:•:' G y p ® ~-;~.;• ;~' e a ~ ~ 0.5 ft _ .~. e uall s aced from ~5 ~ Aggregate ~+ o ~ .t~.l~~ ~, the distribution cell's *---- A * centerline in the distribution cell (Ax6). Project: Jarrod Everts 3-bedroom residential mound Page 3 of 9 End Connection Lateral Layout Diagram Laterals centered over the E P All laterals are identical ~(- }~ -~ I Holes drilled on the bottom of the lateral I equally spaced S Force main connection uia tee or cross to manifold at any point. Laterals & force main of PVC Sch 40 (per COMM Table 84.30-5j 3" Bedd Alarm Manuafacturer LevelArm Alarm Model Number DLV tan Pump Manufacturer Goulds Pump Model Number 3885 WE05HH Pump Must Deliver 29.66 gpm at 31.73 ft TDH Number of Laterals 2 Orifice Diameter Lateral Diameter 1.50 in Orifice Spacing (X) Lateral Length (P) 88.55 ft Orifices per Lateral Lateral Spacing (S) 2.50 ft Orifice Density Lateral Flow Rate 14.83 gpm Manifold Length System Flow Rate 29.66 gpm Manifold Diameter Total Dynamic Head 31.73 ft Forcemain Velocity Dose Tank Information Electrical as per NEC 300 and -- Comm 16.28 WAC Disconnect ~- •a Turn-uprN'ballvalveorcleanoutplug Tank component is properly vented Wieser Concrete Ca acit 646.00 Volume 17.00 Manufacturer Gallons gal/inch A B C D Dimension Inches Gallons A 17.75 301.70 B 2.00 34.00 C D Total 6.50 11.75 38.00 110.55 199.75 646.00 Project: Jarrod Everts 3-bedroom residential mound 0.125 in 2.53 ft 36 6.25 ftz/orifice 2.50 ft 1.50 in 3.03 ft/sec Locking cover with warning label and locking device and sealed watertight 4 in. min. E- Alternate outlet location Forcemain diameter ~ 2 in. Weep hole or anti- siphon device Pump off elevation (ft) 77.48 Do, se tank elevation (ft) 76.50 Page 4 of 9 Mound System Maintenance and Oaeration Specifications Service Provider's Name Bill Schumaker Phone 715-386-3721 POWTS Regulator's Name St. Croix County Zoning Phone 715-386-4680 System Ftow and Load Parameters Design Flow -Peak 450 gpd Maximum Influent Particle Size 1/8 in Estimated Flow -Average 300 gpd Maximum BOD5 220 mg/L Septic Tank Capacity 1000 gal Maximum TSS 150 mg/L Soil Absorption Component Size 450 ftz Maximum FOG 30 mg/L Type of Wastewater Domestic Maximum Fecal Coliform >10E4 cfu/100 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 ct 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 M,~terials Standards 1. Observation pipes are slotted and materials conform to Table Comm 84.30-1, have a watertight cap, and are secured in as shown in the mound component manual. 2. Dispersal cell aggregate conforms to Comm 84.30 (6)(i), Wis. Adm. Code. 3. All gravity and pressure piping materials conform to the requirements in Comm 84, Wis. Adm. Code. 4. Tillage of the basal area is accomplished with a mold board or chisel plow. 5. The mound structure and other disturbed areas will be seeded and mulched to prevent soil erosion and help reduce frost penetration. Lateral Turn-up Detail Finished ~~~~~~~~... .. ............... Grade ~~ 6-8" Diameter Lawn ~ . . Threaded Cleanout Sprinkler Valve Box ~ ~ Plug or Ball Valve Distribution Lateral - -Long Sweep 90 or Two 45 Degree Bends Same Diameter as Lateral Project: Jarrod Everts 3-bedroom residential mound Page 5 of 9 Mound System Management Plan Pursuant to Comm 83.54, Wis. Adm. Code General This system shall be operated in accordance with Comm 82-84 Wis. Adm. Code, and shall mairrtained in accordance with its' component manuals [SBD-10691-P (N.01/01) and SSWMP Publication 9.6 (01/81)] and bcal or state rules pertaining to system maintenance and maintenance reporting. No one should ever enter a septic or pump tank since dangerous gases maybe 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 end covers should be inspected for water tightness and soundness. Access openings used for service and assessment shall be sealed watertight upon the completion of service. Any opening deemed unsound, defective, or subject to failure must be replaced. Exposed access openings greater than 8-inches In diameter shall be secured by an effective locking device to prevent accidental or unauthorized entry into a tank or component. Septic Tank The septic tank shall be maintained by an individual cert~ed to service septic tanks under s. 281.48, Stats. The contents of the septic tank shall be disposed of in accordance with NR 113, Wis. Adm. Code. The operating condition of the septic tank and outlet fitter shall t>e assessed at least once every 3 years by inspection. The outlet fitter shat) be cleaned as necessary to ensure proper operation. The fitter cartridge should not be removed unless provisions are made to retain solids in the tank that may slough off the fitter when removed from its enclosure. If the filter is equipped wfth an alarm, the filter shaft be serviced 'rf 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. PUmD Tank The pump (dosing) tank shalt 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 Pres$~{re 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 muk:hed 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 wtthin the mound and snow compaction in the winter will promote frost penetration. Cold weather installations (October-February) dictate that the mound be heavily mulG~ed 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 BODg, 30 mg/L TSS, 10 mg/L FOG, and 10° cful100 mL for highly treated effluent. Influent flow may not exceed maximum design flow speGfied 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 tie flushed of accumulated solids at least once every 18 months. When a pressure test is pertonned it should be compared to the initial test when the system was installed to determine if orifice Dogging has occurred and if orifice Leaning Is required to maintain equal distribution within the dispersal calf. Observation pipes within the dispersal cell shall be cheGced 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. ntinngncv 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 condttion. If the dosing tank, pump, pump controls, alarm or related wiring becomes defective the defective component(s) shalt 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 arearf toe leakage occurs or by removing biologically Dogged a~orption and dispersal media, and related piping, and replaGng said components as deemed necessary to bring the system into proper operating condition. See Page 6 of this plan for the name and telephone number of your local POWTS regulator and service provider. Project: Jarrod Everts 3-bedroom residential mound Page 6 of 9 ~GOULDS PUMPS ^ Shaft: Corrosion-resistant , stainless steel. Threaded design. Locknut on three phase models to guard against component damage on accidental reverse rotation. ^ Fasteners: 300 series stainless steel. ^ Capable of running dry without damage to components. ^ Designed for continuous operation when fully submerged. APPLICATIONS Specifically designed for the following uses: • Homes • Farms • Trailer courts • Motels • Schools • Hospitals • Industry • Effluent systems SPECIFICATIONS Pump • Solids handling capabilities: i." maximum. • Discharge size: 2" NPT. • Capacities: up to 140 GPM. • Total heads: up to 128 feet TDH. • Temperature: 104=F (40 ~C) continuous 140'F (60 )C) intermittent. • See order numbers on reverse side for specific HP, voltage, phase and RPM's available. FEATURES ^ Impeller: Cast iron, semi- open, non-clog with pump-out vanes for mechanical seal protection. Balanced for smooth operation. Silicon bronze impeller available as an option. ^ Casing: Cast iron volute type T for maximum efficiency. 2'' NPT discharge. ^ Mechanical Seal: SILICON CARBIDE VS. SILICON CARBIDE sealing faces. Stainless steel metal parts, BUNA-N elastomers. m3!hr MOTORS ^ Fully submerged in high- gradeturbine oil for lubrication and efficient heat transfer. ^ Class B insulation. METERS FEET 40r 130 VVE1 SHH 120r 35r 110' WE20H 30F 100! ,....__ ~ 90WE1$H 251r = 80' E1pH a zo ~'r 70' EO7H > 60', _ ~ WE05 i 5 r 50 O EOSH 40 Submersible Effluent Pump 3885 PROSURANCE AVAILABLE FOR RESIDENTIAL APPLICATIONS. Single phase: • Built-in overload with automatic reset. • All single phase models feature capacitor start motors for maximum starting torque. •'/a and''/z HP- 16/3 STTOW with 115, 208 and 230 Volt three prong plug. •'/4-2 HP - 14/3 STOW with bare leads. Three phase: • Overload protection must be provided in starter unit. •'/z-2 HP- 14/4 STOW with bare leads. ^ Designed for Continuous Operation: Pump ratings are within the motor manufacturers recommended working limits, can be operated continuously without damage when fully submerged. ^ Bearings: Upper and lower heavy duty ball bearing construction. ^ Power Cable: Severe duty rated, oil and water resistant. Epoxy seal on motor end provides secondary moisture barrier in case of outer jacket damage and to prevent oil wicking. Standard cord is 20. Optional lengths are available. ^ 0-ring: Assures positive sealing against contaminants and oil leakage. AGENCY LISTINGS S ~ Tested to UL 778 and CSA 22.2 108 Standards ey Canadian Standards C US Association file #LR38549 Goulds Pumps is ISO 9001 Registered. i :SERIES: 3885 . ;. 1 __.. .. __r ;_ -- I ~ 'SIZE: ~%t SOLIDS ' r----~-~ RPM 3500 $ ;. ; .. i -.i I. ' _,1750, -- 5 GPM I . i I I \~. _ _ .,. 5 ,,, _ . _ _... _. _ 20WE03L ~_ ~ , I 10 ~ _. i_ - - .. ,..- _ i o_ o ._ i_..........,. _.: .__; . ._ 0 10 20 0 40 50 60 70 80 90 100 110 120 130 140 150 160 GPM C 5 ~ 10 15 20 25 30 35 CAPACITY 29~G~.~.~f. y~~n~il+u.y, s~yo/yr~ /'cp«,-~~d~oulds Pumps 2002 ~a~lds PUrr,PS C' / ITT Industries ~rfective October, 2002 www goulds com C3~S85 5, ~o~ 9 • so,/ g~/a/uct~ioy~P: 6 Sca./e : / '~ ~D' T ~~od Eves p-q°•, ~, wyyn wyy Sec. //, T. 3/it. Q isw.,Tn. o{~-o,•e3E S~ • CrOir ~.~ cJi,~P`/. '~ oil ios~ ~o-osv ?pt~4cr'csPc./. I ca. may. "P' Fj-oPo~sed we 11 Tp o{' wcll/,/~u~ a{' Ti't e ~-rede 3 y a,cf ~eom s~'s~• yoP~c_ b a;/ol•'n~ sc weI' F~p~std c.~;cW Co„crc~ C~'/Uen~,4'/~/a.E' o~~-t of S.T. fallow f~. /aid Propes.ed Cori ue.way /GYo ~ __~ ~'~ c /d /a ne Co~'i- ~'c /d l ~\ 1 /e~/.n~ (~ °~a S/oj02 wooded/B~u.s~y fir„e ~ 2 'sue . s/o Od c. .~ e id la nc ~ ~o~ccMa:n. ~ b? `\ i~tu/ c a P Corn ~:'c/d code ~'~' ~c /d /a..+e \ /'er+a%itS in use. \ (~~opostd n'lo«.+daf zSSSx N/zs' ~ yn~ uYS'xQo'ol;sptrsa/cc~/. Y',,,~o C~ \ ~ ~` /avria/sat /mil' ~.Sr'ryr ~. 1 ~ ,~ ors ~'G~.S 1~Oa cc d sLC 2.5.3,' i~ ~ 1 1~ \ ~ \; ~ 3 ~~ \ \9 \ \ \ ~~ \\ ~ ~~ ~ s \ \ \ \\\~~ \ \ `\~~ ~ J \ ~\ \ ~ ~` \ \9 `` ,~ ~ \ ~S ~~ \ \° ~ ~ \ ~ ~ \ t ; ~ \ \ q~.o' ~ 47.0' 1 9B. o' ~ _ 80~' 9 Corr~o~.c~ 10/0L/06 MON 09:21 F~A~ 715 386 4686 • - ~ ~~' ~~r.Frv~n _ ~ ~~Q/~ Wlscorrs#n pepartment of Commerce 11l 41i ~ ~ 2.~4~01 ~VA~J PORT Division of Safety and Buildings ; ~/L +~ Page ~ ~ ~ooi s1. tsa, rns. Hom. wce~ G rn, Att h l i l ~lt~ll~ i Plan rTtrut ize an on per no comp ete s te p ac . n s indtsde, but not IimRed to: ve o onlal reference point (BM), direction and per( (,p, /~ O ~ y dyd percent elope, scale or dimensions, north arrow, and location and dictanoe to nearest road. - ~Q [~ Please pr/ni all information. Reviewed Date Personal Infomrstion provide may be used for secondary purposes (Privacy Lew, s. 15.W {1) (m)). Property Ov~mer ` • Property L ' I , _ /r 1 j~ ~ J %W 114 4 S f T r N R~ E Govt. Lot Property 's 'li g A Lot # Bbck # Stbd. Name or CSM# / State ode Phone umber City / ~ © ^ Clry~ [] Village Tv~nn ; Nearest Road / , I ~~ ' C ~i~. [ y C 7 L ~ New Construction User Residential / Number of bedrooms Code derived deskdrl lbw rate ~, }-?~ GPD ~ Replacement ^ Pubtlc or comrnerdai - a cribs; ___-_ -..---.- Parent material r ,/ p n If appligble ~!/Y ~ ~ ft. ~_ Hood Plain elevatio re~e da ons: /~' ~ 5..~ hr ~-- j A~p C6N-G.~r ~ I, ~a ~ ( ~~ # ~ boring ^ Pit Ground surface elev. ~ /Z ft Depth to limiting factor ~" in, Soil ication Rene Horimn Depth Dominant Cobr Redox Description Texture Sbuc6me Consistence Boundary Rools in. Munsetl Qu. Sz. Cont. Cobr Gr. Sz. Sh. 'Eff#1 'E~ o-a ~b ~~ ,~ -~ -$ ~/~ ~ s~- Boring # Boring ^ Plt Ground surface elev. ~~. Depth to Ilmitlng favor ~ in. Sob ~~ Ram Horizon Depth Daninant Color Redox Description Texture . SWcture Consistence Boundary Roots GP Dflt= kt, Munsetl Qu, Sz. Cont. Color Gr. Sz. Sh. •Eft'#1 'Etf#2 ~ y~ a ~ '~ f ~/ ~ Efftuertt #1 = BOD > 30 < 220 mglL and TSS >30 ~ 150 mg1L ` EflkAerq iF1 i l~uu = su ngrL saw r ~~ ~ ~u rrtgrL CST Name (Pie 'nt) ttae ~ ~~ a.,..._., date Evreluatlon C clad Telephtxre Number ~ ~~ ~~~ 10/02/06 MON 09:22 FAX .715 386 4686 C~j 003 PrvpeRy Owner ~ t `~ ~ ~ r C,- ~ Parcel ID # ~ Page of 1 2 I ggvrg # ®- BoFfng n,.,.....~ e. _s.,,.,, .~,.. ~~ ~ /~ ._.. ... .___ _.- - - ...oM....,..~..~..~~, ~•,.,..~ R.~~ ~~~, Soil icatlon Rate Fh~iizgFi' 'bepih ' Dpminant Color ~ i'iedvx Description Texture Sliuchue Consistence boundary Roots GP D/FF in. MunseN Qu: Sz. Cont. Color Car. Sz. Sh. •EftYi1 'Eff#2 j - o ~ ~--~----' ~r , rot ,G - ~ • $ ~` ~ r~ - S ~ ~ ~ v~~ f~ ^ Plt Ground surface elev. ft. Depth to limiting factor ~ :lrx~'. SoN ~~ Rate Horizon Depth Dominant Cobr Redox Description Texture Strucdxe Consistence Boundary Roots GP D/fF tn. MunseN Chu. Sz Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 ~~ # ^ Borng ^ Plt Ground surface elev. ft. Depth to limiting factor in. Sop ion Rate Horizon Depth Dominant Col Redox Description. Texture Stricture Consistence .Boundary Roots GP D/f~ in. MunseN Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 ' Eflluertt #1 = BOD, > 30 < 220 rng/1. and TSS >30 < 150 mgJL ' Emuent #2 = BOD, <_ 30 mglL and TSS < 30 mg~L The Department of Commerce is an equal opportunity service provider and etnployer. 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. sao.e3sa rr~t 10/OZ/06 MON 09;22 FAX 715 386 4686 ' . ~. [~ 002 Soil Test Plot Plan Project dame Micheal Cress Byron Bird Jr. Address 2007 280th st Emerald Wi. 54012 _ ~~_~ CS #220527 Lot Subdivision Date 8f3/2Q05 CountyST. CROIX NW y /4 NW f /4811 T 31 N/R~ ~ W Township For®st [~ Boring ~ Well PL Property Line# Alt. BM ,BM or VRP Assume Elevat{on 1Q4 ft.top of Welt System IIv H.R.P. Same as BM SCALE 1" = 40 ` Unless other wise Noted Pro Taller 125' Driveway Co R. P > than 300' to PL ~, Well SM 45' CO ~O tank 2 , 25' > 300' to PI 100' 75' i5' of Elevation \ 1 between force Main and1~ Bottom of dose tank Bl 125' B3 96' B2 97' 170' 10' 98' pL Wisconsih Department of Commerce G1! f ~ ~' ''" <n~~01 EVAL PORT Page ~ of Divigion of Safety and Buildings ~~. u~~~~~i vui~ i~ ou, vr~a r~ui~~. ~,vaa:i l• ~ County G r Attach complete site plan on f~per not'-J ~Ifllgn F in size. Plan must ~ ~ f ~ include, but not limited to: vertR~ a d~iorizontal reference point (BM), direction and percent scope, scale or dimensions. north arrow, and location and distance to nearest road. Parcel LD. /- ~ ~ y- ~Q C~~`d Please print all information. Reviewed Date Personal information u provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). ~ ~ Q Property Owner Property Lo~~iion' j'~ ~O 5 Govt. Lot /'!O(~/ 1 /4 /4 S l T 3~ N R~ E P~pe~ er's ili g Addr ~ Lot # Block # Subd. N~ a or CSM# ~ ~C/!~a ~ oy.,, Z City ~/ / State 'p Code Phone Number '` a ~ ' ^ Cihr~ ^ Village Town, ..Nearest Road ulG ~ ~ ~ l.S 4 r~ ~ New Construction User Residential / Number of bedrooms _ Code derived design flow rate G~~~ GPD ^ Replacement ^ Public or commercial - Dfe tribe: __ __ _ ___ _ _ ~ Parent material ~~~~ _ ~ ~ ~,~ / ~i~ ~Flood Plain elevation if applicable ~~ ~ ft. General cornrrter>ts ~ ~ S ~ ~ and recommendations: a r ~--- b/~ dJ t' f 8'I ~~ ' CL5 Boring # ®Boring ^ pit Ground surface elev. ~ /Z ft. Depth to limiting factor ~ in. Soil lication Rate Haizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/fP in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 'Eff#2 O- / ~ R6 ~~ -6 -~ Boring # [Boring / ^ Pit Ground surface elev. ~ ~. Depth to limiting factor ~~ in. _ . Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/fP in. Munsel l Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •Eff#2 1 " ~ y ~(9 > 2. Grp-.~--" ! 1 /~` ~7 ~ y~ ad G .~ Z ~~ r 'Effluent #1 = BOD > 30 < 220 mglL and TSS >30 < 1 50 mg/L 'Effluent #2 = BOD < 30 mglL and TSS < 30 mglL CST Name (Please " t) y~~~-7~ nature CST Ntmtber Address Date Evaluation Con clad Telephone Number '~~~ G ~~ G~r~-c_ S~ z • > ~ J Cr~.~ Property Owner /// ~ ~~ _ Parcel ID # ~ Page of Boring # [ .Boring c~ ~ ~/ ^ Pit Ground surface elev. / ~` ft. Depth to limiting factor ~ in. Soil lication hate ttorizoti' `Depth Dominant Color R$dox Description Texture Stnrcture Consistence Boundary Roots GP D/ff` in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 •Eff#2 f a ~ ~-~-~ ~r , r~ +~is - (~j " S Boring # ^ Boring ,, , ,~ ^ Pit Ground surface elev. ft. Depth to limiting factor ~ trk~. Soil lication Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GP D/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 •Eff#2 Q Boring # ~ Boring ^ Pit Ground surface elev. ff. Depth to limiting factor in. ' Soil lication Rate Horizon Depth Dominant Color Redox Description. Texture Structure Consistence .Boundary Roots GP D/ft= in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 'Effluent #1 =BODE > 30 < 220 mglL acrd TSS >30 < 150 mglL • Effluent #2 =GODS < 30 mglL and TSS < 30 mglL The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. SBP8330 (8.6/00) ~~ ~ Soil Test Plot Plan Project Name Micheal Cress Byron Bird 3r. Address 2007 280th st Emerald Wi. 54012 ,,.,, ~~~ CS #220527 Lot Subdivision Date 8/3/2005 CountyST. CROIX NW 1l4NW 1/4S11 T 31 N/R15 W Township Forest Boring Q Well PL Property Line# Alt. BM ,BM or VRP Assume Elevation i 00 ft top of Well System Elv H.R.P. Same as BM SCALE 1" = 40 ` Unless other wise Noted 'Parcel #: 014-1024-60-~5U 11/29/2005 04:35 PM PAGE 1 OF 1 Alt. Parcel #: 11.31.15.166A 014 -TOWN OF FOREST Current '~ X' ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 00 0 Tax Address: Owner(s): O =Current Owner, C =Current Co-Owner O -CRESS, BRADLEY S BRADLEY S CRESS 2257 CTY RD P CLEAR LAKE WI 54005 Districts: SC =School SP =Special Property Address(es): * =Primary Type Dist # Description SC 1127 CLEAR LAKE SP 1700 WITC Legal Description: Acres: 59.870 Plat: N/A-NOT AVAILABLE SEC 11 T31 N R15W NW NW FKA 014-1024-60 Biock/Condo Bldg: (166)NWNW&INCNIOACSWNW&N10 AC OF SE NW Tract(s): (Sec-Twn-Rng 40 1/4 160 1/4) 11-31N-15W NW NW Notes: Parcel History: Date Doc # Vol/Page Type 07/29/2004 770177 2627/87 WD 12/01 /2000 634471 1563/375 QC 12/01 /2000 634469 1563/373 PR 07/23/1997 863/110 2005 SUMMARY Bill #: Fair Market Value: Assessed with: Use Value Assessment Valuations: Last Changed: 10/19/2005 Description Class Acres Land Improve Total State Reason AGRICULTURAL G4 5.000 800 0 800 NO PRODUCTIVEFORSTLANDS G6 54.800 60,300 0 60,300 NO Totals for 2005: General Property 59.800 61,100 0 61,100 Woodland 0.000 0 0 Totals for 2004: General Property 59.870 31,300 0 31,300 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch #: Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 ,~'~~sconsin Department of Commerce SOIL EVALUATION REPORT Division of Safety and Buildings Rage _ ,f __ • in accordance with Comm 85, Wis. Adm. Code ____~. County > ttach complete site plan on paper not less than 8 1/2 x-~ p 'J"tftatresin size. Plan must - ~. C~~''0_ I ~ -_ - __ rnclude, but not limited to: vertical and horizontal r nee=point ABM) (firection and Parcel LD. percent slo e, scale or dimensions, north arrov~; aRyc'}~I ' Lion and dtst8nee.to nearest road. . ~ - ,/'~j v~ P/ease print ai/l~n#plrma#,IQI r ~a t, Reviewed by D; i~ --; Personal informalion you provide may be used fOF se~onda t~r t ~ ry p D`~~s!(briv'acy Law, ~'15~04 (1) (m}). Property Owner _ n „.~. ~ ~ 9n~ Pt'i~e~ty Location lam, /"' .~; t,, ~ Y. QOvt. dot ~1 /4 /1/t~'1 /4 S ~ T ~ N R ~~ E (orb Property Owner's Mailing A dress CJ? ~'~ ,.~o# Block # Subd. Name or CSM# ' c .,.: Ci State Zip Code P -rSe Nuh9t~er -~' t ~ ~~ ityC ~ Village ~}fiown Nearest R^ad ~.,,~ , h' ~` t/_ .-_ O/~ / '`~ r ~ fir/ G° _. _._ . -- .--- _. ___ ___ New Construe,;; "~ Residential / -umber of bedrooms _ Code derived design flow rate G.~R -- - Replacement ^ Public or commercial -Describe: Parent material ~~~ _.. ~ ~ f~~~ Flond Plain elevation if applicable rr General comments and recommendations: Boring # ~' 3°ring j f r,i, Ground surtace elev. ~ ft. Depth to limiting factor /~- in Horizon Depth i Dominant Color Redox Description Texture Structure Consistence Boundary Roots Sol! ,gpp;ication Rate i G~~%ftz ~ n. ~ - Munsell ~o ~ Qu. Sz. Cont. Color ,,Ti' - Gr. Sz. Sh. ~ ,. G •cr{#t i •Eff#2 .J ~a a s ~ ~- ~ ;~ .,~ ~- a- o~~-~~ y _ _ ~ "~ ~ s~ . _ s ~r ~s a . _~ --- .Z :. ~_~ _ i _ ® Boring # ~ Boring _ n Pit Ground surtace elev. ~Li tt no„+-, r., i„n~,,.,., a"..... // Horizon Depth i Dominant Color Redox Description Texture Structure Consistence Boundary Roots Soil Application Rate GPD!ft2 n. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 'Eff#2 B ' ' ~ ~c9 Gr-~ i >~ ~, G ~_~ '_.. O o G~ ~ r- _ ., _ _ ___ ...~.. „ , ,,,, _ ,,,, _ ,,,,, ,,,y,~ CIIIUCIII fhL = CSVUS ~ dU mg/L ano I SS < 30 mg/L CST N e (Please Prints Signature ~ /' d /7 /'~ Addres to Evaluation Conducted Telephone Number ' ~ . ,l ~~ ~ Property Owner ~/ ~ ~ Gy' ''L / 7 Parcel ID # Page ____. _ of Boring Boring # ^ Pit Ground surface elev. ~_ ft. Depth to limiting factor / ~- in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ftz in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 i -~ ^ Boring Boring # _ _ pit Ground surface elev. ft. Depth to limiting factor in. -i ~ ,,. Soi Opp uon Rate Horizon Dominant Color th De Redox Description Texture Structure Consistence Boundary Roots GPD/ft2 i p ~ Munsell in Qu. Sz. Cont. Color Gr. Sz. Sh. _Eff#1 'Eff#2 . i _.__.___. __ i i _.__j 1 i ».~ __ i i j Boring Boring # Ground surface elev. ft. Depth to limiting factor in. iJ Pit Soil Application Rate i H th De Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft2 zon or p in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Effi#1 I 'Eff#2 • Effluent #1 = BODS > 30 < 220 mg/L and TSS >30 < 150 mg/L 'Effluent #2 = BODS < 30 mg/L and TSS < 30 mg/L The Uepartmenr of Commerce is an equal opportunity service provider and employer. If you need assistance to access sere ~ acs or need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-877. SBD-8330 (R.6/00) • ~y.. ' Soil Test Plot Plan Project` Name Micheal Cress Byron Bird Jr. Address 2007 280th st d,~Yr~-'-- /~~~ Emeral Wi. 54012 CSTM #220527 Lot --- Subdivision ---- Date 9/1/Ov NW 1/4 NW 1/4S11 T 31 N/R15 W Township Forest Boring Q Well PL Property Line COUnty ST. CROIX ,BM or VRP Assume Elevation 100 ft top white stake System Elevation 93.5 H.R.P. co rd P SW PL ST. CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHII' CERTIFICATION FORM OwnerBuyer _ ~ ~~.- E: G_ Mailing Address ~ t-:~ _ 17 Praperty Address _ ~- f ~~~ ~ ~, 22' ~ - L~ {Verification required from Planning & Zoning De-partmenr for new construction.) `^~~-'~ ~.~: City/State f_ d ~ ~ : ~` t`~l .~,. Parcel Identification Number ___,~ __~ LEGAL DESCRIPTION Property Location~/~lti/ '/q , _,~,~ 1/4 ,Sec. _ ~~ , T ~N R l~ W, Town of ~~~ t ~ c Subdivision "'"` t+ ~~ C7 r l.ot# Certiitred Survey Map # __ _ ~~- ,Volume _, Page # ^- Warranty Deed # ~ 3 ~~ ~ Spec house yes '~ Volume ___~ ,Page # ~_ Lot lines identifiable yes no SYSTEM MAINTENANCE AND OWNER CERTIIF'ICATION 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 §Comtn. 83.52(1} and in Chapter t2 - St. Croix County Sanitary Ordinance. The property owner agrees to submit to St. Croix County Planning .rk Zoning Department a certification form, signed by the owner and by a master plmnber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1) the on-site wastewater disposal system is in proper operating condition ancL'or (2) after inspection and pumping (if necessary), the septic tank is less than l/3 full of sludge. I/we, the undersigned have read the above requirements and agree tv maintaixi the private sewage disposal system with the standards set forth, herein, as set by the Department of Commerce and the Department of Natural Resources, State of Wisconsin. Certification stating that your septic system has been maintained must be completed and returned to the St. Croix County Planning & Zoning Department within 30 days of the- three year expiration date. I/we certify that all statements an this form are true to the best of rnyiour knowledge. I!we anv`are the owner(sj of the property described above, by virtue of a warranty deed recorded in Register of Deeds Office. Number of bedrooms _ ~~-'? ~ y ~~, ,~~ / ~~:~IGNATURE OF APPLICANT(Sj 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. as/os) !I STATE BAR OF WISCONSIN FORM 1 - 2000 I! ~i WARRANTY DEED it Document Number i ~ This Deed, made between I ,C'e5~ - ;: ~i ~' _ _ Grantor, I' and ~~~ ~.yet"~'S ~'I, I __ ~, ~; --- ~; fa_ ,Grantee. I Grantor, for a valuable consideration, conveys to Grantee the following ' S~' ~ ~~ ~_~, County State of Wisconsin (the ' described real estate in ~' 837 1 ~3 KATHLEEN H. MAL5H REGISTER OF DEEDS ST. CROIX CO. , WI RECEIVED FOR RECORD 10/20/2006 12:50P![ NARRANTY DEED EXERT # REC FEE: 13.00 TRANS FEN: 126.80 COPY FEE: CC FEE: PAGES: 2 "Property") (if more space is needed, please attach addendum): ~~ ___ ice-- _--- - 1 ~ (°. r!-S S d t ~ ~ I I Name and Ret rn Address ~1 '~~,.~ Y d Sere £ver~s 't'h.~ We y 35 ,A.cres ms- ~o.rce.1 ~-014-1oay-~o-oSc~ ~~r'ed ~/e!'tS ~-o ~~e..~ b s ~ ~ d ~ n~ 1~ e~Y`n ;'r .. L a~n,~~ w : \1 b~- Su c-ve~~ z Z `~ S $r1 n ~ y s ~ J~e ~ n . down ~-a ~d Aeres ib5'Q x S'J.$ ~, ~r^~K l/x Syf15.~ L. whe rt and SF -- -1~~.. G tti.v~ ~-~.~ 3' ire d ~~r1-~ I-' -//-/ - - ~e.-v a c- S*z \ 1 S }~a ~ S4. Ne.. 1~S os~~`e.<.~\ '40 ~-~ r ~~~Y~~~2~~ ~J' .- 05~ -. _ ~~,~~ n ~ ~ Parcel Identification Number (PIN) oj 1 S 1qc c ~S ~ c.k, '~ 1~ncZ G tti.~'s v T gjti ~, + e.~/ ~S ~ ~,~ This ] S ~(Zc~'~' homestead property. ( ~~- p!'ic~,1 ~,\ ~-e~1 shy _ (is) (is not) Woa,lcl b Q 5'So ~= t Sr»~ ~ 3'o No ~'-j~ t;;,.r~c~l 35 ~ '~'. '~(b+r-~ Together with all appurtenant rights, title and interests. w-e5~, r o rC:~.Si~ Grantor warrants that the title to the Property is good, indefeasible in fee simple and free and clear of encumbrances except Personally ame before me this a0 day of „?!~fS r 00 ,the above named . y -s ,f TITLE: MEMBER STATE BAR OF WISC~S;~~t;• - ~, t (If not, ~ " ' ' ' t ~. to me known to be the person who executed the foregoing authorized by §706.06, Wis. Stats.~ ul ~ r 4. instrument and acknowledge the sam . j THIS INSTR//U~MENT WAS DR~ED By~ .' r~. , ~ ! ~~~ c' * ^ Notary Public, State of Wisconsin/ i My commi Sion is permanent. (If not, state expiration date: (Signatures may be authenticated or acknowledged. Both are not necessary.) ~,~;5 f ~h ) -- • Natnes of persons signing in any capacity must be typed or printed txlow their signature. I o~~RANTY DEED STATE BAR OF WISCONSIN Wisconsin Legal frank Co., inc. FORM No. 1 - 2000 Mawaukee, Wis. Qated this day of Q~~. ~~ __ C eJt_~A (SEAL) (SEAL) " * ~r~~l \ 21 i C' C2S S ~ (SEAL) (SEAL) ~ * * I` AUTHENTICATION ACKNOWLEDGMENT Signature(s) State of Wisconsin, ~../ ss. authenticated this `z D day of OG d ~ c r , ~ ..7 / ~ ~,1'`~ j)( Coun~ i~, ~. r 4. ~ ter r ~,.r~¢,e.. 5~~~ ~ v e.c~ h e,, s o_~~c~ ~G~ ckrd- ~~s,.~-~oe~~ f~~l~~ e~~.~ s ~o vs~ ~ ~~ W e.s -~' ~ S ~ ~\ ~ ~ 1S ~~~~ o~ ~ 2of2 .+ J _... 2 U 2 / 1 ~ U 1 STATE BAR OF WISCONSIN FORM 1 - 1998 WARRANTY DEED Document Number This Deed, made between ~ I CJ~CtL' ( ~ r~ S.S Grantor. and ~C,-C{ ).o i i ~ _ !_'_4P~S Grantee. Grantor, for a valuable consideration, conveys to Grantee the following described real estate in S~ , C ~'4 t aC County, State of Wisconsin (the "Property"): r \ '~ Qi~-tOa~(-(ot~c>,c~ o~ Parcel Identification Number (PIN) Q 1N.1 V o~~(7 j~~p This homestead property (ls) (is not) ~~ j ~i,~~i~-t,~~5f ~u~~~er o~ -~-~e Nct~}-~ wes~ ~~.a~Trr ~Nu% i/y ~rN~~ i/~!)~~i ~l!~ 11~Or~. 1 a QC !'~S 4~- Thf 5DU-~-~Wt's~` QuI,K~•TCd' ~ ~1u2 1VOtr~1w't5~u(tiuir~4/ ~Su7 ~Ju7 ~%y) c~v~c~ ~ N dr~-h !0 rents a-f ~~2 Se~.~~ ~itS~Qaa~•~er' ~~ Il~o~~~ku~~s~{{ Quay ~'CS~ 1/y n1 tt1 ~~'-I Q t h 5 c i l l ~auw/~ 5~~ 3 ~ ' t.~ ~esi4', ~j f ( e -~- p r1 ~ ~ ) ~~ ~h;r Rgn~t 15 Together with all appurtenant rights, title and interests. Grantor warrants that the title to the Property is good, indefeasible in fee simple and free and clear of encumbrances except Dated this !JS 1 day of 3..~) v `~ex?y /~~ ~~ (SEAL) ~ ~ (SEAL) '! (SEAL) (SEAL) ,' . A THE TI IO 7 Signature (s) authenticated this i~C 1 / ~7 day of ~ lil /V `~1 : . `TITLE: MEMBER STATE BAR OF WISCONSIN (If not, authorized by §706.06, Wls. Stats.) 770 1 77 KATHLEEx H. MALSx REGISTER OF DEEDS ST. CROIX CO. , MI RECEIVED FOR RECORD 87/29/2004 11:45Ali MARRABTY DEED EXElPT # RfiC Ffifi : 1l . N TRAxs Ffifi: 93.98 COPY FEE: CC Ffifi s PAGfiS : 1 Ftr~ a!n^ A•ea Name and Return Address $rc..~c~.1 ~c~ C~'e~ ",~as-~ c-~y Rai P ;; ~'G~e~-r Lcr.h~e. wS SwaU~ _ __ _ ACKNOWLEDGMENT State of Wisconsin, SS. . ~~~ COUrlty ,_. ,Pens ally came before me this c~~_ day of ~~ ~ , ~C~_, the above named ~ me known to be the person who executed the foregoing instrument and acknowledge the same. Notary Public, State of Wisconsin My commission is permanent. (If not, st a expiration date: ',! (Signatures may be authenticated or acknowledged. Both are not ~ - ,) necessary.) L ' __ - _ __- ~ - _ __ `Names of persons signing In any capacity must be typed or printed below their signature. ~~}><• - ~~ STATE BAR OF WISCONSIN ~Q o~l`~~Co.. inc. WARRANTY DEED FORM No. 1 - 1998 ~, yy;s. THIS INSTR MENT DRAFTED BY Parcel #: 014-1024-60-100 02/06/2007 02:53 PM PAGE10F1 Alt. Parcel #: 11.31.15.166A-10 014 -TOWN OF FOREST Current i X' ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type 10/20/2006 00 0 Tax Address: Owner(s): O =Current Owner, C =Current Co-owner ED D JERED D EVERTS ~ -FRANK AMY AMY FRANK 451 14TH AVE BALDWIN WI 54002 Districts: SC =School SP =Special Property Address(es): * =Primary Type Dist # Description SC 1127 CLEAR LAKE SP 1700 WITC Legal Description: Acres: 35.000 Plat: N/A-NOT AVAILABLE SEC 11 T31 N R15W NW NW & PT SW NW THEW 3 CR Block/Condo Bldg: 5 A ES Tract(s): (Sec-Twn-Rng 401/4 1601/4) 11-31N-15W NW NW Notes: Parcel History: Date Doc # Vol/Page Type 12/01 /2006 839879 QC 10/20/2006 837103 WD 07/29/2004 770177 2627/87 WD 12/01 /2000 634471 1563/375 C~C mo ... 9f1(17 SI IMM~RY Bill #: Fair Market Value: Assessed with: Valuations: Description Class Acres 0 Land Improve Totals for 2007: General Property 0.000 Woodland 0.000 Lottery Credit: Claim Count: 0 Certification Date: Batch #: 0 0 0 Last Changed: 11/15/2006 Total State Reason 0 0 Specials: User Special Code Category Amount Special Assessments Special Charges Delinquent Charges Total 0.00 0.00 0.00 C1w ~ ;ten ~ 3 d ~ ~1 ~ ~ sn ~1. • I ~ ~ i a ~ ~ ~~ I ~ ~ ~ , ~ ~ ~ n I ~ o I ? d ~ m~ o ° m m ~ ~ 5. ~ ~ , ~ is ~ ~ I j c ' I a ~ y ~ ~ ~' ON1 m ~ _. O M "'I ~ N ° ° . o. ~O c n I O o ~ e o I m3 ' ° a ~) °~ ~ gH, w w I ~ t I o ~ ~ z i ' ~ v I (n Z D ,~ a a m ~ D ~' a ~ I c c ~" ~' a I 3 ~ ~ ~ j c ~ ~ ~ N N O O ~ ~ O O ~ ~ ~ ~ I N w I ~ ~ Q 3 ~ i o N ~ O O O v! r ~r I ~ c ~ (/~ VJ Ul ~ v twii i ~ I ' m ~ ~ ~ ~' ~ O ~ ~p ' y N ~ ~ ~ I z 3 D D I O O ~ o ~ ~' m ~ N ~• I m ~' ~ ~ j M~ `~ ~i ~ ~ I w m d ~ ? I ~ ~ ~ p ~ ~ M i C A Z ~ ~ ~ Q I . ~ . A ~ ~ N i .. W ~ C w ~ < J a ~ ~ z $ ~ ~ I z °1 3 I , ~ ~ a z w f ~' I o~ Q ~ i ~ I ~ o ~ I ' I a m_ m ~ ~ Z y o a i I 3 ~ I 3 I m ~ A I a ! ~, I ~ fi A ~ I N I ~ i i N ° I ~ ~ o v I o ~ b o I m ~ I ~ ~ ti ~ ~ ~ o I '" `^ °o i i ~+ ti