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HomeMy WebLinkAbout040-1303-00-028 Wisconsin Department of Commerce PRIVATE SEWAGE SYSTEM Safety and Building Division County: St. Croix INSPECTION REPORT Sanitary Permit No: GENERAL INFORMATION (ATTACH TO PERMIT) 563805 0 Personal information you provide may be used for secondary purposes [Privacy Law, s.15.04 (1)(m)]. State Plan ID No: Permit Holder's Name: City Village X Township Parcel Tax No: Oeverin Homes LLC, aka Oeverin Pro ertie Tro Town of CST BM Elev: Insp. BM Elev: BM Descripti 040'1303-00-028 U , Section/Town/Range/Map No: TANK INFORMATION 22.28.19.1763 OANUFA CTURER ,v ELEVATION DATA CAPACITY STATION BS HI FS ELEV. rv Gc7 & Benchmark Alt. B Z.C? q- / 7 Bld ew r Y 30 t' 76-S . St/Ht Inlet (TANK SETBACK INFORMATION St/Ht Outlet 4140 TANK TO P/L WELL BLDG. Vent to Air Intake ROAD Dt Inlet Septic ~ 7 A4-. Dt Bottom Dosing J 7,3 947,3 ,t e Aeration I~ Z`f' l.~j~j ✓~t~, Dis~e Holding ~p spy. ZS Bot. System bV_-, f,z,, 2/35 2.3 3. S~ PUMP IPHON INFORMATION Final Grade acturer b ~b5 Demand St Cover c`.u„ GPM Model Number /~,b TDH Lift Friction Loss System Head TDH i'~G v Z v U 11JC cU.~ Forcemain Length / Dia. i/ Dist. to Well , / ~ ~ ~ 2. SOIL ABSORPTION SYSTEM BED /TRENCH Width n S j Length No. Of Trenches DIMENSIONS IF PIT DIMENSIONS No. Of Pit=` Inside ~ Liquid Depth SETBACK SYSTEM TO P/L BLDG WE ` INFORMATION ` }0T_ LAKE REAM L CHIN Manufacturer: \ Type Of ystem: C OR t d r 54 ( Model Number: DISTRI UT N SYSTEM 7 / Head /M nifold Distribution 01 ~r Pipe( s) S / x ole Size x Hole Spacing Vent to nt Length Dia Length ~ Dia_ Spacing 01( SOIL -ae~a COVER X Pressure Systems only xx mound or At-Grade Systems Only ~f BoulTrench Center Depth Over xx Depth of xx Seeded/S dde 7 Bed/Trench er Edges Topsoil ' f_%1 xx Mul ed Y~ s No Yes 0 No COMMENTS: (Include code discrepencies, persons present, etc. Inspection #1: Inspection #2: 4_1 3b115 Location: 250 Walnut Hill Way River Falls, Wi (SE 1/4 SE 1/4 22 T28N R1 9W) Walnut Hill Farm aka The Tribute Lot 28 Parcel No: 22-28.19.1763 1.) Alt BM Description = r'.~ G$ ~QJ~, / 2.) Bldg sewer length = 2-q " - amount of cover = 'j #e_~ Pla n revision Required? ~ Yes No Use other side for additional informati n. SBD-6710 (R.3/97) Date Insepctors L ,y Cert. No. PLOT PLAN PROJECT Oeverina Homes ADDRESS 1433 Cernohous Ave Suite A New Richmond Wi 54017 SE 1/4 SE 1/4S 22 /T 28 N/R 19 W TOWN Troy COUNTY ST. CROIX SYSTEM ELEVATION 103.6' 1.6' sand Lift! BEDROOM 3 CONVENTIONAL AT-GRADE CONVENTIONAL LIFT HOLDING TANK MOUND XXX SEPTIC TANK SIZE 1000 gallons DOSE TANK SIZE 630 HOLDING TANK SIZE LOAD RATE 1 .0 ABSORPTION AREA 456 # of chambers none BENCHMARK V.R.P. Top of survey iron ASSUME ELEVATION 100' ❑ BOREHOLE O WELL *H.R.P. Same as benchmark Pro Town Road Scale = 1/411 = 10 1 Akre Lot WeiI is to meet alI WDNR setbacks Pro 3 Grading is to be done to divert Bedroom run-off away from system Ho use H uffc utt Co m bo Ta n k D' Tank is to be properly bed and provided with Iockdown covers h G~ 7q B-3 To South GIQ~roved warning labels ~ Area 15' below m o - system is to remain z ~ 6 undisturbed B_2 3% Slope B-1 (S 4v~e S~ ~ ° ~ 101' A rpr B. f~a fio 1 1?s~ i f I%P,0_ County - ' Industry Services Division _ L r*" yt 1400 E Washington Ave anitary permit Number (to be filled in by Co.) S P 1 I P.O. Box 7162 t0 S f ~ Madison, WI 53707-7162 J 0-N 411, rr"~' - tate Trans Number anitary Permit Application s -,AdfferJt ~ In accordance with SPS 383.21("2.), Wis. Adm. Code, submission of this form to the appropriate governmenal~t i[ is required prior to obtaining a stnitary permit. Nofe: Application forms for state-owned POWTS are submittE,fr Prnjec dress (if than~~^ ss) the Department of Safety and Professional Servies. Personal information you provide may be used for secondaty, OGti 250 purposes in accordance with the Privacy Law, s. 15.04(I)(m), Stats. _ I WTf~ 1. Application Information.- Please Print AI! Inf rma ' - Parcel 9 - Property Owneer'ssOName O q 6 - Zw n t,/C f7 l n - Property Location Property Owner's Mailing Add ss Govt. Lot Zip Code Phone Number C' State ~ircle on !j L / T N; R~-Eo W Lot M II. Type of Building {checlt all that apply} 7211 ~ Subdivision Name r~}}'' 1or2Family Dwelling-Number ofBedroom ~'t~ G~b~L-~ 6 K ~1.o y y~_ Block ❑ Public/Commercial - Describe Use ❑ City CSN1 Number - ❑ Village of - ❑ State owned - Describe Use - / - Town oP Ill. Type of Permit: (X-heck only one box on line A. Complete line l3 if applicable) - - ❑ Treatment/Holding Tank Replacement Only ❑ Other Modification to Existing System (explain) A. W System Replacement System Li' evious Permit Number and Date issued ' / ❑ Plu mber [I Pennit'1'ransfer to New B. ❑ PerPermit Revision Change o Owner 7E Befor i~.. _ iV. T e of POWTS System/Component(Device: (Check all that apply) - ❑ Non-Pressurized In-Ground ❑ Pressurized In-Ground ❑ At-Grade ❑ Mound > 24 in. of suitable soil and = 24 in of suitable soil Pretreannent Device(explain)__---- ❑ Holding Tank 11 Ot er Crispersal Component (explain) V. Dis ersal(Creat ent Area Information: Dis c sal Area Propose[ System Eleva[ion -s Design Flow (gpd) Desigr Soil Applicatio (g dsf) Dis ersal Area Requ (s 1 p el \ _7 17 e Tote ll of Manufacturer C o VII. Tank Info apacity to 23 Gallons Gallons Units U s ExistinbTunks / / 0. U yr u C7 Newl'ank / Septic or Holding Tank &yo Dosing Chamber - J attached plans. Responsibility Statement- t, the undersigned, assum parsibility tar installation of the PO'NTS shown on the MP/MPRS Number Business Phone Number Plumber' Name (Print) Plumber' nature - _ r Plumber's Address (Street, City, State, Zip Code) z-- l Z-D Vilt. Co nt /De artment: Use Only Permit FeeDate Jsued Issu.ng A t Signature proved t pp b 625; -416 (/Z~ Ow en Reason for al - - - e~ ~p IX, Conditi~. ,wkwasons for Disapproval 3 ~ ~0:1 +dlfw_. et/e~ r ~ n ( we tank, eflkM* f RK rand : /V) a: •~ft n L Q_ C ;tfSpersall cell must a% ¢e r n~al l.+J tl per rmanagwant plan pirmided by plurrtber• L_ All ate6iiiiiak reqt*wvWft must be triiiiiintak*d 1~ ~ ~ ~Or► ~ / ~_.J~~~ - !'d L-C f►ttach to complete plans for the system and submit to the County only un paper not less than 8 trz x i t inches m s~# J'A SBD-6398 (R0313) DIVISION OF INDUSTRY SERVICES ' o~la~rnx141 NW BARSTOW ST FL 4TH WAUKESHA WI 53188-3789 D Contact Through Relay 3 K www.dsps.wi.gov/sb/ a w www.wisconsin.gov ossroNr~1~~ Scott Walker, Governor Dave Ross, Secretary June 14, 2013 CUST ID No. 226900 ATTN: PO WTS Inspector SHAUN R BIRD ZONING OFFICE BIRD PLUMBING INC ST CROIX COUNTY SPIA 1432 120TH ST 1101 CARMICHAEL RD NEW RICHMOND WI 54017 HUDSON WI 54016 CONDITIONAL APPROVAL Identification Numbers PLAN APPROVAL EXPIRES: 0611412015 Transaction ID No. 2257411 Site ID No. 791671 SITE: Please refer to both identification numbers, Oevering Homes above. in ,III correspondence with the Walnut Hill Farm Lot 28 agency. Town of Troy St Croix County SE1/4, SE1/4, S22, T28N, R19W Lot: 28, Subdivision: Walnut Hill Farm FOR: Description: Mound, 3 bedroom Object Type: POWTS Component Manual Regulated Object ID No.: 1432632 Maintenance required; 450 GPD Flow rate; 17 in Soil minimum depth to limiting factor from original grade; System(s): Mound Component Manual - Ver. 2.0, SBD -10691-P (N.01/01, R. 10/12), Pressure Distribution Component Manual - Ver. 2.0, SBD-10706-P (N.01/01, R. 10/12); Effluent Filter The submittal described above has been reviewed for conformance with applicable Wisconsin Administrative Codes and Wisconsin Statutes. The submittal has been CONDITIONALLY APPROVED. This system is to be constructed and located in accordance with the enclosed approved plans and with any component manual(s) referenced above. The owner, as defined in chapter 101.01(10), Wisconsin Statutes, is responsible for compliance with all code requirements. No person may engage in or work at plumbing in the state unless licensed to do so by the Department per s. 145.06, stats. The following conditions shall be met during construction or installation and prior to occupancy or use: C This system is to be constructed and located in accordance with the enclosed approved p~. e " 01) Component Manual for Private Onsrte Wastewater Systems VERSION 2.0" SBD-10691 -P "Pressure Distribution Component Manual for Private Onsite Wastewater Treatment Systems SBD-10706-P (N.01/01). The building sewer and distribution network piping shall be of material listed i 4. Q=3 and 384.30-5, Wis. Adm. Code. C) y In the event this soil absorption system or any of its component parts malfunctions so as to cr~l~Mte a health hazard, the property owner must follow the contingency plan as described in the approved plans. In addition, the owner must comply with the operation, maintenance and monitoring duties as described in section VIII of the mound component manual. A copy of this information must be given to the owner upon completion of the project. All holding/treatment tanks are to comply with SPS 384.25(7)(a). SHAUN R BIRD Page 2 6/14/2013 Maintenance information must be given to the owner of the tank explaining that periodic cleaning of the filter is required. Access to the filter for cleaning must be provided per SPS 384 product approval conditions. A Sanitary Permit must be obtained from the county where this project is located in accordance with the requirements of Sec. 145.135 and 145.19, Wis. Stats. Inspection of the private sewage system installation is required. Arrangements for inspection shall be made with the designated county official in accordance with the provisions of Sec. 145.20(2)(d), Wis. Stats. Owner Responsibilities: • SPS 383.52 Responsibilities. The owner of a POWTS shall be responsible for ensuring that the operation and maintenance of the POWTS occurs in accordance with this chapter and the approved management plan under s. SPS 383.54(1). • SPS 383.52(2) A POWTS that is not maintained in accordance with the approved management plan or as required under s. SPS 383.54(4) shall be considered a human health hazard. • SPS 383.55 The owner is responsible for submitting a maintenance verification report acceptable to the county for maintenance tracking purposes. Reports shall be submitted at intervals appropriate for the component(s) utilized in the POWTS. A copy of the approved plans, specifications and this letter shall be on-site during construction and open to inspection by authorized representatives of the Department, which may include local inspectors. All permits required by the state or the local municipality shall be obtained prior to commencement of construction/installation/operation. In granting this approval the Division of Industry Services reserves the right to require changes or additions should conditions arise making them necessary for code compliance. As per state stats 101.12(2), nothing in this review shall relieve the designer of the responsibility for designing a safe building, structure, or component. Inquiries concerning this correspondence may be made to me at the telephone number listed below, or at the address on this letterhead. The above left addressee shall provide a copy of this letter and the POWTS management plan to the owner and any others who are responsible for the installation, operation or maintenance of the POWTS. Sinc Fee Required $ 250.00 This Amount Will Be Invoiced. When You Receive That Invoice, Julia Lewis-Osborne Please Include a Copy With Your POWTS Reviewer 2 , Integrated Services Pavment Submittal. (262) 397-6005, Fax: (608) 283-7481 WiSMART code: 7633 julia.lewis@wisconsin. gov Note: Effective January 1, 2012, all codes under the jurisdiction of the Division of Industry Services (formerly Safety & Buildings) will be modified. Code references with prefixes starting with "Comm" have been replaced with "SPS" to recognize the relocation of the Division of Industry Services from the former Department of Commerce to the Department of Safety & Professional Services. Additionally, all IS (formerly S&B) codes have been renumbered and addressed in a "300" series. For future reference, the Wisconsin Commercial Building Code will be addressed by SPS Chapters 360-366. , RECEIVED Cover Page MAY 2 9 2013 INDUSTRY SERVICES Shaun Bird Bird Plumbing Inc. 1432 120th St. New Richmond Wi 54017 715-246-4516 Date: 5/ 25/13 Owner: Oevering Homes Location:SE1/4 SE1/4 S22 T28 N,R19 W Lot 28 Walnut Hill Farm Troy System type: Mound System Manuals Used: Mound Component Manual Version 2.0 (01/31) Pressure Distribution Manual Version 2.0 (01/31) Page# 1. Cover Page 2. Mound Plot Plan 3. Mound Cross Section 4. Pipe Cross Section/Pipe Layout 5. Pump Chamber Cross Section 6. Pump Curve 7-8. M//aintance and Contigency plan 9 Soil test v Filter Specifications cross section I /X Shaun Bird Signature SSA q License number 900 Lac O Fs X020 ~cF s PLOT PLAN PROJECT Oeverina Homes ADDRESS 1433 Cernohous Ave Suite A New Richmond Wi 54017 SE 1/4 SE 1/4S 22 /T 28 N/R 19 W TOWN Troy COUNTY ST. CROIX SYSTEM ELEVATION 103.6' 1.6' sand Lift! BEDROOM 3 CONVENTIONAL AT-GRADE CONVENTIONAL LIFT HOLDING TANK MOUND XXX SEPTIC TANK SIZE 1000 gallons DOSE TANK SIZE 630 HOLDING TANK SIZE LOAD RATE 1 .0 ABSORPTION AREA 456 # of chambers none BENCHMARK V.R.P. Top of survey iron ASSUME ELEVATION 100' ❑ BOREHOLE O WELL -H.R.P. Same as benchmark Pro Town Road Scale = 1/4" = 10' 1 Acre Lot Well is to meet all WDNR setbacks Pro 3 Grading is to be done to divert Bedroom run-off away/ from system House Huffcutt Combo Tank Tank is to be properly bedded and provided with lockdown covers with B-3 To South GlovWroved warning labels 102' Area IS' below system is to remain undisturbed B-2 3% Slope B-1 0 101' B.M. Mound Systa m 'gross Section ',).uid Plan View Dimnensiopt 14'ect a l ► ' _ A _ p M i3 N i ti "r':L'd'L4iL",~ .'i,'s fti4 {L~$Lr-''"'`r-r-. ...j-r-~_{- rLry rL{ .SLr r rrL1Lfi3~'Skr'•'r i;~:; :':.rA.rL?^'{3fLF`{.S r r r r r r+:Lr•rL.LfL ri ~ rnr ~ fLitiL L p _..I_: r L• '-1.f.f. i •L { {'rhf{ L '~{{f{•L.{fL`L•{riY •r1 11:1f{ ti Liq 1 t{{•Vt L _r N L ;{{{t{:• f•r f ' ' ' •L 5:1:1.{{. ~{4 h{{{{{{{1K{\{1{{{{ Li'iy{+4'~{:1{{:1{{:{':{K{{{{}4i1{1iLr{:L{{iY'L{5~{i{i'~fa•}~... r4l1fVL Y . . . _ I M•rM• a M r•r r f•r r r r f r f f 1 .f } f f p t L{ti 4:L•L•4.L:{{'t%{n'~•'1:1.{{{ii{M1•'L.L•1+i:'L:1•'L•L.'Nti.{.{.'~'•{•'Nti.{{'•.{i.1.{{5i1{h{L L Y L 1 V {r;.r{t':ie " N i p K EQ, z. Slope- - LIT- 40 rl'opsoil AST H G 33 C".le,ao aggregate 4 in. sch. 40 pvc rrrrL N Cap Material sand it. % to % in. diva. observation ii1ac 1 , Geolext.rle' tp l N rLr{r LrLrLrLrLr•f•r•f• Fabric r r r f r : ' JL.F+i 1.•i\'. f0.{{{Lf , . - ._X-4i ~ t. I ~~{{3 KKJJ A rL! ~ I l~ Z~i r l `1~L.-. \ r 1 ~ rsr f ~r))[owed Sur,ice a OZ- 0 Ft C:oratoua` 8 > ~~_La.. ~7 ssii ~ zf dope Directuca-a CRENERAL INTALLATIOi~ Tfic mound area is staked oast along, thc: de°sigra contour. I xist.ing vcgeta.tion is rnowed and raked off the site. The mound basal area (1:, x W) is plowed with a moldboard or chisel plow. :Flowing nmay not proceed if the soil is wet enough at [lie plow depth to form a'/4 inch soil wire when a sample is rolled between the palrl-as of the hands. ~-S'tM C-33 quality sand is placed irmxrediately aatl:er plowing„ Sand is placed with a t:r al.cked anachine keeping 12 or more inches of sand under the tracks or 1s placed overhead by a backhoe. Special care must be used wlien. pla.cinp sand of less than one loot thickness to rnirrirnice compaction of th.e plowed surface.. After tl-(c~~ topsoil ca:p is placed, the entire rraound is seeded and mulched to promote veget:a.t:.irvc growl.), liixait erasion and protect: born freezing. I'lie~ observation pipes are slotted in the lovic;r 6 inches and secured in place with rebar or a closet: flange. 10/07 lhl Page o l x , r a sal xNc, _ateral -41Y Cl U1 14 I.wo Mani-fold if1I 4- -Threaded Cleartotrt Lateral Turn-up - ► Plug Mani i)ld Long Force Mail) Sweep t)0 kmd Dish ibutioxa Netwov Spt~Aficatifou's Ilrew-twe System C oltstx• action l,atera.l Djameter° lrr. Manitald Diametc,i In. Laterals rise: c,onstrcact(A of "Schedule 40 l?VC lr , lrr. pipe. Ora t cc s are dx dic.d pe rpendic;tilar to ()r Iliac Diameter X I.1-1 pipe wir:lr a sharp drill bit: and I:acf down. 1, (l.~ttetral 1 c nlZth) Lateral Wni-cil_,s terminate with a threaded - - M (Mayirl'iild l c;rr};tl~)._- f't• _ c;(c;tirrot.tt plag and are i.ruclr>sec:1 in a. 6-13 inch force, Main Dim-never ~ ~hw diameter l,a.xn sprinkler valve box accussible t orce Mai ,r l er~f;th Crom f tlisha d gradel N N e) N N ; r.,~ti : : : ~ N N N N N i1 q!R N N N f_iradc N ~aa+~:.c~ : r 6-8 1 tcth Lawn c~ sprinkler v alve Box Page - of 03/05 lfxl i Tank Manufaesturer Pump N}sat rxtac er ~ c ~Z_ A ji -lank: Mo&1 Number O lE3'rrrrx v3~ ~ Y tYrrmlxei . I'oQ 74 mk Capacity r'd7r. 2 ~ c' Alarm MaYlutfacltuetr 7r Alarm M;3&1 Number Switch I'mt; _ i eyl ll IY iu Head ("MI-1) l emt Filter Manufacturer-~y ~ri Filter model tvTuaml car Mevafia mi HOW ID _ ~iatall?':tfuxsrr~ ~ ca Network Lett: 1Vlirrimutn 1Ptur p perfo)r cep Required 1 orm Main Loss y. `D1 Total t)udat manhole 1v im 4"" Above Grade With Manhole mitt. 4" Abow, Gmde With Locking Device, Looking Device. halet ManhOte' Secuvi i Mcutwtel 6" Below G rWe Sftled Watef tight Yli'isYli d Grade Witt iMia. li"' l.)isc(rrrrre(Jt ~lovrv~ ~':;racle7 lUyet~ns With Vent GAP 4 L 4~r~fYti'~P~~b 4,L~'eY~Y~Y 6 L >YLavY4Y~JYJ •JY J;i41 dYyi ~Y.xw YYL v 4r6J~ YY Vy4~Y YJ d 5~. - i VVUb~ Yyr y`J;Y Y4 outlet Filter' J YL ' XTAOC Raffle Inlet 't Switch SCOW Reserve ~apgrcxt~r J};4 4JY v c `r ,rank salaams - /3 ,LYY, J . -Dinwnsiesu. Tuc;hes ~lexltxrere d +l :rm _ (reserve) A' 4, 5 jovai , J 4 2. 30 rYd e+'.' - ! JydY J' .w.ei iwa°~I Yri -4 V--- Bottom Y..y ( ) 1. ,.e e~n 01 pct J _ y tl`rY y t .[,........__.~u d J' ' V J i~_tlv~i L 4 Y LdL~ Y. " 1'f .;-x-~_ _ _ . '"1 Y Y-1' G"G L-G"L - YYyrYryJyrL~•JyJLii r d Y J tl J J Y JLiv~ ~~~~~G° ytJ J J i V V irl V{ V Y d Y r YIrL JY;i~u°4rY /Y4YYfvdY LdV u L4YJb YJL bYYVYJ Yu VV 1 aG 4Vfi TGJ VLd}JiY JL<+L4~aY-rLVb"Y-~Y~6~Y~Y~L Yrj- tL di~C'Y-ti 6r'4 ia `"L'4 1"L 'G~} S L.t1:~ni+r..1"8'1'°i.6a_L.t.Y~1r }JaJ. • LY.X,Y..t...[~JL..11.C..1-.L1.2..1~Y~.3.:A J~+YdydY YVdY ~1 s v } 6y4J1 YY JYdd dLdY rbdb JG Y4dY YY~YVb dYJ6 rYfY iYdYtlO tl~V ibtl~V~~/r Y3lly }YY Y. r WT.~YS+IC. AF fJON,* Tile se,Yrtic/dose tank is Ire ddg,l 'J *(,k I:11Yeei in act tae:terre yW rrut` Y.~9t GENERAL CrtarraFxctrrre;r~ys product a~l~rdval spaci~icatiotrsY INaxcrxrium depth of br'.►,^~ ~ spectfiedl.lry the ma 'Y be exoeecYe;d without pti 4ppr,5val. Manhole e;ovem exposed tc~ tp'a& Ytave arr. etfe(;tivrer looking denim, (Irsadlock ) 1?i i at the iti t and outlet is of apl ravexl mate ietr" r✓tytrrne tftd t.0 the tack. with watertight fittings, and installed. iir I hey nrc. urain is site'ved `uvitlt V Soh 40 PVC V" to brid~c, the taerlc laid on stable sail U) pendent settling or air;9° e c;avatie7xr tl►e sleeve, isY sealed w atertight. ~,leQrical service a eyrrr lies wit,, I F,C;':It3{I aKrel ~ornrrr k 6.7,:t. Ould Page 0210) SEN-40 Serries 4/10 hp Submersible Effluent Pump, 314.r- Solids, Flow - Uters/Minutte cWiYWI stvillicti1Glrn U 5o 9091 1611 200 250 30U Govel" 35 _ ..1._._I..~. _ I«Uuxy r:c~)rttad c.r~st ir'arr iVi~ar t~ Fas#g k pc,y r K~ItHritrst ~ryl1 e,1 It) s lirlFl~ld~ ikliltelitrt ThermoplaBri9%Llastarrrl9f 25 tU ~ •Irrrk,,~li~tu ~ Opq Volute - g w l:iha,cy rrz;tted (".tst irnrl ~ l 10 ;c lVlsic;F)d191r:d1teit lVibllt, vvitlf c;tzrl,olt afrd _ 8e~1 ,:er~tntlt liacrs 0 20 t ~itf7CTl How 611110113/ Iflu¢e ~ ~1~Nia►rf~f~ta)`ac~ ~j~vt~,, )J. UCl 403- NO, - T-1 SM -40- Al Sr1vAa 5EN tf f' li082i7 AJIO! 11°f 11Y'Z" {vr'r J/92f) 8U !U tl0 X15 ~h 32 i4 2p 26h 179,11 tip 1 pit 9R ; ' d7l 'v SEN 40 AH t ]9z 91 7 7 3 4110 116 f i / I~J+fI~ t U10U 116 AN 60 915 ?6 a 2 I d 20 21 1750 92 t; U S a l~k^ l Ih.(148,1x, 1,'''1(at Franklin Mactric 400 FaSt Sprlr,cl Street, Bluffton, IN 461111 TO: 260.11*1424UU v Iiax: 26U.824.2909 Form: 996,199 7.11 vvww.frailkllrr'©lvctrie.eum PO r S OVINFRIS MANUAL & MANAGEMENT PLAN Page pt P1L.IF' tNFURI1gATFC}N 5lamer .,.,m-.....-~..,.,......, e rtrc '1'a lk Ga molly ,rLr~r 1-J NA ;fa<rl Septic Tank Manufac,turor ,u.. all :1ESIGN NARAME FERS Ce ---~•-...M , f frhaent . Iter Nranufauturr~r . - Number of tiednaorns __j~: ,`'d/~ [ r ►vf§ Cl NA I Otlerit `Itet model Number of Public Farillky Units A NA Pump I fa k Gapaurty Estimated flow (average) -..real I 1 NA _ ~i✓ , ] al/da I'urrip T 'Ht k Nianufactur-ar 7 1-13 NA 10asign flaw (peak), (Estimated x 1,15) _ - - - / J al/da Purnp M aoufacturei L] NA t v_e, 1r - Soil Application Rate J / al/da IFt Pump Moi lei _ ~,tarldar'd lnflueril/~ftluent (.iuaNl EJ NA Y onthly avaorage" Pretreatrrr .nt Unit Fats, Oil & Grease (FO(-,1P) S3() iing/l. C] `;and/G ravel Filter L"7 Feat Filter NocherrNcal Oxygen oernand (BOI7b) -Q20 mij/l., UI NA f-A Mocharical Aeration lJ Wetland Total Suspended Salida, USE) ;5'1 rlo n1'lg/t, i J Dislatut tine El Okher pretreated Effluent CluaNt _ y iVlan{trly avers a DrspersaF :;ell(s) Biochemical Oxygen C)ernancl F3UlJr, L:i NA ( ) SJQ riigh. l:J In-Grow-ad (gravity) t I In-Ground (pressurized) Total Suspended bolids J8,9) rryll. A~NA I'J At,Gra,da Fecal Colif6rnt (geometric mean) X1 0a c fu/9 Q(lrnl mound 1 Drip-Line L l Other ilWaxrrrlt rn Effluent Particle $Ize - f)ther - in fiat L-J NA IfJther I other . - i.. e ..w m.~.. C.] NA "Values typical for domestic wastewater and septic tank affluent. ~.~.m...... lrJ NA NIAINTEMANGE SCHEDULE Service Event. ,a.w_. ,_~..~_.....__~.._.__-._r~,., ,...~..w Service Frequency (Inspect condition of tank - C"1 rnant --^-°-M°-- (s) At least oncer every, (111111041111111U M 3 Years) I J NA I11unip out contents at tank (>y) §Whoo c mubined sludger and sGUM 4 quals one-third of tank volurne ~ - - A linspec t dispersal rell s At least anus aviary 1111X mum 3 years) 1.1 NA Eloan effluent filter At least once every fl, IJ NA rispoct pump, pump controls al"rin Ak least once every. Ef month(s) ear(s) NA f=lush laterals and pressure test _ At least onr.P rovE,ry E j. nt$(s . ) i_I NA _ LEI nionth At least once every (a) CI NA AiNTENANCE IIV97~t1lGrlfJ ~w~ _ .....r...v , _ U NA iUY NS (Inspections of tanks and dispersal cells shall be trade by an individual Carrying one: of the following licenses or c:ertlficationr: Master iplurnber; Master Plumber Restricted Seaver; POW FS Inspector, POWT8 iyialntainer; Septage f5ervicing operator. Tank Inspections must linclude a visual inspection of the tarok(s) to identlft" any missing car broken hardware, Identify any cracks or leaks, measure the volurne of is;ombined sludge and scorn and to check for any back up or pondhig of effluent an the ground sc.rrface. The dispersal cell(s) shall tie visually inspected to check the effluent levels in this observation piper; and to check for any pending of effluent on the ground surfac t). "Theo ponding of effluent on the ground surface i-riay iridicate a failing condition mKf requires the immediate notification of the IocaU f'oUtrlatory authority. When the combined accumulation al' sludge and s..um in any tank equals une-thin] or rriore of the tank voltlrrie, the entire c;ontants of Pie tank shall he removed by a Septage Servicing Operator and disposed ori' in acaordancia with chapter NIA 111, Wisconsin Administrative Code. All other services, including but not limited to the i,,iorvicing of effluent filters, rriec:hanlaal or pressurized components, pretreatment units, lend any servicing at intervals of 5'l2 rr►onths, shall be performed by a uerNfied POW!"E. Maintainer. .I'§ service report shall be provided to the local regulatory authority within 110 clays of conpietion of any service event. Page of START Ufa AND OPERATION For new construction, prior to use of the POWTS check treatment tank(s) for the l ,re7se3nc e of painting producAs or other chennicats ih+.=;t may impede the treatment process and/Or damage the dispersal Cell(s), It higls t,ranrentra;ttiovis are detected have tbo contents cif thj:: tank(s) removed by a septage servicing oparator prior to use. System start up shall not occur when sal conditions are frozen at the Infiltrative sultalce. During power outages purnp tanks may fill above normal highwater levols. Wtiem power is re;stcrre d the excess waastewrater will bla disuharped to the dispersal call(s) In one large doss, overloading the cell(s) and mar'; result in the b ckr.rp or surfaces discharge of effludrdt. To avoid this situation have the contents of the purnp tank removed by a3 Septar(a Servicing Operator prior to restoring power to thin effluent purrip or contact a Plumber or POWTS MMaintainei to assist in manually operating the p nrrp controls to resiote normal levels within the pump tank. Do not drive or park vehides dvor tariks and dispersal cells. Do rust drive or bark over, or otherwise distilth nr compact, the area withIii 15 feet down slope of any mound or at-grade soil absorption artist. Deduction or elimination of the following from the wastrawr=ate:r stream may Improve the performance, and prolong ttre Iffe of the POWT13: antibiotics; baby wipes; allfarette butts; c3ondoins; cotton sweabs; dallrotisesrs; der tal floss; diapers; disinfectants; fat; foundation drarilr) (surnp pump) water; fruit and vegetable peelings; gasoline:; grease; he rbicido., ; rneat scraps; medications; ail; pair'AnU produrils; pesticides; san4ary napkins; tarnpons; and water stifteaner hrive. ABANDONMENT When the POWTS fails and/or is permanently taken out of service the following steps shall be taken to Insure that the system is properly Arid safely abandoned in compliance with chapter Comm 83.33, Wisconsin Adminis rastive Codw All piping to tanks aria fits shall he disoonnected anrf the abandoned pipe ;parings seataied. The contents of all tanks and pits shall be removed and properly dlsposerf,:)f bey a Septage t3ariricing Operator. After purnping, all tank,.; and pits shall be excavated and removed or the r covers removed and the void space filled with gravel or another inert solid material. CONTINGENCY (PLAN If the POW`f'S falls and cannot be repaired the following rnesarserrras haves I)Pt:n, nr must lie take=n, to provide a code cornpl4livi replacement system; 0 A suitable replacement aroa has been eavaluaatSd avid may be utilized for the louatlon of a re placeivie3nt soil absorptiom systelri'r. The repiaaoament area should be pr'atoc:ted from disturbrarice and compaction aril should not be infringed upon try required setbacks from existing and proposed struotura, lot lines and wells. l rallum to protect the replacenre ut area will result In the ncled for a now soil and site evaluation to establish ra suitable wsplaac:carrrent er(%.1 Roplacerneot systerns must coropty with the rule+j in effect at that tirne. A :suitable replacement airea is not available clue to sathrack rand/or soil hinitations. Barring advances In Pc7W'S technology ij holding tank rnaty be Installed as a last resort to replace the faailstj F10W-01 The site has not teen evaluated to Identify ra stiitablei replacement area;. Upors failure of the POVVI-r; ra son and site evaalu""ilea must be performed to locate a suitable r'aplacemew area. if no raMlsiracerrrerat Arcaa is avrailrabfas a haldirsg tank rnery be irsstalledl Er a a Iasi resort to replace the failed POVVI'S. Mound and at-grade sail absorption systems may be re:constiuu.ted in mace following removal of the blornat at the intiltraalive, surface. Reconstructions of such systesrni; must cornply with than rules In. Gitteat at that titno. <<WARNING>> SEPTIC, PUMP AND OTHER 'l RFATfiMENlT TANKS MAY CONTAIN I..,r'11,IAI_ ►SSES ANC ION INSUFFICIENT OXYGEN, W.) iVlO INTER ASEPTIC, PUMP OR OTHER TREA9101ENI`l' `r"ANIC UNDER ANY (ARC.I. M STANGES. DEATH MAY ptE.811Jl.T. RESCUlt. 01-.- A PERSON FROM THE INl"C3l7iCJR OF A'rANK IWA'Y 141 DIFFICULTOR IMMPOSQTIkCE., ADDITIONAL C011111111119NTS POWTS INSTALLER 111OWTS MM'.1 'r TAINER Marne ` ` p y Phone F'hc:rrr SIpTAGF SERVICING OPVRATOL7 JPUMMpIt~j LOCAL. R CVLATORV AUTHORITY Marne ✓ -_-._hiArne / _ Phone .7 ~,..L_ Phone,. C._-j..~.r,..,~~?.y~ ~ f...._._..._> This document was drafted in compllanue with 01`16pte3r SPS 3Wi-P,2(2)(b)(1)(d)&(f) and 381t+zi(I 1, (2) 8 (3), Wisconalre AdmInistralive 0ode. Wisconsin Department of Commerce SOIL EVALUATION REPORT Page of 3 Division of Safety and Buildings rda ' h Comm 85, Wis. Adm. Code Attach complete site plan on I V of le an 8 1/2 x 11 inches in size. Plan must include, but not limited to: verbn nzontal reference point (BM), direction and Parcel I.D. percent slope, scale or dimensions, north arrow, and location and distance to nearest road. A4 L, -134 _00_ 0 Z Please print all information. R. w Date 513) Personal information you provide may be used for secondary purposes (Privacy Law, s. 15.04 (1) (m)). #Za13 L22 Property Owner Property Location f AA~,,~ 0e Je rr n Govt. Lot -5.e2 1/4-f~ 1/4 S ,T ~N R E (o W Property Owner's Mailing Address( Lot # Block # Subd. Name or CSM# ee 4 r3 /L p u~ Z & Lc iGC .c / 5t late Zip Code Phone Number ❑ City ❑ Village ;EgZown Nearest Road Z~-c J L(Jl S t~ . ( ) / r o S New Construction Us esidential / Number of bedrooms Code derived design flow rate GPD ❑ Replacement ❑ Public or commercial - Describe: Parent material _ 1/ r, R-J- Flood Plain elevation if applicable General a reoommendations: New / ~s~ .~Q System Type System Elevation r 71 Boring # y❑ Boring 1~ Pit Ground surface elev. ITZI ft. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/lf in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 'Eff#2 L D JQ!J J ?1 1 r Cr Boring # ❑ Boring ® Pit Ground surface elev. Depth to limiting factor Z7 in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ft' in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. •Eff#1 •Eff#2 -3 go Effluent #1 = BOD > 30 < 220 mg/L and TSS >30 < 150 mg/L ' Effluent #2 = BOD 130 mg/L and TSS < 30 mg/L CST Name (Please Print) Signs CST Number Bird Plumbing, Inc. Shaun Bird 226900 Address Date Evaluation Conducted Telephone Number 1008 192nd Ave, New Richmond, WI 54017 715-246-4516 J p Y P ~ ~1 4ryg~ wry, Parcel ID # Page of Property Owner Boring # ❑ Boring / f~ y,; •~J/~ 1:1 Pit Ground surface elev. Depth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots •E GPD/ft?Eff#2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. d Boring # ❑ Boring ❑ Pit Ground surface elev. ft. Depth to limiting factor in. Soil lication Rate Horizon Depth Dominant Color Rector Description Texture Structure Consistence Boundary Roots GPDIft 'E in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. ff#1 'Eff#2 a Boring # Boring surface elev. ft. Depth to limiting factor in. C] Pit Ground Soil lication Rate Horizon ')epth Dominant Color Redox Description. Texture Structure Consistence Boundary Roots •Eff#1 I GPD/ff*Eff#2 in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. • Effluent #1 = BODS > 30:< 220 mglL and TSS >30 1150 mgA- ' Effluent #2 = BODS < 30 mg/L and TSS < 30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. SBD4330(RAM) F ~ ~~4 w Property Owner Parcel ID # Page of /Q Boring # ❑ Boring Pf F ~ Pit Ground surface elev. le-OZ.Z-ftDepth to limiting factor in. Soil Application Rate Horizon Depth Dominant Color Redox Description Texture Structure Consistence Boundary Roots GPD/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 E'2 - / NdP- -0 15,1 -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/ff in. Munsell Qu. Sz. Cont. Color Gr. Sz. Sh. 'Eff#1 'Eff#2 ❑ Boring # ❑ Boring ❑ pit Ground surface elev. ft. Depth to limiting factor in. Soil Application Rate . Horizon ')epth 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 mgA- ' Effluent #2 = BODS < 30 mg/L and TSS < 30 mg/L The Department of Commerce is an equal opportunity service provider and employer. If you need assistance to access services or need material in an alternate format, please contact the department at 608-266-3151 or TTY 608-264-8777. SBD-8330 (86/00) Soil Test Plot Plan Project Name Oevering Homes Sha, Bird Address 1433 Cernohous Ave Suite A New Richmond Wi 54017 M #226900 Lot 28 Subdivision Walnut Hill Farm Dat 5/25/13 SE 1/4 SE 1/4S 22 T 28 N/R19 W Township Troy R Boring Q Well PL Property Line County ST. CROIX BM or VRP Assume Elevation 100 ft. 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CROIX COUNTY SEPTIC TANK MAINTENANCE AGREEMENT AND OWNERSHIP CER.TIFICATI0N* FORM Owner/Bu er t Mailing Address Property Address aJ O LAja _&A.& ' (Verification required from Planning & Zoning Department f new eonstrnction) City/State Parcel..I.deati:Ccation Numiber LEGAL DESCRIPTION Property Location SH Y4 , '/a , Sec.22--'l' ~N R 9 Town of Subdivision Certified Survey Map ; Volulxt Page #I Warranty Deed # Volunlt, Page # Spec house es no Lot lines identifiable yes no SYSTEM MAINTENANCE AND OWNER CERTIFICATION Improper use and maintenance of your septic system could result in its premature failure to handle wastes. Proper maintenance consists of pumpin.g out., the septic tank every three years or sooner, if needed, by a licensed purnper. What you put into the system can affect the fituction of the septic tank as a treatment stage in the waste di: posal system. Owner maintenance responsibilities are specified in §Couun. 83.52(1) and in Chapter 12 - St. Croix County Sanitary Ordinance. The property owner agrees to submit to St. Croix County Planning & Zoning Department a certification form, signed by the owner and by a master plumber, journeyman plumber, restricted plumber or a licensed pumper verifying that (1.) 'the on-site wastewater disposal system is in proper operating condition and/or (2) after inspection and pumping (if necessary), the septic tank is less than 1 /3 full of sludge. I/we, the undersign d have read the above requirements and agree to anaintam 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 on this form are true to the best of my/our knovile.dge. I/we amlare the owuer(s) of the property described above, by virtue of a warranty de recorded in. Register of Deeds Gffice. Number of bedrooms p IGNATUl i OF APPLICANT(S) DATE ***.Any information that is misrepresented may :result in the sanitary perrnit being revoked by the Planning & Zoning Department. Include with this application a recorded warranty deed from the Register of Deeds Office and a copy (A 'the certified survey map if reference is made in the warranty deed. (,RF, V. 08105) II Illlllllllllillllllll iNlllli 8140849 Tx: 4113918 STATE BAR OF WISCONSIN FORM 3 - 2000 975248 Document Number QUIT CLAIM DEED BETH PABST REGISTER OF DEEDS THIS DEED, made between Citizens State Bank, Grantor, and Oevering ST. CROIX CO., WI Homes LLC, Grantee. 03/20/2013 09:08 AM Grantor quit claims to Grantee the following described real estate in St. EXEMPT#: NA Croix County, State of Wisconsin (the "Property"): REC FEE: 30.00 TRANS FEE: 449.70 Lots being sold `as is'. PAGES: 2 SEE ATTACHED EXHIBIT A Recording Area Name and Return Address: Title One File 19240 Together with all appurtenant rights, title and interests. see attached Parcel Identification Number (PIN) This is not homestead property. Dated this 15th day of March, 2013. Citizens State Bank * Al A H Van erBroeke, rice Presi ent * AUTHENTICATION ACKNOWLEDGMENT STATE OF WISCONSIN ) Signature(s) ST CROIX COUNTY. ss. authenticated this 15th day of March, 2013 Personally came before me this 15th day of March, 2013 the above named Citizens State Bank, Alan H VanDerBroeke, * Vice President to me known to be the person(s) who executed TITLE: MEMBER STATE BAR OF WISCONSIN the foregoing instrument and acknowledged the same. (If not, authorized by § 706.06, Wis. Stats.) THIS INSTRUMENT WAS DRAFTED BY Evelyn Jaeger Notary Public, State of Wisconsin My commission is permanent. (If not, state expiration date: Michael H Forecki, Attorney 12/16/2016 ) (Signatures may be authenticated or acknowledged. Both are not necessary.) *Names of persons signing in any capacity must be typed or printed be] VEL-Y gati b~C~A E S et01 ~J~IISCa~slt~ 1 of 2 QUIT CLAIM DEED STATE BAR OF WISCONSIN FORM No. 3-2000 i i File No.: 19240 EXHIBIT A is 8, PIN 040-1303-00-008;Lot 9, PIN 040-1303-00-009; Lot 23, PIN 040-1303-00-023;Lot 28 PIN 040-1303-00-028 and Lot 40 PIN 040-1303-00-040 of Walnut Hill Farm, All in the own of Troy, St. Croix County, Wisconsin. 2 of 2 I[: t - :Yr ~ gg gS ~ ! pg p :G O ~gy 7 ng EYf dl ~ ip T~ Z Sy y p~ ~q~C a C V ~ Q V L F ~a M1~ S ~IlS C •4) !1 Aim pIm ¢ III),, 3' ~zr. # s w jf W ~w ci .0 NJ NQ ? ~n W Q ~ I 1llllll.ll LLLI Ch I] { EE 2-~~ ! i;t Jll ~l1~1 !l ;li r L - 9 J~ - I I>t 1i ~Yi 1 5~ $ihes[iF§$~ d y as ~ ~ 4 `5435 _ N J R %r~r Wig R'48g Q > N F ~~v a ,3 M f CD -j hh'] 11m s b ?w J ;.1 J .a; a I;I 7z - 11 Ai -t-n, + e e m N I ILL ~ - I I I Z f I y rn ~ 9w v 6 t~Y ~ ~~e of jl F d ~ SIN _ I z V-1 s 14- I I I nunH~o3~n,un ~ rvvearixa3rwune - • I I ~ ~I A1~~11~FIiN%A O]~UO~ I I 4m ~ 5 I ~ b R ~ a I II I ji- - x I - - 5 sia ~ ~ In ~M 9 ern„ Moe~~~ i + ~ I ~ ~r71 ~3ffc~g~ lidii H11111 m z ¢ $ E L:) ci ~ ui ~q yl~~' ~y 8 = F- l 8 04~ gR rn u a Q z y ° o e 4 1111'€ Im.-I film Eb Hill-111 ~ I , 1 I' I I Irl I I 5s I I I ~ a awxrn e.rm.nawim.we ~ I I wunowrmwxa< 1 1- I - i I n , I! I.:, ~ 1 1 1 I ~ II I I: I I I Cm it 1 s O1 ~ 1 3 R I i e ~jl II ; T-~ 1 1 1 F 1 I~ Blpv II 1 Y- A I I I I I I 0 r I ~ I I II 1 ° 1! I I I e I I 1 Y I I b e 1 ti\ O I I 96R 1 ix i Q I I d~ 1/pO,b ~ 11 1 I I ~ ~ I" ~y5,\QQQ~~ I A - I~=='~__~ e 6 ^II II I I ~ I 8 4Y~ I 1 -I A :I 11 • I 1 z~Y b@y3 1 1 b 1 b~ r'--- - - 1 - - _ 1 . a a ! b Z 1 h0 4 II g~` ! I I .11 II f•_ h 1 1 ° ~ x n 11 I I J I N T „ I I Je'u.m.et___.__J O I Y Y I I 1 T--'T I ylp b 1. 1 1 k ~ ; L.. J L J a E4; ~ I I I _J I fi I ~n~ei sus nu ,wv I I ¢ j I ig~ i ~ 1 %~g 1 I I ` 81+II I % I I I I'. II I n I I ~ ~ .11 ~ I k G I I 111 9.~ ~ I I , 11 ~~4 sR Z i i 1i x ~ - I I ~R 1 j l I I I a3 s 1. I I a~j ~ I I 1 ecRlzn 1 ' 1 4 ...ssl(/~~1~ ~ b 88 ~ 'J F Y Wismsmin Department of Commerce SOIL EVALUATION REPORT Page / of 3 Division of Safety and Buildings in accordance with Comm 85, Wis. Adm. Code Attach complete : c«r,ty S7: G,e inClude, but not ur EROSION CONTROL PLAN must be Paroi~ I.D. ~ vT /N Percent M slope, so completed before sanitary permit issuance PeAJOt 3 Cam-- ~j Reviewed by Date Persond InfamaWn you provide may be used for secondary purposes (Privacy Low. s.15.04 (1) (m)). ?0 Property Owner TODO Property LocabT ©jc T'oPD Govt t of l}1 f 5 f, 1/a s ZZ- T 28 N 19 E (a) w 10't Property ownees Mailing Address Lot # Block # Subd. Name or CSM# . (D o t 5 CA #{-i LL- AUP- • Z g tvAL wt> r Kit 1 f~ petit ~ CRY __C" ER State Tip Code Phone Number ❑ city ❑ Village ljd Town Nearest Road m CrPPOE- HT3 MN SS-07(p &S!) z1/8• T,eoy so. erloveR ~c New Construction Use: Residential / Number of bedrooms _ Code derived desgn flow rate O O~U GPD ❑ Replacement ❑ Public or commercial - Describe: tA Parent material 0S S d V Flood Plain elevation if applicable rations: Oa-+ Te5 T_tv s 1, rod/C )P-vie i4- iY OV,~~ F Bodrv# ❑ Boring ~o ~Ss S NN ❑ ® Pit Ground surface elev. ft. Depth to lirrrtrg factor /0 in. ~ t SoN Application Rate Wfi= Depth Dominant Cola Redox Description Texture Siruct re Consistence Boundary Roots GPQff b in. Munsell Qu. Sz. Cont. Color Gr. Sz Sh. 'Etf#1 '011#2 / o`Lo /D 3/ - S lL :~tiwJ`)e d(5 C4) .Z S N 2- • l io YR 3111 dS ti Cs • s 1•1L zl~cs c s - • 5 S S/4 111L 1745 U Z• "'o l~lz- 0 , Y/2 yL61_ Q Z # 2-0 ®P Ground surface elev. 9 ` , b 0 Depth to WnWNg factor in Sod Application Rate Horizon Depth Dominant Color Redgx Description Texture Structure Consistence Boundary Roots GPDff In. Mcnsell Qu. Sz Cora. Color Gr. Sz Sh. •Eft#1 'Eff#2 l 0--7 /o,VR 3/1, TfS l sG C5 /7 • S • Ylt N s, 2 is s Z i io - • s N L• L D S /L .wr C - • S 0 V/2- Z_ 7•S !//e s/ Effluent #1 = BOD > 30 < 220 rng& and TSS >30 < 150 mgll ' Effluent #2 = BOD 130 ng& and TSS < 30 m9& csT Name (Please Print) R -m Lt3 R i c Sigma re A~ z2 ~ r Address Ulbricht & Ass9ciates Data Evakk-Won Conducted Teleptwne Number Private S r: /D - D 7tS• 77A • 3 YY Z 2812 10th Ave. Spring Valley, WI 54767,,&.. ;a f '0AO,- ,q-PPRO X . .Z Jo Pats • °~/O • /ors • yo. COD ~._...~__~...._..__T_...____~.._. N A ❑ ~ L>'~ L °yo- 10x'(0 • /o . oar dyp . 2-0. 0MO o yo 60 oyo•10*6•70-oaa 0 yp . ,©ee' ~o • oaa TODD? T3 JE ~ 5 TEDT - L D S Property a 2 D Z 3 f'ar cei to # Paw 0 °f vwrer S55 Baring 3 ° y ° t Ground surfaceelev. fl_ Depth Cmni6ng ftor Soil Appliastion Rate Z Za Horizon Depth Dorninant Color Redox Description Texture Shucture Consistence Boundary Roots GPM in. Munseff Qu. Sz. Conc. Color Gr. Sz. Sh. "EW1 "Eff#2 /oy 3 S,~ ash a • /Z /o i Sic 2 f C w 3 .20 6 SiL / ash c '40 CS - ~z • 3 D. D c z hors S/C C J~ Z ~o y/e ~l Z 7.s y/Z F i~ # C] SC)drg Pit Ground surface &OV, ft. Depth to limiting factor in. S Sian iZate Horizon Depth Dominant CoW Redox Description Texture Stye Consistence Boundary Roofs Gr. Sz Sh. 'EW1 'Efi#2 in lcnseti Qu Sz Con t. GPDt j ❑ Pit Ground surface elev. ft. Depth to factor In. Sol ApplicabOnRale color Redox Desertion- Texture SkructurO Consistence Boundarll Roots GPDfff Horizon Depth Uarinant In. Munsell 42u. ,S7- Cont. Color Gr. $z Sh. "EW1 'Eff#2 i Boring # Q Boring Pit Ground surface ete it. Depth to lirniting fay in. C1 SW Application Rate GPDN Cotor R Description- Texture stuck" Boandary Roots Hortzon Depth ITar jnar t `Eff#tt TIM IM Munsell Qu. Cont. C~ Gr. Sz. Sh. EEJ mWL ' Effluent #t =BODE > 30:S 220 mglL and TSS >30 f 150 mgii. Effluent #2 = 8t}Dg < _ 3f 1 m9i!- and TSS< 30 The Department of Commerce is an squat opportunity service provider and employer. It you creed assistance to access services or need material in an alternate format, please contact the depattment at 608-266-3151 or ~`rY 60s-264-&7,77. 886-l:SlO (RNrq) 1t1,4z,tiv TODD 5 Je k S TarDT - /0 Pmarfyowner 4 Z 3 Parcel ID # 7 -2~ POW Of 11 t Ground surface etev. 7• it. Depth to fimifng factor Z d in ttottzerr Mpih Dominant Color Redox 0escrfPtion Texture Structures ieaftort Rate In, Munseff Qu. Sz. Cont. Color Ccxtsistensae Boundary Roots GpDlff Gr. Sz. Sh. •EM °Etf#2 z /2 /of Sid 2 f 3 C ..4J G2 koT-5 R6C v~ 2 tit- 'O Y/ e 2- -2, s y~ s Boring # ~-t LJ pit Ground Ourfaceefbv, ft. Depth to limiting factor in. uts Soil G ~ Rate Horizon Depth Dorinant Redox Description Texture 5frut lure ConsisterxEUoundar Ro in Munseft Qu. Sz. Cont Color Or. &z. Sfi. °Eff#9 4092 j' i Boring Pit Ground surface elev. ft. Depth t/ Nrriting factor in. f-fmizo7n Daritnant t;of Retiox Des Appkation Rate cx"on. Teftm ,961chrre Consistence Boundary Roots r.Mff In. Munseil Qu. Sz. Cont. Color i Cad Sz Sh. °EM1 °Eff#2 j El (Iljdng # Boring EJ Fit Ground surface ele ft. Depth to ikaaitirtg factor in. Sort tiara Bate Horizon Depth Dominant Cot R Description- Texture Structure Consistence Boundary Roots [ipi3R In. Munsew Qu. Coat. Color Gr. Sz, Sh. °Eff#1 'Eff#2 I 1 Effluent #1 = BOD > 30 < 220 w4L and TSS >30,c 150 mgli. ° Effluent #2 = BODs 30 rtrgft, and TSS < 30 mgtL The Department of Commerce is an equal opportunity service provider and employer. If you creed assistance to access services or need material in an alternate format, please contact the department at 608-266-3151 or TTY 609-264-9777. saa-exco irzs+noa PLOT PLAN WALNUT HILLS FARM. LOT 2- O Pg. 3 of 3 d = Contour elevation lines. t = Backhoe Soil pits. Q = Benchmarks set, maRRED WITH FLAGGED .lathes. 1/2" steel conduit pipes. rfD J)A.) / w SCALE: 1" = Z -7~ No Go 7~ Z- 00,0 S~ !3 t J ' 4q : 90 3l ~ 8 ado t i • 8 z, io y'a /'0 0' Parcel 040-1303-00-028 05/31/2013 10:09 AM PAGE 1 OF 1 Alt. Parcel M 22.28.19.1763 040 - TOWN OF TROY Current 0 ST. CROIX COUNTY, WISCONSIN Creation Date Historical Date Map # Sales Area Application # Permit # Permit Type # of Units 00 0 Tax Address: Owner(s): O = Current Owner, C = Current Co-Owner CITIZENS STATE BANK O - CITIZENS STATE BANK 375 STAGELINE RD PO BOX 247 HUDSON WI 54016 Districts: SC = School SP = Special Property Address(es): Primary Type Dist # Description 250 WALNUT HILL WAY SC 4893 SCH DIST RIVER FALLS SP 0100 CHIP VALLEY VOTECH Legal Description: Acres: 1.040 Plat: 09-092-WALNUT HILL FARM 1/75 040-03 SEC 22 T28N R19W PT SE SE WALNUT HILL Block/Condo Bldg: LOT 028 FARM LOT 28 (1.040AC) Tract(s): (Sec-Twn-Rng 401/4 1601/4) 22-28N-19W SE SE Notes: Parcel History: Date Doc # Vol/Page Type 03/05/2010 912825 SD 03/28/2006 821622 WD 12/10/2003 748768 2471/594 WD 11/19/2003 747018 9/92 PLAT more... 2013 SUMMARY Bill M Fair Market Value: Assessed with: 0 Valuations: Last Changed: 08/20/2012 Description Class Acres Land Improve Total State Reason RESIDENTIAL G1 1.040 35,000 0 35,000 NO Totals for 2013: General Property 1.040 35,000 0 35,000 Woodland 0.000 0 0 Totals for 2012: General Property 1.040 35,000 0 35,000 Woodland 0.000 0 0 Lottery Credit: Claim Count: 0 Certification Date: Batch Specials: User Special Code Category Amount Total Special Assessments Special Charges Delinquent Charges 0.00 0.00 0.00